Reward Motivation as a Moderator of Maladaptive Fear/Avoidance Relations during Decision-Making

Abstract

Overgeneralization of conditioned fear is a key facet of clinical anxiety, which occurs when fear spreads to safe stimuli resembling learned danger cues. When individuals are confronted with competing motivations (e.g., avoid perceived threats or approach rewards), overgeneralization can drive maladaptive avoidance of safe stimuli at the expense of rewards and valued life goals. Only a few studies have examined moderators of the relationship between overgeneralized fear and maladaptive avoidance (i.e., aversive Pavlovian-instrumental covariation during generalization, or APIC-G), and no studies have examined individual differences in reward motivation as a potential moderator. The current study fills this gap in the literature. 123 participants with and without various anxiety-related disorders completed a validated fear generalization task in which they could avoid the risk of shock at the cost of poorer task performance. The task measured both fear generalization and self-reported desire to win while functional magnetic resonance imaging was obtained. Fear generalization was measured using multiple methods, including changes in activation in neural regions of interest. Hierarchical linear regressions revealed that win motivation significantly moderated the relationship between various indices of fear generalization and subsequent maladaptive behavioral avoidance. This interaction was statistically significant when fear generalization indexed by left anterior insula activation (standardized β = -.22, p = .018), dorsomedial prefrontal cortex activation (standardized β = -.18, p = .030), shock expectancy ratings (standardized β = -.19, p = .011), and retrospective anxiety ratings (standardized β = -.16, p = .007). In this way, greater win motivation was associated with weaker associations between fear generalization and maladaptive avoidance. Key implications for this work include the possibility that individuals higher in reward motivation are less likely to maladaptively avoid due to overgeneralized fear, which could make them less vulnerable to the development of clinical anxiety or more likely to respond to treatment.