scholarly journals The functional neuroanatomy of blood-injection-injury phobia: a comparison with spider phobics and healthy controls

2009 ◽  
Vol 40 (1) ◽  
pp. 125-134 ◽  
Author(s):  
X. Caseras ◽  
V. Giampietro ◽  
A. Lamas ◽  
M. Brammer ◽  
O. Vilarroya ◽  
...  
Keyword(s):  
Anterior Insula ◽  
Anterior Cingulate ◽  
Healthy Controls ◽  
Functional Neuroanatomy ◽  
Psychophysiological Response ◽  
Injection Injury ◽  
Specific Effects ◽  
Neurobiological Substrates ◽  
Blood Injection ◽  
Bii Phobia

BackgroundMost neuroimaging studies of specific phobia have investigated the animal subtype. The blood-injection-injury (BII) subtype is characterized by a unique biphasic psychophysiological response, which could suggest a distinct neural substrate, but direct comparisons between phobia types are lacking.MethodThis study compared the neural responses during the presentation of phobia-specific stimuli in 12 BII phobics, 14 spider (SP) phobics and 14 healthy controls using functional magnetic resonance imaging (fMRI).ResultsSubjective ratings showed that the experimental paradigm produced the desired symptom-specific effects. As in many previous studies, when viewing spider-related stimuli, SP phobics showed increased activation in dorsal anterior cingulate and anterior insula, compared to BII phobics and healthy controls. However, when viewing images of blood-injection-injuries, participants with BII phobia mainly showed increased activation in the thalamus and visual/attention areas (occipito-temporo-parietal cortex), compared with the other two groups. The degree of provoked anxiety and disgust by phobia-relevant images was strongly associated with activation in several common regions across the two phobia groups (thalamus, cerebellum, occipito-temporal regions) but only correlated with activation in the dorsal anterior cingulate gyrus and the anterior insula in the SP phobics.ConclusionsThese results suggest partially distinct neurobiological substrates of animal and BII phobias and support their current classification as two distinct subtypes in the DSM-IV-TR. Further research is needed to better understand the precise neurobiological mechanisms in BII phobia and particularly the fainting response.

scholarly journals Señales de amenaza y sesgo atencional en lafobia a la sangre, inyecciones y heridasy en la fobia a las serpientes

2021 ◽  
Vol 37 (3) ◽  
pp. 459-467
Author(s):  
Juan Pedro Sánchez-Navarro ◽  
José M. Martínez-Selva ◽  
Vladimir Kosonogov ◽  
Eduvigis Carrillo-Verdejo ◽  
Sara Pineda ◽  
...  
Keyword(s):  
Attentional Bias ◽  
Exogenous Attention ◽  
Relevant Stimulus ◽  
Electrocortical Activity ◽  
Injection Injury ◽  
Blood Injection ◽  
Snake Phobia ◽  
Threat Cues ◽  
Bii Phobia ◽  
Los Grupos

El objetivo de esta investigación fue estudiar el efecto de una señal que indica la aparición de una imagen fóbica sobre la actividad electrocortical provocada por el estímulo relevante para el trastorno en la fobia a la sangre por lesión en inyección (BII) y la fobia a las serpientes. Una muestra de 13 participantes con fobia BII, 12 individuos con fobia a las serpientes y 14 controles no fóbicos se sometieron a una tarea S1-S2, donde S1 era una palabra que describía el contenido de una imagen posterior (relacionada con la sangre, serpiente y neutral) que apareció 2 segundos después (S2). Obtuvimos las amplitudes ERP P200 y P300 provocadas por las imágenes. Nuestros resultados revelan que P200 no diferenciaba entre el contenido de las imágenes en la fobia BII mientras que, por el contrario, las imágenes relacionadas con la serpiente y la sangre provocaron las respuestas más grandes en los participantes con fobia a las serpientes. Tanto las imágenes relacionadas con la sangre como las de serpientes provocaron amplitudes de P300 mayores que las imágenes neutrales en todos los grupos. Las señales de amenaza redujeron la reacción electrocortical del BII, posiblemente por la provocación de respuestas anticipatorias o reguladoras. Estos resultados son indicativos de una baja atención automática exógena hacia los estímulos temidos en la fobia BII, como lo revela P200, probablemente relacionado con una falta de sesgo de atención al objeto fóbico. The aim of this research was to study the effect of a cue signalling the upcoming of a phobic picture on the electrocortical activity provoked by the disorder-relevant stimulus in in blood-injection-injury (BII) phobia and snake phobia. A sample of 13 BII phobia participants, 12 snake phobia individuals and 14 non-phobic controls underwent an S1-S2 task, where S1 was a word that described the content of a subsequent picture (blood-related, snake and neutral) that appeared 2 seconds later (S2). We obtained the P200 and P300 ERP amplitudes provoked by the pictures. Our results reveal that P200 did not differentiate between picture contents in BII phobia while, in contrast, snake and blood-related pictures provoked the largest responses in snake phobia participants. Both blood-related and snake pictures provoked greater P300 amplitudes than neutral pictures in all the groups. Threat cues reduced the electrocortical reaction of the BII, possibly by the elicitation of anticipatory or regulatory responses. These results are indicative of a low automatic, exogenous attention towards the feared stimuli in BII phobia, as revealed by P200, probably related to a lack of attentional bias to the phobic object.

