Fear Itself

A 44-year-old woman with a rare form of brain damage can literally feel no fear, according to a case study published yesterday in the journal Current Biology. Referred to as SM, she suffers from a genetic condition called Urbach-Wiethe Disease. The condition is extremely rare, with fewer than 300 reported cases since it was first described in 1929, and is caused by a mutation in a gene on chromosome 1, which encodes an extracellular matrix protein. The symptoms vary widely, and in about 50% of cases there is calcification, or hardening, of structures in the medial temporal lobe of the brain. In SM’s case, it led to degeneration of the amygdala (below), a small, almond-shaped structure known to be involved in fear and other emotions.

SM has been studied extensively during the past two decades. Early investigations showed that her non-verbal visual memory was signficantly impaired but that otherwise she had an IQ in the low-average range. She also displayed inappropriate social behaviours, quickly becoming friendly with the experimenters and making sexual remarks, due to disturbed executive control. Subsequently, it was found that she was unable to recognize emotions in facial expressions, and a study published earlier this year showed that the brain damage had eliminated her monetary loss aversion - that is, she makes risky financial decisions that most of us would avoid because of a fear of losing money.

None of these previous studies assessed her experience of fear, however. Justin Feinstein of the University of Iowa and his colleagues therefore tested SM’s fear responses, using a very simple method - by trying to scare her. First, they took her to an exotic pet store and exposed her to snakes and spiders, which, she had told them, she “hated” and “tried to avoid”. Nevertheless, she seemed fascinated by the large collection of snakes, and was compelled to touch and poke the larger and more dangerous ones, as well as a tarantula, but had to be stopped in case she got bitten. Throughout the visit, she was asked to rate her fear on a scale of 0 to 10, and her ratings were never greater than 2. 

Next, the researchers took SM on a Halloween visit to Waverly Hills Sanatorium in Louisville, Kentucky, which features people dressed as monsters, murderers and ghosts and is reported to be “one of the most haunted places in the world”. When they arrived, she voluntarily led the researchers and a goup of five strange women around the house, walking into dark corners and hallways without hesitation. The hidden monsters tried to scare her numerous times, unsuccessfully. Whereas the five other women in the group screamed loudly whenever they encountered one, SM laughed and smiled at them, and even scared one by poking it in the head because she was curious about how it felt. She rated her fear level at 0 throughout, saying instead that she found it exciting.

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A large body of evidence shows that momentarily making death salient, typically by asking people to think about themselves dying, intensifies people’s strivings to protect and bolster aspects of their worldviews, and to bolster their self-esteem. The most common finding is that MS increases positive reactions to those who share cherished aspects of one’s cultural worldview, and negative reactions toward those who violate cherished cultural values or are merely different.

Our first experiment was conducted with 22 municipal court judges in Tucson, Ariz. We told the judges we were studying the relation between personality traits, attitudes and bond decisions. A bond is a sum of money a defendant pays prior to trial to be released from prison in the interim. The judges completed a set of questionnaires consisting of some standard personality assessment instruments. Embedded in the personality assessments were two questions designed to trigger mortality salience: “Please briefly describe the emotions that the thought of your own death arouses in you” and “Jot down, as specifically as you can, what you think will happen to you as you physically die and once you are physically dead.” Only half of the judges were randomly given these questions to answer.

The judges were then given a legal case brief virtually identical to one they would typically see before a trial. The brief stated the arresting charge, which was prostitution, and the defendant’s address, employment record and length of residency. A copy of the citation issued to the defendant when she was arrested was also included. Finally, the judges were given a form to set bond for the defendant. We chose judges for the study because they are rigorously trained to make rational and uniform decisions based solely on evidence relative to existing laws. And we had them pass judgment on an alleged prostitute because prostitution offends the moral sensibilities of the average American. To the extent that cultural worldviews serve to mitigate mortal terror, we hypothesized that judges who thought about death would set higher bonds than those in the control condition. The results were striking. Judges in the control condition set an average bond of $50, which was typical for this charge in actual cases at the time. However, judges who thought about their death set an average bond of $455.

- The Frontal Cortex

Psychopaths are charming, but they often get themselves and others in big trouble; their willingness to break social norms and lack of remorse means they are often at risk for crimes and other irresponsible behaviors. One hypothesis on how psychopathy works is that it has to do with a fear deficit. A new study, which will be published in an upcoming issue of Psychological Science, a journal of the Association for Psychological Science, finds that children with a particular risk factor for psychopathy don’t register fear as quickly as healthy children.

The hypothesis that psychopaths don’t feel or recognize fear dates back to the 1950s, says the study’s primary author Patrick D. Sylvers, of the University of Washington. “What happens is you’re born without that fear, so when your parents try to socialize you, you don’t really respond appropriately because you’re not scared.” By the same token, if you hurt a peer and they give you a fearful look, “most of us would learn from that and back off,” but a child with developing psychopathy would keep tormenting their classmate.

Some recent research has suggested that the problem is attention; that people with psychopathy just don’t pay attention to fearful faces. That would mean you might be able to help troubled children recognize fear by training them to look into people’s eyes, for example. Some studies have suggested that might help.

Sylvers and his coauthors, Patricia A. Brennan and Scott O. Lilienfeld of Emory University, wondered if something deeper was going on than a failure to pay attention. They recruited boys in the Atlanta area who got in a lot of trouble at home and school, and gave them and their parents a questionnaire about some aspects of psychopathy. For example, they asked the boys whether they felt guilty when they hurt other people. The researchers were most interested in “callous unemotionality” — a lack of regard for others’ feelings. Children who rank high on callous unemotionality are at risk of developing psychopathy later.

In this experiment, each boy watched a screen that showed a different picture to each eye. One eye saw abstract shapes in constant motion.

In the other eye, a still image of a face was faded up extremely quickly — even before subjects could consciously attend to it — while the abstract shapes were faded out just as quickly. The brain is drawn to the moving shapes, while the face is harder to notice. Each face showed one of four expressions: fearful, disgusted, happy, or neutral. The child was supposed to push a button when he saw the face.

Healthy people notice a fearful face faster than they notice a neutral or happy face, but this was not the case in children who scored high on callous unemotionality. In fact, the higher the score, the slower they were to react to a fearful face.

The important point here, Sylvers says, is that the children’s reaction to the face was unconscious. Healthy people are “reacting to a threat even though they’re not aware of it.” That suggests that teaching children to pay attention to faces won’t help solve the underlying problems of psychopathy, because the difference happens before attention comes into play. “I think it’s just going to take a lot more research to figure out what you can do — whether it’s parenting, psychological interventions, or pharmacological therapy. At this point, we just don’t know,” Sylvers says.

The researchers also found that children in the study tended to respond more slowly to faces showing disgust, another threatening emotion — in this case, one that suggests something is toxic or otherwise wrong. Sylvers says psychological scientists should consider that psychopathy may not be related just to fearlessness, but to a more general problem with processing threats.

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(via tamburinaa)