The research, led by Lydia Munns, Chloé Xin-Tong Lu and Alex Lau-Zhu of the Department of Experimental Psychology, set out to fill a gap that has frustrated cognitive theorists for years. Cognitive accounts of anxiety disorders hold that flashforwards are not just a curiosity of the anxious mind but a core maintaining mechanism: sensory-based, affect-laden mental simulations of future threats that arrive unbidden and are experienced as plausible or even impending. Unlike deliberate planning or worry expressed in words, these images carry the vividness of perception, recruiting similar neural and bodily responses as actual events, which may be precisely what makes them so distressing and so persistent.

Yet the field’s standard instruments have largely ignored this phenomenon. Existing imagery questionnaires tend to focus on the vividness or frequency of mental images in general, without targeting future-oriented intrusions, while established anxiety scales measure worry, avoidance and physiological arousal, leaving flashforwards either unmeasured or entangled with other symptoms. That measurement gap, the authors argue, has limited both theoretical insight into how intrusive future imagery drives anxiety and clinical progress in designing interventions that target it directly. To build their scale, the team grounded item development in theory and in previously published measures, and crucially involved stakeholders, gathering feedback from young people and clinicians to ensure the questions reflected real experiences.

The validation study recruited 538 young adults aged between 16 and 24, a window chosen deliberately because adolescence and young adulthood is the developmental period in which many anxiety disorders first emerge. Participants completed the new OFAS alongside the Generalised Anxiety Disorder-7, a widely used clinical screening tool, together with other key measures of related constructs. A subset of 306 participants returned for a follow-up assessment two weeks later, allowing the researchers to examine whether flashforward imagery measured at baseline predicted later anxiety. Smaller subgroups, including 124 participants with lagged data, supported additional longitudinal and network analyses.

The psychometric results were strikingly clean. Exploratory and confirmatory factor analyses converged on a single-factor solution: a compact ten-item scale in which all items tap one underlying construct, the overall salience of intrusive flashforward imagery. The one-factor model showed good fit to the data, and reliability was high, meaning the items consistently measured the same thing across respondents. The researchers also tested whether the scale behaved equivalently across age groups, and demonstrated measurement invariance when comparing participants aged 19 or younger with those over 19, an important property for any instrument intended to be used across adolescence and young adulthood without artifactual score differences.

Validity evidence came from several directions. Concurrent validity was supported by the expected associations between OFAS scores and existing anxiety measures. Incremental validity, the ability of the new scale to explain variance beyond what other instruments capture, was demonstrated, addressing the central criticism that previous measures confound future imagery with broader anxiety symptoms. Discriminant validity was likewise supported, indicating that the scale measures flashforward imagery as a distinguishable construct rather than simply re-labeling worry or fear. Together these analyses suggest the OFAS genuinely isolates the cognitive process it was designed to measure.

Perhaps the most compelling findings came from the prospective and network analyses. In the lagged analysis, flashforward imagery at baseline predicted anxiety levels two weeks later, even after statistically controlling for baseline anxiety and covariates. That pattern of prediction is what psychometricians call predictive validity, and it hints at something more provocative: intrusive images of feared futures may not merely accompany anxiety but anticipate its course. In a cross-sectional world of correlational data, a simple two-week lagged design cannot prove causation, but it moves the evidence a meaningful step beyond co-occurrence, consistent with cognitive models in which vivid threat simulations fuel and perpetuate anxious states.

Network analysis, an increasingly popular statistical approach that treats psychological symptoms as interconnected nodes in a system rather than as parts of a latent disorder, added another layer of nuance. In the anxiety network reconstructed from the data, flashforward imagery was not itself the most central node. That distinction belonged to worry, the repetitive verbal or conceptual rumination about future threat that has long dominated anxiety research. But flashforward imagery was closely connected to worry, sitting adjacent to the network’s most central symptom. The authors interpret this as further support for the scale’s construct validity, and it sketches an intriguing architecture of anxious cognition: word-based worry may occupy the hub, while image-based flashforwards form a tightly linked satellite, feeding into and drawing from the worry process.

The practical implications extend in several directions. Clinically, a brief, freely usable and psychometrically validated measure of flashforward salience gives researchers and practitioners a tool to identify individuals whose anxiety is driven disproportionately by intrusive future imagery, and to evaluate whether imagery-focused interventions, such as cognitive techniques that compete with or rescript threat images, change the outcomes that matter. The scale’s deliberate anchoring to mental imagery, without conflation with avoidance or hyperarousal, means treatment studies can now test whether targeting flashforwards specifically produces benefits that generic anxiety reduction does not. Developmentally, the demonstrated invariance across age groups makes the instrument suitable for studying the period when anxiety disorders typically take hold, potentially enabling earlier identification of young people at risk.

