Behaviour research and therapy
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The treatment of choice for a number of anxiety disorders is exposure therapy. However, successful reduction of fear through exposure is sometimes followed by a (partial) return of symptoms of fear (return of fear, ROF; Clin. Psychol. ⋯ No differences were observed in a reaction time measure of resource allocation to the conditioned stimuli. These findings constitute a first demonstration of reinstatement of conditioned fear responses in humans. Implications for exposure treatment and suggestions for future research are discussed.
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This study examined differences between socially anxious and nonanxious individuals' ability to use effective communication skills and social skills in the context of romantic relationships. Socially anxious (n = 13) and nonanxious (n = 14) individuals and their romantic partners were videotaped while participating in 10-minute neutral, negative, and pleasant conversations. ⋯ Partners of socially anxious and nonanxious individuals did not differ in their communication quality. The results suggest that social anxiety is associated with deficits in relationship maintenance behavior and call for the completion of a larger study examining the interpersonal consequences of social anxiety.
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In a differential human fear conditioning paradigm evidence for ABA-renewal was obtained manipulating the lighting in the experimental room. During acquisition in either a dark or illuminated room, one neutral slide was sometimes paired with a loud aversive noise whereas another slide was not. ⋯ No response recovery was obtained in an AAA-group that received acquisition, extinction and test trials in one and the same context. Several theoretical explanations for this type of return of fear as well as implications for clinical practice are discussed.
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In a human fear conditioning experiment, 32 participants were trained in a differential conditioning procedure with geometrical shapes as CS+ and CS- (four presentations each), and an electric shock as US. Measures of conditioned responding were skin conductance response (SCR) and retrospective US-expectancy ratings. For half of the participants (Generalization Group, GG), the subsequent extinction phase consisted of four nonreinforced presentations of generalization stimuli (GS+ and GS-). ⋯ Interestingly, the size of the conditioned SCR discrimination in the GG is not influenced by the stimulus change after acquisition. This observation points to a differential impact of stimulus change after acquisition vs. extinction treatment. The findings are discussed from the theoretical perspective of renewal and the clinical perspective of Return of Fear.
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Discontinuation of benzodiazepine (BZD) treatment for insomnia can be a difficult task. Cognitive-behavior therapy (CBT) for insomnia, combined with a supervised medication taper, can facilitate withdrawal but there is limited evidence on long-term outcome after discontinuation. The objective of this study was to examine medication-free survival time and predictors of relapse (i.e., resumed BZD hypnotics) over a 2-year period in 47 older adults (mean age 62.1 years) with persistent insomnia and prolonged BZD use (average duration of 18.9 years), who had successfully discontinued BZD following CBT for insomnia, a supervised medication taper program, or a combined approach. ⋯ Significant predictors of relapse included treatment condition, end of treatment insomnia severity, and psychological distress. In conclusion, there is a substantial relapse rate following BZD discontinuation among prolonged users. CBT booster sessions might enhance compliance with CBT and prove useful in preventing relapse.