Cognitive Bias in Spider-Phobic Children: Comparison of a Pictorial and a Linguistic Spider Stroop

The relation between spider fear in children and cognitive processing bias toward threatening information was examined. It was investigated whether spider fear in children is related to a cognitive bias for threatening pictures and words. Pictorial and linguistic Stroop stimuli were administered to 28 spider phobic and 30 control children aged 8–12. Spider-phobic children showed a moderate bias for threatening words. Surprisingly, no bias was found for spider pictures, while the spider-phobic children judged the pictures as more aversive. Moreover, in a recent similar study in adults (Kindt & Brosschot, 1997), a strong relation between spider phobia and bias toward threat words and pictures was found. Several explanations are given to account for this divergence.     

Very brief exposure II: the effects of unreportable stimuli on reducing phobic behavior

This experiment compared the effects of exposure to masked phobic stimuli at a very brief stimulus-onset asynchrony on spider-phobic and non-phobic individuals. Participants were identified through a widely used questionnaire and a Behavioral Avoidance Test (BAT) with a live, caged tarantula to establish baseline levels of avoidance. One week later, they were individually administered one of two continuous series of masked images: spiders or flowers. Preliminary masking experiments showed that independent samples of participants from the same populations failed to recognize these stimuli. Participants in the main experiment reported ratings of subjective distress immediately before and after the exposure manipulation. Then they engaged in the BAT once again. Very brief exposure to images of spiders reduced phobic participants' avoidance of the tarantula. No effects were evidenced on subjective distress, or on non-phobic participants. Theoretical implications for the non-conscious basis of fear are discussed.     

The role of awareness in delay and trace fear conditioning in humans

Expression of conditional fear without awareness has been previously demonstrated during delay conditioning, a procedure in which the conditioned stimulus (CS) and unconditioned stimulus (UCS) overlap. However, less is known about the role of awareness in trace fear conditioning, where an interval of time separates the CS and UCS. The present study assessed skin conductance response (SCR) and UCS expectancy during delay and trace conditioning. UCS predictability was varied on a trial-bytrial basis by presenting perithreshold auditory CSs. Differential UCS expectancies were demonstrated only on perceived delay and trace trials. Learning-related SCRs were observed during both perceived and unperceived delay CSs. In contrast, differential SCRs were demonstrated only for perceived trace CSs. These data suggest that awareness is necessary for conditional responding during trace, but not delay, fear conditioning.     

Individual response differences in spider phobia: Comparing phobic and non-phobic women of different reactivity levels

Abstract

In contrast to previous stress research, studies concerning phobic disorders have never systematically investigated individual response differences between phobic participants integrating numerous different response measures. The aim of this article is to clarify the existence of significant individual response differences in psychophysiological responses (e.g., heart rate, skin conductance responses (SCR), corrugator, cortisol), subjective ratings (e.g., valence, arousal), and avoidance behavior in 46 spider phobic and 44 non-phobic women when exposed to 20 phobic and 20 neutral pictures. Previous studies that did not attend to individual response differences showed that, during phobic stimulation, phobic individuals have increased psychophysiological responses (heart rate, SCR, and corrugator responses), more negative valence rating, and more subjective arousal than non-phobic individuals. These results were confirmed by our data. With regard to individual response uniqueness, 1/3–2/3 of spider-phobic women with low responsiveness in heart rate, cortisol, and avoidance behavior were indistinguishable from non-phobic women during phobic stimulation. With SCR, corrugator EMG, and subjective ratings, no individual response uniqueness was found. Based on the findings, exposure therapy might be improved by tailoring interventions to individuals with a therapeutic focus on those psychophysiological measures that show the highest individual responsivity.     

