Visual mental imagery of nonpredictive central social cues triggers automatic attentional orienting.

Previous research has demonstrated that social cues (e.g., eye gaze, walking direction of biological motion) can automatically guide people's focus of attention, a well-known phenomenon called social attention. The current research shows that voluntarily generated social cues via visual mental imagery, without being physically presented, can produce robust attentional orienting similar to the classic social attentional orienting effect. Combining a visual imagery task with a dot-probe task, we found that imagining a non-predictive gaze cue could orient attention towards the gazed-at hemifield. Such attentional effect persisted even when the imagery gaze cue was counter-predictive of the target hemifield, and could be generalized to biological motion cue. Besides, this effect could not be simply attributed to low-level motion signal embedded in gaze cues. More importantly, an eye-tracking experiment carefully monitoring potential eye movements demonstrated the imagery-induced attentional orienting effect induced by social cues, but not by non-social cues (i.e., arrows), suggesting that such effect is specialized to visual imagery of social cues. These findings accentuate the demarcation between social and non-social attentional orienting, and may take a preliminary step in conceptualizing voluntary visual imagery as a form of internally directed attention.

Investigating the role of mental imagery use in the assessment of anhedonia.

Anhedonia, or a deficit in the liking, wanting, and seeking of rewards, is typically assessed via self-reported "in-the-moment" emotional and motivational responses to reward stimuli and activities. Given that mental imagery is known to evoke emotion and motivational responses, we conducted two studies to investigate the relationship between mental imagery use and self-reported anhedonia. Using a novel Reward Response Scale (adapted from the Dimensional Anhedonia Rating Scale, DARS; Rizvi et al., 2015) modified to assess deliberate and spontaneous mental imagery use, Study 1 (N = 394) compared uninstructed and instructed mental imagery use, and Study 2 (N = 586) conducted a test of replication of uninstructed mental imagery use. Results showed that greater mental imagery use was associated with higher reward response scores (Study 1 & 2), and this relationship was not moderated by whether imagery use was uninstructed or instructed (Study 1). Importantly, mental imagery use moderated the convergence between reward response and depression scale measures of anhedonia, with lower convergence for those reporting higher mental imagery use (Study 1 & 2). Results suggest that higher spontaneous mental imagery use may increase self-reported reward response and reduce the convergence between reward response scale and depression questionnaire measures of anhedonia. [199 / 200 words].

Inducing positive involuntary mental imagery in daily life using personalized photograph stimuli.

Most people experience positive involuntary mental imagery (IMI) frequently in daily life; however, evidence for the importance and effects of positive IMI is largely indirect. The current study adapted a paradigm to experimentally induce positive IMI in participants' daily lives. This could in turn provide a means to directly test positive IMI's effects. In a within-subjects design, participants (N = 41) generated positive mental images (imagery condition) and sentences (verbal condition) from photo cues, half of which participants provided from their own living environment. Participants then recorded involuntary memories of the previously generated images or sentences in a seven-day diary, before returning to the lab and completing some measures including an involuntary memory task. In the diary, participants reported more involuntary memories from the imagery condition than from the verbal condition, and more involuntary memories from their own photos compared to the other photos. A more mixed pattern of findings was found across other tasks in the lab. The study indicates that the paradigm can be used as a means to induce positive IMI and that using photos as the basis for generating positive imagery increases the amount of IMI in daily life. Theoretical and potential clinical implications are discussed.

Beyond self-report: Measuring visual, auditory, and tactile mental imagery using a mental comparison task.

Finding a reliable and objective measure of individual differences in mental imagery across sensory modalities is difficult, with measures relying on self-report scales or focusing on one modality alone. Based on the idea that mental imagery involves multimodal sensorimotor simulations, a mental comparison task (MCT) was developed across three studies and tested on adults (n = 96, 345, and 448). Analyses examined: (a) the internal consistency of the MCT, (b) whether lexical features of the MCT stimuli (word length and frequency) predicted performance, (c) whether the MCT related to two widely used self-report scales, (d) response latencies and accuracies across the visual, auditory, and tactile modalities, and (e) whether MCT performance was independent of processing speed. The MCT showed evidence of reliability and validity. Responses were fastest and most accurate for the visual modality, followed by the auditory and tactile. However, consistent with the idea that self-report questionnaires index a different aspect of mental imagery, the MCT showed minimal correlations with self-report imagery. Finally, relations between MCT scales remained strong after controlling for processing speed. Findings are discussed in relation to current understanding and measurement of mental imagery.

