Can Rachman's indirect pathways be used to un-learn fear? A prospective paradigm to test whether children's fears can be reduced using positive information and modelling a non-anxious response

This study investigated whether children's fears could be un-learned using Rachman's indirect pathways for learning fear. We hypothesised that positive information and modelling a non-anxious response are effective methods of un-learning fears acquired through verbal information. One hundred and seven children aged 6-8 years received negative information about one animal and no information about another. Fear beliefs and behavioural avoidance were measured. Children were randomised to receive positive verbal information, modelling, or a control task. Fear beliefs and behavioural avoidance were measured again. Positive information and modelling led to lower fear beliefs and behavioural avoidance than the control condition. Positive information was more effective than modelling in reducing fear beliefs and both methods significantly reduced behavioural avoidance. The results support Rachman's indirect pathways as viable fear un-learning pathways and supports associative learning theories.     

Learning to fear a second-order stimulus following vicarious learning

Vicarious fear learning refers to the acquisition of fear via observation of the fearful responses of others. The present study aims to extend current knowledge by exploring whether second-order vicarious fear learning can be demonstrated in children. That is, whether vicariously learnt fear responses for one stimulus can be elicited in a second stimulus associated with that initial stimulus. Results demonstrated that children's (5–11 years) fear responses for marsupials and caterpillars increased when they were seen with fearful faces compared to no faces. Additionally, the results indicated a second-order effect in which fear-related learning occurred for other animals seen together with the fear-paired animal, even though the animals were never observed with fearful faces themselves. Overall, the findings indicate that for children in this age group vicariously learnt fear-related responses for one stimulus can subsequently be observed for a second stimulus without it being experienced in a fear-related vicarious learning event. These findings may help to explain why some individuals do not recall involvement of a traumatic learning episode in the development of their fear of a specific stimulus.     

Vicarious learning and the development of fears in childhood

Vicarious learning has long been assumed to be an indirect pathway to fear; however, there is only retrospective evidence that children acquire fears in this way. In two experiments, children (aged 7-9 years) were exposed to pictures of novel animals paired with pictures of either scared, happy or no facial expressions to see the impact on their fear cognitions and avoidance behavior about the animals. In Experiment 1, directly (self-report) and indirectly measured (affective priming) fear attitudes towards the animals changed congruent with the facial expressions with which these were paired. The indirectly measured fear beliefs persisted up to 3 months. Experiment 2 showed that children took significantly longer to approach a box they believed to contain an animal they had previously seen paired with scared faces. These results support theories of fear acquisition that suppose that vicarious learning affects cognitive and behavioral fear emotion, and suggest possibilities for interventions to weaken fear acquired in this way.     

Who's afraid of the big bad wolf: a prospective paradigm to test Rachman's indirect pathways in children.

Rachman's theory [The conditioning theory of fear insition: a critical examination. Behav. Res. Ther. 15 (1977) 375-387] of fear acquisition suggests that fears and phobias can be acquired through three pathways: direct conditioning, vicarious learning and information/instruction. Although retrospective studies have provided some evidence for these pathways in the development of phobias during childhood [see King, Gullone, & Ollendick, Etiology of childhood phobias: current status of Rachman's three pathway's theory. Behav. Res. Ther. 36 (1998) 297-309 for a review], these studies have relied on long-term past memories of adult phobics or their parents. The current study was aimed towards developing a paradigm in which the plausibility of Rachman's indirect pathways could be investigated prospectively. In Experiment 1, children aged between 7 and 9 were presented with two types of information about novel stimuli (two monsters): video information and verbal information in the form of a story. Fear-related beliefs about the monsters changed significantly as a result of verbal information but not video information. Having established an operational paradigm, Experiment 2 looked at whether the source of verbal information had an effect on changes in fear-beliefs. Using the same paradigm, information about the monsters was provided by either a teacher, an adult stranger or a peer, or no information was given. Again, verbal information significantly changed fear-beliefs, but only when the information came from an adult. The role of information in the acquisition of fear and maintenance of avoidant behaviour is discussed with reference to modern conditioning theories of fear acquisition.     

