Modality of fear cues affects acoustic startle potentiation but not heart-rate response in patients with dental phobia

Wannemüller, André; Sartory, Gudrun; Elsesser, Karin; Lohrmann, Thomas; Jöhren, Hans Peter

doi:10.3389/fpsyg.2015.00170

Cited by 8 publications

(13 citation statements)

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“…These findings are partially contradicted by Wannemüller et al’s study [ 13 ] where, despite observing a higher HR during auditory stimuli, the dentally phobic subjects rated visual stimuli as more subjectively anxiety-provoking. Extending the discrepancy, a further study showed that individuals with dental phobia assessed visual dental-related stimuli as more anxiety-provoking, while exposure to dental-related pictures provoked increased levels of HR in individuals with dental phobia and decreased levels of HR in the HCs with no differences in HR reactions observed between dentally phobic subjects and the HCs during exposure to dental-related sounds [ 14 ].…”

Section: Introductionmentioning

confidence: 69%

“…The comparison of auditory to visual modalities yielded mixed results, the auditory modality was found to be more anxiety-provoking than the visual modality by Hilbert et al [ 12 ]; the authors found increased activation in the phobia-associated regions of the brain, using functional magnetic resonance imaging, in dentally phobic subjects relative to the HCs. Auditory stimuli were corroborated as more anxiety-provoking in a study carried out by Wannemüller et al [ 13 ], where dentally phobic subjects exhibited increased HR during auditory stimuli in comparison to visual ones. Similarly, Oosterink et al [ 15 ] reported that stimuli related to invasive dental procedures were very effective at eliciting anxious responses, with drilling sounds provoking more anxiety than the sight of the drill.…”

Section: Introductionmentioning

confidence: 84%

“…However, the results showed no major differences in HR during the three conditions of dental-related stimuli exposure (S1-S3 Appendices) [ 13 – 15 ]. This and equal sweating response to the dental examination and the auditory stimulus modality ( S2 Appendix ) [ 15 ] as well as the SDNN increasing the most during the dental examination were in disagreement with previous research [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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Real-life dental examination elicits physiological responses different to visual and auditory dental-related stimuli

et al. 2021

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Background Previous studies on dental anxiety have examined the psychophysiological responses evoked in dentally anxious subjects by dental-related stimuli, but not during a real-life dental examination, which was achieved in the present study. Methods The heart rate, skin conductance level, and heart rate variability of 25 subjects with dental anxiety and 25 healthy controls were examined. Anxiety was determined by the Modified Dental Anxiety Scale and the Dental Anxiety Scale–Revised. The psychophysiological reactions of the two groups were compared during exposure to dental-related pictures, dental-related sounds, and an actual examination in a dental surgery. Results All the dental-related stimuli provoked an increase in heart rate, i.e. visual stimuli (p<0.001; 95% CI 0.98–3.95 bpm), auditory stimuli (p<0.001; 95% CI 1.34–4.99 bpm), and a dental examination (p<0.001; 95% CI 1.26–5.39 bpm). Dental-related pictures provoked inferior skin conductance level changes compared to dental-related sounds and the dental examination (visual modality vs auditory p<0.001; 95% CI 0.039–0.152; visual modality vs examination p<0.001; 95% CI 0.083–0.275). Heart rate variability manifested in a complex pattern of responses to the dental examination. However, when exposed to all three dental-related stimuli presentation conditions, the heart rate (F = 0.352, p = 0.556), skin conductance level (F = 0.009, p = 0.926), and heart rate variability parameters of subjects with dental anxiety did not differ in comparison to the healthy controls. Conclusions This pilot study represents an evaluation of psychophysiological reactions during a real-life dental examination compared to single modality stimuli, and shows that a real-life dental examination provokes an increase in heart rate, heart rate variability and skin conductance level. Additionally, autonomic responses did not differ between the experimental and control groups. The key issue for future studies is the effect of real-life situations on the physiological and psychological state of the subjects, which should be considered when planning new research and studied in depth.

