Mental imagery interventions in eating disorders and imagery processing in obsessive-compulsive disorders: A systematic review and quantitative study exploring the role of mental imagery

Willcox, Alex 2022. Mental imagery interventions in eating disorders and imagery processing in obsessive-compulsive disorders: A systematic review and quantitative study exploring the role of mental imagery. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

The aim of this research was to explore how mental imagery can impact on eating disorders and obsessive-compulsive disorder (OCD), and to explore whether mental imagery-based interventions can be appropriate and effective for these populations. Mental imagery can be defined as cognitive experiences that have sensory properties, and therefore will closely resemble actual perceptual experiences. These sensory properties can be visual, olfactory, tactile, acoustic, or gustatory. The systematic review aimed to understand the evidence base for mental-imagery interventions in eating disorders. These interventions can include imagery rescripting, positive imagery, and guided imagery, among others. A previous review had been conducted in 2011, which focussed on the effect of imagery interventions in cognitive behavioural therapy. The scope was widened for this review, looking at imagery interventions in any context. Three databases were searched including Psycinfo, EMcare, and Medline, with search terms relating to mental imagery interventions and eating disorders being developed in collaboration with a librarian. Three hundred and forty-two papers were screened, and thirteen papers met the inclusion criteria, and therefore were included in the review. The review found that imagery interventions are comparable to other interventions, such as enhanced cognitive behavioural therapy (CBT-E). However, caution is needed in interpretation as imagery interventions can be included in courses of CBT-E, which may mean that there is some overlap in the delivery of treatments. This review found that imagery interventions were shorter in duration than established interventions and showed a lower attrition rate during therapy than other interventions. Suggestions have been made that imagery interventions may be more meaningful to service users, and therefore may be better at retaining people through therapy. This review acknowledges the need for more high-quality research papers investigating mental imagery interventions in eating disorders, although initial research appears promising in this area when considering effectiveness, retention, and efficiency in delivery. The empirical paper describes a quantitative study that explored the effects of mental imagery processing on a population that display obsessive compulsive behaviours. Current interventions for OCD focus on people’s reactions to verbal cognitions, but mental imagery has been shown to have an important role in people’s processing, especially when considering emotional links. Previous research has found that heightened or distorted mental imagery is present in disorders such as posttraumatic stress disorder (PTSD), generalised anxiety disorder (GAD), and clinical depression. However, there appears to be no research that investigates the difference in impact between verbal and imagery cognitions within the context of OCD. Eighty-five participants were initially recruited through two systems: one university based and the other an online resource bank for those interested in participating in research. Thirteen participants were excluded, leaving seventy-two full sets of results. Participants were required to complete the Obsessive-Compulsive Inventory (OCI), the Spontaneous Use of Imagery Scale (SUIS), and the StateTrait Anxiety Inventory (STAI) before commencing the study. Participants were then asked to look at word-image pairings and instructed to process them either verbally or through imagery. This was manipulated by asking participants to complete a sentence using the word-image pairing in the verbal condition, and the imagery condition asked participants to mentally visualise the word-image pairing. The STAI was used as a measure of anxiety after each processing block. Findings from the empirical study showed that there was no significant difference between anxiety ratings and different types of processing in the full sample. When participants were split based on high and low OCI scores (creating two groups of high and low OCD tendencies), there was no significant difference in the impact of imagery processing on anxiety ratings. Therefore, this study concluded that imagery processing may not significantly affect a population with OCD tendencies more than healthy controls. Other interesting results were apparent from the data, such as the large number of people scoring over the clinical cut-off for the OCI measure, suggesting that OCD rates are higher in the general population that the current estimates, or that the covid-19 pandemic has significantly affected the population and more people are likely to develop OCD as a result. Recommendations for future research are suggested, and limitations with regards to completing this study within a covid-19 context are discussed to inform further research.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	14 October 2022
Last Modified:	13 Oct 2023 01:30
URI:	https://orca.cardiff.ac.uk/id/eprint/153350

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