Thought suppression in spider phobia

Automaticity in anxiety disorders and major depressive disorder

In this paper we examine the nature of automatic cognitive processing in anxiety disorders and Major Depressive Disorder (MDD). Rather than viewing automaticity as a unitary construct, we follow a social cognition perspective (Bargh, 1994) that argues for four theoretically independent features of automaticity: unconscious (processing of emotional stimuli occurs outside awareness), efficient (processing emotional meaning uses minimal attentional resources), unintentional (no goal is needed to engage in processing emotional meaning), and uncontrollable (limited ability to avoid, alter or terminate processing emotional stimuli). Our review of the literature suggests that most anxiety disorders are characterized by uncontrollable, and likely also unconscious and unintentional, biased processing of threat-relevant information. In contrast, MDD is most clearly typified by uncontrollable, but not unconscious or unintentional, processing of negative information. For the anxiety disorders and for MDD, there is no sufficient evidence to draw firm conclusions about efficiency of processing, though early indications are that neither anxiety disorders nor MDD are characterized by this feature. Clinical and theoretical implications of these findings are discussed and directions for future research are offered. In particular, it is clear that paradigms that more directly delineate the different features of automaticity are required to gain a more comprehensive and systematic understanding of the importance of automatic processing in emotion dysregulation.

Psychopathology and thought suppression: a quantitative review

Recent theories of psychopathology have suggested that thought suppression intensifies the persistence of intrusive thoughts, and proposed that difficulty with thought suppression may differ between groups with and without psychopathology. The current meta-analytic review evaluates empirical evidence for difficulty with thought suppression as a function of the presence and specific type of psychopathology. Based on theoretical proposals from the psychopathology literature, diagnosed and analogue samples were expected to show greater recurrence of intrusive thoughts during thought suppression attempts than non-clinical samples. However, results showed no overall differences in the recurrence of thoughts due to thought suppression between groups with and without psychopathology. There was, nevertheless, variation in the recurrence of thoughts across different forms of psychopathology, including relatively less recurrence during thought suppression for samples with symptoms of Obsessive-Compulsive Disorder, compared to non-clinical samples. However, these differences were typically small and provided only mixed support for existing theories. Implications for cognitive theories of intrusive thoughts are discussed, including proposed mechanisms underlying thought suppression.

Suppressing and focusing on a negative memory in social anxiety: Effects on unwanted thoughts and mood

Researchers have hypothesized that thought suppression contributes to the large volume of unwanted thoughts in anxiety disorders. However, comparisons to both non-suppression and non-anxious groups are necessary for studies on thought suppression in high anxiety. Participants completed a series of thought verbalization periods and a social interaction. During one period, participants were randomly assigned to focus upon a negative social memory, suppress it, or think freely while monitoring the memory. Results indicated that thought suppression and focusing caused a greater rise and subsequent decline in unwanted thoughts than monitoring instructions for both high and low social anxiety groups. Importantly, highly socially anxious participants had more unwanted thoughts overall, but did not respond significantly differently to thinking instructions when compared to the less anxious group. Interestingly, highly socially anxious participants did report more thought suppression attempts in their everyday life. They also appeared to benefit by experiencing less shyness after suppression when compared to focusing, a pattern not evident for the low social anxiety group.

An Online Measure of Thought Suppression

An online thought-suppression paradigm was developed to test predictions of ironic process theory. Participants concentrated on or suppressed a particular semantic category. Semantic activation was indexed by the latency to name words from the category. In Experiments 1 and 2, an analog intrusion was introduced while participants were trying to suppress the information. Results consistent with ironic process theory were observed using words with polar opposites in Experiment 1 and words without polar opposites in Experiment 2. To determine whether these effects were dependent on the analog intrusion, Experiment 3 replicated Experiment 1 without the intrusion. Concentration generated semantic activation, but suppression exacerbated this activation. The data imply that hyperaccessibility results from efforts to suppress, whereas the processes of thought suppression identified by ironic process theory require the presence of material inconsistent with a desired cognitive state.

Effects of suppressing neutral and obsession-like thoughts in normal subjects: beyond frequency

Recent cognitive-behavioral theories on obsessive-compulsive disorder (OCD) show that deliberate attempts to suppress intrusive and undesirable thoughts lie at the genesis of clinical obsessions. In this paper the results of an experimental study on the suppression of neutral and obsession-like thoughts in normal subjects are presented. Eighty-seven university students performed in three experimental periods: (1) base-line monitoring, (2) experimental instruction, and (3) monitoring. For each of these periods, the frequency of the occurrence of a "white bear" thought or a personally relevant intrusive thought was registered. Half of the subjects received instructions to suppress the target-thought in period 2, and the other half were instructed to only monitor the target-thought in each of the experimental periods. Several measures were also obtained before and after the experiment: annoyance caused by the intrusion, suppression effort, subjective success, and evaluative appraisals of the target-thought. The results showed neither immediate nor delayed frequency increases of the target thought. However, evidence was found that deliberate thought suppression efforts, regardless of their content, had greater negative consequences than did non suppression. These results are discussed in relation to the recent cognitive proposals about OCD.

