In the past few weeks, cinemagoers have found themselves faced with the sight of Keira Knightley being brutally punched and kicked in an ad for Women's Aid.
The images are designed to shock viewers, but such has been the frequency of shocking ads in recent years, it is being questioned whether their impact is as effective as it once was.
"Shocking ads traditionally worked because the message became so deeply lodged in a per-son's consciousness that they were eventually forced to act upon it," Professor Alex Gardner, a chartered psychologist and psychotherapist, says. "However, if the same message and same tactics are being used all the time, then it just becomes wallpaper to a person and makes it far easier to ignore."
Another problem is that shock tactics in the past have tended to sensationalise situations. Andy Nairn, the executive planning director of Miles Calcraft Briginshaw Duffy, says: "By featuring extreme, shocking images, you're giving people a get-out clause, making them think: 'I'm not that bad.'"
A number of brands now seem to acknowledge the limitations of shock, so, rather than road-safety ads based on a gratuitous car crash or anti-smoking campaigns showing stomach-churning images of fat-filled arteries, agencies have begun to take a different approach. Highlighting the emotional consequences of the issues - how it will affect your conscience or your loved ones - is the new trend.
One of the highest-profile examples of this shift is the Department of Health's Change4Life campaign, which opts for bright colours and a gentle tone of voice in its ads, swapping shocking images for cute Plasticine characters.
"Following intense research, we found that people now want help, support and advice in changing their behaviour; they want to do what's best for their children, rather than be scared into doing so," Sian Jarvis, the director-general of communications for the DoH, says.
The theory is that the public have all heard about the problems that they face before, and have now learnt to simply ignore the ads that try to shock them and vilify them for their behaviour.
That's not to say that shock tactics don't have a place in ads anymore, though.
Take MCBD's recent "I wanna be like you" anti-smoking ad. The thought of a child smoking a cigarette is still shocking, yet the approach taken is far removed from previous campaigns, highlighting the damage that smoking will do to our children rather than to our own health.
However, shocks can still be an effective way for an organisation to quickly and powerfully bring an issue to the forefront of a person's mind. "For charities, the budgets are never going to be very big, so in order to get good cut-through, we have to do something that grabs people's attention and stands out," Diana Tickell, the UK director of communications for Barnardo's, says.
And for the charity's most recent ad, which portrayed a girl being slapped around the head, the results were positive. The campaign saw a 33 per cent increase in awareness of the charity and a 50 per cent rise in people wishing to donate.
As viewers become more familiar with shock tactics, agencies have to continuously look for new approaches to behavioural change issues. But, especially for charities, a well-handled ad that shocks viewers, and not purely for the sake of it, can be an effective way of raising important subjects.
- Got a view? E-mail us at firstname.lastname@example.org
CREATIVE - Paul Brazier, executive creative director, Abbott Mead Vickers BBDO
"We've found that people will accept shock tactics, so long as they're justified.
"If an ad is too shocking, for example, you run the risk of people deliberately avoiding what you say - they look away, change channel, turn the page. Also, if you start adding unnecessary layers of drama, people see through it - they feel they're being manipulated.
"In the 'live with it' ad for the Department for Transport, we didn't want it to be an over-the-top film where a man feels tortured every minute of the day. We wanted it to be real. He's getting on with his life - sometimes he hardly flinches at the memory of the boy, but it's always there."
CLIENT - Sian Jarvis, director-general of communications, Department of Health
"We found during our research for the Change4Life campaign that the media has dealt with the problem of obesity in such a shocking and sensationalised way that when parents thought of the issue, they imagined the 30-stone teenager and didn't realise their child was, in fact, obese.
"Instead, we tried to personalise the issue, and make it approachable and simple for people to tackle.
"If something is shocking and confrontational, you automatically set up a resistance to the messages, whereas if we were letting people know that we understood their problems and were here to provide a solution, then we found that we'd get a far better response."
PLANNER - Andy Nairn, executive planning director, Miles Calcraft Briginshaw Duffy
"Shock advertising can be effective when you need to dislodge people from behaviours and views that are tied up with other lifestyle factors.
"But as issues mature, you need to look at new ways of approaching them. We need to start looking at how we can help people change, rather than just paralysing them with shocking images.
"The key is to be able to offer the same message but with a new graphic depiction that makes people aware of these things.
"Look at the 'hook' ad we did for the Department of Health: it gave a new message and featured powerful creative, but we can't keep on using it as people become desensitised to it."
CLIENT - Diana Tickell, UK director of communications, Barnardo's
"Shocking ads work for us as we need an effective way of capturing the viewer's attention amid a number of more expensive ads for more high-profile brands being broadcast.
"Our aim is all about bringing the issues into the public domain that people don't want to talk about or would usually turn away from.
"They are usually shocking because this is the harsh reality of what happens in the real world - the stories we're covering tend to be disturbing. We're not just being shocking for the sake of it."