Spider Fear Research Articles

Augmenting Exposure Therapy: Mobile Augmented Reality for Specific Phobia

New technologies, such as virtual reality (VR) and augmented reality (AR), can be used as an add-on to exposure therapy for common anxiety disorders. While the benefits of VR for exposure therapy have already been demonstrated extensively in research, AR applications are only just becoming widely available. Evidence for the added value and effectiveness of augmented reality exposure therapy (ARET) is still scarce. The current study aimed to explore whether a first markerless AR iOS app for specific phobia could induce fear for multiple animal species in a general population sample. In two experiments participants made use of the Phobos AR app in a behavioral approach task (BAT), using animals for which they were anxious, but not phobic. Self-report data and physiological measures were recorded. In Experiment 1, 108 participants chose one of the seven available animal species and were either allocated to a smartphone or tablet condition. Results showed increasing levels of self-reported anxiety with increasing levels of BAT difficulty. However, this increase was smaller in individuals reporting low levels of perceived realism. No effects on heart rate (HR) could be established. In Experiment 2, 52 participants were exposed to virtual spiders. For both self-reported anxiety and the interaction with perceived realism, results were similar to Experiment 1. Skin conductance did increase significantly from baseline to the highest level of difficulty of the BAT and the severity of fear of spiders also appeared to be related to the fear response in the BAT. In conclusion, the study shows that animals presented in AR through a mobile device can evoke anxiety, which is a prerequisite for the implementation of ARET. However, further research should establish the effects of ARET in a clinical sample of people with specific phobias.

Decrease in amygdala activity during repeated exposure to spider images predicts avoidance behavior in spider fearful individuals

Spider phobia is characterized by exaggerated fear of situations where spiders could be present, resulting in avoidance of such situations and compromised quality of life. An important component in psychological treatment of spider phobia is exposure to phobic situations that reduces avoidance behaviors. At the neural level, amygdala responses to phobic material are elevated, but normalizes following exposure treatment. To what extent amygdala activity decreases during a session of repeated phobic stimulation, and whether activity decrease is related to subsequent avoidance is not well studied. We hypothesized reduced amygdala activity during the course of repeated exposure to spider pictures, and that the degree of reduction would predict subsequent avoidance of spider pictures. To test our hypothesis, functional magnetic resonance imaging was performed in 45 individuals with spider fear during repeated exposure to spider pictures. Results showed that repeated exposure to spider stimuli attenuated amygdala reactivity and individual differences in activity reductions predicted subsequent avoidance behavior to spider pictures in an incentive-conflict task, with larger attenuations predicting less avoidance. At 6-month follow up, initial reductions in amygdala activation still predicted avoidance. This result demonstrates that reduction in amygdala responses is related to clinically meaningful outcomes in human anxiety, and suggests that within-session reductions in amygdala responses could be an important mechanism explaining the clinical effects of exposure therapy.

Specific Phobias: Maintaining Control in the Face of Chaotic Threats

Introduction: Drawing on existential psychology we examine the possibility that specific phobias can serve a psychological function. Specifically, we propose that phobic objects allow individuals to focalize anxieties about haphazard existential threats into a more manageable form, reducing perceptions of risk and bolstering control. Method: We tested this by assessing perceived control among participants with varying levels of spider fear who were reminded of chaotic hazards (or not) and exposed to spiders images (or not). Results: Study 1 (N = 940) found that among those high in spider fear, salient uncontrollable threats (vs. controllable threats or uncontrollable non-threats) reduced feelings of control unless participants were exposed to their phobic object. Similarly, exposure to spider (vs. non-spider) images bolstered perceived control in the face of salient hazards, but only for those high in spider fear. A second preregistered study (N = 1349) found that the palliative effects of focusing on a phobic object were partially explained by a decreased concern with haphazard harms. Discussion: This supports the premise that phobic objects help to maintain control by narrowing the source of disordered risks, creating a more controllable conception of reality.

