Aversive Pavlovian conditioning in childhood anxiety disorders: impaired response inhibition and resistance to extinction.

Learning-based models of anxiety disorders emphasize the role of aversive conditioning and retarded extinction in the etiology and maintenance of anxiety disorders. Yet few studies have examined these underlying processes in children, despite that some anxiety disorders typically onset during childhood. The authors examined the acquisition and extinction of conditioned responses in 17 anxious children and 18 nonanxious control children between 8 and 12 years old using a discriminative Pavlovian conditioning procedure. One geometric shape conditional stimulus was paired with an unpleasant loud tone unconditional stimulus (CS+) whereas another geometric shape was presented alone (CS-). In the context of similar levels of discriminative conditioning in both groups, anxious children showed larger skin conductance responses to the CS+ and the CS- during acquisition and evaluated the CS+ as more arousing than the CS- compared with control children. They also showed greater resistance to extinction in skin conductance responses but not in arousal ratings to the CS+ vs. the CS- relative to control children. Results suggest that deficits in response inhibition to safety cues and retarded extinction may underlie learning processes involved in the pathogenesis of childhood anxiety disorders.