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Section: Introductionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Real-life dental examination elicits physiological responses different to visual and auditory dental-related stimuli

et al. 2021

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“…The startle response is, however, inhibited for pleasant images. These effects have been reliably replicated for pictures (Bradley et al, 2001;Buchanan et al, 2004;Cook et al, 1991;Guerra et al, 2012;Hamm et al, 1997;Wannemüller et al, 2015) and sounds Roy et al, 2009;Wannemüller et al, 2015) suggesting that during perceptual tasks, the startle blink reflex is modulated by the hedonic value of the encoded material. In imagery contexts, however, a different pattern has been observed.…”

Section: Introductionmentioning

confidence: 88%

Same but different: New insights on the correspondence between subjective affective experience and physiological responses from representational similarity analyses

Ventura‐Bort

Wendt

Weymar

2021

Preprint

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Classical views suggest that experienced affect is related to a specific bodily response (Fingerprint hypothesis), whereas recent perspectives challenge this view postulating that similar affective experiences rather evoke different physiological responses. To further advance this debate in the field, we used representational similarity analysis to investigate the correspondence between subjective affect (arousal and valence ratings) and physiological reactions (skin conductance response [SCR], startle blink response, heart rate and corrugator activity) across various emotion induction contexts (picture viewing task, sound listening task and imagery task). Significant similarities were exclusively observed between SCR and arousal in the picture viewing task. However, none of the other physiological measures showed a significant relation with valence and arousal ratings in any of the tasks. These findings tend to support the populations hypothesis, suggesting that there is no clear match between the evoked physiological responses and the experienced subjective affect between individuals.

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“…More specifically, the startle eyeblink reflex is typically potentiated in the context of an aversive stimulus and inhibited in the context of an appetitive stimulus, e.g. 4 – 6 . These effects may be explained by a relative match or a mismatch between the subject’s motivational state induced by the emotional context and the defensive nature of the startle reflex 7 .…”

Section: Introductionmentioning

confidence: 99%

No consistent startle modulation by reward

Schutte

Baas

Heitland

et al. 2021

Sci Rep

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Previous studies have not clearly demonstrated whether motivational tendencies during reward feedback are mainly characterized by appetitive responses to a gain or mainly by aversive consequences of reward omission. In the current study this issue was addressed employing a passive head or tails game and using the startle reflex as an index of the appetitive-aversive continuum. A second aim of the current study was to use startle-reflex modulation as a means to compare the subjective value of monetary rewards of varying magnitude. Startle responses after receiving feedback that a potential reward was won or not won were compared with a baseline condition without a potential gain. Furthermore, startle responses during anticipation of no versus potential gain were compared. Consistent with previous studies, startle-reflex magnitudes were significantly potentiated when participants anticipated a reward compared to no reward, which may reflect anticipatory arousal. Specifically for the largest reward (20-cents) startle magnitudes were potentiated when a reward was at stake but not won, compared to a neutral baseline without potential gain. In contrast, startle was not inhibited relative to baseline when a reward was won. This suggests that startle modulation during feedback is better characterized in terms of potentiation when missing out on reward rather than in terms of inhibition as a result of winning. However, neither of these effects were replicated in a more targeted second experiment. The discrepancy between these experiments may be due to differences in motivation to obtain rewards or differences in task engagement. From these experiments it may be concluded that the nature of the processing of reward feedback and reward cues is very sensitive to experimental parameters and settings. These studies show how apparently modest changes in these parameters and settings may lead to quite different modulations of appetitive/aversive motivation. A future experiment may shed more light on the question whether startle-reflex modulation after feedback is indeed mainly characterized by the aversive consequences of reward omission for relatively large rewards.

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Modality of fear cues affects acoustic startle potentiation but not heart-rate response in patients with dental phobia

Cited by 8 publications

References 48 publications

Real-life dental examination elicits physiological responses different to visual and auditory dental-related stimuli

Real-life dental examination elicits physiological responses different to visual and auditory dental-related stimuli

Same but different: New insights on the correspondence between subjective affective experience and physiological responses from representational similarity analyses

No consistent startle modulation by reward

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