Citation

Preusser F, Margraf J, Zlomuzica A. Neuropsychopharmacology 2017; 42(13): 2545-2552.

Affiliation

Mental Health Research and Treatment Center, Ruhr-University Bochum, Bochum, Germany.

Copyright

(Copyright © 2017, Nature Publishing Group)

DOI

10.1038/npp.2017.119

PMID

28589965

Abstract

Exposure therapy is highly effective in treating excessive fear related to specific objects and/or situations. However, patients with anxiety disorders often display a generalization of fear responses towards conceptually and perceptually related stimuli and situations. It is unclear whether the beneficial effects of exposure on fear reduction towards treated fear stimuli can extend to untreated fear stimuli. Here, we investigated whether basic principles of extinction generalization apply to exposure. Spider-phobic participants were randomly assigned to either two sessions of exposure treatment (n=23) with spiders or no-treatment (n=24). Prior to and after treatment, behavioral approach tests (BATs) were conducted to examine avoidance, fear and disgust responses towards the treated phobic stimulus (ie spider as the extinction stimulus). Likewise, BATs with the untreated fear stimulus (ie cockroaches) were conducted to dissect the generalization of treatment effects. Treatment was highly effective in increasing approach behavior towards both treated and untreated fear stimuli. Generalization of treatment effects were evident on the behavioral (approach distance during the BAT), subjective (fear levels during the BAT) and the psychophysiological level (heart rate during the BAT). However, a decline in disgust was only evident for the treated fear stimulus. Notably, the herein attained generalization effects were not context-dependent. Hence, exposure therapy for spider phobia was effective in reducing fear of untreated stimuli which share common fear-evoking characteristics with spiders but were never presented during the respective exposure treatment. These findings provide clinical evidence for extinction generalization across different fear-evoking stimuli mediated via exposure.Neuropsychopharmacology accepted article preview online, 07 June 2017. doi:10.1038/npp.2017.119.

Language: en