Disorders - Specific Phobia
Milosevic, I., Radomsky, A. S.
This study examined the effect of safety behavior on belief change during a behavioral experiment. Highly spider fearful participants (N = 126) evaluated a targeted negative belief about spiders during a brief behavioral experiment with a live tarantula. Participants were randomly assigned either to use or not use safety gear during the session. Results demonstrated that after the behavioral experiment, targeted negative beliefs were significantly lower in the safety gear condition than in the control condition. Both conditions benefited from comparable improvements across a broader constellation of negative spider-related beliefs. Safety gear facilitated closer approach to the spider during the session; however, participants who did not use safety gear experienced greater improvement in perceived control. These findings suggest that safety behavior need not impair corrective learning during cognitive-behavioral interventions and that it might indeed enhance it. Results are discussed in terms of cognitive-behavioral treatments for anxiety disorders and of the role of safety behavior therein. (copyright) 2012 Springer Science+Business Media, LLC.
Cognitive Therapy & Research, 37(3) : 557-571
- Year: 2013
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Podina, Ioana R., Koster, Ernst H. W., Philippot, Pierre, Dethier, Vincent, David, Daniel O.
Over the last 30 years, researchers have disagreed over the consequences of diverting attention from threat for exposure efficacy, which is an important theoretical and clinical debate. Therefore, the present meta-analysis assessed the efficacy of attentionally focused exposure against distracted and attentionally uninstructed exposure regarding distress, behavioral, and physiological outcomes. We included 15 randomized studies with specific phobia, totaling 444 participants and targeting outcomes at post-exposure and follow-up. Results indicated no difference between the efficacy of distracted exposure as opposed to focused or uninstructed exposure for distress and physiology. For behavior, at post-exposure, results were marginally significant in favor of distracted as opposed to focused exposure, while at follow-up results significantly favored distraction. However, concerning behavior, uninstructed exposure was superior to distraction. Moderation analyses revealed that, regarding distress reduction and approach behavior, distracted exposure significantly outperformed focused exposure when the distracter was interactive (g=1.010/g=1.128) and exposure was spread over the course of multiple sessions (g=1.527/g=1.606). No moderation analysis was significant for physiological measures. These findings suggest that distraction during exposure could be less counterproductive than previously considered and even beneficial under certain circumstances. Theoretical implications and future directions for research are discussed.; © 2013.
Clinical Psychology Review, 33(8) : 1172-1183
- Year: 2013
- Problem: Specific Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Siegel, Paul, Warren, Richard.
This study tested the hypothesis that an immediate effect of exposure to masked phobic stimuli on avoidance of the corresponding feared object would be maintained 1 year later. Fifty-three spider-phobic participants were identified with a questionnaire and a Behavioral Avoidance Test (BAT) with a live tarantula. One week later, they were administered 1 of 3 types of exposure: very brief (25-ms, masked) or clearly visible (125-ms, unmasked) images of spiders, or very brief images of flowers. They engaged in the BAT again immediately thereafter. One year later, they returned for a follow-up BAT. The immediate effect of exposure to very brief spiders on reducing avoidance of the tarantula was still evident 1 year later. Endurance of an effect by masked stimuli of this duration has not been reported before. Potential theoretical implications are discussed.; PsycINFO Database Record (c) 2013 APA, all rights reserved.
Emotion, 13(2) : 338-344
- Year: 2013
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Pace-Schott, E. F., Verga, P. W., Bennett, T. S., Spencer, R. M. C.