Faster detection of snake and spider phobia: revisited

Snake and spider phobia are one of the most prevalent anxiety disorders, yet quick and reliable measures are rather scarce. Recently, attempts have been made to shorten two widespread measures of snake and spider fear, the Snake Questionnaire (SNAQ) and Spider Questionnaire (SPQ). The new 12-item scales demonstrate very good psychometric qualities in terms of internal consistency and discriminatory power. Using the same approach on a bigger sample from another cultural background, we aimed to verify psychometric properties of the short scales. In total, 2 644 Czechs completed the SNAQ, 1 816 of which also completed the SPQ. The item response theory revealed that nine and seven items on the shorter SNAQ and SPQ, respectively, were identical with the Hungarian study. The 12-item scales show excellent reliability (α = 0.84 and 0.91) and highly correlate with scores on the full versions (r = 0.81 and 0.89) as well as with fear and disgust ratings of snake and spider images. Thus, despite slight discrepancies in the selected items, we confirm that the shorter SNAQ and SPQ keep considerable diagnostic strengths and can be used in the clinical practice as reliable, easy-to- administer, and fast screening tools for snake and spider phobia.

Progesterone levels predict reductions in behavioral avoidance following cognitive restructuring in women with spider phobia

BackgroundOvarian hormones have been implicated as a potential source of variability in the effectiveness of exposure therapy for anxiety disorders in women. Additionally, preclinical studies in healthy women indicate that ovarian hormones are related to cognitive modes of emotion regulation, like cognitive restructuring. The purpose of the current study was to determine whether a relationship exists between endogenous ovarian hormones and the outcomes of cognitive restructuring in clinically anxious women. MethodsNinety women with spider phobia received training in cognitive restructuring or a control task and provided a blood sample for the measurement of serum estradiol and progesterone levels. Behavioral avoidance, using a behavioral approach task with a live spider, and self-reported fear of spiders were measured at baseline and 1-week post-treatment. ResultsThe results indicated that heightened levels of progesterone, but not estradiol, at the time of cognitive restructuring predicted greater post-treatment reductions in behavioral avoidance, but not self-reported fear, amongst women who received cognitive restructuring but not those in the control group. LimitationsAs menstrual cycle phase was not assessed; the present study provides information regarding how the benefits of cognitive therapy are predicted by between-person individual differences in absolute hormone levels, but does not examine the relationship between within-person fluctuations in hormone levels and outcomes. ConclusionsThese results suggest the effectiveness of cognitive therapy for anxiety disorders in women may differ depending on endogenous levels of progesterone, and raise the possibility that progesterone could be a useful pharmacological adjunct to cognitive therapy.

Gamified, Automated Virtual Reality Exposure Therapy for Fear of Spiders: A Single-Subject Trial Under Simulated Real-World Conditions.

BackgroundVirtual Reality exposure therapy (VRET) is an evidence-based treatment of phobias and recent research suggests that this applies also to self-contained, automated interventions requiring no therapist guidance. With the advent and growing adoption of consumer VR technology, automated VR intervention have the potential to close the considerable treatment gap for specific phobias through dissemination as consumer applications, self-help at clinics, or as blended treatment. There is however a lack of translational effectiveness studies on VRET treatment effects under real-world conditions.MethodsWe conducted a single-arm (n = 25), single-subject study of automated, gamified VRET for fear of spiders, under simulated real-world conditions. After setup and reading instructions, participants completed the automated, single-session treatment by themselves. Self-rated fear of spiders and quality of life served as outcome measures, measured twice before, and one and two weeks after treatment, and at a six-month follow-up. Session characteristics and user experience measures were collected at the end of the session.ResultsMixed-effects modeling revealed a significant and large (d = 1.26) effect of treatment-onset on phobia symptoms (p < .001), and a small (d = 0.49) effect on quality of life (p = .025). Results were maintained at a six-month follow-up (p > .053). The intervention was tolerable and practical. There were no significant correlations between any user experience measure and decrease in phobia symptoms (p > .209).ConclusionsAn automated VRET intervention for fear of spiders showed equivalent effects on phobia symptoms under effectiveness conditions as previously reported under efficacy conditions. These results suggest that automated VRET applications are promising self-help treatments also when provided under real-world conditions.Pre-registrationOpen Science Foundation, https://doi.org/10.17605/OSF.IO/78GUB.

