The role of autonomic arousal and of perceived skill in return of fear
Creators: name: Craske, Michelle Genevieve
Publisher: name: University of British Columbia
Year: 2010

description: The hypothesis that high heart rate and low perceived skill would be associated with greater return of fear than low heart rate and high perceived skill was investigated in a group of anxious musical performers (N=63) in response to an anxiety-reduction training program. Musicians were taught progressive muscle relaxation and attention-focusing skills over the course of four weekly meetings. Return of subjective fear was assessed between training program sessions and at a three-month followup assessment. The three major fear response systems were measured at pre, post and followup assessments and throughout the three training program sessions that included behavioural rehearsal. Subjects (pianists, violinists and vocalists) performed a short piece before an audience (at assessments) or before their fellow group members. Performance quality ratings by independent musicians served as the behavioural measure, anticipatory heart rate as the physiological measure, and subjective units of distress scales as the subjective measure. In addition, subjects completed memory questionnaires, designed to assess their recall of the setting and their response to previous performances, and thought questionnaires, to provide data pertinent to processes hypothesised to underlie return of fear. Four classification groups (high heart rate, low perceived skill; high heart rate, high perceived skill; low heart rate, low perceived skill; and low heart rate, high perceived skill) were formed on the basis of median splits of heart rate and perceived skill pre-assessment levels. At post-assessment, each group demonstrated fear reduction, heart rate reduced in high-heart-rate subjects, and performance quality improved overall. Followup return of fear was evident in high-heart-rate subjects regardless of initial perceived skill status, and was not dependent on initial fear levels. Perceived skill was not associated with return of fear. High-heart-rate subjects also overestimated their level of fear for previous performances, and reported more anxious thoughts and thought resensitization between performances. High non-performance heart rate was associated with greater return of fear only in extreme group analyses. Post-hoc analyses compared subjects who did (n=24) and did not (n=25) display followup return of fear. Return-of-fear subjects, in general, had higher heart rates and lower perceived skill than no-return-of-fear subjects, and tended to report thought resensitization between post and followup assessment. In addition, return-of-fear subjects were generally less skilled and performed on fewer occasions over the followup interval. The assessment of between-session return of fear was limited by design faults. The results were consistent with a dishabituation model of return of fear. They also lent support to Wagner's consolidation model in which an alteration of stimulus representations between exposures is believed to producedishabituation. The findings did not support the hypothesis that lack of consolidation may also arise from failure to attend to contextual cues, and hence, impaired retrieval of stimulus representations. Similarities of the data to Bower's description of mood-dependent cognitions were noted. It was suggested that salient internal autonomic cues during mood-congruent states facilitated overestimation of previous fear, expectation of distress and return of fear. Finally, research possibilities and treatment implications were considered.