Negative ‘flashforward’ imagery in children and adolescents with social anxiety disorder: A pilot study of an imagery interview and an EMDR intervention

Description

Onderdeel van symposium: Involving mental imagery in the assessment and treatment of emotional disorders in children and adolescents
Abstract: Social anxiety disorder (SAD) is a prevalent disorder in children and adolescents. Treatment for SAD with CBT is currently less effective than for other anxiety disorders, leaving room for improvement. Mental imagery has been identified as an important maintaining factor by fueling social anxiety and avoidance. However, most studies on imagery features have considered adults rather than young people. Similarly, treatments incorporating imagery have also not been extensively evaluated. Adding interventions as EMDR (eye movement desensitization and reprocessing) to target vivid and distressing negative imagery could possibly dampen detrimental effects on anxiety symptoms. We will present our pilot study on the phenomenology of negative future imagery (i.e., flashforward imagery of feared future catastrophe) in children and adolescents with SAD, and the effects of a short EMDR intervention targeting this negative imagery on both imagery features and anxiety symptoms. We aimed to examine the feasibility and preliminary outcomes of an imagery interview, protocol for EMDR flashforward, and associated measures in 6 young people with SAD. After a 1-week baseline period, participants had a preintervention assessment and then received three EMDR flashforward sessions followed by post-intervention and follow-up assessments. Primary outcomes were social anxiety and avoidance related to participants’ three most feared social situations. Secondary outcomes included vividness, distress and appraisal of their flashforward imagery related to these three social situations, and more general social anxiety and avoidance. We found that almost all (6 out of 7) interviewed adolescents reported negative flashforward imagery that was experienced as distressing and vivid, and appraised negatively. The EMDR intervention in the 6 participants with flashforward imagery (aged 14-17 years old) was followed by a decrease in social anxiety and a similar trend in avoidance. General social anxiety and avoidance showed a similar trend as well, while during the baseline period, no notable changes were observed. Furthermore, the intervention was followed by a decrease in image distress, vividness and negative appraisal. Feasibility appeared satisfactory but we suggested adaptations based on feedback and measure completion rates. Although the current study concerned a small pilot without control group, results suggest that vivid and distressing flashforward imagery is prevalent and that targeting such negative imagery with a short EMDR intervention may aid young people with SAD in daring to face social situations. This may hold promise for future successful treatment additions. Further (experimental) research on the effectiveness and integration of imagery assessments and interventions into current treatments is necessary.

Period	8-Sept-2022
Event title	51st European Association of Behavior and Cognitive Therapies (EABCT) Congress: Re-Thinking CBT: providing strategies for a new way of living
Event type	Conference
Location	Barcelona, SpainShow on map
Degree of Recognition	International