Less is more: Neural activity during very brief and clearly visible exposure to phobic stimuli
Abstract
Research on automatic processes in fear has emphasized the provocation of fear responses rather than their attenuation. We have previously shown that the repeated presentation of feared images without conscious awareness via backward masking reduces avoidance of a live tarantula in spider‐phobic participants. Herein we investigated the neural basis for these adaptive effects of masked exposure. 21 spider‐phobic and 21 control participants, identified by a psychiatric interview, fear questionnaire, and approaching a live tarantula, viewed stimuli in each of three conditions: (1) very brief exposure (VBE) to masked images of spiders, severely limited awareness; (2) clearly visible exposure (CVE) to spiders, full awareness; and (3) masked images of flowers (control), severely limited awareness. Only VBE to masked spiders generated neural activity more strongly in phobic than in control participants, within subcortical fear, attention, higher‐order language, and vision systems. Moreover, VBE activated regions that support fear processing in phobic participants without causing them to experience fear consciously. Counter‐intuitively, CVE to the same spiders generated stronger neural activity in control rather than phobic participants within these and other systems. CVE deactivated regions supporting fear regulation and caused phobic participants to experience fear. CVE‐induced activations also correlated with measures of explicit fear ratings, whereas VBE‐induced activations correlated with measures of implicit fear (color‐naming interference of spider words). These multiple dissociations between the effects of VBE and CVE to spiders suggest that limiting awareness of exposure to phobic stimuli through visual masking paradoxically facilitates their processing, while simultaneously minimizing the experience of fear. Hum Brain Mapp 38:2466–2481, 2017 . © 2017 Wiley Periodicals, Inc.
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Evidence suggests that CBT or medication can modify the cascade of responses to real or perceived threat - CBT by altering behavioral avoidance and information processing related to threat detection and coping, and medication by altering neurotransmitter levels that affect the function and structure of brain circuits.
“Evidence suggests that CBT or medication can modify the cascade of responses to real or perceived threat – CBT by altering behavioral avoidance and information processing related to threat detection and coping [56, 57], and medication by altering neurotransmitter levels that affect the function and structure of brain circuits [58–60].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [56]
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Cites
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Self-citation
- Authors
- Siegel, P., Warren, R., Wang, Z., Yang, J., Cohen, D., Anderson, J. F., Murray, L., & Peterson, B. S.
- Venue
- Human Brain Mapping
- Publisher
- Wiley
- Published
- 2017-02-06
- Volume
- 38
- Issue
- 5
- Pages
- 2466-2481
- ISSN
- 1065-9471
- 1097-0193
- PMC
- PMC5385151
- Cited by
- 34
- References
- 15
- Language
- en
- Funders
- National Institute of Mental Health (7R21MH101564‐02)
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