Cognitive vulnerability: a model of the etiology of fear.

This paper attempts to fill the partial theoretical vacuum surrounding the understanding of fear acquisition. A review of recent and contemporary theories of the etiology of fear is presented, serving as a justification for further theorizing and allowing for greater understanding of those aspects of fear that remain to be adequately explained. A new model of the etiology of specific fears is subsequently put forward and the various aspects and implications of this model are discussed. How an individual perceives a stimulus is proposed as being critical in determining fear in relation to the stimulus. In particular, perceptions of the stimulus as uncontrollable, unpredictable, dangerous and disgusting create a schema of vulnerability. The Cognitive Vulnerability Model integrates much of the extensive body of research on fears and specific phobias into a unifying theory of the etiology of fear. The model offers parsimonious explanations for the various characteristics of specific fears and phobias.

[1]  Melanie V. Tucker,et al.  The roles of gender, sex role, and disgust in fear of animals , 1997 .

[2]  S. Klein,et al.  Learning: Principles and Applications , 1987 .

[3]  R. Tait,et al.  Eysenck's theory of incubation: an empirical test. , 1982, Behaviour research and therapy.

[4]  Joseph E LeDoux Fear and the brain: where have we been, and where are we going? , 1998, Biological Psychiatry.

[5]  Stefan G. Hofmann,et al.  Clinical characteristics of driving phobia , 1994 .

[6]  A. Arntz,et al.  Pathways to spider phobia. , 1992, Behaviour research and therapy.

[7]  A. Bandura,et al.  Cognitive processes mediating behavioral change. , 1977, Journal of personality and social psychology.

[8]  J. Watson,et al.  Conditioned emotional reactions , 1920 .

[9]  J. Riskind,et al.  The loomingness of danger: Does it discriminate focal phobia and general anxiety from depression? , 1992, Cognitive Therapy and Research.

[10]  P. Salkovskis,et al.  Phobic beliefs: do cognitive factors play a role in specific phobias? , 1995, Behaviour research and therapy.

[11]  G. Curtis,et al.  Mode of onset of simple phobia subtypes: Further evidence of heterogeneity , 1991, Psychiatry Research.

[12]  M. Seligman,et al.  Prepared phobias and obsessions: therapeutic outcome. , 1977, Behaviour research and therapy.

[13]  Irwin G. Sarason,et al.  Test anxiety : theory, research, and applications , 1980 .

[14]  M. Seligman Phobias and preparedness , 1971 .

[15]  J. Armfield,et al.  Vulnerability representation: the role of perceived dangerousness, uncontrollability, unpredictability and disgustingness in spider fear. , 1996, Behaviour research and therapy.

[16]  P. Lang,et al.  Preparedness and phobia: effects of stimulus content on human visceral conditioning. , 1986, Journal of abnormal psychology.

[17]  J. Geer,et al.  Evaluating the effects of the prediction-control confound. , 1972, Journal of personality and social psychology.

[18]  H. Merckelbach,et al.  Many stimuli are frightening, but some are more frightening than others: The contributions of preparedness, dangerousness, and unpredictability to making a stimulus fearful , 1988 .

[19]  Stephen W. Smith,et al.  Cognitive Behavior Modification , 1997 .

[20]  C. McLean,et al.  Disgust as a motivator of avoidance of spiders. , 2005, Journal of anxiety disorders.

[21]  Clark McCauley,et al.  Individual differences in sensitivity to disgust: A scale sampling seven domains of disgust elicitors , 1994 .

[22]  Albert Bandura,et al.  Self-Efficacy Determinants of Anticipated Fears and Calamities , 1983 .

[23]  J. Clarke,et al.  The etiology of fear of heights and its relationship to severity and individual response patterns. , 1993, Behaviour research and therapy.

[24]  H. Eysenck The learning theory model of neurosis--a new approach. , 1976, Behaviour research and therapy.

[25]  L. F. Barrett,et al.  Handbook of Emotions , 1993 .

[26]  A. Ohman,et al.  The effects of directional facial cues on electrodermal conditioning to facial stimuli. , 1983, Psychophysiology.

