Desensitization and the experimental reduction of threat

Behaviour Research and Therapy, 1973

AT LEAST two strategies of behavior modification seem possible in the treatment of neurotic disorders. In the first, systematic desensitization is used to reduce the anxiety associated with the avoidance behavior, thus reducing avoidance of the feared stimulus. In the second, anxiety is ignored and approach behavior is shaped by direct reinforcement according to operant conditioning principles. Each procedure enjoys a literature of successful application in both laboratory and clinical settings. Systematic desensitization has been effective in treating fears of small animals (Lang and Lazovik, 1963) interpersonal anxieties (Paul, 1966), and classic phobias (Lazarus, 1961). Operant approaches involving reinforced practice have proved successful in treating agoraphobia (Agras et al., 1968), anorexia nervosa (Bachrach et al., 1965), and various types of behavior of psychotic patients (Risley and Wolf, 1967; Ayllon and Azrin, 1968). The present study was designed to examine the relative therapeutic effectiveness of systematic desenzitization and reinforced practice in the treatment of snake phobia. Although Barlow et al. (1970) have suggested that "shaping" is more effective than systematic desensitization in the reduction of avoidance behavior, Ss in their "shaping" condition were given more experience with the aversive stimulus than desensitization Ss. The present study avoids such confounding.

Behavior Therapy, 1973

Systematic desensitization (SD) is a technique which usually takes place in a social context and involves the use of imagery and possibly other symbolic/cognitive processes as well. Research and theory bearing on these two sets of uniquely human variables are critically reviewed. The main conclusions are as follows: (a) a conceptualization of SD as a procedure which is effective via the induction of eounterphobie cognitions has failed to find replieable support and is, furthermore, questionable on a priori grounds because of the doubtful relevance of attribution theory to the alteration of severe, long-standing phobias; (b) expectation of gain can produce increments in beneficial effects arising from SD but does not appear to account for all improvement; (e) deliberately induced self-instructions may increase the efficacy of SD and may, furthermore, be operating in uncontrolled but important ways in the procedure as currently practiced; (d) the word "cognitive" is used in both a descriptive and an explanatory sense in the literature, threatening even more obfuscation than already exists; (e) experiments designed to determine the role of the desensitizer as a social reinforcer for increased (imaginal) approach behavior are either inappropriate in conception, confounded in design, or productive of inconclusive results; and (f) stimulus-response formulations are proposed not to be ipso [aeto incapable of usefully conceptualizing and manipulating covert processes, including imagery.

Journal of Behavior Therapy and Experimental Psychiatry, 1972

A videotape of anxiety-provoking situations, arranged in a hierarchy from least anxiety-provoking to most anxiety-provoking has been developed for systematic desensitization therapy of test anxiety. This videotape makes it possible to do without a therapist since it can be automated and self-administered by the client. The videotape recording can also be duplicated or altered to fit specific research designs.t

Behaviour Research and Therapy, 2000

To 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 a cognitive load distracter task, (c) exposure with both guided threat reappraisal and cognitive load distracter task and (d) exposure without guided threat reappraisal or cognitive load distracter task. We 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 ®ndings were largely consistent with predictions. The cognitive load task (regardless of focus of available attention) had a detrimental eect on fear reduction, while guided threat reappraisal (regardless of cognitive load) had a facilitative eect. The greatest level of fear reduction and the lowest level of return of fear were observed in the exposure condition involving guided threat reappraisal without cognitive load. Clinical implications and directions for future research are discussed. 7

Journal of Abnormal Psychology, 1969

Forty-four snake and spider phobic 5s, selected from a large pool of undergraduates were exposed to either (a) a form of systematic desensitization treatment, (6) a technique, called T-scope therapy, which embodies most of the expectancy-manipulating features of desensitization, but does not contain the technical elements of the procedure (i.e., relaxation, visualization, and the construction of an anxiety hierarchy), (c) T-scope therapy, presented as an "incomplete" and probably ineffective form of treatment, or (d) no treatment. There were no significant differences (on self-rating, runway, or interview measures) between the effects of the systematic desensitization procedure and T-scope therapy, although 5s receiving either of these treatments improved significantly more than those who received no treatment or T-scope therapy administered under the "low-expectancy" condition.

