Background:Even in cases with complexity, simple techniques can be useful to target a specific symptom. Intrusive mental images are highly disruptive, drive emotion, and contribute to maintaining psychopathology. Cognitive science suggests that we might target intrusive images using competing tasks.Aims:We describe an imagery competing task technique within cognitive behavioural therapy (CBT) with a patient with bipolar disorder and post-traumatic stress disorder (PTSD) symptoms. The intervention – including Tetris computer game-play – was used (1) to target a specific image within one therapy session, and (2) to manage multiple images in daily life.Method:A single case (AB) design was used. (1) To target a specific image, the patient brought the image to mind and, after mental rotation instructions and game-play practice, played Tetris for 10 minutes. Outcomes, pre- and post-technique, were: vividness/distress ratings when the image was brought to mind; reported intrusion frequency over a week. (2) To manage multiple images, the patient used the intervention after an intrusive image occurred. Outcomes were weekly measures of: (a) imagery characteristics; (b) symptoms of PTSD, anxiety, depression and mania.Results:(1) For the target image, there were reductions in vividness (80% to 40%), distress (70% to 0%), and intrusion frequency (daily to twice/week). (2) For multiple images, there were reductions from baseline to follow-up in (a) imagery vividness (38%), realness (66%) and compellingness (23%), and (b) PTSD symptoms (Impact of Events Scale-Revised score 26.33 to 4.83).Conclusion:This low-intensity intervention aiming to directly target intrusive mental imagery may offer an additional, complementary tool in CBT.

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使用竞争任务技术瞄准侵入性图像：案例研究

背景：即使在复杂的情况下，简单的技术也可用于针对特定症状。侵入性的心理图像具有高度破坏性，驱动情绪，并有助于维持精神病理学。认知科学表明，我们可能会使用竞争任务来定位侵入性图像。目的：我们描述了认知行为治疗 (CBT) 中的图像竞争任务技术，用于治疗患有双相情感障碍和创伤后应激障碍 (PTSD) 症状的患者。干预 - 包括俄罗斯方块计算机游戏 - 用于 (1) 在一次治疗期间针对特定图像，以及 (2) 管理日常生活中的多个图像。方法：使用单例 (AB) 设计。（1）针对特定的图像，患者将图像带到脑海中，并在心理旋转指导和游戏练习后，玩了 10 分钟俄罗斯方块。技术前后的结果是： 想到图像时的生动性/痛苦等级；报告的入侵频率超过一周。(2) 为管理多个图像，患者在出现侵入性图像后使用干预。结果是每周测量： (a) 图像特征；(b) PTSD、焦虑、抑郁和躁狂的症状。结果：(1) 对于目标图像，生动性（80% 到 40%）、痛苦（70% 到 0%）和侵入频率（每天每周两次）。(2) 对于多幅图像，(a) 图像生动性 (38%)、真实性 (66%) 和令人信服 (23%) 和 (b) PTSD 症状（事件影响量表）从基线到后续的减少- 将分数 26.33 修改为 4.83)。结论：