Thought suppression in spider-fearful and nonfearful individuals

The authors examined the suppression of spider-related thoughts in spider-fearful (n = 23) and nonfearful (n = 22) individuals. Participants were primed with vivid pictures of spiders and a story about spiders. Next, they were randomly assigned to 1 of 2 conditions: (a) suppression of thoughts associated with the previously presented spider-related stimuli or (b) free expression of any thoughts, including those related to the spider-related stimuli. All participants completed a subsequent free-expression exercise. Results indicated that spider-fearful individuals expressed thoughts about the spider-related stimuli for a longer length of time than did nonfearful individuals, particularly in the suppression condition. Participants in both groups demonstrated a rebound of thoughts associated with the spider-related stimuli following suppression. The authors propose that the priming of feared stimuli makes suppression of fear-related thoughts particularly difficult for fearful individuals, perhaps by activating a state of heightened arousal.

Regulating acute posttrauma distress

The influence of emotion-approach and emotion-avoidance methods of coping on the development (cohort 1) and persistence (cohort 2) of posttraumatic stress symptoms was examined. The two coping methods and the frequency and intensity of intrusive, avoidant, and hyperarousal symptoms were assessed in separate series of 71 and 94 hospitalized acute burn-injured patients. In both samples, subjects who frequently used both mental distancing (emotion-avoidance) and venting emotions (emotion-approach), relative to subjects who used only one or neither of the two coping methods, had higher levels of posttraumatic stress disorder symptoms even when controlling for baseline symptoms. Higgins' (1997) motivational framework, incorporating the needs for controllability and predictability, and Wegner's (1994) theory of mental control are used to interpret the findings.

Trouble in Bed: The Role of Pre-Sleep Worry and Intrusions in the Maintenance of Insomnia

Insomnia chronically affects 1 in 9 individuals. It causes sufferers severe distress as well as social, interpersonal, and occupational impairment. One of the most replicated findings in the insomnia literature is that people who suffer from insomnia attribute their sleep disturbance to unwanted and excessive intrusive thoughts and worries whilst trying to get to sleep. This article aims to provide an overview of published studies relating to unwanted worry and intrusions in insomnia and to establish the extent to which unwanted worry and intrusions, and the management of them, contribute to the maintenance of insomnia. It is argued that a key mechanism underpinning excessive negatively toned cognitive activity is the strategy by which the unwanted thoughts are managed. Preliminary research is presented in support of this proposal and the clinical implications of it are discussed. It is concluded that investigations of the mechanisms underpinning excessive and unwanted pre-sleep intrusions and worry are in their infancy, but that it is a promising area for future research.

Thought suppression: specificity in agoraphobia versus broad impairment in social phobia?

The paradoxical effects of intended thought suppression have been linked to psychological disorders, specifically anxiety disorders. So far, the evidence for thought suppression playing a major role in the disorder is mixed. One important issue is whether thought suppression is impaired only for thoughts related to the disorder, or if the ability for mental control is generally impaired in anxiety patients. This study compared groups of agoraphobics and social phobics with a healthy control group. All subjects were asked to suppress two topics related to the respective central fear of the two disorders and one nonspecific topic. We found a rather specific deficit in thought suppression for the agoraphobics; that is, when compared with the control group, we found the biggest differences for the agoraphobic fear. The social phobics seem to be characterized by a general impairment of mental control, affecting specific and nonspecific stimuli. In addition, among several psychopathological variables, social anxiety proved to be the strongest predictor for problems with thought suppression. Taken together, there are several indicators that generally impaired thought suppression may be an important feature of social phobia.

Eating-related thought suppression in high and low disinhibitors

OBJECTIVE

This study examined the effects of the attempts by high and low disinhibitors to suppress thoughts about food and eating.

METHOD

Seventy-seven females who differed in level of disinhibition were asked to monitor their thoughts about food and eating for three 5-min periods. Participants were administered either a suppression or a nonsuppression instruction relating to thoughts about food and eating. The number of food-related thoughts were recorded. Self-report ratings of anxiety, distress, perceived frequency of thoughts, control over thoughts, and strategies used to control thoughts were also obtained.

