Fear reduction during in vivo exposure to blood-injection stimuli: distraction vs. attentional focus
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Updated: Sep 26, 2026

Real-time fMRI Biofeedback Targeting the Orbitofrontal Cortex for Contamination Anxiety
Published on: January 20, 2012
Naomi S Oliver1, Andrew C Page
1Department of Psychology, University of Western Australia, Australia.
Objective:
This study extends Penfold and Page's (1999) finding that exposure plus distraction enhanced within-session fear reduction to a phobic stimulus by examining whether the within-session advantage could be replicated and translated into longer-term gains.
Design:
To test the effects of distraction, participants were assigned randomly to one of three experimental conditions; exposure plus focusing, exposure plus distraction, or exposure alone.
Method:
Blood-injection fearful participants (N = 48) were assigned randomly to receive 3 weekly sessions of 10-min exposure under one of the experimental conditions.
Results:
Consistent with the previous finding, exposure plus distraction showed the greatest within-session fear reduction. Participants in the exposure plus distraction condition also reported the greatest reduction in fear between sessions, at post-treatment, and at 1-month follow-up. Furthermore, participants in the exposure plus distraction condition reported continued increases in perceived control over their anxiety during the month following the exposure sessions.
Conclusions:
The data suggest that conversation is a distraction that can increase perceived control over anxiety and assists anxiety reduction.

