Imperial College London

Dr Martina Di Simplicio

Faculty of MedicineDepartment of Brain Sciences

Clinical Senior Lecturer in Psychiatry
 
 
 
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Contact

 

+44 (0)20 7594 1071m.di-simplicio

 
 
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Assistant

 

Ms Nicole Hickey +44 (0)20 3313 4161

 
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Location

 

7N11ACommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

71 results found

Di Simplicio O, Di Simplicio M, 2023, AN ANATOMY OF WITCHCRAFT: Between Cognitive Sciences and History, An Anatomy of Witchcraft: between Cognitive Sciences and History, Pages: 1-262

Much has been written on witchcraft by historians, theologians, philosophers, and anthropologists, but nothing by scientists. This book aims to reappraise witchcraft by applying to it the advances in cognitive sciences. The book is divided into four parts. Part I ("Deep History") deals with human emotions and the drive to represent witches as evil female agents. Part II ("Historical Times") focuses on those rare state and church repressions of malefice, which, surprisingly, did not feature in Islamic lands. Modern urbanization dealt a blow to the rural civilizations where accusations of witchcraft were rife. Part III ("In the Laboratory") applies neuroscience to specific case studies to investigate the personification of misfortune, the millenary stereotype witch = woman, the reality of evil, and the phenomenon of treasure hunting. Part IV ("Millenials") wonders whether intentional malefic hatred in a closed chapter in the history of humanity. An Anatomy of Witchcraft is ideal reading for students and scholars. Given its interdisciplinary nature, the book will be of interest to scholars from many fields including evolutionary psychology, anthropology, women’s history, and cognitive sciences.

Journal article

Vannucci C, Bonsall MB, Di Simplicio M, Cairns A, Holmes EA, Burnett Heyes Set al., 2022, Positive moods are all alike? Differential affect amplification effects of 'elated' versus 'calm' mental imagery in young adults reporting hypomanic-like experiences, Translational Psychiatry, Vol: 12, ISSN: 2158-3188

Positive mood amplification is a hallmark of the bipolar disorder spectrum (BPDS). We need better understanding of cognitive mechanisms contributing to such elevated mood. Generation of vivid, emotionally compelling mental imagery is proposed to act as an 'emotional amplifier' in BPDS. We used a positive mental imagery generation paradigm to manipulate affect in a subclinical BPDS-relevant sample reporting high (n = 31) vs. low (n = 30) hypomanic-like experiences on the Mood Disorder Questionnaire (MDQ). Participants were randomized to an 'elated' or 'calm' mental imagery condition, rating their momentary affect four times across the experimental session. We hypothesized greater affect increase in the high (vs. low) MDQ group assigned to the elated (vs. calm) imagery generation condition. We further hypothesized that affect increase in the high MDQ group would be particularly apparent in the types of affect typically associated with (hypo)mania, i.e., suggestive of high activity levels. Mixed model and time-series analysis showed that for the high MDQ group, affect increased steeply and in a sustained manner over time in the 'elated' imagery condition, and more shallowly in 'calm'. The low-MDQ group did not show this amplification effect. Analysis of affect clusters showed high-MDQ mood amplification in the 'elated' imagery condition was most pronounced for active affective states. This experimental model of BPDS-relevant mood amplification shows evidence that positive mental imagery drives changes in affect in the high MDQ group in a targeted manner. Findings inform cognitive mechanisms of mood amplification, and spotlight prevention strategies targeting elated imagery, while potentially retaining calm imagery to preserve adaptive positive emotionality.

