Exposure traced in daily life: improvements in ecologically assessed social and physical activity following exposure-based psychotherapy for anxiety disorders

Research output: Contribution to journalResearch articleContributedpeer-review



Background: Although exposure-based cognitive-behavioral therapy for anxiety disorders has frequently been proven effective, only few studies examined whether it improves everyday behavioral outcomes such as social and physical activity. Methods: 126 participants (85 patients with panic disorder, agoraphobia, social anxiety disorder, or specific phobias, and 41 controls without mental disorders) completed smartphone-based ambulatory ratings (activities, social interactions, mood, physical symptoms) and motion sensor-based indices of physical activity (steps, time spent moving, metabolic activity) at baseline, during, and after exposure-based treatment. Results: Prior to treatment, patients showed reduced mood and physical activity relative to healthy controls. Over the course of therapy, mood ratings, interactions with strangers and indices of physical activity improved, while reported physical symptoms decreased. Overall results did not differ between patients with primary panic disorder/agoraphobia and social anxiety disorder. Higher depression scores at baseline were associated with larger changes in reported symptoms and mood ratings, but smaller changes in physical activity Conclusions: Exposure-based treatment initiates increased physical activity, more frequent interaction with strangers, and improvements in everyday mood. The current approach provides objective and fine-graded process and outcome measures that may help to further improve treatments and possibly reduce relapse.


Original languageEnglish
Article number102792
Number of pages9
JournalJournal of Anxiety Disorders
Publication statusPublished - Jan 2024

External IDs

PubMed 37989038
ORCID /0000-0002-1697-6732/work/155839713
ORCID /0000-0002-7762-4327/work/155840416


Sustainable Development Goals


  • Anxiety disorders, Ecological momentary assessment, Effectiveness of psychotherapy, Exposure therapy, Motor activity, Physical activity, Anxiety Disorders/therapy, Exercise, Humans, Panic Disorder/therapy, Psychotherapy/methods, Phobic Disorders/therapy