For a phenomenon that millions of people experience in the seconds before their stomach drops, flashforwards have been remarkably underserved by measurement science. This new scale does not resolve whether intrusive future imagery causes anxiety, but it provides the rigorous instrument that such questions require, and its predictive and network findings suggest the hypothesis is worth taking seriously. As the authors conclude, the validated tool promotes the study of flashforwards as a distinct cognitive process in anxiety and can provide a foundation to guide anxiety treatment innovation. If future research builds on this foundation, the fleeting, unwelcome pictures of catastrophe that flash through anxious minds may finally get the scientific attention their subjective impact has always demanded.

Subject of Research: Development and validation of a questionnaire measuring intrusive future-oriented mental imagery in anxiety

Article Title: Intrusive “flashforward” imagery and anxiety: development and validation of the Oxford Flashforwards in Anxiety Scale (OFAS)

Article References: Munns, L., Lu, C. X.-T., & Lau-Zhu, A. (2026). Intrusive “flashforward” imagery and anxiety: development and validation of the Oxford Flashforwards in Anxiety Scale (OFAS). BMC Psychiatry. https://doi.org/10.1186/s12888-026-08680-z

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08680-z

Keywords: anxiety, mental imagery, flashforwards, psychometrics, scale validation, worry, adolescence, young adults, cognitive psychology, BMC Psychiatry, network analysis, predictive validity

Tetris may look simple, but successful play requires the brain to perform several operations at once. Players must monitor a falling shape, rotate it mentally, predict where it will fit, remember the current board configuration, track upcoming pieces, and rapidly transform those decisions into finger movements. As the game becomes faster, these processes must operate under intense time pressure. This combination makes Tetris very different from traditional laboratory tasks that isolate a single ability, such as the Stroop task for cognitive control or the n-back task for working memory. Tetrix preserves the game’s integrated demands while allowing researchers to separate its visual, motor, and cognitive components experimentally.

The project was developed by modifying an open-source Python implementation of Tetris using the Pygame library and then integrating the game into PsychoPy, a widely used platform for behavioral and neuroimaging experiments. Its architecture separates the game mechanics from the broader experimental design, allowing investigators to alter settings through configuration files rather than rewriting the entire program. Researchers can define the starting level, control the rate at which blocks fall, determine how many completed lines are needed to advance, adjust scoring rules, and prevent level progression when a constant difficulty is required. They can also select whether the next one, two, or three blocks appear on screen, or remove the preview entirely to reduce visuospatial planning during control conditions.

The program also includes several components that can run in parallel through Python’s multiprocessing framework. A pretrial version measures individual performance and can be used as a standalone behavioral task. A main gameplay process is intended for neuroimaging experiments, while a visually simplified “watching” process displays falling blocks without allowing participants to control them. The paradigm records scanner trigger signals, keypresses, timing information, game events, and performance variables in log files. Researchers can pseudorandomize block sequences and experimental conditions using fixed random seeds, ensuring that the same stimuli can be reproduced across participants or testing sessions. This reproducibility is particularly important in fMRI, where small differences in timing or stimulus content can affect the measured blood-oxygen-level-dependent signal.

Tetrix is built around a set of control conditions designed to identify which parts of Tetris gameplay drive brain activity. In the default design, participants first complete practice rounds so that the game can estimate an appropriate difficulty level. During the main experiment, they play Tetris for 30 seconds, followed by one of three conditions: watching an automated version of the game, making button presses without playing, or viewing a fixation cross as a baseline. The visual control presents blocks that move independently of the participant’s actions and do not stack, while the motor control displays symbols indicating when participants should alternate button presses. Comparing gameplay with these conditions helps researchers distinguish activity related to complex visuospatial operations from activity caused simply by seeing moving shapes, pressing buttons, or maintaining a resting baseline.

To demonstrate that the system could work inside an MRI scanner, the researchers conducted a pilot study involving seven participants. One participant was excluded because strong head motion caused a field-of-view shift, leaving six datasets for the main neuroimaging analysis. Participants completed 21 gameplay trials, each lasting 30 seconds, with variable intervals of six to eight seconds between blocks. Scanning was performed on a 3-Tesla MRI system using a multiband echo-planar imaging sequence with a repetition time of 1.2 seconds. The functional images covered the whole brain at a resolution of approximately 3 millimeters in-plane and 3.3 millimeters through-plane, while a high-resolution T1-weighted anatomical scan was collected for each participant.

The researchers processed the data with SPM12, a standard software package for statistical parametric mapping. Their preprocessing pipeline included motion estimation, correction of outlier volumes, slice-timing correction, anatomical-functional co-registration, tissue segmentation, normalization to the MNI template, and spatial smoothing with an 8-millimeter Gaussian kernel. Motion parameters were included in the statistical model, and an interpolation procedure called SPIKECOR was used to replace unusually affected volumes. The critical analysis tested whether gameplay produced greater activity than watching Tetris, button pressing, and baseline fixation simultaneously. This conjunction contrast was intended to isolate neural responses associated with the distinctive cognitive demands of playing rather than with basic vision or hand movements.

The resulting activation pattern centered on a distributed frontoparietal network. Bilateral regions in the middle and superior frontal gyri, including areas associated with the frontal eye fields, became active during gameplay. Strong responses also appeared in the posterior parietal cortex, including the superior parietal lobule and intraparietal sulcus, as well as the left middle occipital cortex and parts of the right cerebellum. The frontal eye fields and posterior parietal cortex are major components of the dorsal attention network, which helps direct attention toward relevant locations and coordinate goal-driven visual exploration. In Tetris, these regions may support the rapid selection of important board elements, the monitoring of falling pieces, and the shifting of attention between the current block, the playfield, and the preview window.

The authors argue that the same frontoparietal system may also support visuospatial working memory and mental imagery. Players must retain the shape and orientation of Tetrominoes, imagine possible rotations, and compare those imagined configurations with available spaces on the board. The occipital activation that remained after comparison with the visual control condition may reflect top-down modulation of visual processing, although the researchers caution that eye movements could also contribute. Without eye tracking, it is impossible to determine whether the frontal eye-field response reflects cognitive control, differences in saccade frequency, or both. Cerebellar activity may likewise reflect more than simple finger movement, potentially involving movement coordination and predictions about the sensory consequences of rapid actions.

The study also reports voxel-wise Hedges’ g effect-size maps that may help future laboratories estimate sample sizes, although the authors emphasize that the pilot sample is too small for definitive conclusions. Some estimated effects were exceptionally large, exceeding g = 5, a result that can occur when a small sample produces strong but unstable group statistics. An additional group of ten participants showed broadly similar activation clusters, offering preliminary replication, but the study was not designed to establish precise causal roles for the identified regions. Head-motion spikes occurred across participants, underscoring a major challenge for MRI research using physically demanding games. Even with correction and interpolation, frequent hand movements may produce subtle body and head displacement that can contaminate neural measurements.

Tetrix is also connected to a growing clinical interest in Tetris-based interventions. Previous studies have suggested that playing a visuospatial game after trauma may reduce later intrusive memories, possibly by competing with the mental imagery and visuospatial working-memory resources involved in forming or reconsolidating traumatic memories. Tetris-based interventions have been examined in emergency departments, experimental trauma studies, and clinical populations with post-traumatic stress disorder. The new pilot findings raise the possibility that the game’s effects depend not only on working-memory load but also on rapid visuospatial reorientation and sustained engagement of the dorsal attention network. That interpretation remains hypothetical, however, and the present study did not test treatment outcomes or patients with PTSD.

The authors describe Tetrix as an ongoing project rather than a finished clinical instrument. Later versions added adjustable trial lengths, optional experimental blocks, detailed gameplay recording, motor-condition logging, and replay-based controls that can reproduce the timing of earlier gameplay. Such features could allow future studies to manipulate one variable at a time, including game speed, preview-window size, level progression, or motor demands. These experiments may clarify whether Tetris-related brain activity reflects working-memory capacity, mental rotation, attention shifting, motor planning, reward processing, or the interaction of all these functions. For now, Tetrix offers researchers an unusually accessible bridge between a popular game and rigorous cognitive neuroscience: a reproducible, configurable task that can be downloaded, modified, and tested across laboratories and clinical settings.

Subject of Research: A standardized Tetris-based behavioral and fMRI paradigm for studying attention, visuospatial working memory, mental imagery, motor planning, and related neural networks.

Article Title: Tetrix: A novel Tetris-based paradigm for neuroimaging research and clinical applications

Article References: Grote, J., Stocker, J. E., Sommer, J., Hamm, A.-M., Kessler, H., & Jansen, A. (2026). Tetrix: A novel Tetris-based paradigm for neuroimaging research and clinical applications. Behavior Research Methods, 58, Article 279. https://doi.org/10.3758/s13428-026-03150-6

Image Credits: AI Generated

DOI: 10.3758/s13428-026-03150-6

Keywords: Tetris, Tetrix, fMRI, PsychoPy, visuospatial working memory, mental imagery, dorsal attention network, cognitive control, motor planning, neuroimaging, PTSD research