Measuring fear evoked by the scariest animal: Czech versions of the Spider Questionnaire and Spider Phobia Beliefs Questionnaire

Background Although tiny in size and mostly harmless, spiders evoke exceptional fear in a significant part of the population and arachnophobia is one of the most common anxiety disorders with prevalence 2.7–6.1%. Two standard measures have been widely used to reliably assess the emotional and cognitive component of spider fear, the Spider Questionnaire (SPQ) and Spider Phobia Beliefs Questionnaire (SBQ). We aimed to develop and validate their Czech translations, describe distribution of spider fear in the Czech population, and analyse its association with disgust propensity and other sociodemographic characteristics. Methods In Phase 1, we developed Czech translations of both questionnaires using a back-translation procedure and then tested their psychometric properties against their English versions in a counterbalanced experimental design using the Mann-Whitney U test and two-sided t-test. In Phase 2, we analysed scores on the Czech SPQ and SBQ on a larger sample. We evaluated the effects of age, gender, level of education, biology background, and association with the assessments of snake fear (i.e. the Snake Questionnaire, SNAQ) and disgust propensity (i.e. the Disgust Scale-Revised, DS-R) using a Spearman correlation, redundancy analysis, and general linear models. Results We have demonstrated that the Czech SPQ and SBQ are equivalent to their originals and show excellent test-retest reliability (SPQ: 0.93; SBQ: 0.87–0.90). In total, 398 (10.3%) out of 3863 subjects reached the cut-off point for potential spider phobia. In addition, SPQ and SBQ scores were highly correlated (0.73–0.79), significantly more than with the SNAQ (0.21–0.32) or the DS-R (0.36–0.40). Two multivariate statistical methods revealed a significant association between the gender, age, level of education, biology background, or disgust propensity and the SPQ scores. Conclusion The Czech SPQ and SBQ may produce reliable and valid assessments of spider fear, but they must be further psychometrically tested considering the limitation of this study before wider use. We corroborate previous findings that fear of spiders is significantly associated with sociodemographic variables, such as gender, age, or education, as well as with the individual level of disgust propensity.

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

Background: Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. Further components relevant for improved CBT efficacy include raised endogenous GCs and reductions in information-processing biases to threat. Aims: To investigate hydrocortisone as an adjunct to CBT for spider fear and the modulating role of threat bias change and endogenous short-term and long-term GCs for treatment response. Methods: Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone ( n = 17) or placebo ( n = 16) one hour prior to single-session predominantly computerised exposure-based CBT. Spider fear was assessed using self-report and behavioural approach measures at baseline, 1-day and 1-month follow-up. Threat processing was assessed at baseline and 1-day follow-up. Cortisol and cortisone were analysed from hair and saliva samples at baseline. Results/outcomes: Self-report, behavioural and threat processing indices improved following CBT. Hydrocortisone augmentation resulted in greater improvement of self-report spider fear and stronger increase in speed when approaching a spider, but not on threat bias. Neither threat bias nor endogenous GCs predicted symptom change, and no interactive effects with hydrocortisone emerged. Preliminary evidence indicated higher hair cortisone as predictor of a stronger threat bias reduction. Conclusions/interpretation: Our data extend earlier findings by suggesting that GC administration boosts the success of exposure therapy for specific fear even with a low-level therapist involvement. Future studies corroborating our result of a predictive hair GC relationship with threat bias change in larger clinical samples are needed.

Specific Phobias: Maintaining Control in the Face of Chaotic Threats

Introduction: Drawing on existential psychology we examine the possibility that specific phobias can serve a psychological function. Specifically, we propose that phobic objects allow individuals to focalize anxieties about haphazard existential threats into a more manageable form, reducing perceptions of risk and bolstering control. Method: We tested this by assessing perceived control among participants with varying levels of spider fear who were reminded of chaotic hazards (or not) and exposed to spiders images (or not). Results: Study 1 (N = 940) found that among those high in spider fear, salient uncontrollable threats (vs. controllable threats or uncontrollable non-threats) reduced feelings of control unless participants were exposed to their phobic object. Similarly, exposure to spider (vs. non-spider) images bolstered perceived control in the face of salient hazards, but only for those high in spider fear. A second preregistered study (N = 1349) found that the palliative effects of focusing on a phobic object were partially explained by a decreased concern with haphazard harms. Discussion: This supports the premise that phobic objects help to maintain control by narrowing the source of disordered risks, creating a more controllable conception of reality.

D-Cycloserine as Adjunct to Brief Computerised CBT for Spider Fear: Effects on Fear, Behaviour, and Cognitive Biases

In anxiety disorders, cognitive behavioural therapy (CBT) improves information-processing biases such as implicit fear evaluations and avoidance tendencies, which predicts treatment response, so they might constitute important treatment targets. This study investigated (i) whether information-processing biases changed following single-session computerised CBT for spider fear, and (ii) whether this effect could be augmented by administration of D-cycloserine (DCS). Spider-fearful individuals were randomized to receiving 250mg of DCS (n=21) or placebo (n=17) and spider fear was assessed using self-report, behavioural, and information-processing (Extrinsic Affective Simon Task & Approach Avoidance Task) measures. Linear mixed-effects analyses indicated improvements on self-report and behavioural spider fear following CBT, but not on cognitive bias measures. There was no evidence of an augmentation effect of DCS on any outcome. Cognitive biases at 1-day were not predictive of 1-month follow-up spider fear. These findings provide no evidence for information-processing biases relating to CBT response or augmentation with DCS.