Psychophysiological evidence for fear extinction learning via mental imagery

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.

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.

Emotion in the mind's eye: Imagination for adaptive cognition

In a complex world, we are constantly faced with environmental stimuli that shape our moment-to-moment experiences. But just as rich and complex as the external world is the internal milieu-our imagination. Imagination offers a powerful vehicle for playing out hypothetical experiences in the mind's eye. It allows us to mentally time travel to behold what the future might bring, including our greatest desires or fears. Indeed, imagined experiences tend to be emotion-laden. How and why are humans capable of this remarkable feat? Based on psychological findings, we highlight the importance of imagination for emotional aspects of cognition and behavior, namely in the generation and regulation of emotions. Based on recent cognitive neuroscience work, we identify putative neural networks that are most critical for emotional imagination, with a major focus on the default mode network. Finally, we briefly highlight the possible functional implications of individual differences in imagination. Overall, we hope to address why humans have the capacity to simulate hypothetical emotional experiences and how this ability can be harnessed in adaptive (and sometimes maladaptive) ways. We end by discussing open questions.

Fear in the mind's eye: the neural correlates of differential fear acquisition to imagined conditioned stimuli

Mental imagery is involved in both the expression and treatment of fear-related disorders such as anxiety and post-traumatic stress disorder. However, the neural correlates associated with the acquisition and generalization of differential fear conditioning to imagined conditioned stimuli are relatively unknown. In this study, healthy human participants (n = 27) acquired differential fear conditioning to imagined conditioned stimuli paired with a physical unconditioned stimulus (i.e. mild shock), as measured via self-reported fear, the skin conductance response and significant right anterior insula (aIn) activation. Multivoxel pattern analysis cross-classification also demonstrated that the pattern of activity in the right aIn during imagery acquisition was quantifiably similar to the pattern produced by standard visual acquisition. Additionally, mental imagery was associated with significant differential fear generalization. Fear conditioning acquired to imagined stimuli generalized to viewing those same stimuli as measured with self-reported fear and right aIn activity, and likewise fear conditioning to visual stimuli was associated with significant generalized differential self-reported fear and right aIn activity when imagining those stimuli. Together, the study provides a novel understanding of the neural mechanisms associated with the acquisition of differential fear conditioning to imagined stimuli and that of the relationship between imagery and emotion more generally.

Fear in the Theater of the Mind: Differential Fear Conditioning With Imagined Stimuli

Many symptoms of anxiety and posttraumatic stress disorder are elicited by fearful mental imagery. Yet little is known about how visual imagery of conditioned stimuli (CSs) affects the acquisition of differential fear conditioning. Across three experiments with younger human adults (Experiment 1: n = 33, Experiment 2: n = 27, Experiment 3: n = 26), we observed that participants acquired differential fear conditioning to both viewed and imagined percepts serving as the CSs, as measured via self-reported fear and skin conductance responses. Additionally, this differential conditioning generalized across CS-percept modalities such that differential conditioning acquired in response to visual percepts generalized to the corresponding imagined percepts and vice versa. This is novel evidence that perceived and imagined stimuli engage learning processes in very similar ways and is consistent with the theory that mental imagery is depictive and recruits neural resources shared with visual perception. Our findings also provide new insight into the mechanisms of anxiety and related disorders.

Imaginal extinction and the vividness of mental imagery: Exploring the reduction of fear within the mind's eye

Patients are encouraged to produce vivid mental imagery during imaginal exposure, as it is assumed to promote fear reduction. Nevertheless, the link between fear reduction and imagery vividness is unclear. We investigated the impact of vividness on fear responses using an experimental analogue of imaginal exposure - imaginal extinction - in which conditioned fear, measured with skin conductance, is reduced through exposure to mental imagery of the conditioned stimulus. We examined (1) if task-specific vividness (high vs low) of the conditioned stimulus during imaginal extinction moderated the reduction of fear responses, and (2) if task-specific vividness influenced remaining fear responses 24 h later. Findings suggest that high vividness may be advantageous for fear reduction during imaginal extinction, but it may not influence fear responses in the longer term. A possible clinical implication is that high imagery vividness during imaginal exposure may not be vital for overall treatment outcome. As high vividness is associated with increased levels of distress, a future direction would be to explore whether similar fear reduction can be obtained with less vivid imaginal exposure and thereby make treatment tolerable for more patients.

Mental imagery can generate and regulate acquired differential fear conditioned reactivity

Mental imagery is an important tool in the cognitive control of emotion. The present study tests the prediction that visual imagery can generate and regulate differential fear conditioning via the activation and prioritization of stimulus representations in early visual cortices. We combined differential fear conditioning with manipulations of viewing and imagining basic visual stimuli in humans. We discovered that mental imagery of a fear-conditioned stimulus compared to imagery of a safe conditioned stimulus generated a significantly greater conditioned response as measured by self-reported fear, the skin conductance response, and right anterior insula activity (experiment 1). Moreover, mental imagery effectively down- and up-regulated the fear conditioned responses (experiment 2). Multivariate classification using the functional magnetic resonance imaging data from retinotopically defined early visual regions revealed significant decoding of the imagined stimuli in V2 and V3 (experiment 1) but significantly reduced decoding in these regions during imagery-based regulation (experiment 2). Together, the present findings indicate that mental imagery can generate and regulate a differential fear conditioned response via mechanisms of the depictive theory of imagery and the biased-competition theory of attention. These findings also highlight the potential importance of mental imagery in the manifestation and treatment of psychological illnesses.