Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder: implications for treatment
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INTRODUCTION: Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. AREAS COVERED: A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified Expert commentary: Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed.
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Inhibitory learning mechanisms have been suggested to play a role in fear extinction for children with anxiety disorders as well as adults.
“Inhibitory learning mechanisms have been suggested to play a role in fear extinction for children with anxiety disorders as well as adults (McGuire, Orr, Essoe et al., 2016; McGuire, Orr, Wu et al., 2016), but more research examining the inhibitory learning model in exposure with children is needed.”
From Enhancing Inhibitory Learning: The Utility of Variability in Exposure (2019) · cites this paper as McGuire, Orr, Essoe et al., 2016
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Gao, Y., Raine, A., Venables, P. H., Dawson, M. E., & Mednick, S. A. (2009) · Developmental Science · doi:10.1111/j.1467-7687.2009.00874.x · Cited by 62 · cited 2× · see citing works
“Differential conditioning has been reliably observed in children starting at around 6 years of age [51], with SCR and FPS magnitudes increasing with age [54,56] and peaking during adolescence [38].”
Neumann, D. L., Waters, A. M., & Westbury, H. R. (2008) · Behavior Research Methods · doi:10.3758/brm.40.2.622 · Cited by 59 · cited 1× · see citing works
“For example, several reports indicate that extinction is achieved for SCR, FPS, and SR measures among youth [34,52,58,62]; whereas other studies indicate that the CRs persist for SCR and SR measures after extinction [34,53,57–59,62].”
McGuire, J. F., Lewin, A. B., & Storch, E. A. (2014) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2014.934677 · Cited by 57 · cited 3× · see citing works
“cognitive enhancers to augment therapeutic learning in CBT [15].”
Self-citationA developmental analysis of threat/safety learning and extinction recall during middle childhood
Michalska, K. J., Shechner, T., Hong, M., Britton, J. C., Leibenluft, E., Pine, D. S., & Fox, N. A. (2016) · Journal of Experimental Child Psychology · doi:10.1016/j.jecp.2016.01.008 · Cited by 56 · cited 3× · see citing works
“With regard to examining extinction retention and generalization, 9–10-year olds reported greater SR fear to stimuli resembling the CS+, compared to 5–8-year olds [62].”
Farrell, L. J., Barrett, P. M., & Piacentini, J. C. (2006) · Behaviour Change · doi:10.1375/bech.23.2.103 · Cited by 55 · cited 1× · see citing works
“Similarly, in humans, there are distinctions in disorder phenomenology [36,37] and neural architecture [38,39] that strongly challenge the generalization of adult findings to youth.”
Self-citationMcGuire, J. F., Orr, S. P., Wu, M. S., Lewin, A. B., Small, B. J., Phares, V., Murphy, T. K., Wilhelm, S., Pine, D. S., Geller, D., et al. (2016) · Depression and Anxiety · doi:10.1002/da.22468 · Cited by 54 · cited 4× · see citing works
“Moreover, youth in several studies exhibited poor awareness of the CS–US contingency [56,61,75,76].”
InfluentialSelf-citationDrysdale, A. T., Hartley, C. A., Pattwell, S. S., Ruberry, E. J., Somerville, L. H., Compton, S. N., Lee, F. S., Casey, B. J., & Walkup, J. T. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.08.015 · Cited by 50 · cited 2× · see citing works
“While there may be some concern regarding the use of extinction-based treatments for adolescents [36,84], more research is needed to better understand the relationship between adolescence, extinction”
A Meta-Analysis of d-Cycloserine in Exposure-Based Treatment
Mcguire, J. F., Wu, M. S., Piacentini, J. C., McCracken, J. T., & Storch, E. A. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.15r10334 · Cited by 50 · cited 2× · see citing works
“comorbid psychiatric conditions, psychiatricmedication) [19] and/or therapeutic mechanisms (e.”
Self-citationIMAGEN consortium, Tzschoppe, J., Nees, F., Banaschewski, T., Barker, G. J., Büchel, C., Conrod, P. J., Garavan, H., Heinz, A., Loth, E., et al. (2014) · Neuropsychopharmacology · doi:10.1038/npp.2013.287 · Cited by 49 · cited 3× · see citing works
“is explicitly not paired with the US) [36,40,55-68].”
