Negative Mental Images Research Articles

Interventions Targeting Negative Mental Imagery in Social Anxiety: A Systematic Review and Meta-Analysis of Characteristics and Outcomes.

Psychological treatment for social anxiety disorder (SAD) has been found to be less effective than for other anxiety disorders. Targeting the vivid and distressing negative mental images typically experienced by individuals with social anxiety could possibly enhance treatment effectiveness. To provide both clinicians and researchers with an overview of current applications, this systematic review and meta-analysis aimed to evaluate the possibilities and effects of imagery-based interventions that explicitly target negative images in (sub)clinical social anxiety. Based on a prespecified literature search, we included 21 studies, of which 12 studies included individuals with a clinical diagnosis of SAD. Imagery interventions (k = 28 intervention groups; only in adults) generally lasted one or two sessions and mostly used imagery rescripting with negative memories. Others used eye movement desensitization and reprocessing and imagery exposure with diverse intrusive images. Noncontrolled effects on social anxiety, imagery distress and imagery vividness were mostly large or medium. Meta-analyses with studies with control groups resulted in significant medium controlled effects on social anxiety (d = -0.50, k = 10) and imagery distress (d = -0.64, k = 8) and a nonsignificant effect on imagery vividness. Significant controlled effects were most evident in individuals with clinically diagnosed versus subclinical social anxiety. Overall, findings suggest promising effects of sessions targeting negative mental images. Limitations of the included studies and the analyses need to be considered. Future research should examine the addition to current SAD treatments and determine the relevance of specific imagery interventions. Studies involving children and adolescents are warranted.

Attitudes and perceptions of affected women towards endocrine endometriosis therapy: an international survey based on free-word association networks.

What are the attitudes and perceptions towards endocrine endometriosis therapy? Among the study population, endocrine endometriosis therapies are associated with negative mental images and emotions and there seems to be a pre-therapeutic information deficit on the part of physicians. Endocrine therapies, as the current standard of conservative endometriosis treatment, have good efficacy and improve symptoms and quality of life in most patients. Nevertheless, clinical practice repeatedly shows rejection on the part of patients, which may result in reduced compliance and discontinuation of therapy. Cross-sectional study among endometriosis patients using a multilingual questionnaire distributed via the most popular social media channels between November 2020 and February 2021. A total of 3348 women participated in the study. Based on a pilot phase, an international, multilingual online survey was conducted among women affected by endometriosis. The questionnaire included free-word associations and questions about personal medical history, source of information, and demographic data. Mental representations were detected based on modules of the co-occurrence network of associations. Six modules with different dominant emotional labels emerged from the confluence of associations to endocrine endometriosis therapy mentioned by participants. Five modules reflected negative mental associations, with the most frequently mentioned words being 'side effects', 'pain', 'ineffective', 'depression', and 'uncertainty'. Of the 12 most frequently selected emotions, only 'optimistic' was positive. Side effects affecting mental health are the most important reason for deciding against endocrine therapy in our survey population. Twenty-seven percent of respondents reported knowing little about endocrine therapies for endometriosis. Social media are the most frequently used sources of information and were rated as the most useful. By translating the questionnaire, questions might have been understood differently depending on the language. By using social media channels for distribution, digitally literate patients were targeted. The survey population might not be representative as patients who are critical/unhappy with therapy are more likely to seek advice from peer groups. The findings of this study replicate the findings of a recent survey in three European countries. Given the prevalence of endometriosis and the few emerging pharmaceutical alternatives, these data point to a growing need for further research and development of non-hormonal drugs for treating endometriosis. Most endometriosis patients are young and digitally literate, and much information is obtained from alternative sources, such as social media. Careful education before starting therapy should be taken seriously, and patients' concerns should be addressed individually by health care providers. This could help reduce misunderstanding and misinformation and improve treatment adherence and satisfaction. There is no funding or conflict of interest to declare. The trial is not registered at any trial registry.

The State Awaking Or Stealing?

