Modeling corrective experiences as motivational mountain pass

Aim: The landscape metaphor allows viewing corrective experiences (CE) as pathway to a state with relatively lower 'tension' (local minimum). However, such local minima are not easily accessible but obstructed by states with relatively high tension (local maxima) according to the landscape metaphor (Caspar & Berger, 2012). For example, an individual with spider phobia has to transiently tolerate high levels of tension during an exposure therapy to access the local minimum of habituation. To allow for more specific therapeutic guidelines and empirically testable hypotheses, we advance the landscape metaphor to a scientific model which bases on motivational processes. Specifically, we conceptualize CEs as available but unusual trajectories (=pathways) through a motivational space. The dimensions of the motivational state are set up by basic motives such as need for agency or attachment. Methods: Dynamic system theory is used to model motivational states and trajectories using mathematical equations. Fortunately, these equations have easy-to-comprehend and intuitive visual representations similar to the landscape metaphor. Thus, trajectories that represent CEs are informative and action guiding for both therapists and patients without knowledge on dynamic systems. However, the mathematical underpinnings of the model allow researchers to deduct hypotheses for empirical testing. Results: First, the results of simulations of CEs during exposure therapy in anxiety disorders are presented and compared to empirical findings. Second, hypothetical CEs in an autonomy-attachment conflict are reported from a simulation study. Discussion: Preliminary clinical implications for the evocation of CEs are drawn after a critical discussion of the proposed model.

Varying expectancies and attention bias in phobic and non-phobic individuals.

Phobic individuals display an attention bias to phobia-related information and biased expectancies regarding the likelihood of being faced with such stimuli. Notably, although attention and expectancy biases are core features in phobia and anxiety disorders, these biases have mostly been investigated separately and their causal impact has not been examined. We hypothesized that these biases might be causally related. Spider phobic and low spider fearful control participants performed a visual search task in which they specified whether the deviant animal in a search array was a spider or a bird. Shorter reaction times (RTs) for spiders than for birds in this task reflect an attention bias toward spiders. Participants' expectancies regarding the likelihood of these animals being the deviant in the search array were manipulated by presenting verbal cues. Phobics were characterized by a pronounced and persistent attention bias toward spiders; controls displayed slower RTs for birds than for spiders only when spider cues had been presented. More important, we found RTs for spider detections to be virtually unaffected by the expectancy cues in both groups, whereas RTs for bird detections showed a clear influence of the cues. Our results speak to the possibility that evolution has formed attentional systems that are specific to the detection of phylogenetically salient stimuli such as threatening animals; these systems may not be as penetrable to variations in (experimentally induced) expectancies as those systems that are used for the detection of non-threatening stimuli. In sum, our findings highlight the relation between expectancies and attention engagement in general. However, expectancies may play a greater role in attention engagement in safe environments than in threatening environments.

Visual avoidance in phobia: particularities in neural activity, autonomic responding, and cognitive risk evaluations.

We investigated the neural mechanisms and the autonomic and cognitive responses associated with visual avoidance behavior in spider phobia. Spider phobic and control participants imagined visiting different forest locations with the possibility of encountering spiders, snakes, or birds (neutral reference category). In each experimental trial, participants saw a picture of a forest location followed by a picture of a spider, snake, or bird, and then rated their personal risk of encountering these animals in this context, as well as their fear. The greater the visual avoidance of spiders that a phobic participant demonstrated (as measured by eye tracking), the higher were her autonomic arousal and neural activity in the amygdala, orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and precuneus at picture onset. Visual avoidance of spiders in phobics also went hand in hand with subsequently reduced cognitive risk of encounters. Control participants, in contrast, displayed a positive relationship between gaze duration toward spiders, on the one hand, and autonomic responding, as well as OFC, ACC, and precuneus activity, on the other hand. In addition, they showed reduced encounter risk estimates when they looked longer at the animal pictures. Our data are consistent with the idea that one reason for phobics to avoid phobic information may be grounded in heightened activity in the fear circuit, which signals potential threat. Because of the absence of alternative efficient regulation strategies, visual avoidance may then function to down-regulate cognitive risk evaluations for threatening information about the phobic stimuli. Control participants, in contrast, may be characterized by a different coping style, whereby paying visual attention to potentially threatening information may help them to actively down-regulate cognitive evaluations of risk.

Evidence for an encounter expectancy bias in fear of spiders.

Whereas research has demonstrated that phobic or fearful individuals overestimate the likelihood of incurring aversive consequences from an encounter with feared stimuli, it has not yet been systematically investigated whether these individuals also overestimate the likelihood (i.e., the frequency) of such encounters. In the current study, spider-fearful and control participants were presented with background information that allowed them to estimate the overall likelihood that different kinds of animals (spiders, snakes, or birds) would be encountered. Spider-fearful participants systematically overestimated the likelihood of encountering a spider with respect to the likelihood of encountering a snake or a bird. No such expectancy bias was observed in control participants. The results thus strengthen our idea that there indeed exist two different types of expectancy bias in high fear and phobia that can be related to different components of the fear response. A conscientious distinction and examination of these two types of expectancy bias are of potential interest for therapeutic applications.

The Sensitivity of Physiological Measures to Phobic and Nonphobic Fear Intensity

We investigated whether amygdala activation, autonomic responses, respiratory responses, and facial muscle activity (measured over the brow and cheek [fear grin] regions) are all sensitive to phobic versus nonphobic fear and, more importantly, whether effects in these variables vary as a function of both phobic and nonphobic fear intensity. Spider-phobic and comparably low spider-fearful control participants imagined encountering different animals and rated their subjective fear while their central and peripheral nervous system activity was measured. All measures included in our study were sensitive to variations in subjective fear, but were related to different ranges and positions on the subjective fear level continuum. Left amygdala activation, heart rate, and facial muscle activity over the cheek region captured fear intensity variations even within narrowly described regions on the fear level continuum (here within extremely low levels of fear and within considerable phobic fear). Skin conductance and facial muscle activity over the brow region did not capture fear intensity variations within low levels of fear: skin conductance mirrored only extreme levels of fear, and activity over the brow region distinguished phobic from nonphobic fear but also low-to-moderate and high phobic fear. Finally, respiratory measures distinguished phobic from nonphobic fear with no further differentiation within phobic and nonphobic fear. We conclude that a careful consideration of the measures to be used in an investigation and the population to be examined can be critical in order to obtain significant results.