Neumann, D. L., Waters, A. M., Westbury, H. R., & Henry, J. (2008) · Biological Psychology · doi:10.1016/j.biopsycho.2008.08.005 · Cited by 46 · cited 2× · see citing works
“is explicitly not paired with the US) [36,40,55-68].”
Den, M. L., Graham, B. M., Newall, C., & Richardson, R. (2015) · Developmental Psychobiology · doi:10.1002/dev.21330 · Cited by 42 · cited 1× · see citing works
“These include the type of conditioned stimuli [57], contingency awareness [56], attention bias [55], parental clinical psychopathology [59], and youth subclinical psychopathology [60,61].”
Beidel, D. C., & Alfano, C. A. (2011) · Routledge eBooks · doi:10.4324/9780203864258 · Cited by 37 · see citing works
Waters, A. M., & Kershaw, R. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.11.010 · Cited by 34 · cited 1× · see citing works
“When comparing anxious youth to unaffected controls, most studies have found no differences in threat conditioning between affected and unaffected groups [66,71,72].”
Haddad, A. D. M., Lissek, S. M., Pine, D. S., & Lau, J. Y. F. (2010) · Cognition & Emotion · doi:10.1080/02699931.2010.524193 · Cited by 34 · cited 1× · see citing works
“These include the type of conditioned stimuli [57], contingency awareness [56], attention bias [55], parental clinical psychopathology [59], and youth subclinical psychopathology [60,61].”
D-CYCLOSERINE ENHANCES GENERALIZATION OF FEAR EXTINCTION IN CHILDREN
Byrne, S., Rapee, R. M., Richardson, R., Malhi, G. S., Jones, M., & Hudson, J. L. (2015) · Depression and Anxiety · doi:10.1002/da.22356 · Cited by 33 · see citing works
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“Indeed, examining such discrepancies has provided important information among phobic youth [70], and may help to identify specific characteristics of youth who appear to achieve extinction on one outcome”
Haddad, A. D. M., Bilderbeck, A. C., James, A. C., & Lau, J. Y. F. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.05.009 · Cited by 28 · cited 2× · see citing works
“In these studies, differential conditioning is observed across measures of SCR, FPS, SR, and heart rate (HR) [41,71-77].”
Fear acquisition and extinction in offspring of mothers with anxiety and depressive disorders
Waters, A. M., Peters, R.-M., Forrest, K., & Zimmer‐Gembeck, M. J. (2013) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2013.10.007 · Cited by 28 · cited 2× · see citing works
“When exploring potential differences within a group of anxious youth, one study found that threat-avoidant anxious youth had greater unconditioned response and less extinction compared to threatvigilant anxious youth [59].”
Integrating research on development and fear learning: a vision for clinical neuroscience?
Pine, D. S. (2009) · Depression and Anxiety · doi:10.1002/da.20595 · Cited by 28 · cited 1× · see citing works
“can be used to investigate potential neurobiological phenotypes of clinical phenomena [30].”
Torrents‐Rodas, D., Fullana, M. A., Bonillo, A., Andión, Ó., Molinuevo, B., Caseras, X., & Torrúbia, R. (2014) · Psychophysiology · doi:10.1111/psyp.12213 · Cited by 27 · cited 1× · see citing works
“Threat generalization is expressed by increasingly large CRs as stimuli more closely approximate the CS previously paired with the US and increasingly smaller CRs as stimuli become less similar to the CS [44].”
Hofmann, S. G., Carpenter, J. K., Otto, M. W., Rosenfield, D., Smits, J. A. J., & Pollack, M. H. (2015) · Contemporary Clinical Trials · doi:10.1016/j.cct.2015.06.015 · Cited by 27 · cited 1× · see citing works
“Additional research is needed to better understand the nuances of augmenting CBT with cognitive enhancers in youth [24,25].”
High trait anxiety during adolescence interferes with discriminatory context learning
Kadosh, K. C., Haddad, A. D. M., Heathcote, L. C., Murphy, R. A., Pine, D. S., & Lau, J. Y. F. (2015) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2015.05.002 · Cited by 25 · cited 4× · see citing works
“Moreover, youth in several studies exhibited poor awareness of the CS–US contingency [56,61,75,76].”