The 2020 parliamentary elections in Croatia were held in an atmosphere marked by fear and anxiety because of negative consequences of the coronavirus pandemic, and riddled with other unresolved socio-economic and political issues. Therefore, choosing appropriate political slogans that would reflect positive messages of hope, encouragement, and safety to the Croatian people seemed of utmost importance. This paper identifies and discusses political discourse strategies behind the creation of selected billboard slogans used in the pre-election period by different political parties and platforms. Taking into account the results of the elections, the research focuses on the negative reactions to the content of the slogans in the Croatian public space. For this purpose, a corpus of readers’ online comments was built and subjected to a computer sentiment analysis. The results show that the majority of citizens in the research sample created negative mental images of political agents and the policies they promote. Further investigation of the reasons for the negative perception and evaluation revealed that the politico-historical and situational contexts play a significant role in shaping the public opinion, specifically in times of crises and threats to public health and wellbeing.

Using Metaphors to Investigate the Images of Countries

This study researched the use of metaphor among students and teachers to determine the images they had in their minds regarding a specific set of developed countries, and in doing so, utilized a longitudinal design carried out over four stages between November 2015 and November 2018 within a large metropolitan city in Turkey. The study findings revealed that the mental images of both teachers and students contained various stereotypical views about these developed countries. The participants appeared to have the most negative mental images about France, the United Kingdom (UK) and the United States (US), while having the most positive images about Australia and Japan. It was concluded that there is a strong relationship between metaphor creation and age, and that metaphor production increases rapidly as the students get older and more knowledgeable. It was also determined that metaphor quality and production rate decreases as teachers’ professional seniority increased.

Coping with negative mental images in social anxiety disorder: Investigating the potential benefits of image morphing

Negative mental imagery contributes to symptom maintenance in social anxiety disorder (SAD). Here, we investigated the effects of image morphing, a brief mental strategy designed to facilitate access to positive images. Participants with SAD and healthy control (HC) participants were randomly assigned to receive either image morphing or supportive counseling. Although initial training and 1-week daily practice were successful in equipping morphing participants across groups with the required skill, those assigned to morphing failed to demonstrate differential improvements in positive affect, negative affect, or self-perception relative to control participants during a subsequent social stress task. Ancillary analyses revealed that the number of positive details contained in retrieved or morphed images prior to the task significantly predicted the level of positive affect reported after the task, but this effect was observed only for HC participants. We discuss the need for future research to refine innovative imagery-based psychotherapeutic strategies for social anxiety.

Spontaneous childbirth-related mental images among pregnant women: a mixed-method study

ABSTRACTBackground: Mental imagery may reflect the present, past or future. Childbirth is often anticipated with joy but also in some cases with fear, which may negatively impact on the childbirth experience. So far, research on birth-related mental imagery in pregnancy is lacking. This study aimed to investigate in detail the phenomenology of spontaneous childbirth-related mental images and the association between main imagery characteristics (valence, positive/negative percentage ratio and impact on behaviour and decision-making) and fear of childbirth.Methods: A concurrent triangulation mixed methods design was employed. Thirty-seven nulliparous, French-speaking women, aged ≥ 18 years in their third trimester of pregnancy completed self-report questionnaires assessing fear of childbirth, spontaneous use of mental imagery, prenatal depression and trait anxiety, and participated in a mental imagery interview to assess spontaneous childbirth-related mental images. Women with a prenatal diagnosis of malformation were excluded.Results: All participants reported having spontaneous mental images of their impending childbirth. The images captured were rich in detail and included a variety of sensory modalities. More positive mental images were associated with less fear of childbirth (r = –0.533, p = .008) and women who had a higher proportion of negative mental images had a higher fear of childbirth (r = 0.428, p = .005). The impact of the most negative mental images on behaviour and decision-making was positively correlated with fear of childbirth (r = 0.342, p = .038).Conclusion: Our results indicate that negative spontaneous childbirth-related imagery is associated with fear of childbirth. Intervention techniques could be developed that focus on enhancing positive childbirth-related mental images during pregnancy and thus fostering a more positive childbirth experience.