scholarly journals Effective Connectivity of the Hippocampus Can Differentiate Patients with Schizophrenia from Healthy Controls: A Spectral DCM Approach

2021 ◽  
Author(s):  
Lavinia Carmen Uscătescu ◽  
Lisa Kronbichler ◽  
Renate Stelzig-Schöler ◽  
Brandy-Gale Pearce ◽  
Sarah Said-Yürekli ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Effective Connectivity ◽  
Anterior Insula ◽  
Anterior Cingulate ◽  
Frontal Eye Fields ◽  
Healthy Controls ◽  
Dorsal Anterior Cingulate Cortex ◽  
Left Hippocampus ◽  
Male Patients ◽  
The Right

AbstractWe applied spectral dynamic causal modelling (Friston et al. in Neuroimage 94:396–407. 10.1016/j.neuroimage.2013.12.009, 2014) to analyze the effective connectivity differences between the nodes of three resting state networks (i.e. default mode network, salience network and dorsal attention network) in a dataset of 31 male healthy controls (HC) and 25 male patients with a diagnosis of schizophrenia (SZ). Patients showed increased directed connectivity from the left hippocampus (LHC) to the: dorsal anterior cingulate cortex (DACC), right anterior insula (RAI), left frontal eye fields and the bilateral inferior parietal sulcus (LIPS & RIPS), as well as increased connectivity from the right hippocampus (RHC) to the: bilateral anterior insula (LAI & RAI), right frontal eye fields and RIPS. In SZ, negative symptoms predicted the connectivity strengths from the LHC to: the DACC, the left inferior parietal sulcus (LIPAR) and the RHC, while positive symptoms predicted the connectivity strengths from the LHC to the LIPAR and from the RHC to the LHC. These results reinforce the crucial role of hippocampus dysconnectivity in SZ pathology and its potential as a biomarker of disease severity.

A Preliminary Investigation of the Efficacy of Disgust Exposure Techniques in a Subclinical Population With Blood and Injection Fears

2008 ◽  
Vol 25 (3) ◽  
pp. 129-148 ◽  
Author(s):  
Michiyo Hirai ◽  
Heather M. Cochran ◽  
Jennifer S. Meyer ◽  
Jennifer L. Butcher ◽  
Laura L. Vernon ◽  
...  
Keyword(s):  
Preliminary Investigation ◽  
Effect Sizes ◽  
Single Session ◽  
Treatment Groups ◽  
Domain Specific ◽  
Injection Injury ◽  
Blood Injection ◽  
Bii Phobia ◽  
Over Time

AbstractThe current study examined whether a traditional exposure-based treatment for blood-injection-injury (BII) phobia would be effective at reducing disgust responses to BII stimuli and whether the addition of modules targeting disgust would provide incremental efficacy. Participants, many of whom reported subclinical BII phobia symptoms, underwent one of two single-session exposure protocols, one targeting fear alone, and the other targeting both fear and disgust. Both treatments consisted of education components (fear-only or fear-disgust) and in vivo exposure (fear-only or fear-disgust). Both the fear-only and the fear-disgust treatment groups significantly decreased fear and avoidance behaviour toward BII stimuli over time. The two groups also experienced similar reductions in disgust responses to BII-related stimuli and global as well as domain-specific disgust sensitivity. The effect sizes indicated that the fear-disgust group evidenced greater reduction in symptoms than did the fear-only group. The implications of the results for models of phobia maintenance and treatment are discussed.

