Abstract:

Memory specificity training (MEST) alone may improve depressedmood through increased memory specificity as found in previous studies. The purpose of the research was to build and expand on the use of MEST by testing the efficacy and feasibility ofseven treatment sessions with a three month follow up of group CBT with MEST in moderately depressed adults. An initial sample of 60 adult participants had been recruited through advertisements and screening procedures within two London Boroughs. They were block randomised to ensure equal gender and allocated to a within group design with repeated measures using the Autobiographical memory Test to measure changes in memory specificity (AMS) and theBeck depression inventory II (BDI-II) to measure changes in mood. Data from 55 completers was analysed using a one way repeated ANOVA. The results showed the changes in scores from both measures where statistically significant at post treatment and three month follow up compared to the pre-treatment scores with large effect sizes. This outcome rejected thenull hypothesis and showed that MEST was an effective and feasible adjunctwith CBT in improving memory specificity and mood more than was achieved in previous studies using MEST alone. Limitations of the study included, randomisation not fully blind, no independent therapists, low frequency of supervision for checking manual adherence, no SCID, short follow up period and reduced generalisability. Future research could repeat this study use group CBT as a control, participants from out-patient departments, larger sample size, improve blinding before random allocation, using SCID, frequentsupervision and use of independent therapists.

References:

[1] J. Barth, T. Munder, H. Gerger, E. Nüesch, S. Trelle, H. Znoj, P. Juni, P. Cuijpers, Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis. PLoS Medicine (2013), 10(5), e1001454. doi:10.1371/journal.pmed.1001454

[2] P. Cuijpers M. Berking, G. Andersson, L. Quigley, A. Kleiboer, K.S. Dobson, A meta-analysis of cognitive behaviour therapy for adult depression, alone and in comparison to other treatments. Canadian Journal of Psychiatry (2013), 58, 376-385

[3] E. Driessen, H.L. Van, F.J. Don, J. Peen, S. Kool, D. Westra, M. Hendriksen, R.A. Schoevers, P. Cuipers, J.W. Twisk, J.J. Dekker, The efficacy of cognitive behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial. American Journal of Psychiatry (2013), 170:1041–1050. doi: 10.1176/appi.ajp.2013.12070899.

[4] V. Hunot, T.H.M. Moore, D.M. Caldwell, T.A. Furukawa, P. Davies, H. Jones, M. Honyashiki, P. Chen, G. Lewis, R. Churchill, ‘Third wave’ cognitive and behavioural therapies versus other psychological therapies for depression. Cochrane Database of Systematic. (2013),10. Art. No.: CD008704. doi:10.1002/14651858.CD008704.pub2.

[5] T.J. Johnsen and O. Friborg, The Effects of Cognitive Behavioral Therapy As an Anti-Depressive Treatment is Falling: A Meta-Analysis. Psychological Bulletin (2015), Advance online publication.http://dx.doi.org/10.1037/bul0000015

[6] D. Hermans, A. de Decker, S. de Peuter, F. Raes, P. Eelen, J.M.G. Williams, Autobiographical memory specificity and affect regulation: Coping with a negative life event. Depression Anxiety (2008),25:787–792. doi:10.1002/da.20326

[7] D. Hermans, A. Defranc, F. Raes, J.M.G. Williams, P. Eelen, Reduced autobiographical memory specificity as an avoidant coping style. British Journal of Clinical Psychology (2005), 44, 583-589. doi:10.1348/014466505X53461

[8] J.M.G. Williams, T. Barnhofer, C. Crane, D. Herman, F. Raes, E. Watkins, T. Dalgleish, Autobiographical memory specificity and emotional disorder. Psychological Bulletin (2007), 133,:122–148. doi: 10.1037/0033- 2909.133.1.1

[9] J.A. Sumner, J.W. Griffith, S. Mineka, Overgeneral autobiographical memory as a predictor of the course of depression: A meta-analysis. Behaviour Research Therapy (2010), 48, 614–625. doi: 10.1016/j.brat.2010.03.013

