Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-18T20:13:01.308Z Has data issue: false hasContentIssue false

Imagine food, weight and shape: mental imagery in women with eating disorders compared with healthy controls

Published online by Cambridge University Press:  14 September 2020

Kim Hijne
Affiliation:
Rivierduinen Eating Disorders Ursula, PO Box 405, 2300AKLeiden, The Netherlands
Suzan Ben Chamach
Affiliation:
Rivierduinen Eating Disorders Ursula, PO Box 405, 2300AKLeiden, The Netherlands
Alexandra E. Dingemans*
Affiliation:
Rivierduinen Eating Disorders Ursula, PO Box 405, 2300AKLeiden, The Netherlands Institute of Psychology, Leiden University, 2333AKLeiden, The Netherlands
*
*Corresponding author. Email: a.dingemans@rivierduinen.nl

Abstract

Background:

Research into mental disorders has found mental imagery to be a maintaining factor for psychological distress. However, studies investigating mental imagery in eating disorders are scarce.

Aim:

The aim of the present study was to compare spontaneous mental imagery related to eating, weight and/or appearance and intrusive prospective imagery in women with an eating disorder with female healthy controls.

Methods:

Spontaneous mental imagery and intrusive prospective imagery were assessed in adult women with an eating disorder (n = 29) and in female healthy controls (n = 32) using a semi-structured interview and the Impact of Future Events Scale, respectively.

Results:

In comparison with healthy controls, the spontaneous mental images in individuals with an eating disorder involved more sensory modalities (U = 156.50, p < .001, r = –.51), were more vivid (t (52) = 2.04, p = .047, d = .55), negative (U = 103.00, p < .001, r = –.62), and anxiety provoking (U = 158.50, p < .001, r = –.49), and were experienced with a lower sense of control (U = 215.00, p = .009, r = –.36). The emotional impact of intrusive prospective imagery (U = 105.00, p < .001, r = –.66) was also higher in individuals with an eating disorder, as was the number of negative prospective images (U = 283.00, p = .016, r = –.31).

Conclusions:

Our findings are consistent with previous research on mental imagery in other psychiatric disorders, and provide possibilities for incorporating imagery-based techniques in treatment interventions.

Type
Main
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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

