Exposure treatment in multiple contexts attenuates return of fear via renewal in high spider fearful individuals

Bandarian-Balooch, Siavash; Neumann, David L.; Boschen, Mark Justin

doi:10.1016/j.jbtep.2014.12.006

Cited by 36 publications

(35 citation statements)

References 38 publications

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“…The assessment of long-term effectiveness is particularly important because treated phobias in patients (and extinguished fear responses in other animals) are susceptible to relapse. [91][92][93][94][95][96] One of the notable risk factors for relapse is context change, in which the individual reencounters the phobic stimulus or situation outside of the context in which extinction originally occurred. 93,96 Accordingly, studies have sought to extinguish conditioned responses to fear or phobic stimuli in multiple contexts, finding this approach to be comparatively more effective than extinction in a single context.…”

Section: Treatmentmentioning

confidence: 99%

“…93,96 Accordingly, studies have sought to extinguish conditioned responses to fear or phobic stimuli in multiple contexts, finding this approach to be comparatively more effective than extinction in a single context. [95][96][97][98] Pharmacotherapy is not a common treatment choice for specific phobias. However, within the past decade, studies have investigated pharmacological augmentation of exposure therapy in attempts to improve treatment outcomes.…”

Section: Treatmentmentioning

confidence: 99%

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Specific phobias

Eaton

Bienvenu²,

Miloyan

2018

The Lancet Psychiatry

147

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Anxiety disorders are among the most prevalent mental disorders, but the subcategory of specific phobias has not been well studied. Phobias involve both fear and avoidance. For people who have specific phobias, avoidance can reduce the constancy and severity of distress and impairment. However, these phobias are important because of their early onset and strong persistence over time. Studies indicate that the lifetime prevalence of specific phobias around the world ranges from 3% to 15%, with fears and phobias concerning heights and animals being the most common. The developmental course of phobias, which progress from fear to avoidance and then to diagnosis, suggests the possibility that interrupting the course of phobias could reduce their prevalence. Although specific phobias often begin in childhood, their incidence peaks during midlife and old age. Phobias persist for several years or even decades in 10-30% of cases, and are strongly predictive of onset of other anxiety, mood, and substance-use disorders. Their high comorbidity with other mental disorders, especially after onset of the phobia, suggests that early treatment of phobias could also alter the risk of other disorders. Exposure therapy remains the treatment of choice, although this approach might be less effective in the long term than previously believed. This Review discusses the literature regarding the prevalence, incidence, course, risk factors, and treatment of specific phobias, and presents epidemiological data from several population-based surveys.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Specific phobias

Eaton

Bienvenu²,

Miloyan

2018

The Lancet Psychiatry

147

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“…Similar effects of multiple context extinction have been observed in clinical settings: Fearful individuals will show a return of fear following exposure therapy when the fear assessment occurs in a different context than the treatment (Mystkowski, Craske, & Echiverri, ). Similar to laboratory‐based conditioning studies, this return of fear can be attenuated by conducting exposure therapy in multiple contexts (Bandarian‐Balooch, Neumann, & Boschen, ).…”

Section: Applying Associative Learning To the Promotion Of Intergroupmentioning

confidence: 99%

Learning to fear outgroups: An associative learning explanation for the development and reduction of intergroup anxiety

O’Donnell

Neumann

Duffy

et al. 2019

Social & Personality Psych

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Pavlovian conditioning is a form of associative learning shown to contribute to the development and reduction of clinical anxiety and fear, and more recently, intergroup anxiety and fear. The current review provides a synthesis of the --This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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“…Additionally, moving, as opposed to stationary, animals are associated with increased fear and effectiveness of ARET (Bretón-López et al, 2010). ARET can also facilitate executing exposure in multiple contexts, which could attenuate the risk of renewal of fear (Bandarian-Balooch et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Augmenting Exposure Therapy: Mobile Augmented Reality for Specific Phobia

Witte

Scheveneels

Sels

et al. 2020

Front. virtual real.

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New technologies, such as virtual reality (VR) and augmented reality (AR), can be used as an add-on to exposure therapy for common anxiety disorders. Although the benefits of VR for exposure therapy have already been demonstrated extensively in research, AR applications are only just becoming widely available. Evidence for the added value and effectiveness of AR exposure therapy (ARET) is still scarce. The current study aimed to explore whether a first markerless AR iOS app for specific phobia could induce fear for multiple animal species in a general population sample. In two experiments, participants made use of the PHOBOS AR app in a behavioral approach task (BAT), using animals for which they were anxious, but not phobic. Self-report data and physiological measures were recorded. In Experiment 1, 108 participants chose one of the seven available animal species and were allocated to either a smartphone or tablet condition. Results showed increasing levels of self-reported anxiety with increasing levels of BAT difficulty. However, this increase was smaller in individuals reporting low levels of perceived realism. No effects on heart rate (HR) could be established. In Experiment 2, 52 participants were exposed to virtual spiders. For both self-reported anxiety and the interaction with perceived realism, results were similar to those of Experiment 1. Skin conductance did increase significantly from baseline to the highest level of difficulty of the BAT, and the severity of fear of spiders also appeared to be related to the fear response in the BAT. In conclusion, the study shows that animals presented in AR through a mobile device can evoke anxiety, which is a prerequisite for the implementation of ARET. However, further research should establish the effects of ARET in a clinical sample of people with specific phobias.

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Exposure treatment in multiple contexts attenuates return of fear via renewal in high spider fearful individuals

Abstract: Using multiple extinction contexts in combination with other methods of attenuating renewal (e.g., context similarity) may provide a means to reduce the risk of renewal of fear.

Cited by 36 publications

References 38 publications

Specific phobias

Specific phobias

Learning to fear outgroups: An associative learning explanation for the development and reduction of intergroup anxiety

Augmenting Exposure Therapy: Mobile Augmented Reality for Specific Phobia

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