Depressive future-thinking: The role of valence and specificity

Depression and approach-avoidance achievement goals of Chinese undergraduate students: A four-wave longitudinal study

OBJECTIVE

The study explored the prospective relations between depression and approach-avoidance achievement goals of undergraduate students in China.

METHODS

2473 full-time undergraduates reported their depression and achievement goals annually from the freshman to the senior year. Data were analysed using descriptive statistics, correlation analysis and cross-lagged models.

RESULTS

Students' achievement goals decreased gradually during the first 3 years but rose in the fourth year, and the avoidance goals appeared to be less prevalent than the approach goals over time. Depression was negatively associated with approach goals, whereas positively correlated with avoidance goals. Depression in the freshman and sophomore years resulted in more avoidance goals 1 year later, and the depressive problems in the junior year predicted the decline of approach goals in the senior year.

CONCLUSIONS

The present study highlighted the deleterious effects of depression on the achievement goals of college students.

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.

Biased belief updating in depression

Cognitive approaches to depression have benefitted from recent research on belief updating, examining how new information is used to alter beliefs. This review presents recent advances in understanding various sources of bias in belief updating in depression. Specifically, research has demonstrated that people with depression have difficulty revising negative beliefs in response to novel positive information, whereas belief updating in depression is not related to an enhanced integration of negative information. In terms of mechanisms underlying the deficient processing of positive information, research has shown that people with depression use defensive cognitive strategies to devalue novel positive information. Furthermore, the disregard of novel positive information can be amplified by the presence of state negative affect, and the resulting persistence of negative beliefs in turn perpetuates chronically low mood, contributing to a self-reinforcing negative feedback loop of beliefs and affect. Synthesising previous research, this review proposes a coherent framework of when belief change is likely to occur, and argues that future research also needs to elucidate why people with depression hesitate to abandon negative beliefs. Recent insights from belief updating have not only improved the understanding of the psychopathology of depression, but also have the potential to improve its cognitive-behavioural treatment.

Examining multiple features of episodic future thinking and episodic memory among suicidal adults

BCKGROUND

Theories of suicide suggest that suicidal ideation (SI) results in part from difficulty imagining the future, which itself relies on the ability to remember the past. The present study examines multiple components of episodic future thinking and memory including event richness, which is commonly measured within the cognitive literature but has not previously been assessed with suicidal individuals.

METHODS

Here, we tested the associations between SI and episodic future thinking and episodic memory across two studies (Study 1, n = 25; Study 2, n = 141): the first with a healthy comparison group and the second with a psychiatric comparison group.

RESULTS

Future event richness yielded large but statistically non-significant deficits in the SI group relative to healthy controls in Study 1 after controling the false discovery rate. The most robust effects for future thinking emerged in the case of perceived duration of future events, such that the SI group (vs. psychiatric comparison) imagined future events as longer-lasting in Study 2. Across both studies, episodic memory was unrelated to SI, and neither episodic future thinking nor memory predicted future SI.

CONCLUSION

Episodic future thinking may better distinguish individuals with SI history from psychiatric controls when compared with episodic memory, but that this effect is limited to select components of future thinking.

Time is of essence - Abnormal time perspectives mediate the impact of childhood trauma on depression severity

BACKGROUND

Major depressive disorder (MDD) is a multifaceted mental disorder where participants, in addition to various symptoms, often suffer from increased focus on past time perspective and higher incidence of childhood trauma. Whether the abnormal time perspective is a result of the depressive symptoms or, alternatively, mediates between childhood trauma and depression remains unclear.

AIMS

To examine the triangular relationship between early life trauma, time perspective, and depressive symptoms.

METHOD

We investigated a large-scale MDD sample (n = 93) and healthy subject sample (n = 69) with Beck depression inventory-II (BDI-II), Beck hopelessness scale (BHS), childhood traumatic questionnaire-Short Form (CTQ-SF), and the Zimbardo time perspective inventory (ZTPI).

