What is so frightening about spiders? Self-rated and self-disclosed impact of different characteristics and associations with phobia symptoms

Long-term exposure therapy outcome in phobia and the link with behavioral and neural indices of extinction learning

Extinction learning is regarded as a core mechanism underlying exposure therapy. Under this assumption, studies have looked at the predictive value of the extinction learning paradigm for exposure therapy outcomes. However, predicting factors of long-term exposure therapy success have not been established. Participants with a specific phobia (SP) for spiders were included in a double-blind randomized controlled trial. Participants were randomly assigned to receive exposure therapy (n = 25, 24 females) or an active control intervention, progressive muscle relaxation (PMR; n = 18, 15 females). Symptom levels were measured with the Fear of Spiders questionnaire (FSQ) at baseline (T0), after the intervention (T1), and at six- (T2) and twelve (T3) months follow-up. At baseline, participants completed a three-day fMRI fear conditioning, extinction learning, and extinction recall paradigm. Indices of extinction were defined as self-reported threat expectancy and fear, and neural activation during stimulus presentations and threat omission in the ventromedial prefrontal cortex and nucleus accumbens, based on prior data. Mixed model analysis revealed that the exposure therapy group had an overall stronger decrease in phobic symptoms over time than the PMR group (β = 10.95, p < .001). However, none of the indices of extinction learning were predictive for FSQ scores after exposure therapy at the longest follow-up measurement (T3). In sum, the current results show the long-term effectiveness of a single session of exposure therapy for reducing a specific fear of spiders but no baseline characteristics were identified that predicted individual differences in exposure therapy success after one year.

Moving spiders do not boost visual search in spider fear

Previous research on attention to fear-relevant stimuli has largely focused on static pictures or drawings, and thus did not consider the potential effect of natural motion. Here, we aimed to investigate the effect of motion on attentional capture in spider-fearful and non-fearful participants by using point-light stimuli and naturalistic videos. Point-light stimuli consist of moving dots representing joints and thereby visualizing biological motion (e.g. of a walking human or cat) without needing a visible body. Spider-fearful (n = 30) and non-spider-fearful (n = 31) participants completed a visual search task with moving targets (point-light/naturalistic videos) and static distractors (images), static targets and moving distractors, or static targets and static distractors. Participants searched for a specified animal type (snakes, spiders, cats, or doves) as quickly as possible. We replicated previous findings with static stimuli: snakes were detected faster and increased distraction, while spiders just increased distraction. However, contrary to our hypotheses, spider targets did not speed up responses, neither in the group of control nor in the group of spider-fearful participants. Interestingly, stimuli-specific effects were toned down, abolished, or even changed direction when motion was introduced. Also, we demonstrated that point-light stimuli were of similar efficiency as naturalistic videos, indicating that for testing effects of motion in visual search, "pure" motion stimuli might be sufficient. As we do show a substantial modulation of visual search phenomena by biological motion, we advocate for future studies to use moving stimuli, equivalent to our dynamic environment, to increase ecological validity.

The fear of spiders: perceptual features assessed in augmented reality

Background

Persons with specific phobias typically generalize the dangerousness of the phobic animal to all members of its species, possibly as a result of malfunctioning brain circuitry normally providing quick and dirty identification of evolutionary-relevant stimuli. An objective assessment of which perceptual features make an animal more or less scary to phobic and non-phobic people would help overcome the limitations of the few studies available so far, based on self-reports.

Objective

To achieve this aim, we built an augmented reality setting where volunteers with different levels of fear of spiders were asked to make holographic spiders that look either dangerous or harmless. To reach this goal, a computerized interface allowed participants to modify the spider's perceptual features (hairiness, body/leg size, and locomotion) in real time.

Results

On average, the dangerous spiders were made hairy, thick, and moving according to spider-like locomotion; coherently, the harmless spiders were made hairless, slim, and moving according to a butterfly-like locomotion. However, these averaged preferences could not fully describe the complex relationship between perceptual preferences with each other and with arachnophobia symptoms. An example of a key finding revealed by cluster analysis is the similarity in perceptual preferences among participants with little or no fear of spiders, whereas participants with more arachnophobia symptoms expressed more varying preferences.

