Autobiographical memory and problem-solving strategies of parasuicide patients

Thinking about the consequences: The detrimental role of future thinking on intrapersonal problem-solving in depression

Despite the fact that depressed individuals encounter a multitude of social problems in daily life, research on social problem-solving has largely been dominated by research on interpersonal problems and there is a paucity of research on intrapersonal problems. Intrapersonal problems are linked to one's subjective psychological functioning and involve managing one's own feelings and emotions pertaining to the self. Given that depressed individuals exhibit impaired emotion regulation, it is possible that their ability to solve intrapersonal problems may be impaired, especially in relation to future thinking. The aim of this study was to investigate whether future thinking, in the form of thinking about the consequences of a problem being resolved or remaining unresolved has an impact on intrapersonal problem-solving in depression. Forty-five depressed and fifty-four non-depressed participants completed a modified version of the means end problem-solving task (MEPS). In the task, participants were presented with a series of intrapersonal problems and were asked to generate consequences of the problems being resolved or remaining unresolved. Participants were then presented with a positive resolution to each of the problems and were asked to solve the problem to achieve the positive resolution. Following a delay, participants were asked to recall all of the consequences initially generated. Overall, depressed individuals generated fewer-relevant means and less effective solutions to problems than non-depressed participants. Depressed individuals also demonstrated impaired intrapersonal problem-solving following the generation of resolved and unresolved consequences, compared to a baseline condition, where no consequences were generated. These findings suggest that future thinking impairs intrapersonal problem-solving and indicates that a more nuanced approach to future thinking and social problem-solving in depression is needed across different real-life problem-solving contexts.

The Return of Repression? Evidence From Cognitive Psychology

The controversy over alleged repressed and recovered memories of childhood sexual abuse (CSA) was among the most contentious ever to embroil psychology and psychiatry. Adapting paradigms from cognitive psychology, my research group tested hypotheses pertinent to repressed memory and false memory interpretations of recovered memories. We tested adults who: (1) report recovering memories of CSA after not having thought about their abuse for years; (2) report never having forgotten their CSA; (3) believe they harbor "repressed" memories of CSA; and (4) deny having been sexually abused. We tested hypotheses about mechanisms that might figure in the inability to recall memories of one's abuse and those that might render one susceptible to developing false memories of abuse. The purpose of this article is to summarize this work. Finally, I draw on the work of Lionel Penrose to speculate about why the popularity of the concept of repressed memories of trauma-or its synonym, dissociative amnesia for trauma-may be rising today.

Understanding intergenerational transmission of early maladaptive schemas from a memory perspective: Moderating role of overgeneral memory on adverse experiences

BACKGROUND

Previous studies demonstrated that early maladaptive schemas (EMSs) are transmitted from mothers to children through adverse childhood experiences, such as maltreatment and unfulfilled core needs. The traumatic memory literature demonstrated that people with a history of trauma recall their traumatic and/or other negative experiences as categories of events-a phenomenon called overgeneral autobiographical memory (OGM)-to avoid the accompanying intense negative feelings. In the long run, OGM originating from an affect-regulation process after childhood traumatic experiences can facilitate the development of EMSs in children.

OBJECTIVE

This study expands the previous literature by studying whether OGM facilitates the transmission of EMSs by strengthening maladaptive thinking patterns after traumatic experiences.

PARTICIPANTS AND SETTINGS

A total of 120 mothers and late adolescents participated in this study. The mothers filled out the forms online through a link sent to their e-mail addresses, and the adolescents completed the forms online through a link posted on social media.

METHOD

Late adolescents completed the Autobiographical Memory Recall Task, Young Schema Questionnaire-Short Form-3 (YSQ-SF3), Childhood Trauma Questionnaire, and Beck Depression Inventory (BDI). Mothers filled out the YSQ-SF3 and BDI.

RESULTS

The results confirmed that adverse childhood experiences significantly mediated the relationship between mothers' and children's disconnection and rejection schemas. Furthermore, this relationship was stronger, especially for children with a higher tendency of overgeneral retrieval of negative experience (β = 0.26 (0.10), 95% CI [0.09, 0.49]).

CONCLUSIONS

The present study provides evidence that OGM facilitates the transmission of early maladaptive schemas.

The mindfulness trajectories of addressing suicidal behaviour: A systematic review

BACKGROUND AND OBJECTIVES

Suicidal behaviour has been a persistent concern in medical as well as general settings. Many psychotherapeutic approaches have tried to address suicidal behaviour in different ways. Mindfulness-based interventions (MBIs) have garnered much attention in the last decade because of their treatment efficacy. This systematic review aimed to examine evidence-based research regarding the effectiveness of MBIs as a psychotherapy intervention on suicidality and to deliver suggestions that might help future research.

METHOD

The identification of literature was made through an extensive search of the electronic databases, to extract studies relating to the efficacy of MBIs on addressing suicidal behaviour. Additional researches based on library sources were searched manually. The studies' selection was based on a pre-determined inclusion and exclusion criteria as well as the quality of the studies.

RESULTS

The present review helped us identify 13 studies, including six randomised controlled trials, two controlled studies and five pre-post observational studies. The findings reported in the studies were mostly favourable to MBIs as an effective intervention strategy for suicidal behaviour.

CONCLUSION

MBIs show promising effects as an intervention for suicidal behaviour. However, large scale, high-quality trials with active control, and long term intervention efficacy studies are needed to understand the mechanisms through which MBIs reduce suicidal behaviour.

