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Philips, Clare, and Debbie Samson. "The Rescripting of Pain Images." Behavioural and Cognitive Psychotherapy 40, no. 5 (September 6, 2012): 558–76. http://dx.doi.org/10.1017/s1352465812000549.
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Background: The majority of pain sufferers experience images when in pain. The most distressing of these images (the Index image) provokes intense emotional reactions, appraisal shifts, and increases in pain. The ability of pain sufferers to rescript their Index images, and the consequences of doing so, remain to be determined. Aims: To assess the effects upon emotions, appraisals and pain experience of rescripting Index images in pain sufferers. Method: The Index images of a group of 55 pain sufferers were assessed using a voluntary image induction procedure (VIE) to obtain basal levels of pain, appraisal and emotion. Participants were than randomly allocated to one of two groups: Rescripted Image repetition or Index Image repetition. The two groups were compared on their responses to their Index and Rescripted images respectively. Results: The participants found it easy to rescript their distressing Index images. During rescripting, they reported dramatic reductions in emotion, negative appraisals, and pain. The clinically and statistically significant decrements in pain were found independent of reductions in emotion. The pain levels during rescripting were significantly below their basal levels, with 49% reporting no pain at all while viewing a rescripted image. These changes were not a function of image repetition. Conclusion: Index images of pain sufferers can be easily elicited and rescripted. Rescripting leads to remarkable reductions in emotion, cognitions and pain levels that are not attributable to image repetition. The significant reductions in pain were independent of reductions in emotion. The implications of these results for CBT approaches to pain management are considered.
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Kunze, Anna E., Arnoud Arntz, and Merel Kindt. "Investigating the effects of imagery rescripting on emotional memory: A series of analogue studies." Journal of Experimental Psychopathology 10, no. 2 (April 1, 2019): 204380871985073. http://dx.doi.org/10.1177/2043808719850733.
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Imagery rescripting (IR) is a promising treatment for a variety of disorders, but its working mechanisms remain largely unknown. To elucidate the associative and evaluative learning processes underlying IR, we exposed participants to an aversive film clip followed by an instructed fear-conditioning procedure. The acquired fear memory was subsequently manipulated by either rescripting- (IR) or exposure-based (imaginal exposure; IE) interventions and their effects were examined on subjective and psychophysiological fear responses in three successive studies. Though the interpretation of the results was challenged with respect to the employed analogue IR intervention (Exp 1) and unexpected findings in the control condition (Exp 3), the present results establish preliminary evidence for the hypothesis that IR produces differential effects on fear responding when compared to IE. For example, in line with stimulus devaluation theory, IR effectively reduced subjective distress to the conditioned stimulus (Exp 2). Also, IR resulted in decreased physiological fear responses after fear reinstatement (Exp 3). The findings advance our general understanding of the processes involved in IR and they tentatively indicate that rescripting- and exposure-based treatments may work through different mechanisms. Moreover, this line of research demonstrates the challenges encountered when working with analogue models to test mechanisms of therapeutic change.
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Twardawski, Mathias, Mario Gollwitzer, Marlene S. Altenmüller, Anna E. Kunze, and Charlotte E. Wittekind. "Imagery Rescripting Helps Victims Cope With Experienced Injustice." Zeitschrift für Psychologie 229, no. 3 (September 2021): 178–84. http://dx.doi.org/10.1027/2151-2604/a000450.
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Abstract. In clinical psychology, imagery rescripting (ImRs) is a promising intervention to target negative emotional memories after victimization experiences. The present research tested the effects of ImRs in “minor” cases of experienced injustice. After imagining being the victim of an injustice, participants ( N = 272) were randomly assigned to one of four conditions in a univariate design (treatment: active ImRs, passive ImRs; control: pleasant imagery, imagery rehearsal). Dependent variables were positive and negative affect; mediator variables were justice-related satisfaction and empowerment. Both justice-related satisfaction and empowerment increased positive and decreased negative affect, but empowerment was higher in the active than in the passive ImRs condition (while justice-related satisfaction was increased by both ImRs conditions). These results suggest that ImRs can be beneficial even in minor victimization experiences and that these beneficial effects are mediated by both empowerment and justice-related satisfaction.
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Prinz, Jessica, Eshkol Rafaeli, Jana Wasserheß, and Wolfgang Lutz. "Clients’ Emotional Experiences Tied to Therapist-Led (but Not Client-Led) Physiological Synchrony during Imagery Rescripting." Entropy 23, no. 12 (November 23, 2021): 1556. http://dx.doi.org/10.3390/e23121556.
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Imagery rescripting (IR), an effective intervention technique, may achieve its benefits through various change mechanisms. Previous work has indicated that client–therapist physiological synchrony during IR may serve as one such mechanism. The present work explores the possibility that therapist-led vs. client-led synchrony may be differentially tied to clients’ emotional experiences in therapy. The analyses were conducted with data taken from an open trial of a brief protocol for treating test anxiety (86 IR sessions from 50 client–therapist dyads). Physiological synchrony in electrodermal activity was indexed using two cross-correlation functions per session: once for client leading and again for therapist leading (in both cases, with lags up to 10 s). The clients’ and therapists’ in-session emotions were assessed with the Profile of Mood States. Actor–partner interdependence models showed that certain client (but not therapist) in-session emotions, namely higher contentment and lower anxiety and depression, were tied to therapist-led (but not client-led) physiological synchrony. The results suggest that therapist-led synchrony (i.e., clients’ arousal tracking therapists’ earlier arousal) is tied to more positive and less negative emotional experiences for clients.
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Seinsche, Rosa J., Susanne Fricke, Axel Schäfer, Marie Kristin Neudert, Raphaela I. Zehtner, Rudolf Stark, and Andrea Hermann. "Effects of Imagery Rescripting on Emotional Responses During Imagination of a Socially Aversive Experience." Journal of Emotion and Psychopathology 1, no. 1 (February 21, 2023): 113–28. http://dx.doi.org/10.55913/joep.v1i1.12.
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Imagery rescripting (ImRs) of socially aversive memories is a promising intervention in the treatment of Social Anxiety Disorder. Little is known about the effects of ImRs on physiological responses to the rescripted socially aversive memory, which was the focus of this study in a healthy sample. Thirty individuals performed an imagination task measuring psychophysiological responses and subjective feelings (post-hoc) related to the rescripted memory, as well as to two control memories. In a within-subject design, participants completed the imagination task before and after a control intervention, and subsequently after one session ImRs of the socially aversive memory. At one-week follow-up, lasting effects on social anxiety and subjective feelings were assessed online (N = 26). ImRs of the socially aversive memory resulted in a significant reduction in negative feelings and activity of the corrugator supercilii, as well as a significant increase in valence and positive feelings related to the socially aversive memory compared to both control memories. However, only effects for positive feelings and corrugator supercilii were significantly stronger for ImRs compared to the control intervention. Lasting effects appeared for fear of negative evaluation and subjective emotional responses to the rescripted memory. These findings give preliminary evidence for the impact of ImRs on emotional aspects of the rescripted memory, indicating that ImRs might work through changing the representation of the aversive event in memory.
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Philips, H. Clare. "Imagery and Pain: The Prevalence, Characteristics, and Potency of Imagery Associated with Pain." Behavioural and Cognitive Psychotherapy 39, no. 5 (May 31, 2011): 523–40. http://dx.doi.org/10.1017/s1352465811000282.
