Reflecting on imagery: a clinical perspective and overview of the special issue of memory on mental imagery and memory in psychopathology

The authors provide an overview of the papers in the special issue of Memory on mental imagery and memory in psychopathology. The papers address emotional, intrusive mental imagery across a range of psychological disorders including post-traumatic stress disorder (PTSD), agoraphobia, body dysmorphic disorder, mood disorders, and psychosis. They include work on information processing issues including modelling cravings, conditioning, and aversions, as well as imagery qualities such as vividness and emotionality. The overview aims to place the articles in a broader context and draw out some exciting implications of this novel work. It provides a clinical context to the recent growth in this area from a cognitive behavioural therapy (CBT) perspective. We begin with PTSD, and consider links to imagery in other disorders. The clinical implications stemming from this empirical work and from autobiographical memory theory are discussed. These include consideration of a variety of techniques for eliminating troublesome imagery, and creating healthy, realistic alternatives.     

Of snakes and faces: An evolutionary perspective on the psychology of fear

Snakes and faces are unique stimuli because they are deeply grounded in evolutionarily shaped behavior systems. Snakes are the prototypical stimulus in a predatory defense system promoting escape from predators, which prepares primates for efficient processing, attentional priority, and rapid fear acquisition to snakes and other stimuli related to predation. The social submissiveness system plays a similar role on the social arena by promoting yielding to dominant individuals without jeopardizing the protection of the group. Supporting these theoretical propositions, empirical data from a research program spanning four decades demonstrate enhanced fear conditioning to snakes and threatening faces compared to neutral stimuli, as well as fast nonconscious processing of, and prioritized attention to, snakes and threatening faces. Human brain‐imaging data show that these effects are mediated by an extensive fear‐network centering on the amygdala.     

Reflecting on imagery: A clinical perspective and overview of the special issue of Memory on mental imagery and memory in psychopathology

The authors provide an overview of the papers in the special issue of Memory on mental imagery and memory in psychopathology. The papers address emotional, intrusive mental imagery across a range of psychological disorders including post‐traumatic stress disorder (PTSD), agoraphobia, body dysmorphic disorder, mood disorders, and psychosis. They include work on information processing issues including modelling cravings, conditioning, and aversions, as well as imagery qualities such as vividness and emotionality. The overview aims to place the articles in a broader context and draw out some exciting implications of this novel work. It provides a clinical context to the recent growth in this area from a cognitive behavioural therapy (CBT) perspective. We begin with PTSD, and consider links to imagery in other disorders. The clinical implications stemming from this empirical work and from autobiographical memory theory are discussed. These include consideration of a variety of techniques for eliminating troublesome imagery, and creating healthy, realistic alternatives.     

II. Introduction to a reappraisal of fear and trembling 1

The idea of a knighthood of faith which involves a ‘teleological suspension of the ethical‘ is the most arresting feature of Kierkegaard's Fear and Trembling. It amounts to a theological shock treatment. It is therefore understandable that critics and commentators who have discussed Fear and Trembling have focused their attention almost exclusively on this extreme notion of faith. Their preoccupation has been unfortunate, however.     

Pain assessment: state-of-the-art applications from the cognitive-behavioural perspective

This brief report highlights some basic issues in pain assessment. This serves to set the stage for the articles that are presented in this issue of the Behavioral Assessment section. Topics covered include an overview of the cognitive-behavioural perspective, consideration of important dimensions for assessment, and a summary of some of the key issues affecting the state-of-the-art. An overview of the articles that follow as well as future research directions are also presented.     

Pain in children: A review of the literature from a developmental perspective

Abstract

This article presents a review of the current psychological literature about pediatric pain. Prevalence and types of pain problems encountered in children are considered briefly, followed by a developmental perspective on the experience of pain in children, encompassing physical, cognitive, social and behavioral factors. A discussion of the clinical significance of pain in children includes its use in differential diagnosis and the impact of pain on a developing child. Recommendations are made for assessing pain and factors relevant to managing its effects in children. The review concludes with an overview of clinical techniques for management, and recommendations for future research.     

