Mental Imagery: Functional Mechanisms and Clinical Applications

Mental imagery in the context of online compulsive buying-shopping disorder: The role of pleasure and relief

Background

The rise of e-commerce has led to an increase in online compulsive buying-shopping disorder (OCBSD), an addictive disorder potentially driven by preoccupations like mental imagery, yet their occurrence and predictors have not been thoroughly explored.

Methods

This study investigated the expression of and associations with mental imagery in women with pathological (n = 56) or non-problematic buying-shopping (n = 56) applying hierarchical regression analyses. Participants were classified based on a structured diagnostic interview, completed self-report questionnaires assessing experiences of gratification and compensation during shopping, and a 14-day end-of-day ambulatory assessment, evaluating mental imagery intensity.

Results

Women with pathological buying-shopping reported significantly more intense shopping-specific mental imagery compared to women with non-problematic buying-shopping. Mental imagery was significantly predicted only by compensatory experiences in the pathological buying-shopping group with medium effect sizes.

Discussion

The findings suggest that in OCBSD, mental images likely arise from to the anticipated effects of relief, possibly indicating a maladaptive coping strategy.

Does forming an implementation intention lead individuals to spontaneously use visual mental imagery?

Planning through implementation intention involves forming mental representations of a goal-relevant situation and a goal-directed behavior. The main objective of this study was to determine whether mental representations during conscious planning with if-then plan were spontaneously visualized. The sample included 205 participants, asked to perform an easy vs. difficult pro-environmental behavior. They formed an if-then plan vs. a goal intention and were asked whether they spontaneously used mental imagery. Seven days after, 109 participants reported the number of behaviors they performed. The perceived difficulty of the behavior did not differ significantly, this variable was excluded from analyses. A logistic regression was performed and showed that participants who formed an if-then plan used significantly more spontaneous mental imagery compared to goal intention participants. ANCOVAs also revealed that they reported more behaviors than participants who formed a goal intention. However, participants who spontaneously visualized their if-then plan did not report more goal attainment than other participants. This result, which suggests a distinction between spontaneous and instructed visualization (i.e. explicitly requiring participants to visualize their plan), is discussed.

A qualitative exploration of change processes relevant to compassion-focused therapy that occurs when people view both soothing and non-soothing images

OBJECTIVE

Using soothing imagery within psychotherapy may support people to undertake positive visualisation exercises. However, little is known about what processes happen when people view images they find to be soothing or non-soothing.

DESIGN

Exploratory qualitative methods were used.

METHOD

Responses from 644 participants who had written about images they found to be soothing or non-soothing were analysed using thematic analysis.

RESULTS

Two key themes were developed that related to the importance of the image content (such as it being a natural scene or artificial) and the internal cognitive and psychological processes that it triggered within participants as being key drivers for an image being perceived as soothing or non-soothing. This included recall of positive autobiographical memories and liking the image content. Conversely, negative autobiographical memories and disliking image content were associated when people viewed images they considered to be non-soothing.

CONCLUSIONS

Experiences of feeling soothed when viewing an image appear to be maintained by imagining positive sensory experiences that were associated with the image or linking the image to positive experiences from the participant's autobiographical memory. This has implications for the delivery of therapy using pre-existing image sets and suggests there is a need to find out what images are most suited for people accessing services.

Exploring the implementation of a novel, transdiagnostic, hybrid ecological momentary intervention for improving resilience in youth (EMIcompass): A process evaluation in the realist framework

OBJECTIVES

Previous research indicates that the hybrid compassion-focused intervention EMIcompass may reduce stress reactivity and improve quality of life. Our aim was to investigate what components of the intervention work for whom, how, and under which circumstances to contribute to the enhancement of resilience.

METHODS

We conducted a process evaluation using a realist framework. First, we developed initial programme theories using compassion-focused interventions and ecological momentary intervention documents, in addition to conducting a focus group and an interview with an individual expert. Second, we tested the initial programme theories based on qualitative data from 20 participants. Third, we refined the programme theories by analysing and interpreting the data.

RESULTS

We identified four programme components experienced as enhancing the activation of the soothing system and the application of compassion-focused principles. EMIcompass was perceived as lowering the burden of and barriers to treatment and facilitating the translation into daily life. Intra- and interpersonal context factors interacted with the mechanisms, leading to improvement in well-being, which was identified as a main outcome.

DISCUSSION

The intervention worked by strengthening participants' soothing system and facilitating ecological translation leading to improved well-being. Adaptions to improve the intervention may allow for more flexibility in individual intervention trajectories acknowledging different needs and preferences.

The effect of positive mental imagery versus positive verbal thoughts on anhedonia

Anhedonia, the loss of interest in and pleasure from previously enjoyable activities is a core symptom of depression and presents a major challenge to treatments. Interventions involving positive mental imagery generation have been suggested to reduce anhedonia. However, it is not clear whether the imagery component of such interventions is crucial for these effects. The current study aimed to test this by contrasting repeated generation of positive mental imagery versus positive verbal thoughts. Over a one-week period, 53 mildly anhedonic adults completed five sessions of a computerized training program involving the generation of either positive images or positive sentences. Compared to participants who generated sentences, participants who generated imagery showed greater improvements from pre- to post-training on an individualized multi-facetted measure of anhedonia (the Dimensional Anhedonia Rating Scale), but not on standardized measures of anticipated pleasure (the Snaith-Hamilton Pleasure Scale), depression symptoms, or positive affect. The present study supports the proposal that positive imagery could provide a route to improve anhedonia, with generation of imagery in particular (as opposed to positive thoughts in general) as an important driving mechanism for these effects. This has theoretical and clinical implications for understanding the role of imagery in anhedonia and its treatment.

Neurocognitive mechanisms of social scenario imagery generation in individuals with social anxiety

Cognitive behavioral theory emphasizes the significant role of mental imagery in the onset and development of Social Anxiety Disorder (SAD). However, the neural mechanisms underlying the generation of social scenario imagery in individuals with social anxiety remain unclear. In this study, 28 individuals with social anxiety and 31 healthy controls performed a retrospective cue imagery generation task to examine their neural responses. Behavioral results showed that, compared to negative social scenarios, the vividness of positive social scenario imagery was significantly lower in the social anxiety group, while the control group showed no significant difference between the two conditions. Event-related potential (ERP) results revealed that, for the social anxiety group, N170 and LPP amplitudes were significantly larger under the neutral condition compared to the negative condition, whereas the control group exhibited no significant difference between these conditions. Furthermore, the social anxiety group showed significantly larger LPP amplitudes than the control group in both the positive and neutral conditions. These findings provide the first neurophysiological evidence that individuals with social anxiety exhibit processing biases when generating imagery of positive and neutral social scenarios, suggesting heightened neural engagement in these conditions.

Imageless imagery in aphantasia revealed by early visual cortex decoding

Activity in the early visual cortex is thought to tightly couple with conscious experience, including feedback-driven mental imagery. However, in aphantasia (a complete lack of visual imagery), the state of mental imagery, what takes its place, or how any activity relates to qualia remains unknown. This study analyzed univariate (amplitude) and multivariate (decoding) blood-oxygen-level-dependent (BOLD) signals in primary visual cortex during imagery attempts. "Imagery" content could be decoded equally well in both groups; however, unlike in those with imagery, neural signatures in those with validated aphantasia were ipsilateral and could not be cross-decoded with perceptual representations. Further, the perception-induced BOLD response was lower in those with aphantasia compared with controls. Together, these data suggest that an imagery-related representation, but with less or transformed sensory information, exists in the primary visual cortex of those with aphantasia. Our data challenge the classic view that activity in primary visual cortex should result in sensory qualia.

