Using humor in systematic desensitization to reduce fear

Effectiveness of systematic desensitization for fear reduction, using humorous hierarchy scenes without relaxation, was tested. Participants were 40 students highly fearful of spiders. Using a 24-item behavioral approach test with an American tarantula, participants were matched on fear level and randomly assigned to 1 of 3 treatment groups: (a) systematic desensitization, (b) humor desensitization, and (c) untreated controls. Each participant was seen for 6 sessions, including pretest and posttest. Analyses of covariance of posttest scores revealed that the 2 treatment groups showed greater reduction in fear than the controls on 3 measures but did not differ from each other. Therefore, humor in systematic desensitization reduced fear as effectively as more traditional desensitization. This finding may have therapeutic applications; however, it may also be applicable in advertising to desensitize fear of a dangerous product, such as cigarettes.     

Attentional modulation of desensitization to odor

Subjective and behavioral responsiveness to odor diminishes during prolonged exposure. The precise mechanisms underlying olfactory desensitization are not fully understood, but previous studies indicate that the phenomenon may be modulated by central-cognitive processes. The present study investigated the effect of attention on perceived intensity during exposure to a pleasant odor. A within-subjects design was utilized with 19 participants attending 2 sessions. During each session, participants continuously rated their perceived intensity of a 10-minute exposure to a pleasant fragrance administered using an olfactometer. An auditory oddball task was implemented to manipulate the focus of attention in each session. Participants were instructed to either direct their attention toward the sounds, but still to rate odor, or to focus entirely on rating the odor. Analysis revealed three 50-second time windows with significantly lower mean intensity ratings during the distraction condition. Curve fitting of the data disclosed a linear function of desensitization in the focused attention condition compared with an exponential decay function during distraction condition, indicating an increased rate of initial desensitization when attention is distracted away from the odor. In the focused-attention condition, perceived intensity demonstrated a regular pattern of odor sensitivity occurring at approximately 1?2 minutes intervals following initial desensitization. Spectral analysis of low-frequency oscillations confirmed the presence of augmented spectral power in this frequency range during focused relative to distracted conditions. The findings demonstrate for the first time modulation of odor desensitization specifically by attentional factors, exemplifying the relevance of top-down control for ongoing perception of odor.     

Repeated exposure of flight phobics to flights in virtual reality

The present study examined the effects of repeated exposure of flight phobics to flights in virtual reality (VR). Flight phobics were randomly assigned either to complete one VR test flight followed by four VR exposure flights (VR group; N=15) in one lengthy session or to complete one VR test flight followed by a lengthy relaxation training session (relaxation group; N=15). All participants completed a second VR test flight at the end of the session. Fear reports and physiological fear reactions (heart rate, skin conductance level) during VR exposures were registered, and fear of flying was assessed psychometrically from 3 weeks before to 3 months after exposure. Exposure to VR flights elicited subjective and physiological fear responses in flight phobics, and these responses attenuated within and across VR flights. Fear reduction associated with repeated VR exposure was greater than fear reduction caused by relaxation training. Fear of flying improved in both treatment groups, but several outcome measures indicated greater effects in the VR treated group than in the relaxation group. These findings indicate that exposure in virtual reality may offer a new and promising approach for the treatment of fear of flying.     

The Effects of Initial Habit Strength Differences Upon Performance in a Coaction Situation

The present investigation examined the effects of initial habit strength differences upon performance in a coaction situation. During a training session, a habit-strength hierarchy was developed in each of three groups through the establishment of a differential response expectancy for each of four alternative responses. In a subsequent test session, both performance and consistency of performance were affected by the pretraining on the correct habit. However, there was no statistical support for the hypothesis that coaction would interact with the habit-strength condition resulting in an improvement in the coaction/habit-correct group and a decrement in the coaction/habit-incorrect group. Similarly, no differences were found between the coaction and alone conditions.     

