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The functional neuroanatomy of blood-injection-injury phobia: a comparison with spider phobics and healthy controls

Caseras, Xavier, Giampietro, V., Lamas, A., Brammer, M., Vilarroya, O., Carmona, S., Rovira, M., Torrubia, R. and Mataix-Cols, David 2010. The functional neuroanatomy of blood-injection-injury phobia: a comparison with spider phobics and healthy controls. Psychological Medicine 40 (1) , pp. 125-134. 10.1017/S0033291709005972

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Abstract

Background. Most neuroimaging studies of specific phobia have investigated the animal subtype. The blood-injection-injury (BII) subtype is characterized by a unique biphasic psychophysiological response, which could suggest a distinct neural substrate, but direct comparisons between phobia types are lacking. Method. This study compared the neural responses during the presentation of phobia-specific stimuli in 12 BII phobics, 14 spider (SP) phobics and 14 healthy controls using functional magnetic resonance imaging (fMRI). Results Subjective ratings showed that the experimental paradigm produced the desired symptom-specific effects. As in many previous studies, when viewing spider-related stimuli, SP phobics showed increased activation in dorsal anterior cingulate and anterior insula, compared to BII phobics and healthy controls. However, when viewing images of blood-injection-injuries, participants with BII phobia mainly showed increased activation in the thalamus and visual/attention areas (occipito-temporo-parietal cortex), compared with the other two groups. The degree of provoked anxiety and disgust by phobia-relevant images was strongly associated with activation in several common regions across the two phobia groups (thalamus, cerebellum, occipito-temporal regions) but only correlated with activation in the dorsal anterior cingulate gyrus and the anterior insula in the SP phobics. Conclusions. These results suggest partially distinct neurobiological substrates of animal and BII phobias and support their current classification as two distinct subtypes in the DSM-IV-TR. Further research is needed to better understand the precise neurobiological mechanisms in BII phobia and particularly the fainting response.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Psychology
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Anxiety; fear; fMRI; specific phobia
Additional Information: Pdf uploaded in accordance with publisher's policy at http://www.sherpa.ac.uk/romeo/issn/0033-2917/ (accessed 25/02/2014).
Publisher: Cambridge University Press
ISSN: 0033-2917
Date of First Compliant Deposit: 30 March 2016
Last Modified: 04 Jun 2017 03:57
URI: http://orca-mwe.cf.ac.uk/id/eprint/29732

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