Autobiographical memory specificity and emotional disorder.

The authors review research showing that when recalling autobiographical events, many emotionally disturbed patients summarize categories of events rather than retrieving a single episode. The mechanisms underlying such overgeneral memory are examined, with a focus on M. A. Conway and C. W. Pleydell-Pearce's (2000) hierarchical search model of personal event retrieval. An elaboration of this model is proposed to account for overgeneral memory, focusing on how memory search can be affected by (a) capture and rumination processes, when mnemonic information used in retrieval activates ruminative thinking; (b) functional avoidance, when episodic material threatens to cause affective disturbance; and (c) impairment in executive capacity and control that limits an individual's ability to remain focused on retrieval in the face of distraction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sudden gains in cognitive therapy of depression and depression relapse/recurrence.

Cognitive therapy (CT) may have significant advantages over antidepressants in preventing depression relapses. Many CT patients experience sudden gains: large symptom improvement in 1 between-session interval. Past studies have associated CT sudden gains with in-session cognitive changes but not with life events. This study examined sudden gains and depression relapse/recurrence among 60 CT clinical-trial patients. Survival analyses showed that only one third of sudden-gain-responders relapsed in 2 years, and they had 74% lower relapse risks than did non-sudden-gain-responders. Among patients with sustained responses, 73% experienced sudden gains. The authors also replicated J. R. Vittengl, L. A. Clark, and R. B. Jarrett's (see record 2005-01321-021) finding that sudden gains identified with their unique criteria did not predict relapse. The current authors' findings suggest that CT sudden gains are not measurement artifacts, and that sudden gains and their causes and consequences might be important in preventing relapses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduced autobiographical memory specificity and rumination in predicting the course of depression.

Reduced autobiographical memory (AM) specificity is a known vulnerability factor for depression. AM specificity was investigated as a predictor of depression with the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986). When baseline depression scores were partialed, reduced AM specificity to negative cue words predicted higher levels of depression at 7-month follow-up. Once rumination was taken into account by means of the Rumination on Sadness Scale (M. Conway, P. A. R. Csank, S. L. Holm, & C. K. Blake, 2000), AM specificity no longer predicted depression, suggesting that the predictive value of AM specificity observed in previous studies might be--at least partly--explained as an effect of rumination. Further mediation analyses indeed revealed support for rumination as a mediator of the relation between reduced AM specificity and poor outcome of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduced specificity of autobiographical memory in Cluster C personality disorders and the role of depression, worry, and experiential avoidance.

The study objective was to investigate whether, compared with nonclinical controls, participants with an avoidant, dependent, or obsessive–compulsive Cluster C personality disorder (PD) manifested reduced levels of memory specificity and whether the association of Cluster C PDs with memory specificity is mediated by repetitive negative thoughts and experiential avoidance. The Autobiographical Memory Test (R. J. McNally, N. B. Lasko, M. L. Macklin, & R. K. Pitman, 1995) was administered along with self-report measures (translated into Dutch) for repetitive, uncontrollable, and negative thinking in the form of worry (Penn State Worry Questionnaire; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D. Borkovec, 1990) and experiential avoidance (Acceptance and Action Questionnaire; S. C. Hayes et al., 2004) to 294 clinical participants diagnosed with Axis I disorders (assessed with the Structured Clinical Interview for DSM–IV Axis I Disorders [SCID-I]; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1994) and Axis II disorders (assessed with the SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 1997)—202 with avoidant, 49 with dependent, and 120 with obsessive–compulsive PD—and to 108 matched nonclinical controls. Participants with a Cluster C PD showed lower levels of memory specificity than did nonclinical controls. Depression and worry mediated the effect of Cluster C PDs on memory specificity. Besides depression severity, repetitive, uncontrollable, and negative thinking may constitute a general mechanism mediating the association of various Axis I and II disorders with memory specificity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduced specificity of autobiographical memory and depression: The role of executive control.

