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Emotional distress tolerance (EDT)-or the ability to withstand negative emotional states-is considered a transdiagnostic risk factor for psychopathology. Although EDT is theorized to play a role in anxiety development and maintenance, research aiming to delineate the relationship between anxiety and EDT is lacking. The current study tested whether self-reported EDT predicted self-reported and actual avoidance in the presence of feared stimuli using a heights-fearful sample. Moreover, the study tested whether EDT predicted other in-the-moment fear responses, such as peak anxiety, anxious cognitions, and bodily sensations. Participants (N = 128) completed questionnaires assessing fear of heights, negative affect, anxious cognitions, and bodily sensations, as well as two heights behavioral avoidance tasks (BATs). Results demonstrated that EDT did not predict actual avoidance or other in-the-moment fear responses, except for peak anxiety in one BAT. However, EDT predicted self-reported avoidance of heights beyond fear of heights and negative affect. Taken together, results suggest that perception of ability to tolerate emotional distress predicts perception of avoidance of heights, but not actual avoidance of heights or reactions to heights (with the exception of peak anxiety in one BAT). Given these findings, self-reported EDT may not adequately predict how individuals react in anxiety-provoking situations., (Copyright © 2021. Published by Elsevier Ltd.)

Background and Objectives: People who are afraid of heights may have a perceptual bias, such that they see heights as higher than they truly are. The current study tested if there is a causal relationship between treatments for height fear and changes in perceptual bias., Methods: Specifically, the effects on perceptual bias following three height fear interventions (exposure, cognitive bias modification for interpretations, and a combination of exposure and cognitive bias modification) and a control condition were examined in individuals with an extreme fear of heights (N = 107)., Results: Results provided preliminary evidence that some height fear interventions reduce perceptual bias. Specifically, participants that completed exposure had a significant decrease in perceptual bias, and participants in the cognitive bias modification and combination conditions had decreases in perceptual bias at the level of non-significant trends, while no reduction occurred for the control condition., Limitations: Limitations of this study include that the hypothesis was largely informed by data from a parent study and that the effect sizes were small; thus, replicating these results is warranted., Conclusions: These findings suggest that there may be a causal relationship between height fear treatments and altered perception of heights., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background and Objectives: Cognitive Bias Modification to reduce threat interpretations (CBM-I) trains individuals to resolve ambiguous scenarios via completion of word fragments that assign benign meanings to scenarios. The current study tested: 1) whether Internet-based CBM-I can shift interpretations to be more positive/less negative, and 2) whether varying the number of letters missing in the word fragments (assumed to increase task difficulty) moderates CBM-I's effects., Methods: Participants (N = 350) completed a brief online version of CBM-I, followed by assessments of interpretation bias, fear of negative evaluation, and anticipatory anxiety. Participants were randomly assigned to 1 of 5 conditions: control (half of scenarios ended positively, half negatively), or 4 positive conditions (all scenarios ended positively, but word fragments varied on number of letters missing, from 0 to 3)., Results: Relative to the control condition, all positive conditions led to more positive/less negative interpretations. When analyses were re-run with only a highly socially anxious subset of the sample (n = 100), conditions in which the final word of scenarios was missing 0, 1, or 2 letters led to more positive/less negative interpretations compared to the control condition, but the condition missing 3 letters did not differ from the control condition. There were no differences between conditions on other outcome measures., Limitations: Training was brief, and an unselected sample was used., Conclusions: Results suggest a brief Internet-based CBM-I paradigm can shift interpretation bias, but not necessarily other anxiety-relevant outcomes. Making the task too difficult may blunt effects for highly socially anxious individuals., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: Cognitive models of anxiety disorders posit that biases in interpretation maintain, and potentially cause, anxiety. This study tested whether it is possible to decrease height fear symptoms through cognitive bias modification for interpretations (CBM-I). Additionally, the clinical utility of CBM-I was tested by comparing it to an already established treatment: exposure therapy., Method: Extremely height fearful individuals (N = 110) participated in the study. Acrophobic symptoms were measured before and after 2 sessions of CBM-I and were compared to the standard treatment for acrophobia (exposure therapy), a combination of CBM-I and exposure therapy, and a Control condition., Results: In line with hypotheses, participants in the 3 active conditions showed greater response to treatment than the Control condition in height-relevant interpretation bias, symptoms, and behavioral avoidance on a height stressor, with few differences between the active conditions. Further, symptom change was mediated by change in interpretation bias., Conclusions: Overall, findings suggest that different pathways to fear reduction (exposure vs. shifting interpretations) can lead to similar reductions in height fear. This study provides the first evidence that directly shifting cognitive processing, even with no therapist involvement, can reduce symptoms as effectively as the gold standard, therapist-directed exposure therapy., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Three studies were conducted to examine the psychometric properties of a new scale: the Heights Interpretation Questionnaire (HIQ). This scale was designed to measure height fear-relevant interpretation bias to help assess the relationship between biased interpretations and acrophobia symptoms. Studies 1 (N=553) and 2 (N=308) established the scale's factor structure and convergent and discriminant validity among two large undergraduate samples. Study 3 (N=48) evaluated the predictive validity of the HIQ by examining how well the scale predicted subjective distress and avoidance on actual heights. Factor analysis resulted in four distinct factors, and results suggest that each of the factors, along with the full HIQ, have good reliability and validity. Additionally, the scale predicts subjective distress and avoidance on heights beyond self-reported acrophobia symptoms. Overall, the HIQ shows promise as a new tool to investigate cognitive processing biases in acrophobia., (Copyright © 2011 Elsevier Ltd. All rights reserved.)