[27]  Michael W. Otto,et al.  Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic , 1989 .

[28]  Phil A. Silva,et al.  Good teeth, bad teeth and fear of the dentist. , 1997, Behaviour research and therapy.

[29]  S. Thompson Will it hurt less if i can control it? A complex answer to a simple question. , 1981 .

[30]  S. Carlsson,et al.  Treatment of Dental Fear: Systematic Desensitization or Coping? , 1989, Behavioural Psychotherapy.

[31]  K. Mogg,et al.  Selective processing of threat cues in anxiety states: a replication. , 1989, Behaviour research and therapy.

[32]  G. Thomas,et al.  Origins of fear of dogs in adults and children: the role of conditioning processes and prior familiarity with dogs. , 1992, Behaviour research and therapy.

[33]  S. Rachman The conditioning theory of fearacquisition: A critical examination , 1977 .

[34]  G. Davey,et al.  Sensory preconditioning and UCS inflation in human 'fear' conditioning. , 1989, Behaviour research and therapy.

[35]  T. Rosenthal Thesis and antithesis: S-R levers or meaning-perceivers? , 1979, Behavioral and Brain Sciences.

[36]  S. Williams,et al.  Thoughts of agoraphobic people during scary tasks. , 1997, Journal of abnormal psychology.

[37]  D. Tolin,et al.  The relationship between disgust sensitivity and avoidant behavior: studies of clinical and nonclinical samples. , 2002, Journal of anxiety disorders.

[38]  L. F. Barrett,et al.  Handbook of emotions, 2nd ed. , 2000 .

[39]  E. Gibson,et al.  The "visual cliff". , 1960, Scientific American.

[40]  M. Zvolensky,et al.  Prediction and control: operational definitions for the experimental analysis of anxiety. , 2000, Behaviour research and therapy.

[41]  G. Davey 'Nonspecific' rather than 'nonassociative' pathways to phobias: a commentary on Poulton and Menzies. , 2002, Behaviour research and therapy.

[42]  C. MacLeod,et al.  Implicit and explicit memory bias in anxiety: a conceptual replication. , 1995, Behaviour research and therapy.

[43]  G. Davey,et al.  Disease-avoidance model: factor analysis of common animal fears. , 1994, Behaviour research and therapy.

[44]  The role of modeling in prevention and extinction of phobic behaviour in cynomolgus monkeys (Macaca fascicularis). , 1989, Behaviour research and therapy.

[45]  M. Eysenck,et al.  Implicit and explicit memory bias in anxiety. , 1989, Journal of abnormal psychology.

[46]  J. Lick,et al.  External validity of laboratory fear assessment: implications from two case studies. , 1975, Journal of consulting and clinical psychology.

[47]  I. Maltzman,et al.  Stimulus significance and bilateral SCRs to potentially phobic pictures. , 1984, Journal of abnormal psychology.

[48]  S. Mineka,et al.  Unpredictable and uncontrollable events: a new perspective on experimental neurosis. , 1978, Journal of abnormal psychology.

[49]  J. Singer,et al.  Behavioral consequences of adaptation to controllable and uncontrollable noise , 1971 .

[50]  T. Joiner,et al.  The looming maladaptive style predicts shared variance in anxiety disorder symptoms: further support for a cognitive model of vulnerability to anxiety. , 2005, Journal of anxiety disorders.

[51]  R. Rapee,et al.  Perceived control and controllability , 1991 .

[52]  Z. Segal,et al.  Cognitive reactivity and vulnerability: empirical evaluation of construct activation and cognitive diatheses in unipolar depression. , 2005, Clinical psychology review.

[53]  S. Mineka,et al.  Observational conditioning of snake fear in rhesus monkeys. , 1984, Journal of abnormal psychology.

[54]  S. Rachman,et al.  Stimulus estimation and the overprediction of fear. , 1994, The British journal of clinical psychology.

[55]  R. Kleinknecht Comments on:non-associative fear acquisition: a review of the evidence from retrospective and longitudinal research. , 2002, Behaviour research and therapy.

