Grant: Doctoral Research Award - Priority Announcement: Patient-Oriented Research

Anxiety disorders are among the most common mental illnesses. The most effective treatment for anxiety disorders is cognitive behavioural therapy (CBT); however, treatment refusal and drop-out rates are high. Exposure, an effective component of CBT, involves gradually exposing oneself to a feared stimuli or situation to habituate to symptoms of anxiety. Although exposure is effective, many clients are unwilling to complete exposures, or refuse treatment due to fear of exposures. Thus, improving the acceptability of exposure may increase treatment acceptance and reduce drop-outs. The current study proposes the use of distraction during exposure to make it more acceptable to clients. There have been mixed findings regarding the impact of distraction use on treatment outcome; thus, it is important to evaluate factors may play a role in whether distraction will aid or interfere with exposure. Specifically, the type of distraction strategy used as well as individual factors may impact the utility of distraction during exposure. The proposed studies will examine different types of distraction as well as their relationship to individual differences in typical distraction use. Study 1 will involve the construction and validation of a questionnaire assessing distraction use, including items assessing perceived necessity of these strategies. Study 2 will involve validating how difficult or taxing a number of potential distraction tasks are, and Study 3 will use these tasks in the context of an exposure session. In this third study, 120 participants with contamination fear complete an exposure session with a feared stimulus (e.g., a dirty toilet), and will be assigned to a no distraction control, mild distraction, moderate distraction, or high distraction condition. They will rate their anxiety throughout the task and at a follow-up visit (when exposed to the same stimulus). This study will also investigate individual differences in outcome.