Aphantasia and autism: An investigation of mental imagery vividness.

OBJECTIVE: The present study investigated whether autistic adults report different levels of mental imagery vividness than non-autistic adults, and, moreover, if autism is associated with aphantasia which is defined as a condition of reduced or absent voluntary imagery. DESIGN AND METHODS: Clinically diagnosed and self-identifying autistic participants were compared with non-autistic participants in their mental imagery vividness (vision, sound, smell, taste, touch, bodily sensation and emotional feeling) and autistic traits using an online survey (N = 121). RESULTS: The autistic group scored significantly lower than the non-autistic group on imagery vividness (d = -0.44), in addition to having a higher proportion of participants scoring at cut-off for aphantasia. Moreover, a similar difference was observed for the emotional feel (η2 = 0.11). CONCLUSION: The vividness of visual and emotional mental imagery was on average lower for autistic individuals, with a higher proportion presenting at cut-off to be considered an aphantasic.

'Flashforward' mental imagery in adolescents: exploring developmental differences and associations with mental health.

BACKGROUND: Future events can spring to mind unbidden in the form of involuntary mental images also known as 'flashforwards', which are deemed important for understanding and treating emotional distress. However, there has been little exploration of this form of imagery in youth, and even less so in those with high psychopathology vulnerabilities (e.g. due to developmental differences associated with neurodiversity or maltreatment). AIMS: We aimed to test whether flashforwards are heightened (e.g. more frequent and emotional) in autistic and maltreatment-exposed adolescents relative to typically developing adolescents. We also explored their associations with anxiety/depression symptoms. METHOD: A survey including measures of flashforward imagery and mental health was completed by a group of adolescents (n=87) aged 10-16 (and one of their caregivers) who met one of the following criteria: (i) had a diagnosis of autism spectrum disorder; (ii) a history of maltreatment; or (ii) no autism/maltreatment. RESULTS: Flashforwards (i) were often of positive events and related to career, education and/or learning; with phenomenological properties (e.g. frequency and emotionality) that were (ii) not significantly different between groups; but nevertheless (iii) associated with symptoms of anxiety across groups (particularly for imagery emotionality), even after accounting for general trait (non-future) imagery vividness. CONCLUSIONS: As a modifiable cognitive risk factor, flashforward imagery warrants further consideration for understanding and improving mental health in young people. This implication may extend to range of developmental backgrounds, including autism and maltreatment.

The outcomes of imagery-focused interventions in relation to distress in people with delusions: a systematic literature review.

BACKGROUND: Imagery-focused therapies within cognitive behavioural therapy are growing in interest and use for people with delusions. AIMS: This review aimed to examine the outcomes of imagery-focused interventions in people with delusions. METHOD: PsycINFO, PubMed, MEDLINE, Web of Science, EMBASE and CINAHL were systematically searched for studies that included a clinical population with psychosis and delusions who experienced mental imagery. The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and quality appraisal of all included papers was completed using the Crowe Critical Appraisal Tool. Information from included texts was extracted and collated in Excel, which informed the narrative synthesis of results. RESULTS: Of 2,736 studies identified, eight were eligible for inclusion and rated for quality with an average score of 70.63%. These studies largely supported their aims in reducing levels of distress and intrusiveness of imagery. Four of the eight studies used case series designs, two were randomised controlled trials, and two reported single case studies. It appears that interventions targeting mental imagery were acceptable and well tolerated within a population of people experiencing psychosis and delusions. CONCLUSIONS: Some therapeutic improvement was reported, although the studies consisted of mainly small sample sizes. Clinical implications include that people with a diagnosis of psychosis can engage with imagery-focused therapeutic interventions with limited adverse events. Future research is needed to tackle existing weaknesses of design and explore the outcomes of imagery interventions within this population in larger samples, under more rigorous methodologies.

Multisensory approach in Mental Imagery: ALE meta-analyses comparing Motor, Visual and Auditory Imagery.

Mental Imagery is a topic of longstanding and widespread scientific interest. Individual studies have typically focused on a single modality (e.g. Motor, Visual, Auditory) of Mental Imagery. Relatively little work has considered directly comparing and contrasting the brain networks associated with these different modalities of Imagery. The present study integrates data from 439 neuroimaging experiments to identify both modality-specific and shared neural networks involved in Mental Imagery. Comparing the networks involved in Motor, Visual, and Auditory Imagery identified a pattern whereby each form of Imagery preferentially recruited 'higher level' associative brain regions involved in the associated 'real' experience. Results also indicate significant overlap in a left-lateralized network including the pre-supplementary motor area, ventral premotor cortex and inferior parietal lobule. This pattern of results supports the existence of a 'core' network that supports the attentional, spatial, and decision-making demands of Mental Imagery. Together these results offer new insights into the brain networks underlying human imagination.

