Impaired De Novo Fear Conditioning in Opiate-Dependent Outpatients

Substance use disorders are characterized by excessive seeking and taking of drugs in the face of adverse consequences. Impaired learning of contingencies around negative outcomes may influence such drug-use patterns. To our knowledge, no studies to date have examined fear conditioning in drug-dependent humans, nor have they investigated the association between fear conditioning outcomes and neuropsychological functioning. The current study compared de novo fear conditioning in a sample of opiate-dependent outpatients to that in a healthy and an affective-disordered sample in an attempt to isolate the contribution of substance dependence on conditioning outcomes, relative to the substantial comorbidity present in substance using samples. Additionally, a brief neuropsychological battery was completed in the substance dependent sample. We found consistent evidence across three indices of fear acquisition—simple conditioning, differential conditioning, and contingency awareness—that the opiate-dependent learned the cue association less well than the control groups. Some of these deficits were significantly related to impairments in attention and memory. As such, substance use and/or associated neuropsychological impairments may make associative learning difficult, and may contribute to the persistence of maladaptive patterns and the failure to change behavior in response to aversive outcomes.