The relative effectiveness of extinction and counter-conditioning in diminishing children's fear

Newall, Carol; Watson, Tiffany; Grant, Kerry Ann; Richardson, Rick

doi:10.1016/j.brat.2017.05.006

Cited by 39 publications

(24 citation statements)

References 34 publications

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“…CC-training reduced avoidance behaviour for the ThreatCS+ and not for ThreatCS-or ThreatCSnot-trained. These results are in line with the papers by Newall et al (2017) and Reynolds et al, (2018) which found a reduction in avoidance behaviour after the CC. Also in line with previous work, we show that counter-conditioning reduces the negative valence of the ThreatCS+ (De Houwer et al, 2001;Kerkhof, 2010;Newall et al, 2017;Raes & De Raedt, 2012).…”

Section: Discussionsupporting

confidence: 93%

“…However, one can imagine that therapeutic presence and feedback, as well as the application of relaxation techniques during exposure, might already provide some implicit counterconditioning of threat. Our study, while in healthy participants, suggests together with recent studies (Newall et al, 2017;Reynolds et al, 2018) and promising work in spider phobia (De Jong, Vorage, & Van Den Hout, 2000) that appetitive strategies might be used more explicitly in clinical treatment of anxiety and avoidance. Future studies are needed to investigate how a CC-training approach compares to extinction in the reduction of avoidance behaviour in anxiety disorders and whether a combination of CC-training and exposure would yield a higher treatment success than using exposure alone.…”

Section: Discussionsupporting

confidence: 64%

“…The necessary sample size was calculated beforehand using G-Power 3.1 (Faul, Erdfelder, Buchner, & Lang, 2009) with an effect size estimate of η 2 > .045 (Kerkhof, 2010;Newall, Watson, Grant, & Richardson, 2017;Raes & De Raedt, 2012) and α = .05. A sample of 24 participants would yield >80% power for the main analyses (based on repeated measures ANOVA; see pre-registration link above for more information).…”

Section: Participantsmentioning

confidence: 99%

“…; but see Meulders, Karsdorp, Claes, & Vlaeyen, 2015). Recent studies in children showed that CC could decrease avoidance and fear as compared to a control group (Newall et al, 2017;Reynolds et al, 2018). Despite its success in valence change and decreasing avoidance, it remains to be shown whether CC can lead to decreased avoidance during the ecologically valid situation of acute approach-avoidance conflict.…”

mentioning

confidence: 99%

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Tackling Costly Fearful Avoidance using Pavlovian Counterconditioning

Pavert¹,

Am²,

Roelofs³

et al. 2019

Preprint

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Anxiety disorders are prevalent in the population and costly for society, while current treatment is not effective in all individuals. A central symptom of anxiety is avoidance behaviour, with excessive avoidance being predictive of poor clinical outcomes. Appetitive motivation could play a role in decreasing avoidance behaviour by increasing the positive valuation of the feared object. The current study used an approach-avoidance conflict paradigm to measure costly avoidance behaviour in a healthy group of 22 participants. During counterconditioning training one stimulus was followed by eating a tasty snack (CS+), while another was never followed by an outcome (CS-). Results indicated that the CC-training was effective in reducing negative valuation and decreasing avoidance behaviour for the CS+. This study showed the importance of appetitive motivation for avoidance behaviour, suggesting that treatment may benefit from focussing on increasing appetitive motivation to overcome avoidance.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 64%

Section: Participantsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Tackling Costly Fearful Avoidance using Pavlovian Counterconditioning

Pavert¹,

Am²,

Roelofs³

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…food) with the goal of decreasing the fear response over repeated pairings and replacing it with an appetitive response (c.f. Newall et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of treatments for firework fears in dogs

