Online Application of Imagery Rescripting for Pathological Affective Dependence (ImRs-PAD) in Survivors of Intimate Partner Violence: Results From a Multiple Case Series

Authors

  • Erica Pugliese Orcid
    Clinical Psychology Group, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; School of Cognitive Psychology, Rome, Italy
  • Allison Uvelli Orcid
    Department of Medical Science, Surgery and Neurosciences, University of Siena, Siena, Italy
  • Arnold A. P. van Emmerik Orcid
    Clinical Psychology Group, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
  • Arnoud Arntz Orcid
    Clinical Psychology Group, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands

Abstract

Background: This study examined the feasibility and preliminary clinical indications of an imagery rescripting intervention integrating the Pathological Affective Dependence framework (ImRs-PAD) in survivors of Intimate Partner Violence (IPV). Pathological Affective Dependence (PAD) refers to a trauma-related relational vulnerability associated with difficulties in disengaging from abusive intimate relationships. Method: A multiple case series design was used with three female IPV survivors referred by a mental health center in Italy (mean age = 31.3 years, SD = 2.08). All participants reported histories of abusive relationships, marked difficulties with separation, and clinically significant levels of PAD. Participants received an online ImRs-PAD intervention. Repeated self-report measures assessed changes in PAD, trauma-related symptoms, depression, anxiety, somatic symptoms, resilience, self-compassion, and psychological well-being. Results: Across cases, reductions were observed in PAD, depressive and anxiety symptoms, and trauma-related and somatic complaints, alongside increases in resilience, self-compassion, and overall psychological well-being. The online delivery of the intervention was feasible, with no technical or safety issues reported. Conclusion: The findings provide preliminary support for the potential clinical relevance of ImRs-PAD for IPV survivors. Addressing PAD may facilitate disengagement from violent partners and reduce the risk of re-exposure to severe forms of violence.