Can CBT treat fear?

Introduction

Cognitive Behavioral Therapy (CBT) is a widely recognized and effective treatment for various anxiety disorders, including specific phobias and generalized anxiety disorder (GAD). This synthesis examines the efficacy of CBT in treating fear, drawing on multiple research studies to provide a comprehensive overview.

Key Insights

Efficacy of CBT in Reducing Fear and Anxiety Symptoms:
- CBT has been shown to significantly reduce symptoms of anxiety and fear in both adolescents and adults, with moderate to large effect sizes .
- Specific phobias, such as spider fear, show significant improvement in self-reported and behavioral measures following CBT .
Mechanisms of CBT:
- CBT works by altering cognitive biases and reducing avoidance behaviors, which are critical in the maintenance of anxiety disorders .
- The reduction in the "fear of fear" (FOF) is a key mediator in the improvement of panic disorder symptoms through CBT.
Formats and Flexibility of CBT:
- CBT can be effectively delivered in various formats, including brief, computerized, and school-based interventions, making it adaptable to different settings and populations.
- Intensive CBT formats, particularly those involving therapist-guided exposure, are more effective for treating panic disorder with agoraphobia compared to less intensive formats .
Augmentation of CBT:
- The addition of pharmacological agents like D-cycloserine or hydrocortisone to CBT can enhance treatment outcomes, although the evidence is mixed and further research is needed .
Long-term Efficacy and Stability:
- The benefits of CBT for anxiety disorders are not only immediate but also stable over long follow-up periods, indicating its long-term efficacy .

Conclusion

CBT is a highly effective treatment for reducing fear and anxiety across various disorders and populations. Its flexibility in delivery and the potential for augmentation with pharmacological agents make it a versatile and robust therapeutic option. The reduction in cognitive biases and avoidance behaviors are central to its success, and its benefits are sustained over time.

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Can CBT treat fear?

Summary

Consensus Meter

Introduction

Key Insights

Conclusion

Sources and full results

D-cycloserine as adjunct to brief computerised CBT for spider fear: Effects on fear, behaviour, and cognitive biases.

Computerized CBT for spider fear improves self-reported and behavioral symptoms, but does not alter cognitive biases, and D-cycloserine does not enhance these effects.

CBT for Adolescents With Anxiety: Mature Yet Still Developing.

CBT is effective for approximately two-thirds of adolescents with anxiety, producing moderate to large effects and showing superiority over control conditions.

Moderators of intensive CBT for adolescent panic disorder: the of fear and avoidance.

Intensive CBT is more effective for adolescents with lower baseline levels of fear and avoidance, improving their symptoms of adolescent panic disorder.

Psychological treatment for panic disorder with agoraphobia: a randomized controlled trial to examine the role of therapist-guided exposure in situ in CBT.

Therapist-guided exposure in CBT is more effective for agoraphobic avoidance, overall functioning, and panic attacks than CBT without therapist-guided exposure.

Fear of recurrence: a case report of a woman breast cancer survivor with GAD treated successfully by CBT.

CBT effectively reduced the fear of recurrence in a breast cancer survivor with GAD, highlighting the importance of considering cancer survivors' distress.

Mechanism of change in cognitive-behavioral treatment of panic disorder: evidence for the fear of fear mediational hypothesis.

CBT for panic disorder improves symptoms by reducing fear of fear, with full mediation observed for global disability changes and partial mediation for agoraphobia, anxiety, and panic frequency.

Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials.

CBT is effective for adult anxiety disorders, but more research is needed to confirm its effectiveness and include intention-to-treat analyses.

Efficacy of cognitive behaviour therapy in generalized anxiety disorders. Results of a controlled clinical trial (Berlin CBT-GAD Study).

CBT is an effective treatment for generalized anxiety disorders, with significant improvements compared to control groups and stable improvement over 8 months.

Effect of Cognitive-Behavioral Therapy on Neural Correlates of Fear Conditioning in Panic Disorder

CBT reduces activation in the left inferior frontal gyrus and increases connectivity between the IFG and the fear network, resulting in symptom improvement in panic disorder with agoraphobia.

Hydrocortisone as an adjunct to brief cognitive-behavioural therapy for specific fear: Endocrine and cognitive biomarkers as predictors of symptom improvement

Hydrocortisone administration before exposure-based cognitive-behavioral therapy improves spider fear self-report and increases speed when approaching spiders, but does not affect threat bias change.

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