A Systematic Review of Aphantasia: Concept, Measurement, Neural Basis, and Theory Development.

People with aphantasia exhibit the inability to voluntarily generate or form mental imagery in their minds. Since the term "aphantasia" was proposed to describe this, it has gained increasing attention from psychiatrists, neuroscientists, and clinicians. Previous studies have mainly focused on the definition, prevalence, and measurement of aphantasia, its impacts on individuals' cognitive and emotional processing, and theoretical frameworks synthesizing existing findings, which have contributed greatly to our understanding of aphantasia. However, there are still some debates regarding the conclusions derived from existing research and the theories that were constructed from various sources of evidence. Building upon existing endeavors, this systematic review emphasizes that future research is much needed to refine the definition and diagnosis of aphantasia, strengthen empirical investigations at behavioral and neural levels, and, more importantly, develop or update theories. These multiple lines of efforts could lead to a deeper understanding of aphantasia and further guide researchers in future research directions.

Degraded Visibility Body-Specifically Affects Mental Rotation.

The way we perceive our own body is shaped by our perception. Changes in sensory input, such as visual degradation, can lead to visual-to-motor shifts in the reference frame used to mentally represent the body. While this effect has been demonstrated in mental representation of hands, it is still unknown whether it also affects mental representation of other body parts. To fill this gap, we asked 35 neurotypical participants to perform mental rotation (laterality judgement) of hand, foot, and full-body images, while the images' visibility (figure/background contrast) was manipulated. Visibility deteriorations increased the steepness of the response time (RT) slopes for mental rotation of hand images shown from a less common view (palm) and of foot images from a more common view (dorsum), but not of full-body images from either the common or uncommon views. Suggesting that steeper and flatter RT slopes evoke the activation of a motor- or vision-based cognitive strategy for mental rotation, respectively, we propose that visual deterioration induces body-specific visual-to-motor shifts in mental processing. These findings show that the reliance on visual or motor aspects to mentally represent the body can be modulated by a reduction in sensory input, which changes the employed cognitive strategy.

Dorsal Anterior Cingulate Cortex Coordinates Contextual Mental Imagery for Single-Beat Manipulation during Rhythmic Sensorimotor Synchronization.

Flexible pulse-by-pulse regulation of sensorimotor synchronization is crucial for voluntarily showing rhythmic behaviors synchronously with external cueing; however, the underpinning neurophysiological mechanisms remain unclear. We hypothesized that the dorsal anterior cingulate cortex (dACC) plays a key role by coordinating both proactive and reactive motor outcomes based on contextual mental imagery. To test our hypothesis, a missing-oddball task in finger-tapping paradigms was conducted in 33 healthy young volunteers. The dynamic properties of the dACC were evaluated by event-related deep-brain activity (ER-DBA), supported by event-related potential (ERP) analysis and behavioral evaluation based on signal detection theory. We found that ER-DBA activation/deactivation reflected a strategic choice of motor control modality in accordance with mental imagery. Reverse ERP traces, as omission responses, confirmed that the imagery was contextual. We found that mental imagery was updated only by environmental changes via perceptual evidence and response-based abductive reasoning. Moreover, stable on-pulse tapping was achievable by maintaining proactive control while creating an imagery of syncopated rhythms from simple beat trains, whereas accuracy was degraded with frequent erroneous tapping for missing pulses. We conclude that the dACC voluntarily regulates rhythmic sensorimotor synchronization by utilizing contextual mental imagery based on experience and by creating novel rhythms.

Specificity of Episodic Future Thinking in Adolescents: Comparing Childhood Maltreatment, Autism Spectrum, and Typical Development.