It has been widely established that depressed mood states and clinical depression, as well as a range of other psychiatric disorders, are associated with a relative difficulty in accessing specific autobiographical information in response to emotion-related cue words on an Autobiographical Memory Test (AMT; J. M. G. Williams & K. Broadbent, 1986). In 8 studies the authors examined the extent to which this relationship is a function of impaired executive control associated with these mood states and clinical disorders. Studies 1-4 demonstrated that performance on the AMT is associated with performance on measures of executive control, independent of depressed mood. Furthermore, Study 1 showed that executive control (as measured by verbal fluency) mediated the relationship between both depressed mood and a clinical diagnosis of eating disorder and AMT performance. Using a stratified sample in Study 5, the authors confirmed the positive association between depressed mood and impaired performance on the AMT. Studies 6-8 involved experimental manipulations of the parameters of the AMT designed to further indicate that reduced executive control is to a significant extent driving the relationship between depressed mood and AMT performance. The potential role of executive control in accounting for other aspects of the AMT literature is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Care of others and self: A suicidal patient's impact on the psychologist.

Professional psychologists can be profoundly affected by their patients and must know how to take care of themselves physically and emotionally while delivering effective treatment. In this paper, I examine the effects of one patient on my personal and professional lives. Over the course of 2 years, the patient experienced numerous losses and became deeply depressed. Her symptoms included suicidal urges and self-harm (cutting). I describe the impact of the patient's life events on the therapy and on me as the therapist. I enumerate self-care strategies that preserved my ability to treat the patient without becoming distressed or impaired by the demands of the case. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression.

This research examined whether cognitive behavioral therapy and mindfulness interventions that target responses to chronic stress, pain, and depression reduce pain and improve the quality of everyday life for adults with rheumatoid arthritis (RA). The 144 RA participants were clustered into groups of 6-10 participants and randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P); mindfulness meditation and emotion regulation therapy (M); or education-only group (E), which served as an attention placebo control. The authors took a multimethod approach, employing daily diaries and laboratory assessment of pain and mitogen-stimulated levels of interleukin-6 (IL-6), a proinflammatory cytokine. Participants receiving P showed the greatest Pre to Post improvement in self-reported pain control and reductions in the IL-6; both P and M groups showed more improvement in coping efficacy than did the E group. The relative value of the treatments varied as a function of depression history. RA patients with recurrent depression benefited most from M across several measures, including negative and positive affect and physicians' ratings of joint tenderness, indicating that the emotion regulation aspects of that treatment were most beneficial to those with chronic depressive features. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autobiographical memory in the euthymic phase of recurrent depression.

The authors investigated autobiographical memory specificity in subjects who formerly had depression. In 122 euthymic patients with at least two previous major depressive episodes, memory specificity was significantly impaired compared to matched control participants but not related to residual symptoms and illness characteristics, was not differentially affected by cognitive therapy, and was also not predictive of relapse/recurrence during the 2-year follow-up. However, memory specificity was associated with age, education, and immediate and delayed memory recall. The results suggest that memory specificity may reflect a global cognitive impairment that remains in patients who (formerly) had depression but does not constitute a trait marker for vulnerability for relapse/recurrence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the protective effects of mindfulness training on working memory capacity and affective experience.

We investigated the impact of mindfulness training (MT) on working memory capacity (WMC) and affective experience. WMC is used in managing cognitive demands and regulating emotions. Yet, persistent and intensive demands, such as those experienced during high-stress intervals, may deplete WMC and lead to cognitive failures and emotional disturbances. We hypothesized that MT may mitigate these deleterious effects by bolstering WMC. We recruited 2 military cohorts during the high-stress predeployment interval and provided MT to 1 (MT, n = 31) but not the other group (military control group, MC, n = 17). The MT group attended an 8-week MT course and logged the amount of out-of-class time spent practicing formal MT exercises. The operation span task was used to index WMC at 2 testing sessions before and after the MT course. Although WMC remained stable over time in civilians (n = 12), it degraded in the MC group. In the MT group, WMC decreased over time in those with low MT practice time, but increased in those with high practice time. Higher MT practice time also corresponded to lower levels of negative affect and higher levels of positive affect (indexed by the Positive and Negative Affect Schedule). The relationship between practice time and negative, but not positive, affect was mediated by WMC, indicating that MT-related improvements in WMC may support some but not all of MT’s salutary effects. Nonetheless, these findings suggest that sufficient MT practice may protect against functional impairments associated with high-stress contexts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The early course of depression: A longitudinal investigation of prodromal symptoms and their relation to the symptomatic course of depressive episodes.

