Context-specificity of relapse: effects of therapist and environmental context on return of fear

Context-specificity of fear extinction was tested among 65 participants who were fearful of spiders by manipulating the contexts used for exposure tre atment and two-week follow-up assessment. Context was defined by both meani ngful (presence of a particular therapist) and incidental (room location an d furnishings) environmental cues. Distinct phobic stimuli were used to exa mine interactions of context with stimulus. Physiological, behavioral and v erbal indices of fear were measured. Results provided modest support for co ntext-specific return of fear. With one stimulus, participants assessed in a nontreatment context at follow-up exhibited greater returns in heart rate levels. In addition, three of four participants who could not touch the st imulus at follow-up had been tested in a non-treatment context. Future inve stigations may benefit from greater distinctions between contexts or manipu lation of contextual features more directly relevant to fear. Finally, post hoc analyses identified high trait anxiety, slow treatment response, recov ery of phobic cognitions and long duration/high intensity phobic encounters post-treatment as significant predictors of increased return of fear. (C) 1999 Elsevier Science Ltd. All rights reserved.