A brief early intervention for adolescent depression that targets emotional mental images and memories: protocol for a feasibility randomised controlled trial (IMAGINE trial)

BackgroundAdolescent depression is common and impairing. There is an urgent need to develop early interventions to prevent depression becoming entrenched. However, current psychological interventions are difficult to access and show limited evidence of effectiveness. Schools offer a promising setting to enhance access to interventions, including reducing common barriers such as time away from education. Distressing negative mental images and a deficit in positive future images, alongside overgeneral autobiographical memories, have been implicated in depression across the lifespan, and interventions targeting them in adults have shown promise. Here, we combine techniques targeting these cognitive processes into a novel, brief psychological intervention for adolescent depression. This feasibility randomised controlled trial will test the feasibility and acceptability of delivering this imagery-based cognitive behavioural intervention in schools.Methods/designFifty-six adolescents (aged 16–18) with high symptoms of depression will be recruited from schools. Participants will be randomly allocated to the imagery-based cognitive behavioural intervention (ICBI) or the control intervention, non-directive supportive therapy (NDST). Data on feasibility and acceptability will be recorded throughout, including data on recruitment, retention and adherence rates as well as adverse events. In addition, symptom assessment will take place pre-intervention, post-intervention and at 3-month follow-up. Primarily, the trial aims to establish whether it is feasible and acceptable to carry out this project in a school setting. Secondary objectives include collecting data on clinical measures, including depression and anxiety, and measures of the mechanisms proposed to be targeted by the intervention. The acceptability of using technology in assessment and treatment will also be evaluated.DiscussionFeasibility, acceptability and symptom data for this brief intervention will inform whether an efficacy randomised controlled trial is warranted and aid planning of this trial. If this intervention is shown in a subsequent definitive trial to be safe, clinically effective and cost-effective, it has potential to be rolled out as an intervention and so would significantly extend the range of therapies available for adolescent depression. This psychological intervention draws on cognitive mechanism research suggesting a powerful relationship between emotion and memory and uses imagery as a cognitive target in an attempt to improve interventions for adolescent depression.Trial registrationISRCTN85369879

Association between Social Anxiety and Visual Mental Imagery of Neutral Scenes: The Moderating Role of Effortful Control.

According to cognitive theories, verbal processing attenuates emotional processing, whereas visual imagery enhances emotional processing and contributes to the maintenance of social anxiety. Individuals with social anxiety report negative mental images in social situations. However, the general ability of visual mental imagery of neutral scenes in individuals with social anxiety is still unclear. The present study investigated the general ability of non-emotional mental imagery (vividness, preferences for imagery vs. verbal processing, and object or spatial imagery) and the moderating role of effortful control in attenuating social anxiety. The participants (N = 231) completed five questionnaires. The results showed that social anxiety was not necessarily associated with all aspects of mental imagery. As suggested by theories, social anxiety was not associated with a preference for verbal processing. However, social anxiety was positively correlated with the visual imagery scale, especially the object imagery scale, which concerns the ability to construct pictorial images of individual objects. Further, it was negatively correlated with the spatial imagery scale, which concerns the ability to process information about spatial relations between objects. Although object imagery and spatial imagery positively and negatively predicted the degree of social anxiety, respectively, these effects were attenuated when socially anxious individuals had high effortful control. Specifically, in individuals with high effortful control, both object and spatial imagery were not associated with social anxiety. Socially anxious individuals might prefer to construct pictorial images of individual objects in natural scenes through object imagery. However, even in individuals who exhibit these features of mental imagery, effortful control could inhibit the increase in social anxiety.

Metaphors for Learning Mathematics: An Interpretation Based on Learners’ Responses to an Exploratory Questionnaire on Mathematics and Learning

This paper is linked to some work that I have done in my PhD research, which is in progress. It shows metaphors that learners have about mathematics. These metaphors were investigated through a questionnaire with seven open-ended questionnaires. An inductive analysis of the learners’ metaphors for mathematics indicated that learners had well developed and complex metaphors about mathematics, mathematics learning, mathematics teaching and the mathematics teacher. Some mental images were formed: Firstly, the notion that mathematics learning is challenging and may involve anxiety; secondly, that perseverance is needed as continuing effort will bring reward; and lastly, that positive or negative mental images of mathematics are related to the perception of and the active versus passive role of the learner. Considering that the metaphors were collected from learners with an extensive engagement with mathematics learning, the endings would imply that these metaphors reflects the students’ mental images formed as a result of experiencing mathematics learning through the use of metaphors.

