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Hallford DJ, Austin DW, Takano K, Yeow JJ, Rusanov D, Fuller-Tyszkiewicz M, Raes F. 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). J Affect Disord 2024; 358:500-512. [PMID: 38663556 DOI: 10.1016/j.jad.2024.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/11/2024] [Accepted: 04/21/2024] [Indexed: 05/20/2024]
Abstract
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.
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Affiliation(s)
- David John Hallford
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia.
| | - David W Austin
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Keisuke Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, Munich, Germany
| | - Joesph J Yeow
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Danielle Rusanov
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000 Leuven, Belgium
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Barry TJ, Hallford DJ. Transdiagnostic and transtherapeutic strategies for optimising autobiographical memory. Behav Res Ther 2024; 180:104575. [PMID: 38852230 DOI: 10.1016/j.brat.2024.104575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/14/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
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.
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Affiliation(s)
- T J Barry
- Department of Psychology, University of Bath, Bath, UK.
| | - D J Hallford
- School of Psychology, Deakin University, Melbourne, Australia
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3
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Ahern E, White J, Slattery E. Change in Cognitive Function over the Course of Major Depressive Disorder: A Systematic Review and Meta-analysis. Neuropsychol Rev 2024:10.1007/s11065-023-09629-9. [PMID: 38315296 DOI: 10.1007/s11065-023-09629-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 11/29/2023] [Indexed: 02/07/2024]
Abstract
Major depressive disorder (MDD) is associated with significant cognitive deficits during the acute and remitted stages. The aim of this systematic review and meta-analysis was to examine the course of cognitive function whilst considering demographic, treatment, or clinical features of MDD that could moderate the extent of cognitive change. Databases were searched to identify studies that reported on cognitive function in MDD with a ≥12-week test-retest interval. Relevant studies were pooled using random effects modelling to generate an inverse-variance, weighted, mean effect size estimate (Hedges' g) of cognitive change for each cognitive variable and for an overall composite cognitive domain. Of 6898 records, 99 eligible studies were identified from which 69 were meta-analysed, consisting of 4639 MDD patients (agemean = 40.25 years, female% = 64.62%) across 44 cognitive variables. In over 95% of cognitive variables, improvements were either of non-significant, negligible, or of a small magnitude, and when compared to matched healthy controls, the possibility of practice effects could not be precluded. Depressive symptom improvement and the number of previous depressive episodes moderated the extent of cognitive change, demonstrating state- and scar-like features for one-quarter of the cognitive domains. Further longitudinal studies are required to elucidate the MDD cognitive trajectory from initial onset. Findings nonetheless suggest that following pharmacological and non-pharmacological treatment, cognitive change in MDD is typically small, but the capacity for change may be less with episode recurrence. Targeting cognition early in the course of illness may facilitate better prognosis and support a more complete functional recovery.
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Affiliation(s)
- Elayne Ahern
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland.
- Department of Psychology, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.
| | - Jessica White
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Eadaoin Slattery
- Department of Applied Social Sciences, Technological University of the Shannon Midwest, Limerick, Ireland
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4
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Belmans E, De Vuyst HJ, Takano K, Raes F. Reducing the stickiness of negative memory retrieval through positive memory training in adolescents. J Behav Ther Exp Psychiatry 2023; 81:101881. [PMID: 37348168 DOI: 10.1016/j.jbtep.2023.101881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Individuals at risk for depression exhibit a decreased ability to disengage from negative memory retrieval during times of mental distress, partly because they have difficulty retrieving positive memories to repair sad mood. In this study, we tested whether this persistent tendency for negative memory retrieval could be reduced in adolescents through repeated practice to retrieve positive autobiographical memories, namely Positive Memory Specificity Training (PMST). Further, we examined the impact of this intervention on secondary outcomes, including depressive symptoms, emotion regulation strategies, and fear of positive emotions. METHODS Adolescents (n = 68) between 16 and 18 years old were randomly allocated to either PMST or bogus control training. Persistent negative memory retrieval was assessed following the training using a behavioral decision-making task (Emotional Reversal Learning Task). Additionally, participants completed self-report measurements (e.g., depressive symptoms) before and two weeks after the training. RESULTS We found preliminary supportive evidence for a significant training effect such that adolescents following PMST showed less persistence in negative memory retrieval compared to those in the control group. Only for anhedonia a significant training effect was found, indicating a possible adverse effect of the intervention. LIMITATIONS The primary outcome was assessed only at post-intervention to prevent a potential learning effect due to repeated measurements. We cannot exclude the possibility that baseline individual differences contaminated our results. To examine possible adverse effects of PMST, larger sample are needed. CONCLUSIONS PMST may help to reduce persistent negative memory retrieval in adolescents. Recommendations for future studies are addressed.
