Imagery-based interventions for the early stages of Bipolar Disorder

Martina DiSimplicio1, Emily Holmes1; 1University of Cambridge, MRC Cognition and Brain Sciences Unit

Mental imagery is the experience of "seeing with the mind's eye" in the absence of an actual sensory percept. Mental imagery has a strong emotional impact (Holmes and Matthews, 2005) and can influence behaviour (Libby et al., 2007). Patients with bipolar disorder (BD) describe experiencing intrusive 'flashforwards' of negative future events (Hales et al., 2012), or playing worst case scenarios in their mind that amplify anxiety and low mood. This clinical evidence supports the idea that intrusive mental images can act as an 'emotional amplifier' contributing to the escalation of affect in BD (Holmes et al., 2008). I will present data from a recent case series study of a brief imagery-based psychological intervention targeting low mood and anxiety in an selected sample of patients with BD (Holmes et al., 2015). Our result show that targeting distressing mental imagery can reduce mood instability over one month and treatment effects are maintained at six months follow-up. Further, I will present evidence from experimental psychopathology studies on the association between emotional mental imagery and affect lability (Di Simplicio et al., under review) and in particular between hypomanic traits and imagery susceptibility in young people (O'Donnell et al., under review). Based on this evidence, I will propose that imagery-based interventions may be a suitable approach for the early stages of bipolar disorder, an area where early intervention remains underdeveloped and in great need of treatment innovation.

Topic Area: Ultra High Risk / Prodromal Research

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