Change of Threat Expectancy as Mechanism of Exposure-Based Psychotherapy for Anxiety Disorders: Evidence From 8,484 Exposure Exercises of 605 Patients

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Andre Pittig - , Julius-Maximilians-Universität Würzburg, Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Ingmar Heinig - , Professur für Klinische Psychologie und Behaviorale Neurowissenschaft, Technische Universität Dresden (Autor:in)
  • Stephan Goerigk - , Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Technische Universität München (Autor:in)
  • Jan Richter - , Ernst-Moritz-Arndt-Universität Greifswald, University of Hildesheim (Autor:in)
  • Maike Hollandt - , Ernst-Moritz-Arndt-Universität Greifswald (Autor:in)
  • Ulrike Lueken - , Julius-Maximilians-Universität Würzburg, Humboldt University of Berlin (Autor:in)
  • Paul Pauli - , Julius-Maximilians-Universität Würzburg (Autor:in)
  • Jurgen Deckert - , Julius-Maximilians-Universität Würzburg (Autor:in)
  • Tilo Kircher - , Philipps-Universität Marburg (Autor:in)
  • Benjamin Straube - , Philipps-Universität Marburg (Autor:in)
  • Peter Neudeck - (Autor:in)
  • Katja Koelkebeck - , Munster Technological University (Autor:in)
  • Udo Dannlowski - , Munster Technological University (Autor:in)
  • Volker Arolt - , Munster Technological University (Autor:in)
  • Thomas Fydrich - , Humboldt University of Berlin (Autor:in)
  • Lydia Fehm - , Humboldt University of Berlin (Autor:in)
  • Andreas Strohle - , Freie Universität (FU) Berlin (Autor:in)
  • Christina Totzeck - , Ruhr-Universität Bochum (Autor:in)
  • Jurgen Margraf - , Ruhr-Universität Bochum (Autor:in)
  • Silvia Schneider - , Ruhr-Universität Bochum (Autor:in)
  • Jurgen Hoyer - , Professur für Behaviorale Psychotherapie, Technische Universität Dresden (Autor:in)
  • Winfried Rief - , Philipps-Universität Marburg (Autor:in)
  • Michelle G. Craske - , University of California at Irvine (Autor:in)
  • Alfons O. Hamm - , Ernst-Moritz-Arndt-Universität Greifswald (Autor:in)
  • Hans-Ulrich Wittchen - , Professur für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Technische Universität München (Autor:in)

Abstract

Individual responses to behavioral treatment of anxiety disorders vary considerably, which requires a better understanding
of underlying processes. In this study, we examined the violation and change of threat beliefs during exposure. From
8,484 standardized exposure records of 605 patients with different anxiety disorders, learning indicators were derived:
expectancy violation as mismatch between threat expectancy before exposure and threat occurrence, expectancy
change as difference between original and adjusted expectancy after exposure, and prediction-error learning rateas extent to which expectancy violation transferred into change. Throughout sessions, high threat expectancy butlow occurrence and adjusted expectancy indicated successful violation and change of threat beliefs by exposure.Expectancy violation, change, and learning rate substantially varied between patients. Not expectancy violation itself, but higher learning rate and expectancy change predicted better treatment outcome. Successful exposure thus requires expectancy violation to induce actual expectancy change, supporting learning from prediction error as transdiagnostic
mechanism underlying successful exposure therapy.

Details

OriginalspracheEnglisch
Seitenumfang19
FachzeitschriftClinical psychological science
Frühes Online-DatumOkt. 2022
PublikationsstatusVeröffentlicht - 4 Okt. 2022
Peer-Review-StatusJa

Externe IDs

Scopus 85139437438
Mendeley bdceb879-1b4f-398c-a591-b772576e8357
ORCID /0000-0002-7762-4327/work/141543452
ORCID /0000-0002-1697-6732/work/148632185

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Anxiety disorders, Expectancy violation, Exposure therapy, Mechanisms of change, Prediction error, Treatment outcome, expectancy violation, anxiety disorders, exposure therapy, prediction error, mechanisms of change, treatment outcome