Positive Prospective Mental Imagery Characteristics in Young Adults and Their Associations with Depressive Symptoms.

Background: Positive prospective mental imagery plays an important role in mental well-being, and depressive symptoms have been associated with difficulties in generating positive prospective mental images (PPMIs). We used a mobile app to gather PPMIs generated by young adults during the COVID-19 pandemic and analyzed content, characteristics, and associations with depressive symptoms. Methods: This is a secondary analysis of a randomized controlled trial with 95 healthy young adults allocated into two groups (intervention and control). Participants used the mobile app decreasing mental health symptoms for seven consecutive days. Fifty participants in the intervention group reported PPMIs at least three times per day using a mobile app inducing PPMI generation. We categorized entries into themes and applied moderation models to investigate associations between PPMI characteristics and depressive symptoms. Results: We distinguished 25 PPMI themes. The most frequent were related to consuming food and drinks, watching TV/streaming platforms, and doing sports. Vividness and ease of generation of PPMIs, but not their anticipation, pleasure intensity or number of engagements with the app were associated with fewer depressive symptoms. Conclusions: We identified PPMI themes in young adults and found significant negative associations between depressive symptoms and vividness and generation ease of PPMIs. These results may inform prevention and intervention science, including the design of personalized interventions. We discuss implications for future studies and treatment development for individuals experiencing diminished PPMI. Supplementary Information: The online version contains supplementary material available at 10.1007/s10608-023-10378-5.

Is Future Mental Imagery Associated with Reduced Impact of the COVID-19 Pandemic on Negative Affect and Anhedonic Symptoms in Young People?

Background: Difficulties with prospective mental images are associated with adolescent depression. Current treatments mainly focus on verbal techniques to reduce negative affect (e.g. low mood) rather than enhancing positive affect, despite anhedonia being present in adolescents. We investigated the concurrent relationships between the vividness of negative and positive prospective mental imagery and negative affect and positive affect; and examined whether negative and positive prospective mental imagery moderated the impact of recent stress (COVID-19-linked stress) on negative and positive affect. Methods: 2602 young people (12-25 years) completed the Prospective Imagery Task and self-reported on symptoms of negative affect, anhedonia and COVID-19 linked stress. Results: Elevated vividness of negative future mental imagery and reduced vividness of positive future mental imagery were associated with increased negative affect, whereas only reduced vividness of positive future imagery was associated with increased symptoms of anhedonia. Elevated vividness of negative future images amplified the association between COVID-19 linked stress and negative affect, while elevated vividness of positive future images attenuated the association between COVID-19 linked stress and anhedonia. Conclusions: Future mental imagery may be differentially associated with negative and positive affect, but this needs to be replicated in clinical populations to support novel adolescent psychological treatments. Supplementary Information: The online version contains supplementary material available at 10.1007/s10608-023-10352-1.

Future self-imagery of young people in Sweden during the COVID-19 pandemic: an exploratory mixed methods analysis.

Global restrictions imposed during the COVID-19 pandemic significantly limited the capacity to plan for the future. Little is known about young people's future self-images and the impact the COVID-19 pandemic may have had upon them. Given evidence that the ability to imagine a positive future can be protective for mental health, research into the impact of the pandemic on future self-imagery is needed. In two studies, we therefore explored the consequences of the COVID-19 pandemic for future self-imagery in an unselected sample of young people in Sweden, specifically: (a) how content and characteristics of future self-images changed from before to during the pandemic, and (b) how such change was related to trauma history, intrusive memories of COVID-19 media footage, past time perspective and optimism (assessed with questionnaires/intrusive memory diary). Future self-images before and during the pandemic were assessed using the 'I Will Be' task (N Study1=74; N Study2=99). A mixed methods design, combining quantitative analysis, qualitative content coding and thematic analysis was used. Exploratory results of Study 1 indicated that future images were rated as less positive during than before the pandemic and that this reduction was less pronounced in people with higher optimism. Results were replicated in an independent sample (Study 2, collected later during the pandemic). In conclusion, whilst the findings are preliminary and emerged from an unselected sample, they prompt the suggestion that brief, novel interventions which aim to bolster positive future imagery may hold promise as a scalable means by which to enhance mental health for young people in the context of the COVID-19 pandemic. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-022-04100-z.

Improving Hand Hygiene Behavior Using a Novel Theory-Based Intervention During the COVID-19 Pandemic.

BACKGROUND: Promoting the adoption of personal hygiene behaviors known to reduce the transmission of COVID-19, such as avoiding touching one's face with unwashed hands, is important for limiting the spread of infections. PURPOSE: We aimed to test the efficacy of a theory-based intervention to promote the avoidance of touching one's face with unwashed hands to reduce the spread of COVID-19. METHODS: We tested effects of an intervention employing imagery, persuasive communication, and planning techniques in two pre-registered studies adopting randomized controlled designs in samples of Australian (N = 254; Study 1) and US (N = 245; Study 2) residents. Participants were randomly assigned to theory-based intervention or education-only conditions (Study 1), or to theory-based intervention, education-only, and no-intervention control conditions (Study 2). The intervention was delivered online and participants completed measures of behavior and theory-based social cognition constructs pre-intervention and one-week postintervention. RESULTS: Mixed-model ANOVAs revealed a significant increase in avoidance of touching the face with unwashed hands from pre-intervention to follow-up irrespective of intervention condition in both studies, but no significant condition effects. Exploratory analyses revealed significant effects of the theory-based intervention on behavior at follow-up in individuals with low pre-intervention risk perceptions in Study 2. CONCLUSIONS: Results indicate high adoption of avoiding touching one's face with unwashed hands, with behavior increasing over time independent of the intervention. Future research should confirm risk perceptions as a moderator of the effect theory-based interventions on infection-prevention behaviors.

Using a Brief Mental Imagery Competing Task to Reduce the Number of Intrusive Memories: Exploratory Case Series With Trauma-Exposed Women.

BACKGROUND: Novel interventions should be developed for people who have undergone psychological trauma. In a previous case study, we found that the number of intrusive memories of trauma could be reduced with a novel intervention. The intervention included a brief memory reminder, a visuospatial task and mental rotation, and targeted trauma memory hotspots one at a time in separate sessions. OBJECTIVE: This case series (N=3) extended the first case study with 3 new cases to determine whether a similar pattern of beneficial results is observed. We explored whether the brief intervention would result in reduced numbers of intrusive memories and whether it would impact symptoms of posttraumatic stress, depression and anxiety, and general functioning. Acceptability of the intervention was also explored. METHODS: A total of 3 women completed the study: 2 with posttraumatic stress disorder and other comorbidities and 1 with subthreshold posttraumatic stress disorder. The primary outcome was the change in the number of intrusive memories from the baseline phase to the intervention phase and at the 1-month follow-up, with an assessment of the intrusion frequency at 3 months. Participants monitored the number of intrusive memories in a daily diary for 1 week at baseline, for maximum of 6 weeks during the intervention phase and for 1 week at the 1-month and 3-month follow-ups. The intervention was delivered in person or digitally, with guidance from a clinical psychologist. A repeated AB design was used (A was a preintervention baseline phase and B intervention phase). Intrusions were targeted individually, creating repetitions of an AB design. RESULTS: The total number of intrusive memories was reduced from the baseline to the intervention phase for all participants. The total number for participant 3 (P3) reduced from 38.8 per week during the baseline phase to 18.0 per week in the intervention phase. It was 13 at the 3-month follow-up. The total number for P4 reduced from 10.8 per week at baseline to 4.7 per week in the intervention phase. It was 0 at the 3-month follow-up. The total number for P5 was reduced from 33.7 at baseline to 20.7 per week in the intervention phase. It was 8 at the 3-month follow-up. All participants reported reduction in posttraumatic stress symptoms in the postintervention phase. Depression and anxiety symptoms reduced in 2 of the 3 participants in the postintervention phase. Acceptability was favorable. CONCLUSIONS: We observed good compliance with the intervention and intrusive memory diary in all 3 cases. The number of intrusive memories was reduced for all participants during the intervention phase and at the 1-month follow-up, with some improvement in other symptoms and functioning. Further research should explore the remote delivery of the intervention and whether nonspecialists can deliver the intervention effectively.

Social Touch Somatotopically Affects Mental Body Representations.

In pre-Covid days, many daily actions such as hand shaking or cheek kissing implied physical contact between our body and that of other people. With respect to touching an inanimate object (objectual touch), touching a person (social touch) concerns not only touching a human body, but also that this body belongs to a living person. This fundamental difference also may affect the way we figure our own movements and perceptions or, in other words, how we mentally represent our own body. To test this hypothesis, we asked 30 neurotypical participants to perform mental rotation of images representing hands, full bodies, and feet (an active cognitive task able to activate body representations without need of moving) in two tactile conditions: holding (one in each hand) either the thumbs of another person (social touch) or two plastic cylinders (objectual touch) of about the same circumference and size. Results showed that only mental rotation of hand images was affected by varying the tactile conditions, in that participants were faster during social than objectual touch. This suggests that the nature of hand-related tactile input (social or objectual touch) influences local (hand) and not global (body) mental representations of the body, and in a very somatotopic manner (hands but not feet). We interpret these findings with reference to the differentiation between sensorimotor (body schema) and visuospatial (body image) dynamics in the mental representation of our body. The present study shows that external social factors can affect the internal mental representations of one's own body.

Telephone-based behavioral activation with mental imagery for depression: A pilot randomized clinical trial in isolated older adults during the Covid-19 pandemic.

OBJECTIVES: To shield vulnerable persons, particularly the elderly, during the Covid-19 pandemic governments around the world have advised to use social distancing and self-isolation. Social isolation might put older adults at an increased risk for mental health problems such as depression. There is a need for brief, easy-accessible psychological treatments for depressive symptoms that can be delivered remotely. The aim of this study was to investigate the feasibility, acceptability, and preliminary efficacy of telephone-delivered Behavioral Activation with Mental Imagery (BA-MI) for the treatment of depressive symptoms in individuals 65 years and older living in isolation during the Covid-19 pandemic. METHODS: In this open-label pilot randomized clinical trial, N = 41 individuals aged 65 years or older with clinically significant symptoms of depression were randomly assigned to either a BA-MI treatment condition, or an Attention-Assessment control condition delivered over the telephone over a 4-week period. RESULTS: Depressive symptoms decreased more in the treatment condition compared to the control condition. At post-treatment, 2 out of 16 participants in the treatment condition met diagnostic criteria for depression compared to 9 out of 13 in the control condition. Most participants in the treatment condition were satisfied with the treatment and few adverse effects were observed. CONCLUSIONS: This pilot study suggests that behavioral activation with mental imagery delivered over the telephone is feasible, acceptable, and potentially efficacious for the treatment of depressive symptoms in older individuals living in isolation. Replication in larger samples is needed.

Worry, Risk Perception, and Controllability Predict Intentions Toward COVID-19 Preventive Behaviors.

The ongoing pandemic of COVID-19 has already had serious worldwide health, socio-economic, political, and educational consequences. In the present study, we investigated what factors can motivate young adults to comply with the recommended preventive measures against coronavirus infection. Even though young people are less likely to suffer severe medical consequences from the virus, they can still transmit it to more vulnerable individuals. Surprisingly, we found no significant effects of previously successful experimental manipulations (e.g., enhancing self-efficacy, and visual aids) that aimed to improve risk understanding and impact COVID-19 related behavioral intentions. Instead, intentions toward preventive behaviors were predicted by self-reported worry, perceived controllability of the pandemic, and risk perception. Interestingly, worry about health, and worry about restricting personal freedom predicted behavioral intentions in diverging directions. In particular, participants who were worried about health, were more willing to obey strict hygiene and social distancing restrictions. In contrast, participants who were worried about personal restrictions, were less ready to adopt these preventive actions.

Teaching psychomotor skills online: exploring the implications of novel coronavirus on health professions education.

CONTEXT: The safe and effective application of psychomotor skills in the clinical environment is a central pillar of the health professions. The current global coronavirus pandemic has significantly impacted health professions education (HPE) and has been of particular consequence for routine face-to-face (F2F) skill education for health professionals and clinical students worldwide. What is being experienced on an unprecedented scale parallels a problem familiar to regional, rural and remote health professionals and students: the learners are willing, and the educational expertise exists, but the two are separated by the tyranny of distance. This article considers how the problem of physical distance might be overcome, so that quality skill education might continue. ISSUES: Psychomotor skills are undeniably easier to teach and learn F2F, and training schedules in tertiary, in-service and accredited professional courses reflect this. This aspect of HPE is therefore at significant risk in the context of social distancing and physical isolation. Psychomotor skills are much more complex than the physical motor outputs alone might suggest, and an F2F skill session is only one way to build the complementary aspects of new skill performance. This article argues that educators and course designers can progress with psychomotor skill education from a physical distance. LESSONS LEARNED: Videos can be used to either passively present content to learners or actively engage them. It is the design of the educational activity, rather than the resource medium itself, that enables active engagement. Furthermore, while many training schedules have been adapted to accommodate intensive F2F skill training once it is safe to do so, distributed practice and the need for reflection during the acquisition and development of new skills may challenge the pedagogical effectiveness of this approach. Skill development can be fostered in the absence of F2F teaching, and in the absence of a shared physical space. Embracing the creative licence to do so will improve equitable access to regional, rural and remote clinicians and students well beyond the resolution of the current pandemic.