Reduced specificity and increased overgenerality of autobiographical memory persist as cognitive vulnerabilities in remitted major depression: A meta-analysis

Improving usual care outcomes in major depression in youth by targeting memory specificity: A randomized controlled trial of adjunct computerized memory specificity training (c-MeST)

OBJECTIVE

Extending on previous findings that computerized Memory Specificity Training (c-MeST) improves memory specificity and depressive symptoms in Major Depressive Disorder (MDD) in adults, this study aimed to assess the effects of c-MeST in youth with MDD on memory specificity and depression in addition to other treatment.

METHODS

Participants aged 15-25 (N = 359, 76 % female; M age = 19.2, SD = 3.1), receiving predominantly psychological therapy or counseling (85 %) and/or antidepressants (52 %) were randomized to usual care and c-MeST or usual care. Cognitive and clinical outcomes were assessed at baseline and at one, three, and six-month follow-ups.

RESULTS

The usual care and c-MeST group reported higher memory specificity at one-month (d = 0.42, p = .022), but not at three or six months (d's < 0.15, p's > 0.05). The rate of MDE was numerically lower in the c-MeST group at each follow-up time-point, but group was not a statistically significant predictor at one month (64 % usual care and c-MeST vs. 68 % usual care, OR = 0.81, p = .606), three months (67 % usual care and c-MeST vs. 72 % usual care, OR = 0.64, p = .327) or six months (55 % usual care and c-MeST vs. 68 % usual care, OR = 0.56, p = .266). The usual care and c-MeST group did report lower depressive symptoms at one month (d = 0.42, p = .023) and six-months (d = 0.84, p = .001), but not three-months (d = 0.13, p > .05).

CONCLUSIONS

c-MeST may reduce symptoms in youth with MDD when provided alongside other treatments. However, there are significant limitations to this inference, including high attrition in the study and a need for more data on the acceptability of the intervention.

Transdiagnostic and transtherapeutic strategies for optimising autobiographical memory

Our memories for past personally experienced autobiographical events play an important role in therapy, irrespective of presenting issue, diagnoses or therapeutic modality. Here, we summarise evidence for how autobiographical memory abilities can influence our mental health and the relevance of this for the treatment of mental health problems. We then guide the reader through principles and strategies for optimising autobiographical memory within treatment. We ground these recommendations within research for stand-alone interventions for improving autobiographical memory and from studies of how to support the formation and retrieval of therapeutic memories. Options are given for clinicians to guide clients in improving retrieval of autobiographical memories within treatment, for improving autobiographical memory for the therapeutic experience itself, and for creating improvements in autobiographical memory that endure post-treatment. We also provide worksheets for clinicians to use within treatment.

Can neutral episodic memories become emotional? Evidence from facial expressions and subjective feelings

Maladaptive emotional memories are a transdiagnostic feature of mental health problems. Therefore, understanding whether and how emotional memories can change might help to prevent and treat mental disorders. We tested whether neutral memories of naturalistic events can retroactively acquire positive or negative affect, in a preregistered three-day Modification of Valence in Episodes (MOVIE) paradigm. On Day 1, participants (N = 41) encoded memories of neutral movie scenes, representing lifelike naturalistic experiences. On Day 2, they retrieved each episode before viewing a happy, sad, or neutral scene from the same movie (yielding a within-subjects design with a neutral-negative, neutral-positive, and neutral-neutral condition). On Day 3, participants again retrieved each memory from Day 1. We assessed the affective tone of episodes through facial expressions of positive and negative affect (using facial electromyography, fEMG) and through self-reported feelings. Positive updating of neutral episodes led to increased expressions of positive affect, whereas negative updating led to increased self-reported negative feelings. These results suggest that complex neutral episodic memories can retroactively acquire an affective tone, but the effects were modest and inconsistent across affect readouts. Future research should investigate alternative approaches to updating emotional memories that produce more profound changes in the valence of memories.

Hypnotically enhancing behavioral activation in the treatment of depression

Depressive disorders are common conditions associated with high personal and economic burdens. The best treatment outcomes occur in patients receiving both psychotherapy and antidepressant medications. Behavioral activation is one approach within the most widely available and studied psychotherapy frameworks (cognitive behavioral therapy, CBT) utilized for depression, and is effective in treating depression even in isolation from the rest of the CBT approach. Many hypnosis treatments for depression have been developed to incorporate various CBT techniques, including behavioral activation. However, research regarding the applications of hypnosis to facilitate behavioral activation has been slow to emerge. Addressing this relative gap in the literature may be possible through a broader review of the relevant literature. There is quality evidence speaking to the efficacy of diverse clinician-guided visualization or imagery exercises in the treatment of depression by means of behavioral activation. While not explicitly hypnosis, the similarities of these interventions to more typical hypnosis interventions are highly salient. Clinicians and researchers interested in hypnosis's applications to treating depression would benefit from adopting a more comprehensive consideration of the relevant literature.

The influence of electroconvulsive therapy on reconsolidation of autobiographical memories: A retrospective quasi-experimental study in patients with depression

Background/Objective

Electroconvulsive therapy (ECT) is effective for treatment-resistant and psychotic depression. One previously reported side effect of ECT is the disruption of memory reconsolidation. This study examines whether this disruption induced by ECT can be detected in routine neuropsychological assessments.

Methods

In this retrospective study, the Autobiographical Memory Interview (AMI) was applied before and after ECT. Memories of the same events and facts were tested pre and post ECT treatments. 38 patients, receiving ECT for the treatment of unipolar or bipolar depression, were matched for age, sex, and stimulus intensity and divided into two groups: Group A was tested on the day before the first ECT treatment, whereas group B two or more days before.

Results

Patients who were tested by AMI on the day before ECT and thus reactivated memorie shortly before the first ECT treatment deteriorated in AMI score. Patients who had at least two days between memory activation and treatment improved regarding the number of recalled memories. Memory impairment was not associated with depression severity.

Conclusion

This finding suggests that ECT might be capable of impairing reconsolidation. The study demonstrates that memories of personal events can potentially be affected by ECT within a time interval of 24 h of memory vulnerability after reactivation. Implications for practice and future research are discussed.

Do depressed patients really over-report cognitive impairment?

BACKGROUND

Depressed patients report more severe cognitive impairment than is detectable by neuropsychological tests because they may underestimate their cognitive performance. Alternatively, it is possible that cognitive impairment primarily occurs under everyday life conditions as referred to in most questionnaires. The aim of the present study is to investigate the validity of self-reports in patients with major depression in order to better understand the pronounced impairment in self-reports.

METHODS

We investigated 58 patients with major depression and 28 heathy control participants. We administered the "Screen for Cognitive Impairment in Psychiatry" (SCIP) to assess cognitive performance, the "Questionnaire for Cognitive Complaints" (FLei), and the newly developed scale for "Self-Perception of Cognitive Performance in everyday life and test settings" to ask for the self-assessed cognitive performance in everyday life and in a test situation more specifically.

RESULTS

Depressed patients showed an inferior test performance and reported much more general everyday life related cognitive problems compared to healthy participants. When asked more specifically for their cognitive performance in the test-situation compared to others and compared to everyday life, they did not report more test-related and everyday life related impairment than healthy participants did.

LIMITATIONS

Results might be influenced by comorbidity.

CONCLUSIONS

These results have implications for the assessment of subjective cognitive performance of depressed patients and shed light on the negative effects of general versus more specific recall of autobiographical information.

Social operant conditioning of autobiographical memory sharing

The memories for past autobiographical experiences that we share can influence relationship formation and consolidation with important implications for our mental health. However, little is known about how people's responses to our memories can influence subsequent memory sharing. Previous research examined how operant processes (i.e., punishment with aversive sounds) influence the sharing of memories for specific events from our past. Understanding the (social) mechanisms associated with difficulty sharing specific autobiographical memories is important given the association between these difficulties and a range of psychiatric diagnoses. We investigate the effects of verbal and non-verbal social operants on the willingness to share specific autobiographical memories. Participants shared memories with a confederate who coded their memories as specific or non-specific and responded in either an engaged/attentive, dismissive manner or gave no feedback depending on participants' assigned condition. Participants who were reinforced for sharing specific memories and punished for sharing non-specific memories, were more likely to share specific than non-specific memories compared to those who received no feedback. Reinforcement alone was not sufficient for modifying specificity. The ways that we respond to people when they share memories with us can influence their subsequent willingness to share specific events from their past.

Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes

The incidence and collective impact of early adverse experiences, trauma, and pain continue to increase. This underscores the urgent need for translational efforts between clinical and preclinical research to better understand the underlying mechanisms and develop effective therapeutic approaches. As our understanding of these issues improves from studies in children and adolescents, we can create more precise preclinical models and ultimately translate our findings back to clinical practice. A multidisciplinary approach is essential for addressing the complex and wide-ranging effects of these experiences on individuals and society. This narrative review aims to (1) define pain and trauma experiences in childhood and adolescents, (2) discuss the relationship between pain and trauma, (3) consider the role of biological memory, (4) decipher the relationship between pain and trauma using preclinical data, and (5) examine the role of the environment by introducing the importance of epigenetic processes. The ultimate scope is to better understand the wide-ranging effects of trauma, abuse, and chronic pain on children and adolescents, how they occur, and how to prevent or mitigate their effects and develop effective treatment strategies that address both the underlying causes and the associated physiological and psychological effects.

Effects of reminiscence therapy combined with memory specificity training (RT-MeST) on depressive symptoms in older adults: a randomized controlled trial protocol

BACKGROUND

Geriatric depression has become a serious public health problem, and reduced autobiographical memory and increased overgeneral memory, as the main cognitive markers of depression, are not only associated with current depressive symptoms but also associated with the onset and course of depression, which can lead to a range of harms. Economic and effective psychological interventions are urgently needed. The aim of this study is to confirm the effectiveness of reminiscence therapy combined with memory specificity training in improving autobiographical memory and depressive symptoms in older adults.

METHODS

In this multicentre, single-blind, three-arm parallel randomized controlled study, we aim to enrol 78 older adults aged 65 years or older with a score of ≥ 11 on the Geriatric Depression Scale, and participants will be randomly assigned to either a reminiscence therapy group, a reminiscence therapy with memory specificity training group or a usual care group. Assessments will be conducted at baseline (T0) as well as immediately post-intervention (T1) and 1 (T2), 3 (T3) and 6 (T4) months post-intervention. The primary outcome measure is self-reported depressive symptoms, measured using the GDS. Secondary outcome measures include measures of autobiographical memory, rumination, and social engagement.

DISCUSSION

We believe that the intervention will play a positive role in improving autobiographical memory and depressive symptoms in older adults. Poor autobiographical memory is a predictor of depression and a major cognitive marker, and improving autobiographical memory is of great significance in alleviating depressive symptoms in older people. If our program is effective, it will provide a convenient and feasible strategy for further promoting healthy ageing.

TRIAL REGISTRATION

ChiCTR2200065446.

Increasing autobiographical memory specificity: Using kindness meditation to impact features of memory retrieval

Individuals with a history of depression have an increased risk for future episodes. This risk has been linked with impaired features of autobiographical memory retrieval that remain when depressive symptoms abate, including memory specificity, remoteness, valence, and vantage perspective. Rumination has been shown to influence these impairments and can be reduced via compassion training. We therefore investigated the effects of a self-compassion meditation on autobiographical memory retrieval in remitted depression. Baseline data were collected (n = 50) using an extended version of the Autobiographical Memory Test where participants with remitted depression retrieved specific memories from a remote time period (10 cues) and from any time period (10 cues). Valence and vantage perspective were rated. Participants were then randomly allocated to a self-compassion meditation or (control) colouring intervention group. Baseline measures were reassessed after four weeks of the intervention. Results revealed increased retrieval of specific memories in the self-compassion group in comparison to the colouring group, and an increase in positive and field memories across groups while no remoteness changes were observed. This self-compassion meditation demonstrated initial promise as an intervention to influence features of autobiographical memory retrieval in remitted depression. Improvements were shown in specificity, valence, and vantage perspective. Addressing these features with this type of intervention might reduce a cognitive vulnerability to depression and should be investigated in future studies.