Conclusion

Perceptual preferences toward the spider's features were behaviorally assessed through an observational study, objectively confirming a generalization effect characterizing spider-fearful participants. These results advance our knowledge of phobic preferences and could be used to improve the acceptability of exposure therapies.

Animal eMotion, or the emotional evaluation of moving animals

Responding adequately to the behaviour of human and non-human animals in our environment has been crucial for our survival. This is also reflected in our exceptional capacity to detect and interpret biological motion signals. However, even though our emotions have specifically emerged as automatic adaptive responses to such vital stimuli, few studies investigated the influence of biological motion on emotional evaluations. Here, we test how the motion of animals affects emotional judgements by contrasting static animal images and videos. We investigated this question (1) in non-fearful observers across many different animals, and (2) in observers afraid of particular animals across four types of animals, including the feared ones. In line with previous studies, we find an idiosyncratic pattern of evoked emotions across different types of animals. These emotions can be explained to different extents by regression models based on relevant predictor variables (e.g. familiarity, dangerousness). Additionally, our findings show a boosting effect of motion on emotional evaluations across all animals, with an additional increase in (negative) emotions for moving feared animals (except snakes). We discuss implications of our results for experimental and clinical research and applications, highlighting the importance of experiments with dynamic and ecologically valid stimuli.

Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

Background

Fear of spiders, or Arachnophobia, is one of the most common specific phobias. The gold standard treatment, in vivo exposure therapy, is effective, but comes with significant limitations, including restricted availability, high costs, and high refusal rates. Novel technologies, such as augmented reality, may help to overcome these limitations and make Exposure Therapy more accessible by using mobile devices.

Objective

This study will use a Randomized Controlled Trial design to investigate whether ZeroPhobia: Arachnophobia, a 6-week Augmented Reality Exposure Therapy smartphone self-help application, can effectively reduce spider phobia symptoms. Additionally, we will examine user-friendliness of the application and the effect of usage intensity and presence on treatment outcome.

Methods

This study is registered in the Netherlands Trial Registry under NL70238.029.19 (Trial NL9221). Ethical approval was received on October 11, 2019. One-hundred-twelve participants (age 18–64, score ≥ 59) on the Fear of Spiders Questionnaire [FSQ] will be recruited from the general Dutch population and randomly assigned to a treatment or waitlist control group. The ZeroPhobia application can be accessed on users’ smartphone. Baseline, post-test (i.e., at six weeks), 3- and 12-month follow-up assessments will be done, each including the Fear of Spiders Questionnaire as the main outcome measure as well as additional measures of anxiety, depression, user-friendliness, and presence as secondary measures and covariates.

Results

The study was funded on September 25, 2018. Data collection started in September 2021 and the study is expected to run until September 2022.

Conclusions

Our study will improve our understanding of the efficacy and feasibility of providing Exposure Therapy for spider phobia using an Augmented Reality self-help application, with the intention of making mental health care more accessible.

The influence of movement on negative and positive emotional responses to animals

Two studies were conducted to explore whether the addition of animal movement would influence the intensity of emotional reactions towards that animal. Both studies compared self-reported emotional reactions with still images and videos for six animal categories (snakes, spiders, rodents, hoofed animals, animals with flippers, and turtles). In Study 1, participants reported fear and disgust to the animal stimuli, which were averaged into a single negative emotion rating. In Study 2, participants reported either fear and disgust or joy and affection to the animal stimuli, which were averaged into either a single negative or positive emotion rating. Upon combining the reported emotions from the two studies, movement was found to increase negative emotion reported to snakes and spiders and decrease negative emotion reported to rodents, hoofed animals, and animals with flippers. Results from Study 2 indicated that movement increased reported positive emotions to all six animal categories. Our findings suggest that animal movement is an important component of emotional reactions to animals.