Fears in clinic-referred children: relations with child anxiety sensitivity, maternal overcontrol, and maternal phobic anxiety

Relations among maternal phobic anxiety, maternal overcontrol, child anxiety sensitivity, and child level of fear were explored in 156 children referred to an outpatient clinic for psychological evaluation. In addition, these relations were examined separately in analyses of age, gender, and diagnostic status. Overall, age, gender, and child anxiety sensitivity, along with maternal ratings of an overly controlling parenting strategy were significant predictors of levels of fear. These four variables predicted approximately 50% of the variance associated with fear levels. Surprisingly, maternal phobic anxiety was not a significant predictor in this sample of clinic-referred children. In separate analyses of age, gender, and diagnostic status (presence or absence of an anxiety disorder), anxiety sensitivity was a significant predictor of fear levels for both older and younger children, for both boys and girls, and for both children with and without an anxiety disorder. However, maternal overly controlling parenting strategy was significant only for the younger children (and not the older ones) and only for girls (and not boys). Moreover, maternal overcontrol was a marginally significant predictor for the anxiety-disorder group (and not the non-anxiety-disordered group). Results are discussed within a developmental framework, and implications for treatment are explored.     

Phylo- and ontogenetic fears and the expectation of danger: differences between spider- and flight-phobic subjects in cognitive and physiological responses to disorder-specific stimuli

To compare specific phobias with an assumed phylogenetic or ontogenetic origin in responses to fear-relevant (FR) stimuli, 17 spider- and 17 flight-phobic participants were exposed to pictures of spiders, flight accidents, or mushrooms randomly followed by either a startling noise or nothing else. While both groups showed a disorder-specific expectancy bias, only spider-phobic participants exhibited a disorder-specific covariation bias. Spider-phobic participants also showed enhanced skin conductance responses (SCRs), event-related brain potentials (ERPs), and startle responses triggered by disorder-specific FR pictures while flight-phobic participants showed only disorder-specific enhanced SCRs. In sum, our direct comparison between ontogenetic and phylogenetic phobias revealed that the former is characterized by biased and enhanced responses triggered by disorder-specific FR stimuli presumably based on a biological preparedness.     

When spiders appear suddenly: spider-phobic patients are distracted by task-irrelevant spiders

Fear is thought to facilitate the detection of threatening stimuli. Few studies have examined the effects of task-irrelevant phobic cues in search tasks that do not involve semantic categorization. In a combined reaction time and eye-tracking experiment we investigated whether peripheral visual cues capture initial attention and distract from the execution of goal-directed eye movements. Twenty-one spider-phobic patients and 21 control participants were instructed to search for a color singleton while ignoring task-irrelevant abrupt-onset distractors which contained either a small picture of a spider (phobic), a flower (non-phobic, but similar to spiders in shape), a mushroom (non-phobic, and not similar to spiders in shape), or no picture. As expected, patients' reaction times were longer on trials with spider distractors. However, eye movements revealed that this was not due to attentional capture by spider distractors; patients more often fixated on all distractors with pictures, but their reaction times were delayed by longer fixation durations on spider distractors. These data do not support automatic capture of attention by phobic cues but suggest that phobic patients fail to disengage attention from spiders.     

Fear of snakes and facial reactions: A case of rapid emotional responding

The aim of the present study was to explore how rapid emotional responses are manifested as facial electromyographic (EMG) reactions when people with explicit fear of snakes are exposed to their fear relevant stimuli. Fifty-six subjects, high or low in fear of snakes, were exposed to pictures of snakes and flowers while facial EMG activity from the corrugator supercilii and the zygomatic major muscle regions was recorded. Measures of autonomic activity and ratings of the stimuli were also collected. Pictures of snakes evoked a rapid corrugator supercilii muscle reaction which was larger in the High fear group as early as 500ms after stimulus onset. The High fear group also rated snakes as more unpleasant and displayed larger skin conductance responses (SCRs) and increased heart rate (HR) when exposed to snakes. Pictures of flowers tended to evoke increased zygomatic major muscle activity which did not differ among the groups. The present results demonstrate that the facial EMG technique is sensitive enough to detect rapidly evoked negative emotional reactions. The results support the hypothesis that people high in fear of snakes are disposed to react very rapidly with a negative emotional response to their fear relevant stimuli.     

Mechanisms of visual threat detection in specific phobia

People with anxiety or stress-related disorders attend differently to threat-relevant compared with non-threat stimuli, yet the temporal mechanisms of differential allocation of attention are not well understood. We investigated two independent mechanisms of temporal processing of visual threat by comparing spider-phobic and non-fearful participants using a rapid serial visual presentation task. Consistent with prior literature, spider phobics, but not non-fearful controls, displayed threat-specific facilitated detection of spider stimuli relative to negative stimuli and neutral stimuli. Further, signal detection analyses revealed that facilitated threat detection in spider-phobic participants was driven by greater sensitivity to threat stimulus features and a trend towards a lower threshold for detecting spider stimuli. However, phobic participants did not display reliably slowed temporal disengagement from threat-relevant stimuli. These findings advance our understanding of threat feature processing that might contribute to the onset and maintenance of symptoms in specific phobia and disorders that involve visual threat information more generally.     