Journal article

Crawford M, Leeson V, McQuaid A, Samuel O, King J, Di Simplicio M, Tyrer P, Tyrer H, Watt R, Barnicot Ket al., 2022, Severe COVID anxiety among adults in the United Kingdom: protocol for a cohort study and nested feasibility trial of modified Cognitive Behaviour Therapy for Health Anxiety., BMJ Open, Vol: 12, Pages: 1-9, ISSN: 2044-6055

IntroductionSome people are so anxious about COVID that it impairs their functioning. However, little is known about the course of severe COVID anxiety or what can be done to help people who experience it. Methods and analysisCohort study with a nested feasibility trial with follow-up at three and six months. We recruited 306 people who were aged 18 and over, lived in the United Kingdom and had severe COVID anxiety (indicated by a score of nine or more on the Coronavirus Anxiety Scale). To take part in the nested feasibility trial, participants also had to have a score of 20 or more on the Short Health Anxiety Inventory. We excluded people from the trial if they had had COVID-19 within the previous four weeks, if they were currently self-isolating or if they were already receiving psychological treatment. We publicised the study nationally through adverts, social media and posts on chat boards. We also recruited participants via clinicians working in primary and secondary care NHS services in London. All those in the active arm will be offered five to ten sessions of remotely delivered modified Cognitive Behaviour Therapy for Health Anxiety (CBT-HA). We will examine the proportion of participants who remain above threshold on the Coronavirus Anxiety Scale at three and six months and factors that influence levels of COVID anxiety over six months using mixed-effects logistic regression. The key feasibility metrics for the nested trial are the level of uptake of CBT-HA and the rate of follow-up.Ethics and disseminationApproved by Leicester Central Research Ethics Committee (reference: 20/EM/0238). The results of the study will be published in peer-reviewed scientific journals. Trial registration: International Standard Randomised Control Trial Number Register - ISRCTN14973494

Journal article

Girela Serrano BM, Spiers A, Ruotong L, Gangadia S, Toledano MB, Di Simplicio Met al., 2022, Impact of mobile phones and wireless devices use on children and adolescents´ mental health: a systematic review, European Child and Adolescent Psychiatry: official journal of the European Society for Child and Adolescent Psychiatry, ISSN: 1018-8827

Growing use of mobiles phones (MP) and other wireless devices (WD) has raised concerns about their possible effects on children and adolescents’ wellbeing. Understanding whether these technologies affect children and adolescents’ mental health in positive or detrimental ways has become more urgent following further increase in use since the COVID-19 outbreak. To review the empirical evidence on associations between use of MP/WD and mental health in children and adolescents. A systematic review of literature was carried out on Medline, Embase and PsycINFO for studies published prior to July 15th 2019, PROSPERO ID: CRD42019146750. 25 observational studies published between January 1st 2011 and 2019 were reviewed (ten were cohort studies, 15 were cross-sectional). Overall estimated participant mean age and proportion female were 14.6 years and 47%, respectively. Substantial between-study heterogeneity in design and measurement of MP/WD usage and mental health outcomes limited our ability to infer general conclusions. Observed effects differed depending on time and type of MP/WD usage. We found suggestive but limited evidence that greater use of MP/WD may be associated with poorer mental health in children and adolescents. Risk of bias was rated as ‘high’ for 16 studies, ‘moderate’ for five studies and ‘low’ for four studies. More high-quality longitudinal studies and mechanistic research are needed to clarify the role of sleep and of type of MP/WD use (e.g. social media) on mental health trajectories in children and adolescents.

Journal article

Dewa LH, Pappa S, Greene T, Cooke J, Mitchell L, Hadley M, Di Simplicio M, Woodcock T, Aylin Pet al., 2022, The Association Between Sleep Disturbance and Suicidality in Psychiatric Inpatients Transitioning to the Community: Protocol for an Ecological Momentary Assessment Study, JMIR RESEARCH PROTOCOLS, Vol: 11, ISSN: 1929-0748

Journal article

Dewa L, Pappa S, Greene T, Cooke J, Mitchell L, Hadley M, Di Simplicio M, Woodcock T, Aylin Pet al., 2022, The Association Between Sleep Disturbance and Suicidality inPsychiatric Inpatients Transitioning to the Community: Protocolfor an Ecological Momentary Assessment Study, JMIR Research Protocols, Vol: 11, Pages: 1-12, ISSN: 1929-0748

