Augmenting exposure therapy with pre-extinction fear memory reactivation and deepened extinction: A randomized controlled trial.
Behavior therapy
Deepened extinction
Exposure therapy
Phobia
Reconsolidation
Retrieval
Journal
Behaviour research and therapy
ISSN: 1873-622X
Titre abrégé: Behav Res Ther
Pays: England
ID NLM: 0372477
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
01
07
2019
revised:
16
06
2020
accepted:
16
09
2020
pubmed:
24
10
2020
medline:
21
10
2021
entrez:
23
10
2020
Statut:
ppublish
Résumé
Pre-extinction fear memory reactivation (PE-FMR) and deepened extinction (DE) enhance long-term extinction of shock-conditioned fear, and may also enhance long-term extinction of naturally acquired fear. Preliminary data suggest that PE-FMR may additionally boost the speed of fear reduction during exposure therapy. Randomized controlled trial, factorial design. Participants with elevated fears of either spiders or snakes were randomized to (1) exposure therapy alone (n = 41), (2) exposure therapy + PE-FMR (n = 42), (3) exposure therapy + DE (n = 41), or (4) exposure therapy + PE-FMR + DE (n = 42). Participants were assessed at baseline, post-treatment, and one-week follow-up on subjective and behavioral indices of phobia. Because treatment length was tailored to speed of fear reduction, survival analyses were used to examine the speed of fear reduction during treatment. DE did not improve clinical outcomes at post-treatment or follow-up, whereas PE-FMR produced more rapid fear reduction and was able to achive equivalent outcomes even when the duration of exposure therapy (tailored to speed of fear reduction) was shortened by an average of 21%. Data suggest that PE-FMR is a promising strategy for reducing the overall duration of exposure-based therapies. (clinicaltrials.gov)NCT02160470.
Sections du résumé
BACKGROUND
Pre-extinction fear memory reactivation (PE-FMR) and deepened extinction (DE) enhance long-term extinction of shock-conditioned fear, and may also enhance long-term extinction of naturally acquired fear. Preliminary data suggest that PE-FMR may additionally boost the speed of fear reduction during exposure therapy.
DESIGN
Randomized controlled trial, factorial design.
METHODS
Participants with elevated fears of either spiders or snakes were randomized to (1) exposure therapy alone (n = 41), (2) exposure therapy + PE-FMR (n = 42), (3) exposure therapy + DE (n = 41), or (4) exposure therapy + PE-FMR + DE (n = 42). Participants were assessed at baseline, post-treatment, and one-week follow-up on subjective and behavioral indices of phobia. Because treatment length was tailored to speed of fear reduction, survival analyses were used to examine the speed of fear reduction during treatment.
RESULTS
DE did not improve clinical outcomes at post-treatment or follow-up, whereas PE-FMR produced more rapid fear reduction and was able to achive equivalent outcomes even when the duration of exposure therapy (tailored to speed of fear reduction) was shortened by an average of 21%.
CONCLUSIONS
Data suggest that PE-FMR is a promising strategy for reducing the overall duration of exposure-based therapies.
CLINICAL TRIAL REGISTRATION
(clinicaltrials.gov)NCT02160470.
Identifiants
pubmed: 33096291
pii: S0005-7967(20)30184-4
doi: 10.1016/j.brat.2020.103730
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02160470']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
103730Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.