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Stavropoulos L, Briggs N, Grisham JR. Self-guided imagery rescripting for worry images: A preliminary experimental investigation. J Clin Psychol 2024; 80:1213-1230. [PMID: 38356250 DOI: 10.1002/jclp.23660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/30/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Mental images of feared events are overactive and intrusive in generalized anxiety disorder (GAD). Imagery rescripting involves integration of positive or neutral imagery and corrective information into images to facilitate emotional processing, reduce imagery intrusions, and re-structure underlying schema. Yet only one known study has applied the technique to treatment of worry. The present study aimed first to examine the relationship between trait worry and properties of future-oriented worry images, and second to examine the efficacy of a self-guided imagery rescripting intervention in improving individuals' response to their worries. METHODS Participants recruited through Amazon Mechanical Turk (N = 365) identified their major worry and wrote the script of a worst-case scenario mental image. Participants were randomized to three conditions: re-writing the same worry image script (exposure), or writing scripts of either one or three positive alternative future-oriented images (rescripting conditions). RESULTS In preliminary analyses, trait worry negatively predicted participants' ratings of worry images, including valence and ability to cope, and positively predicted distress, anticipated cost, and belief in their negative meaning. In experimental analyses, linear mixed-effects models revealed anxious response and cognitive appraisal of the threat were significantly lower among participants allocated to rescripting relative to exposure. There was no effect of rescripting type. CONCLUSIONS This investigation demonstrated the impact of a future-oriented imagery rescripting task on anxiety and cognitive biases associated with real worries in an unselected sample. Results may contribute to the development of imagery rescripting interventions for GAD.
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Affiliation(s)
| | - Nancy Briggs
- Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, Australia
| | - Jessica R Grisham
- School of Psychology, University of New South Wales, Sydney, Australia
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Marciniak MA, Shanahan L, Myin-Germeys I, Veer IM, Yuen KSL, Binder H, Walter H, Hermans EJ, Kalisch R, Kleim B. Imager-A mobile health mental imagery-based ecological momentary intervention targeting reward sensitivity: A randomized controlled trial. Appl Psychol Health Well Being 2024; 16:576-596. [PMID: 37942875 DOI: 10.1111/aphw.12505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/16/2023] [Indexed: 11/10/2023]
Abstract
Robust reward sensitivity may help preserve mental well-being in the face of adversity and has been proposed as a key stress resilience factor. Here, we present a mobile health application, "Imager," which targets reward sensitivity by training individuals to create mental images of future rewarding experiences. We conducted a two-arm randomized controlled trial with 95 participants screened for reward sensitivity. Participants in the intervention group received an ecological momentary intervention-Imager, which encouraged participants to create mental images of rewarding events for 1 week. The control group participants received only ecological momentary assessment, without the instruction to generate mental images. Adherence to Imager was high; participants in the intervention group engaged in 88% of the planned activities. In the follow-up assessment, the intervention group reported less mental health symptoms, mainly in depression (β = -0.34, df = 93, p = .004) and less perceived stress (β = -0.18, df = 93, p = .035), than control group participants and compared with the baseline assessment. Our results show the positive effects of Imager on mental health symptoms. The encouraging effects of the app on mental health outcomes may lead to greater use of ecological momentary interventions in the clinical preventive practice of affective disorders.
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Affiliation(s)
- Marta Anna Marciniak
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Ilya Milos Veer
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Kenneth S L Yuen
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Erno J Hermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
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Rogers LW, Yeebo M, Collerton D, Moseley P, Dudley R. Non-clinical hallucinations and mental imagery across sensory modalities. Cogn Neuropsychiatry 2024; 29:87-102. [PMID: 38363282 DOI: 10.1080/13546805.2024.2313467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/10/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Vivid mental imagery has been proposed to increase the likelihood of experiencing hallucinations. Typically, studies have employed a modality general approach to mental imagery which compares imagery across multiple domains (e.g., visual, auditory and tactile) to hallucinations in multiple senses. However, modality specific imagery may be a better predictor of hallucinations in the same domain. The study examined the contribution of imagery to hallucinations in a non-clinical sample and specifically whether imagery best predicted hallucinations at a modality general or modality specific level. METHODS In study one, modality general and modality specific accounts of the imagery-hallucination relationship were contrasted through application of self-report measures in a sample of 434 students. Study two used a subsample (n = 103) to extend exploration of the imagery-hallucinations relationship using a performance-based imagery task. RESULTS A small to moderate modality general relationship was observed between self-report imagery and hallucination proneness. There was only evidence of a modality specific relationship in the tactile domain. Performance-based imagery measures were unrelated to hallucinations and self-report imagery. CONCLUSIONS Mental imagery may act as a modality general process increasing hallucination proneness. The observed distinction between self-report and performance-based imagery highlights the difficulty of accurately measuring internal processes.
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Affiliation(s)
- Luke Wilson Rogers
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Mma Yeebo
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Daniel Collerton
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Peter Moseley
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK
| | - Robert Dudley
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
- Department of Psychology, University of York, York, UK
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4
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Sosic-Vasic Z, Schaitz C, Mayer B, Maier A, Connemann B, Kroener J. Treating emotion dysregulation in patients with borderline personality disorder using imagery rescripting: A two-session randomized controlled trial. Behav Res Ther 2024; 173:104454. [PMID: 38194759 DOI: 10.1016/j.brat.2023.104454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/15/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
Studies on Emotionally Dysregulated Behavior (EDB) demonstrated that the conduct thereof is associated with emotion dysregulation and preceded by mental imagery of EDB, which can direct future behavior. These findings are specifically important within the context of Borderline Personality Disorder (BPD), where emotion dysregulation and EDB are at the core of the disorder. The present study aims to evaluate the efficacy of imagery rescripting (IR) in treating emotion dysregulation associated with EDB in patients diagnosed with BPD. Forty-eight females diagnosed with BPD were randomly allocated to the IR intervention or treatment-as-usual group. Assessment took place one week before the first treatment session, as well as one week, and twelve weeks after the last treatment session evaluating emotion regulation strategies, borderline-symptomatology, EDB, depressiveness, impulsivity, mental imagery, and illness severity. Within-, and between subject, intention-to-treat-, and per-protocol analysis were conducted. Results showed decreased maladaptive emotion regulation strategies and increased adaptive emotion regulation strategies within the intervention group. Borderline-symptomatology improved immediately after treatment for the intervention group. Additionally, BPD patients within the intervention group improved regarding their impulsivity, depressiveness, and EDB symptomatology in comparison to patients in the TAU group. The presented intervention has proven to be effective in improving BPD-related symptomatology, such as emotion regulation, EDB, depressiveness, and impulsivity. Imagery rescripting could be routinely applied when EDB related images are present. TRIAL REGISTRATION: German Clinical Trials Registry (DRKS) ID: DRKS00010620.
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Affiliation(s)
- Zrinka Sosic-Vasic
- Christophsbad Goeppingen, Department of Applied Psychotherapy and Psychiatry, Faurndauer Straße 6-28, 73035, Göppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Caroline Schaitz
- MSB Medical School Berlin, Psychotherapeutic Outpatient Facility, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Benjamin Mayer
- Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstrasse 13, 89075, Ulm, Germany
| | - Anna Maier
- Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Bernhard Connemann
- Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Julia Kroener
- Christophsbad Goeppingen, Department of Applied Psychotherapy and Psychiatry, Faurndauer Straße 6-28, 73035, Göppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
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5
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Kroener J, Schaitz C, Sosic-Vasic Z. Prospective Mental Images: A Transdiagnostic Approach to Negative Affectivity and Mood Dysregulation among Borderline Personality Disorder and Depression. Behav Sci (Basel) 2024; 14:81. [PMID: 38392434 PMCID: PMC10886009 DOI: 10.3390/bs14020081] [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: 11/30/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
There is initial evidence that patients diagnosed with Borderline Personality Disorder (BPD) experience intrusive prospective mental images about non-suicidal self-injury (NSSI). These images, in turn, are associated with the conduct of NSSI. As the negative emotional valence of intrusive images has been established across clinical disorders, negative affectivity might play a key role linking mental imagery and psychopathology. Therefore, the present study aimed to investigate the possible mediating role of symptoms of depression as a proxy for negative affectivity linking intrusive prospective imagery to psychopathology in patients diagnosed with BPD. A total of 233 participants (84 diagnosed with MDD, 66 diagnosed with BPD, 83 healthy controls) completed questionnaires on negative affectivity (BDI-II) and prospective intrusive imagery (IFES-S). Before controlling for negative affectivity, there was a positive correlation between group and intrusive prospective imagery, indicating that healthy participants displayed lower amounts of intrusive prospective images in comparison to patients diagnosed with MDD or BPD. After entering negative affectivity as a mediator, the variable group was no longer associated with intrusive prospective images; however, negative affectivity showed a strong and positive relationship with the group on one side, and intrusive prospective imagery on the other, indicating that negative affectivity mediates the association between intrusive prospective images and clinical disorders. The presented findings point towards a mediating role of negative affectivity in the manifestation of intrusive prospective imagery, not only within BPD, but also in patients with MDD. The possibility of intrusive images acting as a transdiagnostic feature, where negative affectivity and mood dysregulation are at the core of the clinical disorder, are being discussed.
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73035 Goeppingen, Germany
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Caroline Schaitz
- Psychotherapeutic Outpatient Facility, Medical School Berlin, Rüdesheimer Straße 50, 14197 Berlin, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73035 Goeppingen, Germany
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
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Tomasino B, Maggioni E, Piani MC, Bonivento C, D'Agostini S, Balestrieri M, Brambilla P. The mental simulation of state/psychological stimuli in anxiety disorders: A 3T fMRI study. J Affect Disord 2024; 345:435-442. [PMID: 37852592 DOI: 10.1016/j.jad.2023.10.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
Mental imagery plays an important role in cognitive and emotional processes, therefore it might contribute to psychopathology in affective disorders. Distressive intrusive imagery is a core feature of anxiety disorders, but the underlying neurobiology remains unexplored. Here, we examined the functional brain mechanisms involved in state/psychological imagery in individuals with anxiety disorders. Functional Magnetic Resonance Imaging (fMRI) was used to assess the brain circuits involved in state/psychological (vs. action) imagery controlled by letter detection on the same stimuli in 33 individuals with anxiety disorders relative to 33 healthy controls. Patients were faster than controls in processing state/psychological stimuli and in general in the imagery task. We found that the left superior frontal gyrus was differentially activated by the state/psychological (vs. action) imagery (vs. letter detection) in the anxious individuals vs. healthy controls. We suggest that this area, which is involved in processing of state/psychological semantic information, appears deregulated during imagery in subjects with anxiety disorders. Our study provided the first evidence of both behavioral and brain functional alterations during imagery, highlighting a key role of the left superior frontal gyrus.
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Affiliation(s)
- Barbara Tomasino
- Scientific Institute IRCCS "Eugenio Medea", Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy.
| | - Eleonora Maggioni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy; Dept. of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Chiara Piani
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy Bern UPD, Bern, Switzerland; Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Carolina Bonivento
- Scientific Institute IRCCS "Eugenio Medea", Dipartimento/Unità Operativa Pasian di Prato, Udine, Italy
| | - Serena D'Agostini
- Neuroradiology, Azienda Sanitaria Universitaria Friuli Centrale, ASU FC, Italy
| | - Matteo Balestrieri
- Psychiatry Unit, Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Paolo Brambilla
- Dept. of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Dept. of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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7
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Nordström EEL, Kaltiala R, Kristensen P, Thimm JC. Somatic symptoms and insomnia among bereaved parents and siblings eight years after the Utøya terror attack. Eur J Psychotraumatol 2024; 15:2300585. [PMID: 38214224 PMCID: PMC10791101 DOI: 10.1080/20008066.2023.2300585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024] Open
Abstract
Background: Levels of prolonged grief symptoms (PGS) and post-traumatic stress symptoms (PTSS) can be high, many years following bereavement after terror, but knowledge concerning somatic health is scarce. Terrorism is a serious public health challenge, and increased knowledge about long-term somatic symptoms and insomnia is essential for establishing follow-up interventions after terrorism bereavement.Objective: To study the prevalence of somatic symptoms and insomnia and their association with PGS, PTSS, and functional impairment among terrorism-bereaved parents and siblings.Methods: A cross-sectional quantitative study included 122 bereaved individuals from the Utøya terror attack in Norway in 2011. The sample comprised 88 parents and 34 siblings aged 19 years and above (Mage = 49.7 years, SDage = 13.8 years, 59.8% females). The participants completed questionnaires 8 years after the attack assessing somatic symptoms (Children's Somatic Symptoms Inventory) and insomnia (Bergen Insomnia Scale) along with measures of PGS (Inventory of Complicated Grief), PTSS (Impact of Event Scale-Revised), and functional impairment (Work and Social Adjustment Scale).Results: Fatigue was the most frequently reported somatic symptom (88% of females and 65% of males). Females reported statistically significantly more somatic symptoms than males. In total, 68% of the bereaved individuals scored above the cut-off for insomnia. There were no statistically significant gender differences for insomnia. Female gender, intrusion, and arousal were associated with somatic symptoms. Intrusion and somatic symptoms were associated with insomnia. Somatic symptoms, avoidance, and hyperarousal were associated with functional impairment.Conclusion: Many bereaved parents and siblings report somatic symptoms and insomnia eight years after the terror attack. Somatic symptoms are associated with functional impairment. Long-term follow-up and support after traumatic bereavement should focus on somatic symptoms and insomnia.
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Affiliation(s)
| | - Riittakerttu Kaltiala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
- Vanha Vaasa Hospital, Vaasa, Finland
| | - Pål Kristensen
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Jens C. Thimm
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
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8
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Monzel M, Karneboge J, Reuter M. The role of dopamine in visual imagery-An experimental pharmacological study. J Neurosci Res 2024; 102:e25262. [PMID: 37849328 DOI: 10.1002/jnr.25262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/18/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
Mental imagery enables people to simulate experiences in their minds without the presence of an external stimulus. The underlying biochemical mechanisms are poorly understood but there is vague evidence that dopamine may play a significant role. A better understanding at the biochemical level could help to unravel the mechanisms of mental imagery and related phenomena such as aphantasia (= lack of voluntary mental imagery), but also opens up possibilities for interventions to enhance or restore mental imagery. To test the hypothesis that acute dopamine depletion leads to a decrease in the strength of mental imagery, N = 22 male participants will be administered an amino acid mixture containing branched-chain amino acids (BCAAs) and tryptophan (TRP) to transiently reduce dopamine synthesis and further N = 22 male participants will receive a placebo. Plasma prolactin (PRL) levels are determined as a peripheral marker of brain dopamine function. The strength of mental imagery will be measured before and after ingestion of the BCAA/TRP mixture using the method of mental imagery priming. Additional exploratory analyses will use genetic data to investigate possible effects of variations on dopaminergic gene loci (e.g., DAT1) on dopamine levels and strength of mental imagery. The results show […].
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Affiliation(s)
- Merlin Monzel
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Jana Karneboge
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Martin Reuter
- Department of Psychology, University of Bonn, Bonn, Germany
- Center for Economics and Neuroscience (CENs), Laboratory of Neurogenetics, University of Bonn, Bonn, Germany
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van den Berg KC, Voncken M, Hendrickson AT, Di Simplicio M, Regeer EJ, Rops L, Keijsers GPJ. Exploring aspects of self-reported emotional mental imagery in patients with bipolar disorder. J Behav Ther Exp Psychiatry 2023; 81:101861. [PMID: 37182427 DOI: 10.1016/j.jbtep.2023.101861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/28/2023] [Accepted: 04/29/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND AND OBJECTIVES CBT for patients with bipolar disorder has modest effects. Across disorders, mental imagery has been used to update CBT to increase effectiveness. In order to enhance CBT for bipolar disorder with imagery techniques, research is needed into emotional imagery quality and, related appraisals of imagery and their relationships with mood instability and subsequent behaviour in bipolar disorder. METHODS Patients with bipolar disorder (n = 106), unipolar depression (n = 51), creative imagery prone participants (n = 53) and participants without a history of a mood disorder (n = 135) completed the Dutch Imagery Survey (DImS), an online imagery survey, adapted from the Imagery Interview, assessing self-reported emotional imagery aspects. Imagery quality, appraisals and their self-perceived effects on emotion and behaviour were compared between groups. As unexpected differences within the bipolar group appeared, these were additionally explored. RESULTS Imagery appraisals but not imagery quality discriminated between the patient groups and non-patient groups Imagery was perceived as an emotional amplifier in all groups, but this was specifically apparent in bipolar manic and bipolar depressed groups. Only in the bipolar group imagery was experienced to amplify behavioural tendencies. LIMITATIONS Results need to be replicated using a larger sample of patients with BD who are currently manic or depressed. CONCLUSIONS Not only quality of imagery, but especially appraisals associated with imagery are differentiating between imagery prone people with and without mood disorder. Imagery amplifies emotion in all groups, but only in those patients with bipolar disorder currently manic or depressed did this influence behaviour.
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Affiliation(s)
- K C van den Berg
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), the Netherlands; Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands.
| | - M Voncken
- Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands
| | - A T Hendrickson
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands
| | - M Di Simplicio
- Imperial College London, Division of Psychiatry, Department of Brain Sciences, UK
| | - E J Regeer
- Altrecht Institute for Mental Health Care, Utrecht, the Netherlands
| | - L Rops
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), the Netherlands
| | - G P J Keijsers
- Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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Nilsson AM, Waern M, Ehnvall A, Skärsäter I. The Meaning of Mental Imagery in Acute Suicidal Episodes: A Qualitative Exploration of Lived Experiences. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231218562. [PMID: 38006244 DOI: 10.1177/00302228231218562] [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: 11/26/2023]
Abstract
Clinical assessment of suicidal ideation focuses on cognitions in the form of verbal thoughts. However, cognitions also take the shape of mental imagery. The aim of this qualitative study was to explore the meaning of mental imagery in acute suicidal episodes (ASEs). Eight persons with severe previous ASEs participated in repeated in-depth interviews and in the semi-structured Suicidal Cognitions Interview. Textual data from both sources underwent content analysis. All participants experienced suicide-related imagery during ASEs. Analysis resulted in two themes. (1) Suicide-approaching imagery: intrusive looming images that contributed to loss of control, flashforwards that clarified the suicidal solution, or desirable but unattainable images. (2) Suicide preventive imagery: death-alienating, life-affirming, or potentially helpful images. The meaning of mental imagery in ASEs is suggested to be understood in relation to the context of the individual ASE. A narrative approach is encouraged, as is an increased clinical focus on mental imagery in general.
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Affiliation(s)
- Anna Maria Nilsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Västra Götalandsregionen, Psychosis Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
- Gothenburg Centre for Person-centred Care, University of Gothenburg, Gothenburg, Sweden
| | - Anna Ehnvall
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Psychiatric Outpatient Clinic, Varberg, Sweden
| | - Ingela Skärsäter
- School of Health and Welfare, Centre of Research on Welfare, Health and Sport, Halmstad University, Halmstad, Sweden
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11
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Hosseini FA, Shaygan M, Jahandideh Z. Positive imagery in depressive suicidal patients: A randomized controlled trial of the effect of viewing loved ones' photos on mood states and suicidal ideation. Heliyon 2023; 9:e22312. [PMID: 38058624 PMCID: PMC10695982 DOI: 10.1016/j.heliyon.2023.e22312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023] Open
Abstract
According to research, it has been suggested that individuals who are affected by depression could potentially engage in the creation and experience emotional advantages relating to positive events directed towards the past or future, with the condition that they are provided with suitable mental imagery techniques. The main aim of this study was to assess the impact of utilizing positive imagery, specifically through the utilization of photographs featuring loved ones, on mood states and suicidal ideation among individuals diagnosed with depression and exhibiting suicidal tendencies. This randomized, double-blind, controlled crossover trial was conducted among 78 hospitalized depressive patients at three psychiatric services between April and August 2019. The patients participated in four individual picture-viewing sessions on four consecutive days. The four categories of pictures were included: loved ones, neutral faces of strangers, natural landscapes, and optical illusions. Directly prior to and immediately following the observation of the visual stimuli (photographs), the Brunel Mood Scale (BRUMS) and the Beck Scale for Suicide Ideation (BSSI) were completed by the patients. Repeated measures ANOVAs conducted in this study revealed a significant main effect of time on ratings of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). Additionally, statistically significant interactions were identified between picture category and time in relation to the variables of tension, depression, fatigue, vigor, calmness, and happiness (P values < 0.001). The analysis did not reveal a significant main effect of time on ratings of anger, confusion, and suicidal ideation (P values > 0.05). Likewise, the interaction between picture category and time did not yield significant results for the variables of anger, confusion, and suicidal ideation (P values > 0.05). The positive imagery procedure using the presentation of loved ones' photos showed beneficial effects on the mood states of depressed patients. The findings of this study suggest that incorporating a greater emphasis on positive imagery within the context of clinical depression may offer potential advantages. This highlights the potential for novel opportunities in the treatment of depression. Trial registration The study has been registered in the Iranian Registry of Clinical Trials (registration number: IRCT20180808040744N1; first registration date: December 22, 2018; website: https://en.irct.ir/trial/33186).
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Affiliation(s)
- Fahimeh Alsadat Hosseini
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shaygan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Jahandideh
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Janssen H, van den Berg KC, Paulik G, Newman-Taylor K, Taylor CDJ, Steel C, Keijsers GPJ, Marcelis MC. Emotional and non-emotional mental imagery and auditory verbal hallucinations (hearing voices): A systematic review of imagery assessment tools. Clin Psychol Psychother 2023. [PMID: 37905563 DOI: 10.1002/cpp.2920] [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: 11/14/2022] [Revised: 07/19/2023] [Accepted: 10/07/2023] [Indexed: 11/02/2023]
Abstract
It is unknown to what extent mental imagery and auditory verbal hallucinations (AVHs) are related. Trials evaluating this issue used both emotional and non-emotional mental imagery tools, thereby complicating outcomes comparisons. Therefore, the present study aimed to systematically review the literature on mental imagery in individuals with AVHs to (1) inventory imagery assessment tools used in this population, (2) to collect information on the relation between emotional and non-emotional mental imagery in all sensory domains and AVHs and (3) to integrate the outcomes of this systematic review in a model of different mental imagery domains and related assessment tools. We conducted a systematic literature search in the PubMed Database. After full-text screening, 17 papers were included. Findings showed that a variety of assessment methods have been used to assess various aspects of mental imagery in people with AVHs, suggesting that there is a lack of agreed theoretical conceptualization of mental imagery and AVHs. In addition, the studies confirmed as was expected that non-emotional mental imagery seemed unrelated to AVHs whereas emotional mental imagery was related to AVHs. Lastly, we proposed a model of mental imagery domains and corresponding assessment methods distinguishing between emotional and non-emotional mental imagery.
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Affiliation(s)
- Hella Janssen
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), Eindhoven, Netherlands
- Department of Psychiatry and Neuropsychology, MHeNs Maastricht University, Maastricht, Netherlands
| | - Karin C van den Berg
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), Eindhoven, Netherlands
- Department of Clinical Psychological Sciences, Maastricht University, Maastricht, Netherlands
| | - Georgie Paulik
- Perth Voices Clinic, Murdoch, Australia
- School of Psychological Science, University of Western Australia, Perth, Australia
- School of Psychology and Exercise Science, Murdoch University, Perth, Australia
| | - Katherine Newman-Taylor
- Psychology Department, University of Southampton, Southampton, UK
- Psychology Department, College Keep, Southern Health NHSF Trust, Southampton, UK
| | - Christopher D J Taylor
- Secondary Care Psychological Therapies Service, Pennine Care National Health Service (NHS) Foundation Trust, Lancashire, UK
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Craig Steel
- Oxford Centre for Psychological Health, Oxford, UK
- Oxford Institute of Clinical Psychology Training and Research, Oxford, UK
| | - Ger P J Keijsers
- Department of Clinical Psychological Sciences, Maastricht University, Maastricht, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Machteld C Marcelis
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), Eindhoven, Netherlands
- Department of Psychiatry and Neuropsychology, MHeNs Maastricht University, Maastricht, Netherlands
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13
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Cairns AJJ, Kelly J, Taylor CDJ. Assessing the delivering of iMAgery-focused therapy for PSychosis (iMAPS) via telehealth. Psychol Psychother 2023; 96:678-696. [PMID: 37002818 DOI: 10.1111/papt.12463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES To examine the feasibility and acceptability of a novel telehealth (video-conferencing software and telephone calls) imagery-based therapeutic intervention for people experiencing persecutory delusions. Utilising a multiple baseline case series design and exploring imagery-focused therapy for psychosis (iMAPS). DESIGN A non-concurrent A-B multiple baseline design was used. METHODS Participants experiencing persecutory delusions and self-reporting a psychosis or schizophrenia-spectrum diagnosis were recruited through online adverts. On completion of assessments, participants were randomly assigned to multiple baseline assessments, of between three and five sessions. Six therapy sessions followed, consisting of imagery formulation, safe-place imagery creation, compassionate imagery, imagery manipulation and rescripting. Participants completed pre- and post-measures and sessional measures via an online survey software or in semi-structured interviews. Two weeks post-intervention, a final measure was completed exploring any potential adverse effects of psychotherapy. RESULTS Five female participants completed all baseline and therapeutic sessions, suggesting the therapy was and mode of delivery was feasible and acceptable. Results indicate strong effect sizes across PANSS positive subscale and mood, as well as participants reporting a clinically significant change in at least one measure, for example, PSYRATS. All participants reported a reduction in the realness and compelling nature of distressing imagery. CONCLUSIONS Results suggest delivering a telehealth imagery-focused therapy is acceptable and feasibly delivered via telehealth. A control group and blinding of assessments would strengthen the methodological limitations present.
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Affiliation(s)
- Aimee J J Cairns
- Clinical Psychology, Lancaster University, Health Innovation Campus, Bailrigg, Lancaster, LA1 4YW, UK
| | - James Kelly
- Clinical Psychology, Lancaster University, Health Innovation Campus, Bailrigg, Lancaster, LA1 4YW, UK
- North Manchester General Hospital, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Christopher D J Taylor
- Community Mental Health Team, Pennine Care NHS Foundation Trust, Humphrey House, Angouleme Way, Bury, Bl9 0EQ, UK
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
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14
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Quayle K, Jones P, Di Simplicio M, Kamboj S, Pitman A. Exploring the phenomenon of intrusive mental imagery after suicide bereavement: A qualitative interview study in a British sample. PLoS One 2023; 18:e0284897. [PMID: 37590210 PMCID: PMC10434947 DOI: 10.1371/journal.pone.0284897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/11/2023] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Each year an estimated 48 million people are bereaved by suicide internationally. Following traumatic events, experiencing intrusive mental imagery relating to the trauma is not uncommon. This phenomenological study aimed to explore the nature, experience and impact of intrusive mental imagery after suicide bereavement. METHODS Semi-structured interview transcripts with 18 adults bereaved by the suicide of a close contact were analysed using thematic analysis to explore patterns and themes within the data, with particular consideration of the content of images, how people experience and relate to the imagery, and the impact that the imagery has on the bereaved. RESULTS Thematic analysis identified common characteristics in the experience of intrusive mental imagery following suicide loss, summarised under two main themes capturing: 1) the descriptive characteristics and 2) the emotional experience of intrusive mental imagery following suicide loss. The majority of participants found the experience of intrusive imagery distressing, but most also described positive aspects, including help in making sense of the death and retaining memories of the deceased. CONCLUSION Findings inform our understanding of the distressing experience of intrusive imagery after suicide loss, also revealing perceived value in processing the death.
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Affiliation(s)
- Katie Quayle
- Research Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | - Poppy Jones
- Research Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | | | - Sunjeev Kamboj
- Research Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | - Alexandra Pitman
- Division of Psychiatry, UCL, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
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Steel C, Wright K, Goodwin GM, Simon J, Morant N, Taylor RS, Brown M, Jennings S, Hales SA, Regan J, Sibsey M, Thomas Z, Meredith L, Holmes EA. The IBER study: a feasibility randomised controlled trial of imagery based emotion regulation for the treatment of anxiety in bipolar disorder. Int J Bipolar Disord 2023; 11:27. [PMID: 37480397 PMCID: PMC10363092 DOI: 10.1186/s40345-023-00305-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/26/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Intrusive mental imagery is associated with anxiety and mood instability within bipolar disorder and therefore represents a novel treatment target. Imagery Based Emotion Regulation (IBER) is a brief structured psychological intervention developed to enable people to use the skills required to regulate the emotional impact of these images. METHODS Participants aged 18 and over with a diagnosis of bipolar disorder and at least a mild level of anxiety were randomly assigned (1:1) to receive IBER plus treatment as usual (IBER + TAU) or treatment as usual alone (TAU). IBER was delivered in up to 12 sessions overs 16 weeks. Clinical and health economic data were collected at baseline, end of treatment and 16-weeks follow-up. Objectives were to inform the recruitment process, timeline and sample size estimate for a definitive trial and to refine trial procedures. We also explored the impact on participant outcomes of anxiety, depression, mania, and mood stability at 16-weeks and 32-weeks follow-up. RESULTS Fifty-seven (28: IBER + TAU, 27: TAU) participants from two sites were randomised, with 50 being recruited within the first 12 months. Forty-seven (82%) participants provided outcome data at 16 and 32-weeks follow-up. Thirty-five participants engaged in daily mood monitoring at the 32-week follow-up stage. Retention in IBER treatment was high with 27 (96%) attending ≥ 7 sessions. No study participants experienced a serious adverse event. DISCUSSION The feasibility criteria of recruitment, outcome completion, and intervention retention were broadly achieved, indicating that imagery-focused interventions for bipolar disorder are worthy of further investigation.
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Affiliation(s)
- Craig Steel
- Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
- University of Oxford, Oxford, UK
| | - Kim Wright
- University of Exeter, Exeter, EX4 4PY, UK.
| | | | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit and Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | | | | | - Susie A Hales
- Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK
| | | | | | | | | | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
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Brandtner A, Wegmann E. The fear in desire: linking desire thinking and fear of missing out in the social media context. BMC Psychol 2023; 11:176. [PMID: 37270492 DOI: 10.1186/s40359-023-01216-0] [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: 10/08/2022] [Accepted: 05/18/2023] [Indexed: 06/05/2023] Open
Abstract
According to the Elaborated Intrusion Theory of Desire, desire thinking and an associated deficit are fundamental factors to the emergence of craving. In the special case of problematic social networking sites (SNS) use, this experienced deficit could be constituted of an online-specific fear of missing out (FoMO). To test the interaction of these cognitions and their influence on problematic SNS use, we tested a serial mediation model on a sample of N = 193 individuals who use SNS (73% female, Mage = 28.3, SD = 9.29). We found that desire thinking predicted FoMO and both variables were only significant predictors of problematic SNS use when considered in interplay with craving. Ad hoc analyses revealed that the verbal subcomponent of desire thinking is more strongly associated with FoMO than imaginal prefiguration. Our results highlight that neither desire thinking nor FoMO are inherently dysfunctional but become problematic when they increase craving for potentially problematic SNS use.
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Affiliation(s)
- Annika Brandtner
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, LE220, 47057, Duisburg, Germany.
| | - Elisa Wegmann
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, LE220, 47057, Duisburg, Germany
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17
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Can mental imagery boost the effect of the positive cognitive bias modification of interpretation (CBM-I) on interpretation bias and memory bias? J Behav Ther Exp Psychiatry 2023; 79:101838. [PMID: 36805612 DOI: 10.1016/j.jbtep.2023.101838] [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: 08/23/2021] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Cognitive bias modification of interpretation (CBM-I) has been widely used and yielded mixed results. This experiment explored the unique role of mental imagery in positive CBM-I. METHODS 60 participants (M = 23.13, SD = 1.04) were randomly assigned to a imagery-based positive CBM-I group (imagery group) and a conventional verbal-based positive CBM-I group (control group). The imagery group received additional practice in generating mental imagery and were instructed to fully focus on the imagery during the formal training. The dependent variables included interpretation bias (probe latencies and similarity ratings for recognition task), memory bias, and intrusive memory. RESULTS (1) For the positive probe scenario, the reaction time of the two groups was shorter in the posterior five blocks than the anterior five blocks. However, the difference in latency between pre- and post- training for the imagery group was larger than that of the control group; (2) For the recognition task, the positive target statement score was significantly higher, while the negative one was significantly lower for the imagery group than that of the control group (3) The imagery group (vs. control); showed more beneficial effects on memory bias. LIMITATIONS The limitations consisted of the difference in time of the manipulation between the two groups, the richness of the imagery operationalization, generalizability, and the lack of pre-manipulation of interpretation bias assessments. CONCLUSIONS The imagery-based CBM-I led to more positive interpretation biases, less negative interpretations, and more positive memory biases, indicating that mental imagery can boost the effect of the positive CBM-I.
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18
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Marciniak MA, Shanahan L, Binder H, Kalisch R, Kleim B. Positive Prospective Mental Imagery Characteristics in Young Adults and Their Associations with Depressive Symptoms. COGNITIVE THERAPY AND RESEARCH 2023; 47:1-12. [PMID: 37363749 PMCID: PMC10140715 DOI: 10.1007/s10608-023-10378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 06/28/2023]
Abstract
Background Positive prospective mental imagery plays an important role in mental well-being, and depressive symptoms have been associated with difficulties in generating positive prospective mental images (PPMIs). We used a mobile app to gather PPMIs generated by young adults during the COVID-19 pandemic and analyzed content, characteristics, and associations with depressive symptoms. Methods This is a secondary analysis of a randomized controlled trial with 95 healthy young adults allocated into two groups (intervention and control). Participants used the mobile app decreasing mental health symptoms for seven consecutive days. Fifty participants in the intervention group reported PPMIs at least three times per day using a mobile app inducing PPMI generation. We categorized entries into themes and applied moderation models to investigate associations between PPMI characteristics and depressive symptoms. Results We distinguished 25 PPMI themes. The most frequent were related to consuming food and drinks, watching TV/streaming platforms, and doing sports. Vividness and ease of generation of PPMIs, but not their anticipation, pleasure intensity or number of engagements with the app were associated with fewer depressive symptoms. Conclusions We identified PPMI themes in young adults and found significant negative associations between depressive symptoms and vividness and generation ease of PPMIs. These results may inform prevention and intervention science, including the design of personalized interventions. We discuss implications for future studies and treatment development for individuals experiencing diminished PPMI. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-023-10378-5.
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Affiliation(s)
- Marta Anna Marciniak
- Department of Psychology, University of Zurich, Lenggstrasse 31, Zurich, 8032 Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Lenggstrasse 31, Zurich, 8032 Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Lenggstrasse 31, Zurich, 8032 Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland
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Werthmann J, Tuschen-Caffier B, Ströbele L, Kübel SL, Renner F. Healthy cravings? Impact of imagined healthy food consumption on craving for healthy foods and motivation to eat healthily - Results of an initial experimental study. Appetite 2023; 183:106458. [PMID: 36638961 DOI: 10.1016/j.appet.2023.106458] [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: 09/23/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
Craving for high-calorie foods predicts consumption of high-calorie foods thereby contributing to unhealthy eating habits and, potentially in the long term, to the development of overweight, obesity, and eating disorder pathology. Thus, effective interventions tackling craving for unhealthy foods and motivating healthy eating behavior are needed. This initial study tested if an experimental mental imagery procedure could induce craving for healthy foods and increase the motivation to eat healthily. Participants (N = 82) were randomized to either a healthy craving mental imagery condition or to a neutral mental imagery control condition. Craving for healthy foods and motivation to eat healthily was assessed before and after the experimental manipulation via self-report. A (disguised) food choice for healthy versus unhealthy food was added as a behavioural measure at the end of the experiment. Repeated measures of variance analyses with time (pre vs. post experimental manipulation) and condition (healthy craving mental imagery versus neutral mental imagery) yielded significant interactions for healthy craving and motivation to eat healthily: Post-hoc tests showed that craving for healthy foods and motivation to eat healthily increased significantly after the experimental manipulation in the healthy craving mental imagery condition, but not in the neutral mental imagery condition. Results of this initial study suggest that an experimental mental imagery induction of craving for healthy food leads to an increase in healthy craving and motivation to eat healthily. Further experimental research is needed to rule out priming effects, to test the underlying mechanisms of this effect, and evaluate the potential of this mental imagery procedure in a clinical context.
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Affiliation(s)
- Jessica Werthmann
- Albert-Ludwigs-University Freiburg, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Freiburg, Germany.
| | - Brunna Tuschen-Caffier
- Albert-Ludwigs-University Freiburg, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Freiburg, Germany
| | - Leonie Ströbele
- Albert-Ludwigs-University Freiburg, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Freiburg, Germany
| | - Sebastian L Kübel
- Albert-Ludwigs-University Freiburg, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Freiburg, Germany; Max Planck Institute for the Study of Crime, Security and Law, Department of Criminology, Freiburg, Germany
| | - Fritz Renner
- Albert-Ludwigs-University Freiburg, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Freiburg, Germany
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van den Berg KC, Hendrickson AT, Hales SA, Voncken M, Keijsers GPJ. Comparing the effectiveness of imagery focussed cognitive therapy to group psychoeducation for patients with bipolar disorder: A randomised trial. J Affect Disord 2023; 320:691-700. [PMID: 36206888 DOI: 10.1016/j.jad.2022.09.160] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Bipolar disorder is a severe, chronic mental disorder. Treatment options are limited, with pharmacological approaches continuing to dominate. However, relapse rates remain high. Several adjunctive psychosocial interventions, mostly psychoeducation (PE) and cognitive behavioural therapy (CBT), have been trialled, but treatment innovation is still needed. In the past, brief group PE has proven as beneficial as longer individual CBT in reducing levels of depression and increasing self-management strategies. We compared the relative effectiveness of group PE to an imagery focussed cognitive behavioural therapy (ImCT). STUDY DESIGN This was a randomised parallel group study with both daily and weekly measures. A total of 62 adult patients were randomly allocated to either ImCT or group PE. Daily, weekly and pre-and post-intervention measures were used to assess impact on (i) mood instability, (ii) overall levels of depression, anxiety and mania, and (iii) general functioning, hopelessness and imagery characteristics. A four-week baseline and 16-week follow-up period were included. RESULTS Mood instability reduced in both conditions after intervention. Levels of mania, depression and anxiety also reduced in both conditions, but on the daily measures, depression and anxiety significantly more so in the ImCT condition. Compared with the PE condition, the ImCT condition additionally showed increased level of functioning, reduced hopelessness, and a decrease in intrusive, problematic imagery. LIMITATIONS These findings need to be replicated in a larger trial. CONCLUSIONS Findings suggest that ImCT is a promising new avenue for management of bipolar disorder, an area in which treatment development is urgently needed.
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Affiliation(s)
- K C van den Berg
- Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), the Netherlands; Department of Clinical Psychological Sciences, Maastricht University, the Netherlands.
| | - A T Hendrickson
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands
| | - S A Hales
- Oxford Institute of Clinical Psychology Training, University of Oxford, UK; Psychological Services, Oxford Health NHS Foundation Trust, Oxford, UK
| | - M Voncken
- Department of Clinical Psychological Sciences, Maastricht University, the Netherlands
| | - G P J Keijsers
- Department of Clinical Psychological Sciences, Maastricht University, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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Månsson V, Andrade J, Jayaram-Lindström N, Berman AH. "I see myself": Craving imagery among individuals with addictive disorders. J Addict Dis 2023; 41:64-77. [PMID: 35382704 DOI: 10.1080/10550887.2022.2058299] [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: 01/21/2023]
Abstract
Craving has been put forward as a core feature of addictive disorders. The present qualitative study investigated the experience of craving among individuals with addictive disorders and recent experiences of cravings. Eleven individuals with Gambling Disorder and ten with Alcohol Use Disorder (n = 21) were recruited. A semi-structured interview explored: (1) modes of thought during craving (mental imagery or verbal thoughts), (2) craving content, (3) coping strategies and (4) craving context. The thematic analysis showed that cravings were initially dominated by imagery, with a subsequent conflict between imagery and verbal thoughts. Craving content included imagery of preparative rituals, anticipation, and sensory activation, imagery of the addictive behavior "me, there and then imagery" and anticipating that "something good will come out of it." Some participants related to craving as a symptom of sickness, and coping with craving were through distraction, reminding oneself of negative consequences, or via sensory control: avoiding stimuli associated with the addiction. Craving contexts included typical settings of drinking or gambling and engagement of both positive and negative emotions. Alcohol craving was described as an expected relief from internal stimuli, such as anxiety or stress, whereas gambling craving was more often described as an expectancy of financial reward. Craving was experienced mainly through imagery containing the preparative routines and expected outcomes. Future research and clinical practice should incorporate mode of thought in cravings to better understand its role in the maintenance of the disorders and their treatment. Supplemental data for this article is available online at https://doi.org/10.1080/10550887.2022.2058299 .
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Affiliation(s)
- Viktor Månsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Jackie Andrade
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Nitya Jayaram-Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anne H Berman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,School of Psychology, University of Plymouth, Plymouth, UK.,Department of Psychology, Uppsala University, Uppsala, Sweden
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22
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Cheng B, Coates JM, Gullo MJ, Chan G, Kavanagh DJ, Feeney GFX, Young RMD, Clark PJ, Connor JP. Development of the motivational thought frequency scale for alcohol abstinence (MTF-A). Alcohol Clin Exp Res 2022; 46:2077-2088. [PMID: 36098356 DOI: 10.1111/acer.14938] [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: 04/07/2022] [Revised: 08/16/2022] [Accepted: 09/08/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS For most treatment-seeking patients with severe Alcohol Use Disorder (AUD), abstinence is the clinically indicated goal. Existing AUD motivation scales are non-specific about treatment consumption goals, which limit their effectiveness. Desires and mental imagery are relevant in the motivation for AUD treatment engagement. The Motivational Thought Frequency Scale for an abstinence goal (MTF-A) was adapted from the MTF for controlled drinking (MTF-CD). This study psychometrically evaluated the MTF-A in an alcohol-dependent sample engaged in treatment with a goal of abstinence. To enhance the clinical utility of the scale, a secondary aim was to evaluate a psychometrically equivalent short version of the MTF-A. METHOD A sample N of 329 treatment-seeking patients with AUD (mean age of 44.44 years, SD = 11.89 years, 72% male) who were undertaking a cognitive behavioral treatment (CBT) program for abstinence completed the Motivational Thought Frequency Scale for Abstinence (MTF-A) and the Severity of Alcohol Dependence Questionnaire (SADQ). The MTF-A measured motivation for abstinence through four factors: intensity, self-efficacy imagery, incentives imagery, and availability. Confirmatory factor analyses (CFAs) were conducted to examine factor structure and model fit. Cronbach's alpha assessed internal consistency. Predictive validity was determined by logistic regression predicting first-session treatment non-attendance and alcohol consumption between baseline assessment and commencement of treatment, controlling for potential confounds. RESULTS A four-factor structure provided the best fit for the MTF-A, compared with one- and three-factor models. A shortened 9-item MTF-A scale (S-MTF-A) provided better fit than the 13-item MTF-A scale. Both MTF-A and S-MTF-A displayed good internal consistency. Although both MTF-A and S-MTF-A successfully predicted first-session treatment non-attendance, neither predicted alcohol consumption between the baseline assessment and commencement of treatment. CONCLUSIONS The model fit of the four-factor, 9-item S-MTF-A was superior to the original 13-item MTF-A. Both scales were predictive of participation of AUD treatment. Desires and mental imagery play an important role in AUD treatment motivation.
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Affiliation(s)
- Brandon Cheng
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason M Coates
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Matthew J Gullo
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - David J Kavanagh
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.,School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gerald F X Feeney
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ross Mc D Young
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Health and Behavioural Sciences, The University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Paul J Clark
- Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason P Connor
- National Centre for Youth Substance Use Research, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Positive moods are all alike? Differential affect amplification effects of 'elated' versus 'calm' mental imagery in young adults reporting hypomanic-like experiences. Transl Psychiatry 2022; 12:453. [PMID: 36261422 PMCID: PMC9581908 DOI: 10.1038/s41398-022-02213-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/08/2022] Open
Abstract
Positive mood amplification is a hallmark of the bipolar disorder spectrum (BPDS). We need better understanding of cognitive mechanisms contributing to such elevated mood. Generation of vivid, emotionally compelling mental imagery is proposed to act as an 'emotional amplifier' in BPDS. We used a positive mental imagery generation paradigm to manipulate affect in a subclinical BPDS-relevant sample reporting high (n = 31) vs. low (n = 30) hypomanic-like experiences on the Mood Disorder Questionnaire (MDQ). Participants were randomized to an 'elated' or 'calm' mental imagery condition, rating their momentary affect four times across the experimental session. We hypothesized greater affect increase in the high (vs. low) MDQ group assigned to the elated (vs. calm) imagery generation condition. We further hypothesized that affect increase in the high MDQ group would be particularly apparent in the types of affect typically associated with (hypo)mania, i.e., suggestive of high activity levels. Mixed model and time-series analysis showed that for the high MDQ group, affect increased steeply and in a sustained manner over time in the 'elated' imagery condition, and more shallowly in 'calm'. The low-MDQ group did not show this amplification effect. Analysis of affect clusters showed high-MDQ mood amplification in the 'elated' imagery condition was most pronounced for active affective states. This experimental model of BPDS-relevant mood amplification shows evidence that positive mental imagery drives changes in affect in the high MDQ group in a targeted manner. Findings inform cognitive mechanisms of mood amplification, and spotlight prevention strategies targeting elated imagery, while potentially retaining calm imagery to preserve adaptive positive emotionality.
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24
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Zhou L, Qin M, Han P. Olfactory metacognition and memory in individuals with different subjective odor imagery abilities. Conscious Cogn 2022; 105:103416. [PMID: 36194996 DOI: 10.1016/j.concog.2022.103416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 01/27/2023]
Abstract
Imagery vividness is one of the key indicators to evaluate the ability to generate mental images. There is large inter-individual variability in olfactory imagery (OI) abilities, however, little is known about the underlying factors for individual OI abilities. Using a word cueing imagery paradigm and the trial-by-trial imagery vividness rating method, participants with high or low OI abilities (differentiated by the Vividness of Olfactory Imagery Questionnaire) completed two OI tasks with either shorter (2 s) or longer (8 s) image generation time. Participants' olfactory function, olfactory-related working memory and episodic recognition memory were measured using validated methods. Moreover, olfactory metacognition was assessed using the Odor Awareness Scale (OAS) and the Importance of Olfaction Questionnaire (IOQ). Compared to participants with high OI abilities, those with low OI abilities reported less vivid odor images during OI tasks. For participants with low OI abilities, the imagery vividness significantly improved as the image generation time increased. There was no difference regarding olfactory perception or olfactory-related memory performances between the high and the low OI ability groups. However, participants with higher OI abilities had significant higher scores on the OAS and the IOQ, indicating a superior olfactory-related metacognition. These results provide evidences supporting the underlying factors that related to variances of subjective ability of generating vivid odor mental images.
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Affiliation(s)
- Luyi Zhou
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Min Qin
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Pengfei Han
- Faculty of Psychology, Southwest University, Chongqing, China; MOE Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China.
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25
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Gulyás E, Gombos F, Sütöri S, Lovas A, Ziman G, Kovács I. Visual imagery vividness declines across the lifespan. Cortex 2022; 154:365-374. [DOI: 10.1016/j.cortex.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/15/2022] [Accepted: 06/21/2022] [Indexed: 11/03/2022]
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26
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Nature-Based Meditation, Rumination and Mental Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159118. [PMID: 35897493 PMCID: PMC9332585 DOI: 10.3390/ijerph19159118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
Novel approaches for children and young people (CYP) in the prevention and intervention of mental illness are needed and nature-based interventions (NBI) may be clinically useful. This proof-of-principle study tested the effects of a novel brief nature-based meditation on rumination, depressive symptoms and wellbeing in young people. Sixty-eight university students were randomised to one of three conditions: active control (n = 23), indoor meditation (n = 22) or nature-based meditation (n = 23). Participants completed self-report measures on state and trait rumination post intervention and depression and wellbeing at a 2-week follow-up. Depressive rumination significantly decreased post intervention in the nature condition and depressive symptoms improved for both intervention groups. Wellbeing only significantly improved at follow-up in the nature condition. Nature condition participants demonstrated one minimal clinically important difference (MCID) for wellbeing at follow-up. Depressive symptoms for this condition were below the clinically significant threshold for depression. The number needed to treat (NNT) analysis suggested that two to five young people would need to complete the intervention. Preliminary evidence suggests NBIs, such as the one in the present study, can reduce depressive rumination and symptoms and improve wellbeing. Replication with larger clinical samples is required to substantiate findings.
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27
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Saneinia S, Zhou R, Gholizadeh A, Asmi F. Immersive Media-Based Tourism Emerging Challenge of VR Addiction Among Generation Z. Front Public Health 2022; 10:833658. [PMID: 35844881 PMCID: PMC9286390 DOI: 10.3389/fpubh.2022.833658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
The virtual reality (VR) applications in entertainment and tourism industry have become growingly intense among generation Z. Interestingly, some pilot research on tourism studied concluded the positive impact of its flow experience on adoption of VR tourism, which is also driving the risk of immersive addictive. In the context of tourism and information and communication technology (ICT)-based innovation, there is a lack of immersive addictive behavior (IAB)-related literature. In addition, during the currently ongoing pandemic crisis, VR technology has gained particular importance in the tourism industry among generation Z. The present venture underlines the mechanism of IAB, investigates the VR addiction while underlining the cognitive abilities of individuals. This study applies empirical framework of cognitive-behavioral model. Results demonstrate that in the case of VR tourism, the immersive experience (presence and flow) determines the addictive behavior. Furthermore, VR imagery (VI), psychological curiosity (PC), and VR convenience (VRC) have significant influence on the VR presence and immersive flow. Moreover, the practical and theoretical implications have been discussed in the current research to prevent IAB.
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Affiliation(s)
- Saba Saneinia
- School of Public Affairs, University of Science and Technology of China, Hefei, China
- Key Laboratory of Immersive Media Technology (Anhui Xinhua Media Co, Ltd.), Ministry of Culture and Tourism, Hefei, China
| | - Rongting Zhou
- Key Laboratory of Immersive Media Technology (Anhui Xinhua Media Co, Ltd.), Ministry of Culture and Tourism, Hefei, China
- School of Humanities and Social Science, University of Science and Technology of China, Hefei, China
| | | | - Fahad Asmi
- Key Laboratory of Immersive Media Technology (Anhui Xinhua Media Co, Ltd.), Ministry of Culture and Tourism, Hefei, China
- Department of Communication of Science and Technology, University of Science and Technology of China, Hefei, China
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28
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Kadriu F, Claes L, Witteman C, Vroling M, Norré J, Krans J. Intrusive images, autobiographical memories, and core beliefs of patients with an eating disorder. APPLIED COGNITIVE PSYCHOLOGY 2022. [DOI: 10.1002/acp.3974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Fortesa Kadriu
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
- Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
- Faculty of Medicine and Health Sciences University Antwerp Antwerp Belgium
| | - Cilia Witteman
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Maartje Vroling
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
- Amarum, Expertise Centre for Eating Disorders GGNet Network for MentalHealth Care Zutphen The Netherlands
| | - Jan Norré
- People Development Leuven Belgium
- Faculty of Psychology and Educational Sciences Free University of Brussels Elsene Belgium
| | - Julie Krans
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
- Faculty of Psychology and Educational Sciences KU Leuven Leuven Belgium
- Pro Persona Overwaal Centre for Anxiety, OCD, and PTSD Nijmegen The Netherlands
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29
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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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30
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Palermo L, Boccia M, Piccardi L, Nori R. Congenital lack and extraordinary ability in object and spatial imagery: An investigation on sub-types of aphantasia and hyperphantasia. Conscious Cogn 2022; 103:103360. [PMID: 35691243 DOI: 10.1016/j.concog.2022.103360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/26/2022]
Abstract
Studies that have shown a distinction between object and spatial imagery suggest more than one type of aphantasia and hyperphantasia, yet this has not been systematically investigated in studies on imagery ability extremes. Also, if the involuntary imagery is preserved in aphantasia and how this condition affects other skills is not fully clear. We collected data on spatial and object imagery, retrospective, and prospective memory, face recognition, and sense of direction (SOD), suggesting a distinction between two subtypes of aphantasia/hyperphantasia. Spatial aphantasia is associated with difficulties in visuo-spatial mental imagery and SOD. Instead, in object aphantasia there are difficulties in imaging single items and events - with no mental visualization of objects, out-of-focus, and black-and-white mental images more frequent than expected - in SOD and face recognition. Furthermore, associative involuntary imagery can be spared in aphantasia. The opposite pattern of performance was found in spatial and object hyperphantasia.
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Affiliation(s)
- Liana Palermo
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
| | - Maddalena Boccia
- Department of Psychology, 'Sapienza' University of Rome, Rome, Italy; I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - Laura Piccardi
- Department of Psychology, 'Sapienza' University of Rome, Rome, Italy; I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - Raffaella Nori
- Department of Psychology, University of Bologna, Bologna, Italy
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31
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Jungmann SM, Becker F, Witthöft M. Erfassung der Lebendigkeit mentaler Vorstellungsbilder. DIAGNOSTICA 2022. [DOI: 10.1026/0012-1924/a000291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Mentale Vorstellungsfähigkeit bezeichnet ein Konstrukt von enormer Bedeutung für diverse psychische Funktionen (z. B. Motivation, Emotion und Handlungssteuerung). Die Lebendigkeit gilt hierbei als ein zentrales und interindividuell variierendes Merkmal mentaler Vorstellungen. Bislang mangelt es allerdings an validierten deutschsprachigen Fragebögen zur Erfassung der Lebendigkeit. Daher wurden an einer Stichprobe von N = 300 Personen aus der Allgemeinbevölkerung (81 % Studierende) deutschsprachige Versionen des Vividness of Visual Imagery Questionnaire (VVIQ; visuelle Vorstellungen) und des Plymouth Sensory Imagery Questionnaire (PSI-Q; multisensorische Erfassung) adaptiert und validiert. Für den VVIQ und PSI-Q konnten die faktorielle (mittels Exploratory Structural Equation Modeling), konvergente und diskriminante Validität belegt werden. Es ergaben sich akzeptable bis hohe interne Konsistenzen, die Retest-Korrelationen (8 Monate) variierten je nach Subskala. Die Lebendigkeit mentaler Vorstellungen zeigte erwartungskonform negative Zusammenhänge mit Defiziten in der emotionalen Verarbeitung (Alexithymie). Insgesamt stellen die beiden Fragebögen ökonomische, reliable und valide Verfahren dar, um die Lebendigkeit mentaler Vorstellungen zu erfassen.
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Affiliation(s)
- Stefanie M. Jungmann
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Fritz Becker
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
- Leibniz-Institut für Wissensmedien, Tübingen
| | - Michael Witthöft
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
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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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Ottonello M, Torselli E, Caneva S, Fiabane E, Vassallo C, Pistarini C. Mental Imagery Skills in Alcohol-Dependent Subjects and Their Associations With Cognitive Performance: An Exploratory Study During Residential Rehabilitation. Front Psychiatry 2021; 12:741900. [PMID: 34912249 PMCID: PMC8666508 DOI: 10.3389/fpsyt.2021.741900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/10/2021] [Indexed: 11/15/2022] Open
Abstract
People in alcohol-detoxification experience deficits in motor and non-motor functions including cognitive performance. Imagery, the cognitive process of generating visual, auditory or kinesthetic experiences in the mind without the presence of external stimuli, has been little studied in Alcohol Use Disorders (AUD). This pilot study aims to observe the cognitive abilities useful for the inspection, maintenance, generation and manipulation of images in these patients during residential rehabilitation and investigate the relationships with their cognitive performance. Thirty-six subjects who completed the 28-day rehabilitation program for alcohol addiction, completed the Mental Imagery Test (MIT) and Neuropsychological Battery (ENB-2). The global score at MIT did not show pathological scores. The 11.1% of AUD patients showed an impaired global score in the cognitive performance and the 5.7% with scoring at limits of norm. Significant correlations were found between Mental Imagery abilities and ENB-2 subscale and stepwise regression analysis showed the close association between the ability of imagery (Mental Imagery Test) and the overall cognitive performance (ENB-2) in alcohol dependent patients and this relationship is stronger than other cognitive tasks.
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Affiliation(s)
- Marcella Ottonello
- Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Istituti Clinici Scientifici (ICS) Maugeri Spa SB, Genoa, Italy
| | - Elisa Torselli
- School of Psychotherapy, Miller Institute for Behavioral and Cognitive Therapy, Genoa, Italy
| | - Stefano Caneva
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Elena Fiabane
- Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Istituti Clinici Scientifici (ICS) Maugeri Spa SB, Genoa, Italy
| | - Claudio Vassallo
- Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Istituti Clinici Scientifici (ICS) Maugeri Spa SB, Genoa, Italy
| | - Caterina Pistarini
- Department of Neurorehabilitation Medicine of Pavia Institute, Istituti Clinici Scientifici (ICS) Maugeri, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Spa SB, Pavia, Italy
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Ji JL, Geiles D, Saulsman LM. Mental imagery-based episodic simulation amplifies motivation and behavioural engagement in planned reward activities. Behav Res Ther 2021; 145:103947. [PMID: 34433114 DOI: 10.1016/j.brat.2021.103947] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 07/27/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022]
Abstract
Preliminary evidence suggests mental imagery-based episodic simulation of planned reward activities may amplify motivation and promote greater behavioural engagement, particularly for activities with high motivational barriers (Renner, Murphy, Ji, Manly, & Holmes, 2019). This study conducted a conceptual replication and extension of Renner et al. (2019). N = 81 first-year university students self-selected and scheduled two reward activities (one hedonic, one mastery) for the following week before being randomly allocated to either an Imagery-Experiential elaboration condition (n = 27), a Verbal-Reasoning elaboration condition (n = 28), or a Scheduling-only Control condition (n = 26). Following the lab session, all participants received standardized daily prompts to complete daily activity diaries online for seven days. The Imagery-Experiential condition reported greater increases in anticipatory pleasure (state mood), anticipated pleasure, and self-reported motivation compared to the Scheduling-only Control condition, and greater increases in anticipatory pleasure (state mood), but not anticipated pleasure or motivation, relative to the Verbal-Reasoning condition. Consistent with Renner et al. (2019), the Imagery-Experiential condition, but not the Verbal-Reasoning condition, reported more frequent engagement in high motivational barrier activities than the Scheduling-only Control condition. Exploratory mediational analyses suggested that mental imagery may exert unique motivational impacts via its impact on anticipatory pleasure (state mood), although indirect effects were only observed for self-reported motivation change in the lab, with real world behavioural effects falling short of statistical significance.
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Affiliation(s)
- Julie L Ji
- School of Psychological Science, University of Western Australia, Australia.
| | - Dylan Geiles
- School of Psychological Science, University of Western Australia, Australia
| | - Lisa M Saulsman
- School of Psychological Science, University of Western Australia, Australia
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35
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Prospective mental imagery in depression: Impact on reward processing and reward-motivated behaviour. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e3013. [PMID: 36397959 PMCID: PMC9667131 DOI: 10.32872/cpe.3013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 02/08/2021] [Indexed: 01/11/2023] Open
Abstract
Background Mental imagery has long been part of cognitive behavioural therapies. More recently, a resurgence of interest has emerged for prospective mental imagery, i.e. future-directed imagery-based thought, and its relation to reward processing, motivation and behaviour in the context of depression. Method We conducted a selective review on the role of prospective mental imagery and its impact on reward processing and reward-motivated behaviour in depression. Results Based on the current literature, we propose a conceptual mechanistic model of prospective mental imagery. Prospective mental imagery of engaging in positive activities can increase reward anticipation and reward motivation, which can transfer to increased engagement in reward-motivated behaviour and more experiences of reward, thereby decreasing depressive symptoms. We suggest directions for future research using multimodal assessments to measure the impact of prospective mental imagery from its basic functioning in the lab to real-world and clinical implementation. Conclusion Prospective mental imagery has the potential to improve treatment for depression where the aim is to increase reward-motivated behaviours. Future research should investigate how exactly and for whom prospective mental imagery works. This review provides a selected update of the literature on prospective mental imagery. Prospective mental imagery might decrease depression via reward processing and reward-motivated behaviours. Suggestions for future research to investigate these hypotheses are provided.
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36
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Kaczmarek T, Kavanagh DJ, Lazzarini PA, Warnock J, Van Netten JJ. Training diabetes healthcare practitioners in motivational interviewing: a systematic review. Health Psychol Rev 2021; 16:430-449. [PMID: 33970799 DOI: 10.1080/17437199.2021.1926308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diabetes presents significant self-care challenges that require sustained motivation. Motivational Interviewing (MI) has substantial support in enhancing motivation for behavioural change, but its effective application in routine healthcare requires practitioners to acquire and use related skills. The aim of this systematic review was to investigate the impact of MI training on MI-related skills of practitioners who provide diabetes healthcare. PubMed, EMBASE and PsycINFO were searched using the terms motivational interviewing, motivation enhancement, and diabetes. Two assessors independently screened titles, abstracts and full texts for papers reporting the impact of MI training on diabetes healthcare practitioners' outcomes. Of 625 abstracts screened, 22 papers from 17 unique studies were included. All 17 studies reported some improvement in MI skills, with 14 finding improvements in more than 50% and three less than 35%. However, the risk of bias and outcome measures varied widely between studies. All studies showed diabetes healthcare practitioners acquired and applied MI skills post-training, to varying levels. Findings suggest training should include education, role play, and ongoing supervision to maintain skills.
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Affiliation(s)
- Tracey Kaczmarek
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.,Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
| | - David J Kavanagh
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia.,Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Peter A Lazzarini
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.,Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Jason Warnock
- Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
| | - Jaap J Van Netten
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.,Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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37
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Çili S, Stopa L. A taxonomy of intrusive mental images in clinical disorders: what can "non-veridical" images tell us about the nature of human memory? Memory 2021; 30:60-66. [PMID: 33998361 DOI: 10.1080/09658211.2021.1910311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Intrusive mental images associated with autobiographical memories or depicting imagined scenes are common in psychological disorders. Although there is a growing body of literature on their contribution to psychopathology and their role in therapy, to date there have been limited attempts to categorise the different types of images that patients experience. In this article, we present a taxonomy which ranges from veridical to non-veridical intrusive images. We highlight the fact that many types of images consist of a blend of veridical and imagined details. After presenting some of the main explanations for the existence of blended and non-veridical images, we reflect on what the evidence on the content and origin of intrusive images tells us about the nature of human memory. We argue that it supports the idea of memory being constructive and briefly discuss what this means for clinical and non-clinical settings in which intrusive images have to be evaluated and used.
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Affiliation(s)
- Soljana Çili
- London College of Fashion, University of the Arts London, London, UK.,School of Psychology, University of Southampton, Southampton, UK
| | - Lusia Stopa
- School of Psychology, University of Southampton, Southampton, UK
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38
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Wicken M, Keogh R, Pearson J. The critical role of mental imagery in human emotion: insights from fear-based imagery and aphantasia. Proc Biol Sci 2021; 288:20210267. [PMID: 33715433 PMCID: PMC7944105 DOI: 10.1098/rspb.2021.0267] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 02/11/2021] [Indexed: 01/10/2023] Open
Abstract
One proposed function of imagery is to make thoughts more emotionally evocative through sensory simulation, which can be helpful both in planning for future events and in remembering the past, but also a hindrance when thoughts become overwhelming and maladaptive, such as in anxiety disorders. Here, we report a novel test of this theory using a special population with no visual imagery: aphantasia. After using multi-method verification of aphantasia, we show that this condition, but not the general population, is associated with a flat-line physiological response (skin conductance levels) to reading and imagining frightening stories. Importantly, we show in a second experiment that this difference in physiological responses to fear-inducing stimuli is not found when perceptually viewing fearful images. These data demonstrate that the aphantasic individuals' lack of a physiological response when imaging scenarios is likely to be driven by their inability to visualize and is not due to a general emotional or physiological dampening. This work provides evidence that a lack of visual imagery results in a dampened emotional response when reading fearful scenarios, providing evidence for the emotional amplification theory of visual imagery.
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Affiliation(s)
- Marcus Wicken
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
| | - Rebecca Keogh
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
| | - Joel Pearson
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia
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39
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Abstract
Anxiety disorders form the most common group of mental disorders and generally start before or in early adulthood. Core features include excessive fear and anxiety or avoidance of perceived threats that are persistent and impairing. Anxiety disorders involve dysfunction in brain circuits that respond to danger. Risk for anxiety disorders is influenced by genetic factors, environmental factors, and their epigenetic relations. Anxiety disorders are often comorbid with one another and with other mental disorders, especially depression, as well as with somatic disorders. Such comorbidity generally signifies more severe symptoms, greater clinical burden, and greater treatment difficulty. Reducing the large burden of disease from anxiety disorders in individuals and worldwide can be best achieved by timely, accurate disease detection and adequate treatment administration, scaling up of treatments when needed. Evidence-based psychotherapy (particularly cognitive behavioural therapy) and psychoactive medications (particularly serotonergic compounds) are both effective, facilitating patients' choices in therapeutic decisions. Although promising, no enduring preventive measures are available, and, along with frequent therapy resistance, clinical needs remain unaddressed. Ongoing research efforts tackle these problems, and future efforts should seek individualised, more effective approaches for treatment with precision medicine.
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Affiliation(s)
- Brenda Wjh Penninx
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands; GGZ inGeest, Amsterdam, Netherlands.
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt-Goethe University, Frankfurt, Germany
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40
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Mental Imagery in the Science and Practice of Cognitive Behaviour Therapy: Past, Present, and Future Perspectives. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00102-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractMental imagery has a long history in the science and practice of cognitive behaviour therapy (CBT), stemming from both behavioural and cognitive traditions. The past decade or so has seen a marked increase in both scientific and clinical interest in mental imagery, from basic questions about the processes underpinning mental imagery and its roles in everyday healthy functioning, to clinical questions about how dysfunctions in mental imagery can cause distress and impairment, and how mental imagery can be used within CBT to effect therapeutic change. This article reflects on the current state of mental imagery in the science and practice of CBT, in the context of past developments and with a view to future challenges and opportunities. An ongoing interplay between the various strands of imagery research and the many clinical innovations in this area is recommended in order to realise the full therapeutic potential of mental imagery in CBT.
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41
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Chuang JY. Romance Scams: Romantic Imagery and Transcranial Direct Current Stimulation. Front Psychiatry 2021; 12:738874. [PMID: 34707523 PMCID: PMC8542716 DOI: 10.3389/fpsyt.2021.738874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Love has an enormous effect on mental health. One does not need an actual romantic relationship to be in love. Indeed, romantic love can be built upon without frequent or real-life encounters, such as with a stranger from a matching website. With the advancement of the Internet and the influence of coronavirus disease, it is believed that these distant romantic relationships and related romance scams are burgeoning. Often, the victims of scams keep emotionally attached to the scammer even after the lie is revealed, which is hypothesized to be attributed to the aberrantly exaggerated romantic imagery of the victims. It is observed that many victims suffer from symptoms similar to a post-traumatic stress disorder, and some even consider suicide. However, there is scant literature on this topic. In this article, it is further postulated that the aberrant romantic imagery might be associated with impulsive acts such as suicide once the ideal but fake romantic relationship is dissolved. Thereafter, it is further speculated that manipulation of the visual network, possibly by transcranial direct current stimulation (tDCS), might be a promising treatment.
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Affiliation(s)
- Jie-Yu Chuang
- Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
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42
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Koerner N, Blackwell SE. Mental imagery in chronic worry and generalized anxiety disorder: Shining a spotlight on a key research and clinical target. Behav Res Ther 2020; 137:103785. [PMID: 33360432 DOI: 10.1016/j.brat.2020.103785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Naomi Koerner
- Department of Psychology, Ryerson University, Canada.
| | - Simon E Blackwell
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany.
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43
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Hypomanic-like experiences and spontaneous emotional mental imagery. J Affect Disord 2020; 277:742-746. [PMID: 32919295 DOI: 10.1016/j.jad.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Bipolar spectrum disorders (BPSD) are associated with frequent and emotional mental imagery, theorized to play a role in mood instability. However, we lack methods for measuring tendency to experience emotional mental imagery in daily life. The current study developed such a measure and evaluated the hypothesis that a high tendency to experience emotional imagery in daily life would be associated with higher levels of hypomanic-like experiences. METHODS We conducted two rounds of studies to develop and refine a measure of spontaneous emotional imagery (E-SUIS) using factor analysis. We conducted a third study to test the relationship between E-SUIS score and hypomanic-like experiences. Participants (total N = 554, age 18-25) comprised an unselected community sample. RESULTS First, factor analysis indicated a unidimensional factor structure and excellent reliability (α=0.87) of our novel measure of spontaneous emotional mental imagery. Second, higher scores on a hypomanic-like experiences scale related to higher use of both spontaneous emotional imagery and spontaneous non-emotional imagery. Spontaneous emotional mental imagery significantly improved the prediction of hypomanic-like experiences over non-emotional mental imagery. LIMITATIONS Only two mental imagery measures were included. To determine discriminant validity of the E-SUIS requires additional imagery measures or interviews. CONCLUSIONS Levels of hypomanic-like experiences were related to the tendency to use emotional imagery in daily life. Additionally, spontaneous use of emotional imagery appears to be a better predictor of hypomanic-like experiences in the general population compared to spontaneous use of non-emotional imagery.
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Saulsman LM, Ji JL, Mcevoy PM. The essential role of mental imagery in cognitive behaviour therapy: What is old is new again. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12406] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Lisa M. Saulsman
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
- Cognitive Behaviour Therapy Services Western Australia, Perth, Western Australia, Australia
| | - Julie L. Ji
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Peter M. Mcevoy
- School of Psychology, Curtin University, Perth, Western Australia, Australia
- Centre for Clinical Interventions, Perth, Western Australia, Australia
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45
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Frewen P, Mistry D, Zhu J, Kielt T, Wekerle C, Lanius RA, Jetly R. Proof of Concept of an Eclectic, Integrative Therapeutic Approach to Mental Health and Well-Being Through Virtual Reality Technology. Front Psychol 2020; 11:858. [PMID: 32581898 PMCID: PMC7290015 DOI: 10.3389/fpsyg.2020.00858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/07/2020] [Indexed: 01/12/2023] Open
Abstract
Across three studies, we provide a proof-of-concept evaluation of an integrative psychotherapeutic application of virtual reality (VR) technology. Study 1 (n = 36) evaluated an unguided “safe-place” imagery task, where participants were instructed “to create a safe space… [such as] a scene, item, design, or any visual representation that makes you feel safe” using either the Google Tilt Brush application (VR condition), the standard Microsoft Paint application (2-D condition), or via eyes-closed mental imagery alone (IMG condition). Study 2 (n = 48) evaluated a narrative episodic recall task, where participants viewed their childhood and adult homes and places of schooling either using either the Google Earth VR application (VR condition) or the standard Google Earth application (2-D condition) or recalled these places with their eyes closed via mental imagery alone (IMG condition). Finally, Study 3 (n = 48) evaluated a guided wilderness imagery task, during which different scripts were narrated, specifically, a trail walk in autumn, a spring meadow, and a hillside walk in snowy winter, while either these same scenes were visually presented using the Nature Treks VR application (VR condition), the scenes were presented using the same software but shown on standard computer monitor (2-D condition), or participants’ eyes were closed (IMG condition). Order of intervention format was randomized across participants. Across all three studies, quantitative survey ratings showed that the VR format of intervention delivery produced greater positive affect and satisfaction and perceived credibility ratings as an intervention for trauma- and stressor-related disorders and psychological well-being as rated by university students who varied in traumatic and stressful life event history and symptoms of posttraumatic stress disorder, whereas qualitative findings revealed additional themes of experiential response including increased experience of presence and vividness in the VR condition. Future research directions and clinical applications are discussed.
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Affiliation(s)
- Paul Frewen
- University of Western Ontario, London, ON, Canada
| | - Divya Mistry
- University of Western Ontario, London, ON, Canada
| | - Jenney Zhu
- University of Western Ontario, London, ON, Canada
| | - Talia Kielt
- University of Western Ontario, London, ON, Canada
| | | | | | - Rakesh Jetly
- Canadian Armed Forces, Ottawa, ON, Canada.,University of Ottawa, Ottawa, ON, Canada
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46
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Di Simplicio M, Lau-Zhu A, Meluken I, Taylor P, Kessing LV, Vinberg M, Holmes EA, Miskowiak KW. Emotional Mental Imagery Abnormalities in Monozygotic Twins With, at High-Risk of, and Without Affective Disorders: Present in Affected Twins in Remission but Absent in High-Risk Twins. Front Psychiatry 2019; 10:801. [PMID: 31780967 PMCID: PMC6856790 DOI: 10.3389/fpsyt.2019.00801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/07/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Mental imagery abnormalities feature across affective disorders including bipolar disorder (BD) and unipolar depression (UD). Maladaptive emotional imagery has been proposed as a maintenance factor for affective symptomatology and a target for mechanism-driven psychological treatment developments. Where imagery abnormalities feature beyond acute affective episodes, further opportunities for innovation arise beyond treatments, such as for tertiary/relapse prevention (e.g., in remitted individuals) or primary prevention (e.g., in non-affected but at-risk individuals). The aim of our study was to investigate for the first time the presence of possible mental imagery abnormalities in affected individuals in remission and at-risk individuals for affective disorders using a familial risk design. Methods: A population-based cohort of monozygotic twins was recruited through linkage between the Danish national registries (N=204). Participants were grouped as: affected (remitted BD/UD; n = 115); high-risk (co-twin with history of BD/UD; n = 49), or low-risk (no co-twin history of BD/UD; n = 40). Twins completed mental imagery measures spanning key subjective domains (spontaneous imagery use and emotional imagery) and cognitive domains (imagery inspection and imagery manipulation). Results: Affected twins in remission reported enhanced emotional mental imagery compared to both low- and high-risk twins. This was characterized by greater impact of i) intrusive prospective imagery (Impact of Future Events Scale) and ii) deliberately-generated prospective imagery of negative scenarios (Prospective Imagery Task). There were no significant differences in these key measures between affected BD and UD twins in remission. Additionally, low- and high-risk twins did not significantly differ on these emotional imagery measures. There were also no significant differences between the three groups on non-emotional measures including spontaneous imagery use and cognitive stages of imagery. Conclusions: Abnormalities in emotional prospective imagery are present in monozygotic twins with affective disorders in remission-despite preserved cognitive stages of imagery-but absent in unaffected high-risk twins, and thus do not appear to index familial risk (i.e., unlikely to qualify as "endophenotypes"). Elevated emotional prospective imagery represents a promising treatment/prevention target in affective disorders.
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Affiliation(s)
- Martina Di Simplicio
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Alex Lau-Zhu
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom.,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Medical Sciences Division, Oxford Institute of Clinical Psychology Training, University of Oxford, Oxford, United Kingdom
| | - Iselin Meluken
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Patrick Taylor
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Emily Alexandra Holmes
- Division of Psychology, Department for Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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