tDCS IMPROVING EXPOSURE THERAPY THROUGH ENHANCED RETRIEVAL INHIBITION

Though cognitive behavioral techniques are generally effective in the treatment of anxiety disorders, some people fail to benefit from exposure therapy or experience a return of fear after terminating exposure therapy. The burgeoning field of non-invasive brain stimulation provides a potential method of augmenting exposure therapy so that it is more effective for treatment-resistant patients. However, very few studies have evaluated the usefulness of non-invasive brain stimulation combined with exposure therapy, and only in posttraumatic stress disorder and with one brain stimulation method. Furthermore, these studies have not assessed the mechanism through which brain stimulation may improve exposure therapy outcomes. The proposed study aims to provide more solid and generalizable evidence that brain stimulation can enhance the effects of exposure therapy as well as to evaluate whether improvements are mediated by an increase in retrieval inhibition, which is the mechanism hypothesized to drive the fear extinction that occurs in exposure therapy. These aims will be addressed in a double blinded experimental study using either active or sham transcranial direct current stimulation (tDCS) in a bilateral montage over the dorsolateral prefrontal cortex (DLPFC) applied during exposure sessions for blood injury injection (BII) fear.