ScienceDirect® Home Skip Main Navigation Links
You have guest access to ScienceDirect. Find out more.
 
Home
Browse
My Settings
Alerts
Help
 Quick Search
 Search tips (Opens new window)
    Clear all fields    
Behaviour Research and Therapy
Volume 46, Issue 1, January 2008, Pages 5-27
 
Font Size: Decrease Font Size  Increase Font Size
 Abstract - selected
Article
Purchase PDF (323 K)

  E-mail Article   
  Add to my Quick Links   
Bookmark and share in 2collab (opens in new window)
Request permission to reuse this article
  Cited By in Scopus (0)
 
 
 
Related Articles in ScienceDirect
View More Related Articles
 
View Record in Scopus
 
doi:10.1016/j.brat.2007.10.003    How to Cite or Link Using DOI (Opens New Window)
Published by Elsevier Ltd.

Invited Essay

Optimizing inhibitory learning during exposure therapy

Michelle G. CraskeCorresponding Author Contact Information, a, E-mail The Corresponding Author, Katharina Kircanskia, Moriel Zelikowskya, Jayson Mystkowskia, Najwa Chowdhurya and Aaron Bakera

aDepartment of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA

Received 3 August 2007; 
revised 29 September 2007; 
accepted 2 October 2007. 
Available online 7 October 2007.

Purchase the full-text article



References and further reading may be available for this article. To view references and further reading you must purchase this article.

Abstract

Prevailing models of exposure therapy for phobias and anxiety disorders construe level of fear throughout exposure trials as an index of corrective learning. However, the evidence, reviewed herein, indicates that neither the degree by which fear reduces nor the ending fear level predict therapeutic outcome. Developments in the theory and science of fear extinction, and learning and memory, indicate that ‘performance during training’ is not commensurate with learning at the process level. Inhibitory learning is recognized as being central to extinction and access to secondary inhibitory associations is subject to influences such as context and time, rather than fear during extinction training. Strategies for enhancing inhibitory learning, and its retrieval over time and context, are reviewed along with their clinical implications for exposure therapy and directions for future research.

Keywords: Fears; Phobias; Exposure; Extinction; Habituation; Inhibitory learning

Article Outline

Introduction
Emotional processing theory
Fear activation, within-session and between-session habituation as indices of learning
Initial fear activation (IFA)
Within-session habituation
Between-session habituation
Summary
New directions for optimizing learning
Fear expression versus fear learning
Fear reduction versus fear toleration
Self-efficacy versus illusion of competency
New directions
Development of non-threat associations
Mismatch with expectancies
Multiple conditioned excitors
Wean safety signals and safety behaviors
Cognitive enhancers: d-cycloserine
Enhancing inhibitory regulation
Enhancing accessibility and retrievability of exposure-based learning
Variability throughout exposure
Spacing of exposure trials
Offsetting context renewal and re-instatement effects
Conclusions
Acknowledgements
References

 
Home
Browse
My Settings
Alerts
Help
Elsevier.com (Opens new window)
About ScienceDirect  |  Contact Us  |  Information for Advertisers  |  Terms & Conditions  |  Privacy Policy
Copyright © 2008 Elsevier B.V. All rights reserved. ScienceDirect® is a registered trademark of Elsevier B.V.