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Extended Summary of The Craske Article

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Contains my notes on the Craske Article, with all the main points. It has a focus on the things describe are most important in the guidelines. I can sell it for just 1€ if you message me on instead. The minimum price I can put here is 2,50€ sorry!:((

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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)

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