Cited by 360Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesObsessive-Compulsive Spectrum DisordersPosttraumatic Stress Disorder Research

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The Efficacy of Exposure Therapy for Anxiety-Related Disorders and Its Underlying Mechanisms: The Case of OCD and PTSD

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Foa, Edna B., McLean, Carmen P.·2016·Annual Review of Clinical Psychology

DOI 10.1146/annurev-clinpsy-021815-093533

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Abstract

In this review we describe the intricate interrelationship among basic research, conceptualization of psychopathology, treatment development, treatment outcome research, and treatment mechanism research and how the interactions among these areas of study further our knowledge about psychopathology and its treatment. In describing the work of Edna Foa and her colleagues in anxiety disorders, we demonstrate how emotional processing theory of anxiety-related disorders and their treatment using exposure therapy have generated hypotheses about the psychopathology of posttraumatic stress disorder and obsessive-compulsive anxiety disorder that have informed the development and refinement of specific treatment protocols for these disorders: prolonged exposure and exposure and response (ritual) prevention. Further, we have shown that the next step after the development of theoretically driven treatment protocols is to evaluate their efficacy. Once evidence for a treatment's efficacy has accumulated, studies of the mechanisms involved in the reduction of the targeted psychopathology are conducted, which in turn inform the theory and further refine the treatments. We conclude our review with a discussion of how the knowledge derived from Foa and colleagues' programmatic research together with knowledge emerging from basic research on extinction learning can inform future research on the psychopathology of anxiety disorders and their treatments.

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Diagnostic and Statistical Manual of Mental Disorders
Siegel, L. J., & Fletcher‐Janzen, E. (2008) · Wiley eBooks · doi:10.1002/9780470373699.speced0655 · Cited by 8,467
Emotional processing of fear: Exposure to corrective information.
Foa, E. B., & Kozak, M. J. (1986) · Psychological Bulletin · doi:10.1037/0033-2909.99.1.20 · Cited by 5,396
Self-citation
Classical conditioning II: Current research and theory.
Black, A. H., & Prokasy, W. F. (1972) · Appleton-Century-Crofts eBooks · Cited by 4,449
A Bio‐Informational Theory of Emotional Imagery
Lang, P. J. (1979) · Psychophysiology · doi:10.1111/j.1469-8986.1979.tb01511.x · Cited by 1,750
The Posttraumatic Cognitions Inventory (PTCI): development and validation
Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F., & Orsillo, S. M. (1999) · Psychological Assessment · doi:10.1037/1040-3590.11.3.303 · Cited by 1,727
Self-citation
Learning theory and behavior.
Mowrer, O. H. (1960) · doi:10.1037/10802-000 · Cited by 1,670
Optimizing inhibitory learning during exposure therapy
Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.10.003 · Cited by 1,607
Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.5.715 · Cited by 1,444
Self-citation
Treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive-behavioral procedures and counseling.
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.59.5.715 · Cited by 1,444
Self-citation
A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims.
Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.4.867 · Cited by 1,294

Show all 134 references

Research works printed but not linked: 9

Abramowitz JS, 2002, Romanian J. Cogn. Behav. Psychother., 2, 89
Foa EB, 1982, Practical Applications of Learning Theories in Psychiatry, 129
Foa EB, 1999, Efficacy and Cost-Effectiveness of Psychotherapy: Clinical Practice, 45, 23
Foa EB, 1985, Anxiety and the Anxiety Disorders, 421
Inst. Med, 2008, Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence.
March J, 1997, J. Clin. Psychiatry, 58, 65
Meyer V, 1974, Obsessional States, 233
Natl. Inst. Health Clin. Excell., ed, 2006, Obsessive Compulsive Disorder: Core Interventions in the Treatment of Obsessive Compulsive Disorder and Body Dysmorphic Disorder
Ursano RJ, 2004, Am. J. Psychiatry, 161, 3

