Effects of distraction and guided threat reappraisal on fear reduction during exposure-based treatments for specific fears

Kamphuis, Jan H; Telch, Michael J

doi:10.1016/s0005-7967(99)00147-3

Cited by 158Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsPosttraumatic Stress Disorder Research

Effects of distraction and guided threat reappraisal on fear reduction during exposure-based treatments for specific fears

Kamphuis, Jan H, Telch, Michael J·2000·Behaviour Research and Therapy

DOI 10.1016/s0005-7967(99)00147-3

Open this paper in CoChat — free account

Abstract

To test predictions derived from the emotional processing theory of fear reduction, claustrophobics (N = 58) were randomized to one of four exposure conditions: (a) exposure with guided threat reappraisal, (b) exposure with a cognitive load distracter task, (c) exposure with both guided threat reappraisal and cognitive load distracter task and (d) exposure without guided threat reappraisal or cognitive load distracter task. We hypothesized that self-guided in vivo exposure would lead to less fear reduction if performed simultaneously with a cognitive load distracter task that severely taxes information processing resources. In contrast, we hypothesized that focusing on core threats during exposure would enhance fear reduction. The main findings were largely consistent with predictions. The cognitive load task (regardless of focus of available attention) had a detrimental effect on fear reduction, while guided threat reappraisal (regardless of cognitive load) had a facilitative effect. The greatest level of fear reduction and the lowest level of return of fear were observed in the exposure condition involving guided threat reappraisal without cognitive load. Clinical implications and directions for future research are discussed.

Integrity signals

Registry

Crossref · 10.1016/s0005-7967(99)00147-3

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Extinction learning is enhanced when distraction is minimal and cognitive loads are manageable.
“Indeed, extinction learning is enhanced when distraction is minimal and cognitive loads are manageable (e.g., Kamphuis & Telch, 2000).”
From How willing are you? Willingness as a predictor of change during treatment of adults with obsessive–compulsive disorder (2017) · cites this paper as Kamphuis & Telch, 2000

