5 - (SYM 15) Memory Matters: Neurocognitive Moderators of Cognitive Behavioral Therapy Outcomes

Fear extinction learning involves the formation and retention of safety memories that compete with fear memories. From this perspective, we propose that extinction learning and retention may be linked to memory indices and other neurocognitive functions. Although limited, studies incorporating exposure therapy and de novo fear conditioning paradigms—a laboratory-based analogue for exposure therapy—have observed associations with working memory, verbal memory, and executive functioning. This presentation will provide an overview of research on extinction learning and memory in relation to cognitive functions. We will also present new findings on the connections between neurocognitive profiles and extinction learning and retention within the context of exposure-based cognitive behavioral therapy (CBT) outcome as indexed by clinical response to exposure-based CBT in a likely sample of 32 individuals diagnosed with anxiety and fear-based disorders. We hypothesize that poorer performance on measures of verbal and working memory as well as associated cognitive factors (e.g., executive function, sustained attention, and inhibitory control) will predict poorer response to treatment at 1-week and 12-weeks post-treatment, as assessed by the Clinical Global Impressions – Improvement Scale. Given the malleability of many neurocognitive deficits, greater understanding of specific deficits and their connection to extinction learning could pave the way for more tailored interventions that align treatment strategies with patients’ neurocognitive profiles. Future treatment innovations could include broad-based cognitive rehabilitation, targeted cognitive interventions, or specialized training to mitigate the effects of specific neurocognitive deficits on exposure therapy outcomes.