D-cycloserine as adjunct to brief computerised CBT for spider fear: Effects on fear, behaviour, and cognitive biases

Background and objectivesIn anxiety disorders, cognitive behavioural therapy (CBT) improves information-processing biases such as implicit fear evaluations and avoidance tendencies, which predicts treatment response. Thus, these cognitive biases might constitute important treatment targets. This study investigated (i) whether information-processing biases could be changed following single-session computerised CBT for spider fear, and (ii) whether this effect could be augmented by administration of D-cycloserine (DCS). MethodsSpider-fearful individuals were randomized to receiving either 250 mg of DCS (n = 21) or placebo (n = 17). Three hours after drug administration, they received single-session computerized CBT, characterized by psychoeducation and exposure elements. Spider fear was assessed using self-report, behavioural, and information processing (Extrinsic Affective Simon Task & Approach Avoidance Task) measures at baseline (before drug administration), post-treatment, 1-day, and 1-month follow-up. ResultsLinear mixed-effects analyses indicated significant improvements on self-report and behavioural spider fear indices following CBT, but not on cognitive bias measures. There was no evidence of an augmentation effect of DCS on any outcome. Cognitive bias measures at 1-day were not predictive of 1-month follow-up spider fear in adjusted linear regression analyses. LimitationsResults might be biased by limited representativeness of the sample (high education and intelligence, largely Caucasian ethnicity, young age). The study was also only powered for detection of medium-sized DCS effects. ConclusionsThese findings do not provide evidence for information-processing biases relating to treatment outcome following computerised CBT for spider fear or augmentation with DCS.

Efficacy of a Gamified Augmented Reality Exposure-based Application in Subjects With Fear of Spiders

Efficacy of a Gamified Augmented Reality Exposure-based Application in Subjects With Fear of Spiders

Reducing avoidance in adults with high spider fear using perceptual discrimination training.

Fear overgeneralization is a central feature of anxiety disorders and can lead to excessive avoidance. As perceptual discrimination is a key component of fear overgeneralization, a perceptual discrimination training task was created aimed at improving perceptual discrimination and reducing fear overgeneralization. Participants with high spider fear were randomized into training or placebo conditions. After completing their assigned task, perceptual discrimination was tested. Thereafter, participants completed a behavioral avoidance test, consisting of five stimuli ranging from a paper spider to a live tarantula. Last, participants completed a threat/safety discrimination task using schematic morphs ranging from a flower to a spider, while self-report and skin conductance responses were collected. The training group showed better perceptual discrimination during the test than did the placebo group. Furthermore, as stimuli became increasingly similar to a live spider, participants in the training group exhibited decreased avoidance behavior. Finally, participants in the training group indicated that schematic morphs were less similar to a spider and showed less physiological arousal than did the placebo group. Together, these results attest to the possible clinical relevance of the perceptual discrimination training.

Content-Specific Interpretation Bias in Children with Varying Levels of Anxiety: The Role of Gender and Age

The current study examined whether children varying in their levels of social anxiety, separation anxiety and spider fear exhibit a negative interpretation bias specific for their fears. Furthermore, age and gender were assessed as moderators of this relation. Children (N = 603) of the age of 7–12 years were asked to solve ambiguous scenarios reflecting social threat, separation threat or spider threat. Children’s levels of anxiety were assessed with self-report questionnaires. Results indicated that children scoring higher on self-reported social anxiety, separation anxiety or spider fear, displayed a negative interpretation bias for the threat-scenarios pertaining to their specific anxiety or fear, even after controlling for comorbidity with other anxiety subtypes. Contrary to our hypotheses, we did not find moderating effects of age or gender. These results indicate that even in a community sample, content-specificity of negative interpretation biases is present.

Possibilities of using virtual reality as a means for therapy from fear of spiders

The subject of this article is to find out whether virtual reality can affect phobia of spiders. For this pre-research were performed 20 experiments on a small sample of subjects. Two approaches were used to measure during the experiments. The values of results are represented by this post.

Immersive 3D exposure-based treatment for spider fear: A randomized controlled trial

Stereoscopic 3D gives the viewer the same shape, size, perspective and depth they would experience viewing the real world and could mimic the perceptual threat cues present in real life. This is the first study to investigate whether an immersive stereoscopic 3D video exposure-based treatment would be effective in reducing fear of spiders. Participants with a fear of spiders (N = 77) watched two psychoeducational videos with facts about spiders and phobias. They were then randomized to a treatment condition that watched a single session of a stereoscopic 3D immersive video exposure-based treatment (six 5-minute exposures) delivered through a virtual reality headset or a psychoeducation only control condition that watched a 30-minute neutral video (2D documentary) presented on a computer monitor. Assessments of spider fear (Fear of Spiders Questionnaire [FSQ], Behavioral Approach Task [BAT], & subjective ratings of fear) were completed pre- and post-treatment. Consistent with prediction, the stereoscopic 3D video condition outperformed the control condition in reducing fear of spiders showing a large between-group change effect size on the FSQ (Cohen’s d = 0.85) and a medium between-group effect size on the BAT (Cohen’s d = 0.47). This provides initial support for stereoscopic 3D video in treating phobias.

