Enhanced discriminative fear learning of phobia-irrelevant stimuli in spider-fearful individuals

Frontiers in Behavioral Neuroscience

Volumn 8, Issue OCT, 2014, Pages

  Mosig, Carina ^a   Merz, Christian J ^a   Mohr, Cornelia ^a   Adolph, Dirk ^a   Wolf, Oliver T ^a   Schneider, Silvia ^a   Margraf, JüRgen ^a   Zlomuzica, Armin ^a  

^a RUHR UNIVERSITY BOCHUM   (Germany)

Author keywords

Anxiety disorders; Conditionability; Differential fear conditioning; Extinction; Fear renewal; Specific phobia; Spider fear; Virtual reality

Indexed keywords

ANXIETY; ARACHNOPHOBIA; ARTICLE; CLINICAL ARTICLE; CONDITIONING; CONTROLLED STUDY; DEPRESSION; DISCRIMINATION LEARNING; FEAR; FEAR ACQUISITION; FEAR DISCRIMINATION; FEAR EXTINCTION; FEMALE; HUMAN; MALADJUSTMENT; MALE; PHOBIA; SPIDER; STIMULUS; STRESS;

EID: 84907613660     PISSN: 16625153     EISSN: None     Source Type: Journal    
DOI: 10.3389/fnbeh.2014.00328     Document Type: Article

References (92)