Emotional processing of fear: Exposure to corrective information.
Foa, E. B., & Kozak, M. J. (1986) · Psychological Bulletin · doi:10.1037/0033-2909.99.1.20 · Cited by 5,396 · see citing works
Conditioned emotional reactions.
Watson, J. B., & Rayner, R. (1920) · Journal of Experimental Psychology · doi:10.1037/h0069608 · Cited by 2,005 · see citing works
The effectiveness of psychotherapy: the Consumer Reports study
Seligman, M. E. P. (1995) · American Psychologist · doi:10.1037/0003-066x.50.12.965 · Cited by 1,608 · see citing works
The effectiveness of psychotherapy: The Consumer Reports study.
Seligman, M. E. P. (1995) · American Psychologist · doi:10.1037//0003-066x.50.12.965 · Cited by 1,591 · see citing works
Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic
Otto, M. (1989) · Psychosomatics · doi:10.1016/s0033-3182(89)72285-4 · Cited by 1,581 · see citing works
Emotional processing
Rachman, S. (1980) · Behaviour Research and Therapy · doi:10.1016/0005-7967(80)90069-8 · Cited by 657 · see citing works
Social phobia: the role of in-situation safety behaviors in maintaining anxiety and negative beliefs
Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (1995) · Behavior Therapy · doi:10.1016/s0005-7894(05)80088-7 · Cited by 548 · see citing works
A psychophysiological analysis of fear modification using an automated desensitization procedure
Lang, P. J., Melamed, B. G., & Hart, J. (1970) · Journal of Abnormal Psychology · doi:10.1037/h0029875 · Cited by 463 · see citing works
The Elimination of Children's Fears.
Jones, M. C. (1924) · Journal of Experimental Psychology · doi:10.1037/h0072283 · Cited by 419 · see citing works
The Effects of Psychological Therapy
(1980) · Elsevier eBooks · doi:10.1016/c2013-0-03226-4 · Cited by 394 · see citing works
An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia
Salkovskis, P. M., Clark, D. M., Hackmann, A., Wells, A., & Gelder, M. G. (1999) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00153-3 · Cited by 310 · see citing works
Analysis of change: Modeling individual growth.
Francis, D. J., Fletcher, J. M., Stuebing, K. K., Davidson, K. C., & al, E. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.59.1.27 · Cited by 275 · see citing works
The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation
Sloan, T., & Telch, M. J. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00007-9 · Cited by 223 · see citing works
Self-citation
Your Memory: A User's Guide
Baddeley, A. D. (1982) · Medical Entomology and Zoology · Cited by 216 · see citing works
Analysis of change: Modeling individual growth.
Francis, D. J., Fletcher, J. M., Stuebing, K. K., Davidson, K. C., & Thompson, N. M. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.27 · Cited by 183 · see citing works
Habituation during exposure treatment: distraction vs attention-focusing
Grayson, J. B., Foa, E. B., & Steketee, G. (1982) · Behaviour Research and Therapy · doi:10.1016/0005-7967(82)90091-2 · Cited by 183 · see citing works
Are intrusive thoughts subject to habituation?
Parkinson, L., & Rachman, S. (1980) · Behaviour Research and Therapy · doi:10.1016/0005-7967(80)90006-6 · Cited by 177 · see citing works
Using growth modeling to examine systematic differences in growth: An example of change in the functioning of families at risk of maladaptive parenting, child abuse, or neglect.
Willett, J. B., AYOUB, C. C., & Robinson, D. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.59.1.38 · Cited by 108 · see citing works
On paradigms and recycled ideologies
Bandura, A. (1978) · Cognitive Therapy and Research · doi:10.1007/bf01172518 · Cited by 92 · see citing works
Instructions to focus upon or distract from internal cues during exposure treatment of agoraphobic avoidance
Craske, M. G., Street, L., & Barlow, D. H. (1989) · Behaviour Research and Therapy · doi:10.1016/0005-7967(89)90150-2 · Cited by 89 · see citing works
A critique of the theoretical bases of cognitive behavioral theories and therapy
Beidel, D. C., & Turner, S. M. (1986) · Clinical Psychology Review · doi:10.1016/0272-7358(86)90011-5 · Cited by 85 · see citing works
The effects of distraction during exposure to phobic stimuli
Rodriguez, B. I., & Craske, M. G. (1993) · Behaviour Research and Therapy · doi:10.1016/0005-7967(93)90106-5 · Cited by 81 · see citing works
Exposure in vivo of obsessive—compulsives under distracting and attention-focusing conditions: replication and extension
Grayson, J. B., Foa, E. B., & Steketee, G. S. (1986) · Behaviour Research and Therapy · doi:10.1016/0005-7967(86)90013-6 · Cited by 71 · see citing works
The facilitative effects of heart-rate feedback in the emotional processing of claustrophobic fear
Telch, M. J., Valentiner, D. P., Ilai, D., Petruzzi, D., & Hehmsoth, M. M. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00038-8 · Cited by 55 · see citing works
Self-citation
Cognitive mechanisms in claustrophobia: An examination of reiss and McNally's expectancy model and Bandura's self-efficacy theory
Valentiner, D. P., Telch, M. J., Petruzzi, D. C., & Bolte, M. C. (1996) · Cognitive Therapy and Research · doi:10.1007/bf02227963 · Cited by 45 · see citing works
Self-citation
Consequences of Increasing the Functional Impact of Internal Emotional Stimuli
Borkovec, T. D., & Grayson, J. B. (1980) · Springer eBooks · doi:10.1007/978-1-4684-3782-9_6 · Cited by 33 · see citing works
On the Need for a Basic Science Approach to Psychotherapy Research
Borkovec, T. D. (1997) · Psychological Science · doi:10.1111/j.1467-9280.1997.tb00398.x · Cited by 16 · see citing works

