Emotional Imagery and the Differential Diagnosis of Anxiety

Thirty-eight anxiety patients participated in a study of diagnostic differences in the psychophysiology of emotional imagery. Tape-recorded scripts based on phobic memories as well as other personal and standardized control scripts were used to prompt imaginal experience. Phobic imagery produced significantly larger heart rate and skin conductance increases than control imagery, and these responses were largest for simple phobics, next largest for social phobics, and smallest for agoraphobics. Autonomic reactivity to phobic scenes was significantly related to questionnaire measures of imagery ability and psychopathology for simple phobics but not for social phobics or agoraphobics. The results suggest important differences between diagnoses in the organization and content of phobic memories. That is, simple phobia is primarily an avoidance disposition. Social phobia involves multiple problems of interpersonal dominance, and agoraphobia has the least coherent verbal-visceral response pattern and may be more similar to generalized anxiety disorder than to other phobic diagnoses.