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Weisenburger RL, Dainer-Best J, Zisser M, McNamara ME, Beevers CG. Negative self-referent cognition predicts future depression symptom change: an intensive sampling approach. Cogn Emot 2024:1-15. [PMID: 39264587 DOI: 10.1080/02699931.2024.2400298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 08/08/2024] [Accepted: 08/29/2024] [Indexed: 09/13/2024]
Abstract
Cognitive theories of depression assert that negative self-referent cognition has a causal role in the development and maintenance of depression symptoms, but few studies have examined temporal associations between these constructs using intensive, longitudinal sampling strategies. In three samples of undergraduate students, we examined associations between change in self-referent processing and depression across 5 daily assessments (Sample 1, N = 303, 1,194 measurements, 79% adherence), 7 daily assessments (Sample 2, N = 313, 1,784 measurements, 81% adherence), and 7 weekly assessments (Sample 3; N = 155, 833 measurements, 81% adherence). Random intercept cross-lagged panel models indicated large cross-lagged effects in two of the three samples (Samples 1 and 3 but not Sample 2), such that more negative self-referent thinking than usual was significantly associated with a subsequent increase in depression symptoms at the next time lag. Notably, change in depression from usual was not associated with increases in negative self-referent processing at the next time point in any sample. These findings suggest that change in negative self-referent processing may be causally linked to future increases in depression on a day-to-day and week-to-week basis, although confidence in this conclusion is tempered somewhat by a lack of replication in Sample 2.
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Affiliation(s)
- Rachel L Weisenburger
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA
| | | | - Mackenzie Zisser
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA
| | - Mary E McNamara
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA
| | - Christopher G Beevers
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, TX, USA
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2
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Stavropoulos L, Cooper DDJ, Champion SM, Keevers L, Newby JM, Grisham JR. Basic processes and clinical applications of mental imagery in worry: A systematic review. Clin Psychol Rev 2024; 110:102427. [PMID: 38640775 DOI: 10.1016/j.cpr.2024.102427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/17/2023] [Accepted: 04/04/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND In this systematic review, we aimed to synthesise existing research on the phenomenology of mental imagery among high worriers compared to healthy individuals, and to characterise the nature and effectiveness of existing imagery-related interventions in treatment of worry. METHODS PsycInfo, CENTRAL, EMBASE, Medline, Medline Epub, and PubMed were searched for studies examining the relationship between worry/GAD and mental imagery, or interventions using imagery in treatment of worry/GAD. We assessed study quality and used qualitative narrative synthesis to comprehensively map study results. RESULTS The search yielded 2589 abstracts that were assessed for eligibility independently by two authors. From this, 183 full texts were screened and 50 qualitatively synthesised. Twenty-seven reported an association between worry/GAD and an aspect of mental imagery. Here, overactive negative and worry imagery, and diminished positive future imagining, were associated with worry/GAD. Twenty-three studies reported an intervention. This literature suggested mixed findings regarding efficacy, including for imaginal exposure as an independent technique for GAD. CONCLUSIONS Findings support dysfunctional negative imagining and diminished positive prospective imagery in GAD. General imagining abilities remain intact, which is promising for efforts to utilise imagery in treatment. Further research is warranted to develop innovative clinical applications of imagery in treatment of GAD.
