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Abed M, Mansureh HH, Masoud GAL, Elaheh H, Mohammad-Hossein NHK, Yamin BD, Abdol-Hossein V. Construction of Meta-Thinking Educational Program Based on Mental-Brain Simulation ( MTMBS) and Evaluating its Effectiveness on Executive Functions, Emotion Regulation, and Impulsivity in Children With ADHD: A Resting-State Functional MRI Study. J Atten Disord 2023; 27:1223-1251. [PMID: 36843348 DOI: 10.1177/10870547231155436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE The aim of present research was to make a Meta-Thinking educational program based on mental-brain simulation and to evaluate its effectiveness on executive functions, emotion regulation and impulsivity in children with ADHD. METHODS The research method was Embedded Design: Embedded Experimental Model. The research sample included 32 children with ADHD who were randomly assigned to two experimental and control groups. The intervention was implemented for eight sessions of 1.5 hr for the experimental group, and fMRI images were taken from them, while the control group didn't receive any treatment. Finally, using semi-structured interviews, coherent information was collected from the parents of the experimental group about the changes made. Data were analyzed with SPSS-24, MAXQDA, fMRIprep, and FSL software. RESULTS The Meta-Thinking Educational Program had effect on performance of ADHD children and suppressed brain regions related to DMN. CONCLUSION The Implementation of this educational program plays a vital role in improving psychological problems of children with ADHD.
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2
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Lawrence HR, Balkind EG, Ji JL, Burke TA, Liu RT. Mental imagery of suicide and non-suicidal self-injury: A meta-analysis and systematic review. Clin Psychol Rev 2023; 103:102302. [PMID: 37329877 PMCID: PMC10330912 DOI: 10.1016/j.cpr.2023.102302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/27/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The vast majority of research on, and clinical assessment of, cognitions related to suicide and non-suicidal self-injury (NSSI) has focused on verbal thoughts. And yet, mental imagery is more realistic and emotionally arousing than verbal thoughts. METHODS We conducted a systematic review and meta-analysis documenting the prevalence of suicidal and NSSI mental imagery and describing the content and characteristics of suicidal and NSSI mental imagery, links between suicidal and NSSI mental imagery and suicidal and NSSI behavior, and how to intervene on suicidal and NSSI mental imagery. Studies published through December 17, 2022 were identified through a systematic search of MEDLINE and PsycINFO. RESULTS Twenty-three articles were included. Prevalence rates of suicidal (73.56%) and NSSI (84.33%) mental imagery were high among clinical samples. Self-harm mental imagery commonly depicts engagement in self-harm behavior and is experienced as vivid, realistic, and preoccupying. When experimentally induced, self-harm mental imagery reduces physiological and affective arousal. Preliminary evidence suggests that suicidal mental imagery is associated with suicidal behavior. CONCLUSIONS Suicidal and NSSI mental imagery are highly prevalent and may be associated with heightened risk for self-harm behavior. Assessments and interventions for self-harm should consider incorporating and addressing suicidal and NSSI mental imagery to mitigate risk.
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Affiliation(s)
- Hannah R Lawrence
- School of Psychological Science, Oregon State University, Corvallis, OR, United States of America.
| | - Emma G Balkind
- Suffolk University, Boston, MA, United States of America
| | - Julie L Ji
- School of Psychological Science, University of Western Australia, WA, Australia; School of Psychology, University of Plymouth, UK
| | - Taylor A Burke
- Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Richard T Liu
- Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
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3
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Hewitt OM, Langdon PE, Hales SA, Larkin M. The phenomenology of mental imagery in people with intellectual disabilities. Psychol Psychother 2023; 96:25-39. [PMID: 36018277 PMCID: PMC10087696 DOI: 10.1111/papt.12424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Mental imagery is important in the development and maintenance of psychological disorders and well-being but has been neglected in people with intellectual disabilities. A detailed idiographic analysis of the lived experience of mental imagery in this population is presented. DESIGN This qualitative study uses interpretative phenomenological analysis (IPA). It involved inclusive research methods with people with intellectual disabilities and other stakeholders (including family members, advocates, support workers and intellectual disability service managers). METHODS Ten individual semi-structured interviews were conducted with people with mild-moderate intellectual disabilities. Participants were opportunistically sampled through organisations providing community services to people with intellectual disabilities in the UK. Two men and eight women (mean age 43 years) participated. Interviews were audio-recorded and analysed using IPA. RESULTS People with intellectual disabilities are able to experience a range of rich and detailed mental images across all sensory modalities. Participants reported changes in affect based on mental imagery, and an ability to experience both spontaneous and deliberate mental images. The emotional saliency of the object of mental imagery appeared to influence participants' ability to engage with imagery. A number of adaptations make mental imagery more accessible and easier to report. The ability of people with intellectual disabilities to experience vivid mental imagery has important clinical implications for the use of a range of mental imagery interventions with this population. CONCLUSIONS The need to consider mental imagery interventions for this population, and how these can be adapted to ensure accessibility is a priority for people with intellectual disabilities and psychological disorders.
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Affiliation(s)
- Olivia Mary Hewitt
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK.,Learning Disability Services, Berkshire Healthcare NHS Foundation Trust, Reading, UK
| | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK.,Coventry and Warwickshire Partnership NHS Trust, Rainbow Unit, Brooklands Hospital, Birmingham
| | - Susie A Hales
- Emotion and Mental Imagery Lab (EMIL), Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Michael Larkin
- Department of Psychology, Institute for Health and Neurodevelopment, Aston University, Birmingham, UK
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4
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García-Soriano G, Carrasco Á, Emerson LM. Obsessional intrusive thoughts in children: An interview based study. Psychol Psychother 2023; 96:249-262. [PMID: 36351751 PMCID: PMC10099857 DOI: 10.1111/papt.12437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/29/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We aimed to investigate the experience of obsessional intrusive thoughts (OITs) in a sample of children aged 8 to 10 years old and to test the main tenets of the cognitive model of OCD. Specifically, we assessed: (1) the prevalence of OITs experienced by young children; (2) their frequency and content; (3) the emotions they evoke; (4) the reasons why they are upsetting; (5) how they are appraised (6) and what control strategies they use. METHODS Forty-nine children (28 girls, 21 boys; mean age 9.1 years) from the community completed two self-report questionnaires assessing anxiety and obsessive-compulsive symptoms. Children were interviewed using the Children's Anxious Thoughts Interview, which assessed their experiences of OITs. RESULTS From the 49 participants, 71.43% reported having experienced at least one OIT. The most frequent contents related to harm and doubt. Of the total sample, 28.6% reported having experienced one OIT recently with at least moderate frequency; these participants reported higher anxiety and obsessive-compulsive interference, described feeling nervous and anxious when experiencing their OIT, and rated their OIT as highly important and distracting. The most frequently reported control strategies were cognitive - suppression, distraction and thought replacement. CONCLUSIONS Almost two thirds of community children reported experiencing OITs. The findings from this study provide preliminary support for the application of the cognitive model of OCD in children. Subtle differences from previous research with adults are discussed.
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Affiliation(s)
- Gemma García-Soriano
- Dpto Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | - Ángel Carrasco
- U. de Salud Mental Infantil de Catarroja, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Lisa Marie Emerson
- Faculty of Health, School of Health Sciences, University of Canterbury, Christchurch, New Zealand
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5
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Halldorsson B, Waite P, Harvey K, Pearcey S, Creswell C. In the moment social experiences and perceptions of children with social anxiety disorder: A qualitative study. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2023; 62:53-69. [PMID: 36214425 PMCID: PMC10091697 DOI: 10.1111/bjc.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Childhood social anxiety disorder (SAD) is a common and disabling condition. General forms of cognitive behavioural treatments have demonstrated poorer efficacy for childhood SAD when compared to other childhood anxiety disorders and further understanding of the psychological factors that contribute to the maintenance of childhood SAD is warranted. Examining the social experiences of children with SAD may help to identify relevant psychological factors and increase our understanding of what keeps childhood SAD going. METHODS The current study used reflexive thematic analysis to analyse the transcripts of interviews with 12 children aged 8-12 years with SAD who had been interviewed about their 'in the moment' social experiences during a social stress induction task. The interview topic guide included factors hypothesized to maintain SAD in adult cognitive models of the disorder. RESULTS The interviews revealed both variety and commonalities in the experiences and interpretations of social events in children with SAD, captured in three related main themes: (i) Discomfort being the centre of attention, (ii) (Lack of) awareness of cognitions and (iii) Managing social fears. Findings indicated likely developmental influences on which maintenance mechanisms apply at which point in time. CONCLUSIONS There is variation in the psychological mechanisms that children with SAD endorse and developmental factors are likely to influence when specific mechanisms are relevant. We now need further studies that take a developmentally informed approach to understand the nature of the association between the factors identified in this study and social anxiety in childhood to inform the development of more effective interventions for childhood SAD.
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Affiliation(s)
- Brynjar Halldorsson
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK.,Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Polly Waite
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Samantha Pearcey
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Cathy Creswell
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
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6
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Thunnissen MR, Nauta MH, de Jong PJ, Rijkeboer MM, Voncken MJ. Flashforward imagery in speech anxiety: Characteristics and associations with anxiety and avoidance. Front Psychol 2022; 13:975374. [PMID: 36267078 PMCID: PMC9577331 DOI: 10.3389/fpsyg.2022.975374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Speech anxiety (SA) is a highly prevalent social fear. Prospective ‘flashforward’ (FF) imagery of an upcoming social catastrophe may be a particularly important cognitive factor in SA persistence via eliciting anxiety and avoidance behaviors. Since earlier research on imagery and social anxiety has not strictly differentiated between types of negative imagery, the occurrence, precise features, and impact of FF imagery remain unclear. We therefore examined the phenomenological characteristics of FF imagery in SA and mapped the relationship between FF imagery features and anxiety and avoidance. Female participants who approached clinical levels of SA (N = 60) completed questionnaires on SA and avoidance behaviors, and rated anxiety and avoidance in anticipation of an actual speech. FF imagery and emotionally linked autobiographical memories were assessed with semi-structured interviews. All participants reported recurring FF images, which were experienced as vivid, distressing, field perspective images with accompanying negative feelings. Image distress and feelings of threat showed most consistent associations with SA and avoidance measures. Findings add to the conceptualization of SA, and support the clinical relevance of assessing FF imagery. Future experimental studies on FF imagery characteristics are necessary to test the proposed causal impact in SA persistence and to inform additional treatment targets.
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Affiliation(s)
- Marjolein R. Thunnissen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
- Accare, University Center for Child and Adolescent Psychiatry, Groningen, Netherlands
- *Correspondence: Marjolein R. Thunnissen,
| | - Maaike H. Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Peter J. de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Marleen M. Rijkeboer
- Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
| | - Marisol J. Voncken
- Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
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7
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Burleigh L, Jiang X, Greening SG. Fear in the Theater of the Mind: Differential Fear Conditioning With Imagined Stimuli. Psychol Sci 2022; 33:1423-1439. [PMID: 35895306 DOI: 10.1177/09567976221086513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Many symptoms of anxiety and posttraumatic stress disorder are elicited by fearful mental imagery. Yet little is known about how visual imagery of conditioned stimuli (CSs) affects the acquisition of differential fear conditioning. Across three experiments with younger human adults (Experiment 1: n = 33, Experiment 2: n = 27, Experiment 3: n = 26), we observed that participants acquired differential fear conditioning to both viewed and imagined percepts serving as the CSs, as measured via self-reported fear and skin conductance responses. Additionally, this differential conditioning generalized across CS-percept modalities such that differential conditioning acquired in response to visual percepts generalized to the corresponding imagined percepts and vice versa. This is novel evidence that perceived and imagined stimuli engage learning processes in very similar ways and is consistent with the theory that mental imagery is depictive and recruits neural resources shared with visual perception. Our findings also provide new insight into the mechanisms of anxiety and related disorders.
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Affiliation(s)
- Lauryn Burleigh
- Department of Psychology, Cognitive and Brain Sciences, Louisiana State University
| | - Xinrui Jiang
- Department of Psychology, Cognitive and Brain Sciences, Louisiana State University
| | - Steven G Greening
- Department of Psychology, Cognitive and Brain Sciences, Louisiana State University.,Department of Psychology, Brain and Cognitive Sciences, University of Manitoba
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8
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Chiu K, Clark DM, Leigh E. Characterising Negative Mental Imagery in Adolescent Social Anxiety. COGNITIVE THERAPY AND RESEARCH 2022; 46:956-966. [PMID: 36156987 PMCID: PMC9492563 DOI: 10.1007/s10608-022-10316-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 11/03/2022]
Abstract
Abstract
Background
Understanding the role of self-imagery in the development of social anxiety in adolescence holds promise for improving intervention. Cross-sectional studies indicate that imagery characteristics are associated with social anxiety symptoms, however, prospective studies are lacking. The current study examined concurrent and prospective associations between two image characteristics, namely observer-perspective and vividness, with social anxiety symptoms in a community adolescent sample (N = 616; 53% girls; aged 11–15 years). In addition, we examined common themes in the negative social anxiety-related images.
Methods
Negative self-imagery and social anxiety symptoms were assessed using questionnaires at baseline and at 4–6-month follow-up. A series of multiple linear regression analyses were performed to see if each image characteristic predicts concurrent and prospective social anxiety symptoms. Topic modelling was performed to infer key topics from verbal data.
Results
Observer-perspective and vividness significantly predicted concurrent social anxiety symptoms beyond the influence of age and gender. Observer-perspective significantly predicted prospective levels of social anxiety symptoms beyond the influence of age, gender, and baseline social anxiety and depression symptoms. Negative self-images clustered into two themes: the fear of appearing anxious and the fear of being judged or viewed as unacceptable.
Conclusions
Specific characteristics and contents of negative self-images may be particularly relevant to the development of adolescent social anxiety.
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9
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Hewitt OM, Steel C, Hales SA, Hayden N, Gundeslioglu H, Tapp K, Langdon P. A systematic review and narrative synthesis of mental imagery tasks in people with an intellectual disability: Implications for psychological therapies. Clin Psychol Rev 2022; 96:102178. [PMID: 35738164 DOI: 10.1016/j.cpr.2022.102178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/22/2022] [Accepted: 06/04/2022] [Indexed: 11/18/2022]
Abstract
Mental imagery is recognised for its role in both psychological distress and wellbeing, with mental imagery techniques increasingly being incorporated into psychological interventions. In this systematic review and narrative synthesis (PROSPERO 2021: CRD42021240930), we identify and evaluate the evidence base for the phenomenon and phenomenology of mental imagery in people with intellectual disabilities, to ascertain the applicability of such interventions for this population. Electronic searches of nine databases and grey literature identified relevant publications. Two reviewers independently assessed titles and abstracts of retrieved records (n = 8609) and full-text articles (n = 101) against eligibility criteria. Data were extracted and quality appraised. Forty-onepapers met our eligibility criteria. The quality and designs were variable. Mental imagery was facilitated through ensuring participants understood tasks, providing opportunity to rehearse tasks (including using concrete prompts) and using scaffolding to help participants elaborate their responses. People with intellectual disabilities can engage with mental imagery, with appropriate adaptations, although the associated phenomenology has not been thoroughly investigated. Mental imagery interventions may be useful for people with intellectual disabilities with appropriate modifications.
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Affiliation(s)
- Olivia Mary Hewitt
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, UK; Learning Disability Services, Berkshire Healthcare NHS Foundation Trust, 7-9 Cremyll Road, Reading RG1 8NQ, UK.
| | - Craig Steel
- xford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Headington, Oxford OX3 7JX, UK
| | - Susie A Hales
- Emotion and Mental Imagery Lab (EMIL), Department of Psychology, Uppsala University, Box 1225, 751 42, Sweden; Oxford Health NHS Foundation Trust, Littlemore Mental Health Centre, Sandford Road, Littlemore, Oxford OX4 4XN, UK
| | - Nikita Hayden
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, UK
| | - Hatice Gundeslioglu
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, UK
| | - Katherine Tapp
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, UK
| | - Peter Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, UK; Coventry and Warwickshire Partnership NHS Trust, Rainbow Unit, Brooklands Hospital, Marston Green, Birmingham B37 5RY, UK
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10
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Henricks LA, Lange WG, Luijten M, Becker ES. A New Social Picture Task to Assess Interpretation Bias related to social fears in adolescents. Res Child Adolesc Psychopathol 2022; 50:1067-1080. [PMID: 35435540 PMCID: PMC9013980 DOI: 10.1007/s10802-022-00915-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 12/02/2022]
Abstract
This pre-registered study focused on developing a new social picture task to assess interpretation bias related to social fears in adolescents. Using such a pictorial task may increase ecological validity and readily trigger emotional processes compared to more traditional verbal tasks that are often used. In the picture task, ambiguous social pictures were presented, followed by a positive and negative interpretation. In this study, we examined how the new task relates to an already existing interpretation bias task and how the new pictorial task relates to social fears in adolescents. The sample consisted of 329 adolescents aged 12 to 18 years. Interpretation bias was assessed with the newly developed pictorial task and with more traditional verbal vignettes. Social fears were measured with self-report questionnaires. The results suggest that the pictorial task was able to assess interpretation bias comparable to the verbal vignettes, suggesting appropriate convergent validity. Interpretation bias assessed with the picture task was linked to higher levels of fear of negative evaluation, the core symptom of social anxiety, but not to social anxiety symptoms in general. The verbal task was linked to both social fears and thus still seems the preferred method to investigate interpretation bias related to social fears in adolescents. However, we do believe that with further improvement of the pictorial task, it could be a useful addition to the research field.
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11
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Boosting exposure and response prevention with imagery-based techniques: a case study tackling sexual obsessions in an adolescent. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Sexual obsessions are common in adolescents with obsessive compulsive disorder (OCD), but how to address these obsessions in a developmentally sensitive manner remains under-explored. This report presents the case of an adolescent who experienced unwanted sexual imagery, undergoing conventional exposure and response prevention, which was subsequently augmented with imagery-based techniques. This approach was associated with remission in symptoms of OCD and marked improvements in symptoms of anxiety and depression. The imagery-based approach was well received and valued as key to treatment success by the adolescent. This raises the tantalising possibility that working directly with images can fuel treatment innovation in tackling sexual (and non-sexual) obsessions in youth OCD.
Key learning aims
(1)
Sexual obsessions are common in adolescent obsessive compulsive disorder (OCD).
(2)
Little guidance is available on how to conduct exposure and response prevention sensitively for sexual obsessions in adolescent OCD.
(3)
Imagery-based techniques can be used effectively for reducing sexual obsessions.
(4)
Imagery-based techniques delivered by videoconferencing can be acceptable for young people.
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12
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Steil R, Fischer A, Gutermann J, Rosner R. Mental imagery in adolescent PTSD patients after child abuse: a comparison with matched healthy controls. BMC Psychiatry 2022; 22:64. [PMID: 35086493 PMCID: PMC8793273 DOI: 10.1186/s12888-022-03706-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Intrusive mental imagery (MI) plays a crucial role in the maintenance of posttraumatic stress disorder (PTSD) in adults. Evidence on the characteristics of MI in adolescents suffering from PTSD is sparse. The aim of this study was to thoroughly assess MI in an adolescent sample suffering from PTSD after the experience of childhood sexual abuse and/or childhood physical abuse (CA). METHODS Thirty-two adolescents with a primary diagnosis of PTSD after CA and 32 adolescents without any mental disorder and without a history of CA, matched for age and gender, completed questionnaires assessing the characteristics of negative and positive MI, as well as images of injury and death that lead to positive emotions (ID-images). RESULTS The PTSD group reported significantly more frequent, more vivid, more distressing and more strongly autobiographically linked negative MI compared to the control group. Although positive MI was highly present in both groups (PTSD: 65.6%; controls: 71.9%), no significant differences emerged between the two groups regarding the distinct characteristics of positive MI. The frequency of the ID-images did not significantly differ between the two groups (PTSD: 21.9%; controls: 9.4%), although the ID-images were more vivid in the PTSD group. DISCUSSION Negative MI appears to be crucial in adolescent PTSD, whilst positive MI are unexpectedly common in both the PTSD and the control group. The role of positive MI as well as that of ID-images remain unclear. Specific interventions for changing negative MI that are tailored to the developmental challenges in adolescents with PTSD should be developed. TRIAL REGISTRATION Some of the PTSD patients in this study were also part of a randomized controlled trial on Developmentally adapted Cognitive Processing Therapy (D-CPT). This trial was registered at the German Clinical Trial Registry (GCTR), DRKS00004787 , 18 March 2013.
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Affiliation(s)
- Regina Steil
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486 Frankfurt am Main, Germany
| | - Anne Fischer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486 Frankfurt am Main, Germany
| | - Jana Gutermann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486 Frankfurt am Main, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Ostenstr. 25, 85072 Eichstätt, Germany
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13
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Sosin LS, Noble SD, Harrichand JJS, Bohecker L. The Creative Arts Personal Growth Group (CAPG): Transforming Fear and Shame. JOURNAL FOR SPECIALISTS IN GROUP WORK 2021. [DOI: 10.1080/01933922.2021.2000083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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Hewitt OM, Tomlin A, Waite P. The experience of panic attacks in adolescents: an interpretative phenomenological analysis study. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2021. [DOI: 10.1080/13632752.2021.1948742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Olivia Mary Hewitt
- Berkshire Healthcare NHS Foundation Trust
- Centre for Educational Development, Appraisal and Research (CEDAR), UK
| | - Alice Tomlin
- Berkshire Healthcare NHS Foundation Trust
- Oxford Institute of Clinical Psychology Training and Research
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
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15
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Jiang X, Greening SG. Psychophysiological evidence for fear extinction learning via mental imagery. Psychophysiology 2021; 58:e13906. [PMID: 34287954 DOI: 10.1111/psyp.13906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 12/01/2022]
Abstract
Imagery-based extinction procedures have long been used in the treatments of fear-related conditions. The assumption is that imagery can substitute for the perceptual stimuli in the extinction process. Yet, experimental validations of this assumption have been limited in number and some have relied exclusively on measures of autonomic reactivity without consideration of conscious feelings of fear. The current investigation sought to assess whether imagery-based exposure could lead to extinction of conditioned fear to the corresponding perceptual stimulus. Conditioned fear responses were measured by both a physiological (i.e., skin conductance response [SCR]) and a subjective (i.e., self-reported fear) measure. Participants (N = 56) first underwent perceptual differential fear conditioning, then imagery extinction, then perceptual extinction. SCR evidence was found for successful fear conditioning, generalization of fear from viewing to imagery, and most importantly, the absence of differential fear after imagery extinction upon re-exposure to the conditioned perceptual stimulus. Self-reported fear confirmed the acquisition and generalization of fear and provided evidence of a significant reduction in differential fear conditioning across extinction. Consistent with clinical evidence of the efficacy of imagery extinction and the existing limited experimental literature, this study offers support for fear extinction to perceptual stimuli via imagery exposure.
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Affiliation(s)
- Xinrui Jiang
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Steven G Greening
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.,Pennington Biomedical Research Center, Baton Rouge, LA, USA.,Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
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Pile V, Winstanley A, Oliver A, Bennett E, Lau JYF. Targeting image-based autobiographical memory in childhood to prevent emotional disorders: Intervention development and a feasibility randomised controlled trial. Behav Res Ther 2021; 144:103913. [PMID: 34214822 DOI: 10.1016/j.brat.2021.103913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 03/15/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022]
Abstract
Maladaptive cognitive styles confer vulnerability for emotional disorders and may emerge in childhood. In three phases, we developed and evaluated a novel parent-led intervention (My Memory Forest) to target overgeneral memory and avoidance of negative memories. In phase 1, the intervention was co-designed using two focus groups (n = 30 children) and consultation with teachers and parents. The acceptability, feasibility, and clinical potential of My Memory Forest was initially evaluated in phase two (n = 12 children aged 6 to 9) and then in a feasibility randomised controlled trial in phase three, against an active control (n = 56 aged 6 to 9). Acceptability and engagement were good, and no harm was reported by parents or participants. Phase 2 identified decreases in self-reported anxiety (d = 1.08), depression (d = 0.51) and vividness of negative events (d = 0.53). There was little change in parent-reported symptoms. In phase 3, recruitment was highly feasible and participant retention excellent (100%) but parent retention poor (55%). Descriptive statistics indicated similar changes in anxiety and depression for both groups. Changes between Phases 2 and 3 (e.g. methods of recruitment) could explain the discrepancy between results. Further development is necessary before proceeding to another trial. TRIAL REGISTRATION: ISRCTN13142918.
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Affiliation(s)
- Victoria Pile
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK
| | - Ali Winstanley
- Cultural Institute, King's College London, Artist, Illustrator and Arts and Wellbeing Project Producer, Lewes, East Sussex, UK
| | - Abigail Oliver
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK
| | - Eleanor Bennett
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK
| | - Jennifer Y F Lau
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK.
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17
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Liu M, Chen Y, Yin X, Peng D, Wang X, Ye B. Measuring Prospective Imagery: Psychometric Properties of the Chinese Version of the Prospective Imagery Task. Front Psychol 2021; 12:645127. [PMID: 34113287 PMCID: PMC8185034 DOI: 10.3389/fpsyg.2021.645127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 04/23/2021] [Indexed: 11/14/2022] Open
Abstract
Objective Prospective negative imagery is suggested to play an important role in the development and maintenance of anxiety and depression. The Prospective Imagery Task (PIT) was developed to assess prospective imagery. Given the importance of prospective imagery for mental health in the Chinese cultural context, our objective was to examine the psychometric properties of the PIT in a Chinese sample. Methods The instrument was validated among a sample of 1,372 Chinese individuals (mean age = 19.98, SD = 4.57; 35.2% male) who completed the PIT immediately following the Beck Depression Inventory-II (BDI-II) and State-Trait Anxiety Inventory-Trait version (STAI-T). Results The two-factor structure of the PIT was in line with the original study, with satisfactory reliability and positive correlations with the BDI-II and STAI-T scores. Latent profile analysis revealed a three-class pattern. The measurement invariance indicated that the instrument can be used among different age groups as well as among males and females. Conclusion The Chinese version of the PIT is a reliable and valid tool to measure prospective imagery, and the positive subscale is meaningful for clinical psychology. Limitations and future research directions are discussed.
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Affiliation(s)
- Mingfan Liu
- Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China.,Institute of Psychological Technology Application, Jiangxi Normal University, Nanchang, China
| | - Yiting Chen
- Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China
| | - Xiaoying Yin
- Jiangxi Provincial People's Hospital, Nanchang, China
| | - Dandan Peng
- Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China
| | - Xinqiang Wang
- Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China.,Institute of Psychological Technology Application, Jiangxi Normal University, Nanchang, China
| | - Baojuan Ye
- Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, China.,Institute of Psychological Technology Application, Jiangxi Normal University, Nanchang, China
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18
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Pile V, Smith P, Leamy M, Oliver A, Bennett E, Blackwell SE, Meiser-Stedman R, Stringer D, Dunn BD, Holmes EA, Lau JYF. A feasibility randomised controlled trial of a brief early intervention for adolescent depression that targets emotional mental images and memory specificity (IMAGINE). Behav Res Ther 2021; 143:103876. [PMID: 34098409 DOI: 10.1016/j.brat.2021.103876] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 10/01/2020] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Brief, evidence-based interventions for adolescent depression are urgently required, particularly for school-settings. Cognitive mechanisms research suggests dysfunctional mental imagery and overgeneral memory could be promising targets to improve mood. This feasibility randomised controlled trial with parallel symptomatic groups (n = 56) compared a novel imagery-based cognitive behavioural intervention (ICBI) to non-directive supportive therapy (NDST) in school settings. Blind assessments (of clinical symptoms and cognitive mechanisms) took place pre-intervention, post-intervention and follow-up three months later. The trial aimed to evaluate the feasibility and acceptability of the methodology and interventions, and estimate the likely range of effects of the intervention on self-reported depression. The pre-defined criteria for proceeding to a definitive RCT were met: full recruitment occurred within eleven months; retention was 89%; ICBI acceptability was above satisfactory; and no harm was indicated. Intention-to-treat analysis found large effects in favour of ICBI (relative to NDST) at post-intervention in reducing depressive symptoms (d = -1.34, 95% CI [-1.87, -0.80]) and improving memory specificity (d = 0.79 [0.35, 1.23]), a key cognitive target. The findings suggest that ICBI may not only improve mood but also strengthen abilities associated with imagining and planning the future, critical skills at this life stage. A fully powered evaluation of ICBI is warranted. Trial Registration: https://www.isrctn.com/; ISRCTN85369879.
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Affiliation(s)
- Victoria Pile
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Patrick Smith
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Mary Leamy
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - Abigail Oliver
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Eleanor Bennett
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Simon E Blackwell
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Dominic Stringer
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden; Sweden and Division of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Y F Lau
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
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19
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Abstract
Recent studies suggest that the developmental curves in adolescence, related to the development of executive functions, could be fitted to a non-linear trajectory of development with progressions and retrogressions. Therefore, the present study proposes to analyze the pattern of development in Perceptual Inhibition (PI), considering all stages of adolescence (early, middle, and late) in intervals of one year. To this aim, we worked with a sample of 275 participants between 10 and 25 years, who performed a joint visual and search task (to measure PI). We have fitted ex-Gaussian functions to the probability distributions of the mean response time across the sample and performed a covariance analysis (ANCOVA). The results showed that the 10- to 13-year-old groups performed similarly in the task and differ from the 14- to 19-year-old participants. We found significant differences between the older group and all the rest of the groups. We discuss the important changes that can be observed in relation to the nonlinear trajectory of development that would show the PI during adolescence.
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20
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Lawrence HR, Nesi J, Burke TA, Liu RT, Spirito A, Hunt J, Wolff JC. Suicidal Mental Imagery in Psychiatrically Hospitalized Adolescents. Res Child Adolesc Psychopathol 2021; 49:393-399. [PMID: 33403495 PMCID: PMC8087180 DOI: 10.1007/s10802-020-00750-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2020] [Indexed: 11/29/2022]
Abstract
Suicide is the second leading cause of death in adolescents and suicide rates in this population have increased in recent years. A critical step in preventing suicide is improving the accuracy of suicide risk assessment. Measurement of suicidal cognitions typically emphasizes assessment of verbal thoughts about suicide. Recent research suggests, however, that suicidal mental imagery, or mentally imagining suicide-related content, may be even more strongly associated with suicidal behavior. No research has evaluated suicidal mental imagery in adolescents, however. The present study evaluated suicidal mental imagery and suicidal verbal thoughts in a sample of adolescents (N = 159) admitted to an adolescent psychiatric inpatient unit. Of those adolescents who reported suicidal cognitions, 63.73% reported suicidal mental imagery. Adolescents who reported suicidal mental imagery had 2.40 greater odds of having made a suicide attempt, after accounting for history of suicidal verbal thoughts and relevant covariates. Findings suggest that suicidal mental imagery should be directly assessed when evaluating suicide risk, and that treatments may be optimized by targeting both suicidal verbal thoughts and suicidal mental imagery.
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Affiliation(s)
- Hannah R Lawrence
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Boston, USA.
| | - Jacqueline Nesi
- Department of Psychiatry & Human Behavior, Division of Clinical Psychology, Brown University, Providence, USA
- Bradley/Hasbro Research Center, Rhode Island Hospital, Providence, USA
| | - Taylor A Burke
- Bradley/Hasbro Research Center, Rhode Island Hospital, Providence, USA
| | - Richard T Liu
- Department of Psychiatry, Massachusetts General Hospital, Boston, USA
| | - Anthony Spirito
- Department of Psychiatry & Human Behavior, Division of Clinical Psychology, Brown University, Providence, USA
| | - Jeffrey Hunt
- Department of Psychiatry & Human Behavior, Division of Clinical Psychology, Brown University, Providence, USA
- Bradley/Hasbro Research Center, Rhode Island Hospital, Providence, USA
| | - Jennifer C Wolff
- Department of Psychiatry & Human Behavior, Division of Clinical Psychology, Brown University, Providence, USA
- Bradley/Hasbro Research Center, Rhode Island Hospital, Providence, USA
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21
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Rackham LA, Lau-Zhu A. Taxing working memory to modulate mental imagery of the 9/11 terrorist attacks following media exposure during childhood: a pilot study in young adult UK residents. ANXIETY STRESS AND COPING 2021; 34:423-436. [PMID: 33412932 DOI: 10.1080/10615806.2020.1870107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Media trauma in civilians is linked to intrusive imagery-based memory symptoms. We investigated whether mental imagery of the 9/11 terrorist attacks following media exposure is dampened by taxing working memory (WM). METHODS Forty-five young adult UK residents, who were exposed to the 9/11 terrorist attacks as children via the media, identified a personally-relevant mental image of the attacks. They were then randomly allocated to: (1) recall + Tetris, (2) recall + eye movements (EMs), or (3) recall-only. Ratings on imagery vividness and emotionality were provided at three time points: pre-, post-manipulations, and at 24-hr follow-up. RESULTS Repeated measures ANOVAs revealed that recall + Tetris and recall + EMs (relative to recall-only) significantly reduced imagery vividness and emotionality from pre- to post-manipulations, but not to follow-up. LIMITATIONS A passive control group is needed to fully rule out the role of natural memory decay; the follow-up was exploratory and took place outside the laboratory with reduced experimental control. CONCLUSIONS Aversive memory imagery from media trauma in civilians can be dampened by taxing WM, at least temporarily, which could be therapeutically useful. The use of such cognitive techniques may also hold relevance for public health approaches to address the impact of collective trauma.
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Affiliation(s)
- Libby A Rackham
- School of Psychology, Cognitive Institute, Plymouth University, Plymouth, UK
| | - Alex Lau-Zhu
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, UK.,Centre for Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
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22
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Pile V, Smith P, Lau JYF. Using Imagery Rescripting as an Early Intervention for Depression in Young People. Front Psychiatry 2021; 12:651115. [PMID: 34497542 PMCID: PMC8419270 DOI: 10.3389/fpsyt.2021.651115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Innovation is urgently needed for school-based early interventions for depression. Imagery rescripting for aversive memories has been shown to be a valuable therapeutic approach in adults. Yet it is rarely applied to young people or to depression. This is surprising given that intrusive images of aversive memories are implicated in the development and maintenance of depression. We review the literature and describe the co-development of an imagery rescripting protocol for young people (age 16-18) with high symptoms of depression. To contextualize and illustrate this approach, we identify three themes of negative images emerging from the 37 participants who completed imagery rescripting and provide a detailed case example for each theme. The identified themes are failure, interpersonal adversity, and family conflict or disruption. Given that there is some therapist concern about using imagery rescripting, we highlight any reported negative consequences of engaging in imagery rescripting. We propose that imagery rescripting is an acceptable and potentially effective tool for early intervention in depression, which is significantly underutilized in current practice.
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Affiliation(s)
- Victoria Pile
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Psychology, Royal Holloway, University of London, Egham, United Kingdom
| | - Patrick Smith
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jennifer Y F Lau
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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23
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Intrusive imagery in anxiety disorders in adolescents. Behav Cogn Psychother 2020; 49:556-568. [PMID: 33371911 DOI: 10.1017/s1352465820000934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Mental imagery plays an important role in models of anxiety disorders in adults. This understanding rests on qualitative and quantitative studies. Qualitative studies of imagery in anxious adolescents have not been reported in the literature. AIMS To address this gap, we aimed to explore adolescents' experiences of spontaneous imagery in the context of anxiety disorders. METHOD We conducted one-to-one semi-structured interviews, with 13 adolescents aged 13-17 years with a DSM-5 anxiety disorder, regarding their experiences of spontaneous imagery. We analysed participants' responses using thematic analysis. RESULTS We identified five superordinate themes relating to adolescents' influences on images, distractions from images, controllability of images, emotional responses to imagery and contextual influences on imagery. CONCLUSIONS Our findings suggest that spontaneous images are an important phenomenon in anxiety disorders in adolescents, associated with negative emotions during and after their occurrence. Contextual factors and adolescents' own cognitive styles appear to influence adolescents' experiences of images in anxiety disorders.
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24
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Mental Imagery and its Relevance for Psychopathology and Psychological Treatment in Children and Adolescents: a Systematic Review. Int J Cogn Ther 2020. [DOI: 10.1007/s41811-020-00092-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractThis review provides an overview of the current state of research concerning the role of mental imagery (MI) in mental disorders and evaluates treatment methods for changing MI in childhood. A systematic literature search using PubMed/Medline, Web of Science, and PsycINFO from 1872 to September 2020 was conducted. Fourteen studies were identified investigating MI, and fourteen studies were included referring to interventions for changing MI. Data from the included studies was entered into a data extraction sheet. The methodological quality was then evaluated. MI in childhood is vivid, frequent, and has a significant influence on cognitions and behavior in posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and depression. The imagery’s perspective might mediate the effect of MI on the intensity of anxiety. Imagery rescripting, emotive imagery, imagery rehearsal therapy, and rational-emotive therapy with imagery were found to have significant effects on symptoms of anxiety disorders and nightmares. In childhood, MI seems to contribute to the maintenance of SAD, PTSD, and depression. If adapted to the developmental stages of children, interventions targeting MI are effective in the treatment of mental disorders.
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25
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Harnessing Mental Imagery and Enhancing Memory Specificity: Developing a Brief Early Intervention for Depressive Symptoms in Adolescence. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10130-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Background
Treatment innovation for depressive symptoms in adolescence is urgently needed. Adult research suggests interventions targeting underlying cognitive mechanisms, such as dysfunctional mental imagery and overgeneral memory, are promising. Here, we describe and evaluate in a case series a brief imagery-based intervention for depressive symptoms that targets these cognitive mechanisms.
Methods
Nine participants completed the four-session intervention, whose principle components were imagery rescripting and memory specificity training. Questionnaires and experimental tasks (assessing symptomatology and cognitive mechanisms) were administered at three time points: pre-intervention, post-intervention and 3-month follow-up.
Results
The intervention was feasible to deliver and acceptable to participants. There was a large reduction in depression symptom scores from pre to post intervention (d = 1.32; 67% showed reliable improvement, RI) and this was maintained at follow-up (d = 1.46; RI = 75%). There were also reductions in anxiety (post: d = 1.15, RI = 44%; follow-up: d = 1.67, RI = 63%), increases in self-esteem (post: d = − 0.70, RI = 44%; follow-up: d = − 1.20, RI = 50%) and noteworthy changes in memory specificity (post: d = − 1.80, RI = 67%; follow-up: d = − 0.94, RI = 63%).
Conclusions
This is the first study to use imagery rescripting and memory specificity training in adolescence. Initial evidence is provided that the intervention is acceptable and may have clinical utility. Future randomised controlled trials are needed to further assess the intervention.
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26
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Image qualities and mood variability: Evaluating the utility of an imagery survey for bipolar disorder. J Affect Disord 2020; 272:77-83. [PMID: 32379623 DOI: 10.1016/j.jad.2020.03.098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/27/2020] [Accepted: 03/28/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Imagery appears to play an important role in mood variability, a core symptom of patients suffering from bipolar disorder. The present study aimed to explore the validity and reliability of an online self-report measure of imagery, the Dutch Imagery Survey (DImS). The DImS is an adaptation of the Imagery interview used in research on imagery in mental disorders. The present study additionally explored the ability of the DImS to detect relationships between self-reported imagery and subsequent mood and subsequent behaviour. METHOD 135 students completed the DImS and additional mental imagery and mood questionnaires. For re-test reliability, 42 students completed the survey again within two days. RESULTS Internal consistencies and test-retest scores of the five scales of the DImS were reasonable. Imagery Quality correlated with Emotions, and to a lesser degree with Behaviour. Positive Appraisals correlated with Positive Emotions, Negative Appraisals with Negative Emotions, and Positive appraisals with Behaviour. Frequency of Imagery, Imagery Quality and Positive Appraisals correlated with elevated mood. Imagery Quality and Negative Appraisals correlated with low mood. The DImS took approximately 15 min to complete. LIMITATIONS Re-test reliability was limited due to participants changing their dominant image. Results need to be replicated in a clinical sample. CONCLUSIONS Psychometric findings with the DImS appeared reasonable and consistent and showed that, in line with other recent studies, imagery is related to current mood and to both self-perceived emotion and subsequent behaviour. These findings suggested that the DImS is suitable to study the role of imagery in bipolar mood variability.
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27
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Leigh E, Chiu K, Clark DM. The effects of modifying mental imagery in adolescent social anxiety. PLoS One 2020; 15:e0230826. [PMID: 32251465 PMCID: PMC7135232 DOI: 10.1371/journal.pone.0230826] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/09/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The identification of negative self-imagery as a maintenance factor in adult social anxiety has led to enhanced treatments for this population. Whilst intrusive negative imagery is commonly reported by socially anxious adolescents, no studies have demonstrated that it plays a causal role in maintaining symptoms. To assess this possibility, we undertook an experimental study manipulating social self-imagery in high socially anxious adolescents. METHODS High socially anxious adolescents undertook two conversations under different conditions. During one conversation they held a negative social self-image in mind, and in the other they held a benign social self-image in mind. Self-report, conversation partner report and independent assessor ratings were taken. RESULTS When participants held a negative self-image in mind, they reported feeling more anxious, and believed they looked more anxious and performed more poorly. Furthermore, they overestimated how anxious they looked compared to conversation partner ratings. As well as distorting participants' perception of their anxious appearance, holding a negative image in mind also had observable effects on the interaction. Participants were rated as looking more anxious and performing less well by their conversation partner when they held such images in mind, and the conversation was rated more critically by conversation partners and independent observers. Finally, a preliminary mediation analysis suggested that the detrimental effect of negative imagery on the social interaction may be partly due to the spontaneous use of avoidant safety behaviours. CONCLUSIONS The findings provide support for a causal role of negative self-imagery in adolescent social anxiety and point to the potential clinical value of techniques targeting imagery to treat the disorder.
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Affiliation(s)
- Eleanor Leigh
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Kenny Chiu
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - David M. Clark
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
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28
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Lau-Zhu A, Henson RN, Holmes EA. Intrusive memories and voluntary memory of a trauma film: Differential effects of a cognitive interference task after encoding. J Exp Psychol Gen 2019; 148:2154-2180. [PMID: 31021150 PMCID: PMC7116494 DOI: 10.1037/xge0000598] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Methods to reduce intrusive memories (e.g., of traumatic events) should ideally spare voluntary memory for the same event (e.g., to report on the event in court). Single-trace memory accounts assume that interfering with a trace should impact both its involuntary and voluntary expressions, whereas separate-trace accounts assume these two can dissociate, allowing for selective interference. This possibility was investigated in 3 experiments. Nonclinical participants viewed a trauma film followed by an interference task (Tetris game-play after reminder cues). Next, memory for the film was assessed with various measures. The interference task reduced the number of intrusive memories (diary-based, Experiments 1 and 2), but spared performance on well-matched measures of voluntary retrieval-free recall (Experiment 1) and recognition (Experiments 1 and 2)-challenging single-trace accounts. The interference task did not affect other measures of involuntary retrieval-perceptual priming (Experiment 1) or attentional bias (Experiment 2). However, the interference task did reduce the number of intrusive memories in a laboratory-based vigilance-intrusion task (Experiments 2 and 3), irrespective of concurrent working memory load during intrusion retrieval (Experiment 3). Collectively, results reveal a robust dissociation between intrusive and voluntary memories, having ruled out key methodological differences between how these two memory expressions are assessed, namely cue overlap (Experiment 1), attentional capture (Experiment 2), and retrieval load (Experiment 3). We argue that the inability of these retrieval factors to explain the selective interference is more compatible with separate-trace than single-trace accounts. Further theoretical developments are needed to account for this clinically important distinction between intrusive memories and their voluntary counterpart. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Alex Lau-Zhu
- Medical Research Council Cognition and Brain Sciences Unit
| | | | - Emily A Holmes
- Medical Research Council Cognition and Brain Sciences Unit
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29
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Russell JK, Strodl E, Connolly J, Kavanagh DJ. A Metacognitive Intervention of Narrative Imagery for young people with cystic fibrosis: A feasibility study. J Health Psychol 2019; 26:1389-1403. [PMID: 31530184 DOI: 10.1177/1359105319876336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cystic fibrosis and its treatment can have substantial functional and emotional impacts on patients and their families. This feasibility study assessed a new cystic fibrosis treatment, Metacognitive Intervention of Narrative Imagery, integrating narrative and meta-cognitive therapies with mental imagery. A total of 13 patients, aged 10-17 years, received three 1-hour sessions and were assessed on emotional functioning, anxiety, and depression at baseline and 4 and 8 weeks post-baseline. Participants had significant improvements in anxiety, and changes in emotional functioning and anxiety had a medium effect size. Participants and parents rated Metacognitive Intervention of Narrative Imagery highly on usability and favourability. Further clinical trials are indicated.
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30
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Leigh E, Clark DM. Understanding Social Anxiety Disorder in Adolescents and Improving Treatment Outcomes: Applying the Cognitive Model of Clark and Wells (1995). Clin Child Fam Psychol Rev 2018; 21:388-414. [PMID: 29654442 PMCID: PMC6447508 DOI: 10.1007/s10567-018-0258-5] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Social anxiety disorder is a condition characterised by a marked and persistent fear of being humiliated or scrutinised by others. Age-of-onset data point to adolescence as a developmentally sensitive period for the emergence of the condition, at a time when the peer group becomes increasingly important. Social anxiety in adolescence is associated with considerable impairment that persists through to adulthood. There are clear potential benefits to delivering effective interventions during adolescence. However, there is limited evidence on the specific efficacy of available therapies. This is in contrast to adults, for whom we have interventions with very specific treatment effects. One such treatment is individual cognitive therapy. Cognitive therapy is based on the cognitive model of social anxiety proposed by Clark and Wells (in: Heimberg, Leibowitz, Hope, Scheiber (eds) Social phobia: diagnosis, assessment and treatment, The Guilford Press, New York, 1995). The present review examines the potential application of this adult cognitive model to the understanding of adolescent social anxiety and considers additional adolescent-specific factors that need to be accommodated. It is suggested that a developmentally sensitive adoption of the cognitive model of social anxiety disorder (Clark and Wells 1995) for adolescents may lead to better treatment outcomes.
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Affiliation(s)
- Eleanor Leigh
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
- Oxford Centre for Anxiety Disorders and Trauma, The Old Rectory, Paradise Square, Oxford, OX1 1TW, UK.
| | - David M Clark
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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Pile V, Smith P, Leamy M, Blackwell SE, Meiser-Stedman R, Stringer D, Ryan EG, Dunn BD, Holmes EA, Lau JYF. A brief early intervention for adolescent depression that targets emotional mental images and memories: protocol for a feasibility randomised controlled trial (IMAGINE trial). Pilot Feasibility Stud 2018; 4:97. [PMID: 29997904 PMCID: PMC6030737 DOI: 10.1186/s40814-018-0287-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 05/02/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Adolescent depression is common and impairing. There is an urgent need to develop early interventions to prevent depression becoming entrenched. However, current psychological interventions are difficult to access and show limited evidence of effectiveness. Schools offer a promising setting to enhance access to interventions, including reducing common barriers such as time away from education. Distressing negative mental images and a deficit in positive future images, alongside overgeneral autobiographical memories, have been implicated in depression across the lifespan, and interventions targeting them in adults have shown promise. Here, we combine techniques targeting these cognitive processes into a novel, brief psychological intervention for adolescent depression. This feasibility randomised controlled trial will test the feasibility and acceptability of delivering this imagery-based cognitive behavioural intervention in schools. METHODS/DESIGN Fifty-six adolescents (aged 16-18) with high symptoms of depression will be recruited from schools. Participants will be randomly allocated to the imagery-based cognitive behavioural intervention (ICBI) or the control intervention, non-directive supportive therapy (NDST). Data on feasibility and acceptability will be recorded throughout, including data on recruitment, retention and adherence rates as well as adverse events. In addition, symptom assessment will take place pre-intervention, post-intervention and at 3-month follow-up. Primarily, the trial aims to establish whether it is feasible and acceptable to carry out this project in a school setting. Secondary objectives include collecting data on clinical measures, including depression and anxiety, and measures of the mechanisms proposed to be targeted by the intervention. The acceptability of using technology in assessment and treatment will also be evaluated. DISCUSSION Feasibility, acceptability and symptom data for this brief intervention will inform whether an efficacy randomised controlled trial is warranted and aid planning of this trial. If this intervention is shown in a subsequent definitive trial to be safe, clinically effective and cost-effective, it has potential to be rolled out as an intervention and so would significantly extend the range of therapies available for adolescent depression. This psychological intervention draws on cognitive mechanism research suggesting a powerful relationship between emotion and memory and uses imagery as a cognitive target in an attempt to improve interventions for adolescent depression. TRIAL REGISTRATION ISRCTN85369879.
