Spontaneous imagery in women with bulimia nervosa: An investigation into content, characteristics and links to childhood memories

The study investigated the presence and characteristics of spontaneous imagery in women with bulimia nervosa (BN) and their links to childhood memories. Using a semi-structured interview, data was collected from three groups of female participants: BN participants (N=13), dieting (N=18) and non-dieting controls (N=20). BN participants reported more spontaneous images than non-dieting control participants. Their images were recurrent and significantly more negative and anxiety provoking than those of controls. They involved more sensory modalities than in dieting controls and were more vivid than in non-dieting controls. BN images typically involved the visual, organic and cutaneous modalities. They were linked to a specific childhood memory, similar in emotional tone and sensory modalities. Once depression was controlled, many of the between-group differences became non-significant. The results suggest that imagery may be a significant feature of BN, potentially distinguishing those with BN from controls, although further research into the link between mood, imagery and memory is needed. The findings have clinical implications, particularly for assessment and for the application of imagery rescripting in BN.