1 / 38

Why Study Mechanism of Fear Reduction

Why Study Mechanism of Fear Reduction. Anxiety disorders represent a highly prevalent and disabling group of disorders Mechanisms of fear change may be applicable across anxiety disorders May lead to the development of new fear reduction procedures or the refinement of existing ones.

salma
Download Presentation

Why Study Mechanism of Fear Reduction

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Why Study Mechanism of Fear Reduction • Anxiety disorders represent a highly prevalent and disabling group of disorders • Mechanisms of fear change may be applicable across anxiety disorders • May lead to the development of new fear reduction procedures or the refinement of existing ones

  2. Conditioning Theoriesof Fear Reduction • Habituation • Definition • Temporary decrement in unlearned emotional response as a result of repeated presentation of the conditioned stimulus in an attenuated form • Variables presumed to facilitate habituation • Repeated stimulation • Presentation of low intensity stimuli

  3. Conditioning Theoriesof Fear Reduction • Extinction • Definition • Decrement in learned emotional response as a result of repeated presentation of the conditioned stimulus and the absence of reinforcement • Things to note • Difficult to know what fears are learned or unlearned • May be more applicable for the behavioral component of fear

  4. Conditioning Theoriesof Fear Reduction • Reciprocal Inhibition • Definition • Inhibition of the conditioned fear response by pairing the stimulus with a response that is antagonistic (incompatible) with the fear response (e.g., relaxation) • Necessary Conditions • Repeated pairings of the conditioned fear stimulus with the antagonistic response • Low levels of fear • Stimulus should be presented in graduated steps of intensity in order for conditioned inhibition to occur

  5. Problems With Conditioning Theories of Fear Reduction • Persistence of pathological fears despite repeat exposures • Difficulty explaining the fear reduction effects of flooding • Difficulty explaining the durability of fear reduction • Difficulty explaining the fear-reducing effects of corrective information • Difficulty explaining the immediate fear reduction effects of safety behaviors • Difficulty explaining the high pill placebo response rate observed in most of the anxiety disorders • Lack explanatory power

  6. Self-efficacy Formulation of Anxiety • Perceived self-efficacy to control potentially threatening events plays a critical role in anxiety • The perception of threat is inherently relational in nature • Avoidance behavior, physiological arousal, and subjective distress are all co-effects of perceived self-efficacy

  7. Self-efficacy Formulation of Anxiety • Perceived coping efficacy operates as a potent mediator of fear reduction • The fear reduction effects of perceived control operate anticipatorily rather than through an attenuation of the threats when they occur; • The most powerful fear-reduction methods involve engineering direct performance mastery

  8. Williams et al (1984) Data from Williams et al (1984). Journal of Consulting and Clinical Psychology, 52, 505-518.

  9. Expectancy Model(Reiss & McNally, 1985) • Basic assumptions of the expectancy model of fear. • People are motivated to avoid stimuli that signal danger; • People differ in their anxiety sensitivity, the predisposition to interpret arousal/anxiety as threatening; • People learn that certain stimuli make them anxious.

  10. Expectancy Model(Reiss & McNally, 1985) Original Expectancy formula Fear Behavior = Ed + (Ea x Sa)Ed = expectancy of dangerEa = expectancy of anxietySa = anxiety sensitivity.

  11. Predictions of Expectancy Model • Some fears are motivated partially or wholly by expectations and sensitivities to anxiety • Anxiety sensitivity is an individual difference variable that can be measured by the ASI • High AS is a risk factor for anxiety disorders

  12. Expectancy Model(Reiss & McNally, 1991) Revised Expectancy formula Fear Response = (Ek x Sd) + (Ej x Sa) + (Ei x Sfne) Ek = expectancy of objective disaster EJ = expectancy of anxiety Ei = expectancy of social disaster Sd = sensitivity to danger Sa = sensitivity to anxiety Sfne = sensitivity to criticism .

  13. Expectancy Model(Reiss & McNally, 1985) • Evidence in support of the model • Valentiner & Telch (1993) • Among a sample of 117 claustrophobics undergoing repeated exposure, the interaction of AS and expected anxiety accounted for unique variance in fear behavior after controlling for expected danger, expected anxiety, and anxiety sensitivity. • Valentiner & Telch (1996) • Among a sample of 340 claustrophobics claustrophobics undergoing repeated exposure, the interaction of AS and expected anxiety accounted for unique variance in fear behavior after controlling for expected danger, expected anxiety, and anxiety sensitivity. But coping self-efficacy accounted for more unique variance in both fear behavior and subjective distress.

