Triggers of Fear: Perceptual Cues Versus Conceptual Information in Spider Phobia

OBJECTIVE: Fear reactions in spider-phobic patients can be activated by specific perceptual cues or by conceptual fear-related information. Matching perceptual fear cues and fear-related information were expected to result in maximal fear responses, perceptual fear cues alone in less fear, and information alone in the weakest responses. METHOD: We used virtual reality to manipulate the available cues and information. Forty-eight phobic patients and 48 healthy participants were repeatedly exposed to either a perceptual cue, information, or a combination of both. RESULTS: In conditions with a fear-relevant perceptual cue, phobic patients reported increased fear compared to the condition with information only. Across exposures trials, these reactions diminished. Skin conductance in phobic patients was significantly higher in the combined than in the cue or the information condition. CONCLUSIONS: Perceptual cues are essential for phobic fear reactions in spider phobia. In combination with fear-relevant information, perceptual cues activate an intense and persistent fear reaction.