Prospective Mental Images: A Transdiagnostic Approach to Negative Affectivity and Mood Dysregulation among Borderline Personality Disorder and Depression.

There is initial evidence that patients diagnosed with Borderline Personality Disorder (BPD) experience intrusive prospective mental images about non-suicidal self-injury (NSSI). These images, in turn, are associated with the conduct of NSSI. As the negative emotional valence of intrusive images has been established across clinical disorders, negative affectivity might play a key role linking mental imagery and psychopathology. Therefore, the present study aimed to investigate the possible mediating role of symptoms of depression as a proxy for negative affectivity linking intrusive prospective imagery to psychopathology in patients diagnosed with BPD. A total of 233 participants (84 diagnosed with MDD, 66 diagnosed with BPD, 83 healthy controls) completed questionnaires on negative affectivity (BDI-II) and prospective intrusive imagery (IFES-S). Before controlling for negative affectivity, there was a positive correlation between group and intrusive prospective imagery, indicating that healthy participants displayed lower amounts of intrusive prospective images in comparison to patients diagnosed with MDD or BPD. After entering negative affectivity as a mediator, the variable group was no longer associated with intrusive prospective images; however, negative affectivity showed a strong and positive relationship with the group on one side, and intrusive prospective imagery on the other, indicating that negative affectivity mediates the association between intrusive prospective images and clinical disorders. The presented findings point towards a mediating role of negative affectivity in the manifestation of intrusive prospective imagery, not only within BPD, but also in patients with MDD. The possibility of intrusive images acting as a transdiagnostic feature, where negative affectivity and mood dysregulation are at the core of the clinical disorder, are being discussed.

Treating emotion dysregulation in patients with borderline personality disorder using imagery rescripting: A two-session randomized controlled trial.

Studies on Emotionally Dysregulated Behavior (EDB) demonstrated that the conduct thereof is associated with emotion dysregulation and preceded by mental imagery of EDB, which can direct future behavior. These findings are specifically important within the context of Borderline Personality Disorder (BPD), where emotion dysregulation and EDB are at the core of the disorder. The present study aims to evaluate the efficacy of imagery rescripting (IR) in treating emotion dysregulation associated with EDB in patients diagnosed with BPD. Forty-eight females diagnosed with BPD were randomly allocated to the IR intervention or treatment-as-usual group. Assessment took place one week before the first treatment session, as well as one week, and twelve weeks after the last treatment session evaluating emotion regulation strategies, borderline-symptomatology, EDB, depressiveness, impulsivity, mental imagery, and illness severity. Within-, and between subject, intention-to-treat-, and per-protocol analysis were conducted. Results showed decreased maladaptive emotion regulation strategies and increased adaptive emotion regulation strategies within the intervention group. Borderline-symptomatology improved immediately after treatment for the intervention group. Additionally, BPD patients within the intervention group improved regarding their impulsivity, depressiveness, and EDB symptomatology in comparison to patients in the TAU group. The presented intervention has proven to be effective in improving BPD-related symptomatology, such as emotion regulation, EDB, depressiveness, and impulsivity. Imagery rescripting could be routinely applied when EDB related images are present. TRIAL REGISTRATION: German Clinical Trials Registry (DRKS) ID: DRKS00010620.

Relationship Dysfunction in Couples When One Partner Is Diagnosed with Borderline Personality Disorder: Findings from a Pilot Study.

Relationship dysfunction-marked by frequent conflicts-is one of the hallmark features of borderline personality disorder (BPD). However, the BPD couple as a dyad and partner-related features have rarely been taken into account. The aim of the present study was to investigate hormonal, personality, and relationship relevant factors, such as relationship satisfaction, attachment, and trauma in both partners within a dyad where one partner is diagnosed with BPD. The total sample consisted of 26 heterosexual couples. All studies were conducted at 2 p.m. Primary outcomes: Neo-Five-Factor-Inventory, Childhood Trauma Questionnaire, Experiences in Close Relationships Scale. Secondary outcomes: Problem List, Partnership Questionnaire, Questionnaire for Assessing Dyadic Coping. Upon questionnaire completion, one saliva sample was taken via passive drool to assess baseline cortisol and testosterone levels. Results showed that females with BPD have higher scores on childhood maltreatment, dysfunctional attachment styles, and neuroticism than mentally healthy females. Furthermore, they have more relationship-related problems and are less satisfied in their romantic relationship. Male partners of women with BPD showed lower testosterone levels, higher levels of childhood maltreatment, dysfunctional attachment styles, neuroticism, and openness compared with the healthy control partners. Furthermore, childhood trauma, neuroticism as well as dysfunctional attachment styles displayed a significant positive correlation with relationship-related problems. Traumatic childhood experiences, insecure attachment styles as well as neurotic personality characteristics contribute to increased relationship disruptions in couples. Relevant hormonal and psychosocial parameters in BPD partners should be taken into account when treating females with BPD.