[56]  J. Clarke,et al.  The etiology of acrophobia and its relationship to severity and individual response patterns. , 1995, Behaviour research and therapy.

[57]  A. Bandura,et al.  Tests of the generality of self-efficacy theory , 1980, Cognitive Therapy and Research.

[58]  J. Maser,et al.  The growth of research on anxiety disorders during the 1980s , 1995 .

[59]  K. Hugdahl,et al.  Biological vs experiential factors in phobic conditioning. , 1981, Behaviour research and therapy.

[60]  J. Langley,et al.  Evidence for a non-associative model of the acquisition of a fear of heights. , 1998, Behaviour research and therapy.

[61]  A. Ohman,et al.  Face the beast and fear the face: animal and social fears as prototypes for evolutionary analyses of emotion. , 1986, Psychophysiology.

[62]  Arne Öhman,et al.  Phobias and preparedness: the selective, automatic, and encapsulated nature of fear , 2002, Biological Psychiatry.

[63]  D. Tolin,et al.  Disgust and disgust sensitivity in blood-injection-injury and spider phobia. , 1997, Behaviour research and therapy.

[64]  A. Arntz,et al.  Conditioning experiences in spider phobics. , 1991, Behaviour research and therapy.

[65]  Fearful distortions. , 1992, Behaviour research and therapy.

[66]  Effects of instruction on acquisition and extinction of electrodermal responses to fear-relevant stimuli. , 1977, Journal of experimental psychology. Human learning and memory.

[67]  B. Rothbaum,et al.  Behavioral/cognitive conceptualizations of post-traumatic stress disorder , 1989 .

[68]  Peter Muris,et al.  Spider phobia interaction of disgust and perceived likelihood of involuntary physical contact. , 2002, Journal of anxiety disorders.

[69]  Stephen Hughes Attachment and Loss. Vol. I , 1969, Mental Health.

[70]  Alejandro A. Lazarte,et al.  Control and attention influence snake phobics' arousal and fear during laboratory confrontations with a caged snake☆ , 1995 .

[71]  P. Lovibond,et al.  Electrodermal and subjective reactions to fear‐relevant stimuli under threat of shock , 1994 .

[72]  Maryanne Martin,et al.  Integral Bias in Naming of Phobia-related Words , 1992 .

[73]  S. Williams,et al.  Perceived danger and perceived self-efficacy as cognitive determinants of acrophobic behavior. , 1985 .

[74]  Megan R. Gunnar,et al.  Effects of temporal predictability on the reactions of 1-year-olds to potentially frightening toys. , 1984 .

[75]  UCS-inflation and acquired fear responses in human conditioning , 1994 .

[76]  A Bandura,et al.  Microanalysis of action and fear arousal as a function of differential levels of perceived self-efficacy. , 1982, Journal of personality and social psychology.

[77]  A. Wenzel,et al.  Anxiety symptoms and disorders at eight weeks postpartum. , 2005, Journal of anxiety disorders.

[78]  J. Cacioppo,et al.  Self-statements and self-evaluations: A cognitive-response analysis of heterosocial anxiety , 1979, Cognitive Therapy and Research.

[79]  C. Lox Perceived Threat as a Cognitive Component of State Anxiety and Confidence , 1992, Perceptual and motor skills.

[80]  P. D. Di Nardo,et al.  Anxiety response patterns and etiological factors in dog-fearful and non-fearful subjects. , 1988, Behaviour research and therapy.

[81]  M. Booth-Butterfield,et al.  The function of uncertainty reduction in alleviating primary tension in small groups , 1988 .

[82]  H. Merckelbach,et al.  The etiology of specific fears and phobias in children: a critique of the non-associative account. , 2002, Behaviour research and therapy.

[83]  G. Davey,et al.  The effects of cued UCS rehearsal on the retention of differential 'fear' conditioning: an experimental analogue of the 'worry' process. , 1990, Behaviour research and therapy.

[84]  F. Watts,et al.  Processing of phobic stimuli. , 1986, The British journal of clinical psychology.

