To look or not to look at threat? Scanpath differences within a group of spider phobics Tobias Pflugshaupt a , Urs P. Mosimann a,b, * , Wolfgang J. Schmitt c , Roman von Wartburg a , Pascal Wurtz a , Mathias Lu ¨thi a , Thomas Nyffeler a , Christian W. Hess a , Rene ´ M. Mu ¨ri a a Perception and Eye Movement Laboratory, Departments of Neurology & Clinical Research, University of Berne, Inselspital, Freiburgstrasse 10, 3010 Berne, Switzerland b Wolfson Research Centre, Newcastle General Hospital, Westgate Road, Newcastle-upon-Tyne NE4 6BE, United Kingdom c Department of Psychiatry, University of Berne, Inselspital, Freiburgstrasse 10, 3010 Berne, Switzerland Received 13 December 2005; received in revised form 31 March 2006; accepted 17 May 2006 Abstract Predicting the behavior of phobic patients in a confrontational situation is challenging. While avoidance as a major clinical component of phobias suggests that patients orient away from threat, findings based on cognitive paradigms indicate an attentional bias towards threat. Here we present eye movement data from 21 spider phobics and 21 control subjects, based on 3 basic oculomotor tasks and a visual exploration task that included close-up views of spiders. Relative to the control group, patients showed accelerated reflexive saccades in one of the basic oculomotor tasks, while the fear-relevant exploration task evoked a general slowing in their scanning behavior and pronounced oculomotor avoidance. However, this avoidance strongly varied within the patient group and was not associated with the scores from spider avoidance- sensitive questionnaire scales. We suggest that variation of oculomotor avoidance between phobics reflects different strategies of how they cope with threat in confrontational situations. # 2006 Elsevier Ltd. All rights reserved. Keywords: Phobia; Eye movements; Visual exploration; Avoidance Journal of Anxiety Disorders 21 (2007) 353–366 * Correspondence to: Department of Neurology, University of Berne, Inselspital, Freiburgstrasse 10, 3010 Berne, Switzerland. Tel.: +41 31 632 3081; fax: +41 31 632 9679. E-mail address: u.p.mosimann@ncl.ac.uk (U.P. Mosimann). 0887-6185/$ – see front matter # 2006 Elsevier Ltd. All rights reserved. doi:10.1016/j.janxdis.2006.05.005