The impact of the narrative mindset on effectivity in social problem solving

The narrative mindset is a tendency to interpret social information in the frame of stories. Two experiments were conducted to determine if and why the narrative mindset increases social problem-solving effectivity. The experiments consisted of two parts: the experimental manipulation (inducing the narrative mindset or control condition) and the observation of effects. In the second part, presented as a separate study, a participant was asked to advise other people facing interpersonal problems (experiment 1) or emotional problems (experiment 2). Three pairs of coders judged each piece of advice independently on three scales: Effectivity of the advice, empathy, and personalization (using their own experiences in providing the advice). The results indicate that the narrative mindset increases empathy, supported by the co-occurring increase in the problem's personalization, which leads to higher effectivity. The results reveal the positive real-life implications of structuring social information within a story frame. It may encourage the introduction of the narrative mindset effects into an area of social cognition research. Finally, the experiments show that the narrative mindset may be activated experimentally, providing an effective instrument to test the impact of narrative knowledge on social cognition.

Search for solutions, learning, simulation, and choice processes in suicidal behavior

Suicide may be viewed as an unfortunate outcome of failures in decision processes. Such failures occur when the demands of a crisis exceed a person's capacity to (i) search for options, (ii) learn and simulate possible futures, and (iii) make advantageous value‐based choices. Can individual‐level decision deficits and biases drive the progression of the suicidal crisis? Our overview of the evidence on this question is informed by clinical theory and grounded in reinforcement learning and behavioral economics. Cohort and case–control studies provide strong evidence that limited cognitive capacity and particularly impaired cognitive control are associated with suicidal behavior, imposing cognitive constraints on decision‐making. We conceptualize suicidal ideation as an element of impoverished consideration sets resulting from a search for solutions under cognitive constraints and mood‐congruent Pavlovian influences, a view supported by mostly indirect evidence. More compelling is the evidence of impaired learning in people with a history of suicidal behavior. We speculate that an inability to simulate alternative futures using one's model of the world may undermine alternative solutions in a suicidal crisis. The hypothesis supported by the strongest evidence is that the selection of suicide over alternatives is facilitated by a choice process undermined by randomness. Case–control studies using gambling tasks, armed bandits, and delay discounting support this claim. Future experimental studies will need to uncover real‐time dynamics of choice processes in suicidal people. In summary, the decision process framework sheds light on neurocognitive mechanisms that facilitate the progression of the suicidal crisis.

This article is categorized under:

Economics > Individual Decision‐Making

Psychology > Emotion and Motivation

Psychology > Learning

Neuroscience > Behavior

Identifying the Links Between Trauma and Social Adjustment: Implications for More Effective Psychotherapy With Traumatized Youth

Background: Past research has highlighted the role of trauma in social adjustment problems, but little is known about the underlying process. This is a barrier to developing effective interventions for social adjustment of traumatized individuals. The present study addressed this research gap through a cognitive model.

Methods: A total of 604 young adults (aged 18–24; living in Australia) from different backgrounds (refugee, non-refugee immigrant, and Australian) were assessed through self-report questionnaires. The data were analyzed through path analysis and multivariate analysis of variance. Two path analyses were conducted separately for migrant (including non-refugee and refugee immigrants) and Australian groups.

Results: Analyses indicated that cognitive avoidance and social problem solving can significantly mediate the relation between trauma and social adjustment (p < 0.05). The model explaining this process statistically fit the data (e.g., NFI, TLI, CFI > 0.95). According to the model, reacting to trauma by cognitive avoidance (i.e., chronic thought suppression and over-general autobiographical memory) can disturb the cognitive capacities that are required for social problem solving. Consequently, a lack of effective social problem solving significantly hinders social adjustment. There were no significant differences among the Australian, non-refugee immigrant and refugee participants on the dependent variables. Moreover, the hypothesized links between the variables was confirmed similarly for both migrant (including refugee and non-refugee immigrants) and Australian groups.

Conclusion: The findings have important implications for interventions targeting the social adjustment of young individuals. We assert that overlooking the processes identified in this study, can hinder the improvement of social adjustment in young adults with a history of trauma. Recommendations for future research and practice are discussed.

Reasons to remember: A functionalist view on the relation between memory and psychopathology

Memory is under investigation as one of the core mechanisms of psychopathology. The traditional cognitive view of memory as a stable structure with a range of set characteristics can be complemented with a perspective that considers remembering as a behaviour that varies fluidly across contexts. Remembering may serve adaptation to the environment by fulfilling a directive function, a self-function and a social function. A failure to fulfil these functions may be a risk factor for psychopathology. Implications of the discussed functionalist perspective include the importance of reinforcing adaptive ways of remembering during early development, the possibility of treating maladaptive ways of remembering through contextual interventions and the added ecological validity of using ambulatory assessment methods.

Time Geography, a Method in Psychiatric Nursing Care

Patients' life history is of primary interest in psychiatric nursing care. Our aim was to illustrate how we used time geography as a method to identify individuals' patterns in relation to certain situations in place. We have used interviews and diaries to construct life charts by hand and with a computer software program. By using time geography, we provide a rich amount of information, which can generate a broader picture of a person's life, to identify stressful as well as social aspects of a person's life. Patients with mental ill health need and value the therapeutic relationship using time geography.

Social problem solving in social anxiety disorder

Successful social problem solving requires both an adaptive orientation toward the problem and the necessary skills to generate relevant and effective solutions. Surprisingly few studies have examined social problem solving in the context of social anxiety. We examined social problem solving in 38 participants with social anxiety disorder (SAD) in comparison to 30 healthy control (HC) participants with no history of anxiety problems. Participants rated their problem solving attitudes and abilities (i.e., problem orientation) and then generated solutions to hypothetical interpersonal problems from both their own perspective and that of an objective other. These solutions were coded for effectiveness and relevance, as well as the degree to which the solution was active versus passive. Participants with SAD exhibited a more negative problem orientation than HC participants. Furthermore, although SAD and HC participants demonstrated no overall differences in generating relevant and effective solutions to interpersonal problems, utilizing a personal perspective facilitated the generation of more active solutions for HC participants, but less active solutions for those with SAD. Findings illuminate new research directions regarding social problem solving in social anxiety, with potential implications for applied intervention.

