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Exercise Augmentation of Exposure Therapy for PTSD: Rationale and Pilot Efficacy Data
Open accessAbstract
Brain-derived neurotrophic factor (BDNF) is associated with synaptic plasticity, which is crucial for long-term learning and memory. Some studies suggest that people suffering from anxiety disorders show reduced BDNF relative to healthy controls. Lower BDNF is associated with impaired learning, cognitive deficits, and poor exposure-based treatment outcomes. A series of studies with rats showed that exercise elevates BDNF and enhances fear extinction. However, this strategy has not been tested in humans. In this pilot study, we randomized participants (N = 9, 8 females, M(Age) = 34) with posttraumatic stress disorder (PTSD) to (a) prolonged exposure alone (PE) or (b) prolonged exposure+exercise (PE+E). Participants randomized to the PE+E condition completed a 30-minute bout of moderate-intensity treadmill exercise (70% of age-predicted HR(max)) prior to each PE session. Consistent with prediction, the PE+E group showed a greater improvement in PTSD symptoms (d = 2.65) and elevated BDNF (d = 1.08) relative to the PE only condition. This pilot study provides initial support for further investigation into exercise augmented exposure therapy.
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“The results indicated that the group who exercised prior to therapy showed greater improvement in PTSD symptoms relative to the group only participating in therapy.”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [60]
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“Greater reduction in PTSD sxs”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [60]
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“One small pilot study did show that acute bouts of exercise after exposure can boost the effect oftherapy 152 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [152]
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Treatment of posttraumatic stress disorder in U.S. combat Veterans: a meta-analytic review
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Self-citationThe Promise of Extinction Research for the Prevention and Treatment of Anxiety Disorders
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Yohimbine Enhancement of Exposure Therapy for Social Anxiety Disorder: A Randomized Controlled Trial
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“…research on fear extinction has supported the development and testing of a number of pharmacological agents, including DCS, as well as other pharmacological and somatic interventions for augmenting exposure therapy (Powers, Smits, Otto, Sanders, & Emmelkamp, 2009; Smits et al., 2013, 2014).”
BackgroundAugmentation of exposure therapy with post-session administration of D-cycloserine
Tart, C. D., Handelsman, P. R., DeBoer, L. B., Rosenfield, D., Pollack, M. H., Hofmann, S. G., Powers, M. B., Otto, M. W., & Smits, J. A. J. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2012.09.024 · Cited by 75
Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder
Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2020) · Routledge eBooks · doi:10.4324/9781315724539-11 · Cited by 75
The effect of attributional processes concerning medication taking on return of fear.
Powers, M. B., Smits, J. A. J., Whitley, D., Bystritsky, A., & Telch, M. J. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.3.478 · Cited by 75
Siette, J., Reichelt, A. C., & Westbrook, R. F. (2014) · Learning & Memory · doi:10.1101/lm.032557.113 · Cited by 65
Reliability and validity of the PDS and PSS-I among participants with PTSD and alcohol dependence
Powers, M. B., Gillihan, S. J., Rosenfield, D., Jerud, A. B., & Foa, E. B. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2012.02.013 · Cited by 63
Zandberg, L. J., Rosenfield, D., McLean, C. P., Powers, M. B., Asnaani, A., & Foa, E. B. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000052 · Cited by 56
Pareja-Galeano, H., Alis, R., Sanchis‐Gomar, F., Cabo, H., Cortell-Ballester, J., Gómez‐Cabrera, M. C., Lucía, A., & Viña, J. (2014) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2014.11.013 · Cited by 52
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TREATMENT PREFERENCES AND DETERMINANTS IN VICTIMS OF SEXUAL AND PHYSICAL ASSAULT
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Translational research perspectives on maximizing the effectiveness of exposure therapy
Powers, M. B., Smits, J. A. J., Leyro, T. M., & Otto, M. W. (2007) · Elsevier eBooks · doi:10.1016/b978-012587421-2/50005-3 · Cited by 40
Extinction retention predicts improvement in social anxiety symptoms following exposure therapy
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The effects of acute exercise on CO2 challenge reactivity
Smits, J. A. J., Meuret, A. E., Zvolensky, M. J., Rosenfield, D., & Seidel, A. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2008.05.009 · Cited by 36
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Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review
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Metadata
- Authors
- Powers, M. B., Medina, J. L., Burns, S., Kauffman, B. Y., Monfils, M., Asmundson, G. J. G., Diamond, A., McIntyre, C., & Smits, J. A. J.
- Affiliations
- The University of Texas at Austin (US)
- University of Regina (CA)
- The University of Texas at Dallas (US)
- Corresponding author
- Powers, Mark B.
- ORCID
- Venue
- Cognitive Behaviour Therapy
- Publisher
- Informa UK Limited
- Published
- 2015-02-23
- Volume
- 44
- Issue
- 4
- Pages
- 314-327
- ISSN
- 1650-6073 (ISSN-L)
- 1651-2316
- PMC
- PMC4464974
- OpenAlex
- W1987008872
- Cited by
- 194
- References
- 120
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 19 · 2023: 23 · 2022: 20 · 2021: 24 · 2020: 23 · 2019: 23 · 2018: 17 · 2017: 15 · 2016: 6 · 2015: 8
- FWCI
- 19.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cognitive Behaviour Therapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- National Institutes of Health (5r01da027533-04)
- National Institute of Mental Health (R15MH099655, R01MH091147)
- National Institute on Drug Abuse (R01-DA027533, F31DA036919, K01DA035930)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- post-traumatic stress disorder, prolonged exposure therapy, physical activity, brain-derived neurotrophic factor, fear extinction, treadmill exercise, anxiety disorders, synaptic plasticity
- MeSH terms
- Adult, Combined Modality Therapy, Exercise Therapy, Female, Humans, Implosive Therapy, Male, Pilot Projects, Stress Disorders, Post-Traumatic, Exercise, Brain-Derived Neurotrophic Factor, Young Adult
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