They are afraid of the animal, so therefore I am too: Influence of peer modeling on fear beliefs and approach-avoidance behaviors towards animals in typically developing children

This study investigated the effect of filmed peer modeling on fear beliefs and approach–avoidance behaviors towards animals in 8- to 10-year-old typically developing children. Ninety-seven children randomly received either a positive or negative modeling film in which they saw peers interact with a novel animal. Before and after this film, children’s fear beliefs and avoidance tendencies towards the modeled and non-modeled control animal were measured. A behavioral approach task was also administered post-modeling. Following positive peer modeling, children’s fear beliefs and avoidance tendencies towards the modeled but also towards the non-modeled animal decreased significantly. After negative modeling, children’s fear beliefs towards the modeled animal increased significantly, but did not change for the non-modeled animal. Negative modeling did not change avoidance tendencies for the modeled animal, while it decreased children’s avoidance of the non-modeled animal. No significant effects were observed on the behavioral approach task. These results support Rachman’s indirect pathway of modeling/vicarious learning as a plausible mechanism by which children can acquire fears of novel stimuli and stresses the important fear-reducing effects of positive peer modeling. Clinical implications and directions for future research are discussed.     

The interaction of pathways to fear in childhood anxiety: a preliminary study

Recent research has shown that the verbal information pathway to fear creates long-term fear cognitions and can create cognitive biases and avoidance in children. However, the interaction between the verbal information pathway to fear and other pathways is untested. This experiment exposed children (aged 6–8) to threat information about a novel animal to see the impact on a measure of avoidance after a subsequent simulated direct negative encounter with that animal. Results showed that a direct negative experience (without prior information) or threat information (without a subsequent negative experience) produced similar effects, but in combination (verbal threat information followed by a direct negative experience) the effect was significantly magnified. These results support theories of fear acquisition that suppose that verbal information impacts on the strength of associations formed in subsequent conditioning episodes, and suggest that pathways to fear have interactive effects.     

Origins of childhood fears: an evaluation of Rachman's theory of fear acquisition

This study explored Rachman's (1977) theory of fear acquisition in a large sample of Australian and American children and adolescents. Participants completed a questionnaire that addressed different pathways of fear acquisition for 10 highly prevalent fears. The majority of children attributed the onset of their fears to vicarious and instructional factors, although these indirect sources of fear were often combined with direct conditioning experiences. Also examined were effects for gender, age, and nationality. Boys and preadolescents were found to report more direct and vicarious experiences than girls or adolescents. Effects due to nationality were minimal. Methodological limitations attendant to self-reports were acknowledged.     

Multimodal classical conditioning of fear: contributions of direct, observational, and verbal experiences to current fears

The authors propose that a multimodal classical conditioning model be considered when clinicians or clinical researchers study the etiology of fears and anxieties learned by human beings. They argue that fears can be built through the combined effects of direct, observed, and verbally presented classical conditioning trials. Multimodal classical conditioning is offered as an alternative to the three pathways to fear argument prominent in the human fear literature. In contrast to the three pathways position, the authors present theoretical arguments for why "learning by observation" and "learning through the receipt of verbal information" should be considered classical conditioning through observational and verbal modes. The paper includes a demonstration of how data, commonly collected in research on the three pathways to fear, would be studied differently using a multimodal classical conditioning perspective. Finally, the authors discuss implications for assessment, treatment, and prevention of learned fears in humans.     

The Role of Verbal Threat Information in the Development of Childhood Fear. “Beware the Jabberwock!”

Rachman’s (Behaviour Research and Therapy 15:372–387, 1977; Clinical Psychology Review 11:155–173, 1991) three pathways theory proposed that childhood fears not only arise as a consequence of direct learning experiences, but can also be elicited by means of threat information transmission. This review looks at the scientific evidence for this idea, which has accumulated during the past three decades. We review research on the influences of media exposure on children’s fears, retrospective parent and child reports on the role of threat information in fear acquisition, and experimental studies that explored the causal effects of threat information on childhood fears. We also discuss possible mechanisms by which threat information exerts its influence and the processes relevant to understand the role of this type of learning experience in the origins of fear. Finally, implications for the prevention and intervention of childhood fears are briefly explored, and potential leads for future research will be highlighted.     

Reducing earthquake-related fears in victim and nonvictim children

In this study, the authors investigated the fears of earthquake victim and nonvictim elementary school students and the effectiveness of an activity-based cognitive fear reduction (ABCF) procedure developed by the authors. To measure fear, the authors collected data from 266 participants using a modified version of the Fear Survey Schedule for Children (FSSC; W. Yule, O. Udwin, & K. Murdoch, 1990). Results demonstrated that earthquake victim children were more fearful on 2 subtests of the FSSC than were nonvictim children and that girls had significantly stronger fears on all subscales than did boys. The ABCF procedure was not an effective approach for reducing the fears of earthquake victims. However, the control group did demonstrate a significant reduction in fears. The authors suggest that the activity designed for this group may have been an intervention in itself. The authors discuss this finding and offer suggestions for researchers and therapists.     

Fear of the beast: a prospective study on the effects of negative information on childhood fear

The current study examined the effects of negative information on the enhancement of childhood fear. A large group of normal primary school children aged between 4 and 12 years (N=285) received either negative or positive information about an unknown, doglike animal, called 'the beast'. Children's fears were assessed at three points in time: before, directly after, and one week after the information about the beast was provided (i.e., pre-, post- and follow-up assessment). Results showed that type of information changed children's fear of the beast in the predicted direction with negative information increasing fear levels and positive information decreasing fear levels. This was not only the case directly after the experimental manipulation but also at one week follow-up. Furthermore, fear of the beast appeared to generalize, that is, children who became more fearful of the beast after receiving negative information, also became more apprehensive of other dogs and predators.     

Learning history in fear of blushing

Two studies, investigating the learning history (i.e. traumatic conditioning experiences, vicarious learning, informational learning) of individuals with and without fear of blushing, are presented. In study 1, individuals high (n=61) and low (n=59) in fear of blushing completed the (revised) Phobic Origin Questionnaire [POQ; Öst, L. G., & Hugdahl, K. (1981). Acquisition of phobias and anxiety response patterns in clinical patients. Behavior Research and Therapy, 19, 439–447]. In study 2, individuals who applied for treatment for fear of blushing (n=31) and a nonfearful, matched control group (n=31) were interviewed with the same instrument, taking into account only specific memories. High fearful individuals reported more negative learning experiences in connection with blushing than low fearful individuals, irrespective of the type of questioning. Meanwhile, study 1 (written POQ) produced higher percentages of negative learning experiences for both high and low fearful individuals than study 2 (interview). It is concluded that the POQ interview showed a more realistic picture than the written POQ. The possible role of learning history in the acquisition of fear of blushing is discussed.     

Temperament moderates the effect of the verbal threat information pathway on children's heart rate responses to novel animals

Temperamental variables such as trait anxiety are risk factors in children for the development of anxiety disorders. This experiment aimed to test whether temperament moderates the effect of verbal threat information on the physiological component of the fear emotion. An experiment is reported in which 6-10 year old children's (N = 54) fear beliefs about novel animals were measured. They were then given threat, positive or no verbal information about these animals following which their heart rate was recorded while they placed their hands in boxes that they believed these animals inhabited. Children also completed a questionnaire measure of trait anxiety. Child-reported temperament moderated the effect that threat information has on the physiological component of the fear emotion. Fear information is, therefore, a possible mechanism through which temperament leads children to acquire animal fears.     

Children's nighttime fears: parent-child ratings of frequency, content, origins, coping behaviors and severity

The present study investigated nighttime fears in normal school children aged 4 to 12 yr (N=176). Children and their parents were interviewed about the frequency, content, origins, coping behaviors and severity of children's nighttime fears. Results showed that 73.3% of the children reported nighttime fears, indicating that these fears are quite prevalent. Inspection of the developmental course of nighttime fears revealed that these fears are common among 4- to 6-year-olds, become even more frequent in 7- to 9-year-olds and then remain relatively stable in 10- to 12-year-olds. Inspection of the origins of nighttime fears revealed that most of the children (i.e., almost 80%) attributed their fear to negative information; conditioning and modeling were endorsed less frequently (25.6% and 13.2%, respectively). A substantial percentage of the children (24.0%) indicated that learning experiences had not played a role in the acquisition of their nighttime fears. Children reported a variety of coping strategies in order to deal with their nighttime fears and generally rated these strategies as helpful in reducing anxiety. Furthermore, children's nighttime fears were associated with moderate levels of anxiety. Moreover, in about 10% of the children, nighttime fears were related to one or more DSM-III-R anxiety disorders. Finally, parental reports of children's nighttime fears substantially deviated from children's reports. Most importantly, parents provided a marked underestimation of the frequency of nighttime fears, at least as reported by their children.     

Mother knows best: effects of maternal modelling on the acquisition of fear and avoidance behaviour in toddlers

The present study was conducted to investigate the influence of parental modelling on the acquisition of fear and avoidance towards novel, fear-relevant stimuli in a sample of 30 toddlers. The toddlers were shown a rubber snake and spider, which were alternately paired with either negative or positive facial expressions by their mothers. Both stimuli were presented again after a 1- and a 10-min delay, while mothers maintained a neutral expression. The children showed greater fear expressions and avoidance of the stimuli following negative reactions from their mothers. This was true for both genders although the degree of modelled avoidance was greater in girls than in boys. The strong observational learning results are consistent with views that modelling constitutes a mechanism by which fear may be acquired early in life.     