Maltreatment and autism can be associated with overlapping difficulties across functional domains (e.g., social, emotional, and sensory) and high rates of mental health problems. A cognitive approach focussing on affect-laden cognition, here on episodic future thinking (FT), could help inform cognitive assessments and adapt psychological interventions. Three groups of adolescents (N = 85), (i) maltreatment (n = 28), (ii) autism (n = 29), and (iii) typical development without maltreatment/autism (TD; n = 28), matched in age (10-16 years old), sex (assigned at birth), and socioeconomic status, completed a newly adapted online Autobiographical Future Thinking Test. As predicted, the maltreatment group generated significantly fewer specific future events relative to the TD group, however, the number of specific future events did not significantly differ between the autism and the other groups. Exploratory analyses showed that lower FT specificity was significantly associated with more depressive (but not anxiety) symptoms across the three groups. These findings shed light on the cognitive profiles of both maltreatment and autism during adolescence and signal FT as a potential therapeutic target for adolescents with these developmental differences. Our study lays the foundation for additional comparisons of maltreatment-related presentations versus autism with improved designs and a broader set of cognitive and clinical domains.

The Impact of Mental Imagery Instructions on Patients' and Therapists' Positive Affect and Strength-Based Behaviours Within Psychotherapy Sessions: A Randomized Controlled Process Study.

OBJECTIVE: Increased attention has recently been paid to the well-being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength-based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions. METHODS: This is a secondary analysis of a randomized controlled trial. Seventy-eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; Mage = 40.31) treated by 13 therapists were selected. PA and strength-based behaviours of patients and therapists were coded on a minute-by-minute basis with the Resource-Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling. RESULTS: Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength-based behaviours were employed in one-fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength-based behaviours in the beginning phase of sessions, p < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, p < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend. CONCLUSION: Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018).

Web-Based Imagery Behavioral Activation (WIMBA): Study Protocol for a Randomized Controlled Trial Testing the Effects, Acceptability, and Feasibility of a Mental Imagery Activity Scheduling Training Delivered Online.

Background: Behavioral activation (BA) is an effective and efficacious treatment for depression. Activity scheduling is the central treatment component of BA and involves planning of potentially enjoyable and rewarding activities. Evidence from non-clinical studies suggests that mental imagery simulations of planned activities can increase motivation and anticipated pleasure for these activities. Method: We describe a randomized controlled trial testing a mental imagery activity scheduling training delivered online in four weekly sessions (total training duration approximately 90 minutes) in a sample meeting diagnostic criteria of a major depressive episode, as indicated by the Diagnostic Short-Interview for Mental Disorders (Mini-DIPS), and not currently receiving treatment. Participants (N = 140) will be randomized to either mental imagery activity scheduling or a wait-list control condition. Depressive symptoms (BDI-II) and behavioral activation (BADS) are the primary outcomes; BDI-II will be measured at Session 1, Session 4, and at two-week follow-up, BADS at Sessions 1-4 and at two-week follow-up. Discussion: It is discussed how the expected results may reflect mechanisms and effects of a mental imagery activity scheduling training delivered online in a sample of individuals with depression. Concluding we outline next steps for future research and highlight the potential of this novel treatment for dissemination in the wider community and integration into routine care.

Developing a Brief Cognitive Task Intervention to Reduce Long-Standing Intrusive Memories of Trauma: A Feasibility Study With Remote Delivery for Women in Iceland.

Background: There is emerging evidence that a brief cognitive task intervention may reduce the frequency of intrusive memories, even long-standing memories of older trauma. However, evaluations to date have involved in-person researcher contact. We investigated the feasibility and acceptability of remote delivery to women (n = 12) in Iceland who had experienced trauma on average two decades earlier. Method: Participants monitored intrusive memories in a daily diary for one week (i.e., baseline phase), completed (at least) two guided, remote intervention sessions (e.g., via secure video platform), and were encouraged to continue to use the intervention self-guided. Results: Eight participants completed the primary outcome and reported fewer intrusive memories in Week 5 (M = 6.98, SD = 5.73) compared to baseline (M = 25.98, SD = 29.39) - a 68% reduction. Intrusions decreased at each subsequent time point; at 3-months (n = 7) there was a 91% reduction compared to baseline. Other psychological symptoms reduced and functioning improved. Importantly, participant ratings and qualitative feedback support feasibility and acceptability. Conclusion: Findings suggest the feasibility of remote delivery of the brief imagery-competing task intervention by non-specialists (who were not mental health professionals) and hold promise for developing psychotherapeutic innovations supporting women with intrusive memories even decades after trauma.

Exploring Temporal Relationships Between Anxiety, Mood and Mental Imagery in Patients With Bipolar Disorder: A Network Analysis.

