Changes In Arousal Research Articles

P667. Stimulating the Ventromedial Prefrontal Cortex in the Context of Virtual Reality Exposure for PTSD: Examining the Role of Emotional Arousal and Electrical Field Distributions

Neurocircuit models of posttraumatic stress disorder (PTSD) point to ventromedial prefrontal cortex (VMPFC) hypoactivation, amygdala hyperreactivity, and hippocampus dysfunction. Non-invasive neuromodulation to boost VMPFC-assisted top-down inhibition of the amygdala in the context of exposure therapy might improve symptoms of PTSD. Here we report data on individual differences in 1) changes in psychophysiological arousal in response to transcranial direct current stimulation (tDCS) targeting the VMPFC combined with virtual reality exposure for PTSD, and 2) tDCS-induced electrical field distributions in VMPFC, amygdala, and hippocampus.

What elicits music-evoked nostalgia? An exploratory study among college students

The purpose of this study was to further explore how song (a) familiarity, (b) enjoyment, (c) autobiographical salience, and (d) emotional arousal as well as a person’s (e) current mood state and (f) nostalgia proneness predicted music-evoked nostalgia. This study also measured the strength of the relationship between self-reports of arousal and electrodermal activity (EDA). Thirty people were recruited from a sample of university students using a multilevel model with repeated measures design. Procedures included listening to personalized playlists to elicit feelings of nostalgia while EDA collected changes in emotional arousal. Participants then answered questions about song familiarity, enjoyment, autobiographical salience, and arousal. Results indicated autobiographical salience was the best predictor of music-evoked nostalgia while holding all other variables constant. Mean skin conductance level ([Formula: see text]) did not correlate with self-reports of arousal. Therefore, this study supports the hypothesis that autobiographical salience predicted music-evoked nostalgia; however, this study did not support the hypothesis of a relationship between self-reports of arousal and EDA. Future research should continue to explore the influence of arousal on nostalgia.

Stability and Change in Sexual Orientation and Genital Arousal over Time

ABSTRACT Longitudinal work suggests that sexual orientation can change over time in men and women. These studies, however, may be susceptible to the bias of self-report. The current study therefore examined self-reported sexual orientation in addition to an objective correlate: genital arousal to erotic videos showing males or females. For 52 men (19 heterosexual, 19 bisexual, 14 homosexual) and 67 women (31 heterosexual, 18 bisexual, 18 homosexual), these measures were taken twice, with approximately 1 year between sessions. For self-reported sexual orientation, women reported lower relative stability (weaker correlation) than men over time, even though women did not change more overall (no stronger mean difference) than men between sessions. Bisexual individuals reported lower relative stability and more mean change than heterosexual and homosexual individuals. For genital arousal, across all groups, response patterns were correlated over time to a similar extent and showed little difference between sessions. Moreover, change in self-reported sexual orientation did not correspond with the change in genital arousal, regardless of sex. Perhaps self-reports overestimate changes in sexual orientation, since these changes were not reflected in physiological sexual response.

The effect of music on accuracy in the Stroop test

AbstractFirst introduced by Frances Raucher, The Mozart Effect is the idea that there is a transient impact of music listening on spatial‐temporal processing. Researchers have found considerable merit to investigate the phenomena. The field has moved beyond the original claims of the Mozart Effect, with the arousal−mood hypothesis as one dominant interpretation. The hypothesis postulates that a modest increase in performance while listening to pleasant, energetic music is understood as a transient consequence of changes in mood and arousal. Therefore, the “Mozart Effect” can influence learning outcomes. The aim of this study is to examine the effect of music through the arousal‐and‐mood hypothesis by using the Stroop task. Subjects were randomly assigned to three conditions Mozart (positive), rock (negative), or no music (control). While working on the stroop task. Participants in all three conditions were assessed with an accuracy score. The results showed that both positively and negatively arousing music enhanced test scores. My study showed that both classical music and rock music had an effect in my experiment. Further studies should be explored if the enhanced cognitive ability can be used for therapeutic purposes.

Cognitive decline and dementia: does delirium matter?