Flagged first, then by citations

Sorted by citations

Optimizing inhibitory learning during exposure therapy
Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.10.003 · Cited by 1,607 · see citing works
Comorbidity: a network perspective
Cramer, A. O. J., Waldorp, L. J., van der Maas, H. L. J., & Borsboom, D. (2010) · Behavioral and Brain Sciences · doi:10.1017/s0140525x09991567 · Cited by 1,575 · see citing works
Toward a unified treatment for emotional disorders
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80036-4 · Cited by 1,430 · see citing works
Major Depression as a Complex Dynamic System
Cramer, A. O. J., van Borkulo, C. D., Giltay, E. J., van der Maas, H. L. J., Kendler, K. S., Scheffer, M., & Borsboom, D. (2016) · PLoS ONE · doi:10.1371/journal.pone.0167490 · Cited by 563 · see citing works
Toward a unified treatment for emotional disorders - republished Article
Barlow, D. H., Allen, L. B., & Choate, M. L. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.11.005 · Cited by 536 · see citing works
Psychological approaches in the treatment of specific phobias: A meta-analysis
Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B., & Telch, M. J. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2008.02.007 · Cited by 530 · see citing works
Self-citation
The ecology of human fear: survival optimization and the nervous system
Mobbs, D., Hagan, C. C., Dalgleish, T., Silston, B., & PrÃ©vost, C. (2015) · Frontiers in Neuroscience · doi:10.3389/fnins.2015.00055 · Cited by 498 · see citing works
Emotion regulation and anxiety disorders
Amstadter, A. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.02.004 · Cited by 417 · see citing works
The effects of acceptance versus control contexts on avoidance of panic-related symptoms
Eifert, G. H., & Heffner, M. (2003) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2003.11.001 · Cited by 375 · see citing works
The effect of a single-session attention modification program on response to a public-speaking challenge in socially anxious individuals
Amir, N., Weber, G., Beard, C., Bomyea, J., & Taylor, C. T. (2008) · Journal of Abnormal Psychology · doi:10.1037/a0013445 · Cited by 356 · see citing works
What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment
Moscovitch, D. A. (2009) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2008.04.002 · Cited by 322 · see citing works
The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation
Sloan, T., & Telch, M. J. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00007-9 · Cited by 223 · see citing works
Self-citation
Tolerate or eliminate? A systematic review on the effects of safety behavior across anxiety disorders.
Helbig‐Lang, S., & Petermann, F. (2010) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2010.01213.x · Cited by 216 · see citing works
Return of fear in a human differential conditioning paradigm caused by a return to the original acquistion context
Vansteenwegen, D., Hermans, D., Vervliet, B., Francken, G., Beckers, T., Baeyens, F., & Eelen, P. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.01.001 · Cited by 188 · see citing works
Does engagement with exposure yield better outcomes? Components of presence as a predictor of treatment response for virtual reality exposure therapy for social phobia
Price, M., Mehta, N., Tone, E. B., & Anderson, P. L. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.03.004 · Cited by 187 · see citing works
The effects of safety behaviors during exposure therapy for anxiety: Critical analysis from an inhibitory learning perspective
Blakey, S. M., & Abramowitz, J. S. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.07.002 · Cited by 186 · see citing works
Dissociation of within- and between-Session Extinction of Conditioned Fear
Plendl, W., & Wotjak, C. T. (2010) · Journal of Neuroscience · doi:10.1523/jneurosci.6038-09.2010 · Cited by 148 · see citing works
Confirmatory factor and measurement invariance analyses of the emotion regulation questionnaire
Melka, S. E., Lancaster, S. L., Bryant, A. R., & Rodriguez, B. F. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20836 · Cited by 149 · see citing works
The effect of the decreased safety behaviors on anxiety and negative thoughts in social phobics
Kim, E. (2004) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2003.11.002 · Cited by 144 · see citing works
Time course of emotion-related responding during distraction and reappraisal
Schönfelder, S., Kanske, P., Heissler, J., & Wessa, M. (2013) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nst116 · Cited by 143 · see citing works
Cognitive-behavioral therapy for the treatment of anxiety disorders.
Otto, M. W., Smits, J. A. J., & Reese, H. E. (2004) · PubMed · Cited by 136 · see citing works
The regulation of emotions in adolescents: Age differences and emotion-specific patterns
Theurel, A., & Gentaz, E. (2018) · PLOS ONE · doi:10.1371/journal.pone.0195501 · Cited by 139 · see citing works
Enhancing exposure therapy for anxiety disorders with glucocorticoids: From basic mechanisms of emotional learning to clinical applications
Bentz, D., Michael, T., de Quervain, D. J. ‐., & Wilhelm, F. H. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.10.011 · Cited by 136 · see citing works
Claustrophobia and Adherence to CPAP Treatment
Chasens, E. R., Pack, A. I., Maislin, G., Dinges, D. F., & Weaver, T. E. (2005) · Western Journal of Nursing Research · doi:10.1177/0193945904273283 · Cited by 136 · see citing works
Managing unwanted intrusive thoughts in obsessive–compulsive disorder: Relative effectiveness of suppression, focused distraction, and acceptance
Najmi, S., Riemann, B. C., & Wegner, D. M. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.02.015 · Cited by 133 · see citing works
fMRI neurofeedback facilitates anxiety regulation in females with spider phobia
Zilverstand, A., Sorger, B., Sarkheil, P., & Goebel, R. (2015) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2015.00148 · Cited by 133 · see citing works
Randomized Controlled Trial of False Safety Behavior Elimination Therapy: A Unified Cognitive Behavioral Treatment for Anxiety Psychopathology
Schmidt, N. B., Buckner, J. D., Pusser, A., Woolaway-Bickel, K., Preston, J. L., & Norr, A. (2012) · Behavior Therapy · doi:10.1016/j.beth.2012.02.004 · Cited by 126 · see citing works
Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach
Weisman, J. S., & Rodebaugh, T. L. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.10.010 · Cited by 117 · see citing works
Therapeutic process during exposure: Habituation model
Benito, K. G., & Walther, M. (2015) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2015.01.006 · Cited by 125 · see citing works
An examination of the decline in fear and disgust during exposure-based treatment
Smits, J. A. J., Telch, M. J., & Randall, P. K. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00094-8 · Cited by 142 · see citing works
Self-citation
Attention to phobic stimuli during exposure: the effect of distraction on anxiety reduction, self-efficacy and perceived control
Johnstone, K. A., & Page, A. C. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00137-2 · Cited by 114 · see citing works
Common pitfalls in exposure and response prevention (EX/RP) for OCD
Gillihan, S. J., Williams, M. T., Malcoun, E., Yadin, E., & Foa, E. B. (2012) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2012.05.002 · Cited by 114 · see citing works
A systematic review of behavioral experiments vs. exposure alone in the treatment of anxiety disorders: A case of exposure while wearing the emperor's new clothes?
McMillan, D., & Lee, R. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.01.003 · Cited by 108 · see citing works
Intensive one-session treatment of specific phobias
Davis, T. E., Ollendick, T., & Öst, L.-G. (2012) · Autism and child psychopathology series · doi:10.1007/978-1-4614-3253-1 · Cited by 79 · see citing works
Factors influencing the success of exposure therapy for specific phobia: a systematic review
Böhnlein, J., Altegoer, L., Muck, N. K., Roesmann, K., Redlich, R., Dannlowski, U., & Leehr, E. J. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.12.009 · Cited by 98 · see citing works
When to throw the switch: The adaptiveness of modifying emotion regulation strategies based on affective and physiological feedback.
Birk, J. L., & Bonanno, G. A. (2016) · Emotion · doi:10.1037/emo0000157 · Cited by 96 · see citing works
A Preliminary Examination of Thought Suppression, Emotion Regulation, and Coping in a Trauma-Exposed Sample
Amstadter, A. B., & Vernon, L. L. (2008) · Journal of Aggression, Maltreatment & Trauma · doi:10.1080/10926770802403236 · Cited by 90 · see citing works
Measuring fear change within exposures: Functionally-defined habituation predicts outcome in three randomized controlled trials for pediatric OCD
Benito, K. G., Machan, J., Freeman, J. B., Garcia, A. M., Walther, M., Frank, H., Wellen, B., Stewart, E., Edmunds, J., Kemp, J., et al. (2018) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000315 · Cited by 73 · see citing works
Emotional processing theory put to test: A meta‐analysis on the association between process and outcome measures in exposure therapy
Rupp, C., Doebler, P., Ehring, T., & Vossbeck‐Elsebusch, A. N. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2039 · Cited by 76 · see citing works
Vigilant and avoidant attention biases as predictors of response to cognitive behavioral therapy for social phobia
Price, M., Tone, E. B., & Anderson, P. L. (2011) · Depression and Anxiety · doi:10.1002/da.20791 · Cited by 76 · see citing works
Predicting rapid response to cognitive-behavioural treatment for panic disorder: The role of hippocampus, insula, and dorsolateral prefrontal cortex
Reinecke, A., Thilo, K., Filippini, N., Croft, A., & Harmer, C. J. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.07.017 · Cited by 75 · see citing works
The effect of attributional processes concerning medication taking on return of fear.
Powers, M. B., Smits, J. A. J., Whitley, D., Bystritsky, A., & Telch, M. J. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.3.478 · Cited by 75 · see citing works
Self-citation
Anxiety-control strategies: Is there room for neutralization in successful exposure treatment?
Parrish, C. L., Radomsky, A. S., & Dugas, M. J. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2008.07.007 · Cited by 73 · see citing works
Effects of Post-Session Administration of Methylene Blue on Fear Extinction and Contextual Memory in Adults With Claustrophobia
Telch, M. J., Bruchey, A. K., Rosenfield, D., Cobb, A. R., Smits, J. A. J., Pahl, S. A., & Gonzalez-Lima, F. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2014.13101407 · Cited by 73 · see citing works
Self-citation
Does change in distress matter? Mechanisms of change in prolonged exposure for PTSD
Bluett, E. J., Zoellner, L. A., & Feeny, N. C. (2014) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2013.09.003 · Cited by 71 · see citing works
“…that between-session habituation is an indicator of successful treatment outcome (e.g., Grayson, Foa, & Steketee, 1982; Jaycox, Foa, & Morral, 1998; Kamphuis & Telch, 2000; Kozak, Foa, & Steketee, 1988; van Minnen & Hagenaars, 2002; Rauch, Foa, Furr, & Filip, 2004; Telch et al., 2004), there is a…”
Fear activation and distraction during the emotional processing of claustrophobic fear
Telch, M. J., Valentiner, D. P., Ilai, D., Young, P. R., Powers, M. B., & Smits, J. A. J. (2004) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2004.03.004 · Cited by 71 · see citing works
Self-citation
Direction of threat attention bias predicts treatment outcome in anxious children receiving cognitive-behavioural therapy
Waters, A. M., Mogg, K., & Bradley, B. P. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.03.006 · Cited by 68 · see citing works
Is There Room for Safety Behaviors in Exposure Therapy for Anxiety Disorders?
Telch, M. J., & Lancaster, C. L. (2012) · Springer eBooks · doi:10.1007/978-1-4614-3342-2_18 · Cited by 65 · see citing works
Self-citation
Clients’ Experiences of Disengaged Moments in Psychotherapy: A Grounded Theory Analysis
Frankel, Z., & Levitt, H. M. (2008) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-008-9087-z · Cited by 63 · see citing works
Neural correlates of immediate and prolonged effects of cognitive reappraisal and distraction on emotional experience
Hermann, A., Kress, L., & Stark, R. M. (2016) · Brain Imaging and Behavior · doi:10.1007/s11682-016-9603-9 · Cited by 63 · see citing works
Does the judicious use of safety behaviors improve the efficacy and acceptability of exposure therapy for claustrophobic fear?
Deacon, B. J., Sy, J. T., Lickel, J. J., & Nelson, E. A. (2010) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2009.10.004 · Cited by 82 · see citing works
Failure to replicate the deleterious effects of safety behaviors in exposure therapy
Sy, J. T., Dixon, L. J., Lickel, J. J., Nelson, E. A., & Deacon, B. J. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.02.005 · Cited by 61 · see citing works
Enhancing Inhibitory Learning: The Utility of Variability in Exposure
Knowles, K. A., & Olatunji, B. O. (2019) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.12.001 · Cited by 60 · see citing works
False safety behavior elimination therapy: A randomized study of a brief individual transdiagnostic treatment for anxiety disorders
Riccardi, C. J., Korte, K. J., & Schmidt, N. B. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.06.003 · Cited by 55 · see citing works
Augmenting In Vivo Exposure With Fear Antagonistic Actions: A Preliminary Test⁎⁎We would like to thank David Seivers and Mind Alive, Inc., for supplying the D.A.V.I.D. devices used to conduct the APS treatment and to Melody Otto, Heather Zapalac, Andrea Cubriel, Brian Coquyt, and Mealika Brown for their assistance with data collection.Portions of these data were previously presented at the 2004 annual meeting of the Association for the Advancement of Behavior Therapy.This research was conducted in partial fulfillment of the Masters of Arts in Psychology for the first author (KBW) under the supervision of the senior author (MJT).
Wolitzky-Taylor, K. B., & Telch, M. J. (2008) · Behavior Therapy · doi:10.1016/j.beth.2007.12.006 · Cited by 56 · see citing works
Self-citation
Clinical perspectives on the combination of D-cycloserine and cognitive-behavioral therapy for the treatment of anxiety disorders.
Otto, M. W., Basden, S. L., Leyro, T. M., McHugh, R. K., & Hofmann, S. G. (2007) · CNS Spectrums · doi:10.1017/s1092852900020526 · Cited by 53 · see citing works
How willing are you? Willingness as a predictor of change during treatment of adults with obsessive–compulsive disorder
Reid, A. M., Garner, L. E., Van Kirk, N., Gironda, C., Krompinger, J. W., Brennan, B. P., Mathes, B. M., Monaghan, S. C., Tifft, E. D., André, M.-C., et al. (2017) · Depression and Anxiety · doi:10.1002/da.22672 · Cited by 52 · see citing works
And yet they correlate: Psychophysiological activation predicts self-report outcomes of exposure therapy in claustrophobia
Alpers, G. W., & Sell, R. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.11.009 · Cited by 52 · see citing works
Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? a pilot study
Shiban, Y., Diemer, J., Müller, J., Brütting, J., Pauli, P., & Mühlberger, A. (2017) · BMC Psychiatry · doi:10.1186/s12888-016-1181-2 · Cited by 52 · see citing works