[10] F. Raes, J.M.G. Williams, D. Hermans, Reducing cognitive vulnerability to depression: A preliminary investigation of Memory Specificity Training (MEST) in inpatients with depressive symptomatology. Journal Behavior Therapy Experimental Psychiatry (2009), 40, 24–38. doi:10.1016/j.jbtep.2008.03.001

[11] H.T. Neshat Doost, T. Dalgleish, W. Yule, M. Kalantari, S.J. Ahmadi, A. Dryregrov, L. Jobson, Enhancing autobiographical memory specificity through cognitive training: an intervention for depression translated from basic

science. Clinical Psychological Science (2013), 1:84–92. doi:10.1177/2167702612454613

[12] E. Eigenhuis, A. Seldenrijk, A. van Schaik, F. Raes, P. vanOppen, Feasibility and effectiveness of memory specificity training in depressed outpatients: a pilot study. Clinical Psychology and Psychotherapy (2015), Dec, doi: 10.1002/cpp.1995

[13] S.A. Moore and L.A. Zoellner, Overgeneral Autobiographical Memory and Traumatic Events: An Evaluative Review. Psychological Bulletin (2007), 419–437. doi 10.1037/0033-2909.133.3.419

[14] T. Dalgleish, A. Bevan, A. McKinnon, L. Breakwell, V. Mueller, I. Chadwick, S. Schweizer, C. Hitchcock, P. Watson, F. Raes, L. Jobson., A. Werner-Seidler, comparison of Memory Specificity Training (MEST) to education and support (ES) in the treatment of recurrent depression: study protocol for a cluster randomised controlled trial. Trials (2014), 15. 1-9. doi:10.1186/1745-6215-15-293

[15] P. McCrone, S. Dhanasiri, A. Patel, M. Knapp, S. Lawton-Smith, Paying the price: the cost of mental health care in England to 2026. The King's Fund, London (2008)

[16] A.J. Ferrari, F.J. Charlson, R.E. Norman, S.B. Patten, G. Freedman, J.L. Murray, T. Vos, H.A. Whiteford, Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010. PLoS Med (2013), 10(11): e10001547.doi:101371

[17] N. Sartorius, The economic and social burden of depression. Journal Clinical Psychiatry (2001), 62(15), 8-11.

[18] M.A. Conway and D.C. Rubin, The structure of autobiographical memory. In A. E. Collins, S. E. Gathercole, M. A. Conway, & P. E. M. Morris (Eds.), Theories of memory (pp. 103-137). Hove, Sussex, England:Erlbaum (1993)

[19] F. Raes, D. Hermans, J.M.G. Williams, W. Beyers, E. Brunfaut, P. Eelen, Reduced autobiographical memory specificity and rumination in predicting the course of depression. Journal Abnormal Psychology (2006),115, 699– 704. http://dx.doi.org/10.1037/0021-843X.115.4.699

[20] M.A. Conway and C.W. Pleydell-Pearce, The construction of autobiographical memories in the self-memory system. Psychological Review (2000),107, 261–88. doi: 10.1037//0033-295X. 107.2.261

[21] F. Peeters, I. Wessel, H. Merckelbach, M. Boon-Vermeeren, Autobiographical memory specificity and the course of major depressive disorder. Comprehensive Psychiatry (2002), 43, 344-350. doi:10.1053/comp.2002.34635

[22] J.M.G. Williams, Capture, rumination, functional avoidance and executive control (carfax). Three processes that underlie over-general memory. Cognition and Emotion (2006), 3/4, 548-568. doi:10.1080/02699930500450465

[23] American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing (2013)

[24] A.T. Beck, R.A. Steer, G.K. Brown, Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation (1996)

[25] D. Barlow, Clinical Handbook of Psychological Disorders, Fifth Edition: A Step-by-Step Treatment Manual. The Guildford Press, London (2008)

[26] A.T. Beck, J.A. Rush, B.F. Shaw, G. Emery, Cognitive therapy for depression. New York: Guilford Press (1979)

[27] K. Efthimiou and M. Psoma, Lewinsohn’s cognitive behavioral group Therapy course for depression: structure, application and efficacy. Encephalos (2012), 49, 60-66

[28] K.P. Suresh, An overview of randomization techniques: An unbiased assessment of outcome in clinical research. Human Reproductive Science (2011), 4, 8–11.doi: 10.4103/0974-1208.82352

[29] J.M.G. Williams and K. Broadbent, Autobiographical memory in suicide attempters. Journal of Abnormal Psychology (1986), 95, 144-149.doi:10.1037/0021- 843X.95.2.144

[30] J.W. Griffith, J.A. Sumner, E. Debeer, F. Raes, D. Hermans, S. Mineka, R.E. Zinbarg., M.G. Craske, An item response theory/confirmatory factor analysis of the Autobiographical Memory Test. Memory (2009), 17, 609–623.doi: 10.1080/09658210902939348

[31] Y.P. Wang and C. Gorenstein, Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. RevistaBrasileira de Psiquiatria (2013),.35:416–431. doi:10.1590/1516-4446-2012-1048

 [32] G.L. Schlomer, S. Bauman, S. N.A. Card, Best Practices for Missing Data Management in Counselling Psychology (2010), Vol. 57, No. 1, 1–10. doi: 10.1037/a0018082

[33] D.A. Bennett, How can I deal with missing data in my study? Australian and New Zealand Journal of Public Health (2001), 25, 464 – 469

[34] C.Y.J. Peng, M. Harwell, S.M. Liou, L.H. Ehman, Advances in missing data methods and implications for educational research. In S. Sawilowsky (Ed.), Real data analysis (pp. 31–78). Greenwich, CT: Information Age (2006)

[35] S.W. Greenhouse and S. Geisser, On methods in the analysis of profile data. Psychometrika (1959), 24, 95–112. doi: 10.1007/BF02289823.

[36] J.M.G. Williams, J. D. Teasdale, Z.V. Segal, J. Soulsby, J. Mindfulness- based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. Journal of Abnormal Psychology (2000), 109, 150-155. doi: 10.1037//0021-843X.109.1.150

[37] van M.F. Vreeswijkand de E.J. Wilde, de, Autobiographical memory specificity, psychopathology, depressed mood and the use of the AMT: A meta-analysis. Behaviour Research and Therapy (2004), 42(6): 731-43

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[39] P.C. Kendall and R.S. Beidas, Professional Psychology: Research and Practice (2007), 38(1), 13-20. http://dx.doi.org/10.1037/0735-7028.38.1.13

Abstract:

Memory specificity training (MEST) alone can improve mood associated with depression as found in previous studies. The aim was to build upon and expand on previous MEST and self-distancing (SD) studies by testing the effectiveness and feasibility of seven treatment sessions with a three month follow up of group CBT with MEST and SD in moderately depressed adults in two London Boroughs. Method was to recruit 60 participants from advertisements and a screening process that included administration of questionnaires, the autobiographical memory test (AMT) and Beck depression inventory (BDI-II) and interviewed to confirm they met the inclusion and exclusion criteria, and met symptoms for depression as listed in the DSM-5. Consent was obtained and then block randomising done to ensure a balanced group. There were 55 participants who completed the treatment at all time points and their data and scores on the AMT and BDI-II was used when running a one way repeated ANOVA as this was a within group design with repeated measures, using SPSS 22. The results showed improvements occurred at post-treatment and three month follow up for AMS and BDI-II scores that was statistically significant with large effect sizes at post-treatment and three month follow up. Discussion, the null hypothesis was rejected and the alternative hypothesis was accepted. MEST with self-distancing is an effective and feasible adjunct with CBT in improving memory specificity and mood. Limitations included; the study was not fully blind, no independent therapist, low frequency of supervision for checking manual adherence, no SCID, short follow up period and reduced generalisability. Future research could repeat this study using group CBT as a control, participants recruited from out-patient departments, larger sample size, improve blinding before random allocation, using SCID, frequent supervision and use of an independent therapist.