scholarly journals Effective connectivity of the hippocampus can differentiate patients with schizophrenia from healthy controls: a spectral DCM approach

2020 ◽  
Author(s):  
Lavinia Carmen Uscătescu ◽  
Lisa Kronbichler ◽  
Renate Stelzig-Schöler ◽  
Brandy-Gale Pearce ◽  
Sarah Said-Yürekli ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Effective Connectivity ◽  
Anterior Insula ◽  
Anterior Cingulate ◽  
Frontal Eye Fields ◽  
Healthy Controls ◽  
Dorsal Anterior Cingulate Cortex ◽  
Left Hippocampus ◽  
Male Patients ◽  
The Right

AbstractWe applied spectral dynamic causal modelling (spDCM; Friston et al., 2014) to analyze the effective connectivity differences between the nodes of three resting state networks (i.e. Default mode network/DMN, Salience network/SAN and Dorsal attention network/DAN) in a dataset of 31 healthy controls (HC) and 25 patients with schizophrenia (SZ), all male. Patients showed increased connectivity from the left hippocampus (LHC) to the dorsal anterior cingulate cortex (DACC), right anterior insula (RAI), left frontal eye fields (LFEF) and the bilateral inferior parietal sulcus (LIPS & RIPS), as well as increased connectivity from the right hippocampus (RHC) to the bilateral anterior insula (LAI & RAI), right frontal eye fields (RFEF) and RIPS. Moreover, negative symptoms predicted the connectivity strengths from the LHC to the DACC, the left inferior parietal sulcus (LIPAR) and the RHC, while positive symptoms predicted the connectivity strengths from the LHC to the LIPAR and from the RHC to the LHC. These results reinforce the crucial role of hippocampus dysconnectivity in SZ pathology and its potential as a biomarker of disease severity.

Effective Connectivity Between the Orbitofrontal Cortex and the Precuneus Differentiates Major Psychiatric Disorders: Results from a Transdiagnostic Spectral DCM Study

2021 ◽  
Vol 20 ◽  
Author(s):  
Sevdalina Kandilarova ◽  
Drozdstoy Stoyanov ◽  
Katrin Aryutova ◽  
Rossitsa Paunova ◽  
Mladen Mantarkov ◽  
...  
Keyword(s):  
Orbitofrontal Cortex ◽  
Resting State ◽  
Depressive Episode ◽  
Bipolar Depression ◽  
Effective Connectivity ◽  
Anterior Insula ◽  
Causal Modeling ◽  
Anterior Cingulate ◽  
Angular Gyrus ◽  
Healthy Controls

Background & Objective: We have previously identified aberrant connectivity of the left precuneus, ventrolateral prefrontal cortex, anterior cingulate cortex, and anterior insula in patients with either a paranoid (schizophrenia), or a depressive syndrome (both unipolar and bipolar). In the current study, we attempted to replicate and expand these findings by including a healthy control sample and separating the patients in a depressive episode into two groups: unipolar and bipolar depression. We hypothesized that the connections between those major nodes of the resting state networks would demonstrate different patterns in the three patient groups compared to the healthy subjects. Method: Resting-state functional MRI was performed on a sample of 101 participants, of which 26 patients with schizophrenia (current psychotic episodes), 24 subjects with bipolar disorder (BD), 33 with major depressive disorder (MDD) (both BD and MDD patients were in a current depressive episode), and 21 healthy controls. Spectral Dynamic Causal Modeling was used to calculate the coupling values between eight regions of interest, including the anterior precuneus (PRC), anterior hippocampus, anterior insula, angular gyrus, lateral orbitofrontal cortex (OFC), middle frontal gyrus, planum temporale, and anterior thalamus. Results & Conclusion: We identified disturbed effective connectivity from the left lateral orbitofrontal cortex to the left anterior precuneus that differed significantly between unipolar depression, where the influence was inhibitory, and bipolar depression, where the effect was excitatory. A logistic regression analysis correctly classified 75% of patients with unipolar and bipolar depression based solely on the coupling values of this connection. In addition, patients with schizophrenia demonstrated negative effective connectivity from the anterior PRC to the lateral OFC, which distinguished them from healthy controls and patients with major depression. Future studies with unmedicated patients will be needed to establish the replicability of our findings.