Biological Psychology, 1973

The capacity of 10 normal subjects to adapt to repeated stress was studied by exploring their emotional and psychophysiological responses on exposure, on four successive days, to stressful film shown on television via a videotape system. Contrary to the prediction that they would adapt on all measures, their skin conductance responses failed to do so. The possible reasons for this were discussed. It was concluded that the use of a videotape system to induce stress provides a flexible and effective means of further exploring the way normal populations cope with repeated stress.

Behaviour Research and Therapy, 1976

Frank and Dachinger (1974) found support for their hypothesis that the effectiveness of systematic desensitization (SD) resides in its activation of unconscious. merging fantasies. Their subjects were subjected to a variant of SD. in which a procedure aimed at stimulating a fantasy of 'merging with mother' was substituted for muscle relaxation. This procedure consisted of the tachistoscopic subliminal exposure of the symbiotic gratification stimulus MOMMY AUD I AKL ONE (experimental) or neutral stimulus PEOPLE WALKING (control). The aim of the present study was to replicate their work with special reference to demand characteristics. using as subjects snake phobics. SD with a symbiotic gratification stimulus was not more effective than SD with a neutral stimulus. which may be explained by the fact that the neutral stimulus in the present study SAKE AND I ARE ONF was more relevant than the neutral stimulus in the Silverman et al. study. Moreover. subjects with a therapy-set improved significantly more than subjects with a research-set.

Behavior Therapy, 1975

Thirty-one subjects were assigned to one of three experimental conditions: cuecontrolled relaxation, systematic desensitization, or no-treatment control. Selfreport anxiety and academic performance data were collected before and after the treatment program. Both cue-controlled and systematic desensitization procedures produced significant reductions in reported anxiety on the two dependent variables directly related to test anxiety. No significant difference was found between experimental conditions on the measure of academic performance. In addition, no significant difference was observed between the cue-controlled and systematic desensitization procedures on any of the dependent variables. The behavioral treatment of test anxiety typically has involved the implementation of systematic desensitization (SD) procedures. The effectiveness of this technique has received considerable support in the literature (Paul & Shannon, 1966; Suinn, 1968; Doctor, Aponte, Burry & Welsh, 1970), although, as Allen (1972) points out, the vast majority of these investigations suffer from methodological shortcomings. Recently, several brief reports have been published demonstrating the applicability of a procedure known as cue-controlled relaxation for the treatment of test anxiety (Russell & Sipich, 1973; Russell & Sipich, 1974: Russell, Miller & June, 1974). To date, these articles have involved the use of the cue-controlled procedure in both individual and group therapy settings. While these investigations have been useful from a procedural standpoint, the conclusions drawn have been only suggestive since relevant control conditions have not been included in the design. Given the potential applicability of the cue-controlled relaxation technique for the treatment of a wide range of anxiety reactions (Russell & Sipich, 1973), a more systematic evaluation of this procedure is needed.

Clinical Psychology Review, 2005

. Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behavior Modification, 27, 300-312] recommended that empirically supported principles be listed instead of empirically supported treatments because the latter approach enables the creation of putatively new therapies by adding functionally inert components to already listed effective treatments. This article attempts to facilitate inquiry into empirically supported principles by reviewing possible mechanisms responsible for the effectiveness of systematic desensitization and exposure therapy. These interventions were selected because they were among the first empirically supported treatments for which some attempt was made at explanation. Reciprocal inhibition, counterconditioning, habituation, extinction, two-factor model, cognitive changes including expectation, self-efficacy, cognitive restructuring, and informal network-based emotional processing explanations are considered. Logical problems and/or available empirical evidence attenuate or undercut these explanations. A connectionist learning-memory mechanism supported by findings from behavioral and neuroscience research is provided. It demonstrates the utility of preferring empirically supported principles over treatments. Problems and limitations of connectionist explanations are presented. This explanation warrants further consideration and should stimulate discussion concerning empirically supported principles. D Clinical Psychology Review 25 (2005) 67 -95

Cognitive Therapy and Research, 1980