What you don't know, can't hurt you: The differential effect of masked versus non-masked counterconditioning and mere exposure to spider pictures on women's affective evaluation of spiders

Exposure therapy is the treatment of choice for specific phobias but prolonged exposure to feared stimuli is strenuous and may lead to treatment dropout. Previous research showed that repeated exposure to masked spiders was effective in reducing psychophysiological and behavioural fear responses, but appeared ineffective in changing subjective feelings towards spiders. This study investigated in an unselected female sample if masked counterconditioning would be more effective in reducing spider dislike compared to masked exposure, and if masked counterconditioning would also be more effective than non-masked counterconditioning. Women with varying levels of spider aversion (N = 272) were randomly assigned to one of four conditions. Three spider pictures were always (counterconditioning) or never (exposure) followed by smiling faces. For half of the participants in each condition the spiders were masked. Results indicated that participants rated the spider more positively after both masked counterconditioning and masked exposure. However, the increase in valence after masked counterconditioning was not significantly larger than after mere masked exposure, or after non-masked counterconditioning. Thus, our findings show that repeated exposure to masked spider pictures is effective in reducing spider aversion, but they provided no support for the anticipated added benefit of pairing the spider with positive stimuli.