Effects of safety behavior fading on appearance concerns and related symptoms.
Wilver, N. L., Summers, B. J., & Cougle, J. R. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000453 · Cited by 50 · see citing works
Perceptual and conceptual processing as predictors of treatment outcome in PTSD
Kindt, M., Buck, N. M. L., Arntz, A. R., & Soeter, M. (2007) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2007.10.002 · Cited by 50 · see citing works
A Critical Review of Attentional Threat Bias and Its Role in the Treatment of Pediatric Anxiety Disorders
Roy, A. K., Dennis, T. A., & Warner, C. M. (2015) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.29.3.171 · Cited by 48 · see citing works
The functional value of preventive and restorative safety behaviors: A systematic review of the literature
Goetz, A. R., Davine, T. P., Siwiec, S. G., & Lee, H. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.12.005 · Cited by 48 · see citing works
Use of a Brief Fear Memory Reactivation Procedure for Enhancing Exposure Therapy
Telch, M. J., York, J., Lancaster, C. L., & Monfils, M. H. (2017) · Clinical Psychological Science · doi:10.1177/2167702617690151 · Cited by 40 · see citing works
Self-citation
Updating Watson & Marks (1971): How Has Our Understanding of the Mechanisms of Extinction Learning Evolved and Where Is Our Field Going Next?
Asnaani, A., McLean, C. P., & Foa, E. B. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.02.003 · Cited by 41 · see citing works
Translational research perspectives on maximizing the effectiveness of exposure therapy
Powers, M. B., Smits, J. A. J., Leyro, T. M., & Otto, M. W. (2007) · Elsevier eBooks · doi:10.1016/b978-012587421-2/50005-3 · Cited by 40 · see citing works
Mechanisms of Change in Exposure Therapy for Anxiety and Related Disorders: A Research Agenda
Benito, K., Pittig, A., Abramowitz, J. S., Arch, J. J., Chavira, D. A., de Kleine, R. A., Nadai, A. S. D., Hermans, D., Hofmann, S. G., Hoyer, J., et al. (2024) · Clinical Psychological Science · doi:10.1177/21677026241240727 · Cited by 37 · see citing works
Self-citation
Inhibitory Learning for Anxiety-Related Disorders
Tolin, D. F. (2018) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2018.07.008 · Cited by 35 · see citing works
Effects of internal and external distraction and focus during exposure to blood-injury-injection stimuli
Oliver, N. S., & Page, A. C. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.01.006 · Cited by 36 · see citing works
Translating Empirically Supported Strategies Into Accessible Interventions: The Potential Utility of Exercise for the Treatment of Panic Disorder
Smits, J. A. J., Powers, M. B., Berry, A. C., & Otto, M. W. (2007) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2006.07.005 · Cited by 33 · see citing works
Does neuroscience hold promise for the further development of behavior therapy? The case of emotional change after exposure in anxiety and depression
Raedt, R. D. (2006) · Scandinavian Journal of Psychology · doi:10.1111/j.1467-9450.2006.00511.x · Cited by 32 · see citing works
tDCS-Augmented in vivo exposure therapy for specific fears: A randomized clinical trial.
Cobb, A. R., O'Connor, P., Zaizar, E., Caulfield, K., Gonzalez-Lima, F., & Telch, M. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102344 · Cited by 26 · see citing works
Self-citation
Coping when pain is a potential threat: The efficacy of acceptance versus cognitive distraction
Jackson, T., Yang, Z., Li, X., Chen, H., Huang, X., & Meng, J. (2011) · European Journal of Pain · doi:10.1002/j.1532-2149.2011.00019.x · Cited by 32 · see citing works
Attentional control moderates fearful responding to a 35% CO(2) challenge.
Richey, J., Keough, M., & Schmidt, N. B. (2012) · The Behavior Therapist · doi:10.1016/j.beth.2011.06.004 · Cited by 37 · see citing works
Attention focusing versus distraction during exposure in dental phobia
Schmid-Leuz, B., Elsesser, K., Lohrmann, T., Jöhren, P., & Sartory, G. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.07.004 · Cited by 30 · see citing works
Optimal attentional focus during exposure in specific phobia: A meta-analysis
Podina, I. R., Koster, E. H. W., Philippot, P., Dethier, V., & David, D. O. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.10.002 · Cited by 25 · see citing works
Failure to loose fear: The impact of cognitive load and trait anxiety on extinction
Raes, A. K., Raedt, R. D., Verschuère, B., & Houwer, J. D. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.08.002 · Cited by 25 · see citing works
Variability in emotion regulation in paediatric obsessive-compulsive disorder: Associations with symptom presentation and response to treatment
McKenzie, M. L., Donovan, C. L., Mathieu, S. L., Hyland, W. J., & Farrell, L. J. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100502 · Cited by 23 · see citing works
Individual differences in cognitive reappraisal usage modulate the time course of brain activation during symptom provocation in specific phobia
Hermann, A., Leutgeb, V., Scharmüller, W., Vaitl, D., Schienle, A., & Stark, R. M. (2013) · Biology of Mood & Anxiety Disorders · doi:10.1186/2045-5380-3-16 · Cited by 23 · see citing works
