Exploring aspects of self-reported emotional mental imagery in patients with bipolar disorder

K C van den Berg; M Voncken; A T Hendrickson; M Di Simplicio; E J Regeer; L Rops; G P J Keijsers

doi:10.1016/j.jbtep.2023.101861

Exploring aspects of self-reported emotional mental imagery in patients with bipolar disorder

J Behav Ther Exp Psychiatry. 2023 Dec:81:101861. doi: 10.1016/j.jbtep.2023.101861. Epub 2023 May 8.

Authors

K C van den Berg¹, M Voncken², A T Hendrickson³, M Di Simplicio⁴, E J Regeer⁵, L Rops⁶, G P J Keijsers⁷

Affiliations

¹ Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), the Netherlands; Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands. Electronic address: karin.vandenberg@maastrichtuniversity.nl.
² Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands.
³ Department of Cognitive Science and Artificial Intelligence, Tilburg University, the Netherlands.
⁴ Imperial College London, Division of Psychiatry, Department of Brain Sciences, UK.
⁵ Altrecht Institute for Mental Health Care, Utrecht, the Netherlands.
⁶ Medical Psychiatric Research Group, Geestelijke Gezondheidszorg Eindhoven (GGzE), the Netherlands.
⁷ Faculty of Psychology and Neuroscience, Department of Clinical Psychological Sciences, Maastricht University, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.

PMID: 37182427
DOI: 10.1016/j.jbtep.2023.101861

Abstract

Background and objectives: CBT for patients with bipolar disorder has modest effects. Across disorders, mental imagery has been used to update CBT to increase effectiveness. In order to enhance CBT for bipolar disorder with imagery techniques, research is needed into emotional imagery quality and, related appraisals of imagery and their relationships with mood instability and subsequent behaviour in bipolar disorder.

Methods: Patients with bipolar disorder (n = 106), unipolar depression (n = 51), creative imagery prone participants (n = 53) and participants without a history of a mood disorder (n = 135) completed the Dutch Imagery Survey (DImS), an online imagery survey, adapted from the Imagery Interview, assessing self-reported emotional imagery aspects. Imagery quality, appraisals and their self-perceived effects on emotion and behaviour were compared between groups. As unexpected differences within the bipolar group appeared, these were additionally explored.

Results: Imagery appraisals but not imagery quality discriminated between the patient groups and non-patient groups Imagery was perceived as an emotional amplifier in all groups, but this was specifically apparent in bipolar manic and bipolar depressed groups. Only in the bipolar group imagery was experienced to amplify behavioural tendencies.

Limitations: Results need to be replicated using a larger sample of patients with BD who are currently manic or depressed.

Conclusions: Not only quality of imagery, but especially appraisals associated with imagery are differentiating between imagery prone people with and without mood disorder. Imagery amplifies emotion in all groups, but only in those patients with bipolar disorder currently manic or depressed did this influence behaviour.

Keywords: Bipolar disorder; Imagery prone healthy; Mental imagery; Unipolar depression.

MeSH terms

Bipolar Disorder* / psychology
Depressive Disorder* / psychology
Emotions
Humans
Mood Disorders
Self Report