Reduced autobiographical memory specificity and affect regulation

Effect of low-dose acute tryptophan depletion on the specificity of autobiographical memory in healthy subjects with a family history of depression

RATIONALE

Low-dose acute tryptophan depletion (LD-ATD), while having no effect on mood, has been shown to reduce specificity of autobiographical memory in patients who have recovered from a depressive episode.

OBJECTIVES

This study aimed to explore if reduced specificity of autobiographical memory with LD-ATD is common to other groups of individuals at risk of depression, specifically a healthy population with a family history of depression.

METHODS

Nineteen healthy young adults with at least one first-degree relative with a history of major depression were recruited. LD-ATD drinks containing 1.15 g of tryptophan (T+) or no tryptophan (T−) were administered on two separate occasions, in a double blind random order crossover design. The Autobiographical Memory Test (AMT) was administered 5 h after drink administration.

RESULTS

Analysis of variance revealed a significant difference in the effects of LD-ATD drinks on plasma free tryptophan with no mood change with either drink. There was no within-subject main effect of LD-ATD on the memory task. However, there was a main effect of order of drink. Exploratory analysis of visit 1 data indicated a large between-subject effect (d=1.4) of LD-ATD on AMT with T− associated with less specificity in response to negative cue words (F(1, 17)08.71, p=0.009).

CONCLUSIONS

Similar to findings following recovery from depression, LD-ATD can reduce specificity of AMT in the absence of lowered mood in healthy individuals with a strong family history of depression. These findings may reflect a 5-HT-dependent cognitive vulnerability to depression in different populations and warrant further research.

A brief guided self-help intervention for psychological distress in palliative care patients: a randomised controlled trial

BACKGROUND

Previous findings implicated rumination (recurrent dwelling on abstract concerns) in elevated psychological distress in palliative patients. We hypothesised that reducing rumination may be important in addressing psychological distress in palliative care.

AIM

This study tested the prediction that a brief guided self-help technique targeting abstract rumination would reduce psychological distress in palliative patients.

DESIGN

A randomised controlled trial evaluated 4 weeks of guided self-help that involved patients practising thinking more concretely by recalling specific and vivid memories of when they were completely absorbed in an activity or scene. Participants completed a combination of standardised questionnaires to assess anxiety, depression, and quality of life.

SETTING/PARTICIPANTS

Palliative care patients who were reporting clinically significant psychological distress, whilst also physically well enough to take part in the trial were recruited from hospices in Devon and Somerset and randomised to either a treatment condition (n = 19) receiving 4 weeks of guided self-help, or a waiting-list control condition (n = 15) receiving treatment as usual.

RESULTS

As predicted, the palliative patients receiving the intervention reported significantly greater reductions in anxiety than the waiting-list controls (F(1,23) = 20.55, p < 0.001, partial η (2) = 0.47). However, no significant effect was found on depression or quality of life.

CONCLUSION

The findings suggest that a brief guided self-help intervention based on concreteness training can be effective in addressing anxiety in palliative care.

40,000 memories in young teenagers: psychometric properties of the Autobiographical Memory Test in a UK cohort study

Although the Autobiographical Memory Test (AMT) is widely used its psychometric properties have rarely been investigated. This paper utilises data gathered from a 10-item written version of the AMT, completed by 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children, to examine the psychometric properties of the measure. The results show that the scale derived from responses to the AMT operates well over a wide range of scores, consistent with the aim of deriving a continuous measure of over-general memory. There was strong evidence of group differences in terms of gender, low negative mood, and IQ, and these were in agreement when comparing an item response theory (IRT) approach with that based on a sum score. One advantage of the IRT model is the ability to assess and consequently allow for differential item functioning. This additional analysis showed evidence of response bias for both gender and mood, resulting in attenuation in the mean differences in AMT across these groups. Implications of the findings for the use of the AMT measure in different samples are discussed.

