Department of Clinical Psychology & Psychotherapy, Faculty of Psychology, University of Basel, CH-4055 Basel, Switzerland.
J Anxiety Disord. 2010 Mar;24(2):223-30. doi: 10.1016/j.janxdis.2009.10.011. Epub 2009 Nov 6.
Current neurophysiological and psychological accounts view exposure therapy as the clinical analog of extinction learning that results in persistent modifications of the fear memory involved in the pathogenesis, symptomatology, and maintenance of anxiety disorders. Evidence from studies in animals and humans indicate that glucocorticoids have the potential to facilitate the processes that underlie extinction learning during exposure therapy. Particularly, glucocorticoids can restrict retrieval of previous aversive learning episodes and enhance consolidation of memory traces relating to non-fearful responding in feared situations. Thus, glucocorticoid treatment especially in combination with exposure therapy might be a promising approach to optimize treatment of anxiety disorders. This review examines the processes involved in aversive conditioning, fear learning and fear extinction, and how glucocorticoids might enhance restructuring of fear memories during therapy.
目前的神经生理学和心理学研究认为，暴露疗法是消退学习的临床类似物，它导致与焦虑障碍的发病机制、症状和维持有关的恐惧记忆的持久改变。动物和人类研究的证据表明，糖皮质激素有可能促进暴露疗法中消退学习的过程。具体来说，糖皮质激素可以限制对以前厌恶学习事件的检索，并增强与在恐惧情况下非恐惧反应有关的记忆痕迹的巩固。因此，糖皮质激素治疗，特别是与暴露疗法结合使用，可能是优化焦虑症治疗的一种有前途的方法。这篇综述检查了厌恶条件作用、恐惧学习和恐惧消退的过程，以及糖皮质激素如何在治疗过程中增强恐惧记忆的重构。
