Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T22:27:42.278Z Has data issue: false hasContentIssue false

Imagery rescripting in non-clinical paranoia: a pilot study of the impact on key cognitive and affective processes

Published online by Cambridge University Press:  15 July 2019

Katherine Newman-Taylor*
Affiliation:
Psychology Department, University of Southampton, Shackleton Building, Highfield Campus, Southampton SO17 1BJ, UK
Pamela McSherry
Affiliation:
Psychology Department, University of Southampton, Shackleton Building, Highfield Campus, Southampton SO17 1BJ, UK
Lusia Stopa
Affiliation:
Psychology Department, University of Southampton, Shackleton Building, Highfield Campus, Southampton SO17 1BJ, UK
*
*Corresponding author. Email: [email protected]

Abstract

Background:

Paranoia is often accompanied by distressing intrusions associated with traumatic memories, yet one of the best-evidenced interventions, imagery rescripting (IR), is not routinely offered. This is likely to be due to poor understanding of the effects of IR on postulated mechanisms of change as well as the absence of a robust evidence base.

Aims:

This study aimed to establish proof of principle that IR impacts key cognitive-affective processes associated with distressing intrusions – memory characteristics and self-representations – and level of paranoia.

Method:

We used a within-subject repeated measures design to examine the effect of single-session IR on memory characteristics (level of intrusions, vividness, distress, encapsulated belief strength, emotion intensity and frequency), self-representation variables, affect and paranoia. Fifteen participants were seen once before and once after the IR session, to gather baseline and follow-up data.

Results:

As predicted, participants reported reductions in memory characteristics, improved self-esteem and positive affect, and reduced negative affect and paranoia, with large effect sizes. These effects were maintained at follow-up.

Conclusions:

While a within-subject design is useful for initial exploration of novel interventions, controlled studies are needed to determine causality. This is the first study to examine mechanisms of IR in paranoia. A controlled trial is now warranted.

Type
Main
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arntz, A. (2011). Imagery rescripting for personality disorders. Cognitive and Behavioral Practice, 18, 466481.CrossRefGoogle Scholar
Arntz, A. (2012). Imagery rescripting as a therapeutic technique: review of clinical trials, basic studies and research agenda. Journal of Experimental Psychopathology, 3, 189208.CrossRefGoogle Scholar
Arntz, A., Sofi, D., & van Breukelen, G. (2013). Imagery rescripting as treatment for complicated PTSD in refugees: a multiple baseline case series study. Behaviour Research and Therapy, 51, 274283.CrossRefGoogle ScholarPubMed
Arntz, A., & Weertman, A. (1999). Treatment of childhood memories: theory and practice. Behaviour Research and Therapy, 37, 715740.CrossRefGoogle ScholarPubMed
Bebbington, P. E., McBride, O., Steel, C., Kuipers, E., Radovanoviⓒ, M., Brugha, T., … Freeman, D. (2013). The structure of paranoia in the general population. The British Journal of Psychiatry, 202, 419427.CrossRefGoogle ScholarPubMed
Beck, J. G., Grant, D. M., Read, J., Clapp, J., Coffey, S., Miller, L. M., & Palyo, S. A. (2008). The impact of event scale– revised: psychometric properties in a sample of motor vehicle accident survivors. Journal of Anxiety Disorders, 22, 187198.CrossRefGoogle Scholar
Bendall, S., Jackson, H. J., Hulbert, C. A., & McGorry, P. D. (2008). Childhood trauma and psychotic disorders: a systematic, critical review of the evidence. Schizophrenia Bulletin, 34, 568579.CrossRefGoogle Scholar
Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489498.CrossRefGoogle ScholarPubMed
Brand, R. M., McEnery, C., Rossell, S., Bendall, S., & Thomas, N. (2018). Do trauma-focussed psychological interventions have an effect on psychotic symptoms? A systematic review and meta-analysis. Schizophrenia Research, 195, 1322.CrossRefGoogle ScholarPubMed
Brewin, C. R. (2006). Understanding cognitive behaviour therapy: a retrieval competition account. Behaviour Research and Therapy, 44, 765784.CrossRefGoogle ScholarPubMed
Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychological Review, 117, 210232.CrossRefGoogle ScholarPubMed
Brewin, C. R., Wheatley, J., Patel, T., Fearon, P., Hackmann, A., Wells, A., …& Myers, A. (2009). Imagery rescripting as a brief stand-alone treatment for depressed patients with intrusive memories. Behaviour Research and Therapy, 47, 569576.CrossRefGoogle ScholarPubMed
Çili, S., Pettit, S., & Stopa, L. (2017). Impact of imagery rescripting on adverse self-defining memories and post-recall working selves in a non-clinical sample: a pilot study. Cognitive Behaviour Therapy, 46, 7589.CrossRefGoogle Scholar
Crawford, J. R., & Henry, J. D. (2004). The positive and negative affect schedule (PANAS): construct validity, measurement properties and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 43, 245265.CrossRefGoogle Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155159 CrossRefGoogle ScholarPubMed
Cutajar, M. C., Mullen, P. E., Ogloff, J. R., Thomas, S. D., Wells, D. L., & Spataro, J. (2010). Schizophrenia and other psychotic disorders in a cohort of sexually abused children. Archives of General Psychiatry, 67, 11141119.CrossRefGoogle Scholar
Dibbets, P., & Arntz, A. (2016). Imagery rescripting: is incorporation of the most aversive scenes necessary? Memory, 24, 683695.CrossRefGoogle ScholarPubMed
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power: a flexible statistical power analysis program for the social, behavioral and biomedical sciences. Behavior Research Methods, 39, 175191.CrossRefGoogle ScholarPubMed
Fenigstein, A., & Vanable, P. A. (1992). Paranoia and self-consciousness. Journal of Personality and Social Psychology, 62, 129138.CrossRefGoogle ScholarPubMed
Freeman, D., Bradley, J., Waite, F., Sheaves, B., DeWeever, N., Bourke, E., … & Garety, P. (2016). Targeting recovery in persistent persecutory delusions: a proof of principle study of a new translational psychological treatment (the Feeling Safe Programme). Behavioural and Cognitive Psychotherapy, 44, 539552.CrossRefGoogle Scholar
Garety, P. A., & Freeman, D. (2013). The past and future of delusions research: from the inexplicable to the treatable. British Journal of Psychiatry, 203, 327333.CrossRefGoogle ScholarPubMed
Hackmann, A., & Holmes, E. A. (2004). Reflecting on imagery: a clinical perspective and overview of the special issue of memory on mental imagery and memory in psychopathology. Memory, 12, 389402.CrossRefGoogle ScholarPubMed
Hackmann, A., Surawy, C., & Clark, D. M. (1998). Seeing yourself through others’ eyes: a study of spontaneously occurring images in social phobia. Behavioural and Cognitive Psychotherapy, 26, 312.CrossRefGoogle Scholar
Hardy, A. (2017). Pathways from trauma to psychotic experiences: a theoretically informed model of posttraumatic stress in psychosis. Frontiers in Psychology, 8, 697.CrossRefGoogle ScholarPubMed
Heatherton, T. F., & Polivy, J. (1991). Development and validation of a scale for measuring state self-esteem. Journal of Personality and Social Psychology, 60, 895910.CrossRefGoogle Scholar
Holmes, E. A., & Mathews, A. (2010). Mental imagery in emotion and emotional disorders. Clinical Psychology Review, 30, 349362.CrossRefGoogle ScholarPubMed
Ison, R., Medoro, L., Keen, N., & Kuipers, E. (2014). The use of rescripting imagery for people with psychosis who hear voices. Behavioural and Cognitive Psychotherapy, 42, 129142.CrossRefGoogle ScholarPubMed
Jones, C., Hacker, D., Cormac, I., Meaden, A., & Irving, C. B. (2012). Cognitive behaviour therapy versus other psychosocial treatments for schizophrenia. Cochrane Database of Systematic Reviews, 18(4), CD008712.Google Scholar
Jones, C., Hacker, D., Meaden, A., Cormac, I., Irving, C. B., Xia, J., Zhao, S., Shi, C., & Chen, J. (2018). Cognitive behavioural therapy plus standard care versus standard care plus other psychosocial treatments for people with schizophrenia. Cochrane Database of Systematic Reviews, 11, CD008712. doi: 10.1002/14651858.CD008712.pub3 Google ScholarPubMed
Keen, N., Hunter, E. C. M., & Peters, E. (2017). Integrated trauma-focused cognitive-behavioural therapy for post-traumatic stress and psychotic symptoms: a case-series study using imaginal reprocessing strategies. Frontiers in Psychiatry, 8. doi: 10.3389/fpsyt.2017.00092 CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.CrossRefGoogle ScholarPubMed
Lee, S. W., & Kwon, J. H. (2013). The efficacy of imagery rescripting (IR) for social phobia: a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 44, 351360.CrossRefGoogle ScholarPubMed
McFarland, C., & Ross, M. (1982). Impact of causal attributions on affective reactions to success and failure. Journal of Personality and Social Psychology, 43, 937946.CrossRefGoogle Scholar
Matheson, S. L., Shepherd, A. M., Pinchbeck, R. M., Laurens, K. R., & Carr, V. J. (2013). Childhood adversity in schizophrenia: a systematic meta-analysis. Psychological Medicine, 43, 225238.CrossRefGoogle ScholarPubMed
Morina, N., Lancee, J., & Arntz, A. (2017). Imagery rescripting as a clinical intervention for aversive memories: a meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 55, 615.CrossRefGoogle ScholarPubMed
Morrison, A. (2004). The use of imagery in cognitive therapy for psychosis: a case example. Memory, 12, 517524.CrossRefGoogle ScholarPubMed
Morrison, A. P., Beck, A. T., Glenworth, D., Dunn, H., Reid, G. S., Larkin, W., & Williams, S. (2002). Imagery and psychotic symptoms: a preliminary investigation. Behaviour Research and Therapy, 40, 10531062.CrossRefGoogle ScholarPubMed
Morrison, A. P., Frame, L., & Larkin, W. (2003). Relationships between trauma and psychosis: a review and integration. British Journal of Clinical Psychology, 42, 331353.CrossRefGoogle Scholar
Nezlek, J. B., & Plesko, R. M. (2001). Day-to-day relationships among self-concept clarity, self-esteem, daily events, and mood. Personality and Social Psychology Bulletin, 27, 201211.CrossRefGoogle Scholar
Nilsson, J., Lundh, L., & Viborg, G. (2012). Imagery rescripting of early memories in social anxiety disorder: an experimental study. Behaviour Research and Therapy, 50, 387392.CrossRefGoogle ScholarPubMed
Read, J., van Os, J., Morrison, A., & Ross, C. A. (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112, 330350.CrossRefGoogle ScholarPubMed
Ronald, A., Sieradzka, D., Cardno, A., Haworth, C., McGuire, P., & Freeman, D. (2014). Characterization of psychotic experiences in adolescence using the Specific Psychotic Experiences Questionnaire (SPEQ): findings from a study of 5000 16 year old twins. Schizophrenia Bulletin, 40, 868877.CrossRefGoogle ScholarPubMed
Salter, C., Parker, E., Brown, G., Leithy, S., & Wheatley, J. (2015). Imagery rescripting coding framework and manual. Unpublished manuscript.Google Scholar
Schulze, K., Freeman, D., Green, C., & Kuipers, E. (2013). Intrusive mental imagery in patients with persecutory delusions. Behaviour Research and Therapy, 51, 714.CrossRefGoogle ScholarPubMed
Serruya, G., & Grant, P. (2009). Cognitive-behavioral therapy of delusions: mental imagery within a goal directed framework. Journal of Clinical Psychology, 65, 791802.CrossRefGoogle ScholarPubMed
Sheaves, B., Onwumere, J., Keen, N., & Kuipers, E. (2015). Treating your worst nightmare: a case-series of imagery rehearsal therapy for nightmares in individuals experiencing psychotic symptoms. The Cognitive Behaviour Therapist, 8, e27.CrossRefGoogle Scholar
Sitko, K., Bentall, R. P., Shevlin, M., & Sellwood, W. (2014). Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey. Psychiatry Research, 217, 202209.CrossRefGoogle ScholarPubMed
Smucker, M. R., Dancu, C. V., Foa, E. B., & Niederee, J. L. (1995). Imagery rescripting: a new treatment for survivors of childhood sexual abuse suffering from post-traumatic stress. Journal of Cognitive Psychotherapy: An International Quarterly, 9, 317.CrossRefGoogle Scholar
Spitzer, R., Kroenke, K., & Williams, J. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. Journal of the American Medical Association, 282, 17371744.CrossRefGoogle ScholarPubMed
SPSS (2015). SPSS base user’s guide. Chicago, IL, USA: SPSS Inc.Google Scholar
Taylor, C. D. J., Bee, P. E., Kelly, J., & Haddock, G. (2018). iMAgery focused therapy for persecutory delusions in PSychosis (iMAPS): a novel treatment approach. Cognitive and Behavioural Practice. doi: 10.1016/j.cbpra.2018.10.002 CrossRefGoogle Scholar
Teasdale, J. D. (1993). Emotion and two kinds of meaning: cognitive therapy and applied cognitive science. Behaviour Research and Therapy, 31, 339354.CrossRefGoogle ScholarPubMed
Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W. et al. (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin, 38, 661671.CrossRefGoogle ScholarPubMed
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54, 10631070.CrossRefGoogle ScholarPubMed
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Retrieved from the National Centre for PTSD website: http://www.ptsd.va.gov Google Scholar
Weiss, D. S., & Marmar, C. R. (1997). The Impact of Event Scale – Revised. In Wilson, J., and Keane, T. M. (eds). Assessing Psychological Trauma and PTSD (pp. 399411). New York, USA: Guilford Press.Google Scholar
Wickham, S., & Bentall, R. (2016). Are specific early-life adversities associated with specific symptoms of psychosis?: a patient study considering just world beliefs as a mediator. Journal of Nervous and Mental Disease, 204, 606.CrossRefGoogle ScholarPubMed
Wild, J., Hackmann, A., & Clark, D. M. (2008). Rescripting early memories linked to negative images in social phobia: a pilot study. Behavior Therapy, 39, 4756.CrossRefGoogle ScholarPubMed
van Os, J., Hanssen, M., Bijl, R.V., & Ravelli, A. (2000). Strauss (1969) revisited: a psychosis continuum in the general population. Schizophrenia Research, 45, 1120.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.