Delirium, an acute change in arousal, attention, and other aspects of cognition, affects more than one in five older inpatients, causes distress for patients and carers, and is associated with in-hospital complications, functional decline, and mortality.1 Delirium is costly for society, and evidence-based preventive measures should be implemented in routine clinical practice.2 Research has indicated that delirium might be associated with long-term cognitive decline and dementia.3

The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany

BackgroundPreliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare.AimThe objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany.MethodsAn anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms.OutcomesDemographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected.ResultsA total of 1,368 cis women participants were included: heterosexual women (n = 844), lesbian women (n = 293), bisexual women (n = 231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences before and during the pandemic lesbian women showed significant changes in sexual arousal whereas heterosexual women showed significant changes in all dimensions except capability to enjoy sexual intercourse. The data of bisexual women showed significant changes in almost all dimensions except for frequency of sexual intercourse and sexual arousal. Results of the multiple regression analysis revealed that being younger than 36 years-old, and being in a relationship as well as being heterosexual (compared with being lesbian) is positively associated with general satisfaction with sexual life during the pandemic.Clinical ImplicationsThe findings suggest that during a pandemic sexual and mental health care for (cis) women should be provided and address the specific needs of sexual minority groups.Strengths & LimitationsThis is the first study to describe sexual behavior in heterosexual, lesbian and bisexual women during the COVID-19 pandemic in Germany. Limitations, however, include the fact that the data described were obtained at only one time point so there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46.ConclusionThis study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises.Batz F, Lermer E, Hatzler L, et al. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19:907–922.

41 Supracervical approach may improve sexual function indices compared to total hysterectomy

Introduction and aims of the study: Supracervical hysterectomy (SCH) is technically simpler than total abdominal hysterectomy (TAH) and has lower intraoperative morbidity. In Sweden, the ratio of SCH to TAH was found to be as high as 0.56 similarly to all Scandinavian countries compared to UK. Despite such potential benefits, robust data regarding sexual function lack in the literature. In the present study, it was aimed to compare the sexual function in SCH versus TAH in their early period. Methods: In this prospective cohort study, sexually active and postmenopausal 48 patients (2:1 fashion) who did not fit to laparoscopy and underwent uncomplicated TAH or SCH due to benign uterine disorders were enrolled. The sexual function were assessed preoperatively and postoperatively at 3th months with Female Sexual Function Index (FSFI). A detailed clinical and demographic features were evaluated. Results: Supracervical and total hysterectomy was performed in 16 (33.3%) and 32 (66.7%), respectively. Both groups represented similar demographic features in terms of age, BMI, education, occupation, income and parity (p=0.18, 1.0, 0.84, 0.71, 0.29, 0.34, respectively). Total FSFI score, satisfaction, lubrication and desire were found to be significantly increased in SCH when compared to TAH (p=0.007, 0.016, 0.034 and 0.004, respectively). The change in arousal, orgasm and pain domains were comparable in both groups (p=0.19, 0.21, 0.47, respectively). Conclusions: Supracervical hysterectomy might be non-inferior to total hysterectomy in terms of sexual functions and exhibited significant improve in certain domains including satisfaction, lubrication and desire. This could be related to the preservation of a feminine organ or cervical ring structures.

Aggression, Erection, and Masturbation in Feral Pottoka Ponies and Implications for Equine Welfare.

Simple SummaryHorse trainers and handlers have expressed concerns that equine erection and masturbation may be associated with unwanted or dangerous behaviors. Such concerns and attitudes may guide decisions that affect the welfare of male horses. In this study, male feral ponies were observed before, during, and after natural occurrences of erection and masturbation. Erection and masturbation were not associated with reproductive or aggressive behavior, and they did not predict a change in intensity or energy of behavior. Rather, they were often performed in relaxed moments, with the pony displaying calm behaviors. Understanding the natural presentation of these behaviors can help handlers and trainers to interpret them when in the context of horse-human interactions.Erection and masturbation in horses are considered unwanted behaviors in training contexts, despite recognition that these are naturally occurring behaviors that are integral to the welfare of male horses. Equestrians, especially those who use positive reinforcement in their training, expressed concern that the presence of such behaviors might be associated with aggressive or sexual behaviors aimed at humans participating in horse-human interactions. The implications of such attitudes could negatively affect male horses by excluding them from welfare-friendly training systems. In this study, feral stallions were observed to describe and quantify behaviors that occurred before, during, and after erection and masturbation, and to identify change in arousal. This study did not find evidence that erection and masturbation are associated with increases in arousal, or to sexual or aggressive behavior toward other horses. The possible presence or induction of erection or masturbation alone might not limit male horses from participating in certain handling, training, or riding contexts. These findings, along with further research, may be used to inform interpretations of horse–human interactions that involve erection or masturbation.

