Effects of Engaging in Repeated Mental Imagery of Future Positive Events on Behavioural Activation in Individuals with Major Depressive Disorder

Fritz Renner, Julie L Ji, Arnaud Pictet, Emily A Holmes, Simon E Blackwell, Fritz Renner, Julie L Ji, Arnaud Pictet, Emily A Holmes, Simon E Blackwell

Abstract

Depression is associated with decreased engagement in behavioural activities. A wide range of activities can be promoted by simulating them via mental imagery. Mental imagery of positive events could thus provide a route to increasing adaptive behaviour in depression. The current study tested whether repeated engagement in positive mental imagery led to increases in behavioural activation in participants with depression, using data from a randomized controlled trial (Blackwell et al. in Clin Psychol Sci 3(1):91-111, 2015. doi:10.1177/2167702614560746). Participants (N = 150) were randomized to a 4-week positive imagery intervention or an active non-imagery control condition, completed via the internet. Behavioural activation was assessed five times up to 6 months follow-up using the Behavioural Activation for Depression Scale (BADS). While BADS scores increased over time in both groups, there was an initial greater increase in the imagery condition. Investigating mental imagery simulation of positive activities as a means to promote behavioural activation in depression could provide a fruitful line of enquiry for future research.

Keywords: Behavioral activation; Cognitive bias modification; Depression; Mental imagery.

Conflict of interest statement

Conflict of Interest

Fritz Renner, Julie L. Ji, Arnaud Pictet, Emily A. Holmes and Simon E. Blackwell declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the studies.

Animal Rights

No animal studies were carried out by the authors for this article.

Figures

Fig. 1
Fig. 1
Behavioural Activation for Depression Scale (BADS) total score over five time points for both the positive mental imagery and control conditions showing mixed regression-based estimated means (lines) and observed means (rectangles for the positive imagery intervention group and triangles for the control group) and standard errors, indicating a significant advantage of the positive mental imagery condition. Note, the BADS total score can range from 0 to 100. For a clearer visual representation of the average scores the vertical axis in this figure starts at 50
Fig. 2
Fig. 2
Behavioural Activation for Depression Scale (BADS) subscales over five time points for both the positive mental imagery and control conditions showing mixed regression-based estimated means (lines) and observed means (rectangles for the positive imagery intervention group and triangles for the control group) and standard errors, showing the significant advantage of the positive mental imagery condition on the Avoidance/Rumination and Social Impairment subscales

