Fears born and bred: toward a more inclusive theory of fear acquisition

Something Scary is Out There II: the Interplay of Childhood Experiences, Relict Sexual Dinichism, and Cross-cultural Differences in Spatial Fears

Children’s nighttime fear is hypothesized as a cognitive relict reflecting a long history of natural selection for anticipating the direction of nighttime predatory attacks on the presumed human ancestor, Australopithecus afarensis, whose small-bodied females nesting in trees would have anticipated predatory attacks from below. Heavier males nesting on the ground would have anticipated nighttime predatory attacks from their sides. Previous research on preschool children and adults supports this cognitive-relict hypothesis by showing developmental consistencies in their remembrances of the location of a “scary thing” relative to their beds. The current study expands this research by investigating whether nighttime fear in childhood, including the effect of parental threats to behave, influenced adult spatial fears in different biotic and abiotic situations. A 25-item questionnaire employing ordinal scales was given to 474 foreign-born Vietnamese and ethnic Chinese adults living in the USA. Univariate analyses of adult remembrances of childhood indicated that females were more fearful of something scary below their beds than males. To examine the influence of childhood nighttime fear on adult fears, exploratory factor analyses supported three factors: (1) indeterminate agents, indicated something scary under the bed, the difficulty locating unspecific threats, and the brief appearances of large apparitions; (2) environmental uncertainty, indicated by potential encounters with unseen animate threats; (3) predictable animals, as the relative comfort of viewing animals in zoo exhibits. Using structural equation modeling, the results suggest that childhood nighttime fear influenced only the latent variable, indeterminate agents, in both groups via the mediating variable, parental threats.

The birth, death and resurrection of avoidance: a reconceptualization of a troubled paradigm

Research on avoidance conditioning began in the late 1930s as a way to use laboratory experiments to better understand uncontrollable fear and anxiety. Avoidance was initially conceived of as a two-factor learning process in which fear is first acquired through Pavlovian aversive conditioning (so-called fear conditioning), and then behaviors that reduce the fear aroused by the Pavlovian conditioned stimulus are reinforced through instrumental conditioning. Over the years, criticisms of both the avoidance paradigm and the two-factor fear theory arose. By the mid-1980s, avoidance had fallen out of favor as an experimental model relevant to fear and anxiety. However, recent progress in understanding the neural basis of Pavlovian conditioning has stimulated a new wave of research on avoidance. This new work has fostered new insights into contributions of not only Pavlovian and instrumental learning but also habit learning, to avoidance, and has suggested that the reinforcing event underlying the instrumental phase should be conceived in terms of cellular and molecular events in specific circuits rather than in terms of vague notions of fear reduction. In our approach, defensive reactions (freezing), actions (avoidance) and habits (habitual avoidance) are viewed as being controlled by unique circuits that operate nonconsciously in the control of behavior, and that are distinct from the circuits that give rise to conscious feelings of fear and anxiety. These refinements, we suggest, overcome older criticisms, justifying the value of the new wave of research on avoidance, and offering a fresh perspective on the clinical implications of this work.

Revisiting the fear of snakes in children: the role of aposematic signalling

Why humans fear snakes is an old, yet unresolved debate. Its innate origin from evolutionary causes is debated against the powerful influence early experience, culture, media and religion may have on people’s aversion to snakes. Here we show that the aversion to snakes in human beings may have been mistaken for an aversion to aposematic signals that are commonly displayed by snakes. A total of 635 children were asked to rate single item images as “nice” or “mean”. Snakes, pets and smiley emoticon items were not rated as “mean” unless they displayed subtle aposematic signals in the form of triangular (rather than round) shapes. Another 722 children were shown images featuring two items and asked which item was “nice” and which item was “mean”. This context dependent comparison triggered even sharper responses to aposematic signals. We hypothesise that early primates evolved an aversion for aposematic signals in the form of potentially harmful triangular shapes such as teeth, claws or spikes, not for snakes per se. Further, we hypothesise that this adaptation was in turn exploited by snakes in their anti-predatory threat display as a triangular head or dorsal zig-zag pattern, and is currently the basis for efficient international road-danger signalling.

