An Implementation Intention Combining Reappraisal and Anger Counteraction Reduces Fear Reinstatement

Abstract

Fear extinction requires exposure to the conditioned stimulus (CS), yet patients with fear- and anxiety-related disorders often avoid the CS, thereby undermining extinction learning. Implementation intention (II) is a self-regulation strategy that automates goal-directed behavior through "if-then" planning. Building on the approach motivation elicited by anger and the principle of emotion-action incompatibility, we designed a novel II: "If I feel afraid when seeing fish/bird images (the CSs), then I will remind myself that it is foolish to fear a mere picture, and I will clench my fists and feel angry with myself." This strategy aims to transform fear-driven avoidance into self-directed anger, thereby promoting reappraisal and approach behavior. In a three-day differential fear conditioning paradigm, participants who practiced this II during extinction exhibited shorter avoidance distances to the CS+ than the standard-extinction control group. On Day 3, reinstatement testing revealed significantly lower subjective fear, anger, threat expectancy, and avoidance in the II group. These findings suggest that the combined reappraisal-plus-anger II requires practice during extinction to effectively reduce fear return without inducing overt aggression, offering a promising direction for optimizing exposure-based therapies.