1932
0
  1. Home
  2. A-Z Publications
  3. Annual Review of Clinical Psychology
  4. Volume 12, 2016
  5. Article

Annual Review of Clinical Psychology

Volume 12, 2016

The Efficacy of Exposure Therapy for Anxiety-Related Disorders and Its Underlying Mechanisms: The Case of OCD and PTSD

Abstract

In this review we describe the intricate interrelationship among basic research, conceptualization of psychopathology, treatment development, treatment outcome research, and treatment mechanism research and how the interactions among these areas of study further our knowledge about psychopathology and its treatment. In describing the work of Edna Foa and her colleagues in anxiety disorders, we demonstrate how emotional processing theory of anxiety-related disorders and their treatment using exposure therapy have generated hypotheses about the psychopathology of posttraumatic stress disorder and obsessive-compulsive anxiety disorder that have informed the development and refinement of specific treatment protocols for these disorders: prolonged exposure and exposure and response (ritual) prevention. Further, we have shown that the next step after the development of theoretically driven treatment protocols is to evaluate their efficacy. Once evidence for a treatment's efficacy has accumulated, studies of the mechanisms involved in the reduction of the targeted psychopathology are conducted, which in turn inform the theory and further refine the treatments. We conclude our review with a discussion of how the knowledge derived from Foa and colleagues' programmatic research together with knowledge emerging from basic research on extinction learning can inform future research on the psychopathology of anxiety disorders and their treatments.

Keyword(s): exposure and response (ritual) prevention, exposure therapy, obsessive-compulsive disorder, posttraumatic stress disorder, prolonged exposure
Loading

Article metrics loading...

/content/journals/10.1146/annurev-clinpsy-021815-093533
2016-03-28
2025-04-29
Loading full text...

Full text loading...

/deliver/fulltext/clinpsy/12/1/annurev-clinpsy-021815-093533.html?itemId=/content/journals/10.1146/annurev-clinpsy-021815-093533&mimeType=html&fmt=ahah

