Imperial College London

Dr Martina Di Simplicio

Faculty of MedicineDepartment of Brain Sciences

Clinical Senior Lecturer in Psychiatry
 
 
 
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Contact

 

m.di-simplicio

 
 
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Assistant

 

Ms Nicole Hickey +44 (0)20 3313 4161

 
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Location

 

7N11ACommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

27 results found

Holmes EA, Hales SA, Young K, Simplicio MDet al., 2019, Imagery-Based Cognitive Therapy for Bipolar Disorder and Mood Instability, Publisher: Guilford Publications, ISBN: 9781462539055

This book presents a novel brief treatment that focuses on working with mental images to reduce distress and enhance mood stability.

Book

Schultebraucks K, Duesenberg M, Di Simplicio M, Holmes EA, Roepke Set al., Suicidal imagery in borderline personality disorder and major depressive disorder, Journal of Personality Disorders, ISSN: 0885-579X

A better understanding of suicidal behavior is important to detect suicidality in at-risk populations such as patients with Borderline Personality Disorder (BPD), Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD). Suicidal tendencies are clinically assessed by verbal thoughts rather than specifically asking about mental images. This study examines whether imagery and verbal thoughts about suicide occur and differ between patients with BPD with and without comorbid PTSD compared to patients with MDD (clinical controls). All patient groups experienced suicide-related images. Patients with BPD with comorbid PTSD reported significantly more vivid images than patients with MDD. Severity of suicidal ideation, number of previous suicide attempts and childhood traumata were significantly associated with suicidal imagery across all patient groups. We demonstrate for the first time that suicide-related mental imagery occurs in BPD and is associated with suicidal ideation. This highlight the importance of assessing mental imagery-related to suicide in clinical practice.

Journal article

Ji JL, Holmes EA, Kavanagh DJ, MacLeod C, Di Simplicio Met al., 2019, Mental imagery in psychiatry: conceptual & clinical implications, CNS Spectrums, Vol: 24, Pages: 114-126, ISSN: 2165-6509

Mental imagery refers to the experience of perception in the absence of external sensory input. Deficits in the ability to generate mental imagery or to distinguish it from actual sensory perception are linked to neurocognitive conditions such as dementia and schizophrenia, respectively. However, the importance of mental imagery to psychiatry extends beyond neurocognitive impairment. Mental imagery has a stronger link to emotion than verbal-linguistic cognition, serving to maintain and amplify emotional states, with downstream impacts on motivation and behavior. As a result, anomalies in the occurrence of emotion-laden mental imagery has transdiagnostic significance for emotion, motivation, and behavioral dysfunction across mental disorders. This review aims to demonstrate the conceptual and clinical significance of mental imagery in psychiatry through examples of mood and anxiety disorders, self-harm and suicidality, and addiction. We contend that focusing on mental imagery assessment in research and clinical practice can increase our understanding of the cognitive basis of psychopathology in mental disorders, with the potential to drive the development of algorithms to aid treatment decision-making and inform transdiagnostic treatment innovation.

Journal article

Meluken I, Ottesen NM, Phan KL, Goldin PR, Di Simplicio M, Macoveanu J, Siebner HR, Kessing LV, Vinberg M, Miskowiak KWet al., 2019, Neural response during emotion regulation in monozygotic twins at high familial risk of affective disorders, NeuroImage: Clinical, Vol: 21, Pages: 101598-101598, ISSN: 2213-1582

Journal article

O'Donnell C, Di Simplicio M, Brown R, Holmes EA, Heyes SBet al., 2018, The role of mental imagery in mood amplification: An investigation across subclinical features of bipolar disorders, CORTEX, Vol: 105, Pages: 104-117, ISSN: 0010-9452

Journal article

Hales SA, Di Simplicio M, Iyadurai L, Blackwell SE, Young K, Fairburn CG, Geddes JR, Goodwin GM, Holmes EAet al., Imagery-Focused Cognitive Therapy (ImCT) for Mood Instability and Anxiety in a Small Sample of Patients with Bipolar Disorder: a Pilot Clinical Audit., Behavioural and Cognitive Psychotherapy, ISSN: 1352-4658

Journal article

Hasking PA, Di Simplicio M, McEvoy PM, Rees CSet al., 2018, Emotional cascade theory and non-suicidal self-injury: the importance of imagery and positive affect, COGNITION & EMOTION, Vol: 32, Pages: 941-952, ISSN: 0269-9931

Journal article

Ng RMK, Di Simplicio M, McManus F, Kennerley H, Holmes EAet al., 2016, 'Flash-forwards' and suicidal ideation: A prospective investigation of mental imagery, entrapment and defeat in a cohort from the Hong Kong Mental Morbidity Survey, PSYCHIATRY RESEARCH, Vol: 246, Pages: 453-460, ISSN: 0165-1781