References

    1. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. Text revision (4th ed.). Washington D.C.: American Psychiatric Association.
    1. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996.
    1. Blackwell SE, Browning M, Mathews A, Pictet A, Welch J, Davies J, Holmes EA. Positive imagery-based cognitive bias modification as a web-based treatment tool for depressed adults: a randomized controlled trial. Clinical Psychological Science. 2015;3(1):91–111. doi: 10.1177/2167702614560746.
    1. Chan CKY, Cameron LD. Promoting physical activity with goal-oriented mental imagery: a randomized controlled trial. Journal of Behavioral Medicine. 2012;35(3):347–363. doi: 10.1007/s10865-011-9360-6.
    1. Crisp Richard J, Husnu Senel, Meleady Rose, Stathi Sofia, Turner Rhiannon N. From imagery to intention: A dual route model of imagined contact effects. European Review of Social Psychology. 2010;21(1):188–236. doi: 10.1080/10463283.2010.543312.
    1. Cuijpers P, Van Straten A, Warmerdam E. Behavioral activation treatments of depression: A meta-analysis. Clinical Psychology Review. 2007;27(3):318–326. doi: 10.1016/j.cpr.2006.11.001.
    1. Dimidjian S, Hollon SD, Dobson KS, Schmaling KB, Kohlenber RJ, Addis ME, Jacobson NS. Randomized trial of behavioural activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology. 2006;74(4):658–670. doi: 10.1037/0022-006X.74.4.658.
    1. Dunn BD. Helping depressed clients reconnect to positive emotional experience: Current insights and future directions. Clinical Psychology and Psychotherapy. 2012;19:326–340. doi: 10.1002/cpp.1799.
    1. Ekers D, Webster L, Van Straten A, Cuijpers P, Richards D, Gilbody S. Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis. PLoS ONE. 2014;9(6):1–11. doi: 10.1371/journal.pone.0100100.
    1. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured clinical interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P) New York: Biometrics Research, New York State Psychiatric Institute; 2002.
    1. Fredrickson BL, Branigana C. Positive emotions broaden the scope of attention and thought-action repertoires. Cognition and Emotion. 2005;19(3):313–332. doi: 10.1080/02699930441000238.
    1. Gregory, W. L., Cialdini, R. B., & Carpenter, K. M. (1982). Self-relevant scenarios as mediators of likelihood estimates and compliance: Does imagining make it so. Journal of Personality and Social Psychology, 43(1), 89–99. doi:10.1037/0022-3514.43.1.89.
    1. Holmes EA, Blackwell SE, Burnett Heyes S, Renner F, Raes F. Mental imagery in depression: Phenomenology, potential mechanisms, and treatment implications. Annual Review of Clinical Psychology. 2016;12:249–280. doi: 10.1146/annurev-clinpsy-021815-092925.
    1. Holmes EA, Craske MG, Graybiel AM. Psychological treatments: A call for mental-health science. Clinicians and neuroscientists must work together to understand and improve psychological treatments. Nature. 2014;511(7509):287–289. doi: 10.1038/511287a.
    1. Holmes EA, Lang TJ, Shah DM. Developing interpretation bias modification as a ‘cognitive vaccine’ for depressed mood: Imagining positive events makes you feel better than thinking about them verbally. Journal of Abnormal Psychology. 2009;118(1):76–88. doi: 10.1037/a0012590.
    1. Holmes EA, Mathews A. Mental imagery and emotion: A special relationship? Emotion. 2005;5(4):489–497. doi: 10.1037/1528-3542.5.4.489.
    1. Holmes EA, Mathews A, Dalgleish T, Mackintosh B. Positive interpretation training: Effects of mental imagery versus verbal training on positive mood. Behavior Therapy. 2006;37(3):237–247. doi: 10.1016/j.beth.2006.02.002.
    1. Holmes EA, Mathews A, Mackintosh B, Dalgleish T. The causal effect of mental imagery on emotion assessed using picture–word cues. Emotion. 2008;8(3):395–409. doi: 10.1037/1528-3542.8.3.395.
    1. Hopko DR, Mullane CM. Exploring the relation of depression and overt behavior with daily diaries. Behaviour Research and Therapy. 2008;46:1085–1089. doi: 10.1016/j.brat.2008.05.002.
    1. Ji, J. L., Burnett Heyes, S., MacLeod, C., & Holmes, E. A. (in press). Emotional mental imagery as simulation of reality: fear and beyond. A tribute to Peter Lang. Behavior Therapy. doi:10.1016/j.beth.2015.11.004
    1. Kanter JW, Mulick PS, Busch AM, Berlin KS, Martell CR. The Behavioral Activation for Depression Scale (BADS): Psychometric properties and factor structure. Journal of Psychopathology and Behavioral Assessment. 2007;29:191–202. doi: 10.1007/s10862-006-9038-5.
    1. Kanter JW, Rusch LC, Busch AM, Sedivy SK. Validation of the Behavioral Activation for Depression Scale (BADS) in a community sample with elevated depressive symptoms. Journal of Psychopathology and Behavioral Assessment. 2009;31:36–42. doi: 10.1007/s10862-008-9088-y.
    1. Kavanagh DJ, Andrade J, May J. Imaginary relish and exquisite torture: The elaborated intrusion theory of desire. Psychological Review. 2005;112(2):446–467. doi: 10.1037/0033-295X.112.2.446.
    1. Knäuper B, McCollam A, Rosen-Brown A, Lacaille J, Kelso E, Roseman M. Fruitful plans: Adding targeted mental imagery to implementation intentions increases fruit consumption. Psychol Health. 2011;26(5):601–617. doi: 10.1080/08870441003703218.
    1. Kosslyn SM, Ganis G, Thompson WL. Neural foundations of imagery. Nature Reviews Neuroscience. 2001;2(9):635–642. doi: 10.1038/35090055.
    1. Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry. 2002;59:877–883. doi: 10.1001/archpsyc.59.10.877.
    1. Lang PJ. A bio-informational theory of emotional imagery. Psychophysiology. 1979;16(6):495–512. doi: 10.1111/j.1469-8986.1979.tb01511.x.