Reduced autobiographical memory specificity affects general distress through poor social support

Sharing specific autobiographical events is likely to influence the support people give us; a person who shares little detail of their lives may be unlikely to attract social support and this may in turn contribute towards anxious and depressive symptoms. Participants (N = 142) reported memories evoked by negative and positive cue words and these memories were coded for whether or not they referred to a specific event lasting less than 24 h. At this time (T1) and one year later (T2), participants also completed the UCLA Life Stress Interview (LSI), which includes a measure of social support, and measures of depression and anxiety comprising a general distress latent construct. The tendency to recall fewer specific memories was associated with lower social support given by friends and romantic partners and this was in turn associated with elevated general distress at T2, even when accounting for T1 social support and general distress. Our findings contribute to the literature regarding the social function of memory and suggest another route via which reduced specificity contributes to emotional disorders.

The transportability of Memory Specificity Training (MeST): adapting an intervention derived from experimental psychology to routine clinical practices

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.

Autobiographical Memory Specificity Predicts Social Problem-Solving Ability in Old and Young Adults

Based on recent research with young, depressed adults, age-related cognitive declines and decreased autobiographical specificity were hypothesized to predict poorer social problem-solving ability in older than in younger healthy adults. Priming autobiographical memory (ABM) was hypothesized to improve social problem-solving performance for older adults. Subsequent to cognitive tests, old and young participants’ specific ABMs were tested using a cued recall task, followed by a social problem-solving task. The order of the tasks was counterbalanced to test for a priming effect. Autobiographical specificity was related to cognitive ability and predicted social problem-solving ability for both age groups. However, priming of ABM did not improve social problem-solving ability for older or younger adults. This study provides support for the hypothesis that autobiographical memory serves a directive function across the life-span.

The Importance of Memory Specificity and Memory Coherence for the Self: Linking Two Characteristics of Autobiographical Memory

Autobiographical memory forms a network of memories about personal experiences that defines and supports well-being and effective functioning of the self in various ways. During the last three decades, there have been two characteristics of autobiographical memory that have received special interest regarding their role in psychological well-being and psychopathology, namely memory specificity and memory coherence. Memory specificity refers to the extent to which retrieved autobiographical memories are specific (i.e., memories about a particular experience that happened on a particular day). Difficulty retrieving specific memories interferes with effective functioning of the self and is related to depression and post-traumatic stress disorder. Memory coherence refers to the narrative expression of the overall structure of autobiographical memories. It has likewise been related to psychological well-being and the occurrence of psychopathology. Research on memory specificity and memory coherence has developed as two largely independent research domains, even though they show much overlap. This raises some important theoretical questions. How do these two characteristics of autobiographical memory relate to each other, both theoretically and empirically? Additionally, how can the integration of these two facilitate our understanding of the importance of autobiographical memory for the self? In this article, we give a critical overview of memory specificity and memory coherence and their relation to the self. We link both features of autobiographical memory by describing some important similarities and by formulating hypotheses about how they might relate to each other. By situating both memory specificity and memory coherence within Conway and Pleydell-Pearce’s Self-Memory System, we make a first attempt at a theoretical integration. Finally, we suggest some new and exciting research possibilities and explain how both research fields could benefit from integration in future research.

The relationship between autobiographical memory, cognition, and emotion in older adults: a review

Over the past 30 years, the concept of "autobiographical memory" has been highlighted in numerous behavioral and neuroanatomical studies. Importantly, episodic autobiographical memory, an aspect of autobiographical memory, has been shown to decrease with age but can be improved by training. Autobiographical memory is deeply associated with the default mode network (especially posterior cingulate cortex and medial prefrontal cortex), which is particularly interesting in the context of better understanding the relationship between autobiographical memory, cognition, and emotion in older adults. This article provides an overview of the behavioral and neuroanatomical characteristics of autobiographical memory, as well as its relationship with the default mode network, cognition, emotion, and aging. This article also provides an overall review of autobiographical memory training.

Neural correlates of autobiographical problem-solving deficits associated with rumination in depression

BACKGROUND

Analytical rumination can be characterized as negative thoughts focused on searching for answers to personal problems. Failure to think concretely during autobiographical problem-solving (APS) is hypothesized to drive the inability of ruminators to generate effective solutions. Clarifying the brain correlates underlying APS deficits in depressed ruminators may identify novel biological targets for treatment.

METHOD

Forty participants (22 unmedicated depressed and 18 never-depressed adults) ranging in rumination engaged in APS and negative self-referential processing (NSP) of negative trait adjectives during fMRI. We contrasted activation during APS with activation during NSP to isolate regions contributing to APS.

RESULTS

Rumination was associated with having generated fewer solutions during APS and with a failure to recruit the angular gyrus (AG) and the medial frontal gyrus (MFG) during APS. Rumination was associated with greater MFG activation during NSP and stronger connectivity between the AG and the rostrolateral prefrontal cortex (RLPFC) during APS relative to NSP. Findings were not driven by clinical status.

LIMITATIONS

The use of an extreme groups approach can result in overestimation of effects sizes.

CONCLUSIONS

Ruminators fail to recruit regions with the default network (DN) that support APS. In particular, a failure to recruit the AG during APS may drive the abstract thinking style previously shown to explain depressed ruminator's difficulty generating concrete solutions. Targeting this mechanism directly may reduce rumination.

