The 2018 Thomas William Salmon Lecture and Medal in Psychiatry: “Mechanisms of Threat Control in Humans” – Elizabeth A. Phelps, PhD

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• Science & Health

Animal models of associative threat learning provide a basis for understanding human fears and anxiety. Building on research from animal models, we explore a range of means maladaptive defensive responses can be diminished in humans. Extinction and emotion regulation, techniques adapted in cognitive behavioral therapy, can be used to control learned defensive responses via inhibitory signals from the ventromedial prefrontal cortex to the amygdala. One drawback of these techniques is that these responses are only inhibited and can return, with one factor being stress. Dr. Phelps will review research examining the lasting control of maladaptive defensive responses by targeting memory reconsolidation and present evidence suggesting that the behavioral interference of reconsolidation in humans diminishes involvement of the prefrontal cortex inhibitory circuitry, although there are limitations to its efficacy. She will also describe two novel behavioral techniques that might result in a more lasting fear reduction, the first by providing control over stressor and the second by substituting a novel, neutral cue for the aversive unconditioned stimulus.