INTRODUCTION: Bipolar disorder is a severe mental health problem with limited treatment success. There is a call for improving interventions, requiring an increased understanding of factors driving mood instability. One promising avenue is to study temporal associations between factors that appear relevant according to the emotional amplifier model of Holmes are changes in mood, anxiety and mental imagery. METHODS: The current study used data from a recent RCT for a secondary analysis which applied a network analysis approach to explore temporal associations between weekly measurements of mania, depression, anxiety and mental imagery measured during 32 weeks in two randomised groups (N = 55) receiving either imagery-focused cognitive therapy (ImCT) or group psychoeducation (PE). RESULTS: Both negative intrusive mental imagery and anxiety appeared central in the network analyses, driving changes in both mania and depression, but only in the PE group. In the ImCT group, only anxiety was driving changes in mania and depression. CONCLUSION: Although exploratory, findings suggest that prior increases in anxiety and negative intrusive mental imagery might be associated with subsequent increases in depression and mania symptoms in patients with bipolar disorder. Anxiety might in turn increase negative intrusive imagery and associated negative emotions. Although more research is needed, results are in line with the emotional amplifier model and stress that future interventions with a focus on anxiety and imagery might help to improve psychosocial therapies for patients with bipolar disorder. In addition, this study suggests that a network approach is a helpful and feasible way to study mood instability, anxiety and mental imagery to increase our understanding of mechanisms underpinning mood instability.

Measures of mental imagery in emotional disorders: A COSMIN systematic review of psychometric properties.

BACKGROUND: Dysfunctional imagery processes characterise a range of emotional disorders. Valid, reliable, and responsive mental imagery measures may support the clinical assessment of imagery and advance research to develop theory and imagery-based interventions. We sought to review the psychometric properties of mental imagery measures relevant to emotional disorders. METHODS: A systematic review registered on the Open Science Framework was conducted using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Five databases were searched. COSMIN tools were used to assess the quality of study methodologies and psychometric properties of measures. RESULTS: Twenty-three articles describing twenty-one self-report measures were included. Measures assessed various imagery processes and were organised into four groups based on related emotional disorders. Study methodological quality varied: measure development and reliability studies were generally poor, while internal consistency and hypothesis testing studies were higher quality. Most measurement properties assessed were of indeterminate quality. CONCLUSION: Imagery measures were heterogenous and primarily disorder specific. Due to a lack of high-quality psychometric assessment, it is unclear whether most included imagery measures are valid, reliable, or responsive. Measures had limited evidence of content validity suggesting further research could engage clinical populations to ensure their relevance and comprehensiveness.

Multisensory mental imagery of fatigue in patients with multiple Sclerosis. Preliminary evidence from a fMRI study.

Fatigue, defined as a subjective lack of physical and/or mental energy, is a clinical symptom highly characterizing multiple sclerosis (MS). The present study utilized a novel approach to the study of fatigue, examining first person-mental imagery of the symptom. Eighteen right-handed patients with MS (14F, 4 M, mean age 45.8 ± 8.15 years) were evaluated and were compared to nineteen healthy controls (10F, 9 M, mean age 43.15 ± 8.34 years) Patients were all in relapsing remitting form and no patient had presented relapses in the 6 months prior to inclusion in the study. We evaluated their behavioral performance and fMRI activations. We used an fMRI paradigm used to trigger first person-mental imagery of fatigue, through short sentences describing the principal manifestations of fatigue. Participants were asked to imagine the corresponding sensations (Sensory Imagery, SI). As a control, they had to imagine the visual scenes (Visual Imagery, VI) described in short phrases. They made a vividness rating by pressing the corresponding button. Behaviorally, we found that patients' mean scores at the Multidimensional Fatigue Symptom Inventory for the general scale, physical scale, and mental scale were significantly higher than healthy controls (p = 0.05, p = 0.002, p = 0.006 respectively), but not for the emotional scale and for vigor scale (p = 0.207, n.s., p = 0.06, n.s.). In the imagery fMRI task, patients were significantly slower (mean reaction times and standard deviation: 2.24 s ± 0.33) than controls (mean reaction times and standard deviation: 1.918 s ± 0.455) for the SI task (Z=-2.058, p = 0.040), while no significant difference was found for the VI task. Regarding brain mapping, our main result is a group by task interaction. The SI task (vs. VI task) in healthy controls (relative to patients) increased activation in the left inferior parietal lobule. These preliminary results indicate that fatigue is related to dysfunctions in higher-order aspects of motor control, given the role of the posterior parietal lobe in motor planning and multisensory integration.