RESULTS

The MDD patients reported more childhood trauma experiences, and were featured by abnormal time perspectives on past and future when compared to healthy control. By applying two alternative mediation models, we observed that the time perspective acted as a mediator between childhood trauma and depressive symptom severity, rather than as a consequence of depressive symptom. Furthermore, this abnormal time perspective was a risk factor to MDD, as the childhood trauma only mediated the time perspective in MDD. Finally, we showed that time perspective was a long-term personal trait and unchanged after the remission of depression symptoms under five-day transcranial magnetic stimulation.

CONCLUSIONS

Abnormal time perspective mediates the impact of early childhood trauma on depressive symptomatology. Besides better understanding of the temporal basis of depressive symptoms, we highlight the importance of preventive time perspective therapy in subjects with childhood trauma.

Cognitive mechanisms of episodic simulation in psychiatric populations

Episodic simulation is the construction of a mental representation of a specific autobiographical future event. Episodic simulation has increasingly been studied in psychiatric populations. Here we 1) review evidence indicating that episodic simulation is compromised in patients with depression, anxiety, schizophrenia, bipolar disorder, and PTSD; and 2) consider several potential cognitive mechanisms of episodic simulation in psychiatric populations: episodic retrieval, scene construction, mental imagery, components of the CaRFAX model (i.e., capture and rumination, functional avoidance, and executive functioning), and narrative style. We evaluate evidence regarding these mechanisms across psychiatric populations, and identify areas of future research. Understanding the factors that contribute to episodic simulation impairment in psychiatric populations may lead to targeted and effective treatment approaches.

The effect of induced optimism on the optimistic update bias

Background

Individuals tend to have an optimism bias, processing desirable information more frequently than undesirable information. However, people who have been diagnosed with depression often have a more pessimistic view of the future. A recent study suggests that future expectations in individuals with dysphoria become more optimistic when asked to make optimistic future predictions about the future. In the present study, we investigated the differential effects of induced optimism training which making optimistic future prediction to change future beliefs in normal participants with various levels of dysphoria (low, mild, high).

Methods

We recruited normal participants (n = 69) from a local university students and divided participants into three groups (low, mild, high dysphoria) by measuring dysphoric mood. These three groups were assigned to the induced optimism training or control condition. After the training, participants performed the two-stage belief updating task. In the first stage, participants estimated their personal probability of experiencing adverse events while being presented with the average probability of the event occurring to a living person. This information could be desirable for participants(when presented with a probability that was below their estimation) or undesirable (when presented with a probability that was above their estimation). To assess how desirable versus undesirable information influenced beliefs, participants estimated their personal probability of experiencing the events again in the second stage. The amount of update error was calculated as the difference between the estimates in the first stage and the second stage. The difference between the errors was classified as the update bias.

Results

After the induced optimism training, individuals with the mild dysphoria demonstrated a higher update bias than low (p < .001) and the high dysphoria (p < .05) group in induced optimism condition. Significant differences were not found in control group. Results indicates that individuals in the mild dysphoria group showed an increased update bias after being exposed to the induced optimism training Dysphoric mood and trait optimism remained unchanged in both the experimental and control groups.

Conclusions

Results suggest that induced optimism training has potential to change individuals with mild dysphoria perceptions’ about the future.

Specificity of Future Thinking in Depression: A Meta-Analysis

Reduced specificity of autobiographical memory has been well established in depression, but whether this overgenerality extends to future thinking has not been the focus of a meta-analysis. Following a preregistered protocol, we searched six electronic databases, Google Scholar, and personal libraries and contacted authors in the field for studies matching search terms related to depression, future thinking, and specificity. We reduced an initial 7,332 results to 46 included studies, with 89 effect sizes and 4,813 total participants. Random-effects meta-analytic modeling revealed a small but robust correlation between reduced future specificity and higher levels of depression (r = -.13, p < .001). Of the 11 moderator variables examined, the most striking effects were related to the emotional valence of future thinking (p < .001) and the sex of participants (p = .025). Namely, depression was linked to reduced specificity for positive (but not negative or neutral) future thinking, and the relationship was stronger in samples with a higher proportion of males. This meta-analysis contributes to our understanding of how prospection is altered in depression and dysphoria and, by revealing areas where current evidence is inconclusive, highlights key avenues for future research.

