Internet-delivered approach-avoidance conflict task shows temporal stability and relation to trait anxiety

Excessive avoidance causes functional impairment and maintains anxiety disorders. In the laboratory, approach-avoidance conflict tasks (AACT) can be used to study approach-avoidance behavior in mixed outcome situations (i.e., the same behavior entails both aversive and rewarding consequences). We tested the feasibility of a novel, internet-delivered AACT (iAACT) by conceptually replicating results from laboratory AACTs, including the temporal stability of results and the relation between trait anxiety and approach-avoidance behavior. Individuals from the general population (n = 186) completed a measure of trait anxiety and the iAACT, which entailed choosing either to approach aversive stimuli (image-sound) and receive a reward (points), or to avoid them and not receive a reward (i.e., costly avoidance). The temporal stability of approach-avoidance behavior was assessed by inviting participants to repeat the iAACT six weeks later (n = 91). Consistent with previous findings in laboratory AACTs, results showed that approach behavior to aversive stimuli increased with higher reward levels. These findings were replicated in the follow-up session. Also consistent with previous studies, higher trait anxiety was associated with elevated costly avoidance. In conclusion, the consistency of our results with laboratory studies indicates that the iAACT is feasible and may provide a cost-effective and scalable method to study anxiety-related approach-avoidance behavior remotely.