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

Newman‐Taylor, Katherine; McSherry, Pamela; Stopa, Lusia

doi:10.1017/s1352465819000419

Cited by 7 publications

(7 citation statements)

References 57 publications

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“…These results add to the growing body of literature demonstrating the impact of imagery for people with psychosis, within a broadly cognitive behavioural framework (Ison et al, 2014;Morrison, 2004;Paulik et al, 2019;Sheaves et al, 2015;Taylor et al, 2019), and show that a task designed to facilitate interpersonal safety was beneficial to people with a diagnosis of schizophrenia characterised by persecutory delusions.…”

Section: Discussionsupporting

confidence: 56%

“…These preliminary attachment imagery studies build on a growing body of work demonstrating the prevalence of intrusive images in psychosis (Schulze et al, 2013), and benefits of therapeutic imagery for this group (Morrison, 2004;Ison et al, 2014;Paulik et al, 2019;Sheaves et al, 2015;Taylor et al, 2019). There is also evidence that people with psychosis report positive imagery which might be developed in therapy (Laing et al, 2016), and that imagery interventions impact the same cognitive and emotional processes as are affected in other presentations (Newman-Taylor et al, 2019).…”

Section: Attachment Imagery As a Means Of Regulating Emotion In Psychmentioning

confidence: 86%

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Impact of attachment imagery on paranoia and mood: evidence from two single case studies

Pitfield

Maguire

Newman‐Taylor

2020

Behav. Cogn. Psychother.

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Background: Cognitive behavioural therapy (CBT) for psychosis currently yields modest outcomes and must be improved. Attachment imagery may be an effective means of reducing severity of paranoid beliefs and associated affect. Experimental studies have demonstrated these effects in non-clinical groups. The impact in clinical populations remains untested. Aims: This study assessed the impact of a brief attachment imagery task on paranoia and mood, in two people with a diagnosis of schizophrenia. Method: Two single case studies are presented. Both participants were working age adults with persecutory delusions. The study utilised an A-B-A design. Participants were recruited for a 6-week period, with a 2- and 3-week baseline respectively, 1-week intervention phase, and follow-up phase matched to duration of baseline. Trait paranoia and attachment were measured at the start of the baseline. State paranoia and affect were measured daily over the 6-week period. Results: For both participants, the baseline phase was characterised by high and variable levels of paranoia, which reduced during the intervention phase, with a return to baseline scores at follow-up. We found a similar pattern for negative affect, and the reverse pattern for positive affect. Conclusions: Attachment imagery may function as an effective emotion regulation strategy for people with psychosis. Continued use is likely to be needed to maintain gains. This brief task could prove valuable to people needing skills to manage paranoia and mood, and give clinicians confidence that people can manage short-term distress in CBT for psychosis, for example when addressing past trauma.

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Section: Discussionsupporting

confidence: 56%

Section: Attachment Imagery As a Means Of Regulating Emotion In Psychmentioning

confidence: 86%

Impact of attachment imagery on paranoia and mood: evidence from two single case studies

Pitfield

Maguire

Newman‐Taylor

2020

Behav. Cogn. Psychother.

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“…Indeed, these results also de Bont et al, 2016;Paulik et al, 2019;van den Berg et al, 2013;van den Berg & van der Gaag, 2012). This is in line with findings in delusions (Morrison, 2004;Newman-Taylor et al, 2020;Serruya & Grant, 2009;Taylor et al, 2020). The studies focusing on delusions exclusively work with traumatic memories but targeted also emotional mental images associated with the delusions in their treatment approaches.…”

Section: Emotional Mental Imagery and Avhs: Findingssupporting

confidence: 85%

Emotional and non‐emotional mental imagery and auditory verbal hallucinations (hearing voices): A systematic review of imagery assessment tools

Janssen,

van den Berg,

Paulik

et al. 2023

Clin Psychology and Psychoth

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It is unknown to what extent mental imagery and auditory verbal hallucinations (AVHs) are related. Trials evaluating this issue used both emotional and non‐emotional mental imagery tools, thereby complicating outcomes comparisons. Therefore, the present study aimed to systematically review the literature on mental imagery in individuals with AVHs to (1) inventory imagery assessment tools used in this population, (2) to collect information on the relation between emotional and non‐emotional mental imagery in all sensory domains and AVHs and (3) to integrate the outcomes of this systematic review in a model of different mental imagery domains and related assessment tools. We conducted a systematic literature search in the PubMed Database. After full‐text screening, 17 papers were included. Findings showed that a variety of assessment methods have been used to assess various aspects of mental imagery in people with AVHs, suggesting that there is a lack of agreed theoretical conceptualization of mental imagery and AVHs. In addition, the studies confirmed as was expected that non‐emotional mental imagery seemed unrelated to AVHs whereas emotional mental imagery was related to AVHs. Lastly, we proposed a model of mental imagery domains and corresponding assessment methods distinguishing between emotional and non‐emotional mental imagery.

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“…This is in contrast to the growing number of studies examining cognitive behavioural interventions targeting distressing intrusions in psychosis, including IR (e.g. Ison et al, 2014;Keen et al, 2017;Paulik et al, 2019;Sheaves et al, 2015;Taylor et al, 2018), and evidence that IR affects the same cognitive-affective processes in non-clinical paranoia as has been shown in people with depression and anxiety (Newman-Taylor et al, 2019). If we are reluctant to offer effective interventions for fear of causing harm, the question is: how can we offer trauma-focused CBT safely and effectively to people with psychosis?…”

Section: Introductionmentioning

confidence: 60%

‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study

Newman‐Taylor

2020

tCBT

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

Cited by 7 publications

References 57 publications

Impact of attachment imagery on paranoia and mood: evidence from two single case studies

Impact of attachment imagery on paranoia and mood: evidence from two single case studies

Emotional and non‐emotional mental imagery and auditory verbal hallucinations (hearing voices): A systematic review of imagery assessment tools

‘Felt security’ as a means of facilitating imagery rescripting in psychosis: a clinical protocol and illustrative case study

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