An exploratory investigation of the origin and maintenance of phobias

Phobies were asked to relate past events which they believed caused or contributed to their fear, and to describe cognitive events experienced while imagining phobic interactions. Approximately half the subjects were able to recall relevant learning experiences, with direct experiences far more common than vicarious experiences or learning based on verbal instruction. Almost all of the subjects reported self-verbalizations while imagining the phobic situation, in every case phobic relevant. However, in a minority of instances were the verbalizations ‘catastrophic’ in nature. In only about half the cases did the phobies report that, in vivo, thoughts preceeded fear in the phobic situation (in contrast to a comparison group of less fearful subjects for which thoughts did preceed fear to a significant degree). Results are discussed in terms of possible limitations of a cognitive interpretation of phobic behavior.     

When two paradigms meet: Does evaluative learning extinguish in differential fear conditioning?

Contemporary theories of Pavlovian conditioning propose a distinction between signal learning (SL), in which a conditioned stimulus (CS) becomes a predictor for a biologically significant unconditioned stimulus (US), and evaluative learning (EL), in which the valence of the US is transferred to the CS. This distinction is based largely on the different susceptibilities of EL and SL to extinction. This study compared the extinction of indices of EL (online valence ratings) and SL (US-expectancy ratings and skin conductance responses, SCRs) in a differential fear conditioning design using complex CSs. Only half of the participants gave online valence ratings, allowing us to confirm that online valence measurement did not influence SCRs. In line with the distinction between EL and SL, SCRs extinguished rapidly while valence ratings showed resistance to extinction. US-expectancy ratings, however, were not distinguishable from valence ratings indicating that verbal indicators of EL and SL share a similar time course.     

'Fear of panic': an investigation of its role in panic occurrence, phobic avoidance, and treatment outcome

The concept of 'fear of fear' has recently received empirical attention regarding its role in panic occurrence and phobic avoidance. Overall, the results of such studies have indicated that anticipation of panic is positively correlated (albeit weakly) with self-reports of avoidance. The present study examined the relationship of panic anticipation--panic occurrence, phobic avoidance and treatment outcome, using a more direct measure of this fear than has been used in previous studies. Results indicated that anticipation of panic was slightly correlated with breadth and severity of avoidance, and moderately correlated with overall clinical severity. In addition, anticipation of panic was found to decrease significantly throughout treatment, but appeared to be independent of actual panic experience. These results may suggest the operation of an intervening variable which accounts for the reduction of both anticipated and actual panic events. Implications for assessment and treatment are discussed.     

Psychophysiology of prospective memory

Prospective memory involves the self-initiated retrieval of an intention upon an appropriate retrieval cue. Cue identification can be considered as an orienting reaction and may thus trigger a psychophysiological response. Here we present two experiments in which skin conductance responses (SCRs) elicited by prospective memory cues were compared to SCRs elicited by aversive stimuli to test whether a single prospective memory cue triggers a similar SCR as an aversive stimulus. In Experiment 2 we also assessed whether cue specificity had a differential influence on prospective memory performance and on SCRs. We found that detecting a single prospective memory cue is as likely to elicit a SCR as an aversive stimulus. Missed prospective memory cues also elicited SCRs. On a behavioural level, specific intentions led to better prospective memory performance. However, on a psychophysiological level specificity had no influence. More generally, the results indicate reliable SCRs for prospective memory cues and point to psychophysiological measures as valuable approach, which offers a new way to study one-off prospective memory tasks. Moreover, the findings are consistent with a theory that posits multiple prospective memory retrieval stages.     