Pre-stimulus activities affect subsequent visual processing: Empirical evidence and potential neural mechanisms

PURPOSE

Humans obtain most of their information from visual stimuli. The perception of these stimuli may be modulated by the ongoing pre-stimulus brain activities. Depending on the task design, the processing of different cognitive functions such as spatial attention, feature-based attention, temporal attention, arousal, and mental imagery may start prior to the stimulus onset.

METHOD

This process is typically accompanied by changes in pre-stimulus oscillatory activities including power, phase, or connectivity in different frequency bands. To explain the effect of these changes, several mechanisms have been proposed. In this article, we review these changes and the potential mechanisms in the context of the pre-stimulus enabled cognitive functions. We provide evidence both in favor of and against the most documented mechanisms and conclude that no single mechanism can solely delineate the effects of pre-stimulus brain activities on later processing. Instead, multiple mechanisms may work in tandem to guide pre-stimulus brain activities.

FINDING

Additionally, our findings indicate that in many studies a combination of these cognitive functions begins prior to stimulus onset.

CONCLUSION

Thus, dissociating these cognitive functions is challenging based on the current literature, and the need for precise task designs in later studies to differentiate between them is crucial.

The effect of nature on creativity through mental imagery

Immersion in nature has been linked to wide-ranging benefits on mental health and cognitive functions, from reducing stress to enhancing creativity. However, a walk in nature is not always feasible, and whether a proxy for nature immersion via a mental walk in nature can elicit the same benefits as a physical walk remains largely unknown. Accordingly, the current study utilized guided imagery to examine whether a mental walk in nature would improve creativity in general and when compared to a mental walk in an urban environment. We implemented a within-subjects design, wherein participants completed both mental walk conditions (in a nature and urban environment) at least five days apart in counterbalanced order on an online platform. During each session, participants (N = 97) completed two pre-walk tasks assessing convergent (measured by the Remote Associates Test) and divergent creative thinking (measured by the Alternate Uses Test), followed by a mental walk in either a nature or urban environment, then finally the identical two post-walk creativity tasks. After five days, they repeated the same procedure with a mental walk in the other environment. While comparisons of post-walk creativity scores between the nature and urban environment did not significantly differ from each other, the comparisons between the pre- and post-walk creativity scores revealed a significant improvement in convergent creative thinking in the nature environment condition, but not the urban environment condition. Our results suggest that taking a mental walk in nature can enhance at least one aspect of creativity, therefore providing preliminary evidence for the potential to access the creative benefits of mentally immersing ourselves in nature. These findings have important implications for those who wish to enjoy the benefits of nature but are unable to readily access nature physically.

Drawing as an efficient encoding tool in younger but not always older adults: The case of associative memory

Episodic memory strongly declines in healthy aging, at least partly because of reduced abilities to create and remember associations (associative memory) and to use efficient memory strategies. Several studies have shown that drawing the to-be-remembered material is a reliable encoding tool to enhance memory of individual items (item memory) because it simultaneously integrates elaborative, pictorial, and motoric processes. These processes in isolation can enhance associative memory in older adults. Nevertheless, their simultaneous impact on associative memory has never been investigated in drawing as an encoding tool. We aimed to investigate whether drawing as an encoding tool not only enhances item memory, but whether its benefit extends to associative memory in younger and older adults. Therefore, we tested 101 older and 100 younger participants in two online experiments and one in-person experiment. Using a memory task for unrelated word-pairs, we compared relational drawing and repeatedly writing (non-relational) as encoding tools and assessed immediate recognition memory of items and associations. In Experiment 2, we additionally assessed recognition memory after 1 week. The findings were consistent across the three experiments: while younger participants benefited from drawing over writing in item and associative memory, older participants benefited in item but not in associative memory. The observed effects remained after 1 week. Thus, we could extend the benefit of drawing to relational drawing in associative memory in younger adults. The lack of benefit in older adults' associative memory might be explained by age-related difficulties in benefiting from memory strategies, and in creating and retrieving associations.

Integrating alternative and complementary medicine in the management of epilepsy and its comorbidities in low- and middle-income settings

Traditional/alternative and complementary medicine (TCM) encompasses products, practices and practitioners that do not form part of conventional treatment and are not an integral part of the main health care systems. They are very common in the management of epilepsy and mental health conditions, particularly in low- and middle-income countries (LMIC). For instance, in a population-based survey in Africa, over 70% of people with epilepsy had visited a traditional health practitioner before the survey, with similarly high estimates reported in Asia and South America. Accessibility, cultural appropriateness/alignment, non-response to conventional (biomedical) medicine, and exercise of control over one's treatment were some of the reasons TCM was preferred over conventional medicine. There is also emerging evidence that TCM products administered alone or together with anti-seizure medications result in improvement in seizure control, psychiatric comorbidities, and quality of life. Most of the convincing evidence is from biological-based therapies for example, multivitamin supplementation, ketogenic diet and cannabidiol extracts. Mind-based therapies e.g. Yoga and whole-body systems therapies e.g. Ayurdelic and Traditional Chinese Medicine have also generated interest in epilepsy care. There is a paucity of effectiveness studies of these therapies in LMIC such as Africa, where capacity to take these products through clinical trials is limited. There are however serious concerns on reliability of reported findings because of inadequate randomization, and small sample sizes, and concerns on quality and safety owing to lack of standardization of bioactive compounds, accidental or intention botanical substitution of products and unhygienic handling. There is growing interest in TCM worldwide because of its economic potential, concerns on safety and quality and potential for integration into the health care systems. There is urgent need to develop and implement national TCM regulatory policies and programmes aimed at expanding the knowledge base and providing guidance on quality assurance standards. However, LMIC continue to lag in implementation of these policies and guidelines, especially in the areas of research and development and regulation of TCM practice. Working with stakeholders, countries are advised to assess their own national situations in relation to TCM, and then develop practical solutions to accommodate these approaches. For instance, conduct surveys on benefits and risks of TCM in the management of epilepsy in the local context and use this information to promote appreciation of a role for TCM, which will ease integration into the main health systems.

Could Motor Imagery Training Provide a Novel Load Management Solution for Athletes? Recommendations for Sport Medicine and Performance Practitioners

CONTEXT

Athletes often face the dual challenge of high training loads with insufficient time to recover. Equally, in any team, sports medicine and performance staff are required to progress training loads in healthy athletes and avoid prolonged reductions in training load in injured athletes. In both cases, the implementation of a well-established psychological technique known as motor imagery (MI) can be used to counteract adverse training adaptations such as excessive fatigue, reduced capacity, diminished performance, and heightened injury susceptibility.

STUDY DESIGN

Narrative overview.

LEVEL OF EVIDENCE

Level 5.

RESULTS

MI has been shown to enhance performance outcomes in a range of contexts including rehabilitation, skill acquisition, return-to-sport protocols, and strength and conditioning. Specific performance outcomes include reduction of strength loss and muscular atrophy, improved training engagement of injured and/or rehabilitating athletes, promotion of recovery, and development of sport-specific skills/game tactics. To achieve improvements in such outcomes, it is recommended that practitioners consider the following factors when implementing MI: individual skill level (ie, more time may be required for novices to obtain benefits), MI ability (ie, athletes with greater capacity to create vivid and controllable mental images of their performance will likely benefit more from MI training), and the perspective employed (ie, an internal perspective may be more beneficial for increasing neurophysiological activity whereas an external perspective may be better for practicing technique-focused movements).

