The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
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, 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
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,766
Lobbestael, J., Leurgans, M., & Arntz, A. (2011) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.693 · Cited by 1,124
Demmel, R. (1999) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026//0084-5345.28.1.68 · Cited by 1,010
DIRECT MEASUREMENT OF SKIN CONDUCTANCE: A PROPOSAL FOR STANDARDIZATION
Lykken, D. T., & Venables, P. H. (1971) · Psychophysiology · doi:10.1111/j.1469-8986.1971.tb00501.x · Cited by 988
Van Breukelen, G. J. P. (2006) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.02.007 · Cited by 765
Treatment of specific phobia in adults
Choy, Y., Fyer, A. J., & Lipsitz, J. D. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.10.002 · Cited by 571 · cited 1×
“Nevertheless, working with these disorders is still a major challenge for clinicians because of the high risk of relapse (Choy et al., 2007; Lipsitz, Mannuzza, Klein, Ross, & Fyer, 1999).”
BackgroundVirtual reality exposure therapy of anxiety disorders: A review
Krijn, M., Emmelkamp, P. M. G., Olafsson, R. P., & Biemond, R. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.04.001 · Cited by 492
A retrieval cue for extinction attenuates spontaneous recovery.
Brooks, D. C., & Bouton, M. E. (1993) · Journal of Experimental Psychology Animal Behavior Processes · doi:10.1037/0097-7403.19.1.77 · Cited by 272
Conducting exposure treatment in multiple contexts can prevent relapse
Gunther, L. M., Denniston, J. C., & Miller, R. R. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)10019-5 · Cited by 210
Effects of varied-stimulus exposure training on fear reduction and return of fear
Rowe, M. K., & Craske, M. G. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)10017-1 · Cited by 202 · cited 1×
“However, addressing a related question, Rowe and Craske (1998) examined spider-phobic patients and reported that using multiple stimuli (different spiders) during extinction reduced renewal during a subsequent follow-up test 3 weeks later.”
BackgroundLang, S., Kroll, A., Lipinski, S. J., Wessa, M., Ridder, S., Christmann, C., Schad, L. R., & Flor, H. (2009) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2009.06624.x · Cited by 171
Virtual Reality Exposure Therapy for Post-Traumatic Stress Disorder and Other Anxiety Disorders
Gerardi, M., Cukor, J., Difede, J., Rizzo, A., & Rothbaum, B. O. (2010) · Current Psychiatry Reports · doi:10.1007/s11920-010-0128-4 · Cited by 154
Vansteenwegen, D., Vervliet, B., Iberico, C., Baeyens, F., Van den Bergh, O., & Hermans, D. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.08.023 · Cited by 148
Extinction in multiple contexts does not necessarily make extinction less vulnerable to relapse
Bouton, M. E., Garcı́a-Gutiérrez, A., Zilski-Pineño, J. M., & Moody, E. W. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.07.007 · Cited by 138
Massive extinction treatment attenuates the renewal effect
Denniston, J. C., Chang, R. C., & Miller, R. R. (2003) · Learning and Motivation · doi:10.1016/s0023-9690(02)00508-8 · Cited by 120
Attenuation of the Renewal Effect by Extinction in Multiple Contexts
Chelonis, J. J., Calton, J. L., Hart, J. A., & Schachtman, T. R. (1999) · Learning and Motivation · doi:10.1006/lmot.1998.1022 · Cited by 116
Mühlberger, A., Bülthoff, H., Wiedemann, G., & Pauli, P. (2007) · Psychological Assessment · doi:10.1037/1040-3590.19.3.340 · Cited by 101
Self-citationOne-session group treatment of spider phobia
Öst, L.-G. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(96)00022-8 · Cited by 97
Neumann, D. L., Lipp, O. V., & Cory, S. E. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.02.001 · Cited by 90
Extinction treatment in multiple contexts attenuates ABC renewal in humans
Bandarian‐Balooch, S., Neumann, D. L., & Boschen, M. J. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.06.003 · Cited by 80
Mühlberger, A., Weik, A., Pauli, P., & Wiedemann, G. (2005) · Psychotherapy Research · doi:10.1080/10503300500090944 · Cited by 68
Self-citationNeumann, D. L. (2005) · Learning and Motivation · doi:10.1016/j.lmot.2005.06.004 · Cited by 66
Bandarian‐Balooch, S., & Neumann, D. L. (2010) · Learning and Motivation · doi:10.1016/j.lmot.2010.08.008 · Cited by 65
Neumann, D. L., & Kitlertsirivatana, E. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.03.002 · Cited by 51
Extensive extinction in multiple contexts eliminates the renewal of conditioned fear in rats
Thomas, B. L., Vurbic, D., & Novak, C. (2008) · Learning and Motivation · doi:10.1016/j.lmot.2008.10.002 · Cited by 42
‘Nonspecific’ rather than ‘nonassociative’ pathways to phobias: a commentary on Poulton and Menzies
Davey, G. C. L. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00046-8 · Cited by 36
Associative Learning and Conditioning Theory
Laborda, M. A., McConnell, B. L., & Miller, R. R. (2011) · Cited by 36
Preventing Recovery From Extinction and Relapse
Miller, R. R., & Laborda, M. A. (2011) · Current Directions in Psychological Science · doi:10.1177/0963721411418466 · Cited by 34
Laborda, M. A., McConnell, B. L., & Miller, R. R. (2011) · ResearchOnline at James Cook University (James Cook University) · Cited by 22
van Breukelen, G. (2006) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.10.002 · Cited by 9
Lorberbaum (1999) · doi:10.1002/(sici)1520-6394(1999)10:3
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Diemer, J., Alpers, G. W., Peperkorn, H. M., Shiban, Y., & Mühlberger, A. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00026 · Cited by 959
“Here, VR has become established as a medium for investigating threat perception, fear, and exposure treatment (Mühlberger et al., 2007; Rothbaum, 2009; Opris et al., 2012; Glotzbach-Schoon et al., 2013; Shiban et al., 2013; Diemer et al., 2014).”
BackgroundInfluentialSelf-citationThe use of virtual reality technology in the treatment of anxiety and other psychiatric disorders
Maples-Keller, J. L., Bunnell, B. E., Kim, S.-J., & Rothbaum, B. O. (2017) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000138 · Cited by 862
Lonsdorf, T. B., Menz, M. M., Andreatta, M., Fullana, M. A., Golkar, A., Haaker, J., Heitland, I., Hermann, A., Kuhn, M., Kruse, O., et al. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.02.026 · Cited by 837
Self-citationValmaggia, L. R., Latif, L., Kempton, M. J., & Rus-Calafell, M. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.01.015 · Cited by 500
“…(Malbos et al., 2013; Meyerbroeker et al., 2013; Pelissolo et al., 2012; Penate-Castro et al., 2014; Pitti et al., 2015); social anxiety and fear of public speaking (Anderson et al., 2013; Safir et al., 2012); and spider phobia (Shiban et al., 2015a; Shiban et al., 2013; Shiban et al., 2015b).”
BackgroundRecent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review
Botella, C., Fernández-Álvarez, J., Guillén, V., García-Palacios, A., & Baños, R. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0788-4 · Cited by 460
Metadata
- 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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