Latent Classes of Dysregulated Behaviors Relate to Negative Mental Images

Dysregulated behaviors (DBs), such as self-harm or binge eating, are related to various negative outcomes. In this study, we investigate how classes of individuals vary in their level of DBs. We compare the classes with regards to their experiences regarding negative mental images and emotion regulation strategies. A web-based survey assessed eleven DBs in a sample of N=912 adults. A latent class analysis (LCA) identified a class of 168 adults that were prone to various DBs (“high(DBs)”). Another class (n = 46) reported drunkenness and risks for drug use and overeating (“high(Intake)”). The majority of individuals (n = 698) featured a low rate of DBs (“low(DBs)”). The high(DBs) exhibited the highest scores in distressing imagery and maladaptive emotion regulation. The high(Intake) had a low overall profile; however, it displayed increased imagery nowness. Class differences were leveled by depressive symptoms. The findings help extend the knowledge on DBs and their correlates. Clinical implications are discussed.

Distressing visual mental images in depressed patients and healthy controls - Are they one and the same?

Negative mental images are common in a range of mental disorders. So far, only inconclusive evidence has been obtained for depression specificity. We assessed the disparities and similarities of a variety of imagery characteristics in 17 patients suffering from depressive disorders and 17 healthy matched controls who all reported negative mental images. The number of intrusive images, their frequency, and the associated distress were significantly greater for the depressed individuals. Compared with non-depressed controls, negative images during depression were more frequently triggered by internal factors and led to depression-related emotions. Approximately 30% of the images in the depressed group did not consist of actual memories of real-life events. No significant differences in vividness or perceived controllability were observed, but the depressed patients experienced significantly more bodily symptoms during the intrusions than the healthy controls. The results indicate that the central characteristics of the negative mental images of depressed and non-depressed individuals are distinguishable, despite some similarities, and may contribute to depressive symptoms.

Visual mental imagery and symptoms of depression - results from a large-scale web-based study.

BackgroundMental imagery may influence the onset and maintenance of depression, but specific mechanisms have not yet been determined.MethodsNine hundred twelve participants completed questionnaires on positive and negative mental images, as well as images of injury and death that lead to positive emotions (“ID-images”), and depressive symptomatology. The assessment was carried out online to reduce effects of social desirability.ResultsPositive images were reported by 87 % of the sample, negative images by 77 %. ID-images were present in one-third of the sample. A connection with depression severity was found for the absence of positive mental images and the presence of negative images as well as ID-images. Higher depression scores were associated with more frequent and vivid negative images, greater imagery distress, and a higher proportion of negative relative to positive images.ConclusionsMental images are clearly related to depression. Future research should focus on ID-images and their connection to suicide-risk in depressed patients.

The impact of imagery rescripting on memory appraisals and core beliefs in social anxiety disorder

Negative mental images in social anxiety disorder (SAD) are often rooted in autobiographical memories of formative, distressing life events. In the present study, 25 participants with SAD retrieved an idiosyncratic negative mental image and associated autobiographical memory. Participants were then randomly assigned either to a single-session of imagery rescripting (IR) targeting the retrieved autobiographical memory or to a non-intervention control condition (no-IR). Outcomes were assessed one week later. Compared to control participants, those who received IR experienced substantial reduction in SAD symptoms accompanied by more positive and less negative appraisals of their autobiographical memories. Moreover, IR relative to no-IR participants reported marked shifts in the content, validity, and accuracy of their memory-derived negative core beliefs about self and others, but not about the world. Results support the promise of IR as a stand-alone intervention for SAD and suggest important directions for future research to enhance our understanding of the cognitive mechanisms that underlie its effects.

The Role of Mental Imagery in Depression: Negative Mental Imagery Induces Strong Implicit and Explicit Affect in Depression.

