TL;DR: Examples to clinicians are provided for how to apply an inhibitory learning model of extinction to optimize exposure therapy with anxious clients, in ways that distinguish it from a 'fear habituation' approach and 'belief disconfirmation' approach within standard cognitive-behavior therapy.
TL;DR: In a randomized clinical trial, 24 Vietnam veterans with a diagnosis of post-traumatic stress disorder (PTSD) were randomly assigned either to a group receiving 14 to 16 sessions of implosive therapy or to a waiting-list control as discussed by the authors.
TL;DR: A meta-analysis of DCS-augmented fear extinction and exposure therapy literature suggests that DCS is a useful target for translational research on augmenting exposure-based treatment via compounds that impact neuroplasticity.
TL;DR: Electrophysiologic studies of brain serotonergic neurons in behaving animals indicate that their activity is closely related to the sleep-wake-arousal cycle and to certain specific types of repetitive motor activity.
Abstract: The authors use six case vignettes to illustrate underrecognized complications occurring during flooding therapy for posttraumatic stress disorder (PTSD), including exacerbation of depression, relapse of alcoholism, and precipitation of panic disorder. A common denominator to the majority of these cases appears to be the mobilization of negative posttrauma appraisal, accompanied by shame, guilt, and anger. The authors suggest that flooding may not be helpful for these negative emotions in the manner that it is for anxiety. Suggestions for preventing and treating complications of flooding therapy for PTSD include employing more cognitive forms of therapy in cases at risk; supporting abstinence from alcohol and other substances; providing adjunctive pharmacologic treatment as indicated, e.g., tricyclics for depression or panic; and providing long-term follow-up.