Verbalisation of attention regulation strategies and background music enhance extinction learning and retention

Relapse and return of fear are common following exposure-based treatments which aim to decrease anxiety by reducing danger expectancies and negative stimulus evaluations. Using Pavlovian conditioning and extinction procedures, recent studies found that verbalising catchphrases to prompt attention to, and memory of, stimulus contingencies during extinction prevented US expectancy generalisation to safe stimuli and reduced anxiety ratings. Verbalizations did not improve negative evaluations of conditional stimuli. Given that negative evaluations predict return of fear, the current study examined whether verbalisation strategies combined with listening to liked, non-lyrical background music enhanced expectancy learning and positively changed stimulus evaluations. A differential Pavlovian conditioning procedure was used involving fear acquisition, extinction, and extinction retest phases. Participants were assigned to a verbalisation condition (N = 21), a verbalisation plus liked, non-lyrical music condition (N = 21) or a control condition (N = 21) during extinction. The verbalisation strategies, with and without music, prevented the generalisation of US expectancies to safe stimuli at retest. Verbalisation strategies plus music increased positive evaluations of conditional stimuli during extinction and retest. Further research on the role of verbalising attention regulation strategies and liked, non-lyrical background music during extinction is warranted with clinical samples.