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The Role of Mental Imagery in Mood Amplification View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by University of Birmingham Research Portal University of Birmingham The role of mental imagery in mood amplification O'Donnell, Caitlin; Di Simplicio, Martina; Brown, Randi; Holmes, Emily; Burnett Heyes, Stephanie DOI: 10.1016/j.cortex.2017.08.010 License: Creative Commons: Attribution (CC BY) Document Version Publisher's PDF, also known as Version of record Citation for published version (Harvard): O'Donnell, C, Di Simplicio, M, Brown, R, Holmes, E & Burnett Heyes, S 2017, 'The role of mental imagery in mood amplification: an investigation across subclinical features of bipolar disorders', Cortex, vol. 105, pp. 104- 117. https://doi.org/10.1016/j.cortex.2017.08.010 Link to publication on Research at Birmingham portal General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. •Users may freely distribute the URL that is used to identify this publication. •Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. •User may use extracts from the document in line with the concept of ‘fair dealing’ under the Copyright, Designs and Patents Act 1988 (?) •Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive. If you believe that this is the case for this document, please contact [email protected] providing details and we will remove access to the work immediately and investigate. Download date: 01. Mar. 2020 cortex 105 (2018) 104e117 Available online at www.sciencedirect.com ScienceDirect Journal homepage: www.elsevier.com/locate/cortex Special issue: Research report The role of mental imagery in mood amplification: An investigation across subclinical features of bipolar disorders Caitlin O'Donnell a,b, Martina Di Simplicio c,d, Randi Brown a, * Emily A. Holmes e and Stephanie Burnett Heyes f, a Department of Experimental Psychology, University of Oxford, Oxford, UK b Graduate School of Applied and Professional Psychology, Rutgers University, USA c MRC Cognition and Brain Sciences Unit, Cambridge, UK d Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK e Institute of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden f School of Psychology, University of Birmingham, UK article info abstract Article history: Vivid emotional mental imagery has been identified across a range of mental disorders. In Received 13 February 2017 bipolar spectrum disorders e psychopathologies characterized by mood swings that Reviewed 19 April 2017 alternate between depression and mania, and include irritability and mixed affect states e Revised 16 June 2017 mental imagery has been proposed to drive instability in both ‘positive’ and ‘negative’ Accepted 9 August 2017 mood. That is, mental imagery can act as an “emotional amplifier”. The current experi- Published online 18 August 2017 mental study tested this hypothesis and investigated imagery characteristics associated with mood amplification using a spectrum approach to psychopathology. Young adults Keywords: (N ¼ 42) with low, medium and high scores on a measure of subclinical features of bipolar Mental imagery disorder (BD), i.e., hypomanic-like experiences such as overly ‘positive’ mood, excitement Hypomania and hyperactivity, completed a mental imagery generation training task using positive Bipolar disorder picture-word cues. Results indicate that (1) mood amplification levels were dependent on Mood amplification self-reported hypomanic-like experiences. In particular, (2) engaging in positive mental Imagery vividness imagery led to mood amplification of both positive and negative mood in those participants higher in hypomanic-like experiences. Further, (3) in participants scoring high for hypomanic-like experiences, greater vividness of mental imagery during the experimental task was associated with greater amplification of positive mood. Thus, for individuals with high levels of hypomanic-like experiences, the generation of emotional mental imagery may play a causal role in their mood changes. This finding has implications for under- standing mechanisms driving mood amplification in bipolar spectrum disorders, such as targeting imagery vividness in therapeutic interventions. © 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). * Corresponding author. School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. E-mail addresses: [email protected] (M. Di Simplicio). [email protected] (S. Burnett Heyes). http://dx.doi.org/10.1016/j.cortex.2017.08.010 0010-9452/© 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/). cortex 105 (2018) 104e117 105 Hypomanic experiences are considered a risk factor for the 1. Introduction development of full blown BD (Axelson et al., 2015; Hirschfeld et al., 2000; Lewinsohn, Seeley, & Klein, 2003). Mental imagery is the perception of an image in the ‘mind's Several studies have indicated a correlation between bi- eye’ when the corresponding item is not actually present polar spectrum features and self-report measures of mental (Kosslyn, Ganis, & Thompson, 2001; Pearson, Naselaris, imagery. Holmes, & Kosslyn, 2015). Mental imagery can occur in mul- Hypomanic-traits. Individuals with high levels of tiple sensory modalities (Kosslyn, Seger, Pani, Hillger, & hypomanic-like experiences have been found to present Stephen, 1990). Imagery can involve both re-experiencing of increased trait-like tendency to spontaneously experience the past and creating mental time travel into the future emotionally-neutral imagery and a greater emotional impact (Addis, Pan, Vu, Laiser, & Schacter, 2009; D'Argembeau, of imagery for the future (Deeprose & Holmes, 2010; Malik, Renaud, & Van der Linden, 2011; Holmes, Mathews, Goodwin, Hoppitt, & Holmes, 2014; McGill & Moulds, 2014) Mackintosh, & Dagleish, 2008). Mental imagery can be highly measured by self-report scales (the Spontaneous Use of Im- emotionally-evocative compared to verbal thoughts (Holmes, agery Scale e SUIS, Nelis, Holmes, Griffith, & Raes, 2014; and Mathews et al., 2008). Emotional processing in the brain may the Impact of Future Events Scale, IFES, Deeprose & Holmes, be particularly sensitive to mental imagery (Holmes & 2010). Levels of intrusive visual imagery measured via a Mathews, 2005; Pearson et al., 2015). bespoke questionnaire (not limited to imagery of the future) Studies have highlighted the importance of imagery-based predicted levels of hypomania in another large sample study symptomatology in numerous disorders (Holmes & Mathews, (McCarthy-Jones, Knowles, & Rowse, 2012). Finally, high 2010) and recently also suggested a relationship between hypomanic-traits have also been associated with greater mental imagery and bipolar disorder (BD) (Ng, Di Simplicio, & susceptibility to experience more intrusive imagery following Holmes, 2016). Investigating mental imagery in patients with exposure to an experimental trauma film paradigm (Malik mental disorders, in particular mood disorders, can reveal et al., 2014). important aspects of the role of imagery in cognitive processes Bipolar disorder. Increased trait-like tendency to sponta- such as affect regulation, and more broadly in the mainte- neously experience emotionally-neutral imagery and a nance of psychological wellbeing (Szpunar, Spreng, & greater emotional impact of imagery for the future have been Schacter, 2014). reported also in individuals with BD (Hales, Deeprose, BD is characterised by recurring episodes of depression Goodwin, & Holmes, 2011; Holmes et al., 2011; Ng, Burnett and mania at various levels of duration and intensity (DSM 5 e Heyes, McManus, Kennerley, & Holmes, 2016), as well as a APA, 2013). A manic episode refers to excessively elated or higher reported frequency of imagery use over verbal thought irritable mood and increased goal-directed activity often over the previous week measured on a visual analogue scale including disinhibition and risky behaviours, alongside other (Holmes et al., 2011). The relationship between higher re- symptoms such as abnormally high energy levels, inflated ported frequency of imagery use over verbal thought and BD self-esteem and grandiosity, distractibility, accelerated was also found using semi-structured interviews that asked thoughts and speech, and reduced need for sleep. A depres- individuals to describe the experience of imagery and verbal sive episode instead presents with depressed (low) mood, lack cognitions at times of positive mood, for example how of motivation and anhedonia, together with other symptoms exciting or compelling were mental images
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