{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T05:21:03Z","timestamp":1775193663792,"version":"3.50.1"},"reference-count":6,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T00:00:00Z","timestamp":1531440000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Cogn. Psychother."],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> While exposure therapy effectively reduces anxiety associated with specific phobias, not all individuals respond to treatment and some will experience a return of fear after treatment ceases. <jats:bold>Aims:<\/jats:bold> This study aimed to test the potential benefit of increasing the intensity of exposure therapy by adding an extra step that challenged uncontrollability (Step 15: allowing a spider to walk freely over one's body) to the standard fear hierarchy. <jats:bold>Method:<\/jats:bold> Fifty-one participants who had a severe fear of spiders completed two 60-min exposure sessions 1 week apart in a context that was either the same or different from the baseline and follow-up assessment context. Participants were categorized into groups based on the last hierarchy step they completed during treatment (Step 14 or fewer, or Step 15). <jats:bold>Results:<\/jats:bold> Those who completed Step 15 had greater reductions in fear and beliefs about the probability of harm from baseline to post-treatment than those who completed fewer steps. Although completing Step 15 did not prevent fear from returning after a context change, it allowed people to maintain their ability to tolerate their fear, which earlier steps did not. Despite some fear returning after a context change, individuals who completed Step 15 tended to report greater reductions in fear from baseline to the follow-up assessment than participants who completed 14 or fewer steps. <jats:bold>Conclusions:<\/jats:bold> Overall, these results suggest that more intensive exposure that directly challenges harm beliefs may lead to greater changes in fear and fear beliefs than less intensive exposure.<\/jats:p>","DOI":"10.1017\/s1352465818000437","type":"journal-article","created":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T00:45:39Z","timestamp":1531442739000},"page":"754-760","source":"Crossref","is-referenced-by-count":16,"title":["The Scarier the Better: Maximizing Exposure Therapy Outcomes for Spider Fear"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7840-9007","authenticated-orcid":false,"given":"Melissa M.","family":"Norberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amie R.","family":"Newins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianqiu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduard","family":"Forcadell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Alberich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett J.","family":"Deacon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2018,7,13]]},"reference":[{"key":"S1352465818000437_ref003","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(05)80374-0"},{"key":"S1352465818000437_ref004","volume-title":"Classical Conditioning II: Current Research and Theory","author":"Rescorla","year":"1972"},{"key":"S1352465818000437_ref001","doi-asserted-by":"publisher","DOI":"10.1016\/0146-6402(93)90012-Q"},{"key":"S1352465818000437_ref005","doi-asserted-by":"publisher","DOI":"10.1007\/BF02354458"},{"key":"S1352465818000437_ref002","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(02)80035-1"},{"key":"S1352465818000437_ref006","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2008.02.007"}],"container-title":["Behavioural and Cognitive Psychotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1352465818000437","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T18:59:23Z","timestamp":1555095563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1352465818000437\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,13]]},"references-count":6,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["S1352465818000437"],"URL":"https:\/\/doi.org\/10.1017\/s1352465818000437","relation":{},"ISSN":["1352-4658","1469-1833"],"issn-type":[{"value":"1352-4658","type":"print"},{"value":"1469-1833","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,13]]}}}