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Published on: May 22, 2019
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Augmenting behavioural activation with mental imagery improves post-stroke depressive symptoms
Kyle Joseph Kelleher1, Nele Demeyere2, Andrea Kusec2
1UCL Division of Psychology and Language Sciences, University College London, London, UK.
Neuropsychological Rehabilitation
|October 23, 2025
Summary
Augmenting behavioral activation (BA) with mental imagery significantly reduced depression in stroke survivors. This approach may help recall positive activities, improving mood outcomes post-stroke.
Area of Science:
- Neuroscience
- Psychiatry
- Rehabilitation Medicine
Background:
- Depression is common in stroke survivors (approx. 30%).
- Behavioral activation (BA) is an effective depression intervention.
- Post-stroke cognitive deficits, particularly episodic memory issues, may hinder BA effectiveness.
Purpose of the Study:
- To evaluate if augmenting BA with mental imagery improves mood and activity outcomes in stroke survivors compared to BA alone.
- To explore the role of memory in depression and activity engagement post-stroke.
Main Methods:
- A randomized controlled trial comparing BA with mental imagery versus standard BA.
- Participants (N=45) received either BA with activity-focused mental imagery or BA with an unrelated imagery control.
- Depressive symptoms and activity measures were assessed weekly over 3 sessions.
- Mixed-effects modeling was used to analyze between-group differences, with exploratory analyses including memory measures.
Main Results:
- BA with mental imagery demonstrated a significantly greater reduction in depressive symptoms compared to standard BA (t(79)=-2.72, p=.008, Cohen's d=0.65).
- Subjective memory, but not objective memory, correlated with depression severity and activity engagement.
- No significant between-group differences were observed in activity measures.
Conclusions:
- Mental imagery may enhance mood outcomes when combined with BA in stroke survivors.
- This augmentation might support positive activity recall, potentially irrespective of activity completion, offering a novel approach to managing post-stroke depression.