Spontaneous motor tempo over the course of a week: the role of the time of the day, chronotype, and arousal

The spontaneous motor tempo (SMT) or internal tempo describes the natural pace of predictive and emergent movements such as walking or hand clapping. One of the main research interests in the study of the spontaneous motor tempo relates to factors affecting its pace. Previous studies suggest an influence of the circadian rhythm (i.e., 24-h cycle of the biological clock), physiological arousal changes, and potentially also musical experience. This study aimed at investigating these effects in participants‘ everyday life by measuring their SMT four times a day over seven consecutive days, using an experience sampling method. The pace of the SMT was assessed with a finger-tapping paradigm in a self-developed web application. Measured as the inter-tap interval, the overall mean SMT was 650 ms (SD = 253 ms). Using multi-level modelling (MLM), results show that the pace of the SMT sped up over the course of the day, and that this effect depended on the participants’ chronotype, since participants tending towards morning type were faster in the morning compared to participants tending towards evening type. During the day, the pace of the SMT of morning types stayed relatively constant, whereas it became faster for evening-type participants. Furthermore, higher arousal in participants led to a faster pace of the SMT. Musical sophistication did not influence the SMT. These results indicate that the circadian rhythm influences the internal tempo, since the pace of SMT is not only dependent on the time of the day, but also on the individual entrainment to the 24-h cycle (chronotype).

Lateralized deficits in arousal processing after insula lesions: Behavioral and autonomic evidence

A large body of evidence ascribes a pivotal role in emotion processing to the insular cortex. However, the complex structure and lateralization of emotional deficits following insular damage are not understood. Here, we investigated emotional ratings of valence and arousal and skin conductance responses (SCR) to a graded series of emotionally arousing scenes in patients with left (n = 10) or right (n = 9) insular damage and in healthy controls (n = 18). We found a significant reduction in overall SCRs, arousal ratings and valence extremity scores in right-lesioned patients, as compared to left-lesioned patients and healthy controls. The degree of right insular damage was significantly correlated with the degree of arousal, SCR and extremity attenuation. Additional analyses of correlations between subjective arousal ratings resp. SCR and normative arousal ratings revealed that both lesion groups had evaluative and physiological difficulties to discover changes in stimulus arousal. Although no group differences emerged on overall ratings of valence, analysis of correlations between subjective and normative valence ratings displayed markedly reduced accuracy in right-lesioned patients, as compared to left-lesioned patients and healthy controls. Our findings support the hypothesis that the left and right insulae subserve different functions in emotion processing, potentially due to asymmetrical representations of autonomic information in the left and right human forebrain. The right insula may serve as integral node for sympathetic arousal and cognitive-affective processing.

Behavioral and physiological monitoring for awake neurovascular coupling experiments: a how-to guide.

.SignificanceFunctional brain imaging in awake animal models is a popular and powerful technique that allows the investigation of neurovascular coupling (NVC) under physiological conditions. However, ubiquitous facial and body motions (fidgeting) are prime drivers of spontaneous fluctuations in neural and hemodynamic signals. During periods without movement, animals can rapidly transition into sleep, and the hemodynamic signals tied to arousal state changes can be several times larger than sensory-evoked responses. Given the outsized influence of facial and body motions and arousal signals in neural and hemodynamic signals, it is imperative to detect and monitor these events in experiments with un-anesthetized animals.AimTo cover the importance of monitoring behavioral state in imaging experiments using un-anesthetized rodents, and describe how to incorporate detailed behavioral and physiological measurements in imaging experiments.ApproachWe review the effects of movements and sleep-related signals (heart rate, respiration rate, electromyography, intracranial pressure, whisking, and other body movements) on brain hemodynamics and electrophysiological signals, with a focus on head-fixed experimental setup. We summarize the measurement methods currently used in animal models for detection of those behaviors and arousal changes. We then provide a guide on how to incorporate this measurements with functional brain imaging and electrophysiology measurements.ResultsWe provide a how-to guide on monitoring and interpreting a variety of physiological signals and their applications to NVC experiments in awake behaving mice.ConclusionThis guide facilitates the application of neuroimaging in awake animal models and provides neuroscientists with a standard approach for monitoring behavior and other associated physiological parameters in head-fixed animals.