CONCLUSION

We provide practical recommendations grounded in established frameworks on how MI can be used to reduce strength loss and fear of reinjury in athletes with acute injury, improve physical qualities in rehabilitating athletes, reduce physical loads in overtrained athletes, and to develop tactical and technical skills in healthy athletes.

Brain regions supporting retrieval of words drawn at encoding: fMRI evidence for multimodal reactivation

Memory for words that are drawn or sketched by the participant, rather than written, during encoding is typically superior. While this drawing benefit has been reliably demonstrated in recent years, there has yet to be an investigation of its neural basis. Here, we asked participants to either create drawings, repeatedly write, or list physical characteristics depicting each target word during encoding. Participants then completed a recognition memory test for target words while undergoing functional magnetic resonance imaging (fMRI). Behavioural results showed memory was significantly higher for words drawn than written, replicating the typical drawing effect. Memory for words whose physical characteristics were listed at encoding was also higher than for those written repeatedly, but lower than for those drawn. Voxel-wise analyses of fMRI data revealed two distributed sets of brain regions more active for items drawn relative to written, the left angular gyrus (BA 39) and bilateral frontal (BA 10) regions, suggesting integration and self-referential processing during retrieval of drawn words. Brain-behaviour correlation analyses showed that the size of one's memory benefit for words drawn relative to written at encoding was positively correlated with activation in brain regions linked to visual representation and imagery (BA 17 and cuneus) and motor planning (premotor and supplementary motor areas; BA 6). This study suggests that drawing benefits memory by coactivating multiple sensory traces. Target words drawn during encoding are subsequently remembered by re-engaging visual, motoric, and semantic representations.

Mental Time Travel: A Retrospective

Because imagination activates the same neural circuits used in understanding the present, one can access that imagination even in non-linguistic animals through decoding techniques applied to large neural ensembles. This personal retrospective traces the history of the initial discovery that hippocampal theta sequences sweep forward to goals during moments of deliberation and discusses the history that was necessary to put ourselves in the position to recognize this signal. It also discusses how that discovery fits into the larger picture of hippocampal function and the concept of cognition as computation.

Stage 2 Registered Report: Propositional Thought Is Sufficient for Imaginal Extinction as Shown by Contrasting Participants With Aphantasia, Simulated Aphantasia, and Controls

Imaginal exposure is a standard procedure of cognitive behavioral therapy for the treatment of anxiety and panic disorders. It is often used when in vivo exposure is not possible, too stressful for patients, or would be too expensive. The Bio-Informational Theory implies that imaginal exposure is effective because of the perceptual proximity of mental imagery to real events, whereas empirical findings suggest that propositional thought of fear stimuli (i.e., thinking about the stimuli without seeing them in the mind's eye) could be sufficient. To investigate whether mental imagery or propositional thought is crucial for the success of imaginal exposure, participants with the rare state of aphantasia (= absence of sensory mental imagery) and two control groups were subjected to a fear conditioning paradigm followed by imaginal exposure and a reinstatement procedure. During imaginal exposure, a control group (N = 30) stared at a bright screen to disrupt visual imagery by incoming luminance (=simulated aphantasia), while a second control group (N = 30) and participants with actual aphantasia (N = 30) kept their eyes closed. Results showed successful extinction in all groups, thus demonstrating that imaginal extinction is possible using propositional thought. Moreover, exploratory analyses revealed less subjective fear in people with aphantasia during the fear conditioning procedure, potentially due to similar mechanisms as in alexithymia, that is, a decoupling between physiological arousal and emotional experience.

Tactile imagery affects cortical responses to vibrotactile stimulation of the fingertip

Mental imagery is a crucial cognitive process, yet its underlying neural mechanisms remain less understood compared to perception. Furthermore, within the realm of mental imagery, the somatosensory domain is particularly underexplored compared to other sensory modalities. This study aims to investigate the influence of tactile imagery (TI) on cortical somatosensory processing. We explored the cortical manifestations of TI by recording EEG activity in healthy human subjects. We investigated event-related somatosensory oscillatory dynamics during TI compared to actual tactile stimulation, as well as somatosensory evoked potentials (SEPs) in response to short vibrational stimuli, examining their amplitude-temporal characteristics and spatial distribution across the scalp. EEG activity exhibited significant changes during TI compared to the no-imagery baseline. TI caused event-related desynchronization (ERD) of the contralateral μ-rhythm, with a notable correlation between ERD during imagery and real stimulation across subjects. TI also modulated several SEP components in sensorimotor and frontal areas, showing increases in the contralateral P100 and P300, contra- and ipsilateral P300, frontal P200, and parietal P600 components. The results clearly indicate that TI affects cortical processing of somatosensory stimuli, impacting EEG responses in various cortical areas. The assessment of SEPs in EEG could serve as a versatile marker of tactile imagery in practical applications. We propose incorporating TI in imagery-based brain-computer interfaces (BCIs) to enhance sensorimotor restoration and sensory substitution. This approach underscores the importance of somatosensory mental imagery in cognitive neuroscience and its potential applications in neurorehabilitation and assistive technologies.

Individualized functional magnetic resonance imaging neuromodulation enhances visuospatial perception: a proof-of-concept study

This proof-of-concept study uses individualized functional magnetic resonance imaging neuromodulation (iNM) to explore the mechanisms that enhance BOLD signals in visuospatial perception (VP) networks that are crucial for navigation. Healthy participants (n = 8) performed a VP up- and down-direction discrimination task at full and subthreshold coherence through peripheral vision, and superimposed direction through visual imagery (VI) at central space under iNM and control conditions. iNM targets individualized anatomical and functional middle- and medial-superior temporal (MST) networks that control VP. We found that iNM engaged selective exteroceptive and interoceptive attention (SEIA) and motor planning (MP) networks. Specifically, iNM increased overall: (i) area under the curve of the BOLD magnitude: 100% in VP (but decreased for weak coherences), 21-47% in VI, 26-59% in MP and 48-76% in SEIA through encoding; and (ii) classification performance for each direction, coherence and network through decoding, predicting stimuli from brain maps. Our findings, derived from encoding and decoding models, suggest that mechanisms induced by iNM are causally linked in enhancing visuospatial networks and demonstrate iNM as a feasibility treatment for low-vision patients with cortical blindness or visuospatial impairments that precede cognitive decline.This article is part of the theme issue 'Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation'.

Feedback scales the spatial tuning of cortical responses during both visual working memory and long-term memory

Perception, working memory, and long-term memory each evoke neural responses in visual cortex. While previous neuroimaging research on the role of visual cortex in memory has largely emphasized similarities between perception and memory, we hypothesized that responses in visual cortex would differ depending on the origins of the inputs. Using fMRI, we quantified spatial tuning in visual cortex while participants (both sexes) viewed, maintained in working memory, or retrieved from long-term memory a peripheral target. In each condition, BOLD responses were spatially tuned and aligned with the target's polar angle in all measured visual field maps including V1. As expected given the increasing sizes of receptive fields, polar angle tuning during perception increased in width up the visual hierarchy from V1 to V2, V3, hV4, and beyond. In stark contrast, the tuned responses were broad across the visual hierarchy during long-term memory (replicating a prior result) and during working memory. This pattern is consistent with the idea that mnemonic responses in V1 stem from top-down sources, even when the stimulus was recently viewed and is held in working memory. Moreover, in long-term memory, trial-to-trial biases in these tuned responses (clockwise or counterclockwise of target), predicted matched biases in memory, suggesting that the reinstated cortical responses influence memory guided behavior. We conclude that feedback widens spatial tuning in visual cortex during memory, where earlier visual maps inherit broader tuning from later maps thereby impacting the precision of memory.