The phenomenological characteristics of autobiographical future thinking in dysphoric and non-dysphoric individuals

Depressive symptoms are associated with deficits in objectively-rated detail and specificity in autobiographical future thinking for personally-relevant events. However, how depressive symptoms might affect the subjective, phenomenal characteristics of future thinking in general is not well understood. This study examined future thinking as self-reported by dysphoric (n = 79; probable major depression on the Patient Health Questionnaire and very or extremely difficult impact on functioning) and non-dysphoric adults (n = 79; as defined by normal range on the PHQ) that were matched on age and gender. The dysphoric group reported more frequent thoughts about their future in general, particularly for the long-term future, which persisted after controlling for emotional-valence. Dysphoric individuals perceived their future thinking as being more frequently vivid and detailed, more often involving mental imagery and inner speech, more often involuntary, more often unrealistic or implausible, more negatively-valenced, and more often from a third-person perspective. The findings indicate differences in the phenomenology of thinking about one's future among dysphoric individuals, some of which contrast with prior research findings. The implications for understanding autobiographical future thinking in depression are discussed, and studies are indicated to further clarify the content, function, and context of future thinking in altered affective states.

Time perspective differences between depressed patients and non-depressed participants, and their relationships with depressive and anxiety symptoms

BACKGROUND

Time perspective (TP) can be described as an individual's attitude towards his personal past, present and future. Literature suggests that it plays a role in several areas of psychological functioning (self-efficacy, coping) and impacts actual thoughts and behaviors. However, TP has seldom been studied in mental health, despite previous studies suggesting that the temporal profile is altered in depressed patients. This study investigates the differences of TP between depressed patients and non-depressed participants, and its relationship with depressive and anxiety symptoms.

METHODS

45 patients diagnosed with major depressive disorder were compared to 43 non-depressed participants recruited in the general population. Participants were asked to answer time perspective (ZTPI), depression (BDI-13) and anxiety (STAI-Y) self-report inventories. Statistical analysis included comparisons of scores between depressed patients and non-depressed participants, correlation and regression analysis.

RESULTS

Results indicate that TP is significantly altered in depressed patients. They display a more negative view of their past, a less hedonistic perspective towards their present, and a more fatalistic perspective when compared to non-depressed participants. Regression analysis shows that depressive and anxiety symptoms are associated with negative past and fatalistic present, and similar results are found with correlation analysis.

LIMITATIONS

The size of the sample was small, and longitudinal studies are needed to understand the dynamics and causal relationship between TP and depression.

CONCLUSIONS

These results underline the importance of considering TP in depressed patients, and encourage an in depth study of the relationship between TP and mood disorders. Therapeutic perspectives are discussed.

A review on future episodic thinking in mood and anxiety disorders

Future episodic thinking refers to the ability to imagine oneself in the future and project oneself into specific future events. This cognitive process is related to decision making and planning for the future. Although healthy populations commonly project themselves into the future (e.g. while planning a trip or career), patients with mood disorders show impairment in this ability. In this review article, we discuss the similarities and differences in future thinking among the following populations: major depressive disorder, dysphoria, anxiety, and post-traumatic stress disorder (PTSD). Importantly, we highlight the methodological variations in future episodic memory tasks in the literature that may explain the differences in the existing results.

Positive and Negative Expectations of Hopelessness as Longitudinal Predictors of Depression, Suicidal Ideation, and Suicidal Behavior in High-Risk Adolescents

The relationship between hopelessness and depression in predicting suicide-related outcomes varies based on the anticipation of positive versus negative events. In this prospective study of adolescents at elevated risk for suicide, we used two Beck Hopelessness Scale subscales to assess the impact of positive and negative expectations in predicting depression, suicidal ideation, and suicidal behavior over a 2- to 4-year period. In multivariate regressions controlling for depression, suicidal ideation, and negative-expectation hopelessness, positive-expectation hopelessness was the only significant predictor of depressive symptoms and suicidal behavior. Clinical interventions may benefit from bolstering positive expectations and building optimism.

