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?