Stress and Fear Extinction
Open accessAbstract
Stress has a critical role in the development and expression of many psychiatric disorders, and is a defining feature of posttraumatic stress disorder (PTSD). Stress also limits the efficacy of behavioral therapies aimed at limiting pathological fear, such as exposure therapy. Here we examine emerging evidence that stress impairs recovery from trauma by impairing fear extinction, a form of learning thought to underlie the suppression of trauma-related fear memories. We describe the major structural and functional abnormalities in brain regions that are particularly vulnerable to stress, including the amygdala, prefrontal cortex, and hippocampus, which may underlie stress-induced impairments in extinction. We also discuss some of the stress-induced neurochemical and molecular alterations in these brain regions that are associated with extinction deficits, and the potential for targeting these changes to prevent or reverse impaired extinction. A better understanding of the neurobiological basis of stress effects on extinction promises to yield novel approaches to improving therapeutic outcomes for PTSD and other anxiety and trauma-related disorders.
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Exaggerated fear is a core symptom of clinical anxiety and fear responding is closely linked to stress.
“Exaggerated fear is a core symptom of clinical anxiety and fear responding is closely linked to stress (Maren and Holmes, 2016;McEwen et al., 2016;Raio and Phelps, 2015), which (as described in Sections VI.G. and VII.H.) is tightly intertwined with gut-brain axis function.”
From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Maren and Holmes, 2016
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- Authors
- Maren, S., & Holmes, A.
- Affiliations
- Texas A&M University (US)
- National Institutes of Health (US)
- Corresponding author
- Maren, Stephen
- Venue
- Neuropsychopharmacology
- Published
- 2015-06-24
- Volume
- 41
- Issue
- 1
- Pages
- 58-79
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC4677122
- OpenAlex
- W1607592238
- Cited by
- 412
- References
- 51
- Citations by year
- 2026: 25 · 2025: 46 · 2024: 60 · 2023: 39 · 2022: 40 · 2021: 38 · 2020: 35 · 2019: 33 · 2018: 38 · 2017: 27 · 2016: 20 · 2015: 11
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Defense
- McKnight Foundation
- National Institutes of Health
- Center for Neuroscience and Regenerative Medicine
- National Institute on Alcohol Abuse and Alcoholism
- National Institute of Mental Health (R01MH065961)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- stress, fear extinction, post-traumatic stress disorder, amygdala, prefrontal cortex, hippocampus, exposure therapy, anxiety disorders, trauma recovery
- MeSH terms
- Amygdala, Animals, Extinction, Psychological, Fear, Hippocampus, Humans, Nerve Net, Stress Disorders, Post-Traumatic, Prefrontal Cortex
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