In Pavlovian fear conditioning, contingency awareness provides an indicator of explicit fear learning. A less studied aspect of fear-based psychopathologies and their treatment, awareness of learned fear is a common cause of distress in persons with such conditions and is a focus of their treatment. The present work is a substudy of a broader fear-conditioning fMRI study. Following fear conditioning, we identified a subset of individuals who did not exhibit explicit awareness of the CS-US contingency. This prompted an exploratory analysis of differences in “aware” versus “unaware” individuals after fear conditioning. Self-reported expectancies of the CS-US contingency obtained immediately following fear conditioning were used to differentiate the two groups. Results corrected for multiple comparisons indicated significantly greater BOLD signal in the bilateral dlPFC, right vmPFC, bilateral vlPFC, left insula, left hippocampus, and bilateral amygdala for the CS+>CS− contrast in the aware group compared with the unaware group (all p values ≤ 0.004). PPI analysis with a left hippocampal seed indicated stronger coupling with the dlPFC and vmPFC in the aware group compared with the unaware group (all p values ≤ 0.002). Our findings add to our current knowledge of the networks involved in explicit learning and awareness of conditioned fear, with important clinical implications.

在巴甫洛夫恐惧条件反射中，应急意识提供了明确恐惧学习的指标。基于恐惧的精神病理学及其治疗研究较少的一个方面，对习得性恐惧的认识是患有此类疾病的人感到痛苦的常见原因，并且是他们治疗的重点。目前的工作是对更广泛的恐惧调节 fMRI 研究的子研究。在恐惧条件反射之后，我们确定了一部分没有表现出对 CS-US 突发事件的明确认识的人。这促使对恐惧条件反射后“有意识”与“无意识”个体的差异进行探索性分析。使用恐惧条件反射后立即获得的 CS-US 意外事件的自我报告预期来区分两组。p值 ≤ 0.004）。使用左侧海马种子的 PPI 分析表明，与无意识组相比，有意识组与 dlPFC 和 vmPFC 的耦合更强（所有p值 ≤ 0.002）。我们的发现增加了我们目前对显性学习和条件恐惧意识所涉及的网络的了解，具有重要的临床意义。