Exposure therapy for arachnophobia can benefit unrelated fears, study finds

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Researchers have found that people who are scared of one thing often become scared of similar things too, a process known as fear generalization. Exposure therapy, where people are gradually exposed to what they’re afraid of in a controlled way, is the best treatment we have, teaching the brain that the feared thing is no longer a threat. This therapy doesn’t just reduce fear of the specific thing it’s aimed at but can also lessen fear of other, similar things. For example, treating a fear of spiders might also reduce a fear of cockroaches.

Iris Kodzaga and colleagues looked into whether this effect can apply to completely different fears, like treating a fear of spiders to help with a fear of heights, to understand how broad and effective this therapy can be. This research was published in Translational Psychiatry.

A telephone screening process identified individuals between 18–40 years old who reported fears of spiders and heights, excluding those with acute psychological conditions or ongoing treatments. This process narrowed down the participant pool to a final sample of 50, divided into exposure and control groups.

Materials used in the study included a non-venomous house spider and a 72-meter church tower for the fear-inducing stimuli, alongside various diagnostic and assessment tools such as the Mini-DIPS, Beck’s Depression Inventory-II, and the Fear of Spiders Questionnaire. Behavioral Approach Tests (BATs) assessed fear and avoidance behaviors towards spiders and heights.

The study started with the initial screening and recruitment, followed by a pre-assessment phase where participants completed diagnostic interviews and questionnaires, and underwent BATs for spiders and heights to establish baseline fear levels. The exposure group then received therapy based on Öst’s protocol, involving 14 steps of increasing proximity to the spider, monitored by the Subjective Unit of Distress Scale.

A post-assessment for this group involved repeating the BATs and questionnaires to gauge changes in fear and avoidance behaviors. The control group underwent a similar process but without the exposure therapy, to assess the impact of time and task repetition alone.

Exposure therapy significantly reduced fear and avoidance behaviors in individuals with a fear of spiders, with improvements observed in both subjective fear levels and behavioral scores during spider BATs. These effects were not only confined to the treated spider fear but also generalized to an untreated fear of heights.

Both the exposure and control groups exhibited increased approach behavior towards heights, but the exposure group showed a more substantial reduction in fear, as evidenced by decreased subjective fear ratings and Acrophobia Questionnaire scores. This indicates that exposure therapy not only directly addresses specific fears but also has a broader impact on reducing related, untreated fears, showcasing its effectiveness in tackling fear generalization.

Future studies ought to replicate these findings across various anxiety disorders and include long-term follow-ups to assess the durability of these generalization effects.

The paper, “Generalization of beneficial exposure effects to untreated stimuli from another fear category”, was authored by Iris Kodzaga, Ekrem Dere, and Armin Zlomuzica.

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