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Annu Rev Clin Psychol. 2016;12:249-80. doi: 10.1146/annurev-clinpsy-021815-092925. Epub 2016 Jan 15.

Mental Imagery in Depression: Phenomenology, Potential Mechanisms, and Treatment Implications.

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Medical Research Council Cognition and Brain Sciences Unit, Cambridge CB2 7EF, United Kingdom; email: , ,
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 77, Sweden.
School of Psychology, University of Birmingham, Birmingham, West Midlands B15 2TT, United Kingdom; email:
Department of Experimental Psychology, University of Oxford, Oxford OX1 3UD, United Kingdom.
Faculty of Psychology and Educational Sciences, University of Leuven, 3000 Leuven, Belgium; email:


Mental imagery is an experience like perception in the absence of a percept. It is a ubiquitous feature of human cognition, yet it has been relatively neglected in the etiology, maintenance, and treatment of depression. Imagery abnormalities in depression include an excess of intrusive negative mental imagery; impoverished positive imagery; bias for observer perspective imagery; and overgeneral memory, in which specific imagery is lacking. We consider the contribution of imagery dysfunctions to depressive psychopathology and implications for cognitive behavioral interventions. Treatment advances capitalizing on the representational format of imagery (as opposed to its content) are reviewed, including imagery rescripting, positive imagery generation, and memory specificity training. Consideration of mental imagery can contribute to clinical assessment and imagery-focused psychological therapeutic techniques and promote investigation of underlying mechanisms for treatment innovation. Research into mental imagery in depression is at an early stage. Work that bridges clinical psychology and neuroscience in the investigation of imagery-related mechanisms is recommended.


intrusive imagery; optimism; overgeneral memory; rescripting; vividness

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