Desensitization to media violence over a short period of time

This study investigated the desensitization to violence over a short period of time. Participants watched nine violent movie scenes and nine comedy scenes, and reported whether they enjoyed the violent or comedy scenes and whether they felt sympathetic toward the victim of violence. Using latent growth modeling, analyses were carried out to investigate how participants responded to the different scenes across time. The findings of this study suggested that repeated exposure to media violence reduces the psychological impact of media violence in the short term, therefore desensitizing viewers to media violence. As a result, viewers tended to feel less sympathetic toward the victims of violence and actually enjoy more the violence portrayed in the media. Additionally, desensitization to media violence was better represented by a curvilinear pattern, whereas desensitization to comedy scenes was better represented by a linear pattern. Finally, trait aggression was not related to the pattern of change over time, although significant effects were found for initial reports of enjoyment and sympathy. Aggr. Behav. 35:179–187, 2009. © 2009 Wiley‐Liss, Inc.     

The effects of instructional set on physiological response to stressful imagery

Centrally mediated or cognitive variables have received considerable attention in clinical research. With the establishment of the effectiveness of such specific treatment techniques as systematic desensitization (Paul. 1969a. 1969b). a question arises as to the influence of cognitions on process and outcome variables in such learning based treatments (Lang. 1971). Research investigating the influence of demand characteristics and subject expectancies has demonstrated such centrally mediated variables can significantly influence overt, behavioral and self-report measures of fear, stress, or anxiety (cf. Borkovec. 1972: Marcia. Rubin and Efran. 1969; McGlynn. Maelia and Nawas. 1969: McGlynn. Reynolds and Linder. 1971: Oliveau. Agras. Leitenberg and Wright. 1969; Rappaport. 1972: Rosen. 1974).However. Borkovec (1972) and Rappaport (1972) failed to obtain expectancy effects on physiological measures of anxiety. Neither investigation provided for an independent assessment of subjects' actual expectancies, or belief in the instructions, as recommended by Davison and Wilson (1973). Borkovec administered clinical procedures over four sessions and varied the information communicated about the ‘purpose’ of the treatments (physiological versus therapeutic instructions). Differential rationales for differential expectancies of physiological reactivity were not provided. After each session, subjects reviewed the same false physiological records depicting reductions in fear responses. Although these changes were explained either physiologically or therapeutically. the fact that such reductions were emphasized should have attenuated differences between groups. Rappaport (1972) exposed subjects to a fearful stimulus and varied the suggestion and rationale for the pseudotreatment: no expectancy (stress research): therapeutic expectancy (fear reduction); and negative expectancy (fear increase). The lack of an independent assessment of the expectancy manipulation, as well as the exclusion of a specific therapeutic procedure, make it impossible to interpret the results in relation to expectancy effects on physiological fear responses during the administration of therapeutic procedures. There is other evidence, however, that suggestion and instructional set can significantly influence somatic and autonomic response systems (Barber. 1961. 1965; Sternbach. 1964. 1965).The primary purpose of this study was to evaluate the effects of instructional set on physiological responses to stressful imagery. This was an early step in a research program investigating the effects of instructional and informational variables on physiological responses of clinical interest. One half of the subjects received abbreviated live relaxation training (R) as described m a manual by Bernstein and Borkovec (1972) and based upon the original work of Jacobson (1938). The other half received an inert placebo pill and undertook a target detection task (P). The latter procedure was similar to that used by Paul (1966). Although both procedures had previously been shown to have relaxing effects, the P task was included as an additional control for any potential effects specific to the tension-release procedure of R. In order to evaluate the effects of instructional set, one half of each of the above two groups received instructions designed to lead to an expectancy of response inhibition to stressful imagery by the respective procedure (Decrease Stress Response. DSR). while the other half received instructions designed to lead to an expectancy of an increased response to stressful imagery by the respective procedure (Increase Stress Response. ISR). Each subject visualized three individually specified items that were the most frightening scenes imaginable prior to training and four times after training visualized the scene producing the largest response. Considerable effort was devoted to eliciting from each subject the most frightening items possible for her. and it was clear from subject comments that the items did elicit negative emotional responses.Since previous research (Barber. 1961. 1965; Sternbach. 1964. 1965) indicated that instructional set can influence physiological reactivity, it was hypothesized the DSR) subjects should exhibit a greater reduction in emotional response from pre- to posttraining than ISR subjects.     