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Background: There is a dearth of information about imagery in pain sufferers. Aim: The aim of this study was to collect data on the characteristics, prevalence, and potency of imagery associated with pain. Method: The images of 59 pain sufferers were assessed by means of a semi-structured interview. The emotional, cognitive, behavioural, and pain-inducing properties (potency) of their index images were assessed by an image induction procedure and self-report scales of anxiety, depression and trauma symptoms. Results: The results showed a remarkably high incidence of images in pain sufferers, with 78% of participants reporting one or more repetitive images when in pain. Exposure to their most powerful/distressing image (Index image) resulted in significant increases in negative emotions, negative cognitive appraisals, and in pain levels. In a sub-group of sufferers with significant levels of trauma symptoms, the index images elicited significantly higher levels of emotion and pain increment than did those respondents in a low/no trauma group. Conclusion: It was concluded that imagery is a prevalent, often “unobserved” but potent cognition in pain sufferers. The implications for CBT approaches to chronic pain, including image rescripting, are considered.
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Köhler, Cristiano A., André F. Carvalho, Gilberto S. Alves, Roger S. McIntyre, Thomas N. Hyphantis, and Martín Cammarota. "Autobiographical Memory Disturbances in Depression: A Novel Therapeutic Target?" Neural Plasticity 2015 (2015): 1–14. http://dx.doi.org/10.1155/2015/759139.
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Major depressive disorder (MDD) is characterized by a dysfunctional processing of autobiographical memories. We review the following core domains of deficit: systematic biases favoring materials of negative emotional valence; diminished access and response to positive memories; a recollection of overgeneral memories in detriment of specific autobiographical memories; and the role of ruminative processes and avoidance when dealing with autobiographical memories. Furthermore, we review evidence from functional neuroimaging studies of neural circuits activated by the recollection of autobiographical memories in both healthy and depressive individuals. Disruptions in autobiographical memories predispose and portend onset and maintenance of depression. Thus, we discuss emerging therapeutics that target memory difficulties in those with depression. We review strategies for this clinical domain, including memory specificity training, method-of-loci, memory rescripting, and real-time fMRI neurofeedback training of amygdala activity in depression. We propose that the manipulation of the reconsolidation of autobiographical memories in depression might represent a novel yet largely unexplored, domain-specific, therapeutic opportunity for depression treatment.
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Paquet, C., and J. Davis. "1070 An Examination of the Relationship Between Language Use in Post-Trauma Nightmares and Psychological Sequelae in a Treatment Seeking Population." Sleep 43, Supplement_1 (April 2020): A407—A408. http://dx.doi.org/10.1093/sleep/zsaa056.1066.
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Abstract Introduction Studying language use in dreams and nightmares has become an increasingly used tool to understand underlying emotional and cognitive processes. Specifically, in regards to post-trauma nightmares (PTNMs), nightmare transcriptions can offer a lens to understand a survivor’s interpretation of their trauma. The current study will utilize a method of quantitative text analysis to analyze the relationship between specific psychological constructs and symptoms of posttraumatic stress disorder (PTSD) and nightmare qualities. It is hypothesized that there will be a positive correlation between words related to perceptual processes and negative emotions in nightmares and PTSD symptom and nightmare severity. There will be a negative correlation between cognitive processes and positive emotion words, and PTSD symptom and nightmare severity. Methods Fifty-three nightmares were collected from participants that were recruited from the community in a Midwestern city as part of an ongoing investigation of the effectiveness of a brief cognitive-behavioral intervention for PTNM, Exposure, Relaxation, and Rescripting Therapy (ERRT). All participants were over the age of 18, have experienced a criterion A trauma, and have nightmares at least once weekly. Linguistic Inquiry and Word Count (LIWC) was utilized to analyze the nightmare transcriptions. The Posttraumatic Stress Disorder Checklist for the DSM-5 (PCL-5) and the Trauma-related Nightmare Survey (TRNS) were used to measure symptom severity. A Pearson’s correlation analysis was used for this exploratory study. Results Words related to perceptual processes were significantly positively correlated with PTSD symptom and nightmare severity (p<.05) Neither negative nor positive emotion words were significantly related to PTSD and nightmare symptoms (p>.05). Cognitive processing words were significantly negatively correlated with PTSD and nightmare symptoms (p<.05). Conclusion The results of this study support the hypothesis that language use in nightmares reveals important information about underlying cognitive and emotional functioning. The results of this study may have an important impact on treatment considerations for those who have experienced trauma. Analyzing language use in PTNM may help to understand the etiology and maintenance of PTSD symptoms. Support Support for this study comes from the University of Tulsa Institute of Trauma, Adversity, and Injustice.
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Buck, Harleah G., Diego F. Hernandez, Tina Mason, Cindy Tofthagen, and Kevin E. Kip. "A TALE OF TWO CASE STUDIES: ACCELERATED RESOLUTION THERAPY FOR COMPLICATED GRIEF IN OLDER ADULTS." Innovation in Aging 3, Supplement_1 (November 2019): S272. http://dx.doi.org/10.1093/geroni/igz038.1010.
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Abstract Complicated grief (CG) is characterized by lengthy, intense, and functionally impairing grief which disproportionately affects older adults. Accelerated Resolution Therapy (ART) is a brief, protocol driven, exposure/imagery rescripting therapy which uses lateral left-right eye movements. ART, unlike traditional psychotherapy, directs the person to perform two tasks simultaneously (e.g. re-experiencing the grief experience and performing eye movements), taxing limited working memory capacity. Importantly, this may force memory traces representing events, emotions, and sensations to compete for permanence, as well as reduce the vividness and emotional intensity of the original grief. Two CG case studies are presented (expected; unexpected death) with their response to ART. Stake’s instrumental case study methodology was used to identify and study cases which reflect a range of CG. Additionally, CG was measured by the Inventory of Complicated Grief (ICF). ICF’s range is 0-76 with scores > 24 indicating CG. Case 1 was a spousal caregiver with a single, expected death where helplessness, guilt, shame, and a life alone had resulted in CG (baseline ICF 33). Her ICF at 8 weeks post-ART was 10. Case 2 was an adult child caregiver with multiple (parent, sibling), unexpected deaths in quick succession where loss, guilt, anger, and helplessness had resulted in CG (baseline ICF 25). Her ICF at 8 weeks post-ART was 9. Both participants were able to process the distressing sensations that emerged during the imaginal exposure component facilitated with the use of eye movements. This suggests that ART may be a powerful new mind-body treatment for CG.
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Young, Susan. "Autoethnographic Animation and The Metabolism of Trauma: A Multimethod Investigation." International Journal of Film and Media Arts 6, no. 3 (December 31, 2021): 93–113. http://dx.doi.org/10.24140/ijfma.v6.n3.07.
