Visual mental imagery and symptoms of depression - results from a large-scale web-based study

Mental imagery may influence the onset and maintenance of depression, but specific mechanisms have not yet been determined.

Nine hundred twelve participants completed questionnaires on positive and negative mental images, as well as images of injury and death that lead to positive emotions ("ID-images"), and depressive symptomatology. The assessment was carried out online to reduce effects of social desirability.

Positive images were reported by 87 % of the sample, negative images by 77 %. ID-images were present in one-third of the sample. A connection with depression severity was found for the absence of positive mental images and the presence of negative images as well as ID-images. Higher depression scores were associated with more frequent and vivid negative images, greater imagery distress, and a higher proportion of negative relative to positive images.

Mental images are clearly related to depression. Future research should focus on ID-images and their connection to suicide-risk in depressed patients.