Table 3.
Differences between conditions and associations between characteristics of exposure and anxiety outcomes, by assessment timepoint
| Construct | Study | Anxiety Type | Studies (n) | Effect Size by assessment timepoint | Cohen’s d or r | |
|---|---|---|---|---|---|---|
| Before exposure | ||||||
| DCS 1 h before exposure | Farrell et al. (2013) | OCD (difficult to treat) | 1 |
PT = 0.00 1 m = -0.50 3 m = -0.40 |
NE Medium Small |
d |
|
Pa: PT = − 0.15 Pa: 1 m = − 0.69□ Pa: 3 m = 0.22 |
NE Large Small |
d | ||||
| Storch et al (2010) | OCD | 2 | PT = -0.67 | Medium | d | |
| Storch et al (2016) | PT = ⋄ | - | - | |||
| Leyfer et al (2019) | Panic | 1 |
PT = 0.18□ 3 m = 0.04□ |
NE NE |
d | |
| Scheeringa and Weems (2014) | PTSD | 1 |
PT = 0.71□ 3 m = 0.62□ |
Medium Medium |
d | |
| Byrne et al. (2015) | ||||||
| Same context | Specific Phobia | 1 | 1w = 0.19 | Small | r | |
| Novel context | 1w = -0.37* | Medium | r | |||
| DCS at the commencement of exposure | Farrell et al (2018) | Specific Phobia | 1 |
PT = ⋄ 1 m = ⋄ 3 m = ⋄ |
- - - |
- - - |
| Rapee et al (2016) | Mixed | 1 | PT = 0.56□ | Medium | d | |
| Pa: PT = -0.23□ | Small | |||||
| Sertraline |
Storch et al (2013) RegSert |
OCD | 2 | PT = −0.02□ | NE | d |
| SlowSert | PT = 0.23□ | Small | d | |||
| The POTS Study (2004) | PT = −0.31□** | Small | d | |||
| Attention Training to Positive Stimuli (ATP) | Waters et al (2014) | Specific phobia | 1 |
PT = 0.25□ 3 m = 0.12□ |
Small NE |
d |
| Observational Learning |
Menzies and Clarke (1993) Same context |
Fear of Water | 2 |
PT = ⋄ 12w = ⋄* |
- | - |
| Novel Context | 1w = ⋄ | - | ||||
|
Weiss et al (1998) Peer Mastery |
PT = -0.60□* 4d = -0.42□ |
Medium Small |
d | |||
| Peer Coping |
PT = -0.50□* 4d = -0.11□ |
Medium NE |
d | |||
| Social Skills Training | Olivares-Olivares et al (2019) | Social | 1 |
PT = 1.06Δ*** 6 m = 1.00Δ*** 12 m = 0.95Δ*** |
Large Large Large |
d |
| Preparation | Tiwari et al (2013) | Mixed | 1 | PT = 0.15Δ♦ | Small | r |
| Within exposure | ||||||
| Quantity of Exposure | Hedtke et al (2009) | Mixed | 1 | PT = ⋄* | – | – |
| Benito et al (2018) | OCD | 2 | PT = ⋄ | – | – | |
| Kircanski & Peris (2015) |
PT = ⋄ 3 m = ⋄ |
– – |
– | |||
| Time spent on Exposure |
Hedtke et al (2009) Average length of exposure tasks per session |
Mixed | 1 | PT = ⋄ | – | – |
|
Benito et al (2018) Duration of exposures |
OCD | 2 | PT = ⋄ | – | – | |
|
Kircanski & Peris (2015) Minutes spent on ERP tasks per session |
OCD |
PT = ⋄ 3 m = ⋄ |
– – |
– | ||
| Cumulative Dose of Exposure | Peris et al (2017) | Mixed | 1 | PT = ⋄*** | - | - |
| Percentage of Session with Exposure | Peris et al (2017) | Mixed | 1 | PT = ⋄*** | - | - |
| Percentage of Session with Difficult Exposure | Peris et al (2017) | Mixed | 1 | PT = ⋄*** | - | - |
| Proportion of Session with Combined Exposure | Kircanski & Peris (2015) | OCD | 1 |
PT = ⋄ 3 m = ⋄ |
- - |
- |
| Frequency of Exposure Task Type | Hedtke et al (2009) | Mixed | 1 | PT = ⋄ | - | - |
| Location of Exposure Task | Hedtke et al (2009) | Mixed | 1 | PT = ⋄ | - | - |
| Safety Seeking | Hedtke et al (2009) | Mixed | 1 | PT = -0.37Δ♦* | Medium | r |
| Cognitive Strategy | Benito et al (2012) | OCD | 1 | PT = ⋄ | - | - |
| Avoidance Statement | 1 | PT = ⋄ | - | - | ||
| Avoidant Behaviour | 1 | PT = ⋄ | - | - | ||
| Compliance | Peris et al (2017) | Mixed | 1 | PT = ⋄*** | - | - |
| Mastery | Peris et al (2017) | Mixed | 1 | PT = ⋄*** | - | - |
| Coping | Hedtke et al (2009) | Mixed | 1 | PT = 0.11Δ♦ | Small | r |
