University of Groningen. Moving onwards Slofstra, Christine
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1 University of Groningen Moving onwards Slofstra, Christine IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2017 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Slofstra, C. (2017). Moving onwards: Affective change, mental imagery, and depressive relapse [Groningen]: Rijksuniversiteit Groningen Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date:
2 The research in this thesis was funded by grant from NWO, the Netherlands Organization for Scientific Research, awarded to the Dutch-Flemish Research School Experimental Psychopathology. The research in chapters 5 7 was funded by ZonMW: The Netherlands association for Health research and Development ( ) and by OOG Grant ( ). ISBN (print): ISBN (pdf ): Cover design by Christine Slofstra Typeset in Mercury and Whitney by the Hoefler Type Foundry Typesetting by Gerard Jan Ritsema van Eck and Christine Slofstra Printed on 90 grams Biotop paper by Ridderprint BV
3 Moving Onwards Affective change, mental imagery, and depressive relapse Proefschrift ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen op gezag van de rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op donderdag 30 november 2017 om uur door Christine Slofstra Geboren op 25 maart 1988 te Leiden
4 Promotores Prof. dr. C.L.H. Bockting Prof. dr. E.A. Holmes Copromoter Dr. M.H. Nauta Beoordelingscommissie Prof. dr. G.H.M. Pijnenborg Prof. dr. J.J.M. Dekker Prof. dr. Ph.A.E.G. Delespaul
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7 Table of Contents Preface 9 1. General introduction Imagery rescripting: The impact of conceptual and perceptual changes on aversive autobiographical memories Attentional breathing during recall of aversive memories: A replication study and a Bayesian summary of results Rethinking a negative event: The affective impact of ruminative versus imagery-based processing of aversive autobiographical memories Imagine your mood: Study design and protocol of a randomized controlled micro-trial using app-based experience sampling methodology to explore processes of change during relapse prevention interventions for recurrent depression Exploring the relation between visual mental imagery and affect in the daily life of previously depressed and never depressed individuals Detecting individual negative affective trajectories during different depressive relapse prevention strategies: An explorative experience sampling methodology study General discussion 157 References 177 Nederlandse samenvatting 209 Dankwoord 221 Curriculum Vitae 227 List of abbreviations 228
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9 Preface
10 Preface 0P You have just opened this thesis about affective change and mental imagery in depression. At this moment, how do you feel? What if you d stop for a moment, and think back about an event that made you feel very anxious or sad? See the events as they unfolded, looking with your mind s eye. What do you hear in your mind s ear? Include your other senses as well. Take your time to take yourself on this mental journey and tell me, how do you feel now? Possibly, you now feel more negative feelings and less positive feelings. In other words, you may just have experienced affective change. Depression is characterized by an abundance of negative affect and a lack of positive affect. The transition into and out of a depressive episode thus entails profound affective changes. Furthermore, in previously depressed individuals, the answer to the question how do you feel now predicts future depressive relapse. Therefore, finding ways to change affect in (previously) depressed individuals may help them to move onwards. It may contribute to the treatment of depression and the prevention of relapse. Using mental imagery may be a powerful technique to change emotions. Imagination is transformed in something tangible in the magical world of Harry Potter, where beings that take on the form of one s worst fear socalled Boggards can bring someone to tears in a stressful period (Hermione Granger: P-P-Professor McGonagall! Sh-she told me I d failed everything! ). Conversely, J.K. Rowling illustrates how imagination may be used to 10
11 Preface 0P0 repel these demons. Forcing a Boggard to take on a ridiculous shape ( Riddikulus! ) can result in the laughter needed to defeat its spell. Imagination may also be used to vividly recall a positive memory and thereby conjure a protective charm ( Expecto Patronum! ) against a Dementor. Dementors feed on positive emotions, and suck out every good feeling, every happy memory so that you will be left with nothing but the worst experiences of your life. A description not dissimilar to depression. Outside of the magical world, imagination is as normal as can be. You may often use your imagination in everyday life, for example when picturing a dish to remember what ingredients to buy or having an idea of how the person on the other end of the telephone line looks like. But using your imagination may also affect your mood in either a positive or negative way. For example, the memory of a deceased loved one can cast a cloud on a bright and sunny day. Engaging in positive imagery may, conversely, boost our mood, for example by cherishing positive memories or dreaming up fantastic events for the future. And possibly, mentally making changes to an upsetting image may help break its spell. Although your imagination cannot change reality, it can change the way you feel. Therefore, in this thesis, it was examined how emotions may change under influence of mental imagery and how changing emotions may be of relevance to relapse in depression. 11
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