F3SP1 - Working mechanisms of imagery and imagery rescripting
Tracks
Track 2
Science & Research
| Friday, May 31, 2024 |
| 2:30 PM - 4:00 PM |
Overview
Symposium
Details
If the presenter suggests breaking into groups then you should access the Breakout Foyer HERE
The symposium consists of four presentations highlighting the latest research results on the effectiveness of imagery techniques (primarily imagery rescripting) when compared to EMDR, imaginal exposure or cognitive restructuring. The methodological care with which these studies were conducted made it possible to verify the role of candidate working mechanisms of the imagery treatment, such as prediction error, disruption of memory reconsolidation, image vividness, and image-related beliefs. The conclusions presented at the symposium are based on a variety of different self-report, behavioral and neuronal findings.
The efficacy of incorporating mental imagery in cognitive restructuring techniques on reducing hostility
Jill Lobbestael
Abstract
Hostility is a trait dimension that consists of a tendency to (I) behave aggressively, (II) experience angry affect and (III) hold cynical cognitions (e.g., hostile beliefs), that can be considered a transdiagnostic phenomenon in mental disorders. While Cognitive Restructuring (CR) is an effective intervention for hostility, the number of patients who fail to benefit suggest that the efficacy of CR can be further improved. The present study investigated whether enhancing CR with mental imagery techniques can increase its efficacy. For the current study, a high hostility sample (28% male, and 72% female) was randomized over one session of imagery enhanced CR (I-CR) (n = 34), traditional CR (n = 32) or an active control session (AC) (n = 21). Changes in hostile beliefs, aggressive tendencies, state anger and hostility traits were assessed pre- and post-treatment, and at one-week follow-up. Results showed that both I-CR and CR efficaciously reduced hostile beliefs, aggressive tendencies and anger, to a stronger degree than AC. I-CR was more efficacious and sustainable over time than both CR and AC in reducing hostile beliefs and aggressive tendencies. Overall, findings suggest that implementing imagery techniques in CR for hostile beliefs enhances its’ efficacy. We will also present explorative data on the potential working mechanisms for I-CR, that we assessed by analyzing the individual I-CR sessions. The results of this study can inform clinical practice on how to effectively target hostility via imagery techniques.
Target Audience
Beginners, intermediate, and advanced-level participants
Effectiveness and mechanism of imagery techniques. The role of prediction error in imagery rescripting and imaginal exposure
Julia Bączek, SWPS University, Poznań, Poland
Abstract
There are numerous studies proving the effectiveness of imagery rescripting (ImRs) and imagery exposure (IE) in the treatment of various disorders. So far, studies comparing the effectiveness of both techniques have not provided clear evidences about the advantage of one of them. The aim of this RCT was to investigate the effectiveness of ImRs and IE in the treatment of fear of failure. The research focused on changes in the area of fear of failure, physiological arousal, basic emotions and several secondary self-report measures. Additionally, attempts were made to identify possible working mechanisms of ImRs.
Participants (18-35 years of age) were randomly assigned to both groups. The inclusion criteria: (1) high fear of failure (2) not meet criteria for severe mood disorders, anxiety disorders, personality disorders and substance addiction at the time of their pre-treatment evaluation for this study. Before starting the study, the participants took part in three sessions with a therapist. The firs aimed at eligibility check. During two subsequent sessions, therapists obtained participants' biographical images. The study began with pre-treatment sessions (baseline data). Then, the subjects underwent 4 therapeutic sessions (ImRs or IE) within the period of two weeks. Two weeks after the pre-treatment session, the effectiveness of the changes was assessed. During the 3- and 6-month follow-up, test the stability of the changes obtained.
The results showed that fear was reduced after ImRs and IE, which was reflected in a decrease in SCL and self-report measures. Several differences between techniques are observed in effectiveness and stability. The results also show significant between-group differences in prediction error and its possible role in boosting treatment effects.