Acquisition of agoraphobia, mode of onset and anxiety response patterns

The ways in which 80 agoraphobic patients had acquired their phobia were investigated. The patients were requested to answer a questionnaire concerning: (a) the origin of the phobia, with items relevant for conditioning experiences, vicarious experiences and experiences of negative information/instruction; (b) physiological reactions; (c) anticipatory anxiety; (d) negative thoughts while in the phobic situation. In addition, data on mode of onset, precipitating factors, family history of phobias, marital and occupational status and severity of the phobia were obtained. The reported anxiety reaction was conceptualized in terms of the Three-Systems Model of fear and anxiety, i.e. anxiety as composed of a physiological, cognitive and behavioral component. The results showed that a large majority (81%) of the patients attributed their phobias to conditioning experiences, while 9% recalled vicarious learning, none recalled instruction/information and 10% could not recall any specific onset circumstances at all. In another classification 46% of the patients had a rapid, 36% a gradual and 18% a slow onset of their phobias. There was no relationship between either the ways of acquisition, or the modes of onset, and the anxiety components, nor did the conditioning and the indirect groups differ in severity of phobic reactions.     

Individual response differences in spider phobia: comparing phobic and non-phobic women of different reactivity levels

In contrast to previous stress research, studies concerning phobic disorders have never systematically investigated individual response differences between phobic participants integrating numerous different response measures. The aim of this article is to clarify the existence of significant individual response differences in psychophysiological responses (e.g., heart rate, skin conductance responses (SCR), corrugator, cortisol), subjective ratings (e.g., valence, arousal), and avoidance behavior in 46 spider phobic and 44 non-phobic women when exposed to 20 phobic and 20 neutral pictures. Previous studies that did not attend to individual response differences showed that, during phobic stimulation, phobic individuals have increased psychophysiological responses (heart rate, SCR, and corrugator responses), more negative valence rating, and more subjective arousal than non-phobic individuals. These results were confirmed by our data. With regard to individual response uniqueness, 1/3-2/3 of spider-phobic women with low responsiveness in heart rate, cortisol, and avoidance behavior were indistinguishable from non-phobic women during phobic stimulation. With SCR, corrugator EMG, and subjective ratings, no individual response uniqueness was found. Based on the findings, exposure therapy might be improved by tailoring interventions to individuals with a therapeutic focus on those psychophysiological measures that show the highest individual responsivity.     

Context-specificity of relapse: effects of therapist and environmental context on return of fear.

Context-specificity of fear extinction was tested among 65 participants who were fearful of spiders by manipulating the contexts used for exposure treatment and two-week follow-up assessment. Context was defined by both meaningful (presence of a particular therapist) and incidental (room location and furnishings) environmental cues. Distinct phobic stimuli were used to examine interactions of context with stimulus. Physiological, behavioral and verbal indices of fear were measured. Results provided modest support for context-specific return of fear. With one stimulus, participants assessed in a non-treatment context at follow-up exhibited greater returns in heart rate levels. In addition, three of four participants who could not touch the stimulus at follow-up had been tested in a non-treatment context. Future investigations may benefit from greater distinctions between contexts or manipulation of contextual features more directly relevant to fear. Finally, post hoc analyses identified high trait anxiety, slow treatment response, recovery of phobic cognitions and long duration/high intensity phobic encounters post-treatment as significant predictors of increased return of fear.     

Constraint, alcoholism, and electrodermal response in aversive classical conditioning and mismatch novelty paradigms

This study investigated whether low levels of the personality trait of constraint and early-onset alcoholism would be associated with deficits in aversive conditioning and smaller responses to novelty in a stimulus mismatch protocol. Personality traits (constraint and socialization) and skin conductance responses (SCRs) during conditioning and novelty paradigms were assessed in alcoholics (n=41) and non-alcoholics (n=32). The conditioning protocol involved measuring SCRs after conditioned stimuli (CS+: tones) paired with shock, CS− tones unpaired with shock, and CS+ probes unpaired with shock. The mismatch protocol involved measuring SCRs to auditory stimuli consisting of a series of 5 pure tones of the same pitch followed a shorter white noise stimulus (the novel stimulus). Contrary to the hypothesis, alcoholics did not differ from non-alcoholics in SCRs to CS+ probes or on the mismatch measure (SCR novel tone—SCR to 5^th tone). Higher levels of constraint and self-reports of fear during conditioning were associated with smaller responses to both the CS+ probes and the CS− tones as well as the mismatch measure within non-alcoholics, but not within alcoholics. In alcoholics, low constraint was associated with greater habituation to CS+ probes, and poor differential conditioning on measures of change across trials in SCR to CS+ probes and CS− stimuli. The results suggest that different processes influence levels of constraint in non-alcoholics and alcoholics. The data indicate that low constraint in non-alcoholics is associated with allocating fewer processing resources to potentially significant stimuli, rather than being associated with a specific deficit in aversive conditioning per se.     