The Legacy of Seligman's "Phobias and Preparedness" (1971)

Seligman's (1971) classic article, "Phobias and Preparedness," marked a break from traditional conditioning theories of the etiology of phobias, inspiring a line of research integrating evolutionary theory with learning theory. In this article, I briefly sketch the context motivating the preparedness theory of phobias before summarizing the initial wave of laboratory conditioning experiments pioneered by Öhman and conducted by his team and by others to test predictions derived from Seligman's theory. Finally, I review the legacy of Seligman's article, including theoretical developments embodied in Öhman and Mineka's fear module approach as well as alternatives for explaining "preparedness" phenomena, including the selective sensitization, expectancy, and nonassociative theories. Although Seligman himself soon moved on to other topics, his seminal article in Behavior Therapy continues to inspire research more than four decades later that has deepened our understanding of the etiology of phobias.

Eye Movement Desensitization and Reprocessing in the Treatment of Panic Disorder With Agoraphobia

This article describes a comprehensive treatment of a case of panic disorder with agoraphobia. A thorough history taking revealed that experiential contributors had a pivotal role in the development of the condition. Therefore, eye movement desensitization and reprocessing (EMDR) was used to address early traumatic events as well as the present stimuli that caused disturbance and had maintained symptomatology for the past 12 years. Although the client's symptoms were resolved after 15 sessions, EMDR was also effective in addressing future behaviors and resolving anticipatory anxiety. During EMDR processing, the client demonstrated emotional and cognitive changes consistent with trauma resolution, insight, and personal growth. The client gradually enacted functional new behaviors spontaneously as treatment unfolded. The therapeutic process and the targets are described in detail.

Fear of the unknown: One fear to rule them all?

The current review and synthesis was designed to provocatively develop and evaluate the proposition that "fear of the unknown may be a, or possibly the, fundamental fear" (Carleton, 2016) underlying anxiety and therein neuroticism. Identifying fundamental transdiagnostic elements is a priority for clinical theory and practice. Historical criteria for identifying fundamental components of anxiety are described and revised criteria are offered. The revised criteria are based on logical rhetorical arguments using a constituent reductionist postpositivist approach supported by the available empirical data. The revised criteria are then used to assess several fears posited as fundamental, including fear of the unknown. The review and synthesis concludes with brief recommendations for future theoretical discourse as well as clinical and non-clinical research.

Autobiographical memories of vomiting in people with a specific phobia of vomiting (emetophobia)

BACKGROUND

Vomiting is an almost universal phenomenon, but little is known about the aetiology of a specific phobia of vomiting (SPOV). The associations with vomiting during childhood and autobiographical memories may have relevance for our understanding of the development of SPOV and its treatment.

METHOD

Two groups: (a) a group with SPOV (n = 94) and (b) a control group (n = 90) completed a self-report questionnaire assessing their lifetime memories of both their own vomiting and others vomiting.

RESULTS

People with SPOV recalled the memories of their own and others vomiting experiences from an earlier age and rated them as significantly more distressing than the control group. There was no difference between the groups in the number of memories of their own vomiting recalled before the age at which vomiting became a problem. However, the SPOV group recalled more memories of others vomiting before the onset of the problem. After the age at which the phobia became a problem they recalled less memories of their own vomiting and more memories of others vomiting than the control group. They recalled significantly more memories of vomiting associated with inter-personal events, health or emotional or unrelated life events.

CONCLUSIONS

Avoidance and hyper-vigilance for others vomiting after the onset of the phobia may have slightly reduced the risk of vomiting. There is some evidence for associative learning in SPOV with aversive consequences of vomiting and an unrelated life event. It suggests a model of autobiographical memories of vomiting that have lost a time perspective and context, which are being reactivated with cues for vomiting. The limitations of the study are those of memory biases in both groups.

Making implicit measures of associations with snack foods more negative through evaluative conditioning

The present study examined whether implicit measures of associations with snack foods and food consumer behaviour could be changed through a picture-picture evaluative conditioning procedure. In the experimental condition (n=41), female participants completed a conditioning procedure in which pictures of snack foods were paired with images of negatively valenced female body shapes, and pictures of fruits were paired with images of positively valenced body shapes. In a control condition (n=44), snack and fruit stimuli were randomly paired with positively and negatively valenced body shapes. Implicit measures of associations with high-fat snack foods were obtained by using a positive and a negative unipolar single category Implicit Association Test (sc-IAT). A virtual supermarket task was used to assess food consumer behaviour. Results indicated that participants in the experimental condition held a less positive association with high-fat foods on the positive sc-IAT and a more negative association with these foods on the negative sc-IAT as compared to control participants. Opposed to our hypothesis, no behavioural differences were found between the groups. These results imply that this form of associative learning can produce shifts in implicit measures of food evaluations, though behavioural effects were absent.

