Clovis Varangot-Reille, Giovanni Pezzulo, Mick Thacker
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The fear-avoidance model as an embodied prediction of threat.
The fear-avoidance model is a well-established framework in the understanding of persistent pain. It proposes a dichotomous path: either the context is interpreted as safe; there is no fear reaction and, therefore, the individual engages in active (positive) coping; or the context is interpreted as threatening, leading to a self-reinforcing vicious circle of fear and (negative) avoidance. We propose an embodied interpretation of this phenomenon employing the joint framework of predictive coding and active inference. The key idea is that multisensory integration of exteroceptive, proprioceptive, and interoceptive sensory inputs can lead to dysfunctional experiences of threat in nonthreatening situations. Threat inference can promote fear responses, maladaptive strategies (i.e., avoidance) and self-provides evidence for threat in associated or future contexts, or both. Under this treatment, the prediction of nonrealized threat becomes self-evidencing and context-invariant, and hence self-perpetuating. Safety cues are unable to attenuate the interpretation of the negative context as the dominant inference of the context is threatful and gains more precision and becomes resistant over time. Our model provides an explanation for the emergence of a dysfunctional fear response in the clinical setting despite apparent safety based on modern concepts from theoretical (computational) neuroscience.
期刊介绍:
Cognitive, Affective, & Behavioral Neuroscience (CABN) offers theoretical, review, and primary research articles on behavior and brain processes in humans. Coverage includes normal function as well as patients with injuries or processes that influence brain function: neurological disorders, including both healthy and disordered aging; and psychiatric disorders such as schizophrenia and depression. CABN is the leading vehicle for strongly psychologically motivated studies of brain–behavior relationships, through the presentation of papers that integrate psychological theory and the conduct and interpretation of the neuroscientific data. The range of topics includes perception, attention, memory, language, problem solving, reasoning, and decision-making; emotional processes, motivation, reward prediction, and affective states; and individual differences in relevant domains, including personality. Cognitive, Affective, & Behavioral Neuroscience is a publication of the Psychonomic Society.