Imagery-based cognitive therapy to reduce emotional dysregulation and mood instability in bipolar disorder: a case-series study

INTRODUCTION

Bipolar disorder (BD) has a significant impact on functioning in the absence of acute mood episodes. This has been associated with subsyndromal symptoms, co-morbidities, and emotional dysregulation. The present study aims to evaluate the acceptability and preliminary efficacy of imagery-based cognitive therapy (ImCT) in a French community setting. We were particularly interested in the link between mental imagery and emotional dysregulation as this may clarify the mechanisms involved in the potential efficacy of the therapy and ultimately improve its relevance.

METHOD

Ten participants underwent ImCT, with weekly assessments of mood fluctuations, anxiety, and emotional dysregulation conducted over 1 month (i.e. pre-therapy, post-therapy and 1-month follow-up). Recovery, post-traumatic stress symptoms and self-compassion were measured at baseline and post-therapy. Attrition rates and satisfaction were measured.

RESULTS

All participants who completed therapy (n=8) reported high levels of satisfaction. Five of them showed reliable individual improvement on emotion dysregulation scores. At the group level, a significant decrease in mood fluctuation with a large effect size was found post-therapy.

CONCLUSION

ImCT showed good acceptability among participants who completed the study. Importantly, our study is the first to provide an indication that ImCT may alleviate subsyndromal mood symptoms but also emotional dysregulation in individuals with BD. This latter finding is particularly relevant given the scarcity of validated psychosocial interventions targeting emotional dysregulation in BD.

From anticipation to action: A RCT on mental imagery exercises in daily life as a motivational amplifier for individuals with depressive symptoms

Encouraging engagement in rewarding or pleasant activities is one of the most important treatment goals for depression. Mental imagery exercises have been shown to increase the motivation for planned behaviour in the lab but it is unclear whether this is also the case in daily life. Therefore, we aimed to investigate the effect of mental imagery exercises on motivation and behaviour in daily life. Participants with depressive symptoms (N = 59) were randomly assigned to a group receiving mental imagery (MI) exercises or a control group receiving relaxation (RE) exercises via study phones. We employed an experience sampling design with 10 assessments per day for 10 days (three days baseline, four days with two exercises per day and three days post-intervention). Data was analysed using t-tests and multilevel linear regression analyses. As predicted, MI exercises enhanced motivation and reward anticipation during the intervention phase compared to RE. However, MI did not enhance active behaviour or strengthen the temporal association from reward anticipation (t-1) to active behaviour (t). Mental imagery exercises can act as a motivational amplifier but its effects on behaviour and real-life reward processes remain to be elucidated.

Measures of mental imagery in emotional disorders: A COSMIN systematic review of psychometric properties

BACKGROUND

Dysfunctional imagery processes characterise a range of emotional disorders. Valid, reliable, and responsive mental imagery measures may support the clinical assessment of imagery and advance research to develop theory and imagery-based interventions. We sought to review the psychometric properties of mental imagery measures relevant to emotional disorders.

METHODS

A systematic review registered on the Open Science Framework was conducted using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Five databases were searched. COSMIN tools were used to assess the quality of study methodologies and psychometric properties of measures.

RESULTS

Twenty-three articles describing twenty-one self-report measures were included. Measures assessed various imagery processes and were organised into four groups based on related emotional disorders. Study methodological quality varied: measure development and reliability studies were generally poor, while internal consistency and hypothesis testing studies were higher quality. Most measurement properties assessed were of indeterminate quality.

CONCLUSION

Imagery measures were heterogenous and primarily disorder specific. Due to a lack of high-quality psychometric assessment, it is unclear whether most included imagery measures are valid, reliable, or responsive. Measures had limited evidence of content validity suggesting further research could engage clinical populations to ensure their relevance and comprehensiveness.

The outcomes of imagery-focused interventions in relation to distress in people with delusions: a systematic literature review

BACKGROUND

Imagery-focused therapies within cognitive behavioural therapy are growing in interest and use for people with delusions.

AIMS

This review aimed to examine the outcomes of imagery-focused interventions in people with delusions.

METHOD

PsycINFO, PubMed, MEDLINE, Web of Science, EMBASE and CINAHL were systematically searched for studies that included a clinical population with psychosis and delusions who experienced mental imagery. The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and quality appraisal of all included papers was completed using the Crowe Critical Appraisal Tool. Information from included texts was extracted and collated in Excel, which informed the narrative synthesis of results.

RESULTS

Of 2,736 studies identified, eight were eligible for inclusion and rated for quality with an average score of 70.63%. These studies largely supported their aims in reducing levels of distress and intrusiveness of imagery. Four of the eight studies used case series designs, two were randomised controlled trials, and two reported single case studies. It appears that interventions targeting mental imagery were acceptable and well tolerated within a population of people experiencing psychosis and delusions.

CONCLUSIONS

Some therapeutic improvement was reported, although the studies consisted of mainly small sample sizes. Clinical implications include that people with a diagnosis of psychosis can engage with imagery-focused therapeutic interventions with limited adverse events. Future research is needed to tackle existing weaknesses of design and explore the outcomes of imagery interventions within this population in larger samples, under more rigorous methodologies.

Differential Hemodynamic Responses to Motor and Tactile Imagery: Insights from Multichannel fNIRS Mapping

Tactile and motor imagery are crucial components of sensorimotor functioning and cognitive neuroscience research, yet the neural mechanisms of tactile imagery remain underexplored compared to motor imagery. This study employs multichannel functional near-infrared spectroscopy (fNIRS) combined with image reconstruction techniques to investigate the neural hemodynamics associated with tactile (TI) and motor imagery (MI). In a study of 15 healthy participants, we found that MI elicited significantly greater hemodynamic responses (HRs) in the precentral area compared to TI, suggesting the involvement of different cortical areas involved in two different types of sensorimotor mental imagery. Concurrently, the HRs in S1 and parietal areas exhibited comparable patterns in both TI and MI. During MI, both motor and somatosensory areas demonstrated comparable HRs. However, in TI, somatosensory activation was observed to be more pronounced. Our results highlight the distinctive neural profiles of motor versus tactile imagery and indicate fNIRS technique to be sensitive for this. This distinction is significant for fundamental understanding of sensorimotor integration and for developing advanced neurotechnologies, including imagery-based brain-computer interfaces (BCIs) that can differentiate between different types of mental imagery.

Visual mental imagery abilities in autism

In autistic individuals, the role, performance, and autonomy of perceptual functioning are atypical. Overlapping underlying mechanisms of perception and mental imagery predict that the mental imagery abilities of autistic individuals should differ from those of non‐autistic individuals. While enhanced abilities to manipulate mental images have been demonstrated in autism, the other stages of mental imagery (generation, maintenance, inspection) remain to be explored. Forty‐four autistic adults and 42 typical participants performed four tasks to assess different stages of mental imagery: the Image generation task (mentally generating a letter on a grid and indicating whether it passes over a probe located in the grid), the Visual pattern test (maintaining visual patterns in memory), the Image scanning test (inspecting mental images) and the Mental rotation test (mentally manipulating representations of geometric figures). In the image generation task and the mental rotation test, autistic and typical individuals performed equivalently, both in accuracy and response time. The span observed in the visual pattern test was significantly higher in the autistic group, indicating better maintenance of mental images. In the image scanning test, response times were influenced by the distance to mentally inspect in the typical group but not in the autistic group. Autistic participants were equally fast regardless of distance to inspect. Preserved, greater or differently influenced visual mental imagery abilities are in line with an atypical perceptual functioning in autism, possibly reflecting an increased weight of perception‐based information relatively to the top‐down effect of knowledge and language‐based influence.