[85]  J. Hoogstraten,et al.  Experience with Dental Pain and Fear of Dental Pain , 2005, Journal of dental research.

[86]  Robert M. Schwartz,et al.  The internal dialogue: On the asymmetry between positive and negative coping thoughts , 1986, Cognitive Therapy and Research.

[87]  W. Silverman,et al.  Specific phobia. , 2005, Child and adolescent psychiatric clinics of North America.

[88]  J. Roberts Psychosocial Effects of Workplace Hazardous Exposures: Theoretical Synthesis and Preliminary Findings , 1993 .

[89]  L. Janda,et al.  An exploratory investigation of the origin and maintenance of phobias. , 1977, Behaviour research and therapy.

[90]  David H. Barlow,et al.  Abnormal Psychology: An Integrative Approach , 1994 .

[91]  C. Spielberger,et al.  Stress and Anxiety , 1981 .

[92]  Specific fears and panic attacks: A survey of clinical and nonclinical samples , 1993 .

[93]  M. Mahoney,et al.  Cognitive Processes and Emotional Disorders: A Structural Approach to Psychotherapy , 1983 .

[94]  B. Jaffe Cognitive Therapy and the Emotional Disorders , 1977 .

[95]  R. Poulton,et al.  Water trauma and swimming experiences up to age 9 and fear of water at age 18: a longitudinal study. , 1999, Behaviour research and therapy.

[96]  C. Braet,et al.  Cognitive vulnerability in remitted depressed children and adolescents. , 2004, Behaviour research and therapy.

[97]  A Bandura,et al.  Cognitive processes mediating behavioral change. , 1977, Journal of personality and social psychology.

[98]  S. Rachman Neo-conditioning and the classical theory of fear acquisition☆ , 1991 .

[99]  J. Riskind,et al.  Using mental imagery with subclinical OCD to 'freeze' contamination in its place: evidence for looming vulnerability theory. , 1997, Behaviour research and therapy.

[100]  P Milgrom,et al.  Adolescent dental fear and control: prevalence and theoretical implications. , 1992, Behaviour research and therapy.

[101]  Philip C. Kendall,et al.  The future for cognitive assessment of anxiety: Let's get specific. , 1987 .

[102]  A. Arntz,et al.  The role of evaluative learning and disgust sensitivity in the etiology and treatment of spider phobia , 1993 .

[103]  F. Watts,et al.  Phobics show poor recall of anxiety words. , 1993, The British journal of medical psychology.

[104]  O. Mowrer A stimulus-response analysis of anxiety and its role as a reinforcing agent. , 1939 .

[105]  G. Curtis,et al.  Blood-injury-illness phobia: a review. , 1985, Journal of clinical psychology.

[106]  J. Wine Test anxiety and direction of attention. , 1971, Psychological bulletin.

[107]  G. Davey,et al.  Characteristics of individuals with fear of spiders , 1991 .

[108]  J. Burger Negative reactions to increases in perceived personal control. , 1989 .

[109]  P. D. Di Nardo,et al.  Etiology and maintenance of dog fears. , 1988, Behaviour research and therapy.

[110]  S. Rachman Fears born and bred: non-associative fear acquisition? , 2002, Behaviour research and therapy.

[111]  J. Averill Personal control over aversive stimuli and its relationship to stress. , 1973 .

[112]  Phobias and preparedness: replication and extension. , 1988, Behaviour research and therapy.

[113]  M. Condiotte,et al.  Effects of uncertainty about the behavior of a phobic stimulus on subjects' fear reactions. , 1978, Journal of consulting and clinical psychology.

[114]  K. Hugdahl,et al.  Acquisition of phobias and anxiety response patterns in clinical patients. , 1981, Behaviour research and therapy.

[115]  M. Seligman On the generality of the laws of learning , 1970 .

[116]  G. Davey,et al.  A test of a disease-avoidance model of animal phobias. , 1991, Behaviour research and therapy.

[117]  E. Murray,et al.  The origins of fear of snakes. , 1979, Behaviour research and therapy.