1. Alvarez, R. P., Johnson, L., and Grillon, C. (2007). Contextual-specificity of short- delay extinction in humans: renewal of fear-potentiated startle in a virtual environment. Learn. Mem. 14, 247-253. doi:10.1101/lm.493707
2. Amir, N., and Foa, E. B. (2001). “Cognitive biases in social phobia,” in From Social Anxiety to Social Phobia: Multiple Perspectives, eds S. G. Hofmann and P. M. Dibartolo (Boston: Allyn and Bacon), 254-267.
3. Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., and Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychol. Assess. 10, 176-181. doi:10.1037/1040-3590.10.2.176
4. Arnaudova, I., Krypotos, A. M., Effting, M., Boddez, Y., Kindt, M., and Beckers, T. (2013). Individual differences in discriminatory fear learning under conditions of ambiguity: a vulnerability factor for anxiety disorders? Front. Psychol. 4:298. doi:10.3389/fpsyg.2013.00298
5. Beck, K. D., Jiao, X., Pang, K. C., and Servatius, R. J. (2010). Vulnerability factors in anxiety determined through differences in active-avoidance behavior. Prog. Neuropsychopharmacol. Biol. Psychiatry 34, 852-860. doi:10.1016/j.pnpbp.2010.03.036
6. Bedford, A., and Foulds, G. (1978). Delusions-Symptoms-States Inventory State of Anxiety and Depression. Windsor: NFER-Nelson.
7. Blechert, J., Michael, T., Vriends, N., Margraf, J., and Wilhelm, F. H. (2007). Fear conditioning in posttraumatic stress disorder: evidence for delayed extinction of autonomic, experiential, and behavioural measures. Behav. Res. Ther. 45, 2019-2033. doi:10.1016/j.brat.2007.02.012
8. Blechert, J., Michael, T., Williams, L. S., Purkis, H. M., and Wilhelm, F. H. (2008). When two paradigms meet: Does evaluative learning extinguish in differential fear conditioning? Learn. Mot. 39, 58-70. doi:10.1016/j.lmot.2007.03.003
9. Bouton, M. E. (1988). Context and ambiguity in the extinction of emotional learning: Implications for exposure therapy. Behav. Res. Ther. 26, 137-149. doi:10.1016/0005-7967(88)90113-1
10. Bouton, M. E. (1991). “A contextual analysis of fear extinction,” in Handbook of Behavior Therapy and Psychological Science: An Integrative Approach, ed. P. R. Martin (Elmsford, NY: Pergamon), 435-453.
11. Bouton, M. E. (1994). Conditioning, remembering, and forgetting. J. Exp. Psychol. 20, 219-231.
12. Bouton, M. E. (2004). Context and behavioral processes in extinction. Learn. Mem. modulation of extinction: behavioral and biological mechanisms. Biol. Psychiatry 60, 352-360. doi:10.1016/j. biopsych.2005.12.015
13. Bouton, M. E., and Bolles, R. C. (1979). Contextual control of the extinction of conditioned fear. Learn. Mot. 10, 445-466. doi:10.1016/0023-9690(79)90057-2
14. Bouton, M. E., and Nelson, J. B. (1998). “The role of context in classical conditioning: some implications for cognitive behavior therapy,” in Learning Theory and Behavior Therapy, ed. W. T. O’Donohue (Boston: Allyn Bacon), 59-83.
15. Caulfield, M. D., McAuley, J. D., and Servatius, R. J. (2013). Facilitated acquisition of eyeblink conditioning in those vulnerable to anxiety disorders. Front. Hum. Neurosci. 7:348. doi:10.3389/fnhum.2013.00348
16. Cheng, D. T., Knight, D. C., Smith, C. N., Stein, E. A., and Helmstetter, F. J. (2003). Functional MRI of human amygdala activity during Pavlovian fear conditioning: stimulus processing versus response expression. Behav. Neurosci. 117, 3-10. doi:10.1037/0735-7044.117.1.3
17. Clara, I. P., Cox, B. J., and Enns, M. W. (2001). Confirmatory factor analysis of the depression anxiety stress scales in depressed and anxious patients. Psychopath. Behav. Assess. 23, 61-67. doi:10.1023/A:1011095624717
18. Cochrane, A., Barnes-Holmes, D., and Barnes-Holmes, Y. (2008). The perceived- threat behavioral approach test (PT-BAT): measuring avoidance in high-, mid-, and low- spider-fearful participants. Psychol. Rec. 58, 585-596.
19. Cook, E. W., Melamed, B. G., Cuthbert, B. N., McNeil, D. W., and Lang, P. J. (1988). Emotional imagery and the differential diagnosis of anxiety. J. Consult. Clin. Psychol. 56, 734-740. doi:10.1037/0022-006X.56.5.734
20. Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., and Vervliet, B. (2014). Maximizing exposure therapy: an inhibitory learning approach. Behav. Res. Ther. 9, 58C. doi:10.1016/j.brat.2014.04.006
21. Cuthbert, B. N., Lang, P. J., Strauss, C., Drobes, D., Patrick, C. J., and Bradley, M. M. (2003). The psychophysiology of anxiety disorder: fear memory imagery. Psychophysiology 40, 407-422. doi:10.1111/1469-8986.00043
22. Davis, M., Falls, W. A., and Gewirtz, J. (2000). “Neural systems involved in fear inhibition: extinction and conditioned inhibition,” in Contemporary Issues in Modeling Psychopathology, eds M. Myslobodsky and I. Weiner (Boston: Kluwer Academic), 113-141.
23. Dibbets, P., van denBroek, A., and Evers, E. A. (2014). Fear conditioning and extinction in anxiety- and depression-prone persons. Memory. doi:10.1080/09658211. 2014.886704
24. Dilger, S., Straube, T., Mentzel, H. J., Fitzek, C., Reichenbach, J. R., Hecht, H., et al. Brain activation to phobia-related pictures in spider phobic humans: an event-related functional magnetic resonance imaging study. Neurosci. Lett. 348, 29-32. doi:10.1016/S0304-3940(03)00647-5
25. Dunsmoor, J. E., Ahs, F., Zielinski, D. J., and LaBar, K. S. (2014). Extinction in multiple virtual reality contexts diminishes fear reinstatement in humans. Neurobiol. Learn. Mem. 113, 157-164. doi:10.1016/j.nlm.2014.02.010
26. Ehlers, A., and Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behav. Res. Ther. 38, 319-345. doi:10.1016/S0005-7967(99) 00123-0
27. Etkin, A. M. D., and Wager, T. D. (2007). Functional neuroimaging of anxiety: a meta-analyses of emotional processing in PTSD, social anxiety disorder, and specific phobia. Am. J. Psychiatry 164, 10. doi:10.1176/appi.ajp.2007. 07030504
28. Fani, N., Tone, E. B., Phifer, J., Norrholm, S. D., Bradley, B., Ressler, K. J., et al. Attention bias toward threat is associated with exaggerated fear expression and impaired extinction in PTSD. Psychol. Med. 42, 533-543. doi:10.1017/ S0033291711001565
29. Fisler, M. S., Federspiel, A., Horn, H., Dierks, T., Schmitt, W., Wiest, R., et al. Spider phobia is associated with decreased left amygdala volume: a crosssectional study. BMC Psychiatry 13:70. doi:10.1186/1471-244X-13-70
30. Fox, N. A., Henderson, H. A., Marshall, P. J., Nichols, K. E., and Ghera, M. M. (2005). Behavioral inhibition: linking biology and behavior within a developmental framework. Annu. Rev. Psychol. 56,235-262. doi:10.1146/annurev.psych. 55.090902.141532
31. Gazendam, F. J., and Kindt, M. (2012). Worrying affects associative fear learning: a startle fear conditioning study. PLoS ONE 7:4. doi:10.1371/journal.pone. 0034882
32. Gerdes, A. B. M., and Alpers, G. W. (2014). You see what you fear: spiders gain preferential access to conscious perception in spider-phobic patients. J. Exp. Psy- chopathol. 5,14-28. doi:10.5127/jep.033212
33. Globisch, J., Hamm, A. O., Esteves, F., and Ohman, A. (1999). Fear appears fast: temporal course of startle reflex potentiation in animal fearful subjects. Psychophysiology 36, 66-75. doi:10.1017/S0048577299970634
34. Goossens, L., Sunaert, S., Peeters, R., Griez, E., and Schruers, K. (2007). Amygdala hyperfunction in phobic fear normalizes after exposure. Biol. Psychiatry 62, 1119-1125. doi:10.1016/j.biopsych.2007.04.024
35. Grillon, C. (2002). Startle reactivity and anxiety disorders: aversive conditioning, context, and neurobiology. Biol. Psychiatry 52, 958-975. doi:10.1016/S0006- 3223(02)01665-7
36. Grillon, C., Ameli, R., Goddard, A., Woods, S. W., and Davis, M. (1994). Baseline and fear-potentiated startle in panic disorder patients. Biol. Psychiatry 35, 431-439. doi:10.1016/0006-3223(94)90040-X
37. Grillon, C., Baas, J. M. P., Cornwell, B., and Johnson, L. (2006). Context conditioning and behavioral avoidance in a virtual reality environment: effect of predictability. Biol. Psychiatry 60, 752-759. doi:10.1016/j.biopsych.2006.03.072