Riemer

2019

Preprint

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AbstractAn online questionnaire survey investigated (1) management and (2) treatment methods for firework fears in dogs employed by dog owners and their (perceived) effectiveness. A PCA on data from 1225 respondents revealed four management strategies (i.e. interventions during firework exposure): the principal components “Environmental modification” (e.g. providing a hiding place, keeping windows and blinds closed, and playing music), “Feed/Play” (providing the dog with chews, play and food during fireworks in general, as well as contingent on loud bangs), “Alternative” (use of calming nutraceuticals, pheromones, herbal products, homeopathic products, Bach flowers, and essential oils) and “Interaction” (allowing body contact, petting and talking to the dog when loud bangs occurred). To explore possible effects of these management methods on fear development, the components were correlated with a score for fear progression. Of the four components, only “Feed/Play” was statistically associated with an improvement in fear responses to fireworks. To evaluate the effectiveness of various treatment strategies, owners were asked to select from a range of options which interventions they had used and whether they considered them as effective. With prescription medication (N=202), improvements were noted by 69% of owners, with high success rates reported for the most frequently prescribed drugs, alprazolam (91%) and Sileo® (74%). While individual products were not evaluated, the reported success rates for the categories “pheromones” (N=316), “herbal products” (N=282), “nutraceuticals” (N=211), “essential oils” (N=183), “homeopathic remedies” (N=250) and “Bach flowers” (N=281) were all in the range of 27-35%, which is not higher than would be expected based on a placebo effect. Pressure vests were deemed as effective by 44% of respondents (N=300). Counterconditioning (providing desirable stimuli after the occurrence of noises) was the most successful training technique according to the owners (N=694), with a reported effectiveness of over 70%. Relaxation training (N=433) was reported to be almost as successful at 69%, while noise CDs (N=377) were effective in 55% of cases. Thus, counterconditioning, relaxation training and anxiolytic medication appear to be the most effective strategies in the treatment of firework fears in dogs. On this basis it is recommended that ad-hoc counterconditioning and relaxation training should complement the standard behavioral technique of desensitization/ counterconditioning with noise recordings.HighlightsAn online survey on treatment options for firework fears in dogs was performedFeeding or playing with dogs during fireworks was associated with fear improvementSuccess was highest for ad-hoc counterconditioning, relaxation training and medicationSuccess was similar for pheromones, nutraceuticals and other alternative productsSuccess rates for these alternative products are consistent with a placebo effect

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Lessons learned developing and testing family‐based interoceptive exposure for adolescents with low‐weight eating disorders

Hildebrandt

Peyser

Sysko

2021

Intl J Eating Disorders

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Background Anorexia nervosa (AN) usually develops in early adolescence and is characterized by high rates of morbidity and mortality. Family‐based therapy (FBT) is the leading evidence‐based treatment for adolescents with AN, but not all patients experience sufficient improvement. The purpose of this manuscript is to describe the development and subsequent experience with a Family‐Based Interoceptive Exposure (FBT‐IE) for adolescents with a broader form of low‐weight eating disorders. Methods The novel IE‐based behavioral intervention is a six‐session family‐based treatment module designed to directly target and modify disgust by altering the prefrontal regulation of the insula response to aversive stimuli by decreasing visceral sensitivity (e.g., bloating). Each session teaches a new skill regarding tolerating distress to visceral sensations associated with disgust and an in‐vivo “IE exercise,” in which the family is provided with a meal replacement shake of unknown content and caloric density. Results In this novel treatment, the patient learns to tolerate disgust in the context of a challenging food stimulus as a way to increase consumption of restricted foods outside of session. Conclusion We discuss successes and challenges executing this treatment with patients with low‐weight eating disorders and propose future directions for the intervention.

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The relative effectiveness of extinction and counter-conditioning in diminishing children's fear

Cited by 39 publications

References 34 publications

Tackling Costly Fearful Avoidance using Pavlovian Counterconditioning

Tackling Costly Fearful Avoidance using Pavlovian Counterconditioning

Effectiveness of treatments for firework fears in dogs

Lessons learned developing and testing family‐based interoceptive exposure for adolescents with low‐weight eating disorders

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