Target Audience
Beginners, intermediate, and advanced-level participants
Change mechanisms of Imagery Rescripting compared with EMDR
Arnoud Arntz
Abstract
Imagery Rescripting (ImRs) and EMDR are two effective treatments for Posttraumatic Stress Disorder (PTSD). It is assumed that with EMDR, taxing the working memory by the double task of imagining the trauma and following the moving fingers decreases the vividness and distress of traumatic memories. In ImRs, rescripting is hypothesised to decrease the core beliefs and memories-related distress. The current study investigated whether the changes in both treatments work through these mechanisms. For distress, it was explored whether this was stronger for EMDR or ImRs. The current study is part of a multicentre trial in which 155 patients with childhood-related PTSD were offered up to 12 sessions of EMDR or ImRs. During the Imagination Interview, patients imagined the most severe event of the index trauma, and rated the associated vividness, distress and credibility of the core belief. The severity of PTSD was measured using the IES-R (self-report) and CAPS-5 (clinical interview). To test the hypotheses about change mechanisms mixed regression and Granger causality were used. The results showed that the relationship between changes in distress and core beliefs, and severity of PTSD symptoms at the next (vs previous) measurement time point were stronger for ImRs than for EMDR. No evidence of changes in vividness as an underlying change mechanism was found for EMDR. The findings suggest that during ImRs, changes in distress and core beliefs are underlying mechanisms of action. Despite the fact that these changes did not appear to be mechanisms of action in EMDR, both treatments were about equally effective. This study is the first to directly compare the underlying mechanisms of EMDR and ImRs. Understanding more about these mechanisms is important to improve treatments and may allow us to combine effective components of treatments or offer treatments according to specific symptom profiles.
Target Audience
Beginners, intermediate, and advanced-level participants
Imagery rescripting and disruption of memory reconsolidation -psychophysiological and fMRI study
Stanisław Karkosz, SWPS University, Poznań, Poland
Abstract
Imagery rescripting (ImRs) is an efficient form of treatment, although its foundations are still undergoing research. In the present study, we aimed to combine ImRs with a procedure enabling disruption of memory reconsolidation, as the latter was shown beneficial for acquisition of knowledge in previous studies. In our study, we conducted two experiments that researched the effectiveness of this combination in young adults with high fear of failure, using a framework for turning aversive childhood memories into standardized audio recordings. In the first experiment, we studied this using self-evaluation and skin conductance as dependent variables in two groups: one undergoing ImRs and the other one undergoing ImRs combined with a procedure aimed at disrupting memory reconsolidation. In the second study, we conducted the same procedure using fMRI measurement. In both experiments, we invited participants with high fear of failure, who first listened to standardized audio recordings of their own criticism experiences and neutral situations and then participated in 4 intervention sessions in a period of two weeks. After two weeks they took part in a second measurement when they once again listened to the audio recordings of criticism and neutral scenes. The same was repeated at follow-up sessions that were conducted 3 and 6 months after treatment completion. Both experiments provided evidences that ImRs effectively reduces the fear of failure and related physiological or neuronal activity. In the first experiment, we didn’t detect differences between the two ImRs groups, which may suggest that the memory reconsolidation disruption is involved in imagery rescripting regardless of experimental condition. Preliminary results from the second (fMRI) experiment provide evidences that memories of criticism evoke lower responses in fear-related brain areas after ImRs.
Target Audience
Beginners, intermediate, and advanced-level participants
The symposium consists of four presentations highlighting the latest research results on the effectiveness of imagery techniques (primarily imagery rescripting) when compared to EMDR, imaginal exposure or cognitive restructuring. The methodological care with which these studies were conducted made it possible to verify the role of candidate working mechanisms of the imagery treatment, such as prediction error, disruption of memory reconsolidation, image vividness, and image-related beliefs. The conclusions presented at the symposium are based on a variety of different self-report, behavioral and neuronal findings.
