Title: Emotional disorders and mental imagery
Funder: Medical Research Council

Abstract: Overall Aim Our programme combines perspectives from cognitive science (mental imagery) and clinical psychology (psychological disorders and their treatment) to develop and improve cognitive therapies for mental health. We focus on three disorders in which imagery contributes to symptoms – PTSD (post-traumatic stress disorder), depression and bipolar disorder. Importance Even our best treatments for these three mental health disorders require improvement. For example, although there are evidence-based treatments for full-blown PTSD, we lack preventative interventions for the immediate aftermath of trauma. Depression is a leading cause of global burden of disease, and yet our best treatments fail to help almost half of patients. Bipolar Disorder is a chronic and disabling condition, with poor health outcomes and substantial costs for the NHS, and for which there have been no major treatment advances since lithium in the 1950s. Treatment innovation is required. Specific research objectives There are three clinical research streams which concern: (1) how to prevent the build-up of negative flashback images after a traumatic event; (2) the benefits of boosting positive imagery in depression; (3) understanding imagery as an emotional amplifier which can destabilise negative and positive mood in bipolar disorder. Plan and methodology, including experimental design The scientific approach to address the clinical issues raised in each of the three streams is through cognitive psychology, the unifying thread being the special relationship between imagery and emotion. Stream 1: Using an experimental analogue of trauma in the laboratory, we will examine how to modify analogue flashback memories using cognitive tasks. The research also moves to the first translation of our cognitive task approach to a clinical setting. Stream 2: We use cognitive bias modification (CBM) techniques to boost positive imagery in depressed mood using computerised training. There are both laboratory studies in volunteers as well as a randomised controlled trial (RCT) via the Internet for patients with depression. Stream 3: Experiments will explore the hypothesis that bipolar traits are characterised by intrusive imagery, anxiety and mood instability. We will also map specific imagery abnormalities in established bipolar disorder. Working clinically with patients with bipolar disorder, we will work towards developing an imagery-based CBT treatment innovation. Clinical and translational research issues Liaison with clinical stakeholders is facilitated by clinician scientists in the new team (clinical psychologists Holmes, Blackwell and psychiatrist Di Simplicio) alongside experimental psychologists (Investigator Scientist post). Questions central to the three research streams are informed by a clinical perspective and placed within a cognitive formulation regarding the onset or maintenance of symptoms. Candidate treatments evolved via experimental studies will be developed in clinical populations through the Cambridge Centre for Affective Disorders (C2:AD) and links with the Cambridgeshire and Peterborough NHS Foundation Trust. Specific goals/plans for medical/public health exploitation/applications Depending on the results of the treatment innovation studies, these plans will be developed over time.


Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH