Brain activation to phobia-related pictures in spider phobic humans: an event-related functional magnetic resonance imaging study

Dilger, Stefan; Straube, Thomas; Mentzel, Hans‐Joachim; Fitzek, Clemens; Reichenbach, Jürgen R.; Hecht, Holger; Krieschel, Silke; Gutberlet, Ingmar; Miltner, Wolfgang H. R.

doi:10.1016/s0304-3940(03)00647-5

Cited by 176 publications

(115 citation statements)

References 21 publications

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“…Whereas in most studies of OCD, PTSD and depression, the inducing triggers had to be tailored individually, the symptoms of spider phobia could be mimicked by standardised images 14 or film sequences 30 of spiders, contrasted with innocuous animals or natural objects. This use of identical stimulus material across participants removes a source of variance that is especially undesirable in studies with small sample sizes.…”

Section: Phobiasmentioning

confidence: 99%

“…This is at odds with most studies of affective stimulus processing and aversive conditioning, and indeed with current models of the pathophysiological network of simple phobias, and might be explained by habituation effects in the block design. 14 Several studies of patients with social phobia have also shown hyperactivity of the amygdala, even with a weak form of symptom provocation, presentation of human faces. 32,33 After successful treatment, either with CBT or citalopram, activation of amygdala and hippocampus was reduced in the symptom provocation study by Furmark et al, 34 who utilised a public speaking task.…”

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confidence: 99%

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How psychotherapy changes the brain – the contribution of functional neuroimaging

2006

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A thorough investigation of the neural effects of psychotherapy is needed in order to provide a neurobiological foundation for widely used treatment protocols. This paper reviews functional neuroimaging studies on psychotherapy effects and their methodological background, including the development of symptom provocation techniques. Studies of cognitive behavioural therapy (CBT) effects in obsessive-compulsive disorder (OCD) were consistent in showing decreased metabolism in the right caudate nucleus. Cognitive behavioural therapy in phobia resulted in decreased activity in limbic and paralimbic areas. Interestingly, similar effects were observed after successful intervention with selective serotonin reuptake inhibitors (SSRI) in both diseases, indicating commonalities in the biological mechanisms of psycho-and pharmacotherapy. These findings are discussed in the context of current neurobiological models of anxiety disorders. Findings in depression, where both decreases and increases in prefrontal metabolism after treatment and considerable differences between pharmacological and psychological interventions were reported, seem still too heterogeneous to allow for an integrative account, but point to important differences between the mechanisms through which these interventions attain their clinical effects. Further studies with larger patient numbers, use of standardised imaging protocols across studies, and ideally integration with molecular imaging are needed to clarify the remaining contradictions. This effort is worthwhile because functional imaging can then be potentially used to monitor treatment effects and aid in the choice of the optimal therapy. Finally, recent advances in the functional imaging of hypnosis and the application of neurofeedback are evaluated for their potential use in the development of psychotherapy protocols that use the direct modulation of brain activity as a way of improving symptoms.

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Section: Phobiasmentioning

confidence: 99%

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confidence: 99%

How psychotherapy changes the brain – the contribution of functional neuroimaging

2006

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“…Carlsson et al (2004), for instance, found that conscious perception of animal phobia-related pictures led to selective activation in the amygdala, anterior insula, medial orbitofrontal cortex (mOFC), anterior cingulate cortex (ACC), and periaqueductal gray (see also Dilger et al, 2003;Rauch et al, 1995), activations that were not seen for evolutionary fear-relevant but non-phobogenic animals. At the same time, activity was reduced in both the dorsolateral prefrontal cortex (dlPFC) and the right lateral OFC, when phobogenic trials were contrasted with fear-relevant trials.…”

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confidence: 99%

Brain systems underlying encounter expectancy bias in spider phobia

Aue

Hoeppli

Piguet

et al. 2015

Cogn Affect Behav Neurosci

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Spider-phobic individuals are characterized by exaggerated expectancies to be faced with spiders (so-called encounter expectancy bias). Whereas phobic responses have been linked to brain systems mediating fear, little is known about how the recruitment of these systems relates to exaggerated expectancies of threat. We used fMRI to examine spiderphobic and control participants while they imagined visiting different locations in a forest after having received background information about the likelihood of encountering different animals (spiders, snakes, and birds) at these locations. Critically, imagined encounter expectancies modulated brain responses differently in phobics as compared with controls. Phobics displayed stronger negative modulation of activity in the lateral prefrontal cortex, precuneus, and visual cortex by encounter expectancies for spiders, relative to snakes or birds (within-participants analysis); these effects were not seen in controls. Between-participants correlation analyses within the phobic group further corroborated the hypothesis that these phobia-specific modulations may underlie irrationality in encounter expectancies (deviations of encounter expectancies from objective background information) in spider phobia; the greater the negative modulation a phobic participant displayed in the lateral prefrontal cortex, precuneus, and visual cortex, the stronger was her bias in encounter expectancies for spiders. Interestingly, irrationality in expectancies reflected in frontal areas relied on right rather than left hemispheric deactivations. Our data accord with the idea that expectancy biases in spider phobia may reflect deficiencies in cognitive control and contextual integration that are mediated by right frontal and parietal areas.

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“…The available neuroimaging studies have yielded divergent results: Whereas Johanson et al (1998) reported overactive frontal areas in spider-phobic individuals during exposure to phobiarelated stimuli, Dilger et al (2003) showed increased amygdala activation during presentation of phobia-related visual stimuli in spider phobics. Thus, to date, the issue of whether animal-fearful individuals mainly exhibit overactive subcortico-cortical (bottom-up) or cortico-cortical (top-down) pathways during exposure to phobia-related stimuli remains unresolved.…”

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confidence: 99%

Neurocognitive effects of phobia-related stimuli in animal-fearful individuals

Kopp¹,

Altmann

2005

Cognitive, Affective, & Behavioral Neuroscience

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Two experiments were conducted to explore neurocognitive effects of phobia-related stimuli. Contingency assessments and event-related potentials (ERPs) were collected from animal-fearful individuals during probabilistic classification learning in diverse motivational-affective contexts. As revealed by ERPs, attentional amplification of cortical sensory processing occurred in response to phobiarelated stimuli. In particular, the posterior selection negativity in the ERPs to phobia-related stimuli had its origin in a bottom-up route, probably the amygdaloid-extrastriate cortex path. No evidence for top-down modulation of phobia-related attentional amplification was obtained. The covariation bias occurred only when aversive motivational-affective expectancies prevailed, suggesting a role of retrieval from associative emotional memory. Finally, phobia-related cue competition was probably related to the disruption of elaboration in memory of neutral and aversive stimulus pairings that was induced by belonging pairings of phobia-related and aversive stimuli. The findings have far-reaching implications for the interface between cognition and emotion.

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Brain activation to phobia-related pictures in spider phobic humans: an event-related functional magnetic resonance imaging study

Cited by 176 publications

References 21 publications

How psychotherapy changes the brain – the contribution of functional neuroimaging

How psychotherapy changes the brain – the contribution of functional neuroimaging

Brain systems underlying encounter expectancy bias in spider phobia

Neurocognitive effects of phobia-related stimuli in animal-fearful individuals

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