Factors influencing the success of exposure therapy for specific phobia: A systematic review

Böhnlein, Joscha; Altegoer, Luisa; Muck, Nina Kristin; Roesmann, Kati; Redlich, Ronny; Dannlowski, Udo; Leehr, Elisabeth J.

doi:10.1016/j.neubiorev.2019.12.009

Cited by 64 publications

(49 citation statements)

References 144 publications

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“…Specific phobia is a highly prevalent mental illness for which exposure therapy is the first-choice treatment (Baus and Bouchard, 2014;Böhnlein et al, 2020). Specific phobia refers to a persistent unreasonable fear concerning a specific object or situation, which is accompanied by avoidance of the object or situation and results in clinically significant distress or impairment (Eaton et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Introductionmentioning

confidence: 99%

“…Anxiety is associated with an increase in skin conductance (SC) and heart rate (HR). HR activity is seen as a contributor to exposure success (Böhnlein et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Augmenting Exposure Therapy: Mobile Augmented Reality for Specific Phobia

Witte

Scheveneels

Sels

et al. 2020

Front. virtual real.

View full text Add to dashboard Cite

show abstract

“…The greatest empirical support in the treatment of specific phobias, as well as other anxiety disorders, has been in vivo exposure (Böhnlein et al, 2020; Thng et al, 2020) but this tends to generate rejection in the patients because they have to directly face the stimuli. Around 25% of patients reject in vivo exposure, and a significant churn rate tends to occur (up to 45%) (Choy et al, 2007) therefore various types of interventions and strategies have been conducted to reduce fear gradually.…”

Section: Theoretical and Research Bases For Treatmentmentioning

confidence: 99%

Progressive Multimedia Exposure for Specific Phobias: A Clinical Case of Claustrophobia and Acrophobia

Ruiz‐García

Aguayo

2021

Clinical Case Studies

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We present a multimedia exposure intervention for specific phobias using images and videos in a specific case of claustrophobia and acrophobia. The patient was a 47-year-old woman named “Jane” (anonymized name) who was diagnosed with fear of heights (acrophobia) and fear of confined spaces and enclosed areas (claustrophobia). The procedure was a single-case A-B design with several concurrent baselines, pre-post measurements, and two follow-ups (6 and 12 months). For the assessment, there were several questionnaires on anxiety and phobias and the continuous evaluation of anxiety and heart rate during treatment assays for each session. The treatment consisted of eight sessions of progressive multimedia exposure: images, videos, and in vivo settings. The results showed a decrease in the score for pre-post questionnaires ( Z = −4.196, p < .0010) and also a total decrease in anxiety in the different baselines (PND 100%). The benefits were maintained during 1 year of follow-up. After the treatment, “Jane” could be confronted with situations she previously feared, such as being on floors of different levels (up to ninth floor), in closed places, in crowded elevators, and traveling on buses and trains for long distances.

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“…Pavlovian conditioning being the primary method in the study of fear learning (Stjepanović & LaBar, 2018), behaviorism has probably contributed to the study of fears and phobias more than any other school of thought. Fear conditioning is widely used in research, and behavioral interventions remain the treatment of choice when it comes to the treatment of specific phobias (Böhnlein et al, 2020).…”

Section: When Threats Were Not Different; Behaviorism and Equipotentiality Withmentioning

confidence: 99%

Snakes vs. Guns: A Systematic Review of Comparisons Between Phylogenetic and Ontogenetic Threats

Shapouri¹,

Martin²

2021

Preprint

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The potential differences between phylogenetic threats (e.g., snakes) and ontogenetic threats (e.g., guns) can have a wide-ranging impact on a variety of theoretical and practical issues, from etiology of specific phobias to stimulus selection in psychophysiological studies, yet this line of research has not been systematically reviewed. Here, we summarize and synthesize findings from fear conditioning, illusory correlation, attention bias and neuroimaging studies that have compared these two types of threats to human survival. While a few brain imaging studies reveals preliminary evidence for different brain networks involved in the processing of phylogenetic and ontogenetic threats, attention bias studies tentatively show faster reaction time for modern threats, illusory correlation bias is evident for both types of threats, and fear conditioning studies are far from conclusive. The results of behavioral experiments, especially attention bias research, pose a challenge to established theories like biological preparedness and fear module. We discuss the findings in terms of other theories that might explain the same results and conclude with potential future directions.

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Factors influencing the success of exposure therapy for specific phobia: A systematic review

Cited by 64 publications

References 144 publications

Augmenting Exposure Therapy: Mobile Augmented Reality for Specific Phobia

Augmenting Exposure Therapy: Mobile Augmented Reality for Specific Phobia

Progressive Multimedia Exposure for Specific Phobias: A Clinical Case of Claustrophobia and Acrophobia

Snakes vs. Guns: A Systematic Review of Comparisons Between Phylogenetic and Ontogenetic Threats

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