Does raising heart rate prior to a behavioural test enhance learning in cognitive therapy for anxiety? An experimental test for the treatment of fear of heights using virtual reality.
Anxiety
Cognitive therapy
Exercise
Fear of heights
Virtual reality (VR)
Journal
Behaviour research and therapy
ISSN: 1873-622X
Titre abrégé: Behav Res Ther
Pays: England
ID NLM: 0372477
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
29
08
2020
revised:
18
06
2021
accepted:
29
06
2021
pubmed:
12
7
2021
medline:
9
11
2021
entrez:
11
7
2021
Statut:
ppublish
Résumé
A key clinical issue is how to maximise the belief change central to cognitive therapy. Physiological arousal is a key internal cue confirming threat beliefs in anxiety disorders. Deeper extinction of anxiety may occur if catastrophizing responses to physiological arousal are inhibited prior to joint exposure with external phobic stimuli. The aim of the study was to test whether increasing physiological arousal using exercise increases the benefits of behavioural tests. Sixty individuals with a fear of heights had one session of VR cognitive treatment. They were randomised to have the treatment either with periods of intense physical exercise (cycling at 80% of maximum heart rate) prior to exposures or without. Linear mixed effects models were used to check the manipulation and test the primary hypothesis of a group difference in degree of conviction in the phobic threat belief. Heart rate was significantly higher in the exercise group throughout compared with the control group. Both groups showed significant reductions in threat beliefs after the VR treatment (d = 1.0, p < 0.001) but there was no significant group difference (d = 0.1, p = 0.56). An increase in physiological arousal achieved via exercise did not enhance cognitive change in beliefs about feared stimuli.
Sections du résumé
BACKGROUND
A key clinical issue is how to maximise the belief change central to cognitive therapy. Physiological arousal is a key internal cue confirming threat beliefs in anxiety disorders. Deeper extinction of anxiety may occur if catastrophizing responses to physiological arousal are inhibited prior to joint exposure with external phobic stimuli. The aim of the study was to test whether increasing physiological arousal using exercise increases the benefits of behavioural tests.
METHODS
Sixty individuals with a fear of heights had one session of VR cognitive treatment. They were randomised to have the treatment either with periods of intense physical exercise (cycling at 80% of maximum heart rate) prior to exposures or without. Linear mixed effects models were used to check the manipulation and test the primary hypothesis of a group difference in degree of conviction in the phobic threat belief.
RESULTS
Heart rate was significantly higher in the exercise group throughout compared with the control group. Both groups showed significant reductions in threat beliefs after the VR treatment (d = 1.0, p < 0.001) but there was no significant group difference (d = 0.1, p = 0.56).
DISCUSSION
An increase in physiological arousal achieved via exercise did not enhance cognitive change in beliefs about feared stimuli.
Identifiants
pubmed: 34246887
pii: S0005-7967(21)00127-3
doi: 10.1016/j.brat.2021.103928
pii:
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
103928Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.