Abstract
The 'two-system' view of fear builds on traditional conceptualisations of emotion; proposing that the mechanisms responsible for behavioural and physiological responses to threat may be distinct from those underpinning the (conscious) emotional experience itself. We empirically tested this notion within a novel, applied context of social and economic importance: fear of falling in older adults. Older adults stood on the edge of a raised platform and were stratified based on whether they reported fear in response to this postural threat. Irrespective of whether participants reported fear, we observed behaviours indicative of postural 'stiffening' during the threat condition. Self-reports indicated that participants cognitively monitored these changes in balance, and fear of falling was experienced in those who interpreted these behaviours to imply that harm was likely to occur. Fearful participants exhibited additional changes in balance (increased movement complexity and altered utilisation of sensory feedback) - behaviours likely influenced by attempts to consciously control balance. Taken together, these findings provide novel insight into the systems that regulate behavioural and emotional responses to postural threats. The novel conceptual framework developed from these findings helps identify specific mechanisms that might be targeted through clinical intervention.
Highlights
Many older adults will report feelings of fear when their balance is threatened (Ellmers et al, 2020)
There is a need to explore behavioural responses to postural threats in older adults that do, and those that do not, experience fear of falling. Conducting such analysis is the primary aim of the present work. This unique analysis will allow us to isolate automatic defensive responses from behaviours associated with the conscious experience of fear
Post-hoc tests revealed a significant increase in fear of falling from Baseline to threaten their balance (Threat) in the Fear group only (p < .001); with fear of falling values being identical between Baseline and Threat for the No Fear group (p = 1.00)
Summary
Many older adults will report feelings of fear when their balance is threatened (Ellmers et al, 2020). Researchers have attempted to isolate fear-related behaviours that may impair balance safety (Adkin & Carpenter, 2018) Interpretations of this literature have been limited by a failure to acknowledge contemporary theoretical models of fear and anxiety. The aim of this present study is to explore fear of falling with reference to LeDoux’s ‘two-system’ model of fear (2013, 2014; LeDoux & Pine, 2016). This framework argues that there is one set of neural circuits responsible for the ‘automatic’ defensive responses (e.g., rapid threat detection, heart rate, freeze response, etc.), and another responsible for the ‘conscious’ feelings of fear (e.g., the recognition that one is in imminent danger and the subsequent emotional response) and associated behavioural actions (e.g., threat avoidance). Subliminally presented threats will trigger peripheral physiological ‘threat’ responses despite participants being unaware of the threat’s presence and reporting no change in fear (Frumento et al, 2021; LeDoux, 2014; Luo et al, 2010; Phelps, 2006; Taschereau-Dumouchel et al, 2018; Walen et al, 2004). LeDoux and Pine (2016) argue that fear “reflects awareness of a potential for harm, occurring when one cognitively monitors and interprets signals from the brain and/or body, and integrates these signals with information about the external situation” (p. 1087)
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