CBT: Extended Summary of The Craske Article
Craske, M. G., Treanor, M., Zbozinek, T. D., & Vervliet, B. (2022). Optimizing
exposure therapy with an inhibitory retrieval approach and the OptEx
Nexus. Behaviour Research and Therapy, 152, Article
104069. https://doi.org/10.1016/j.brat.2022.104069.
Exposure therapy = repeated confrontation with the feared stimuli (US) in the absence of
the feared outcome (CS)
Original association = CS-US
New inhibitory meaning = (CS-noUS)
Inhibitory retrieval model = posits that the original association acquired during fear
conditioning is not erased during extinction, rather it is left intact while new secondary
learning develops – specifically that the CS no longer predicts the US
Thus, retrieval of the extinction memory inhibits retrieval of the original excitatory
memory
Retention of the original excitatory memory can be uncovered in several ways (Return of
fear = ROF):
Spontaneous recovery = return of fear with the lapse of time
Renewal = if the surrounding context is changed between extinction and retest
(ABA, ABC, AAB)
Reinstatement = Fear returns if unsignaled US presentations occur after extinction
(ex. an individual may undergo exposure therapy for a primary fear of spiders and
, have a secondary fear of snakes)
Reacquisition = the CS-US pairing is repeated after exposure therapy
Therefore, important to: (1) develop competing associations, and (2) increase these
associations’ retrievability to mitigate ROF
Extinction learning and retrievability may be impaired in individuals with anxiety
disorders (in part due to Dysregulation in neural regions)
OptEx (optimal exposure) nexus:
An associative map determining all factors that affect the expectancy for a given
CS-US => aversive outcome (US), predictors (CS), occasion setters, and inhibitors
(safety signals)
These factors combine into the ultimate exposure
Replaces the traditional fear hierarchy (ranking situations in terms of fear levels)
Craske, M. G., Treanor, M., Zbozinek, T. D., & Vervliet, B. (2022). Optimizing
exposure therapy with an inhibitory retrieval approach and the OptEx
Nexus. Behaviour Research and Therapy, 152, Article
104069. https://doi.org/10.1016/j.brat.2022.104069.
Exposure therapy = repeated confrontation with the feared stimuli (US) in the absence of
the feared outcome (CS)
Original association = CS-US
New inhibitory meaning = (CS-noUS)
Inhibitory retrieval model = posits that the original association acquired during fear
conditioning is not erased during extinction, rather it is left intact while new secondary
learning develops – specifically that the CS no longer predicts the US
Thus, retrieval of the extinction memory inhibits retrieval of the original excitatory
memory
Retention of the original excitatory memory can be uncovered in several ways (Return of
fear = ROF):
Spontaneous recovery = return of fear with the lapse of time
Renewal = if the surrounding context is changed between extinction and retest
(ABA, ABC, AAB)
Reinstatement = Fear returns if unsignaled US presentations occur after extinction
(ex. an individual may undergo exposure therapy for a primary fear of spiders and
, have a secondary fear of snakes)
Reacquisition = the CS-US pairing is repeated after exposure therapy
Therefore, important to: (1) develop competing associations, and (2) increase these
associations’ retrievability to mitigate ROF
Extinction learning and retrievability may be impaired in individuals with anxiety
disorders (in part due to Dysregulation in neural regions)
OptEx (optimal exposure) nexus:
An associative map determining all factors that affect the expectancy for a given
CS-US => aversive outcome (US), predictors (CS), occasion setters, and inhibitors
(safety signals)
These factors combine into the ultimate exposure
Replaces the traditional fear hierarchy (ranking situations in terms of fear levels)
