Effects of varied-stimulus exposure training on fear reduction and return of fear

Rowe, Melissa; Craske, Michelle G.

doi:10.1016/s0005-7967(97)10017-1

Cited by 189 publications

(117 citation statements)

References 20 publications

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“…In accord, we have shown that progressively increasing amount of time between exposure practices (such as 1 day, 4 days, 10 days) is more effective at follow-up than massed exposure in 2 studies of spider-fearful samples [Rowe and Craske, 1998a;Tsao and Craske, 2000]. This result speaks to the value of booster sessions following completion of exposure therapy, which we have shown to be a correlate of superior outcomes at 18 month followup .…”

Section: Enhancing Retrieval Of Inhibitory Learningsupporting

confidence: 52%

“…We found that variable stimuli resulted in less fear at follow-up behavioral avoidance testing in spider-fearful [Rowe and Craske, 1998a] and height-fearful samples [Lang and Craske, 2000], although a third study of contaminant anxiety showed trends only [Kircanski et al, 2012]. Traditional exposure proceeds steadily from one hierarchy item to the next, with each item repeated a number of times until anxiety decreases.…”

Section: Stimulus Variabilitymentioning

confidence: 74%

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Optimizing Exposure Therapy for Anxiety Disorders: An Inhibitory Learning and Inhibitory Regulation Approach

Craske¹

2015

Verhaltenstherapie

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Exposure-based cognitive-behavioral therapy is the treatment of choice for anxiety disorders. Unfortunately, many individuals fail to benefit from treatment or demonstrate a return of fear. Inhibitory learning and inhibitory regulation models provide a parsimonious and unifying framework from which to situate exposure therapy and provide useful strategies to augment exposure therapy, especially as individuals with anxiety disorders show inhibitory deficits. This paper provides an overview of our application of inhibitory learning from the science of extinction, and inhibitory regulation from the neuroscience of emotion regulation, to exposure therapy for anxiety disorders.

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Section: Enhancing Retrieval Of Inhibitory Learningsupporting

confidence: 52%

Section: Stimulus Variabilitymentioning

confidence: 74%

Optimizing Exposure Therapy for Anxiety Disorders: An Inhibitory Learning and Inhibitory Regulation Approach

Craske¹

2015

Verhaltenstherapie

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“…The conclusion that the authors made was that during exposure, patients appear to learn exceptions to the rule rather than a fundamental change of that rule. 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.…”

Section: Discussionmentioning

confidence: 99%

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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“…Additionally, exposures should involve similar triggers to those that will be encountered in "real-world" situations. Behavioral research supports that introducing a wide variety of stimuli in a variety of contexts supports the best generalization of treatment gains from exposure (Bouton 2002;Rowe and Craske 1998), especially important since one drawback of intensive treatment is potentially higher relapse than weekly therapy (Storch et al 2007). Thus, throughout these sexual exposures, Kyle conducted exposures with multiple triggering stimuli and repeat exposures (often for homework) in new contexts different than the one conducted in session.…”

Section: Illustrative Treatment Coursementioning

confidence: 96%

Treatment of Sexual Obsessive-Compulsive Symptoms During Exposure and Response Prevention

Reid

Flores

Olsen

et al. 2015

Clinical Handbook of Obsessive-Compulsive and Related Disorders

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Effects of varied-stimulus exposure training on fear reduction and return of fear

Cited by 189 publications

References 20 publications

Optimizing Exposure Therapy for Anxiety Disorders: An Inhibitory Learning and Inhibitory Regulation Approach

Optimizing Exposure Therapy for Anxiety Disorders: An Inhibitory Learning and Inhibitory Regulation Approach

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

Treatment of Sexual Obsessive-Compulsive Symptoms During Exposure and Response Prevention

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