[118]  G. Davey Factors influencing self-rated fear to a novel animal , 1993 .

[119]  A. Ohman,et al.  "Unconscious anxiety": phobic responses to masked stimuli. , 1994, Journal of abnormal psychology.

[120]  Holger Ursin,et al.  Coping and Health , 1980 .

[121]  R. McNally,et al.  The preparedness theory of phobias and human safety-signal conditioning. , 1982, Behaviour research and therapy.

[122]  I. Marks Innate and learned fears are at opposite ends of a continuum of associability. , 2002, Behaviour research and therapy.

[123]  D. Barlow Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. , 2000 .

[124]  B. Melamed,et al.  Blood phobics and nonphobics: psychological differences and affect during exposure. , 1992, Behaviour research and therapy.

[125]  S. Thompson Social Learning Theory , 2008 .

[126]  R. Lazarus Psychological stress and the coping process , 1970 .

[127]  A. Read Abnormal psychology, 6th edn.: G. C. Davison and J. M. Neale: Wiley, New York (1994). xxiv + 782 pp. £21.00 , 1995 .

[128]  J. Riskind Looming vulnerability to threat: a cognitive paradigm for anxiety. , 1997, Behaviour research and therapy.

[129]  S. Hofmann,et al.  CLINICAL FEATURES OF FOUR DSM-IV–SPECIFIC PHOBIA SUBTYPES , 2002, The Journal of nervous and mental disease.

[130]  S. Folkman,et al.  Coping as a mediator of emotion. , 1988, Journal of personality and social psychology.

[131]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[132]  A. Ohman,et al.  Preattentive processing, preparedness and phobias: effects of instruction on conditioned electrodermal responses to masked and non-masked fear-relevant stimuli. , 1993, Behaviour research and therapy.

[133]  R. McNally,et al.  Preparedness and phobias: a review. , 1987, Psychological bulletin.

[134]  A. Ohman,et al.  On the automatic nature of phobic fear: conditioned electrodermal responses to masked fear-relevant stimuli. , 1993, Journal of abnormal psychology.

[135]  J. Price Anxiety Disorders and Phobias. A Cognitive Perspective . By Aaron T. Beck and Gary Emery. (Basic Books, New York, 1985.) , 1986, Journal of Biosocial Science.

[136]  S. Folkman,et al.  Journal of Personality and Social Psychology If It Changes It Must Be a Process: Study of Emotion and Coping during Three Stages of a College Examination , 2022 .

[137]  Stephen Maren Neurobiology of Pavlovian fear conditioning. , 2001, Annual review of neuroscience.

[138]  J. Brown,et al.  Dental phobia. , 1984, Australian dental journal.

[139]  C. Beevers Cognitive vulnerability to depression: a dual process model. , 2005, Clinical psychology review.

[140]  G. Davey,et al.  Familial resemblances in disgust sensitivity and animal phobias. , 1993, Behaviour research and therapy.

[141]  H. Merckelbach,et al.  Conditioning experiences and phobias. , 1989, Behaviour research and therapy.

[142]  U Dimberg,et al.  Facial expressions as conditioned stimuli for electrodermal responses: a case of "preparedness"? , 1978, Journal of personality and social psychology.

[143]  H. Hekmat Origins and development of human fear reactions , 1987 .

[144]  Assessing the perceived predictability of anxiety-related events: a report on the perceived predictability index. , 2000, Journal of behavior therapy and experimental psychiatry.

[145]  A. Ellis Reason and emotion in psychotherapy , 1962 .

[146]  D. Delprato Hereditary determinants of fears and phobias: A critical review , 1980 .

[147]  Suzanne M. Miller,et al.  Controllability and human stress: method, evidence and theory. , 1979, Behaviour research and therapy.

[148]  R. McNally,et al.  Disgust has arrived. , 2002, Journal of anxiety disorders.

[149]  R. C. Fraley,et al.  Attachment and Loss , 2018 .

[150]  B. Fitzgerald,et al.  Adolescent Recall of Childhood Fears and Coping Strategies , 1985, Psychological reports.

[151]  D. Barlow,et al.  Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. , 2000, The American psychologist.