Brain state and dynamic transition patterns of motor imagery revealed by the bayes hidden markov model

Motor imagery (MI) is a high-level cognitive process that has been widely applied to brain-computer inference (BCI) and motor recovery. In practical applications, however, huge individual differences and unclear neural mechanisms have seriously hindered the application of MI and BCI systems. Thus, it is urgently needed to explore MI from a new perspective. Here, we applied a hidden Markov model (HMM) to explore the dynamic organization patterns of left- and right-hand MI tasks. Eleven distinct HMM states were identified based on MI-related EEG data. We found that these states can be divided into three metastates by clustering analysis, showing a highly organized structure. We also assessed the probability activation of each HMM state across time. The results showed that the state probability activation of task-evoked have similar trends to that of event-related desynchronization/synchronization (ERD/ERS). By comparing the differences in temporal features of HMM states between left- and right-hand MI, we found notable variations in fractional occupancy, mean life time, mean interval time, and transition probability matrix across stages and states. Interestingly, we found that HMM states activated in the left occipital lobe had higher occupancy during the left-hand MI task, and conversely, during the right-hand MI task, HMM states activated in the right occipital lobe had higher occupancy. Moreover, significant correlations were observed between BCI performance and features of HMM states. Taken together, our findings explored dynamic networks underlying the MI-related process and provided a complementary understanding of different MI tasks, which may contribute to improving the MI-BCI systems.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11571-024-10099-9.

Aphantasia and autism: An investigation of mental imagery vividness

OBJECTIVE

The present study investigated whether autistic adults report different levels of mental imagery vividness than non-autistic adults, and, moreover, if autism is associated with aphantasia which is defined as a condition of reduced or absent voluntary imagery.

DESIGN AND METHODS

Clinically diagnosed and self-identifying autistic participants were compared with non-autistic participants in their mental imagery vividness (vision, sound, smell, taste, touch, bodily sensation and emotional feeling) and autistic traits using an online survey (N = 121).

RESULTS

The autistic group scored significantly lower than the non-autistic group on imagery vividness (d = -0.44), in addition to having a higher proportion of participants scoring at cut-off for aphantasia. Moreover, a similar difference was observed for the emotional feel (η2 = 0.11).

CONCLUSION

The vividness of visual and emotional mental imagery was on average lower for autistic individuals, with a higher proportion presenting at cut-off to be considered an aphantasic.

Attention control mediates the relationship between mental imagery vividness and emotion regulation

Contradictory findings suggest mental imagery may both exacerbate and protect against negative affect. We aimed to reconcile these contradictory findings by considering individual differences (N=989) in imagery vividness, attention control, resilience, emotion regulation strategy, and negative affect (depressive, anxious, and posttraumatic stress symptomology). We hypothesized that attention control would mediate relationships between imagery vividness and emotion regulation strategy use, and psychopathology symptomology. Results revealed that imagery vividness, as mediated by attention control, predicted greater levels of healthy reappraisal and deleterious rumination. Attention control also mediated negative relationships between imagery vividness and catastrophizing, self-blame, and psychopathology symptomology. An exploratory latent structural equation model revealed that imagery vividness and attention control aggregated positively with reappraisal and resilience scores. The present investigation suggests an adaptive function of imagery vividness via the indirect effects of attention control, facilitating adaptive emotion regulation and limiting maladaptive strategy use, thereby protecting against negative affect.

The Neural Underpinnings of Aphantasia: A Case Study of Identical Twins

Aphantasia is a condition characterized by reduced voluntary mental imagery. As this lack of mental imagery disrupts visual memory, understanding the nature of this condition can provide important insight into memory, perception, and imagery. Here, we leveraged the power of case studies to better characterize this condition by running a pair of identical twins, one with aphantasia and one without, through mental imagery tasks in an fMRI scanner. We identified objective, neural measures of aphantasia, finding less visual information in their memories which may be due to lower connectivity between frontoparietal and occipitotemporal lobes of the brain. However, despite this difference, we surprisingly found more visual information in the aphantasic twin's memory than anticipated, suggesting that aphantasia is a spectrum rather than a discrete condition.

A Systematic Review of Aphantasia: Concept, Measurement, Neural Basis, and Theory Development

People with aphantasia exhibit the inability to voluntarily generate or form mental imagery in their minds. Since the term "aphantasia" was proposed to describe this, it has gained increasing attention from psychiatrists, neuroscientists, and clinicians. Previous studies have mainly focused on the definition, prevalence, and measurement of aphantasia, its impacts on individuals' cognitive and emotional processing, and theoretical frameworks synthesizing existing findings, which have contributed greatly to our understanding of aphantasia. However, there are still some debates regarding the conclusions derived from existing research and the theories that were constructed from various sources of evidence. Building upon existing endeavors, this systematic review emphasizes that future research is much needed to refine the definition and diagnosis of aphantasia, strengthen empirical investigations at behavioral and neural levels, and, more importantly, develop or update theories. These multiple lines of efforts could lead to a deeper understanding of aphantasia and further guide researchers in future research directions.

A guided single session intervention to reduce intrusive memories of work-related trauma: a randomised controlled trial with healthcare workers in the COVID-19 pandemic

BACKGROUND

Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic.

METHODS

Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71). The number of intrusive memories was assessed at baseline and 5 weeks after the guided session (primary endpoint).

RESULTS

The intervention significantly reduced intrusive memory frequency compared with control [intervention Mdn = 1.0 (IQR = 0-3), control Mdn = 5.0 (IQR = 1-17); p < 0.0001, IRR = 0.30; 95% CI = 0.17-0.53] and led to fewer post-traumatic stress-related symptoms at 1, 3 and 6 month follow-ups (secondary endpoints). Participants and statisticians were blinded to allocation. Adverse events data were acquired throughout the trial, demonstrating safety. There was high adherence and low attrition.

CONCLUSIONS

This brief, single-symptom, repeatable digital intervention for subclinical-to-clinical samples after trauma allows scalability, taking a preventing-to-treating approach after trauma.

TRIAL REGISTRATION

2020-07-06, ClinicalTrials.gov identifier: NCT04460014.

A Spatio-Temporal Capsule Neural Network with Self-Correlation Routing for EEG Decoding of Semantic Concepts of Imagination and Perception Tasks

Decoding semantic concepts for imagination and perception tasks (SCIP) is important for rehabilitation medicine as well as cognitive neuroscience. Electroencephalogram (EEG) is commonly used in the relevant fields, because it is a low-cost noninvasive technique with high temporal resolution. However, as EEG signals contain a high noise level resulting in a low signal-to-noise ratio, it makes decoding EEG-based semantic concepts for imagination and perception tasks (SCIP-EEG) challenging. Currently, neural network algorithms such as CNN, RNN, and LSTM have almost reached their limits in EEG signal decoding due to their own short-comings. The emergence of transformer methods has improved the classification performance of neural networks for EEG signals. However, the transformer model has a large parameter set and high complexity, which is not conducive to the application of BCI. EEG signals have high spatial correlation. The relationship between signals from different electrodes is more complex. Capsule neural networks can effectively model the spatial relationship between electrodes through vector representation and a dynamic routing mechanism. Therefore, it achieves more accurate feature extraction and classification. This paper proposes a spatio-temporal capsule network with a self-correlation routing mechaninsm for the classification of semantic conceptual EEG signals. By improving the feature extraction and routing mechanism, the model is able to more effectively capture the highly variable spatio-temporal features from EEG signals and establish connections between capsules, thereby enhancing classification accuracy and model efficiency. The performance of the proposed model was validated using the publicly accessible semantic concept dataset for imagined and perceived tasks from Bath University. Our model achieved average accuracies of 94.9%, 93.3%, and 78.4% in the three sensory modalities (pictorial, orthographic, and audio), respectively. The overall average accuracy across the three sensory modalities is 88.9%. Compared to existing advanced algorithms, the proposed model achieved state-of-the-art performance, significantly improving classification accuracy. Additionally, the proposed model is more stable and efficient, making it a better decoding solution for SCIP-EEG decoding.

