Early phase testing of functional imagery training as an intervention for anxiety

This is the authors' abstract. We don't add key points for this paper.

Cognitive models hypothesize a role for motivated behaviour in anxiety disorders, with safety behaviours leading to exaggerated threat appraisals and increased anticipatory anxiety. Based on the Affective Imagery Theory of Motivation, we propose that increasing motivation for engagement behaviours will reduce motivation for safety behaviours through competition for limited capacity cognitive resources supporting motivational imagery. We hypothesise that imagining successful engagement will reduce anxiety directly, and through promoting subsequent engagement. We present preliminary evidence that functional imagery training (FIT), an intervention that develops and teaches motivational imagery, reduces anxiety. FIT was delivered to undergraduates with anxiety in one session lasting 40–60 minutes, with two booster calls over 2 weeks (10-20 minutes). Qualitative data from study 1a (N=9) showed that FIT reduced anxiety by strengthening motivation for engagement goals and by the calming and empowering effects of imagery practice. Study 1b (N=10) replicated these findings. Using a stepped wedge design, study 2 (N=29) showed that anxiety reduction over 4 weeks was specifically due to FIT rather than generic experimental factors. GAD-7 scores reduced sooner for a group who received FIT immediately after baseline assessments than for a delayed group who received FIT after the week 2 assessments (BF 10 =25 for group x time interaction). Thus, at week 2, GAD-7 scores were lower for the immediate group (M = 7.2, SD = 3.86) than for the delayed group who had not yet received FIT (M = 13.0, SD = 3.80; BF 10 =71). The results provide initial evidence that brief imagery-based motivational support can reduce anxiety. • We describe a new theory, the Affective Imagery Theory of Motivation, and apply it to anxiety • We present a first test of functional imagery training (FIT) for managing anxiety • Data from two qualitative studies show that FIT reduces anxiety by strengthening motivation for engagement goals and by the calming and empowering effects of imagery practice. • Quantitative data showed that FIT reduced anxiety compared with waitlist control.