Leveraging Social Support to Enhance Approach in Interoceptive Exposure
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Authors
Smirnova, Mary
Issue Date
2025
Type
Dissertation
Language
en_US
Keywords
Alternative Title
Abstract
Anxiety sensitivity is a transdiagnostic construct that impacts the maintenance of various anxiety disorders. Exposure therapy is one of the most potent techniques for reducing symptoms of anxiety sensitivity. However, estimates suggest that about 50% do not fully respond to treatment and about 45% dropout due to avoidance. Therefore, strategies to enhance exposure therapy and facilitate fear extinction are needed. One potential target for enhancing fear extinction could be through leveraging social support. We randomized 48 participants with high levels of anxiety sensitivity to look at either a social support image (N = 24) or a neutral control image (N = 24) during interoceptive exposure. We assessed both approach behavior and peak fear during the brief exposure therapy session using a straw breathing task. Additionally, participants completed behavioral approach tasks in the training context (straw breathing) and in a generalization context (hyperventilation), and symptom measures, at baseline, post-treatment, and one-week follow-up. Analyses (2 x 3 ANOVAs) suggest that viewing a social support image during interoceptive exposure decreased peak fear during both a straw breathing and hyperventilation behavioral approach test. However, participants did not differ in their approach behavior during interoceptive exposure. These findings suggest that presenting a social support cue may facilitate fear extinction, even with similar levels of exposure. Therefore, leveraging social support cues during exposure therapy can be a potential avenue for augmenting exposure therapy.