The association between fear extinction, the ability to accomplish exposure and exposure therapy outcome in specific phobia
Open accessAbstract
Great interest exists in maximizing exposure therapy efficacy in anxiety disorders. At the same time, reduced frequency and shortened duration of exposure sessions are required to meet the specific regularities in routine care settings. Extinction has emerged as the key mechanism of exposure treatment in anxiety disorders. Examining exposure treatment processes from the perspective of extinction learning might provide novel insights into variability in exposure treatment duration and outcome. The present study sought to examine the functional link between fear extinction, the ability to accomplish exposure in a predetermined time and exposure therapy outcome in specific phobia. Treatment-seeking individuals (N = 53) with spider phobia underwent a context-dependent fear conditioning paradigm prior to a standardized exposure. Spider-phobic participants who were able to complete exposure within the pre-determined time (i.e., completers) showed a more pronounced short- and long-term exposure therapy benefit. In the fear conditioning task, a more pronounced decline in CS-US contingency ratings during extinction (retrieval) was found in completers relative to non-completers. The failure to further extinguish US expectancy to the CSs in non-completers might offer a potential mechanistic explanation why non-completers have difficulties to accomplish all exposure steps in a fixed time and show less pronounced treatment gains. Our findings bear specific implications for the implementation of exposure treatment to routine care settings.
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Exposure therapy is based on the assumption that phobic anxiety and fear are reduced by repeated exposure to feared or avoided stimuli, resulting in habituation and fear extinction by repeated violation of threat expectancy.
“In general, exposure therapy is based on the assumption that phobic anxiety and fear are reduced by repeated exposure to feared or avoided stimuli, resulting in habituation and fear extinction by repeated violation of threat expectancy (62, 63).”
From Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report (2022) · cites this paper as [62]
The Introduction says exposure repeatedly presents feared or avoided situations to decrease fear and identifies extinction as a candidate mechanism. The Discussion links reduced threat expectancy during extinction to better treatment gains. However, the paper does not describe habituation as a mechanism of exposure therapy or say that repeated violations of threat expectancy produce both habituation and extinction; its discussion of habituation concerns the laboratory conditioning task. The indexed passages have section labels but no page numbers. (LLM, conf=0.86)
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- Authors
- Raeder, F., Merz, C. J., Margraf, J., & Zlomuzica, A.
- Affiliations
- Ruhr University Bochum (DE)
- Corresponding author
- Zlomuzica, Armin
- Venue
- Scientific Reports
- Published
- 2020-03-09
- Volume
- 10
- Issue
- 1
- Pages
- 4288-4288
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC7062844
- OpenAlex
- W3010450807
- Cited by
- 53
- References
- 42
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 8 · 2023: 11 · 2022: 11 · 2021: 7 · 2020: 1
- FWCI
- 4.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (FOR 1581, project 9 to A.Z. and J.M.; SFB 1280, project number 316803389)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- fear extinction, exposure therapy, specific phobia, spider phobia, treatment outcomes, extinction learning, anxiety disorders
- MeSH terms
- Adult, Animals, Anxiety Disorders, Brain, Conditioning, Classical, Fear, Female, Humans, Implosive Therapy, Male, Phobic Disorders, Spiders, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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