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This paper provides an overview of my practice-based doctoral research: Bearing Witness: Autoethnographic Animation and the Metabolism of Trauma, which uses a multimethod approach (cognitive focus, thematic analysis of qualitative data and artistic practice), to investigate autoethnographic animation’s capacity to moderate psychological trauma. Traumatic events such as child abuse, domestic violence and military conflict often present a major health challenge for survivors, with many experiencing significantly impaired function due to symptoms such as nightmares, emotional dysregulation, negative cognitions and dissociative states. The symptoms most commonly reported are intrusive memories-sensory-perceptual impressions that involuntarily intrude into consciousness, causing distress and a sense of reexperiencing the trauma. A number of cognitive studies have measured how these intrusions may be moderated through models that either interfere with imagery, simulate trauma, or change its narrative. My research uses interviews, thematic analysis and artistic practice to investigate whether animation may similarly moderate intrusions through processes that utilise the medium’s visuospatial capacities and its potential for rescripting, or changing, the trauma narrative. The desire to use personal experience as data motivated my interest in autoethnography as a methodology for qualitative inquiry. Autoethnography is a reflexive approach that explores autobiographical stories and connects these to wider socio-cultural-political issues through writing, performance and other media. In this research I am using autoethnography to both address my lived experience of trauma and to moderate its symptoms through my animation practice.
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Bouchard, Mathieu, Steve Maguire, and Luciano Barin Cruz. "Rescripting Client Action: Emotion Work and the Boundaries of Professional Jurisdiction." Academy of Management Proceedings 2020, no. 1 (August 2020): 10300. http://dx.doi.org/10.5465/ambpp.2020.10300abstract.
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Ovanessian, Melina M., Naomi Koerner, Martin M. Antony, and Michel J. Dugas. "A preliminary test of the therapeutic potential of written exposure with rescripting for generalized anxiety disorder." Journal of Experimental Psychopathology 10, no. 2 (April 1, 2019): 204380871984152. http://dx.doi.org/10.1177/2043808719841529.
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This experiment tested a novel written exposure intervention for generalized anxiety disorder (GAD) that consisted of guided rescripting of participants’ worst fear. After describing their worst fear, adults with GAD ( N = 79) were randomly assigned to one of three writing interventions, each consisting of three sessions on consecutive days: (1) standard written exposure (WE), (2) written exposure with rescripting (RWE), and (3) neutral control writing (NC). Measures of symptoms and worry-associated processes were administered at pre- and post-intervention, and at 1-week and 1-month follow-ups. Worry declined significantly in all three conditions. Participants in WE reported significant reductions in fear of anxiety, whereas those in RWE reported significant reductions in fear of anger. Participants in RWE and NC reported a significant decrease in fear of positive emotion. Following RWE, participants perceived their feared scenario as less costly and perceived themselves as better able to cope with it, whereas participants in the WE and NC did not show these changes. Cognitive avoidance, intolerance of uncertainty, and negative problem orientation did not change. Findings suggest overall, RWE was not superior to WE, and that more research is needed to assess their therapeutic potential. Strengths and limitations are discussed for the benefit of future research on exposure for GAD.
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Abramov, Volodymyr. "Comparative analysis and ways of integration of Schema Therapy and Narrative Psychotherapy." Bulletin of Taras Shevchenko National University of Kyiv. Series “Psychology”, no. 2 (12) (2020): 5–9. http://dx.doi.org/10.17721/bsp.2020.2(12).1.
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The article compares schema-therapy to narrative therapy across three domains: (i) theoretical methodological and philosophical framework; (ii) technics (both methods and their theoretical background), and (iii) mechanisms of change in therapy. Several ways of integrating these two therapies are proposed. Schema therapy and narrative psychotherapy are based on contradicting methodologies of structuralism and post-structuralism. Schema therapy develops the concept of schemes, introduced by A. Beck, adding emotions, physiological reactions and memories to its structure, and stresses the importance of using emotion-focused techniques to change them. Narrative psychotherapy is based on theories of dialogical self, introduced by H. Hermans and narrative theories of identity, introduced by T. Sarbin and D. Bruner. Both methods use the idea of multimodal structure of personality. Schema therapy partly uses the idea of distancing from and observing modes, introduced by the third wave of cognitive-behavioral therapies. Narrative psychotherapy uses externalization of symptoms as one of the core techniques. Both methods modify the narrative of the person. Narrative psychotherapy seeks unique events to develop a new narrative of the person according to their values. Schema therapy uses imagery rescripting to meet the needs of a child mode and change emotions experienced in traumatic memory. Both therapies also use internalization of attachment figures. Schema therapy can integrate metaphors from narrative therapy to deal with personality modes. It also can be enriched by treating these modes as sub personalities of narrative psychotherapy and focusing on their narratives and values.
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Kröner, J., H. Graf, Z. Sosic-Vasic, and C. Schaitz. "Zum Einsatz und Nutzen mentaler Bilder oder Imaginationen in der kognitiven Verhaltenstherapie." Nervenheilkunde 36, no. 09 (2017): 719–25. http://dx.doi.org/10.1055/s-0038-1627517.
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ZusammenfassungDa mentale Bilder und Imagination tatsächlichen sensorischen Erfahrungen ähneln, beeinflussen sie menschliches Lernen und Verhalten und können im Vergleich zu verbaler Verarbeitung Emotionen besser aktivieren und verändern. Zudem sind aversive mentale Bilder in Form von Intrusionen an der Ätiologie und Psychopathologie vieler psychischer Störungen beteiligt, weshalb sie in der modernen Verhaltenstherapie als Behandlungsmethode vielfach eingesetzt werden. Dabei hat sich insbesondere die Methode des Imagery Rescripting (ImR) als effektive Behandlungsmethode für die posttraumatische Belastungsstörung, Angststörungen wie die soziale und spezifische Phobie, affektive Störungen sowie zur Therapie von Persönlichkeitsstörungen hervorgetan und ihre Wirksamkeit anhand randomisiert kontrollierter Studien bewiesen. Da beim ImR aversiv erlebte mentale Bilder, die den verschiedenen Störungen zugrunde liegt, in angenehmere mentale Vorstellungen umschreiben werden, wird eine Reduktion der mit der Störung assoziierten Beschwerden und Symptome ermöglicht.
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Strohm, Miriam, Marena Siegesleitner, Anna E. Kunze, Thomas Ehring, and Charlotte E. Wittekind. "Imagery Rescripting of Aversive Autobiographical Memories: Effects on Memory Distress, Emotions, and Feelings of Mastery." Cognitive Therapy and Research 43, no. 6 (April 26, 2019): 1005–17. http://dx.doi.org/10.1007/s10608-019-10021-2.
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Takanashi, Rieko, Naoki Yoshinaga, Keiko Oshiro, Satoshi Matsuki, Mari Tanaka, Hanae Ibuki, Fumiyo Oshima, Yuko Urao, Daisuke Matsuzawa, and Eiji Shimizu. "Patients’ perspectives on imagery rescripting for aversive memories in social anxiety disorder." Behavioural and Cognitive Psychotherapy 48, no. 2 (September 17, 2019): 229–42. http://dx.doi.org/10.1017/s1352465819000493.