[152]  S. Rachman The determinants and treatment of simple phobias , 1990 .

[153]  S. Folkman,et al.  The relationship between coping and emotion: implications for theory and research. , 1988, Social science & medicine.

[154]  A. Arntz,et al.  Negative beliefs of spider phobics: A psychometric evaluation of the spider phobia beliefs questionnaire , 1993 .

[155]  P. J. Bersh,et al.  Eysenck's theory of incubation: a critical analysis. , 1980, Behaviour research and therapy.

[156]  P. Adair,et al.  Clinical management of dental anxiety: what works for whom? , 2005, International dental journal.

[157]  F P McKenna,et al.  Colour naming of phobia-related words. , 1986, British journal of psychology.

[158]  J. Dietch Anxiety Disorders and Phobias: A Cognitive Perspective , 1986 .

[159]  J. Weinberg,et al.  Psychobiology of Coping in Animals: The Effects of Predictability , 1980 .

[160]  D. Cummins,et al.  Biological preparedness and evolutionary explanation , 1999, Cognition.

[161]  R. Silverman,et al.  Perception of Social Diversity and Fear of Crime , 1985 .

[162]  J. Weiss,et al.  Effects of coping behavior in different warning signal conditions on stress pathology in rats. , 1971, Journal of comparative and physiological psychology.

[163]  Lars-Göran Öst Acquisition of blood and injection phobia and anxiety response patterns in clinical patients. , 1991 .

[164]  B. Sandín,et al.  The incubation theory of fear/anxiety: experimental investigation in a human laboratory model of Pavlovian conditioning. , 1989, Behaviour research and therapy.

[165]  J. Weiss Effects of coping responses on stress. , 1968, Journal of comparative and physiological psychology.

[166]  R. Rapee,et al.  Memory bias in social phobia. , 1994, Behaviour research and therapy.

[167]  A. Arntz,et al.  Avoidance of pain of unpredictable intensity. , 1991, Behaviour research and therapy.

[168]  R. McNally,et al.  Fear of flying in agoraphobia and simple phobia: Distinguishing features☆ , 1992 .

[169]  War Neuroses after Psychological Trauma , 1945, British medical journal.

[170]  K. Hugdahl,et al.  Preparedness and electrodermal fear-conditioning: ontogenetic vs phylogenetic explanations. , 1989, Behaviour research and therapy.

[171]  E. Altmaier,et al.  An investigation of the self-statement systems of phobic and nonphobic individuals , 1983, Cognitive Therapy and Research.

[172]  G. Davey Classical conditioning and the acquisition of human fears and phobias: A review and synthesis of the literature , 1992 .

[173]  S. Mineka,et al.  Fears, phobias, and preparedness: toward an evolved module of fear and fear learning. , 2001, Psychological review.

[174]  R. Bootzin,et al.  Theoretical Issues in Behavior Therapy , 1985 .

[175]  G. Davey,et al.  Self-reported fears to common indigenous animals in an adult UK population: the role of disgust sensitivity. , 1994, British journal of psychology.

[176]  J S J Veerkamp,et al.  The etiology of childhood dental fear: the role of dental and conditioning experiences. , 2002, Journal of anxiety disorders.

[177]  P. Muris,et al.  Fears and Phobias in Children: Phenomenology, Epidemiology, and Aetiology , 2002 .

[178]  T. Marteau,et al.  Fear of animals: what is prepared? , 1984 .

[179]  P. Lang,et al.  Preparedness and phobia: effects of stimulus content on human visceral conditioning. , 1986, Journal of abnormal psychology.

[180]  S. Rachman,et al.  The passing of the two-stage theory of fear and avoidance: fresh possibilities. , 1976, Behaviour research and therapy.

[181]  Bruce G. Link,et al.  Fear of People with Mental Illnesses: The Role of Personal and Impersonal Contact and Exposure to Threat or Harm∗ , 2004, Journal of health and social behavior.

[182]  Lauren Dundes,et al.  Strategies for combating dental anxiety. , 2004, Journal of dental education.