Emotional imagery in simple and social phobia: fear versus anxiety.

In a first study, phobic volunteer subjects (N = 60) reacted psychophysiologically with greater vigor to imagery of their own phobic content than to other fearful or nonaffective images. Imagery heart rate responses were largest in subjects with multiple phobias. For simple (dental) phobics, cardiac reactivity was positively correlated with reports of imagery vividness and concordant with reports of affective distress; these relationships were not observed for social (speech) phobics. In a second study, these phobic volunteers were shown to be similar on most measures to an outpatient clinically phobic sample. In an analysis of the combined samples, fearful and socially anxious subtypes were defined by questionnaires. Only the fearful subtype showed a significant covariation among physiological responses, imagery vividness, and severity of phobic disorder. This fearful-anxious distinction seems to cut across diagnostic categories, providing a heuristic perspective from which to view anxiety disorders.