Adhip Rawal

Rumination, experiential avoidance, and dysfunctional thinking in eating disorders.

The majority of research in eating disorders (ED) has investigated the content of disorder-specific thoughts, while few studies have addressed underlying cognitive-affective processes. A better understanding of processes underpinning ED may have important implications for treatment development. Two studies were conducted that investigated levels of rumination, beliefs about rumination, experiential avoidance, and aspects of schematic thinking in individuals with eating pathology. The latter was assessed with a newly designed ED-Sentence Completion Task (ED-SCT). Study 1 (N = 177) examined relations between ED psychopathology and these variables in a student population. Extending this, Study 2 (N = 26) assessed differences between patients with anorexia nervosa and healthy control participants. The results showed that ED psychopathology was related to disorder-specific cognitions, experiential avoidance as well as ruminative brooding but not reflection. A follow-up of anorexia nervosa patients indicated that changes in ED psychopathology were associated with changes in dysfunctional attitudes and maladaptive cognitive-affective processes. These findings highlight cognitive processes that may play an important role in the maintenance of eating pathology.

Examining Overgeneral Autobiographical Memory as a Risk Factor for Adolescent Depression.

OBJECTIVE Identifying risk factors for adolescent depression is an important research aim. Overgeneral autobiographical memory (OGM) is a feature of adolescent depression and a candidate cognitive risk factor for future depression. However, no study has ascertained whether OGM predicts the onset of adolescent depressive disorder. OGM was investigated as a predictor of depressive disorder and symptoms in a longitudinal study of high-risk adolescents. In addition, cross-sectional associations between OGM and current depression and OGM differences between depressed adolescents with different clinical outcomes were examined over time. METHOD A 1-year longitudinal study of adolescents at familial risk for depression (n = 277, 10-18 years old) was conducted. Autobiographical memory was assessed at baseline. Clinical interviews assessed diagnostic status at baseline and follow-up. RESULTS Currently depressed adolescents showed an OGM bias compared with adolescents with no disorder and those with anxiety or externalizing disorders. OGM to negative cues predicted the onset of depressive disorder and depressive symptoms at follow-up in adolescents free from depressive disorder at baseline. This effect was independent of the contribution of age, IQ, and baseline depressive symptoms. OGM did not predict onset of anxiety or externalizing disorders. Adolescents with depressive disorder at both assessments were not more overgeneral than adolescents who recovered from depressive disorder over the follow-up period. CONCLUSIONS OGM to negative cues predicted the onset of depressive disorder (but not other disorders) and depressive symptoms over time in adolescents at familial risk for depression. Results are consistent with OGM as a risk factor for depression.

Effects of analytical and experiential self-focus on stress-induced cognitive reactivity in eating disorder psychopathology

Previous research suggests distinct modes of self-focus, each with distinct functional properties: Analytical self-focus appears maladaptive, with experiential self-focus having more adaptive effects on indices of cognitive-affective functioning (e.g., Watkins, Moberly, & Moulds, 2008). The authors applied this framework to eating disorder (ED) psychopathology and manipulated the mode of self-focus prior to exposure to a stressor (imagining eating a large meal; Shafran, Teachman, Kerry, & Rachman, 1999). Study 1 showed that students high in ED psychopathology reported lower post-stressor feelings of weight or shape change and less subsequent attempts to neutralise (e.g., imagining exercising) after experiential relative to analytical self-focus. Study 2 found that partially weight restored patients with anorexia nervosa had lower post-stressor estimates of their own weight and reported lower urge to cancel stressor effects following experiential compared to analytical self-focus. Experiential self-focus was also followed by less neutralisation than analytical self-focus. Results suggest that the mode of self-focus affects cognitive reactivity following a stressor in individuals with ED psychopathology. Examining the mode within which individuals with ED psychopathology focus on self and body may raise important implications for understanding of psychopathology and open new possibilities for augmenting current treatments.

Can Basic Risk Research Help in the Prevention of Childhood and Adolescent Depression? Examining a Cognitive and Emotional Regulation Approach

This paper aims to highlight ways in which basic research findings in the field of childhood and adolescent depression can help to inform and refine preventive intervention efforts. We selectively review basic research evidence from community, clinical, and high-risk populations that identifies cognitive mechanisms (thought processes and reactions to negative affect) and emotional regulation as key processes involved in the onset and maintenance of depression. We focus on cognitive and emotional mechanisms in order to allow comparability with the majority of current preventive interventions. A range of basic research strategies and studies are then suggested that could be employed to help the development and refinement of prevention strategies. These include the need for prospective longitudinal studies to identify causal risk and protective factors, an integration of research approaches and methods, and a focus on understanding potential aetiological heterogeneity between childhood and adolescent depression.

A longitudinal study of processes predicting the specificity of autobiographical memory in the adolescent offspring of depressed parents

Deficits in specific autobiographical memory retrieval are closely associated with depression. The ability to retrieve specific autobiographical memories develops throughout childhood and adolescence and is associated with adolescent depression within and across time. Studying young samples before they first experience depression provides an approach for testing processes that underlie reduced autobiographical memory specificity. This study is the first to examine the longitudinal association of rumination and executive function with autobiographical memory specificity in a sample of adolescents at elevated risk for future depression. A total of 259 adolescents (aged between 10 and 18 years) completed the Autobiographical Memory Test at baseline and 1-year follow-up. Measures of rumination, executive function, and depressive symptoms were obtained at baseline. The interaction between rumination and executive function predicted autobiographical memory specificity over time. Whereas rumination in the context of low executive function predicted reduced specificity, this was not the case in the context of high executive function. The interaction between rumination and executive function was independent of the effects of age, gender, IQ, baseline levels of memory specificity, and depressive symptoms.