Aardoom, J. J., Dingemans, A. E., Slof Op’t Landt, M. C. T., & van Furth, E. F. (2012). Norms and discriminative validity of the Eating Disorder Examination Questionnaire (EDE-Q). Eating Behaviors, 13, 305309. https://doi.org/10.1016/j.eatbeh.2012.09.002 CrossRefGoogle Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn). Arlington, VA, USA: American Psychiatric Publishing.Google Scholar
Arntz, A. (2012). Imagery rescripting as a therapeutic technique: review of clinical trials, basic studies, and research agenda. Journal of Experimental Psychopathology, 3, 189208. https://doi.org/10.5127/jep.024211 CrossRefGoogle Scholar
Bloomgarden, A. & Calogero, R. M. (2008). A randomized experimental test of the efficacy of EMDR treatment on negative body image in eating disorder inpatients. Eating Disorders, 16, 418427. https://doi.org/10.1080/10640260802370598 CrossRefGoogle ScholarPubMed
Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: focus on PTSD. Eating Disorders, 15, 285304. https://doi.org/10.1080/10640260701454311 CrossRefGoogle ScholarPubMed
Brewin, C. R. (2015). Re-experiencing traumatic events in PTSD: new avenues in research on intrusive memories and flashbacks. European Journal of Psychotraumatology, 6, 27180. https://doi.org/10.3402/ejpt.v6.27180 CrossRefGoogle 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, 210232. https://doi.org/10.1037/a0018113 CrossRefGoogle ScholarPubMed
Cooper, M. J. (2009). Imagery and the negative self in eating disorders. In Stopa, L. (ed), Imagery and the Threatened Self: Perspectives on Mental Imagery and the Self in Cognitive Therapy (pp. 181205). East Sussex, UK: Routledge.Google Scholar
Cooper, M. J., Todd, G., & Turner, H. (2007). The effects of using imagery to modify core emotional beliefs in bulimia nervosa: an experimental pilot study. Journal of Cognitive Psychotherapy, 21, 117122. https://doi.org/10.1891/088983907780851577 CrossRefGoogle Scholar
Day, S., Holmes, E., & Hackmann, A. (2004). Occurrence of imagery and its link with early memories in agoraphobia. Memory, 12, 416427. https://doi.org/10.1080/09658210444000034 CrossRefGoogle ScholarPubMed
Deeprose, C. & Holmes, E. A. (2010). An exploration of prospective imagery: the Impact of Future Events Scale. Behavioural and Cognitive Psychotherapy, 38, 201209. https://doi.org/10.1017/S1352465809990671 CrossRefGoogle ScholarPubMed
Deeprose, C., Malik, A., & Holmes, E. A. (2011). Measuring intrusive prospective imagery using the Impact of Future Events Scale (IFES): psychometric properties and relation to risk for bipolar disorder. International Journal of Cognitive Therapy, 4, 187196. https://doi.org/10.1521/ijct.2011.4.2.187 CrossRefGoogle ScholarPubMed
Di Simplicio, M., Renner, F., Blackwell, S. E., Mitchell, H., Stratford, H. J., Watson, P., Myers, N., Nobre, A. C., Lau-Zhu, A., & Holmes, E. A. (2016). An investigation of mental imagery in bipolar disorder: exploring ‘the mind’s eye’. Bipolar Disorders, 18, 669683. https://doi.org/10.1111/bdi.12453 CrossRefGoogle Scholar
Dugué, R., Keller, S., Tuschen-Caffier, B., & Jacob, G. A. (2016). Exploring the mind’s eye: contents and characteristics of mental images in overweight individuals with binge eating behaviour. Psychiatry Research, 246, 554560. https://doi.org/10.1016/j.psychres.2016.10.028 CrossRefGoogle ScholarPubMed
Fairburn, C. G. & Beglin, S. J. (2008). Eating Disorder Examination Questionnaire (EDE-Q 6.0). In Fairburn, C. G. (ed), Cognitive Behavior Therapy and Eating Disorders (pp. 309313). New York, NY, USA: Guilford Press.Google ScholarPubMed
Fairburn, C. G. & Cooper, Z. (1993). The Eating Disorder Examination. In Fairburn, C. G. & Wilson, G. T. (eds), Binge Eating: Nature, Assessment and Treatment (pp. 317360). New York, NY, USA: Guilford Press.Google Scholar
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy, 41, 509528. https://doi.org/10.1016/S0005-7967(02)00088-8 CrossRefGoogle ScholarPubMed
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991). Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715723. https://doi.org/10.1037/0022-006x.59.5.715 CrossRefGoogle ScholarPubMed
Godley, J., Tchanturia, K., MacLeod, A., & Schmidt, U. (2001). Future-directed thinking in eating disorders. British Journal of Clinical Psychology, 40, 281296. https://doi.org/10.1348/014466501163698 CrossRefGoogle ScholarPubMed
