Comparison of self-report and overt-behavioral procedures for assessing acrophobia

Cohen, David

doi:10.1016/s0005-7894(77)80116-0

Cited by 185 publications

(143 citation statements)

References 5 publications

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“…As measured with the acrophobia questionnaire, a standard questionnaire to reliably assess fear of heights (37), patients who received cortisol together with the three VR exposure sessions, showed significantly greater reductions in phobic fear both at posttreatment and at 1-mo follow-up (Fig. 1), compared with patients who received placebo.…”

Section: Discussionmentioning

confidence: 99%

Glucocorticoids enhance extinction-based psychotherapy

Quervain

Bentz

Michael

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

237

148

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Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, doubleblind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions. Subjects returned for a posttreatment assessment 3-5 d after the last treatment session and for a follow-up assessment after 1 mo. Adding cortisol to exposure therapy resulted in a significantly greater reduction in fear of heights as measured with the acrophobia questionnaire (AQ) both at posttreatment and at follow-up, compared with placebo. Furthermore, subjects receiving cortisol showed a significantly greater reduction in acute anxiety during virtual exposure to a phobic situation at posttreatment and a significantly smaller exposure-induced increase in skin conductance level at follow-up. The present findings indicate that the administration of cortisol can enhance extinction-based psychotherapy.memory | retrieval | consolidation P hobic disorders can be characterized as disorders involving disturbed emotional learning and memory resulting in an enhanced fear response. A central mechanism in the pathogenesis of anxiety disorders is associative learning or conditioning that leads to formation of a fear memory (1-5). In phobic individuals, exposure to a phobic stimulus almost invariably provokes retrieval of stimulus-associated fear memory, which leads to the fear response (6-9). Exposure-based behavioral therapy of phobia is thought to rely on extinction of these fear responses (10-13). Extinction occurs when conditioned responding to a stimulus decreases when the reinforcer is omitted (12,14). Accordingly, fear reduction induced by exposure therapy is the result of decrements in the conditioned response over successive extinction trials. Extinction leads to the formation of an alternative set of nonfearful memory associations (extinction memory) that competes with, but does not erase original fear memory associations (14, 15). Considering the importance of extinction learning for exposure therapy, pharmacological interventions aimed at enhancing extinction processes are promising approaches to enhance exposure therapy, as it has been demonstrated with D-cycloserine (16-18).Glucocorticoids (cortisol in humans, corticosterone in rodents) are stress hormones released from the adrenal cortex and it has long been recognized that they readily enter the brain and affect learning and memory (19-24). Importantly, basic research studies in animals and humans have shown that the mnemonic effects of glucocorticoids can facilitate extinction processes (22,(25)(26)(27)(28)(29). Therefore, we aimed at investigating whether the administrati...

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Section: Discussionmentioning

confidence: 99%

Glucocorticoids enhance extinction-based psychotherapy

Quervain

Bentz

Michael

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

237

148

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“…These included the Acrophobia Questionnaire (AQ; Cohen, 1997), a widely used measure of height phobia with anxiety and avoidance subscales. Additionally, participants climbed a ladder to measure self-reported fear (on a 0-100 verbal analogue scale) and behavioral avoidance (operationalized as time to ascend ladder); a common provocation in acrophobia research (Menzies & Clarke, 1995).…”

Section: Methodsmentioning

confidence: 99%

A new mode of fear expression: Perceptual bias in height fear.

Teachman

Stefanucci

Clerkin

et al. 2008

Emotion

121

106

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Emotion and psychopathology researchers have described the fear response as consisting of four main components -subjective affect, physiology, cognition, and behavior. The current study provides evidence for an additional component in the domain of height fear -perception -and shows that it is distinct from measures of cognitive processing. Individuals High (N = 35) and Low (N = 36) in acrophobic symptoms looked over a two-story balcony ledge and estimated its vertical extent using a direct height estimation task (visual matching), and an indirect task (size estimation); the latter task seems to exhibit little influence from cognitive factors. In addition, implicit and explicit measures of cognitive processing were obtained. Results indicated that, as expected, the High Fear group showed greater relative, implicit height fear associations and explicit threat cognitions. Of primary interest, the High (compared to Low) Fear group estimated the vertical extent to be higher, and judged target sizes to be greater, even when controlling for the cognitive bias measures. These results suggest that emotional factors such as fear are related to perception. Keywords visual perception; implicit associations; height fear; acrophobiaIndividuals typically think about emotion in terms of the subjective affect they experience. Yet, emotion researchers have long recognized that there are other modes for expressing emotion. For example, Lang's (1979) seminal bio-informational theory proposed three components to the fear response -physiology, cognition, and behavior. More recently, Barlow (2002) and others (Davis & Ollendick, 2005) have noted the importance of the affective state in feeling fearful as well. While these four modalities encompass a large part

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“…4. The two height anxiety questionnaires as introduced by Cohen [2] consisting of 20 situations which evoke a fear of heights. 5.…”

Section: Questionnairesmentioning

confidence: 99%

The Visual, the Auditory and the Haptic – A User Study on Combining Modalities in Virtual Worlds

Fröhlich

Wachsmuth

2013

Lecture Notes in Computer Science

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Abstract. In order to make a step further towards understanding the impact of multi-modal stimuli in Virtual Reality we conducted a user study with 80 participants performing tasks in a virtual pit environment. Participants were divided into four groups, each presented a different combination of multi-sensory stimuli. Those included real-time 3D graphics, audio stimuli (ambient, static and event sounds), and haptics consisting of wind and tactile feedback when touching objects. A presence questionnaire was used to evaluate subjectively reported presence on the one hand, and on the other physiological sensors were used to measure heart rate and skin conductance as an objective measure. Results strongly indicate that an increase of modalities does not automatically result in an increase of presence.

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Comparison of self-report and overt-behavioral procedures for assessing acrophobia

Cited by 185 publications

References 5 publications

Glucocorticoids enhance extinction-based psychotherapy

Glucocorticoids enhance extinction-based psychotherapy

A new mode of fear expression: Perceptual bias in height fear.

The Visual, the Auditory and the Haptic – A User Study on Combining Modalities in Virtual Worlds

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