A longitudinal high-risk study of adolescent anxiety, depression and parent-severity on the developmental course of risk-adjustment

Background Adolescence is associated with developments in the reward system and increased rates of emotional disorders. Familial risk for depression may be associated with disruptions in the reward system. However, it is unclear how symptoms of depression and anxiety influence the development of reward-processing over adolescence and whether variation in the severity of parental depression is associated with hyposensitivity to reward in a high-risk sample. Methods We focused on risk-adjustment (adjusting decisions about reward according to the probability of obtaining reward) as this was hypothesized to improve over adolescence. In a one-year longitudinal sample (N = 197) of adolescent offspring of depressed parents, we examined how symptoms of depression and anxiety (generalized anxiety and social anxiety) influenced the development of risk-adjustment. We also examined how parental depression severity influenced adolescent risk-adjustment. Results Risk-adjustment improved over the course of the study indicating improved adjustment of reward-seeking to shifting contingencies. Depressive symptoms were associated with decreases in risk-adjustment over time while social anxiety symptoms were associated with increases in risk-adjustment over time. Specifically, depression was associated with reductions in reward-seeking at favourable reward probabilities only, whereas social anxiety (but not generalized anxiety) led to reductions in reward-seeking at low reward probabilities only. Parent depression severity was associated with lowered risk-adjustment in offspring and also influenced the longitudinal relationship between risk-adjustment and offspring depression. Conclusions Anxiety and depression distinctly alter the pattern of longitudinal change in reward-processing. Severity of parent depression was associated with alterations in adolescent offspring reward-processing in a high-risk sample.

Examining reward-seeking, negative self-beliefs and over-general autobiographical memory as mechanisms of change in classroom prevention programs for adolescent depression

Background Effective methods to prevent adolescent depressive symptoms could reduce suffering and burden across the lifespan. However, psychological interventions delivered to adolescents show efficacy only in symptomatic or high-risk youth. Targeting causal risk factors and assessing mechanistic change can help devise efficacious universal or classroom based prevention programs. Methods A non-randomized longitudinal design was used to compare three classroom-based prevention programs for adolescent depression (Behavioral Activation with Reward Processing, “Thinking about Reward in Young People” (TRY); Cognitive Behavioral Therapy (CBT) and Mindfulness Based Cognitive Therapy (MBCT)), and determine cognitive mechanisms of change in these programs. Cognitive mechanisms examined were reward-seeking, negative self-beliefs (assessed with behavioral tasks) and over-general autobiographical memory. 256 healthy adolescents aged 13–14 participated with 236 (92%) and 227 (89%) completing the pre- and post-assessments. Results TRY was the only intervention associated with a reduction in depressive symptoms at follow-up. Reward-seeking increased following TRY. In the other programs there were non-significant changes in cognitive mechanisms, with more reflective negative self-beliefs in CBT and fewer over-general autobiographical memories in MBCT In the TRY program, which focused on increasing sensitivity to rewarding activities, reward seeking increased and this was associated with decreased depressive symptoms. Limitations Due to the infeasibility of a cluster randomized controlled trial, a non-randomized design was used. Conclusions Increased reward-seeking was associated with decreased depressive symptoms and may be a mechanism of depressive symptom change in the intervention with a focus on enhancing sensitivity and awareness of reward. This study provides preliminary evidence to suggest that incorporating activities to enhance reward sensitivity may be fruitful in randomized controlled trials of universal prevention programs for depression.

A Sense of Embodiment Is Reflected in People's Signature Size

Background The size of a persons signature may reveal implicit information about how the self is perceived although this has not been closely examined. Methods/Results We conducted three experiments to test whether increases in signature size can be induced. Specifically, the aim of these experiments was to test whether changes in signature size reflect a persons current implicit sense of embodiment. Experiment 1 showed that an implicit affect task (positive subliminal evaluative conditioning) led to increases in signature size relative to an affectively neutral task, showing that implicit affective cues alter signature size. Experiments 2 and 3 demonstrated increases in signature size following experiential self-focus on sensory and affective stimuli relative to both conceptual self-focus and external (non-self-focus) in both healthy participants and patients with anorexia nervosa, a disorder associated with self-evaluation and a sense of disembodiment. In all three experiments, increases in signature size were unrelated to changes in self-reported mood and larger than manipulation unrelated variations. Conclusions Together, these findings suggest that a persons sense of embodiment is reflected in their signature size.

An Exploratory Study of Cognitive Style in Performance on Matched and Mismatched Tasks

Researchers have suggested that task performance is often dependent upon the congruence of cognitive style and task. To explore this suggestion, 44 female and 4 male undergraduates were administered the Cognitive Style Analysis, the Closure Flexibility, the Composite Gestalt Completion Test, and the Vocabulary subtest from the WAIS. Specifically, four hypotheses were tested: (1) that participants with an analytic style will perform better than those with a wholistic style on the Closure Flexibility; (2) that participants with a wholistic style will perform better than those with an analytic style on the Composite Gestalt Completion Test; (3) that participants with an intermediate style will outperform persons with an analytic style on the Composite Gestalt Completion Test; and (4) that intermediate scorers would perform better than those with a wholistic style on Closure Flexibility. Only the second hypothesis was supported, so results provide only minimal support for the effect of match or mismatch of cognitive style and task performance.