Literature Cited

  1. Abramowitz JS, Foa EB, Franklin ME. 2003. Exposure and ritual prevention for obsessive-compulsive disorder: effects of intensive versus twice-weekly sessions. J. Consult. Clin. Psychol. 71:2394–98 [Google Scholar]
  2. Abramowitz JS, Franklin ME, Foa EB. 2002. Empirical status of cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analytic review. Romanian J. Cogn. Behav. Psychother. 2:89–104 [Google Scholar]
  3. Am. Psychiatr. Assoc 1994. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: Am. Psychiatr. Assoc., 4th ed.. [Google Scholar]
  4. Asukai N, Saito A, Tsuruta N, Kishimoto J, Nishikawa T. 2010. Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: a randomized controlled study. J. Trauma. Stress 23:6744–50 [Google Scholar]
  5. Barry H, Etheredge EE, Miller NE. 1965. Counterconditioning and extinction of fear fail to transfer from amobarbital to nondrug state. Psychopharmacologia 8:2150–56 [Google Scholar]
  6. Blanco C, Olfson M, Stein DJ, Simpson HB, Gameroff MJ, Narrow WH. 2006. Treatment of obsessive-compulsive disorder by US psychiatrists. J. Clin. Psychiatry 67:6946–51 [Google Scholar]
  7. Boelen PA, de Keijser J, van den Hout MA, van den Bout J. 2007. Treatment of complicated grief: a comparison between cognitive-behavioral therapy and supportive counseling. J. Consult. Clin. Psychol. 75:2277–84 [Google Scholar]
  8. Bontempo A, Panza KE, Bloch MH. 2012. D-cycloserine augmentation of behavioral therapy for the treatment of anxiety disorders: a meta-analysis. J. Clin. Psychiatry 73:4533–37 [Google Scholar]
  9. Bouton ME, Kenney FA, Rosengard C. 1990. State-dependent fear extinction with two benzodiazepine tranquilizers. Behav. Neurosci. 104:144–55 [Google Scholar]
  10. Bouton ME, Swartzentruber D. 1991. Sources of relapse after extinction in Pavlovian and instrumental learning. Clin. Psychol. Rev. 11:2123–40 [Google Scholar]
  11. Breslau N, Reboussin BA, Anthony JC, Storr CL. 2005. The structure of posttraumatic stress disorder: latent class analysis in 2 community samples. Arch. Gen. Psychiatry 62:121343–51 [Google Scholar]
  12. Bryant RA, Moulds ML, Guthrie RM, Dang ST, Mastrodomenico J. et al. 2008. A randomized controlled trial of exposure therapy and cognitive restructuring for posttraumatic stress disorder. J. Consult. Clin. Psychol. 76:4695–703 [Google Scholar]
  13. Bryant RA, Moulds ML, Guthrie RM, Dang ST, Nixon RDV. 2003. Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder. J. Consult. Clin. Psychol. 71:4706–12 [Google Scholar]
  14. Bryant RA, Sackville T, Dang ST, Moulds M, Guthrie R. 1999. Treating acute stress disorder: an evaluation of cognitive behavior therapy and supportive counseling techniques. Am. J. Psychiatry 156:111780–86 [Google Scholar]
  15. Cahill S, Rothbaum BO, Resick PA, Follette V. 2009. Cognitive-behavioural therapy for adults. Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies EB Foa, TM Keane, M Friedman, J Cohen 139–223 New York: Guilford, 2nd ed.. [Google Scholar]
  16. Cain CK, Blouin AM, Barad M. 2004. Adrenergic transmission facilitates extinction of conditional fear in mice. Learn. Mem. 11:2179–87 [Google Scholar]
  17. Cloitre M, Stovall-McClough KC, Nooner K, Zorbas P, Cherry S. et al. 2010. Treatment for PTSD related to childhood abuse: a randomized controlled trial. Am. J. Psychiatry 167:8915–24 [Google Scholar]
  18. Cottraux J, Mollard E, Bouvard M, Marks I, Sluys M. et al. 1990. A controlled study of fluvoxamine and exposure in obsessive-compulsive disorder. Int. Clin. Psychopharmacol. 5:117–30 [Google Scholar]
  19. Craske MG, Kircanski K, Zelikowsky M, Mystkowski J, Chowdhury N, Baker A. 2008. Optimizing inhibitory learning during exposure therapy. Behav. Res. Ther. 46:15–27 [Google Scholar]
  20. de Kleine RA, Hendriks G-J. Broekman TG, van Minnen A. , Kusters WJC, 2012. A randomized placebo-controlled trial of D-cycloserine to enhance exposure therapy for posttraumatic stress disorder. Biol. Psychiatry 71:11962–68 [Google Scholar]
  21. Dep. Veterans Aff. Def 2004. VA/DoD Clinical Practice Guidelines. http://www.healthquality.va.gov/
  22. Dollard J, Miller NE. 1950. Personality and Psychotherapy New York: McGraw-Hill [Google Scholar]
  23. Fals-Stewart W, Marks AP, Schafer J. 1993. A comparison of behavioral group therapy and individual behavior therapy in treating obsessive-compulsive disorder. J. Nerv. Ment. Dis. 181:3189–93 [Google Scholar]
  24. Foa EB. 1979. Failure in treating obsessive-compulsives. Behav. Res. Ther. 17:3169–76 [Google Scholar]
  25. Foa EB, Abramowitz JS, Franklin ME, Kozak MJ. 1999a. Feared consequences, fixity of belief, and treatment outcome in patients with obsessive-compulsive disorder. Behav. Ther. 30:4717–24 [Google Scholar]
  26. Foa EB, Cahill SP. 2001. Psychological therapies: emotional processing. International Encyclopedia of the Social & Behavioral Sciences NJ Smelser, PB Baltes 12363–69 Amsterdam/New York: Elsevier [Google Scholar]
  27. Foa EB, Dancu CV, Hembree EA, Jaycox LH, Meadows EA, Street GP. 1999b. A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. J. Consult. Clin. Psychol. 67:2194–200 [Google Scholar]
  28. Foa EB, Ehlers A, Clark DM, Tolin DF, Orsillo SM. 1999c. The Posttraumatic Cognitions Inventory (PTCI): development and validation. Psychol. Assess. 11:3303–14 [Google Scholar]
  29. Foa EB, Goldstein A. 1978. Continuous exposure and complete response prevention in the treatment of obsessive-compulsive neurosis. Behav. Ther. 9:5821–29 [Google Scholar]
  30. Foa EB, Grayson JB, Steketee GS. 1982. Depression, habituation and treatment outcome in obsessive-compulsives. Practical Applications of Learning Theories in Psychiatry J Boulougouris 129–41 New York: Wiley [Google Scholar]
  31. Foa EB, Grayson JB, Steketee GS, Doppelt HG, Turner RM, Latimer PR. 1983. Success and failure in the behavioral treatment of obsessive-compulsives. J. Consult. Clin. Psychol. 51:2287–97 [Google Scholar]
  32. Foa EB, Hembree EA, Cahill SP, Rauch SAM, Riggs DS. et al. 2005a. Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. J. Consult. Clin. Psychol. 73:5953–64 [Google Scholar]
  33. Foa EB, Hembree EA, Rothbaum BO. 2007. Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences: Therapist Guide New York: Oxford Univ. Press [Google Scholar]
  34. Foa EB, Huppert JD, Cahill SP. 2006. Emotional processing theory: an update. Pathological Anxiety: Emotional Processing in Etiology and Treatment BO Rothbaum 3–24 New York: Guilford [Google Scholar]
  35. Foa EB, Jaycox LH. 1999. Cognitive-behavioral theory and treatment of posttraumatic stress disorder. Efficacy and Cost-Effectiveness of Psychotherapy: Clinical Practice 45 D Speigel 23–61 Washington, DC: Am. Psychiatr. Assoc. Press [Google Scholar]
  36. Foa EB, Kozak MJ. 1985. Treatment of anxiety disorders: implications for psychopathology. Anxiety and the Anxiety Disorders AH Tuma, JD Maser 421–52 Hillsdale, NJ: Erlbaum [Google Scholar]
  37. Foa EB, Kozak MJ. 1986. Emotional processing of fear: exposure to corrective information. Psychol. Bull. 99:120–35 [Google Scholar]
  38. Foa EB, Kozak MJ. 1997. Beyond the efficacy ceiling? Cognitive behavior therapy in search of theory. Behav. Ther. 28:4601–11 [Google Scholar]
  39. Foa EB, Kozak MJ, Steketee GS, McCarthy PR. 1992. Treatment of depressive and obsessive-compulsive symptoms in OCD by imipramine and behaviour therapy. Br. J. Clin. Psychol. 31:279–92 [Google Scholar]
  40. Foa EB, Liebowitz MR, Kozak MJ, Davies S, Campeas R. et al. 2005b. Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. Am. J. Psychiatry 162:1151–61 [Google Scholar]
  41. Foa EB, McLean CP, Capaldi S, Rosenfield D. 2013a. Prolonged exposure versus supportive counseling for sexual abuse-related PTSD in adolescent girls: a randomized clinical trial. JAMA 310:242650–57 [Google Scholar]
  42. Foa EB, McNally RJ. 1996. Mechanisms of change in exposure therapy. Current Controversies in the Anxiety Disorders RM Rapee 329–43 New York: Guilford [Google Scholar]