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Affiliation(s)
- Eline Belmans
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium; Child & Youth Institute, KU Leuven, Leuven, Belgium.
| | - Hendrik-Jan De Vuyst
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium; Neuromodulation Laboratory, Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Leuven 3001, Belgium.
| | - Keisuke Takano
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Leopoldstraße 13, Munich, Germany; Human Informatics and Interaction Research Institute (HIIRI), National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8560, Japan.
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium; Child & Youth Institute, KU Leuven, Leuven, Belgium.
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5
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Marsh LC, Patel SD, Smith AJ, So M, Armstrong H, Elliott R, Watkins E, Moulds M, Dalgleish T, Hitchcock C. From basic science to clinical practice: Can cognitive behavioural therapy tasks be augmented with enhanced episodic specificity? Behav Res Ther 2023; 167:104352. [PMID: 37331240 DOI: 10.1016/j.brat.2023.104352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/28/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023]
Abstract
Individuals with depression typically remember their past in a generalised manner, at the cost of retrieving specific event memories. This may impair engagement with cognitive behavioural therapy (CBT) tasks that use concrete episodic information to challenge maladaptive beliefs, potentially limiting their therapeutic benefit. Study 1 demonstrated that an episodic specificity induction increased detail and specificity of autobiographical memory in people with major depression, relative to control conditions (N = 88). We therefore examined whether the induction enhanced the efficacy of CBT tasks that depend on episodic memory - cognitive reappraisal (Study 2, N = 30), evidence gathering (Study 2, N = 30), and planning behavioural experiments (Study 3a, N = 30). Across all three tasks, there were no significant differences in emotion- or belief-change between the specificity and control conditions. Although the induction temporarily enhanced specificity in depressed individuals, it did not significantly augment the efficacy of CBT tasks theorised to benefit from the use of specific mnemonic information.
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Affiliation(s)
- Laura C Marsh
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Shivam D Patel
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Alicia J Smith
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Melody So
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | - Rachel Elliott
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | | | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Caitlin Hitchcock
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Melbourne School of Psychological Science, University of Melbourne, Australia.
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6
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Oversampled and undersolved: Depressive rumination from an active inference perspective. Neurosci Biobehav Rev 2022; 142:104873. [PMID: 36116573 DOI: 10.1016/j.neubiorev.2022.104873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 11/22/2022]
Abstract
Rumination is a widely recognized cognitive deviation in depression. Despite the recognition, researchers have struggled to explain why patients cannot disengage from the process, although it depresses their mood and fails to lead to effective problem-solving. We rethink rumination as repetitive but unsuccessful problem-solving attempts. Appealing to an active inference account, we suggest that adaptive problem-solving is based on the generation, evaluation, and performance of candidate policies that increase an organism's knowledge of its environment. We argue that the problem-solving process is distorted during rumination. Specifically, rumination is understood as engaging in excessive yet unsuccessful oversampling of policy candidates that do not resolve uncertainty. Because candidates are sampled from policies that were selected in states resembling one's current state, "bad" starting points (e.g., depressed mood, physical inactivity) make the problem-solving process vulnerable for generating a ruminative "halting problem". This problem leads to high opportunity costs, learned helplessness and diminished overt behavior. Besides reviewing evidence for the conceptual paths of this model, we discuss its neurophysiological correlates and point towards clinical implications.
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7
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An early intervention for adolescent depression targeting emotional mental images and memory specificity: a process evaluation. Eur Child Adolesc Psychiatry 2021; 32:783-795. [PMID: 34786629 PMCID: PMC10147746 DOI: 10.1007/s00787-021-01902-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/24/2021] [Indexed: 10/19/2022]
Abstract
We have evaluated a novel early intervention for adolescent depression (age 16-18) in a feasibility randomised controlled trial. This nested process evaluation aimed to understand how this complex intervention worked. We sought to understand participants' views and experiences of receiving and interacting with the intervention to evaluate whether the underpinning theoretical basis of the intervention is justified and whether it contributes to valued outcomes for participants. Twelve participants were invited to take part in semi-structured interviews. Framework analysis was employed to identify important aspects of adolescents' experiences. The active ingredients identified by participants were consistent with and extended our understanding of the theoretical basis of the intervention. Four principle themes were identified: understanding how memory works and being able to remember memories in more detail; processing negative experiences and letting go; imagining positive future events; and understanding and being kinder to myself. The outcomes of the intervention were valued by participants. Six principle themes were identified: improving mood and well-being; reducing impact of negative memories; motivation and goal-directed behaviour; overcoming avoidance and rumination; relationships, communication and being open; and self-understanding and acceptance. A simplified logic model is also proposed to connect the intervention components, active ingredients, and valued outcomes. The findings provide an in-depth understanding of how participants interacted with the intervention and what they derived from it. For example, the findings establish processing negative experiences as a core intervention component, extend it to include letting go of these memories, and highlight that reducing the impact of negative memories is valued by participants. This richer understanding guides further intervention development and future implementation.
