Paul Siegel

Very brief exposure: The effects of unreportable stimuli on fearful behavior

A series of experiments tested the hypothesis that very brief exposure to feared stimuli can have positive effects on avoidance of the corresponding feared object. Participants identified themselves as fearful of spiders through a widely used questionnaire. A preliminary experiment showed that they were unable to identify the stimuli used in the main experiments. Experiment 2 (N=65) compared the effects of exposure to masked feared stimuli at short and long stimulus onset asynchronies (SOA). Participants were individually administered one of three continuous series of backwards masked or non-masked stimuli: unreportable images of spiders (25-ms SOA), clearly visible images of spiders (500-ms SOA), or unreportable images of trees (25-ms SOA). Immediately thereafter, they engaged in a Behavioral Avoidance Test (BAT) with a live, caged tarantula. Exposure to unreportable images of spiders resulted in greater approach towards the tarantula than unreportable neutral images. A post-hoc comparison with clearly visible exposure to these same images approached significance. These effects were maintained at a 1-week follow-up (N=57). In Experiment 3 (N=26), participants engaged in the BAT 1 week prior to the exposure manipulation in order to provide a baseline measurement of their avoidant behavior, and again immediately after the exposure manipulation. Exposure to unreportable images of spiders reduced avoidance of the tarantula. Similar exposure to trees did not. Implications for the non-conscious basis of fear are discussed.

What you cannot see can help you: the effect of exposure to unreportable stimuli on approach behavior.

We examined effects of exposure to unreportable images of spiders on approach towards a tarantula. Pretests revealed awareness of the stimuli was at chance. Participants high or low (top and bottom 15%) on fear of spiders were randomly assigned to receive computer-generated exposure to unreportable pictures of spiders or outdoor scenes. They then engaged in a Behavioral Approach Task (BAT) with a live tarantula. Non-fearful participants completed more BAT items than spider-fearful individuals. Additionally, as predicted, a significant interaction (F(1,48)=5.12, p<.03) between fear of spiders and stimulus demonstrated that spider-fearful participants exposed to spiders completed more BAT items than spider-fearful participants exposed to control stimuli (but not as many as non-fearful participants). The findings support the hypothesis that exposure to unreportable feared stimuli promotes approach towards the feared object. Future research and clinical implications were discussed.

Less is more: the effects of very brief versus clearly visible exposure.

This study compared the effects of exposure to masked and unmasked phobic stimuli on phobic behavior. Participants were identified as spider-phobic with a questionnaire and a Behavioral Avoidance Test (BAT) with a live tarantula (N = 101). One week later, they were administered one of three types of exposure: very brief (25 ms) or clearly visible (120 ms) images of spiders, or very brief images of flowers. They reported ratings of subjective distress just before and after these exposures, and engaged in the BAT again thereafter. Two weeks later, 57 participants returned for a follow-up BAT. The results indicated a double dissociation between the effects of very brief and clearly visible exposure: the former reduced avoidance of the tarantula and did not affect distress, whereas the latter increased distress but did not affect avoidance. The behavioral effect lasted for two weeks. These findings suggest that avoidance of a feared object can be reduced without full conscious awareness. The theoretical implications are discussed.

Affective scripts: A systematic case study of change in psychotherapy

Abstract This article presents a systematic case study of maladaptive interpersonal schemas. These schemas are conceived of as affective scripts, or sequences of behaviors that regulate emotion in interpersonal relationships. Part I presents a test of the method for identifying affective scripts. Independent raters applied FRAMES (Fundamental Repetitive and Maladaptive Emotion Structures; Hoelzer & Dahl, 1996) to a representative sample of transcripts of a long-term psychotherapy. Empirical checks of each assessment procedure verified the identification of five maladaptive scripts in hundreds of narratives and enactments with the therapist. In Part II, these scripts were tracked across treatment to identify adaptive changes. Statistical analyses indicated a reduction in maladaptive scripts and an increase in adaptive changes. The evolution of the most pervasive script is described in detail. Strengths and weaknesses of the method are discussed.

FRAMES: The Method in Action and the Assessment of Its Reliability.

This article reintroduces an alternative method of thematic structure and content analysis called FRAMES (Fundamental, Repetitive, and Maladaptive Emotion Structures). Although this measure has been generally received as clinically sensitive and compelling, it has not been widely used by psychotherapy researchers, presumably because of methodological concerns and logistical complexity. First, we present a brief overview of FRAMES for the unfamiliar reader, including the methodological refinements that have been made. This new method for finding FRAMES is demonstrated for the first time with segments of verbatim psychotherapy transcripts. A set of methods for assessing the interrater reliability of this method is then introduced. The results of the first study of the reliability of FRAMES in a psychotherapy case are then presented. This study is a precursor to future articles that present the results of the first longitudinal study of FRAMES in this same case.

Less is still more: maintenance of the very brief exposure effect 1 year later.

