Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-06-01T03:28:50.971Z Has data issue: false hasContentIssue false
  • English
  • Français

Imagery rescripting and negative self-imagery in social anxiety disorder: a systematic literature review

Published online by Cambridge University Press:  28 February 2022

James Lloyd Open the ORCID record for James Lloyd [Opens in a new window]  and
Magda Marczak
James Lloyd*
Affiliation:
School of Psychological, Social and Behavioural Sciences, Faculty of Health and Life Sciences, Coventry University, Priory Street, CoventryCV1 5FB, UK
Magda Marczak
Affiliation:
School of Psychological, Social and Behavioural Sciences, Faculty of Health and Life Sciences, Coventry University, Priory Street, CoventryCV1 5FB, UK
*
*Corresponding author. Email: lloydj19@uni.coventry.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Imagery rescripting (IR) is an effective intervention for social anxiety disorder (SAD) that targets memories of distressing formative events linked to negative self-imagery (NSI). IR is thought to update unhelpful schema by addressing the needs of the younger self within the memory. An accumulating body of evidence indicates that by modifying NSI, IR can significantly affect distressing imagery, memory appraisal, and beliefs about the self.

Aims:

This systematic review aims to critically evaluate and synthesise literature investigating the existing research on the effects IR has on NSI in SAD.

Method:

A systematic electronic search of Academic Search Complete, ProQuest, Medline, Scopus and PubMed was performed in February 2021 using pre-defined criteria. Ten studies met the inclusion criteria and were selected for review.

Results:

Analysis of the reviewed articles’ findings identified three main themes: Changes to negative self-images, Memories linked to images and Encapsulated beliefs. IR was associated with significant decreases in image distress, image vividness, memory vividness, memory distress, and encapsulated beliefs. Although reductions were found with image frequency, they were non-significant. Interpretation of results is limited by the small number of studies.

Conclusions:

IR appears to effectively alter images, memories and beliefs in SAD in as little as a single session. The findings indicate that IR could be utilised as a cost-effective intervention for SAD. However, additional studies and longer-term follow-ups are needed.

Keywords

early memoriesimagery rescriptingnegative self-imagerysocial anxiety disordersystematic literature review
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 50 , Issue 3 , May 2022 , pp. 280 - 297
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahn, J. K., & Kwon, J. H. (2018). Modifying negative self-imagery increases the effectiveness of cognitive behaviour therapy for social anxiety disorder: a benchmarking study. Cognitive Therapy and Research, 42, 598–611. https://doi.org/10.1007/s10608-018-9918-5 CrossRefGoogle Scholar
Altman, D. G. (1990). Practical Statistics for Medical Research. CRC Press. https://doi.org/10.1201/9780429258589 CrossRefGoogle Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596.x00diagnosticclassification CrossRefGoogle Scholar
Arntz, A. (2012). Imagery rescripting as a therapeutic technique: review of clinical trials, basic studies, and research agenda. Journal of Experimental Psychopathology, 3, 189–208. https://doi.org/10.5127/jep.024211 CrossRefGoogle Scholar
Arntz, A., & Weertman, A. (1999). Treatment of childhood memories: theory and practice. Behaviour Research and Therapy, 37, 715–740. https://doi.org/10.1016/s0005-7967(98)00173-9 CrossRefGoogle ScholarPubMed
Ashbaugh, A. R., Fishman, K. N., & Houle-Johnson, S. A. (2019). Intrusive social images in individuals with high and low social anxiety: a multi-method analysis. Behavioural and Cognitive Psychotherapy, 47, 594–610. https://doi.org/10.1017/s1352465819000043 CrossRefGoogle ScholarPubMed
Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety Disorders and Phobias: A Cognitive Perspective. Basic Books.Google Scholar
Beck, J. S., & Beck, A. T. (1995). Cognitive Therapy: Basics and Beyond. New York, USA: Guilford Press.Google Scholar
Borenstein, M., Cooper, H., Hedges, L., & Valentine, J. (2009). Effect sizes for continuous data. The Handbook of Research Synthesis and Meta-Analysis, 2, 221–235.Google Scholar
Brewin, C. R. (2006). Understanding cognitive behaviour therapy: a retrieval competition account. Behaviour Research and Therapy, 44, 765–784.10.1016/j.brat.2006.02.005CrossRefGoogle ScholarPubMed
Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychological Review, 117, 210.10.1037/a0018113CrossRefGoogle ScholarPubMed
Chiupka, C. A., Moscovitch, D. A., & Bielak, T. (2012). In vivo activation of anticipatory vs. post-event autobiographical images and memories in social anxiety. Journal of Social and Clinical Psychology, 31, 783–809. https://doi.org/10.1521/jscp.2012.31.8.783 CrossRefGoogle Scholar
Cili, S., & Stopa, L. (2015). The retrieval of self-defining memories is associated with the activation of specific working selves. Memory, 23(2), 233-253. https://doi.org/10.1080/09658211.2014.882955 CrossRefGoogle ScholarPubMed
Clark, D. M., Ehlers, A., Hackmann, A., McManus, F., Fennell, M., Grey, N., … & Wild, J. (2006). Cognitive therapy versus exposure and applied relaxation in social phobia: a randomised controlled trial. Journal of Consulting and Clinical Psychology, 74, 568. https://doi.org/10.1186/isrctn11178360 CrossRefGoogle Scholar
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In Heimberg, G., Liebowitz, M. R., Hope, D., & Scheier, F. (eds), Social Phobia: Diagnosis, Assessment, and Treatment (pp. 69–93). New York, USA: Guilford Press.Google Scholar
Davey, G. (1997). A conditioning model of phobias. Phobias: A Handbook of Theory, Research and Treatment, pp. 302–322. Wiley.Google Scholar
Davey, G. C. (1989). UCS revaluation and conditioning models of acquired fears. Behaviour Research and Therapy, 27, 521–528.10.1016/0005-7967(89)90086-7CrossRefGoogle ScholarPubMed
Dryman, M. T., Gardner, S., Weeks, J. W., & Heimberg, R. G. (2016). Social anxiety disorder and quality of life: how fears of negative and positive evaluation relate to specific domains of life satisfaction. Journal of Anxiety Disorders, 38, 1–8.10.1016/j.janxdis.2015.12.003CrossRefGoogle ScholarPubMed
Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601–610. https://doi.org/10.1016/s0005-7967(99)00161-8 CrossRefGoogle ScholarPubMed