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8
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Miguel-Alvaro A, Guillén AI, Contractor AA, Crespo M. Positive memory intervention techniques: a scoping review. Memory 2021; 29:793-810. [PMID: 34110270 DOI: 10.1080/09658211.2021.1937655] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The scoping review examines and summarises the available knowledge base on intervention techniques focused on positive memories. An iterative series of PsycInfo and Medline searches was conducted up to April 2021 following PRISMA-ScR guidelines. Thirty-nine studies, spanning 12 intervention techniques, were selected and described including: (1) theoretical basis; (2) type of study, sample, and measures; (3) intervention protocol; and (4) results of empirical studies if applicable. Results indicated that most techniques have only been tested in one-two studies with modest sample sizes and, when follow-ups are conducted, they are typically short. Results indicate that working with positive memories has the greatest impact on improving positive affect and reducing depressive symptoms, and that these effects are often temporary. This review serves as a quick reference guide to help professionals' access to descriptions and information on empirical evidence of positive memory techniques, improving their therapeutic arsenal to enhance well-being and therapeutic outcomes in their patients.
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Affiliation(s)
| | - Ana I Guillén
- Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
| | | | - María Crespo
- Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
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9
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Abstract
Depression is both prevalent and costly, and many individuals do not adequately respond to existing psychopharmacological and behavioral interventions. The current article describes the use of neuroscience in augmenting behavioral interventions for depression in two primary areas: anhedonia and cognitive deficits/biases. Neuroscience research has increased our understanding of the neural bases of reward processing and regulation of positive affect, and anhedonia among depressed samples can be related to deficits in each of these domains. Treatments that specifically target reward processing and regulation of positive affect in order to reduce anhedonia represent a recent advance in the field. Depression is also associated with aberrant processes relating to working memory, autobiographical memory, attentional bias, and interpretive bias. Neuroscience findings have increasingly been leveraged to augment the efficacy of cognitive-training and bias-modification interventions in these domains. The use of neuroscience to inform the development and augmentation of behavioral interventions for depression is a promising avenue of continued research.
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10
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Barry TJ, Hallford DJ, Hitchcock C, Takano K, Raes F. The current state of memory Specificity Training (MeST) for emotional disorders. Curr Opin Psychol 2021; 41:28-33. [PMID: 33689992 DOI: 10.1016/j.copsyc.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/07/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022]
Abstract
Memory Specificity Training (MeST) is an intervention developed from basic science that has found clinical utility. MeST uses cued recall exercises to target the difficulty that some people with emotional disorders have in recalling personally experienced events. MeST is simple enough to be delivered alongside traditional interventions or online by artificial intelligence. Currently, research indicates MeST's effects are immediate but short-lived, and there is limited research indicating its superiority over established interventions. Future investigations must establish the dosage and specific components of MeST that are necessary for clinically significant effects. Further, it must establish the secondary processes (e.g., problem-solving) that mediate between MeST-driven improvements in memory and symptoms. Similar interventions that build upon the idea of training autobiographical memory specificity are also emerging and warrant further investigation.
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Affiliation(s)
- Tom J Barry
- Faculty of Social Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - David J Hallford
- School of Psychology, Deakin University, Melbourne, Australia; School of Health and Life Sciences, Federation University, Mount Helen, Australia
| | - Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Keisuke Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, München, Germany
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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11
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Hallford D, Austin D, Takano K, Fuller-Tyszkiewicz M, Raes F. Computerized Memory Specificity Training (c-MeST) for major depression: A randomised controlled trial. Behav Res Ther 2021; 136:103783. [DOI: 10.1016/j.brat.2020.103783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022]
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12
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Clifford G, Hitchcock C, Dalgleish T. Fractured Pasts: The Structure of the Life Story in Sexual-Trauma Survivors With Posttraumatic Stress Disorder. Clin Psychol Sci 2020; 8:723-738. [PMID: 32832257 PMCID: PMC7411540 DOI: 10.1177/2167702620917984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 12/28/2019] [Indexed: 11/23/2022]
Abstract
We examined the organization of past and future affective autobiographical knowledge in sexual-trauma survivors compared with control participants. Participants (N = 113) divided their past (and future) life into chapters (e.g., “college,” “marriage”), then characterized each chapter using positive or negative attributes. Sexual-trauma survivors (n = 27) endorsed a greater proportion of negative attributes, demonstrated greater affective compartmentalization (separation of positive and negative attributes into different chapters), and showed reduced redundancy (consistent endorsement across chapters) of positive attributes relative to control participants (n = 23). Groups did not differ on negative redundancy for past life structure or any metrics for future life structure. In a secondary analysis, we compared life structures for the sexual-trauma group and for individuals with chronic depression but no sexual-trauma history (n = 30) and matched control participants (n = 56), which revealed significantly greater negative redundancy in the depressed group. The distinct life structure presented by sexual-trauma survivors may reflect efforts to constrain the impact of trauma on an individual’s self-identity.
