The effects of ethanol intoxication on phobic anxiety

Behavioral conceptions of alcohol abuse often include the hypothesis that drinking behavior is a negatively reinforced operant, with ethanol intoxication viewed as alleviating aversive environmental and internal states. This hypothesis has not been confirmed or refuted by previous studies which employed mild stressors and limited assessment methodology. In the present experiment, 22 patients with severe phobias approached their phobic animal under two consecutive conditions—first while sober and second after drinking either a placebo or an intoxicating dose of ethanol. The severe anxiety induced was assessed behaviorally, physiologically and by the patient's self-report of fear. The intoxicated patients did not experience decreased anxiety, tachycardia or avoidance, compared to the placebo group. These results have clinical implications and suggest the need to reconsider tension-reduction theories of alcohol abuse.     

A physiological model of phobic anxiety and desensitization

The relationship between arousal and phobic anxiety is discussed with regard to recent psychophysiological studies of habituation in normal subjects and in groups of anxious and phobic patients. A physiological model of the mechanisms underlying generalized and phobic anxiety is postulated. Some criticisms of Wolpe's conception of systematic desensitization are offered and an alternative explanation consistent with the above postulate is put forward. This alternative states that the underlying mechanism of systematic desensitization is identical with that of habituation proceeding under optimal conditions (the “maximal habituation” hypothesis). The two accounts of desensitization are compared and contrasted.     

Attention to phobic stimuli during exposure: the effect of distraction on anxiety reduction, self-efficacy and perceived control

To replicate and extend the finding that distraction facilitates between session anxiety reduction (), 27 spider phobics underwent three 10-min sessions of in vivo exposure followed by one 10-min exposure session at a 4-week follow-up, while having either stimulus-relevant focused conversation or stimulus-irrelevant distracting conversation with the experimenter. Physiological arousal and subjective anxiety were measured during exposure, and self-efficacy, perceived control and performance on a behavioural task were measured at pre-treatment, post session-3, and follow-up. Monitoring and blunting coping styles were also measured at pre-treatment to assess their impact on treatment outcome. Despite equal physiological activation between the groups, those who underwent distracted exposure showed greater reductions in subjective fear within and between sessions, and showed greater increases in self-efficacy ratings, internal perceived control and performance on a behavioural task. Coping style did not interact with the effect of distraction or focusing during exposure, however blunters had less subjective anxiety reduction overall, particularly when they underwent focused exposure. Results are discussed in terms of the emotional processing model and self-efficacy theory.     

The effect of worry on cardiovascular response to phobic imagery

Cardiovascular response to phobic exposures has been shown to reflect the degree of emotional processing of phobic material and relates in important ways to outcome in exposure therapy. The present study investigated the effect of worry on such processing. Speech anxious subjects visualized a phobic scene for 10 trials. Three groups differed according to whether they engaged in relaxed, neutral, or worrisome thinking just prior to each scene presentation. Although the three types of thinking had no effect on cardiovascular activity during the thinking periods, subjects in the worry group displayed significantly less heart rate response to the phobic image than those in the neutral condition who had significantly less response than the relaxed condition. However, the worry group showed significantly greater subjective fear to the images than the neutral condition, with the relaxed group near to the level of the worry group and not significantly different from either of the other two conditions. The results suggest that worry may inhibit emotional processing and thus preserve cognitive/affective fear structure, and are discussed in terms of Gray's (Behavioral and Brain Sciences, 5, 469-534, 1982) theory of the behavioral inhibition system and semantic satiation effects in cognitive psychology.     

Social phobic interoception: effects of bodily information on anxiety, beliefs and self-processing

It has been suggested that body-state information influences self-perception and negative thinking in social phobia [Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment and treatment (pp. 69-93). New York: Guilford Press.]. This study explored the effects of body-state information on anxiety and cognition in patients with generalised social phobia during a feared social interaction. It was hypothesised that information concerning an increase in pulse rate would lead to increments in anxiety, negative beliefs and self-processing whilst information concerning a decrease in pulse rate would have the opposite effect. The results of this study were generally consistent with the hypotheses. These findings are important as they may help to account for fluctuations in anxiety, negative beliefs and self-processing in social situations that do not present objective social threat. In particular, social anxiety appears to be modulated by body-state information. The implications of the present findings for cognitive therapy of social phobia are briefly discussed.     