Perceived problem-solving deficits and suicidal ideation: Evidence for the explanatory roles of thwarted belongingness and perceived burdensomeness in five samples

Perceived social problem-solving deficits are associated with suicide risk; however, little research has examined the mechanisms underlying this relationship. The interpersonal theory of suicide proposes 2 mechanisms in the pathogenesis of suicidal desire: intractable feelings of thwarted belongingness (TB) and perceived burdensomeness (PB). This study tested whether TB and PB serve as explanatory links in the relationship between perceived social problem-solving (SPS) deficits and suicidal thoughts and behaviors cross-sectionally and longitudinally. The specificity of TB and PB was evaluated by testing depression as a rival mediator. Self-report measures of perceived SPS deficits, TB, PB, suicidal ideation, and depression were administered in 5 adult samples: 336 and 105 undergraduates from 2 universities, 53 homeless individuals, 222 primary care patients, and 329 military members. Bias-corrected bootstrap mediation and meta-analyses were conducted to examine the magnitude of the direct and indirect effects, and the proposed mediation paths were tested using zero-inflated negative binomial regressions. Cross-sectionally, TB and PB were significant parallel mediators of the relationship between perceived SPS deficits and ideation, beyond depression. Longitudinally and beyond depression, in 1 study, both TB and PB emerged as significant explanatory factors, and in the other, only PB was a significant mediator. Findings supported the specificity of TB and PB: Depression and SPS deficits were not significant mediators. The relationship between perceived SPS deficits and ideation was explained by interpersonal theory variables, particularly PB. Findings support a novel application of the interpersonal theory, and bolster a growing compendium of literature implicating perceived SPS deficits in suicide risk. (PsycINFO Database Record

Cognitive, Emotional, Temperament, and Personality Trait Correlates of Suicidal Behavior

Suicide is one of the leading causes of violent death in many countries and its prevention is included in worldwide health objectives. Currently, the DSM-5 considers suicidal behavior as an entity that requires further study. Among the three validators required for considering a psychiatric disorder, there is one based on psychological correlates, biological markers, and patterns of comorbidity. This review includes the most important and recent studies on psychological factors: cognitive, emotional, temperament, and personality correlates (unrelated to diagnostic criteria). We included classic factors related to suicidal behavior such as cognitive, inflexibility, problem-solving, coping, rumination, thought suppression, decision-making, autobiographical memory, working memory, language fluency, burdensomeness, belongingness, fearless, pain insensitivity, impulsiveness, aggressiveness, and hopelessness. The personality correlates reported are mainly based on the personality theories of Cloninger, Costa and McCrae, and Eysenck. Moreover, it explores conceptual links to other new pathways in psychological factors, emptiness, and psychological pain as a possible origin and common end path for a portion of suicidal behaviors.

Suicidal behaviour and memory: A systematic review and meta-analysis

OBJECTIVES

Suicidal behaviour results from a complex interplay between stressful events and vulnerability factors, including cognitive deficits. It is not yet clear if memory impairment is part of this specific vulnerability. Therefore, the objective of this study was to examine the association between memory deficits and vulnerability to suicidal acts.

METHODS

A literature review was performed using Medline, Embase, and PsycInfo databases. Twenty-four studies (including 2,595 participants) met the selection criteria. Four different types of memory (i.e., working memory, short- and long-term memory, and autobiographical memory) were assessed in at least three different studies.

RESULTS

Autobiographical memory was significantly less specific and more general in patients with a history of suicide attempt relative to those without such a history (Hedges' g = 0.8 and 0.9, respectively). Long-term memory and working memory were both more impaired in suicide attempters than in patient and healthy controls. Only short-term memory did not differentiate suicide attempters from patient controls.

CONCLUSIONS

Memory may play a significant role in the risk of suicidal acts, perhaps by preventing these individuals from using past experiences to solve current problems and to envision the future, and by altering inhibitory processes. More studies are necessary to better clarify these relationships.

Enhancing self-efficacy improves episodic future thinking and social-decision making in combat veterans with posttraumatic stress disorder

Posttraumatic Stress Disorder (PTSD) is associated with maladaptive changes in self-identity, including impoverished perceived self-efficacy. This study examined if enhancing perceptions of self-efficacy in combat veterans with and without symptoms of PTSD promotes cognitive strategies associated with positive mental health outcomes. Prior to completing a future thinking and social problem-solving task, sixty-two OEF/OIF veterans with and without symptoms of PTSD were randomized to either a high self-efficacy (HSE) induction in which they were asked to recall three autobiographical memories demonstrating self-efficacy or a control condition in which they recalled any three autobiographical events. An interaction between HSE and PTSD revealed that individuals with symptoms of PTSD in the HSE condition generated future events with more self-efficacious statements than those with PTSD in the control condition, whereas those without PTSD did not differ in self-efficacy content across the conditions. In addition, individuals in the HSE condition exhibited better social problem solving than those in the control condition. Increasing perceptions of self-efficacy may promote future thinking and problem solving in ways that are relevant to overcoming trauma and adversity.

Autobiographical Memory in the Angry Self

The impact of anger on autobiographical recall was examined in two studies. In Experiment 1, 76 participants differing in trait anger completed an autobiographical memory task (AMT). In Experiment 2, 50 participants with elevated trait anger were either provoked or not provoked and subsequently completed an AMT. Across both studies, participants with high dispositional anger reported more anger-related memories, describing themselves as the primary agent of anger. In Experiment 2, provoked participants reported more memories describing themselves as the target of anger. These findings highlight the distinct patterns of memory recall associated with trait versus state anger. Findings are discussed in terms of retrieval biases operating in angry individuals and proposals stemming from self-memory system models of autobiographical memory.

