Do laboratory fear extinction, avoidance and generalization predict exposure outcomes for fear of spiders?

This study assessed the predictive potential of laboratory conditioning processes (extinction, avoidance, and generalization) for exposure therapy outcomes in 112 spider-fearful women. Three aversive conditioning tasks were followed by a baseline assessment of spider fear, virtual reality exposure training, a post assessment after one week and a three-month follow-up assessment. Initial analyses indicated significant positive correlations between reduced extinction, increased avoidance of a conditioned threat stimulus, and overgeneralization, particularly evident in verbal measures. In subsequent analyses, neither individual extinction and generalization indices reliably predicted exposure outcomes, contrasting prior research. Notably, excessive avoidance of the conditioned stimulus did emerge as a potential predictor of less favorable exposure outcomes, aligning with previous research on fear avoidance. Overall, our findings underscore the complexity of predicting exposure therapy outcomes. Moreover, they call for further investigation into the impact of methodological decisions on determining the relationship between basic learning processes and treatment efficacy. • We examined conditioning tasks as predictors of VR exposure outcomes. • Correlations reveal baseline interplay of extinction, avoidance, and generalization. • Extinction and generalization indices did not robustly predict exposure outcomes. • Elevated avoidance in the lab may predict poorer exposure outcomes.