The Association Between Test Anxiety, Self-Efficacy, and Mental Images Among University Students: Results From an Online Survey.

Background and Objectives: A substantial portion of students report test anxiety, and those reporting low levels of self-efficacy seem to be especially affected. Previous research has indicated the relevance of mental images in the maintenance of anxiety disorders, however, no data are available with respect to test anxiety. In order to close this gap, the present study investigates the association between test anxiety, self-efficacy and mental images. Method: One hundred sixty-three university students completed an online survey. Test anxiety (PAF), general self-efficacy (WIRKALL-r), study-related self-efficacy (WIRK_STUD), intrusiveness of mental images (IFES), spontaneous use of imagery (SUIS) and vividness of imagery (VVIQ) were examined. Results: Test-related mental images were frequently reported among the surveyed students. Test anxiety showed a positive correlation with IFES and a negative correlation with self-efficacy. Mediation analyses showed that about one fifth of the influence of self-efficacy on test anxiety is mediated by IFES. Discussion: The present study gives first indication about an association between test anxiety, self-efficacy and mental images, even though the results are limited with respect to generalizability. Further investigations with respect to the impact of test-related mental images on the self-efficacy/test-anxiety linkage are needed.

Imagery Rescripting: Exploratory Evaluation of a Short Intervention to Reduce Test Anxiety in University Students.

BACKGROUND: Test anxiety is common in university students. Demanding schedules may contribute to the relatively low utilization of professional counseling, when compared to other anxiety disorders. A possible solution could be a psychotherapeutic short-term intervention. The present exploratory study implemented a short-term psychotherapeutic treatment, consisting of two imagery rescripting (IR) sessions. The efficacy of IR techniques has already been demonstrated in the treatment of various anxiety disorders including test anxiety. METHODS: Nine students suffering from test anxiety (m = 3, f = 6) underwent two weekly applied sessions of IR. Outcome variables were examined one week prior to (t1), immediately after (t2) and three months after (t3) the intervention, using self-evaluation questionnaires on test anxiety (PAF), depressive symptoms (BDI II), life satisfaction (FLZ), general self-efficacy and study-specific self-efficacy (WIRKALL; WIRK_STUD), intrusiveness of mental images (IFES), and change and acceptance (VEV; ZUF; BFTB). RESULTS: There were no dropouts. According to results from ZUF and BFTB, the participants where highly satisfied with the intervention. PAF scores decreased significantly over time (t1 to t3), whereas WIRKALL scores (t1 to t3) and WIRK_STUD scores (t1 to t3 and t2 to t3) increased significantly. IFES scores decreased immediately after the intervention (t1 compared to t2) and further after the follow-up (t1 to t3). No changes in BDI-II scores were observed. DISCUSSION: The findings indicate a high acceptance and efficacy of the two-session IR-intervention. Limits are the lack of a control group, and the small sample size. Further evaluation in future controlled studies is needed.

Short Imagery Rescripting Intervention to Treat Emotionally Dysregulated Behavior in Borderline Personality Disorder: An Exploratory Study.

BACKGROUND: Current research on borderline personality disorder report an association between emotionally dysregulated behaviors and intrusive mental imagery depicting similar scenes. Imagery rescripting techniques have proven effective in reducing intrusive mental imagery in numerous contexts. We developed a two session-short intervention in which intrusive mental images are identified, analyzed, and modified for daily rehearsal at home. This study aimed to reduce the negative emotions and cognitions associated with self-injurious behaviors by replacing unhealthy imagery with more adaptive content. METHODS: Seven females diagnosed with borderline personality disorder who reported intrusive mental imagery of dysregulated behaviors were recruited for participation. Each participant engaged in two individualized treatment sessions and daily homework requiring the rehearsal of modified imagery. Emotion regulation strategies, borderline symptom severity, and depressiveness were assessed before and after treatment. RESULTS: Acceptance was positive, as no patient dropped out from treatment. Symptom exacerbation was not observed. Borderline symptom reduction was noted and indicia of emotional dysregulation and negative affect declined. LIMITATIONS: The generalizability of results is limited by the small sample size and the absence of a control group. Conclusions: This new two-session short intervention was shown to decrease the emotionally dysregulated behaviors that accompany negative feelings in females with borderline personality disorder.

