The cost of fear: Impairments of decision-making in specific phobia

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-01-18 DOI:10.1016/j.brat.2025.104688

Ulrike Senftleben , Esther Seidl , Lieselotte Leonhardt , Kevin Hilbert , Stefan Scherbaum , Markus Muehlhan , Katja Beesdo-Baum , Judith Schäfer

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引用次数: 0

Abstract

Background

Decision-making processes may play a pivotal role in the etiology and maintenance of specific phobia. However, empirical evidence is limited. This study examined whether decision-making is only impaired in presence of fear-related stimuli or whether general impairments exist but are more pronounced in the presence of fear-related stimuli. Further, we examine which components of the decision-making process might be impaired.

Methods

We examined a spider phobia group (SP, n = 109) relative to matched healthy controls (HC, n = 81) using a virtual decision game. To tap the approach-avoidance-conflict, either a fear-related version (using spiders) or a non-phobic version of the task was used in a between-subjects design to measure how the presence of fear-related or non-phobic stimuli was associated with optimal decision-making (collecting rewards). Based on drift diffusion modelling, underlying decision-making processes such as processing ability and cautiousness were investigated.

Results

No clear evidence for general impairments of decision-making for SP participants relative to HC in the absence of fear-related stimuli was found, but a strong phobia-specific impairment when fear-related stimuli were present. These avoidant decisions were associated with a reduced ability to process the optimal choice option and increased cautiousness in the SP group.

Conclusions

Decision-making processes in specific phobia are specifically impaired in the presence of fear-related stimuli, which might contribute to maladaptive, costly avoidance behavior.

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.