Impact of Cognitive Therapy Analogue on Startle Reactivity During Anticipation of Aversive Stimuli

Theories of anxiety have long implicated the importance of exposure to unpredictable aversive situations in the etiology of anxiety disorders. Some people are more uncomfortable with unpredictable situations than others. Specifically, individuals who are intolerant of uncertainty are particularly sensitive to uncertain circumstances and exhibit heightened anxiety and excessive worry when they are exposed to uncertain situations relative to those who are more tolerant (Dugas and Robichaud, 2007). Cognitive therapy aimed at improving tolerance for uncertainty has been shown to increase subjective tolerance for uncertain situations and decrease symptoms of anxiety (Dugas et al., 2010; Ladouceur et al., 2000). Little is known, however, about whether improving tolerance for uncertainty can influence in vivo physiological responding to an uncertain aversive stimulus. To investigate this question, we tested whether a cognitive therapy (CT) analogue directed at improving tolerance for uncertainty would reduce aversive responding (in vivo startle eyeblink response and subjective report) relative to a control intervention during an anxiety-inducing task. Using a variant of an established experimental paradigm, we varied predictability of shock and measured participants’ aversive responses to both predictable and unpredictable threats of shocks (Grillon et al., 2004, 2008). Results indicated that the cognitive intervention reduced subjective but not psychophysiological responding relative to the control intervention. Our findings supported the hypothesis that teaching cognitive strategies would produce immediate, subjective emotional relief for people facing anxiety-provoking situations; however, the brief cognitive intervention did not appear to impact eyeblink startle response.