Abstract
Objective: Large-group one-session treatments (LG-OSTs) might represent a promising treatment tool as increasing evidence suggests their effectiveness in individuals with different situational fears. In the present study, we explored feasibility and effectiveness of an exposure-based LG-OST protocol applying applied tension and diaphragmatic breathing as coping strategies in a sample of 40 individuals, highly fearful of blood-injury-injection (BII).Method: We assessed participants’ BII-fear using questionnaires and a behavioral approach test (BAT) before and after treatment, consisting of a blood-drawing procedure. Stability of treatment effects was assessed via online-survey at 7-month follow-up.Results: The LG-OST procedure evidenced feasible and effective. Pre-post treatment comparisons showed medium to large treatment effects (d = 0.40–0.93) regarding the questionnaire measures. After being treated, 70% of the individuals successfully underwent a blood drawing. Moreover, participants continued to improve in the post follow-up interval leading to large treatment effects (d = 1.19–1.62).Conclusion: In treating BII-fear, LG-OSTs might not only serve within a framework of a stepped care approach but also could represent a useful single-treatment option. Additionally, due to their high efficiency and standardization of treatment delivery, LG-OST protocols might foster research at the interface of basic and clinical research.
Highlights
With a reported 12-month prevalence rate between 7 and 9% (Wittchen et al, 2011), Specific Phobias (SPs) are among the most frequent single mental disorders in adults in Western countries
In the Phase I study, we investigated the feasibility and effectiveness of the LG-one-session treatments (OSTs) protocol in a group of 40 participants and explored potential outcome-predictors of large-group settings (LG-OSTs)
Prior LG-OST trials conducted in spider fearful (Wannemueller et al, 2016) and dental fearful individuals (Wannemueller et al, 2017) were already promising, and the results of the present study clearly underline the feasibility and usefulness of LG-OST protocols
Summary
With a reported 12-month prevalence rate between 7 and 9% (Wittchen et al, 2011), Specific Phobias (SPs) are among the most frequent single mental disorders in adults in Western countries. Just like in other phobia-subtypes, a main feature of BII-phobia is an intense, persistent subjective fear response difficult to control when phobia-related stimuli are present or anticipated (see American Psychiatric Association [APA], 2013 for all symptom criteria) BII-phobia is distinctive among SPs due to its unique physiological response pattern differing from other phobia subtypes. In about 75% of cases, an initial sympathetic activating response is followed by a vasovagal response (American Psychiatric Association [APA], 2013). This diphasic pattern first described by Graham et al (1961) leads to pre-syncopal symptoms (e.g., nausea, blurred vision) and may result in fainting and loss of consciousness triggered by a decreased transient cervical perfusion. It can be considered to be among the most debilitating SPs
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