InfluentialKircanski, K., Wu, M. S., & Piacentini, J. C. (2013) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2013.05.004 · Cited by 23 · cited 2× · see citing works
“regarding SR extinction and extinction retention (via subjective units of distress, SUDS) predicting treatment outcome in individual CBT [86,87].”
Self-citationDifferential GSR conditioning as a function of age.
Morrow, M. C., Boring, F. W., Keough, T. E., & Haesly, R. R. (1969) · Developmental Psychology · doi:10.1037/h0027688 · Cited by 19 · cited 1× · see citing works
“is explicitly not paired with the US) [36,40,55-68].”
Mcguire, J. F., Lewin, A. B., GELLER, D. A., Brown, A., Ramsey, K. A., Mutch, J., Andrew Mittelman, B., Micco, J. A., Jordan, C., Wilhelm, S., et al. (2012) · Neuropsychiatry · doi:10.2217/npy.12.38 · Cited by 17 · see citing works
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“While cue-specific threat conditioning and threat generalization has been used to examine and explain transient fear, contextual conditioning has been used to explain the occurrence of more generalized and/or sustained threat response [45,46].”
The conditioning and extinction of fear in youths: What's sex got to do with it?
Chauret, M., Buissonnière-Ariza, V. L., Lamoureux-Tremblay, V., Suffren, S., Servonnet, A., Pine, D. S., & Maheu, F. S. (2014) · Biological Psychology · doi:10.1016/j.biopsycho.2014.06.001 · Cited by 14 · cited 1× · see citing works
“These include the type of conditioned stimuli [57], contingency awareness [56], attention bias [55], parental clinical psychopathology [59], and youth subclinical psychopathology [60,61].”
Cardiac Classical Conditioning and Reversal in the Mongoloid, Encephalopathic, and Normal Child
Block, J. D., Sersen, E. A., & Wortis, J. (1970) · Child Development · doi:10.2307/1127223 · Cited by 13 · see citing works
Looking Beyond Fear and Extinction Learning: Considering Novel Treatment Targets for Anxiety
Britton, J. C., Evans, T. C., & Hernandez, M. V. (2014) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-014-0015-0 · Cited by 10 · see citing works
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- [8](POTS) POTS Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder JAMA 292 16 1969 1976 2004 15507582
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Pittig, A., Treanor, M., LeBeau, R. T., & Craske, M. G. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.03.015 · Cited by 294 · see citing works
“…deficits in fear extinction, including the acquisition of extinction learning as well as long term extinction retention (Blechert et al., 2007; Craske et al., 2008b; Duits et al., 2015; Lissek et al., 2005; McGuire et al., 2016; McLaughlin et al., 2015b; Milad et al., 2013; Norrholm et al., 2011).”
Harmonizing the Neurobiology and Treatment of Obsessive-Compulsive Disorder
Goodman, W. K., Storch, E. A., & Sheth, S. A. (2021) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.20111601 · Cited by 268 · see citing works
Self-citationMechanisms linking childhood adversity with psychopathology: Learning as an intervention target
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“While most studies have been conducted in adults, increasing evidence documents alterations in fear learning in youth with anxiety (Craske, Waters, et al., 2008b; Lau et al., 2008; Waters, Henry, & Neumann, 2009), PTSD (Gamwell et al., 2015; McGuire et al., 2016), and externalizing problems (Fairchild, van Goozen, Sto…”
InfluentialSchaumberg, K., Reilly, E. E., Gorrell, S., Levinson, C. A., Farrell, N. R., Brown, T. A., Smith, K. M., Schaefer, L. M., Essayli, J. H., Haynos, A. F., et al. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101952 · Cited by 121 · see citing works
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BackgroundInfluentialImpact of Gender on Child and Adolescent PTSD
Garza, K. M., & Jovanović, T. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0830-6 · Cited by 106 · see citing works
Stern, C. A. J., da Silva, T. R., Raymundi, A. M., de Souza, C. P., Sato, V., Kato, L., Guimarães, F. S., Andreatini, R., Takahashi, R. N., & Bertoglio, L. J. (2017) · Neuropharmacology · doi:10.1016/j.neuropharm.2017.07.024 · Cited by 96 · see citing works
An Inhibitory Learning Approach to Cognitive-Behavioral Therapy for Children and Adolescents
McGuire, J. F., & Storch, E. A. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.12.003 · Cited by 82 · see citing works
Self-citationEnhancing Inhibitory Learning: The Utility of Variability in Exposure
Knowles, K. A., & Olatunji, B. O. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.12.001 · Cited by 60 · see citing works
Roth, Y., Tendler, A., Arıkan, M. K., Vidrine, R., Kent, D. M., Muir, O. S., MACMILLAN, C. M., Casuto, L., Grammer, G. G., Sauve, W., et al. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.11.009 · Cited by 66 · see citing works
Miller, M. L., & McGuire, J. F. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.08.132 · Cited by 63 · see citing works
“For instance, impairments in extinction learning are implicated in the etiology, development, and maintenance of anxiety-related disorders (Adolph et al., 2022; McGuire et al., 2016; Steuber and McGuire, 2022).”