The present study explored longitudinal evidence for prodromal symptoms of depression episodes. A model based on previous findings of the relations between prodromal and residual symptoms was described and used to generate hypotheses tested in this study. Data were analyzed from 160 participants from the Cognitive Vulnerability to Depression (CVD) project (L. Alloy & L. Abramson, 1999) who experienced an episode of depression during the prospective follow-up period and 60 CVD participants who did not. Congruent with the hypothesis, individuals who subsequently developed an episode of depression experienced significantly greater numbers of depression symptoms in the period of time leading up to the acute episode compared with those who did not develop a depressive episode. Seven depression symptoms were particularly likely to appear before the onset of an acute episode. Furthermore, all 3 predictions from the model were supported: the durations of prodromal and residual phases were correlated, the prodromal and residual symptom profiles were quite similar, and the order of symptom onset was significantly and highly negatively correlated with the order of symptom remission. Additionally, residual symptom profiles were similar to subsequent prodromal symptom profiles in individuals who experienced more than 1 depressive episode. These findings are discussed in terms of the importance of understanding the earliest prodromal symptoms to appear and their relation to the symptomatic course of depression episodes. Implications for early intervention are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dispositional mindfulness and depressive symptomatology: Correlations with limbic and self-referential neural activity during rest.

To better understand the relationship between mindfulness and depression, we studied normal young adults (n = 27) who completed measures of dispositional mindfulness and depressive symptomatology, which were then correlated with (a) rest: resting neural activity during passive viewing of a fixation cross, relative to a simple goal-directed task (shape-matching); and (b) reactivity: neural reactivity during viewing of negative emotional faces, relative to the same shape-matching task. Dispositional mindfulness was negatively correlated with resting activity in self-referential processing areas, whereas depressive symptomatology was positively correlated with resting activity in similar areas. In addition, dispositional mindfulness was negatively correlated with resting activity in the amygdala, bilaterally, whereas depressive symptomatology was positively correlated with activity in the right amygdala. Similarly, when viewing emotional faces, amygdala reactivity was positively correlated with depressive symptomatology and negatively correlated with dispositional mindfulness, an effect that was largely attributable to differences in resting activity. These findings indicate that mindfulness is associated with intrinsic neural activity and that changes in resting amygdala activity could be a potential mechanism by which mindfulness-based depression treatments elicit therapeutic improvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.

Objective: Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. Method: We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions. Results: Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges’s g = 0.63) and mood symptoms (Hedges’s g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges’s g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up. Conclusions: These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of mindfulness in predicting individual performance.

Mindfulness refers to an individual difference variable regarding the degree to which a person is in the present moment (K. W. Brown & R. M. Ryan, 2003). Despite a growing interest in the benefits of mindfulness in health and clinical outcomes, little research has explored whether mindfulness relates to individual performance. The authors examined whether mindfulness was related to performance among a group of MBA students (N = 149). The results show that mindfulness interacted with gender to predict performance. Specifically, the positive association between mindfulness and performance was stronger for women than for men. Implications and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Language-based measures of mindfulness: Initial validity and clinical utility.

