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Optimizing Exposure Therapy for Anxiety Disorders: An Inhibitory Learning and Inhibitory Regulation Approach
Open accessAbstract
Exposure-based cognitive-behavioral therapy is the treatment of choice for anxiety disorders. Unfortunately, many individuals fail to benefit from treatment or demonstrate a return of fear. Inhibitory learning and inhibitory regulation models provide a parsimonious and unifying framework from which to situate exposure therapy and provide useful strategies to augment exposure therapy, especially as individuals with anxiety disorders show inhibitory deficits. This paper provides an overview of our application of inhibitory learning from the science of extinction, and inhibitory regulation from the neuroscience of emotion regulation, to exposure therapy for anxiety disorders.
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“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 [63]
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“Inhibitory learning is currently deemed the more suitable explanation model for anxiety disorders, especially since these patients display impaired inhibitory regulation and learning and thus extinction (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 [63]
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“Exposure therapy, a potent behavioral treatment approach used in CBT, reduces anxiety by weakening learned associations between feared stimuli and negative outcomes, and strengthening inhibitory learning (i.e., a feared stimulus does not signal threat) (Craske, 2015).”
From Exposure Therapy Acceptability Among Pregnant Latinas With Anxiety: A Qualitative Content Analysis (2025) · cites this paper as Craske, 2015
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Wechsler, T. F., Kümpers, F., & Mühlberger, A. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01758 · Cited by 282
Kleindienst, N., Priebe, K., Görg, N., Dyer, A., Steil, R., Lyssenko, L., Winter, D., Schmahl, C., & Bohus, M. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.30375 · Cited by 105
“Specifically, Craske (2015) argues that exposure therapy needs to counter the patients’ original expectations, thereby inducing a secondary inhibitory association.”
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“Exposure therapy in anxiety disorders has been reformulated as a therapy to disconfirm negative expectations, and to increase inhibition of avoidance behavior (Craske, 2015; Craske et al., 2014).”
BackgroundAdaptive and maladaptive emotion processing and regulation, and the case of alexithymia
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“…use of ineffective coping can compromise decision making, solidification of coping repertoires, resilience during future challenges and social effectiveness (Aldao et al., 2010; Craske, 2015; Kashdan & Rottenberg, 2010) incurring increased allostatic load and compromised physical and mental health.”
BackgroundErwartungsfokussierte Psychotherapeutische Interventionen (EFPI)
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“Michelle Craske [Craske, 2015; Craske et al., 2014] brachte für die Expositionsbehandlung exzellente Ideen vor, wie deren Ergebnis durch die Berücksichtigung von grundlegenden Lernmechanismen (z.B. die Rolle des Kontextlernens) verbessert werden kann.”
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- Craske, M.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Craske, Michelle
- ORCID
- Craske, Michelle
- Venue
- Verhaltenstherapie
- Publisher
- S. Karger AG
- Published
- 2015
- Volume
- 25
- Issue
- 2
- Pages
- 134-143
- ISSN
- 1016-6262 (ISSN-L)
- 1423-0402
- OpenAlex
- W4294949187
- Cited by
- 124
- References
- 90
- Citations by year
- 2026: 14 · 2025: 11 · 2024: 10 · 2023: 8 · 2022: 18 · 2021: 13 · 2020: 14 · 2019: 11 · 2018: 9 · 2017: 5 · 2016: 8 · 2015: 2
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Verhaltenstherapie (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- exposure therapy, anxiety disorders, inhibitory learning, extinction, emotion regulation, cognitive behavioral therapy, augmentation therapy, inhibitory deficits, return of fear
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