Effect of multiple context exposure on renewal in spider phobia
Abstract
Background Renewal of fear is one form of relapse that occurs after successful exposure therapy as a result of an encounter with a feared object in a context different from the exposure context. The current study is the first to examine whether virtual reality (VR) exposure conducted in multiple contexts reduces the likelihood of renewal.Method Thirty spider-phobic patients were randomly allocated to one of two groups that were exposed to a virtual spider four times either in a single context or in multiple contexts. All participants completed a renewal test in a novel virtual context, and an in-vivo behavior avoidance test with a real spider before and after exposure.Results As reflected in the ratings, skin conductance level, and behavioral measures, the fear of spiders decreased significantly in both groups within and between the exposure trials and from pre to post exposure. Importantly, extinction in multiple contexts was able to significantly reduce renewal compared to extinction in a single context.Conclusions Based on highly controlled context manipulations using VR, this study was able to successfully transfer animal work to phobic patients. These findings strongly suggest that exposure in multiple contexts improves the generalizability of exposure to a new context. Consequently, we recommend the application of multiple context exposures in a clinical setting to reduce the likelihood of renewal. In addition, virtual reality was demonstrated to be a helpful tool for inducing contextual shifts during the exposures.
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In laboratory studies, using multiple contexts during exposure led to less renewal of fear in spider phobia and snake phobia than single-context exposure.
“In laboratory studies, the use of multiple contexts during exposure has led to less renewal of fear in those with spider phobia (Bandarian-Balooch, Neumann, & Boschen, 2015; Shiban, Pauli, & Mühlberger, 2013) and snake phobia (Olatunji, Tomarken, Wentworth, & Fritzsche, 2017) compared to those with whom exposure was conducted in a single context.”
From Enhancing Inhibitory Learning: The Utility of Variability in Exposure (2019) · cites this paper as Shiban, Pauli, & Mühlberger, 2013
There is fairly large variance in treatment outcomes between different VRET studies.
“However, there is fairly large variance in treatment outcomes between different VRET studies”
From Virtual reality exposure therapy for fear of spiders: an open trial and feasibility study of a new treatment for arachnophobia (2024) · cites this paper as [19]
VR/AR facilitates exposure to different contexts, producing a positive effect in terms of fear renewal and generalization of results.
“Regarding this last strategy, as mentioned above, VR/AR facilitates the exposure to different contexts, producing a positive effect in terms of fear renewal and generalization of results [75,76,87].”
From In Vivo versus augmented reality exposure in the treatment of small animal phobia: A randomized controlled trial (2016) · cites this paper as [75]
Exposure to multiple virtual contexts and multiple virtual phobic stimuli reduces the recurrence of fear to a greater extent than exposure to only one scenario and the same stimuli, making it possible to generalize the results.
“Results showed that exposure to multiple virtual contexts and multiple virtual phobic stimuli reduced the recurrence of fear to a greater extent than exposure to only one scenario and the same stimuli, making it possible to generalize the results.”
From In Vivo versus augmented reality exposure in the treatment of small animal phobia: A randomized controlled trial (2016) · cites this paper as [75]
The data from this study coincide with findings from studies where VR was used to treat specific phobia (animal subtype), where VR was effective in reducing fear and avoidance.
“Similarly, data from the present study also coincide with findings from studies where VR was used to treat SP (animal subtype), such as those by [31, 33–35,75,76]; where VR was effective in reducing the fear and avoidance experienced by the participants.”
From In Vivo versus augmented reality exposure in the treatment of small animal phobia: A randomized controlled trial (2016) · cites this paper as [75]
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- Authors
- Shiban, Y., Pauli, P., & Mühlberger, A.
- Affiliations
- University of Würzburg (DE)
- Corresponding author
- Mühlberger, Andreas
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 51
- Issue
- 2
- Pages
- 68-74
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W1997352122
- Cited by
- 162
- References
- 32
- Citations by year
- 2025: 6 · 2024: 8 · 2023: 15 · 2022: 9 · 2021: 22 · 2020: 10 · 2019: 20 · 2018: 19 · 2017: 15 · 2016: 8 · 2015: 17 · 2014: 7 · 2013: 6
- FWCI
- 12.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Julius-Maximilians-Universität Würzburg
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Keywords
- spider phobia, fear extinction, renewal, virtual reality exposure therapy, skin conductance, avoidance behavior, phobia treatment
- MeSH terms
- Adolescent, Adult, Analysis of Variance, Animals, Fear, Female, Humans, Male, Middle Aged, Phobic Disorders, Psychiatric Status Rating Scales, Spiders, Young Adult, Virtual Reality Exposure Therapy
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