Simulated exposure therapy for spider phobia served as a clinically naturalistic model to study effects of sleep on extinction. Spider-fearing, young adult women (N = 66), instrumented for skin conductance response (SCR), heart rate acceleration (HRA) and corrugator electromyography (EMG), viewed 14 identical 1-min videos of a behaving spider before a 12-hr delay containing a normal night's Sleep (N = 20) or continuous daytime Wake (N = 23), or a 2-hr delay of continuous wake in the Morning (N = 11) or Evening (N = 12). Following the delay, all groups viewed this same video 6 times followed by six 1-min videos of a novel spider. After each video, participants rated disgust, fearfulness and unpleasantness. In all 4 groups, all measures except corrugator EMG diminished across Session 1 (extinction learning) and, excepting SCR to a sudden noise, increased from the old to novel spider in Session 2. In Wake only, summed subjective ratings and SCR to the old spider significantly increased across the delay (extinction loss) and were greater for the novel vs. the old spider when it was equally novel at the beginning of Session 1 (sensitization). In Sleep only, SCR to a sudden noise decreased across the inter-session delay (extinction augmentation) and, along with HRA, was lower to the novel spider than initially to the old spider in Session 1 (extinction generalization). None of the above differentiated Morning and Evening groups suggesting that intervening sleep, rather than time-of-testing, produced differences between Sleep and Wake. Thus, sleep following exposure therapy may promote retention and generalization of extinction learning. (copyright) 2012 Elsevier Ltd.
Journal of Psychiatric Research, 46(8) : 1036-1044
- Year: 2012
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Other complementary & alternative interventions
Gutner, C. A.: Weinberger, J., Hofmann, S. G.
Research on d-cycloserine (DCS) has demonstrated a significant effect on symptom reduction in human studies that utilized conventional exposure-based approaches. Recent studies have offered promising results for targeting fears through subliminal paradigms. In this double-blind, randomized placebo-controlled study, 45 spider fearful individuals received DCS or placebo pills prior to completing a subliminal cue exposure task to images of spiders. Participants completed self-report questionnaires and a behavioral approach task to a live caged tarantula. After repeated exposure to subliminal spider cues, participants in the DCS group reported a greater reduction in disgust than individuals in the placebo group. No difference was observed in fear ratings. These findings suggest that DCS augments the reduction in disgust in spider fearful subjects after subliminal exposure to spider cues. (copyright) 2012 Copyright Swedish Association for Behaviour Therapy.
Cognitive Behaviour Therapy, 41(4) : 335-344
- Year: 2012
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, D-cycloserine (DCS)
Kashdan, T. B., Adams, L., Read, J., Hawk, L.
Preliminary evidence suggests that 3 hours of behavior therapy can reduce fear responses to phobic stimuli. Most of this research, however, has relied on self-reports and clinician assessments, and failed to include a comparison group. To extend this literature, with 32 adults with spider phobia, we investigated the effects of a single hour of . in vivo exposure on subjective and electrophysiological aspects of fear; comparisons were made to a wait-list control group. Pre- and post-assessments included phobia-relevant questionnaires and startle reflex responses to spider, negative, neutral and positive stimuli. Compared to the control group, our one-hour treatment reduced self-reported and physiological responses to spider stimuli. These data provide preliminary support for the ability of affective startle modulation to be changed by very brief exposure therapy. (copyright) 2012 Elsevier Ltd.
Psychiatry Research, 196(1) : 79-82
- Year: 2012
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Leutgeb, V., Schafer, A., Kochel, A., Schienle, A.
Neurobiological studies have demonstrated that psychotherapy is able to alter brain function in adults, however little exists on this topic with respect to children. This waiting-list controlled investigation focused on therapy-related changes of the P300 and the late positive potential (LPP) in 8- to 13-year-old spider phobic girls. Thirty-two patients were presented with phobia-relevant, generally disgust-inducing, fear-inducing, and affectively neutral pictures while an electroencephalogram was recorded. Participants received one session of up to 4. h of cognitive-behavioral exposure therapy. Treated children showed enhanced amplitudes of the LPP at frontal sites in response to spider pictures. This result is interpreted to reflect an improvement in controlled attentional engagement and is in line with already existing data for adult females. Moreover, the girls showed a therapy-specific reduction in overall disgust proneness, as well as in experienced arousal and disgust when viewing disgust pictures. Thus, exposure therapy seems to have broad effects in children. (copyright) 2012 Elsevier B.V.
Biological Psychology, 90(1) : 97-104
- Year: 2012
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Gallo, K. P., Chan, P. T., Buzzella, B. A., Whitton, S. W., Pincus, D. B.
Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets. (copyright) 2011.