  43. Foa EB, Rauch SAM. 2004. Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder. J. Consult. Clin. Psychol. 72:5879–84 [Google Scholar]
  44. Foa EB, Riggs DS, Massie ED, Yarczower M. 1995b. The impact of fear activation and anger on the efficacy of exposure treatment for posttraumatic stress disorder. Behav. Ther. 26:3487–99 [Google Scholar]
  45. Foa EB, Rothbaum BO. 1989. Behavioural psychotherapy for posttraumatic stress disorder. Int. Rev. Psychiatry 1:3219–26 [Google Scholar]
  46. Foa EB, Rothbaum BO. 1998. Treating the Trauma of Rape: A Cognitive Behavioral Therapy for PTSD New York: Guilford [Google Scholar]
  47. Foa EB, Rothbaum BO, Riggs DS, Murdock TB. 1991. Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling. J. Consult. Clin. Psychol. 59:5715–23 [Google Scholar]
  48. Foa EB, Simpson HB, Rosenfield D, Liebowitz MR, Cahill SP. et al. 2015. Six-month outcomes from a randomized trial augmenting serotonin reuptake inhibitors with exposure and response prevention or risperidone in adults with obsessive-compulsive disorder. J. Clin. Psychiatry 76:4440–46 [Google Scholar]
  49. Foa EB, Steketee G, Grayson JB, Turner RM, Latimer PR. 1984. Deliberate exposure and blocking of obsessive-compulsive rituals: immediate and long-term effects. Behav. Ther. 15:5450–72 [Google Scholar]
  50. Foa EB, Steketee G, Turner RM, Fischer SC. 1980. Effects of imaginal exposure to feared disasters in obsessive-compulsive checkers. Behav. Res. Ther. 18:5449–55 [Google Scholar]
  51. Foa EB, Yadin E, Lichner TK. 2012. Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder: Therapist Guide New York: Oxford Univ. Press., 2nd ed.. [Google Scholar]
  52. Foa EB, Yusko DA, McLean CP, Suvak MK, Bux DA Jr. et al. 2013b. Concurrent naltrexone and prolonged exposure therapy for patients with comorbid alcohol dependence and PTSD: a randomized control trial. JAMA 310:5488–95 [Google Scholar]
  53. Franklin ME, Abramowitz JS, Bux DA Jr, Zoellner LA, Feeny NC. 2002. Cognitive-behavioral therapy with and without medication in the treatment of obsessive-compulsive disorder. Prof. Psychol. Res. Pract. 33:2162–68 [Google Scholar]
  54. Franklin ME, Abramowitz JS, Kozak MJ, Levitt JT, Foa EB. 2000. Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: randomized compared with nonrandomized samples. J. Consult. Clin. Psychol. 68:4594–602 [Google Scholar]
  55. Gilboa-Schechtman E, Foa EB, Shafran N, Aderka IM, Powers MB. et al. 2010. Prolonged exposure versus dynamic therapy for adolescent PTSD: a pilot randomized controlled trial. J. Am. Acad. Child Adolesc. Psychiatry 49:101034–42 [Google Scholar]
  56. Gillihan SJ, Foa EB. 2011. Fear extinction and emotional processing theory: a critical review. Conditioning and Animal Learning: Human and Non-Human Animal Applications TR Schachtman, S Reilly 27–43 Oxford, UK: Oxford Univ. Press [Google Scholar]
  57. Grayson JB, Foa EB, Steketee G. 1982. Habituation during exposure treatment: distraction versus attention-focusing. Behav. Res. Ther. 20:4323–28 [Google Scholar]
  58. Greist JH, Jefferson JW, Kobak KA, Katzelnick DJ, Serlin RC. 1995. Efficacy and tolerability of serotonin transport inhibitors in obsessive-compulsive disorder. A meta-analysis. Arch. Gen. Psychiatry 52:153–60 [Google Scholar]
  59. Groves PM, Lynch GS. 1972. Mechanisms of habituation in the brain stem. Psychol. Rev. 79:3237–44 [Google Scholar]
  60. Harned MS, Korslund KE, Foa EB, Linehan MM. 2012. Treating PTSD in suicidal and self- injuring women with borderline personality disorder: development and preliminary evaluation of a dialectical behavior therapy prolonged exposure protocol. Behav. Res. Ther. 50:6381–86 [Google Scholar]
  61. Hayes AM, Beevers CG, Feldman GC, Laurenceau J-P, Perlman C. 2005. Avoidance and processing as predictors of symptom change and positive growth in an integrative therapy for depression. Int. J. Behav. Med. 12:2111–22 [Google Scholar]
