{"doi":"10.1016/j.jad.2025.01.133","title":"Long-term exposure therapy outcome in phobia and the link with behavioral and neural indices of extinction learning","abstract":null,"journal":"Journal of Affective Disorders","year":2025,"id":643755,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":325738,"name":"Iris Lange","orcid":"0000-0003-2107-9224","position":1,"is_corresponding":false},{"id":1242540,"name":"Liesbet Goossens","orcid":"0000-0003-0368-2732","position":2,"is_corresponding":false},{"id":1675153,"name":"Nicole K. Leibold","orcid":null,"position":3,"is_corresponding":false},{"id":1675154,"name":"Klara de Cort","orcid":null,"position":4,"is_corresponding":false},{"id":1675155,"name":"Jindra Bakker","orcid":null,"position":5,"is_corresponding":false},{"id":466973,"name":"Stijn Michielse","orcid":"0000-0003-3930-8646","position":6,"is_corresponding":false},{"id":289187,"name":"Machteld Marcelis","orcid":"0000-0003-0045-9244","position":7,"is_corresponding":false},{"id":22877,"name":"Jim van Os","orcid":"0000-0002-7245-1586","position":8,"is_corresponding":false},{"id":1675156,"name":"Therese van Amelsvoort","orcid":null,"position":9,"is_corresponding":false},{"id":240744,"name":"David E.J. Linden","orcid":"0000-0002-5638-9292","position":10,"is_corresponding":false},{"id":1675157,"name":"Koen R.J. Schruers","orcid":null,"position":11,"is_corresponding":false},{"id":1675152,"name":"Jette H. de Vos","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Long-term exposure therapy outcome in phobia and the link with behavioral and neural indices of extinction learning","abstract":"Extinction learning is regarded as a core mechanism underlying exposure therapy. Under this assumption, studies have looked at the predictive value of the extinction learning paradigm for exposure therapy outcomes. However, predicting factors of long-term exposure therapy success have not been established. Participants with a specific phobia (SP) for spiders were included in a double-blind randomized controlled trial. Participants were randomly assigned to receive exposure therapy ( n = 25, 24 females) or an active control intervention, progressive muscle relaxation (PMR; n = 18, 15 females). Symptom levels were measured with the Fear of Spiders questionnaire (FSQ) at baseline (T0), after the intervention (T1), and at six- (T2) and twelve (T3) months follow-up. At baseline, participants completed a three-day fMRI fear conditioning, extinction learning, and extinction recall paradigm. Indices of extinction were defined as self-reported threat expectancy and fear, and neural activation during stimulus presentations and threat omission in the ventromedial prefrontal cortex and nucleus accumbens, based on prior data. Mixed model analysis revealed that the exposure therapy group had an overall stronger decrease in phobic symptoms over time than the PMR group (β = 10.95, p < .001). However, none of the indices of extinction learning were predictive for FSQ scores after exposure therapy at the longest follow-up measurement (T3). In sum, the current results show the long-term effectiveness of a single session of exposure therapy for reducing a specific fear of spiders but no baseline characteristics were identified that predicted individual differences in exposure therapy success after one year. • Long-term (12-month follow-up) persistence of exposure therapy induced reductions of fear of spiders in spider phobia. • Fear of spiders was reduced after just one exposure therapy session • Behavioral indices of extinction learning were not predictive of long-term therapy outcomes. • Neural indices of extinction learning were not predictive of long-term therapy outcomes.","is_dataset_classified":null,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39889926","pmcid":null,"openalex_id":"https://openalex.org/W4406979827","authors":[],"funders":[{"funder_name":"Stichting De Weijerhorst","grant_id":"","title":null},{"funder_name":"Maastricht University","grant_id":"","title":null}],"total_grants":2,"fwci":1.4595,"citation_percentile":0.77964922,"influential_citations":0,"citation_trend":[{"year":2025,"count":1},{"year":2026,"count":1}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://doi.org/10.1016/j.jad.2025.01.133","host_type":"journal"},{"url":"https://doi.org/10.1016/j.jad.2025.01.133","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0165032725001545?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0165032725001545?httpAccept=text/plain","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39889926","host_type":"repository"},{"url":"https://cris.maastrichtuniversity.nl/en/publications/21d419f7-8208-403e-942e-bff8b199a409","host_type":"repository"},{"url":"https://dspace.library.uu.nl/handle/1874/460543","host_type":"repository"}],"fields_of_study":["Memory and Neural Mechanisms","Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes","Sleep and Wakefulness Research","Adult","Animals","Female","Humans","Male","Young Adult","Conditioning, Classical","Double-Blind Method","Extinction, Psychological","Fear","Implosive Therapy","Magnetic Resonance Imaging","Phobic Disorders","Spiders","Treatment Outcome","Phobia, Specific","Arachnophobia"],"mesh_terms":["Adult","Animals","Conditioning, Classical","Double-Blind Method","Extinction, Psychological","Fear","Female","Humans","Implosive Therapy","Magnetic Resonance Imaging","Male","Nucleus Accumbens","Phobic Disorders","Spiders","Treatment Outcome","Prefrontal Cortex","Young Adult"],"keywords":["Exposure therapy","Extinction (optical mineralogy)","Psychology","Expectancy theory","Randomized controlled trial","Ventromedial prefrontal cortex","Audiology","Clinical psychology","Anxiety","Medicine","Prefrontal cortex","Psychiatry","Internal medicine","Cognition","fMRI","Extinction Learning","Specific Phobia","Extinction Recall"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-08T18:41:46.163706Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}