Systemic alarms in fear conditioning I: A reappraisal of what is being conditioned

Many behavior therapists have questioned the adequacy of direct respondent conditioning for explaining phobic fear acquisition because fears may develop in the absence of direct experience with environmental trauma. Much of the debate has been fueled by confusion about what constitutes a traumatic event, and what is it that is being conditioned in phobic fear. The purpose of this paper is to (a) review recent arguments for and against direct traumatic conditioning based on clinical observation and laboratory conditioning studies, and (b) present an alternate view of direct conditioning that does not require a readily identifiable conditioned stimulus (CS) or unconditioned stimulus (UCS). What is required is a negatively evaluated abrupt and aversive systemic response ('alarm') that constitutes the primary conditioning event in human fear acquisition. Using examples of specific phobias and illness fears, we illustrate how alarms can account for fear acquisition without a readily identifiable aversive environmental event.