In recent years, various research groups aimed to augment extinction learning (the most important underlying mechanism of exposure therapy) using glucocorticoids (GCs), in particular the stress hormone cortisol. In this review, we introduce the STaR (Stress Timing affects Relapse) model, a theoretical model of the timing-dependent effects of stress/GCs treatment on extinction and relapse. In particular, we show that (1) pre-extinction stress/GCs promote memory consolidation in a context-independent manner, making extinction memory more resistant to relapse following context change. (2) Post-extinction stress also enhances extinction consolidation, but in a context-bound manner. These differences may result from the timing-dependent effects of cortisol on emotional memory contextualization. At the neural level, extinction facilitation is reflected in alterations in the amygdala-hippocampal-prefrontal cortex network. (3) Stress/GCs before a retrieval test impair extinction retrieval and promote relapse. This may result from strengthening amygdala signaling or disruption of the inhibitory functioning of the prefrontal cortex. The STaR model can contribute to the understanding and prevention of relapse processes.

近年来，各种研究小组旨在通过使用糖皮质激素（GCs），特别是应激激素皮质醇来增强灭绝学习（暴露疗法的最重要的潜在机制）。在这篇综述中，我们介绍了STaR（应激时机影响复发）模型，这是应力/ GCs治疗对灭绝和复发的时间依赖性影响的理论模型。特别地，我们表明（1）灭绝前的压力/ GC以上下文无关的方式促进记忆整合，使消退记忆更能抵抗上下文变化后的复发。（2）灭绝后的压力也增强了灭绝的巩固程度，但有一定的局限性。这些差异可能是由于皮质醇对情绪记忆语境的时间依赖性所致。在神经层面上 扁桃体-海马-前额叶皮层网络的改变反映了灭绝的便利。（3）恢复测试前的压力/ GC会影响消光恢复并促进复发。这可能是由于杏仁核信号增强或前额叶皮层抑制功能破坏所致。STaR模型可以有助于理解和预防复发过程。