  62. Hohagen F, Winkelmann G, Rasche-Rauchle H, Hand I, Konig A. et al. 1998. Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo. Results of a multicentre study. Br. J. Psychiatry 173:71–78 [Google Scholar]
  63. Huppert JD, Simpson HB, Nissenson KJ, Liebowitz MR, Foa EB. 2009. Quality of life and functional impairment in obsessive-compulsive disorder: a comparison of patients with and without comorbidity, patients in remission, and healthy controls. Depress. Anxiety 26:139–45 [Google Scholar]
  64. Inst. Med 2008. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, DC: Natl. Acad. Press [Google Scholar]
  65. Jaycox LH, Foa EB, Morral AR. 1998. Influence of emotional engagement and habituation on exposure therapy for PTSD. J. Consult. Clin. Psychol. 66:1185–92 [Google Scholar]
  66. Kalisch R, Korenfeld E, Stephan KE, Weiskopf N, Seymour B, Dolan RJ. 2006. Context-dependent human extinction memory is mediated by a ventromedial prefrontal and hippocampal network. J. Neurosci. 26:379503–11 [Google Scholar]
  67. Kampman M, Keijsers GPJ, Hoogduin CAL, Verbraak M. 2002. Addition of cognitive-behaviour therapy for obsessive-compulsive disorder patients non-responding to fluoxetine. Acta Psychiatr. Scand. 106:4314–19 [Google Scholar]
  68. Keane TM, Fairbank JA, Caddell JM, Zimering RT. 1989. Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans. Behav. Ther. 20:2245–60 [Google Scholar]
  69. Kilpatrick DG, Veronen LJ, Resick PA. 1982. Psychological sequelae to rape: assessment and treatment strategies. Behavioral Medicine DM Dolays, RL Meredith, AR Ciminero 473–96 Boston: Plenum [Google Scholar]
  70. Kleim B, Ehlers A, Glucksman E. 2007. Early predictors of chronic post-traumatic stress disorder in assault survivors. Psychol. Med. 37:101457–67 [Google Scholar]
  71. Kozak MJ, Foa EB, Steketee G. 1988. Process and outcome of exposure treatment with obsessive-compulsives: psychophysiological indicators of emotional processing. Behav. Ther. 19:2157–69 [Google Scholar]
  72. Lang PJ. 1977. Imagery in therapy: an information processing analysis of fear. Behav. Ther. 8:5862–86 [Google Scholar]
  73. Lang PJ. 1979. A bio-informational theory of emotional imagery. Psychophysiology 16:6495–512 [Google Scholar]
  74. Lang PJ, Melamed BG, Hart J. 1970. A psychophysiological analysis of fear modification using an automated desensitization procedure. J. Abnorm. Psychol. 76:2220–34 [Google Scholar]
  75. Lindsay W, Neilson C, Lawrenson H. 1997. Cognitive-behaviour therapy for anxiety in people with learning disabilities. Cognitive-Behaviour Therapy for People with Learning Disabilities BS Kroese, D Dagnan, K Loumidis 124–40 London/New York: Routledge [Google Scholar]
  76. Litz BT, Salters-Pedneault K, Steenkamp MM, Hermos JA, Bryant RA. et al. 2012. A randomized placebo-controlled trial of D-cycloserine and exposure therapy for posttraumatic stress disorder. J. Psychiatr. Res. 46:91184–90 [Google Scholar]
  77. Mancebo MC, Eisen JL, Pinto A, Greenberg BD, Dyck IR, Rasmussen SA. 2006. The Brown Longitudinal Obsessive Compulsive Study: treatments received and patient impressions of improvement. J. Clin. Psychiatry 67:111713–20 [Google Scholar]
  78. March J, Frances A, Carpenter L, Kahn D. 1997. Expert consensus treatment guidelines for obsessive-compulsive disorder: a guide for patients and families. J. Clin. Psychiatry 58:Suppl. 465–72 [Google Scholar]
  79. Marks IM. 1981. Cure and Care of Neuroses: Theory and Practice of Behavioral Psychotherapy New York: Wiley [Google Scholar]
  80. Marks IM, Hodgson R, Rachman S. 1975. Treatment of chronic obsessive-compulsive neurosis by in-vivo exposure. A two-year follow-up and issues in treatment. Br. J. Psychiatry 127:349–64 [Google Scholar]
  81. Marks IM, Lelliott P, Basoglu M, Noshirvani H, Monteiro W. et al. 1988. Clomipramine, self-exposure and therapist-aided exposure for obsessive-compulsive rituals. Br. J. Psychiatry 152:522–34 [Google Scholar]
  82. Marks IM, Lovell K, Noshirvani H, Livanou M, Thrasher S. 1998. Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: a controlled study. Arch. Gen. Psychiatry 55:4317–25 [Google Scholar]