The mechanisms underlying overgeneral autobiographical memory: an evaluative review of evidence for the CaR-FA-X model

Overgeneral autobiographical memory (OGM) has been found to be an important cognitive phenomenon with respect to depression and trauma-related psychopathology (e.g., posttraumatic stress disorder), and researchers have been interested in better understanding the factors that contribute to this proposed vulnerability factor. The most prominent model of mechanisms underlying OGM to date is Williams et al.'s (2007) CaR-FA-X model. This model proposes that three processes influence OGM: capture and rumination, functional avoidance, and impaired executive control. The author reviews the current state of support for the CaR-FA-X model by evaluating 38 studies that have examined OGM and one or more mechanisms of the model. Collectively, these studies reveal robust support for associations between OGM and both rumination and impaired executive control. OGM also appears to be a cognitive avoidance strategy, and there is evidence that avoiding the retrieval of specific memories reduces distress after an aversive event, at least in the short term. Important issues that have been left unresolved are highlighted, including the nature of the capture phenomenon, the role of trauma in functional avoidance, and the developmental nature of functional avoidance. Recommendations for future research that will enhance understanding of the factors that contribute to OGM are suggested.

Overgeneral autobiographical memory effect in older depressed adults

OBJECTIVES

This research aims to investigate the characteristics of autobiographical retrieval in a group of older depressed adults compared with a control group of the same age.

METHOD

The sample was recruited from local primary care services. All participants were administered a demographic questionnaire and completed the Mini-Mental State Examination (MMSE; Lobo, A., Ezquerra, J., Gómez-Burgada, F., Sala, J.M., & Seva-Díaz, A. (1979). El Mini-Examen Cognoscitivo: Un test sencillo y práctico para detectar alteraciones intelectuales en pacientes médicos. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencia, 3, 189-202), the Life Satisfaction Index (LSI; Stock, W., Okun, M., & Gómez, J. (1994). Subjective well-being measures: Reliability and validity among Spanish elders. International Journal of Aging and Human Development, 38, 221-235), and the Beck Hopelessness Scale (BHS; Beck, A.T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861-865). Finally, all participants completed the Autobiographical Memory Test (AMT; Williams, J.M.G., & Broadbent, K. (1986). Autobiographical memory in suicide attempters. Journal of Abnormal Psychology, 95, 144-149).

RESULTS

Older adults with depression were less specific in their memories than the controls. Higher categoric retrieval for negative cue words compared with positive cue words was only found for older adults with depression. Specific retrieval in the group without depression was positively related to Life Satisfaction and negatively to hopelessness.

CONCLUSION

The overgeneral effect appeared for older adults with depression due to the higher presence of extended memories (events lasting for more than 24 h) rather than categoric retrievals (summary of repeated events). The strong correlation between specific memories and Life Satisfaction among non-depressed older adults suggests its potential role as a protective factor for depression.

Autobiographical memory following cognitive behaviour therapy for complicated grief

A deficit in the ability to retrieve specific autobiographical memories has been linked to a number of negative consequences, including poor problem solving skills, reduced ability to imagine the future, and the onset of symptoms following trauma. This study investigated the impact of cognitive behaviour therapy (CBT) on memory retrieval specificity in patients with Complicated Grief (CG). Twenty individuals with CG who were seeking treatment were administered an autobiographical memory task (AMT) before and after completing a 10-week CBT program. Pre-treatment retrieval specificity did not predict treatment outcome. However, there was a significant correlation between symptom reduction and increased specific retrieval to positive cues following treatment. These results suggest that overgeneral retrieval in CG can be modified by CBT, and may point to one means by which CBT can alleviate CG symptoms.