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AbstractBackground:Imagery rescripting (IR) for early aversive memories in patients with social anxiety disorder (SAD) has shown promising results, but no study has investigated the reactions and perspectives of patients who received IR.Aims:This study aimed to gain understanding of patients’ experiences/perspectives on IR as an adjunct to cognitive behavioural therapy (CBT) for SAD.Method:Twenty-five individuals with SAD received one or two sessions of IR over 16 CBT sessions. Contents of recurrent images and linked memories were identified during IR. Outcome measures included social anxiety, image and memory distress and vividness, and encapsulated belief. Patients completed a questionnaire about their perspectives of IR after the session. Thematic analysis was used to analyse the qualitative data.Results:IR resulted in significant within-session improvement in most outcome measures. Linked memories to negative recurrent images in social situations were categorized into nine groups. Common memories were ‘Being criticized by others’, ‘Being made fun of’, ‘Failing or not doing something well’ and ‘Being left out in a group’. Most patients (82%) experienced IR as impressive, and more than half of patients (59%) found IR effective. Themes of reasons of impressiveness and effectiveness were categorized as ‘Results of IR session’ and ‘Processes of IR session’. The theme ‘Results of IR session’ included six subthemes, and the theme ‘Processes of the IR session’ included five subthemes.Conclusions:Regarding patients’ perspectives, although they may experience negative emotions in the process of an IR session, our results suggest that many patients with SAD found IR sessions effective.
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Langkaas, Tomas Formo, Asle Hoffart, Tuva Øktedalen, Pål G. Ulvenes, Elizabeth A. Hembree, and Mervin Smucker. "Exposure and non-fear emotions: A randomized controlled study of exposure-based and rescripting-based imagery in PTSD treatment." Behaviour Research and Therapy 97 (October 2017): 33–42. http://dx.doi.org/10.1016/j.brat.2017.06.007.
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Newman-Taylor, Katherine, Pamela McSherry, and Lusia Stopa. "Imagery rescripting in non-clinical paranoia: a pilot study of the impact on key cognitive and affective processes." Behavioural and Cognitive Psychotherapy 48, no. 1 (July 15, 2019): 54–66. http://dx.doi.org/10.1017/s1352465819000419.
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AbstractBackground: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.
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Toukolehto, Olli T., Wendi M. Waits, Daniella M. Preece, and Kathleen M. Samsey. "Accelerated Resolution Therapy-Based Intervention in the Treatment of Acute Stress Reactions During Deployed Military Operations." Military Medicine 185, no. 3-4 (November 18, 2019): 356–62. http://dx.doi.org/10.1093/milmed/usz315.
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Abstract Introduction The treatment and resolution of psychological traumas during military deployments directly supports medical readiness and the military mission and potentially prevents symptom progression to post-traumatic stress disorder (PTSD). However, current evidence-based trauma-focused psychotherapies can be difficult to employ during military contingency operations due to various barriers. Deployed military behavioral health providers need an effective, trauma-focused intervention that is suitable for the operational environment. In this retrospective case series, we describe how a therapeutic intervention based on accelerated resolution therapy (ART), an emerging trauma-focused psychotherapy, was pivotal in the treatment of acute stress reactions in eight deployed U.S. Army soldiers. Materials and Method ART can be conceptualized as a hybrid of several evidence-based psychotherapy techniques. In brief, ART is a manualized, procedural adaptation of eye movement desensitization and reprocessing (EMDR) that incorporates mindful awareness of emotions and sensations, bilateral eye movements, imaginal exposure, desensitization, visual and cognitive rescripting, and gestalt-style interventions for the processing of traumatic experiences. The eight deployed U.S. soldiers in this case series received a single 45 to 60 minute session of an ART-based intervention within 96 hours of a traumatic death. Results All of the treated soldiers had rapid improvement in both depressive and acute stress symptoms after treatment. Furthermore, the therapeutic benefits were sustained at 1 year postincident despite continued exposure to the stress of deployed military operations for up to 6 months after treatment. Conclusion Based on these encouraging preliminary findings, the authors recommend that behavioral health providers who are preparing to deploy become familiar with ART or related interventions in order to develop the confidence and the skills that are needed to provide timely and effective trauma-focused care for deployed soldiers.
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Mancini, Alessandra, and Francesco Mancini. "Rescripting Memory, Redefining the Self: A Meta-Emotional Perspective on the Hypothesized Mechanism(s) of Imagery Rescripting." Frontiers in Psychology 9 (April 20, 2018). http://dx.doi.org/10.3389/fpsyg.2018.00581.
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Strohm, Miriam, Marena Siegesleitner, Anna E. Kunze, Thomas Ehring, and Charlotte E. Wittekind. "Imagery rescripting versus cognitive restructuring for social anxiety: Treatment effects and working mechanisms." Clinical Psychology in Europe 3, no. 3 (September 30, 2021). http://dx.doi.org/10.32872/cpe.5303.
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Background Negative mental images in social anxiety are often linked to memories of distressing social experiences. Imagery Rescripting (ImRs) has been found to be a promising intervention to target aversive memories, but mechanisms underlying ImRs are largely unknown. The present study aimed (a) to investigate the effects of ImRs compared to cognitive restructuring (CR) on social anxiety symptoms and (b) to extend previous research by examining whether ImRs works by fostering reappraisal of negative emotional self-beliefs. Method Highly socially anxious individuals (N = 77) were randomly allocated to ImRs, CR, or no intervention control (NIC). A speech task was performed at baseline and at 1-week follow-up. Results Only CR significantly reduced social anxiety symptoms from baseline to follow-up. Decreases in negative appraisals and emotional distress in response to the speech task did not differ between conditions. Regarding working mechanisms, ImRs led to stronger increases in positive emotions than CR and NIC. Both CR and ImRs yielded short-term reductions in emotionally anchored idiosyncratic self-beliefs, but CR was superior to ImRs at follow-up. Conclusions The present study provides evidence for the efficacy of a single-session of CR for social anxiety symptoms. As one specific version of ImRs was applied, it is conceivable that other or optimized versions of ImRs might be more effective.
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Brown, Gary, Caroline Salter, Eleanor Parker, Hannah Murray, Kathy Looney, Sharif El Leithy, Evelina Medin, Barbora Novakova, and Jonathan Wheatley. "Imagery re-scripting for PTSD: session content and its relation to symptom improvement." Behavioural and Cognitive Psychotherapy, October 19, 2022, 1–10. http://dx.doi.org/10.1017/s1352465822000479.
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Abstract Imagery rescripting (ImRs) is a therapy technique that, unlike traditional re-living techniques, focuses less on exposure and verbal challenging of cognitions and instead encourages patients to directly transform the intrusive imagery to change the depicted course of events in a more desired direction. However, a comprehensive account of how and in what circumstances ImRs brings about therapeutic change is required if treatment is to be optimised, and this is yet to be developed. The present study reports on the development of a coding scheme of ImRs psychotherapy elements identified in the literature as potential ImRs mechanisms. The codes were assessed in relation to short-term outcomes of 27 individuals undergoing ImRs for post-traumatic stress disorder. The timing of the change in the image, degree of activation of the new image and associated cognitive, emotional and physiological processes, self-guided rescripting, rescript believability, narrative coherence and cognitive and emotional shift were identified as being related to symptom change and so are potentially important factors for the re-scripting process.
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ten Napel-Schutz, Marieke C., Maartje Vroling, Suzanne H. W. Mares, and Arnoud Arntz. "Treating PTSD with Imagery Rescripting in underweight eating disorder patients: a multiple baseline case series study." Journal of Eating Disorders 10, no. 1 (March 9, 2022). http://dx.doi.org/10.1186/s40337-022-00558-1.
