Extinction retention predicts improvement in social anxiety symptoms following exposure therapy

Abstract

Several researchers have argued that basic research on extinction learning can guide efforts to enhance the efficacy of exposure-based therapy. At the basis of this translational research paradigm is the assumption that extinction retention is important to the outcome of exposure-based therapy. This study is the first to examine the relationship between extinction retention, which comprises the amount of fear reduction that is retained between two exposure sessions and improvement in anxiety symptoms following exposure treatment. Adults (N=90), participating in two separate studies, who received three sessions of repeated exposure to public speaking provided ratings of peak fear during exposure treatment and completed the Liebowitz Social Anxiety Scale Self-Report version, LSAS-SR, Baker et al. [2002: Behav Res Ther 40:701-715] at baseline, posttreatment, and follow-up. After controlling for within-session extinction, extinction retention accounted for significant variance in the improvement of LSAS-SR scores over time. Our findings suggest that the consolidation of extinction learning into long-term memory is associated with improvements in fear and avoidance related to social situations following exposure therapy. Implications for exposure therapy augmentation studies are discussed.