Lynn A. Watson

Guided self-help concreteness training as an intervention for major depression in primary care: a Phase II randomized controlled trial.

Background The development of widely accessible, effective psychological interventions for depression is a priority. This randomized trial provides the first controlled data on an innovative cognitive bias modification (CBM) training guided self-help intervention for depression. Method One hundred and twenty-one consecutively recruited participants meeting criteria for current major depression were randomly allocated to treatment as usual (TAU) or to TAU plus concreteness training (CNT) guided self-help or to TAU plus relaxation training (RT) guided self-help. CNT involved repeated practice at mental exercises designed to switch patients from an unhelpful abstract thinking habit to a helpful concrete thinking habit, thereby targeting depressogenic cognitive processes (rumination, overgeneralization). Results The addition of CNT to TAU significantly improved depressive symptoms at post-treatment [mean difference on the Hamilton Rating Scale for Depression (HAMD) 4.28, 95% confidence interval (CI) 1.29–7.26], 3- and 6-month follow-ups, and for rumination and overgeneralization post-treatment. There was no difference in the reduction of symptoms between CNT and RT (mean difference on the HAMD 1.98, 95% CI −1.14 to 5.11), although CNT significantly reduced rumination and overgeneralization relative to RT post-treatment, suggesting a specific benefit on these cognitive processes. Conclusions This study provides preliminary evidence that CNT guided self-help may be a useful addition to TAU in treating major depression in primary care, although the effect was not significantly different from an existing active treatment (RT) matched for structural and common factors. Because of its relative brevity and distinct format, it may have value as an additional innovative approach to increase the accessibility of treatment choices for depression.

Seeing yourself in a positive light: Brain correlates of the self-positivity bias

Individuals are found to have better recall for self-referent information than other types of information. However, attribution research has shown that self-reference is highly correlated with emotional valence. The present study attempted to identify and separate the processing of self-reference and emotional valence using ERPs. Participants performed a two-choice task, judging the self-referential content of positive and negative words. Reaction times revealed an interaction between self-reference and emotional valence. Faster responses occurred after self-positive and non-self negative words as compared to self-negative and non-self-positive words. A similar interaction was identified in ERP waveforms in the time range of the N400 component at fronto-central electrode sites, with larger N400 amplitudes for words outwith the self-positivity bias. Thus, the size of the N400 may indicate the extent to which information is discrepant with the individuals self-concept.

The characteristics of involuntary and voluntary autobiographical memories in depressed and never depressed individuals.

This study compares involuntary and voluntary autobiographical memories in depressed and never depressed individuals. Twenty depressed and twenty never depressed individuals completed a memory diary; recording their reactions to 10 involuntary and 10 voluntary memories over 14-30 days. Psychiatric status (Structured Clinical Interview for DSM-IV, SCID-1), psychopathology, rumination and avoidance were assessed. For both groups, involuntary memories more frequently lead to strong reactions than voluntarily memories. For both modes of retrieval, depressed individuals reported more frequent negative reactions than never depressed individuals and rated memories as more central to identity with higher levels of rumination and avoidance. Depressed individuals retrieved both positive and negative memories during involuntary retrieval. These findings support the view that involuntary memory retrieval represents a basic mode of retrieval during healthy and disordered cognition, and that during depression, both involuntary and voluntary memories are central to identity and associated with rumination and avoidance.

Changes in the relationship between self-reference and emotional valence as a function of dysphoria.

The self-positivity bias is found to be an aspect of normal cognitive function. Changes in this bias are usually associated with changes in emotional states, such as dysphoria or depression. The aim of the present study was to clarify the role of emotional valence within self-referential processing. By asking non-dysphoric and dysphoric individuals to rate separately the emotional and self-referential content of a set of 240 words, it was possible to identify the differences in the relationship between self-reference and emotional valence, which are associated with dysphoria. The results support the existence of the self-positivity bias in non-dysphoric individuals. More interestingly, dysphoric individuals were able to accurately identify the emotional content of the word stimuli. They failed, however, to associate this emotional valence with self-reference. These findings are discussed in terms of attributional self-biases and their consequences for cognition.

Emotional Intensity and Emotion Regulation in Response to Autobiographical Memories During Dysphoria

Retrieving personal memories may provoke different emotions and a need for emotion regulation. Emotional responses have been studied scarcely in relation to autobiographical memory retrieval. We examined the emotional response to everyday involuntary (spontaneously arising) and voluntary (strategically retrieved) memories, and how this response may be different during dysphoria. Participants (20 dysphoric and 23 non-depressed) completed a structured diary where the intensity of basic emotions and regulation strategies employed upon retrieval of memories were rated. Brooding, memory suppression, and emotional suppression were higher for all individuals’ involuntary memories than voluntary memories. Negative emotions and regulation strategies were greater for dysphoric individuals for both involuntary and voluntary memories after controlling for the valence of the remembered events. The results provide new insights into the understudied topic of emotional responses to everyday memories and suggest a novel interpretation of the intrusive nature of memories in psychological disorders, such as depression.

Negative autobiographical memories in social anxiety disorder: A comparison with panic disorder and healthy controls.

