Mechanisms of exposure therapy: how neuroscience can improve psychological treatments for anxiety disorders.
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.
McNally
Richard J
RJ
Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138 USA. rjm@wjh.harvard.edu
D000679:Amygdala / Q000187:drug effects / Q000503:physiopathology; D000818:Animals; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000503:physiopathology* / Q000628:therapy*; D001143:Arousal / Q000187:drug effects / Q000502:physiology*; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003523:Cycloserine / Q000627:therapeutic use; D003887:Desensitization, Psychologic / Q000379:methods*; D004292:Dominance, Cerebral / Q000187:drug effects / Q000502:physiology; D005108:Extinction, Psychological / Q000187:drug effects / Q000502:physiology; D005239:Fear / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D011939:Mental Recall / Q000187:drug effects / Q000502:physiology; D009415:Nerve Net / Q000187:drug effects / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000187:drug effects / Q000503:physiopathology; D051381:Rats; D016194:Receptors, N-Methyl-D-Aspartate / Q000819:agonists
D014151:Anti-Anxiety Agents; D016194:Receptors, N-Methyl-D-Aspartate; D003523:Cycloserine