Fear conditioning in posttraumatic stress disorder: evidence for delayed extinction of autonomic, experiential, and behavioural responses

Aversive conditioning has been proposed as an important factor involved in the etiology of posttraumatic stress disorder (PTSD). However, it is not yet fully understood exactly which learning mechanisms are characteristic for PTSD. PTSD patients (n=36), and healthy individuals with and without trauma exposure (TE group, n=21; nTE group, n=34), underwent a differential fear conditioning experiment consisting of habituation, acquisition, and extinction phases. An electrical stimulus served as the unconditioned stimulus (US), and two neutral pictures as conditioned stimuli (CS+, paired; CS-, unpaired). Conditioned responses were quantified by skin conductance responses (SCRs), subjective ratings of CS valence and US-expectancy, and a behavioural test. In contrast to the nTE group, PTSD patients showed delayed extinction of SCRs to the CS+. Online ratings of valence and US-expectancy as well as the behavioural test confirmed this pattern. These findings point to a deficit in extinction learning and highlight the role of affective valence appraisals and cognitive biases in PTSD. In addition, there was some evidence that a subgroup of PTSD patients had difficulties in learning the CS-US contingency, thereby providing preliminary evidence of reduced discrimination learning.     

Assessing Fear of Storms and Severe Weather: Validation of the Storm Fear Questionnaire (SFQ)

To date, research on storm phobia has been limited by a lack of validated self-report measures for evaluating the severity of anxiety, phobic avoidance, and distress associated with storms and severe weather. The current research presents the development and validation of the Storm Fear Questionnaire (SFQ), a 15-item self-report questionnaire that assesses the cognitive, affective, and behavioral aspects thought to be associated with Storm Phobia in adults. Three studies were conducted to assess 1) the factor structure, internal consistency, and convergent and discriminant validity of the SFQ, 2) the test-retest reliability of the SFQ, 3) the extent that scores on the SFQ were associated with subjective anxiety ratings during a Behavioral Approach Test (BAT) involving exposure to a virtual thunderstorm, and the extent to which SFQ scores distinguished community participants with versus without a fear of storms. Exploratory factor analyses supported a one-factor model with good internal consistency (Cronbach’s α?=?.95), good convergent and discriminant validity with self-report measures of anxiety, worry, depression, and other specific phobias, and acceptable test-retest reliability. Moreover, there was a significant positive association between SFQ scores and anxiety ratings following the BAT involving exposure to a virtual thunderstorm and participants with a high fear of storms reported significantly higher SFQ scores than those with a low fear of storms. In sum, the SFQ has good psychometric properties and appears to be a valuable tool for assessing the severity of fear associated with storms and severe weather. Research evaluating the diagnostic and clinical utility of the SFQ is still needed.     

The anxiety disorder spectrum: Fear imagery,physiological reactivity,and differential diagnosis∗

Abstract

This review considers recent research assessing psychophysiological reactivity to fear imagery in anxiety disorder patients. As in animal subjects, fear cues prompt in humans a state of defensive motivation in which autonomic and somatic survival reflexes are markedly enhanced. Thus, a startle stimulus presented in a fear context yields a stronger (potentiated) reflex, providing a quantitative measure of fearful arousal. This fear potentiation is further exaggerated in specific or social phobia individuals when viewing pictures or imagining the phobic object. Paradoxically, fear imagery studies with more severe anxiety disorder patients – panic disorder with agoraphobia, generalized anxiety disorder, or anxious patients with comorbid depression – show a blunted, less robust fear potentiated response. Furthermore, this reflex blunting appears to systematically be more pronounced over the anxiety disorder spectrum, coincident with lengthier chronicity, worsening clinician-based judgments of severity and prognosis, and increased questionnaire-based indices of negative affectivity, suggesting that normal defensive reactivity may be compromised by an experience of long-term stress.