The role of mental imagery in non-clinical paranoia

Abstract

Background & objectives: Cognitive models of paranoia incorporate many of the processes implicated in the maintenance of anxiety disorders. Despite this, the role of mental imagery in paranoia remains under-researched. The current study examined the impact of a self-imagery manipulation in people with high non-clinical paranoia. Methods:We used a mixed design with one between-subjects variable (type of self-imagery) and one within-subjects variable (time -pre and post imagery manipulation). Thirty participants with high trait paranoia were allocated alternately to a positive or negative self-imagery condition. Scripts were used to elicit positive and negative self-imagery. All participants completed self-report state measures of paranoia, mood, self-esteem and self-compassion.Results: Group by time interaction effects were found for each of the dependent variables.Positive imagery led to less state paranoia, anxiety and negative affect, and more positive affect, self-esteem and self-compassion, compared with the negative imagery group.Limitations: This was a non-blind study, limited by allocation method and a brief time-frame which did not allow us to assess longevity of effects. We recruited a relatively small and predominantly female sample of people with high non-clinical paranoia. The study did not include a neutral control condition, a low paranoia comparison group, or a manipulation check following the imagery task. Conclusions:Self-imagery manipulations may affect paranoia, mood and self-beliefs. If the findings are replicated with clinical groups, and maintained over a longer period, this would suggest that imagery-based interventions targeting persecutory delusions might be usefully examined. Highlights:• We examined the impact of imagery manipulation on paranoia, mood and self-beliefs in people with non-clinical paranoia.• Positive imagery led to less state paranoia, anxiety and negative affect, and more positive affect, self-esteem and self-compassion, compared with a negative imagery group.• We now need to replicate the findings with clinical groups, and examine longevity of effects, in order to determine clinical implications.

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

“…Participants described the task as easy to use, and there was no evidence of adverse effects. These findings are consistent with analogue studies showing that secure attachment priming reduces paranoia and distress (Bullock et al, 2016;Newman-Taylor et al, 2017), and is the first to demonstrate the impact of attachment imagery in clinical participants.…”

“…Preliminary experimental studies have used imagery tasks to prime interpersonal safety or 'felt security,' and compared this with interpersonal threat primes, in analogue groups (or sub-samples) with high levels of non-clinical paranoia. This research indicates that secure attachment imagery reduces state paranoia and anxiety, and improves mood compared with insecure attachment imagery (Bullock et al, 2016;Newman-Taylor et al, 2017). These results are promising but limited by a lack of follow-up data.…”

“…Participants were asked to recall an interpersonal memory of a time when they felt relaxed, safe, secure and trusting. The researcher then used a standard script adapted from Bullock et al (2016) to develop an individualised audio-clip of between 4 and 5 minutes, designed to evoke the secure attachment image simply and vividly. Participants were asked to listen to the guided imagery recording each day for 7 days, and continue to complete the daily state measures.…”

iMAgery focused psychological therapy for persecutory delusions in PSychosis (iMAPS): a multiple baseline experimental case series

“…In recent years, a small number of studies have examined imagery-focused work in relation to different aspects of psychotic experience, such as voices (Ison et al, 2014), and more recently in relation to voice hearers with traumatic experiences (Paulik et al, 2019), nightmares (Sheaves et al, 2015) and in generating positive imagery in first episode psychosis (Laing et al, 2016). In relation to imagery and paranoia, there have been two studies in non-clinical analogue samples: Bullock et al (2016) and Newman-Taylor et al (2019). To date, none of the above studies has focused on using an imagery-focused approach to work with images and schemas to reduce paranoia.…”

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

“…Recent advances in CBT for psychosis draw on the attachment literature to formulate psychosis in developmental context (Berry et al, 2017;Gumley et al, 2008), and preliminary experimental studies show that attachment-based imagery designed to strengthen felt security reduces paranoia and anxiety, and improves mood and self-esteem in analogue groups (e.g. Bullock et al, 2016;Newman-Taylor et al, 2018).…”