title: Psychophysiological reactivity of currently dental phobic-, remitted dental phobic- and never-dental phobic individuals during exposure to dental-related and other affect-inducing materials.
abstract: Psychophysiological responses indicating the preparation of defensive behaviour, such as heart rate (HR)-increase and startle-response (SR) potentiation, have often been reported amongst individuals suffering from phobic disorders when exposed to phobia-related information. Although exposure is widely considered the 'gold standard' for treatment of Specific Phobia, it is unclear to what extent psychophysiological defensive response patterns change following treatment, and whether any changes are maintained. We assessed the acoustic SR- and HR-response to neutral, positive, negative and phobia-related pictures and sounds in 41 individuals currently suffering from dental phobia, 22 formerly dental phobic individuals who had remitted following an exposure-based treatment eight months prior to assessment, and 29 control individuals with no history of dental phobia. We observed SR-potentiation to dental-related stimuli in controls combined with HR-deceleration. In contrast, amongst phobic individuals SR-potentiation was accompanied by HR-acceleration to dental pictures. Successfully treated individuals showed inhibited startle reactivity in combination with HR-deceleration to dental related materials of both modalities. Our findings suggest inappropriate fight-flight preparation amongst individuals with dental phobia, reflecting overactivation of the defensive system. However, successful treatment results in inhibited physiological defence preparation, with remitted individuals displaying a response pattern that differed from that of phobic individuals and controls.
authors.affiliation: Mental Health Research and Treatment Center, University of Bochum, Germany. Electronic address: andre.wannemueller@rub.de.
authors.forename: André
authors.initials: A
authors.lastname: Wannemueller
authors.affiliation: Mental Health Research and Treatment Center, University of Bochum, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Adolph
authors.affiliation: Dental Clinic Bochum, Germany.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Joehren
authors.affiliation: Mental Health Research and Treatment Center, University of Bochum, Germany; Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Simon E
authors.initials: SE
authors.lastname: Blackwell
authors.affiliation: Mental Health Research and Treatment Center, University of Bochum, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Margraf
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003813:Dentistry; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000503:physiopathology*; D010775:Photic Stimulation; D013216:Reflex, Startle / Q000502:physiology*; D012074:Remission Induction; D055815:Young Adult
keywords: Cardiac defensive responses; Defence preparation; Dental fear; Dental phobia; Specific phobia; Startle potentiation