Goldberg, D. & Williams, P. (1988). A User’s Guide to the General Health Questionnaire. Windsor, UK: NFER-Nelson.Google Scholar
Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601610. https://doi.org/10.1016/S0005-7967(99)00161-8 CrossRefGoogle ScholarPubMed
Hackmann, A. & Holmes, E. (2004). Reflecting on imagery: a clinical perspective and overview of the special issue of Memory on mental imagery and memory in psychopathology. Memory, 12, 389402. https://doi.org/10.1080/09658210444000133 CrossRefGoogle ScholarPubMed
Hilbert, A., Hoek, H. W., & Schmidt, R. (2017). Evidence-based clinical guidelines for eating disorders: international comparison. Current Opinion in Psychiatry, 30, 423437. https://doi.org/10.1097/YCO.0000000000000360 CrossRefGoogle ScholarPubMed
Hinrichsen, H., Morrison, T., Waller, G., & Schmidt, U. (2007). Triggers of self-induced vomiting in bulimic disorders: the roles of core beliefs and imagery. Journal of Cognitive Psychotherapy, 21, 261272. https://doi.org/10.1891/088983907781494528 CrossRefGoogle Scholar
Holmes, E. A., Deeprose, C., Fairburn, C. G., Wallace-Hadrill, S. M. A., Bonsall, M. B., Geddes, J. R., & Goodwin, G. M. (2011). Mood stability versus mood instability in bipolar disorder: a possible role for emotional mental imagery. Behaviour Research and Therapy, 49, 707713. https://doi.org/10.1016/j.brat.2011.06.008 CrossRefGoogle ScholarPubMed
Holmes, E. A. & Mathews, A. (2010). Mental imagery in emotion and emotional disorders. Clinical Psychology Review, 30, 349362. https://doi.org/10.1016/j.cpr.2010.01.001 CrossRefGoogle ScholarPubMed
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209218. https://doi.org/10.1097/00006842-197905000-00004 CrossRefGoogle ScholarPubMed
Hovens, J. E., Bramsen, I., & van der Ploeg, H. M. (2002). Self-rating inventory for posttraumatic stress disorder: review of the psychometric properties of a new brief Dutch screening instrument. Perceptual and Motor Skills, 94, 9961008. https://doi.org/10.2466/pms.2002.94.3.996 CrossRefGoogle ScholarPubMed
Hovens, J. E., Bramsen, I., van der Ploeg, H. M., & Reuling, I. E. (2000). Test-retest reliability of the trauma and life events self-report inventory. Psychological Reports, 87, 750752. https://doi.org/10.2466/pr0.2000.87.3.750 CrossRefGoogle ScholarPubMed
IBM Corporation (2013) IBM SPSS Statistics for Windows, version 22.0. Armonk, NY, USA: IBM Corporation.Google Scholar
Jansen, A. (2000). Eating Disorder Examination (EDE 12.0). Interview ter vaststelling van de specifieke psychopathologie van eetstoornissen. Lisse, the Netherlands: Swets & Zeitlinger.Google Scholar
Kadriu, F., Claes, L., Witteman, C., Norré, J., Vrieze, E., & Krans, J. (2019). Characteristics and content of intrusive images in patients with eating disorders. European Eating Disorders Review, 27, 495506. https://doi.org/10.1002/erv.2671 CrossRefGoogle ScholarPubMed
Keel, P. K. & Brown, T. A. (2010). Update on course and outcome in eating disorders. International Journal of Eating Disorders, 43, 195204. https://doi.org/10.1002/eat.20810 Google ScholarPubMed
Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E., Endicott, J., McDonald-Scott, P., & Andreasen, N. C. (1987). The Longitudinal Interval Follow-up Evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540548. https://doi.org/10.1001/archpsyc.1987.01800180050009 CrossRefGoogle ScholarPubMed
Koeter, M. W. J. & Ormel, J. (1991). General Health Questionnaire: Dutch Manual. Lisse, the Netherlands: Swets & Zeitlinger.Google Scholar
Kosslyn, S. M., Ganis, G., & Thompson, W. L. (2001). Neural foundations of imagery. Nature Reviews Neuroscience, 2, 635642. https://doi.org/10.1038/35090055 CrossRefGoogle ScholarPubMed
Krämer, B. (1996). LIFE II based Eating Disorders Interview, LIFE-II-BEI. Revised version of the LIFE Eat II, adapted for the German multi center study on eating disorders. Stuttgart, Germany: Centre for Psychotherapy Research.Google Scholar
Libby, L. K., Shaeffer, E. M., Eibach, R. P., & Slemmer, J. A. (2007). Picture yourself at the polls: visual perspective in mental imagery affects self-perception and behavior. Psychological Science, 18, 199203. https://doi.org/10.1111/j.1467-9280.2007.01872.x CrossRefGoogle ScholarPubMed