What Makes Spiders Frightening and Disgusting to People?

The quality of human-animal interactions may crucially influence conservation efforts. Unfortunately, and despite their important roles in the functioning of the ecosystem, some animals are considered notoriously unpopular. Using the forced-choice paradigm, we investigated which cues humans perceive as frightening and disgusting in spiders, one of the most unpleasant animals in the world. The research was carried out with a representative sample of N = 1,015 Slovak adults. We found that perceived fear and disgust of spiders were triggered predominantly by enlarged chelicerae, enlarged abdomen, and the presence of body hair. Longer legs were associated with perceived fear as well; however, the presence of two eyes did not produce any statistical significance in terms of fear. We hope that further research in this field, where additional cues can be manipulated (e.g., color and number of legs), will improve conservation efforts by using an improved reputation of spiders in the eyes of the general public.

Experiences of Gamified and Automated Virtual Reality Exposure Therapy for Spider Phobia: Qualitative Study

Background

Virtual reality exposure therapy is an efficacious treatment of anxiety disorders, and recent research suggests that such treatments can be automated, relying on gamification elements instead of a real-life therapist directing treatment. Such automated, gamified treatments could be disseminated without restrictions, helping to close the treatment gap for anxiety disorders. Despite initial findings suggesting high efficacy, very is little is known about how users experience this type of intervention.

Objective

The aim of this study was to examine user experiences of automated, gamified virtual reality exposure therapy using in-depth qualitative methods.

Methods

Seven participants were recruited from a parallel clinical trial comparing automated, gamified virtual reality exposure therapy for spider phobia against an in vivo exposure equivalent. Participants received the same virtual reality treatment as in the trial and completed a semistructured interview afterward. The transcribed material was analyzed using thematic analysis.

Results

Many of the uncovered themes pertained directly or indirectly to a sense of presence in the virtual environment, both positive and negative. The automated format was perceived as natural and the gamification elements appear to have been successful in framing the experience not as psychotherapy devoid of a therapist but rather as a serious game with a psychotherapeutic goal.

Conclusions

Automated, gamified virtual reality exposure therapy appears to be an appealing treatment modality and to work by the intended mechanisms. Findings from the current study may guide the next generation of interventions and inform dissemination efforts and future qualitative research into user experiences.

Gamified, Automated Virtual Reality Exposure Therapy for Fear of Spiders: A Single-Subject Trial Under Simulated Real-World Conditions

BACKGROUND

Virtual Reality exposure therapy (VRET) is an evidence-based treatment of phobias and recent research suggests that this applies also to self-contained, automated interventions requiring no therapist guidance. With the advent and growing adoption of consumer VR technology, automated VR intervention have the potential to close the considerable treatment gap for specific phobias through dissemination as consumer applications, self-help at clinics, or as blended treatment. There is however a lack of translational effectiveness studies on VRET treatment effects under real-world conditions.

METHODS

We conducted a single-arm (n = 25), single-subject study of automated, gamified VRET for fear of spiders, under simulated real-world conditions. After setup and reading instructions, participants completed the automated, single-session treatment by themselves. Self-rated fear of spiders and quality of life served as outcome measures, measured twice before, and one and two weeks after treatment, and at a six-month follow-up. Session characteristics and user experience measures were collected at the end of the session.

RESULTS

Mixed-effects modeling revealed a significant and large (d = 1.26) effect of treatment-onset on phobia symptoms (p < .001), and a small (d = 0.49) effect on quality of life (p = .025). Results were maintained at a six-month follow-up (p > .053). The intervention was tolerable and practical. There were no significant correlations between any user experience measure and decrease in phobia symptoms (p > .209).

CONCLUSIONS

An automated VRET intervention for fear of spiders showed equivalent effects on phobia symptoms under effectiveness conditions as previously reported under efficacy conditions. These results suggest that automated VRET applications are promising self-help treatments also when provided under real-world conditions.

PRE-REGISTRATION

Open Science Foundation, https://doi.org/10.17605/OSF.IO/78GUB.