1 - (SYM 10) Perceived Acceptability of Habituation- and Inhibitory Learning-based Rationales for Exposure Therapy in a Clinical Sample

Exposure therapy is a first-line treatment for anxiety and related disorders, yet many patients hesitate to begin or prematurely discontinue it. How exposure is explained—the treatment rationale—may influence its perceived acceptability. This study examined whether two widely discussed exposure rationales differ in perceived acceptability among clinically anxious adults awaiting treatment: a habituation-based explanation grounded in emotional processing theory and an inhibitory learning-based explanation emphasizing expectancy violation and new learning. Twenty-nine clinically referred adults on a cognitive-behavioral therapy waitlist read two carefully matched vignettes describing exposure therapy that differed in explanatory frame (habituation versus inhibitory learning). After each vignette, participants completed validated self-report measures of acceptability-related constructs and a forced-choice treatment preference. Results indicated that ratings of perceived acceptability, endorsement, and anticipated discomfort did not differ between rationales, and forced-choice preferences did not significantly depart from chance. Ratings for both explanations were generally positive and above scale midpoints. Conclusions suggest that, in this vignette context, two clearly articulated exposure rationales elicited similarly positive acceptability ratings. These findings are consistent with analogue work reporting comparable credibility across exposure rationales and highlight the need for larger studies in which rationales are delivered by therapists and linked to behavioral engagement outcomes.