Dysregulation in level of goal and action identification across psychological disorders

Goals, events, and actions can be mentally represented within a hierarchical framework that ranges from more abstract to more concrete levels of identification. A more abstract level of identification involves general, superordinate, and decontextualized mental representations that convey the meaning of goals, events, and actions, "why" an action is performed, and its purpose, ends, and consequences. A more concrete level of identification involves specific and subordinate mental representations that include contextual details of goals, events, and actions, and the specific "how" details of an action. This review considers three lines of evidence for considering that dysregulation of level of goal/action identification may be a transdiagnostic process. First, there is evidence that different levels of identification have distinct functional consequences and that in non-clinical samples level of goal/action identification appears to be regulated in a flexible and adaptive way to match the level of goal/action identification to circumstances. Second, there is evidence that level of goal/action identification causally influences symptoms and processes involved in psychological disorders, including emotional response, repetitive thought, impulsivity, problem solving and procrastination. Third, there is evidence that the level of goal/action identification is biased and/or dysregulated in certain psychological disorders, with a bias towards more abstract identification for negative events in depression, GAD, PTSD, and social anxiety.

Cognitive processing specificity of anxious apprehension: impact on distress and performance during speech exposure

The present study examined the impact of different modes of processing anxious apprehension on subsequent anxiety and performance in a stressful speech task. Participants were informed that they would have to give a speech on a difficult topic while being videotaped and evaluated on their performance. They were then randomly assigned to one of three conditions. In a specific processing condition, they were encouraged to explore in detail all the specific aspects (thoughts, emotions, sensations) they experienced while anticipating giving the speech; in a general processing condition, they had to focus on the generic aspects that they would typically experience during anxious anticipation; and in a control, no-processing condition, participants were distracted. Results revealed that at the end of the speech, participants in the specific processing condition reported less anxiety than those in the two other conditions. They were also evaluated by judges to have performed better than those in the control condition, who in turn did better than those in the general processing condition.

Autobiographical memory functioning among abused, neglected, and nonmaltreated children: the overgeneral memory effect

BACKGROUND

This investigation addresses whether there are differences in the form and content of autobiographical memory recall as a function of maltreatment, and examines the roles of self-system functioning and psychopathology in autobiographical memory processes.

METHODS

Autobiographical memory for positive and negative nontraumatic events was evaluated among abused, neglected, and nonmaltreated school-aged children.

RESULTS

Abused children's memories were more overgeneral and contained more negative self-representations than did those of the nonmaltreated children. Negative self-representations and depression were significantly related to overgeneral memory, but did not mediate the relation between abuse and overgeneral memory.

CONCLUSIONS

The meaning of these findings for models of memory and for the development of overgenerality is emphasized. Moreover, the clinical implications of the current research are discussed.

Regulating emotion during imaginal exposure to social anxiety: impact of the specificity of information processing

The present study investigates the emotional impact of a specific vs. generic mode of information processing during imaginal exposure. Forty-nine socially anxious students mentally relived a personally experienced stressful social situation. Half of the participants were instructed to activate generic elements of the target event (i.e., elements repetitively experienced in similar social situations); the other half had to recall the specific features of the target event. Results showed that participants who focused on specific elements reported less distress than those who focused on generic features. Clinical implications are discussed.

Autobiographical memory specificity and affect regulation: coping with a negative life event

Two decades of research have shown that depressed patients experience significant difficulties retrieving specific autobiographical memories. Importantly, reduced autobiographical memory (AM) specificity is a known vulnerability factor for depression and is predictive of a more chronic course. One of the models that has been put forward to explain the origin of this reduced specificity is the affect-regulation model, which assumes that being less specific might help to prevent negative or painful emotions by recalling events in a less specific way. This avoidant memory style might have beneficial effects in the short run (less emotional impact of stressful events) but is detrimental in the long run. The affect-regulation model, and more in particular the beneficial short-term effect of reduced memory specificity, was investigated in a prospective study. Students were followed over a period of 9 weeks after they failed at their first exams at university. In line with the affect-regulation model, memory specificity predicted the course of symptoms that were experienced as a result of failing these exams. The less specific the student, the less durable the emotional distress over this 9-week period. The correlational nature of this study limits to some extent the conclusions that can be drawn. The results offer support for the affect-regulation account of reduced autobiographical memory specificity.

