Imagery in adolescent anxiety disorders

Background: mental imagery plays an important role in models of anxiety disorders in adults. This understanding rests on qualitative and quantitative studies. Qualitative studies of imagery in anxious adolescents have not been reported in the literature. Aims: to address this gap, we aimed to explore adolescents’ experiences of spontaneous imagery in the context of anxiety disorders.Method: we conducted one-to-one semi-structured interviews, with 13 adolescents aged 13-17 years with a DSM-5 anxiety disorder, regarding their experiences of spontaneous imagery. We analysed participants’ responses using thematic analysis.Results: we identified five super-ordinate themes relating to adolescents’ influences on images, distractions from images, controllability of images, emotional responses to imagery and contextual influences on imagery. Conclusions: our findings suggest spontaneous images are an important phenomenon in anxiety disorders in adolescents, associated with negative emotions during and after their occurrence. Contextual factors and adolescents’ own cognitive styles appear to influence adolescents’ experiences of images in anxiety disorders.