Fear Reduction Processes in Imaginal and In Vivo Flooding: A Comment on James' Review

Abstract

The research comparing imaginal and in vivo exposure in the treatment of clinically significant fear, recently reviewed by James (1986), is reexamined from the perspective of bioinformational theory and the concept of emotional processing. Fear is assumed to be stored in long term memory as a network of propositionally-coded information, which has to be processed if treatment is to be successful. Emotional processing is indicated by activation of fear responses and their habituation within and across treatment sessions. Consistent with the theory, our review indicates that successful treatment via imaginal and in vivo exposure is indeed related to activation and habituation of fear responses; interference with processing has a negative impact upon fear reduction, regardless of the specific treatment techniques employed. Furthermore, some apparently discrepant findings in the available research literature can be understood in terms of the theories cited. These ideas provide a useful perspective from which to plan future research efforts and to advance our understanding of the processes underlying reduction of pathological fear.

An experimental study of the role of vulnerability related perceptions in spider fear: Comparing an imaginal and in vivo encounter

“…Hecker (1990), for instance, found that when the degree of emotional processing is held constant, there are few differences in treatment outcome between imaginal and in vivo exposure for analogue snake phobics. Drawing on bio-informational theory, Hecker and Thorpe (1987;Hecker, 1990) claim that it is the degree of emotional processing, rather than the treatment procedure per se that is associated with the treatment outcome for phobic anxiety. Invariably, greater vividness accompanies in vivo exposure in comparison to imaginal exposure and this is consistent with findings that fear reduction following exposure is more pronounced for good imagers than for poor imagers (Van den Burgh, Eelen, & Baeyens, 1989).…”

In vivo flooding for anxiety disorders: Proposing its utility in the treatment posttraumatic stress disorder

“…From a theoretical perspective, Lang's (1985) theory would suggest that vivo exposure would allow more accurate or consistent processing of the fear network due to the closeness of real life stimuli to the postulated stimulus elements of the fear network, whereas this processing may be less consistent when imaginal exposure methods are used due to individual's failing to access or activate the components of the memory through imagery (Hecker & Thorpe, 1987). It is of interest however, that although emotional processing would be predicted to be more consistent with real life stimuli such as that experienced within in vivo exposure, a number of studies have shown that reduction of trauma-related fear is achieved successfully through imaginal or prolonged exposure techniques in PTSD (cf.…”

Emotional Processing in the Treatment of Simple Phobia: A Comparison of Imaginal and In Vivo Exposure

“…Across-session habituation is indicated by a decrease in the activation of fear in response to the initial presentation of phobic stimuli during subsequent treatment sessions. By examining the available studies comparing imaginal and in vivo flooding with respect to the indices of emotional processing, we were able to show that fear reduction was related to the degree of processing that occurred during treatment (Hecker and Thorpe, 1987). Procedural differences (i.e., imaginal versus in vivo exposure) were not as important as whether or not the procedure engendered emotional processing.…”

“…In a earlier article in this journal, we argued that bioinformational theory (Lang, 1979(Lang, , 1984(Lang, , 1985 and the concept of emotional processing (Foa & Kozak, 1986) provided a useful framework from which to evaluate the literature comparing imaginal and in vivo flooding (Hecker and Thorpe, 1987).…”