Positive valence reduces susceptibility to return of fear and enhances approach behavior

•We test the effect of valence training plus exposure on return of fear.•We elucidate the relation between CS valence and return of fear following exposure.•The Training group demonstrated less behavioral avoidance at follow-up.•Change in valence predicted subjective fear at follow-up.•Valence training may enhance the longevity of exposure treatment.

Background and objectivesAlthough exposure therapy is highly efficacious for anxiety disorders, many individuals do not respond. Drawing from the science of fear extinction and reinstatement, the current study evaluated whether a training designed to increase valence of the feared stimulus improved the longevity of treatment outcomes.MethodsParticipants were 61 undergraduate students with fear of spiders (>10 on Spider Phobia Questionnaire, M = 20.45, SD = 3.98) who were randomized to receive positive valence training or control training. Participants completed exposure over two days, with training conditions at the end of the first day. Tests of spontaneous recovery and reinstatement were conducted one week later.ResultsCompared to control, the Positive Valence Training group demonstrated significantly less subjective fear at test of spontaneous recovery and less behavioral avoidance after reinstatement. Change in valence predicted subjective fear at spontaneous recovery and after reinstatement but did not predict behavioral avoidance after reinstatement.LimitationsDue to the relatively small size and homogeneity of the sample, as well as the limited methods of training (i.e., film clips only) and outcome measurement (i.e., self-report and behavioral measures), current results should be interpreted with caution.ConclusionsAdjunct positive valence training may enhance the longevity of exposure treatment.