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Affiliation(s)
- Georgina Clifford
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge.,Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
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13
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Harnessing Mental Imagery and Enhancing Memory Specificity: Developing a Brief Early Intervention for Depressive Symptoms in Adolescence. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10130-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Background
Treatment innovation for depressive symptoms in adolescence is urgently needed. Adult research suggests interventions targeting underlying cognitive mechanisms, such as dysfunctional mental imagery and overgeneral memory, are promising. Here, we describe and evaluate in a case series a brief imagery-based intervention for depressive symptoms that targets these cognitive mechanisms.
Methods
Nine participants completed the four-session intervention, whose principle components were imagery rescripting and memory specificity training. Questionnaires and experimental tasks (assessing symptomatology and cognitive mechanisms) were administered at three time points: pre-intervention, post-intervention and 3-month follow-up.
Results
The intervention was feasible to deliver and acceptable to participants. There was a large reduction in depression symptom scores from pre to post intervention (d = 1.32; 67% showed reliable improvement, RI) and this was maintained at follow-up (d = 1.46; RI = 75%). There were also reductions in anxiety (post: d = 1.15, RI = 44%; follow-up: d = 1.67, RI = 63%), increases in self-esteem (post: d = − 0.70, RI = 44%; follow-up: d = − 1.20, RI = 50%) and noteworthy changes in memory specificity (post: d = − 1.80, RI = 67%; follow-up: d = − 0.94, RI = 63%).
Conclusions
This is the first study to use imagery rescripting and memory specificity training in adolescence. Initial evidence is provided that the intervention is acceptable and may have clinical utility. Future randomised controlled trials are needed to further assess the intervention.
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14
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Increasing Anticipatory Pleasure in Major Depression through Enhancing Episodic Future Thinking: a Randomized Single-Case Series Trial. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09820-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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15
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Rochat L, Renaud O, Arnould A, Lardi Robyn C, Barbot F, Azouvi P, Van der Linden M. Self-defining memories after severe traumatic brain injury: A preliminary study. J Neuropsychol 2020; 15:112-128. [PMID: 32515900 DOI: 10.1111/jnp.12212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 05/06/2020] [Indexed: 11/28/2022]
Abstract
Autobiographical memory plays a major role in the (re)construction of sense of identity, a recurrent issue after a traumatic brain injury (TBI). Although the recall of specific autobiographical events is frequently impaired in patients with TBI, little is known about how these changes affect their sense of self and identity. Thus, we examined self-defining memories (SDMs), that is, the most significant personal memories supporting one's sense of identity, in 16 patients with severe TBI and in matched controls. To this end, participants recalled three SDMs and rated their emotions in response to memory retrieval. In addition, characteristics of SDMs such as specificity, meaning-making, self-connections that reflect identity stability or identity change, content (theme, presence of tension, and redemption sequences) were analysed by independent raters. The main results showed that patients' SDMs were less specific and contained fewer redemption sequences than did those of controls but did not significantly differ in thematic content, presence of tension, meaning-making, self-connections that reflect identity stability or identity change and affective responses to memory retrieval. Furthermore, among the patients' memories that refer to the TBI-related event itself, only one contained an explicit meaning. Despite the lack of specificity in memories, patients with severe TBI were able to extract meaning from personal memories although they could struggle with integrating the TBI-related event into their sense of identity. These characteristics of SDMs may contribute to disturbances in sense of self and continuity in patients with severe TBI, as well as difficulties in personal or social adjustment. These results also open up relevant prospects for psychological interventions in identity-related issues in patients with TBI.
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Affiliation(s)
- Lucien Rochat
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - Olivier Renaud
- Methodology and Data Analysis, Section of Psychology, University of Geneva, Switzerland
| | - Annabelle Arnould
- Department of Physical Medicine and Rehabilitation, AP-HP, Raymond Poincare Hospital, Garches, France.,EA 4047, HANDIReSP, University of Versailles-Saint-Quentin-en Yvelines, France
| | - Claudia Lardi Robyn
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - Frédéric Barbot
- INSERM CIC 1429, APHP, Raymond Poincare Hospital, Garches, France
| | - Philippe Azouvi
- Department of Physical Medicine and Rehabilitation, AP-HP, Raymond Poincare Hospital, Garches, France.,EA 4047, HANDIReSP, University of Versailles-Saint-Quentin-en Yvelines, France
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16
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Dalgleish T, Black M, Johnston D, Bevan A. Transdiagnostic approaches to mental health problems: Current status and future directions. J Consult Clin Psychol 2020; 88:179-195. [PMID: 32068421 PMCID: PMC7027356 DOI: 10.1037/ccp0000482] [Citation(s) in RCA: 253] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 12/19/2022]
Abstract
Despite a longstanding and widespread influence of the diagnostic approach to mental ill health, there is an emerging and growing consensus that such psychiatric nosologies may no longer be fit for purpose in research and clinical practice. In their place, there is gathering support for a "transdiagnostic" approach that cuts across traditional diagnostic boundaries or, more radically, sets them aside altogether, to provide novel insights into how we might understand mental health difficulties. Removing the distinctions between proposed psychiatric taxa at the level of classification opens up new ways of classifying mental health problems, suggests alternative conceptualizations of the processes implicated in mental health, and provides a platform for novel ways of thinking about onset, maintenance, and clinical treatment and recovery from experiences of disabling mental distress. In this Introduction to a Special Section on Transdiagnostic Approaches to Psychopathology, we provide a narrative review of the transdiagnostic literature in order to situate the Special Section articles in context. We begin with a brief history of the diagnostic approach and outline several challenges it currently faces that arguably limit its applicability in current mental health science and practice. We then review several recent transdiagnostic approaches to classification, biopsychosocial processes, and clinical interventions, highlighting promising novel developments. Finally, we present some key challenges facing transdiagnostic science and make suggestions for a way forward. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Melissa Black
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - David Johnston
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Anna Bevan
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
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17
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Hallford DJ, Carmichael AM, Austin DW, Takano K, Raes F, Fuller-Tyszkiewicz M. A study protocol for a randomised trial of adjunct computerised memory specificity training (c-MeST) for major depression in youth: targeting cognitive mechanisms to enhance usual care outcomes in mental health settings. Trials 2020; 21:85. [PMID: 31937350 PMCID: PMC6961400 DOI: 10.1186/s13063-019-4036-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/29/2019] [Indexed: 12/31/2022] Open
Abstract
Background Youth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning. Evidence-based treatments are available, but many young people do not respond or sufficiently recover with first-line options, and a significant proportion experience relapse. Consequently, there is clear scope to enhance intervention in this critical period of early-onset depression. Memory specificity training (MeST) is a low-intensity intervention for depression that targets reduced specificity when recalling memories of the past, a common cognitive vulnerability in depression. This randomised controlled trial will assess the efficacy of adding a computerised version of MeST (c-MeST) to usual care for youth depression. Methods/design Young people aged 15–25 years with a major depressive episode (MDE) will be recruited and randomised to have immediate access to the seven session online c-MeST program in addition to usual care, or to usual care and wait-list for c-MeST. The primary outcomes will be diagnostic status of an MDE and self-reported depressive symptoms assessed at baseline, 1-, 3- and 6-month intervals. Autobiographical memory specificity and other variables thought to contribute to the maintenance of reduced memory specificity and depression will be assessed as mediators of change. Discussion Online provision of c-MeST provides a simple, low-intensity option for targeting a cognitive vulnerability that predicts the persistence of depressive symptoms. If found to be efficacious as an adjunct to usual care for depressed youth, it could be suitable for broader roll-out, as c-MeST is highly accessible and implementation requires only minimal resources due to the online and automated nature of intervention. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000234112p. Registered on the 18 February 2019. All items from the WHO Trial Registration Data Set can be found within the protocol. Protocol version 1.0
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Affiliation(s)
- D J Hallford
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia. .,School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Melbourne, Victoria, 3125, Australia.
| | - A M Carmichael
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
| | - D W Austin
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
| | - K Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 131, 80802, Munich, Germany
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000, Leuven, Belgium
| | - M Fuller-Tyszkiewicz
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
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18
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Martens K, Takano K, Barry TJ, Holmes EA, Wyckaert S, Raes F. Remediating reduced memory specificity in bipolar disorder: A case study using a Computerized Memory Specificity Training. Brain Behav 2019; 9:e01468. [PMID: 31747124 PMCID: PMC6908894 DOI: 10.1002/brb3.1468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/08/2019] [Accepted: 10/13/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Reduced autobiographical memory specificity (rAMS) is a vulnerability factor found across unipolar depression (UD), posttraumatic stress disorder (PTSD), eating disorder, schizophrenia, and bipolar disorder (BD). A group delivered psychological therapy training called Memory Specificity Training (MeST) remediates rAMS in UD and PTSD, with additional downstream effects on related psychological processes and symptoms. Its impact in BD is unknown. In this case study, we examined the impact of a computerized version of MeST (c-MeST) on improving AMS and related symptoms and processes in participant with rapid cycling type I BD. METHOD An experimental case study with an ABA design was used. During baseline (14 days, Phase A), the training phase (nine sessions across 17 days, Phase B), and a 1-month follow-up (Phase A), memory specificity, depressive symptoms, and related processes and symptoms were repeatedly measured. RESULTS Memory specificity increased significantly after the participant completed c-MeST. Session-to-session scores indicated that AMS improved most from the in-person baseline assessment to the first online session. All other measures of processes and symptoms deteriorated during the training phase but regressed to baseline during follow-up. CONCLUSION Memory specificity was improved as indicated by increased AMS from pre-intervention measurement to 1-month follow-up. Other improvements in symptoms were not observed. Rather, some related maladaptive psychological processes and symptoms worsened during the training phase and regressed to baseline during follow-up.
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Affiliation(s)
- Kris Martens
- Faculty of Psychology and Educational SciencesKU LeuvenLeuvenBelgium
| | | | - Tom J. Barry
- Department of PsychologyThe University of Hong KongHong KongHong Kong
- Department of PsychologyThe Institute of PsychiatryKing's College LondonLondonUK
| | | | - Sabine Wyckaert
- University Psychiatric Center KU Leuven, Campus KortenbergKortenbergBelgium
| | - Filip Raes
- Faculty of Psychology and Educational SciencesKU LeuvenLeuvenBelgium
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19
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Martens K, Barry TJ, Takano K, Onghena P, Raes F. Efficacy of online Memory Specificity Training in adults with a history of depression, using a multiple baseline across participants design. Internet Interv 2019; 18:100259. [PMID: 31890612 PMCID: PMC6926331 DOI: 10.1016/j.invent.2019.100259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/26/2019] [Accepted: 06/29/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Memory Specificity Training (MeST), a group training protocol, is effective in improving autobiographical memory specificity (AMS), and in so doing, reducing emotional disorder symptoms amongst clinical groups. We examined MeST's effectiveness when the core component (memory specificity trials) is offered online and individually (c-MeST). METHODS A multiple-baseline across-participants design with a randomization-to-baseline length (14 to 33 days) was used. Participants were twenty adults (16 female; M age = 50, SD = 12) experiencing reduced AMS, at least one lifetime depressive episode and who currently reported at least minimal depressive symptoms. During baseline, the training phase (nine sessions across 17 days) and a three-month follow-up assessment, AMS, depressive symptoms and related processes were measured. RESULTS AMS improved significantly by three months follow-up. Session-to-session scores indicated that AMS improved most from baseline to the first online session, with no further improvement thereafter. In contrast to studies with clinical participants, no significant change in symptoms or secondary processes such as rumination was found. CONCLUSIONS Translating MeST into an online, individual version is a feasible, low-cost intervention for reduced AMS. Future research should examine c-MeST's potential for preventing increases in symptoms in at-risk samples with longer follow-ups as well as its potential for reducing symptoms in clinical groups.
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Affiliation(s)
- Kris Martens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Tom J. Barry
- Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong
- Department of Psychology, The Institute of Psychiatry, King's College London, London, United Kingdom
| | - Keisuke Takano
- Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Patrick Onghena
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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20
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Identifying the Most Effective Strategies for Improving Autobiographical Memory Specificity and Its Implications for Mental Health Problems: A Meta-analysis. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10061-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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21
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Hitchcock C, Newby J, Timm E, Howard RM, Golden AM, Kuyken W, Dalgleish T. Memory category fluency, memory specificity, and the fading affect bias for positive and negative autobiographical events: Performance on a good day-bad day task in healthy and depressed individuals. J Exp Psychol Gen 2019; 149:198-206. [PMID: 31192634 PMCID: PMC6921927 DOI: 10.1037/xge0000617] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In mentally healthy individuals, autobiographical memory is typically biased toward positive events, which may help to maintain psychological well-being. Our aim was to assess a range of important positive memory biases in the mentally healthy and explore the possibility that these biases are mitigated in those with mental health problems. We administered a novel recall paradigm that required recollection of multiple good and bad past events (the Good Day–Bad Day task) to healthy and depressed individuals. This allowed us to explore differences in memory category fluency (i.e., the ability to generate integrated sets of associated events) for positive and negative memories, along with memory specificity, and fading affect bias—a greater reduction in the intensity of memory-related affect over time for negative versus positive events. We found that healthy participants demonstrated superior category fluency for positive relative to negative events but that this effect was absent in depressed participants. Healthy participants exhibited a strong fading affect bias that was significantly mitigated, although still present, in depression. Finally, memory specificity was reduced in depression for both positive and negative memories. Findings demonstrate that the positive bias associated with mental health is maintained by multiple autobiographical memory processes and that depression is as much a function of the absence of these positive biases as it is the presence of negative biases. Results provide important guidance for developing new treatments for improving mental health.
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Affiliation(s)
| | | | - Emma Timm
- MRC Cognition and Brain Sciences Unit
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22
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Martens K, Takano K, Barry TJ, Goedleven J, Van den Meutter L, Raes F. Remediating Reduced Autobiographical Memory in Healthy Older Adults With Computerized Memory Specificity Training (c-MeST): An Observational Before-After Study. J Med Internet Res 2019; 21:e13333. [PMID: 31094362 PMCID: PMC6538238 DOI: 10.2196/13333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/13/2022] Open
Abstract
Background The ability to retrieve specific autobiographical memories decreases with cognitive aging. This decline is clinically relevant due to its association with impairments in problem solving, daily functioning, and depression. A therapist-delivered group training protocol, Memory Specificity Training (MeST), has been shown to enhance the retrieval of specific memories while ameliorating the impairments and negative outcomes associated with reduced specificity. The therapist-delivered nature of this intervention means it is relatively expensive to deliver and difficult for people with mobility impairments, such as older people, to receive. Objective The objective of this study was to test if a novel, Web-based computerized version of a group training protocol called Memory Specificity Training, has the potential to increase autobiographical memory specificity and impact associated secondary psychological processes. Methods A total of 21 participants (13 female; mean age 67.05, SD 6.55) who experienced a deficit in retrieving specific autobiographical memory were trained with c-MeST. We assessed memory specificity at preintervention and postintervention, as well as secondary processes such as depressive symptoms, rumination, and problem-solving skills. Results Memory specificity increased significantly after participants completed c-MeST (r=.57). Session-to-session scores indicated that autobiographical memory specificity improved most from the online baseline assessment to the first Web-based session. Symptoms or secondary processes such as problem-solving skills did not change significantly. Conclusions A Web-based automated individual version of MeST is a feasible, low-cost intervention for reduced memory specificity in healthy older adults. Future studies should clarify the preventive impact of c-MeST in other at-risk sample populations with longer follow-up times.
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Affiliation(s)
- Kris Martens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Keisuke Takano
- Department of Psychology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Tom J Barry
- Department of Psychology, The University of Hong Kong, Hong Kong, China.,Department of Psychology, The Institute of Psychiatry, King's College London, London, United Kingdom
| | - Jolien Goedleven
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | | | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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23
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Barry TJ, Sze WY, Raes F. A meta-analysis and systematic review of Memory Specificity Training (MeST) in the treatment of emotional disorders. Behav Res Ther 2019; 116:36-51. [DOI: 10.1016/j.brat.2019.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 11/30/2018] [Accepted: 02/01/2019] [Indexed: 01/28/2023]
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24
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Hitchcock C, Rodrigues E, Rees C, Gormley S, Dritschel B, Dalgleish T. Misremembrance of Things Past: Depression Is Associated With Difficulties in the Recollection of Both Specific and Categoric Autobiographical Memories. Clin Psychol Sci 2019; 7:693-700. [PMID: 32655985 PMCID: PMC7324083 DOI: 10.1177/2167702619826967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Impaired retrieval of specific, autobiographical memories of personally
experienced events is characteristic of major depressive disorder (MDD).
However, findings in subclinical samples suggest that the reduced specificity
phenomenon may reflect a broader impairment in the deliberate retrieval of all
autobiographical memory types. This experiment (N = 68)
explored this possibility by requiring individuals with and without MDD to
complete a cued-recall task that required retrieval of specific, single-incident
memories to a block of cues; retrieval of categoric, general memories to a block
of cues; and to alternate between retrieval of specific and general memories for
a block of cues. Results demonstrated that relative to never-depressed controls,
individuals with MDD experience reduced recall of both specific
(d = 0.48) and general memories (d = 1.00)
along with reduced flexibility in alternating between specific and general
memories (d = 0.90). Findings support further development of
autobiographical memory–based interventions that target a range of retrieval
deficits rather than specificity alone.
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Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge.,Cambridgeshire and Peterborough National Health Service Foundation Trust
| | - Evangeline Rodrigues
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Catrin Rees
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Siobhan Gormley
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge.,Cambridgeshire and Peterborough National Health Service Foundation Trust
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25
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Hallford DJ, Austin DW, Raes F, Takano K. Computerised memory specificity training (c-MeST) for the treatment of major depression: a study protocol for a randomised controlled trial. BMJ Open 2019; 9:e024508. [PMID: 30819707 PMCID: PMC6398714 DOI: 10.1136/bmjopen-2018-024508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Major depression is a prevalent and debilitating disorder, but many sufferers do not receive support or respond to current treatments. The development of easily accessible and low-intensity treatments that have clear cognitive mechanisms of change is indicated. Memory specificity training (MeST) is an intervention for depression that targets deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial will assess the efficacy of an online, computerised version of MeST (c-MeST). METHODS AND ANALYSIS Adults aged 18 and over with a current major depressive episode (MDE) will be recruited and randomised to have access to the seven session, online c-MeST programme for 2 weeks, or to a wait-list control group. The primary outcomes will be diagnostic status of MDE and self-reported depressive symptoms at postintervention. One-month and three-month follow-ups will be collected. Increases in autobiographical memory specificity will be assessed as a mediator of change, as well as other variables thought to contribute to reduced memory specificity, such as rumination and cognitive avoidance. ETHICS AND DISSEMINATION Ethics approval has been granted by the Deakin University Human Research Ethics Committee to conduct the study (ID: 2017_168). The findings will be disseminated through scholarly publications and workshops and will inform future trials, such as with an active comparator or as an adjunct treatment. TRIAL REGISTRATION NUMBER ACTRN12618000257268; Pre-results.
