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. 2023 Jan 25;11(1):23.
doi: 10.1186/s40359-023-01054-0.

Study protocol of an investigation of attention and prediction error as mechanisms of action for latent inhibition of dental fear in humans

Laura D Seligman  1 , Andrew L Geers  2 , Lauren Kramer  2 , Kelly S Clemens  2 , Keenan A Pituch  3 , Ben Colagiuri  4 , Hilary A Marusak  5 , Christine A Rabinak  6 , Natalie Turner  7 , Michael Nedley  7
Affiliations

Study protocol of an investigation of attention and prediction error as mechanisms of action for latent inhibition of dental fear in humans

Laura D Seligman et al. BMC Psychol. .

Abstract

Background: Evidence suggests that dental anxiety and phobia are frequently the result of direct associative fear conditioning but that pre-exposure to dental stimuli prior to conditioning results in latent inhibition of fear learning. The mechanisms underlying the pre-exposure effect in humans, however, are poorly understood. Moreover, pain sensitivity has been linked to dental fear conditioning in correlational investigations and theory suggests it may moderate the latent inhibition effect, but this hypothesis has not been directly tested. These gaps in our understanding are a barrier to the development of evidence-based dental phobia prevention efforts.

Methods: Healthy volunteers between the ages of 6 and 35 years will be enrolled across two sites. Participants will complete a conditioning task in a novel virtual reality environment, allowing for control over pre-exposure and the examination of behaviour. A dental startle (a brief, pressurized puff of air to a tooth) will serve as the unconditioned stimulus. Using a within-subjects experimental design, participants will experience a pre-exposed to-be conditioned stimulus, a non-pre-exposed to-be conditioned stimulus, and a neutral control stimulus. Two hypothesized mechanisms, changes in prediction errors and attention, are expected to mediate the association between stimulus condition and fear acquisition, recall, and retention. To ascertain the involvement of pain sensitivity, this construct will be measured through self-report and the cold pressor task.

Discussion: Dental phobia negatively affects the dental health and overall health of individuals. This study aims to determine the mechanisms through which pre-exposure retards conditioned dental fear acquisition, recall, and retention. A randomized control trial will be used to identify these mechanisms so that they can be precisely targeted and maximally engaged in preventative efforts.

Keywords: Dental phobia; Eye tracking; Fear learning; Latent inhibition; Pain sensitivity; Pre-exposure; Virtual reality.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Hall and Rodriguez model
Fig. 2
Fig. 2
Example scene from VR task
Fig. 3
Fig. 3
Dental startle equipment
See this image and copyright information in PMC

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References

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