Out with the bad, in with the good: A review on augmented extinction learning in humans

Abstract

Several leading therapies for anxiety-related disorders rely on the principles of extinction learning. However, despite decades of development and research, many of these treatments remain only moderately effective. Developing techniques to improve extinction learning is an important step towards developing improved and mechanistically-informed exposure-based therapies. In this review, we highlight human research on strategies that might augment extinction learning through reward neurocircuitry and dopaminergic pathways, with an emphasis on counterconditioning and other behaviorally-augmented forms of extinction learning (e.g., novelty-facilitated extinction, positive affect training). We also highlight emerging pharmacological and non-pharmacological methods of augmenting extinction, including L-DOPA and aerobic exercise. Finally, we discuss future directions for augmented extinction learning and memory research, including the need for more work examining the influence of individual differences and psychopathology.