Mental imagery, seeing with the mind’s eyes, can induce stronger positive as well as negative affect compared to verbal processing. Given this emotion-amplifying effect, it appears likely that mental images play an important role in affective disorders. According to the subcomponents model of depression, depressed mood is maintained by both negative imagery (which amplifies negative mood) and less efficient positive imagery processes. Empirical research on the link between mental imagery and affect in clinical depression, however, is still sparse. This study aimed at testing the role of mental imagery in depression, using a modified version of the affect misattribution procedure (AMP) and the self-assessment manikin (SAM) to assess implicit (AMP) and explicit (SAM) affect elicited by mental images, pictures, and verbal processing in clinically depressed participants (n = 32) compared to healthy controls (n = 32). In individuals with a depressive disorder, compared to healthy controls, negative mental images induced stronger negative affect in the explicit as well as implicit measure. Negative mental imagery did not, however, elicit greater increases in explicitly and implicitly assessed negative affect compared to other processing modalities (verbal processing, pictures) in the depressed group. Additionally, a positive imagery deficit in depression was observed in the explicit measure. Interestingly, the two groups did not differ in implicitly assessed affect after positive imagery, indicating that depressed individuals might benefit from positive imagery on an implicit or automatic level. Overall, our findings suggest that mental imagery also plays an important role in depression and confirm the potential of novel treatment approaches for depression, such as the promotion of positive imagery.

Third-year University Mathematics Education Students' Metaphorical Understanding of Mathematics Teaching and Learning

This paper reports on the metaphors that 36 third-year university mathematics education students have about mathematics. These metaphors were investigated through a questionnaire with five open-ended items. An inductive analysis of the students' metaphors for mathematics indicated that students had well developed and complex metaphors about mathematics, mathematics learning, mathematics teaching and the mathematics teacher. Several common themes emerged, including the view that hard work, patience and perseverance are needed for success in mathematics. Some students emphasised their role in learning mathematics as active while others view their role of the teacher as crucial. Three mental images are common: firstly, the notion that mathematics learning is challenging and may involve anxiety; secondly, that perseverance is needed as continuing effort will bring reward; and lastly, that positive or negative mental images of mathematics are related to the perception of and the active vs passive role of the learner. Considering that the metaphors were collected from students with an extensive engagement with mathematics learning, the findings implied that these metaphors reflect the students' mental images formed as a result of experiencing mathematics learning.

Looking in the mirror for the first time after facial burns: A retrospective mixed methods study

Appearance-related concerns are common following burns. However, there is minimal research that has specifically investigated patients’ reactions when they looked in the mirror for the first time following facial burns. The current study aimed to investigate patients’ reactions and factors associated with distress. Burns patients (n=35) who had sustained facial injuries completed a questionnaire which examined their reactions when looking in the mirror for the first time. Data were collected between April and July 2013. Participants had sustained their burns 12 months prior to participating, on average (ranging from one to 24 months). Forty-seven percent (n=16) of patients were worried about looking for the first time, 55% (n=19) were concerned about what they would see, and 42% (n=14) held negative mental images about what their faces looked like before they looked. Twenty-seven percent (n=9) of patients initially avoided looking, 38% (n=13) tried to ‘read’ others’ reactions to them to try to gauge what they looked like, and 73% (n=25) believed that it was important for them to look. Mean ratings suggested that patients found the experience moderately distressing. Patients most often found the experience less distressing compared to their expectations. Distress was related to feeling less prepared, more worried and increased negative mental images prior to looking. In conclusion, patients’ reactions to looking in the mirror for the first time vary. Adequately preparing patients and investigating their expectations beforehand is crucial. The findings have a number of important implications for practice.

The relevance bias: Valence-specific, relevance-modulated performance in a two-choice detection task

The aim of this study was to test the hypothesis that relevance modulates subsequent non-emotional behaviour, using a personalised mental-imagery-cued relevance manipulation paradigm. Participants had to build positive, negative and neutral mental images based on personalised scenarios that had been selected during an earlier picture-cued imagery phase. Participants imagined situations that were highly relevant for them and situations that were moderately relevant for them, depending on the effects the situations could exert on them. After each mental image, the effect of the relevance manipulation was tested in a two-choice detection task. The interaction of relevance and valence was found to be predictive of the response times. Moreover, in the high-relevance condition, longer response times were observed for positive scenarios compared to negative ones, whereas in the low-relevance condition, shorter response times were observed for positive scenarios compared to negative ones. Results are consistent with the motivational theory of emotions, which posits that low-relevance stimuli trigger valence-specific attention modulations, whereas high-relevance stimuli trigger valence-specific action tendencies.

