Evidence map›Paper›PMID 42026031›Full record

ArticleTranslational psychiatry2026

Augmenting extinction with counterconditioning strengthens and sustains neural safety representations in PTSD.

Samuel E Cooper, Nicole E Keller, Elizabeth A Bauer, Sydney R Lambert, Augustin C Hennings, Ameera A Azar, Sophia A Bibb, Charles B Nemeroff, Josh M Cisler, Jarrod A Lewis-Peacock and 1 more

Abstract read
In one paragraph

Article in Translational psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Samuel E CooperDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA. samuel.cooper@austin.utexas.edu.ORCID http://orcid.org/0000-0001-9563-1750
Nicole E KellerExponent, Inc, Denver, Colorado, USA.ORCID http://orcid.org/0000-0002-0259-6720
Elizabeth A BauerDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.
Sydney R LambertDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.
Augustin C HenningsPrinceton Neuroscience Institute, Princeton University, Princeton, New Jersey, USA.
Ameera A AzarDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.
Sophia A BibbNeuroscience Graduate Program, Ohio State University, Columbus, Ohio, USA.
Charles B NemeroffDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.ORCID http://orcid.org/0000-0001-7867-1160
Josh M CislerDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.
Jarrod A Lewis-PeacockDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.ORCID http://orcid.org/0000-0002-9918-465X
Joseph E DunsmoorDepartment of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA. joseph.dunsmoor@austin.utexas.edu.ORCID http://orcid.org/0000-0002-5448-6873

Funding

1/3 Understanding PTSD through Postmortem Targeted Brain Multi-omicsR01MH117293 · NIMH · UNIVERSITY OF TEXAS AT AUSTIN · PI CHARLES B NEMEROFF · 2018 to 2026
$4.3M
1/2 Neurodevelopmental and clinical trajectories of youth at risk for bipolar I disorderR01MH125886 · NIMH · UNIVERSITY OF TEXAS AT AUSTIN · PI ALMEIDA, JORGE R C, STRAKOWSKI, STEPHEN M · 2021 to 2025
$4.3M
Neural and Cognitive Mechanisms for Removing Emotional Information from Working MemoryR01MH129042 · NIMH · UNIVERSITY OF COLORADO · PI BANICH, MARIE T, LEWIS-PEACOCK, JARROD A · 2022 to 2025
$3.0M
Alcohol, Approach-Avoidance, and Neurocircuitry Interactions in PTSDR01AA030740 · NIAAA · UNIVERSITY OF TEXAS AT AUSTIN · PI Joshua M Cisler, Elizabeth Thomas Cox Lippard · 2023 to 2026
$2.7M
Computational Biases of Learning and Decision-Making in PTSDR01MH119132 · NIMH · UNIVERSITY OF WISCONSIN-MADISON · PI CISLER, JOSHUA M · 2019 to 2023
$2.6M
Biological Risk Factors for the Prospective Development of Alcohol Use Disorders in Young Adults with Bipolar Disorder and Typically Developing Young AdultsR01AA030038 · NIAAA · UNIVERSITY OF TEXAS AT AUSTIN · PI Elizabeth Thomas Cox Lippard · 2023 to 2026
$2.5M
Training in Learning and MemoryT32MH106454 · NIMH · UNIVERSITY OF TEXAS AT AUSTIN · PI PRESTON, ALISON R · 2015 to 2025
$2.1M
Dopamine Enhancement of fear extinction learning in PTSDR33MH108753 · NIMH · UNIVERSITY OF WISCONSIN-MADISON · PI CISLER, JOSHUA M · 2020 to 2022
$1.1M
Computational Neuroscience to Decode Higher-Order Fear in PTSDK23MH138889 · NIMH · UNIVERSITY OF TEXAS AT AUSTIN · PI Samuel Emerson Cooper · 2025 to 2026
$874k
NIAAA NIH HHS R01 AA030038NIAAA NIH HHS R01 AA030740NIMH NIH HHS R01 MH117293NIMH NIH HHS R01 MH119132NIMH NIH HHS R01 MH125886NIMH NIH HHS R01 MH129042NIMH NIH HHS R33 MH108753NIMH NIH HHS T32 MH106454U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH) K23MH138889
6 · The paper itself

Abstract

Because extinction forms the empirical foundation of exposure therapy, strategies to enhance extinction could lead to more effective interventions for posttraumatic stress disorder (PTSD). Here, we used functional MRI to compare immediate and long-term efficacy of enhanced versus standard extinction in 54 adults with (n = 32) and without (n = 22) PTSD. In both control and PTSD groups, counterconditioning-an enhanced form of extinction that replaces threat with positive outcomes-was more effective than standard extinction. It reduced threat-related neural activity and promoted reinstatement of safety (extinction) patterns in the ventromedial prefrontal cortex (a region involved in learning and retrieving safety associations). However, the PTSD group continued to reinstate both threat- and safety-related neural patterns in the dorsal anterior cingulate cortex (a region involved in learning and retrieving threat associations). These findings represent novel evidence that enhanced extinction outperforms standard extinction in promoting more rapid and persistent neural representations of safety in PTSD.

Indexed as

Conditioning, ClassicalExtinction, PsychologicalGyrus CinguliPrefrontal CortexStress Disorders, Post-TraumaticAdultBrain MappingFemaleHumansMagnetic Resonance ImagingMale

Identifiers

PMID42026031
PMCPMC13237184

What OpenQuestion holds

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Registered trials

None linked

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.