Effects of an expanding-spaced vs massed exposure schedule on fear reduction and return of fear

Rowe, Melissa; Craske, Michelle G.

doi:10.1016/s0005-7967(97)10016-x

Cited by 1,280 publications

(77 citation statements)

References 255 publications

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“…Research findings on exposure in anxiety disorders suggest that generalization and maintenance can be enhanced by a number of measures, including the provision of exposures to the full variety of contexts and natural settings in which fear has been experienced, 49 ample variation of different stimuli during the exposure, 50 and the application of an exposure over a longer period of time rather than for a limited number of weeks. 51 It is plausible that in our study generalization was facilitated by the repeated exposure to essential and individually identified stimuli, as measured with PHODA. The finding that activity monitor data follow the same picture as the self-reported measures further supports the assumption that treatment gains produced during the exposure to activities typical of the treatment setting do generalize to the home setting and in the absence of therapists.…”

Section: Discussionmentioning

confidence: 70%

The Treatment of Fear of Movement/(Re)injury in Chronic Low Back Pain: Further Evidence on the Effectiveness of Exposure In Vivo

Vlaeyen¹,

Jong²,

Geilen³

et al. 2002

The Clinical Journal of Pain

452

238

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Abstract:Background and objective: Several cognitive-behavioral factors contribute to the persistence of pain disability in patients with chronic back pain. Fear-avoidance beliefs and fear of movement/(re)injury in particular have been shown to be strong predictors of physical performance and pain disability. Patients reporting substantial pain-related fear might benefit from exposure in vivo to a set of individually tailored, fear-eliciting, and hierarchically ordered physical movements rather than more general graded activity.Patients and interventions: Six consecutive patients with chronic low back pain who reported substantial fear of movement/(re)injury were included in the study. After a no-treatment baseline measurement period, the patients were randomly assigned to one of two interventions. In the first intervention, patients received exposure in vivo first, followed by graded activity. In the second intervention, the sequence of treatment modules was reversed. Before each treatment module, treatment credibility was assessed. Daily measures of pain-related fear, pain catastrophizing, and pain intensity were completed using visual analog scales. In addition, standardized measures of pain disability, pain-related fear, and pain vigilance were taken before and after each treatment module and at the 1-year follow-up. To obtain more objective data on actual activity levels, an ambulatory activity monitor was carried by the patients during 1 week before and after each treatment module.Results: Time series analysis of the daily measures showed that improvements in pain-related fear and pain catastrophizing occurred only during the exposure in vivo and not during the graded activity, irrespective of the treatment order. Analysis of the pretreatment to post-treatment differences also revealed that decreases in pain-related fear also concurred with decreases in pain disability and pain vigilance and an increase in physical activity levels. All improvements remained at the 1-year follow-up.Key Words: Anxiety-Cognitive-behavioral treatment-Exposure in vivo-Fearavoidance beliefs-Low back pain.The early notion that, in chronic patients, the lowered ability to accomplish tasks of daily living is merely the consequence of pain severity has now been reconsidered. Indeed, a steadily increasing number of studies are showing that observable physical performance and selfreported disability levels in subacute and chronic pain are associated with cognitive and behavioral aspects of

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Section: Discussionmentioning

confidence: 70%

The Treatment of Fear of Movement/(Re)injury in Chronic Low Back Pain: Further Evidence on the Effectiveness of Exposure In Vivo

Vlaeyen¹,

Jong²,

Geilen³

et al. 2002

The Clinical Journal of Pain

452

238

View full text Add to dashboard Cite

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“…While both training procedures can lead to the same level of learning, memory persists longer with spaced training than it does with massed training (e.g., cramming for an exam). Thus, for example, in studies of agoraphobia in humans, it has been shown that massed training results in greater reductions in anxiety than spaced training, but that the latter results in better long-term retention (Rowe and Craske 1998). Similar data have been obtained in Aplysia habituation and sensitization studies (Carew et al 1972) as well as in studies of other vertebrate and invertebrate species (Hermitte 1999;Lechner et al 1999).…”

mentioning

confidence: 72%

Operant Conditioning in Lymnaea: Evidence for Intermediate- and Long-term Memory

Lukowiak¹,

Adatia²,

Krygier³

et al. 2000

Learn. Mem.

151

129

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Aerial respiration of the pond snail, Lymnaea stagnalis, can be operantly conditioned; however, the parameters necessary to produce long-term (LTM) or intermediate term memory (ITM) have not previously been investigated. We conducted training using procedures that varied in the duration of the training session, the number of training sessions per day or the amount of time between subsequent training sessions (SI). We found that by varying the duration and frequency of the training session learning could be differentially produced. Furthermore, the ability to form LTM was dependent not only on the duration of the training session was also the interval between training sessions, the SI. Thus it was possible to produce ITM, which persists for up to 3 hr, and not form LTM, which persists at least 18 hr. Learning, ITM, and LTM can be differentially produced by altering the SI, the duration of the training session, or the number of training sessions per day. These findings may allow us to begin to elucidate the underlying neural mechanisms of learning, ITM, and LTM.

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“…Previously, our thinking was that the training procedures used before memory consolidation were the major factor in determining how long memory persisted. For example, 'massed' training and 'spaced' training in Lymnaea result in a similar level of performance; yet 'spaced' training results in a memory that is significantly longer lasting (Carew et al, 1972;Rowe and Craske, 1998;Lukowiak et al, 2000). A greater number of training sessions in Lymnaea result in a longer lasting memory.…”

Section: Resultsmentioning

confidence: 99%

Forgetting and the extension of memory inLymnaea

Sangha

McComb

Lukowiak

2003

Journal of Experimental Biology

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SUMMARYAerial respiratory behaviour in Lymnaea stagnalis was operantly conditioned using a procedure that results in long-term memory (LTM) persisting for 1 but not 3 days. By manipulating the snails' post-training environment, i.e. preventing Lymnaea from performing aerial respiratory behaviour, memory persistence was significantly extended. Memory retention, however, is only extended if snails are prevented from performing aerial respiration in the same context in which they were trained. Snails trained in the `standard' context but prevented from performing aerial respiration in the `carrot-odor' context (and vice versa) did not extend their memory. These data are consistent with the hypothesis that forgetting is due to interfering events, that occur following learning and memory consolidation.

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Effects of an expanding-spaced vs massed exposure schedule on fear reduction and return of fear

Cited by 1,280 publications

References 255 publications

The Treatment of Fear of Movement/(Re)injury in Chronic Low Back Pain: Further Evidence on the Effectiveness of Exposure In Vivo

The Treatment of Fear of Movement/(Re)injury in Chronic Low Back Pain: Further Evidence on the Effectiveness of Exposure In Vivo

Operant Conditioning in Lymnaea: Evidence for Intermediate- and Long-term Memory

Forgetting and the extension of memory inLymnaea

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