Psychiatric disorders in the elderly

Recent research has shown that depression, anxiety disorders, and psychosis are more common than previously supposed in elderly populations without dementia. It is unclear whether the frequency of these disorders increases or decreases with age. Clinical expression of psychiatric disorders in old age may be different from that seen in younger age groups, with less and often milder symptoms. Concurrently, comorbidity between different psychiatric disorders is immense, as well as comorbidity with somatic disorders. Cognitive function is often decreased in people with depression, anxiety disorders, and psychosis, but whether these disorders are risk factors for dementia is unclear. Psychiatric disorders in the elderly are often related to cerebral neurodegeneration and cerebrovascular disease, although psychosocial risk factors are also important. Psychiatric disorders, common among the elderly, have consequences that include social deprivation, poor quality of life, cognitive decline, disability, increased risk for somatic disorders, suicide, and increased nonsuicidal mortality.

Children's risky play from an evolutionary perspective: the anti-phobic effects of thrilling experiences

This theoretical article views children's risky play from an evolutionary perspective, addressing specific evolutionary functions and especially the anti-phobic effects of risky play. According to the non-associative theory, a contemporary approach to the etiology of anxiety, children develop fears of certain stimuli (e.g., heights and strangers) that protect them from situations they are not mature enough to cope with, naturally through infancy. Risky play is a set of motivated behaviors that both provide the child with an exhilarating positive emotion and expose the child to the stimuli they previously have feared. As the child's coping skills improve, these situations and stimuli may be mastered and no longer be feared. Thus fear caused by maturational and age relevant natural inhibition is reduced as the child experiences a motivating thrilling activation, while learning to master age adequate challenges. It is concluded that risky play may have evolved due to this anti-phobic effect in normal child development, and it is suggested that we may observe an increased neuroticism or psychopathology in society if children are hindered from partaking in age adequate risky play.

An evidence-based causal model of panic disorder

Recently, Fava and Morton (2009) described what they termed a 'causal model' of panic disorder (Causal modeling of panic disorder theories, Clinical Psychology Review, 29, 623-637). We examined several critical tenets of this proposed model, and offer significant revisions. Our revised causal model includes elements that have received empirical support, and exclude those with known limitations in explaining the etiology and treatment of panic disorder. Chief among these revisions are (1) an increased emphasis on anxiety sensitivity, (2) elimination of the more general psychodynamic conceptualization in favor of empirically supported findings regarding early attachment, and (3) placing biological and psychophysiological reactions as outcomes of false alarm threat, rather than causal mechanisms of panic.

A population-based study on phobic fears and DSM-IV specific phobia in 70-year olds

This population-based study reports on the prevalence and characteristics of specific phobia (SP) and phobic fears in an elderly population. A representative population sample of Swedish 70-year-olds without dementia (N = 558) was examined using semi-structured interviews. Phobic fears included fear of animals, natural environment, specific situations, blood-injection-injury and 'other'. Mental disorders, including SP, were diagnosed according to DSM-IV. Phobic fears (71.0% vs. 37.9%) and SP (13.8% vs. 4.5%) were more common in women than in men. Among those with phobic fears, more than 80% reported onset before age 21. Of those with SP, 35.7% had another DSM-IV diagnosis compared to 8.5% of those reporting no fear. Fear of specific situations and 'other' fears were related to SP and other anxiety disorders. SP was related to lower global functioning. We conclude that specific phobia in the elderly should receive attention from health professionals as it is common and associated with a decrease in global functioning.

Cognitive enhancers for anxiety disorders

Cognitive-behavioral therapy is an effective intervention for anxiety disorders. However, a significant number of people do not respond or only show partial response even after an adequate course of the treatment. Recent research has shown that the efficacy of the intervention can be improved by the use of cognitive enhancers that augment the core learning processes of cognitive-behavior therapy. This manuscript provides a review of the current state of cognitive enhancers for the treatment of anxiety disorders.