Strategies to Improve Bladder Control: A Preliminary Case Study

Background: Lower urinary tract symptoms (LUTSs) are a common complaint in adult and elderly men with bladder outlet obstruction, and have a considerable impact on their quality of life. Symptoms affect storage, voiding and post micturition stages. Among the latter, a feeling of incomplete emptying is one of the most bothersome for the patients; a condition that in turn contributes to affect urinary urgency, nocturia and frequency. Common recommendations include self-management practices (e.g., control of fluid intake, double-voiding and distraction techniques) to relieve patients' symptoms, whose effectiveness, however, is under debate. Methods: In this report we describe two pioneering procedures to favor bladder residual content voiding in people complaining of LUTS disorders. The first is based on motor imagery and the second on the use of odors. The beneficial effects of Mental imagery techniques on various tasks (e.g., in the treatment of several pathological conditions or as valid mnemonics aids have a long tradition and have received consistently experimental support. Thus, a patient (a 68-year-old Caucasian man) complaining of LUTS was trained to use a motor imagery technique (building up a visual image comprising the bladder, the detrusor muscle and the urethra, and to imagine the detrusor muscle contracting and the flow of urine expelled) for 90 days and two odors (coffee and a lavender scented cleanser) for 10 days, as a trigger for micturition. He was asked to record-immediately after the first morning micturition-the time interval between the first (free) and the second (cued) micturition. Results: Reported data suggest the efficacy of motor imagery in favoring the bladder residual urine voiding in a few minutes (M = 4.75 min.) compared to the control condition, i.e., the baseline of the patient (M = 79.5 min.), while no differences between the odor-based procedures (M 1st odorant = 70.6 min.; M 2nd odorant = 71.1 min) and the latter were observed. Conclusions: A procedure based on an imagery technique may, therefore, be of general value-as a suggested protocol-and accordingly can be applicable to clinical settings. An olfactory bladder control hypothesis cannot, however, be ruled out and is discussed as a promising future line of research.

Neural signatures of imaginary motivational states: desire for music, movement and social play

The literature has demonstrated the potential for detecting accurate electrical signals that correspond to the will or intention to move, as well as decoding the thoughts of individuals who imagine houses, faces or objects. This investigation examines the presence of precise neural markers of imagined motivational states through the combining of electrophysiological and neuroimaging methods. 20 participants were instructed to vividly imagine the desire to move, listen to music or engage in social activities. Their EEG was recorded from 128 scalp sites and analysed using individual standardized Low-Resolution Brain Electromagnetic Tomographies (LORETAs) in the N400 time window (400-600 ms). The activation of 1056 voxels was examined in relation to the 3 motivational states. The most active dipoles were grouped in eight regions of interest (ROI), including Occipital, Temporal, Fusiform, Premotor, Frontal, OBF/IF, Parietal, and Limbic areas. The statistical analysis revealed that all motivational imaginary states engaged the right hemisphere more than the left hemisphere. Distinct markers were identified for the three motivational states. Specifically, the right temporal area was more relevant for "Social Play", the orbitofrontal/inferior frontal cortex for listening to music, and the left premotor cortex for the "Movement" desire. This outcome is encouraging in terms of the potential use of neural indicators in the realm of brain-computer interface, for interpreting the thoughts and desires of individuals with locked-in syndrome.

Experiences of imagery-based treatment for anxiety in bipolar disorder: A qualitative study embedded within the image based emotion regulation feasibility randomised controlled trial

OBJECTIVES

Intrusive mental imagery is associated with anxiety in bipolar disorder (BD) and presents a novel treatment target. Imagery-based treatments show promise in targeting anxiety and improving mood instability. This qualitative study explored experiences of receiving up to 12 sessions of a brief structured psychological intervention: Image-Based Emotion Regulation (IBER), which targets maladaptive mental imagery in the context of BD with an aim to modify the emotional impact of these images.

DESIGN

A qualitative study embedded within the Image Based Emotion Regulation (IBER) feasibility randomised controlled trial.

METHODS

Semi-structured interviews were conducted with 12 participants in the treatment arm of the trial who received IBER + treatment as usual. Data were analysed using thematic analysis.

RESULTS

Despite some initial scepticism about imagery-focused treatment, all participants expressed broadly positive accounts of treatment experiences. High levels of engagement with imagery modification techniques, beneficial use of techniques post treatment and improvements in anxiety management and agency were described by some. Three sub-groups were identified: those who reported a powerful transformative impact of treatment; those who embedded some new techniques into their daily lives, and those who felt they had techniques to use when needed. No participants reported overall negative experiences of the IBER treatment.

CONCLUSIONS

Findings from this study highlight the value for treatment recipients of modifying the underlying meanings associated with maladaptive imagery, and the personalised skills development to manage anxiety within bipolar disorders. Findings can inform treatment refinements and further trial-based evaluations.

Vividness of visual imagery is associated with the effect of relaxation response meditation training in elderly people with nonorganic insomnia: A randomized, double-blind, multi-center clinical trial

BACKGROUND

This study aims to explore the efficacy of Relaxation Response Meditation Training (RRMT) on elderly individuals with different levels of vividness of visual imagery.

METHODS

In this randomized controlled, double-blind, multi-center clinical trial, we recruited a total of 136 elderly individuals who were over 60 years with nonorganic sleep disorders to participate in a 4-week RRMT intervention from October 2020 to October 2022. The intervention occurred twice a week, totaling eight times. These individuals were divided into high and low groups based on the vividness of visual imagery, and then randomly assigned to either the control or intervention groups, as follows: low-visualizers intervention group (LI group); low-visualizers control group (LC group); high-visualizers intervention group (HI group); high-visualizers control group (HC group). Their social and psychological parameters were assessed before and after the intervention by the Pittsburgh Sleep Quality Index (PSQI), the Revised Piper's fatigue scale (RPFS), General well-being scale (GWB), and Satisfaction rating. The alpha waves of patients were also collected through electroencephalogram to assess their level of relaxation.

RESULTS

Compared to the LI group, the HI group had a greater reduction rate in the PSQI score [25.2 % (18.8 % to 31.7 %), P < 0∙001], shorter sleep latency (P = 0.001), lower frequency of sleep medication (P < 0.001), lower PSQI scores (P < 0.001), and higher GWB scores (P < 0.001). There were significant differences in all indicators in the HI group vs. HC group and in the LI group vs. LC group. In the first five relaxation training sessions, there was no statistically significant difference in the proportion of α waves between the LI group and the LC group; however, from the sixth session onward, we observed a statistically significant difference (t = 2.86, P = 0.019)，while The HI group and HC group showing significant differences in the first relaxation training session (t = 4.464, P < 0.001). There was a statistically significant difference in subjective satisfaction between the intervention group and the control group (x2 = 49.605, P < 0.001).

CONCLUSION

In this study, we found that most elderly people benefitted from RRMT regardless of their vividness of visual imagery. However, low-visualizers experienced slower and less effective results, so these patients may benefit more from alternative approaches.

