Hilleke, Marina 
ORCID: 0000-0002-3557-2768, Lang, Thomas ORCID: 0000-0002-7016-4946, Helbig-Lang, Sylvia, Alpers, Georg W. ORCID: 0000-0001-9896-5158, Arolt, Volker ORCID: 0000-0002-2445-9778, Deckert, Jürgen ORCID: 0000-0003-1008-4650, Fydrich, Thomas ORCID: 0000-0003-0122-2302, Hamm, Alfons O. ORCID: 0000-0002-3352-6231, Kircher, Tilo ORCID: 0000-0002-2514-2625, Richter, Jan ORCID: 0000-0002-7127-6990, Ströhle, Andreas ORCID: 0000-0003-0935-3702, Wittchen, Hans-Ulrich ORCID: 0000-0002-6311-7711, Gerlach, Alexander L. ORCID: 0000-0001-6794-5349 and Arafat, S. M. Yasir
(2025).
How Do Patients’ Fear Prediction and Fear Experience Impact Exposure‐Based Therapy for Panic Disorder With Agoraphobia? A Comprehensive Analysis of Fear Prediction.
Depression and Anxiety, 2025 (1).
pp. 1-14.
Wiley.
ISSN 1091-4269
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Abstract
[Artikel-Nr.: 963860] Expectancy violation has been proposed as a potential core mechanism of action in psychotherapy, particularly in exposure therapy for anxiety disorders. However, various relevant expectations have been discussed, and empirical studies examining their significance are still scarce. This study aimed to investigate one specific form of expectancy violation, based on Rachman’s (1994) match‐mismatch model, specifically by comparing expected and experienced fear and examining their relationship to safety behaviour during exposure in vivo in 268 patients meeting DSM‐IV criteria for panic disorder with agoraphobia. Participants underwent exposure to a highly controlled manual‐based cognitive behaviour therapy in a randomised multicenter psychotherapy study. Participants tended to overpredict fear during exposure. Both expected and experienced fear significantly decreased over the course of repeated exposure exercises, while prediction (in)accuracy (difference between expected and experienced fear) remained stable. The decrease in expected fear over time was a strong predictor of treatment outcomes for the Bodily Sensations Questionnaire (BSQ) and Panic and Agoraphobia Scale (PAS) at post. Even more, the reduction in expected fear was a significant predictor of treatment success across all outcome measures in the follow‐up assessment. These findings suggest that violating excessive fear expectancies is not a necessary condition for symptom reduction during exposure therapy.
| Item Type: | Article |
| Creators: | Creators Email ORCID ORCID Put Code Helbig-Lang, Sylvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Arafat, S. M. Yasir UNSPECIFIED UNSPECIFIED UNSPECIFIED |
| URN: | urn:nbn:de:hbz:38-802291 |
| Identification Number: | 10.1155/DA/6963860 |
| Journal or Publication Title: | Depression and Anxiety |
| Volume: | 2025 |
| Number: | 1 |
| Page Range: | pp. 1-14 |
| Number of Pages: | 14 |
| Date: | 19 June 2025 |
| Publisher: | Wiley |
| ISSN: | 1091-4269 |
| Language: | English |
| Faculty: | Faculty of Medicine |
| Divisions: | Faculty of Medicine > Medizinische Psychologie > Abteilung für Medizinische Psychologie |
| Subjects: | Psychology Medical sciences Medicine |
| ['eprint_fieldname_oa_funders' not defined]: | Publikationsfonds UzK |
| Refereed: | Yes |
| URI: | http://kups.ub.uni-koeln.de/id/eprint/80229 |
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