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Pharmacological Enhancement of Behavioral Therapy: Focus on Posttraumatic Stress Disorder

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Behavioral Neurobiology of Anxiety and Its Treatment

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 2))

Abstract

Improved efficacy in the treatment of posttraumatic stress disorder (PTSD) and other anxiety disorders is urgently needed. Traditional anxiety treatments of hypnosis and psychodynamic therapy may be of some help, but uncontrolled studies lead to inconclusive results on the efficacy of these treatment techniques. There is a larger literature supporting the efficacy of cognitive-behavioral procedures with PTSD, including prolonged exposure therapy, eye movement desensitization and reprocessing, and anxiety management techniques. The cutting-edge technology of virtual reality-based exposure therapy for PTSD is particularly exciting. To further build on effective psychosocial treatments, current pharmacological augmentation approaches to emotional learning are being combined with psychotherapy. In particular, d-cycloserine, a partial NMDA agonist, has shown to be effective in facilitating the exposure/extinction therapy to improve the efficacy of treating anxiety disorders, and may guide the way for new pharmacological enhancements of behavioral therapy.

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Abbreviations

AMT:

Anxiety management training

CBGT:

Cognitive-behavioral group therapy

CBT:

Cognitive-behavioral therapy

CS:

Conditioned stimulus

DCS:

d-cycloserine

EMDR:

Eye movement desensitization and reprocessing

ERP:

Exposure and ritual prevention

OCD:

Obsessive-compulsive disorder

PCT:

Present-centered therapy

PE:

Prolonged imaginal exposure

PTSD:

Posttraumatic stress disorder

SAD:

Social anxiety disorder

SD:

Systematic desensitization

SIT:

Stress inoculation training

SSRI:

Selective serotonin reuptake inhibitor

SUDS:

Subjective units of discomfort

TBI:

Traumatic brain injury

TF-CBT:

Trauma-focused cognitive-behavioral therapy

UCS:

Unconditioned stimulus

VRE:

Virtual reality exposure

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Yerkes Research Center, Emory University, 954 Gatewood Dr, Atlanta, GA, 30329, USA

    Dennis C. Choi, Barbara O. Rothbaum, Maryrose Gerardi & Kerry J. Ressler

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  1. Dennis C. Choi
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  2. Barbara O. Rothbaum
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  3. Maryrose Gerardi
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  4. Kerry J. Ressler
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Correspondence to Kerry J. Ressler .

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Editors and Affiliations

  1. Dept. Psychiatry, University of California, San Diego, Gilman Drive 9500, La Jolla, 92093-0985, USA

    Murray B. Stein

  2. Research & Development, CNS - Affective Spectrum, Johnson & Johnson Pharmaceutical, Turnhoutseweg 30, Beerse, 2340, Belgium

    Thomas Steckler

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Choi, D.C., Rothbaum, B.O., Gerardi, M., Ressler, K.J. (2009). Pharmacological Enhancement of Behavioral Therapy: Focus on Posttraumatic Stress Disorder. In: Stein, M., Steckler, T. (eds) Behavioral Neurobiology of Anxiety and Its Treatment. Current Topics in Behavioral Neurosciences, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2009_10

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