38. Grillon, C., and Morgan, C. A. (1999). Fear-potentiated startle conditioning to explicit and contextual cues in Gulf War veterans with posttraumatic stress disorder. J.Abnorm. Psychol. 108, 134-142. doi:10.1037/0021-843X.108.1.134
39. Haaker, J., Gaburro, S., Sah, A., Gartmann, N., Lonsdorf, T. B., Meier, K., et al. (2013). Single dose of L-dopa makes extinction memories context-independent and prevents the return of fear. Proc. Natl. Acad. Sci. U.S.A. 110, 26. doi:10.1073/pnas. 1303061110
40. Henry, J. D., and Crawford, J. R. (2005). The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br. J. Clin. Psychol. 44, 2. doi:10.1348/014466505X29657
41. Hermans, D., Vansteenwegen, D., Crombez, G., Baeyens, F., and Eelen, P. (2002). Expectancy-learning and evaluative learning in human classical conditioning: affective priming as an indirect and unobtrusive measure of conditioned stimulus valence. Behav. Res. Ther. 40,217-234. doi:10.1016/S0005-7967(01)00006-7
42. Holloway, J. L., Allen, M. T., Myers, C. E., and Servatius, R. J. (2014). Behaviorally inhibited individuals demonstrate significantly enhanced conditioned response acquisition under non-optimal learning conditions. Behav. Brain Res. 261,49-55. doi:10.1016/j.bbr.2013.10.041
43. Huff, N. C., Hernandez, J. A., Fecteau, M. E., Zielinski, D. J., Brady, R., and Labar, K. S. (2011). Revealing context-specific conditioned fear memories with full immersion virtual reality. Front. Behav. Neurosci. 5:75. doi:10.3389/fnbeh.2011.00075
44. Jovanovic, T., Ely, T., Fani, N., Glover, E. M., Gutman, D., Tone, E. B., et al. Reduced neural activation during an inhibition task is associated with impaired fear inhibition in a traumatized civilian sample. Cortex 49, 1884-1891. doi:10.1016/j.cortex.2012.08.011
45. Knight, D. C., Smith, C. N., Cheng, D. T., Stein, E. A., and Helmstetter, F. J. Amygdala and hippocampal activity during acquisition and extinction of human fear conditioning. Cogn. Affect. Behav. Neurosci. 4, 317-325. doi:10.3758/CABN.4.3.317
46. LaBar, K.S., Gatenby, J. C., Gore, J. C., LeDoux, J. E., and Phelps, E. A. (1998). Human amygdala activation during conditioned fear acquisition and extinction: a mixed- trial fMRI study. Neuron 20, 937-945. doi:10.1016/S0896-6273(00)80475-4
47. Laborda, M. A., McConnell, B. L., and Miller, R. R. (2011). “Behavioral techniques to reduce relapse after exposure therapy: applications of studies of experimental extinction,” in Associative Learning and Conditioning Theory: Human and NonHuman Applications, eds T. R. Schachtman and S. Reilly (New York, NY: Oxford University Press), 79-103.
48. Lang, P. J., and McTeague, L. M. (2009). The anxiety disorder spectrum: fear imagery, physiological reactivity, and differential diagnosis. Anxiety Stress Coping 22, 1. doi:10.1080/10615800802478247
49. Larson, C. L., Schaefer, H. S., Siegle, G. J., Jackson, C. A., Anderle, M. J., and Davidson, R. J. (2006). Fear is fast in phobic individuals: amygdala activation in response to fear-relevant stimuli. Biol. Psychiatry 60, 410-417. doi:10.1016/j.biopsych.2006. 03.079
50. LeDoux, J. E. (2000). Emotion circuits in the brain. Annu. Rev. Neurosci. 23,155-184. doi:10.1146/annurev.neuro.23.1.155
51. Lissek, S., Powers, A. S., McClure, E. B., Phelps, E. A., Woldehawariat, G., and Grillon, (2005). Classical fear conditioning in the anxiety disorders: a meta-analysis. Behav. Res. Ther. 43, 1391-1424. doi:10.1016/j.brat.2004.10.007
52. Lloyd, D. R., Gancarz, A. M., Ashrafioun, L., Kausch, M. A., and Richards, J. B. (2012). Habituation and the reinforcing effectiveness of visual stimuli. Behav. Processes 91,184-191. doi:10.1016/j.beproc.2012.07.007
53. Lommen, M. J., Engelhard, I. M., Sijbrandij, M., van den Hout, M. A., and Hermans, (2013). Pre-trauma individual differences in extinction learning predict post- traumatic stress. Behav. Res. Ther. 51, 63-67. doi:10.1016/j.brat.2012.11.004
54. Lovibond, S. H., and Lovibond, P. F. (1995). Manualfor theDepressionAnxietyStress Scales. Sydney: Psychology Foundation.
