Self-Compassion And Imagery Rescripting: A Brief Online Intervention To Reduce Body Dissatisfaction in Women

Background: Due to the prevalence of body dissatisfaction, and given that it is a significant risk factor for eating disorders and obesity, understanding the mechanisms of change, and finding new ways on how to reduce body dissatisfaction are important avenues of research. The current study aimed to investigate whether a brief online intervention of imagery rescripting is more effective in reducing state body dissatisfaction in women than the widely used intervention of self-compassion, or a control condition. Methods: One-hundred and twenty-three Australian women with high levels of body dissatisfaction were allocated to one of the three intervention conditions: imagery rescripting, self-compassion, or control. Participants completed a screening questionnaire, a visual analogue scale (VAS) on mood, and a physical appearance state and trait anxiety scale (PASTAS) on state body dissatisfaction before and after a body dissatisfaction inducing mirror task, and again after the intervention. Results: Results showcased a significant decrease in state body dissatisfaction from post-induction to post-intervention for imagery rescripting compared to the control. Conclusion: Imagery rescripting was identified as an effective brief intervention for reducing state body dissatisfaction in women and inspiring body acceptance compared to the control condition. Future studies should investigate the impact of multiple sessions of imagery rescripting for women with high levels of body dissatisfaction.

Comparison of the Effects of the Choice Theory and Behavioral Activation Therapies with and without Guided Imagery Rescripting on the Adversity Quotient and Cognitive Emotion Regulation of MS Patients in Ahvaz, Iran

Background: Complications of multiple sclerosis (MS) severely impact self-image and have debilitative effects on the adversity quotient. Objectives: The present study aimed to investigate the effects of the choice theory and behavioral activation therapies with and without guided imagery rescripting on the adversity quotient and cognitive emotion regulation of MS patients in Ahvaz, Iran. Methods: This quasi-experimental study was conducted with a pretest-posttest design and a control group. The sample population included the male and female MS patients visiting the Caspian Physiotherapy Center of Ahvaz, Iran in 2019. In total, 60 MS patients were selected via convenience sampling and randomly divided into three experimental groups and one control group (15 per each). Data were collected using the Adversity Response Profile Questionnaire (ARPQ) and the Cognitive Emotion Regulation Questionnaire (CERQ). Data analysis was performed using the multivariate analysis of covariance. Results: A significant difference was observed between the effects of the choice theory (CT) and behavioral activation (BA) therapies with and without guided imagery rescripting (ImRs) on the improvement of the adversity quotient (AQ) and positive cognitive emotion regulation (CER) of the MS patients, as well as the reduction of negative CER (P < 0.001). Compared to the CT and BA therapies without guided ImRs, the BA therapy with guided ImRs more effectively enhanced the AQ and positive CER of the MS patients and decreased their negative CER (P < 0.001). Conclusions: According to the results, BA with ImRs is a more effective method for enhancing the AQ and positive CER of MS patients and mitigating their negative CER compared to other approaches.

Imagery Rescripting Versus Extinction: Distinct and Combined Effects on Expectancy and Revaluation Learning

Anxiety disorders are effectively treated with exposure therapy, but relapse remains high. Fear may reinstate after reoccurrence of the negative event because the expectancy of the aversive outcome (unconditioned stimulus [US]) is adjusted but not its evaluation. Imagery rescripting (ImRs) is an intervention that is proposed to work through revaluation of the US. The aim of our preregistered study was to test the effects of ImRs and extinction on US expectancy and US revaluation. Day 1 ( n = 106) consisted of acquisition with an aversive film clip as US. The manipulation (ImRs + extinction, extinction-only, or ImRs-only) took place on Day 2. Reinstatement of fear was tested on Day 3. Results showed expectancy learning in both extinction conditions but not in the ImRs-only condition and no enhanced revaluation learning in ImRs. The combination of ImRs and extinction slowed down extinction but did not protect against reinstatement, which pleads in favor of stand-alone interventions in clinical practice.