Effects of instructed visual imagining on emergent conditional discriminations

Visual imagining has been proposed to play a role in the emergence of derived stimulus relations. We examined whether test-relevant visual imagining during baseline training would, accordingly, facilitate emergent visual-visual conditional discriminations at test. Adult participants (n = 75) were randomly assigned to three groups. Baseline tact training established conditional discriminations among sets of image samples and textual comparisons (AC/BD), and baseline intraverbal training established conditional discriminations among pairs of textual stimuli (CD). Two groups received tact before intraverbal training, and one group received the reverse sequence. During intraverbal training, one of the former groups was instructed to visualize the images that went with the textual stimuli. These instructions did not affect participants' retrospective self-reports of test-relevant visual imagining during training. Nevertheless, they produced a large effect on correct responding in an image-matching test (AB/BA) that followed intraverbal training. This effect was independent of baseline retention.

Suffering more in imagination than in reality? Mental imagery and fear generalization

Mental imagery may represent a weaker form of perception and, thus, mental images may be more ambiguous than visual percepts. If correct, the acquisition of fear would be less specific for imagined fears in comparison to perceptual fears, perhaps facilitating broader fear generalization. To test this idea, a two-day differential fear conditioning experiment (N = 98) was conducted. On day one, two groups of participants underwent differential fear conditioning such that a specific Gabor patch orientation (CS+) was paired with mild shocks (US) while a second Gabor patch of orthogonal orientation (CS-) was never paired with shock. Critically, one group imagined the Gabor patches and the other group was visually presented the Gabor patches. Next, both groups were presented visual Gabor patches of similar orientations (GCS) to the CS+. On day two, to assess the persistence of imagined fear, participants returned to the lab and were tested on the GCS devoid of shock. For day one, in contrast to our primary hypothesis, both self-report and skin conductance response measures did not show a significant interaction between the GCS and groups. On day two, both measures demonstrated a persistence of imagined fear, without US delivery. Taken together, rather than demonstrating an overgeneralization effect, the results from this study suggest that imagery-based fear conditioning generalizes to a similar extent as perceptually acquired fear conditioning. Further, the persistence of imagery-based fear may have unique extinction qualities in comparison to perceptual-based fear.

Picturing self-harm: Investigating flash-forward mental imagery as a proximal and modifiable driver of non-suicidal self-injury

OBJECTIVES

Non-suicidal self-injury (NSSI) is theorized to be reinforced by its emotional consequences. Mental images of NSSI are commonly reported as occurring prior to NSSI. Based on the known functional properties of anticipatory mental imagery as an emotional and motivational amplifier, this study investigated whether NSSI mental imagery constitutes a proximal and dynamic mechanism underpinning NSSI risk.

METHOD

An intensive ecological momentary assessment (EMA) study was conducted to track the occurrence and characteristics of NSSI mental imagery alongside NSSI urge and behavior in naturalistic settings. A sample of N = 43 individuals aged 17 to 24 with a history of repetitive NSSI completed EMA surveys seven times a day for 14 days.

RESULTS

Mental preoccupation in the form of NSSI mental imagery-based flash-forwards to the actions, bodily sensations, and emotional benefits of NSSI was found to occur when NSSI urge was high but not when urge was low. Critically, objective cross-panel analyses showed that higher frequencies of NSSI imagery occurrence predicted greater future NSSI urge and increased likelihood of acting on urge, over and above current urge.

CONCLUSIONS

Mental imagery of NSSI is not simply an epiphenomenal by-product of NSSI urge and may constitute a dynamic and proximal novel intervention target.

Buffering effect of fiction on negative emotions: engagement with negatively valenced fiction decreases the intensity of negative emotions

Previous research has investigated how the context of perception affects emotional response. This study investigated how engagement with perceived fictional content vs perceived everyday-life content affects the way people experience negative emotions. Four studies with an experimental design tested how engagement with perceived fictional content vs perceived everyday life content affects the intensity of negative emotional response to negative emotional content, the motivation to decrease negative emotions, and cognitive reappraisal. Participants were presented with negatively valenced images and were asked to imagine either that they were witnessing them, or that a bystander was witnessing them, or that they were viewing a movie including these scenes. After the manipulation, all participants observed a different set of negatively valenced images or a set of negatively valenced videos and reported their emotional response. We found that the intensity of negative emotions and motivation to decrease them was lower among participants in the fiction condition compared to participants in the everyday life condition. Although perspective-taking had a similar effect on negative emotions, fiction condition was more successful in decreasing negative emotions. This might indicate that fiction plays a buffering role in decreasing the negative emotions people experience when facing negative emotional content.

Attenuating conditioned fear using imagery-based interventions: An overview

A growing literature has sought to include mental imagery in fear conditioning studies. Imaginal extinction and imagery rescripting are mental imagery-based interventions that reduce conditioned fear. In the current study, we reviewed the recent findings on the efficacy of imaginal extinction and imagery rescripting as interventions to attenuate conditioned fear responses among healthy individuals. In accordance with the PRISMA guidelines, we conducted a literature search in four databases, PubMed, Scopus, Science Direct, and Web of Science to find published original empirical articles involving imagery-based interventions using a fear conditioning paradigm. The inclusion criteria were (i) use of an imagery-based intervention (either imaginal extinction or imagery rescripting), and (ii) use of a differential fear conditioning paradigm. 13 original articles reporting 15 experimental studies were included in the review. The review revealed that imagery-based interventions are effective in reducing conditioned fear. Although studies have shown that imaginal extinction and standard extinction have comparable effects in fear extinction, many studies have not been conducted to confirm the findings, or explore the underlying mechanisms. We also found the need for a standardized intervention protocol to enhance experimental control in intervention-based fear conditioning studies.

The Nature of Mental Imagery and Its Relationship With Amotivational Psychopathology in People With Schizophrenia Spectrum Disorders

Many people with schizophrenia spectrum disorders (SSDs) experience profound amotivation, which is strongly related to anticipatory anhedonia. Yet, the neuropsychological fundamentals of anticipatory anhedonia and amotivation are barely understood, resulting in a lack of effective treatments for these patients. Aberrancies in positive mental imagery may interfere with the anticipation of pleasure and could thus explain anticipatory anhedonia and amotivation. However, the nature of mental imagery and its relationship with amotivational psychopathology in SSD is largely unknown. In this preregistered study, we therefore examined mental imagery characteristics and their relation to anticipatory anhedonia, amotivation, and daily life activity in SSD. TheN = 86 participants included individuals with SSD (n = 43) and demographically matched healthy controls (n = 43). Mental imagery, anticipatory pleasure, amotivation, and activity engagement were assessed with structured interviews and self-report questionnaires. Ecological momentary assessment was used to measure state anticipatory pleasure and activity engagement in daily life (n = 81). Compared to the control group, the SSD group showed comparable quantity, but less vividness of mental imagery. Reduced vividness of mental imagery in SSD was significantly associated with higher anticipatory anhedonia, amotivation, and low activity engagement in cross-sectional and prospective analyses. Reduced mental imagery vividness may cause a lack of internal incentive to seek pleasurable experiences and could explain amotivation. Interventions aiming to improve mental imagery vividness and related anticipatory pleasure responses in SSD may be effective in targeting amotivation.

The Impact of Mental Imagery Instructions on Patients' and Therapists' Positive Affect and Strength-Based Behaviours Within Psychotherapy Sessions: A Randomized Controlled Process Study

OBJECTIVE

Increased attention has recently been paid to the well-being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength-based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions.

METHODS

This is a secondary analysis of a randomized controlled trial. Seventy-eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; Mage = 40.31) treated by 13 therapists were selected. PA and strength-based behaviours of patients and therapists were coded on a minute-by-minute basis with the Resource-Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling.

