A systematic review of imagery rescripting interventions for OCD, and an interpretative phenomenological analysis of experiences of imagery in OCD

Wedge, Hannah 2022. A systematic review of imagery rescripting interventions for OCD, and an interpretative phenomenological analysis of experiences of imagery in OCD. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Mental images are an important part of how we experience the world. Imagery can involve one sense or multiple senses. One good way to explain imagery is to imagine a lemon: you can probably ‘see’ a picture of the lemon in your mind, with colour, shape, and texture; maybe you can ‘smell’ the scent of a lemon; maybe you get that salivary response at the bottom of your mouth as you would if you tasted a lemon. Not only are mental images part of our everyday lives, but they are also a key criterion for the diagnosis of obsessive-compulsive disorder (OCD). People with OCD experience obsessions and/or compulsions; obsessions are recurrent intrusive thoughts, urges or images, and compulsions are repetitive behaviours or mental acts people feel they have to do in response to obsessions. Due to imagery being an important part of OCD, it is possible that imagery-based interventions may be helpful in reducing OCD symptoms. Imagery rescripting interventions aim to change the content and meaning of distressing mental images. There has been lots of research into these interventions as treatments for post-traumatic stress disorder (PTSD), but not much that looks at whether they are effective interventions for people with OCD. A systematic literature review was conducted in order to summarise and evaluate this research. Seven databases were searched using specific search terms relevant to imagery rescripting and OCD. The search resulted in 395 studies, which were then methodically screened to ascertain whether they met the inclusion criteria for the review. Eight studies were included in the review; five of them looked at eye movement desensitisation and reprocessing (EMDR) and three looked at imagery rescripting (ImRs). Data from these studies was extracted and narrative synthesis was used to examine the results. The results showed that although there was some limited evidence that both EMDR and ImRs were effective interventions to treat OCD, there were a lot of limitations with the designs, methods, and analyses of the studies. This means that any conclusions about the effectiveness of imagery rescripting interventions should be taken cautiously, and that there is a need for more high-quality research in this area. There has also been limited research into how people with OCD experience mental imagery. A research study was conducted with the aim of exploring people’s experiences of and reactions to imagery in OCD. An expert-by-experience helped to design the study, to make sure that the questions being asked were relevant and appropriate for people with OCD. Eight adults with OCD were interviewed, and their interviews were transcribed. The data was analysed using Interpretative Phenomenological Analysis (IPA). Six main themes were found, which showed that imagery in OCD is vivid and involves multiple senses, that people feel unable to control their OCD imagery, and that they elaborate upon the imagery they experience. The themes also showed that OCD imagery involves both past memories and future fears, that people respond to their OCD imagery as if it is real, and that therapy can help to shift imagery. These are important results which give insight into how people with OCD experience imagery; it can be intense, and it is a significant part of their everyday lives. It will be important for therapists and clinicians to think about and engage with imagery when they are working with people who have OCD.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	16 September 2022
Last Modified:	05 Jan 2024 08:27
URI:	https://orca.cardiff.ac.uk/id/eprint/152403

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