Training forgetting of negative material in depression

In this study, the authors investigated whether training participants to use cognitive strategies can aid forgetting in depression. Participants diagnosed with major depressive disorder (MDD) and never-depressed participants learned to associate neutral cue words with a positive or negative target word and were then instructed not to think about the negative targets when shown their cues. The authors compared 3 different conditions: an unaided condition, a positive-substitute condition, and a negative-substitute condition. In the substitute conditions, participants were instructed to use new targets to keep from thinking about the original targets. After the training phase, participants were instructed to recall all targets when presented with the cues. MDD participants, in contrast with control participants, did not exhibit forgetting of negative words in the unaided condition. In both the negative and positive substitute conditions, however, MDD participants showed successful forgetting of negative words and a clear practice effect. In contrast, negative substitute words did not aid forgetting by the control participants. These findings suggest that training depressed individuals to use cognitive strategies can increase forgetting of negative words.

Depressive rumination: investigating mechanisms to improve cognitive behavioural treatments

Rumination has been identified as a core process in the development and maintenance of depression. Treatments targeting ruminative processes may, therefore, be particularly helpful for treating chronic and recurrent depression. The development of such treatments requires translational research that marries clinical trials, process-outcome research, and basic experimental research that investigates the mechanisms underpinning pathological rumination. For example, a program of experimental research has demonstrated that there are distinct processing modes during rumination that have distinct functional effects for the consequences of rumination on a range of clinically relevant cognitive and emotional processes: an adaptive style characterized by more concrete, specific processing and a maladaptive style characterized by abstract, overgeneral processing. Based on this experimental work, two new treatments for depression have been developed and evaluated: (a) rumination-focused cognitive therapy, an individual-based face-to-face therapy, which has encouraging results in the treatment of residual depression in an extended case series and a pilot randomized controlled trial; and (b) concreteness training, a facilitated self-help intervention intended to increase specificity of processing in patients with depression, which has beneficial findings in a proof-of-principle study in a dysphoric population. These findings indicate the potential value of process-outcome research (a) explicitly targeting identified vulnerability processes and (b) developing interventions informed by research into basic mechanisms.

Concreteness training reduces dysphoria: a pilot proof-of-principle study

We hypothesized that a tendency towards abstract, general and decontextualized processing is a cognitive distortion that causally contributes to symptoms of depression. This hypothesis predicts that training dysphoric individuals to become more concrete and specific in their thinking would reduce depressive symptoms. To test this prediction, participants with stable dysphoria (scoring ≥ 14 on BDI-II at 2 consecutive weekly assessments) were randomly allocated in an additive design either to an active intervention control consisting of relaxation training or relaxation training plus concreteness training. Concreteness training involved repeated mental exercises designed to encourage more concrete and specific thinking about emotional events. Both interventions involved a training session and then repeated daily use of compact disc recordings for 7 days. Relaxation training plus concreteness training resulted in significantly greater decreases in depressive symptoms and marginally significantly greater decreases in state rumination than relaxation training alone. These findings suggest the potential value of concreteness training as a guided self-help intervention for mild-to-moderate depressive symptoms.

Processing mode causally influences emotional reactivity: distinct effects of abstract versus concrete construal on emotional response

Three studies are reported showing that emotional responses to stress can be modified by systematic prior practice in adopting particular processing modes. Participants were induced to think about positive and negative scenarios in a mode either characteristic of or inconsistent with the abstract-evaluative mind-set observed in depressive rumination, via explicit instructions (Experiments 1 and 2) and via implicit induction of interpretative biases (Experiment 3), before being exposed to a failure experience. In all three studies, participants trained into the mode antithetical to depressive rumination demonstrated less emotional reactivity following failure than participants trained into the mode consistent with depressive rumination. These findings provide evidence consistent with the hypothesis that processing mode modifies emotional reactivity and support the processing-mode theory of rumination.