The efficacy of incorporating mental imagery in cognitive restructuring techniques on reducing hostility
Jill Lobbestael
Abstract
Hostility is a trait dimension that consists of a tendency to (I) behave aggressively, (II) experience angry affect and (III) hold cynical cognitions (e.g., hostile beliefs), that can be considered a transdiagnostic phenomenon in mental disorders. While Cognitive Restructuring (CR) is an effective intervention for hostility, the number of patients who fail to benefit suggest that the efficacy of CR can be further improved. The present study investigated whether enhancing CR with mental imagery techniques can increase its efficacy. For the current study, a high hostility sample (28% male, and 72% female) was randomized over one session of imagery enhanced CR (I-CR) (n = 34), traditional CR (n = 32) or an active control session (AC) (n = 21). Changes in hostile beliefs, aggressive tendencies, state anger and hostility traits were assessed pre- and post-treatment, and at one-week follow-up. Results showed that both I-CR and CR efficaciously reduced hostile beliefs, aggressive tendencies and anger, to a stronger degree than AC. I-CR was more efficacious and sustainable over time than both CR and AC in reducing hostile beliefs and aggressive tendencies. Overall, findings suggest that implementing imagery techniques in CR for hostile beliefs enhances its’ efficacy. We will also present explorative data on the potential working mechanisms for I-CR, that we assessed by analyzing the individual I-CR sessions. The results of this study can inform clinical practice on how to effectively target hostility via imagery techniques.
Target Audience
Beginners, intermediate, and advanced-level participants
Effectiveness and mechanism of imagery techniques. The role of prediction error in imagery rescripting and imaginal exposure
Julia Bączek, SWPS University, Poznań, Poland
Abstract
There are numerous studies proving the effectiveness of imagery rescripting (ImRs) and imagery exposure (IE) in the treatment of various disorders. So far, studies comparing the effectiveness of both techniques have not provided clear evidences about the advantage of one of them. The aim of this RCT was to investigate the effectiveness of ImRs and IE in the treatment of fear of failure. The research focused on changes in the area of fear of failure, physiological arousal, basic emotions and several secondary self-report measures. Additionally, attempts were made to identify possible working mechanisms of ImRs.
Participants (18-35 years of age) were randomly assigned to both groups. The inclusion criteria: (1) high fear of failure (2) not meet criteria for severe mood disorders, anxiety disorders, personality disorders and substance addiction at the time of their pre-treatment evaluation for this study. Before starting the study, the participants took part in three sessions with a therapist. The firs aimed at eligibility check. During two subsequent sessions, therapists obtained participants' biographical images. The study began with pre-treatment sessions (baseline data). Then, the subjects underwent 4 therapeutic sessions (ImRs or IE) within the period of two weeks. Two weeks after the pre-treatment session, the effectiveness of the changes was assessed. During the 3- and 6-month follow-up, test the stability of the changes obtained.
The results showed that fear was reduced after ImRs and IE, which was reflected in a decrease in SCL and self-report measures. Several differences between techniques are observed in effectiveness and stability. The results also show significant between-group differences in prediction error and its possible role in boosting treatment effects.
Target Audience
Beginners, intermediate, and advanced-level participants
Change mechanisms of Imagery Rescripting compared with EMDR
Arnoud Arntz
Abstract
Imagery Rescripting (ImRs) and EMDR are two effective treatments for Posttraumatic Stress Disorder (PTSD). It is assumed that with EMDR, taxing the working memory by the double task of imagining the trauma and following the moving fingers decreases the vividness and distress of traumatic memories. In ImRs, rescripting is hypothesised to decrease the core beliefs and memories-related distress. The current study investigated whether the changes in both treatments work through these mechanisms. For distress, it was explored whether this was stronger for EMDR or ImRs. The current study is part of a multicentre trial in which 155 patients with childhood-related PTSD were offered up to 12 sessions of EMDR or ImRs. During the Imagination Interview, patients imagined the most severe event of the index trauma, and rated the associated vividness, distress and credibility of the core belief. The severity of PTSD was measured using the IES-R (self-report) and CAPS-5 (clinical interview). To test the hypotheses about change mechanisms mixed regression and Granger causality were used. The results showed that the relationship between changes in distress and core beliefs, and severity of PTSD symptoms at the next (vs previous) measurement time point were stronger for ImRs than for EMDR. No evidence of changes in vividness as an underlying change mechanism was found for EMDR. The findings suggest that during ImRs, changes in distress and core beliefs are underlying mechanisms of action. Despite the fact that these changes did not appear to be mechanisms of action in EMDR, both treatments were about equally effective. This study is the first to directly compare the underlying mechanisms of EMDR and ImRs. Understanding more about these mechanisms is important to improve treatments and may allow us to combine effective components of treatments or offer treatments according to specific symptom profiles.