Helbig, S., & Fehm, L. (2004). Problems with homework in CBT: rare exception or rather frequent? Behavioural and Cognitive Psychotherapy, 32, 291. https://doi.org/10.1017/s1352465804001365 CrossRefGoogle Scholar
Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327, 557–560. https://doi.org/10.1136/bmj.327.7414.557 CrossRefGoogle ScholarPubMed
Hirsch, C., Meynen, T., & Clark, D. (2004). Negative self-imagery in social anxiety contaminates social interactions. Memory, 12, 496–506.10.1080/09658210444000106CrossRefGoogle ScholarPubMed
Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 36, 193–209. https://doi.org/10.1080/16506070701421313 CrossRefGoogle ScholarPubMed
Holmes, E. A., Arntz, A., & Smucker, M. R. (2007). Imagery rescripting in cognitive behaviour therapy: images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38, 297–305. https://doi.org/10.1016/j.jbtep.2007.10.007 CrossRefGoogle ScholarPubMed
Hyett, M. P., Bank, S. R., Lipp, O. V., Erceg-Hurn, D. M., Alvares, G. A., Maclaine, E., … & McEvoy, P. M. (2018). Attenuated psychophysiological reactivity following single-session group imagery rescripting versus verbal restructuring in social anxiety disorder: results from a randomised controlled trial. Psychotherapy and Psychosomatics, 87, 340–349. https://doi.org/10.1159/000493897 CrossRefGoogle Scholar
Kazantzis, N., Lampropoulos, G. K., & Deane, F. P. (2005). A national survey of practicing psychologists’ use and attitudes toward homework in psychotherapy. Journal of Consulting and Clinical Psychology, 73, 742. https://doi.org/10.1037/0022-006x.73.4.742 CrossRefGoogle ScholarPubMed
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. https://doi.org/10.1001/archpsyc.62.6.593 CrossRefGoogle ScholarPubMed
Kmet, L. M., Cook, L. S., & Lee, R. C. (2004). Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Edmonton: Alberta Heritage Foundation for Medical Research (AHFMR). https://doi.org/10.7939/R37M04F16 Google Scholar
Knutsson, J., Nilsson, J. E., Eriksson, Å., & Järild, L. (2019). Imagery rescripting and exposure in social anxiety: a randomized trial comparing treatment techniques. Journal of Contemporary Psychotherapy, 50, 233–240.10.1007/s10879-019-09448-1CrossRefGoogle Scholar
Lee, S. W., & Kwon, J. H. (2013). The efficacy of imagery rescripting (IR) for social phobia: a randomised controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 44, 351–360. https://doi.org/10.1016/j.jbtep.2013.03.001 CrossRefGoogle Scholar
Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173. https://doi.org/10.1159/000414022 CrossRefGoogle ScholarPubMed
Marks, D. F. (1973). Visual imagery differences in the recall of pictures. British Journal of Psychology, 64(1), 17–24. https://doi.org/10.1111/j.2044-8295.1973.tb01322.x CrossRefGoogle ScholarPubMed
McEvoy, P. M., & Saulsman, L. M. (2014). Imagery-enhanced cognitive behavioural group therapy for social anxiety disorder: a pilot study. Behaviour Research and Therapy, 55, 1–6. https://doi.org/10.1016/j.brat.2014.01.006 CrossRefGoogle ScholarPubMed
Mineka, S., & Zinbarg, R. (2006). A contemporary learning theory perspective on the etiology of anxiety disorders: it’s not what you thought it was. American Psychologist, 61, 10.10.1037/0003-066X.61.1.10CrossRefGoogle Scholar
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, Prisma. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6, e1000097.10.1371/journal.pmed.1000097CrossRefGoogle ScholarPubMed
Morina, N., Lancee, J., & Arntz, A. (2017). Imagery rescripting as a clinical intervention for aversive memories: a meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 55, 6–15. https://doi.org/10.1016/j.jbtep.2016.11.003 CrossRefGoogle ScholarPubMed
Moscovitch, D. A., Gavric, D. L., Merrifield, C., Bielak, T., & Moscovitch, M. (2011). Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure. Behaviour Research and Therapy, 49, 505–517. https://doi.org/10.1016/j.brat.2011.05.009 CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (2013). Mental health. London, UK: NICE.Google Scholar
Ng, A. S., Abbott, M. J., & Hunt, C. (2014). The effect of self-imagery on symptoms and processes in social anxiety: a systematic review. Clinical Psychology Review, 34, 620–633.10.1016/j.cpr.2014.09.003CrossRefGoogle ScholarPubMed