Linardon, J., Wade, T. D., de la Piedad Garcia, X., & Brennan, L. (2017). The efficacy of cognitive-behavioral therapy for eating disorders: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 85, 10801094. https://doi.org/10.1037/ccp0000245 CrossRefGoogle ScholarPubMed
Malcolm, C. P., Picchioni, M. M., & Ellett, L. (2015). Intrusive prospective imagery, posttraumatic intrusions and anxiety in schizophrenia. Psychiatry Research, 230, 899904. https://doi.org/10.1016/j.psychres.2015.11.029 CrossRefGoogle Scholar
Mathews, A., Ridgeway, V., & Holmes, E. A. (2013). Feels like the real thing: imagery is both more realistic and emotional than verbal thought. Cognition & Emotion, 27, 217229. https://doi.org/10.1080/02699931.2012.698252 CrossRefGoogle ScholarPubMed
Morina, N., Deeprose, C., Pusowski, C., Schmid, M., & Holmes, E. A. (2011). Prospective mental imagery in patients with major depressive disorder or anxiety disorders. Journal of Anxiety Disorders, 25, 10321037. https://doi.org/10.1016/j.janxdis.2011.06.012 CrossRefGoogle 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, 615. https://doi.org/10.1016/j.jbtep.2016.11.003 CrossRefGoogle ScholarPubMed
Muse, K., McManus, F., Hackmann, A., Williams, M., & Williams, M. (2010). Intrusive imagery in severe health anxiety: prevalence, nature and links with memories and maintenance cycles. Behaviour Research and Therapy, 48, 792798. https://doi.org/10.1016/j.brat.2010.05.008 CrossRefGoogle ScholarPubMed
National Institute of Clinical Excellence (NICE) (2005). Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. London, UK: NICE.Google Scholar
Osman, S., Cooper, M., Hackmann, A., & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory, 12, 428436. https://doi.org/10.1080/09658210444000043 CrossRefGoogle ScholarPubMed
Pearson, J., Naselaris, T., Holmes, E. A., & Kosslyn, S. M. (2015). Mental imagery: functional mechanisms and clinical applications. Trends in Cognitive Sciences, 19, 590602. https://doi.org/10.1016/j.tics.2015.08.003 CrossRefGoogle ScholarPubMed
Pennesi, J. L. & Wade, T. D. (2018). Imagery rescripting and cognitive dissonance: a randomized controlled trial of two brief online interventions for women at risk of developing an eating disorder. International Journal of Eating Disorders, 51, 439448. https://doi.org/10.1002/eat.22849 CrossRefGoogle ScholarPubMed
Schacter, D. L., Addis, D. R., & Buckner, R. L. (2007). Remembering the past to imagine the future: the prospective brain. Nature Reviews Neuroscience, 8, 657661. https://doi.org/10.1038/nrn2213 CrossRefGoogle ScholarPubMed
Shapiro, F. (2002). EMDR 12 years after its introduction: past and future research. Journal of Clinical Psychology, 58, 122. https://doi.org/10.1002/jclp.1126 CrossRefGoogle ScholarPubMed
Somerville, K., Cooper, M. J., & Hackmann, A. (2007). Spontaneous imagery in women with bulimia nervosa: an investigation into content, characteristics and links to childhood memories. Journal of Behavior Therapy and Experimental Psychiatry, 38, 435446. https://doi.org//10.1016/j.jbtep.2007.09.003 CrossRefGoogle ScholarPubMed
Speckens, A. E. M., Hackmann, A., Ehlers, A., & Cuthbert, B. (2007). Imagery special issue: intrusive images and memories of earlier adverse events in patients with obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 38, 411422. https://doi.org/10.1016/j.jbtep.2007.09.004 CrossRefGoogle ScholarPubMed
Szpunar, K. K., Spreng, R. N., & Schacter, D. L. (2014). A taxonomy of prospection: introducing an organizational framework for future-oriented cognition. Proceedings of the National Academy of Sciences of the USA, 111, 1841418421. https://doi.org/10.1073/pnas.1417144111 CrossRefGoogle ScholarPubMed
Tatham, M. (2011). The role of imagery-based techniques in cognitive-behavioural therapy for adults with eating disorders. Clinical Psychology Review, 31, 11011109. https://doi.org/10.1016/j.cpr.2011.06.008 CrossRefGoogle ScholarPubMed
White, K. D., Ashton, R., & Brown, R. M. D. (1977). The measurement of imagery vividness: normative data and their relationship to sex, age, and modality differences. British Journal of Psychology, 68, 203211. https://doi.org/10.1111/j.2044-8295.1977.tb01576.x CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.