This study examined relationships among language use, mindfulness, and substance-use treatment outcomes in the context of an efficacy trial of mindfulness-based relapse prevention (MBRP) for adults with alcohol and other drug use (AOD) disorders. An expert panel generated two categories of mindfulness language (ML) describing the mindfulness state and the more encompassing “mindfulness journey,” which included words describing challenges of developing a mindfulness practice. MBRP participants (n = 48) completed baseline sociodemographic and AOD measures, and participated in the 8-week MBRP program. AOD data were collected during the 4-month follow-up. A word count program assessed the frequency of ML and other linguistic markers in participants’ responses to open-ended questions about their postintervention impressions of mindfulness practice and MBRP. Findings supported concurrent validity of ML categories: ML words appeared more frequently in the MBRP manual compared to the 12-step Big Book. Further, ML categories correlated with other linguistic variables related to the mindfulness construct. Finally, predictive validity was supported: greater use of ML predicted fewer AOD use days during the 4-month follow-up. This study provided initial support for ML as a valid, clinically useful mindfulness measure. If future studies replicate these findings, ML could be used in conjunction with self-report to provide a more complete picture of the mindfulness experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autobiographical memory specificity after manipulating retrieval cues in adults reporting childhood sexual abuse.

Traumatized samples have relative difficulty in generating specific autobiographical memories on a cue word task, compared to nonexposed controls. Simultaneously, trauma is associated with highly specific intrusive trauma memories in day-to-day life. Possibly, day-to-day intrusions and memories generated to cue words rely on different retrieval processes, with the former dependent on close associations between retrieval cues and specific memory representations (direct retrieval), and the latter on iterative retrieval cycles through a hierarchical memory system (generative retrieval). This study investigated this distinction using two versions of the cue word task, designed to promote generative and direct retrieval, respectively, in participants with or without a history of child sexual abuse (CSA). The data demonstrated that CSA participants were less specific than nonabused controls to generative retrieval cues, but this difference disappeared with direct retrieval cues. This interaction was stronger in CSA participants with relatively greater posttraumatic stress and remained significant when participants with past or current major depressive disorder were excluded and also when only those participants with corroborated CSA were included. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention.

Objective: A strong relation between negative affect and craving has been demonstrated in laboratory and clinical studies, with depressive symptomatology showing particularly strong links to craving and substance abuse relapse. Mindfulness-based relapse prevention (MBRP), shown to be efficacious for reduction of substance use, uses mindfulness-based practices to teach alternative responses to emotional discomfort and lessen the conditioned response of craving in the presence of depressive symptoms. The goal in the current study was to examine the relation between measures of depressive symptoms, craving, and substance use following MBRP. Method: Individuals with substance use disorders (N = 168; mean age 40.45 years, SD = 10.28; 36.3% female; 46.4% non-White) were recruited after intensive stabilization, then randomly assigned to either 8 weekly sessions of MBRP or a treatment-as-usual control group. Approximately 73% of the sample was retained at the final 4-month follow-up assessment. Results: Results confirmed a moderated-mediation effect, whereby craving mediated the relation between depressive symptoms (Beck Depression Inventory) and substance use (Timeline Follow-Back) among the treatment-as-usual group but not among MBRP participants. MBRP attenuated the relation between postintervention depressive symptoms and craving (Penn Alcohol Craving Scale) 2 months following the intervention (?2 = .21). This moderation effect predicted substance use 4 months following the intervention (?2 = .18). Conclusion: MBRP appears to influence cognitive and behavioral responses to depressive symptoms, partially explaining reductions in postintervention substance use among the MBRP group. Although results are preliminary, the current study provides evidence for the value of incorporating mindfulness practice into substance abuse treatment and identifies a potential mechanism of change following MBRP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of coping-oriented couples therapy on depression: A randomized clinical trial.