Background:Patients are at high risk of suicidal behaviour and death by suicide immediately followingdischarge from an inpatient psychiatric hospital. Furthermore, there is a high prevalence ofsleep problems in inpatient settings which is associated with worse outcomes followinghospitalisation. However, it is unknown whether poor sleep is associated with suicidalityfollowing initial hospital discharge.Objective:Our study objective is to describe the ecological momentary assessment (EMA) studyprotocol that aims to examine the relationship between sleep and suicidality in dischargedpatients.Methods:Our study will use EMA design using a wearable device to examine the sleep-suiciderelationship during the transition from acute inpatient care to the community. Prospectivelydischarged inpatients aged 18-35 with a mental disorder (n=50) will be assessed foreligibility and recruited across two sites. Data on suicidal ideation, behaviour and imagery,non-suicidal self-harm and imagery, defeat, entrapment, and hopelessness, affect and sleepwill be collected on the Pro-Diary V wrist-worn electronic watch for up to 14 days. Objectivesleep and daytime activity will be measured using the inbuilt MotionWare software.Questionnaires will be administered face-to-face at baseline and follow-up while data willalso be collected on the acceptability and feasibility of using the Pro-Diary V watch tomonitor the transition following discharge. The study has been, and will continue to be, coproduced with young people with experience of being in an inpatient setting and suicidality.Results:South Birmingham Research Ethics Committee (Ref: 21/WM/0128) approved the study onJune 28th 2021. We expect to see a relationship between poor sleep and post-dischargesuicidality. Results will be available in 2022.DiscussionThis protocol describes the first co-produced EMA study to examine the relationshipbetween sleep and suicidality, and to apply the IMV model in young patients transitioningfrom psychiatric

Journal article

Dewa LH, Pappa S, Greene T, Cooke J, Mitchell L, Hadley M, Di Simplicio M, Woodcock T, Aylin Pet al., 2021, The Association Between Sleep Disturbance and Suicidality in Psychiatric Inpatients Transitioning to the Community: Protocol for an Ecological Momentary Assessment Study (Preprint)

<sec> <title>BACKGROUND</title> <p>Patients are at high risk of suicidal behavior and death by suicide immediately following discharge from inpatient psychiatric hospitals. Furthermore, there is a high prevalence of sleep problems in inpatient settings, which is associated with worse outcomes following hospitalization. However, it is unknown whether poor sleep is associated with suicidality following initial hospital discharge.</p> </sec> <sec> <title>OBJECTIVE</title> <p>Our study objective is to describe a protocol for an ecological momentary assessment (EMA) study that aims to examine the relationship between sleep and suicidality in discharged patients.</p> </sec> <sec> <title>METHODS</title> <p>Our study will use an EMA design based on a wearable device to examine the sleep-suicide relationship during the transition from acute inpatient care to the community. Prospectively discharged inpatients 18 to 35 years old with mental disorders (N=50) will be assessed for eligibility and recruited across 2 sites. Data on suicidal ideation, behavior, and imagery; nonsuicidal self-harm and imagery; defeat, entrapment, and hopelessness; affect; and sleep will be collected on the Pro-Diary V wrist-worn electronic watch for up to 14 days. Objective sleep and daytime activity will be measured using the inbuilt MotionWare software. Questionnaires will be administered face-to-face at baseline and follow up, and data will also be collected on the acceptability and feasibility of using the Pro-Diary V watch to monitor the transition following discharge. The study has been, and will continue to be, coproduced with young people with experience of being in an inpatient settin

Journal article

Dewa L, Pappa S, Greene T, Cooke J, Mitchell L, Hadley M, Di Simplicio M, Woodcock T, Aylin Pet al., 2021, SWAY: Sleep disturbance as an early warning sign of suicidality in psychiatric inpatients transitioning to the community: an ecological momentary assessment study protocol