Group preprogrammed systematic desensitization without the simultaneous presentation of aversive scenes with relaxation training

This study investigated the assumption that it is necessary to simultaneously present muscle relaxation and aversive scenes in order for decrements in anxiety to occur. Utilizing 70 high test anxious students, the following treatment groups were delineated: (a) preprogrammed systematic desensitization, (b) non-simultaneous (scenes presented prior to muscle relaxation), (c) relaxation, and (d) no-treatment control. Self-report measures of test and general anxiety as well as college grades constituted the dependent measures. The results indicated that there tended to be no significant differences between the preprogrammed systematic desensitization and non-simultaneous groups on the dependent measures and that the latter group tended to show significant decrements in anxiety and obtain better grades than the relaxation and no-treatment control groups. These findings question the necessity of simultaneously pairing muscle relaxation and aversive scenes in treating anxiety by this method.     

Expectancy-value constructs and expectancy violation as predictors of exercise adherence in previously sedentary women.

This prospective study examined effects of expectancy of exercise benefits, value of benefits, expectancy violation, and self-efficacy (SE) on exercise behavior and study dropout in sedentary women (n=86). SE predicted exercise for study completers but did not predict study dropout. After 6 and 12 weeks, participants evidenced expectancy violations, particularly for fitness and weight. Initial value, expectancy, and Expectancy X Value did not predict exercise for study completers, but dropouts had higher initial positive expectancies than did completers. Expectancy violations produced in Weeks 1-6 did not predict exercise in Weeks 7-12 in study completers, but dropouts in Weeks 7-12 had higher expectancy violations for weight in Weeks 1-6 than did completers. Follow-up revealed that study dropouts stopped exercising. Identifying individuals with high initial expectancies and expectancy violations may improve health behavior intervention and research.     

Chronic exposure to violent video games is not associated with alterations of emotional memory

Although acute effects of violent video game (VVG) exposure on affect and behaviour have been studied extensively, less is known about VVG effects on cognition. The present study examined whether chronic exposure to VVGs was associated with alterations in emotional long‐term memory. Participants completed an old‐new recognition task with 300 pictures of scenes ranging in emotion (negative, neutral and positive). We analysed accuracy and reaction time data using diffusion modelling to test a desensitization hypothesis. According to this hypothesis, VVG players would show reduced memory or a less liberal response bias for negative stimuli, compared with nonplayers. Contrary to the desensitization hypothesis, VVG exposure was not associated with differences in memory or response bias. This result suggests that, unlike other cognitive domains, long‐term memory may be robust to deleterious influences of chronic VVG exposure. Copyright © 2010 John Wiley & Sons, Ltd.     

The contribution of relaxation to symbolic modeling in the modification of dental fears.

Studies of symbolic modeling suggest that it is a technique which is at least as effective and more efficient (faster) than imaginal desensitization in the treatment of fears (Bandura el al., 1969; Woody and Schaible, 1969). Bandura et al. (1969) assessed the contributions of relaxation to the procedure and found less subjective anxiety and greater positive attitude change with relaxation but no significant differences in oven behavior nor in generalized anxiety reduction. In this study the ‘symbolic modeling only’ subjects received their treatment after they and the other subjects had received the original post-testing assessment. The present experiment was an attempt to assess the contributions of deep muscle relaxation to symbolic modeling without such confounding and with a more nearly clinical population. Dental fear represents a ‘near clinical’ phobia which satisfies Bernstein and Paul's (1971) criteria for analogue desensitization research. That is. dental phobics exhibit a strong, costly and distressing avoidance response which increases in strength as a function of exposure despite high demand.     

Predictors of Response to Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a common and distressing or impairing preoccupation with a perceived defect in physical appearance. Individuals with BDD engage in time-consuming rituals to check, hide, or “fix” their appearance or alleviate distress. BDD is associated with substantial psychosocial impairment and high rates of depression, hospitalization, and suicidality. Cognitive-behavioral therapy (CBT) is the treatment of choice for BDD, but not everyone benefits. We examined predictors of CBT-related improvement, an important topic that has received very limited investigation. Treatment was delivered in weekly individual sessions over 18–22 weeks. Results indicated that greater motivation/readiness to change (University of Rhode Island Change Assessment Questionnaire), greater treatment expectancy (Treatment Credibility/Expectancy Questionnaire), and better baseline BDD-related insight (Brown Assessment of Beliefs Scale) significantly predicted better CBT response at posttreatment. Baseline BDD symptom severity and depression did not predict outcome, suggesting that even patients with more severe BDD and depressive symptoms can benefit from CBT for BDD. Efforts should be aimed at enhancing readiness to change and confidence in the treatment at treatment onset as well as addressing the poor insight that often characterizes BDD.     