Trajectories of suicidal ideation in depressed older adults undergoing antidepressant treatment

Suicide is a public health concern in older adults. Recent cross sectional studies suggest that impairments in executive functioning, memory and attention are associated with suicidal ideation in older adults. It is unknown whether these neuropsychological features predict persistent suicidal ideation. We analyzed data from 468 individuals ≥ age 60 with major depression who received venlafaxine XR monotherapy for up to 16 weeks. We used latent class growth modeling to classify groups of individuals based on trajectories of suicidal ideation. We also examined whether cognitive dysfunction predicted suicidal ideation while controlling for time-dependent variables including depression severity, and age and education. The optimal model using a zero inflated Poisson link classified individuals into four groups, each with a distinct temporal trajectory of suicidal ideation: those with 'minimal suicidal ideation' across time points; those with 'low suicidal ideation'; those with 'rapidly decreasing suicidal ideation'; and those with 'high and persistent suicidal ideation'. Participants in the 'high and persistent suicidal ideation' group had worse scores relative to those in the "rapidly decreasing suicidal ideation" group on the Color-Word 'inhibition/switching' subtest from the Delis-Kaplan Executive Function Scale, worse attention index scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and worse total RBANS index scores. These findings suggest that individuals with poorer ability to switch between inhibitory and non-inhibitory responses as well as worse attention and worse overall cognitive status are more likely to have persistently higher levels of suicidal ideation. CLINICALTRIAL.

GOV NUMBER

NCT00892047.

Overgeneral autobiographical memory predicts higher prospective levels of depressive symptoms and intrusions in borderline patients

Overgeneral memory (OGM), the tendency to retrieve categories of events from autobiographical memory instead of single events, is found to be a reliable predictor for future mood disturbances and post-traumatic symptom severity. Patients with borderline personality disorder (BPD) often report co-morbid episodes of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Therefore, we investigated whether OGM would predict depression severity and (post-traumatic) stress symptoms in BPD patients. At admission (N = 54) and at six-month follow-up (N ≥ 31), BPD patients completed the Structured Clinical Interview for DSM-IV Disorders, the Assessment of DSM-IV Personality Disorders, the Autobiographical Memory Test, the Beck Depression Inventory-2nd edition (BDI-II), and the Impact of Event Scale. OGM at baseline predicted (a) higher levels of depressive symptoms at follow-up and (b) more intrusions related to a stressful event over and above baseline levels of borderline symptoms, depressive symptoms, and intrusions, respectively. No association was found between memory specificity and event-related avoidance at follow-up. Despite previous findings suggesting that OGM in BPD is less robust than in MDD and PTSD, our results suggest that memory specificity in BPD patients may have some relevance for the course of depressive and stress symptomatology in BPD.

The influence of eating psychopathology on autobiographical memory specificity and social problem-solving

The primary aim was to examine the influence of subclinical disordered eating on autobiographical memory specificity (AMS) and social problem solving (SPS). A further aim was to establish if AMS mediated the relationship between eating psychopathology and SPS. A non-clinical sample of 52 females completed the autobiographical memory test (AMT), where they were asked to retrieve specific memories of events from their past in response to cue words, and the means-end problem-solving task (MEPS), where they were asked to generate means of solving a series of social problems. Participants also completed the Eating Disorders Inventory (EDI) and Hospital Anxiety and Depression Scale. After controlling for mood, high scores on the EDI subscales, particularly Drive-for-Thinness, were associated with the retrieval of fewer specific and a greater proportion of categorical memories on the AMT and with the generation of fewer and less effective means on the MEPS. Memory specificity fully mediated the relationship between eating psychopathology and SPS. These findings have implications for individuals exhibiting high levels of disordered eating, as poor AMS and SPS are likely to impact negatively on their psychological wellbeing and everyday social functioning and could represent a risk factor for the development of clinically significant eating disorders.

Autobiographical memory and hierarchical search strategies in depressed and non-depressed participants

BACKGROUND

There is a growing body of literature showing individuals with depression and other trauma-related disorders (e.g., posttraumatic stress disorder) recall more overgeneral and less specific autobiographical memories compared to normal participants. Although the mechanisms underlying overgeneral memory are quite clear, the search strategy operated within the autobiographical knowledge base, at time of recollection, requires further exploration. The current study aimed to examine the hierarchical search sequence used to recall autobiographical memories in depressed and non-depressed participants, with a view to determining whether depressed participants exhibited truncated search strategies.

METHODS

Thirteen depressed and an equal number of non-depressed participants retrieved 15 memories each, in response to 15 commonly used cue words. Participants reported the first memory that entered in their mind. All memory descriptions were recorded and later transcribed verbatim for content analysis.

RESULTS

Depressed participants retrieved autobiographical memories faster, produced shorter memory descriptions and were less likely to recall positive memories than non-depressed participants. Non-depressed participants were more likely to commence retrieval by accessing lifetime period knowledge followed by general event and event specific knowledge, whereas depressed participants showed a tendency to terminate retrieval at the general event level.

CONCLUSIONS

It is concluded that depressed participants do adhere to the same hierarchical search strategy as non-depressed participants when retrieving specific autobiographical memories, but that they terminate their search early, resulting in overgeneral memories.

Suicidal behaviour and cognitive problem solving therapy: theory, application and review

Suicidal behaviour is a major public health problem worldwide, both with regard to mortality and treatment of clients who have deliberately harmed themselves. It is a multifaceted problem resulting from complex interactions between social, biological and psychological factors. There is insufficient evidence on which to make firm recommendations about the most effective forms of treatment This is remarkable considering the extent of the problem worldwide, and the importance of dealing with it appropriately in order to prevent further suicides.