The effect of twice-weekly versus once-weekly sessions of either imagery rescripting or eye movement desensitization and reprocessing for adults with PTSD from childhood trauma (IREM-Freq): a study protocol for an international randomized clinical trial

Background Trauma-focused treatments for posttraumatic stress disorder (PTSD) are commonly delivered either once or twice a week. Initial evidence suggests that session frequency affects treatment response, but very few trials have investigated the effect of session frequency. The present study’s aim is to compare treatment outcomes of twice-weekly versus once-weekly sessions of two treatments for PTSD related to childhood trauma, imagery rescripting (ImRs) and eye movement desensitization and reprocessing (EMDR). We hypothesize that both treatments will be more effective when delivered twice than once a week. How session frequency impacts treatment response, whether treatment type moderates the frequency effect, and which treatment type and frequency works best for whom will also be investigated. Methods The IREM-Freq trial is an international multicenter randomized clinical trial conducted in mental healthcare centers across Australia, Germany, and the Netherlands. We aim to recruit 220 participants, who will be randomized to one of four conditions: (1) EMDR once a week, (2) EMDR twice a week, (3) ImRs once a week, or (4) ImRs twice a week. Treatment consists of 12 sessions. Data are collected at baseline until one-year follow-up. The primary outcome measure is clinician-rated PTSD symptom severity. Secondary outcome measures include self-reported PTSD symptom severity, complex PTSD symptoms, trauma-related cognitions and emotions, depressive symptoms, dissociation, quality of life, and functioning. Process measures include memory, learning, therapeutic alliance, motivation, reluctance, and avoidance. Additional investigations will focus on predictors of treatment outcome and PTSD severity, change mechanisms of EMDR and ImRs, the role of emotions, cognitions, and memory, the optimization of treatment selection, learned helplessness, perspectives of patients and therapists, the network structure of PTSD symptoms, and sudden treatment gains. Discussion This study will extend our knowledge on trauma-focused treatments for PTSD related to childhood trauma and, more specifically, the importance of session frequency. More insight into the optimal session frequency could lead to improved treatment outcomes and less dropout, and in turn, to a reduction of healthcare costs. Moreover, the additional investigations will broaden our understanding of how the treatments work and variables that affect treatment outcome. Trial registration Netherlands Trial Register NL6965, registered 25/04/2018.

Clients’ Emotional Experiences Tied to Therapist-Led (but Not Client-Led) Physiological Synchrony during Imagery Rescripting

Imagery rescripting (IR), an effective intervention technique, may achieve its benefits through various change mechanisms. Previous work has indicated that client–therapist physiological synchrony during IR may serve as one such mechanism. The present work explores the possibility that therapist-led vs. client-led synchrony may be differentially tied to clients’ emotional experiences in therapy. The analyses were conducted with data taken from an open trial of a brief protocol for treating test anxiety (86 IR sessions from 50 client–therapist dyads). Physiological synchrony in electrodermal activity was indexed using two cross-correlation functions per session: once for client leading and again for therapist leading (in both cases, with lags up to 10 s). The clients’ and therapists’ in-session emotions were assessed with the Profile of Mood States. Actor–partner interdependence models showed that certain client (but not therapist) in-session emotions, namely higher contentment and lower anxiety and depression, were tied to therapist-led (but not client-led) physiological synchrony. The results suggest that therapist-led synchrony (i.e., clients’ arousal tracking therapists’ earlier arousal) is tied to more positive and less negative emotional experiences for clients.

Mechanisms and Effectiveness of Imagery Strategies in Reducing Disgust in Contamination-Related Obsessive–Compulsive Disorder: Comparing Imagery Rescripting, Imagery Self-compassion and Mood-Focused Imagery

Background Strong feelings of disgust and anxiety are maintaining factors in contamination-related obsessive–compulsive disorder (C-OCD). To this day there are not many studies that investigated strategies for changing pathological disgust. In a previous study, it was shown that imagery rescripting could successfully change disgust. However, whether imagery rescripting or more general imagery processing, helps to reduce pathological disgust, remains unclear. Therefore, the aim of the present study was to investigate how successful imagery rescripting is in comparison to imagery self-compassion and a passive positive imagery condition in reducing disgust. Methods For this, the three strategies were compared to each other on 2 days (within-subject) in a laboratory experiment. The study included 24 subjects with diagnosed C-OCD, and 24 matched, healthy controls (between-subject). Results The results show that all three strategies changed disgust, they do not differ from each other and that different traits appear to influence the strategies’ success or failure. The theoretically derived underlying mechanisms of the strategies were found in an elaborate content analysis. Conclusions The present study provides first indications that imagery in general can help to change pathological disgust experience.