Visuo-vestibular contributions to anxiety and fear

Neurosci Biobehav Rev. 2015 Jan;48:148-59. doi: 10.1016/j.neubiorev.2014.10.023. Epub 2014 Nov 6.


The interactive roles of the visual and vestibular systems allow for postural control within boundaries of perceived safety. In specific circumstances, visual vestibular and postural interactions act as a cue that trigger fear, similarly to what occurs in motion sickness. Unusual patterns of visuo-vestibular interaction that emerge without warning can elicit fear, which can then become associated to a certain stimuli or situation, creating a CS-US association, (i.e., phobia), or can emerge without warning but also without becoming associated to a particular concomitant event (i.e., panic). Depending on the individual sensitivity to visuo-vestibular unusual patterns and its impact in postural control, individuals will be more or less vulnerable to develop these disorders. As such, the mechanism we here propose is also sufficient to explain the lack of certain fears albeit exposure. Following this rationale, a new subcategory of anxiety disorders, named visuo-vestibular fears can be considered. This model brings important implications for developmental and evolutionary psychological science, and invites to place visuo-vestibular fears in a particular subtype or specification within the DSM-5 diagnostic criteria.

Keywords: Acrophobia; Anxiety; Driving; Hypophobia; Motion sickness; Panic; Phobias; Postural stability; Sensory conflict; Vestibular system.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anxiety Disorders / physiopathology*
  • Fear / physiology*
  • Humans
  • Postural Balance / physiology*
  • Visual Perception / physiology*