Constructive and unconstructive repetitive thought

The author reviews research showing that repetitive thought (RT) can have constructive or unconstructive consequences. The main unconstructive consequences of RT are (a) depression, (b) anxiety, and (c) difficulties in physical health. The main constructive consequences of RT are (a) recovery from upsetting and traumatic events, (b) adaptive preparation and anticipatory planning, (c) recovery from depression, and (d) uptake of health-promoting behaviors. Several potential principles accounting for these distinct consequences of RT are identified within this review: (a) the valence of thought content, (b) the intrapersonal and situational context in which RT occurs, and (c) the level of construal (abstract vs. concrete processing) adopted during RT. Of the existing models of RT, it is proposed that an elaborated version of the control theory account provides the best theoretical framework to account for its distinct consequences.

Constructive and unconstructive repetitive thought

The author reviews research showing that repetitive thought (RT) can have constructive or unconstructive consequences. The main unconstructive consequences of RT are (a) depression, (b) anxiety, and (c) difficulties in physical health. The main constructive consequences of RT are (a) recovery from upsetting and traumatic events, (b) adaptive preparation and anticipatory planning, (c) recovery from depression, and (d) uptake of health-promoting behaviors. Several potential principles accounting for these distinct consequences of RT are identified within this review: (a) the valence of thought content, (b) the intrapersonal and situational context in which RT occurs, and (c) the level of construal (abstract vs. concrete processing) adopted during RT. Of the existing models of RT, it is proposed that an elaborated version of the control theory account provides the best theoretical framework to account for its distinct consequences.

Constructive and unconstructive repetitive thought

The author reviews research showing that repetitive thought (RT) can have constructive or unconstructive consequences. The main unconstructive consequences of RT are (a) depression, (b) anxiety, and (c) difficulties in physical health. The main constructive consequences of RT are (a) recovery from upsetting and traumatic events, (b) adaptive preparation and anticipatory planning, (c) recovery from depression, and (d) uptake of health-promoting behaviors. Several potential principles accounting for these distinct consequences of RT are identified within this review: (a) the valence of thought content, (b) the intrapersonal and situational context in which RT occurs, and (c) the level of construal (abstract vs. concrete processing) adopted during RT. Of the existing models of RT, it is proposed that an elaborated version of the control theory account provides the best theoretical framework to account for its distinct consequences.

A sentence completion procedure as an alternative to the Autobiographical Memory Test for assessing overgeneral memory in non-clinical populations

Overgeneral memory (OGM) has been proposed as a vulnerability factor for depression (Williams et al., 2007) or depressive reactivity to stressful life-events (e.g., Gibbs & Rude, 2004). Traditionally, a cue word procedure known as the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986) is used to assess OGM. Although frequently and validly used in clinical populations, there is evidence suggesting that the AMT is insufficiently sensitive to measure OGM in non-clinical groups. Study 1 evaluated the usefulness of a sentence completion method to assess OGM in non-clinical groups, as an alternative to the AMT. Participants were 197 students who completed the AMT, the Sentence Completion for Events from the Past Test (SCEPT), a depression measure, and visual analogue scales assessing ruminative thinking. Results showed that the mean proportion of overgeneral responses was markedly higher for the SCEPT than for the standard AMT. Also, overgeneral responding on the SCEPT was positively associated to depression scores and depressive rumination scores, whereas overgeneral responding on the AMT was not. Results suggest that the SCEPT, relative to the AMT, is a more sensitive instrument to measure OGM, at least in non-clinical populations. Study 2 further showed that this enhanced sensitivity is most likely due to the omission of the instruction to be specific rather than to the SCEPT's sentence completion format (as opposed to free recall to cue words).

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.