A01 A02 A03 A04 A05 A06 A07 A09 A10 A11 A12 A13 A14 A18 A19 A21 F01 F02 INF Ö

A13 – The impact of modification of stimulus-outcome contingencies on extinction and exposure in anxiety disorders

Armin Zlomuzica, Marcella Woud, Jürgen Margraf

Exposure is considered the most effective treatment option for anxiety disorders with extinction representing a central mechanism to achieve this. Exposure therapy benefit can vary considerably among patients. The principal aim of this project is to identify novel tools to optimize extinction and thus exposure-based therapy outcome in spider-fearful individuals. We will study the potential role of stress and self-efficacy enhancement on exposure-therapy outcome and generalization of treatment effects. To dissect the underlying behavioral and neuronal mechanisms, the effects of self-efficacy enhancement on differential fear conditioning with electrodermal, neuronal and subjective responses as dependent measures will be examined.

Guiding questions of A13:

  • Can we modulate fear extinction and retrieval via stress and the promotion of self-efficacy in spider-fearful participants?
  • Can we apply these interventions to yield more efficient and persistent reductions of avoidance behavior and fear in spider-fearful participants during and after EBT?
  • Are these interventions sufficient to induce fear reductions at different fear system levels (subjective, behavioral and physiological)?
  • Can we attribute the beneficial effect of SEE to a more optimized extinction learning and retrieval?
  • Is SEE associated with changes in neuronal activation in specific brain regions strongly implicated in fear extinction? Is SEE reflected by specific activations of downstream pathways, that is, an increased engagement of specific prefrontal cortex subregions?
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Armin Zlomuzica

Project Lead A13

Ruhr University Bochum

Marcella Woud

Project Lead A13

University of Göttingen

Jürgen Margraf

Project Lead A13

Ruhr University Bochum

Beray Macit

PhD Student A13

Ruhr University Bochum

Annalisa Lipp

PhD Student A13

Ruhr University Bochum

10 project-relevant publications

Labrenz F, Woud ML, Elsenbruch S, Icenhour A (2022) The good, the bad, and the ugly – chances, challenges, and clinical implications of avoidance research in psychosomatic medicine. Front. Psychiatry; 13:841734. https://doi.org/10.3389/fpsyt.2022.841734

Lipp A, Macit B, Woud ML, Dere E, Zlomuzica A (2023a) Conscious knowledge of CS-UCS contingency information affects extinction retrieval of conditioned disgust responses: findings from an online de novo disgust conditioning task. Int. J. Clin. Health. Psychol. 23(3):100368. https://doi.org/10.1016/j.ijchp.2023.100368

Lipp A, Zhang XC, Dere E, Zlomuzica A (2023b) The role of self-efficacy in specific fears. PLoS One, 24;18(3):e0283660.  https://doi.org/10.1371/journal.pone.0283660

Lipp A, Zlomuzica A (2025) Differences in conditioning using unconditioned stimuli evoking fear, disgust or both emotions simultaneously.  https://doi.org/10.31234/osf.io/8j7fw_v1

Macit B, Lipp A, Zlomuzica A, Engler H, Blackwell S, Würtz F, Margraf J, Woud ML (submitted) Challenging heights: Findings from a randomized controlled trial testing interpretation bias modification as an adjunct to exposure therapy for acrophobic patients. https://doi.org/10.31234/osf.io/s48aq_v1

Raeder F, Merz CJ, Margraf J, Zlomuzica A (2020) The association between fear extinction, the ability to accomplish exposure and exposure therapy outcome in specific phobia. Sci. Rep., 9;10(1):4288. https://doi.org/10.1038/s41598-020-61004-3

Raeder F, Merz CJ, Tegenthoff M, Dere E, Wolf OT, Margraf J, … Zlomuzica A (2023) Do oral contraceptives modulate the effects of stress induction on one-session exposure efficacy and generalization in women? Psychopharmacology (Berl), 240(5):1075-1089. https://doi.org/10.1007/s00213-023-06345-3

Raeder F, Heidemann F, Schedlowski M, Margraf J, Zlomuzica A (2019c) No pills, more skills: The adverse effect of hormonal contraceptive use on exposure therapy benefit. J. Psychiatr. Res. 119:95-101. https://doi.org/10.1016/j.jpsychires.2019.09.016

Raeder F, Woud ML, Schneider S, Totzeck C, Adolph D, Margraf J, Zlomuzica A (2019a) Reactivation and evaluation of mastery experiences promotes exposure benefit in height phobia. Cognitive Ther. Res., 43, 948-958. https://doi.org/10.1007/s10608-019-10018-x

Raeder F, Merz CJ, Tegenthoff M, Wolf OT, Margraf J, Zlomuzica A (2019d) Post-exposure cortisol administration does not augment the success of exposure therapy: A randomized placebo-controlled study. Psychoneuroendocrinology 99:174-182. https://doi.org/10.1016/j.psyneuen.2018.09.015

New Year, New Me: The Facts

As the calendar turns to a new year, millions of people around the world commit to New Year’s resolutions, making promises to use the new year as a fresh beginning and an opportunity for transformation. In 2024, almost three-quarters of the British population set themselves New Year’s resolutions — that’s around 40 million people (or the entire population of Canada). This tradition was particularly strong among younger generations, with 96% of Generation Z (aged 18-27) planning resolutions, compared to just 35% of the Silent Generation (aged 79+).

Most common new years resolutions:

  1. Saving more money (52%)
  2. Eat healthier (50%)
  3. Exercise more (48%)
  4. Lose weight (37%)
  5. Spend more time with family/friends (35%)

How long do most resolutions normally last before being broken?

  • Data from America (2016) shows that 75% of individuals maintain their resolutions through the first week. 
  • 64% of individuals maintain their resolutions through the first month. 
  • 46% of individuals in America keep their resolutions past the 6-month mark.

What makes resolutions stick?

Oscarsson et al. (2020) conducted research into what makes New Year’s resolutions stick. Biggest success rates depended on how people phrased their goals. Participants who set approach-oriented goals (trying to move toward or maintain a desirable outcome or state) than those with avoidance-oriented goals (trying to move toward or maintain a desirable outcome or state) were significantly more successful (58.9% vs. 47.1%) at sticking to their goals.

The study also investigates the effects of outside support. These participants received monthly follow-ups and emails with information and exercises for coping with hurdles when striving toward personal goals, and were also encouraged to set goals using the SMART technique and to set interim goals. The group that received some support was exclusively and significantly more successful compared to the groups who received a lot of support or no support at all. 

Additionally, you might feel more successful if you set goals that are measurable in numbers. While success for a person striving to quit smoking or lose weight could easily be measured in the number of cigarettes smoked or body mass index, the success for a person striving to “take better care of themselves” could be highly subjective and possibly impossible to measure.

So as we enter 2026, let’s remember to work with our brain’s natural learning system: Frame your goals positively, break them into manageable steps, and celebrate small wins along the way.