RESULTS

Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength-based behaviours were employed in one-fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength-based behaviours in the beginning phase of sessions, p < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, p < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend.

CONCLUSION

Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018).

Representations of imaginary scenes and their properties in cortical alpha activity

Imagining natural scenes enables us to engage with a myriad of simulated environments. How do our brains generate such complex mental images? Recent research suggests that cortical alpha activity carries information about individual objects during visual imagery. However, it remains unclear if more complex imagined contents such as natural scenes are similarly represented in alpha activity. Here, we answer this question by decoding the contents of imagined scenes from rhythmic cortical activity patterns. In an EEG experiment, participants imagined natural scenes based on detailed written descriptions, which conveyed four complementary scene properties: openness, naturalness, clutter level and brightness. By conducting classification analyses on EEG power patterns across neural frequencies, we were able to decode both individual imagined scenes as well as their properties from the alpha band, showing that also the contents of complex visual images are represented in alpha rhythms. A cross-classification analysis between alpha power patterns during the imagery task and during a perception task, in which participants were presented images of the described scenes, showed that scene representations in the alpha band are partly shared between imagery and late stages of perception. This suggests that alpha activity mediates the top-down re-activation of scene-related visual contents during imagery.

Effectiveness of motor imagery on sports performance in football players: A randomised control trial

Background

Nowadays, the development of training programs for speed, agility and reaction time responses in football players is increasing widely. Motor imagery is a new method that uses collateral with physical training. However, there is still a scarcity of evidence concerning the addition of motor imagery protocol to routine training programs.

Objective

The main objective was to compare speed, agility and reaction time after motor imagery training in university athletes and amateur athletes who received and did not receive motor imagery training for 2 weeks.

Methods

Participants were divided into 4 subgroups as follows: university athlete group with motor imagery training and control group, amateur athlete group with motor imagery training and control group. This study collected the training effects of speed, agility and reaction time. The Wilcoxon signed-rank test and the Mann-Whitney U test were selected to analyse the differences within and between groups, respectively.

Results

The result presented positive changes in all variables after training sessions for 2 weeks in all groups. Speed at 20 m, agility, and reaction time were found to be significantly different after motor imagery training in both university athletes and amateur athletes.

Conclusion

This finding demonstrated that the addition of the motor imagery training along with routine physical training promotes physical performance in athletes at all experience levels. In further studies, the retention effect after practice should be considered.

Bilinguals on the footbridge: the role of foreign-language proficiency in moral decision making

Socio-cognitive research on bilinguals points to a moral foreign-language effect (MFLE), with more utilitarian choices (e.g., sacrificing someone to save more people) for moral dilemmas presented in the second language (L2) relative to the first language. Yet, inconsistent results highlight the influence of subject-level variables, including a critical underexplored factor: L2 proficiency (L2p). Here we provide a systematic review of 57 bilingualism studies on moral dilemmas, showing that L2p rarely modulates responses to impersonal dilemmas, but it does impact personal dilemmas (with MFLEs proving consistent at intermediate L2p levels but unsystematic at high L2p levels). We propose an empirico-theoretical framework to conceptualize such patterns, highlighting the impact of L2p on four affective mediating factors: mental imagery, inhibitory control, prosocial behavior and numerical processing. Finally, we outline core challenges for the field. These insights open new avenues at the crossing of bilingualism and social cognition research.

No clear evidence of a difference between individuals who self-report an absence of auditory imagery and typical imagers on auditory imagery tasks

Aphantasia is characterised by the inability to create mental images in one's mind. Studies investigating impairments in imagery typically focus on the visual domain. However, it is possible to generate many different forms of imagery including imagined auditory, kinesthetic, tactile, motor, taste and other experiences. Recent studies show that individuals with aphantasia report a lack of imagery in modalities, other than vision, including audition. However, to date, no research has examined whether these reductions in self-reported auditory imagery are associated with decrements in tasks that require auditory imagery. Understanding the extent to which visual and auditory imagery deficits co-occur can help to better characterise the core deficits of aphantasia and provide an alternative perspective on theoretical debates on the extent to which imagery draws on modality-specific or modality-general processes. In the current study, individuals that self-identified as being aphantasic and matched control participants with typical imagery performed two tasks: a musical pitch-based imagery and voice-based categorisation task. The majority of participants with aphantasia self-reported significant deficits in both auditory and visual imagery. However, we did not find a concomitant decrease in performance on tasks which require auditory imagery, either in the full sample or only when considering those participants that reported significant deficits in both domains. These findings are discussed in relation to the mechanisms that might obscure observation of imagery deficits in auditory imagery tasks in people that report reduced auditory imagery.

Neurocognitive mechanisms of mental imagery-based disgust learning

Disgust imagery represents a potential pathological mechanism for disgust-related disorders. However, it remains controversial as to whether disgust can be conditioned with disgust-evoking mental imagery serving as the unconditioned stimulus (US). Therefore, we examined this using a conditioned learning paradigm in combination with event-related potential (ERP) analysis in 35 healthy college students. The results indicated that the initial neutral face (conditioned stimulus, CS+) became more disgust-evoking, unpleasant, and arousing after pairing with disgust-evoking imagery (disgust CS+), compared to pairing with neutral (neutral CS+) and no (CS-) imagery. Moreover, we observed that mental imagery-based disgust conditioning was resistant to extinction. While the disgust CS + evoked larger P3 and late positive potential amplitudes than CS- during acquisition, no significant differences were found between disgust CS+ and neutral CS+, indicating a dissociation between self-reported and neurophysiological responses. Future studies may additionally acquire facial EMG as an implicit index of conditioned disgust. This study provides the first neurobiological evidence that associative disgust learning can occur without aversive physical stimuli, with implications for understanding how disgust-related disorders may manifest or deteriorate without external perceptual aversive experiences, such as in obsessive-compulsive disorder (OCD).

Investigating the different mechanisms in related neural activities: a focus on auditory perception and imagery

Neuroimaging studies have shown that the neural representation of imagery is closely related to the perception modality; however, the undeniable different experiences between perception and imagery indicate that there are obvious neural mechanism differences between them, which cannot be explained by the simple theory that imagery is a form of weak perception. Considering the importance of functional integration of brain regions in neural activities, we conducted correlation analysis of neural activity in brain regions jointly activated by auditory imagery and perception, and then brain functional connectivity (FC) networks were obtained with a consistent structure. However, the connection values between the areas in the superior temporal gyrus and the right precentral cortex were significantly higher in auditory perception than in the imagery modality. In addition, the modality decoding based on FC patterns showed that the FC network of auditory imagery and perception can be significantly distinguishable. Subsequently, voxel-level FC analysis further verified the distribution regions of voxels with significant connectivity differences between the 2 modalities. This study complemented the correlation and difference between auditory imagery and perception in terms of brain information interaction, and it provided a new perspective for investigating the neural mechanisms of different modal information representations.

Victim identifiability, number of victims, and unit asking in charitable giving

This study examines the identifiable victim effect (being more willing to help an identified victim than an unidentified), the singularity effect (i.e., being more willing to help a single identified victim than a group of identified victims), and unit asking (first asking donors for their willingness to donate for one unit and then asking for donations for multiple units) in charitable giving. In five studies (N = 7996), we vary the level of identifiability, singularity, and group size. We find that unit asking is making people more sensitive to the number of people in need. Further, while the level of identifiability influences affective reactions, this effect does not extend to donations and, thus, is not affected by unit asking. We do, however, find an "emotion asking effect" where asking donors to rate their affect before donating increase donation levels (compared to donors asked to rate affect after). Emotion asking was attenuated when combined with unit asking.