A single case series of imagery rescripting of intrusive autobiographical memories in depression

Background and objectives: Intrusive memories are a common feature of depression, thought to be related to the onset and maintenance of the disorder. Intrusive memories have been successfully targeted in posttraumatic stress disorder through imagery rescripting. Yet there is limited evidence for the effectiveness of this technique in depression. We examined whether 12 weekly sessions of imagery rescripting was associated with reductions in depression, rumination and intrusive memories in a sample of patients with major depressive disorder (MDD). Methods: Fifteen clinically depressed participants completed 12 weeks of imagery rescripting treatment while completing daily measures of depression symptoms, rumination and intrusive memory frequency. Results: There were significant reductions on pre-post treatment and daily assessment measures of depression symptoms, rumination and intrusive memories. Reductions in depression symptoms represented a large effect size, while 13 participants (87%) showed reliable improvement and 12 participants (80%) demonstrated clinically significant improvement and no longer met diagnostic criteria for MDD. Limitations: The sample size was small, however the intensive daily assessment protocol ensured the viability of within-person analyses. Conclusions: Imagery rescripting as a stand-alone intervention appears to be effective at reducing depression symptoms. Additionally, the treatment was well tolerated by clients and observed to overcome several traditional treatment barriers in this population.