Adolescence is characterized as a period of social reorientation toward peer relationships, entai... more Adolescence is characterized as a period of social reorientation toward peer relationships, entailing the emergence of sophisticated social abilities. Two studies (Study 1: N = 42, ages 13–17; Study 2: N = 81, ages 13–16) investigated age group differences in the impact of relationship reciprocation within school-based social networks on an experimental measure of cooperation behavior. Results suggest development between mid- and late adolescence in the extent to which reciprocation of social ties predicted resource allocation. With increasing age group, investment decisions increasingly reflected the degree to which peers reciprocated feelings of friendship. This result may reflect social-cognitive development, which could facilitate the ability to navigate an increasingly complex social world in adolescence and promote positive and enduring relationships into adulthood.
Suicide is a significant world health problem, with more deaths by suicide globally than by war. ... more Suicide is a significant world health problem, with more deaths by suicide globally than by war. We need to better understand the cognitive processes underlying suicidal thinking for improved treatment development. Cognitive psychology indicates that mental imagery can be causal in determining future behavior, yet the occurrence of suicide-related imagery has not previously been investigated.
Distressing mental images are common in anxiety disorders and have recently been found to have an... more Distressing mental images are common in anxiety disorders and have recently been found to have an important role in the maintenance of anxious problems. For example, in post-traumatic stress disorder (PTSD) the hallmark feature is the presence of recurrent sensory images of a past trauma, known as 'flashbacks'. These flashbacks comprise the key information that needs to be addressed in cognitive–behavioural therapy (CBT) to treat this disorder successfully.
Abstract. There is active, current speculation about the relationship between trauma and psychosi... more Abstract. There is active, current speculation about the relationship between trauma and psychosis. However, little is known about the information-processing mechanisms underlying the development of trauma-related intrusions in this area. Our account highlights the role of contextual integration, ie the need for experiential information to be effectively integrated into a temporal and spatial context in order to facilitate voluntary recall.
Abstract We define intrusive prospective imagery as the experience of mental imagery of events th... more Abstract We define intrusive prospective imagery as the experience of mental imagery of events that may happen in the future and which come to mind involuntarily. This everyday phenomenon may be exacerbated in psychological disorders such as bipolar disorder (Holmes, Geddes, Colom, & Goodwin, 2008) although specific measures to assess this have been lacking. We recently developed the Impact of Future Events Scale (IFES; Deeprose & Holmes, 2010), which is further examined in the current paper.
Abstract Bipolar disorder is a psychiatric condition characterized by episodes of elevated mood i... more Abstract Bipolar disorder is a psychiatric condition characterized by episodes of elevated mood interspersed with episodes of depression. While treatment developments and understanding the disruptive nature of this illness have focused on these episodes, it is also evident that some patients may have chronic week-to-week mood instability. This is also a major morbidity. The longitudinal pattern of this mood instability is poorly understood as it has, until recently, been difficult to quantify.
Acknowledgements Funding and support References Rethinking 'Mental Health Stigma'component of END... more Acknowledgements Funding and support References Rethinking 'Mental Health Stigma'component of END is a talk by one or more volunteers with experience of mental illness; the volunteers recount their life experiences before, during and after the onset of their mental illness, discuss their recovery and relay instances in which they have felt discriminated against or stigmatized and how these instances have affected their lives.
Peritraumatic dissociation is thought to effect trauma information encoding, leading to PTSD symp... more Peritraumatic dissociation is thought to effect trauma information encoding, leading to PTSD symptoms like intrusive memories. Most studies have focused on peritraumatic psychological dissociation. The present experiment studied the impact of hypnotically induced somatoform dissociation (dissociative non-movement) versus deliberate non-movement during an aversive film on intrusion development.
Abstract A salient feature of clinical anxiety and its disorders is an elevated subjective probab... more Abstract A salient feature of clinical anxiety and its disorders is an elevated subjective probability judgement that future negative events will happen to the individual. A neglected area of research is the cognitive mechanisms that might underlie this judgement in patient populations. First, we investigated the ease of being able to simulate imaginary negative events happening to the individual ('the simulation heuristic').
1 This is in contrast to intrusive images where the content depicts a worry or fear about somethi... more 1 This is in contrast to intrusive images where the content depicts a worry or fear about something that could (have) happen (ed) but has not necessarily happened (eg the image of people laughing when preparing for a presentation as in social phobia). However, research indicates that many intrusive images, at least in psychological disorders, are related to some earlier experience (Brewin, 1998).
