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Latent cause inference during extinction learning in trauma-exposed individuals with and without PTSD

Published online by Cambridge University Press:  08 March 2021

Agnes Norbury Open the ORCID record for Agnes Norbury [Opens in a new window] ,
Hannah Brinkman Open the ORCID record for Hannah Brinkman [Opens in a new window] ,
Mary Kowalchyk ,
Elisa Monti Open the ORCID record for Elisa Monti [Opens in a new window] ,
Robert H. Pietrzak Open the ORCID record for Robert H. Pietrzak [Opens in a new window] ,
Daniela Schiller Open the ORCID record for Daniela Schiller [Opens in a new window]  and
Adriana Feder
Agnes Norbury*
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Hannah Brinkman
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Mary Kowalchyk
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Elisa Monti
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Robert H. Pietrzak
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
Daniela Schiller
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Adriana Feder
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
*
Author for correspondence: Agnes Norbury, E-mail: agnes.norbury@mssm.edu
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Abstract

Background

Problems in learning that sights, sounds, or situations that were once associated with danger have become safe (extinction learning) may explain why some individuals suffer prolonged psychological distress following traumatic experiences. Although simple learning models have been unable to provide a convincing account of why this learning fails, it has recently been proposed that this may be explained by individual differences in beliefs about the causal structure of the environment.

Methods

Here, we tested two competing hypotheses as to how differences in causal inference might be related to trauma-related psychopathology, using extinction learning data collected from clinically well-characterised individuals with varying degrees of post-traumatic stress (N = 56). Model parameters describing individual differences in causal inference were related to multiple post-traumatic stress disorder (PTSD) and depression symptom dimensions via network analysis.

Results

Individuals with more severe PTSD were more likely to assign observations from conditioning and extinction stages to a single underlying cause. Specifically, greater re-experiencing symptom severity was associated with a lower likelihood of inferring that multiple causes were active in the environment.

Conclusions

We interpret these results as providing evidence of a primary deficit in discriminative learning in participants with more severe PTSD. Specifically, a tendency to attribute a greater diversity of stimulus configurations to the same underlying cause resulted in greater uncertainty about stimulus-outcome associations, impeding learning both that certain stimuli were safe, and that certain stimuli were no longer dangerous. In the future, better understanding of the role of causal inference in trauma-related psychopathology may help refine cognitive therapies for these disorders.

Keywords

Causal inferenceextinction learningPTSDgeneralizationcomputational psychiatry
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 16 , December 2022 , pp. 3834 - 3845
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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