Changes in caffeine states enhance return of fear in spider phobia

Department of Psychology, Northwestern University, Evanston, Illinois, United States
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 05/2003; 71(2):243-50. DOI: 10.1037/0022-006X.71.2.243
Source: PubMed


Treatment of phobias is sometimes followed by a return of fear. Animal and human research has shown that changes in external and internal contexts between the time of treatment and follow-up tests often enhance return of fear. The present study examined whether shifts in caffeine (C) state would enhance return of fear. Participants who were highly afraid of spiders (n = 43) were treated in 1-session exposure-based therapy and tested for follow-up 1 week later. Participants were randomly assigned to 1 of 4 groups and received either placebo (P) or C at treatment and follow-up sessions: CC, PP, CP, and PC. Results demonstrated state-dependent learning. Participants experiencing incongruent drug states during treatment and follow-up (CP and PC) exhibited greater return of fear than those experiencing congruent drug states (CC and PP).

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Available from: Richard E Zinbarg
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    • "At both the treatment session and the reassessment session, participants received either a placebo (P) or caffeine (C), such that there were four groups of participants: PP, PC, CC, and CP. Participants who were randomized to the incongruent drug state conditions (i.e., PC or CP) experienced higher levels of fear at the reassessment relative to those experiencing congruent drug states (Mystkowski, Mineka, Vernon, & Zinbarg, 2003). In the second study,Mystkowski et al. (2006)reported that imagining the context of the exposure can influence generalization. "
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    • "Findings have shown that individuals with panic disorder who have consumed caffeine tend to have a reduced capacity to tolerate the unpleasant physical symptoms generated by those tasks, compared to individuals without panic disorder (Masdrakis et al., 2008). Other investigators have examined the effect of caffeine as an adjunct to exposure therapy for spider phobia, and found support for state-dependent learning in the extinction of fear (Mystkowski et al., 2003). Those who consumed caffeine or placebo at both test and follow-up periods (e.g., congruent drug state) reported significantly less return of fear than individuals who consumed different drugs at both time-points (e.g., incongruent drug state) (Mystkowski et al., 2003). "
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    • "Contexts can also include the internal state (i.e., arousal) of an individual. A study with 43 spiderfearful individuals showed that incongruent internal states during treatment and follow-up can produce a return of fear (Mystkowski et al. 2003). Internal states were manipulated by the ingestion of caffeine or placebo. "
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