Increased body sway in phobic patients exposed to images of spiders

Linares, Ila M.P.; Nardi, Antonio E.; Guimarães, Francisco S.; Arrais, Katia C.; Chagas, Marcos H.; Osório, Flavia L.; Hallak, Jaime E.; Zuardi, Antonio W.; Coimbra, Norberto C.; Crippa, José A.

doi:10.1590/1516-4446-2020-1466

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Brazilian Journal of Psychiatry

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ORIGINAL ARTICLE • Braz J Psychiatry 43 (5) • Sep-Oct 2021 • https://doi.org/10.1590/1516-4446-2020-1466 copy

Increased body sway in phobic patients exposed to images of spiders

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

The aim of the present study was to analyze the body sway response in specific phobia (SP) patients and healthy controls while viewing neutral, phobic, and disgusting images.

Methods:

The participants’ heart rate (HR) and skin conductance were also recorded during the procedure. Nineteen patients with arachnophobia and 19 healthy volunteers matched by age, gender, and years of education underwent a postural control test on a stabilometric platform.

Results:

The platform recorded increased body sway in the SP group when exposed to spider images (SPI). The SP group presented increases in most parameters (SD, velocity, frequency, area, p ≤ 0.05) when viewing pictures of the SPI category. Psychometric measures of subjective anxiety (State-Trait Anxiety Inventory, STAI) and physiological states (HR; skin conductance responses; spontaneous fluctuations in skin conductance) showed increased anxiety (p ≤ 0.05) in the SP group compared to healthy volunteers. High anxiety levels were observed throughout the assessment, including the task of exposure to SPI (p ≤ 0.05). No significant effect or correlation was found between skin conductance and body sway measures (p > 0.05).

Conclusions:

The results of the postural control test suggest the occurrence of a defensive escape response in SP, in agreement with previous evidence.

Specific phobia; sway; stabilometric platform; exposure to spiders

Characteristics	SP	CG	Statistics	p-value
Gender, n
Male	2	2	χ² = 0.00	1.00
Female	17	17
Handedness, n
Right	18	17	χ² = 0.36	0.54
Left	1	2
Age (years)	30.78±1.92	30.94±1.85	t₃₆ = -0.59	0.95
Education (years)	14.43±0.61	15.47±0.46	t₃₆ = 1.20	0.20
Socioeconomic level, %
A1/A2	31.57	31.57
B1/B2	47.36	52.63
C1/C2	21.05	15.78
D	0.00	0.00
E	0.00	0.00
BAI	11.10±1.46	5.68±1.67	t₃₆ = -2.46	0.32
SPQ	113.73±2.34^* * Significant at p < 0.05.	21.84±1.44	t₃₆ = 33.20	0.001
STAI-trait	14.6±0.60^* * Significant at p < 0.05.	11.4±0.50	t₃₆ = 3.20	0.02

Posturographic parameter	SP	CG
Neutral (NE1)
Area (mm²)	201.55±31.90	209.2±22.50
ML SD (mm)	3.75±0.27	4.4±0.20
AP SD (mm)	4.23±0.47	3.90±0.30
ML freq (Hz)	0.37±0.03	0.20±0.01
AP freq (Hz)	0.24±0.01	0.20±0.01
ML (vel)	10.65±0.83	9.40±0.50
AP (vel)	9.02±0.44	8.00±0.40
Disgusting (DI)
Area (mm²)	192.86±29.09	161.50±18.30
ML SD (mm)	4.09±0.34	3.90±0.20
AP SD (mm)	3.76±0.27	3.40±0.20
ML freq (Hz)	0.31±0.03	0.20±0.02
AP freq (Hz)	0.24±0.01	0.20±0.01
ML (vel)	10.24±0.85	9.00±0.50
AP (vel)	8.35±0.38	7.60±0.20
Neutral (NE2)
Area (mm²)	189.73±24.87	158.60±20.10
ML SD (mm)	4.25±0.29	4.00±0.30
AP SD (mm)	3.63±0.29	3.20±0.20
ML freq (Hz)	0.27±0.01	0.20±0.01
AP freq (Hz)	0.22±0.01	0.20±0.01
ML (vel)	9.70±0.50	8.90±0.40
AP (vel)	7.90±0.35	7.40±0.20
Spider (SPI)
Area (mm²)	374.65±61.97^* * p ≤ 0.05 compared to the CG (analysis of variance [ANOVA]); † p ≤ 0.05 compared to SP.	167.90±21.10
ML SD (mm)	4.70±0.40	4.10±0.30
AP SD (mm)	6.10±0.57^* * p ≤ 0.05 compared to the CG (analysis of variance [ANOVA]); † p ≤ 0.05 compared to SP. ^†	3.40±0.10
ML freq (Hz)	0.41±0.02^* * p ≤ 0.05 compared to the CG (analysis of variance [ANOVA]); † p ≤ 0.05 compared to SP. ^†	0.20±0.020
AP freq (Hz)	0.21±0.01	0.20±0.010
ML (vel)	14.30±1.30^* * p ≤ 0.05 compared to the CG (analysis of variance [ANOVA]); † p ≤ 0.05 compared to SP. ^†	8.90±0.50
AP (vel)	14.20±1.21^* * p ≤ 0.05 compared to the CG (analysis of variance [ANOVA]); † p ≤ 0.05 compared to SP. ^†	7.80±0.30
Neutral (NE3)
Area (mm²)	231.31±31.70	149.90±20.30
ML SD (mm)	4.40±0.30	3.70±0.20
AP SD (mm)	4.30±0.35	3.20±0.33
ML freq (Hz)	0.31±0.02	0.20±0.02
AP freq (Hz)	0.24±0.01	0.20±0.02
ML (vel)	10.54±0.60	8.50±0.36
AP (vel)	9.80±0.55	7.80±0.32
Spider-like (SL)
Area (mm²)	246.40±45.10	198.50±34.04
ML SD (mm)	4.30±0.40	4.50±0.40
AP SD (mm)	34.50±0.30	3.50±0.30
ML freq (Hz)	0.30±0.02	0.20±0.02
AP freq (Hz)	0.20±0.02	0.20±0.02
ML (vel)	10.50±0.80	8.80±0.40
AP (vel)	9.60±0.50	8.10±0.20

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[1] Correspondence: José A. Crippa, Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Av. Bandeirantes, 3900, terceiro andar, CEP 14048-900, Ribeirão Preto, SP, Brazil.E-mail: jcrippa@fmrp.usp.br