Episodic memories in anxiety disorders: clinical implications

The aim of this review is to summarize research on the emerging role of episodic memories in the context of anxiety disorders (AD). The available literature on explicit, autobiographical, and episodic memory function in AD including neuroimaging studies is critically discussed. We describe the methodological diversity of episodic memory research in AD and discuss the need for novel tests to measure episodic memory in a clinical setting. We argue that alterations in episodic memory functions might contribute to the etiology of AD. We further explain why future research on the interplay between episodic memory function and emotional disorders as well as its neuroanatomical foundations offers the promise to increase the effectiveness of modern psychological treatments. We conclude that one major task is to develop methods and training programs that might help patients suffering from AD to better understand, interpret, and possibly actively use their episodic memories in a way that would support therapeutic interventions and counteract the occurrence of symptoms.

Overgenerality memory style for past and future events and emotions related in bipolar disorder. What are the links with problem solving and interpersonal relationships?

This study investigated patients with Bipolar Disorder's abilities to generate specific past and future events in response to positive and negative cues words as well as emotional intensity related to these ones. The relationships between the number of generated specific events cognitive functioning, interpersonal problems and the ability to problem solving were investigated. Nineteen BD and nineteen healthy controls completed a French version of the AMT to evaluate the past and future events recall, in function of their valence, and emotions related. Furthermore, they completed the Optional Thinking Test, the Inventory of Interpersonal Problems and the neuropsychological measures. Compared to healthy controls, BD recollected (1) fewer specific past negative events and (2) fewer future specific positive and negative events furthermore, (3) they felt more emotional intensity related to future events. These results were explained in the light of theoretical models. Finally, specific past memories deficits in BD were linked with issues in problem solving but not with levels of distress arising from interpersonal problems. In view of AM functions in everyday life, all types of deficits should be taken into consideration, and AM remediation envisaged.

Is self-generated thought a means of social problem solving?

Appropriate social problem solving constitutes a critical skill for individuals and may rely on processes important for self-generated thought (SGT). The aim of the current study was to investigate the link between SGT and social problem solving. Using the Means-End Problem Solving task (MEPS), we assessed participants' abilities to resolve daily social problems in terms of overall efficiency and number of relevant means they provided to reach the given solution. Participants also performed a non-demanding choice reaction time task (CRT) and a moderately-demanding working memory task (WM) as a context in which to measure their SGT (assessed via thought sampling). We found that although overall SGT was associated with lower MEPS efficiency, it was also associated with higher relevant means, perhaps because both depend on the capacity to generate cognition that is independent from the hear and now. The specific content of SGT did not differentially predict individual differences in social problem solving, suggesting that the relationship may depend on SGT regardless of its content. In addition, we also found that performance at the WM but not the CRT was linked to overall better MEPS performance, suggesting that individuals good at social processing are also distinguished by their capacity to constrain attention to an external task. Our results provide novel evidence that the capacity for SGT is implicated in the process by which solutions to social problems are generated, although optimal problem solving may be achieved by individuals who display a suitable balance between SGT and cognition derived from perceptual input.

Differential contributions of executive and episodic memory functions to problem solving in younger and older adults

The relationship of higher order problem solving to basic neuropsychological processes likely depends on the type of problems to be solved. Well-defined problems (e.g., completing a series of errands) may rely primarily on executive functions. Conversely, ill-defined problems (e.g., navigating socially awkward situations) may, in addition, rely on medial temporal lobe (MTL) mediated episodic memory processes. Healthy young (N = 18; M = 19; SD = 1.3) and old (N = 18; M = 73; SD = 5.0) adults completed a battery of neuropsychological tests of executive and episodic memory function, and experimental tests of problem solving. Correlation analyses and age group comparisons demonstrated differential contributions of executive and autobiographical episodic memory function to well-defined and ill-defined problem solving and evidence for an episodic simulation mechanism underlying ill-defined problem solving efficacy. Findings are consistent with the emerging idea that MTL-mediated episodic simulation processes support the effective solution of ill-defined problems, over and above the contribution of frontally mediated executive functions. Implications for the development of intervention strategies that target preservation of functional independence in older adults are discussed.

Modeling bipolar disorder suicidality

OBJECTIVES

To review the psychosocial, neuropsychological, and neurobiological evidence regarding suicide and bipolar disorder (BD), to enable the development of an integrated model that facilitates understanding, and to provide a useful framework for future research.

METHODS

A two-stage literature review was conducted. First, an electronic literature search was performed using key words (e.g., bipolar disorder, suicide risk, and neuroimaging) and standard databases (e.g., MEDLINE). Second, theoretical suicide models were reviewed, and their evidence base and relevance to BD were evaluated in order to determine a guiding theoretical framework for contextualizing suicide in BD.

RESULTS

Although accumulating clinical, cognitive, and neurobiological correlates of suicide have been identified in BD, extant research has been largely atheoretical. The Cry of Pain (CoP) and an adapted version of the model, the Schematic Appraisals Model of Suicide (SAMS), provide a useful schema for examining vulnerability to suicide in BD, by taking into account biopsychosocial determinants of suicidality. In combination, these also provide a model within which the neural correlates of suicide can be integrated.

CONCLUSIONS

The proposed Bipolar Suicidality Model (BSM) highlights the psychosocial precursors to suicidality in BD, while recognizing the key role of cognitive deficits and underlying functional neurobiological abnormalities. It usefully integrates our knowledge, and provides a novel perspective that is intended to meaningfully inform future research initiatives, and can lead to a better understanding of suicidality in bipolar disorder. Ultimately, it is hoped that it will facilitate the development of targeted interventions that diminish the risk of suicide in bipolar disorder.