This study tested the hypothesis that an immediate effect of exposure to masked phobic stimuli on avoidance of the corresponding feared object would be maintained 1 year later. Fifty-three spider-phobic participants were identified with a questionnaire and a Behavioral Avoidance Test (BAT) with a live tarantula. One week later, they were administered 1 of 3 types of exposure: very brief (25-ms, masked) or clearly visible (125-ms, unmasked) images of spiders, or very brief images of flowers. They engaged in the BAT again immediately thereafter. One year later, they returned for a follow-up BAT. The immediate effect of exposure to very brief spiders on reducing avoidance of the tarantula was still evident 1 year later. Endurance of an effect by masked stimuli of this duration has not been reported before. Potential theoretical implications are discussed.

The effect of very brief exposure on experienced fear after in vivo exposure

Two experiments tested the effect of exposure to masked phobic stimuli at a very brief stimulus onset asynchrony on reducing the subjective experience of fear caused by in vivo exposure to a feared object. In the main experiment, 35 spider-fearful and 35 non-fearful participants were identified with a questionnaire and a Behavioural Avoidance Test (BAT) with a live tarantula. One week later, they were individually administered one of two continuous series of masked images: spiders or flowers. They engaged in the BAT again immediately thereafter. They provided ratings of subjective fear at the end of each BAT (pre- and post-manipulation). Very brief exposure to images of spiders reduced the fearful groups and not the non-fearful groups experience of fear at the end of the BAT. This effect was replicated with another sample of 26 spider-fearful participants from the same population. Theoretical implications are discussed.

A dissociation between detection and identification of phobic stimuli: Unconscious perception?

A psychophysical paradigm for investigating unconscious perception was used to test the hypothesis of dissociation between detection and identification of phobic stimuli. Spider-phobic and non-phobic participants were presented with masked images of spiders and flowers and an equal number of control stimuli in a random sequence. After each masked stimulus was flashed, participants first reported whether or not an object was presented. Then they identified each stimulus as either a spider or a flower, regardless of their prior detection response. Phobic participants identified both detected and undetected spiders better than chance, as assessed by two measures of response bias. They did not exhibit dissociation between detection and identification for flowers. Non-phobic participants did not exhibit detection–identification dissociation for either spiders or flowers. These results are consistent with the interpretation that phobic individuals unconsciously perceive their feared stimulus, and constitute the first direct demonstration of such for emotional stimuli.

Less is more: Neural activity during very brief and clearly visible exposure to phobic stimuli.

Research on automatic processes in fear has emphasized the provocation of fear responses rather than their attenuation. We have previously shown that the repeated presentation of feared images without conscious awareness via backward masking reduces avoidance of a live tarantula in spider‐phobic participants. Herein we investigated the neural basis for these adaptive effects of masked exposure. 21 spider‐phobic and 21 control participants, identified by a psychiatric interview, fear questionnaire, and approaching a live tarantula, viewed stimuli in each of three conditions: (1) very brief exposure (VBE) to masked images of spiders, severely limited awareness; (2) clearly visible exposure (CVE) to spiders, full awareness; and (3) masked images of flowers (control), severely limited awareness. Only VBE to masked spiders generated neural activity more strongly in phobic than in control participants, within subcortical fear, attention, higher‐order language, and vision systems. Moreover, VBE activated regions that support fear processing in phobic participants without causing them to experience fear consciously. Counter‐intuitively, CVE to the same spiders generated stronger neural activity in control rather than phobic participants within these and other systems. CVE deactivated regions supporting fear regulation and caused phobic participants to experience fear. CVE‐induced activations also correlated with measures of explicit fear ratings, whereas VBE‐induced activations correlated with measures of implicit fear (color‐naming interference of spider words). These multiple dissociations between the effects of VBE and CVE to spiders suggest that limiting awareness of exposure to phobic stimuli through visual masking paradoxically facilitates their processing, while simultaneously minimizing the experience of fear. Hum Brain Mapp 38:2466–2481, 2017.

Masking exposure to phobic stimuli reduces fear without inducing electrodermal activity

A series of experiments has shown that limiting awareness of exposure to feared stimuli through visual masking-or very brief exposure (VBE)-reduces avoidance of a live tarantula by spider-phobic participants. We investigated this process of fear reduction by directly relating the effects of VBE on electrodermal activity to its ensuing effects on phobic behavior. Sixty spider-phobic participants, identified by approaching a live tarantula and a questionnaire, were administered either VBE to masked spiders or control exposure to masked flowers. Skin conductance levels (SCLs) were continuously recorded during exposure. The participants approached the tarantula again immediately thereafter. VBE reduced avoidance of the tarantula and did not increase SCLs or cause subjective distress relative to control exposure. SCL increases during VBE were strongly negatively correlated with the reduction of self-reported fear of the tarantula: the less that SCLs increased during VBE, the more it reduced fear. VBE only increased SCLs in participants whose fear was not reduced; it did not increase SCLs in participants whose fear of the tarantula was reduced. Awareness of the stimuli did not mediate these effects. Control exposure did not yield any of these effects. In a second experiment, clearly visible exposure to spider images increased SCLs and subjective distress more than both VBE and control exposure, whereas VBE did not increase SCLs or subjective distress relative to control exposure within the same spider-phobic participants. These findings suggest that exposure to phobic images can reduce fear even when it bypasses the induction of electrodermal activity.