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Abstract Background Eating disorder patients with posttraumatic stress disorder have worse treatment results regarding their eating disorder than patients without posttraumatic stress disorder. Many eating disorder patients with co-morbid posttraumatic stress disorder symptoms are not treated for posttraumatic stress disorder symptoms during an underweight state. We propose that treatment of posttraumatic stress disorder is possible for underweight patients and that their trauma symptoms decrease with the use of Imagery Rescripting. We also investigated whether treatment of trauma influences eating disorder pathology in general and the process of weight gain specifically. Method Ten patients in clinical treatment (BMI 14–16.5) participated. A multiple baseline design was used, with baseline varying from 6 to 10 weeks, a 6-week treatment phase, a 3-week follow-up period and a 3-month follow-up measurement. Data were analysed with mixed regression. Results Evidence was found that Imagery Rescripting had strong positive effects on posttraumatic stress disorder symptoms without interfering with eating disorder treatment. Positive effects were also found on a range of secondary emotional and cognitive measures. Conclusion Imagery Rescripting of traumatic memories is a possible and safe intervention for underweight eating disorder patients. It also had positive clinical effects. Trial registration Netherlands trial register (NTR) Trial NL5906 (NTR6094). Date of registration 09/23/2016. https://www.trialregister.nl/trial/5906.
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Strohm, Miriam, Marena Siegesleitner, Anna E. Kunze, Gabriela G. Werner, Thomas Ehring, and Charlotte E. Wittekind. "Psychological and Physiological Effects of Imagery Rescripting for Aversive Autobiographical Memories." Cognitive Therapy and Research, May 25, 2021. http://dx.doi.org/10.1007/s10608-021-10233-5.
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Abstract Background Imagery Rescripting (ImRs) is a promising intervention to reduce symptoms associated with aversive memories, but little is known about its working mechanisms. The present study investigates whether ImRs increases perceived mastery and attenuates emotional reactivity to memory retrieval on a subjective and physiological level. Methods Seventy-nine individuals reporting memories of distressing real-life events were randomly allocated to ImRs, positive imagery (PI), or no-intervention control (NIC). The memory was reactivated before the intervention and at 1-week follow-up to assess subjective measures and physiological reactivity (heart rate [HR], skin conductance level [SCL], and facial electromyography activity [EMG]) during memory retrieval. Results ImRs was superior to PI and NIC on subjective memory distress and helplessness, but not on other emotions. ImRs did not exceed PI and NIC in reducing state stress symptoms or increasing perceived mastery. Physiological reactivity (HR, EMG) decreased from pre-intervention to follow-up with no differences between groups. Conclusions Positive effects of ImRs on helplessness and distress were found. Null findings regarding mastery might result from timing of its assessment or the fact that rather high-functioning participants were included. The lack of between group differences on physiological responses indicates that ImRs did not exceed habituation effects in the present sample.
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Tenore, Katia, Alessandra Mancini, Olga Ines Luppino, and Francesco Mancini. "Group Imagery Rescripting on Childhood Memories Delivered via Telehealth: A Preliminary Study." Frontiers in Psychiatry 13 (June 23, 2022). http://dx.doi.org/10.3389/fpsyt.2022.862289.
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BackgroundImagery Rescripting (ImR) has proved to be effective in the treatment of different mental disorders as an integral part of broader clinical protocols or as a standalone technique. ImR has also been successfully incorporated as part of group Schema Therapy treatment; however, to the best of our knowledge, it has never been assessed as a standalone technique in a group setting.AimIn this study, we focused on ImR delivered via telehealth in groups and we aimed to assess whether group ImR is effective in responding to basic emotional needs, in changing participants’ affective state, and in reducing dysfunctional beliefs. We also wanted to assess whether memory realism is associated with a greater effectiveness of the technique.MethodsA total of 52 participants were presented with 3 ImR sessions on childhood memories related to the current dysfunctional belief that elicited more suffering.ResultsThe technique was effective in facilitating the retrieval of a memory in almost the entire sample (in the range of 92.3–100%). Overall, memory realism values (level of vividness, ability to immerse, and participants’ distance from the images) were high in all three sessions. Almost all participants were reported having their needs met during ImR (89.7%). Importantly, need satisfaction was associated with the ability to immerse in the image. In addition, the intensity of the dysfunctional belief decreased significantly from pre-test to Session 3. The technique also changed the affective state, reducing arousal. Importantly, we also observed a general reduction in shame levels from the first to the third session.ConclusionA telehealth delivered ImR group intervention on childhood memories provides cognitive and emotional improvement. Along with the ability to satisfy the patient’s basic emotional needs, the technique seems to be effective in modifying maladaptive beliefs encapsulated in memory.
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Sündermann, Oliver, Jonathan Wheatley, and David Veale. "‘If you have good skin, you are god. If you have bad skin, you are a piece of rubbish’. Mastery of shame and anger in treatment-resistant body dysmorphic disorder: a single case study." Cognitive Behaviour Therapist 9 (2016). http://dx.doi.org/10.1017/s1754470x16000118.
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AbstractBody dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived flaw in one's appearance, and is often emotionally linked with early adverse experiences. Cognitive behavioural therapy (CBT) is effective but may not resolve shame and anger that can be at the emotional root of BDD. This paper presents a single-case study of a 25-year-old man with a history of treatment-resistant BDD characterized by a preoccupation with facial skin linked to a developmental history of sexual abuse and bullying. He was treated at a national residential specialist unit for 16 weeks during which time he received three individual 1-hour weekly CBT sessions (42 sessions overall), and participated in the residential group programme and therapeutic community. CBT was enhanced using imagery rescripting, compassion-focused therapy and family work to specifically target shame and anger-based past experiences. Severity of BDD was assessed with the BDD-Yale–Brown Obsessive Compulsive Scale (BDD-YBOCS) at pre-, mid-, post-, 3-month and 18-month follow-ups; a weekly self-report measure (Appearance Anxiety Inventory), and a client-drawn self-portrait of his perceived skin flaws at pre- and post-treatment. Treatment outcome was positive. The BDD-YBOCS dropped 94% from the extremely severe range pre-treatment to the sub-clinical range post-treatment. BDD symptoms improved progressively throughout treatment, and when the emotions of anger and shame were resolved (as reported by the client) fell to the non-clinical range. Gains were maintained at 18-month follow-up. We conclude that enhancing CBT for BDD using emotion-focused techniques is to be recommended, particularly when emotional memories continue to affect body shame.
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Looney, Kathy, Sharif El-Leithy, and Gary Brown. "The role of simulation in imagery rescripting for post-traumatic stress disorder: a single case series." Behavioural and Cognitive Psychotherapy, November 6, 2020, 1–15. http://dx.doi.org/10.1017/s1352465820000806.
