A behavioural neuroscience perspective on the aetiology and treatment of anxiety disorders

Kindt, Merel

doi:10.1016/j.brat.2014.08.012

Cited by 101 publications

(95 citation statements)

References 211 publications

(230 reference statements)

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“…A major component of trauma-focused CBT is graded exposure that aims to reduce avoidance through repeated exposure to the threatening cue, while challenging unhelpful/harmful thoughts/beliefs associated with the stimuli (Craske, Treanor, Conway, Zbozinek, & Vervliet, 2014). In essence, exposure treatment works on the premise that repeated reexposure to anxiety-inducing stimuli effectively reduces a learned fear response by creating a new, more appropriate response (Kindt, 2014). The context in which performance blocks are experienced requires a direct need for the individual to reenter the problemassociated environment to train and compete.…”

Section: Trauma-focused Cognitive-behavioral Therapymentioning

confidence: 99%

Preliminary Evidence for the Treatment of Performance Blocks in Sport: The Efficacy of EMDR With Graded Exposure

Bennett

Bickley²,

Vernon

et al. 2017

J EMDR Prac Res

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Sport psychologists are increasingly confronted with performance problems in sport where athletes suddenly lose the ability to execute automatic movements (Rotheram, Maynard, Thomas, Bawden, & Francis, 2012). Described as performance blocks (Bennett, Hays, Lindsay, Olusoga, & Maynard, 2015), these problems manifest as locked, stuck, and frozen movements and are underpinned by an aggressive anxiety component. This research used both qualitative and quantitative methods in a single case study design to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy with graded exposure as a treatment method. The participant was a 58-year-old professional male golfer who had been suffering a performance block for 11 years. Specifically, the participant was experiencing involuntary spasms, shaking, muscle tension, and jerking in the lower left forearm while executing a putting stroke. Physical symptoms were coupled with extreme anxiety, panic, and frustration. The study tested the hypothesis that reprocessing related significant life events and attending to dysfunctional emotional symptoms would eliminate the performance block and related symptoms and that the individual would regain his ability to execute the affected skill. Pre-, mid-, and postintervention performance success, using the Impact of Event scale, subjective units of distress (SUD; Wolpe, 1973), and kinematic testing revealed improvements in all associated symptoms in training and competition. These findings suggest that previous life experiences might be associated with the onset of performance blocks and that EMDR with graded exposure might offer an effective treatment method.

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Section: Trauma-focused Cognitive-behavioral Therapymentioning

confidence: 99%

Preliminary Evidence for the Treatment of Performance Blocks in Sport: The Efficacy of EMDR With Graded Exposure

Bennett

Bickley²,

Vernon

et al. 2017

J EMDR Prac Res

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“…Fear conditioning has become widely regarded as a valid experimental model of clinical anxiety disorders and thus it is hoped that further advances in the scientific study of fear-conditioning processes will yield translational benefits in the form of optimized pathophysiological models of these common mental health disorders. 2 Several experimental paradigms have been developed for the study of fear conditioning. Most typically, these paradigms focus on establishing conditioned fear responses (conditioned response) to a specific foreground cue (cue-conditioning) or a general background context (context conditioning).…”

Section: Introductionmentioning

confidence: 99%

Neural signatures of human fear conditioning: an updated and extended meta-analysis of fMRI studies

et al. 2015

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Classical Pavlovian fear conditioning remains the most widely employed experimental model of fear and anxiety, and continues to inform contemporary pathophysiological accounts of clinical anxiety disorders. Despite its widespread application in human and animal studies, the neurobiological basis of fear conditioning remains only partially understood. Here we provide a comprehensive meta-analysis of human fear-conditioning studies carried out with functional magnetic resonance imaging (fMRI), yielding a pooled sample of 677 participants from 27 independent studies. As a distinguishing feature of this meta-analysis, original statistical brain maps were obtained from the authors of 13 of these studies. Our primary analyses demonstrate that human fear conditioning is associated with a consistent and robust pattern of neural activation across a hypothesized genuine network of brain regions resembling existing anatomical descriptions of the 'central autonomic-interoceptive network'. This finding is discussed with a particular emphasis on the neural substrates of conscious fear processing. Our associated meta-analysis of functional deactivations-a scarcely addressed dynamic in fMRI fear-conditioning studies-also suggests the existence of a coordinated brain response potentially underlying the 'safety signal' (that is, non-threat) processing. We attempt to provide an integrated summary on these findings with the view that they may inform ongoing studies of fear-conditioning processes both in healthy and clinical populations, as investigated with neuroimaging and other experimental approaches.

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“…Extinction learning is seen as a major mechanism for the reduction of fear during exposure therapy and, thus laboratory extinction procedures are used as experimental models for exposure-based interventions [5]. Current research targets extinction deficits in patients with anxiety disorders and potential strategies to enhance extinction learning to pave the way for treatment optimization.…”

Section: Introductionmentioning

confidence: 99%

The key role of extinction learning in anxiety disorders

Pittig

Berg

Vervliet

2016

Current Opinion in Psychiatry

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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.

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A behavioural neuroscience perspective on the aetiology and treatment of anxiety disorders

Cited by 101 publications

References 211 publications

Preliminary Evidence for the Treatment of Performance Blocks in Sport: The Efficacy of EMDR With Graded Exposure

Preliminary Evidence for the Treatment of Performance Blocks in Sport: The Efficacy of EMDR With Graded Exposure

Neural signatures of human fear conditioning: an updated and extended meta-analysis of fMRI studies

The key role of extinction learning in anxiety disorders

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