Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder: implications for treatment

Joseph McGuire, Scott P. Orr, Joey K.Y. Essoe, James T. McCracken, Eric A. Storch, John Piacentini

Research output: Contribution to journalReview article

Abstract

Introduction: Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. Areas covered: A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified Expert commentary: Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed.

Original languageEnglish (US)
Pages (from-to)1155-1174
Number of pages20
JournalExpert Review of Neurotherapeutics
Volume16
Issue number10
DOIs
StatePublished - Oct 2 2016
Externally publishedYes

Fingerprint

Obsessive-Compulsive Disorder
Post-Traumatic Stress Disorders
Anxiety Disorders
Learning
Cognitive Therapy
Therapeutics
Psychological Extinction
PubMed
Conditioning (Psychology)

Keywords

  • adolescence
  • anxiety disorders
  • Conditioning
  • exposure therapy
  • extinction
  • fear
  • inhibitory learning
  • obsessive compulsive disorder
  • post-traumatic stress disorder
  • threat

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder : implications for treatment. / McGuire, Joseph; Orr, Scott P.; Essoe, Joey K.Y.; McCracken, James T.; Storch, Eric A.; Piacentini, John.

In: Expert Review of Neurotherapeutics, Vol. 16, No. 10, 02.10.2016, p. 1155-1174.

Research output: Contribution to journalReview article

McGuire, Joseph ; Orr, Scott P. ; Essoe, Joey K.Y. ; McCracken, James T. ; Storch, Eric A. ; Piacentini, John. / Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder : implications for treatment. In: Expert Review of Neurotherapeutics. 2016 ; Vol. 16, No. 10. pp. 1155-1174.
@article{9ff20b713f1345fcb4038a0f4283c4af,
title = "Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder: implications for treatment",
abstract = "Introduction: Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. Areas covered: A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified Expert commentary: Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed.",
keywords = "adolescence, anxiety disorders, Conditioning, exposure therapy, extinction, fear, inhibitory learning, obsessive compulsive disorder, post-traumatic stress disorder, threat",
author = "Joseph McGuire and Orr, {Scott P.} and Essoe, {Joey K.Y.} and McCracken, {James T.} and Storch, {Eric A.} and John Piacentini",
year = "2016",
month = "10",
day = "2",
doi = "10.1080/14737175.2016.1199276",
language = "English (US)",
volume = "16",
pages = "1155--1174",
journal = "Expert Review of Neurotherapeutics",
issn = "1473-7175",
publisher = "Expert Reviews Ltd.",
number = "10",

}

TY - JOUR

T1 - Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder

T2 - implications for treatment

AU - McGuire, Joseph

AU - Orr, Scott P.

AU - Essoe, Joey K.Y.

AU - McCracken, James T.

AU - Storch, Eric A.

AU - Piacentini, John

PY - 2016/10/2

Y1 - 2016/10/2

N2 - Introduction: Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. Areas covered: A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified Expert commentary: Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed.

AB - Introduction: Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. Areas covered: A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified Expert commentary: Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed.

KW - adolescence

KW - anxiety disorders

KW - Conditioning

KW - exposure therapy

KW - extinction

KW - fear

KW - inhibitory learning

KW - obsessive compulsive disorder

KW - post-traumatic stress disorder

KW - threat

UR - http://www.scopus.com/inward/record.url?scp=84988009660&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988009660&partnerID=8YFLogxK

U2 - 10.1080/14737175.2016.1199276

DO - 10.1080/14737175.2016.1199276

M3 - Review article

C2 - 27275519

AN - SCOPUS:84988009660

VL - 16

SP - 1155

EP - 1174

JO - Expert Review of Neurotherapeutics

JF - Expert Review of Neurotherapeutics

SN - 1473-7175

IS - 10

ER -