  83. Marks IM, Stern RS, Mawson D, Cobb J, McDonald R. 1980. Clomipramine and exposure for obsessive-compulsive rituals: I. Br. J. Psychiatry 136:1–25 [Google Scholar]
  84. Mathews A. 1978. Fear-reduction research and clinical phobias. Psychol. Bull. 85:2390–404 [Google Scholar]
  85. McLean CP, Foa EB. 2011. Prolonged exposure therapy for post-traumatic stress disorder: a review of evidence and dissemination. Expert Rev. Neurother. 11:81151–63 [Google Scholar]
  86. McLean CP, Foa EB. 2013. Dissemination and implementation of prolonged exposure therapy for posttraumatic stress disorder. J. Anxiety Disord. 27:8788–92 [Google Scholar]
  87. McLean CP, Foa EB. 2014. The use of prolonged exposure therapy to help patients with PTSD. Clin. Pract. 11:2233–41 [Google Scholar]
  88. McLean CP, Su Y, Foa EB. 2015. Mechanisms of symptom reduction in a combined treatment for comorbid posttraumatic stress disorder and alcohol dependence. J. Consult. Clin. Psychol. 83:3655–61 [Google Scholar]
  89. McLean CP, Yeh R, Rosenfield D, Foa EB. 2015. Changes in negative cognitions mediate PTSD symptom reductions during client-centered therapy and prolonged exposure for adolescents. Behav. Res. Ther. 68:64–69 [Google Scholar]
  90. Meyer V. 1966. Modification of expectations in cases with obsessional rituals. Behav. Res. Ther. 4:273–80 [Google Scholar]
  91. Meyer V, Levy R. 1973. Modification of behavior in obsessive compulsive disorders. Issues and Trends in Behavior Therapy HE Adams, IP Unikel 77–137 Springfield, IL: Thomas [Google Scholar]
  92. Meyer V, Levy R, Schnurer A. 1974. The behavioural treatment of obsessive compulsive disorders. Obsessional States HR Beech 233–58 London: Methuen [Google Scholar]
  93. Milad MR, Wright CI, Orr SP, Pitman RK, Quirk GJ, Rauch SL. 2007. Recall of fear extinction in humans activates the ventromedial prefrontal cortex and hippocampus in concert. Biol. Psychiatry 62:5446–54 [Google Scholar]
  94. Milad MR, Zeidan MA, Contero A, Pitman RK, Klibanski A. et al. 2010. The influence of gonadal hormones on conditioned fear extinction in healthy humans. Neuroscience 168:3652–58 [Google Scholar]
  95. Moser JS, Hajcak G, Simons RF, Foa EB. 2007. Posttraumatic stress disorder symptoms in trauma-exposed college students: the role of trauma-related cognitions, gender, and negative affect. J. Anxiety Disord. 21:81039–49 [Google Scholar]
  96. Mowrer OH. 1960. Learning Theory and Behavior XIV Oxford, UK: Wiley [Google Scholar]
  97. Mowrer OH, Suter JW. 1950. Further evidence for a two-factor theory of learning. Learning Theory and Personality Dynamics OH Mowrer 279–83 New York: Ronald Press [Google Scholar]
  98. Nacasch N, Foa EB, Huppert JD, Tzur D, Fostick L. et al. 2011. Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual. J. Clin. Psychiatry 72:091174–80 [Google Scholar]
  99. Nacasch N, Huppert JD, Su Y-J, Kivity Y, Dinshtein Y. et al. 2015. Are 60-minute prolonged exposure sessions with 20-minute imaginal exposure to traumatic memories sufficient to successfully treat PTSD? A randomized noninferiority clinical trial. Behav. Ther. 46:3328–41 [Google Scholar]
  100. Natl. Inst. Health Clin. Excell., ed 2006. Obsessive Compulsive Disorder: Core Interventions in the Treatment of Obsessive Compulsive Disorder and Body Dysmorphic Disorder Leicester, UK: Br. Psychol. Soc./Royal Coll. Psychiatr. [Google Scholar]
  101. Norberg MM, Krystal JH, Tolin DF. 2008. A meta-analysis of D-cycloserine and the facilitation of fear extinction and exposure therapy. Biol. Psychiatry 63:121118–26 [Google Scholar]
  102. Obsessive Compuls. Cogn. Work. Group 1997. Cognitive assessment of obsessive-compulsive disorder. Behav. Res. Ther. 35:7667–81 [Google Scholar]
  103. Obsessive Compuls. Cogn. Work. Group 2001. Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory. Behav. Res. Ther. 39:8987–1006 [Google Scholar]
