title: Influence of perceptual cues and conceptual information on the activation and reduction of claustrophobic fear.
abstract: BACKGROUND
  Fear reactions in phobic patients can be activated by specific perceptual cues (C) or by conceptual fear-related information (I). An earlier study with spider phobic participants documented that perceptual stimuli are particularly potent to trigger fear responses. Because fear of spiders is activated by very circumscribed stimuli, we set out to investigate whether another phobia with more contextual fear-elicitation (i.e., a situational phobia) would yield similar patterns. Thus, we investigate the two paths of fear activation (cues vs. information) and fear reduction during exposure in claustrophobic patients.
  
  
  METHODS
  Forty-eight claustrophobic patients and 48 healthy control participants were randomly assigned to one of three virtual reality exposure conditions: C, I, or a combination of both (CI). Exposure lasted 5 min and was repeated 4 times. Self-report and physiological reactions were assessed.
  
  
  RESULTS
  Claustrophobic patients experienced more initial self-reported fear when confronted with fear-relevant perceptual cues than conceptual information, when the perceptual cues were combined with conceptual information there was no significant enhancement. Furthermore, fear habituated more in the perceptual condition. For the physiological parameters, groups differed and in claustrophobic patients heart rate decreased differently in the conditions.
  
  
  CONCLUSIONS
  Longer exposure duration and long-term effects of the manipulation were not investigated.
  
  
  CONCLUSIONS
  We found similar patterns in a situational phobia as compared to a specific-cue related phobia (animal type). Thus, once more this highlights the central role of visual cues in phobic fear and the potential of virtual reality for conducting exposure therapy.
authors.affiliation: University of Regensburg, Department of Psychology (Clinical Psychology and Psychotherapy), Universitätsstraße 31, 93053 Regensburg, Germany.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Shiban
authors.affiliation: University of Würzburg, Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Marcusstraße 9-11, 97070 Würzburg, Germany.
authors.forename: Henrik
authors.initials: H
authors.lastname: Peperkorn
authors.affiliation: University of Mannheim, School of Social Sciences, Department of Psychology, 68131 Mannheim, Germany.
authors.forename: Georg W
authors.initials: GW
authors.lastname: Alpers
authors.affiliation: University of Würzburg, Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Marcusstraße 9-11, 97070 Würzburg, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Pauli
authors.affiliation: University of Regensburg, Department of Psychology (Clinical Psychology and Psychotherapy), Universitätsstraße 31, 93053 Regensburg, Germany. Electronic address: Andreas.muehlberger@ur.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mühlberger
mesh_terms: D000328:Adult; D002245:Carbon Dioxide / Q000378:metabolism; D016022:Case-Control Studies; D003210:Concept Formation / Q000502:physiology*; D003463:Cues; D005239:Fear / Q000523:psychology; D005260:Female; D005712:Galvanic Skin Response; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010465:Perception / Q000502:physiology*; D010698:Phobic Disorders / Q000523:psychology* / Q000534:rehabilitation*; D010812:Physical Stimulation; D011569:Psychiatric Status Rating Scales; D012119:Respiration; D012463:Saliva / Q000737:chemistry; D011795:Surveys and Questionnaires; D063367:Virtual Reality Exposure Therapy / Q000379:methods*; D055815:Young Adult
chemical_list: D002245:Carbon Dioxide; D006854:Hydrocortisone
keywords: Claustrophobia; Conceptual information; Exposure; Fear; Perceptual cues; Virtual reality