The Tap-to-Safety Task: A Novel fMRI Paradigm Assessing Repetitive Threat-Neutralization.

Existing experimental threat-related paradigms focus primarily on active or passive avoidance behavior, but do not model the common behavioral pattern of repetitive, effortful actions aimed at neutralizing perceived threats. Here, we describe and provide initial validation for the Tap-to-Safety (TTS) Task, a novel human paradigm designed to experimentally elicit repetitive threat-neutralization behavior during functional magnetic resonance imaging (fMRI). Adult participants completed the TTS Task; one sample completed the task online and an additional sample completed the task in person, with a subsample completing fMRI. Task stimuli included a threat cue (CS+) paired with an aversive unconditioned stimulus (US), safety cues (CS-) never paired with the US, and safe generalization stimuli (GSs) varying in similarity to the CS+. During an extinction phase, the CS+ was no longer paired with the US. Trials included passive viewing trials, without a neutralization option; and choice trials, in which participants could tap a button repeatedly to gain protection from the US (i.e., repetitive threat-neutralization) while reducing accumulation of reward points. Linear mixed-effects models (LMEs) were used to assess behavioral and neural responses. For fMRI analyses in a subset of participants, a priori regions of interest (ROIs) were used with Bonferroni correction. In-person results (n = 49) demonstrated increased threat expectancy, anxiety, and repetitive threat-neutralization behavior that were higher to the threat cue than to safety cues (ps < 0.001, η