Fear reactivity to cognitive dyscontrol via novel head-mounted display perceptual illusion exercises

Anxiety sensitivity cognitive concerns (ASCC), refer to fears of mental catastrophe or losing control over mental processes. Recent findings show that ASCC are related to suicide risk, mood disorders and trauma-related disorders. Using controlled experimental psychopathology paradigms could be one heretofore unutilized method of increasing understanding of ASCC. Our goal was to test fear reactivity to four head-mounted display perceptual illusion challenges designed to bring on feelings of cognitive dyscontrol (i.e., derealization, depersonalization) in a group of high and low anxiety sensitivity cognitive concerns participants.

Participants (N=49) with Anxiety Sensitivity Index-3 cognitive scores at least 1.5 SD above or below the mean completed four cognitive dyscontrol challenges utilizing head-mounted display technology.

Results showed all four challenges successfully elicited high cognitive anxiety symptoms. Consistent with other laboratory challenge studies; high versus low ASCC participants reported comparable cognitive symptoms but reported significantly greater fear.

This was an initial proof of concept study designed to examine fear reactivity to cognitive dyscontrol challenges. Therefore, no control exercises were evaluated.

The finding that fear reactivity to the laboratory challenges can potentially serve as a viable behavioral correlate of ASCC provides a potentially useful exposure exercise for clients experiencing high levels of ASCC. Given the association between ASCC and severe psychopathology, with further investigation and refinement, such exposure exercises could be integrated into cognitive-behavioral treatments.