Each of 16 phobic patients was treated by six sessions of flooding and six sessions of desensitization in a balanced crossover design. Clinical and physiological measurements were made before treatment and after the sixth and 12th sessions of treatment. Physiological measures were made of increase in heart rate and in spontaneous fluctuations and maximum change in level of skin conductance during neutral and phobic imagery. Patients estimated subjective anxiety during the imagery. Heart rate, skin conductance, and subjective anxiety ratings all differentiated significantly between phobic and neutral imagery. Increase in autonomic activity during imagery was roughly proportional to the intensity of the imagery in a phobic hierarchy. Autonomic changes during imagery imagined in silence did not produce autonomic changes considerably different from those during imagery stimulated by a running commentary from the therapist. Clinical ratings correlated significantly with measures of skin conductance, so that autonomic measures can be useful indicators of change after treatment. However, heart rate, skin conductance, and subjective anxiety during brief periods of imagery did not usually correlate significantly with one another. This supports the view of emotion as a System of responses linked imperfectly across several Systems.
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