Running Head: MECHANISMS OF FEAR REDUCTIONAbstractMethodParticipantsExperimental DesignProcedureScreeningBehavior Approach Tests (BATs)BAT-2. The procedure for BAT-2 was similar to that for BAT-1. Participants were first instructed to look inside a filing cabinet measuring .91m by .43 m. by 1.98 m. for five sec., after which they completed a prediction questionnaire similar to that used for BAT-1. Next, participants were instructed to squeeze inside the cabinet and remain standing there with the door closed. Heart rate and length of time in the cabinet were again monitored. The maximum duration of BAT 2 was 2 min., although participants were not informed of this. If the participant remained in the cabinet for the full 2-min., the experimenter opened the door and instructed the participant to exit. Upon exiting, the participant completed a post-exposure questionnaire similar to that for BAT-1. Recovery HR data were collected for five min. while the participant sat in an adjacent room facing a public hallway with the door open.Treatment Procedures Common to All ConditionsExperimental conditionsAssessmentsOutcome IndicesProcess IndicesStatistical AnalysesAnalyses of Treatment ProcessTreatment Group EquivalenceManipulation CheckTreatment OutcomeWithin-Group Changes from Pre to PosttreatmentEffects of Treatment Condition on Fear ReductionGeneralization of Fear ReductionWithin Treatment EffectsEffects of Treatment Condition on Fear Reduction at Follow-upDiscussionAuthor NoteFootnotesFigure CaptionsFear Reduction 1Running Head: MECHANISMS OF FEAR REDUCTION Effects of Distraction and Guided Threat Reappraisal on theReduction of Claustrophobic FearJan H. Kamphuis1 and Michael J. Telch2The University of Texas at AustinBEHAVIOUR RESEARCH AND THERAPY (IN PRESS)Fear Reduction 2AbstractTo 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 cognitive load distracter task; (c) exposure with both guided threat re-appraisal and cognitive load distracter task; and (d) exposure without guided threat re-appraisal or cognitive load distracter task. It was 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 re-appraisal (regardless of cognitive load) had a facilitative effect. The greatest level of fear reduction and thelowest level of return of fear were observed in the exposure condition involving guided threat re-appraisal without cognitive load. Clinical implications and directions for future research are discussed.Fear Reduction 3Effects of Distraction and Guided Threat Reappraisal on theReduction of Claustrophobic FearThe experimental search for effective fear reduction techniques dates back to Watson and Rayner's paper on Little Albert (1920) and Mary Cover Jones' writings(1924) on fear extinction in children. Evidence accumulated over several decades and numerous domains of situationally bound fear has demonstrated the potency ofexposure-based methods in the treatment of phobic disorders (Barlow, 1988; Marks, 1978; Rachman 1978). Nevertheless, considerable debate still exists regarding the mechanisms governing the reduction of pathological fear. Rachman (1980) proposed a theoretical account of fear reduction based on emotional processing. He defined emotional processing as the decline of emotional disturbance to the extent that other experiences and behaviors proceed without disruption, and as a process that was dependent upon direct experiencing of the emotional disturbance. Signs of incomplete processing include return of fear and disturbing dreams. Based on Rachman’s emotional processing theory and Lang’s bioinformational theory of fear (Lang, 1977), Foa and Kozak (1986) outlined an emotional processing account of fear reduction that proposed two necessary conditions for emotional processing. First, the fear structure must be activated. The fear structureis construed as a set of propositions about the stimulus, the response (including thephysical, behavioral, and cognitive response systems), and interpretive information about the meaning of the stimulus and the response. Activation of the fear structure is believed to occur by providing information that matches a part of the network, as would an accelerated heart rate match the response proposition of fear. Through generalization of activation, the other sections of the networkFear Reduction 4become activated, particularly in the cohesive networks representative of specific phobias. According to Foa and Kozak (1986), a second necessary condition for emotional processing to occur is that information incompatible with elements of the fear structure must be made available and cognitively processed. Incompatible information is believed to emerge as a result of the experience of short-term, within-session physiological habituation. That is, reduction of arousal results in a disassociation between the stimulus and response propositions. As a result of repeated exposures, the perception of harm from the stimulus is lowered, as is the negative valence associated with the stimulus. These cognitive changes accruing from repeated disconfirmatory experience result in less drive for preparatory arousal, in turn resulting in between-session habituationAccordingly, factors which inhibit initial fear activation, or which interfere withphysiological habituation and cognitive change, should retard fear reduction. The factors identified by Foa and Kozak resemble the features suggested by Rachman (1981) as potentially interfering with complete emotional processing. These include personality factors, and stimulus factors that could impede emotional processing, with the latter category including concentration on a separate task and excessively brief presentations of the stimulus. To date, systematic investigations ofthese factors have been few and have focused primarily on the role of distraction. Several investigators have suggested that
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