Working paper

Dewa L, Crandell C, Choong E, Jaques J, Bottle R, Kilkenny C, Lawrence-Jones A, Di Simplicio M, Nicholls D, Aylin Pet al., 2021, CCopeY: a mixed-methods co-produced study on the mental health status and coping strategies of young people during COVID-19 UK lockdown, Journal of Adolescent Health, ISSN: 1054-139X

PurposeExploring the impact of COVID-19 pandemic on young people’s mental health is an increasing priority. Studies to date are largely surveys and lack meaningful involvement from service users in their design, planning and delivery. The study aimed to examine the mental health status and coping strategies of young people during the first UK COVID-19 lockdown using co-production methodology.MethodsThe mental health status of young people (aged 16-24) in April 2020 was established utilising a sequential explanatory co-produced mixed methods design. Factors associated with poor mental health status including coping strategies were also examined using an online survey and semi-structured interviews.Results30.3% had poor mental health and 10.8% had self-harmed since lockdown. Young people identifying as Black/Black-British ethnicity had the highest increased odds of experiencing poor mental health (odds ratio [OR] 3.688, 95% CI 0.54-25.40). Behavioural disengagement (OR 1.462, 95% CI 1.22-1.76), self-blame (OR 1.307 95% CI 1.10-1.55), and substance use (OR 1.211 95% CI 1.02-1.44) coping strategies, negative affect (OR 1.109, 95% CI 1.07-1.15), sleep problems (OR 0.915 95% CI 0.88-0.95) and conscientiousness personality trait (OR 0.819 95% CI 0.69-0.98) were significantly associated with poor mental health. Three qualitative themes were identified: (1) pre-existing/developed helpful coping strategies employed, (2) mental health difficulties worsened and (3) mental health and non-mental health support needed during and after lockdown.ConclusionPoor mental health is associated with dysfunctional coping strategies. Innovative coping strategies can help other young people cope during and after lockdowns, with digital and school promotion and application.

Journal article

O'Donnell C, Simplicio MD, Heyes SB, 2020, Hypomanic-like experiences and spontaneous emotional mental imagery, JOURNAL OF AFFECTIVE DISORDERS, Vol: 277, Pages: 742-746, ISSN: 0165-0327

Journal article

Dewa L, Crandell C, Choong E, Jaques J, Bottle R, Kilkenny C, Lawrence-Jones A, Nicholls D, Di Simplicio M, Aylin Pet al., 2020, CCopeY: a mixed-methods co-produced study on the mental health status and coping strategies of young people during COVID-19 UK lockdown

Working paper

Schultebraucks K, Duesenberg M, Di Simplicio M, Holmes EA, Roepke Set al., 2020, Suicidal imagery in borderline personality disorder and major depressive disorder, Journal of Personality Disorders, Vol: 34, Pages: 546-564, ISSN: 0885-579X

A better understanding of suicidal behavior is important to detect suicidality in at-risk populations such as patients with Borderline Personality Disorder (BPD), Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD). Suicidal tendencies are clinically assessed by verbal thoughts rather than specifically asking about mental images. This study examines whether imagery and verbal thoughts about suicide occur and differ between patients with BPD with and without comorbid PTSD compared to patients with MDD (clinical controls). All patient groups experienced suicide-related images. Patients with BPD with comorbid PTSD reported significantly more vivid images than patients with MDD. Severity of suicidal ideation, number of previous suicide attempts and childhood traumata were significantly associated with suicidal imagery across all patient groups. We demonstrate for the first time that suicide-related mental imagery occurs in BPD and is associated with suicidal ideation. This highlight the importance of assessing mental imagery-related to suicide in clinical practice.