BACKGROUND AND OBJECTIVES Empirical interest in mental imagery in social anxiety disorder (SAD) has grown over the past years but still little is known about the specificity to SAD. The present study therefore examines negative autobiographical memories in participants with social anxiety disorder (SAD), compared to patients with panic disorder (PD), and healthy controls (HCs). METHODS A total of 107 participants retrieved four memories cued by verbal phrases associated with either social anxiety (SA) or panic anxiety (PA), with two memories for each cue category. RESULTS PA-cued memories were experienced with stronger imagery and as more traumatic. They were also rated as more central to identity than SA-cued memories, but not among participants with SAD, who perceived SA-cued memories as equally central to their identity. When between-group effects were detected, participants with anxiety disorders differed from HCs, but not from each other. LIMITATIONS Central limitations include reliance on self-report measures, comorbidity in the anxiety disorder groups, and lack of a neutrally cued memory comparison. CONCLUSIONS The findings align with models of SAD suggesting that past negative social events play a central role in this disorder. Future research is suggested to further explore the function of negative memories, not only in SAD, but also in other anxiety disorders.

Prolonged grief reactions after old age spousal loss and centrality of the loss in post loss identity

BACKGROUND The loss of a spouse is a major life event. Previous research found that centrality of the loss to ones identity using Centrality of Event Scale (CES) is related to complicated bereavement reactions, such as depression, posttraumatic stress symptoms (PTS), and prolonged grief symptoms (PGS). This study aims to examine loss-centrality in elderly bereaved people up to 4 years post loss, to determine the relation of loss-centrality to complicated bereavement reactions, such as PGS, depression, and PTS, and to identify early predictors of loss-centrality. METHOD Self-reported data were collected from 208 elderly bereaved people (mean age 72 years, 63.9% women), who completed measures of psychological distress (PTS, depression, PGS) as well as intra- and interpersonal factors (coping-style, crisis support, satisfaction with life, and NEO-PI-R) at 2, 6, and 48 months post spousal loss. CES was measured 48 months post spousal loss. RESULTS In line with previous findings (Boelen, 2012a), loss-centrality 4 years following the loss was significantly related to depression, PTS, and PGS. Additionally, early PGS and gender predicted later loss-centrality. LIMITATIONS Self-repport data was used rather than clinical interviews. CES was only measured 48 months post loss. PGS was first measured 6 months post. CONCLUSIONS The results support the link between loss-centrality and post loss psychopathology in a population particularly vulnerable to complicated bereavement reactions. The close link between prolonged grief and CES may be relevant in developing treatments for PGS, especially considering the potential relationship between high CES, high PGS, and possibly lack of acceptance of the loss.

Clinical Perspectives on Autobiographical Memory

Autobiographical memory plays a key role in psychological well-being, and the field has been investigated from multiple perspectives for more than thirty years. One large body of research has examined the basic mechanisms and characteristics of autobiographical memory during general cognition, and another body has studied what happens to it during psychological disorders, and how psychological therapies targeting memory disturbances can improve psychological well-being. This edited collection reviews and integrates current theories on autobiographical memory when viewed in a clinical perspective. It presents an overview of basic applied and clinical approaches to autobiographical memory, covering memory specificity, traumatic memories, involuntary and intrusive memories, and the role of self-identity. The book discusses a wide range of psychological disorders, including depression, posttraumatic stress disorder, borderline personality disorder, and autism, and how they affect autobiographical memory. It will be of interest to students of psychology, clinicians, and therapists alike.

Autobiographical memory functions and posttraumatic stress symptoms across adulthood

ABSTRACT Previous research has documented robust individual differences in the functions served by autobiographical memories, and shown that different autobiographical memory functions are related to both positive and negative indicators of psychological well-being, and that their frequency varies with age. In this study, we examined the unique relationship between autobiographical memory functions and posttraumatic stress symptoms (PTSS) and whether such relationships varied with age across adulthood. A representative sample of 1040 adult Danes (20–70 years old) reported the frequency with which they recall autobiographical memories for different purposes as well as their level of posttraumatic stress disorder (PTSD) symptoms. Higher reflective and ruminative functions, as well as lower social function, predicted higher levels of PTSS. There were no moderating effects of age. The results suggest that although the frequency of various autobiographical functions varies throughout the adult years, their association with PTSS is similar across adulthood.

Changes in perceived centrality of anxious events following cognitive behavioral therapy for social anxiety disorder and panic disorder

BACKGROUND AND OBJECTIVE The purpose of the present study was to explore the association between reductions in symptoms of psychopathology and perceived centrality of negative autobiographical memories in participants with social anxiety disorder (SAD) or panic disorder (PD). METHODS Thirty-nine individuals with SAD or PD recalled and rated four negative autobiographical memories before and after ten sessions of cognitive behavioral therapy (CBT) over a three-month period. Twenty-eight healthy controls did the same before and after a three-month period. RESULTS As hypothesized, results showed a decrease in perceived centrality following CBT. This decrease in perceived centrality was larger, although at the trend level, for individuals who experienced reliable change on disorder-specific symptoms. LIMITATIONS The correlational nature of the study prevents establishing the causal relationship between changes in perceived centrality and psychopathology, and future studies should explore such mechanisms. CONCLUSIONS The present study adds to the emerging body of literature, investigating changes in centrality of event following psychotherapy.