Mechanisms of action underlying virtual reality exposure treatment in spider phobia: Pivotal role of within-session fear reduction.
Roesmann, K., Leehr, E., Böhnlein, J., Gathmann, B., Herrmann, M. J., Junghöfer, M., Schwarzmeier, H., Seeger, F., Siminski, N., Straube, T., et al. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2023.102790 · Cited by 15 · see citing works
Avoiding Treatment Failures in Specific Phobias
Alpers, G. W. (2009) · Springer eBooks · doi:10.1007/978-1-4419-0612-0_12 · Cited by 22 · see citing works
Safety aid use and social anxiety symptoms: The mediating role of perceived control
Korte, K. J., Unruh, A. S., Oglesby, M. E., & Schmidt, N. B. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.06.006 · Cited by 20 · see citing works
On the Nature and Treatment of Scrupulosity
Deacon, B. J., & Nelson, E. A. (2008) · Pragmatic Case Studies in Psychotherapy · doi:10.14713/pcsp.v4i2.932 · Cited by 19 · see citing works
Empirically supported psychological treatments and the Research Domain Criteria (RDoC)
McKay, D., & Tolin, D. F. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.10.018 · Cited by 17 · see citing works
Augmenting exposure therapy with pre-extinction fear memory reactivation and deepened extinction: A randomized controlled trial
Lancaster, C. L., Monfils, M., & Telch, M. J. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103730 · Cited by 17 · see citing works
Self-citation
Exposure therapy for phobias
Hirai, M., Vernon, L. L., & Cochran, H. M. (2007) · Elsevier eBooks · doi:10.1016/b978-012587421-2/50012-0 · Cited by 6 · see citing works
The effect of very brief exposure on experienced fear after in vivo exposure
Siegel, P., & Warren, R. (2013) · Cognition & Emotion · doi:10.1080/02699931.2012.756803 · Cited by 13 · see citing works
Optimizing Exposure Therapy for Pathological Health Anxiety: Considerations From the Inhibitory Learning Approach
Gropalis, M., Witthöft, M., Bailer, J., & Weck, F. (2017) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2017.09.001 · Cited by 14 · see citing works
Exposure Therapy
Telch, M. J., Cobb, A. R., & Lancaster, C. L. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch35 · Cited by 14 · see citing works
Self-citation
Effects of verbal instructions and physical threat removal prior to extinction training on the return of conditioned fear
Wendt, J., Hufenbach, M. C., König, J., & Hamm, A. O. (2020) · Scientific Reports · doi:10.1038/s41598-020-57934-7 · Cited by 14 · see citing works
Ethical Issues When Considering Exposure
Wolitzky-Taylor, K. B., Viar-Paxton, M. A., & Olatunji, B. O. (2012) · Autism and child psychopathology series · doi:10.1007/978-1-4614-3253-1_10 · Cited by 12 · see citing works
Exposure Therapy: Promoting Emotional Processing of Pathological Anxiety
Zalta, A. K., & Foa, E. B. (2012) · doi:10.1002/9781118470886.ch4 · Cited by 13 · see citing works
Claustrophobia: Efficacy and Treatment Protocols
Wiederhold, B. K., & Bouchard, S. (2014) · Springer eBooks · doi:10.1007/978-1-4899-8023-6_7 · Cited by 12 · see citing works
Combining Cognitive-Behavioral Therapy and Pharmacotherapy for the Treatment of Panic Disorder
Smits, J. A. J., O’Cleirigh, C. M., & Otto, M. W. (2006) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.20.1.75 · Cited by 12 · see citing works
Modulation of threat extinction by working memory load: An event-related potential study
Cheng, Y., Jackson, T. B., & MacNamara, A. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104031 · Cited by 11 · see citing works
Masking exposure to phobic stimuli reduces fear without inducing electrodermal activity
Siegel, P. F., Warren, R., Jacobson, G., & Merritt, E. (2017) · Psychophysiology · doi:10.1111/psyp.13045 · Cited by 11 · see citing works
Clinicians’ perspectives of interfering behaviors in the treatment of anxiety and obsessive-compulsive disorders in adults and children
Davis, M. L., Fletcher, T. L., McIngvale, E., Cepeda, S. L., Schneider, S. C., Buissonnière-Ariza, V. L., Egberts, J., Goodman, W. K., & Storch, E. A. (2019) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2019.1579857 · Cited by 11 · see citing works
Comparison of patient-reported distress during harm avoidance and incompleteness exposure tasks for youth with OCD
Milgram, L., Sheehan, K. G., Cain, G. H., Carper, M. M., O’Connor, E., Freeman, J. B., Garcia, A. M., Case, B. G., & Benito, K. (2022) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2022.100760 · Cited by 9 · see citing works
Examining parent-report of Children's emotion regulation in paediatric OCD: Associations with symptom severity, externalising behaviour and family accommodation
McKenzie, M. L., Donovan, C. L., Zimmer‐Gembeck, M. J., Waters, A. M., Mathieu, S. L., & Farrell, L. J. (2020) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2020.100508 · Cited by 9 · see citing works
Enhanced Mental Reinstatement of Exposure to Improve Extinction Generalization: A Study on Claustrophobia and MRI Fear
Carpenter, J. K., Moskow, D. M., & Hofmann, S. G. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.08.002 · Cited by 8 · see citing works