Acquisition of blood, injury, and needle fears and phobias

The origins of fear and phobia of blood, injury, and injections were investigated in a sample of 128 fearful university students. Based on Mutilation Questionnaire scores, subjects were designated as common fear, high fear, or phobic. Ss reports of their onset experiences obtained from structured interviews were categorized into one or more acquisition pathways of conditioning, vicarious observation, and information. Of the 73% of Ss who recalled one or more onset experiences, 76% reported conditioning-like events as the primary pathway with the majority reporting fear-related UCSs. Vicarious experiences were reported as primary by 20% and 3% reported information as being primary in their fear onset. Severity of fear was unrelated to the pathway by which it was acquired, to whether the onset was recalled, and if recalled, whether it was due to a single or to multiple traumatic events. Results are discussed in terms of methodological problems of memory issues and means by which data are collected.     

The effects of verbal information on children's fear beliefs about social situations

Two experiments explored the role of verbal information in changing children's fear-related beliefs about social situations. In Experiment 1, 118 6- to 8- and 12- to 13-year-olds heard positive, negative, or no information about individuals' experiences of three social situations. Fear beliefs regarding each situation were assessed before and after this manipulation. Verbal information had no significant influence on children's fear beliefs. In Experiment 2, the same paradigm was used with 80 12- to 13-year-olds, but the information took the form of multiple attitude statements about the situations expressed by groups of peers, older children, or adults. An affective priming task of implicit attitudes was used to complement the explicit questions about fear beliefs. Negative information influenced both explicit and implicit fear beliefs. The source of information and the child's own social anxiety did not moderate these effects. Implications for our understanding of the socialisation of childhood fears are discussed.     

The verbal threat information pathway to fear in children: the longitudinal effects on fear cognitions and the immediate effects on avoidance behavior

Verbal information has long been assumed to be an indirect pathway to fear. Children (aged 6-8 or 12-13 years) were exposed to threat, positive, or no information about 3 novel animals to see the long-term impact on their fear cognitions and the immediate impact on avoidance behavior. Their directly (self-report) and indirectly (implicit association task) measured attitudes toward the animals changed congruent with the information provided, and the changes persisted up to 6 months later. Verbal threat information also induced behavioral avoidance of the animal. Younger children formed stronger animal- threat and animal-safe associations because of threat and positive verbal information than older children, but there were negligible age effects on self-reported fear beliefs and avoidance behaviors. These results support theories of fear acquisition that suppose that verbal information affects components of the fear emotion.     

Affect Labeling to Facilitate Inhibitory Learning: Clinical Considerations

Exposure-based treatments known to be effective for a wide range of psychopathology are thought to work via inhibitory learning, where new learning acquired during exposure exercises inhibits previously learned fear and avoidance responses. One way in which this inhibitory learning may be enhanced is through affect labeling, during which clients verbalize their internal emotional experiences. Theoretically, affect labeling may be a subtle, implicit form of emotion regulation and may facilitate more explicit forms of extinction learning. Experimental research suggests that affect labeling may lead to attenuated fear responses to emotionally evocative stimuli in healthy samples and may be a helpful strategy in reducing physiological arousal experienced during exposure tasks, particularly for clients with inhibitory deficits. Research with clinical samples is limited and mixed, at best. Case examples illustrate how affective labeling may help get a client “unstuck” from unproductive processing loops, can contribute to shifts in perspective and meaning making, and may modulate distress and promote distress tolerance. We argue that routine use of affect labeling in clinical care is premature. When used, it should be employed strategically within a broader case conceptualization and may be of a limited benefit beyond what is already employed in quality exposure therapy.     

Fear information and social phobic beliefs in children: a prospective paradigm and preliminary results

This paper presents a first attempt to develop a prospective paradigm to test Rachman's (Behav. Res. Ther. 15 (1977) 375) theory of fear acquisition for social fears. Following the prospective paradigm for animal fears developed by Field et al. (Behav. Res. Ther. 39 (2001) 1259) an attempt is made to adapt this paradigm to look at the effect of fear information in the development of social fears. A large group of normal children (N=135) who were at an age (10-13 years) at which social concerns are most pertinent were tested using this paradigm. They were given positive, negative or neutral information about three social situations: public speaking, eating in public, and meeting a new group of children. Children's fear beliefs were measured before and after the information was given and the information was given by a teacher, a same age peer or no information was given (a control). The results indicate that although information can change social fear beliefs it is dependent upon the type of social activity and who provides the information. The implications of these initial results for our understanding of both the role of fear information in the development of social fear beliefs, and the limitations of this current paradigm are discussed.