The German Impact of Future Events Scale (IFES-S): Adaption and Validation for Clinical Samples.

Prospective intrusive mental images occur frequently among several psychological disorders. Their assessment is an important tool since the imagination of events can drive future behavior, such as suicidal acts. One valid measure evaluating those prospective images is the impact of future events scale (IFES). However, to date, there is no German equivalent to the English IFES. Therefore, the aim of the present study was to adapt and validate the IFES at hand of a clinical sample and a healthy control sample.After translation, item analyzes were conducted, and as a result, four items were excluded from further analysis resulting in the German short version of the IFES, the IFES-S. Construct validity of the German IFES-S was tested through correlational analysis with convergent and divergent measures. Specificity and sensitivity were assessed through ROC analysis. The German IFES-S showed good internal consistency for the overall measurement with a Cronbach's α of .93. Additionally, it displayed good convergent and divergent validity. An optimal cutoff score of 23 was established to discriminate between clinical populations and healthy controls. In summary, the German IFES-S promises to be a valid self-report instrument for the assessment of prospective intrusive imagery within the context of clinical samples.

Attentional modulation of masked semantic priming by visible and masked task cues.

In contrast to classical theories of cognitive control, recent evidence suggests that cognitive control and unconscious automatic processing influence each other. First, masked semantic priming, an index of unconscious automatic processing, depends on attention to semantics induced by a previously executed task. Second, cognitive control operations (e.g., implementation of task sets indicating how to process a particular stimulus) can be activated by masked task cues, presented outside awareness. In this study, we combined both lines of research. We investigated in three experiments whether induction tasks and presentation of visible or masked task cues, which signal subsequent semantic or perceptual tasks but do not require induction task execution, comparably modulate masked semantic priming. In line with previous research, priming was consistently larger following execution of a semantic rather than a perceptual induction task. However, we observed in experiment 1 (masked letter cues) a reversed priming pattern following task cues (larger priming following cues signaling perceptual tasks) compared to induction tasks. Experiment 2 (visible letter cues) and experiment 3 (visible color cues) showed that this reversed priming pattern depended only on apriori associations between task cues and task elements (task set dominance), but neither on awareness nor on the verbal or non-verbal format of the cues. These results indicate that task cues have the power to modulate subsequent masked semantic priming through attentional mechanisms. Task-set dominance conceivably affects the time course of task set activation and inhibition in response to task cues and thus the direction of their modulatory effects on priming.

The Construct Validity of the German Academic Self-regulation Questionnaire (SRQ-A) within Primary and Secondary School Children.

The assessment of students' motivation can be a powerful tool in enhancing and understanding students' learning. One valid and often applied self-report measure is the Academic Self-Regulation Questionnaire (SRQ-A) which is grounded in the self-determination theory. However, to date, there is still no German equivalent to the English version of this questionnaire. Therefore, the aim of the present study was to adapt and validate the SRQ-A on a representative German student sample, consisting of 672 children (327 girls), ages 8-14 from one primary and two secondary German schools. First, the translation-back-translation method was used to ensure the linguistic equivalence of the German questionnaire. Second, item analysis of the generated scores of the German SRQ-A were conducted. Third, the multidimensional factorial structure of the original measure was tested with confirmatory factor analysis (CFA) using maximum likelihood estimation. Last, additional construct validity of the German SRQ-A was tested using correlational analyses with convergent and divergent measures. After conducting CFA, four items were excluded from the original questionnaire, due to loadings lower than 0.40, resulting in 28 items. The German SRQ-A showed good internal consistency for all subscales, with Chronbach's α ranging between 0.75 and 0.88. The simplex-structure of the original measurement could also be confirmed, however, the four-factorial model could not be replicated. The measurement showed good convergent and discriminant validity with other related questionnaires. In summary, the German SRQ-A is a reliable and valid self-report instrument for the assessment of self-determined motivational styles within the school context.