Trial-wise exposure to visual emotional cues increases physiological arousal but not temporal discounting.

Humans and many animals devalue future rewards as a function of time (temporal discounting). Increased discounting has been linked to various psychiatric conditions, including substance-use-disorders, behavioral addictions, and obesity. Despite its high intra-individual stability, temporal discounting is partly under contextual control. One prominent manipulation that has been linked to increases in discounting is the exposure to highly arousing appetitive cues. However, results from trial-wise cue exposure studies appear highly mixed, and changes in physiological arousal were not adequately controlled. Here we tested the effects of appetitive (erotic), aversive, and neutral visual cues on temporal discounting in 35 healthy male participants. The contribution of single-trial physiological arousal was assessed using comprehensive monitoring of autonomic activity (pupil size, heart rate, electrodermal activity). Physiological arousal was elevated following aversive and in particular erotic cues. In contrast to our pre-registered hypothesis, steepness of temporal discounting was not significantly affected by emotional cues of either valence. Aversive cues tended to increase decision noise. Computational modeling revealed that trial-wise arousal only accounted for minor variance over and above aversive and erotic condition effects, arguing against a general effect of physiological arousal on temporal discounting.

Effects of Sun Salutation in Yoga on Mood and Arousal Changes

Effects of Sun Salutation in Yoga on Mood and Arousal Changes

Sexual Function of Women With Deep Endometriosis Before and After Surgery: A Prospective Study

Deep endometriosis (DE) may significantly affect women's quality of life. Limited data exists on the effect of surgery on the several domains of sexual function. To prospectively compare various domains of sexual function before and after laparoscopic surgery for DE. A prospective observational cohort study in a tertiary university-affiliated referral center. Patients with suspected DE who were planned to undergo laparoscopic surgery completed the Female Sexual Function Index questionnaire before surgery. The same questionnaire was completed by the participants 6 weeks, 6 months, and 12 months after surgery. Rate of sexual dysfunction over time was compared using multilevel logistic regression. Summary scores were then compared at each time point to the corresponding score before surgery using multilevel linear regression. Multivariable analysis was performed of potential confounders. Change in desire, arousal, orgasm, lubrication, satisfaction and pain summary scores as well as in the full-scale score between before and after surgery. We followed 149 patients with surgically confirmed DE. Sexual dysfunction rate as per the full-scale score was 75.5% before surgery and remained over 60% to 12 months after. The full-scale sexual function score improved at 6 (change in score = 2.8 ± 9.5, P = .004) and 12 months (change in score = 2.1 ± 9.9, P = .03). None of the summary scores improved at 6 weeks. Desire score (P < .001), arousal score (P = .02), and pain score (P = .01) improved at 6 months. Desire score (P = .03) and pain score (P = .01) also improved at 12 months, as compared to before surgery. On multivariable multilevel analysis, scores before surgery significantly contributed to the scores after surgery (P < .001). While sexual function improved after surgery, dysfunction rate remained substantial. Proper preoperative counseling should address sexual function measures and clinical and research attention should be given to seek ways to further reduce sexual dysfunction. The main strengths of our study are the prospective design, the relatively long follow-up and the use of a detailed validated questionnaire allowing assessment of a large variety of clinically relevant sexual function domains and scores as well as a full-scale score. Among our limitations are the lower response rate at 12 months and the limited generalizability as this is a single center study. Sexual function is a major and often under reported domain of quality of life. Further research is needed to identify the specific populations who may improve, not change or experience deterioration in their sexual functioning after surgery.