The role of mental relaxation in experimental desensitization

Certain evidence indicates that training in peripheral muscle relaxation is not an essential factor in the successful experimental desensitization of phobias. Rachman (1968) has suggested that a sense of calmness or mental relaxation is the necessary component and that all the preliminary training techniques leading to successful desensitization, have, as the basis for their success, the inadvertent induction of this state of mental calmness. The direct induction of mental relaxation then, ought to be at least as effective an adjunct to desensitization as training in muscle relaxation. Using spider phobia as the target behaviour, the present study compared the effectiveness of (a) hierarchy presentation paired with deep muscle relaxation; (b) hierarchy presentation paired with instructions to feel calm and relaxed and alternated with imagining a pleasant scene; (c) a combination of these two procedures paired with hierarchy presentation; and (d) a placebo control procedure. The treatment groups all improved significantly more than controls and there there were no differences between treatments. The results were seen as offering strong support of Rachman's position. Both theoretical and practical implications of the results are discussed with consideration being given to the nature of “mental calmness”.     

The effect of video game violence on physiological desensitization to real-life violence

Past research shows that violent video game exposure increases aggressive thoughts, angry feelings, physiological arousal, aggressive behaviors, and decreases helpful behaviors. However, no research has experimentally examined violent video game effects on physiological desensitization, defined as showing less physiological arousal to violence in the real world after exposure to video game violence in the virtual world. This experiment attempts to fill this gap. Participants reported their media habits and then played one of eight violent or nonviolent video games for 20 min. Next, participants watched a 10-min videotape containing scenes of real-life violence while heart rate (HR) and galvanic skin response (GSR) were monitored. Participants who previously played a violent video game had lower HR and GSR while viewing filmed real violence, demonstrating a physiological desensitization to violence. Results are interpreted using an expanded version of the General Aggression Model. Links between desensitization, antisocial, and prosocial behavior are discussed.     

The Expectancy Challenge Alcohol Literacy Curriculum (ECALC): A single session group intervention to reduce alcohol use

The Expectancy Challenge Alcohol Literacy Curriculum (ECALC) is a single session group-delivered program designed to modify alcohol expectancy processes and reduce alcohol use among children and young adults. The objective of this study was to demonstrate the effectiveness of the ECALC in reducing risky alcohol use among heavy drinking college men. Four fraternities at a large state university were randomly assigned to receive either the single session ECALC or a control presentation (2 fraternity houses per condition, n = 250). Alcohol expectancies were assessed before and immediately after program presentation. Results demonstrated significant changes on 5 of the 7 subscales of the Comprehensive Effects of Alcohol Scale (CEOA) among students who received the ECALC when compared with control participants. Alcohol use data were collected for 4 weeks before and 4 weeks after program presentation. Compared with those in the control condition, students who received the ECALC demonstrated significant reductions in all facets of alcohol use measured, including decreased mean and peak blood alcohol content (BAC), decreased mean number of days drinking per week, decreased mean drinks per sitting, and decreased number of binge-drinking episodes per month. This study represents 2 important advances. First is the significant reduction in risky alcohol use produced by a single session group-delivered program. The second important advance is the success in changing expectancy processes without using impractical elements common in previous expectancy challenge methods (e.g., a "barlab" environment and actual alcohol administration). (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The effectiveness of various treatment techniques on different degrees and durations of sleep-onset insomnia

Mild and moderate insomniacs were randomly assigned to one of five group therapy conditions: relaxation without muscle-tension, stimulus control plus relaxation without muscletension, placebo, self-monitoring, and waiting list. Mild insomniacs were differentiated according to the duration of their sleep disturbance. Insomniacs were told that improvement would not be noticeable until after the final therapy session. During this counterdemand period, the two relaxation groups showed significantly greater decreases in sleep onset latency than the control conditions. In addition, it appeared that duration affected treated outcome. The effectiveness of treatment packages and self-monitoring in alleviating insomnia is briefly discussed.     

