Journal
EXPERT REVIEW OF NEUROTHERAPEUTICS
Volume 16, Issue 10, Pages 1155-1174Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14737175.2016.1199276
Keywords
Conditioning; extinction; threat; fear; anxiety disorders; obsessive compulsive disorder; post-traumatic stress disorder; adolescence; inhibitory learning; exposure therapy
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Funding
- Tourette Association of American
- National Institutes of Mental Health (NIMH) [T32MH073517]
- National Institutes of Health/National Institute of Mental Health (NIH/NIMH) [1R21MH101567]
- Department of Defense
- Department of Veterans Affairs
- National Institute of Health [T32MH073517]
- Seaside Therapeutics
- Roche
- Otsuka
- National Institute of Mental Health [R01MH093381]
- CDC
- Agency for Healthcare Research and Quality
- IOCDF
- All Children's Hospital Research Foundation
- Ortho-McNeil Scientific Affairs
- All Children's Hospital Guild Endowed Chair
- National Institute of Mental Health (NIMH) [T32MH073517]
- Tourette Syndrome Association (TSA)
- Pfizer
- Pettit Family Foundation
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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 identifiedExpert 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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