Angststörungen gehören sowohl im Kindes- und Jugendalter als auch im Erwachsenenalter zu den häufigsten psychischen Störungen. Als wirksamste Behandlungsform mit dem höchsten Evidenzgrad hat sich bei Angststörungen in allen Altersgruppen die Kognitive Verhaltenstherapie (KVT) erwiesen. Dabei scheint die Wirksamkeit der KVT im Wesentlichen auf das Therapieelement der Exposition zurückzuführen zu sein und die Exposition wiederum auf dem Lernprinzip der Extinktion (Inhibitionslernen) zu beruhen. Unter Berücksichtigung translationaler Studien arbeitet der vorliegende Artikel den aktuellen Forschungsstand zur Rolle der Exposition bei der Therapie von Angststörungen bei Kindern und Jugendlichen sowie Erwachsenen auf und gibt einen Überblick über empirisch fundierte Strategien zur Steigerung des Expositionserfolgs durch die gezielte Förderung des Extinktionslernens. Hierbei werden Methoden wie die massierte oder variierte Exposition berücksichtigt sowie Mechanismen wie die Kontextkonditionierung, die zu einem erhöhten Rückfallrisiko nach erfolgreicher Therapie führen kann. Ein weiterer Schwerpunkt liegt auf kognitiven Expositionsverstärkern wie D-Cycloserin oder Cortisol, die bei gezielter Einnahme vor oder nach der Exposition die neurologischen Prozesse des Extinktionslernens und der Gedächtniskonsolidierung unterstützen.

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