Abstract

Individuals often utilize distraction strategies to cope with distress that results from anxiety-provoking situations. While some theories suggest that distraction will impede improvement during exposure, others suggest it may not be harmful, and may in fact aid in fear reduction. Experimental results parallel these divergent theories, with support for distraction both helping and hindering treatment. Given these mixed findings, the goal of these studies was to investigate factors that may help explain the differences observed in the extant literature. In Study 1 a measure of maladaptive beliefs about distraction, the Beliefs about Distraction Inventory (BADI), was developed and validated in an unselected student sample (N = 506) and confirmed in a contamination-fearful sample (N = 132). Results indicated that the BADI was psychometrically sound and consisted of two factors: Distraction is Necessary and Distraction is Effective. This factor structure was confirmed in the contamination-fearful sample, and similar psychometric properties were observed. Study 2 was comprised of two studies that together aimed to assess the impact of differing levels of distraction on exposure outcome. In Experiment 1 verbal distraction tasks were experimentally validated in an undergraduate sample (N = 180) using a reaction time task. Three different levels of distraction were established, categorized as utilizing low, moderate, and high levels of cognitive load. In Experiment 2 the three tasks varying in distraction intensity were compared to a no distraction control during an exposure session with contamination-fearful individuals (N = 124). Changes in behavioural approach did not differ significantly across conditions at post-exposure or at one-week follow-up. However, treatment acceptability was highest in conditions utilizing moderate or high levels of distraction, and changes in self-efficacy were greatest in the moderate distraction condition. Finally, preliminary analyses were conducted to assess the impact of maladaptive beliefs about distraction on exposure outcome. Results showed that high BADI scores were related to less improvement over the course of an exposure session when moderate distraction was utilized. The results of these studies are discussed in terms of theoretical and clinical implications, including the cognitive-behavioural treatment of anxiety and related disorders.