The simulation heuristic and visual imagery in pessimism for future negative events in anxiety

A salient feature of clinical anxiety and its disorders is an elevated subjective probability judgement that future negative events will happen to the individual. A neglected area of research is the cognitive mechanisms that might underlie this judgement in patient populations. First, we investigated the ease of being able to simulate imaginary negative events happening to the individual ('the simulation heuristic'). Second, we conducted the first investigation to our knowledge into the possible role of visual imagery characteristics on subjective probability for negative events. Twenty-six patients who had a clinical level of anxiety and 26 low-anxiety control participants simulated mentally and also formed visual images of future negative events. They then rated the likelihood of the events happening to them. As predicted, with anxious patients the simulation heuristic was correlated with subjective probability, and they reported increased access to their simulations compared to control participants. The visual image results were more complex: anxious patients' ease of image formation was correlated with subjective probability but did not differ from that of the control participants, and vividness and dismissibility were enhanced in anxious patients but did not correlate with subjective probability. Clinically, helping anxious patients to improve their access to simulations of why events will not happen may help lower their subjective probability. Future research could seek to confirm this experimentally in a clinical intervention study, as well as isolate further the different roles particular visual image characteristics may play in specific aspects of clinical anxiety. Copyright (c) 2005 John Wiley & Sons, Ltd.