Does threatening imagery sensitize distress during contaminant exposure?

Prominent models of fear focus on the role of cognition in the development and maintenance of maladaptive responses. Little research, however, has evaluated the impact of cognition on distress reduction. The current study uses an experimental design to examine the effect of different types of imagery (moving harm, static harm, and safety) on reduction of distress associated with a contaminating stimulus in a normal university sample. Results indicate that use of moving harm imagery sensitizes distress during a 30-min exposure, whereas static harm and safety imagery reduce distress. These findings demonstrate that cognitive factors can moderate affective response during exposure. Clinical implications for the treatment of anxiety disorders are discussed.

Do patients drop out prematurely from exposure therapy for PTSD?

Many studies have demonstrated the efficacy of exposure therapy in the treatment of chronic post-traumatic stress disorder (PTSD). Despite the convincing outcome literature, a concern that this treatment may exacerbate symptoms and lead to premature dropout has been voiced on the basis of a few reports. In this paper, we examined the hypothesis that treatments that include exposure will be associated with a higher dropout rate than treatments that do not include exposure. A literature search identified 25 controlled studies of cognitive-behavioral treatment for PTSD that included data on dropout. The results indicated no difference in dropout rates among exposure therapy, cognitive therapy, stress inoculation training, and EMDR. These findings are consistent with previous research about the tolerability of exposure therapy.