    1. Lang TJ, Blackwell SE, Harmer CJ, Davison P, Holmes EA. Cognitive bias modification using mental imagery for depression: Developing a novel computerized intervention to change negative thinking styles. European Journal of Personality. 2012;26(2):145–157. doi: 10.1002/per.855.
    1. Lejuez CW, Hopko DR, LePage JP, Hopko SD, McNeil DW. A brief behavioral activation treatment for depression. Cognitive and Behavioral Practice. 2001;8:164–175. doi: 10.1016/S1077-7229(01)80022-5.
    1. Lewinsohn PM. A behavioral approach to depression. Oxford: Wiley; 1974.
    1. Libby LK, Shaeffer EM, Eibach RP, Slemmer JA. Picture yourself at the polls-visual perspective in mental imagery affects self-perception and behavior. Psychological Science. 2007;18(3):199–203. doi: 10.1111/j.1467-9280.2007.01872.x.
    1. Loft MH, Cameron LD. Using mental imagery to deliver self-regulation techniques to improve sleep behaviors. Annals of Behavioral Medicine. 2013;46(3):260–272. doi: 10.1007/s12160-013-9503-9.
    1. MacLeod AK. Well-being, positivity and mental health: an introduction to the special issue. Clinical Psychology and Psychotherapy. 2012;19:279–282. doi: 10.1002/cpp.1794.
    1. MacLeod AK, Moore R. Positive thinking revisited: Positive cognitions, well-being and mental health. Clinical Psychology and Psychotherapy. 2000;7:1–10. doi: 10.1002/(SICI)1099-0879(200002)7:1<1::AID-CPP228>;2-S.
    1. Martell CR, Addis ME, Jacobson NS. Depression in context: Strategies for guided action. New York: Norton Press; 2001.
    1. Martell CR, Dimidjian S, Herman-Dunn R. Behavioral activation for depression: A clinician’s guide. New York, NY: The Guilford Press; 2010.
    1. Mathews A, Ridgeway V, Holmes EA. Feels like the real thing: Imagery is both more realistic and emotional than verbal thought. Cognition and Emotion. 2013;27(2):217–229. doi: 10.1080/02699931.2012.698252.
    1. Moradveisi L, Huibers MJH, Renner F, Arasteh M, Arntz A. Behavioural activation v. antidepressant medication for treating depression in Iran: randomised trial. The British Journal of Psychiatry. 2013;202(3):204–211. doi: 10.1192/bjp.bp.112.113696.
    1. Morina N, Deeprose C, Pusowski C, Schmid M, Holmes EA. Prospective mental imagery in patients with major depressive disorder or anxiety disorders. Journal of Anxiety Disorders. 2011;25(8):1032–1037. doi: 10.1016/j.janxdis.2011.06.012.
    1. Moulton ST, Kosslyn SM. Imagining predictions: Mental imagery as mental emulation. Philosophical Transactions of The Royal Society B: Biological Sciences. 2009;364(1521):1273–1280. doi: 10.1098/rstb.2008.0314.
    1. National Institute for Health and Clinical Excellence . Depression: The treatment and management of depression in adults (update) London: National Institute for Health and Clinical Excellence; 2009.
    1. Pearson J, Naselaris T, Holmes EA, Kosslyn SM. Mental imagery: Functional mechanisms and clinical applications. Trends in Cognitive Sciences. 2015;19(10):590–602. doi: 10.1016/j.tics.2015.08.003.
    1. Pictet A, Coughtrey AE, Mathews A, Holmes EA. Fishing for happiness: The effects of positive imagery on interpretation bias and a behavioral task. Behaviour Research and Therapy. 2011;49(12):885–891. doi: 10.1016/j.brat.2011.10.003.
    1. Reardon S. NIH rethinks psychiatry trials. Nature. 2014;507:288.
    1. Rennie L, Harris PR, Webb TL. The impact of perspective in visualizing health-related behaviors: First-person perspective increases motivation to adopt health-related behaviors. Journal of Applied Social Psychology. 2014;44(12):806–812. doi: 10.1111/jasp.12266.
    1. Rennie L, Uskul AK, Adams C, Appleton K. Visualisation for increasing health intentions: enhanced effects following a health message and when using a first-person perspective. Psychol Health. 2014;29(2):237–252. doi: 10.1080/08870446.2013.843685.
    1. Riebe G, Fan MY, Unutzer J, Vannoy S. Activity scheduling as a core component of effective care management for late-life depression. International Journal of Geriatric Psychiatry. 2012;27(12):1298–1304. doi: 10.1002/gps.3784.
    1. Sanchez A, Vazquez C. Looking at the eyes of happiness: Positive emotions mediate the influence of life satisfaction on attention to happy faces. The Journal of Positive Psychology. 2014;9(5):435–448. doi: 10.1080/17439760.2014.910827.
    1. Schacter DL, Addis DR, Buckner RL. Episodic simulation of future events concepts, data, and applications. New York Academy of Sciences. 2008;1124:39–60. doi: 10.1196/annals.1440.001.
    1. Simon, G. E., & Ludman, E. J. (2009). It’s time for disruptive innovation in psychotherapy. Lancet, 374(9690), 594–595. Retrieved from <Go to ISI>://000269222600007
    1. Suddendorf T, Corballis MC. The evolution of foresight: What is mental time travel, and is it unique to humans? Behavioral and Brain Sciences. 2007;30:299–351.
    1. Teismann T, Ertle A, Furka N, Willutzki U, Hoyer J. The German Version of the Behavioral Activation for Depression Scale (BADS): A psychometric and clinical investigation. Clinical Psychology and Psychotherapy. 2015
    1. Torkan H, Blackwell SE, Holmes EA, Kalantari M, Neshat-Doost HT, Maroufi M, Talebi H. Positive imagery cognitive bias modification in treatment-seeking patients with major depression in Iran: A pilot study. Cognitive Therapy and Research. 2014;38:132–145. doi: 10.1007/s10608-014-9598-8.
    1. Whiteford HA, Degenhardt L, Rehm J, Baxter A, Ferrari AJ, Erskine HE, Vos T. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. The Lancet. 2013;382(9904):1575–1586. doi: 10.1016/S0140-6736(13)61611-6.
    1. Whiting SW, Dixon MR. Effects of mental imagery on gambling behavior. Journal of Gambling Studies. 2013;29(3):525–534. doi: 10.1007/s10899-012-9314-0.

Source: PubMed

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