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Affiliation(s)
- Lauren Stavropoulos
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
| | - David D J Cooper
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Sophie M Champion
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Luke Keevers
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Jill M Newby
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, UNSW, Hospital Road, Randwick, Sydney 2022, Australia
| | - Jessica R Grisham
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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3
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Kroener J, Schaitz C, Sosic-Vasic Z. Prospective Mental Images: A Transdiagnostic Approach to Negative Affectivity and Mood Dysregulation among Borderline Personality Disorder and Depression. Behav Sci (Basel) 2024; 14:81. [PMID: 38392434 PMCID: PMC10886009 DOI: 10.3390/bs14020081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
There is initial evidence that patients diagnosed with Borderline Personality Disorder (BPD) experience intrusive prospective mental images about non-suicidal self-injury (NSSI). These images, in turn, are associated with the conduct of NSSI. As the negative emotional valence of intrusive images has been established across clinical disorders, negative affectivity might play a key role linking mental imagery and psychopathology. Therefore, the present study aimed to investigate the possible mediating role of symptoms of depression as a proxy for negative affectivity linking intrusive prospective imagery to psychopathology in patients diagnosed with BPD. A total of 233 participants (84 diagnosed with MDD, 66 diagnosed with BPD, 83 healthy controls) completed questionnaires on negative affectivity (BDI-II) and prospective intrusive imagery (IFES-S). Before controlling for negative affectivity, there was a positive correlation between group and intrusive prospective imagery, indicating that healthy participants displayed lower amounts of intrusive prospective images in comparison to patients diagnosed with MDD or BPD. After entering negative affectivity as a mediator, the variable group was no longer associated with intrusive prospective images; however, negative affectivity showed a strong and positive relationship with the group on one side, and intrusive prospective imagery on the other, indicating that negative affectivity mediates the association between intrusive prospective images and clinical disorders. The presented findings point towards a mediating role of negative affectivity in the manifestation of intrusive prospective imagery, not only within BPD, but also in patients with MDD. The possibility of intrusive images acting as a transdiagnostic feature, where negative affectivity and mood dysregulation are at the core of the clinical disorder, are being discussed.
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73035 Goeppingen, Germany
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | - Caroline Schaitz
- Psychotherapeutic Outpatient Facility, Medical School Berlin, Rüdesheimer Straße 50, 14197 Berlin, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73035 Goeppingen, Germany
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
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4
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Li T, Chen J, Yang L, Lyu M, Liu J, Ren P. Central symptoms and network associations of depressive symptoms among school-aged students: A network analysis. J Affect Disord 2024; 345:284-292. [PMID: 37879414 DOI: 10.1016/j.jad.2023.10.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/06/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Depression is one of the most prevalent mental health problems occurred among school-aged students. Conceptualizing depressive symptoms as a network of interacting symptoms, this study used network analysis to identify central symptoms and network associations of depressive symptoms. The study also investigated how networks of depressive symptoms differ across school aged periods. METHODS A total of 2514 Chinese school-aged students in Grades 4 to 11 were recruited and asked to complete the Child Depression Inventory in this study. RESULTS The results showed that self-hatred consistently emerged as a central symptom of depressive symptoms across all school stages. Beyond this, each school stage had its unique central symptoms: loneliness was prominent in both elementary school and junior high school, while fatigue was more specific symptom to senior high school. When comparing the network structures across different school stages, there was a significant difference in network structure between elementary school students and junior high school students. The comparison in global strength showed that the network connectivity of depression network is stronger among elementary school students, with showing closer symptom associations. CONCLUSIONS By identifying central symptoms and their distinct associations, particularly the pronounced symptom interconnections among elementary school students, this study emphasize the critical importance of early interventions. Recognizing these stage-specific characteristics is essential for the development of effective prevention and intervention programs for depressive symptoms in school-aged students.
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Affiliation(s)
- Tian Li
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jiahui Chen
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
| | - Liu Yang
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
| | - Muhua Lyu
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
| | - Jia Liu
- Tsinghua Laboratory of Brain & Intelligence, Tsinghua University, Beijing 100084, China
| | - Ping Ren
- Collaborative Innovation Center of Assessment toward Basic Education Quality, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China.
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5
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Marsh LC, Patel SD, Smith AJ, So M, Armstrong H, Elliott R, Watkins E, Moulds M, Dalgleish T, Hitchcock C. From basic science to clinical practice: Can cognitive behavioural therapy tasks be augmented with enhanced episodic specificity? Behav Res Ther 2023; 167:104352. [PMID: 37331240 DOI: 10.1016/j.brat.2023.104352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/28/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023]
Abstract
Individuals with depression typically remember their past in a generalised manner, at the cost of retrieving specific event memories. This may impair engagement with cognitive behavioural therapy (CBT) tasks that use concrete episodic information to challenge maladaptive beliefs, potentially limiting their therapeutic benefit. Study 1 demonstrated that an episodic specificity induction increased detail and specificity of autobiographical memory in people with major depression, relative to control conditions (N = 88). We therefore examined whether the induction enhanced the efficacy of CBT tasks that depend on episodic memory - cognitive reappraisal (Study 2, N = 30), evidence gathering (Study 2, N = 30), and planning behavioural experiments (Study 3a, N = 30). Across all three tasks, there were no significant differences in emotion- or belief-change between the specificity and control conditions. Although the induction temporarily enhanced specificity in depressed individuals, it did not significantly augment the efficacy of CBT tasks theorised to benefit from the use of specific mnemonic information.
