A systematic review of interventions to increase positive imagery

Background: In psychotherapeutic practice, the role of mental imagery in promoting positive cognitions is often neglected in lieu of assessing and challenging negative verbal cognitions. Mental imagery has been found to play and important role in generating and maintaining symptoms in mood and anxiety problems and has been referred to as an ‘emotional amplifier.’ This study therefore reviewed psychotherapeutic interventions aimed at increasing positive imagery in individuals experiencing depressive symptoms. Methods: Searches were undertaken of PsycINFO, MEDLINE and EMBASE, as well as reference lists of primary studies and review articles identified. Selection Criteria. i) psychotherapeutic interventions aimed at increasing positive imagery, ii) studies with individuals above 16 years old, and iii) use of at least one clinically relevant measure of mood or anxiety symptoms. Only published studies were included. Study Appraisal and Synthesis. Studies were rated for risk of bias using the Cochrane Risk of Bias tool. Results: Results suggest a small effect of the intervention on depressive symptoms (Cohen’s d = 0.29) and no effect of the intervention on depression at follow-up (median time = 4 weeks; Cohen’s d = 0.20). Conclusions: This review presents encouraging results for the efficacy of imagery-based interventions in the context of major depressive disorder and further highlights key trends for future research.