Different retrieval mechanisms of overgeneral autobiographical memory for positive and negative cues in remitted major depressive disorder

BACKGROUND AND OBJECTIVES

Overgeneral autobiographical memory (OGM) has been shown to occur in depressed and previously depressed populations regardless of the emotional valence of cues. However, recent research has pointed out that the retrieval process underlying OGM, generative retrieval (i.e., retrieval requiring effort or additional information) or direct retrieval (i.e., memory that comes to consciousness without effort or additional information), may differ depending on the emotional valence of cues. We examined the hypotheses that a remitted MDD (major depressive disorder), group compared with a control group, would show (a) more direct retrieval of categoric memories for negative cues, (b) more generative retrieval of categoric memories for positive cues, and (c) less direct retrieval of specific memories for positive cues.

METHODS

A remitted clinical MDD group (n = 21) and control group (n = 21) completed the Autobiographical Memory Test with minimal instruction, and were required to subjectively judge generative retrieval and direct retrieval.

RESULTS

As expected, results showed that the remitted MDD group reported more frequent direct retrieval of categoric memory for negative cues and more generative retrieval of categoric memory for positive cues than the control group.

LIMITATIONS

Our paradigm for distinguishing between generative and direct retrieval relied on subjective judgements.

CONCLUSIONS

This extends the findings from student sample in previous studies to a help-seeking population. Increased availability of negative categoric memories and the attenuation of positive specific recall represent vulnerabilities for MDD. We discuss how these findings provide further rationale for memory therapeutics for MDD and refinement of those techniques.

Autobiographical memory and psychopathology: Is memory specificity as important as we make it seem?

Several decades of research have established reduced autobiographical memory specificity, or overgeneral memory, as an important cognitive factor associated with the risk for and maintenance of a range of psychiatric diagnoses. In measuring this construct, experimenters code autobiographical memories for the presence or absence of a single temporal detail that indicates that the remembered event took place on a single, specific, day (Last Thursday when I rode bikes with my son), or multiple days (When I rode bikes with my son). Studies indicate that the specificity of memories and the amount of other episodic detail that they include (e.g., who, what, and where) are related and may rely on the same neural processes to elicit their retrieval. However, specificity and detailedness are nonetheless separable constructs: imperfectly correlated and differentially associated with current and future depressive symptoms and other associated intrapersonal (e.g., rumination) and interpersonal (e.g., social support) outcomes. The ways in which the details of our memories align with narrative themes (i.e., agency, communion, identity) and the coherence with which these details are presented, are also emerging as important factors associated with psychopathology. The temporal specificity of autobiographical memories may be important, but other memory constructs warrant further attention in research and theory, especially given the associations, and dependencies, between each of these constructs. Researchers in this area must consider carefully whether their research questions necessitate a focus on autobiographical memory specificity or whether a more inclusive analysis of other autobiographical memory features is necessary and more fruitful. This article is categorized under: Psychology > Memory.

Reduced specificity and increased overgenerality of autobiographical memory persist as cognitive vulnerabilities in remitted major depression: A meta-analysis

Difficulty in accessing specific memories, referred to as reduced memory specificity or overgeneral memory (OGM), has been established as a marker of clinical depression. However, it is not clear if this deficit persists following the remission of depressive episodes. The current study involved a systematic review and meta-analysis of empirical studies with the aim of establishing whether remitted depression was associated with retrieving fewer specific and more overgeneral autobiographical memories. Seventeen studies were identified as eligible. The results indicated that people with remitted depression recalled fewer specific memories (k = 15; g = -0.314, 95% CI [-0.543; -0.085], z = -2.69, p = .007) and more categoric memories (k = 9; g = 0.254, 95% CI [0.007; 0.501], z = 2.02, p = .043) compared to people who had never been depressed. Given these deficits have elsewhere been shown to be prognostic of future depressive symptoms, these findings suggest that reduced memory specificity/overgeneral memory persists following remission and may be a risk factor for future episodes of depression in those that are in remission. The findings are discussed in terms of how this knowledge might influence clinical understanding of relapse prevention and maintenance of remission in those with a history of depression.