ReviewClinical psychology review2017
An empirical review of potential mediators and mechanisms of prolonged exposure therapy.
Review in Clinical psychology review, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed.
- Maximizing expectancy violation and exposure outcomes in patients with PTSD.European journal of psychotraumatology · 2025Trial
- Identifying predictors of long-term treatment outcomes using narratives from written exposure therapy and cognitive processing therapy for PTSD.Psychological trauma : theory, research, practice and policy · 2025Trial
- Can Interpersonal Trust Predict and Account for Symptom Change During Group Cognitive Processing Therapy for PTSD? An Investigation of the Iterated Trust Game.Journal of clinical psychology · 2025Trial
- Within-patient association between emotion regulation and outcome in prolonged exposure for posttraumatic stress disorder.Journal of consulting and clinical psychology · 2024Trial
- Childhood-related PTSD: the role of cognitions in EMDR and imagery rescripting.European journal of psychotraumatology · 2024Trial
- Mediators of change in a condensed online exposure-based intervention provided soon after trauma: insights from a randomised controlled trial.European journal of psychotraumatology · 2024Trial
- Using Client Narratives to Identify Predictors of Outcome in Written Exposure Therapy and Cognitive Processing Therapy.Behavior therapy · 2023Trial
- Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder.European journal of psychotraumatology · 2023Trial
- Posttraumatic Stress Disorder Symptom Cluster Structure in Prolonged Exposure Therapy and Virtual Reality Exposure.Journal of traumatic stress · 2021Trial
- Trial
- Deepfake perpetrator conversation for adults with sexual abuse-related posttraumatic stress disorder: intervention development and multiple baseline study protocol.European journal of psychotraumatology · 2026Article
- Is Morning Exposure Therapy More Successful? Pilot Data on Exposure Process Indicators and Diurnal Cortisol in Obsessive-Compulsive Disorder or Agoraphobia.Journal of clinical medicine · 2026Article
- Subtypes of Severe OCD and Treatment Outcome: A Latent Profile Analysis of the Yale-Brown Obsessive-Compulsive Severity Scale.Cognitive therapy and research · 2025Article
- Mechanisms of Change in Exposure Therapy for Anxiety and Related Disorders: A Research Agenda.Clinical psychological science : a journal of the Association for Psychological Science · 2025Article
- Video Narrative Exposure Therapy (NET) with Children and Young People who Witnessed Domestic Violence: A Naturalistic Single Case Study Series.Journal of child & adolescent trauma · 2025Article
- VIRTUS: virtual reality exposure training for adolescents with social anxiety - a randomized controlled trial.BMC psychiatry · 2025Article
- Pilot Study of Self-Distancing Augmentation to Exposure Therapy for Youth Anxiety.Child psychiatry and human development · 2025Article
- 'If I am Reminded of my Trauma, I will …': Assessing Threat Expectancies for Being Confronted with Trauma Reminders.Cognitive therapy and research · 2025Article
- Veterans who focus on sexual assault trauma show slower between-session habituation and symptom reduction during prolonged exposure treatment for posttraumatic stress disorder.Psychological trauma : theory, research, practice and policy · 2025Article
- Within-session habituation and salivary cortisol during exposure treatment in obsessive-compulsive disorder - A link and an influence of DHEA?Indian journal of psychiatry · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Prolonged exposure (PE) is an empirically-supported treatment for posttraumatic stress disorder (PTSD), but the precise mechanism(s) by which PE promotes symptom change are not well established. Understanding how PE works is critical to improving clinical outcomes, advancing dissemination efforts, and enhancing transdiagnostic models of psychopathology. However, mechanisms research conducted in clinical treatment settings is complex, and findings may be difficult to interpret without appropriate context. This is the first review of potential mechanisms of PE to provide such context, by rigorously evaluating empirical findings in line with essential criteria for effective research on mechanisms (or mediators). We begin by describing six putative mechanisms identified by emotional processing theory and contemporary models of fear extinction, before thoroughly reviewing empirical findings from clinical research on PE and similar PTSD treatments. We provide a detailed description of each study and mechanism test, as well as ratings of strength of evidence and quality of evaluation based on a novel rating scheme. We highlight variables with strong evidence (belief change and between-session habituation), intermediate evidence (inhibitory learning and emotional engagement), and minimal support (narrative organization and within-session habituation). After discussing limitations of the extant literature and this review, we summarize specific challenges for research on PE mechanisms and highlight directions for future study based on clinical and research implications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.