Fear reactivation prior to exposure therapy: Does it facilitate the effects of VR exposure in a randomized clinical sample?
Abstract
Background and objectives The current study is the first to examine whether reactivation of fear memory prior to exposure therapy reduces relapse in a randomized clinical sample.Methods In a standardized treatment protocol combining virtual reality and in-vivo exposure, patients underwent a fear reactivation procedure using a virtual spider 10 min prior to a virtual reality (VR) exposure (reactivation group: RG, n = 15). A control group (CG, n = 17) was exposed to a virtual plant 10 min prior to the VR exposure. Outcome measures were a VR spontaneous recovery test (SRT) and in-vivo a behavioral avoidance test assessed 24 h after VR exposure. One week later an in-vivo exposure session followed. Additionally, a follow-up using psychometric assessment was conducted six months after the first session.Results Both groups benefitted significantly and equally from the combined treatment, and importantly, the SRT revealed no return of fear in both groups. Furthermore, follow-up tests showed long-term treatment effects with no group differences.Limitations Due to different study components (VR treatment and in-vivo), we were not able to determine which treatment module was mainly responsible for the long-term treatment effect. Furthermore, no direct measure of memory destabilization was possible in this study.Conclusions Our treatment package was highly effective in reducing phobic fear up to 6 months following treatment. Explicit fear reactivation prior to exposure was not beneficial in VR exposure treatment, possibly due to a failure to induce a memory destabilization or due to an implicit fear reactivation prior to treatment in both groups.
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Fear reactivation prior to exposure had no effect on treatment outcomes.
“These studies found no effect of fear reactivation prior to exposure on treatment outcomes”
From Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review (2017) · cites this paper as [76]
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- Authors
- Shiban, Y., Brütting, J., Pauli, P., & Mühlberger, A.
- Affiliations
- University of Regensburg (DE)
- University of Würzburg (DE)
- Corresponding author
- Mühlberger, Andreas
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 46
- Pages
- 133-140
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W1967729120
- Semantic Scholar
- ec72585241a6bafe7f80a96f72a8d754fbe49486
- Cited by
- 60
- References
- 40
- Citations by year
- 2025: 4 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 8 · 2019: 6 · 2018: 11 · 2017: 8 · 2016: 4 · 2015: 2
- FWCI
- 6.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- virtual reality exposure therapy, phobia treatment, memory destabilization, relapse prevention, spontaneous recovery, avoidance behavior, memory reconsolidation, spider phobia, long-term treatment outcomes
- MeSH terms
- Adolescent, Adult, Analysis of Variance, Animals, Fear, Female, Follow-Up Studies, Galvanic Skin Response, Humans, Implosive Therapy, Male, Middle Aged, Phobic Disorders, Psychometrics, Surveys and Questionnaires, Spiders, Young Adult, Virtual Reality Exposure Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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