title: Initial and sustained brain responses to threat anticipation in blood-injection-injury phobia.
abstract: Blood-injection-injury (BII) phobia differs from other subtypes of specific phobia in that it is associated with elevated disgust-sensitivity as well as specific autonomic and brain responses during processing of phobia-relevant stimuli. To what extent these features play a role already during threat anticipation is unclear. In the current fMRI experiment, 16 female BII phobics and 16 female healthy controls anticipated the presentation of phobia-specific and neutral pictures. On the behavioral level, anxiety dominated the anticipatory period in BII phobics relative to controls, while both anxiety and disgust were elevated during picture presentation. By applying two different models for the analysis of brain responses to anticipation of phobia-specific versus neutral stimuli, we found initial and sustained increases of activation in anterior cingulate cortex (ACC), insula, lateral and medial prefrontal cortex (PFC), thalamus and visual areas, as well as initial activation in the amygdala for BII phobics as compared to healthy controls. These results suggest that BII phobia is characterized by activation of a typical neural defense network during threat anticipation, with anxiety as the predominant emotion.
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, D-48149 Muenster, Germany.
authors.forename: Leonie
authors.initials: L
authors.lastname: Brinkmann
authors.affiliation: Department of Biological and Clinical Psychology, Friedrich-Schiller-University Jena, Am Steiger 3, D-07743 Jena, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Poller
authors.affiliation: Laboratory of Psychophysiology and Functional Imaging, University Hospital Wuerzburg, Fuechsleinstraße 15, D-97080 Wuerzburg, Germany.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Herrmann
authors.affiliation: Department of Biological and Clinical Psychology, Friedrich-Schiller-University Jena, Am Steiger 3, D-07743 Jena, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Miltner
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, D-48149 Muenster, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Straube
mesh_terms: D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059031:Anticipation, Psychological / Q000502:physiology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006470:Hemorrhage / Q000523:psychology; D006801:Humans; D007267:Injections / Q000523:psychology; D008279:Magnetic Resonance Imaging; D010698:Phobic Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012686:Septal Nuclei / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult
keywords: Amygdala; Anterior cingulate cortex; Bed nucleus of the stria terminalis (BNST); Insula; fMRI