RESULTS

Low disinhibitors who were instructed to suppress had more food-related thoughts than high disinhibitors who were instructed to suppress. The reverse was true in the nonsuppression condition. High disinhibitors reported higher levels of anxiety and distress. Furthermore, high disinhibitors had less difficulty controlling their thoughts than low disinhibitors when asked to suppress, whereas the reverse was true when they did not receive suppression instructions. Thought control strategies were found to correlate significantly with anxiety ratings, self-reported frequency of intrusions, actual number of thought intrusions, and distress.

DISCUSSION

High disinhibitors are able to successfully suppress their thoughts about food and eating, at least across relatively short periods of time. However, there appears to be associated negative consequences.

Suppression of obsession-like thoughts in nonclinical individuals: impact on thought frequency, appraisal and mood state

Wegner's (1994, Psychological Review, 101, 34-52) research on the paradoxical effect of thought suppression has been incorporated into contemporary cognitive-behavioural models of obsessive-compulsive disorder. However, findings on the effects of thought suppression on thought frequency have been inconsistent and few studies have actually examined the suppression of thoughts that are obsessional in nature. In the present study 219 nonclinical participants were randomly assigned to suppress or not suppress a neutral, obsessional or positive thought during an initial monitoring interval. In a second thought monitoring interval, all participants received instructions not to suppress their target thought. No paradoxical effect of suppression on frequency was observed for any type of thought, although suppression of obsessional thoughts was associated with greater subsequent discomfort and a more negative mood state than suppression of positive or neutral target thoughts.

Paradoxical effects of thought suppression: a meta-analysis of controlled studies

Research has shown that attempts to suppress a thought can cause an increase in the frequency of the thought. These paradoxical effects of thought suppression play a key role in cognitive-behavioral models of several emotional disorders. Laboratory studies of this phenomenon, however, have yielded mixed results; and narrative summaries of the literature have not been able to draw firm conclusions about the effects of thought suppression. We used meta-analysis to quantitatively examine the magnitude of thought suppression effects across controlled studies. Moreover, we explored whether the variability in effect sizes could be explained by methodological differences within and between studies. Results indicated a small to moderate rebound effect of thought suppression that varied in magnitude depending on the nature of the target thought and the method by which thought frequency was measured. Participants with clinical diagnoses did not show larger rebound effects than nonclinical or analogue participants, however, only a few studies included clinical samples. Findings are discussed in terms of implications for the ironic process theory of thought suppression, and avenues for future research on this phenomenon.

Die Unterdrückung unerwünschter Gedanken: Vergleich zweier Varianten eines experimentellen Paradigmas

Zusammenfassung. Theoretischer Hintergrund: Die Rolle von Gedankenunterdrückung bei der Entstehung und Aufrechterhaltung psychischer Störungen wird immer häufiger auch experimentell untersucht. Dabei unterscheiden sich die Studien darin, ob die Versuchspersonen während der Unterdrückungsphasen laut oder leise denken sollen. Fragestellung: Untersuchung des Effekts dieser Variation auf die Prozesse und den Erfolg der Gedankenunterdrückung sowie auf das Erleben der Versuchspersonen. Methode: 108 Personen wurden einer der beiden experimentellen Bedingungen (lautes/leises Denken) zugeordnet. Ergebnisse: Zwischen den Gruppen zeigten sich nur geringe Unterschiede beim Erfolg der Unterdrückung und den verwendeten Strategien. Hinsichtlich der Befindlichkeit und der Präferenz der Versuchspersonen fiel das leise Denken deutlich positiver aus. Schlußfolgerung: Für die Arbeit mit Patientenstichproben ist das leise Denken zu empfehlen.

Thought suppression

Although thought suppression is a popular form of mental control, research has indicated that it can be counterproductive, helping assure the very state of mind one had hoped to avoid. This chapter reviews the research on suppression, which spans a wide range of domains, including emotions, memory, interpersonal processes, psychophysiological reactions, and psychopathology. The chapter considers the relevant methodological and theoretical issues and suggests directions for future research.

Implicit associations for fear-relevant stimuli among individuals with snake and spider fears

This study investigated an implicit measure of cognitive processing, the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998), as a measure of fear-related automatic associations. Sixty-seven students with snake or spider fears completed 4 IAT tasks in which they classified pictures of snakes and spiders along with descriptive words indicating valence, fear, danger, or disgust. Results indicated that all 4 tasks discriminated between fear groups in terms of their implicit associations, and fear-specific effects were significant even after controlling for the impact of valence evaluation. Findings are discussed in terms of applications of the IAT methodology to examine cognitive processing and schemata in anxiety and potential uses for assessing anxiety disorders.