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Abstract Background: Imagery rescripting (ImRs) is an experiential therapy technique used to change the content and meaning of intrusive imagery in post-traumatic stress disorder (PTSD) by imagining alternative endings to traumatic events. There is growing evidence that ImRs is an effective treatment for PTSD; however, little is known about how it brings about change. Aims: This study aimed to explore the role of mental simulation as a candidate mechanism of action in ImRs, and, specifically, whether well-simulated imagery rescripts are associated with greater change in symptom severity during ImRs. Method: Using a single-case experimental design, seven participants receiving cognitive therapy for PTSD were assessed before, during and after sessions of imagery rescripting for one intrusive image. Participants completed continuous symptom severity measures. Sessions were recorded, then coded for goodness of simulation (GOS) as well as additional factors (e.g. rescript believability, vividness). Results: Participants were divided into high- and low-responders and coding was compared across groups. Correlational analyses were supported by descriptive analysis of individual sessions. High-responders’ rescripts tended to be rated as well-simulated compared with those of low-responders. Specific factors (e.g. intensity of thoughts/emotions related to original and new imagery elements, level of cognitive and emotional shift and belief in the resultant rescript) were also associated with reductions in symptom severity. Conclusions: There was tentative evidence that well-simulated rescripted images tended to be associated with greater reductions in symptom severity of the target image. Clinical implications and avenues for further research are discussed.
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Shibuya, Takayuki, Yoichi Seki, Shinobu Nagata, Tomokazu Murata, Yoichi Hiramatsu, Fuminori Yamada, Mizue Yokoo, et al. "Imagery rescripting of traumatic memories for panic disorder: an exploratory study." Cognitive Behaviour Therapist 11 (2018). http://dx.doi.org/10.1017/s1754470x18000028.
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AbstractImagery rescripting (ImRs) is a psychological intervention designed to change the meaning of images and associated memories and reduce emotional distress. Recent studies have shown that ImRs can be successfully applied to many psychological problems and disorders; however, little has been reported on the application of ImRs for panic disorder (PD). Consequently, we explored the therapeutic effects of ImRs on patients with PD. Fifteen patients with PD received 16 individual cognitive behavioural therapy (CBT) sessions weekly, including one ImRs session. Early traumatic memories associated with recurrent images in panic situations were identified and rescripted to alleviate maladaptive encapsulated beliefs. ImRs ratings (vividness and distress of the images and memories and conviction degree of encapsulated beliefs) were measured prior to and after ImRs. Self-negative contents not directly related to symptoms of panic attack were observed as common themes in the worst meaning of the image, the memory, and in the encapsulated belief. Whilst five (33%) patients had anticipatory anxiety, 10 (67%) patients had other self-negative beliefs. ImRs significantly reduced distress from images, memories and encapsulated beliefs; however, it did not change the vividness of images and memories. There was no significant correlation between the reduction in PD severity over the CBT program and the change in each ImRs rating. The results of this study are promising for certain aspects of panic disorder. However, further research is needed to overcome the limitations of this study.
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Newman-Taylor, Katherine. "‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study." Cognitive Behaviour Therapist 13 (2020). http://dx.doi.org/10.1017/s1754470x20000288.
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Abstract People with psychosis do not have routine access to trauma-focused cognitive behavioural therapy (CBT) interventions such as imagery rescripting (IR), partly due to clinical caution. This case study describes the use of a simple imagery task designed to engender ‘felt security’, as a means of facilitating IR with a woman struggling with distressing memory intrusions, linked to her voices and paranoia. We assessed the impact of the felt security task, which was used before IR to enable Kip to engage in reprocessing of her trauma memories, and again after IR so that she would leave sessions feeling safe. The brief imagery task was effective in improving felt security before IR sessions. Felt security then reduced during IR, when distressing material was recalled and reprocessed, and increased again when the task was repeated. It is not yet clear whether trauma-focused interventions such as IR need to be routinely adapted for people with psychosis. In the event that individuals express concerns about IR, if the person’s formulation indicates that high levels of arousal may trigger an exacerbation of voices, paranoia or risk, or where clinicians are otherwise concerned about interventions likely to increase emotional arousal in the short term, the felt security task may facilitate safe and effective reprocessing of trauma memories. This in turn may increase access to trauma-focused CBT for people with psychosis. Key learning aims (1) To understand that people with psychosis need access to trauma-focused CBT. (2) To be familiar with a simple attachment-based imagery task designed to foster ‘felt security’. (3) To learn that this task may facilitate imagery rescripting in people with psychosis.
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Kredlow, M. Alexandra, Lycia D. de Voogd, and Elizabeth A. Phelps. "A Case for Translation From the Clinic to the Laboratory." Perspectives on Psychological Science, March 4, 2022, 174569162110398. http://dx.doi.org/10.1177/17456916211039852.
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Laboratory procedures have been used for decades as analogues for clinical processes with the goal of improving our understanding of psychological treatments for emotional disorders and identifying strategies to make treatments more effective. This research has often focused on translation from the laboratory to the clinic. Although this approach has notable successes, it has not been seamless. There are many examples of strategies that work in the laboratory that fail to lead to improved outcomes when applied clinically. One possible reason for this gap between experimental and clinical research is a failure to focus on translation from the clinic to the laboratory. Here, we discuss potential benefits of translation from the clinic to the laboratory and provide examples of how this might be implemented. We first consider two well-established laboratory analogues (extinction and cognitive reappraisal), identify critical aspects of the related clinical procedures (exposure and cognitive restructuring) that are missing from these analogues, and propose variations to better capture the clinical process. Second, we discuss two clinical procedures that have more recently been brought into the laboratory (eye-movement desensitization and reprocessing and imagery rescripting). We conclude by highlighting potential implications of this proposed shift in focus for translational research.
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Aarts, Inga, Chris Vriend, Aishah Snoek, Arne van den End, Matthijs Blankers, Aartjan T. F. Beekman, Jack Dekker, Odile A. van den Heuvel, and Kathleen Thomaes. "Neural correlates of treatment effect and prediction of treatment outcome in patients with PTSD and comorbid personality disorder: study design." Borderline Personality Disorder and Emotion Dysregulation 8, no. 1 (May 5, 2021). http://dx.doi.org/10.1186/s40479-021-00156-8.
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Abstract Background Neural alterations related to treatment outcome in patients with both post-traumatic stress disorder (PTSD) and comorbid personality disorder are unknown. Here we describe the protocol for a neuroimaging study of treatment of patients with PTSD and comorbid borderline (BPD) or cluster C (CPD) personality disorder traits. Our specific aims are to 1) investigate treatment-induced neural alterations, 2) predict treatment outcome using structural and functional magnetic resonance imaging (MRI) and 3) study neural alterations associated with BPD and CPD in PTSD patients. We hypothesize that 1) all treatment conditions are associated with normalization of limbic and prefrontal brain activity and hyperconnectivity in resting-state brain networks, with additional normalization of task-related activation in emotion regulation brain areas in the patients who receive trauma-focused therapy and personality disorder treatment; 2) Baseline task-related activation, together with structural brain measures and clinical variables predict treatment outcome; 3) dysfunction in task-related activation and resting-state connectivity of emotion regulation areas is comparable in PTSD patients with BPD or CPD, with a hypoconnected central executive network in patients with PTSD+BPD. Methods We aim to include pre- and post-treatment 3 T-MRI scans in 40 patients with PTSD and (sub) clinical comorbid BPD or CPD. With an expected attrition rate of 50%, at least 80 patients will be scanned before treatment. MRI scans for 30 matched healthy controls will additionally be acquired. Patients with PTSD and BPD were randomized to either EMDR-only or EMDR combined with Dialectical Behaviour Therapy. Patients with PTSD and CPD were randomized to Imaginary Rescripting (ImRs) or to ImRs combined with Schema Focused Therapy. The scan protocol consists of a T1-weighted structural scan, resting state fMRI, task-based fMRI during an emotional face task and multi-shell diffusion weighted images. For data analysis, multivariate mixed-models, regression analyses and machine learning models will be used. Discussion This study is one of the first to use neuroimaging measures to predict and better understand treatment response in patients with PTSD and comorbid personality disorders. A heterogeneous, naturalistic sample will be included, ensuring generalizability to a broad group of treatment seeking PTSD patients. Trial registration Clinical Trials, NCT03833453 & NCT03833531. Retrospectively registered, February 2019.