55. Maren, S., Phan, K. L., and Liberzon, I. (2013). The contextual brain: implications for fear conditioning, extinction and psychopathology. Nat. Rev. Neurosci. 14, doi:10.1038/nrn3492
56. Merz, C. J., Wolf, O. T., Schweckendiek, J., Klucken, T., Vaitl, D., and Stark, R. (2013). Stress differentially affects fear conditioning in men and women. Psychoneuroendocrinology 38, 2529-2541. doi:10.1016/j.psyneuen.2013.05.015
57. Michael, T., Blechert, J., Vriends, N., Margraf, J., and Wilhelm, F. H. (2007). Fear conditioning in panic disorder: enhanced resistance to extinction. J. Abnorm. Psychol. 45,2019-2033. doi:10.1037/0021-843X.116.3.612
58. Michael, T., Munsch, S., and Margraf, J. (2009). “Exposition und Konfrontation,” in Enzyklopadie der Psychologie - Psychologische Interventionsmethoden: Band Psychotherapeutische Methoden, eds M. Hautzinger and P. Pauli (Gottingen: Hogrefe), 325-386.
59. Milad, M. R., Pitman, R. K., Ellis, C. B., Gold, A. L., Shin, L. M., Lasko, N. B., et al. Neurobiological basis of failure to recall extinction memory in post- traumatic stress disorder. Biol. Psychiatry 66,1075-1082. doi:10.1016/j.biopsych. 2009.06.026
60. Milad, M. R., Quinn, B. T., Pitman, R. K., Orr, S. P., Fischl, B., and Rauch, S. L. (2005). Thickness of ventromedial prefrontal cortex in humans is correlated with extinction memory. Proc. Natl. Acad. Sci. U.S.A. 102, 10706-10711. doi:10.1073/pnas.0502441102
61. Miltner, W. H. R., Krieschel, S., Hecht, H., Trippe, R., and Weiss, T. (2004). Eye movements and behavioral responses to threatening and nonthreatening stimuli during visual search in phobic and nonphobic subjects. Emotion 4, 323-339. doi:10.1037/1528-3542.4.4.323
62. Mineka, S. S., Mystkowski, J. L., Hladek, D. D., and Rodriguez, B. B. I. (1999). The effects of changing contexts on return of fear following exposure therapy for spider fear. J. Consult. Clin. Psychol. 67, 599-604. doi:10.1037/0022-006X.67.4.599
63. Muller, B. H., Kull, S., Wilhelm, F. H., and Michael, T. (2011). One-session computer- based exposure treatment for spider-fearful individuals - efficacy of a minimal self-help intervention in a randomised controlled trial. J. Behav. Ther. Exp. Psychiatry 42, 179-184. doi:10.1016/j.jbtep.2010.12.001
64. Muris, P., and Merckelbach, H. (1996). A comparison of two spider fear questionnaires. J. Behav. Ther. Exp. Psychiatry 27, 214-244. doi:10.1016/S0005-7916(96) 00022-5
65. Myers, C. E., Vanmeenen, K. M., McAuley, J. D., Beck, K. D., Pang, K. C., and Ser- vatius, R. J. (2012). Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans. Stress 15, 1. doi:10.3109/10253890.2011.578184
66. Myers, K. M., Ressler, K. J., and Davis, M. (2006). Different mechanisms of fear extinction dependent on length of time since fear acquisition. Learn. Mem. 13, 216-223. doi:10.1101/lm.119806
67. Mystkowski, J. L., Craske, M. G., and Echiverri, A. M. (2002). Treatment context and return of fear in spider phobia. Behav. Ther. 33, 399-416. doi:10.1016/S0005- 7894(02)80035-1
68. Mystkowski, J. L., Craske, M. G., Echiverri, A. M., and Labus, J. S. (2006). Mental reinstatement of context and return of fear in spider-fearful participants. Behav. Ther. 37, 49-60. doi:10.1016/j.beth.2005.04.001
69. Norrholm, S. D., Jovanovic, T., Olin, I. W., Sands, L. A., Karapanou, I., Bradley, et al. (2011). Fear extinction in traumatized civilians with posttraumatic stress disorder: relation to symptom severity. Biol. Psychiatry 69, 556-563. doi:10.1016/j.biopsych.2010.09.013
70. Ohman, A., Flykt, A., and Esteves, F. (2001). Emotion drives attention: detecting the snake in the grass. J. Exp. Psychol. Gen. 130, 466-478. doi:10.1037/0096-3445. 130.3.466
71. Ohman, A., and Mineka, S. (2001). Fears, phobias, and preparedness: toward an evolved module of fear and fear learning. Psychol. Rev. 108, 483-522. doi:10.1037/0033-295X.108.3.483
72. Orr, S. P., Metzger, L. J., Lasko, N. B., Macklin, M. L., Peri, T., and Pitman, R. K. De novo conditioning in trauma-exposed individuals with and without posttraumatic stress disorder. J. Abnorm. Psychol. 109, 290-298. doi:10.1037/ 0021-843X.109.2.290