  14. Emotional Processing Model (Foa & Kozak, 1986) Fear Reduction Mechanisms

  15. Emotional Processing Model (Foa & Kozak, 1986) • Nature of fear structures • information about the feared stimulus • information about verbal, physiological, and overt behavioral responses; • interpretive information about the meaning of the stimulus and response elements of the structure

  16. Emotional Processing Model (Foa & Kozak, 1986) • Three indicators of emotional processing • Physiologic and subjective information that the fear structure has been activated; • Habituation within treatment sessions; • Habituation between treatment sessions

  17. Emotional Processing Model (Foa & Kozak, 1986) • Variables that affect emotional processing • Degree of attention • Content of information • Medium • Duration of exposure

  18. Emotional Processing Model (Foa & Kozak, 1986) • Mechanisms of emotional processing • Dissociation of response and stimulus propositions • Changes in the meaning of stimuli and responses

  19. Emotional Processing Model (Foa & Kozak, 1986) • Obstacles for emotional processing • Cognitive Avoidance • Absence of short-term habituation • Excessively high reactivity • Depression • Overvalued ideation • Safety behaviors

  20. Emotional Processing Model (Foa & Kozak, 1986) • Empirical Support • Kozak et al (1988) • Telch et al (2000) • Kamphuis & Telch (in press) • Sloan & Telch (under review)

  21. Empirical Tests of Emotional Processing Theory • Telch et al (2000) • Claustrophobics randomized to one of three 30-min exposure conditions: • Self-guided exposure + HR feedback (HRF) • Self-guided exposure + paced-tone control (PTC) • Self-guided exposure only control (EOC)

  22. Clinical Outcome for the Three Exposure Conditions Data from Telch et al Behaviour Research and Therapy, 2000

  23. Treatment Process Findings for the Three Exposure Conditions Data from Telch et al Behaviour Research and Therapy, in press

  24. Empirical Tests of Emotional Processing Theory • Kamphuis & Telch (2000) • Claustrophobics randomized to one of four30-min self-guided exposure conditions: • Guided threat reappraisal (GTR) • Cognitive load distracter task (CLDT) • Guided threat reappraisal + Cognitive load distracter task (GTR + CLDT)

  25. Treatment Outcome Across Exposure Conditions Data from Kamphuis & Telch, Behaviour Research and Therapy (in press)

  26. Return of Fear Across Exposure Conditions Data from Kamphuis & Telch, Behaviour Research and Therapy (in press)

  27. Between-Trial Habituation Across Exposure Conditions Data from Kamphuis & Telch, Behaviour Research and Therapy (in press)

  28. Empirical Tests of Emotional Processing Theory • Telch et al (under review) • Claustrophobics randomized to one of four 30-min self-guided exposure conditions: • Threat word focus • Neutral word focus • Cognitive load task (Seashore Rhythm Test) • Exposure only control

  29. Treatment Outcome Across the Four Exposure Conditions Data from Telch et al (in prep)

  30. Role of Safety Behaviors in Fear Reduction Fear Reduction Mechanisms

  31. How Safety Behaviors Might Interfere with Fear Reduction • SB’s interfere with disconfirmation of perceived threat • Misattribution hypothesis (Salkovskis, 1991) • Cognitive resource hypothesis (Sloan & Telch, in press) • Threat transmission hypothesis (Sloan & Telch, in press)

  32. Support for the Disruptive Effects of Safety Behaviors • Sloan & Telch (2001) • 46 Claustrophobics were randomized to one of three exposure conditions: GTR, SBU, and Exposure Control.

  33. Dimensions of Exposure-Based Treatments • Mode of exposure • Graduated vs. non-graduated • Massed vs. spaced • Brief vs. prolonged • Group vs. individual • Therapist-assisted vs. self-directed • Anxiety evocations vs. anxiety kept at a minimum • Utilization of anxiety control strategies • Utilization of cognitive change strategies • Utilization of mastery aids

  34. The Special Case of Blood Injury phobia • Blood injury phobia • Ost and colleagues (Ost et al, 1996)

More Related