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'.

想象暴露，即通过暴露于心理意象来减少恐惧，是一种广泛使用的心理治疗技术，用于治疗功能失调的恐惧。然而，对其潜在的神经机制知之甚少。本研究使用一种新颖的实验程序检查想象暴露的神经基础，该程序包括重复暴露于恐惧（蜘蛛）和中性（手套）刺激的闪点心理意象。一周后检查了 10 分钟长的想象暴露程序是否可以减少恐惧反应。三十名害怕蜘蛛的参与者接受了实验程序。使用功能性磁共振成像（第 1 次会议）评估神经活动。在整个研究过程中（第 1 和第 2 阶段）测量主观恐惧和皮肤电导反应。想象中的暴露引起了强烈的恐惧和皮肤电导反应的增强，并表明在包括杏仁核、中扣带回皮层和岛叶在内的几个大脑区域有强烈的激活。研究结果表明，处理恐惧的大脑区域中的神经活动可以仅通过生成恐惧刺激的心理图像来引发，也就是说，在没有感知的情况下。与治疗发展相关，结果表明，单次 10 分钟的短暂暴露于闪点心理意象可以导致主观和生理层面的恐惧恐惧持续减少。研究结果表明，处理恐惧的大脑区域中的神经活动可以仅通过生成恐惧刺激的心理图像来引发，也就是说，在没有感知的情况下。与治疗发展相关，结果表明，单次 10 分钟的短暂暴露于闪点心理意象可以导致主观和生理层面的恐惧恐惧持续减少。研究结果表明，处理恐惧的大脑区域中的神经活动可以仅通过生成恐惧刺激的心理图像来引发，也就是说，在没有感知的情况下。与治疗发展相关，结果表明，单次 10 分钟的短暂暴露于闪点心理意象可以导致主观和生理层面的恐惧恐惧持续减少。

这篇文章是主题问题“离线感知：没有匹配外部刺激的自愿和自发的感知体验”的一部分。