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Paquet, Caitlin B., Chelsea M. Cogan, and Joanne L. Davis. "Does Nightmare Rescription Lead to Meaningful Changes in Language Use? An Investigation within a Treatment Seeking Sample with Chronic Post-Trauma Nightmares." Imagination, Cognition and Personality, April 18, 2022, 027623662210939. http://dx.doi.org/10.1177/02762366221093926.
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Given language's significant relationship to underlying psychological functioning, studying changes in language use regarding post-trauma nightmare (PTNM) content throughout a rescription-based treatment can offer insight into the nature of change in language associated with such treatments. LIWC2015 is an efficient tool that analyzes bodies of text for words that are theoretically representative of verbal and written expressions of underlying emotional and cognitive processes. LIWC2015 has not been extensively studied with PTNMs. The current study analyzed changes in language across cognitive and emotional domains using LIWC in a trauma-exposed treatment-seeking sample. Our analyses revealed significant changes in the frequency of words related to emotions and cognitive processing from the nightmare to rescription. In general, the rescripted imagery, relative to the nightmare, contained significantly fewer words pertaining to cognitive processing and negative emotions. This is the first known study to examine the change in language use, via word count, between nightmares and their rescripted versions. As language use is strongly associated with psychological health, these findings have clinical implications for providers and clients alike.
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Murray, Hannah, Evelina Medin, and Gary Brown. "Treatment of survivor guilt after trauma using imagery rescripting: a proof-of-concept study." Behavioural and Cognitive Psychotherapy, October 13, 2020, 1–5. http://dx.doi.org/10.1017/s1352465820000715.
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Abstract Survivor guilt can arise after surviving a trauma in which others die. No studies have systematically investigated psychological treatment for survivor guilt. The present study was a proof-of-concept investigation of treatment of survivor guilt using imagery rescripting. Thirteen participants with post-traumatic stress disorder and self-reported survivor guilt attended two consecutive imagery therapy sessions, to first elaborate and then rescript related imagery. Significant improvements were observed on idiographic process measures of cognitons, emotions and distress related to survivor guilt following the rescripting session. The study provides preliminary evidence that imagery rescripting can be used as an experiential technique to treat survivor guilt.
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Azza, Yasmine, Frank H. Wilhelm, Erich Seifritz, Klaus Junghanns, Birgit Kleim, and Ines Wilhelm. "Sleep’s role in updating aversive autobiographical memories." Translational Psychiatry 12, no. 1 (March 24, 2022). http://dx.doi.org/10.1038/s41398-022-01878-1.
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AbstractAversive autobiographical memories play a key role in the development and maintenance of many mental disorders. Imagery rescripting is a well-established psychotherapeutic intervention aiming to create a more adaptive version of an aversive memory by modifying its interpretation. Sleep has been shown to support reconsolidation of updated neutral memories. Here, we investigated in healthy participants whether a 90-min nap compared to wake supports the adaptive reconsolidation of autobiographical memories. Forty-four university students received a single 50-min imagery rescripting session. Thereafter, half of the participants took a 90-min nap, whereas the other half stayed awake. Subjective (arousal ratings, reports of emotions and dysfunctional cognitions) and heart rate (HR) responses to individual memory scripts were measured before the intervention (pre), after the 90-min retention interval (post 1) and 7 days later (post 2). Results demonstrate a significant decrease in distress of aversive memories pre to post imagery rescripting. The nap group showed less distressing dysfunctional cognitions along with a lower HR in response to the negative memory script as compared to the wake group at post 1. These differences were no longer evident 1 week later (post 2). Central sleep spindle density during the nap was correlated with the reduction in HR in response to the negative memory script from pre to post 1. Our results provide first evidence for sleep benefitting adaptive reconsolidation of aversive autobiographical memories. Future research should expand this approach to clinical populations and investigate precise conditions under which sleep may benefit psychotherapeutic interventions utilizing reconsolidation mechanisms.
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Bahadori, Rahil, Parvin Ehteshamzadeh, Zahra Eftekhar Saadi, and Reza Pasha. "Comparison of the Effects of the Choice Theory and Behavioral Activation Therapies with and Without Guided Imagery Rescripting on the Adversity Quotient and Cognitive Emotion Regulation of MS Patients in Ahvaz, Iran." Journal of Kermanshah University of Medical Sciences 25, no. 4 (December 27, 2021). http://dx.doi.org/10.5812/jkums.118428.
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Background: Complications of multiple sclerosis (MS) severely impact self-image and have debilitative effects on the adversity quotient. Objectives: The present study aimed to investigate the effects of the choice theory and behavioral activation therapies with and without guided imagery rescripting on the adversity quotient and cognitive emotion regulation of MS patients in Ahvaz, Iran. Methods: This quasi-experimental study was conducted with a pretest-posttest design and a control group. The sample population included the male and female MS patients visiting the Caspian Physiotherapy Center of Ahvaz, Iran in 2019. In total, 60 MS patients were selected via convenience sampling and randomly divided into three experimental groups and one control group (15 per each). Data were collected using the Adversity Response Profile Questionnaire (ARPQ) and the Cognitive Emotion Regulation Questionnaire (CERQ). Data analysis was performed using the multivariate analysis of covariance. Results: A significant difference was observed between the effects of the choice theory (CT) and behavioral activation (BA) therapies with and without guided imagery rescripting (ImRs) on the improvement of the adversity quotient (AQ) and positive cognitive emotion regulation (CER) of the MS patients, as well as the reduction of negative CER (P < 0.001). Compared to the CT and BA therapies without guided ImRs, the BA therapy with guided ImRs more effectively enhanced the AQ and positive CER of the MS patients and decreased their negative CER (P < 0.001). Conclusions: According to the results, BA with ImRs is a more effective method for enhancing the AQ and positive CER of MS patients and mitigating their negative CER compared to other approaches.
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Ghaderi, Ata, Elisabeth Welch, Cecilia Zha, and Emily A. Holmes. "Imagery Rescripting for Reducing Body Image Dissatisfaction: A Randomized Controlled Trial." Cognitive Therapy and Research, February 12, 2022. http://dx.doi.org/10.1007/s10608-022-10295-z.
