Induction of conditioned avoidance via mental imagery
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Abstract
There is a growing interest on how mental imagery may be involved in the onset and maintenance of anxiety-related disorders. Here, we used an experimental design to investigate whether a key symptom across anxiety-related disorders, namely avoidance, can be induced via mental imagery. Healthy participants first learned that one neutral stimulus (A) was associated with a mild electric shock and two other neutral stimuli (B and C) were not. They then learned to cancel the shock when A was presented, by pressing a button on a keyboard ('behavioral avoidance'). Next, they were asked to imagine that stimulus B was followed by the shock (i.e., without actual B or shock presentations; Experiment 1; N = 66) or they were shown B and asked to imagine the shock (i.e., without actual shock presentations; Experiment 2; N = 60). Finally, in the test phase, they were shown each of the three stimuli (without the shock) and given the opportunity to make the avoidance response. Results showed that participants tended to avoid B in the test phase in Experiment 1, even though it had never been presented with the shock but not in Experiment 2. We discuss how the findings may explain the acquisition of avoidance in the presentation of innocuousstimuli across anxiety-related disorders.
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If patients with anxiety disorders experience intense threat imagery, they might be too anxious or unwilling to confront feared stimuli, which could explain the low attrition rates in exposure therapy.
“If patients with anxiety disorders experience intense threat imagery, they might be too anxious [27, 28] or unwilling to confront feared stimuli [28–30], which could explain the low attrition rates in exposure therapy.”
From Eye movement desensitization and reprocessing (EMDR) therapy or supportive counseling prior to exposure therapy in patients with panic disorder: study protocol for a multicenter randomized controlled trial (IMPROVE) (2023) · cites this paper as [28]
The Introduction (p. 4) proposes that mental imagery may lead to behavioral avoidance, including avoidance of innocuous stimuli by people with anxiety symptoms. The experiment described in the Abstract (p. 2) found imagery-induced avoidance in healthy participants. It does not establish that patients experiencing intense threat imagery become too anxious or unwilling to confront feared stimuli; the exposure-therapy explanation is the citing authors’ inference, not a finding of this study. (LLM, conf=0.83)
Experimental — accuracy not yet measuredMental imagery of potential threats can result in fear and avoidance learning.
“It has been emphasized in fear conditioning research that mental imagery of potential threats can result in fear and avoidance learning (e.g., Krypotos et al. 2020;Mertens, Krypotos, and Engelhard 2020;Mueller, Sperl, and Panitz 2019).”
From Negative Flashforward Imagery in Adolescent Social Anxiety Disorder: A Pilot Study of Imagery Reports and a Short EMDR Intervention. (2024) · cites this paper as Krypotos et al. 2020
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“If patients with anxiety disorders experience intense threat imagery, they might be too anxious [27, 28] or unwilling to confront feared stimuli [28–30], which could explain the low attrition rates in exposure therapy.”
BackgroundSelf-citation
- Authors
- Krypotos, A.-M., Mertens, G., Leer, A., & Engelhard, I. M.
- Affiliations
- Utrecht University (NL)
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 132
- Pages
- 103652
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W3033848123
- Cited by
- 36
- References
- 40
- Citations by year
- 2026: 8 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 3 · 2021: 9 · 2020: 2
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Behaviour Research and Therapy (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lirias (submittedVersion, other-oa)
- Research portal (Tilburg University) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- PsyArXiv (OSF Preprints) (submittedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- mental imagery, avoidance conditioning, anxiety disorders, avoidance learning, fear conditioning, electric shock, behavioral avoidance, stimulus generalization
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