Exposure therapy is an effective intervention for fears and anxiety disorders, but a substantial number of individuals fail to respond or show a return of fear. Translation from the basic science of extinction learning offers strategies for increasing response rates and reducing return of fear after exposure therapy. I will present our latest experimental and clinical evidence for overgeneralization of conditional fear and deficits in extinction as correlates and risk factors for fear and anxiety disorders, and latest evidence for our inhibitory retrieval model of exposure therapy designed to strengthen extinction learning and its retrieval over time and context. Furthermore, I will present our parallel work using neurofeedback to treat phobic fear without conscious awareness. Next, I will present our latest findings regarding reward hyposensitivity as a correlate and predictor of anxiety and depression, which led us to develop a treatment that specifically targets reward hyposensitivity, termed Positive Affect Treatment. I will present our latest evidence showing symptomatic changes with this treatment occurring in parallel with changes in target measures of reward anticipation-motivation and attainment. I will conclude with evidence for reward-related mechanisms within the context of exposure therapy for fears and anxiety, and potential methods for targeting such mechanisms.

 

Prof. Michelle Craske

Distinguished Professor of Psychology, and of Psychiatry and Biobehavioral Sciences, Kevin Love Fund Centennial Chair, Director of the Anxiety and Depression Research Center, and Associate Director of the Staglin Family Music Center for Behavioral and Brain Health, at the University of California, Los Angeles. She is also co-director of the UCLA Depression Grand Challenge.

 

Michelle Craske – Targeting extinction learning and reward sensitivity in behavioral treatments for anxiety and depression