Symptom provocation in dental anxiety using cross-phobic video stimulation


Ulrike Lueken, Institute of Clinical Psychology and Psychotherapy/Neuroimaging Center, Department of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187 Dresden, Germany
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Lueken U, Hoyer J, Siegert J, Gloster AT, Wittchen H-U. Symptom provocation in dental anxiety using cross-phobic video stimulation.
Eur J Oral Sci 2011; 119: 61–68. © 2011 Eur J Oral Sci

Although video stimulation has been successfully employed in dental phobia, conclusions regarding the specificity of reactions are limited. A novel, video-based paradigm using cross-phobic video stimulation was validated based on subjective and autonomic responses. Forty subjects were stratified according to dental anxiety as measured by the Dental Fear Survey (DFS) using a median-split procedure (high-DFS and low-DFS groups). Anxiety stimuli comprised dental-anxiety scenes and non-dental-anxiety control scenes (snake stimuli). Neutral scenes were tailored to each anxiety stimulus. Dental, but not snake, stimuli were rated as more anxiety provoking only in the high-DFS group. Elevated skin-conductance amplitudes were observed in the high-DFS group for dental anxiety vs. neutral videos, but not for snake anxiety vs. neutral videos. State and trait anxiety and autonomic reactivity were correlated according to expectations. Using cross-phobic video stimulation, it was demonstrated that phobogenic reactions in dental anxiety are specific to the respective stimulus material and do not generalize to other non-dental-anxiety control conditions. The validation of the paradigm may support and stimulate future research on the characterization of dental anxiety on different response systems, including its underlying neural substrates.