Fears in clinic-referred children: relations with child anxiety sensitivity, maternal overcontrol, and maternal phobic anxiety

Relations among maternal phobic anxiety, maternal overcontrol, child anxiety sensitivity, and child level of fear were explored in 156 children referred to an outpatient clinic for psychological evaluation. In addition, these relations were examined separately in analyses of age, gender, and diagnostic status. Overall, age, gender, and child anxiety sensitivity, along with maternal ratings of an overly controlling parenting strategy were significant predictors of levels of fear. These four variables predicted approximately 50% of the variance associated with fear levels. Surprisingly, maternal phobic anxiety was not a significant predictor in this sample of clinic-referred children. In separate analyses of age, gender, and diagnostic status (presence or absence of an anxiety disorder), anxiety sensitivity was a significant predictor of fear levels for both older and younger children, for both boys and girls, and for both children with and without an anxiety disorder. However, maternal overly controlling parenting strategy was significant only for the younger children (and not the older ones) and only for girls (and not boys). Moreover, maternal overcontrol was a marginally significant predictor for the anxiety-disorder group (and not the non-anxiety-disordered group). Results are discussed within a developmental framework, and implications for treatment are explored.     

The modification of delusional beliefs: A single-subject evaluation

The multiple-baseline across responses design was used to assess the effectiveness of a belief-modification treatment package to alter the intensity of three delusional beliefs of a chronically mentally ill inpatient. Results revealed reductions in belief intensity to zero levels for all three beliefs. Generalization effects were obtained for an individualized interview and psychiatric rating scale. These results were maintained through a 6-month follow-up period.     

The effect of attentional focus on social anxiety

The aim of the present study was to examine the effect of attentional focus on social anxiety in a group of high and low blushing-anxious subjects. One hundred and fourteen psychology undergraduate students were screened using the Fear of Blushing subscale of the Blushing Questionnaire [B?gels, S. M., & Reith, W. (1999). Validity of two questionnaires to assess social fears: The Dutch social phobia and anxiety questionnaire and the blushing, trembling and sweating questionnaire. Journal of Psychopathology and Behavioral Assessment, 21, 51-66]. Those with the most extreme scores in the top and bottom 20% of the distribution were selected to form a high (n=22) and a low (n=22) blushing-anxious group. Subjects were randomly allocated to either a self-focused attention (SFA) condition or a task-focused attention (TFA) condition. They were asked to engage in a 5 min conversation with the first author, and were instructed to either self-focus (SFA condition) or task-focus (TFA condition). Levels of social anxiety and self-awareness were measured using visual analogue scales. Results suggest that the there was a significant condition by group interaction, with high blushing individuals showing considerably higher levels of social anxiety in the SFA condition compared to the TFA condition while low blushing individuals showed no significant difference across the two conditions.     

The prediction of phobic behaviour

A 10-point rating scale, a pair comparison forced choice technique and a repertory grid were used to predict phobic behaviour in a standardized avoidance situation. The rating scale and pair comparison technique were significantly more accurate than the grid, but did not differ from each other. The results were seen to be consistent with others demonstrating that simple and economic self-report measures can often be more useful than apparently more sophisticated instruments. The results can also be taken to underline the need for including a variety of measures in validity studies of the repertory grid, and the caution necessary in the clinical application of this same instrument. The generality of the present conclusions to other situations needs, however, to be demonstrated rather than assumed. Social desirability, for example, is not thought to be an important variable in the present situation.     

The phobic stimuli response scales: a new self-report measure of fear

Data from two large undergraduate samples were used to develop the phobic stimuli response scales (PSRS). Factor analyses of data from the first sample (N = 380) led to the creation of several scales, two of which (Social and Blood-Injection Fears) demonstrated good reliability and convergent validity. Analyses of data from a second sample (N = 330) were used to modify the three remaining scales (Animal, Bodily Harm, and Physical Confinement Fears), which also showed sound psychometric properties. As predicted, the PSRS were differentially correlated with neuroticism and extraversion, which may represent predisposing factors for these phobic responses. These new scales improve our understanding of the individual differences that are associated with various fears.