Department of Psychology, Uppsala University, Box 1225, 75142 Uppsala, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Retzius väg 8, 17165 Solna, Stockholm, Sweden.
Philos Trans R Soc Lond B Biol Sci. 2021 Feb;376(1817):20190690. doi: 10.1098/rstb.2019.0690. Epub 2020 Dec 14.
Imaginal exposure, i.e. reducing fear using exposure to mental imagery, is a widely used psychological treatment technique for dysfunctional fears. Yet, little is known about its underlying neural mechanisms. The present study examines the neural basis of imaginal exposure using a novel experimental procedure consisting of repeated exposure to flashpoint mental imagery of phobic (spiders) and neutral (gloves) stimuli. Whether the 10 min long imaginal exposure procedure could reduce fear responses was examined one week later. Thirty participants fearful of spiders underwent the experimental procedure. Neural activity was assessed using functional magnetic resonance imaging (session 1). Subjective fear and skin conductance responses were measured throughout the study (sessions 1 and 2). Imaginal exposure evoked intense fear and heightened skin conductance responses, and indicated robust activation in several brain regions, including amygdala, midcingulate cortex and insula. Findings demonstrate that neural activity in fear-processing brain areas can be elicited solely by generating a mental image of a phobic stimulus, that is, in the absence of the percept. Relevant for treatment development, results reveal that a single 10 min session of brief exposures to flashpoint mental imagery can lead to lasting reductions in phobic fear at both the subjective and physiological levels. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.
表象暴露，即通过暴露于心理意象来减少恐惧，是一种广泛应用于功能失调性恐惧的心理治疗技术。然而，其潜在的神经机制知之甚少。本研究使用一种新的实验程序来研究表象暴露的神经基础，该程序包括对恐惧（蜘蛛）和中性（手套）刺激的关键点心理意象进行重复暴露。一周后，我们检验了 10 分钟的想象暴露程序是否可以减少恐惧反应。30 名害怕蜘蛛的参与者接受了实验程序。使用功能磁共振成像（第 1 次会议）评估神经活动。在整个研究过程中（第 1 次和第 2 次会议）测量主观恐惧和皮肤电反应。表象暴露引起强烈的恐惧和皮肤电反应升高，并在几个大脑区域（包括杏仁核、中扣带回皮层和脑岛）显示出强烈的激活。研究结果表明，仅仅通过产生恐惧刺激的心理意象，即没有感知的情况下，就可以引起恐惧处理大脑区域的神经活动。与治疗开发相关的是，结果表明，单次 10 分钟的简短闪亮点心理意象暴露可以导致主观和生理水平上的恐惧持续减少。本文是“离线感知：无匹配外部刺激的自愿和自发感知体验”主题特刊的一部分。