Journal article

Di Simplicio M, Renner F, Blackwell SE, Mitchell H, Stratford HJ, Watson P, Myers N, Nobre AC, Lau-Zhu A, Holmes EAet al., 2016, An investigation of mental imagery in bipolar disorder: Exploring "the mind's eye", BIPOLAR DISORDERS, Vol: 18, Pages: 669-683, ISSN: 1398-5647

ObjectivesMental imagery abnormalities occur across psychopathologies and are hypothesized to drive emotional difficulties in bipolar disorder (BD). A comprehensive assessment of mental imagery in BD is lacking. We aimed to test whether (i) mental imagery abnormalities (abnormalities in cognitive stages and subjective domains) occur in BD relative to non‐clinical controls; and (ii) to determine the specificity of any abnormalities in BD relative to depression and anxiety disorders.MethodsParticipants included 54 subjects in the BD group (depressed/euthymic; n=27 in each subgroup), subjects with unipolar depression (n=26), subjects with anxiety disorders (n=25), and non‐clinical controls (n=27) matched for age, gender, ethnicity, education, and premorbid IQ. Experimental tasks assessed cognitive (non‐emotional) measures of mental imagery (cognitive stages). Questionnaires, experimental tasks, and a phenomenological interview assessed subjective domains including spontaneous imagery use, interpretation bias, and emotional mental imagery.Results(i) Compared to non‐clinical controls, the BD combined group reported a greater impact of intrusive prospective imagery in daily life, more vivid and “real” negative images (prospective imagery task), and higher self‐involvement (picture‐word task). The BD combined group showed no clear abnormalities in cognitive stages of mental imagery. (ii) When depressed individuals with BD were compared to the depressed or anxious clinical control groups, no significant differences remained—across all groups, imagery differences were associated with affective lability and anxiety.ConclusionsCompared to non‐clinical controls, BD is characterized by abnormalities in aspects of emotional mental imagery within the context of otherwise normal cognitive aspects. When matched for depression and anxiety, these abnormalities are not specific to BD—rather, imagery may reflect a transdiagnostic marker of emotional psychopatholo

Journal article

Di Simplicio M, Harmer CJ, 2016, Oxytocin and emotion processing, JOURNAL OF PSYCHOPHARMACOLOGY, Vol: 30, Pages: 1156-1159, ISSN: 0269-8811

Journal article

Ng RMK, Di Simplicio M, Holmes EA, 2016, Mental imagery and bipolar disorders: Introducing scope for psychological treatment development?, INTERNATIONAL JOURNAL OF SOCIAL PSYCHIATRY, Vol: 62, Pages: 110-113, ISSN: 0020-7640

Journal article

Holmes EA, Bonsall MB, Hales SA, Mitchell H, Renner F, Blackwell SE, Watson P, Goodwin GM, Di Simplicio Met al., 2016, Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series, TRANSLATIONAL PSYCHIATRY, Vol: 6, ISSN: 2158-3188

Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals’ mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (

Journal article

Di Simplicio M, Holmes EA, Rathbone CJ, 2015, Self-images in the present and future: Role of affect and the bipolar phenotype, JOURNAL OF AFFECTIVE DISORDERS, Vol: 187, Pages: 97-100, ISSN: 0165-0327

BackgroundBipolar Spectrum Disorder (BPSD) is associated with changes in self-related processing and affect, yet the relationship between self-image and affect in the BPSD phenotype is unclear.Methods47 young adults were assessed for hypomanic experiences (BPSD phenotype) using the Mood Disorders Questionnaire. Current and future self-images (e.g. I am… I will be…) were generated and rated for emotional valence, stability, and (for future self-images only) certainty. The relationship between self-image ratings and measures of affect (depression, anxiety and mania) were analysed in relation to the BPSD phenotype.ResultsThe presence of the BPSD phenotype significantly moderated the relationship between (1) affect and stability ratings for negative self-images, and (2) affect and certainty ratings for positive future self-images. Higher positivity ratings for current self-images were associated with lower depression and anxiety scores.LimitationsThis was a non-clinical group of young adults sampled for hypomanic experiences, which limits the extension of the work to clinical levels of psychopathology. This study cannot address the causal relationships between affect, self-images, and BPSD. Future work should use clinical samples and experimental mood manipulation designs.ConclusionsBPSD phenotype can shape the relationship between affect and current and future self-images. This finding will guide future clinical research to elucidate BPSD vulnerability mechanisms and, consequently, the development of early interventions.

Journal article

Hales S, Blackwell SE, Di Simplicio M, Iyadurai L, Young K, Holmes EAet al., 2015, Imagery-Based Cognitive-Behavioral Assessment

Mental imagery can have apowerful impact on emotion, and dysfunctional mental imagery may play an importantrole in maintaining distress or problematic behavior in many psychologicaldisorders. However, mental imagery is often neglected in assessment procedures. Avariety of means can be used to assess mental imagery, including questionnaires,computer tasks, and interviews. A thorough assessment of mental imagery can aiddevelopment of a formulation to guide the application of powerful imagery-focusedtechniques in treatment. However, patients often do not spontaneously report mentalimages, and so it is crucial that clinicians inquire specifically about them inorder to ascertain their presence and potential as a target for treatment.

