Treatment sensitivity of implicit threat evaluation, avoidance tendency and visual working memory bias in specific phobia

Reinecke, Andrea; Soltau, Christian; Hoyer, Jürgen; Becker, Eni S.; Rinck, Mike

doi:10.1016/j.janxdis.2011.12.010

Cited by 23 publications

(23 citation statements)

References 31 publications

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“…In time, if our findings can be replicated, one might try to use implicit avoidance tendencies, and the degree to which they occur for different stimuli, as an additional indicator of PTSD severity before treatment. In line with this, another clinically important question is whether the implicit avoidance of high-threat stimuli remains after treatment, or whether it diminishes with successful treatment, as in spider phobics (see Reinecke, Soltau, Hoyer, Becker, & Rinck, 2012). Moreover, the degree to which implicit avoidance remains present—or remains generalized—might be an independent predictor of relapse after treatment, next to strategic or explicit avoidance.…”

Section: Discussionmentioning

confidence: 99%

Implicit and explicit avoidance in sexual trauma victims suffering from posttraumatic stress disorder: a pilot study

Fleurkens

Rinck

Minnen

2014

European Journal of Psychotraumatology

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BackgroundAvoidance of stimuli that are associated with the traumatic event is a key feature of posttraumatic stress disorder (PTSD). Thus far, studies on the role of avoidance in the development and maintenance of PTSD focused primarily on strategic or explicit avoidance. However, patients may also show implicit avoidance behavior, which may remain even when explicit avoidance is reduced.ObjectivesThe present pilot study was designed to test the hypothesis that PTSD patients show implicit avoidance of threatening, trauma-related stimuli. In addition, it was tested whether this avoidance behavior also occurs for other stimuli.MethodsThe Approach-Avoidance Task was used as an indirect measure of avoidance. Participants were 16 women suffering from PTSD who had experienced a sexual trauma, and 23 healthy non-traumatized women. Using a joystick, they pulled pictures closer to themselves or pushed them away. The pictures varied in content, being either high-threat sexual, non-threat sexual, high-threat accident, or positive.ResultsCompared to control participants, PTSD patients avoided high-threat sexual pictures, and the degree of avoidance was predicted by self-reported arousal level. Moreover, PTSD patients with high levels of self-reported explicit avoidance, depressive symptoms, and PTSD symptom severity also avoided high-threat accident pictures.ConclusionsThese findings point to the possible importance of threat value instead of trauma-relatedness in explaining implicit avoidance. The results are discussed in light of cognitive-behavioral models of PTSD, and clinical implications are suggested.

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Section: Discussionmentioning

confidence: 99%

Implicit and explicit avoidance in sexual trauma victims suffering from posttraumatic stress disorder: a pilot study

Fleurkens

Rinck

Minnen

2014

European Journal of Psychotraumatology

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“…We speculate that neocortical processing in the otherwise healthy brain underpins the more complex aspects of phobic behaviour (such as LC's elaborate premorbid avoidance strategies), while impaired neocortical processing (e.g., following onset of SemD) may remove the cognitive significance of the phobic situation along with its autonomic resonance. It may be that attenuation of both these components of the phobic experience is required to “cure” the phobia, as indeed psychologically based treatment strategies would suggest [34, 35]. …”

Section: Discussionmentioning

confidence: 99%

“The Mind Is Its Own Place”: Amelioration of Claustrophobia in Semantic Dementia

Clark

Downey

Golden

et al. 2014

Behavioural Neurology

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Phobias are among the few intensely fearful experiences we regularly have in our everyday lives, yet the brain basis of phobic responses remains incompletely understood. Here we describe the case of a 71-year-old patient with a typical clinicoanatomical syndrome of semantic dementia led by selective (predominantly right-sided) temporal lobe atrophy, who showed striking amelioration of previously disabling claustrophobia following onset of her cognitive syndrome. We interpret our patient's newfound fearlessness as an interaction of damaged limbic and autonomic responsivity with loss of the cognitive meaning of previously threatening situations. This case has implications for our understanding of brain network disintegration in semantic dementia and the neurocognitive basis of phobias more generally.

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“…Longitudinally, we could replicate effectiveness of computerised, one-session CBT for reducing subjective and behavioural measures of spider fear immediately following one-session treatment and further reduced until 1-month FU (Müller et al, 2011). Cognitive biases of avoidance and implicit fear evaluation were not affected by short computerised CBT treatment, however, which contrasts earlier work where a longer in-vivo setting was used (Reinecke et al, 2012). Results from exploratory analyses further showed that these cognitive biases at 1-day FU did not were more pronounced before treatment in the earlier study both on the EAST and the AAT.…”

Section: Discussionmentioning

confidence: 74%

“…Threat bias was assessed using the Extrinsic Affective Simon Task (EAST) and the Approach Avoidance Task (AAT) with fear-related stimuli that were used in previous research (Reinecke et al, 2010(Reinecke et al, , 2012Rinck & Becker, 2007) the images. This approach was validated in previous research and had shown that it decreased self-report (i.e., FSQ) and behavioural (i.e., BAT) spider fear post-treatment and until 1month FU when compared to non-treatment controls (Müller et al, 2011).…”

Section: Threat Bias Measuresmentioning

confidence: 99%

D-Cycloserine as Adjunct to Brief Computerised CBT for Spider Fear: Effects on Fear, Behaviour, and Cognitive Biases

Kappelmann

Suesse²,

Steudte-Schmiedgen³

et al. 2019

Preprint

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In anxiety disorders, cognitive behavioural therapy (CBT) improves information-processing biases such as implicit fear evaluations and avoidance tendencies, which predicts treatment response, so they might constitute important treatment targets. This study investigated (i) whether information-processing biases changed following single-session computerised CBT for spider fear, and (ii) whether this effect could be augmented by administration of Dcycloserine (DCS). Spider-fearful individuals were randomized to receiving 250mg of DCS (n=21) or placebo (n=17) and spider fear was assessed using self-report, behavioural, and information-processing (Extrinsic Affective Simon Task & Approach Avoidance Task) measures. Linear mixed-effects analyses indicated improvements on self-report and behavioural spider fear following CBT, but not on cognitive bias measures. There was no evidence of an augmentation effect of DCS on any outcome. Cognitive biases at 1-day were not predictive of 1-month follow-up spider fear. These findings provide no evidence for information-processing biases relating to CBT response or augmentation with DCS.

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Treatment sensitivity of implicit threat evaluation, avoidance tendency and visual working memory bias in specific phobia

Cited by 23 publications

References 31 publications

Implicit and explicit avoidance in sexual trauma victims suffering from posttraumatic stress disorder: a pilot study

Implicit and explicit avoidance in sexual trauma victims suffering from posttraumatic stress disorder: a pilot study

“The Mind Is Its Own Place”: Amelioration of Claustrophobia in Semantic Dementia

D-Cycloserine as Adjunct to Brief Computerised CBT for Spider Fear: Effects on Fear, Behaviour, and Cognitive Biases

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