Assessing the process of desensitization therapy: Five practical measures

Assessment of phobic behavior has included self-report, physiological, and in vivobehavioral measures. While self-report measures are convenient, they suffer from subject bias and a low predictive validity. Physiological and in vivobehavioral measures are often too cumbersome to implement in standard clinical practice. The current study investigated the validity of five convenient measures of phobic behavior during the process of desensitization therapy. Responses of 14 clinically phobic patients were compared on phobic and neutral scenes presented within the context of systematic desensitization therapy. Phobic scenes resulted in less clarity of scene visualization, a longer latency to clear scene visualization, higher subjective units of discomfort (SUDs) at clear visualization, a longer latency to relaxation, and higher SUDs at relaxation. The measures seemed to reflect accurately the process and stages of desensitization therapy and showed low to high intercorrelations. The pragmatic value of these measures is discussed, as well as suggestions for future validational research.     

Goal-directed fantasy, hypnotic susceptibility, and expectancies

We conducted an initial screening session in which hypnosis was presented as a "test of imagination" and administered with other imagination measures. In a second session, we instructed high- and low-hypnotizable subjects to imagine along with suggestions but to resist responding to motoric suggestions. Subjects received either instructions to use goal-directed fantasies (GDFs) or no facilitative instructions. Sizable individual difference effects were secured. Hypnotizable subjects exhibited more suggestion-related movements and reported greater involuntariness than did low-hypnotizable subjects. With GDF instructions, low- and high-hypnotizable subjects reported equivalent GDF absorption and frequencies. However, hypnotizable subjects exhibited greater responsiveness and reported greater involuntariness than did those low in hypnotizability, even when their GDFs were equivalent. Thus, no support was generated for the hypotheses that sustained, elaborated suggestion-related imagery mediates response to suggestion (Arnold, 1946) or that absorption in suggestions is of particular importance for low-hypnotizable subjects (Zamansky & Clark, 1986). Our finding that measures of response expectancy paralelled responding and reports of nonvolition support the hypothesis that expectancies mediate the relation between imagination, involuntariness, and responding (Kirsch, 1985; Spanos, 1982). Hypnotizable imagining subjects in the study discussed here exhibited greater responsiveness than a comparable sample of subjects did in a previous countersuggestion study (Lynn, Nash, Rhue, Frauman, & Stanley, 1983) in which no attempt was made to foster an association between imagining and involuntary responding in the initial screening session.     

How does information from low and high spatial frequencies interact during scene categorization?

Current models of visual perception suggest that, during scene categorization, low spatial frequencies (LSF) are rapidly processed and activate plausible interpretations of visual input. This coarse analysis would be used to guide subsequent processing of high spatial frequencies (HSF). The present study aimed to further examine how information from LSF and HSF interact and influence each other during scene categorization. In a first experimental session, participants had to categorize LSF and HSF filtered scenes belonging to two different semantic categories (artificial vs. natural). In a second experimental session, we used hybrid scenes as stimuli made by combining LSF and HSF from two different scenes which were semantically similar or dissimilar. Half of the participants categorized LSF scenes in hybrids, and the other half categorized HSF scenes in hybrids. Stimuli were presented for 30 or 100?ms. Session 1 results showed better performance for LSF than HSF scene categorization. Session 2 scene categorization was faster when participants attended and categorized LSF than HSF scene in hybrids. The semantic interference of a semantically dissimilar HSF scene on LSF scene categorization was greater than the semantic interference of a semantically dissimilar LSF scene on HSF scene categorization, irrespective of exposure duration. These results suggest a LSF advantage for scene categorization, and highlight the prominent role of HSF information when there is uncertainty about the visual stimulus, in order to disentangle between alternative interpretations.     

Group desensitization of test anxiety

Following an orientation session in which test-anxious students were instructed in the theory and method of desensitization, 18 ISU undergraduates applied for a desensitization and counseling program for test-taking anxiety. All students committed themselves to attend 7 weekly meetings and to practice daily the relaxation exercises at home. Nine of these 18 subjects were assigned to the treatment group and 9 to the wait-list control group on the basis of a free class hour at program time. Treatment consisted of 7 desensitization and counseling sessions. The treatment and control groups did not differ significantly in initial Grade Point Average or scores on the A.C.T. Test. Both groups improved their G.P.A. in the program quarter but only the treatment group demonstrated a statistically significant improvement (p< 0.05). It is concluded that counseling and group desensitization in this 7-session model is an effective and efficient technique to modify anxiety responses to test taking situations.