Target Audience
Beginners, intermediate, and advanced-level participants
Imagery rescripting and disruption of memory reconsolidation -psychophysiological and fMRI study
Stanisław Karkosz, SWPS University, Poznań, Poland
Abstract
Imagery rescripting (ImRs) is an efficient form of treatment, although its foundations are still undergoing research. In the present study, we aimed to combine ImRs with a procedure enabling disruption of memory reconsolidation, as the latter was shown beneficial for acquisition of knowledge in previous studies. In our study, we conducted two experiments that researched the effectiveness of this combination in young adults with high fear of failure, using a framework for turning aversive childhood memories into standardized audio recordings. In the first experiment, we studied this using self-evaluation and skin conductance as dependent variables in two groups: one undergoing ImRs and the other one undergoing ImRs combined with a procedure aimed at disrupting memory reconsolidation. In the second study, we conducted the same procedure using fMRI measurement. In both experiments, we invited participants with high fear of failure, who first listened to standardized audio recordings of their own criticism experiences and neutral situations and then participated in 4 intervention sessions in a period of two weeks. After two weeks they took part in a second measurement when they once again listened to the audio recordings of criticism and neutral scenes. The same was repeated at follow-up sessions that were conducted 3 and 6 months after treatment completion. Both experiments provided evidences that ImRs effectively reduces the fear of failure and related physiological or neuronal activity. In the first experiment, we didn’t detect differences between the two ImRs groups, which may suggest that the memory reconsolidation disruption is involved in imagery rescripting regardless of experimental condition. Preliminary results from the second (fMRI) experiment provide evidences that memories of criticism evoke lower responses in fear-related brain areas after ImRs.
Target Audience
Beginners, intermediate, and advanced-level participants
Speaker
Jill Lobbestael
Associate Professor
Maastricht University
The efficacy of incorporating mental imagery in cognitive restructuring techniques on reducing hostility
Biography
Dr. Jill Lobbestael is an associate professor at Maastricht University, at the department of Clinical Psychological Science, where she chairs the Clinical Psychology section. Her research focuses on personality disorders and aggression, and on ways to assess and lower aggression, and includes both more fundamental experimental studies as well as clinical effectiveness studies.
Julia Bączek
Phd Student
SWPS University
Effectiveness and mechanism of imagery techniques. The role of prediction error in imagery rescripting and imaginal exposure
Biography
Julia Bączek - psychologist and certified CBT therapist. PhD student at the Doctoral School of the SWPS University in Warsaw. Her doctoral thesis concerns the effectiveness and mechanisms of action of psychotherapeutic imagery techniques. She is a member of the Poznań Laboratory of Affective Neuroscience.
Prof. Arnoud Arntz
Professor Of Clinical Psychology
University of Amsterdam
Change mechanisms of Imagery Rescripting compared with EMDR
Biography
Arnoud Arntz is an Professor Emeritus of Clinical Psychology at the University of Amsterdam. He contributed to the development and empirical validation of Schema Therapy and Imagery Rescripting. He is a Honorary Scientific Advisor of the ISST.
Stanisław Karkosz
PHD student
Poznań Laboratory of Affective Neuroscience, SWPS University
Imagery rescripting and disruption of memory reconsolidation - psychophysiological and fMRI study
Biography
Stanisław Karkosz is a cognitive scientist, Ph.D. student of psychology at SWPS University, and Co-Founder of Fido Therapeutics. His research focuses on imagery techniques mechanisms, schemat therapy and agent-guided cognitive behavioral therapy. He is cocreating Fido, one of first mental health chatbots in Poland.
