Neurocognitive mechanisms of mental imagery-based fear conditioning in individuals with social anxiety.

Fear learning serves as a foundational framework for understanding anxiety disorders, with growing interest in the role of mental imagery in fear conditioning. The present study examined whether individuals with social anxiety can acquire fear responses toward neutral conditioned stimuli (CS) via imagined fear-related social scenarios acting as unconditioned stimuli (US). Employing an imagery-based fear conditioning paradigm integrated with event-related potentials (ERPs), we recruited 31 participants with high social anxiety and 30 with low social anxiety. Behaviorally, neutral faces, initially rated as affectively neutral, were subsequently perceived as more unpleasant and elicited greater arousal when paired with fear-related imagery, relative to those paired with neutral imagery or no imagery. Furthermore, the high social anxiety group reported significantly heightened arousal to the fear CS + compared to the low social anxiety group. Neurally, during acquisition, the high social anxiety group displayed amplified P3 and LPP amplitudes for the fear CS + relative to the neutral CS+ and CS-, while the low social anxiety group exhibited no significant differences in P3 and LPP amplitudes between the fear CS+ and CS-. Additionally, the high social anxiety group demonstrated significantly larger P3 and LPP amplitudes to the fear CS + than the low social anxiety group. These findings offer initial evidence that individuals with social anxiety can acquire fear toward neutral stimuli exclusively through mental imagery. Collectively, the results enhance our comprehension of imagery-mediated fear learning in social anxiety and emphasize the therapeutic promise of imagery-based interventions for anxiety disorders.