A Cognitive Attachment Model of prolonged grief: integrating attachments, memory, and identity

Prolonged grief (PG), otherwise known as complicated grief, has attracted much attention in recent years as a potentially debilitating condition that affects approximately 10% of bereaved people. We propose a model of PG that integrates processes of attachment, self-identity, and autobiographical memory. The paper commences with a discussion of the PG construct and reviews current evidence regarding the distinctiveness of PG from other bereavement related-outcomes. We then review the evidence regarding the dysfunctional attachments, appraisals, and coping styles that people with PG display. Recent evidence pertaining to the patterns of autobiographical memory in PG is described in the context of the self-memory system. This system provides a unifying framework to understand the roles of personal memories, identity, attachments, and coping responses in PG. The proposed model places emphasis on how one's sense of identity influences yearning, memories of the deceased, appraisals, and coping strategies, to maintain a focus on the loss. The model is discussed in relation to existing models of PG. The potential for shaping treatment strategies to shift perceptions of the self is then outlined. Finally, we outline future directions to test propositions stemming from the model and enhance our understanding of the mechanisms underlying PG.

Grasping the dynamics of suicidal behaviour: combining time-geographic life charting and COPE ratings

ACCESSIBLE SUMMARY

•  A primary aim of suicide research is to gain a profound knowledge of the suicidal individual so preventive strategy can be formulated. •  Time-geographic life charting used in combination with the pattern of coping strategies may be helpful when assessing risk of suicidal behaviour. •  It can also be a therapeutic intervention to look back and to reflect coping styles.

ABSTRACT

The aim of this study is to explore whether a time-geographic life charting, combined with a survey of a person's coping capacities over time, elucidates the pathway to suicidal behaviour, and therefore could be useful in suicide prevention. Twenty-three patients were recruited shortly after a suicide attempt. A time-geographic life charting and COPE inventory ratings were used separately and in combination. According to COPE ratings, the participants could be divided into three groups using different coping strategies: (1) adaptive, (2) maladaptive, and (3) both adaptive and maladaptive coping. Within these subgroups, three different pathways to suicidal behaviour were described and illustrated. We conclude that time-geographic life charting used in combination with the pattern of coping strategies may be helpful when assessing risk of suicidal behaviour, because this approach strengthens the comprehensive picture of the patient's life situation.

The dynamics of word retrieval in major depression

OBJECTIVE

Impairment in the retrieval of specific episodes from autobiographical memory is commonly observed in major depression. However, it is unclear whether impairment in retrieval processes is a general characteristic of major depression or is confined to the recollection of personal memories. This study examined the time course of the retrieval of words from semantic memory.

METHOD

A letter fluency test was administered to 65 inpatients with major depression and 50 healthy controls. A two-parameter model was fit to the decay curve representing the production of words over a 90-second period. One parameter, N, is an estimate of the total number of words that would be generated if the respondent was given unlimited time. The other, tau, is the average of the difference in time between the first word generated and each subsequent word.

RESULTS

There was evidence of a deficit in the retrieval of words from long-term memory in depressed patients. The significant difference between groups suggested that even if given an extended period of time in which to respond to compensate for possible slowness, the depressed group would not retrieve as many words as the controls. The retrieval failure could not be attributed solely to cognitive slowing or the effects of antidepressant medication.

CONCLUSIONS

The results extend findings of a deficit in the process of retrieving specific episodes from autobiographical memory and suggest that a generalised impairment in memory retrieval may be characteristic of major depression.

Autobiographical memory and differentiation of schematic models in substance-dependent patients

BACKGROUND AND OBJECTIVES

This study aims at investigating reduced autobiographical memory specificity in substance-dependent patients. We examined whether this phenomenon is related to undifferentiated schematic models of self and to depression and anxiety levels. We also investigated the maintenance of these impairments after early clinical remission.

METHODS

Seventy-three dependent patients (including 30 active users, 23 methadone-maintained patients, 20 early abstinent patients) and 31 control participants were given Williams' and Scott's Autobiographical Memory Test (AMT) to evaluate the level of memory specificity. Depression and anxiety levels were assessed with the Hospital Anxiety and Depression Scale (HADS), and the ability of differentiation in affect-related schematic models of self with the Level of Emotional Awareness Scale (LEAS).

RESULTS

Dependent patients recall less specific memories than control individuals to the AMT. For all the participants, only the ability to differentiate emotional states predicts the level of specificity, whereas reduced specificity is not linked to depression and anxiety levels. The results also show that reduced specificity is still observable in methadone-maintained patients and in abstinent patients.

LIMITATIONS

Despite the absence of difference in the level of memory specificity in the three groups of dependent patients, we cannot state that reduced memory specificity is stable over time because non-active consumers may not remain in remission for a long period.

CONCLUSIONS

Only a lack of emotional differentiation seems to impede the access to specific memories in dependent patients and in general population. The reduced memory specificity observed in dependent patients seems to last after recent clinical improvement.

Reduced memory specificity predicts the acquisition of problem solving skills in psychoeducation

BACKGROUND AND OBJECTIVES

Research has shown that overgeneral autobiographical memory (OGM) is a valid predictor for the course of depression. It is not known, however, whether OGM also moderates information uptake and consolidation in a psychoeducation program to prevent stress, anxiety and depression. The present study was designed to investigate whether the Autobiographical Memory Test (AMT; Williams, & Broadbent, 1986) is a valid predictor for the actual unfolding of skills learned through psychoeducation.

