Transfer of fear reduction through systematic desensitization

Systematic desensitization therapy involves the presentation of fear-provoking situations through visualization As the visualizations cease to evoke emotional responses, the fear-provoking potential of the real situations decreases. Research has clearly shown that such transfer does indeed occur with a wide variety of fears. Transfer has been demonstrated, for example, with fear of small animals (Lang and Lazovik, 1963), interpersonal performance anxiety (Paul, 1966), classic phobias (Lazarus, 1961), test anxiety (Katahn, Strenger and Cherry, 1966), impotence (Wolpe, 1958) and frigidity (Lazarus, 1963). However, the nature of transfer has received little attention. Wolpe (1963) has claimed that transfer from therapy to the real life situation is almost complete and direct: “There is almost invariably a one-to one relationship between what the patient can imagine without anxiety and what he can experience in reality without anxiety”. This claim has received support from Rachman (1966) who found that fear reduction transferred immediately to the real situation in 82 per cent of his observations. Hoenig and Reed (1966) reported that after a brief delay, transfer effects were observed in the case of words representing fearful stimuli but were inconsistent in the case of the real stimuli. Agras (1967) found transfer to be delayed in all his cases. He further reported that, though all patients improved, a direct relationship between therapeutic progress and symptom reduction was not found. Both Hain et al. (1966) and Meyer and Crisp (1966) have described the failure of therapeutic effects to transfer to real life.These somewhat inconsistent reports may stem in part from the measurement of transfer effects at different times. Another possibility is that more fearful Ss may evidence less transfer than less fearful Ss. Lang and Lazovik (1963) reported that Ss who completed less than 75 per cent of the hierarchy showed little improvement although direct transfer effects were observed for less fearful Ss (those who complete 75 per cent or more hierarchy items). The present study of transfer effects was designed to remove confoundingof level of fear with extent of progress in systematic desensitization.     

A comparison of self-directed and therapist-directed practice for fear reduction

Various amounts of self-directed and therapist-directed practice were evaluated in reducing fear of snakes. The conditions included an exclusively self-directed condition, a predominantly self-directed condition, a predominantly therapist-directed condition, and an exclusively therapist-directed condition. All treatments resulted in reduced fear on behavioral and self-report measures. The predominantly therapist-directed subjects showed more improvement than subjects in the exclusively self-directed and predominantly self-directed conditions, but not more improvement than subjects in the exclusively therapist-directed condition.     

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.     

Psychophysiological responses during analogue systematic desensitization and non-relaxation control procedures

This investigation tested the hypotheses than an analogue systematic desensitization procedure (SD) would be both more effective and more efficient than a comparable non-relaxation control procedure (NRC) with respect to subjective report, behavioral and psychophysiological variables. Phobic subjects responded to slides depicting a feared aversive stimulus. The SD procedure resulted in significantly less reported fear, fewer trials to a criterion level of decrease in subjective fear, and significantly greater decreases in ANS baseline measures. However, measures of behavioral avoidance and measures of decrease in psychophysiological responsivity to the aversive stimuli revealed significant changes within both SD and NRC groups, and no significant differences between the groups, whether or not the groups were equated for number of stimulus presentations. The results, indicating equivalent efficacy and efficiency for the SD and NRC procedures, suggested a limited role for relaxation in systematic desensitization. An extinction or habituation hypothesis was supported at the expense of a counterconditioning hypothesis.     

Treatment of secondary orgasmic dysfunction: a comparison of systematic desensitization and sex therapy

Forty-eight couples complaining of secondary orgasmic dysfunction were randomly allocated to one of three treatment methods or to a control group. Sexual function, sexual anxiety and satisfaction with the total relationship were evaluated in a pretest, an intermediate test (after 12 therapeutic sessions) and a follow-up test. The intermediate test revealed significant improvement in the sexual function of women treated by systematic desensitization, and that of women and men treated by an adapted version of the Masters and Johnson method. The follow-up test showed significant improvement in women and men treated by desensitization. Both methods significantly improved the satisfaction with the total relationship in men and women, and desensitization significantly reduced sexual anxiety in men and women. The results of combined treatment —desensitization followed by treatment according to Masters and Johnson—were very poor. The control group showed no significant changes. Evaluation of the differences between the treatments revealed a near-significant difference in sexual function of women in the intermediate test, with desensitization and the Masters and Johnson method yielding better results than combined treatment or no treatment.     

