title: The key role of extinction learning in anxiety disorders: behavioral strategies to enhance exposure-based treatments.
abstract: OBJECTIVE
  Extinction learning is a major mechanism for fear reduction by means of exposure. Current research targets innovative strategies to enhance fear extinction and thereby optimize exposure-based treatments for anxiety disorders. This selective review updates novel behavioral strategies that may provide cutting-edge clinical implications.
  
  
  RESULTS
  Recent studies provide further support for two types of enhancement strategies. Procedural enhancement strategies implemented during extinction training translate to how exposure exercises may be conducted to optimize fear extinction. These strategies mostly focus on a maximized violation of dysfunctional threat expectancies and on reducing context and stimulus specificity of extinction learning. Flanking enhancement strategies target periods before and after extinction training and inform optimal preparation and post-processing of exposure exercises. These flanking strategies focus on the enhancement of learning in general, memory (re-)consolidation, and memory retrieval.
  
  
  CONCLUSIONS
  Behavioral strategies to enhance fear extinction may provide powerful clinical applications to further maximize the efficacy of exposure-based interventions. However, future replications, mechanistic examinations, and translational studies are warranted to verify long-term effects and naturalistic utility. Future directions also comprise the interplay of optimized fear extinction with (avoidance) behavior and motivational antecedents of exposure.
authors.affiliation: aInstitute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, GermanybDepartment of Psychiatry, Harvard Medical School at Massachusetts General Hospital, Boston, Massachusetts, USAcCenter for Excellence on Generalization in Health and Psychopathology, KU Leuven, Leuven, Belgium.
authors.forename: Andre
authors.initials: A
authors.lastname: Pittig
authors.forename: Linda
authors.initials: L
authors.lastname: van den Berg
authors.forename: Bram
authors.initials: B
authors.lastname: Vervliet
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology* / Q000628:therapy*; D005108:Extinction, Psychological; D005239:Fear; D006801:Humans; D008568:Memory