The observer perspective: biased imagery in social phobia, agoraphobia, and blood/injury phobia.

Clark and Wells' (1995): 'A cognitive model of social phobia'. In Social phobia: Diagnosis, assessment, and treatment (pp. 69-93), R. G. Heimberg, M. R. Liebowitz, D. A. & F. R. Hope (eds.); cognitive model of social phobia proposes that social phobics generate a negative impression of how they appear to others. This impression often occurs in the form of an image from an "observer" perspective in which social phobics can see themselves as if from another person's vantage point. This study investigated the specificity of the observer perspective among patients with social phobia, agoraphobia, and blood/injury phobia. All participants were asked to recall and imagine a recent anxiety-provoking social situation and a non-social/non-anxiety-provoking situation, and rate their perspective for each. Consistent with predictions only patients with social-evaluative concerns (social phobics and agoraphobics) reported observer perspectives for anxiety-provoking social situations. Only social phobics showed a significant shift from an observer to a field perspective across the two conditions. The clinical implications of these findings are briefly discussed.     

Adaptive patterns of stress responsivity: a preliminary investigation

The adaptive calibration model (ACM) is an evolutionary-developmental theory of individual differences in stress responsivity. In this article, we tested some key predictions of the ACM in a middle childhood sample (N = 256). Measures of autonomic nervous system activity across the sympathetic and parasympathetic branches validated the 4-pattern taxonomy of the ACM via finite mixture modeling. Moreover, the 4 patterns of responsivity showed the predicted associations with family stress levels but no association with measures of ecological stress. Our hypotheses concerning sex differences in responsivity were only partly confirmed. This preliminary study provides initial support for the key predictions of the ACM and highlights some of the methodological challenges that will need to be considered in future research on this topic.     

Failure to overcome 'innate' fear: a developmental test of the non-associative model of fear acquisition

The non-associative, Darwinian theory of fear acquisition proposes that some individuals fail to overcome biologically-relevant fears (e.g. height) because they (1) do not have sufficient safe exposure to the relevant stimuli early in life or (2) are poor habituators who have difficulty 'learning not to fear'. These two hypotheses were tested in a longitudinal birth cohort study. Study 1 found evidence for reduced exposure to height stimuli in childhood for individuals with a fear of heights compared to study members without fear. Study 2 found evidence for higher levels of stress reactivity (a proxy for habituation) in childhood and adolescence among 18-year-old height phobics compared to study members with dental phobia and those with no fear. The results were discussed in relation to recent findings suggesting that some evolutionary-relevant fears may appear in the absence of traumatic 'learning' experiences. The merits of adding a fourth, non-associative pathway to Rachman's [Rachman, S. (1977)]. The conditioning theory of fear acquisition: a critical examination. Behaviour Research and Therapy, 15, 375-387) three pathways model of fear acquisition were briefly considered.     

False physiological feedback and persuasion: Effect of fear arousal vs. fear reduction on attitude change

Two experiments tested the hypothesis that increases in false physiological feedback of fear arousal will enhance persuasion and that reduction in the arousal feedback is unnecessary for increased persuasion to occur. Prior research has usually found a positive relation between level of arousal and persuasion, but support for the drive reduction hypothesis is tenuous. However, Harris and Jellison (1971) claimed support for such a hypothesis. They manipulated subjects' fear arousal cognitively via false physiological feedback while the subjects listened to a persuasive communication. The present experiments used a similar procedure in an attempt to test an "arousal only" against an "arousal reduction" hypothesis. Subjects listened to a persuasive speech while receiving false feedback via a meter concerning their fear arousal. In Experiment I half of the subjects received high arousal and half received moderate arousal information. Within each of these conditions half of the subjects had their arousal reduced, and the other half did not. In Experiment II subjects received either low arousal, high arousal, or high then low arousal feedback while listening. The results of the two studies generally provided support for the "arousal only" hypothesis. An interpretation in terms of Bem's attribution theory was tentatively suggested.