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Mental imagery and symptom patterns
Giuseppe Sacco , Vezio Ruggieri

(L’articolo completo si trova in Immagination, Cognition and Personality, 17(4): 313-321, 1998)

Introduction
Numerous reports have shown the existence of significative relationships between psychophysiological variables (ex. eyeblink startle, skin conductance, cardiac frequency, muscular tension etc.) and emotional processes (Teasdale, Bancroft, 1978; Greenwald, 1989; Lang, 1993; etc.).
Analogously, there are numerous studies which focus on the existing relationships between the imaginative processes in which emotions are often elicited, and the different psychophysiological variables (ex. Carrol, 1982; Miller, 1987; Lang, 1980; 1983; Ruggieri, Alfieri, 1992; Ruggieri, 1994; Hawk, 1992; Vrana, 1994; etc.).
The imaginative processes have turned out to be powerful means for the theoretical understanding of cognitive-emotional processes, but also useful, applicable tools in such contexts as psychological clinics, sports, etc. (Cristoph, Singer, 1981; Singer, 1974; Strosahl, Ascough, 1981; Tower, Singer,1980; Martin, Williams, 1990; Sacco, 1989; 1994;1998).
Some works have given particular attention to “imagery myographic patterns”, studying the EMG in the fronto-facial area during imagery and exploring the potential for possible relationships with some aspects of personality (Cacioppo, 1988; Carney, 1981; Hawk, 1992; May, 1977; Vrana, 1994; Vrana, Lang, 1990; Witvliet, Vrana, 1995; Fridlund, lzard, 1983).
However, there still is a lack of studies which focus on the relationships between the fronto-facial EMG during imagery and the presence of clinical symptom patterns.
Accordingly, based on the above-mentioned research, with this work we have intended to begin the study of myographic patterns of the muscular forehead area (corrugator supercili) in subjects characterized by the presence of evident clinical symptom patterns among those occuring most frequently, during the imagery process of an anxiety-creating situation.

Research objective
The purpose of the research is to verify the presence of possible patterns of myographic tension during imagery of an anxiety-creating scene, in four experimental groups, each one chosen having the characteristic of a specific symptom patterns: depressive, obsessive, eating disorders, phobic.

Method
1. Subjects
The participants in the research were university students majoring in Psychology who knew neither what type of test was being used, nor, before the experiment, even what the objectives of the research were. They were only specific given descriptions of the research phases which involved them directly.
On the whole, the average age of the experiment subjects was 26.2, oscillatine between 20 and 30.

The experiment subjects underwent a selection made up of 2 phases:
-during the first phase those with points higher than the CBA and EAT-40 scales were chosen.
-in the second phase these subjects were given elinical interviews in order to determine any possible presenece of more serious pathologies.

2. Tools and equipment
I) Equipment
An electromyograph was used with tbc following technical characteristics:
” Grounding set-up: This was achieved by connecting the metal structure of the cabinet device to the alternator frame, through a conductor conneeted to the ground of the network socket. The magnetically isolated differenzia preamp was connected through electrodes to the subject, and was isolated galvanically from the frame of the main generatori
” Electrodes: AgCl (silver chloride) electrodes were used. Their diameter was 5 mm and they were attached to the skin with adhesive disks. A laycr of electroconductor gel was applied between the skin and the electrodes.
” Amplification: The overall amplification of the system was: A=100,000

” Filters: I) 50 Hz Notch filter with a reduction to 48 db/ott; ll) high pass filter with a time constant T = 0.016
” Band: BP = 10Hz, 5Khz, 6db
” Noise: the total noise at the input is = / o lower than 3 micro Vpp.
” Measurement: the electromyograph is made up of 2 units: I) amplification and filtering units; II) measurement units.

The amplification unit is made up of a differential low-noise amplifier, a line amplifier with a high pass filter and a notch filter, and an output amplifier.
The measurement unit consist of a RMS detector, a tension/frequency convertor (v/f), a Sample-and-Hold circuit, and a digital counter.

Samples signalled at 4-second intervals were taken. Their values were expressed in arbitrary units and were proportional to the effective value (V eff) of the electromyographic signal.