The aim of this study was to evaluate the effectiveness of treating depression with coping-oriented couples therapy (COCT) as compared with cognitive-behavioral therapy (CBT; A. T. Beck, C. Ward, & M. Mendelson, 1961) and interpersonal psychotherapy (IPT; M. M. Weissman, J. C. Markowitz, & G. L. Klerman, 2000). Sixty couples, including 1 clinically depressed partner, completed pre- and posttest questionnaires as well as follow-up assessments at 6-month intervals over the subsequent 1.5 years. Effects of the 3 treatments on depressive symptomatology assessed by the Beck Depression Inventory (A. T. Beck, A. J. Rush, B. L. Shaw, & G. Emery, 1979) and Hamilton Rating Scale for Depression (M. Hamilton, 1960); recovery rates; and relapse rates were examined. Additionally, changes in relationship quality were evaluated. Results suggest that the COCT is as effective in improving depressive symptomatology as are the well-established, evidenced-based CBT and IPT approaches. The COCT did not demonstrate a significantly better outcome with regard to self-reported relationship satisfaction or dyadic coping; however, it did produce significant improvements in partners' expressed emotion, changes that were not seen in other treatment conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical explorations of mindfulness: Conceptual and methodological conundrums.

This commentary reflects on the articles in this Special Issue. The appearance of this group of articles underscores the important idea that a major target of mindfulness practice is on emotion. Transformation in trait affect is a key goal of all contemplative traditions. This commentary addresses several key methodological and conceptual issues in the empirical study of mindfulness. The many ways in which the term “mindfulness” is used in the articles in this Special Issue are noted, and they include its reference to states, traits, and independent variables that are manipulated in an experimental context. How the term “mindfulness” is conceptualized and operationalized is crucial, and for progress to be made it is essential that we qualify the use of this term by reference to how it is being operationalized in each context. Other methodological issues are considered, such as the duration of training and how it should be measured, and the nature of control and comparison groups in studies of mindfulness-based interventions. Finally, the commentary ends with a consideration of the targets within emotion processing that are likely to be impacted by mindfulness. This collection of articles underscores the substantial progress that has occurred in the empirical study of mindfulness and it is a harbinger of a very promising future in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impairment in risk-sensitive decision-making in older suicide attempters with depression.

Suicidal behavior is a potentially lethal complication of late-life depression. In younger adults, suicide has been linked to abnormal decision-making ability. Given that there are substantial age-related decreases in decision-making ability, and that older adults experience environmental stressors that require effective decision-making, we reasoned that impaired decision-making may be particularly relevant to suicidal behavior in the elderly. We thus compared performance on a probabilistic decision-making task that does not involve working memory (“Cambridge Gamble Task”) in four groups of older adults: (1) individuals with major depression and a history of suicide attempt (n = 25), (2) individuals with major depression with active suicidal ideation but no suicide attempt (n = 13), (3) individuals with major depression without suicidality (n = 35), and (4) nondepressed control subjects (n = 22). There was a significant effect of group on quality of decision-making, whereby the suicide attempters exhibited poorer ability to choose the likely outcome, compared with the nonsuicidal depressed and nondepressed comparison subjects. There were no group differences in betting behavior. The suicide attempters differed in several aspects of social problem-solving on a self-report scale. Quality of decision-making was negatively correlated with the score on the impulsive/careless problem-solving subscale. These data suggest that older suicide attempters have a deficit in risk-sensitive decision-making, extending observations in younger adults. More specifically, older suicide attempters seem to neglect outcome probability and make poor choices. These impairments may precipitate and perpetuate suicidal crisis in depressed elders. Identification of decision-making impairment in suicidal elders may help with designing effective interventions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Encoding specificity in interpersonal communication.

The article reports two experiments that assess the adequacy of some people's encodings as cues for other people's semantic retrieval. The central finding is of encoding specificity. That is, encodings dedicated to some discriminative purpose are less effective for discriminations that are either more precise or more general than the intended one. The theoretical focus of the article regards parallels between episodic memory and interpersonal communication. An effective communication is one that transfers well from the initial encoding context to the discriminative context in which the message is received. An effective memory encoding is one that transfers well from the study context to the retrieval environment. Thus transfer-appropriate processing benefits both sorts of task relative to transfer-inappropriate processing, and the characteristics that determine the appropriateness of processing are importantly similar in memory and communication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)