Fear reduction during in vivo exposure to blood-injection stimuli: Distraction vs. attentional focus

Objective. This study extends Penfold and Page's (1999) finding that exposure plus distraction enhanced within-session fear reduction to a phobic stimulus by examining whether the within-session advantage could be replicated and translated into longer-term gains. Design. To test the effects of distraction, participants were assigned randomly to one of three experimental conditions; exposure plus focusing, exposure plus distraction, or exposure alone. Method. Blood-injection fearful participants (N = 48) were assigned randomly to receive 3 weekly sessions of 10-min exposure under one of the experimental conditions. Results. Consistent with the previous finding, exposure plus distraction showed the greatest within-session fear reduction. Participants in the exposure plus distraction condition also reported the greatest reduction in fear between sessions, at post-treatment, and at 1-month follow-up. Furthermore, participants in the exposure plus distraction condition reported continued increases in perceived control over their anxiety during the month following the exposure sessions. Conclusions. The data suggest that conversation is a distraction that can increase perceived control over anxiety and assists anxiety reduction.