The Origins of Specific Phobias: Influential Theories and Current Perspectives

Fears are quick and adaptive responses that permit powerful reply to imminent threats. Less adaptive, phobias are extreme manifestations of fear to objects or situations in the absence of a proportional danger. Although the utility of fear is accepted, the nature of phobias is controversial. Initial theories favored a fear conditioning-based explanation, with vicarious and information learning pathways subsequently included as additional routes to the development of specific phobias. More recently, an important group of investigations strengthened the case for a nonassociative account of fear acquisition proposing that evolutionarily relevant fears can occur without any need of critical learning experiences. In parallel, there is some evidence for a dedicated fear module in the detection of threats, involving the amygdala, which is relatively independent from conscious cognitive control. Nonetheless, cognitive models stress learning and developmental factors and their role in the etiology and maintenance of phobic behavior. This article critically reviews each of these views and theories stressing their recent developments, weaknesses, and controversies with an aim to provide the groundwork for the construction of a more integrated position. Finally, the authors suggest encouraging trends in recent research.

Fear of heights: cognitive performance and postural control

INTRODUCTION

Fear of heights, or acrophobia, is one of the most frequent subtypes of specific phobia frequently associated to depression and other anxiety disorders. Previous evidence suggests a correlation between acrophobia and abnormalities in balance control, particularly involving the use of visual information to keep postural stability. This study investigates the hypotheses that (1) abnormalities in balance control are more frequent in individuals with acrophobia even when not exposed to heights, that (2) acrophobic symptoms are associated to abnormalities in visual perception of movement; and that (3) individuals with acrophobia are more sensitive to balance-cognition interactions.

METHOD

Thirty-one individuals with specific phobia of heights and thirty one non-phobic controls were compared using dynamic posturography and a manual tracking task.

RESULTS

Acrophobics had poorer performance in both tasks, especially when carried out simultaneously. Previously described interference between posture control and cognitive activity seems to play a major role in these individuals.

DISCUSSION

The presence of physiologic abnormalities is compatible with the hypothesis of a non-associative acquisition of fear of heights, i.e., not associated to previous traumatic events or other learning experiences. Clinically, this preliminary study corroborates the hypothesis that vestibular physical therapy can be particularly useful in treating individuals with fear of heights.

Developmental-genetic effects on level and change in childhood fears of twins during adolescence

BACKGROUND

If the adaptive significance of specific fears changes with age, the genetic contribution to individual differences may be lowest at the age of greatest salience. The roles of genes and environment in the developmental-genetic trajectory of five common childhood fears are explored in 1094 like-sex pairs of male and female monozygotic and dizygotic twins assessed on up to three occasions during adolescence (ages 8-18 years).

METHODS

Dichotomous self-ratings of a cluster of five correlated fears from Ollendick's schedule of fears (FSSC-R) were extracted for subjects at each occasion of assessment. The effects of genes and environment on overall level of fears and rates of adolescent decline were explored by fitting an item-response theory ('IRT') model that allowed for individual genetic and environmental differences in initial fear level ('intercept') and rates of adolescent change ('slope') across the repeated waves of measurement. Different forms of the model were explored using Markov Chain Monte Carlo (MCMC) methods to derive the posterior distribution of subject and item parameters from the raw responses.

RESULTS

Additive genetic differences affect the common factor underlying the five fear-items. The same genes also affect rates of change with age, especially in boys. Male adolescents with higher overall genetic predisposition to childhood fears tended to show slower recovery with age than subjects with relatively low initial values. Thus, the genetic variance apparently increases with age.

CONCLUSIONS

This finding is consistent with a prediction that the regulation of genetic differences will be strongest, and thus the additive genetic variance will be smallest, at the age when the particular stimulus is most salient. Items differed in the extent to which they were sensitive to underlying random differences in the rate of developmental change. Individual differences in rates of change with age were more marked in boys than girls.

A double-blind placebo-controlled study into the efficacy of a homeopathic remedy for fear of firework noises in the dog (Canis familiaris)

Seventy-five dogs that showed a fear response to fireworks participated in a double-blinded, placebo-controlled clinical trial to assess the efficacy of a homeopathic remedy for the alleviation of their behavioural signs. Dogs were randomly assigned to one of two treatments; the homeopathic treatment or the placebo treatment. At the baseline assessments the owners identified the behavioural signs of fear that their dogs normally displayed in response to fireworks, rated their frequency and intensity, and assessed the global severity of their dog's responses. These measures were repeated at the final assessment and owners also completed weekly diaries for the length of the trial. There were significant improvements in the owners' rating of 14/15 behavioural signs of fear in the placebo treatment group and all 15 behavioural signs in the homeopathic treatment group. Both treatment groups also showed significant improvement in the owners' rating of the global severity of their dog's responses. However, there was no significant difference in the response seen between the two treatment groups.

