Autobiographical Memory and Episodic Future Thinking in Severe Health Anxiety: A Comparison with Obsessive–Compulsive Disorder

People experience similar intrusions about past and future autobiographical negative experiences

We know much about people's problematic reactions-such as distressing intrusions-to negative, stressful, or traumatic past events. But emerging evidence suggests people react similarly to negative and potentially-traumatic future events. Given similar processes underlie remembering the past and imagining the future more generally, we wondered how similar involuntary memories, or intrusions, are for experienced vs. anticipated events. We focused primarily on intrusions because they are a transdiagnostic reaction to traumatic events. We asked subjects to report either a very stressful event they had experienced in the past 6 months, or one they anticipated they could experience in the next 6 months. We measured the frequency of intrusions about these reported events, and intrusions' phenomenological characteristics (such as emotional intensity), negative appraisals about their meaning, and reactions to them more generally. Overall, we found intrusions about experienced vs. anticipated autobiographical events were similarly troubling. This pattern supports the idea that anticipating the future can be aversive and elicit post-traumatic-stress-like symptoms, just as remembering the past can. Our findings have implications for theoretical models of traumatic-stress and treatment of traumatic-stress symptoms.

Specific topics, specific symptoms: linking the content of recurrent involuntary memories to mental health using computational text analysis

Researchers debate whether recurrent involuntary autobiographical memories (IAMs; memories of one's personal past retrieved unintentionally and repetitively) are pathological or ordinary. While some argue that these memories contribute to clinical disorders, recurrent IAMs are also common in everyday life. Here, we examined how the content of recurrent IAMs might distinguish between those that are maladaptive (related to worse mental health) versus benign (unrelated to mental health). Over two years, 6187 undergraduates completed online surveys about recurrent IAMs; those who experienced recurrent IAMs within the past year were asked to describe their memories, resulting in 3624 text descriptions. Using a previously validated computational approach (structural topic modeling), we identified coherent topics (e.g., "Conversations", "Experiences with family members") in recurrent IAMs. Specific topics (e.g., "Negative past relationships", "Abuse and trauma") were uniquely related to symptoms of mental health disorders (e.g., depression, PTSD), above and beyond the self-reported valence of these memories. Importantly, we also found that content in recurrent IAMs was distinct across symptom types (e.g., "Communication and miscommunication" was related to social anxiety, but not symptoms of other disorders), suggesting that while negative recurrent IAMs are transdiagnostic, their content remains unique across different types of mental health concerns. Our work shows that topics in recurrent IAMs-and their links to mental health-are identifiable, distinguishable, and quantifiable.

Vividness of imagery and affective response to episodic memories and episodic future thoughts: a systematic review and meta-analysis

Recalling personal past events and imagining personal future events are closely linked, yet also show differences. It has been claimed that episodic future thinking produces stronger intensity of in-the-moment affect than does recalling episodic memories [Schubert, T., Eloo, R., Scharfen, J., & Morina, N. (2020). How imagining personal future scenarios influences affect: Systematic review and meta-analysis. Clinical Psychology Review, 75, 101811. https://doi.org/10.1016/j.cpr.2019.101811]. In contrast, the literature indicates that memories are experienced more vividly than are episodic future thoughts, a quality that would be expected to produce a stronger rather than a weaker affective response. In this systematic review and meta-analysis, we examined (a) the intensity of affect, (b) the vividness and (c) the valence of emotion experienced in response to remembering personal past events compared to imagining personal future events. Sixteen studies with a combined sample of 1735 met criteria for inclusion. Remembered past events were experienced more vividly than imagined future events but there was no difference between the two types of representations on emotional intensity. Imagined future events were associated with more positive emotion than memories. Future research could examine factors responsible for the equivalent strength of emotional response in memories and future-thinking despite their differences in vividness.

Predictors of obsessive-compulsive symptomology: mind wandering about the past and future

Purpose

Obsessive and compulsive tendencies are known to occur in the general population and involve worry around specific concerns (obsessions) and an urge to resolve the concern with thoughts or behaviours (compulsions). Spontaneous, but not deliberate, mind wandering experiences (when attention turns to internal mentation), have been found to predict obsessive– compulsive tendencies [Seli, P., Risko, E.F., Purdon, C. & Smilek, D. (2017). Intrusive thoughts: linking spontaneous mind wandering and OCD symptomatology. Psychological Research, 81, 392–398. 10.1007/s00426-016-0756-3]. Recent cognitive theory suggests a particular role for future-oriented spontaneous thought in obsessive–compulsive (OC) symptoms. Thus, we hypothesised that future-oriented rather than past-oriented spontaneous mind wandering would predict OC symptoms, such that more future-oriented mind wandering would be associated with increases in OC symptoms.

Methods

In an online survey design (nonclinical sample of 104 adults), participants completed three measures: Mind wandering: Spontaneous (MW-S) and Deliberate (MW-D) (Carriere, Seli & Smilek, 2013); Involuntary Autobiographical Memory Inventory (Berntsen, Rubin & Salgado, 2015); and Dimensional Obsessive–Compulsive Scale (DOCS) (Abramowitz et al., 2010). We adopted a linear regression approach to examine our hypotheses.

Results

We provided the first replication of the finding that OC symptoms are predicted by the frequency of spontaneous (but not deliberate) mind wandering, with an underlying positive relationship. Additionally, we found that temporality of spontaneous thought had different predictive effects as a function of the dimension of OC symptoms (i.e., responsibility, unacceptable thoughts, need for symmetry/completeness).

Conclusions

We found moderate support for our temporality hypothesis, which highlights how the construct of temporality can add to our understanding of OC symptoms. The present study also adds to recent conceptual debates regarding mind wandering. We suggest new cognitive and methodological approaches to enhance the understanding of obsessive–compulsive disorder, opening new avenues for clinical and experimental research.

Health Anxiety

Abstract. Health anxiety, characterized by excessive concern about one’s health, is a serious and costly public health problem. The disorder might become chronic if left untreated. Unfortunately many patients do not receive timely or proper treatment due to sparse treatment resources. Also, existing treatment programs, though effective for many, do not work for all. This paper discusses the conceptualization of health anxiety and future directions based on novel research findings. These include: (i) the content and characteristics of autobiographical memories and episodic future thoughts in severe health anxiety, (ii) related concepts such as cyberchondria with excessive Internet browsing on health issues and health anxiety by proxy, where parents display and might confer health anxiety towards their children, (iii) an epidemiological perspective on the association between health anxiety and subclinical psychotic experiences in preadolescence. Exploring these new dimensions could have important implications for the further development of preventive strategies and effective treatment.