  104. Obsessive Compuls. Cogn. Work. Group 2005. Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—part 2: factor analyses and testing of a brief version. Behav. Res. Ther. 43:111527–42 [Google Scholar]
  105. Paunovic N, Ost LG. 2001. Cognitive-behavior therapy versus exposure therapy in the treatment of PTSD in refugees. Behav. Res. Ther. 39:101183–97 [Google Scholar]
  106. Pitman RK, Orr SP, Altman B, Longpre RE, Poire RE, Macklin ML. 1996. Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder. Compr. Psychiatry 37:6419–29 [Google Scholar]
  107. Powers MB, Halpern JM, Ferenschak MP, Gillihan SJ, Foa EB. 2010. A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clin. Psychol. Rev. 30:6635–41 [Google Scholar]
  108. Quirk GJ, Garcia R, González-Lima F. 2006. Prefrontal mechanisms in extinction of conditioned fear. Biol. Psychiatry 60:4337–43 [Google Scholar]
  109. Rachman S, Hodgson R, Marks IM. 1971. The treatment of chronic obsessive-compulsive neurosis. Behav. Res. Ther. 9:3237–47 [Google Scholar]
  110. Rauch SAM, Foa EB, Furr JM, Filip JC. 2004. Imagery vividness and perceived anxious arousal in prolonged exposure treatment for PTSD. J. Trauma. Stress 17:6461–65 [Google Scholar]
  111. Rescorla RA, Wagner AR. 1972. A theory of Pavlovian conditioning: variations in the effectiveness of reinforcement and non-reinforcement. Classical Conditioning II: Current Research and Theory AH Black, WF Prokasy 64–99 New York: Appleton-Century-Crofts [Google Scholar]
  112. Resick PA, Galovski TE, Uhlmansiek MO, Scher CD, Clum GA, Young-Xu Y. 2008. A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. J. Consult. Clin. Psychol. 76:2243–58 [Google Scholar]
  113. Resick PA, Nishith P, Weaver TL, Astin MC, Feuer CA. 2002. A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J. Consult. Clin. Psychol. 70:4867–79 [Google Scholar]
  114. Resick PA, Williams LF, Suvak MK, Monson CM, Gradus JL. 2012. Long-term outcomes of cognitive-behavioral treatments for posttraumatic stress disorder among female rape survivors. J. Consult. Clin. Psychol. 80:2201–10 [Google Scholar]
  115. Rodrigues H, Figueira I, Lopes A, Gonçalves R, Mendlowicz MV. et al. 2014. Does D-cycloserine enhance exposure therapy for anxiety disorders in humans? A meta-analysis. PLOS ONE 9:7e93519 [Google Scholar]
  116. Rothbaum BO, Astin MC, Marsteller F. 2005. Prolonged exposure versus eye movement desensitization and reprocessing (EMDR) for PTSD rape victims. J. Trauma. Stress. 18:6607–16 [Google Scholar]
  117. Rothbaum BO, Price M, Jovanovic T, Norrholm SD, Gerardi M. et al. 2014. A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans. Am. J. Psychiatry 171:6640–48 [Google Scholar]
  118. Schiller D, Monfils M-H, Raio CM, Johnson DC, Ledoux JE, Phelps EA. 2010. Preventing the return of fear in humans using reconsolidation update mechanisms. Nature 463:727749–53 [Google Scholar]
  119. Schnurr PP, Friedman MJ, Engel CC, Foa EB, Shea MT. et al. 2007. Cognitive behavioral therapy for posttraumatic stress disorder in women: a randomized controlled trial. JAMA 297:8820–30 [Google Scholar]
  120. Shapiro F. 1989. Eye movement desensitization: a new treatment for post-traumatic stress disorder. J. Behav. Ther. Exp. Psychiatry 20:3211–17 [Google Scholar]
  121. Shapiro F. 1995. Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures New York: Guilford [Google Scholar]
  122. Shear K, Frank E, Houck PR, Reynolds CF. 2005. Treatment of complicated grief: a randomized controlled trial. JAMA 293:212601–8 [Google Scholar]
  123. Simpson H, Foa EB, Liebowitz MR, Huppert JD, Cahill S. et al. 2013. Cognitive-behavioral therapy versus risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiatry 70:111190–99 [Google Scholar]
  124. Simpson HB, Foa EB, Liebowitz MR, Ledley DR, Huppert JD. et al. 2008. A randomized, controlled trial of cognitive-behavioral therapy for augmenting pharmacotherapy in obsessive-compulsive disorder. Am. J. Psychiatry 165:5621–30 [Google Scholar]
  125. Smith DP, Battersby MW, Harvey PW, Pols RG, Ladouceur R. 2015. Cognitive versus exposure therapy for problem gambling: randomised controlled trial. Behav. Res. Ther. 69:100–10 [Google Scholar]