Journal article

Di Simplicio M, Appiah-Kusi E, Wilkinson P, Watson P, Meiser-Stedman C, Kavanagh DJ, Holmes EAet al., 2020, <i>Imaginator</i>: A Proof-of-Concept Feasibility Trial of a Brief Imagery-Based Psychological Intervention for Young People Who Self-Harm, SUICIDE AND LIFE-THREATENING BEHAVIOR, Vol: 50, Pages: 724-740, ISSN: 0363-0234

Journal article

Clogs M, Di Simplicio M, Hammerle F, Steil Ret al., 2020, Mental images, entrapment and affect in young adults meeting criteria of nonsuicidal self-injury disorder (NSSID) - a daily diary study, BORDERLINE PERSONALITY DISORDER AND EMOTION DYSREGULATION, Vol: 7, ISSN: 2051-6673

Journal article

Di Simplicio M, Lau-Zhu A, Meluken I, Taylor P, Kessing LV, Vinberg M, Holmes EA, Miskowiak KWet al., 2019, Emotional mental imagery abnormalities in monozygotic twins with, at high-risk of, and without affective disorders: present in affected twins in remission but absent in high-risk twins, Frontiers in Psychiatry, Vol: 10, Pages: 1-12, ISSN: 1664-0640

Background: Mental imagery abnormalities feature across affective disorders including bipolar disorder (BD) and unipolar depression (UD). Maladaptive emotional imagery has been proposed as a maintenance factor for affective symptomatology and a target for mechanism-driven psychological treatment developments. Where imagery abnormalities feature beyond acute affective episodes, further opportunities for innovation arise beyond treatments, such as for tertiary/relapse prevention (e.g., in remitted individuals) or primary prevention (e.g., in non-affected but at-risk individuals). The aim of our study was to investigate for the first time the presence of possible mental imagery abnormalities in affected individuals in remission and at-risk individuals for affective disorders using a familial risk design.Methods: A population-based cohort of monozygotic twins was recruited through linkage between the Danish national registries (N=204). Participants were grouped as: affected (remitted BD/UD; n = 115); high-risk (co-twin with history of BD/UD; n = 49), or low-risk (no co-twin history of BD/UD; n = 40). Twins completed mental imagery measures spanning key subjective domains (spontaneous imagery use and emotional imagery) and cognitive domains (imagery inspection and imagery manipulation).Results: Affected twins in remission reported enhanced emotional mental imagery compared to both low- and high-risk twins. This was characterized by greater impact of i) intrusive prospective imagery (Impact of Future Events Scale) and ii) deliberately-generated prospective imagery of negative scenarios (Prospective Imagery Task). There were no significant differences in these key measures between affected BD and UD twins in remission. Additionally, low- and high-risk twins did not significantly differ on these emotional imagery measures. There were also no significant differences between the three groups on non-emotional measures including spontaneous imagery use and cognitive stages of i

Journal article

Holmes EA, Hales SA, Young K, Simplicio MDet al., 2019, Imagery-Based Cognitive Therapy for Bipolar Disorder and Mood Instability, Publisher: Guilford Publications, ISBN: 9781462539055

This book presents a novel brief treatment that focuses on working with mental images to reduce distress and enhance mood stability.

Book

Ji JL, Holmes EA, Kavanagh DJ, MacLeod C, Di Simplicio Met al., 2019, Mental imagery in psychiatry: conceptual & clinical implications, CNS Spectrums, Vol: 24, Pages: 114-126, ISSN: 2165-6509

Mental imagery refers to the experience of perception in the absence of external sensory input. Deficits in the ability to generate mental imagery or to distinguish it from actual sensory perception are linked to neurocognitive conditions such as dementia and schizophrenia, respectively. However, the importance of mental imagery to psychiatry extends beyond neurocognitive impairment. Mental imagery has a stronger link to emotion than verbal-linguistic cognition, serving to maintain and amplify emotional states, with downstream impacts on motivation and behavior. As a result, anomalies in the occurrence of emotion-laden mental imagery has transdiagnostic significance for emotion, motivation, and behavioral dysfunction across mental disorders. This review aims to demonstrate the conceptual and clinical significance of mental imagery in psychiatry through examples of mood and anxiety disorders, self-harm and suicidality, and addiction. We contend that focusing on mental imagery assessment in research and clinical practice can increase our understanding of the cognitive basis of psychopathology in mental disorders, with the potential to drive the development of algorithms to aid treatment decision-making and inform transdiagnostic treatment innovation.