The reduction of anxiety in children: a comparison of the effects of 'systematic desensitization in vitro' and 'systematic desensitization in vivo'

Twenty-four children between the ages of 5 and 10. selected on the basis of fear of water, as determined by parents and swimming teachers, were divided into two experimental groups and one control group. One of the experimental groups was treated with four sessions of in vitro desensitization (gradual imaginal exposure to fear evoking stimuli plus relaxation), followed by four sessions of in vivo desensitization (real-life exposure to fear evoking stimuli plus relaxation). The other group received eight sessions of in vivo desensitization. The control group took part only in the tests, which were administered at the commencement of treatment, after four sessions, and at the end of the course of treatments. In testing, a behavior observation record was used to score the subject's behavior in the given situation; in addition, two teacher's records were used, in which swimming teachers recorded their evaluation of the subject's anxiety in each situation.Better results were achieved by desensitization in vivo than by desensitizalion in vitro or by the control procedure. No differences were found between the latter two groups. It could not be demonstrated that desensitization in vitro increased the effectiveness of subsequent desensitization in vivo     

Stimulus hierarchy generalization in systematic desensitization

A group of snake phobic Ss were desensitized to the first 5 items of a standard 7 item snake fear hierarchy in which the items were ordered on the basis of distance from a snake. This group and a no-treatment control group (which did not receive the desensitization) were treated for fear of all the hierarchy stimuli in terms of ratings both before and after the desensitization. The Ss rated their fear responses to all the stimuli as presented to them in (1) real form (2) by slide, and (3) in imaginal form. The results verified all four experimental hypotheses: (1) The experimental Ss showed greater fear reduction than the control Ss to both the training stimuli (the stimuli on which desensitization done) and the generalization stimuli (the other two stimuli), (2) The systematic desensitization (SD) group showed (a) more fear reduction to the last training stimuli than to the lower generalization stimulus and (b) more to the latter than to the higher generalization stimulus, (3) The SD group showed less fear reduction to the generalization stimuli in their real form than in both the slide and imaginai modalities (in the desensitization each stimulus presentation was done first in slide form and then in imaginal form), and (4) There were significant overall individual differences in generalization of fear reduction to the generalization stimuli.     

Play desensitization of fear of darkness in preschool children.

Systematic desensitization therapy (SDT) is considered to be a technique of established effectiveness in reducing monosymptomatic fears (Paul, 1969a, 1969b), yet little systematic research has been done to investigate the merit of desensitization procedures in modifying children's behavior. The few available controlled studies (Miller et al., 1972; Obler and Terwilliger, 1970; Oliver, 1971) on desensitization with children have produced equivocal results. Although imagery and relaxation have been reported of benefit when used separately (Graziano and Kean, 1971; Lazarus and Abramovitz, 1962), evidence suggests that the usual combination of imagery and relaxation is not effective in reducing children's fears (Miller et al., 1972). Investigators in this area have often modified traditional SDT to include alternatives to imagery such as pictures, drawings, play (Cassell, 1965; Lazarus, 1960; Obler and Terwilliger, 1970; Patterson, 1965), or in vivo exposure to the feared stimulus (Obler and Terwilliger, 1970). Relaxation has often been replaced with other responses thought to be incompatible with anxiety such as eating (Jones, 1924). Another deviation from traditional SDT has been the delivery of positive reinforcement (food, praise, or toys) contingent upon the child's approaching the feared object (Obler and Terwilliger, 1970; Patterson, 1965). On the basis of such varied techniques, it is impossible to determine which of these procedures constitutes an effective treatment method for children. In the following study, three desensitization procedures involving graded exposure to the feared stimulus (darkness) through symbolic play, were compared to no-treatment and placebo control groups under differing instructional sets. Treatments were designed to determine the therapeutic efficacy of play as a method of stimulus presentation with children, and to determine whether reciprocal inhibition, extinction, operant reinforcement, or instructional set contribute to fear reduction in desensitization with children.