Claustrophobia Treatment Project

Statement of the Problem:
Traditional cognitive and behavioral approaches to the treatment of anxiety disorders have sought to change the form of cognitions and emotions as a precursor to behavior change. Behavioral techniques typically aim to attenuate the anxiety response, and cognitive therapies aim to correct faulty threat appraisals. In contrast, the more recently developed mindfulness and acceptance-based interventions have sought to influence behavior by changing the client’s understanding of the context in which these maladaptive thoughts and emotions occur. In the current study, we will consider whether augmenting an exposure treatment for claustrophobia with an acceptance-based intervention, or with a well-established cognitive change intervention, will lead to different outcomes in behavioral, physiological, and subjective fear. By investigating this question, we hope to better understand how these distinct treatments may affect anxiety reduction and avoidance behavior.

Specific Aims
This study will compare the relative treatment efficacy of Exposure + Guided Threat Reappraisal (E + GTR), exposure + Acceptance and Mindfulness (E + AM), exposure + Relaxation (E + RL), and an exposure only (E) control condition in the treatment of claustrophobia. Moreover, we will examine whether the E + GTR and E + AM interventions work via distinct mechanisms. Specifically, we will consider whether these interventions differentially affect perceptions of threat and measures of state mindfulness and acceptance, and whether these changes lead to reductions in anxiety. Although the disorder under study is specific phobia, our findings should have implications for the improvement of exposure treatments across the anxiety disorders.

Study Design
Participants who meet the DSM-IV criteria for specific phobia (in the assessment phase) will be randomized into one of four different speech exposure conditions: Exposure + Guided Threat Reappraisal (E + GTR), exposure + Acceptance and Mindfulness (E + AM), exposure + Relaxation (E + RL), and an exposure only (E) control condition. All participants will receive 30 minutes of total exposure to our claustrophobia chamber. They will immediately complete a behavioral assessment test and will return in one month for a follow-up behavioral assessment test.

Eligibility Criteria
a. Individuals whose total scores on the Claustrophobia Questionnaire fall on top 15% among the pool of introductory psychology students at the University of Texas, or community participants responding to advertisements who meet all other eligibility criteria
b. Individuals meeting for the principal Axis-I diagnosis of specific phobia as determined by Composite International Diagnostic Interview (CIDI-Auto; World Health Organization, 1997)
c. Individuals displaying a peak fear greater than 50 (on a 0 to 100 scale) in a behavioral approach task (BAT), or who fail to complete the task
d. Between the ages of 18-65
e. Fluent in English (written and spoken). This is required because instruments are validated only in English and researcher does not speak Spanish.

Project Coordinator/Contact Person:
Jonathan Horowitz

Contact Phone number: 512-471-3722

Contact Email: horowitz@mail.utexas.edu
All calls and emails will be kept confidential. Thank you for your interest in our research!