The Journal of nervous and mental disease, Jan 1, 2004
Intrusive mental experiences occur within posttraumatic stress disorder (PTSD) and some psychotic... more Intrusive mental experiences occur within posttraumatic stress disorder (PTSD) and some psychotic disorders. Similarities in the phenomenology and content in the intrusions of both disorders have been noted. Currently there is little understanding of any common etiology in terms of information-processing styles. This study investigated predictors of analogue posttraumatic intrusive cognitions within a nonclinical sample, including schizotypy, dissociation, and trauma history. Forty-two participants watched a trauma video and recorded trauma-related intrusions occurring for 1 week. More reported intrusive experiences were associated with high positive symptom schizotypy. Our findings are discussed in relation to the possible role of trauma-related intrusions within psychotic disorders.
The authors provide an overview of the papers in the special issue of Memory on mental imagery an... more The authors provide an overview of the papers in the special issue of Memory on mental imagery and memory in psychopathology. The papers address emotional, intrusive mental imagery across a range of psychological disorders including post‐traumatic stress disorder (PTSD), agoraphobia, body dysmorphic disorder, mood disorders, and psychosis. They include work on information processing issues including modelling cravings, conditioning, and aversions, as well as imagery qualities such as vividness and emotionality. The overview aims to place the articles in a broader context and draw out some exciting implications of this novel work. It provides a clinical context to the recent growth in this area from a cognitive behavioural therapy (CBT) perspective. We begin with PTSD, and consider links to imagery in other disorders. The clinical implications stemming from this empirical work and from autobiographical memory theory are discussed. These include consideration of a variety of techniques for eliminating troublesome imagery, and creating healthy, realistic alternatives.
Recent cognitive models suggest that mental imagery can help us understand the maintenance of anx... more Recent cognitive models suggest that mental imagery can help us understand the maintenance of anxiety disorders (e.g., de Silva, 1986; Hackmann, Surawy, & Clark, 1998). However, imagery is relatively unexplored within agoraphobia. Such images are also thought to be useful in uncovering memories that occurred around the onset of a disorder (Hackmann, Clark, & McManus, 2000). A total of 20 patients with agoraphobia and 20 matched controls took part in this investigation. Participants described any recurrent images they experienced in agoraphobic situations, and also any associated memories. All patients with agoraphobia (but no control participants) reported having distinct recurrent images in “agoraphobic situations”. Most images involved several sensory modalities and in the majority of cases appeared to be linked with unpleasant memories of events experienced many years previously. While these exploratory findings require replication, potential treatment implications are discussed.
This review aims to clarify the use of the term ‘dissociation’ in theory, research and clinical p... more This review aims to clarify the use of the term ‘dissociation’ in theory, research and clinical practice. Current psychiatric definitions of dissociation are contrasted with recent conceptualizations that have converged on a dichotomy between two qualitatively different phenomena: ‘detachment’ and ‘compartmentalization’. We review some evidence for this distinction within the domains of phenomenology, factor analysis of self-report scales and experimental research. Available evidence supports the distinction but more controlled evaluations are needed. We conclude with recommendations for future research and clinical practice, proposing that using this dichotomy can lead to clearer case formulation and an improved choice of treatment strategy. Examples are provided within Depersonalization Disorder, Conversion Disorder and Posttraumatic Stress Disorder (PTSD).
Journal of behavior therapy and experimental psychiatry, Jan 1, 2005
This study aimed to investigate the emotions and cognitions contained in “hotspots” of memory for... more This study aimed to investigate the emotions and cognitions contained in “hotspots” of memory for trauma, as well as their associated images. Thirty-two participants at a specialist outpatient trauma clinic had experienced a range of traumatic events and met diagnostic criteria for Posttraumatic Stress Disorder (PTSD). Data were collected within an agreed protocol, involving reliving therapy. Patients described the different intrusive images of the trauma that they were re-experiencing. Their reports of cognitions and emotions during “hotspots” in their memory of the traumatic experience were recorded as part of reliving therapy. Hotspots refer to moments of peak emotional distress during the event. There was a high degree of match reported between intrusive images and hotspots. The cognitive and emotional contents of hotspots were qualitatively analysed into themes. The relative of frequency of these peritraumatic themes is presented. The exploratory findings are discussed with respect to our understanding and treatment of intrusive imagery in PTSD.
Nonclinical participants watched a trauma film under two processing conditions. During part of th... more Nonclinical participants watched a trauma film under two processing conditions. During part of the film participants carried out a concurrent visuospatial grounding task consisting of the construction of shapes out of plasticine (modelling clay), while the rest of the film constituted a control, no task condition. The visuospatial task was predicted to selectively compete for processing resources required for intrusive image formation. As predicted, spontaneous intrusive images during the succeeding week were significantly less common from those parts of the film that coincided with the concurrent task. The task had no effect on levels of distress or peritraumatic dissociation, consistent with the hypothesis that intrusions were reduced because the task competed for resources necessary for encoding into an image-based memory system.
