Date of Award

4-1-2004

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. C. Richard Spates

Second Advisor

Dr. Lisa Baker

Third Advisor

Dr. Amy Naugle

Fourth Advisor

Dr. Lisa Largo-Marsh

Abstract

Current research suggests that exposure-based interventions are the treatment of choice for anxiety disorders (Barlow & Wolfe, 1981; Barlow, 1988; 2002; Zinbarg, Barlow, Brown, & Hertz, 1992; Foa, Rothbaum, & Kozak, 1989). While the evidence to date supports the efficacy of these procedures, the precise mechanisms by which they achieve symptom reduction are not yet fully understood. Most theoretical explanations of exposure therapy appeal to the respondent and operant conditioning processes from which the procedure was originally derived. While it is frequently argued that in order to achieve operant and respondent extinction, exposure must be delivered continuously, without interruption (Barlow, 1988; Foa & Kozak, 1986; Groves & Thompson, 1970; Rachman, 1980), the empirical evidence suggests that under the right circumstances interrupted exposure is capable of producing extinction. The present study examined exposure-based therapies for anxiety by isolating the exposure procedure from these complex treatment packages. Two experiments were used. The first experiment tested the hypothesis that in vivo exposure to anxiety-producing stimuli in the absence of other treatment package components leads to a reduction in anxiety symptoms. Three participants with public speaking anxiety were exposed to a continuous public speaking task in a multiple-baseline across subjects design. The intervention produced reductions in anxiety symptoms in those symptom clusters for which initial reactivity was evident. However, there was much variability both within and across participants with regard to the overall effectiveness of the interventions. On self-report measures administered at pre- and post-treatment, the results were variable across participants. The second experiment tested the hypothesis that anxiety reduction is achieved when the exposure is delivered in brief doses. Three participants with public speaking anxiety were exposed to a public speaking task in 30-sec. doses in a multiple-baseline across subjects design. The intervention produced reductions in anxiety symptoms across clusters between pre- and post-treatment. Within-session response patterns suggested lower levels of anxiety within the intervention than those evident during the continuous intervention.The results are discussed within the context of the existing exposure therapy literature and current theoretical accounts of exposure therapy.

Access Setting

Dissertation-Open Access

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