Citation

Culver NC, Stoyanova M, Craske MG. J. Behav. Ther. Exp. Psychiatry 2011; 43(2): 787-793.

Affiliation

UCLA Department of Psychology, University of California Los Angeles, 405 Hilgard Avenue, Box 951563, Los Angeles, CA 90095-1563, USA.

Copyright

(Copyright © 2011, Elsevier Publishing)

DOI

10.1016/j.jbtep.2011.10.009

PMID

22123332

Abstract

BACKGROUND AND OBJECTIVES: In traditional exposure therapy for phobias and anxiety disorders, reduction of fear responding is used as an index of learning. However, recent evidence in animal models suggests that sustained arousal and enhanced fear responding throughout exposure may actually predict better long-term outcomes (Rescorla, 2000). METHODS: The effects of sustained arousal during exposure were investigated in a clinical analog sample of 59 participants fearful of public speaking. Participants completed exposure with or without the presence of additional excitatory stimuli which were intended to enhance arousal and fear responding throughout exposure. RESULTS: Group assignment (exposure versus exposure with additional excitatory stimuli) did not significantly predict outcome at 1-week follow-up testing, as measured physiologically, subjectively, and behaviorally. A set of regression analyses investigating whether any exposure process measures predicted outcome indicated that sustained arousal throughout exposure as well as variability in subjective fear responding throughout exposure (e.g., Kircanski et al., in press) predicted lower levels of fear at follow-up testing (p < 0.05; p < 0.001) after controlling for demographic variables as well as pre-exposure fear levels. LIMITATIONS: The excitatory stimuli used failed to produce the intended effects. However, some participants did maintain elevated arousal throughout exposure and this predicted better outcomes at 1-week follow-up testing. CONCLUSIONS: Sustained arousal throughout exposure as well as variability in subjective fear responding during exposure may be better predictors of long-term outcomes than habituation of fear across exposure.

Language: en