Retrieval-induced forgetting is associated with increased positivity when imagining the future

People often think of themselves and their experiences in a more positive light than is objectively justified. Inhibitory control processes may promote this positivity bias by modulating the accessibility of negative thoughts and episodes from the past, which then limits their influence in the construction of imagined future events. We tested this hypothesis by investigating the correlation between retrieval-induced forgetting and the extent to which individuals imagine positive and negative episodic future events. First, we measured performance on a task requiring participants to imagine personal episodic events (either positive or negative), and then we correlated that measure with retrieval-induced forgetting. As predicted, individuals who exhibited higher levels of retrieval-induced forgetting imagined fewer negative episodic future events than did individuals who exhibited lower levels of retrieval-induced forgetting. This finding provides new insight into the possible role of retrieval-induced forgetting in autobiographical memory.

Depression and prospection

OBJECTIVES

Prospection, the mental representation of possible futures, is usually adaptive. When it goes awry, however, it disrupts emotion and motivation. A negative view of the future is typically seen as one symptom of depression, but we suggest that such negative prospection is the core causal element of depression. Here, we describe the empirical evidence supporting this framework, and we explore the implications for clinical interventions.

METHODS

We integrate several literatures: Using the database PsycInfo, we retrieved empirical studies with the keywords prospection, prediction, expectation, pessimism, mental simulation, future-thinking, future-directed thinking, foresight, and/or mental time travel, in conjunction with depression, depressed, or depressive.

RESULTS

Three kinds of faulty prospection, taken together, could drive depression: Poor generation of possible futures, poor evaluation of possible futures, and negative beliefs about the future. Depressed mood and poor functioning, in turn, may maintain faulty prospection and feed a vicious cycle. Future-oriented treatment strategies drawn from cognitive-behavioural therapy help to fix poor prospection, and they deserve to be developed further.

CONCLUSIONS

Prospection-based techniques may lead to transdiagnostic treatment strategies for depression and other disorders.

The future is here: a review of foresight systems in anxiety and depression

Cognitive models of anxiety and depression have long suggested a central role for future-oriented thinking in these disorders. Experimental studies suggest that anxiety and depression are characterised by distinct future-oriented thinking profiles, and that these profiles are markedly different from those of asymptomatic adults. In this paper, we review these profiles and propose two explanatory models marked by two different neurocognitive systems. The Reconstructive Memory Model emphasises a role for emotionally driven learning and retrieval in episodic foresight (i.e., the construction of future-oriented scenarios), and the Valuation Model proposes that an overweighing of risk and uncertainty estimates can be invoked to explain the future-oriented thought patterns. We consider the effectiveness of interventions aimed at altering such thought patterns. We suggest that future research aimed at elucidating the neurobiological underpinnings of future-oriented thinking in anxiety and depression can play an important role in advancing development of effective biological and psychosocial interventions for these disorders.

Context insensitivity during positive and negative emotional expectancy in depression assessed with functional magnetic resonance imaging

Patients with depression show an enhanced preoccupation with negative expectations and are often unable to look forward to positive events. Here we studied anticipatory emotional processes in unmedicated depressed patients using functional magnetic resonance imaging. Consistent with a negative processing bias, we hypothesized enhanced responses to negative and attenuated responses to positive expectancy cues in brain areas associated with emotional expectancy. Participants comprised 19 drug-free depressed patients and 19 matched healthy control subjects who viewed affective photographs. Pictures were preceded by an expectancy cue which signaled the emotional valence of the upcoming picture in half of the trials. Depressed patients showed attenuated blood-oxygen-level-dependent responses in the left lateral prefrontal cortex (inferior frontal gyrus, Brodmann area 44) during positive expectancy and-contrary to our hypothesis-in the right lateral orbitofrontal cortex (middle frontal gyrus, Brodmann area 47) during negative expectancy. This attenuation was specific for the anticipation (as opposed to the perception) of emotional pictures and correlated with a clinical measure of depressive symptoms. The observed attenuation suggests emotion-context insensitivity rather than a negative processing bias during anticipatory emotional processes in depression. This hyporeactivity may contribute to clinical features like anergia, apathy, and loss of motivation in the context of both positive and negative incentives.