Targeting ASIC1a reduces innate fear and alters neuronal activity in the fear circuit

BACKGROUND

The molecular mechanisms underlying innate fear are poorly understood. Previous studies indicated that the acid sensing ion channel ASIC1a influences fear behavior in conditioning paradigms. However, these differences may have resulted from an ASIC1a effect on learning, memory, or the expression of fear.

METHODS

To test the hypothesis that ASIC1a influences the expression of fear or anxiety independent of classical conditioning, we examined the effects of disrupting the mouse ASIC1a gene on unconditioned fear in the open field test, unconditioned acoustic startle, and fear evoked by the predator odor trimethylthiazoline (TMT). In addition, we tested the effects of acutely inhibiting ASIC1a with PcTx, an ASIC1a antagonist in tarantula venom. Our immunohistochemistry suggested ASIC1a is expressed in the bed nucleus of the stria terminalis, medial amygdala, and periaqueductal gray, which are thought to play important roles in the generation and expression of innate fear. Therefore, we also tested whether ASIC1a disruption altered c-fos expression in these structures following TMT exposure.

RESULTS

We found that the loss of ASIC1a reduced fear in the open field test, reduced acoustic startle, and inhibited the fear response to TMT. Similarly, intracerebroventricular administration of PcTx reduced TMT-evoked freezing in ASIC1a(+/+) mice but not ASIC1a(-/-) mice. In addition, loss of ASIC1a altered TMT-evoked c-fos expression in the medial amydala and dorsal periaqueductal gray.

CONCLUSIONS

These findings suggest that ASIC1a modulates activity in the circuits underlying innate fear. Furthermore, the data indicate that targeting the ASIC1a gene or acutely inhibiting ASIC1a suppresses fear and anxiety independent of conditioning.

The role of imagery in the maintenance and treatment of snake fear

Two studies assessed the role of mental imagery in the maintenance of fear of common phobic stimuli. Study 1 asked participants who were afraid of a wide range of phobic stimuli to report their visual and somatic imagery. Blind ratings of the imagery on horror and vividness were positively correlated with participant's self-reported fear and avoidance. Study 2 tested the efficacy of modifying imagery using cognitive restructuring compared to in vivo exposure and a minimal exposure, relaxation control in snake fearful participants. Both active treatment groups improved significantly more than the control group in self-reported snake fearfulness and behavioral approach. Condition also interacted with initial severity. Highly fearful subjects responded better to the cognitive imagery modification than to the in vivo exposure, and found the cognitive intervention significantly less aversive. These results are seen as supporting a cognitive model of the maintenance of specific phobia.

Specific phobia

This article describes specific phobia of childhood and its clinical presentation, discusses issues related to the differential diagnosis of specific phobia, considers the issue of comorbidity among phobic and anxiety disorders and developmental trends in the manifestation of fears, summarizes the epidemiology, causes, and course of specific phobia, and presents assessment and treatment issues. Finally, a case study is offered that serves to illuminate the major topics outlined in the article.

Pessimism and the Evolution of Negativity

The universal and nonrandom distribution of anxiety, fears, and depression suggests that there may have been underlying evolutionary pressures leading to adaptations for pessimistic thinking. Symptoms and processes that today we may label as psychopathology may have solved problems in an evolutionarily relevant environment, providing variations in individual behavior as a response to variations in availability of resources and vulnerability to threats and danger from predation. For example, investment strategies, the focus of this article, change with seasonal variation. Hibernation is marked by reduction of demand by limiting metabolic rates, activity, and arousal during winter months when resources are reduced, and conservation is salient, whereas manic enthusiasm focuses on short windows of opportunity, emphasizing overvaluation of pleasure, exploration, breeding, and diversification. A general theoretical model of investment strategies is proposed that accounts for sex differences in parental investments. Cognitive schemata focused on pessimistic strategies are viewed as operating through evolved algorithms that attempt to assure that behavioral and genetic investments are protected. These cognitive biases may account for male strategies of diversification and female strategies of consolidation and protection, and suggest possible determinants of a greater likelihood of females to be characterized by inhibition and depression.