References:

[1] J. Barth, T. Munder, H. Gerger, E. Nüesch,. S. Trelle, H. Znoj, P. Juni, P. Cuijpers, Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis. PLoS Medicine, (2013), 10(5), e1001454. doi:10.1371/journal.pmed.1001454

[2] P. Cuijpers M. Berking, G. Andersson, L. Quigley, A. Kleiboer A, K.S. Dobson, A meta-analysis of cognitive behavior therapy for adult depression, alone and in comparison to other treatments. Canadian Journal of Psychiatry, (2013), 58, 376-385

[3] E. Driessen, H.L. Van, F.J. Don, J. Peen, S. Kool, D. Westra, M. Hendrikson,, M. Schoevers., P. Cuipers, J. Twisk, J.J. Dekker, The efficacy of cognitive behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial. American Journal of Psychiatry (2013), 170:1041–1050. doi: 10.1176/appi.ajp.2013.12070899

[4] V. Hunot, T.H.M. Moore, D.M. Caldwell, T.A. Furukawa, P. Davies, H. Jones, M. Honyashiki, P. Chen, G. Lewis, R. Churchill R, ’Third wave’ cognitive and behavioural therapies versus other psychological therapies for depression. Cochrane Database of Systematic 10 (2013),. Art. No.: CD008704. doi:10.1002/14651858.CD008704.pub2.

[5] T.J. Johnsen and  O. Friborg, The Effects of Cognitive Behavioral Therapy As an Anti-Depressive Treatment is Falling: A Meta-Analysis. Psychological Bulletin. (2015), Advance online publication.doi.org/10.1037/bul000015

[6] F. Raes, D. Hermans, A. De Decker, P. Eelen, J.M.G. Williams, Autobiographical Memory Specificity and affect regulation : an experimental approach. Emotion (2003), 3, 201-206, doi:10.1037/1528-3542.3.2.201

[7] J.M.G. Williams, T. Barnhofer, C. Crane, D. Herman, F. Raes, E. Watkins, T. Dalgleish, Autobiographical memory specificity and emotional disorder. Psychological Bulletin, (2007), 133,:122–148. doi: 10.1037/0033-2909.133.1.122

[8] J.A. Sumner, J.W. Griffith, S. Mineka, S. Overgeneral autobiographical memory as a predictor of the course of depression: A meta-analysis. Behaviour Research Therapy (2010), 48, 614–625.doi: 10.1016/j.brat.2010.03.013

[9] F. Raes, J.M.G. Williams, D. Hermans, Reducing cognitive vulnerability to depression: A preliminary investigation of Memory Specificity Training (MEST) in inpatients with depressive symptomatology. Journal Behavior Therapy Experimental Psychiatry (2009), 40, 24–38.doi:10.1016/j.jbtep.2008.03.001

[10] H.T. NeshatDoost, T. Dalgleish, W. Yule, M. Kalantari, S.J. Ahmadi, A. Dryregrov, L. Jobson, L. Enhancing autobiographical memory specificity through cognitive training: an intervention for depression translated from basicscience. Clinical Psychological Science (2013), 1:84–92. doi: 10.1177/2167702612454613

[11] E. Eigenhuis, A. Seldenrijk, A. van Schaik, F. Raes, P. vanOppen, Feasibility and effectiveness of memory specificity training in depressed outpatients: a pilot study. Clinical Psychology and Psychotherapy. (2015), doi: 10.1002/cpp.1995

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[28] P. McCrone, S. Dhanasiri, A. Patel, M. Knapp, S. Lawton-Smith, Paying the price: the cost of mental health care in England to 2026. The King's Fund, London (2008)

[29] A.J. Ferrari, F.J. Charlson, R.E. Norman, S.B. Patten, G. Freedman, C.L.J. Murray, T. Vos, H.A. Whiteford, Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010. PLoS Med (2013), 10(11): e10001547.doi:101371

[30] N. Sartorius, The economic and social burden of depression. Journal Clinical Psychiatry (2001), 62(15), 8-11.

[31] American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing (2013)

[32] Conway, M. A., and Rubin, D. C. (1993). The structure of autobiographical memory. In A. E. Collins, S. E. Gathercole, M. A. Conway, & P. E. M. Morris (Eds.), Theories of memory (pp. 103-137). Hove, Sussex, England:Erlbaum

[33] Peeters, F., Wessel, I., Merckelbach, H., and Boon-Vermeeren, M. (2002). Autobiographical memory specificity and the course of major depressive disorder. Comprehensive Psychiatry, 43, 344-350. doi:10.1053/comp.2002.34635

[34] M.A. Conway and C.W. Pleydell-Pearce, The construction of autobiographical memories in the self-memory system. Psychological Review, (2000), 107, 261–88.doi: 10.1037//0033-295X. 107.2.261

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[39] D. Barlow, Clinical Handbook of Psychological Disorders, Fifth Edition: A Step-by-Step Treatment Manual. The Guildford Press, London (2008)

[40] K. Efthimiou and M. Psoma, Lewinsohn’s cognitive behavioral group Therapy course for depression: structure, application and efficacy. Encephalos, (2012), 49, 60-66.

[41] K.P. Suresh, An overview of randomization techniques: An unbiased assessment of outcome in clinical research. Human Reproductive Science (2011), 4, 8–11.doi: 10.4103/0974-1208.82352

[42] J.M.G. Williams and K. Broadbent, Autobiographical memory in suicide attempters. Journal of Abnormal Psychology (1986), 95, 144-149.doi:10.1037/0021- 843X.95.2.144

[43] J.W. Griffith, J.A. Sumner, E. Debeer, F. Raes, D. Hermans, S. Mineka, R.E. Zinbarg, M.G. Craske, An item response theory/confirmatory factor analysis of the Autobiographical Memory Test. Memory (2009), 17, 609–623.

[44] Y.P. Wang and  C. Gorenstein, Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. RevistaBrasileira de Psiquiatria (2013),.35:416– 431. doi:10.1590/1516-4446-2012-1048

[45] G.L. Schlomer, S. Bauman, S. N.A. Card, Best Practices for Missing Data Management in Counselling Psychology (2010), Vol. 57, No. 1, 1–10. DOI: 10.1037/a0018082

[46] D.A. Bennett, How can I deal with missing data in my study?Australian and New Zealand Journal of Public Health, (2001), 25, 464 – 469

[47] C.Y.J. Peng, M. Harwell, S.M. Liou, L.H. Ehman, Advances in missing data methods and implications for educational research. In S. Sawilowsky (Ed.), Real data analysis (pp. 31–78). Greenwich, CT: Information Age, (2006)

[48] S.W. Greenhouse and S. Geisser, On methods in the analysis of profile data. Psychometrika (1959), 24, 95–112. doi: 10.1007/BF02289823.

[49] E. Watkins and J.D. Teasdale, Rumination and overgeneral memory in depression: effects of self-focus and analytic thinking. Journal of AbnormalPsychology (2001), 110, 353–357.

[50] M.F. van Vreeswijk and de E.J. Wilde, de, Autobiographical memory specificity, psychopathology, depressed mood and the use of the AMT: A meta-analysis. Behaviour Research and Therapy (2004), 42(6): 731-43

[51] M .Seligman, The effectiveness of psychotherapy. American Psychologist (1995), 50, 965 –974.

[52] P.C. Kendall and R.S. Beidas, Professional Psychology: Research and Practice (2007), 38(1), 13-20. http://dx.doi.org/10.1037/0735-7028.38.1.13

[53]The factor structure of the Autobiographical Memory Test in recent trauma survivors.

J.W. Griffith, B. Kleim, J.A. Sumner, Jennifer and A. Ehlers (2012), The factor structure of the Autobiographical Memory Test in recent trauma survivors. Psychological Assessment, 24(3), 640-646. http://dx.doi.org/10.1037/a0026510