II) Tests and Questionnares
a) Questionnaire upon Mental Imagery (QMI) (Sacco, Reda 1998; Betts, 1909; Sheehan, 1967) for measuring imagery vividness on 7 sensorial channels.
b) Cognitive-Behavioral Assessment (CBA) (Sanavio et al. 1987); particularly the scales for measuring phobic, obsessive, and depressive aspects.
c) EAT-40 (Cuzzolaro, Petrilli, 1988) for measuring eating disorders.
d) Lang’s anxiety-creating scene standard (1983) (see appendix b).
e) Cognitive – emotional schedula, self-instrument – reports for evaluating the attribution of “fearfulness” to the proposed stimulus and the emotional reaction experienced by whoever is connected (see appendix c).

Procedure
First Phase
Four experimental groups were created, chosen from the participants presenting the highest score(above the median) on the test which measured the following symptomatic patterns:
I) 23 subjects (15 females and 8 males) with depressive patterns;
II) 25 subjects (16 females and 9 males) with eating disorder patterns;
III) 23 subjects (15 females and 8 males) with obsessive patterns;
IV) 25 subjects (16 females and 9 males) with phobic patterns.
Together they totalled 96 units,

Second Phase
Results and discussion
The four experimental groups showed diverse patterns of myographic tension width during imagery of the proposed anxiety-creating scene. The appendix (a) includes the chart of averages and standard deviations of the points of the four participant groups and the diagram of the averages in the 3 phases of the experiment.
Based on our results, it turns out, above all, that already in baseline phase conditions there are statistically significative differences in the width of myographic activity of the corrugator muscle during rest.
The lowest levels appear in depressive pattern subjects, followed by the obsessive, and then the eating disorder subjects. The highest points in rest conditions were obtained by the phobic symptomatic pattern subjects.
The differences among the four groups stand out even more in the instruction and imagery phases, in which a progressive decrease of myographic activity in depressive pattern subjects was observed.
The obsessive symptomatic pattern participants had a significative increase in the instructions phase, followed by a strong decrease in the imagery phase, while the groups with eating disorder and phobic patterns, despite both of them departing from high baseline phases and reaching elevated levels in the

imagery phase, however showed an inverted tendency in the instruction phase: the eating disorder subjects showed a significative reduction, while the phobic pattern subjects showed a significative increase of myographic width.
Therefore, the results shown so far suggest the possibility of the existence of specific forehead myographic patterns which are modified also in relation to the prevalence of various symptomatologic patterns considered.
Specifically:
1. The depressive pattern subjects showed a myographic behavior that could be defined as “withdrawal pattern”. In fact, facing an anxiety-creating stimulus, these subjects, who had already departed from a low myographic activation level, responded with a further lowering of muscle tension in their forehead in the stimulus phase and especially in the post-stimulus phase.

2. Eating disorder pattern subjects showed a myographic behavior that could be defined as “turbulent response pattern”. Facing an anxiety-creating stimulus they showed an increase of muscular tension during the response phase, however remaining stable in the other phases.

3. The obsessive pattern subjects showed a myographic behavior that could be defined as “stimulus turbulence pattern”. They reacted with a muscular tension increase during the administration of the stimulus, however returning to the departure levels proviously achieved in the response phase.

4. The phobic pattern subjects showed a myographic behavior definable as “generalized turbulence pattern”. They reacted with a generalized increase of muscular tension which became acute during the phase of the administration of the stimulus, without returning to the beginning levels, not even after the post- stimulus phase (recuperation difficulty).

The results of our preliminary research demonstrate how, in dealing with the uniqueness of the construction of each individual response, there are basic, steady characteristics that can be attributed to groups of subjects having similar symptomatologic patterns which are displayed also through specific myographic – imaginative patterns that were hypothesized and made evident in this investigation.
Such results lead us to an initial reflection regarding some clinical consequences of the results obtained in this first research. Particularly, it may be useful to consider the myographic-imaginative patterns which seem to emerge from this research during the psychotherapeutic application of relaxation and imagery techniques, in order to opportunely monitor and modulate clinical interventions according to the type of patíent and his or her response pattern.
However, it is necessary to investigate this field of study further, to eventually come to a confirmation of our results and a more accurate definition of the response patterns we individuated.

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