A randomized controlled trial of the judicious use of safety behaviors during exposure therapy

Safety behaviors—actions performed to prevent, escape from, or reduce the severity of perceived threat—are typically eliminated during exposure therapy for clinical anxiety. Yet some experts have called for the strategic and “judicious use” of safety behaviors during exposure to improve treatment acceptability/tolerability without diminishing its efficacy. Empirical findings regarding this debate are mixed and existing work is subject to several methodological limitations. The current randomized controlled trial incorporated longitudinal design and multimethod assessment to compare the efficacy of traditional exposure with the elimination of safety behaviors (E/ESB) and exposure with judiciously used safety behaviors (E/JU). Adults with clinically significant spider fear (N = 60) were randomized to four twice-weekly sessions of E/ESB or E/JU. Self-report and behavioral measures were administered at pretreatment, posttreatment, and 1-month follow-up. Participants exhibited large effects on all measures from pretreatment to posttreatment, with no change from posttreatment to follow-up. There were no significant group differences in treatment outcome or treatment acceptability/tolerability. Exploratory analyses were used to compare behavioral and inhibitory learning processes between conditions. Clinical implications, study limitations, and future directions are discussed in terms of inhibitory learning theory.

Development of a Pictorial Semi-Structured Child Anxiety and Coping Interview (CACI): Preliminary Analysis with School Children aged 5–7 years

This school-based study reports on the development and preliminary analysis of the new pictorial semi-structured Child Anxiety and Coping Interview (CACI). Participants included 195 children (Mage= 6.71;SDage= .76) drawn from 29 primary schools located in Western Sydney, Australia. The study used a mixed qualitative and quantitative design. The CACI was used to elicit the children's self-report on their problems, emotions, coping strategies, and coping self-efficacy. Qualitative content and thematic analysis were used to code the children's nominated coping strategies for their problems in the home and school contexts. The top five most common problems reported were as follows: fear of spiders or insects, fear of the dark, going places without parents, doing badly at school, and heights. The top five most common coping strategies reported by the children were support seeking, behavioural avoidance, solving the problem, facing the challenge, and behavioural distraction. Self-reported negative emotional intensity was highest for fear of the dark. Coping self-efficacy for fear of the dark was also high, suggesting the children found their coping strategies helpful, including those that were maladaptive. The clinical implications of these findings are discussed.

Re-Examining Psychological Mechanisms Underlying Virtual Reality-Based Exposure for Spider Phobia.

The proposed study aims at expanding results from a previous study on mechanisms of change after exposure in virtual reality (VR) and documenting the impact of adding tactile and haptic feedback. It was predicted that change in the severity of spider phobia according to the Fear of Spiders Questionnaire (FSQ) would be significantly predicted by change in dysfunctional beliefs toward spiders and self-efficacy, over and above the variance explained by a physiological measure of fear during exposure (heart rate) and presence during the immersion. Participants (N = 59) were randomly assigned to the presentation of visual stimuli only, visual plus tactile stimuli, or visual, tactile plus haptic feedback stimuli. A standard multiple regression was conducted to predict change on the FSQ using the following predictors: beliefs about spiders, beliefs about one's own behavior when facing spiders, perceived self-efficacy, disgust, presence, and heart rate. Only changes in beliefs about spiders and in perceived self-efficacy significantly predicted the reduction in fear of spiders. This result enhances our understanding of the mechanisms involved in exposure conducted in VR. Analyses of variance also show that participants reported statistically significant changes in their clinical condition, with little added value to the addition of tactile and haptic feedback. The advantages of tactile and haptic stimulation are questioned, at least in the context of only one brief exposure session and the equipment used.

The feasibility of an augment reality system to study the psychophysiological correlates of fear-related responses.

