A systematic review of cognitive and neurobiologic factors associated with specific phobias

Abstract

Summary Background: To clarify the role of cognitive and neurobiologic factors in the aetiopathogenesis of specific phobia, a systematic review of studies investigating these factors was performed. MEDLINE, PsycINFO, EMBASE, and Cochrane Central were searched up to March 23, 2012. Method: Thirty-four studies were analyzed in detail for this systematic review. Results: Persons with specific phobia differed from healthy persons in their reaction to the exposure to phobia-related stimuli due to biased attentional, memory and interpretational processes. Longer reaction times, increased recall and recognition performances for threat-related information, and a tendency to misinterpret ambiguous stimuli were found in persons with specific phobia. Regarding brain activity measures as indicators of neurobiologic factors following exposure to fear-related stimuli, amygdala, anterior cingulated cortex, insula, fusiform gyrus, and dorsomedial prefrontal cortex activities were most commonly reported to be increased in persons with specific phobia. Other studies revealed increased amplitudes of event-related potentials (N100, P300, and late positive potentials) in persons with specific phobia.