Mechanisms of exposure therapy: how neuroscience can improve psychological treatments for anxiety disorders

Clin Psychol Rev. 2007 Jul;27(6):750-9. doi: 10.1016/j.cpr.2007.01.003. Epub 2007 Jan 18.

Abstract

Exposure therapy for anxiety disorders has been one of success stories of clinical psychology and psychiatry. Nevertheless, a significant minority of patients fail to benefit from extant treatments. This clinical impasse is prompting renewed attempts to understand fear and its reduction at neural, cellular, and molecular as well as behavioral levels of analysis. The purpose of this article is to provide a review of theories of exposure therapy, including recent developments in emotional processing theory, and to discuss insights from neuroscience that promise to improve psychological treatments for reducing pathological fears.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Amygdala / drug effects
  • Amygdala / physiopathology
  • Animals
  • Anti-Anxiety Agents / therapeutic use
  • Anxiety Disorders / physiopathology*
  • Anxiety Disorders / therapy*
  • Arousal / drug effects
  • Arousal / physiology*
  • Brain / drug effects
  • Brain / physiopathology*
  • Cognitive Behavioral Therapy / methods*
  • Cycloserine / therapeutic use
  • Desensitization, Psychologic / methods*
  • Dominance, Cerebral / drug effects
  • Dominance, Cerebral / physiology
  • Extinction, Psychological / drug effects
  • Extinction, Psychological / physiology
  • Fear / drug effects
  • Fear / physiology*
  • Humans
  • Mental Recall / drug effects
  • Mental Recall / physiology
  • Nerve Net / drug effects
  • Nerve Net / physiopathology
  • Prefrontal Cortex / drug effects
  • Prefrontal Cortex / physiopathology
  • Rats
  • Receptors, N-Methyl-D-Aspartate / agonists

Substances

  • Anti-Anxiety Agents
  • Receptors, N-Methyl-D-Aspartate
  • Cycloserine