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Effects of distraction and guided threat reappraisal on fear reduction during exposure-based treatments for specific fears
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.
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“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
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Metadata
- Authors
- Kamphuis, J. H., & Telch, M. J.
- Affiliations
- The University of Texas at Austin (US)
- Corresponding author
- Kamphuis, Jan H
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2000-12
- Volume
- 38
- Issue
- 12
- Pages
- 1163-1181
- ISSN
- 0005-7967 (ISSN-L)
- 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
- 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
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