73. Otto, M. W., Leyro, T. M., Christian, K., Deveney, C. M., Reese, H., Pollack, M. H., et al. (2007). Prediction of “fear” acquisition in healthy control participants in a de novo fear-conditioning paradigm. Behav. Modif. 31, 32-51. doi:10.1177/0145445506295054
74. Peperkorn, H. M., Alpers, G. W., and Muhlberger, A. (2014). Triggers of fear: perceptual cues versus conceptual information in spider phobia. J. Clin. Psychol. 70, 704-714. doi:10.1002/jclp.22057
75. Peri, T., Ben-Shakhar, G., Orr, S. P., and Shalev, A. Y. (2000). Psychophysiologic assessment of aversive conditioning in posttraumatic stress disorder. Biol. Psychiatry 47, 512-519. doi:10.1016/S0006-3223(99)00144-4
76. Pflugshaupt, T., Mosimann, U. P., Schmitt, W. J., von Wartburg, R., Wurtz, P., Luthi, M., et al. (2007). To look or not to look at threat?: Scanpath differences within a group pf spider phobics. J. Anx. Disord. 21, 353-366. doi:10.1016/j.janxdis.2006.05.005
77. Phelps, E. A., Delgado, M. R., Nearing, K. I., and LeDoux, J. E. (2004). Extinction learning in humans: role of the amygdala and vmPFC. Neuron 43, 897-905. doi:10.1016/j.neuron.2004.08.042
78. Phelps, E. A., O’Connor, K. J., Gatenby, J. C., Gore, J. C., Grillon, C., and Davis, M. Activation of the left amygdala to a cognitive representation of fear. Nat. Neurosci. 4, 437-441.
79. doi:10.1038/86110
80. Rachman, S. J. (1989). The return of fear: review and prospect. Clin. Psychol. Rev. 9, 439-447. doi:10.1016/0272-7358(89)90025-1
81. Rauch, S. L., Shin, L. M., and Wright, C. I. (2003). Neuroimaging studies of amygdala function in anxiety disorders. Ann. N. Y. Acad. Sci. 985, 389-410. doi:10.1111/j.1749-6632.2003.tb07096.x
82. Ricart, T. M., De Niear, M. A., Jiao, X., Pang, K. C., Beck, K. D., and Servatius, R. J. (2011). Deficient proactive interference of eyeblink conditioning in Wistar- Kyoto rats. Beh. Brain Res. 216, 59-65. doi:10.1016/j.bbr.2010.07.005
83. Rinck, M., Bundschuh, S., Engler, S., Muller, A., Wissmann, J., Ellwart, T., et al. (2002). Reliability and validity of German versions of three instruments mea- suringfear ofspiders. Diagnostica 48,141-149. doi:10.1026//0012-1924.48.3.141
84. Schweckendiek, J., Klucken, T., Merz, C. J., Tabbert, K., Walter, B., Ambach, W., et al. Weaving the (neuronal) web: fear learning in spider phobia. Neuroimage 54, 681-688. doi:10.1016/j.neuroimage.2010.07.049
85. Soliman, F., Glatt, C. E., Bath, K. G., Levita, L., Jones, R. M., Pattwell, S. S., et al. A genetic variant BDNF polymorphism alters extinction learning in both mouse and human. Science 327, 5967. doi:10.1126/science.1181886
86. Soravia, L. M., Heinrichs, M., Winzeler, L., Fisler, M., Schmitt, W., Horn, H., et al. Glucocorticoids enhance in vivo exposure-based therapy of spider phobia. Depress. Anxiety 31, 429-435. doi:10.1002/da.22219
87. Stevens, J. S., Jovanovic, T., Fani, N., Ely, T. D., Glover, E. M., Bradley, B., et al. (2013). Disrupted amygdala-prefrontal functional connectivity in civilian women with posttraumatic stress disorder. J. Psychiatr. Res. 47, 1469-1478. doi:10.1016/j.jpsychires.2013.05.031
88. Szymanski, J., and O’Donohue, W. (1995). Fear of spiders questionnaire. J. Behav. Ther. Exp. Psychiatry 26, 31-34. doi:10.1016/0005-7916(94)00072-T
89. Vervliet, B., Craske, M. G., and Hermans, D. (2013).Fear extinctionandrelapse: state of the art. Annu. Rev. Clin. Psychol. 9, 215-248. doi:10.1146/annurev-clinpsy- 050212-185542
90. Watts, F. N., and Sharrock, R. (1984). Questionnaire dimensions of spider phobia. Behav. Res. Ther. 22, 575-580. doi:10.1016/0005-7967(84)90061-5
91. Wright, C. I., Fischer, H., Whalen, P. J., Mclnerney, S., Shin, L. M., and Rauch, S. L. (2001). Differential prefrontal cortexand amygdalahabituation to repeatedly presented emotional stimuli. Neuroreport 12, 379-383. doi:10.1097/00001756- 200102120-00039
92. Zigmond, A. S., and Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatr. Scand. 67, 361-370. doi:10.1111/j.1600-0447.1983.tb09716.x