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in Humans
M A T S FREDRIKSON, P H D , O R J A N S U N D I N , P H D ,
AND M A R I A N N E F R A N K E N H A E U S E R , P H D
Twelve subjects with specific phobias were exposed to slides with a phobic or a neutral content
while cortisol excretion, electrodermal activity, and distress-ratings were studied. Six subjects
fearful of blood and mutilation, and six of snakes or spiders, were presented with two sets of
ten different slides (phobic or neutral; 8-sec exposures, separated by 50-sec intervals) with the
order of presentation balanced between days. Before and after each session, subjects rated
feelings of distress, and urine samples were obtained for the determination of cortisol by
radioimmunoassay. Electrodermal activity was recorded before and during slide presentation.
Compared to neutral exposures, phobic slides elicited larger cortisol excretion, higher distress
ratings, and greater skin-conductance responses with slower recovery. No differences between
animal and blood and mutilation phobics were observed. Thus, humans having specinc phobias
exhibit pituitary-adrenal cortical arousal during the defense reaction elicited by slides of their
phobic objects.
From the Psychology Division, Department of Psychiatry and Psychology, Karolinska Institute, and Department of Psychology, University of Stockholm
(M.F.; M.F.) and the Department of Clinical Physiology, University Hospital, Uppsala, Uppsala, Sweden (M.F.; O.S.).
Address reprint requests to: Mats Fredrikson, Department of Psychiatry and Psychology, Karolinska
Hospital, Box 60500, S-104 01 Stockholm, Sweden.
Received November 4,1983; revision received October 2, 1984.
Subjects
Twelve phobics were recruited by means of advertisements in a local paper. Three men and three
women were phobic of blood and mutilation, three
women were phobic of snakes, and three woman were
phobic of spiders. They were paid for their partici-
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0033-3174/8553.30
RESULTS
TABLE 1.
Means ( SEM) and Paired f-Tests of Cortisol Excretion Before and After Exposure to
Neutral or Phobic Slides
Before Exposure
(pmol/min)
857.3 (275.8)
559.0 (288 8)
Neutral
Phobic
After Exposure
(pmol/min)
747.3
1024.0
(172.8)
(420.0)
1(10) = 3.42"
400 1
Q-
300-
2 200 -
100--
NEUTRAL
STIMULI
PHOBIC
STIMULI
Fig. 1. Means ( SEM) for cortisol excretion in percentage of pretest during exposure to neutral
or phobic slides.
315
TABLE 2. Means (SEM) and Paired f-Tests of Skin Conductance Levels Before and After Exposure to
Neutral or Phobic Slides
After
Exposure
((imol/min)
Before
Exposure
(|xmol/min)
Neutral
Phobic
3.94
4.55
(0.74)
(1.01)
3.91
5.23
(0.81)
(1.14)
((11) < 1
((11) = 2 96a
p < 0.05.
~ 1201
400 1
300110200 -
PRETEST LEVEL
100
100
0J
NEUTRAL
PHOBIC
STIMULI
STIMULI
316
J/)
NEUTRAL
STIMULI
PHOBIC
STIMULI
Fig. 3. Means (SEM) for distress ratings in percentage of pretest during exposure to neutral
or phobic slides.
Neutral
Slides
Response magnitude ((xmho)
Half-time recovery (sec)
Trials to criterion
0.50
8.48
2.40
(0.07)
(2.13)
(1.05)
0.89 (0.09)
14.00 (1.24)
5.70 (1.50)
= 3.13a
= 2.89b
= 2.746
p < 0.01.
p < 0.05.
electrodermal response pattern is consistent with previous findings (cf. 1] and indicates that phobic, but not neutral slides
elicit the defense reaction. The increase in
cortisol during phobic, but not neutral,
stimulation is consistent with increased
plasma cortisol levels observed during direct hypothalamic stimulation that induces the defense reaction in animals (10,
11) and with the cortisol increase elicited
by fear-producing conditions in normal
human subjects (9). In contrast, flooding
procedures produced only moderate elevations of plasma cortisol levels in four
out of six subjects phobic of snakes, birds,
and insects (18). Even though the present
study and Curtis et al. (18) differ in type
of phobics included this might not be crucial for the different results obtained, as
the present study found no differences in
cortisol excretion between animal and
blood and mutilation phobics. However,
the present study and that of Curtis et al.
(18) differ in several respects that might
account for the discrepancy: 1) Curtis et
al. measured plasma cortisol levels,
whereas we used urine levels. Sampling
effects are probably not crucial since Curtis et al. (18) sampled every 20 min and
the half-life of plasma cortisol approximates 1 hr. In addition, plasma and urinary cortisol excretion are positively correlated (19). 2) Venipuncture, used by Curtis
317
REFERENCES
1. Fredrikson M: Orienting and defensive reactions to phobic and conditioned fear stimuli in phobics
and normals. Psychophysiology 18:454463, 1981
2. Hare RD: Orienting and defensive responses to visual stimuli. Psychophysiology 10:453464, 1973
3. Hare RD, Blevings G: Defensive responses to phobic stimuli. Biol Psychol 3:1-13, 1975
4. Klorman R, Wiesenfeld AR, Austin ML: Autonomic responses to affective visual stimuli. Psychophysiology 12:553-560, 1975
5. Klorman R, Weissberg RP, Wiesenfeld AR: Individual differences in fear and autonomic reaction to
affective stimulation. Psychophysiology 14:45-51, 1977
6. Abrahams VC, Hilton SM, Zybrozyna A: Active muscle vasodilation produced by stimulation of the
brain stem: Its significance in the defense reaction. J Physiol 154:491-513, 1960
7. Sokolov EN: Perception and the Conditioned Reflex. Oxford, Pergamon, 1963
8. Frankenhaeuser M: The sympathetic-adrenal and pituitary-adrenal response to challenge: Comparison
between the sexes. In T Dembroski, TH Schmidt, G Blumchen (eds), Biobehavioral Bases of Coronary
Heart Disease. Basel, Karger, 1982, pp 91-106.
9. Henry JP, Stephens PM: Stress, Health and the Social Environment. A Sociobiologic Approach to
Medicine. New York. Springer, 1977
10. Folkow BP, Hedner B, Lisander B, Rubinstein E: Release of cortisol upon stimulation of the hypothalamic
"defense area" in cats. In Levi L (ed), Emotional Stress. New York, Elsevier, 1967, pp 114-119
11. Natelson BH, Smith GP, Stokes PE, Root AW: Plasma 17-hydroxycorticosteroids and growth hormone
during defense reactions. Am J Physiol 226:560-567, 1974
12. Edelberg R: The information content of the recovery limb of the electrodermal orienting response.
Psychophysiology 6:527-529, 1970
13. Fredrikson M: Reliability and validity of some specific fear questionnaires. Scand J Psychol 14:331-334,
1983
14. Klorman R, Weerts TC, Hastings JE. Melamed BG, Lang PJ: Psychometric description of some specific
fear questionnaires. Behav Ther 5.401^09, 1974
15. Fredrikson M, Danielssons T, Iremark H, Sundin O: Autonomic nervous blockades and phobic fear
responses. Submitted.
16. Lundberg U, Frankenhaeuser M: Pituitaryadrenal and sympathetic-adrenal correlates of distress and
effort. I Psychosom Res 24:125-130, 1980
17. Ruder HJR, Guy RL, Lipsett A: A radioimmunoassay for cortisol in plasma and urine. J Clin Endocrinol
Metab 35:219-224, 1972
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