The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation
Sloan, T., & Telch, M. J. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00007-9 · Cited by 223 · see citing works
Self-citation
Fear activation and distraction during the emotional processing of claustrophobic fear
Telch, M. J., Valentiner, D. P., Ilai, D., Young, P. R., Powers, M. B., & Smits, J. A. J. (2004) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2004.03.004 · Cited by 71 · see citing works
Self-citation
Intervention
(2016)
The effect of distraction on fear reduction during In Vivo exposure for Spider-fearful individuals: Exploring the relationship between fear level and distraction load
Ellis, S. A. T. (2012) · Murdoch University Research Portal · Cited by 1 · see citing works
Guided threat focus and reappraisal was better than safety seeking behaviour for reducing fear in claustrophobia
Richardson, P., & Holland, A. (2002) · Evidence-Based Mental Health · doi:10.1136/ebmh.5.3.86

Authors: Kamphuis, J. H., & Telch, M. J.
Affiliations: The University of Texas at Austin (US)
Corresponding author: Kamphuis, Jan H
ORCID: Kamphuis, Jan H
Telch, Michael J
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2000-12
Volume: 38
Issue: 12
Pages: 1163-1181
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/s0005-7967(99)00147-3
OpenAlex: W2148093646
Cited by: 158
References: 27
Citations by year: 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 5 · 2018: 5 · 2017: 10 · 2016: 9 · 2015: 8 · 2014: 7 · 2013: 8 · 2012: 13
FWCI: 2.71
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords: fear reduction, distraction, cognitive load, claustrophobia, exposure therapy, emotional processing theory, return of fear, in vivo exposure, attentional focus
MeSH terms: Adolescent, Adult, Analysis of Variance, Desensitization, Psychologic, Fear, Female, Habituation, Psychophysiologic, Humans, Male, Models, Psychological, Phobic Disorders, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome, Imagery, Psychotherapy

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 ›

Are you an author, or do you see a problem with this page? Request a review

Effects of distraction and guided threat reappraisal on fear reduction during exposure-based treatments for specific fears

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks