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Imagine food, weight and shape: mental imagery in women with eating disorders compared with healthy controls

Published online by Cambridge University Press:  14 September 2020

Kim Hijne ,
Suzan Ben Chamach  and
Alexandra E. Dingemans Open the ORCID record for Alexandra E. Dingemans [Opens in a new window]
Kim Hijne
Affiliation:
Rivierduinen Eating Disorders Ursula, PO Box 405, 2300AKLeiden, The Netherlands
Suzan Ben Chamach
Affiliation:
Rivierduinen Eating Disorders Ursula, PO Box 405, 2300AKLeiden, The Netherlands
Alexandra E. Dingemans*
Affiliation:
Rivierduinen Eating Disorders Ursula, PO Box 405, 2300AKLeiden, The Netherlands Institute of Psychology, Leiden University, 2333AKLeiden, The Netherlands
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

Research into mental disorders has found mental imagery to be a maintaining factor for psychological distress. However, studies investigating mental imagery in eating disorders are scarce.

Aim:

The aim of the present study was to compare spontaneous mental imagery related to eating, weight and/or appearance and intrusive prospective imagery in women with an eating disorder with female healthy controls.

Methods:

Spontaneous mental imagery and intrusive prospective imagery were assessed in adult women with an eating disorder (n = 29) and in female healthy controls (n = 32) using a semi-structured interview and the Impact of Future Events Scale, respectively.

Results:

In comparison with healthy controls, the spontaneous mental images in individuals with an eating disorder involved more sensory modalities (U = 156.50, p < .001, r = –.51), were more vivid (t (52) = 2.04, p = .047, d = .55), negative (U = 103.00, p < .001, r = –.62), and anxiety provoking (U = 158.50, p < .001, r = –.49), and were experienced with a lower sense of control (U = 215.00, p = .009, r = –.36). The emotional impact of intrusive prospective imagery (U = 105.00, p < .001, r = –.66) was also higher in individuals with an eating disorder, as was the number of negative prospective images (U = 283.00, p = .016, r = –.31).

Conclusions:

Our findings are consistent with previous research on mental imagery in other psychiatric disorders, and provide possibilities for incorporating imagery-based techniques in treatment interventions.

Keywords

eating disordermental imageryprospective imagerypost-traumatic stress disorder
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 3 , May 2021 , pp. 328 - 339
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Aardoom, J. J., Dingemans, A. E., Slof Op’t Landt, M. C. T., & van Furth, E. F. (2012). Norms and discriminative validity of the Eating Disorder Examination Questionnaire (EDE-Q). Eating Behaviors, 13, 305–309. https://doi.org/10.1016/j.eatbeh.2012.09.002 CrossRefGoogle Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn). Arlington, VA, USA: American Psychiatric Publishing.Google Scholar
Arntz, A. (2012). Imagery rescripting as a therapeutic technique: review of clinical trials, basic studies, and research agenda. Journal of Experimental Psychopathology, 3, 189–208. https://doi.org/10.5127/jep.024211 CrossRefGoogle Scholar
Bloomgarden, A. & Calogero, R. M. (2008). A randomized experimental test of the efficacy of EMDR treatment on negative body image in eating disorder inpatients. Eating Disorders, 16, 418–427. https://doi.org/10.1080/10640260802370598 CrossRefGoogle ScholarPubMed
Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: focus on PTSD. Eating Disorders, 15, 285–304. https://doi.org/10.1080/10640260701454311 CrossRefGoogle ScholarPubMed
Brewin, C. R. (2015). Re-experiencing traumatic events in PTSD: new avenues in research on intrusive memories and flashbacks. European Journal of Psychotraumatology, 6, 27180. https://doi.org/10.3402/ejpt.v6.27180 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, 210–232. https://doi.org/10.1037/a0018113 CrossRefGoogle ScholarPubMed
Cooper, M. J. (2009). Imagery and the negative self in eating disorders. In Stopa, L. (ed), Imagery and the Threatened Self: Perspectives on Mental Imagery and the Self in Cognitive Therapy (pp. 181–205). East Sussex, UK: Routledge.Google Scholar
Cooper, M. J., Todd, G., & Turner, H. (2007). The effects of using imagery to modify core emotional beliefs in bulimia nervosa: an experimental pilot study. Journal of Cognitive Psychotherapy, 21, 117–122. https://doi.org/10.1891/088983907780851577 CrossRefGoogle Scholar
Day, S., Holmes, E., & Hackmann, A. (2004). Occurrence of imagery and its link with early memories in agoraphobia. Memory, 12, 416–427. https://doi.org/10.1080/09658210444000034 CrossRefGoogle ScholarPubMed
Deeprose, C. & Holmes, E. A. (2010). An exploration of prospective imagery: the Impact of Future Events Scale. Behavioural and Cognitive Psychotherapy, 38, 201–209. https://doi.org/10.1017/S1352465809990671 CrossRefGoogle ScholarPubMed
Deeprose, C., Malik, A., & Holmes, E. A. (2011). Measuring intrusive prospective imagery using the Impact of Future Events Scale (IFES): psychometric properties and relation to risk for bipolar disorder. International Journal of Cognitive Therapy, 4, 187–196. https://doi.org/10.1521/ijct.2011.4.2.187 CrossRefGoogle ScholarPubMed
Di Simplicio, M., Renner, F., Blackwell, S. E., Mitchell, H., Stratford, H. J., Watson, P., Myers, N., Nobre, A. C., Lau-Zhu, A., & Holmes, E. A. (2016). An investigation of mental imagery in bipolar disorder: exploring ‘the mind’s eye’. Bipolar Disorders, 18, 669–683. https://doi.org/10.1111/bdi.12453 CrossRefGoogle Scholar
Dugué, R., Keller, S., Tuschen-Caffier, B., & Jacob, G. A. (2016). Exploring the mind’s eye: contents and characteristics of mental images in overweight individuals with binge eating behaviour. Psychiatry Research, 246, 554–560. https://doi.org/10.1016/j.psychres.2016.10.028 CrossRefGoogle ScholarPubMed
Fairburn, C. G. & Beglin, S. J. (2008). Eating Disorder Examination Questionnaire (EDE-Q 6.0). In Fairburn, C. G. (ed), Cognitive Behavior Therapy and Eating Disorders (pp. 309–313). New York, NY, USA: Guilford Press.Google ScholarPubMed
Fairburn, C. G. & Cooper, Z. (1993). The Eating Disorder Examination. In Fairburn, C. G. & Wilson, G. T. (eds), Binge Eating: Nature, Assessment and Treatment (pp. 317–360). New York, NY, USA: Guilford Press.Google Scholar
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy, 41, 509–528. https://doi.org/10.1016/S0005-7967(02)00088-8 CrossRefGoogle ScholarPubMed
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991). Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715–723. https://doi.org/10.1037/0022-006x.59.5.715 CrossRefGoogle ScholarPubMed
Godley, J., Tchanturia, K., MacLeod, A., & Schmidt, U. (2001). Future-directed thinking in eating disorders. British Journal of Clinical Psychology, 40, 281–296. https://doi.org/10.1348/014466501163698 CrossRefGoogle ScholarPubMed
Goldberg, D. & Williams, P. (1988). A User’s Guide to the General Health Questionnaire. Windsor, UK: NFER-Nelson.Google Scholar
Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601–610. https://doi.org/10.1016/S0005-7967(99)00161-8 CrossRefGoogle ScholarPubMed
Hackmann, A. & Holmes, E. (2004). Reflecting on imagery: a clinical perspective and overview of the special issue of Memory on mental imagery and memory in psychopathology. Memory, 12, 389–402. https://doi.org/10.1080/09658210444000133 CrossRefGoogle ScholarPubMed
Hilbert, A., Hoek, H. W., & Schmidt, R. (2017). Evidence-based clinical guidelines for eating disorders: international comparison. Current Opinion in Psychiatry, 30, 423–437. https://doi.org/10.1097/YCO.0000000000000360 CrossRefGoogle ScholarPubMed
Hinrichsen, H., Morrison, T., Waller, G., & Schmidt, U. (2007). Triggers of self-induced vomiting in bulimic disorders: the roles of core beliefs and imagery. Journal of Cognitive Psychotherapy, 21, 261–272. https://doi.org/10.1891/088983907781494528 CrossRefGoogle Scholar
Holmes, E. A., Deeprose, C., Fairburn, C. G., Wallace-Hadrill, S. M. A., Bonsall, M. B., Geddes, J. R., & Goodwin, G. M. (2011). Mood stability versus mood instability in bipolar disorder: a possible role for emotional mental imagery. Behaviour Research and Therapy, 49, 707–713. https://doi.org/10.1016/j.brat.2011.06.008 CrossRefGoogle ScholarPubMed
Holmes, E. A. & Mathews, A. (2010). Mental imagery in emotion and emotional disorders. Clinical Psychology Review, 30, 349–362. https://doi.org/10.1016/j.cpr.2010.01.001 CrossRefGoogle ScholarPubMed
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209–218. https://doi.org/10.1097/00006842-197905000-00004 CrossRefGoogle ScholarPubMed
Hovens, J. E., Bramsen, I., & van der Ploeg, H. M. (2002). Self-rating inventory for posttraumatic stress disorder: review of the psychometric properties of a new brief Dutch screening instrument. Perceptual and Motor Skills, 94, 996–1008. https://doi.org/10.2466/pms.2002.94.3.996 CrossRefGoogle ScholarPubMed
Hovens, J. E., Bramsen, I., van der Ploeg, H. M., & Reuling, I. E. (2000). Test-retest reliability of the trauma and life events self-report inventory. Psychological Reports, 87, 750–752. https://doi.org/10.2466/pr0.2000.87.3.750 CrossRefGoogle ScholarPubMed
IBM Corporation (2013) IBM SPSS Statistics for Windows, version 22.0. Armonk, NY, USA: IBM Corporation.Google Scholar
Jansen, A. (2000). Eating Disorder Examination (EDE 12.0). Interview ter vaststelling van de specifieke psychopathologie van eetstoornissen. Lisse, the Netherlands: Swets & Zeitlinger.Google Scholar
Kadriu, F., Claes, L., Witteman, C., Norré, J., Vrieze, E., & Krans, J. (2019). Characteristics and content of intrusive images in patients with eating disorders. European Eating Disorders Review, 27, 495–506. https://doi.org/10.1002/erv.2671 CrossRefGoogle ScholarPubMed
Keel, P. K. & Brown, T. A. (2010). Update on course and outcome in eating disorders. International Journal of Eating Disorders, 43, 195–204. https://doi.org/10.1002/eat.20810 Google ScholarPubMed
Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E., Endicott, J., McDonald-Scott, P., & Andreasen, N. C. (1987). The Longitudinal Interval Follow-up Evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540–548. https://doi.org/10.1001/archpsyc.1987.01800180050009 CrossRefGoogle ScholarPubMed
Koeter, M. W. J. & Ormel, J. (1991). General Health Questionnaire: Dutch Manual. Lisse, the Netherlands: Swets & Zeitlinger.Google Scholar
Kosslyn, S. M., Ganis, G., & Thompson, W. L. (2001). Neural foundations of imagery. Nature Reviews Neuroscience, 2, 635–642. https://doi.org/10.1038/35090055 CrossRefGoogle ScholarPubMed
Krämer, B. (1996). LIFE II based Eating Disorders Interview, LIFE-II-BEI. Revised version of the LIFE Eat II, adapted for the German multi center study on eating disorders. Stuttgart, Germany: Centre for Psychotherapy Research.Google Scholar
Libby, L. K., Shaeffer, E. M., Eibach, R. P., & Slemmer, J. A. (2007). Picture yourself at the polls: visual perspective in mental imagery affects self-perception and behavior. Psychological Science, 18, 199–203. https://doi.org/10.1111/j.1467-9280.2007.01872.x CrossRefGoogle ScholarPubMed
Linardon, J., Wade, T. D., de la Piedad Garcia, X., & Brennan, L. (2017). The efficacy of cognitive-behavioral therapy for eating disorders: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 85, 1080–1094. https://doi.org/10.1037/ccp0000245 CrossRefGoogle ScholarPubMed
Malcolm, C. P., Picchioni, M. M., & Ellett, L. (2015). Intrusive prospective imagery, posttraumatic intrusions and anxiety in schizophrenia. Psychiatry Research, 230, 899–904. https://doi.org/10.1016/j.psychres.2015.11.029 CrossRefGoogle Scholar
Mathews, A., Ridgeway, V., & Holmes, E. A. (2013). Feels like the real thing: imagery is both more realistic and emotional than verbal thought. Cognition & Emotion, 27, 217–229. https://doi.org/10.1080/02699931.2012.698252 CrossRefGoogle ScholarPubMed
Morina, N., Deeprose, C., Pusowski, C., Schmid, M., & Holmes, E. A. (2011). Prospective mental imagery in patients with major depressive disorder or anxiety disorders. Journal of Anxiety Disorders, 25, 1032–1037. https://doi.org/10.1016/j.janxdis.2011.06.012 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, 6–15. https://doi.org/10.1016/j.jbtep.2016.11.003 CrossRefGoogle ScholarPubMed
Muse, K., McManus, F., Hackmann, A., Williams, M., & Williams, M. (2010). Intrusive imagery in severe health anxiety: prevalence, nature and links with memories and maintenance cycles. Behaviour Research and Therapy, 48, 792–798. https://doi.org/10.1016/j.brat.2010.05.008 CrossRefGoogle ScholarPubMed
National Institute of Clinical Excellence (NICE) (2005). Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. London, UK: NICE.Google Scholar
Osman, S., Cooper, M., Hackmann, A., & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory, 12, 428–436. https://doi.org/10.1080/09658210444000043 CrossRefGoogle ScholarPubMed
Pearson, J., Naselaris, T., Holmes, E. A., & Kosslyn, S. M. (2015). Mental imagery: functional mechanisms and clinical applications. Trends in Cognitive Sciences, 19, 590–602. https://doi.org/10.1016/j.tics.2015.08.003 CrossRefGoogle ScholarPubMed
Pennesi, J. L. & Wade, T. D. (2018). Imagery rescripting and cognitive dissonance: a randomized controlled trial of two brief online interventions for women at risk of developing an eating disorder. International Journal of Eating Disorders, 51, 439–448. https://doi.org/10.1002/eat.22849 CrossRefGoogle ScholarPubMed
Schacter, D. L., Addis, D. R., & Buckner, R. L. (2007). Remembering the past to imagine the future: the prospective brain. Nature Reviews Neuroscience, 8, 657–661. https://doi.org/10.1038/nrn2213 CrossRefGoogle ScholarPubMed
Shapiro, F. (2002). EMDR 12 years after its introduction: past and future research. Journal of Clinical Psychology, 58, 1–22. https://doi.org/10.1002/jclp.1126 CrossRefGoogle ScholarPubMed
Somerville, K., Cooper, M. J., & Hackmann, A. (2007). Spontaneous imagery in women with bulimia nervosa: an investigation into content, characteristics and links to childhood memories. Journal of Behavior Therapy and Experimental Psychiatry, 38, 435–446. https://doi.org//10.1016/j.jbtep.2007.09.003 CrossRefGoogle ScholarPubMed
Speckens, A. E. M., Hackmann, A., Ehlers, A., & Cuthbert, B. (2007). Imagery special issue: intrusive images and memories of earlier adverse events in patients with obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 38, 411–422. https://doi.org/10.1016/j.jbtep.2007.09.004 CrossRefGoogle ScholarPubMed
Szpunar, K. K., Spreng, R. N., & Schacter, D. L. (2014). A taxonomy of prospection: introducing an organizational framework for future-oriented cognition. Proceedings of the National Academy of Sciences of the USA, 111, 18414–18421. https://doi.org/10.1073/pnas.1417144111 CrossRefGoogle ScholarPubMed
Tatham, M. (2011). The role of imagery-based techniques in cognitive-behavioural therapy for adults with eating disorders. Clinical Psychology Review, 31, 1101–1109. https://doi.org/10.1016/j.cpr.2011.06.008 CrossRefGoogle ScholarPubMed
White, K. D., Ashton, R., & Brown, R. M. D. (1977). The measurement of imagery vividness: normative data and their relationship to sex, age, and modality differences. British Journal of Psychology, 68, 203–211. https://doi.org/10.1111/j.2044-8295.1977.tb01576.x CrossRefGoogle Scholar
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