Adolescence is characterized as a period of social reorientation toward peer relationships, entai... more Adolescence is characterized as a period of social reorientation toward peer relationships, entailing the emergence of sophisticated social abilities. Two studies (Study 1: N = 42, ages 13–17; Study 2: N = 81, ages 13–16) investigated age group differences in the impact of relationship reciprocation within school-based social networks on an experimental measure of cooperation behavior. Results suggest development between mid- and late adolescence in the extent to which reciprocation of social ties predicted resource allocation. With increasing age group, investment decisions increasingly reflected the degree to which peers reciprocated feelings of friendship. This result may reflect social-cognitive development, which could facilitate the ability to navigate an increasingly complex social world in adolescence and promote positive and enduring relationships into adulthood.
Suicide is a significant world health problem, with more deaths by suicide globally than by war. ... more Suicide is a significant world health problem, with more deaths by suicide globally than by war. We need to better understand the cognitive processes underlying suicidal thinking for improved treatment development. Cognitive psychology indicates that mental imagery can be causal in determining future behavior, yet the occurrence of suicide-related imagery has not previously been investigated.
Distressing mental images are common in anxiety disorders and have recently been found to have an... more Distressing mental images are common in anxiety disorders and have recently been found to have an important role in the maintenance of anxious problems. For example, in post-traumatic stress disorder (PTSD) the hallmark feature is the presence of recurrent sensory images of a past trauma, known as 'flashbacks'. These flashbacks comprise the key information that needs to be addressed in cognitive–behavioural therapy (CBT) to treat this disorder successfully.
Abstract. There is active, current speculation about the relationship between trauma and psychosi... more Abstract. There is active, current speculation about the relationship between trauma and psychosis. However, little is known about the information-processing mechanisms underlying the development of trauma-related intrusions in this area. Our account highlights the role of contextual integration, ie the need for experiential information to be effectively integrated into a temporal and spatial context in order to facilitate voluntary recall.
Abstract We define intrusive prospective imagery as the experience of mental imagery of events th... more Abstract We define intrusive prospective imagery as the experience of mental imagery of events that may happen in the future and which come to mind involuntarily. This everyday phenomenon may be exacerbated in psychological disorders such as bipolar disorder (Holmes, Geddes, Colom, & Goodwin, 2008) although specific measures to assess this have been lacking. We recently developed the Impact of Future Events Scale (IFES; Deeprose & Holmes, 2010), which is further examined in the current paper.
Abstract Bipolar disorder is a psychiatric condition characterized by episodes of elevated mood i... more Abstract Bipolar disorder is a psychiatric condition characterized by episodes of elevated mood interspersed with episodes of depression. While treatment developments and understanding the disruptive nature of this illness have focused on these episodes, it is also evident that some patients may have chronic week-to-week mood instability. This is also a major morbidity. The longitudinal pattern of this mood instability is poorly understood as it has, until recently, been difficult to quantify.
Acknowledgements Funding and support References Rethinking 'Mental Health Stigma'component of END... more Acknowledgements Funding and support References Rethinking 'Mental Health Stigma'component of END is a talk by one or more volunteers with experience of mental illness; the volunteers recount their life experiences before, during and after the onset of their mental illness, discuss their recovery and relay instances in which they have felt discriminated against or stigmatized and how these instances have affected their lives.
Peritraumatic dissociation is thought to effect trauma information encoding, leading to PTSD symp... more Peritraumatic dissociation is thought to effect trauma information encoding, leading to PTSD symptoms like intrusive memories. Most studies have focused on peritraumatic psychological dissociation. The present experiment studied the impact of hypnotically induced somatoform dissociation (dissociative non-movement) versus deliberate non-movement during an aversive film on intrusion development.
Abstract A salient feature of clinical anxiety and its disorders is an elevated subjective probab... more Abstract A salient feature of clinical anxiety and its disorders is an elevated subjective probability judgement that future negative events will happen to the individual. A neglected area of research is the cognitive mechanisms that might underlie this judgement in patient populations. First, we investigated the ease of being able to simulate imaginary negative events happening to the individual ('the simulation heuristic').
1 This is in contrast to intrusive images where the content depicts a worry or fear about somethi... more 1 This is in contrast to intrusive images where the content depicts a worry or fear about something that could (have) happen (ed) but has not necessarily happened (eg the image of people laughing when preparing for a presentation as in social phobia). However, research indicates that many intrusive images, at least in psychological disorders, are related to some earlier experience (Brewin, 1998).
The Journal of nervous and mental disease, Jan 1, 2004
Intrusive mental experiences occur within posttraumatic stress disorder (PTSD) and some psychotic... more Intrusive mental experiences occur within posttraumatic stress disorder (PTSD) and some psychotic disorders. Similarities in the phenomenology and content in the intrusions of both disorders have been noted. Currently there is little understanding of any common etiology in terms of information-processing styles. This study investigated predictors of analogue posttraumatic intrusive cognitions within a nonclinical sample, including schizotypy, dissociation, and trauma history. Forty-two participants watched a trauma video and recorded trauma-related intrusions occurring for 1 week. More reported intrusive experiences were associated with high positive symptom schizotypy. Our findings are discussed in relation to the possible role of trauma-related intrusions within psychotic disorders.
The authors provide an overview of the papers in the special issue of Memory on mental imagery an... more The authors provide an overview of the papers in the special issue of Memory on mental imagery and memory in psychopathology. The papers address emotional, intrusive mental imagery across a range of psychological disorders including post‐traumatic stress disorder (PTSD), agoraphobia, body dysmorphic disorder, mood disorders, and psychosis. They include work on information processing issues including modelling cravings, conditioning, and aversions, as well as imagery qualities such as vividness and emotionality. The overview aims to place the articles in a broader context and draw out some exciting implications of this novel work. It provides a clinical context to the recent growth in this area from a cognitive behavioural therapy (CBT) perspective. We begin with PTSD, and consider links to imagery in other disorders. The clinical implications stemming from this empirical work and from autobiographical memory theory are discussed. These include consideration of a variety of techniques for eliminating troublesome imagery, and creating healthy, realistic alternatives.
Recent cognitive models suggest that mental imagery can help us understand the maintenance of anx... more Recent cognitive models suggest that mental imagery can help us understand the maintenance of anxiety disorders (e.g., de Silva, 1986; Hackmann, Surawy, & Clark, 1998). However, imagery is relatively unexplored within agoraphobia. Such images are also thought to be useful in uncovering memories that occurred around the onset of a disorder (Hackmann, Clark, & McManus, 2000). A total of 20 patients with agoraphobia and 20 matched controls took part in this investigation. Participants described any recurrent images they experienced in agoraphobic situations, and also any associated memories. All patients with agoraphobia (but no control participants) reported having distinct recurrent images in “agoraphobic situations”. Most images involved several sensory modalities and in the majority of cases appeared to be linked with unpleasant memories of events experienced many years previously. While these exploratory findings require replication, potential treatment implications are discussed.
This review aims to clarify the use of the term ‘dissociation’ in theory, research and clinical p... more This review aims to clarify the use of the term ‘dissociation’ in theory, research and clinical practice. Current psychiatric definitions of dissociation are contrasted with recent conceptualizations that have converged on a dichotomy between two qualitatively different phenomena: ‘detachment’ and ‘compartmentalization’. We review some evidence for this distinction within the domains of phenomenology, factor analysis of self-report scales and experimental research. Available evidence supports the distinction but more controlled evaluations are needed. We conclude with recommendations for future research and clinical practice, proposing that using this dichotomy can lead to clearer case formulation and an improved choice of treatment strategy. Examples are provided within Depersonalization Disorder, Conversion Disorder and Posttraumatic Stress Disorder (PTSD).
Journal of behavior therapy and experimental psychiatry, Jan 1, 2005
This study aimed to investigate the emotions and cognitions contained in “hotspots” of memory for... more This study aimed to investigate the emotions and cognitions contained in “hotspots” of memory for trauma, as well as their associated images. Thirty-two participants at a specialist outpatient trauma clinic had experienced a range of traumatic events and met diagnostic criteria for Posttraumatic Stress Disorder (PTSD). Data were collected within an agreed protocol, involving reliving therapy. Patients described the different intrusive images of the trauma that they were re-experiencing. Their reports of cognitions and emotions during “hotspots” in their memory of the traumatic experience were recorded as part of reliving therapy. Hotspots refer to moments of peak emotional distress during the event. There was a high degree of match reported between intrusive images and hotspots. The cognitive and emotional contents of hotspots were qualitatively analysed into themes. The relative of frequency of these peritraumatic themes is presented. The exploratory findings are discussed with respect to our understanding and treatment of intrusive imagery in PTSD.
Nonclinical participants watched a trauma film under two processing conditions. During part of th... more Nonclinical participants watched a trauma film under two processing conditions. During part of the film participants carried out a concurrent visuospatial grounding task consisting of the construction of shapes out of plasticine (modelling clay), while the rest of the film constituted a control, no task condition. The visuospatial task was predicted to selectively compete for processing resources required for intrusive image formation. As predicted, spontaneous intrusive images during the succeeding week were significantly less common from those parts of the film that coincided with the concurrent task. The task had no effect on levels of distress or peritraumatic dissociation, consistent with the hypothesis that intrusions were reduced because the task competed for resources necessary for encoding into an image-based memory system.
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Papers by Emily Holmes