This RCT tested whether prospective mental imagery (vs. psychoeducation-only control) improves anticipatory reward processing, approach motivation, and behavioral engagement in socially anxious adults (N=136) over one week.
The mental imagery group showed greater increases in anticipated pleasure, anticipatory pleasure, and approach motivation toward feared social situations compared to controls; however, no significant differences in reward anticipation or actual behavioral engagement with feared situations were found. Increases in approach motivation were statistically mediated by anticipatory reward processing.
Lack of temporal precedence between mediator and outcome prevents causal conclusions about the mediation pathway; behavioral engagement was only assessed at one week, limiting longer-term inference; the control condition (psychoeducation-only) may not fully match for therapist attention or expectancy effects.
Prospective mental imagery may be a useful pre-treatment tool to boost anticipatory pleasure and willingness to approach feared social situations — a key barrier to starting exposure therapy. Higher imagery vividness appears linked to stronger effects, so clinicians may want to support vividness training.
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