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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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Endhoven B, De Cort K, Matthijssen SJMA, de Jongh A, van Minnen A, Duits P, Schruers KRJ, van Dis EAM, Krypotos AM, Gerritsen L, Engelhard IM. Eye movement desensitization and reprocessing (EMDR) therapy or supportive counseling prior to exposure therapy in patients with panic disorder: study protocol for a multicenter randomized controlled trial (IMPROVE). BMC Psychiatry 2023; 23:157. [PMID: 36918861 PMCID: PMC10011792 DOI: 10.1186/s12888-022-04320-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/18/2022] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Exposure-based therapy is the treatment of choice for anxiety disorders, but many patients do not benefit sufficiently from it. Distressing images of threat related to the future or past may maintain the anxiety symptomatology or impede exposure therapy. An intervention that targets threat-related imagery is eye movement desensitization and reprocessing (EMDR) therapy. The main goal of this multicenter randomized controlled trial is to investigate whether EMDR therapy plus exposure therapy, relative to supportive counseling plus exposure therapy, improves treatment efficacy, tolerability, and adherence in patients with panic disorder. In addition, we will examine potential predictors of optimal treatment allocation, mechanisms of change as well as the long term effects of treatment. Finally, we will assess cost-effectiveness. METHODS A multicenter randomized controlled trial mixed design will be conducted. Participants will be 50 patients, aged ≥ 18, diagnosed with a panic disorder. They will be randomly assigned to one of two conditions: EMDR therapy (i.e., flashforward strategy) or supportive counseling (each consisting of four weekly sessions of 90 min each) prior to exposure therapy (consisting of eight weekly sessions of 90 min each). Assessments will be made pre-treatment (T1), between-treatments (T2), post-treatment (T3), one month post-treatment (FU1) and six months post-treatment (FU2) by an assessor blind to treatment condition. The primary outcome measure is severity of panic-related symptoms. Secondary outcome measures are: tolerability of exposure therapy (initial avoidance, willingness to start exposure therapy, considered drop-out; no-show and drop-out), related symptomatology (generalized anxiety, depression), and functional impairment. DISCUSSION The primary goals of this research are to compare the efficacy, tolerability, and adherence of EMDR therapy plus exposure therapy and supportive counseling plus exposure therapy and to identify predictors, moderators, and mediators for treatment success. This multi-center research aims to make a significant contribution to our understanding as to how treatment for patients with anxiety disorders can be optimized, and elucidate who can benefit most from this novel approach. TRIAL REGISTRATION ISRCTN-ISRCTN29668369: Improving anxiety treatment by modifying emotional memories before real-life exposure. Registered 27 June 2022-retrospectively registered. ISRCTN-ISRCTN29668369.
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Affiliation(s)
- Bart Endhoven
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.
- Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands.
| | - Klara De Cort
- Academic Anxiety Center, Mondriaan/PsyQ, Oranjeplein 10, 6624 KD, Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616, 6200MD, Maastricht, The Netherlands
| | - Suzy J M A Matthijssen
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
- Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands
| | - Ad de Jongh
- PSYTREC, Professor Bronkhorstlaan 2, 3723 MB, Bilthoven, The Netherlands
- Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Agnes van Minnen
- PSYTREC, Professor Bronkhorstlaan 2, 3723 MB, Bilthoven, The Netherlands
- Behavioural Science Institute, Radboud University, PO Box 9104, 6500HE, Nijmegen, The Netherlands
| | - Puck Duits
- Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands
| | - Koen R J Schruers
- Academic Anxiety Center, Mondriaan/PsyQ, Oranjeplein 10, 6624 KD, Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616, 6200MD, Maastricht, The Netherlands
- Research Group Health Psychology, PO Box 3726, 3000, Leuven, KU, Belgium
| | - Eva A M van Dis
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Angelos M Krypotos
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
- Research Group Health Psychology, PO Box 3726, 3000, Leuven, KU, Belgium
| | - Lotte Gerritsen
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Iris M Engelhard
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
- Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands
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Carona C, Ramos K, Salvador C. Psychotherapy by Reciprocal Inhibition: Wolpe's unique legacy to the evolution of cognitive–behavioural therapy. BJPSYCH ADVANCES 2022. [DOI: 10.1192/bja.2022.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
SUMMARY
The book Psychotherapy by Reciprocal Inhibition (1968) is widely acclaimed as the masterwork of Joseph Wolpe, a great pioneer in the development of behavioural therapy, and is considered one of the most influential books in the history of clinical psychology. In this article, a brief biography of Wolpe is followed by a critical review of the book that illustrates his major contributions to the evolution of cognitive–behavioural therapy (CBT) as the most empirically supported model of psychotherapy.
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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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Heise M, Werthmann J, Murphy F, Tuschen-Caffier B, Renner F. Imagine How Good That Feels: The Impact of Anticipated Positive Emotions on Motivation for Reward Activities. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10306-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract
Background
Disease burden and unsatisfactory treatment outcomes call for innovation in treatments of depression. Prospective mental imagery, i.e. future-directed voluntary imagery-based thought, about potentially-rewarding activities may offer a mechanistically-informed intervention that targets deficits in reward processing, a core clinical feature of depression. We propose that the previously described impact of prospective mental imagery on motivation for everyday activities is facilitated by affective forecasting, i.e. predictions about an individual’s emotional response to the imagined activities.
Methods
Participants (N = 120) self-nominated six activities to engage in over the following week and were randomized to either: (1) an affective forecasting imagery condition (n = 40); (2) a neutral process imagery condition (n = 40); or (3) a no-imagery control condition (n = 40).
Results
As predicted, increases in motivation ratings from pre to post experimental manipulation were significantly higher following affective forecasting imagery compared to both neutral process imagery (d = 0.62) and no-imagery (d = 0.91). Contrary to predictions, the number of activities participants engaged in did not differ between conditions.
Conclusions
Results provide initial evidence for a potentially important role of affective forecasting in prospective mental imagery. We discuss how these findings can inform future research aiming to harness prospective mental imagery’s potential for clinical applications.
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Landkroon E, van Dis EAM, Meyerbröker K, Salemink E, Hagenaars MA, Engelhard IM. Future-Oriented Positive Mental Imagery Reduces Anxiety for Exposure to Public Speaking. Behav Ther 2022; 53:80-91. [PMID: 35027160 DOI: 10.1016/j.beth.2021.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 12/25/2022]
Abstract
Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticipatory anxiety and distress during exposure, and increases exposure willingness and duration. Forty-three individuals with moderate public speaking anxiety were randomized to a standardized positive mental imagery exercise about future public speaking or no-task. All participants were then asked to present in a virtual reality environment. Anticipatory anxiety reduced in the positive mental imagery group, but not in the control group. Additionally, the positive mental imagery group reported lower distress during exposure than the control group, but groups did not differ in exposure willingness. Due to limited variance, effects on exposure duration could not be tested. Future-oriented positive mental imagery is promising to prepare individuals for exposure to previously avoided situations.
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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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9
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Attitudes and applications of chairwork amongst CBT therapists: a preliminary survey. COGNITIVE BEHAVIOUR THERAPIST 2021. [DOI: 10.1017/s1754470x21000052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Chairwork refers to a collection of experiential interventions which utilise chairs, their positioning, movement, and dialogue to facilitate therapeutic change. Chair-based methods are used in several models of psychotherapy, including cognitive behavioural therapy (CBT). However, little is known about cognitive behavioural therapists’ use and attitudes towards chairwork. A mixed methods survey was conducted of 102 therapists who provided CBT. Overall, training in chairwork was weak amongst CBT therapists (35%). Quantitative results indicated that most therapists perceived chairwork to be clinically effective and consistent with the cognitive behavioural model, but did not feel competent using these methods. Perceived competence was highest amongst therapists who had been trained in chairwork and practised it frequently, but was unrelated to CBT accreditation or clinical experience. Qualitative feedback identified a number of factors that encouraged the use of chairwork (e.g. overcoming limitations associated with verbal restructuring methods), as well as inhibitors (e.g. therapist anxiety and limited access to training). These preliminary findings highlight a need for further research relating to cognitive behavioural chairwork and suggest that increased training in experiential interventions could go some way towards improving outcomes in CBT.
Key learning aims
As a result of reading this paper, readers should:
(1)
Understand cognitive behavioural therapists’ attitudes towards chairwork.
(2)
Appreciate therapists’ anxiety and avoidance in relation to chairwork.
(3)
Identify the key factors that facilitate or inhibit the use of cognitive behavioural chairwork.
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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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Pérez-Fabello MJ, Campos A. Spanish Version of the Plymouth Sensory Imagery Questionnaire. Front Psychol 2020; 11:916. [PMID: 32670126 PMCID: PMC7326069 DOI: 10.3389/fpsyg.2020.00916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Objective The current interest in mental imagery in fields such as sport and physical training, health, education, underscore the need for designing general measures of imagery vividness that include different sensorial modalities such as the Plymouth Sensory Imagery Questionnaire (Psi-Q; Andrade et al., 2014). The Psi-Q measures imagery vividness in seven sensorial modalities with a factorial structure of seven factors corresponding to the sensorial modalities, and has good internal consistency. The aim of the present study was to translate the Psi-Q into Spanish and to assess its psychometric properties. Methods The questionnaire was back-translated, and administered to 394 fine arts undergraduates. Moreover, this test was compared to other questionnaires measuring different types de imagery. Results A confirmatory factor analysis found that the Psi-Q had seven factors (vision, sound, smell, taste, touch, bodily sensation, and emotional feeling) with results similar to the original test. Values suggested a better fit for the model of the short version. The internal consistency values were 0.93 for the long and 0.89 for the short test. The Psi-Q subscales correlated significantly (p < 0.01) with the total of the Betts' QMI subscales, and the VVIQ, with the highest significance observed between the Psi-Q Touch and Betts' QMI Cutaneous (r = -0.57), and between the Psi-Q Olfactory and Betts' QMI Smell (r = -0.56). Owing to its novelty, the high correlation and significance (p < 0.01) between Psi-Q Vision and the OSIVQ Object (r = 0.36) is worth noting. Conclusion The Spanish version of the Psi-Q was an adequate measure for evaluating different sensorial modalities of imagery vividness, and exhibited similar psychometric properties to those of the original version. The growing interest in mental imagery in different fields of application justifies the need for adapting the Psi-Q for the Spanish speaking population. This questionnaire is a valuable tool for the understanding of imagery as a psychological process, and as a variable influencing other processes.
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Affiliation(s)
| | - Alfredo Campos
- Department of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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