scholarly journals Effective Connectivity between Major Nodes of the Limbic System, Salience and Frontoparietal Networks Differentiates Schizophrenia and Mood Disorders from Healthy Controls

2021 ◽  
Author(s):  
Sevdalina Kandilarova ◽  
Drozdstoy Stoyanov ◽  
Rositsa Paunova ◽  
Anna Todeva-Radneva ◽  
Katrin Aryutova ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Limbic System ◽  
Effective Connectivity ◽  
Anterior Insula ◽  
Causal Modeling ◽  
The Self ◽  
Anterior Cingulate ◽  
Imaging Biomarkers ◽  
Salience Network ◽  
Healthy Controls

This study was conducted to examine whether there are quantitative or qualitative differences in the connectome between psychiatric patients and healthy controls and to delineate the connectome features of major depressive disorder (MDD), schizophrenia (SCZ), bipolar disorder (BD) and the severity of these disorders. Toward this end, we have performed effective connectivity analysis of resting state functional MRI data in these three patient groups and healthy controls. We have used spectral Dynamic Causal Modeling (spDCM), and the derived connectome features were further subjected to machine learning. The results outlined a model of 5 connections, which discriminate patients from controls, comprising major nodes of the limbic system (amygdala (AMY), hippocampus (HPC) and anterior cingulate cortex (ACC)), the salience network (anterior insula (AI), fronto-parietal and dorsal attention network (middle frontal gyrus (MFG) corresponding to dorsolateral prefrontal cortex, frontal eye field (FEF)). Notably, the alterations in the self-inhibitory connection of the anterior insula emerged as a feature of both mood disorders and SCZ. Moreover, 4 out of the 5 connectome features that discriminate mental illness from controls are features of mood disorders (both MDD and BD), namely the MFG→FEF, HPC→FEF, AI→AMY, and MFG→AMY connections, whereas one connection is a feature of SCZ, namely the AMY→SPL connectivity. A large part of the variance in the severity of depression (31.6%) and SCZ (40.6%) was explained by connectivity features. In conclusion, dysfunctions in the self-regulation of the salience network may underpin major mental disorders, while other key connectome features shape differences between mood disorders and SCZ, and can be used as potential imaging biomarkers.

scholarly journals Loss anticipation and outcome during the Monetary Incentive Delay Task: a neuroimaging systematic review and meta-analysis

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4749 ◽  
Author(s):  
Jules R. Dugré ◽  
Alexandre Dumais ◽  
Nathalie Bitar ◽  
Stéphane Potvin
Keyword(s):  
Meta Analysis ◽  
Monetary Incentive ◽  
Anterior Insula ◽  
Anterior Cingulate ◽  
Healthy Controls ◽  
Imaging Studies ◽  
Delay Task ◽  
Monetary Incentive Delay Task ◽  
Monetary Incentive Delay ◽  
Neuro Imaging

Background Reward seeking and avoidance of punishment are key motivational processes. Brain-imaging studies often use the Monetary Incentive Delay Task (MIDT) to evaluate motivational processes involved in maladaptive behavior. Although the bulk of research has been done on the MIDT reward events, little is known about the neural basis of avoidance of punishment. Therefore, we conducted a meta-analysis of brain activations during anticipation and receipt of monetary losses in healthy controls. Methods All functional neuro-imaging studies using the MIDT in healthy controls were retrieved using PubMed, Google Scholar & EMBASE databases. Functional neuro-imaging data was analyzed using the Seed-based d Mapping Software. Results Thirty-five studies met the inclusion criteria, comprising 699 healthy adults. In both anticipation and loss outcome phases, participants showed large and robust activations in the bilateral striatum, (anterior) insula, and anterior cingulate gyrus relatively to Loss > Neutral contrast. Although relatively similar activation patterns were observed during the two event types, they differed in the pattern of prefrontal activations: ventro-lateral prefrontal activations were observed during loss anticipation, while medial prefrontal activations were observed during loss receipt. Discussion Considering that previous meta-analyses highlighted activations in the medial prefrontal cortex/anterior cingulate cortex, the anterior insula and the ventral striatum, the current meta-analysis highlighted the potential specificity of the ventro-lateral prefrontal regions, the median cingulate cortex and the amygdala in the loss events. Future studies can rely on these latter results to examine the neural correlates of loss processing in psychiatric populations characterized by harm avoidance or insensitivity to punishment.