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Affiliation(s)
- Victoria Pile
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Patrick Smith
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | - Mary Leamy
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | - Simon E. Blackwell
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | | | - Dominic Stringer
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Elizabeth G. Ryan
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Emily A. Holmes
- Department for Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer Y. F. Lau
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF UK
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Visual and Verbal Depressive Cognition: Implications for the Rumination–Depression Relationship. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9890-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ozsivadjian A, Hollocks MJ, Southcott J, Absoud M, Holmes E. Anxious Imagery in Children With and Without Autism Spectrum Disorder: An Investigation into Occurrence, Content, Features and Implications for Therapy. J Autism Dev Disord 2017; 47:3822-3832. [PMID: 27328680 PMCID: PMC5676832 DOI: 10.1007/s10803-016-2840-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Mental imagery has been implicated in anxiety disorders in adults, but has not been investigated in child and adolescent populations. Anxiety is highly prevalent in autism spectrum disorder (ASD), and as people with ASD are often thought of as 'visual thinkers', the potential role of distressing imagery in children with ASD merits exploration. Participants aged 8-16 years were grouped as follows: ASD/high anxiety, ASD/low anxiety, non-ASD/high anxiety and non-ASD/low anxiety. Imagery and associated features were assessed using an interview. Group differences were found in number and frequency of images experienced. There were few differences between the groups in the characteristics of the spontaneous images, which included emotional valence, vividness, controllability and realism. Implications for treatment are discussed.
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Affiliation(s)
- Ann Ozsivadjian
- Children's Complex Neurodevelopmental Disability Service, Children's Neurosciences Centre Newcomen at St Thomas', South Wing, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
| | - Matthew J Hollocks
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Jess Southcott
- Children's Complex Neurodevelopmental Disability Service, Children's Neurosciences Centre Newcomen at St Thomas', South Wing, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - Michael Absoud
- Children's Complex Neurodevelopmental Disability Service, Children's Neurosciences Centre Newcomen at St Thomas', South Wing, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | - Emily Holmes
- MRC Cognition and Brain Sciences Unit, Cambridge, UK
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Imagine the bright side of life: A randomized controlled trial of two types of interpretation bias modification procedure targeting adolescent anxiety and depression. PLoS One 2017; 12:e0181147. [PMID: 28715495 PMCID: PMC5513454 DOI: 10.1371/journal.pone.0181147] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/23/2017] [Indexed: 11/20/2022] Open
Abstract
Introduction Anxiety and depression are highly prevalent during adolescence and characterized by negative interpretation biases. Cognitive bias modification of interpretations (CBM-I) may reduce such biases and improve emotional functioning. However, as findings have been mixed and the traditional scenario training is experienced as relatively boring, a picture-based type of training might be more engaging and effective. Methods The current study investigated short- and long-term effects (up to 6 months) and users’ experience of two types of CBM-I procedure in adolescents with heightened symptoms of anxiety or depression (N = 119, aged 12–18 year). Participants were randomized to eight online sessions of text-based scenario training, picture-word imagery training, or neutral control training. Results No significant group differences were observed on primary or secondary emotional outcomes. A decrease in anxiety and depressive symptoms, and improvements in emotional resilience were observed, irrespective of condition. Scenario training marginally reduced negative interpretation bias on a closely matched assessment task, while no such effects were found on a different task, nor for the picture-word or control group. Subjective evaluations of all training paradigms were relatively negative and the imagery component appeared particularly difficult for adolescents with higher symptom levels. Conclusions The current results question the preventive efficacy and feasibility of both CBM-I procedures as implemented here in adolescents.
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Sosin LS, Rockinson-Szapkiw AJ. Creative Exposure Intervention as Part of Clinical Treatment for Adolescents Exposed to Bullying and Experiencing Posttraumatic Stress Disorder Symptoms. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2016. [DOI: 10.1080/15401383.2016.1251370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Emotion Regulation Strategies in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review. J Youth Adolesc 2016; 46:261-276. [DOI: 10.1007/s10964-016-0585-0] [Citation(s) in RCA: 239] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 09/29/2016] [Indexed: 12/29/2022]
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Mental Imagery-Based Training to Modify Mood and Cognitive Bias in Adolescents: Effects of Valence and Perspective. COGNITIVE THERAPY AND RESEARCH 2016; 41:73-88. [PMID: 28239214 PMCID: PMC5306169 DOI: 10.1007/s10608-016-9795-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Mental imagery has a powerful impact on emotion and cognitive processing in adults, and is implicated in emotional disorders. Research suggests the perspective adopted in mental imagery modulates its emotional impact. However, little is known about the impact of mental imagery in adolescence, despite adolescence being the key time for the onset of emotional dysfunction. We administered computerised positive versus mixed valence picture-word mental imagery training to male adolescent participants (N = 60, aged 11–16 years) across separate field and observer perspective sessions. Positive mood increased more following positive than mixed imagery; pleasantness ratings of ambiguous pictures increased following positive versus mixed imagery generated from field but not observer perspective; negative interpretation bias on a novel scrambled sentences task was smaller following positive than mixed imagery particularly when imagery was generated from field perspective. These findings suggest positive mental imagery generation alters mood and cognition in male adolescents, with the latter moderated by imagery perspective. Identifying key components of such training, such as imagery perspective, extends understanding of the relationship between mental imagery, mood, and cognition in adolescence.
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Haller SPW, Raeder SM, Scerif G, Cohen Kadosh K, Lau JYF. Measuring online interpretations and attributions of social situations: Links with adolescent social anxiety. J Behav Ther Exp Psychiatry 2016; 50:250-6. [PMID: 26476463 DOI: 10.1016/j.jbtep.2015.09.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/01/2015] [Accepted: 09/18/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We evaluated the utility of a novel, picture-based tool to measure how adolescents interpret and attribute cause to social exchanges and whether biases in these processes relate to social anxiety. Briefly presented ambiguous visual social scenes, each containing a photograph of the adolescent as the protagonist, were followed by three possible interpretations (positive, negative, neutral/unrelated) and two possible causal attributions (internal, external) to which participants responded. METHOD Ninety-five adolescents aged 14 to 17 recruited from mainstream schools, with varying levels of social anxiety rated the likelihood of positive, negative and unrelated interpretations before selecting the single interpretation they deemed as most likely. This was followed by a question prompting them to decide between an internal or external causal attribution for the interpreted event. RESULTS Across scenarios, adolescents with higher levels of social anxiety rated negative interpretations as more likely and positive interpretations as less likely compared to lower socially anxious adolescents. Higher socially anxious adolescents were also more likely to select internal attributions to negative and less likely to select internal attributions for positive events than adolescents with lower levels of social anxiety. CONCLUSIONS Adolescents with higher social anxiety display cognitive biases in interpretation and attribution. This tool is suitable for measuring cognitive biases of complex visual-social cues in youth populations with social anxiety and simulates the demands of daily social experiences more closely. LIMITATIONS As we did not measure depressive symptoms, we cannot be sure that biases linked to social anxiety are not due to concurrent low mood.
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Affiliation(s)
- Simone P W Haller
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Sophie M Raeder
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Jennifer Y F Lau
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Department of Psychology, Institute of Psychiatry, King's College London, London, UK.
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Holmes EA, Blackwell SE, Burnett Heyes S, Renner F, Raes F. Mental Imagery in Depression: Phenomenology, Potential Mechanisms, and Treatment Implications. Annu Rev Clin Psychol 2016; 12:249-80. [PMID: 26772205 DOI: 10.1146/annurev-clinpsy-021815-092925] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mental imagery is an experience like perception in the absence of a percept. It is a ubiquitous feature of human cognition, yet it has been relatively neglected in the etiology, maintenance, and treatment of depression. Imagery abnormalities in depression include an excess of intrusive negative mental imagery; impoverished positive imagery; bias for observer perspective imagery; and overgeneral memory, in which specific imagery is lacking. We consider the contribution of imagery dysfunctions to depressive psychopathology and implications for cognitive behavioral interventions. Treatment advances capitalizing on the representational format of imagery (as opposed to its content) are reviewed, including imagery rescripting, positive imagery generation, and memory specificity training. Consideration of mental imagery can contribute to clinical assessment and imagery-focused psychological therapeutic techniques and promote investigation of underlying mechanisms for treatment innovation. Research into mental imagery in depression is at an early stage. Work that bridges clinical psychology and neuroscience in the investigation of imagery-related mechanisms is recommended.