Behavior Therapy, 43(1) : 153-159
- Year: 2012
- Problem: Panic Disorder, Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Psychoeducation, Other Psychological Interventions
Goldbeck, L., Ellerkamp, T.
Background: Music therapy has been shown to be effective for children with psychopathology, providing an alternative nonverbal approach to the treatment of children with anxiety disorders. Objective: This pilot study investigates the efficacy of Multimodal Music Therapy (MMT), a combination of music therapy and cognitive-behavioral therapy, compared to treatment as usual (TAU). Methods: Thirty-six children aged 8-12 years with a primary diagnosis of an anxiety disorder were randomly assigned to 15 sessions of MMT or to TAU. Diagnostic status and dimensional outcome variables were assessed at the end of treatment and 4 months later. Results: MMT was superior compared to TAU according to the remission rates after treatment (MMT 67%; TAU 33%; x2 5 4.0; p 5 0.046) and remissions persisted until four months post-treatment. Dimensional measures showed equivalent improvement after either MMT or TAU. Conclusions: The results regarding the efficacy of MMT are promising for children with anxiety disorders. Further evaluation with larger samples and comparisons to pure CBT are recommended. (copyright) 2012 by the American Music Therapy Association.
Journal of Music Therapy, 49(4) : 395-413
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Davis-III, TE., May, Anna., Whiting, Sara E.
Research on treatments for childhood anxiety disorders has increased greatly in recent decades. As a result, it has become increasingly necessary to synthesize the findings of these treatment studies into reviews in order to draw wider conclusions on the efficacy of treatments for childhood anxiety. Previous reviews of this literature have used varying criteria to determine the evidence base. For the current review, stricter criteria consistent with the original Task Force (1995) guidelines were used to select and evaluate studies. Studies were divided by anxiety disorder; however, many studies combine various anxiety disorders in their samples. As a result, these were included in a combined anxiety disorder group. Using more traditional guidelines, studies were assigned a status of well-established, probably efficacious, or experimental based on the available literature and the quality of the studies. While some treatments do meet the criteria for well-established status, it is clear from this examination that gaps remain and replication is necessary to establish many of these treatments as efficacious. In addition, there still appears to be a lack of research on the effects of treatment on the physiological and cognitive aspects of fear and anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Clinical Psychology Review, 31(4) : 592-602
- Year: 2011
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Choplin, Christine E., Carter, Michele M.
This study examined the role of fear and disgust in repeated exposure among spider phobics. Thirty spider phobics were randomly assigned to one of two experimental groups. Both groups completed measures of fear and disgust and performed two initial standardized Behavioral Avoidance Tests (BATs; one with a fear stimulus—live tarantula, and one with a disgust stimulus—dead rat). One group was then repeatedly exposed to the tarantula and the other to the dead rat. Results of the study indicated that exposure to either the disgust stimulus or the live tarantula was associated with significant decreases in fear, avoidance, and disgust. However, it was found that repeated exposure to the fear stimulus produced a greater decrease in avoidance behavior. Results suggest that both types of exposure can be effective in alleviating associated symptoms and provide additional evidence that disgust sensitivity plays a role in the treatment of spider phobia. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Behavioral Interventions, 26(1) : 23-40
- Year: 2011
- Problem: Specific Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention
Lester, K. J., Field, A. P., & Muris, P. E. H. M.
Using an experimental bias modification task, an interpretation bias towards or away from threat was induced about animal or social situations in a sample of 103 children split into a young (7-10 years) and old age group (11-15 years). Children rapidly learned to select outcomes of ambiguous situations which were congruent with their assigned modification condition. Following positive modification, children's threat interpretation biases significantly decreased, while threat biases increased (non-significantly) after negative modification. Bias modification effects also varied as a function of age with children appearing particularly vulnerable to acquiring biases about stimuli that were congruent with the normative fears for their age group. Weak age-related modification-congruent effects on younger but not older children's anxiety vulnerability in response to a behavioral task were also observed. However, no consistent effects of bias modification on avoidance behavior were found.
Journal of Anxiety Disorders, 25(5) : 697-705
- Year: 2011
- Problem: Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification