Approach-Avoidance Conflict Paradigms in Animal and Human Studies of Anxiety-A Narrative Review

Anxiety disorders are among the most prevalent mental health conditions worldwide, yet their assessment and treatment have long been limited by insufficient validity. To address this challenge, researchers have increasingly sought to translate approach-avoidance conflict paradigms from animal models into human experimental tasks. This review synthesizes the translational practices of four classic paradigms, namely the conditioned conflict paradigm, the open-field test, the Morris water maze, and the elevated plus maze, and introduces a "three-level, five-dimension" evaluation framework. The framework encompasses experimental design (reproducibility and operability), construct measurement (construct validity), and applied functionality (predictive and discriminant validity). Evaluation of existing studies indicates that human translational paradigms are generally feasible, showing strengths in operability and reproducibility. These paradigms reveal behavioral patterns consistent with animal anxiety models, underscoring their translational potential. However, evidence remains largely limited to behavioral indices, with little integration of subjective, physiological, or neural measures. Predictive validity is scarcely tested, and discriminant validity is confined to broad group differences rather than clinical subtypes. Current human translational paradigms provide a useful starting point but fall short of capturing the complexity of human anxiety. Future research should strengthen ecological validity, incorporate multimodal indicators, and expand testing in clinical populations to enhance predictive and discriminant validity. Such efforts are essential for advancing these paradigms toward dynamic tracking and individualized applications in both research and clinical contexts.