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Affiliation(s)
- David J Hallford
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - David W Austin
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Vlaanderen, Belgium
| | - Keisuke Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Bavaria, Germany
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26
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Martens K, Barry TJ, Takano K, Raes F. The transportability of Memory Specificity Training (MeST): adapting an intervention derived from experimental psychology to routine clinical practices. BMC Psychol 2019; 7:5. [PMID: 30709422 PMCID: PMC6359774 DOI: 10.1186/s40359-019-0279-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/25/2019] [Indexed: 11/24/2022] Open
Abstract
Background Accumulating evidence shows that a cognitive factor associated with a worsening of depressive symptoms amongst people with and without diagnoses of depression – reduced Autobiographical Memory (rAMS) – can be ameliorated by a group cognitive training protocol referred to as Memory Specificity Training (MeST). When transporting interventions such as MeST from research to routine clinical practices (RCPs), modifications are inevitable, with potentially a decrease in effectiveness, so called voltage drop. We examined the transportability of MeST to RCPs as an add-on to treatment as usual with depressed in- and out- patients. Methods We examined whether 1) MeST was adaptable to local needs of RCPs by implementing MeST in a joint decision-making process in seven Belgian RCPs 2) without losing its effect on rAMS. The effectiveness of MeST was measured by pre- and post- intervention measurements of memory specificity. Results Adaptations were made to the MeST protocol to optimize the fit with RCPs. Local needs of RCPs were met by dismantling MeST into different subparts. By dismantling it in this way, we were able to address several challenges raised by clinicians. In particular, multidisciplinary teams could divide the workload across different team members and, for the open version of MeST, the intervention could be offered continuously with tailored dosing per patient. Both closed and open versions of MeST, with or without peripheral components, and delivered by health professionals with different backgrounds, resulted in a significant increase in memory specificity for depressed in- and out- patients in RCPs. Conclusions MeST is shown to be a transportable and adaptable add-on intervention which effectively maintains its core mechanism when delivered in RCPs. Trial registration ISRCTN registry, IDISRCTN10144349, registered on January 22, 2019. Retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s40359-019-0279-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kris Martens
- Faculty of Psychology and Educational Science, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium
| | - Tom J Barry
- Department of Psychology, The University of Hong Kong, Jockey Club Tower, Pokfulam Road, Hong Kong, Hong Kong. .,Department of Psychology, The Institute of Psychiatry, King's College London, BOX PO77, Henry Wellcome Building, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
| | - Keisuke Takano
- Department of Psychology, Ludwig-Maximilians-University of Munich, Leopoldstrasse 13, 80802, Munich, Germany
| | - Filip Raes
- Faculty of Psychology and Educational Science, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium
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Farina FR, Barry TJ, Damme I, Hie T, Raes F. Depression diagnoses, but not individual differences in depression symptoms, are associated with reduced autobiographical memory specificity. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 58:173-186. [DOI: 10.1111/bjc.12207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 10/05/2018] [Indexed: 11/27/2022]
Affiliation(s)
| | - Tom J. Barry
- The University of Hong Kong Hong Kong
- The Institute of Psychiatry, Psychology & Neuroscience King's College London UK
| | - Ilse Damme
- University of Hasselt Belgium
- University of Leuven Belgium
| | - Thijs Hie
- University of Leuven Belgium
- Centre for Mental Health Haacht Belgium
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28
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Hitchcock C, Gormley S, Rees C, Rodrigues E, Gillard J, Panesar I, Wright IM, Hammond E, Watson P, Werner-Seidler A, Dalgleish T. A randomised controlled trial of memory flexibility training (MemFlex) to enhance memory flexibility and reduce depressive symptomatology in individuals with major depressive disorder. Behav Res Ther 2018; 110:22-30. [PMID: 30199738 PMCID: PMC6173798 DOI: 10.1016/j.brat.2018.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/31/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022]
Abstract
Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval can thereby have a detrimental impact on mental health. This randomised controlled phase II exploratory trial (N = 60) evaluated the potential of a novel intervention drawn from basic science - an autobiographical Memory Flexibility (MemFlex) training programme - which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and diagnostic status at three-month follow-up. These effect sizes could subsequently be used to estimate sample size for a fully-powered trial. Results demonstrated small-moderate, though as expected statistically non-significant, effect sizes in favour of MemFlex for memory flexibility (d = 0.34, p = .20), and loss of diagnosis (OR = 0.65, p = .48), along with the secondary outcome of depression-free days (d = 0.36, p = .18). A smaller effect size was observed for between-group difference in self-reported depressive symptoms (d = 0.24, p = .35). Effect sizes in favour of MemFlex in this early-stage trial suggest that fully-powered evaluation of MemFlex may be warranted as an avenue to improving low-intensity treatment of depression. TRIAL REGISTRATION ClinicalTrials.gov, Identifier NCT02371291.
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Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom.
| | - Siobhan Gormley
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Catrin Rees
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Evangeline Rodrigues
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Julia Gillard
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Inderpal Panesar
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| | - Isobel M Wright
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
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