BackgroundPrevious studies have successfully used augmented reality (AR) as an aid to exposure‐based treatments for anxiety disorders. However, to the best of our knowledge, none of these studies have measured the physiological correlates of the fear response, relying solely on self‐reports and behavioral avoidance tests.MethodsAs the physiological defensive reactivity pattern impacts on the treatment effectiveness, we tested the feasibility of an AR system integrated in a mobile and wearable device for assessing the psychophysiological mechanisms (heart rate) involved in fear responses in real‐life contexts. Specific phobia was used as a model given its prototypical defensive hyperreactivity toward the feared stimulus (spiders to spider phobics, in the current study).ResultsThe results showed that the stimuli presented using AR were able to induce physiological alterations in the participants, which were specific depending on the stimulus type (fear or neutral) and on the participants’ level of spider fear (phobic and control group). These physiological correlates of the fear response were reflected both in the intensity of heart rate (in relation to the baseline) and in the time needed to react and recover after the stimulus exposure. Finally, we tested a theoretical model that showed that the physiological responses of phobic individuals when facing their phobic stimulus only explained its own data.ConclusionsWe argue in favor of the system's feasibility at capturing and quantifying the physiological dimension of fear‐related responses, which may be of great value for diagnostic and treatment purposes in anxiety disorders, namely specific phobia.

Facing fear-provoking stimuli: The role of courage and influence of task-importance

ABSTRACTCourage research is emerging, although there is little empirical literature on task-importance, and morality or nobility within courage. This experimental study assessed courage, persistence despite fear, in the relationship between anxiety, behavioral approach and task-importance. Twenty-eight participants with elevated spider fear were randomly assigned to high or low importance conditions. Participants undertook a behavioral approach test where they moved their hand alongside a ruler to as close as they felt comfortable to a non-living spider display. In partial support of the first hypothesis, courage scores predicted behavioral approach distance above-and-beyond spider fear when task-importance was not experimentally augmented. Supporting the second hypothesis, experimentally induced task-importance significantly moderated the relationship between courage and behavioral approach distance such that high importance participants moved closer to the spiders at all levels of courage. This study provides foundational evidence that 1) self-report measures can predict behavioral courage above-and-beyond fear 2) perceived task-importance influences behaviour.

The Scarier the Better: Maximizing Exposure Therapy Outcomes for Spider Fear.

While exposure therapy effectively reduces anxiety associated with specific phobias, not all individuals respond to treatment and some will experience a return of fear after treatment ceases. This study aimed to test the potential benefit of increasing the intensity of exposure therapy by adding an extra step that challenged uncontrollability (Step 15: allowing a spider to walk freely over one's body) to the standard fear hierarchy. Fifty-one participants who had a severe fear of spiders completed two 60-min exposure sessions 1 week apart in a context that was either the same or different from the baseline and follow-up assessment context. Participants were categorized into groups based on the last hierarchy step they completed during treatment (Step 14 or fewer, or Step 15). Those who completed Step 15 had greater reductions in fear and beliefs about the probability of harm from baseline to post-treatment than those who completed fewer steps. Although completing Step 15 did not prevent fear from returning after a context change, it allowed people to maintain their ability to tolerate their fear, which earlier steps did not. Despite some fear returning after a context change, individuals who completed Step 15 tended to report greater reductions in fear from baseline to the follow-up assessment than participants who completed 14 or fewer steps. Overall, these results suggest that more intensive exposure that directly challenges harm beliefs may lead to greater changes in fear and fear beliefs than less intensive exposure.

Spider Fear Versus Scorpion Fear in Undergraduate Students at Five American Universities

Spider Fear Versus Scorpion Fear in Undergraduate Students at Five American Universities

Immersive 3D exposure-based treatment for spider fear: A randomized controlled trial

Stereoscopic 3D gives the viewer the same shape, size, perspective and depth they would experience viewing the real world and could mimic the perceptual threat cues present in real life. This is the first study to investigate whether an immersive stereoscopic 3D video exposure-based treatment would be effective in reducing fear of spiders. Participants with a fear of spiders (N = 77) watched two psychoeducational videos with facts about spiders and phobias. They were then randomized to a treatment condition that watched a single session of a stereoscopic 3D immersive video exposure-based treatment (six 5-min exposures) delivered through a virtual reality headset or a psychoeducation only control condition that watched a 30-min neutral video (2D documentary) presented on a computer monitor. Assessments of spider fear (Fear of Spiders Questionnaire [FSQ], Behavioral Approach Task [BAT], & subjective ratings of fear) were completed pre- and post-treatment. Consistent with prediction, the stereoscopic 3D video condition outperformed the control condition in reducing fear of spiders showing a large between-group effect size on the FSQ (Cohen’s d = 0.85) and a medium between-group effect size on the BAT (Cohen’s d = 0.47). This provides initial support for stereoscopic 3D video in treating phobias.