The dichotomy between classical conditioned and cognitively learned anxiety.

This paper describes how fears develop on the basis of one or other of two distinct processes--direct autonomic conditioning or the establishment of new cognitive associations to already existing fears. The dichotomy relates both to the appropriate fears of everyday life and to neurotic fears. In the case of the latter, the appropriate treatment procedure should be dictated by the fear basis that behavior analysis reveals. Failure to carry out such analysis is the reason for much confusion and inconclusiveness in therapeutic outcome studies. A retrospective survey of anxiety cases revealed that one-third of their fears were cognitively based and two-thirds due to autonomic conditioning. A study of a clinical population on the basis of a questionnaire designed to separate between cognitively based and conditioned fears has shown the expected bi-modal distribution. These findings undercut the conditioning versus cognition controversy on the causation of neurotic fears.