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Abstract Background Brief, innovative, mechanistically-driven psychological treatments for body dissatisfaction are needed. We aimed to explore the occurrence of body-related mental images among females reporting a subjective sense of body dissatisfaction (study 1), and to investigate the potential efficacy of a single session of imagery rescripting (ImRS) to reduce body dissatisfaction (Study 2: pilot; Study 3 randomized controlled trial). Methods and Results In study 1 (n = 31), participants reported occurrence of both positive and negative body-related mental imagery. Frequency of body-related mental imagery and negative valence of such images were significantly related to body dissatisfaction. The pilot trial (n = 63) indicated feasibility, whereby ImRS of a distressing body-related mental image significantly reduced the believability, vividness, negative affect and distress of the image within-session and one-week post-session versus an active placebo condition (Expressive writing about body related thoughts and emotions). However, ImRS did not result in significant changes in body dissatisfaction. Study 3 was a randomized controlled trial (n = 113) with 3 conditions—ImRS, Expressive writing, and wait-list control. ImRS resulted in a significant reduction of vividness, controllability and negative affect caused by the image compared to Expressive writing condition, after the intervention. However, there were no significant reductions in body dissatisfaction from baseline to 1-week assessment, nor in post-hoc analyses at the 1-month follow-up. Findings suggest that a single session of imagery rescripting seems to alleviate the negative properties of the image (i.e., has proximal effects as hypothesized in our mechanistic account), but does not bring about a significant change in body dissatisfaction (i.e., transfer downstream to more distal effects). Conclusions Given some promising effects of ImRS on negative body-related emotions, but lack of a downstream effect on body dissatisfaction itself, further investigation of the format, dose and focus of ImRS in this context is warranted.
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Schaitz, Caroline, Julia Kroener, Anna Maier, Bernhard J. Connemann, and Zrinka Sosic-Vasic. "Short Imagery Rescripting Intervention to Treat Emotionally Dysregulated Behavior in Borderline Personality Disorder: An Exploratory Study." Frontiers in Psychiatry 11 (May 20, 2020). http://dx.doi.org/10.3389/fpsyt.2020.00425.
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Lortye, Sera A., Joanne P. Will, Loes A. Marquenie, Anna E. Goudriaan, Arnoud Arntz, and Marleen M. de Waal. "Treating posttraumatic stress disorder in substance use disorder patients with co-occurring posttraumatic stress disorder: study protocol for a randomized controlled trial to compare the effectiveness of different types and timings of treatment." BMC Psychiatry 21, no. 1 (September 7, 2021). http://dx.doi.org/10.1186/s12888-021-03366-0.
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Abstract Background Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have high comorbidity. Although prior research indicated that PTSD can effectively be treated with Prolonged Exposure (PE) in these patients, reported effects are small and treatment dropout rates high. Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group. Furthermore, it is unclear whether PTSD treatment is most effective when offered simultaneous to or after SUD treatment. Methods In this article, the Treatment Of PTSD and Addiction (TOPA) study is described: a Dutch randomized controlled trial (RCT) that studies the effectiveness of PTSD treatment as an add-on to regular SUD treatment in patients with SUD and co-occurring PTSD. Effects of PE, EMDR, ImRs, and a 3-month SUD treatment only condition will be compared, as well as simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment. The primary outcome measure is PTSD symptoms. Secondary outcomes are: treatment completion, psychological distress, substance use, interpersonal problems, emotion dysregulation, and trauma-related emotions guilt, shame, and anger. Discussion This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well. This RCT will provide more knowledge about the effectiveness of different treatment strategies for PTSD in patients with co-occurring SUD and will ultimately improve treatment outcomes for patients with this common co-morbidity worldwide. Trial registration Netherlands Trial Register (NTR), Identifier: NL7885. Registered 22 July 2019.
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Schaich, Anja, Diana Braakmann, Anja Richter, Clara Meine, Nele Assmann, Sandra Köhne, Arnoud Arntz, Ulrich Schweiger, and Eva Fassbinder. "Experiences of Patients With Borderline Personality Disorder With Imagery Rescripting in the Context of Schema Therapy—A Qualitative Study." Frontiers in Psychiatry 11 (December 3, 2020). http://dx.doi.org/10.3389/fpsyt.2020.550833.
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Imagery Rescripting (IR) is a therapeutic technique that is used in a wide spectrum of therapeutic methods for various mental disorders. As an important component of Schema Therapy (ST), IR is frequently used in the treatment of patients with borderline personality disorder (BPD). However, little is known about how IR is experienced by individuals with BPD. The aim of this study was to explore BPD patients' experiences with receiving IR. Qualitative data were collected through semi-structured interviews with 21 individuals (86% females) with a primary diagnosis of BPD who received IR within their ST treatment. Interview data were analyzed following the procedures of qualitative content analysis. Participants reported various effects of IR including initial high emotionality and exhaustion. Long-term effects included a better understanding of schemas and an improvement regarding emotion regulation and interpersonal relationships. Participants reported factors hindering the successful implementation of IR, such as external noise, stress, and a fast pace during IR. Facilitating factors included adequate time for debriefing, a transparent structure, and preparation of IR as well as the therapist providing safety. Implications of the findings for optimizing IR in clinical practice are discussed.
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Wibbelink, Carlijn J. M., Christopher W. Lee, Nathan Bachrach, Sarah K. Dominguez, Thomas Ehring, Saskia M. van Es, Eva Fassbinder, et al. "The effect of twice-weekly versus once-weekly sessions of either imagery rescripting or eye movement desensitization and reprocessing for adults with PTSD from childhood trauma (IREM-Freq): a study protocol for an international randomized clinical trial." Trials 22, no. 1 (November 27, 2021). http://dx.doi.org/10.1186/s13063-021-05712-9.
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Abstract Background Trauma-focused treatments for posttraumatic stress disorder (PTSD) are commonly delivered either once or twice a week. Initial evidence suggests that session frequency affects treatment response, but very few trials have investigated the effect of session frequency. The present study’s aim is to compare treatment outcomes of twice-weekly versus once-weekly sessions of two treatments for PTSD related to childhood trauma, imagery rescripting (ImRs) and eye movement desensitization and reprocessing (EMDR). We hypothesize that both treatments will be more effective when delivered twice than once a week. How session frequency impacts treatment response, whether treatment type moderates the frequency effect, and which treatment type and frequency works best for whom will also be investigated. Methods The IREM-Freq trial is an international multicenter randomized clinical trial conducted in mental healthcare centers across Australia, Germany, and the Netherlands. We aim to recruit 220 participants, who will be randomized to one of four conditions: (1) EMDR once a week, (2) EMDR twice a week, (3) ImRs once a week, or (4) ImRs twice a week. Treatment consists of 12 sessions. Data are collected at baseline until one-year follow-up. The primary outcome measure is clinician-rated PTSD symptom severity. Secondary outcome measures include self-reported PTSD symptom severity, complex PTSD symptoms, trauma-related cognitions and emotions, depressive symptoms, dissociation, quality of life, and functioning. Process measures include memory, learning, therapeutic alliance, motivation, reluctance, and avoidance. Additional investigations will focus on predictors of treatment outcome and PTSD severity, change mechanisms of EMDR and ImRs, the role of emotions, cognitions, and memory, the optimization of treatment selection, learned helplessness, perspectives of patients and therapists, the network structure of PTSD symptoms, and sudden treatment gains. Discussion This study will extend our knowledge on trauma-focused treatments for PTSD related to childhood trauma and, more specifically, the importance of session frequency. More insight into the optimal session frequency could lead to improved treatment outcomes and less dropout, and in turn, to a reduction of healthcare costs. Moreover, the additional investigations will broaden our understanding of how the treatments work and variables that affect treatment outcome. Trial registration Netherlands Trial Register NL6965, registered 25/04/2018.