  126. Smith P, Yule W, Perrin S, Tranah T, Dalgleish T, Clark DM. 2007. Cognitive-behavioral therapy for PTSD in children and adolescents: a preliminary randomized controlled trial. J. Am. Acad. Child Adolesc. Psychiatry 46:81051–61 [Google Scholar]
  127. Smits JAJ, Rosenfield D, Davis ML, Julian K, Handelsman PR. et al. 2014. Yohimbine enhancement of exposure therapy for social anxiety disorder: a randomized controlled trial. Biol. Psychiatry 75:11840–46 [Google Scholar]
  128. Sripada RK, Rauch SAM, Tuerk PW, Smith E, Defever AM. et al. 2013. Mild traumatic brain injury and treatment response in prolonged exposure for PTSD. J. Trauma. Stress 26:3369–75 [Google Scholar]
  129. Steketee G, Foa EB, Grayson JB. 1982. Recent advances in the behavioral treatment of obsessive-compulsives. Arch. Gen. Psychiatry 39:121365–71 [Google Scholar]
  130. Taylor S, Thordarson DS, Maxfield L, Fedoroff IC, Lovell K, Ogrodniczuk J. 2003. Comparative efficacy, speed, and adverse effects of three PTSD treatments: exposure therapy, EMDR, and relaxation training. J. Consult. Clin. Psychol. 71:2330–38 [Google Scholar]
  131. Telch MJ, Bruchey AK, Rosenfield D, Cobb AR, Smits J. et al. 2014. Effects of post-session administration of methylene blue on fear extinction and contextual memory in adults with claustrophobia. Am. J. Psychiatry 171:101091–98 [Google Scholar]
  132. Tolin DF, Maltby N, Diefenbach GJ, Hannan SE, Worhunsky P. 2004. Cognitive-behavioral therapy for medication nonresponders with obsessive-compulsive disorder: a wait-list-controlled open trial. J. Clin. Psychiatry 65:7922–31 [Google Scholar]
  133. Ursano RJ, Bell C, Eth S, Friedman M, Norwood A. et al. 2004. Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Am. J. Psychiatry 161:11 Suppl.3–31 [Google Scholar]
  134. VA/DoD Guidel. Work. Group 2010. VA/DoD Clinical Practice Guideline for Management of Post-Traumatic Stress. Washington, DC: US Dep. Veterans Aff. [Google Scholar]
  135. van den Berg DPG, de Bont PAJM, van der Vleugel BM, de Roos C, de Jongh A. et al. 2015. Prolonged exposure versus eye movement desensitization and reprocessing versus waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. JAMA Psychiatry 72:3259–67 [Google Scholar]
  136. van Minnen A, Foa EB. 2006. The effect of imaginal exposure length on outcome of treatment for PTSD. J. Trauma. Stress 19:4427–38 [Google Scholar]
  137. van Minnen A, Hagenaars M. 2002. Fear activation and habituation patterns as early process predictors of response to prolonged exposure treatment in PTSD. J. Trauma. Stress 15:5359–67 [Google Scholar]
  138. Vaughan K, Armstrong MS, Gold R, O'Connor N, Jenneke W, Tarrier N. 1994. A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder. J. Behav. Ther. Exp. Psychiatry 25:4283–91 [Google Scholar]
  139. Wilhelm S, Steketee G. 2006. Cognitive Therapy for Obsessive-Compulsive Disorder: A Guide for Professionals Oakland, CA: New Harbinger Publ. [Google Scholar]
  140. Zalta AK, Gillihan SJ, Fisher AJ, Mintz J, McLean CP. et al. 2014. Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure. J. Consult. Clin. Psychol. 82:1171–75 [Google Scholar]
  141. Zandberg LJ, Zang Y, McLean CP, Yeh R, Simpson HB, Foa EB. 2015. Change in obsessive-compulsive symptoms mediates subsequent change in depressive symptoms during exposure and response prevention. Behav. Res. Ther. 68:76–81 [Google Scholar]
/content/journals/10.1146/annurev-clinpsy-021815-093533
Loading
The Efficacy of Exposure Therapy for Anxiety-Related Disorders and Its Underlying Mechanisms: The Case of OCD and PTSD
Annual Review of Clinical Psychology 12, 1 (2016); https://doi.org/10.1146/annurev-clinpsy-021815-093533
/content/journals/10.1146/annurev-clinpsy-021815-093533
/content/journals/10.1146/annurev-clinpsy-021815-093533
Loading

Data & Media loading...

  • Article Type: Review Article

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error