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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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Abstract
Purpose Many individuals with autism experience social anxiety (SA), yet, to date, this has almost exclusively been investigated using quantitative research methods. We know very little about why individuals with autism perceive they develop SA, what they view the impact and consequences of symptoms to be, and which coping strategies they find helpful. Methods Using a qualitative study design, six men with autism (aged 23–52 years old) participated in individual semi-structured interviews. Data were transcribed verbatim and analysed using thematic analysis. Results Seven overarching themes were identified: (1) causal influences for SA; (2) anxiety-provoking social situations; (3) symptoms of SA; (4) chronicity; (5) coping; (6) impact; and (7) interventions. Conclusions Further studies are needed to more fully establish why individuals with autism are vulnerable to developing SA, to inform development of targeted interventions.
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Affiliation(s)
- Debbie Spain
- Institute of Psychiatry, Psychology & Neuroscience, King's College London , London, UK.,South London & Maudsley NHS Foundation Trust , England
| | - Esra Zıvralı Yarar
- Department of Psychology, Social Sciences University of Ankara , Ankara, Turkey
| | - Francesca Happé
- Institute of Psychiatry, Psychology & Neuroscience, King's College London , London, UK
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Image qualities and mood variability: Evaluating the utility of an imagery survey for bipolar disorder. J Affect Disord 2020; 272:77-83. [PMID: 32379623 DOI: 10.1016/j.jad.2020.03.098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/27/2020] [Accepted: 03/28/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Imagery appears to play an important role in mood variability, a core symptom of patients suffering from bipolar disorder. The present study aimed to explore the validity and reliability of an online self-report measure of imagery, the Dutch Imagery Survey (DImS). The DImS is an adaptation of the Imagery interview used in research on imagery in mental disorders. The present study additionally explored the ability of the DImS to detect relationships between self-reported imagery and subsequent mood and subsequent behaviour. METHOD 135 students completed the DImS and additional mental imagery and mood questionnaires. For re-test reliability, 42 students completed the survey again within two days. RESULTS Internal consistencies and test-retest scores of the five scales of the DImS were reasonable. Imagery Quality correlated with Emotions, and to a lesser degree with Behaviour. Positive Appraisals correlated with Positive Emotions, Negative Appraisals with Negative Emotions, and Positive appraisals with Behaviour. Frequency of Imagery, Imagery Quality and Positive Appraisals correlated with elevated mood. Imagery Quality and Negative Appraisals correlated with low mood. The DImS took approximately 15 min to complete. LIMITATIONS Re-test reliability was limited due to participants changing their dominant image. Results need to be replicated in a clinical sample. CONCLUSIONS Psychometric findings with the DImS appeared reasonable and consistent and showed that, in line with other recent studies, imagery is related to current mood and to both self-perceived emotion and subsequent behaviour. These findings suggested that the DImS is suitable to study the role of imagery in bipolar mood variability.
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Griffiths R, Mansell W, Edge D, Tai S. Sources of Distress in First-Episode Psychosis: A Systematic Review and Qualitative Metasynthesis. QUALITATIVE HEALTH RESEARCH 2019; 29:107-123. [PMID: 30066602 DOI: 10.1177/1049732318790544] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In this study, we aim to increase our understanding of the self-reported sources of distress among people who have experienced first-episode psychosis. Following a systematic literature search, 33 relevant studies containing first-person accounts of first-episode psychosis were identified, which were synthesized using thematic analysis. Two interrelated superordinate themes were identified: intrapersonal distress and interpersonal distress. Participants reported multiple, diverse, and multifaceted sources of distress across both themes. These were substantially different from those routinely recognized and targeted in clinical practice. This review suggests that practitioners who maintain a stance of genuine curiosity about the potential sources of distress for this population will be perceived as more helpful. The findings also highlight the importance of being service user-led when planning and delivering mental health care. Additional clinical and research implications are discussed.
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Affiliation(s)
- Robert Griffiths
- 1 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Warren Mansell
- 2 The University of Manchester, Manchester, United Kingdom
| | - Dawn Edge
- 2 The University of Manchester, Manchester, United Kingdom
| | - Sara Tai
- 2 The University of Manchester, Manchester, United Kingdom
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Schneider A, Andrade J, Tanja-Dijkstra K, Moles DR. Mental imagery in dentistry: Phenomenology and role in dental anxiety. J Anxiety Disord 2018; 58:33-41. [PMID: 30025254 DOI: 10.1016/j.janxdis.2018.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/16/2018] [Accepted: 06/22/2018] [Indexed: 12/26/2022]
Abstract
Dental anxiety is a prevalent problem with marked psychological, physical and public health implications. Based on cognitive theory and evidence, we hypothesized that vivid, sensory image-based cognitions play a role in dental anxiety. A quantitative online survey (N = 306) and qualitative semi-structured interviews (N = 18) found that vivid sensory images were common irrespective of dental anxiety levels, but that their content, associated distress and responses varied. Participants reporting higher anxiety experienced intense and intrusive fear-provoking dental imagery focusing on unpleasant sensations, which were associated with the intrusive recollection of negative past experiences and avoidance of dentistry. Participants with lower anxiety ratings, reported images that were less distressing and centered around reassuring aspects and positive appointment outcomes, potentially acting as protective factors against dental anxiety and facilitating appointment attendance. The inclusion of components aimed at reducing intrusive memories and dental imagery rescripting may help improve interventions for dental anxiety.
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Affiliation(s)
- Annegret Schneider
- Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
| | - Jackie Andrade
- School of Psychology, Cognition Institute, University of Plymouth, United Kingdom
| | - Karin Tanja-Dijkstra
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, VU Amsterdam, The Netherlands
| | - David R Moles
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, United Kingdom
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Laing J, Morland T, Fornells-Ambrojo M. The Phenomenology and Generation of Positive Mental Imagery in Early Psychosis. Clin Psychol Psychother 2015; 23:523-532. [PMID: 26555700 DOI: 10.1002/cpp.1976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/09/2015] [Accepted: 08/11/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Theoretical models of depression and bipolar disorder emphasise the importance of positive mental imagery in mood and behaviour. Distressing, intrusive images are common in psychosis; however, little is known about positive imagery experiences or their association with clinical symptoms. The aim of the current study was to examine the phenomenology of positive imagery in early psychosis and the relationship between the characteristics of positive, future-oriented imagery and symptom severity. METHOD Characteristics, thematic content and appraisals of recent self-reported images were examined in 31 people with early psychosis. The vividness and perceived likelihood of deliberately generated, future-oriented images were investigated in relation to clinical symptoms. RESULTS Eighty-four percent of participants reported experiencing a recent positive image. Themes included the achievement of personal goals, spending enjoyable time with peers and family, loving, intimate relationships and escape from current circumstances. The vividness and perceived likelihood of generated prospective imagery were negatively correlated with levels of depression and social anxiety. CONCLUSIONS The relationship between emotional problems and the ability to imagine positive, future events may have implications for motivation, mood and goal-directed behaviour in psychosis. Everyday experiences of positive imagery may represent the simulation of future goals, attempts to cope or avoid aversive experiences or idealised fantasy. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE The majority of participants experienced a recent positive image with themes related to goal attainment and social relationships. Depression and social anxiety levels were correlated with the vividness of intentionally generated positive future-oriented images and their perceived likelihood. The assessment of positive imagery in early psychosis appears warranted and may provide insights regarding individual coping strategies, values and goals.
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Affiliation(s)
- Jennifer Laing
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Tristan Morland
- Early Intervention in Psychosis Services, North East London NHS Foundation Trust, London, UK
| | - Miriam Fornells-Ambrojo
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Brooks J, McCluskey S, Turley E, King N. The Utility of Template Analysis in Qualitative Psychology Research. QUALITATIVE RESEARCH IN PSYCHOLOGY 2014; 12:202-222. [PMID: 27499705 PMCID: PMC4960514 DOI: 10.1080/14780887.2014.955224] [Citation(s) in RCA: 590] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Thematic analysis is widely used in qualitative psychology research, and in this article, we present a particular style of thematic analysis known as Template Analysis. We outline the technique and consider its epistemological position, then describe three case studies of research projects which employed Template Analysis to illustrate the diverse ways it can be used. Our first case study illustrates how the technique was employed in data analysis undertaken by a team of researchers in a large-scale qualitative research project. Our second example demonstrates how a qualitative study that set out to build on mainstream theory made use of the a priori themes (themes determined in advance of coding) permitted in Template Analysis. Our final case study shows how Template Analysis can be used from an interpretative phenomenological stance. We highlight the distinctive features of this style of thematic analysis, discuss the kind of research where it may be particularly appropriate, and consider possible limitations of the technique. We conclude that Template Analysis is a flexible form of thematic analysis with real utility in qualitative psychology research.
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Affiliation(s)
- Joanna Brooks
- University of Huddersfield, Centre for Applied Psychological and Health Research, Institute for Research in Citizenship and Applied Human Sciences , Huddersfield , UK
| | - Serena McCluskey
- University of Huddersfield, Centre for Applied Psychological and Health Research, Institute for Research in Citizenship and Applied Human Sciences , Huddersfield , UK
| | - Emma Turley
- Manchester Metropolitan University, Department of Health Professions , Manchester , UK
| | - Nigel King
- University of Huddersfield, Centre for Applied Psychological and Health Research, Institute for Research in Citizenship and Applied Human Sciences , Huddersfield , UK
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Pearson DG, Deeprose C, Wallace-Hadrill SMA, Burnett Heyes S, Holmes EA. Assessing mental imagery in clinical psychology: a review of imagery measures and a guiding framework. Clin Psychol Rev 2013; 33:1-23. [PMID: 23123567 PMCID: PMC3545187 DOI: 10.1016/j.cpr.2012.09.001] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 07/13/2012] [Accepted: 09/04/2012] [Indexed: 01/03/2023]
Abstract
Mental imagery is an under-explored field in clinical psychology research but presents a topic of potential interest and relevance across many clinical disorders, including social phobia, schizophrenia, depression, and post-traumatic stress disorder. There is currently a lack of a guiding framework from which clinicians may select the domains or associated measures most likely to be of appropriate use in mental imagery research. We adopt an interdisciplinary approach and present a review of studies across experimental psychology and clinical psychology in order to highlight the key domains and measures most likely to be of relevance. This includes a consideration of methods for experimentally assessing the generation, maintenance, inspection and transformation of mental images; as well as subjective measures of characteristics such as image vividness and clarity. We present a guiding framework in which we propose that cognitive, subjective and clinical aspects of imagery should be explored in future research. The guiding framework aims to assist researchers in the selection of measures for assessing those aspects of mental imagery that are of most relevance to clinical psychology. We propose that a greater understanding of the role of mental imagery in clinical disorders will help drive forward advances in both theory and treatment.
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Van den Berg DPG, Van der Vleugel BM, Staring ABP, De Bont PAJ, Jongh AD. EMDR in Psychosis: Guidelines for Conceptualization and Treatment. JOURNAL OF EMDR PRACTICE AND RESEARCH 2013. [DOI: 10.1891/1933-3196.7.4.208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A significant proportion of clients with psychosis have experienced childhood trauma and suffer from comorbid posttraumatic stress disorder. Research indicates that exposure to distressing early life events plays an important role in the emergence and persistence of psychotic symptoms—either directly or indirectly. The Two Method Approach of EMDR conceptualization and recent findings on reprocessing of psychosis-related imagery fit with the existing cognitive models of psychosis. This article presents a series of preliminary guidelines for conceptualizing EMDR treatment in psychosis, which are based on both theory and clinical experience and are illustrated with case examples. Several obstacles and related treatment strategies for using EMDR in psychosis are described. EMDR in psychosis can very well be combined with other standard interventions such as psychotropic medication and cognitive behavioral therapy.
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