Imagery Rescripting for Pathological Affective Dependence and Intimate Partner Violence

Condition(s) studied

Investigational drug(s) / intervention(s)

Imagery Rescripting: Experimental: Baseline-Preparation-Imagery Rescripting-Post Treatment Each participant follows this sequence: (1) 5-9 weeks waitlist during which no treatment is offered; (2) 4 weekly preparatory sessions. During these sessions the rationale of ImRs will be explained in more detail and a list of painful (childhood) memories to be addressed with ImRs is to be compiled, based on any further input from the patient; and a case conceptualization is made; (3) 12 sessions (45-60 minutes) of ImRs will be offered to participating patients. The treatment for PAD will be based upon the protocol described by Arntz \& Weertman (1999); (4) After end of active treatment (ImRs) 4 weeks follow during which only weekly assessments are done.

Study summary

The goal of this multiple baseline case series study is to evaluate the effectiveness of Imagery Rescripting for Pathological Affective Dependence (PAD) in victims of Intimate Partner Violence (IPV). The primary research questions are:

Does Imagery Rescripting reduce PAD and/or commitment to the abusive relationship after separation? Does Imagery Rescripting also reduce traumatic symptoms? Does Imagery Rescripting improve general mental health, self-compassion, and resilience in IPV victims? Participants will undergo a waiting period of 5-9 weeks (to assess time effects without treatment), followed by 4 weekly preparation sessions, 12 weekly Imagery Rescripting sessions, and 1 month of post-treatment.

Throughout the study, participants will rate the severity of PAD and relational commitment on a weekly basis. They will also complete more detailed questionnaires assessing mental health, traumatic symptoms, resilience, and self-compassion before each phase, at 1 month post-treatment, 3 months post-treatment, and during follow-ups at 6 and 12 months.

Eligibility

Primary outcome measure(s)

• Pathological Affective Dependence Scale (PADS) — 22-32 weeks plus 3, 6 and 12 months follow-ups
  The PADS (Pugliese et al., 2024) is a 17-item Likert-type scale designed to assess both the state and trait manifestations of Pathological Affective Dependence (PAD), particularly focusing on the factors that compel individuals to remain in abusive relationships. These factors include internal conflict, the inability to separate from an abusive partner, and experiences of partner abuse. The scale is administered twice, with instructions tailored to measure both state and trait PAD. Each item is rated on a 5-point Likert scale, where 1 = not at all, 2 = slightly, 3 = sometimes, 4 = often, and 5 = always.
• Relational Commitment (RC) — 22-32 weeks plus 3, 6 and 12 months follow-ups
  The seven items of the Relationship Commitment scale (Rusbult, Martz, \& Agnew, 1998) include the following items: for example, "I am committed to maintaining my relationship with my partner"; "I want our relationship to last for a very long time"; "I feel very attached to our relationship". Responses are rated on an 8-point scale ranging from 1 (Do not agree at all) to 8 (Agree completely).

Trial sites (3)