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Experimental single-session imagery rescripting of distressing memories in bowel/bladder-control anxiety: a case series.

Pajak R, Kamboj SK - Front Psychiatry (2014)

Bottom Line: We have previously described the nature of intrusive mental imagery in BBCA and found imagery themes to be linked to actual experiences of loss of control or to "near misses." A causal role for imagery in symptom maintenance can be inferred by examining the effects of imagery rescripting.After rescripting, two participants experienced pronounced reductions in imagery vividness, distress, shame, disgust, and belief conviction.Most importantly, all three participants experienced a reduction in fear-associated bladder and/or bowel sensations.

View Article: PubMed Central - PubMed

Affiliation: Research Department of Clinical, Educational and Health Psychology, University College London , London , UK.

ABSTRACT
Bowel and bladder obsession [bowel/bladder-control anxiety (BBCA)] is a viscerally centered phobic syndrome involving a specific concern about losing control of bowel or bladder functioning in a public place. Like other anxiety disorders, BBCA is characterized by intrusive imagery. We have previously described the nature of intrusive mental imagery in BBCA and found imagery themes to be linked to actual experiences of loss of control or to "near misses." A causal role for imagery in symptom maintenance can be inferred by examining the effects of imagery rescripting. Moreover, successful rescripting may point to a potentially efficacious avenue for treatment development. Three cases of imagery rescripting are described here with pre-, post-, and follow-up (1-week) data reported. After rescripting, two participants experienced pronounced reductions in imagery vividness, distress, shame, disgust, and belief conviction. Most importantly, all three participants experienced a reduction in fear-associated bladder and/or bowel sensations. The results support a causal role for mental imagery in bowel-bladder-control anxiety and suggest that rescripting of distressing intrusive memories linked to recurrent images may be a useful avenue for development of cognitive-behavioral treatments of bladder/bowel-control anxiety.

No MeSH data available.


Related in: MedlinePlus

Participant 1’s ratings for (A) vividness, distress, nowness, and strength of belief conviction and (B) anxiety, shame, disgust, and bodily sensations.
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Figure 1: Participant 1’s ratings for (A) vividness, distress, nowness, and strength of belief conviction and (B) anxiety, shame, disgust, and bodily sensations.

Mentions: Prior to rescripting, Participant 1 experienced this image as highly vivid (95%), although the associated distress was not high (30%; see Figure 1A). The belief accompanying this imagery was summarized thus: “I am not in control of my own body, or even my own mind,” which was held with a moderate-high level of conviction (70%). Anxiety was the strongest emotion associated with the image, rated at 35%. It was noted that Participant 1 had not experienced the image at all in the week before the rescripting session.


Experimental single-session imagery rescripting of distressing memories in bowel/bladder-control anxiety: a case series.

Pajak R, Kamboj SK - Front Psychiatry (2014)

Participant 1’s ratings for (A) vividness, distress, nowness, and strength of belief conviction and (B) anxiety, shame, disgust, and bodily sensations.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4265982&req=5

Figure 1: Participant 1’s ratings for (A) vividness, distress, nowness, and strength of belief conviction and (B) anxiety, shame, disgust, and bodily sensations.
Mentions: Prior to rescripting, Participant 1 experienced this image as highly vivid (95%), although the associated distress was not high (30%; see Figure 1A). The belief accompanying this imagery was summarized thus: “I am not in control of my own body, or even my own mind,” which was held with a moderate-high level of conviction (70%). Anxiety was the strongest emotion associated with the image, rated at 35%. It was noted that Participant 1 had not experienced the image at all in the week before the rescripting session.

Bottom Line: We have previously described the nature of intrusive mental imagery in BBCA and found imagery themes to be linked to actual experiences of loss of control or to "near misses." A causal role for imagery in symptom maintenance can be inferred by examining the effects of imagery rescripting.After rescripting, two participants experienced pronounced reductions in imagery vividness, distress, shame, disgust, and belief conviction.Most importantly, all three participants experienced a reduction in fear-associated bladder and/or bowel sensations.

View Article: PubMed Central - PubMed

Affiliation: Research Department of Clinical, Educational and Health Psychology, University College London , London , UK.

ABSTRACT
Bowel and bladder obsession [bowel/bladder-control anxiety (BBCA)] is a viscerally centered phobic syndrome involving a specific concern about losing control of bowel or bladder functioning in a public place. Like other anxiety disorders, BBCA is characterized by intrusive imagery. We have previously described the nature of intrusive mental imagery in BBCA and found imagery themes to be linked to actual experiences of loss of control or to "near misses." A causal role for imagery in symptom maintenance can be inferred by examining the effects of imagery rescripting. Moreover, successful rescripting may point to a potentially efficacious avenue for treatment development. Three cases of imagery rescripting are described here with pre-, post-, and follow-up (1-week) data reported. After rescripting, two participants experienced pronounced reductions in imagery vividness, distress, shame, disgust, and belief conviction. Most importantly, all three participants experienced a reduction in fear-associated bladder and/or bowel sensations. The results support a causal role for mental imagery in bowel-bladder-control anxiety and suggest that rescripting of distressing intrusive memories linked to recurrent images may be a useful avenue for development of cognitive-behavioral treatments of bladder/bowel-control anxiety.

No MeSH data available.


Related in: MedlinePlus