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Affiliation(s)
- Laura C Marsh
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Shivam D Patel
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Alicia J Smith
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Melody So
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | - Rachel Elliott
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | | | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Caitlin Hitchcock
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Melbourne School of Psychological Science, University of Melbourne, Australia.
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6
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Srivastava P, Felonis CR, Piers AD, Nunez N, Fitzpatrick B, Juarascio A, Manasse S. Reward mediates the association between engagement in noneating activities and state body dissatisfaction: An ecological momentary assessment study. Int J Eat Disord 2023; 56:562-573. [PMID: 36444116 DOI: 10.1002/eat.23862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/27/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Momentary worsening (i.e., greater than one's average levels) of state body dissatisfaction (BD) has been implicated as a proximal risk factor for eating disorder (ED) behaviors in binge-spectrum EDs. Yet, research exploring the prospective association between noneating activities in daily life (e.g., chores, self-care/coping) and momentary state BD remains limited. Understanding the momentary link between engagement in noneating activities and state BD, and pathways through which engagement in said activities influences momentary state BD is critical to informing treatments. The current ecological momentary assessment (EMA) study examined whether (1) engagement in noneating activities at Time 1 prospectively predicted momentary state BD at Time 2 and (2) reward drawn from noneating activities at Time 1 mediates the prospective association between engagement in noneating activities at Time 1 and momentary state BD at Time 2. METHOD Sixty-six adults with transdiagnostic binge eating completed an EMA protocol over 7-14 days. Participants received six EMA signals per day (total EMA observations = 4038). Multilevel modeling was used to examine the research questions. RESULTS Engagement in an indoor hobby, outdoor recreation, socializing, and self-care/coping strategies prospectively predicted momentary state BD improvements, while using TV/social media and cooking prospectively predicted momentary state BD worsening. Reward drawn from engagement in these noneating activities mediated the associations. DISCUSSION If replicated, these findings suggest that increasing the frequency of certain noneating activities and enhancing their rewarding aspects to improve state BD and decrease ED behavior risk during treatment may be worthy of further exploration. PUBLIC SIGNIFICANCE Momentary worsening of state body dissatisfaction (BD) is a risk factor for eating disorder behaviors in individuals with binge eating. This study found that engaging in certain noneating activities (e.g., socializing) prospectively predicted momentary improvements in state BD, while other noneating activities (e.g., cooking) predicted momentary worsening of state BD. Reward drawn from activities mediated these relations. To improve state BD, treatments should target the frequency of, and reward obtained from these noneating activities.
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Affiliation(s)
- Paakhi Srivastava
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christina R Felonis
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amani D Piers
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Nicole Nunez
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Brighid Fitzpatrick
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne Juarascio
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie Manasse
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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7
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Hitchcock PF, Britton WB, Mehta KP, Frank MJ. Self-judgment dissected: A computational modeling analysis of self-referential processing and its relationship to trait mindfulness facets and depression symptoms. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:171-189. [PMID: 36168080 PMCID: PMC9931629 DOI: 10.3758/s13415-022-01033-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/08/2022]
Abstract
Cognitive theories of depression, and mindfulness theories of well-being, converge on the notion that self-judgment plays a critical role in mental health. However, these theories have rarely been tested via tasks and computational modeling analyses that can disentangle the information processes operative in self-judgments. We applied a drift-diffusion computational model to the self-referential encoding task (SRET) collected before and after an 8-week mindfulness intervention (n = 96). A drift-rate regression parameter representing positive-relative to negative-self-referential judgment strength positively related to mindful awareness and inversely related to depression, both at baseline and over time; however, this parameter did not significantly relate to the interaction between mindful awareness and nonjudgmentalness. At the level of individual depression symptoms, at baseline, a spectrum of symptoms (inversely) correlated with the drift-rate regression parameter, suggesting that many distinct depression symptoms relate to valenced self-judgment between subjects. By contrast, over the intervention, changes in only a smaller subset of anhedonia-related depression symptoms showed substantial relationships with this parameter. Both behavioral and model-derived measures showed modest split-half and test-retest correlations. Results support cognitive theories that implicate self-judgment in depression and mindfulness theories, which imply that mindful awareness should lead to more positive self-views.
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Affiliation(s)
- Peter F Hitchcock
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, USA.
| | | | - Kahini P Mehta
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael J Frank
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, USA
- Carney Institute for Brain Science, Brown University, Providence, RI, USA
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8
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Zheng M, Zhang X, Xiao H. Effects of a WeChat-Based Life Review Program for Patients With Digestive System Cancer: 3-Arm Parallel Randomized Controlled Trial. J Med Internet Res 2022; 24:e36000. [PMID: 36006665 PMCID: PMC9459832 DOI: 10.2196/36000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/22/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Patients with digestive system cancer often experience psychospiritual distress. Life review is an evidence-based psychological intervention for patients with cancer, but the effects of digital life review programs are unclear, especially for patients with digestive system cancer. Objective We examined the effects of a WeChat-based life review program on the psychospiritual well-being of patients with digestive system cancer. Methods This study was a 3-arm parallel randomized controlled trial. Eligible patients with digestive system cancer were recruited from a university hospital in Fujian, China. They were randomized to a life review group and 2 control groups. All participants received routine care, and the life review group also received the 4-week WeChat-based life review program. Control group 1 also received a 4-week program of friendly visiting. Anxiety, depression, hope, and self-transcendence were measured at baseline and 2 days, 1 month, and 6 months after the intervention. Results A total of 150 participants were randomly allocated to the WeChat-based life review group (n=50), control group 1 (n=50), or control group 2 (n=50). The overall dropout rate was 10% (15/150), and 92% (46/50) of participants in the the life review group completed the intervention. Significant interaction effects for time and group membership were found for anxiety (P<.001), depression (P<.001), hope (P<.001), and self-transcendence (P<.001) at all follow-up time points. For anxiety and depression, the scores did not differ significantly between the life review group and control group 1 on day 2 (P=.80 for anxiety, P=.51 for depression), but the scores were significantly lower in the life review group at month 1 and month 6 (P=.02 for anxiety at both months 1 and 6; P=.003 and P<.001 for depression at months 1 and 6, respectively). Significant increases in hope and self-transcendence were revealed in the life review group compared to control group participants at all follow-up sessions. Conclusions The WeChat-based life review program was effective in reducing anxiety and depressive symptoms and in improving the level of hope and self-transcendence among patients with digestive system cancer. Though friendly visiting can also help to relieve anxiety, its effects are short-term. Trial Registration Chinese Clinical Trial Registry ChiCTR-IOR-17011998; https://tinyurl.com/5acycpd4
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Affiliation(s)
- Meihua Zheng
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China.,The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, China
| | - Xiaoling Zhang
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
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9
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Schürmann-Vengels J, Victor PP, Odyniec P, Flückiger C, Teismann T, Willutzki U. A Mental Imagery Micro-Intervention to Increase Positive Affect in Outpatient CBT Sessions (PACIfIC): Study Protocol of a Randomized Controlled Implementation Trial. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e7043. [PMID: 36397941 PMCID: PMC9667424 DOI: 10.32872/cpe.7043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
Background Recent findings indicated that mental disorders are associated with both an up-regulation of negative affect and a down-regulation of positive affect (PA) as distinct processes. Established treatment approaches focus on the modification of problems and negative affect only. Experimental paradigms in healthy samples and research on strengths-based approaches showed that fostering PA may improve psychotherapy process and outcome. Specific and easily implementable interventions targeting PA in treatment sessions are scarce. Mental imagery was shown to be a promising strategy for boosting positive emotional experiences. Method The PACIfIC-study is planned as a longitudinal randomized-controlled trial in the context of cognitive behavioral therapy, implemented at a German outpatient training and research center. In the process analysis, trajectories of PA over the first twelve treatment sessions will be examined with weekly questionnaires. In the intervention analysis, a six-minute positive mental imagery intervention to enhance PA will be developed and tested. The intervention is implemented with loudspeakers at the beginning of each session for a standardized induction of PA. The experimental group will be compared to an active control group (neutral mental imagery) and treatment as usual. Procedures in all treatment arms are parallelized. Main outcomes after twelve sessions of psychotherapy will be psychosocial resources, resilience and self-esteem (theory-driven), as well as psychopathology and working alliance (secondary outcome). Multilevel modeling will be conducted to address the nested data structure. Conclusion Study results may have implications on the consideration of positive constructs in mental disorders and the implementation of strengths-based interventions in psychotherapy.
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Affiliation(s)
- Jan Schürmann-Vengels
- Department of
Psychology and Psychotherapy, Universität
Witten/Herdecke, Witten,
Germany
| | - Philipp Pascal Victor
- Department of
Psychology and Psychotherapy, Universität
Witten/Herdecke, Witten,
Germany
| | - Patrizia Odyniec
- Department of
Psychology and Psychotherapy, Universität
Witten/Herdecke, Witten,
Germany
| | - Christoph Flückiger
- Department of
Clinical Psychology and Psychotherapy, University
of Zurich, Zurich,
Switzerland
| | - Tobias Teismann
- Mental Health
Research and Treatment Center, Ruhr-Universität
Bochum, Bochum, Germany
| | - Ulrike Willutzki
- Department of
Psychology and Psychotherapy, Universität
Witten/Herdecke, Witten,
Germany
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10
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McNamara ME, Shumake J, Stewart RA, Labrada J, Alario A, Allen JJB, Palmer R, Schnyer DM, McGeary JE, Beevers CG. Multifactorial prediction of depression diagnosis and symptom dimensions. Psychiatry Res 2021; 298:113805. [PMID: 33647705 PMCID: PMC8042639 DOI: 10.1016/j.psychres.2021.113805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/10/2021] [Indexed: 01/07/2023]
Abstract
While depression is a leading cause of disability, prior investigations of depression have been limited by studying correlates in isolation. A data-driven approach was applied to identify out-of-sample predictors of current depression from adults (N = 217) sampled on a continuum of no depression to clinical levels. The current study used elastic net regularized regression and predictors from sociodemographic, self-report, polygenic scores, resting electroencephalography, pupillometry, actigraphy, and cognitive tasks to classify individuals into currently depressed (MDE), psychiatric control (PC), and no current psychopathology (NP) groups, as well as predicting symptom severity and lifetime MDE. Cross-validated models explained 20.6% of the out-of-fold deviance for the classification of MDEs versus PC, 33.2% of the deviance for MDE versus NP, but -0.6% of the deviance between PC and NP. Additionally, predictors accounted for 25.7% of the out-of-fold variance in anhedonia severity, 65.7% of the variance in depression severity, and 12.9% of the deviance in lifetime depression (yes/no). Self-referent processing, anhedonia, and psychosocial functioning emerged as important differentiators of MDE and PC groups. Findings highlight the advantages of using psychiatric control groups to isolate factors specific to depression.
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Affiliation(s)
- Mary E McNamara
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA.
| | - Jason Shumake
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - Rochelle A Stewart
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - Jocelyn Labrada
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - Alexandra Alario
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - John J B Allen
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Rohan Palmer
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - David M Schnyer
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - John E McGeary
- Veterans Affairs, Providence RI and Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, Rhode Island, USA
| | - Christopher G Beevers
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
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11
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Mental Imagery in the Science and Practice of Cognitive Behaviour Therapy: Past, Present, and Future Perspectives. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00102-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractMental imagery has a long history in the science and practice of cognitive behaviour therapy (CBT), stemming from both behavioural and cognitive traditions. The past decade or so has seen a marked increase in both scientific and clinical interest in mental imagery, from basic questions about the processes underpinning mental imagery and its roles in everyday healthy functioning, to clinical questions about how dysfunctions in mental imagery can cause distress and impairment, and how mental imagery can be used within CBT to effect therapeutic change. This article reflects on the current state of mental imagery in the science and practice of CBT, in the context of past developments and with a view to future challenges and opportunities. An ongoing interplay between the various strands of imagery research and the many clinical innovations in this area is recommended in order to realise the full therapeutic potential of mental imagery in CBT.
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12
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Dominguez-Rodriguez A, De La Rosa-Gómez A, Hernández Jiménez MJ, Arenas-Landgrave P, Martínez-Luna SC, Alvarez Silva J, García Hernández JE, Arzola-Sánchez C, Acosta Guzmán V. A Self-Administered Multicomponent Web-Based Mental Health Intervention for the Mexican Population During the COVID-19 Pandemic: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e23117. [PMID: 33196449 PMCID: PMC7704282 DOI: 10.2196/23117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has become a public health emergency of international concern; it has not only threatened people's physical health but has also affected their mental health and psychological well-being. It is necessary to develop and offer strategies to reduce the psychological impact of the outbreak and promote adaptive coping. OBJECTIVE This study protocol aims to describe a self-administered web-based intervention (Mental Health COVID-19) based on the principles of positive psychology supported by elements of cognitive behavioral therapy and behavioral activation therapy to reduce the symptoms of anxiety and depression and increase positive emotions and sleep quality during and after the COVID-19 outbreak through a telepsychology system. METHODS A randomized controlled clinical superiority trial with two independent groups will be performed, with intrasubject measures at four evaluation periods: pretest, posttest, 3-month follow-up, and 6-month follow-up. Participants will be randomly assigned to one of two groups: self-administered intervention with assistance via chat or self-administered intervention without assistance via chat. The total required sample size will be 166 participants (83 per group). RESULTS The clinical trial is ongoing. This protocol was approved by the Research Ethics Board of the Free School of Psychology-University of Behavioral Sciences (Escuela libre de Psicología-Universidad de Ciencias del Comportamiento). The aim is to publish the preliminary results in December 2020. A conservative approach will be adopted, and the size effect will be estimated using the Cohen d index with a significance level (α) of .05 (95% reliability) and a conventional 80% power statistic. CONCLUSIONS The central mechanism of action will be to investigate the effectiveness of an intervention based on positive psychology through a web platform that can be delivered through computers and tablets, with content that has been rigorously contextualized to the Mexican culture to provide functional strategies to help the target users cope with the COVID-19 pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/ct2/show/NCT04468893. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/23117.
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Affiliation(s)
| | - Anabel De La Rosa-Gómez
- Coordinación de Educación a Distancia, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | | | | | | | - Carlos Arzola-Sánchez
- Institute of Social Sciences, Autonomous University of Ciudad Juárez, Juarez, Mexico
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Hsu KJ, McNamara ME, Shumake J, Stewart RA, Labrada J, Alario A, Gonzalez GD, Schnyer DM, Beevers CG. Neurocognitive predictors of self-reported reward responsivity and approach motivation in depression: A data-driven approach. Depress Anxiety 2020; 37:682-697. [PMID: 32579757 PMCID: PMC7951991 DOI: 10.1002/da.23042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/18/2020] [Accepted: 04/19/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Individual differences in reward-related processes, such as reward responsivity and approach motivation, appear to play a role in the nature and course of depression. Prior work suggests that cognitive biases for valenced information may contribute to these reward processes. Yet there is little work examining how biased attention, processing, and memory for positively and negatively valenced information may be associated with reward-related processes in samples with depression symptoms. METHODS We used a data-driven, machine learning (elastic net) approach to identify the best predictors of self-reported reward-related processes using multiple tasks of attention, processing, and memory for valenced information measured across behavioral, eye tracking, psychophysiological, and computational modeling approaches (n = 202). Participants were adults (ages 18-35) who ranged in depression symptom severity from mild to severe. RESULTS Models predicted between 5.0-12.2% and 9.7-28.0% of held-out test sample variance in approach motivation and reward responsivity, respectively. Low self-referential processing of positively valenced information was the most robust, albeit modest, predictor of low approach motivation and reward responsivity. CONCLUSIONS Self-referential processing of positive information is the strongest predictor of reward responsivity and approach motivation in a sample ranging from mild to severe depression symptom severity. Experiments are now needed to clarify the causal relationship between self-referential processing of positively valenced information and reward processes in depression.
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Affiliation(s)
- Kean J. Hsu
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC,Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX,Corresponding Author: Kean J. Hsu, Ph.D., Department of Psychiatry, Georgetown University Medical Center, 2115 Wisconsin Ave. NW, Suite 200, Washington, DC 20007 ()
| | - Mary E. McNamara
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - Jason Shumake
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | | | - Jocelyn Labrada
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - Alexandra Alario
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA
| | - Guadalupe D.S. Gonzalez
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - David M. Schnyer
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - Christopher G. Beevers
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
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14
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Hards E, Ellis J, Fisk J, Reynolds S. Negative view of the self and symptoms of depression in adolescents. J Affect Disord 2020; 262:143-148. [PMID: 31733458 DOI: 10.1016/j.jad.2019.11.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/11/2019] [Accepted: 11/02/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although negative self-evaluation is a common symptom of depression in adolescents, there is little understanding of how the self is associated with depression. Beck (1967) proposed that a negative view of the self was a 'hallmark' of depression. In contrast Linville (1985; 1987) proposed that holding multiple aspects of the self was associated with lower levels of depression. The aim of this paper is to evaluate these two models of self and depression in adolescents. METHODS Young people aged 13-18 years (n = 822) reported symptoms of depression (the Mood and Feelings Questionnaire) and completed a measure of self-concept, the Twenty Statements Test (TST). We coded responses to the TST to reflect the valance (positive to negative) and the complexity of their self-concept (number of self-aspects). RESULTS Valence, but not complexity, of self-concept was significantly associated with severity of depression symptoms. The valance of young people's self-concept accounted for 25% of the variance in depression symptoms. Adolescent's with more positive self-concept tended to have fewer symptoms of depression. LIMITATIONS The cross-sectional design of this study precludes any conclusions about the causal relationship between depression and negative self-evaluation; experimental and longitudinal research is needed to assess the causal direction of the relationship. CONCLUSIONS The results of this study supported the cognitive model of depression. Negative self-evaluation may constitute a risk factor for depression in adolescents and could offer a potential target for prevention and early intervention in adolescents.
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Affiliation(s)
- Emily Hards
- School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights Road, Reading RG6 6AL, United Kingdom.
| | - Judi Ellis
- School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights Road, Reading RG6 6AL, United Kingdom
| | - Jennifer Fisk
- School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights Road, Reading RG6 6AL, United Kingdom
| | - Shirley Reynolds
- School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Whiteknights Road, Reading RG6 6AL, United Kingdom
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15
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Beevers CG, Mullarkey MC, Dainer-Best J, Stewart RA, Labrada J, Allen JJB, McGeary JE, Shumake J. Association between negative cognitive bias and depression: A symptom-level approach. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:212-227. [PMID: 30652884 PMCID: PMC6449499 DOI: 10.1037/abn0000405] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cognitive models of depression posit that negatively biased self-referent processing and attention have important roles in the disorder. However, depression is a heterogeneous collection of symptoms and all symptoms are unlikely to be associated with these negative cognitive biases. The current study involved 218 community adults whose depression ranged from no symptoms to clinical levels of depression. Random forest machine learning was used to identify the most important depression symptom predictors of each negative cognitive bias. Depression symptoms were measured with the Beck Depression Inventory-II. Model performance was evaluated using predictive R-squared (Rpred2), the expected variance explained in data not used to train the algorithm, estimated by 10 repetitions of 10-fold cross-validation. Using the self-referent encoding task (SRET), depression symptoms explained 34% to 45% of the variance in negative self-referent processing. The symptoms of sadness, self-dislike, pessimism, feelings of punishment, and indecision were most important. Notably, many depression symptoms made virtually no contribution to this prediction. In contrast, for attention bias for sad stimuli, measured with the dot-probe task using behavioral reaction time (RT) and eye gaze metrics, no reliable symptom predictors were identified. Findings indicate that a symptom-level approach may provide new insights into which symptoms, if any, are associated with negative cognitive biases in depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Christopher G Beevers
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | - Michael C Mullarkey
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | - Justin Dainer-Best
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | - Rochelle A Stewart
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | - Jocelyn Labrada
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
| | | | | | - Jason Shumake
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin
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