The effect of worry on cardiovascular response to phobic imagery

Cardiovascular response to phobic exposures has been shown to reflect the degree of emotional processing of phobic material and relates in important ways to outcome in exposure therapy. The present study investigated the effect of worry on such processing. Speech anxious subjects visualized a phobic scene for 10 trials. Three groups differed according to whether they engaged in relaxed, neutral, or worrisome thinking just prior to each scene presentation. Although the three types of thinking had no effect on cardiovascular activity during the thinking periods, subjects in the worry group displayed significantly less heart rate response to the phobic image than those in the neutral condition who had significantly less response than the relaxed condition. However, the worry group showed significantly greater subjective fear to the images than the neutral condition, with the relaxed group near to the level of the worry group and not significantly different from either of the other two conditions. The results suggest that worry may inhibit emotional processing and thus preserve cognitive/affective fear structure, and are discussed in terms of Gray's (Behavioral and Brain Sciences, 5, 469-534, 1982) theory of the behavioral inhibition system and semantic satiation effects in cognitive psychology.