Single-Session Imagery Rescripting for Social Anxiety Disorder: Efficacy and Mechanisms.

Abstract

Cognitive theories of social anxiety propose that negative mental imagery plays a central role in the maintenance of the disorder. Research has indicated that the content of such mental imagery represents negative core beliefs and derives from specific formative, negative autobiographical events. This dissertation examines the efficacy and mechanisms of imagery rescripting (IR), a novel intervention for social anxiety that works with the content of the negative autobiographical event to transform embedded meaning and corresponding affect. A total of 27 participants with a clinical diagnosis of SAD completed diagnostic assessment and a semi-structured interview designed to identify recurrent images, corresponding autobiographical memories, and the personal meaning these represent to the individual. Then, participants were randomly assigned either to waitlist or a single session of IR. Results from between- and within-group analyses indicated superiority of IR to waitlist as evidenced by significant changes in conjunction with IR from pre- to post-intervention in symptoms of emotional distress and core negative cognitions as well as other hypothesized outcome variables. These gains were generally maintained at 1-week and 1-month follow-up, with substantial effect sizes. Results indicated, in particular, that IR leads to robust changes in self-related cognitions, which, in turn, lead to decreases in SAD symptoms. Implications and future directions are discussed.