Self-citationBrooks, S. J., Löchner, C., SHOPTAW, S. J., & Stein, D. J. (2017) · Progress in brain research · doi:10.1016/bs.pbr.2017.08.002 · Cited by 69 · see citing works
Essoe, J., Reggente, N., Ohno, A., Baek, Y., Dell'Italia, J., & Rissman, J. (2022) · npj Science of Learning · doi:10.1038/s41539-022-00147-6 · Cited by 60 · see citing works
Self-citationSafety learning during development: Implications for development of psychopathology
Grasser, L. R., & Jovanović, T. (2021) · Behavioural Brain Research · doi:10.1016/j.bbr.2021.113297 · Cited by 54 · see citing works
The relative effectiveness of extinction and counter-conditioning in diminishing children's fear
Newall, C., Watson, T. D., Grant, K., & Richardson, R. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.05.006 · Cited by 44 · see citing works
“Second, understanding the learning processes involved in reducing fear will contribute to the development of effective prevention and treatment strategies (McGuire et al., 2016).”
BackgroundMarusak, H. A., Hehr, A., Bhogal, A., Peters, C. A., Iadipaolo, A. S., & Rabinak, C. A. (2020) · Behavioural Brain Research · doi:10.1016/j.bbr.2020.112958 · Cited by 42 · see citing works
“Although fewer studies have been conducted in children and adolescents, impaired extinction learning is consistently reported across youth with anxiety disorders and PTSD [19,20].”
BackgroundLa Buissonniere-Ariza, V., Fitzgerald, K., Meoded, A., Williams, L. L., Liu, G., Goodman, W. K., & Storch, E. A. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.12.182 · Cited by 29 · see citing works
Self-citationOn making (and turning adaptive to) maladaptive aversive memories in laboratory rodents
Gazarini, L., Stern, C. A. J., & Bertoglio, L. J. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105101 · Cited by 25 · see citing works
Optimising Exposure for Children and Adolescents with Anxiety, OCD and PTSD: A Systematic Review
Plaisted, H., Waite, P., Gordon, K., & Creswell, C. (2021) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-020-00335-z · Cited by 25 · see citing works
“However, anxiety disorders, OCD and PTSD are all characterised by clinically significant fear, anxiety and distress in response to stimuli and/or situational cues (McGuire et al. 2016).”
BackgroundThreat-related disorders as persistent motivational states of defense
Corchs, F., & Schiller, D. (2018) · Current Opinion in Behavioral Sciences · doi:10.1016/j.cobeha.2018.10.007 · Cited by 23 · see citing works
Chauret, M., Suffren, S., Pine, D. S., Nassim, M., Saint‐Amour, D., & Maheu, F. S. (2019) · Biological Psychology · doi:10.1016/j.biopsycho.2019.107744 · Cited by 22 · see citing works
A Method to Provoke Obsessive Compulsive Symptoms for Basic Research and Clinical Interventions
Tendler, A., Sisko, E., Barnea‐Ygael, N., Zangen, A., & Storch, E. A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00814 · Cited by 23 · see citing works
Self-citationSookman, D., Phillips, K. A., Anholt, G. E., Bhar, S. S., Bream, V., Challacombe, F. L., Coughtrey, A. E., Craske, M. G., Foa, E. B., Gagné, J.-P., et al. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113752 · Cited by 22 · see citing works
Pittenger, C., Brennan, B. P., Koran, L. M., Mathews, C. A., Nestadt, G., Pato, M. T., Phillips, K. A., Rodríguez, C. I., Simpson, H. B., Skapinakis, P., et al. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113853 · Cited by 22 · see citing works
Self-citationFamily-Based Cognitive Behavioral Therapy for Youth With Misophonia: A Case Report
Dover, N., & McGuire, J. F. (2023) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2021.05.005 · Cited by 22 · see citing works
“…habituation to distress is an important consideration, emerging research suggests that exposures that incorporate strategies to optimize inhibitory learning may better address deficits in extinction learning and produce more robust clinical outcomes (McGuire et al., 2016; McGuire & Storch, 2019).”
Self-citationVega-Torres, J. D., Azadian, M. M., Rios-Orsini, R. A., Reyes-Rivera, A. L., Ontiveros‐Ángel, P., & Figueroa, J. D. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00562 · Cited by 20 · see citing works
Buissonnière-Ariza, V. L., Séguin, J. R., Nassim, M., Boivin, M., Pine, D. S., Leporé, F., Tremblay, R. E., & Maheu, F. S. (2019) · Biological Psychology · doi:10.1016/j.biopsycho.2019.03.019 · Cited by 20 · see citing works
“Fear conditioning tasks are extensively used in the study of fear circuitry function in humans and animals as their underlying mechanisms are closely involved in the pathophysiology and treatment of anxiety disorders (Lissek et al., 2005; Lissek, 2012; McGuire et al., 2016; Milad & Quirk, 2012).”
BackgroundFord, J. D., Spinazzola, J., & van der Kolk, B. A. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1929028 · Cited by 21 · see citing works
“DTD was designed to be of particular relevance for children with multiple psychiatric disorders (Feenstra, Busschbach, Verheul, & Hutsebaut, 2011; McGuire et al., 2016).”
BackgroundInfluentialPiacentini, J., Wu, M. S., Rozenman, M., Bennett, S., McGuire, J., Nadeau, J. M., Lewin, A., Sookman, D., Bergman, R., Storch, E., et al. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113854 · Cited by 15 · see citing works
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Susman, E. S., Weissman, D. G., Sheridan, M. A., & McLaughlin, K. A. (2021) · Developmental Psychobiology · doi:10.1002/dev.22176 · Cited by 15 · see citing works
“…2000; Peri et al., 2000; Zuj, Palmer, Hsu et al., 2016; Zuj, Palmer, Lommen et al., 2016), and other forms of psychopathology (Craske et al., 2008;McGuire et al., 2016;Michael et al., 2007), higher vagal tonemay protect against transdiagnostic psychopathology through associated reductions in…”
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Cognitive Behavioral Therapy for Anxiety and Depression in Children and Adolescents
Smárason, O., Skarphéðinsson, G., & Storch, E. A. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.002 · Cited by 22 · see citing works
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“Nonetheless, fear, anxiety, and distress in response to stimuli associated with potential threats remain integral components of both conditions (Grupe and Nitschke, 2013; McGuire et al., 2016).”
BackgroundMa, Y., Jiao, F., Batsikadze, G., Yavari, F., & Nitsche, M. A. (2024) · Brain Stimulation · doi:10.1016/j.brs.2024.07.004 · Cited by 9 · see citing works
“Cognitive behavioral therapy, which is based on the principles of extinction [57], decreased LiFG activity in respective patients [55].”
BackgroundRibeiro, T. O., Bueno-de-Camargo, L. M., Waltrick, A. P. F., de Oliveira, A. R., Brandão, M. L., Munhoz, C. D., & Zanoveli, J. M. (2019) · Psychopharmacology · doi:10.1007/s00213-019-05388-9 · Cited by 9 · see citing works
“…of this fear memory could have therapeutic implication in the treatment of diseases that present an overconsolidation of fear/traumatic memories such as PTSD that is related to the fear generalization and/or the difficulty in extinguishing the fear memory (Yehuda et al. 2015; McGuire et al. 2016).”
BackgroundJenness, J. L., DeLonga, K., Lewandowski, R. E., Spiro, C. N., Crowe, K., Martell, C. R., Towbin, K. E., Stringaris, A. K., & McCauley, E. (2022) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2022.2042871 · Cited by 8 · see citing works
“While there are different proposed mechanisms of symptom change for anxiety (i.e., desensitization and inhibitory learning; Craske, 2015; Geller et al., 2019; McGuire et al., 2016) and depression (i.”