Nilsson, J. E., Lundh, L. G., & Viborg, G. (2012). Imagery rescripting of early memories in social anxiety disorder: an experimental study. Behaviour Research and Therapy, 50, 387–392. https://doi.org/10.1016/j.brat.2012.03.004 CrossRefGoogle ScholarPubMed
Norton, A. R., & Abbott, M. J. (2016). The efficacy of imagery rescripting compared to cognitive restructuring for social anxiety disorder. Journal of Anxiety Disorders, 40, 18–28. https://doi.org/10.1016/j.janxdis.2016.03.009 CrossRefGoogle ScholarPubMed
Patel, A., Knapp, M., Henderson, J., & Baldwin, D. (2002). The economic consequences of social phobia. Journal of Affective Disorders, 68, 221–233. https://doi.org/10.1016/s0165-0327(00)00323-2 CrossRefGoogle ScholarPubMed
Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–756. https://doi.org/10.1016/s0005-7967(97)00022-3 CrossRefGoogle ScholarPubMed
Reimer, S. G., & Moscovitch, D. A. (2015). The impact of imagery rescripting on memory appraisals and core beliefs in social anxiety disorder. Behaviour Research and Therapy, 75, 48–59. https://doi.org/10.1016/j.brat.2015.10.007 CrossRefGoogle ScholarPubMed
Romano, M., Hudd, T., Huppert, J. D., Reimer, S. G., & Moscovitch, D. A. (2020b). Imagery rescripting of painful memories in social anxiety disorder: a qualitative analysis of needs fulfillment and memory updating. Cognitive Therapy and Research, 45, 1–16.Google Scholar
Romano, M., Moscovitch, D. A., Huppert, J. D., Reimer, S. G., & Moscovitch, M. (2020a). The effects of imagery rescripting on memory outcomes in social anxiety disorder. Journal of Anxiety Disorders, 69, 102169.10.1016/j.janxdis.2019.102169CrossRefGoogle ScholarPubMed
Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. The Lancet, 371, 1115–1125. https://doi.org/10.1016/s0140-6736(08)60488-2 CrossRefGoogle ScholarPubMed
Stopa, L. (ed) (2009). Imagery and the Threatened self: Perspectives on Mental Imagery and the Self in Cognitive Therapy. Routledge.10.4324/9780203878644CrossRefGoogle Scholar
Stopa, L. (2011). Imagery rescripting across disorders: a practical guide. https://doi.org/10.1016/j.cbpra.2011.05.001 CrossRefGoogle Scholar
Takanashi, R., Yoshinaga, N., Oshiro, K., Matsuki, S., Tanaka, M., Ibuki, H., … & Shimizu, E. (2020). Patients’ perspectives on imagery rescripting for aversive memories in social anxiety disorder. Behavioural and Cognitive Psychotherapy, 48, 229–242. https://doi.org/10.1017/s1352465819000493 CrossRefGoogle Scholar
von Hippel, P. T. (2015). The heterogeneity statistic I2 can be biased in small meta-analyses. BMC Medical Research Methodology, 15, 1–8. https://doi.org/10.1186/s12874-015-0024-z CrossRefGoogle Scholar
Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 603–613. https://doi.org/10.1001/archpsyc.62.6.603 CrossRefGoogle ScholarPubMed
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54, 1063. https://doi.org/10.1037/0022-3514.54.6.1063 CrossRefGoogle ScholarPubMed
Wild, J., Hackmann, A., & Clark, D. M. (2007). When the present visits the past: updating traumatic memories in social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 38, 386–401. https://doi.org/10.1016/j.jbtep.2007.07.003 CrossRefGoogle ScholarPubMed
Wild, J., Hackmann, A., & Clark, D. M. (2008). Rescripting early memories linked to negative images in social phobia: a pilot study. Behavior Therapy, 39, 47–56. https://doi.org/10.1016/j.beth.2007.04.003 CrossRefGoogle ScholarPubMed
Wong, Q. J., Gregory, B., Norton, A. R., Shikatani, B., Boulton, K. A., Torok, M., … & Antony, M. M. (2021). Psychometric properties of the Self-Beliefs related to Social Anxiety (SBSA) scale in a sample of individuals with social anxiety disorder. Journal of Anxiety Disorders, 78, 102365. https://doi.org/10.1016/j.janxdis.2021.102365 CrossRefGoogle Scholar
Supplementary material: PDF

Lloyd and Marczak supplementary material

Lloyd and Marczak supplementary material

Download Lloyd and Marczak supplementary material(PDF)
PDF 193.7 KB
Submit a response

Comments

No Comments have been published for this article.