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| 2. |
- Singh, Laura, et al.
(författare)
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Developing thinking around mental health science : the example of intrusive, emotional mental imagery after psychological trauma
- 2020
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Ingår i: Cognitive Neuropsychiatry. - : Routledge. - 1354-6805 .- 1464-0619. ; 25:5, s. 348-363
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: One route to advancing psychological treatments is to harness mental health science, a multidisciplinary approach including individuals with lived experience and end users (e.g., Holmes, E. A., Craske, M. G., & Graybiel, A. M. (2014). Psychological treatments: A call for mental-health science. Nature, 511(7509), 287–289. doi:10.1038/511287a). While early days, we here illustrate a line of research explored by our group—intrusive imagery-based memories after trauma.Method/Results: We illustrate three possible approaches through which mental health science may stimulate thinking around psychological treatment innovation. First, focusing on single/specific target symptoms rather than full, multifaceted psychiatric diagnoses (e.g., intrusive trauma memories rather than all of posttraumatic stress disorder). Second, investigating mechanisms that can be modified in treatment (treatment mechanisms), rather than those which cannot (e.g., processes only linked to aetiology). Finally, exploring novel ways of delivering psychological treatment (peer-/self-administration), given the prevalence of mental health problems globally, and the corresponding need for effective interventions that can be delivered at scale and remotely for example at times of crisis (e.g., current COVID-19 pandemic).Conclusions: These three approaches suggest options for potential innovative avenues through which mental health science may be harnessed to recouple basic and applied research and transform treatment development.
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| 3. |
- Holmes, Emily A., et al.
(författare)
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Prospective and positive mental imagery deficits in dysphoria
- 2008
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Ingår i: Behaviour Research and Therapy. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0005-7967 .- 1873-622X. ; 46:8, s. 976-981
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Tidskriftsartikel (refereegranskat)abstract
- We know less about positive mental imagery than we do about negative mental imagery in depression. This study examined the relationship between depressed mood and the subjective experience of emotion in imagined events; specifically, prospective imagery, and imagery in response to emotionally ambiguous stimuli. One hundred and twenty-six undergraduates completed measures of depression, imagery vividness for future events, and a homograph interpretation task in which they generated images and subsequently rated image pleasantness and vividness. As predicted, compared to low dysphoria, high dysphoria was associated with poorer ability to vividly imagine positive (but not negative) future events. These findings were augmented by the observation that high dysphorics provided lower pleasantness ratings of images generated in response to homographs they interpreted as positive. We suggest that an imbalance in the inability to vividly imagine positive but riot negative future events may curtail the ability of high dysphorics to be optimistic. High dysphoric individuals are further disadvantaged: even when they interpret ambiguity positively, the resulting images they generate are associated with less positive affect. Therapeutic Strategies that address both such positive-specific imagery biases hold Promise for depression treatment innovation. (C) 2008 Elsevier Ltd. All rights reserved.
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| 4. |
- Hoppe, Johanna M., et al.
(författare)
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Hotspots in the immediate aftermath of trauma : Mental imagery of worst moments highlighting time, space and motion
- 2022
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Ingår i: Consciousness and Cognition. - : Elsevier. - 1053-8100 .- 1090-2376. ; 99
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Tidskriftsartikel (refereegranskat)abstract
- Intrusive memories of trauma (memories that enter consciousness involuntarily) highjack cognitive processing, cause emotional distress, and represent a core symptom of posttraumatic stress disorder. Intrusive memories often contain the worst moment/s (‘hotspots’) of the trauma memory. Little is known about hotspots shortly after they are formed, i.e., in the first hours after trauma. We investigated the features of hotspots in trauma-exposed individuals (n = 21) within 72 h post-trauma, using linguistic analysis and qualitative coding. On average, participants reported three hotspots per traumatic event (M = 7.8 words/hotspot). Hotspots primarily contained words related to time, space, motion, and sensory processing. Most hotspots contained sensory features (97%) and motion (59%). Few cognitions and no emotion words were identified. Results indicate that hotspots collected shortly post-trauma are expressed as motion-rich sensory-perceptual experiences (mental imagery) with little detail about emotion/cognition. Findings are discussed in terms of the function of hotspots (e.g., preparedness for action) and clinical implications.
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| 5. |
- Kanstrup, Marie, et al.
(författare)
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A simple cognitive task intervention to prevent intrusive memories after trauma in patients in the Emergency Department : A randomized controlled trial terminated due to COVID-19
- 2021
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Ingår i: BMC Research Notes. - : BioMed Central (BMC). - 1756-0500. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThis randomised controlled trial (RCT) aimed to investigate the effects of a simple cognitive task intervention on intrusive memories ("flashbacks") and associated symptoms following a traumatic event. Patients presenting to a Swedish emergency department (ED) soon after a traumatic event were randomly allocated (1:1) to the simple cognitive task intervention (memory cue + mental rotation instructions + computer game "Tetris" for at least 20 min) or control (podcast, similar time). We planned follow-ups at one-week, 1-month, and where possible, 3- and 6-months post-trauma. Anticipated enrolment was N = 148.ResultsThe RCT was terminated prematurely after recruiting N = 16 participants. The COVID-19 pandemic prevented recruitment/testing in the ED because: (i) the study required face-to-face contact between participants, psychology researchers, ED staff, and patients, incurring risk of virus transmission; (ii) the host ED site received COVID-19 patients; and (iii) reduced flow of patients otherwise presenting to the ED in non-pandemic conditions (e.g. after trauma). We report on delivery of study procedures, recruitment, treatment adherence, outcome completion (primary outcome: number of intrusive memories during week 5), attrition, and limitations. The information presented and limitations may enable our group and others to learn from this terminated study.
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| 6. |
- Lang, Tamara J., et al.
(författare)
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Reducing depressive intrusions via a computerized cognitive bias modification of appraisals task : Developing a cognitive vaccine
- 2009
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Ingår i: Behaviour Research and Therapy. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0005-7967 .- 1873-622X. ; 47:2, s. 139-145
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Tidskriftsartikel (refereegranskat)abstract
- A feature of depression is the distressing experience of intrusive, negative memories. The maladaptive appraisals of such intrusions have been associated with symptom persistence. This study aimed to experimentally manipulate appraisals about depressive intrusions via a novel computerized cognitive bias modification (CBM) of appraisals paradigm, and to test the impact on depressive intrusion frequency for a standardized event (a depressive film). Forty-eight participants were randomly assigned to either a session of positive or negative CBM. Participants then watched a depressing film (including scenes of bereavement and bullying) and subsequently monitored the occurrence of depressive intrusions related to the film in a diary for one week. At one-week follow-up, participants completed additional measures of intrusions - the Impact of Event Scale (IES) and an intrusion provocation task. As predicted, compared to the negative condition, participants who underwent positive CBM showed a more positive appraisal bias. Further, one week later, positive CBM participants reported fewer intrusions of the film and had lower IES scores. Our findings demonstrate that it is possible to manipulate maladaptive appraisals about depressive intrusions via a computerized CBM task. Further, this effect transfers to reducing intrusive symptomatology related to a standardized event (a depressive film) over one week, suggesting novel clinical implications. (c) 2008 Elsevier Ltd. All rights reserved.
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| 7. |
- McEvoy, Peter M., et al.
(författare)
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Assessing the efficacy of imagery-enhanced cognitive behavioral group therapy for social anxiety disorder : Study protocol for a randomized controlled trial
- 2017
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Ingår i: Contemporary Clinical Trials. - : ELSEVIER SCIENCE INC. - 1551-7144 .- 1559-2030. ; 60, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive behavior group therapy (CBGT) is effective for social anxiety disorder (SAD), but a substantial proportion of patients do not typically achieve normative functioning. Cognitive behavioral models of SAD emphasize negative self-imagery as an important maintaining factor, and evidence suggests that imagery is a powerful cognitive mode for facilitating affective change. This study will compare two group CBGT interventions, one that predominantly uses verbally-based strategies (VB-CBGT) and another that predominantly uses imagery-enhanced strategies (IE-CBGT), in terms of (a) efficacy, (b) mechanisms of change, and (c) cost-effectiveness. This study is a parallel groups (two-arm) single-blind randomized controlled trial. A minimum of 96 patients with SAD will be recruited within a public outpatient community mental health clinic in Perth, Australia. The primary outcomes will be self-reported symptom severity, caseness (SAD present: yes/no) based on a structured diagnostic interview, and clinician-rated severity and life impact. Secondary outcomes and mechanism measures include blind observer-rated use of safety behaviors, physiological activity (heart rate variability and skin conductance level) during a standardized speech task, negative self-beliefs, imagery suppression, fear of negative and positive evaluation, repetitive negative thinking, anxiety, depression, self-consciousness, use of safety behaviors, and the EQ-5D-5L and TiC-P for the health economic analysis. Homework completion, group cohesion, and working alliance will also be monitored. The outcomes of this trial will inform clinicians as to whether integrating imagery-based strategies in cognitive behavior therapy for SAD is likely to improve outcomes. Common and distinct mechanisms of change might be identified, along with relative cost-effectiveness of each intervention.
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| 8. |
- McEvoy, Peter M., et al.
(författare)
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Impacts of imagery-enhanced versus verbally-based cognitive behavioral group therapy on psychophysiological parameters in social anxiety disorder : Results from a randomized-controlled trial
- 2022
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 155
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) is associated with marked physiological reactivity in social-evaluative situations. However, objective measurement of biomarkers is rarely evaluated in treatment trials, despite potential utility in clarifying disorder-specific physiological correlates. This randomized controlled trial sought to examine the differential impact of imagery-enhanced vs. verbal-based cognitive behavioral group therapy (IE-CBGT, n = 53; VB-CBGT, n = 54) on biomarkers of emotion regulation and arousal during social stress in people with SAD (pre and post-treatment differences in heart rate variability (HRV) and skin conductance). We acquired psycho physiological data from randomized participants across four social stress test phases (baseline, speech preparation, speech, interaction) at pre-treatment, and 1-and 6-months post-treatment. Analyses revealed that IECBGT selectively attenuated heart rate as indexed by increases in median heart rate interval (median-RR) compared to VB-CBGT at post-treatment, whereas one HRV index showed a larger increase in the VB-CBGT condition before but not after controlling for median-RR. Other psychophysiological indices did not differ between conditions. Lower sympathetic arousal in the IE-CBGT condition may have obviated the need for parasympathetic downregulation, whereas the opposite was true for VB-CBGT. These findings provide preliminary insights into the impact of imagery-enhanced and verbally-based psychotherapy for SAD on emotion regulation biomarkers.
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| 9. |
- Moulds, Michelle L., et al.
(författare)
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Intrusive Imagery in Psychopathology : A Commentary
- 2011
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Ingår i: International Journal of Cognitive Therapy. - : SPRINGER INTERNATIONAL PUBLISHING AG. - 1937-1209 .- 1937-1217. ; 4:2, s. 197-207
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Spontaneous, intrusive images of negative events are commonly experienced in everyday life. In clinical disorders, this imagery is extreme: recurrently experienced, highly distressing and vivid, and capable of eliciting significant negative affect. This special issue under the editorial lead of Julie Krans presents an intriguing series of studies that examine the role of intrusive imagery in psychopathology The authors of this work have applied rigorous laboratory approaches in order to address prevailing questions about the role of intrusive phenomena in clinical conditions. The studies highlight the value of convergent evidence from the laboratory and the clinic in forwarding our understanding of this topic. Furthermore, collectively the studies speak to three key questions: (1) Must an event be experienced in order to be intrusive? (2) Do trait variables influence vulnerability to intrusion development? (3) Do encoding processes influence intrusion development? In this commentary, we reflect on the findings reported and consider them in the context of these broader themes. We discuss the ways in which the findings have scope to extend existing theoretical accounts and to inform treatment developments for disorders that are characterized by recurrent and distressing intrusions.
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| 10. |
- Newby, Jill M., et al.
(författare)
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Alleviating distressing intrusive memories in depression : A comparison between computerised cognitive bias modification and cognitive behavioural education
- 2014
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Ingår i: Behaviour Research and Therapy. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0005-7967 .- 1873-622X. ; 56, s. 60-67
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Tidskriftsartikel (refereegranskat)abstract
- Negative appraisals maintain intrusive memories and intrusion-distress in depression, but treatment is underdeveloped. This study compared the efficacy of computerised bias modification positive appraisal training (CBM) versus a therapist-delivered cognitive behavioural therapy session (CB-Education) that both aimed to target and alter negative appraisals of a negative intrusive autobiographical memory. Dysphoric participants (Mean BDI-II = 27.85; N = 60) completed baseline ratings of a negative intrusive memory, negative appraisals and the Impact of Event Scale, and were randomly allocated either one session of CBM, CB-Education, or a no intervention monitoring control condition (Control). Mood and intrusion symptoms were assessed at one week follow-up. For all groups, there were significant reductions over one week in mood (depression and anxiety), memory intrusiveness and negative appraisals. Groups differed in terms of intrusion-related distress, with the CB-Education group showing greatest reduction, followed by the CBM group. The study provides evidence for the link between maladaptive appraisals of intrusive memories and distress in depressed mood. Further, both a single session of CB-Education and (to a lesser degree) CBM are useful in reducing intrusion-related distress. This study may have been underpowered to detect differences and replication is needed with larger samples. (C) 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).
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| 11. |
- Singh, Laura, et al.
(författare)
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A first remotely-delivered guided brief intervention to reduce intrusive memories of psychological trauma for healthcare staff working during the ongoing COVID-19 pandemic : Study protocol for a randomised controlled trial
- 2022
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Ingår i: Contemporary Clinical Trials Communications. - : Elsevier BV. - 2451-8654. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- Addressing the mental health needs of healthcare staff exposed to psychologically traumatic events at work during the COVID-19 pandemic is a pressing global priority. We need to swiftly develop interventions to target the psychological consequences (e.g., persistent intrusive memories of trauma). Interventions for healthcare staff must be brief, flexible, fitted around the reality and demands of working life under the pandemic, and repeatable during ongoing/further trauma exposure. Intervention delivery during the pandemic should be remote to mitigate risk of infection; e.g., here using a blend of digitalized self-administered materials (e.g., video instructions) and guided (remote) support from a researcher. This parallel groups, two-arm, randomised controlled trial (RCT) with healthcare staff working during the COVID-19 pandemic is the first evaluation of whether a digitalized form of a brief cognitive task intervention, which is remotely-delivered (guided), reduces intrusive memories. Healthcare staff who experience intrusive memories of work-related traumatic event(s) during the COVID-19 pandemic (≥2 in the week before inclusion) will be randomly allocated (1:1) to receive either the cognitive task intervention or an active (attention placebo) control, and followed up at 1-week, 1-month, 3-months, and 6-months post-intervention. The primary outcome will be the number of intrusive memories reported during Week 5; secondary and other outcomes include the number of intrusive memories reported during Week 1, and other intrusive symptoms. Findings will inform further development and dissemination of a brief cognitive task intervention to target intrusive memories.
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| 12. |
- Singh, Laura, et al.
(författare)
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Future self-imagery of young people in Sweden during the COVID-19 pandemic : an exploratory mixed methods analysis.
- 2022
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Ingår i: Current Psychology. - : Springer Science and Business Media LLC. - 1046-1310 .- 1936-4733. ; , s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- UNLABELLED: Global restrictions imposed during the COVID-19 pandemic significantly limited the capacity to plan for the future. Little is known about young people's future self-images and the impact the COVID-19 pandemic may have had upon them. Given evidence that the ability to imagine a positive future can be protective for mental health, research into the impact of the pandemic on future self-imagery is needed. In two studies, we therefore explored the consequences of the COVID-19 pandemic for future self-imagery in an unselected sample of young people in Sweden, specifically: (a) how content and characteristics of future self-images changed from before to during the pandemic, and (b) how such change was related to trauma history, intrusive memories of COVID-19 media footage, past time perspective and optimism (assessed with questionnaires/intrusive memory diary). Future self-images before and during the pandemic were assessed using the 'I Will Be' task (N Study1=74; N Study2=99). A mixed methods design, combining quantitative analysis, qualitative content coding and thematic analysis was used. Exploratory results of Study 1 indicated that future images were rated as less positive during than before the pandemic and that this reduction was less pronounced in people with higher optimism. Results were replicated in an independent sample (Study 2, collected later during the pandemic). In conclusion, whilst the findings are preliminary and emerged from an unselected sample, they prompt the suggestion that brief, novel interventions which aim to bolster positive future imagery may hold promise as a scalable means by which to enhance mental health for young people in the context of the COVID-19 pandemic.SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-022-04100-z.
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| 13. |
- Singh, Laura, et al.
(författare)
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Using a daily diary for monitoring intrusive memories of trauma : A translational data synthesis study exploring convergent validity
- 2023
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Ingår i: International Journal of Methods in Psychiatric Research. - : John Wiley & Sons. - 1049-8931 .- 1557-0657. ; 32:1
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveIntrusive memories are a core feature of posttraumatic stress disorder and have transdiagnostic relevance across mental disorders. Establishing flexible methods to monitor intrusions, including patterns and characteristics, is a key challenge. A daily diary has been developed in experimental settings to provide symptom count data, without the need for retrospective self-report over extended time periods (e.g., 1 week, 1 month). We conducted an exploratory, pre-registered data synthesis investigating convergence between the diary and questionnaire measures of intrusive symptoms long used in clinical practice (Impact of Event Scale, IES, and revised version, IES-R, Intrusion subscale).ResultsUtilising datasets using the daily diary from 11 studies (4 real-world trauma studies, seven analogue trauma studies; total N = 578), we found significant positive associations between the diary and IES/IES-R Intrusion subscale. Exploratory analyses indicated that the magnitude of this association was stronger for the IES (vs. the IES-R), and in individuals with real-world (vs. analogue) trauma.ConclusionThis study provides first evidence of convergent validity of a daily diary for monitoring intrusions with a widely used questionnaire. A diary may be a more flexible methodology to obtain information about intrusions (frequency, characteristics, triggers, content), relative to questionnaires which rely on retrospective reporting of symptoms over extended timeframes. We discuss potential benefits of daily monitoring of intrusions in clinical and research contexts.
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