# Neural and Behavioral Mechanisms of Avoidance Behavior and its Impact on Fear Extinction in Adults with PTSD

> **NIH NIH F31** · WAYNE STATE UNIVERSITY · 2020 · $43,252

## Abstract

PROJECT SUMMARY
Avoidance is a core feature of posttraumatic stress disorder (PTSD) that is associated with an exacerbation of
PTSD symptoms, an increase in suicide attempts, and worse treatment outcomes. However, the underlying
neurobehavioral mechanisms through which avoidance behavior impairs recovery from PTSD are poorly
understood. The persistent and pervasive relationship between avoidance and impaired recovery emphasizes
the need to adapt treatment strategies, such as Prolonged Exposure therapy, with the potential to circumvent
long-lasting psychopathology. Extensive preclinical work demonstrates that activation of the striatum, amygdala,
and prelimbic cortex (PL) is necessary for avoidance behavior, and that inactivating projections between these
regions impairs avoidance expression. Avoidance behavior in healthy humans also depends on functional
connectivity of the amygdala with both the striatum and dorsal anterior cingulate cortex (dACC; human analog
of PL). Research on avoidance and its impact on fear extinction in trauma-exposed adults is lacking. The goal
of this training project is to test the hypothesis that greater avoidance behavior in trauma-exposed adults will be
associated with worse extinction recall, and that these effects are mediated by increased functional connectivity
of the amygdala with the striatum and dACC. We focus on real-time avoidance as our primary measure of
avoidance behavior. We will test this hypothesis in 50 individuals reporting exposure to a Criterion A trauma,
defined by the Clinician-Administered PTSD Scale-5. Participants will undergo a validated virtual reality (VR)-
based Pavlovian fear learning/extinction paradigm during functional magnetic resonance imaging (fMRI) and
psychophysiological recordings. During the task, participants will be allowed to approach (move towards) and
avoid (move away from) conditioned stimuli that are associated with an aversive stimulus in their VR
environment, allowing us to determine real-time avoidance behavior. This fellowship study provides an important
scientific advancement in understanding mechanisms of avoidance psychopathology in trauma-exposed adults.
With key training from the mentoring team in methodological and mechanistic approaches (fear learning, fMRI,
skin conductance, multivariate statistics, assessment of psychopathology) at an urban research university
holding the Carnegie Foundation’s highest classification for research, this project is ideally suited for the F31
mechanism. This training project will provide PI Zabik with the critical skills and research training to subsequently
expand on this work as a postdoctoral research fellow, identifying other risky behaviors and their impact on
treatment responsiveness and long-term remittance in persons with PTSD. It will also prepare PI Zabik for a
career committed to identifying targets for therapeutic intervention.

## Key facts

- **NIH application ID:** 10065948
- **Project number:** 1F31MH124279-01
- **Recipient organization:** WAYNE STATE UNIVERSITY
- **Principal Investigator:** Nicole Lauren Zabik
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $43,252
- **Award type:** 1
- **Project period:** 2020-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10065948

## Citation

> US National Institutes of Health, RePORTER application 10065948, Neural and Behavioral Mechanisms of Avoidance Behavior and its Impact on Fear Extinction in Adults with PTSD (1F31MH124279-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10065948. Licensed CC0.

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