Enhancing exposure therapy with acute exercise : an initial test
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Exposure-based therapies are one of the most effective strategies for treating a large range of anxiety disorders; yet there remains a substantial (20-50%) non-response rate. Since exposure therapies are based on fear extinction principles, strategies that can enhance the acquisition and retention of fear extinction memories should, theoretically, facilitate the outcome of exposure therapy. Pharmacological agents acting as cognitive enhancers have shown some effectiveness in augmenting exposure therapy. Aerobic exercise may similarly act as a cognitive enhancer as it has been shown to affect learning and memory processes broadly. The current study builds upon the extant literature by conducting an initial test of the efficacy of acute aerobic exercise for enhancing exposure therapy outcomes. Adults with a marked fear of heights were randomized to either 30-minutes of vigorous aerobic exercise or rest immediately prior to 30-minutes of virtual reality exposure therapy (VRET). Participants’ fear of heights was assessed 1- and 2-weeks later by clinician ratings and self-report questionnaires. On average, participants showed significant decreases in fear of heights from baseline to 1- and 2-weeks post-VRET, but these changes did not significantly differ by treatment condition. This remained true even after including potential moderators of treatment condition. These findings do not support acute exercise as an augmentation strategy for exposure therapy. Clinical and research implications are discussed.