Journal article

Meluken I, Ottesen NM, Phan KL, Goldin PR, Di Simplicio M, Macoveanu J, Siebner HR, Kessing LV, Vinberg M, Miskowiak KWet al., 2019, Neural response during emotion regulation in monozygotic twins at high familial risk of affective disorders, NeuroImage: Clinical, Vol: 21, Pages: 101598-101598, ISSN: 2213-1582

Journal article

O'Donnell C, Di Simplicio M, Brown R, Holmes EA, Heyes SBet al., 2018, The role of mental imagery in mood amplification: An investigation across subclinical features of bipolar disorders, CORTEX, Vol: 105, Pages: 104-117, ISSN: 0010-9452

Journal article

Hales SA, Di Simplicio M, Iyadurai L, Blackwell SE, Young K, Fairburn CG, Geddes JR, Goodwin GM, Holmes EAet al., 2018, Imagery-Focused Cognitive Therapy (ImCT) for Mood Instability and Anxiety in a Small Sample of Patients with Bipolar Disorder: a Pilot Clinical Audit., Behavioural and Cognitive Psychotherapy, ISSN: 1352-4658

Journal article

Hasking PA, Di Simplicio M, McEvoy PM, Rees CSet al., 2018, Emotional cascade theory and non-suicidal self-injury: the importance of imagery and positive affect, COGNITION & EMOTION, Vol: 32, Pages: 941-952, ISSN: 0269-9931

Journal article

Ng RMK, Di Simplicio M, McManus F, Kennerley H, Holmes EAet al., 2016, 'Flash-forwards' and suicidal ideation: A prospective investigation of mental imagery, entrapment and defeat in a cohort from the Hong Kong Mental Morbidity Survey, PSYCHIATRY RESEARCH, Vol: 246, Pages: 453-460, ISSN: 0165-1781

Journal article

Di Simplicio M, Renner F, Blackwell SE, Mitchell H, Stratford HJ, Watson P, Myers N, Nobre AC, Lau-Zhu A, Holmes EAet al., 2016, An investigation of mental imagery in bipolar disorder: Exploring "the mind's eye", BIPOLAR DISORDERS, Vol: 18, Pages: 669-683, ISSN: 1398-5647

ObjectivesMental imagery abnormalities occur across psychopathologies and are hypothesized to drive emotional difficulties in bipolar disorder (BD). A comprehensive assessment of mental imagery in BD is lacking. We aimed to test whether (i) mental imagery abnormalities (abnormalities in cognitive stages and subjective domains) occur in BD relative to non‐clinical controls; and (ii) to determine the specificity of any abnormalities in BD relative to depression and anxiety disorders.MethodsParticipants included 54 subjects in the BD group (depressed/euthymic; n=27 in each subgroup), subjects with unipolar depression (n=26), subjects with anxiety disorders (n=25), and non‐clinical controls (n=27) matched for age, gender, ethnicity, education, and premorbid IQ. Experimental tasks assessed cognitive (non‐emotional) measures of mental imagery (cognitive stages). Questionnaires, experimental tasks, and a phenomenological interview assessed subjective domains including spontaneous imagery use, interpretation bias, and emotional mental imagery.Results(i) Compared to non‐clinical controls, the BD combined group reported a greater impact of intrusive prospective imagery in daily life, more vivid and “real” negative images (prospective imagery task), and higher self‐involvement (picture‐word task). The BD combined group showed no clear abnormalities in cognitive stages of mental imagery. (ii) When depressed individuals with BD were compared to the depressed or anxious clinical control groups, no significant differences remained—across all groups, imagery differences were associated with affective lability and anxiety.ConclusionsCompared to non‐clinical controls, BD is characterized by abnormalities in aspects of emotional mental imagery within the context of otherwise normal cognitive aspects. When matched for depression and anxiety, these abnormalities are not specific to BD—rather, imagery may reflect a transdiagnostic marker of emotional psychopatholo

Journal article

Di Simplicio M, Harmer CJ, 2016, Oxytocin and emotion processing, JOURNAL OF PSYCHOPHARMACOLOGY, Vol: 30, Pages: 1156-1159, ISSN: 0269-8811

Journal article

Ng RMK, Di Simplicio M, Holmes EA, 2016, Mental imagery and bipolar disorders: Introducing scope for psychological treatment development?, INTERNATIONAL JOURNAL OF SOCIAL PSYCHIATRY, Vol: 62, Pages: 110-113, ISSN: 0020-7640

Journal article

Holmes EA, Bonsall MB, Hales SA, Mitchell H, Renner F, Blackwell SE, Watson P, Goodwin GM, Di Simplicio Met al., 2016, Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series, TRANSLATIONAL PSYCHIATRY, Vol: 6, ISSN: 2158-3188

Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals’ mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (

Journal article

Di Simplicio M, Holmes EA, Rathbone CJ, 2015, Self-images in the present and future: Role of affect and the bipolar phenotype, JOURNAL OF AFFECTIVE DISORDERS, Vol: 187, Pages: 97-100, ISSN: 0165-0327

BackgroundBipolar Spectrum Disorder (BPSD) is associated with changes in self-related processing and affect, yet the relationship between self-image and affect in the BPSD phenotype is unclear.Methods47 young adults were assessed for hypomanic experiences (BPSD phenotype) using the Mood Disorders Questionnaire. Current and future self-images (e.g. I am… I will be…) were generated and rated for emotional valence, stability, and (for future self-images only) certainty. The relationship between self-image ratings and measures of affect (depression, anxiety and mania) were analysed in relation to the BPSD phenotype.ResultsThe presence of the BPSD phenotype significantly moderated the relationship between (1) affect and stability ratings for negative self-images, and (2) affect and certainty ratings for positive future self-images. Higher positivity ratings for current self-images were associated with lower depression and anxiety scores.LimitationsThis was a non-clinical group of young adults sampled for hypomanic experiences, which limits the extension of the work to clinical levels of psychopathology. This study cannot address the causal relationships between affect, self-images, and BPSD. Future work should use clinical samples and experimental mood manipulation designs.ConclusionsBPSD phenotype can shape the relationship between affect and current and future self-images. This finding will guide future clinical research to elucidate BPSD vulnerability mechanisms and, consequently, the development of early interventions.

Journal article

Freeman D, Dunn G, Murray RM, Evans N, Lister R, Antley A, Slater M, Godlewska B, Cornish R, Williams J, Di Simplicio M, Igoumenou A, Brenneisen R, Tunbridge EM, Harrison PJ, Harmer CJ, Cowen P, Morrison PDet al., 2015, How Cannabis Causes Paranoia: Using the Intravenous Administration of a†<SUP>9</SUP>-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia, SCHIZOPHRENIA BULLETIN, Vol: 41, Pages: 391-399, ISSN: 0586-7614

Journal article

Stratford HJ, Cooper MJ, Di Simplicio M, Blackwell SE, Holmes EAet al., 2015, Psychological therapy for anxiety in bipolar spectrum disorders: A systematic review, CLINICAL PSYCHOLOGY REVIEW, Vol: 35, Pages: 19-34, ISSN: 0272-7358

Journal article

Hales S, Blackwell SE, Di Simplicio M, Iyadurai L, Young K, Holmes EAet al., 2015, Imagery-Based Cognitive-Behavioral Assessment

Mental imagery can have a powerful impact on emotion, and dysfunctional mental imagery may play an important role in maintaining distress or problematic behavior in many psychological disorders. However, mental imagery is often neglected in assessment procedures. A variety of means can be used to assess mental imagery, including questionnaires, computer tasks, and interviews. A thorough assessment of mental imagery can aid development of a formulation to guide the application of powerful imagery-focused techniques in treatment. However, patients often do not spontaneously report mental images, and so it is crucial that clinicians inquire specifically about them in order to ascertain their presence and potential as a target for treatment.

Journal article

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