ISSN 1671-3710
CN 11-4766/R

Advances in Psychological Science ›› 2024, Vol. 32 ›› Issue (8): 1221-1232.doi: 10.3724/SP.J.1042.2024.01221

• Conceptual Framework •     Next Articles

Identifying the impact of unconscious fear on adolescent anxiety: Cognitive neural mechanisms and interventions

LEI Yi1, MEI Ying1, Wang Jinxia1, YUAN Zixin2   

  1. 1Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China;
    2School of Business Administeaction, Faculty of Business Administeaction, Southwestern University of Finance and Economics, Chengdu 611130, China
  • Received:2023-11-14 Online:2024-08-15 Published:2024-06-05

Abstract: Fear plays an important role in the development of anxiety disorders, with abnormalities in conditioned fear—specifically in the aspects of conditioning, generalization, and extinction—being central mechanisms. Neuroimaging evidence suggests that overreactivity of the amygdala and insufficient prefrontal modulation are key factors in the abnormal processing of fear among adolescents. This phenomenon is attributed to the earlier maturation of the amygdala compared to the prefrontal cortex, with the volume of the amygdala peaking during adolescence. Fear can manifest at both conscious and unconscious levels. Unconscious fear is automatic and not directly accessible to introspection. It's closely linked to anxiety-related symptoms because it can trigger physiological and psychological responses without the individual consciously recognizing the source of the threat. Adolescents are particularly sensitive to unconscious fear due to the ongoing development of their brains. Yet, current research on unconscious fear and its neural underpinnings in adolescents is limited. Thus, exploring unconscious fear could shed light on the developmental mechanisms underlying anxiety in adolescents. Traditional CBT focuses on altering maladaptive thought patterns and behaviors associated with anxiety, requiring a level of self-awareness and cognitive maturity that adolescents may not fully possess. Pharmacological treatments, on the other hand, target the biochemical aspects of anxiety but can come with side effects that may affect compliance and overall well-being. Examining the effects of neurofeedback on the unconscious fear in adolescents has the potential to significantly improve the efficacy of anxiety treatments in this age group.
This study aims to investigate the development and cognitive neural mechanisms of unconscious fear in adolescents, uncovering its role in the development of anxiety disorders, and exploring neurofeedback intervention techniques. Study 1 primarily investigates the dynamic change patterns of neural circuits related to unconscious fear processing in adolescents from a developmental perspective. It examines the cognitive neural mechanisms of unconscious fear processing in adolescents, utilizing the Pavlovian conditioning paradigm. Furthermore, it explores the role of chronic stress in the modulation of conditioned fear acquisition, extinction, and generalization. Study 1 aims to provide new insights into why anxiety susceptibility is higher in adolescence and uncover potential reasons for the increased prevalence of anxiety disorders in this age group. Study 2 aims to examine unconscious fear in adolescents with different types of anxiety disorders, highlighting potential differences in brain region activation patterns across these disorders. Together, the two studies offer a comprehensive view of adolescent anxiety, enhancing our understanding and management strategies. We anticipate that the results of Studies 1 and 2 will collectively indicate a pattern of either prefrontal underdevelopment in healthy adolescents or prefrontal underactivation in adolescents with anxiety disorders. Study 3 focuses on the prefrontal neural mechanisms, particularly targeting the vmPFC (ventromedial prefrontal cortex), to investigate the effects of neurofeedback on unconscious fear processing in adolescents. This has significant implications for the optimization of treatment methods for adolescent anxiety disorders.
Considering that the amygdala develops during adolescence, but the prefrontal cortex is still maturing, adolescents are more likely to have stronger unconscious fear responses. Therefore, the current research is expected to offer substantial insights into the psychopathological frameworks that underpin anxiety among adolescents. Furthermore, the capacity of neurofeedback to target the brain's fear circuits directly might offer a faster, more efficient means to reduce anxiety by helping adolescents learn to regulate their own brain activity associated with fear responses. This could help them manage anxiety better and for longer, giving them skills that traditional treatments may not fully realize. The current research could significantly enhance our understanding and treatment of anxiety disorders in adolescents, offering a complementary or alternative option that is both innovative and tailored to their developmental stage.

Key words: fear, anxiety disorders, adolescent, cognitive neural mechanism, fear extinction

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