Within the mind's eye: Negative mental imagery activates different emotion regulation strategies in high versus low socially anxious individuals

Background and objectivesThe link between social anxiety (SA) and maladaptive emotion regulation has been clearly established, but little is known about the spontaneous regulation strategies that may be activated during social stress by negative involuntary mental images and whether the nature of such strategies might distinguish individuals with high vs. low trait SA. MethodsParticipants with high (n = 33) or low (n = 33) trait SA performed an evaluative speech and reported whether they experienced an involuntary negative mental image during the task. They also rated their negative affect (NA) and positive affect (PA) and the extent to which they viewed their image as being controllable and malleable. Finally, they described the types of strategies they spontaneously used to try to control or change their image intrusions. Reported strategies were then subjected to a content analysis and categorized by blinded coders. ResultsAmong high SA participants, image controllability was both diminished overall and positively correlated with PA. Whereas 90% of low SA individuals reported that they spontaneously self-regulated by altering the content or perceptual features of their images, only about half of the high SA participants used this strategy, with the other 50% reporting that they either suppressed their images or succumbed passively to them in whatever form they took. Limitations and conclusionsAlthough these initial findings require replication in future experimental studies on clinical samples, they also help to enrich our understanding of the strategies that are commonly used by high and low SA individuals to manage their image intrusions during in-vivo stress and suggest potential avenues for future research on the role of imagery in adaptive and maladaptive emotion regulation.

In Vivo Activation of Anticipatory vs. Post-Event Autobiographical Images and Memories in Social Anxiety

The features of negative mental images and associated autobiographical memories were compared in high (n = 39) versus low (n = 46) socially anxious (HSA and LSA) participants using a modified version of the Waterloo Images and Memories Interview (WIMI; Moscovitch, Gavric, Bielak, Merrifield, & Moscovitch, 2011) either in anticipation of a videotaped speech or during post-event processing. Results indicated that negative images and memories were endorsed more frequently by HSA (vs. LSA) participants, and by those in the Anticipation (vs. Post-Event Processing) condition. Moreover, HSA relative to LSA participants reported more negative emotional consequences associated with bringing their images and memories to mind. Finally, post-event relative to anticipatory images and memories were associated with greater reported negative impact on participants' perceptions of self and others. Results and their potential theoretical and clinical implications are discussed in relation to contemporary cognitive-behavioral models of social anxiety.

Involuntary Memories after a Positive Film Are Dampened by a Visuospatial Task: Unhelpful in Depression but Helpful in Mania?

Spontaneous negative mental images have been extensively researched due to the crucial role they play in conditions such as post-traumatic stress disorder. However, people can also experience spontaneous positive mental images, and these are little understood. Positive images may play a role in promoting healthy positive mood and may be lacking in conditions such as depression. However, they may also occur in problematic states of elevated mood, such as in bipolar disorder. Can we apply an understanding of spontaneous imagery gained by the study of spontaneous negative images to spontaneous positive images? In an analogue of the trauma film studies, 69 volunteers viewed an explicitly positive (rather than traumatic) film. Participants were randomly allocated post-film either to perform a visuospatial task (the computer game ‘Tetris’) or to a no-task control condition. Viewing the film enhanced positive mood and immediately post-film increased goal setting on a questionnaire measure. The film was successful in generating involuntary memories of specific scenes over the following week. As predicted, compared with the control condition, participants in the visuospatial task condition reported significantly fewer involuntary memories from the film in a diary over the subsequent week. Furthermore, scores on a recognition memory test at 1 week indicated an impairment in voluntary recall of the film in the visuospatial task condition. Clinical implications regarding the modulation of positive imagery after a positive emotional experience are discussed. Generally, boosting positive imagery may be a useful strategy for the recovery of depressed mood. Copyright © 2012 John Wiley & Sons, Ltd.