Effects of arousal modulation via resonance breathing on craving and affect in women with substance use disorder

BackgroundCraving for alcohol and other drugs is a complex in-the-moment experience that involves within-person changes in physiological arousal and affect. We evaluated the utility of a just-in-time, self-administered resonance breathing smartphone application (app) to reduce craving and improve affect in women during outpatient treatment for substance use disorders (SUD). MethodsWomen (N = 57) receiving outpatient addiction treatment were randomized to practice either cardiovascular resonance breathing (0.1 Hz/6 breaths per minute) or a sham (∼0.23 Hz/14 breaths per minute) in the face of urges over an 8-week intervention. Craving (Penn Alcohol Craving Scale) and affect (Positive and Negative Affect Scale) were collected weekly throughout the intervention. App data were uploaded weekly to assess frequency of use. Generalized Estimated Equations modeled craving and affect as a function of group randomization and app use frequency across the 8-week intervention.Findings: Higher levels of craving were associated with more frequent app use. The group X app use interaction was significant for craving. Frequent app use during the intervention phase was associated with lower craving levels in the resonance breathing group relative to the sham group over the 8-week intervention. There was no effect of app use frequency on affect measures. ConclusionsWomen assigned to practice sham breathing who used the intervention frequently experienced elevations in craving that are commonly reported during outpatient SUD treatment. Women assigned to resonance breathing who used the intervention frequently did not experience such increases. Resonance breathing may be protective against triggers in outpatient treatment. Physiological mechanisms are discussed.

Prediction Errors for Aversive Events Shape Long-Term Memory Formation through a Distinct Neural Mechanism.

Prediction errors (PEs) have been known for decades to guide associative learning, but their role in episodic memory formation has been discovered only recently. To identify the neural mechanisms underlying the impact of aversive PEs on long-term memory formation, we used functional magnetic resonance imaging, while participants saw a series of unique stimuli and estimated the probability that an aversive shock would follow. Our behavioral data showed that negative PEs (i.e., omission of an expected outcome) were associated with superior recognition of the predictive stimuli, whereas positive PEs (i.e., presentation of an unexpected outcome) impaired subsequent memory. While medial temporal lobe (MTL) activity during stimulus encoding was overall associated with enhanced memory, memory-enhancing effects of negative PEs were linked to even decreased MTL activation. Additional large-scale network analyses showed PE-related increases in crosstalk between the "salience network" and a frontoparietal network commonly implicated in memory formation for expectancy-congruent events. These effects could not be explained by mere changes in physiological arousal or the prediction itself. Our results suggest that the superior memory for events associated with negative aversive PEs is driven by a potentially distinct neural mechanism that might serve to set these memories apart from those with expected outcomes.

Psychological and Psychophysiological Responses to Challenge Variations for Virtual Hand Training in Game-based Smart Rehabilitation System

Background: Maintaining motivation is one of the most important characteristics of rehabilitation strategies for successful treatment. Understanding the underlying mechanism of mental state is helpful for developing new therapeutic methods based on virtual reality and serious game technologies. Objective: The present study aims to develop a cost-benefit game-based hand rehabilitation system and assess the influence on the psychological state of subjects when they interact with a virtual reality environment in different task difficulty levels. Methods: First, we introduced a low-cost smart hand rehabilitation system based on the Leap Motion tracker; then, the experimental study was performed with 20 healthy participants. Their mental states were evoked using interaction with two separate games in four different difficulty levels. Three measures from the SAM self-reported test described as a psychological response to this condition, and also four features were extracted from Photoplethysmogram signal in order to quantify psychophysiological responses of Autonomic Nervous System. Results: Comparison of the different difficulty levels revealed significant changes in arousal and dominance correspond to under challenging and over the challenging condition, respectively. The results of psychophysiological feature analysis showed significant differences only for the standard deviation of intervals between consecutive heartbeats. Conclusion: The developed system is a low-cost smart solution that can be useful for upper limb neurological rehabilitation. Regulating difficulty parameters of the implemented game can be used to influence the motivation of users through rehabilitation procedures. It seems Photoplethysmogram is an appropriate psychophysiological indicator of mental states, but further studies are required.