Journal article

Freeman D, Dunn G, Murray RM, Evans N, Lister R, Antley A, Slater M, Godlewska B, Cornish R, Williams J, Di Simplicio M, Igoumenou A, Brenneisen R, Tunbridge EM, Harrison PJ, Harmer CJ, Cowen P, Morrison PDet al., 2015, How Cannabis Causes Paranoia: Using the Intravenous Administration of a dagger(9)-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia, SCHIZOPHRENIA BULLETIN, Vol: 41, Pages: 391-399, ISSN: 0586-7614

Journal article

Stratford HJ, Cooper MJ, Di Simplicio M, Blackwell SE, Holmes EAet al., 2015, Psychological therapy for anxiety in bipolar spectrum disorders: A systematic review, CLINICAL PSYCHOLOGY REVIEW, Vol: 35, Pages: 19-34, ISSN: 0272-7358

Journal article

Di Simplicio M, Doallo S, Costoloni G, Rohenkohl G, Nobre AC, Harmer CJet al., 2014, 'Can you look me in the face?' Short-term SSRI Administration Reverts Avoidant Ocular Face Exploration in Subjects at Risk for Psychopathology, NEUROPSYCHOPHARMACOLOGY, Vol: 39, Pages: 3059-3066, ISSN: 0893-133X

Journal article

Clark IA, Niehaus KE, Duff EP, Di Simplicio MC, Clifford GD, Smith SM, Mackay CE, Woolrich MW, Holmes EAet al., 2014, First steps in using machine learning on fMRI data to predict intrusive memories of traumatic film footage, BEHAVIOUR RESEARCH AND THERAPY, Vol: 62, Pages: 37-46, ISSN: 0005-7967

Journal article

Ivins A, Di Simplicio M, Close H, Goodwin GM, Holmes Eet al., 2014, Mental imagery in bipolar affective disorder versus unipolar depression: Investigating cognitions at times of 'positive' mood, JOURNAL OF AFFECTIVE DISORDERS, Vol: 166, Pages: 234-242, ISSN: 0165-0327

Journal article

Di Simplicio M, Norbury R, Reinecke A, Harmer CJet al., 2014, Paradoxical effects of short-term antidepressant treatment in fMRI emotional processing models in volunteers with high neuroticism, PSYCHOLOGICAL MEDICINE, Vol: 44, Pages: 241-252, ISSN: 0033-2917

Journal article

Di Simplicio M, McInerney JE, Goodwin GM, Attenburrow M-J, Holmes EAet al., 2012, Revealing the Mind's Eye: Bringing (Mental) Images Into Psychiatry, AMERICAN JOURNAL OF PSYCHIATRY, Vol: 169, Pages: 1245-1246, ISSN: 0002-953X

Journal article

Di Simplicio M, Costoloni G, Western D, Hanson B, Taggart P, Harmer CJet al., 2012, Decreased heart rate variability during emotion regulation in subjects at risk for psychopathology, PSYCHOLOGICAL MEDICINE, Vol: 42, Pages: 1775-1783, ISSN: 0033-2917

Journal article

Di Simplicio M, Norbury R, Harmer CJ, 2012, Short-term antidepressant administration reduces negative self-referential processing in the medial prefrontal cortex in subjects at risk for depression, MOLECULAR PSYCHIATRY, Vol: 17, Pages: 503-510, ISSN: 1359-4184

Journal article

Horder J, Browning M, Di Simplicio M, Cowen PJ, Harmer CJet al., 2012, Effects of 7 days of treatment with the cannabinoid type 1 receptor antagonist, rimonabant, on emotional processing, JOURNAL OF PSYCHOPHARMACOLOGY, Vol: 26, Pages: 125-132, ISSN: 0269-8811

Journal article

Serretti A, Calati R, Goracci A, Di Simplicio M, Castrogiovanni P, De Ronchi Det al., 2010, Antidepressants in healthy subjects: What are the psychotropic/psychological effects?, EUROPEAN NEUROPSYCHOPHARMACOLOGY, Vol: 20, Pages: 433-453, ISSN: 0924-977X

Journal article

Horder J, Cowen PJ, Di Simplicio M, Browning M, Harmer CJet al., 2009, Acute administration of the cannabinoid CB1 antagonist rimonabant impairs positive affective memory in healthy volunteers, PSYCHOPHARMACOLOGY, Vol: 205, Pages: 85-91, ISSN: 0033-3158

Journal article

Di Simplicio M, Massey-Chase R, Cowen PJ, Harmer CJet al., 2009, Oxytocin enhances processing of positive versus negative emotional information in healthy male volunteers, JOURNAL OF PSYCHOPHARMACOLOGY, Vol: 23, Pages: 241-248, ISSN: 0269-8811

Journal article

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