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Affiliation(s)
- Emily A Holmes
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge CB2 7EF, United Kingdom; , , .,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Simon E Blackwell
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge CB2 7EF, United Kingdom; , ,
| | - Stephanie Burnett Heyes
- School of Psychology, University of Birmingham, Birmingham, West Midlands B15 2TT, United Kingdom; .,Department of Experimental Psychology, University of Oxford, Oxford OX1 3UD, United Kingdom
| | - Fritz Renner
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge CB2 7EF, United Kingdom; , ,
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, University of Leuven, 3000 Leuven, Belgium;
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Weßlau C, Cloos M, Höfling V, Steil R. Visual mental imagery and symptoms of depression - results from a large-scale web-based study. BMC Psychiatry 2015; 15:308. [PMID: 26631081 PMCID: PMC4668647 DOI: 10.1186/s12888-015-0689-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 11/24/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Mental imagery may influence the onset and maintenance of depression, but specific mechanisms have not yet been determined. METHODS Nine hundred twelve participants completed questionnaires on positive and negative mental images, as well as images of injury and death that lead to positive emotions ("ID-images"), and depressive symptomatology. The assessment was carried out online to reduce effects of social desirability. RESULTS Positive images were reported by 87 % of the sample, negative images by 77 %. ID-images were present in one-third of the sample. A connection with depression severity was found for the absence of positive mental images and the presence of negative images as well as ID-images. Higher depression scores were associated with more frequent and vivid negative images, greater imagery distress, and a higher proportion of negative relative to positive images. CONCLUSIONS Mental images are clearly related to depression. Future research should focus on ID-images and their connection to suicide-risk in depressed patients.
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Affiliation(s)
- Charlotte Weßlau
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University Frankfurt, P.O. Box 11 19 32-120, 60054, Frankfurt Main, Germany.
| | - Marie Cloos
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University Frankfurt, P.O. Box 11 19 32-120, 60054, Frankfurt Main, Germany.
| | - Volkmar Höfling
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University Frankfurt, P.O. Box 11 19 32-120, 60054, Frankfurt Main, Germany.
| | - Regina Steil
- Department of Clinical Psychology and Intervention, Institute of Psychology, Goethe University Frankfurt, P.O. Box 11 19 32-120, 60054, Frankfurt Main, Germany.
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Self-images in the present and future: Role of affect and the bipolar phenotype. J Affect Disord 2015; 187:97-100. [PMID: 26322714 PMCID: PMC4595481 DOI: 10.1016/j.jad.2015.08.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/26/2015] [Accepted: 08/12/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Bipolar Spectrum Disorder (BPSD) is associated with changes in self-related processing and affect, yet the relationship between self-image and affect in the BPSD phenotype is unclear. METHODS 47 young adults were assessed for hypomanic experiences (BPSD phenotype) using the Mood Disorders Questionnaire. Current and future self-images (e.g. I am… I will be…) were generated and rated for emotional valence, stability, and (for future self-images only) certainty. The relationship between self-image ratings and measures of affect (depression, anxiety and mania) were analysed in relation to the BPSD phenotype. RESULTS The presence of the BPSD phenotype significantly moderated the relationship between (1) affect and stability ratings for negative self-images, and (2) affect and certainty ratings for positive future self-images. Higher positivity ratings for current self-images were associated with lower depression and anxiety scores. LIMITATIONS This was a non-clinical group of young adults sampled for hypomanic experiences, which limits the extension of the work to clinical levels of psychopathology. This study cannot address the causal relationships between affect, self-images, and BPSD. Future work should use clinical samples and experimental mood manipulation designs. CONCLUSIONS BPSD phenotype can shape the relationship between affect and current and future self-images. This finding will guide future clinical research to elucidate BPSD vulnerability mechanisms and, consequently, the development of early interventions.
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Sándor P, Szakadát S, Kertész K, Bódizs R. Content analysis of 4 to 8 year-old children's dream reports. Front Psychol 2015; 6:534. [PMID: 25983708 PMCID: PMC4415323 DOI: 10.3389/fpsyg.2015.00534] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 04/14/2015] [Indexed: 11/13/2022] Open
Abstract
The role of dreaming in childhood and in adulthood are still equally enigmatic fields yet to be fully explored. However, while there is a consensus at least about the typical content and formal characteristics of adult dream reports, these features are still a matter of debate in the case of young children. Longitudinal developmental laboratory studies concluded that preschoolers' dreams usually depict static images about mostly animals and body states of the dreamer but they basically lack the active representation of the self, human characters, social interactions, dream emotions and motion imagery. Due to methodological arguments these results became the reference points in the literature of developmental dream research, in spite of the significantly different results of numerous recent and relevant studies using extra-laboratory settings. This study aims to establish a methodologically well-controlled and valid way to collect children's dreams for a representative period of time in a familiar home setting to serve as a comparison to the laboratory method. Pre trained parents acted as interviewers in the course of a 6 week-period of dream collection upon morning awakenings. Our results suggest that even preschoolers are likely to represent their own self in an active role (70%) in their mostly kinematic (82%) dream narratives. Their dream reports contain more human, than animal characters (70 and 7% of all dream characters respectively), and social interactions, self-initiated actions, and emotions are usual part of these dreams. These results are rather similar to those of recent extra-laboratory studies, suggesting that methodological issues may strongly interfere with research outcomes especially in the case of preschoolers' dream narratives. We suggest that nighttime awakenings in the laboratory setting could be crucial in understanding the contradictory results of dream studies in case of young children.
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Affiliation(s)
- Piroska Sándor
- Institute of Behavioral Sciences, Semmelweis University Budapest, Hungary
| | - Sára Szakadát
- Institute of Behavioral Sciences, Semmelweis University Budapest, Hungary ; Department of General Psychology, Pázmány Péter Catholic University Budapest, Hungary
| | - Katinka Kertész
- Institute of Behavioral Sciences, Semmelweis University Budapest, Hungary
| | - Róbert Bódizs
- Institute of Behavioral Sciences, Semmelweis University Budapest, Hungary ; Department of General Psychology, Pázmány Péter Catholic University Budapest, Hungary
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Prenatal cocaine exposure and adolescent neural responses to appetitive and stressful stimuli. Neuropsychopharmacology 2014; 39:2824-34. [PMID: 24903650 PMCID: PMC4200493 DOI: 10.1038/npp.2014.133] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/15/2014] [Accepted: 05/21/2014] [Indexed: 12/16/2022]
Abstract
Preclinical research has demonstrated the effects of prenatal cocaine exposure (PCE) on brain regions involved in emotional regulation, motivational control, and addiction vulnerability-eg, the ventral striatum (VS), anterior cingulate (ACC), and prefrontal cortex (PFC). However, little is known about the function of these regions in human adolescents with PCE. Twenty-two adolescents with PCE and 22 age-, gender-, and IQ-matched non-cocaine exposed (NCE) adolescents underwent functional magnetic resonance imaging (fMRI) during exposure to individually personalized neutral/relaxing, stressful, and favorite-food cues. fMRI data were compared using group-level two-tailed t-tests in the BioImage Suite. In comparison with NCE adolescents, PCE adolescents had reduced activity within cortical and subcortical brain regions, including the VS, ACC, and medial and dorslolateral PFC during exposure to favorite-food cues but did not differ in neural responses to stress cues. Subjective food craving was inversely related to dorsolateral PFC activation among PCE adolescents. Among PCE adolescents, subjective anxiety ratings correlated inversely with activations in the orbitofrontal cortex and brainstem during the stress condition and with ACC, dorsolateral PFC, and hippocampus activity during the neutral-relaxing condition. Thus adolescents with PCE display hypoactivation of brain regions involved in appetitive processing, with subjective intensities of craving and anxiety correlating inversely with extent of activation. These findings suggest possible mechanisms by which PCE might predispose to the development of addictions and related disorders, eg, substance-use disorders and binge-eating.
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