Disgust Processing in Phobia of Blood-Injection-Injury

2003 ◽  
Vol 17 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Anne Schienle ◽  
Axel Schäfer ◽  
Rudolf Stark ◽  
Bertram Walter ◽  
Peter Kirsch ◽  
...  
Keyword(s):  
Inferior Frontal Gyrus ◽  
Self Report ◽  
Dynamic Responses ◽  
Left Inferior Frontal Gyrus ◽  
Injection Injury ◽  
Lingual Gyrus ◽  
Fmri Study ◽  
Blood Injection ◽  
The Right ◽  
Bii Phobia

Abstract An elevated disgust sensitivity (DS) is considered to be a vulnerability factor for the development of a blood-injection-injury (BII) phobia. Within the present functional Magnetic Resonance Imaging (fMRI) study, 12 female BII phobics were scanned while viewing alternating blocks of 40 disgust-inducing, 40 fear-inducing, and 40 affectively neutral pictures. Each block lasted 60s and was repeated six times during the experiment. All scenes were phobia-irrelevant. Afterwards, the subjects gave affective ratings for the pictures and described their DS on a self-report measure for different areas (e.g., poor hygiene, unusual food, death/deformation). The responses were compared with those of 12 nonphobic females. The BII phobics showed a stronger occipital activation within the right cuneus and lingual gyrus during the first viewing of the disgusting pictures. Aside from this finding, which could be interpreted as reflecting increased attention, there was little evidence for a generally elevated DS in BII phobia. On the DS questionnaire, the patients had indicated a greater reactivity only for disorder-relevant contents (death/deformation). Further, both groups gave similar disgust ratings for the pictures and showed comparable brain-dynamic responses over all blocks of the disgust condition, which included the activation of both amygdalae and the left inferior frontal gyrus.

scholarly journals Cognitive Biases in Blood-Injection-Injury Phobia: A Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Elinor Abado ◽  
Tatjana Aue ◽  
Hadas Okon-Singer
Keyword(s):  
Cognitive Biases ◽  
Health Workers ◽  
A Priori ◽  
Attention Bias ◽  
Medical Procedures ◽  
Memory Biases ◽  
Injection Injury ◽  
Interpretation Biases ◽  
Blood Injection ◽  
Bii Phobia

Blood-injection-injury (BII) phobia can lead to avoidance of crucial medical procedures and to detrimental health consequences, even among health workers. Yet unlike other specific phobias, BII phobia has been understudied. Specifically, while cognitive biases have been extensively investigated in other anxiety disorders, little is known about the same biases in BII phobia. The current article reviews cognitive biases in BII phobia and suggest future directions for further study and treatment. The reviewed biases include attention, expectancy, memory, perception, and interpretation biases. The investigation of these biases is highly relevant, as cognitive biases have been found to interact with anxiety symptoms. Results showed that attention, expectancy, and memory biases are involved in BII phobia, while no studies were found on interpretation nor perception biases. Mixed results were found for attention bias, as different studies found different components of attention bias, while others found no attention bias at all. Similarly, some studies found a-priori/a-posteriori expectancy biases, while other studies found only one type of bias. A better understanding of the cognitive particularities of BII phobia may lead to better treatments and ultimately reduce avoidance of needles and blood-related situations, thereby enabling individuals with BII phobia to undergo potentially life-saving medical procedures.

Medical Avoidance and Anxiety in Subtypes of Blood-Injection-Injury Phobia

2000 ◽  
Author(s):  
Craig N. Sawchuk ◽  
Suzanne A. Meunier ◽  
Jeffrey M. Lohr ◽  
David F. Tolin
Keyword(s):  
Injection Injury ◽  
Blood Injection ◽  
Blood Injection Injury Phobia
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