Changes in caffeine states enhance return of fear in spider phobia.

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).

[1]  J. A. Boer.  Social anxiety disorder/social phobia: Epidemiology, diagnosis, neurobiology, and treatment , 2000 .

[2]  State-dependent fear extinction with two benzodiazepine tranquilizers. , 1990 .

[3]  R. Thayer.  Activation-Deactivation Adjective Check List: Current Overview and Structural Analysis , 1986 .

[4]  Joseph Wolpe,et al.  The practice of behavior therapy , 1969 .

[5]  I. Marks,et al.  Enhanced Relief of Phobias by Flooding During Waning Diazepam Effect , 1972, British Journal of Psychiatry.

[6]  P. Lelliott,et al.  Alprazolam and Exposure Alone and Combined in Panic Disorder with Agoraphobia , 1993, British Journal of Psychiatry.

[7]  S. Mineka,et al.  Context-specificity of relapse: effects of therapist and environmental context on return of fear. , 1999, Behaviour research and therapy.

[8]  G. Lowe.  State-dependent retrieval effects with social drugs. , 1988, British journal of addiction.

[9]  M. Craske,et al.  Treatment context and return of fear in spider phobia , 2002 .

[10]  M. Kozak,et al.  Emotional processing of fear: exposure to corrective information. , 1986, Psychological bulletin.

[11]  M. Bouton.  Conditioning, remembering, and forgetting. , 1994 .

[12]  J. Gray,et al.  The psychology of fear and stress , 1971 .

[13]  David H. Barlow,et al.  Anxiety and its disorders : the nature and treatment of anxiety and panic , 1988 .

[14]  A. Arntz,et al.  Negative beliefs of spider phobics: A psychometric evaluation of the spider phobia beliefs questionnaire , 1993 .

[15]  D. A. King,et al.  Contextual control of the extinction of conditioned fear: tests for the associative value of the context. , 1983, Journal of experimental psychology. Animal behavior processes.

[16]  A Bandura,et al.  Relative efficacy of desensitization and modeling approaches for inducing behavioral, affective, and attitudinal changes. , 1969, Journal of personality and social psychology.

[17]  S. Rachman.  The return of fear: Review and prospect , 1989 .

[18]  D. Simmons.  Caffeine and its effect on persons with mental disorders. , 1996, Archives of psychiatric nursing.

[19]  M. Bouton,et al.  Context and ambiguity in the extinction of emotional learning: implications for exposure therapy. , 1988, Behaviour research and therapy.

[20]  W. Revelle,et al.  Impulsivity and time of day: is rate of change in arousal a function of impulsivity? , 1994, Journal of personality and social psychology.

[21]  K. J. Anderson,et al.  Impulsitivity, caffeine, and task difficulty: A within-subjects test of the Yerkes-Dodson law , 1994 .

[22]  Paul R. Martin.  Handbook of behavior therapy and psychological science : an integrative approach , 1991 .

[23]  S. Mineka,et al.  The effects of changing contexts on return of fear following exposure therapy for spider fear. , 1999, Journal of consulting and clinical psychology.

[24]  Isaac Marks.  Fears, phobias, and rituals , 1987 .

[25]  G. Davey,et al.  Phobias: A Handbook of Theory, Research and Treatment , 2000, Journal of Cognitive Psychotherapy.

[26]  Mark E. Bouton,et al.  Sources of relapse after extinction in Pavlovian and instrumental learning , 1991 .

[27]  N. Spear.  Retrieval of memory in animals. , 1973 .

[28]  Mark E. Bouton,et al.  The role of context in classical conditioning: Some implications for cognitive behavior therapy. , 1998 .

[29]  P. Lang,et al.  Psychometric description of some specific-fear questionnaires. , 1974 .

[30]  C. Cunningham.  Alcohol as a cue for extinction: State dependency produced by conditioned inhibition , 1979 .

[31]  Michelle G. Craske,et al.  Anxiety Disorders: Psychological Approaches To Theory And Treatment , 1998 .

[32]  M. Bouton.  Context, time, and memory retrieval in the interference paradigms of Pavlovian learning. , 1993, Psychological bulletin.

[33]  R. Thayer,et al.  Factor Analytic and Reliability Studies on the Activation-Deactivation Adjective Check List , 1978, Psychological reports.

[34]  D. Chute,et al.  Drug discrimination and state dependent learning , 1978 .

[35]  M. Lader,et al.  Anxiogenic effects of caffeine in patients with anxiety disorders. , 1992, Archives of general psychiatry.

[36]  R. Bolles,et al.  Contextual control of the extinction of conditioned fear , 1979 .