Taming temptations: Comparing the effectiveness of counterconditioning and extinction in reducing food cue reactivity

In today's "obesogenic" environment, Pavlovian cues signaling the availability of high-calorie foods may elicit strong expectancies of eating and food cravings. Such cue-elicited appetitive responses, collectively referred to as food cue reactivity, may foster overeating and weight gain. Moreover, food-related cues may also elicit instrumental actions aimed at obtaining those foods via Pavlovian-to-Instrumental Transfer (PIT). This study compared extinction and counterconditioning in reducing food cue reactivity, measured by outcome expectancies, craving, and liking, as well as in decreasing outcome-specific PIT. We used a three-phase PIT paradigm: In the first two phases, participants learned Pavlovian associations between two conditioned stimuli (CSs+) and two food outcomes, and instrumental associations between two responses and the same outcomes. An additional stimulus was never paired with food outcomes (CS-). Participants then underwent either extinction or counterconditioning for one CS+ while the other CS+ remained unchanged, or received no additional learning (control). In the test phase, instrumental responding was measured in the presence and absence of Pavlovian stimuli. In all phases, we measured outcome expectancies, craving and liking of the Pavlovian stimuli. Both extinction and counterconditioning reduced cue-elicited outcome expectancies, but only counterconditioning significantly decreased CS+ liking. Neither procedure effectively reduced cue-elicited craving. Outcome-specific PIT was observed across conditions, though counterconditioning lead to a general decrease in instrumental responding to all stimuli in the test phase. These findings suggest that counterconditioning more effectively targets the affective value of conditioned stimuli and reduces food cue reactivity compared to extinction, though its impact on PIT warrants further investigation.