Attempting suppression of traumatic memories over extended periods in acute stress disorder

This study investigated the influence of attempted suppression and thought control strategies on traumatic memories. Survivors of civilian trauma with acute stress disorder (ASD; n = 20) and without ASD (n = 20) monitored their trauma-related thoughts for three 24-h periods. In period 1, participants were instructed to think about anything. In period 2, participants were administered suppression or nonsuppression instructions relating to thoughts of the trauma. In period 3, participants were again instructed to think about anything. The results revealed no evidence for an increase in trauma-related thoughts following suppression instructions. Punishment and worry thought control strategies correlated significantly with both anxiety and suppression ratings. Frequency of intrusions was associated with a distraction cognitive strategy. These findings point to the importance of traumatised individuals' cognitive strategies in mediating the management and occurrence of posttraumatic intrusions.

Thought suppression and psychopathology

Wegner's seminal investigations of effects of thought suppression on later thought frequency have had a significant impact on recent approaches to understanding emotional disorders characterized by the occurrence of persistent, repetitive, unwanted thoughts. Thought suppression has now been implicated as a etiological and/or maintaining factor in depression, generalized anxiety disorder, specific phobia, posttraumatic stress disorder and obsessive-compulsive disorder. These developments are fairly new, and it has not been until recently that studies have investigated the effects of suppressing thoughts that are actually analogous to problematic thoughts characteristic of emotional disorder. This paper provides a review of this body of work, including the findings and their relevance for existing models of specific disorders. Directions for future research are suggested.

The effects of suppressing trauma-related thoughts on women with rape-related posttraumatic stress disorder

A hallmark symptom of posttraumatic stress disorder (PTSD) is the presence of intrusive thoughts that come to mind against an individual's will and are frequently accompanied by considerable distress. This investigation examined the effects of deliberate suppression of rape-related thoughts on female sexual assault survivors, in order to explore this facet of PTSD. Seventeen women with chronic PTSD following a sexual assault were contrasted with nineteen survivors without PTSD, using a thought suppression paradigm (e.g. [Wegner, Schneider, Carter, & White (1987) Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53 5-13]). Results indicated that PTSD participants experienced a rebound in the frequency of rape-related thoughts following deliberate suppression, whereas non-PTSD participants did not experience a rebound. Reported level of perceived controllability over rape-related thoughts for the PTSD participants was significantly lower during the suppression phase (as compared with the expression phase) relative to the non-PTSD participants. PTSD participants were significantly more anxious, depressed and distressed throughout the procedure relative to non-PTSD participants, although mood changes did not parallel the rebound effect found with rape-related thoughts in the PTSD group. Results are discussed in light of the role that intrusive thoughts may play in the maintenance of PTSD.

The role of valence in attempted thought suppression

Thought control was investigated in participants (N = 72) who were shown either a violent, humorous or neutral film and then administered either suppression or nonsuppression instructions. Following the presentation of a three minute segment from one film, participants monitored their thoughts for two 3-minute periods. In Period 1, participants were administered suppression or nonsuppression instructions relating to thoughts of the film. In Period 2, participants were instructed to think about anything. During both periods participants were instructed to press a response button if they had a trauma-related thought. Participants who viewed the violent film gave higher ratings of distress and lower pleasantness ratings than those who viewed the humorous and neutral films. Participants who were given suppression instructions demonstrated a delayed increase in trauma-related thoughts in the period subsequent to suppression across the valence conditions.

The effect of attempted thought suppression in acute stress disorder

Attempted suppression of traumatic memories was investigated in survivors of motor vehicle accidents with acute stress disorder (ASD; n = 24) and without ASD (n = 24). Participants monitored their trauma-related thoughts for three 5-minute periods. In Period 1, participants were instructed to think about anything. For Period 2, participants were administered suppression or non-suppression instructions relating to thoughts of the trauma. In Period 3, participants were again instructed to think about anything. ASD participants reported higher ratings of anxiety, frequency of trauma-related thoughts, and attempted suppression of trauma-related thoughts than non-ASD participants. Participants who were given suppression instructions demonstrated a delayed increase in trauma-related thoughts in the period subsequent to suppression.

Effects of thought suppression on episodic memory

Subjects were shown a short film fragment. Following this, one group of subjects (n = 26) was instructed to suppress their thoughts about the film, while the other group (n = 24) received no instructions. After 5 hrs subjects returned to the laboratory and completed a questionnaire testing their memory about the film. Results showed that suppression subjects reported a higher frequency of thoughts about the film than control subjects. No evidence was obtained for Wegner, Quillian, and Houston's (1996; Journal of Personality and Social Psychology, 71, 680-691) claim that suppression has an undermining effect on memory for chronology. Possible causes for the differences between the results as obtained by Wegner et al., and those found in the present study are discussed. These causes may pertain to the experimental design, but also to differences in emotional impact of the stimulus material that was used in both studies.