A mindfulness meditation mobile app improves depression and anxiety in adults with sleep disturbance: Analysis from a randomized controlled trial

ObjectiveThe objective of this study was to 1) determine the effects of a meditation app on depression and anxiety in adults with sleep disturbance, and 2) explore the potential mediating effects of fatigue, daytime sleepiness, and pre-sleep arousal on the relationship between use of the meditation app and changes in depression and anxiety. MethodsParticipants were 239 adults with elevated insomnia symptoms (i.e., scores ≥ 10 on the Insomnia Severity Index) and limited or no previous experience with meditation. Depression, anxiety, fatigue, daytime sleepiness, and pre-sleep arousal were assessed at baseline, four weeks, and eight weeks. Repeated-measures ANCOVAs assessed intervention effects on depression and anxiety. Mediation models were estimated using the PROCESS macro. ResultsParticipants in the meditation group had more improvement in depression and anxiety symptoms during the intervention period than did those in the control group. Changes in somatic and cognitive pre-sleep arousal at mid-intervention fully mediated effects on depression and partially mediated effects on anxiety. There were no significant indirect effects of fatigue and daytime-sleepiness on changes in mental health. ConclusionsA meditation app may improve depression and anxiety in adults with sleep disturbance, with effects being driven by improvements in pre-sleep arousal. Future studies should consider targeting pre-sleep arousal to improve mental health in this population.

How Do Music Activities Affect Health and Well-Being? A Scoping Review of Studies Examining Psychosocial Mechanisms.

Background: This scoping review analyzed research about how music activities may affect participants' health and well-being. Primary outcomes were measures of health (including symptoms and health behaviors) and well-being. Secondary measures included a range of psychosocial processes such as arousal, mood, social connection, physical activation or relaxation, cognitive functions, and identity. Diverse music activities were considered: receptive and intentional music listening; sharing music; instrument playing; group singing; lyrics and rapping; movement and dance; and songwriting, composition, and improvisation.Methods: Nine databases were searched with terms related to the eight music activities and the psychosocial variables of interest. Sixty-three papers met selection criteria, representing 6,975 participants of all ages, nationalities, and contexts.Results: Receptive and intentional music listening were found to reduce pain through changes in physiological arousal in some studies but not others. Shared music listening (e.g., concerts or radio programs) enhanced social connections and mood in older adults and in hospital patients. Music listening and carer singing decreased agitation and improved posture, movement, and well-being of people with dementia. Group singing supported cognitive health and well-being of older adults and those with mental health problems, lung disease, stroke, and dementia through its effects on cognitive functions, mood, and social connections. Playing a musical instrument was associated with improved cognitive health and well-being in school students, older adults, and people with mild brain injuries via effects on motor, cognitive and social processes. Dance and movement with music programs were associated with improved health and well-being in people with dementia, women with postnatal depression, and sedentary women with obesity through various cognitive, physical, and social processes. Rapping, songwriting, and composition helped the well-being of marginalized people through effects on social and cultural inclusion and connection, self-esteem and empowerment.Discussion: Music activities offer a rich and underutilized resource for health and well-being to participants of diverse ages, backgrounds, and settings. The review provides preliminary evidence that particular music activities may be recommended for specific psychosocial purposes and for specific health conditions.

Nothing to Fear but Fear Itself: A Mechanistic Test of Unconscious Exposure

BackgroundWhile effective, exposure therapy can be distressing, which creates problems with treatment acceptance. Can exposure be effectively delivered unconsciously—and thus without causing phobic people to experience distress? No study has tested this hypothesis in a sufficiently rigorous experiment that selected between mechanisms for reducing fear unconsciously. MethodsWe conducted a psychophysiological experiment of an unconscious exposure intervention to discern its mechanism of therapeutic action. We identified 98 highly spider-phobic participants with a validated fear questionnaire and a Behavioral Avoidance Test in which they gradually approached and exhibited impairment of a live tarantula, which was indicative of a DSM-5 diagnosis of specific phobia. These participants were randomized to viewing unconscious exposure to spiders, visible exposure to spiders, or unconscious exposure to flowers (control). In a novel psychophysiological design, concurrent changes in sympathetic arousal and subjective fear were monitored throughout exposure. Shortly thereafter, phobic participants approached the tarantula again in order to measure exposure-induced changes in real-life avoidance behavior and experienced fear. ResultsUnconscious exposure did not induce concurrent changes in sympathetic arousal or subjective fear, and subsequently reduced fear of the tarantula. Visible exposure to the same phobic stimuli, by contrast, induced significant arousal and fear, but did not affect fear of the tarantula. Levels of arousal during exposure moderated effects on fear of the tarantula: lower arousal during unconscious exposure, but not during conscious exposure, predicted greater fear reduction. ConclusionsUnconscious exposure reduces fear by generating new implicit learning of nonaversive, stimulus-response associations that facilitate fear extinction in phobic persons.