| Processing | Hayes et al (2017) | PTSD | 2 | |||
| Negative Emotion | PT = 0.21♦ | Small | r | |||
| Avoidance | PT = 0.00♦ | NE | r | |||
| Ruminative Processing | PT = 0.06♦ | NE | r | |||
| Decentring | PT = -0.02♦ | NE | r | |||
| Ready et al (2015) | ||||||
| Overgeneralisation (beliefs) |
PT = 0.15 6 m = 0.24* 9 m = -0.12 1y = 0.08 |
Small Small Small NE |
r | |||
| Accommodation |
PT = -0.12 6 m = -0.16 9 m = 0.09 1y = 0.19 |
Small Small NE Small |
r | |||
| Initial distress | Kircanski & Peris (2015) | OCD | 1 |
PT = ⋄ 3 m = ⋄ |
- - |
- |
| Fear activation | Hedtke et al (2009) | Mixed | 2 | PT = ⋄ | - | - |
| Peterman et al (2016) |
PT = -0.11 1y = -0.16 |
Small Small |
r | |||
| Benito et al (2018) | OCD | 1 | PT = ⋄ | - | - | |
| Fear Reduction | Peterman et al (2016) | Mixed | 2 | |||
| Between session |
PT = 0.00 1y = -0.05 |
NE NE |
r | |||
| Within session |
PT = -0.20 1y = -0.17 |
Small Small |
r | |||
| Waters et al (2015) | PT = 0.42Δ* | Medium | r | |||
| Benito et al (2018) | OCD | 2 | PT = ⋄* | – | - | |
| Kircanski & Peris (2015) |
PT = ⋄ 3 m = ⋄ |
– – |
– | |||
| 50% Rule | Peterman et al (2016) | Mixed | 1 |
PT = -0.08 1y = -0.05 |
NE NE |
r |
| Variability of distress | Waters et al (2015) | Mixed | 1 | PT = 0.50Δ** | Large | r |
| Benito et al (2018) | OCD | 2 | PT = ⋄ | - | - | |
| Kircanski and Peris (2015) |
PT = ⋄ 3 m = -0.40Δ♦* |
- Medium |
- r |
|||
| Expected minus actual distress | Kircanski & Peris (2015) | OCD | 1 |
PT = ⋄ 3 m = ⋄ |
- - |
- |
| Final distress | Kircanski & Peris (2015) | OCD | 1 |
PT = ⋄ 3 m = ⋄ |
- - |
- |
| Parent involvement | Hedtke et al (2009) | Mixed | 1 | PT = ⋄ | - | - |
|
Benito et al (2012) Discourage avoidance |
OCD | 1 |
PT = ⋄ 3 m = 0.84Δ** |
- Very Large |
- r |
|
| Externalising statements |
PT = ⋄ 3 m = ⋄ |
- - |
- | |||
| Ollendick et al (2015) | Specific Phobia | 2 |
PT = 0.24 1 m = 0.17 6 m = 0.20 |
Small NE Small |
d | |
| Ost et al. (2001) |
PT = 0.25□ 1y = 0.17□ BAT PT = ⋄ BAT 1y = ⋄ |
Small NE - - |
d - |
|||
| Therapist Involvement |
Benito et al (2012) Discourage avoidance |
OCD | 1 |
PT = ⋄ 3 m = 0.73Δ** |
- Very Large |
r |
| Unrelated Talk |
PT = ⋄ 3 m = ⋄ |
- – |
- | |||
| Exposure comments (to increase anxiety) |
PT = ⋄ 3 m = ⋄ |
- - |
- | |||
| After exposure | ||||||
| Child processing | Tiwari et al (2013) | Mixed | 1 | PT = 0.18Δ♦* | Small | r |
| DCS after exposure | Mataix-Cols et al. (2014) | OCD | 1 |
PT = 0.07 3 m = 0.10 6 m = 0.19 1y = 0.15 |
NE NE NE NE |
d |
| Between sessions | ||||||
| Fear Reduction | Peterman et al (2016) | Mixed | 1 |
PT = 0.00 1y = −0.05 |
NE NE |
r |
| Kircanski & Peris (2015) | OCD | 2 |
PT = ⋄ 3 m = ⋄ |
– | – | |
| Kircanski, Wu and Piacentini (2014) | PT = ⋄** | – | – | |||
| PaPT = ⋄*** | – | – | ||||
| Homework Compliance | Park et al (2014) | OCD | 1 | PT = -0.65 | Large | r |
Pa = parent report; PT = post-treatment; Follow-up: d = day, w = week, m = month, y = year; For between-subject studies (d): negative effect indicates lower anxiety level for “EXP plus” condition; positive effect indicates lower anxiety level for “EXP only/placebo” control condition; Δ = measure reported as change between assessment timepoints so that a higher score indicates a greater reduction in anxiety; ♦ = r imputed from β coefficients using Peterson and Brown’s (2005) imputation approach; □ = effect size calculated using available data; ⋄ = insufficient data available to calculate effect size; *p < .05, ** p < .01, *** p < .001; NE = did not meet the threshold for a small effect, BAT Behavioural Approach Test