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Background
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Self-citation
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Background
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Background
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Method
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Self-citation
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“For example, ERP also is the first-line psychotherapy for obsessive compulsive disorder (OCD) (Foa & Goldstein, 1978; Foa & McLean, 2016; Marks et al., 1975) and involves the provocation of anxiety-producing obsessions and the inhibition of compulsions that, whilst alleviating short-term anxiety,…”
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“Treatments for these forms of psychopathology and for youth exposed to ELS often focus on altering maladaptive contingencies (Foa & McLean, 2016; Forgatch & Patterson, 2010; Stanger & Budney, 2019).”
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“The overall goal of exposure therapy, according to the American Psychiatric Association, is to “reduce a patient’s fear and decrease avoidance” of a patient to his “feared objects, activities, or situations” using a safe environment [28].”
Background
Immune cells mediated the causal relationship between the gut microbiota and anxiety disorders: A Mendelian randomization study
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“A specific behavioural exercise that would appear to be important to include in therapist training would be exposure interventions, due to their importance in treating a range of anxiety conditions (Foa and McLean, 2016; Kaczkurkin and Foa, 2015; Mineka and Thomas, 1999).”
Background
Hope and Anxiety: A Meta‐analytic Review
Richardson, A. L., Long, L. J., & Gallagher, M. W. (2025) · Journal of Clinical Psychology · doi:10.1002/jclp.70068 · Cited by 8
“CBT builds coping skills and fosters confidence in managing distress (Dobson and Dobson 2016), while exposure supports patients in confronting feared situations in ways that challenge and reduce catastrophic expectations (Foa and McLean 2016; Gallagher et al. 2013).”
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Resting-state functional connectivity of amygdala subregions predicts treatment outcome for cognitive behavioral therapy in obsessive-compulsive disorder at a 4-month follow-up
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“…are characterized by fear dysregulation that manifests through deficits in fear extinction learning (i.e., safety acquisition) and recall (i.e., safety retention/consolidation; Craske et al., 2022; Duits et al., 2015; Foa & McLean, 2016; Lebron-Milad & Milad, 2012; Marin et al., 2016, 2017).”
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“In these disorders, “exposure and response prevention” (ERP) is a key feature of gold-standard psychological treatment [20].”
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“For example, Foa and colleagues ’ Emotional Processing Theory assumes that during exposures, information that is incompatible with the so-called fear structure is acquired and the integration of this disconfirming information is a mechanism of change [7,8].”
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Clinical presentation of comorbid obsessive-compulsive disorder and posttraumatic stress disorder in Latin American individuals
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Motivation to recover for adolescent and adult eating disorder patients in residential treatment
Manwaring, J. L., Blalock, D. V., Grange, D. L., Duffy, A., McClanahan, S. F., Johnson, C., Mehler, P. S., Plotkin, M., & Rienecke, R. D. (2021) · European Eating Disorders Review · doi:10.1002/erv.2828 · Cited by 3
“These findings also support the use of exposure and response prevention for both EDs (Butler & Heimberg, 2020) and behaviours related to anxiety (Foa & McLean, 2016).”
Result
Foundations of Prolonged Exposure
Foa, E. B., Hembree, E. A., ROTHBAUM, B. O., & Rauch, S. A. M. (2019) · Oxford University Press eBooks · doi:10.1093/med-psych/9780190926939.003.0001 · Cited by 3
Self-citation
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“These results are consistent with the studies conducted by Foa and McLean [34], Watts [35] and Ochberg [36] that the use of cognitive behavioural therapy (CBT), eye movement desensitization and reprocessing therapy (EMDR), exposure therapy, cognitive processing therapy (CPT), supportive counselling, or as well as for…”
Result
Group-based behaviour therapy improves self-care, glycaemic control and distress in adults with type 1 diabetes
Burkhardt, M. S., Pirri, C., Summers, M. A., Barrie, P., Aghabozorgi, M., Fegan, P. G., & Yeap, B. B. (2024) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2024.111095 · Cited by 4

Authors: Foa, E. B., & McLean, C. P.
Affiliations: University of Pennsylvania (US)
ORCID: Foa, Edna B.
McLean, Carmen P.
Venue: Annual Review of Clinical Psychology
Publisher: Annual Reviews
Published: 2016-03-28
Volume: 12
Issue: 1
Pages: 1-28
ISSN: 1548-5943 (ISSN-L)
1548-5951
DOI: 10.1146/annurev-clinpsy-021815-093533
OpenAlex: W1923241527
Cited by: 360
References: 134
Citations by year: 2026: 31 · 2025: 38 · 2024: 45 · 2023: 42 · 2022: 36 · 2021: 29 · 2020: 50 · 2019: 42 · 2018: 23 · 2017: 14 · 2016: 9
FWCI: 1.98
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Annual Review of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Funders: University of Pennsylvania
National Institute on Alcohol Abuse and Alcoholism
National Institute of Mental Health
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords: exposure therapy, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, prolonged exposure, exposure and response prevention, emotional processing theory, extinction learning, therapeutic mechanisms, treatment efficacy, psychopathology
MeSH terms: Anxiety Disorders, Humans, Implosive Therapy, Obsessive-Compulsive Disorder, Stress Disorders, Post-Traumatic, Treatment Outcome

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The Efficacy of Exposure Therapy for Anxiety-Related Disorders and Its Underlying Mechanisms: The Case of OCD and PTSD

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