METHODS

The questionnaire included primarily the AMT and the Stress Anxiety Depression Means-Ends Problem Solving Questionnaire (SAD-MEPS). It was filled in prior to and after the psychoeducational course by 23 participants.

RESULTS

Correlations were calculated for the AMT at baseline and the differences between the pre and post measurements on the SAD-MEPS. Significant correlations were observed between the number of specific responses and the changes in the number of relevant means (r = .49, p < .01).

LIMITATIONS

The sample size was rather small, but several checks were able to reduce the chance of spurious findings.

CONCLUSIONS

These findings may have important implications for the guidance to and the setup of psychoeducational interventions. Suggestions include screening and memory specificity training prior to course commencement.

The effects of imagery on problem-solving ability and autobiographical memory

Williams et al. (2006) found that increased imageability of cue words during an autobiographical memory task increased specificity of autobiographical memory (ABM) and improved subsequent social problem-solving (SPS). This study explored whether imagery during SPS improved SPS skill, perceived SPS ability, and the specificity of ABMs retrieved in the process of SPS in dysphoric students. Additionally, this study hypothesised that both memory specificity and perceived SPS ability would positively correlate with SPS skill. Dysphoric and non-dysphoric students solved hypothetical social problems on a modified version of the Means-End Problem-Solving task with a verbal or an imagery focus. Participants also completed a questionnaire about ABMs retrieved during SPS and rated their perceived effectiveness of their solutions. Contrary to Williams et al. (2006), the imagery focus did not improve SPS skill or influence perceived effectiveness. Additionally, in contrast to the hypothesis, the imagery group retrieved more overgeneral memories. Finally, ABM specificity did not correlate with SPS skill. However, dysphoric participants perceived specific memories to be significantly less helpful to SPS whereas non-dysphoric participants perceived specific memories to be helpful potentially supporting work on overgeneral ABM and functional avoidance.

Generalization of conditioned responding: effects of autobiographical memory specificity

Generalization of acquired responses appears to be a crucial, yet under investigated process in emotional disorders. Generalization occurs when a conditioned response is elicited by a stimulus different from the original conditioned stimulus. The expansion of complaints, often seen in emotional disorders, is at least in part due to processes of generalization. In the present study, generalization is approached from a memory perspective. It is hypothesized that generalization of conditioned responding is associated with autobiographical memory specificity. Higher levels of generalization are predicted for people who are characterized by limited memory specificity. In a human contingency-learning procedure, participants learned the association between two pictures of female faces and a schematic drawing of a lightning bolt. Subsequently, six morphed pictures functioning as generalization stimuli (GSs) were introduced and conditioned responses to these GSs were measured. The results showed that memory specificity was significantly associated with the extent of generalization. Participants low in autobiographical memory specificity exhibited significantly stronger conditioned responses to GSs as compared to participants high in autobiographical memory specificity.

Cognitive and neural aspects of information processing in major depressive disorder: an integrative perspective

Researchers using experimental paradigms to examine cognitive processes have demonstrated that Major Depressive Disorder (MDD) is associated not with a general deficit in cognitive functioning, but instead with more specific anomalies in the processing of negatively valenced material. Indeed, cognitive theories of depression posit that negative biases in the processing of information play a critical role in influencing the onset, maintenance, and recurrence of depressive episodes. In this paper we review findings from behavioral studies documenting that MDD is associated with specific difficulties in attentional disengagement from negatively valenced material, with tendencies to interpret information in a negative manner, with deficits in cognitive control in the processing of negative material, and with enhanced memory for negative material. To gain a better understanding of the neurobiological basis of these abnormalities, we also examine findings from functional neuroimaging studies of depression and show that dysfunction in neural systems that subserve emotion processing, inhibition, and attention may underlie and contribute to the deficits in cognition that have been documented in depressed individuals. Finally, we briefly review evidence from studies of children who are at high familial risk for depression that indicates that abnormalities in cognition and neural function are observable before the onset of MDD and, consequently, may represent a risk factor for the development of this disorder. By integrating research from cognitive and neural investigations of depression, we can gain a more comprehensive understanding not only of how cognitive and biological factors interact to affect the onset, maintenance, and course of MDD, but also of how such research can aid in the development of targeted strategies for the prevention and treatment of this debilitating disorder.

Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide

BACKGROUND

Cognitive therapy has been found to be effective in decreasing the recurrence of suicide attempts. A theoretical aim of cognitive therapy is to improve problem-solving skills so that suicide no longer remains the only available option. This study examined the differential rate of change in problem-solving appraisal following suicide attempts among individuals who participated in a randomized controlled trial for the prevention of suicide.

METHOD

Changes in problem-solving appraisal from pre- to 6-months post-treatment in individuals with a recent suicide attempt, randomized to either cognitive therapy (n = 60) or a control condition (n = 60), were assessed by using the Social Problem-Solving Inventory-Revised, Short Form.

RESULTS

Improvements in problem-solving appraisal were similarly observed for both groups within the 6-month follow-up. However, during this period, individuals assigned to the cognitive therapy condition demonstrated a significantly faster rate of improvement in negative problem orientation and impulsivity/carelessness. More specifically, individuals receiving cognitive therapy were significantly less likely to report a negative view toward life problems and impulsive/carelessness problem-solving style.

CONCLUSIONS

Cognitive therapy for the prevention of suicide provides rapid changes within 6 months on negative problem orientation and impulsivity/carelessness problem-solving style. Given that individuals are at the greatest risk for suicide within 6 months of their last suicide attempt, the current study demonstrates that a brief cognitive intervention produces a rapid rate of improvement in two important domains of problem-solving appraisal during this sensitive period.