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The Phenomenology and Generation of Positive Mental Imagery in Early Psychosis

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Clinical Psychology & Psychotherapy

Published online on

Abstract

Background Theoretical models of depression and bipolar disorder emphasise the importance of positive mental imagery in mood and behaviour. Distressing, intrusive images are common in psychosis; however, little is known about positive imagery experiences or their association with clinical symptoms. The aim of the current study was to examine the phenomenology of positive imagery in early psychosis and the relationship between the characteristics of positive, future‐oriented imagery and symptom severity. Method Characteristics, thematic content and appraisals of recent self‐reported images were examined in 31 people with early psychosis. The vividness and perceived likelihood of deliberately generated, future‐oriented images were investigated in relation to clinical symptoms. Results Eighty‐four percent of participants reported experiencing a recent positive image. Themes included the achievement of personal goals, spending enjoyable time with peers and family, loving, intimate relationships and escape from current circumstances. The vividness and perceived likelihood of generated prospective imagery were negatively correlated with levels of depression and social anxiety. Conclusions The relationship between emotional problems and the ability to imagine positive, future events may have implications for motivation, mood and goal‐directed behaviour in psychosis. Everyday experiences of positive imagery may represent the simulation of future goals, attempts to cope or avoid aversive experiences or idealised fantasy. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The majority of participants experienced a recent positive image with themes related to goal attainment and social relationships. Depression and social anxiety levels were correlated with the vividness of intentionally generated positive future‐oriented images and their perceived likelihood. The assessment of positive imagery in early psychosis appears warranted and may provide insights regarding individual coping strategies, values and goals.