Veenstra 170 - Anxiety Disorders Association of America
Veenstra 170 - Anxiety Disorders Association of America
Veenstra 170 - Anxiety Disorders Association of America
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A. Amygdala Circuits for Fear<br />
Safety signal<br />
VMPFC input<br />
Basolateral<br />
amygdala<br />
(Sensing)<br />
Fear stimuli<br />
Sensory input<br />
Fear Extinction<br />
Glut Glut<br />
Gaba<br />
Glut<br />
Intercalated<br />
cell mass<br />
Fear Conditioning<br />
B. Extinction Study Diagrams<br />
US = Unconditioned stimulus<br />
CS = Conditioned stimulus<br />
BLA = Basolateral amygdala<br />
CEA = Central amygdala<br />
ICM = Intercalated cell masses<br />
PFC = Medial prefrontal cortex<br />
C. Goal <strong>of</strong> Exposure<br />
Old View<br />
To extinguish is<br />
to reduce this<br />
Fear Conditioning<br />
Goal = feel less anxious<br />
Turn <strong>of</strong>f the "on signal"<br />
D. Naive Behavioral Exposure<br />
Naive Behavioral<br />
Replace with Negative<br />
Fear Override<br />
Fear Conditioning<br />
Reject and End<br />
3. Exposure Diagrams<br />
Glut<br />
Local inhibition neurons<br />
Extinction neurons<br />
Fear neurons<br />
Excitatory activity associated w fear<br />
Excitatory activity associated w extinction<br />
Inhibition<br />
Central<br />
amygdala<br />
(Responding)<br />
Adapted from Stahl, 3rd Ed, 2008<br />
New View<br />
To extinguish is<br />
to increase this<br />
Fear Extinction<br />
Goal = feel more calm<br />
Turn on the "<strong>of</strong>f signal"<br />
Fear Conditioning<br />
Not focus on this<br />
= "White knuckling"<br />
Can work if<br />
overrriding emotion<br />
is intense enough to win<br />
But not really extinguishing<br />
and fear conditioning<br />
remains activated and<br />
ready to reemerge<br />
Sah, P. & Westbrook, R. (2008). The circuit <strong>of</strong> fear. Nature, Vol 454, pp. 589-590<br />
E. Mindful Emotional Exposure<br />
Knowledgeable Emotion<br />
Join with Positive<br />
Fear Extinction<br />
Fear Conditioning<br />
Accept and Let Be<br />
= Effective Exposure<br />
Add into the fear<br />
second soothing emotion<br />
which focus upon and<br />
judge progress by<br />
Accept as inevitable<br />
but not focus on<br />
and just let pass through<br />
so not judge by presence<br />
© Glenn <strong>Veenstra</strong> 3/13
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