Behavioral approach test (BAT)
COLD
Both fear and avoidance of spiders and cockroaches were assessed with separate and independent BATs at the beginning of the first experimental session (“Pre”), at the post-stress-treatment and guided spider exposure efficacy evaluation stage (“Post”), as well as during the long term fear reduction stability assessment and generalization stage (“Follow-up”; Fig. Outline of the experimental design and main outcome measures. At the beginning of the experiment the participants underwent two BATs (spider and cockroach), and thereafter, presented with spider and cockroach-related questionnaires (Pre-SECPT treatment stage). Thereafter, the participants underwent the SECPT either under the stress condition with hands submerged in cold water or under the no-stress condition with hands submerged in warm water. Twenty-five minutes after the SECPT, all participants received a short psychoeducation and in-vivo guided spider exposure. After a delay of 24 h, the spider BAT was repeated and both the spider and the cockroach fear-related questionnaires were presented (Post-treatment phase). Long-term effects of exposure were evaluated four weeks later (Follow-up phase). At follow-up, both spider and cockroach BATs were repeated and spider and the cockroach fear-related questionnaires were presented. Abbreviations: BAT: Behavioral avoidance test, SECPT: Socially evaluated cold-pressor testBoth the spider and cockroach BATs were scaled in approach distance which comprised fifteen different steps according to a modified and expanded version of the BAT introduced by Lass-Hennemann and Michael (