Treating major depression by creating positive expectations for the future: a pilot study for the effectiveness of future-directed therapy (FDT) on symptom severity and quality of life

INTRODUCTION

This nonrandomized pilot study assesses the efficacy of a new future-oriented form of therapy, known as future-directed therapy (FDT), as a treatment for patients with Major Depressive Disorder (MDD) in a naturalistic hospital-based outpatient psychiatry clinic. The study measured symptom severity of depression and anxiety, in addition to quality of life pre- and posttreatment.

AIMS

The study examined a new manualized treatment designed to help people anticipate a more positive future. The intervention consists of twenty 90-min group sessions administered twice a week over 10 weeks. The intervention was compared to depressed patients in the same clinic who enrolled in traditional cognitive-based group psychotherapy. Sixteen patients with MDD completed the FDT intervention as part of their outpatient treatment for depression. Seventeen patients with MDD participated in treatment as usual (TAU) cognitive-based group therapy. The Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form, self-report instruments were administered prior to and immediately after the completion of therapy.

RESULTS

Patients treated with FDT demonstrated significant improvements in depression (P = 0.001), anxiety (P = 0.021) and quality of life (P = 0.035), and also reported high satisfaction with the therapy. Compared to the TAU group, patients treated with FDT showed greater improvements in depressive symptoms (P = 0.049).

CONCLUSIONS

FDT may have the potential of becoming an additional treatment option for patients with MDD.

Cognitive bias in back pain patients attending osteopathy: testing the enmeshment model in reference to future thinking

BACKGROUND

Depressive symptoms are common in chronic pain. Previous research has found differences in information-processing biases in depressed pain patients and depressed people without pain. The schema enmeshment model of pain (SEMP) has been proposed to explain chronic pain patients' information-processing biases. Negative future thinking is common in depression but has not been explored in relation to chronic pain and information-processing models.

OBJECTIVES

The study aimed to test the SEMP with reference to future thinking.

METHODS

An information-processing paradigm compared endorsement and recall bias between depressed and non-depressed chronic low back pain patients and control participants. Twenty-five depressed and 35 non-depressed chronic low back pain patients and 25 control participants (student osteopaths) were recruited from an osteopathy practice. Participants were asked to endorse positive and negative ill-health, depression-related, and neutral (control) adjectives, encoded in reference to either current or future time-frame. Incidental recall of the adjectives was then tested.

RESULTS

While the expected hypothesis of a recall bias by depressed pain patients towards ill-health stimuli in the current condition was confirmed, the recall bias was not present in the future condition. Additionally, patterns of endorsement and recall bias differed.

DISCUSSION

Results extend understanding of future thinking in chronic pain within the context of the SEMP.

Modifying cognitive errors promotes cognitive well being: a new approach to bias modification

BACKGROUND

Cognitive Bias Modification (CBM) procedures have been used to train individuals to interpret ambiguous information in a negative or benign direction and have provided evidence that negative biases causally contribute to emotional vulnerability.

METHOD

Here we present the development and validation of a new form of CBM designed to manipulate the cognitive errors known to characterize both depression and anxiety. Our manipulation was designed to modify the biased cognitions identified by Beck's cognitive error categories (e.g. arbitrary inference, overgeneralisation) and typically targeted during therapy.

RESULTS

In a later test of spontaneous inferences, unselected (Experiment 1) and vulnerable participants (Experiment 2) who had generated positive alternatives rather than errors perceived novel hypothetical events, their causes and outcomes in a non-distorted manner. These groups were also less vulnerable to two different types of emotional stressor (video clips; and an imagined social situation). Furthermore participants' interpretation of their own performance on a problem-solving task was improved by the manipulation, despite actual performance showing no significant change.

CONCLUSIONS

These findings demonstrate that Cognitive Error Modification can promote positive inferences, reduce vulnerability to stress and improve self-perceptions of performance.

Episodic simulation of future events: concepts, data, and applications

This article focuses on the neural and cognitive processes that support imagining or simulating future events, a topic that has recently emerged in the forefront of cognitive neuroscience. We begin by considering concepts of simulation from a number of areas of psychology and cognitive neuroscience in order to place our use of the term in a broader context. We then review neuroimaging, neuropsychological, and cognitive studies that have examined future-event simulation and its relation to episodic memory. This research supports the idea that simulating possible future events depends on much of the same neural machinery, referred to here as a core network, as does remembering past events. After discussing several theoretical accounts of the data, we consider applications of work on episodic simulation for research concerning clinical populations suffering from anxiety or depression. Finally, we consider other aspects of future-oriented thinking that we think are related to episodic simulation, including planning, prediction, and remembering intentions. These processes together comprise what we have termed "the prospective brain," whose primary function is to use past experiences to anticipate future events.

Retrospective and prospective cognitions in adolescents: anxiety, depression, and positive and negative affect

Research with anxious and depressed adults has suggested that anxiety is related to an increased anticipation of both negative memories and negative expectancies whereas depression is related to a reduction in positive memories and expectancies. The present study examined whether anxiety and depression in 123 school-aged adolescents would show the same pattern. Small groups completed a memory and future thinking task in which they were asked to generate future and past, positive and negative events. Adolescents with higher levels of depression and those with higher levels of anxiety reported significantly more negative events relative to controls, but neither group generated fewer positive events. The results provide support for the involvement of cognitions in mood disturbance although do not support the idea that these cognitions are different in anxiety and depression.

The use of daily diaries to assess the relations among mood state, overt behavior, and reward value of activities

Recent data has sparked renewed interest in behavioral treatments for depression; however several fundamental questions remain regarding the mechanisms of such approaches. To this end, the current study directly tested the assumption that non-clinical mildly depressed individuals receive less response-contingent positive reinforcement than non-depressed individuals, indicated by less engagement in behaviors perceived as rewarding in terms of both immediate pleasure and potential for these behaviors to result in more distal rewards. The data presented support this assumption and provide support for the role of reinforcement-based strategies such as behavioral activation in the treatment of depression.

Unspezifität des autobiographischen Gedächtnisses bei Depressiven

Zusammenfassung. Williams und Mitarbeiter sowie andere Forschergruppen konnten seit 1986 in zahlreichen Studien nachweisen, daß depressive und suizidale Patienten Schwierigkeiten haben, auf emotionale Hinweisworte hin (z.B. glücklich, traurig) eine örtlich und zeitlich spezifische Erinnerung zu berichten. Sie reagierten häufiger mit summarischen Beschreibungen von Ereignissen, während gesunde Kontrollpersonen mehrheitlich mit einem spezifischen Ereignis antworteten. Der folgende Beitrag gibt einen Überblick über die Forschungsgeschichte dieses Phänomens. Die Befunde an Gruppen mit verschiedenen Störungsbildern deuten auf die differentielle Bedeutsamkeit des unspezifischeren Gedächtniszugriffs bei Patienten hin, die eine Depressionssymptomatik haben. Gesichert erscheint auch, daß ein eher unspezifischer Zugriff auf Vergangenes mit der Generierung weniger effizienter Problemlösestrategien und mit Unspezifität in der Repräsentation zukünftiger Ereignisse korreliert ist. Eigene Befunde unterstützen die Annahme von Williams, daß Personen mit Depressionssymptomatik durch den Mechanismus eines “Mnemonic Interlock“-Prozesses (“Hängenbleiben“ bei unspezifisch-kategorialen Ereignisdeskriptionen) gehindert werden, auf spezifische Ereignisse zuzugreifen. Widersprüchliche Befunde oder nur schwache Belege erschweren derzeit noch Aussagen zur Valenzabhängigkeit des Phänomens und zu seinem Status als Trait-Marker. Die abschließend diskutierten Folgerungen für die klinisch-psychologische Grundlagen- und Therapieforschung machen deutlich, daß insbesondere die weitere empirische Klärung von Verursachungs- und Mechanismenannahmen wünschenswert ist.