The impact of imagery rescripting on non-clinical paranoia

Abstract

Imagery rescripting (IR) is a transdiagnostic technique that aims to change the meaning associated with distressing memories. The literature review discusses advances in the evidence base for the efficacy of IR, optimal methods of delivering the technique and the mechanisms underlying it, published since the last review by Arntz (2012). Research has identified beneficial effects from single and multiple sessions of IR, both with and without additional cognitive restructuring, across a range of disorders. Exploration into the optimal approach to adopt when using IR, and the mechanisms underlying it,remains in its infancy. IR research is generally limited by methodological differences across studies, predominantly relying on case study designs, making it difficult to generalise findings. Overall, the literature supports the efficacy of IR as a transdiagnostic technique, however continued research is needed to explain the mechanisms underlying it and clarify the optimal method to delivering the intervention.

The empirical paper provides encouraging evidence for the impact of a single session of IR on non-clinical paranoia. A within subjects design was used with fifteen university students experiencing high levels of non-clinical paranoia. Participants attended three sessions. During the first session, participants recalled a recurrent, distressing memory, which was then rescripted in the second session. Participants attended a follow-up session one-week later. The impact of the intervention was assessed through measures of paranoia, affect and the self, taken at each session. Results revealed reductions in paranoia, negative affect and negative core beliefs about the self, alongside improvements in self-esteem and positive affect following IR. The impact of memory intrusions, strength of encapsulated belief, memory related distress and the emotional impact of the memory targeted were also reduced following the intervention. Effects were either further reduced or maintained at follow-up. Limitations and clinical and theoretical implications of these findings are discussed.

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