BackgroundLaurent, R. S., Kusche, K. M., Rein, B. A., Raymond, K. B., Kreitzer, A. C., & Malenka, R. C. (2024) · Biological Psychiatry · doi:10.1016/j.biopsych.2024.10.021 · Cited by 10 · see citing works
Exposure therapy for specific phobias in children and adolescents
Mobach, L., Oar, E. L., & Hudson, J. L. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-815915-6.00008-1 · Cited by 8 · see citing works
Fear-potentiated startle reveals diminished threat extinction in pathological anxiety
Newsome, P., Ruiz, S. G., Gold, A. L., Pine, D. S., & Abend, R. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.11.011 · Cited by 8 · see citing works
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“…al., 2014, 2018, 2022; Dunsmoor et al., 2015; Elsey & Kindt, 2017; Jansen et al., 2016; Keller et al., 2020; Kummar et al., 2019; Lipp et al., 2020; McGuire et al., 2016; McGuire & Storch, 2019; Monfils & Holmes, 2018; Pittig et al., 2016; Sewart & Craske, 2020; Tolin, 2019; van den Akker et al.,…”
Psychoeducation for exposure therapy
Lavell, C. H., Cadman, J., Waters, A. M., & Farrell, L. J. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-815915-6.00003-2 · Cited by 7 · see citing works
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Self-citationDevelopmental regulation of fear memories by an obesogenic high-saturated fat/high-sugar dietPreprint
Vega-Torres, J. D., Reyes-Rivera, A. L., & Figueroa, J. D. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/748079 · Cited by 4 · see citing works
“The inability to consolidate extinction memory and inhibit conditioned fear under safe conditions underlies some of the hallmark symptoms of anxiety and stress-related disorders (McGuire et al., 2016; Milad et al., 2009; Waters and Pine, 2016).”
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Behavioral interventions to eliminate fear responses
Yue, J.-L., Shi, L., Lin, X., Khan, M. Z., Shi, J., & Lü, L. (2018) · Science China Life Sciences · doi:10.1007/s11427-018-9294-4 · Cited by 3 · see citing works
Using latent patient-centered fear extinction profiles to guide treatment in pediatric OCD
Ingram, K. M., Storch, E. A., GELLER, D. A., Small, B. J., Wilhelm, S., & Mcguire, J. F. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116664 · Cited by 2 · see citing works
Self-citationOverlap of obsessive and posttraumatic symptoms: A systematic review
Medina-Rodríguez, J. C., & Villegas, E. M. S. (2022) · Salud Mental · doi:10.17711/sm.0185-3325.2022.018 · Cited by 2 · see citing works
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Sexually dimorphic interplay between anxiety-related phenotype and fear memory extinctionPreprint
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“By directly targeting hyperarousal and related difficulties in extinction learning (McGuire et al., 2016), such interventions may help children and adolescents break maladaptive emotional cycles and support longer-term resilience.”
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Self-citation
- Authors
- McGuire, J. F., Orr, S. P., Essoe, J. K.-Y., McCracken, J. T., Storch, E. A., & Piacentini, J.
- Affiliations
- University of California, Los Angeles (US)
- Harvard University (US)
- Johns Hopkins University (US)
- Corresponding author
- McGuire, Joseph F.
- ORCID
- Venue
- Expert Review of Neurotherapeutics
- Publisher
- Informa UK Limited
- Published
- 2016-06-27
- Volume
- 16
- Issue
- 10
- Pages
- 1155-1174
- ISSN
- 1473-7175 (ISSN-L)
- 1744-8360
- PMC
- PMC5967402
- OpenAlex
- W2412831890
- Cited by
- 67
- References
- 96
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 5 · 2022: 8 · 2021: 15 · 2020: 9 · 2019: 7 · 2018: 6 · 2017: 4
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Expert Review of Neurotherapeutics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (T32MH073517)
- 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
- extinction learning, fear conditioning, childhood anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, inhibitory learning, differential conditioning, cognitive behavioral therapy, maltreatment
- MeSH terms
- Adolescent, Adult, Child, Child Behavior Disorders, Extinction, Psychological, Fear, Humans, Obsessive-Compulsive Disorder, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy
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