![]() ![]() In fact, phobic patients have shown deficits in basic mechanisms (e.g., inhibitory learning) supposed to underlie exposure therapies, whose benefits can be maximized by adopting strategies that counterbalance patient's pathological functioning ( Craske et al., 2014). ![]() This has the paradoxical consequence that only a minority of phobic patients seeks psychological help for specific phobia ( Stinson et al., 2007): among these, a relevant rate of unresponsiveness to treatment ( Loerinc et al., 2015) and dropouts ( Eaton et al., 2018) has been reported. This approach has proven to be effective, but it also presents some disadvantages: patients have to remain in the presence of the phobic stimulus until the phobic response has fully recovered, but the more fearful patients are not able to face the stimulus for so long ( Choy et al., 2007). To facilitate this process, presentation of the phobic stimulus is often graded and/or combined with guided relaxation techniques. He also suggested that both pathways could be malfunctioning in phobias, however current therapies only affect the cortical pathway.Ĭonditioning-based interventions based on in vivo exposure are the gold standard treatments for specific phobias ( Choy et al., 2007): patients are exposed to the phobic stimulus with the aim of extinguishing the acquired phobic response. More recently, LeDoux (1994) proposed that fear responses are processed through different pathways in the brain: a subcortical pathway providing quick-and-dirty information, and a cortical pathway accounting for a more detailed analysis. Experimental demonstrations, that certain associations are more readily acquired depending on their evolutionary significance ( Garcia and Koelling, 1966) supported this view. Also, the Seligman's Theory of Preparedness ( Seligman, 1971) described specific phobias in terms of conditioning, but incorporated the notion that some stimuli are more conditionable than others, thus providing a convenient explanation for the high incidence of specific phobias concerning spiders and snakes. According to Mowrer's 2-factor model ( Mowrer, 1947, 1956), phobias are acquired through classical conditioning (e.g., snake-related trauma) and subsequently maintained through operant conditioning (e.g., avoiding woods to reduce the possibility to meet snakes, and getting relieved by such avoidance). Learning by classical conditioning usually needs repeated pairing of stimuli, but a highly-emotional stimulus can trigger the learning process in a single event learning by operant conditioning is based of rewards and punishments associated (or thought to be associated) with a behavior. They are traditionally considered a product of conditioning, both classical and operant. Specific phobias are a prototypical example of emotional dysregulation, being characterized by marked and disproportionate fear for specific objects or situations ( American Psychiatric Association, 2013). ![]() Systematic Review Registration: identifier. We integrate those results with recent bifactorial models of emotional regulation, proposing a new form of exposure therapy whose effectiveness and acceptability should be maximized by a preliminary subliminal stimulation. While not inducing the distress caused by current (supraliminal) exposure therapies, exposure to subliminal phobic stimuli still results in successful extinction of both psychophysiological and behavioral correlates: however, it hardly improves subjective fear. Stimulations were found to elicit: (1) cardiac defense responses, (2) specific brain activations of both subcortical (e.g., amygdala) and cortical structures, (3) skin conductance reactions, only when stimuli lasted >20 ms and were administered with intertrial interval >20 s. We systematically review 26 papers investigating subjective, behavioral, and psychophysiological correlates of subliminal exposure to phobic stimuli in phobic patients. 3Azienda Ospedaliero-Universitaria Pisana, Dipartimento di Specialità cliniche, Pisa, Italy.2National Research Council, Institute of Clinical Physiology, Pisa, Italy.1Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.Sergio Frumento 1 †, Danilo Menicucci 1 †, Paul Kenneth Hitchcott 1, Andrea Zaccaro 1 and Angelo Gemignani 1,2,3 * ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |