Citation

Lang PJ, McTeague LM. Anxiety Stress Coping 2009; 22(1): 5-25.

Affiliation

Center for the Study of Emotion & Attention, University of Florida, Gainesville, FL, USA. plang@phhp.ufl.edu

Copyright

(Copyright © 2009, Informa - Taylor and Francis Group)

DOI

10.1080/10615800802478247

PMID

19096959

PMCID

PMC2766521

Abstract

This review considers recent research assessing psychophysiological reactivity to fear imagery in anxiety disorder patients. As in animal subjects, fear cues prompt in humans a state of defensive motivation in which autonomic and somatic survival reflexes are markedly enhanced. Thus, a startle stimulus presented in a fear context yields a stronger (potentiated) reflex, providing a quantitative measure of fearful arousal. This fear potentiation is further exaggerated in specific or social phobia individuals when viewing pictures or imagining the phobic object. Paradoxically, fear imagery studies with more severe anxiety disorder patients--panic disorder with agoraphobia, generalized anxiety disorder, or anxious patients with comorbid depression--show a blunted, less robust fear potentiated response. Furthermore, this reflex blunting appears to systematically be more pronounced over the anxiety disorder spectrum, coincident with lengthier chronicity, worsening clinician-based judgments of severity and prognosis, and increased questionnaire-based indices of negative affectivity, suggesting that normal defensive reactivity may be compromised by an experience of long-term stress.

Language: en