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

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

Methods: 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.

Results: 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.

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