An event-related potential study on exposure therapy for patients suffering from spider phobia

The present event-related potential (ERP) study investigated electrocortical changes related to cognitive behavior therapy (CBT) in spider phobic females. Forty-five patients and twenty non-phobic women were presented with phobia-relevant, generally fear-inducing, disgust-inducing and affectively neutral pictures in a first EEG session. Phobic patients were randomly assigned to either a therapy (TG) or a waiting-list (WG) group. EEG measurement was repeated after CBT or a waiting period. ERPs were extracted in the time windows 340-500ms (P300), 550-770ms (late positive potential (LPP), early LPP) and 800-1500ms (late LPP). Relative to controls, untreated phobics showed enhanced amplitudes of P300 and early LPP in response to spider pictures. This most likely reflects the emotional significance of the phobic stimulus, which automatically draws attention. The therapy effect consisted of a significant enhancement of late LPP amplitudes in response to spider pictures. Results are discussed in terms of reduced attentional avoidance.