Studies using emotionally salient stimuli have demonstrated neural activation in limbic and paralimbic brain regions. In some studies, subjects passively perceive evocative stimuli, while in other studies, they perform specific cognitive tasks. Evidence is emerging that even a simple cognitive task performed on emotionally salient stimuli can affect neural activation in emotion-associated brain regions. We tested the hypothesis that rating the subjective experience of an aversive visual stimulus would decrease limbic/paralimbic activation and increase activity in medial frontal regions. Ten healthy subjects underwent (15)O PET scans while they viewed pictures of aversive (AV) and nonaversive (NA) content, taken from the International Affective Picture System. Subjects appraised pictures on a scale of pleasantness/unpleasantness during one set of scans (RTNG), and they passively viewed pictures during another set (PSVW). After each scan, emotional responses were assessed. RTNG was associated with significantly less intensity of sadness and significantly less activation (AV - NA) of the right insula/amygdala and left insula, relative to PSVW. RTNG also activated the dorsal medial prefrontal cortex and the anterior cingulate sulcus, which were not differentially activated during PSVW. For both RTNG and PSVW, subjects activated the left fusiform gyrus. The results support the proposition that task instructions about how subjects should process evocative stimuli can affect neural activity.