-
[show abstract]
[hide abstract]
ABSTRACT: Functional avoidance is considered as one of the key mechanisms underlying overgeneral autobiographical memory (OGM). According to this view OGM is regarded as a learned cognitive avoidance strategy, based on principles of operant conditioning; i.e., individuals learn to avoid the emotionally painful consequences associated with the retrieval of specific negative memories. The aim of the present study was to test one of the basic assumptions of the functional avoidance account, namely that autobiographical memory retrieval can be brought under operant control. Here 41 students were instructed to retrieve personal memories in response to 60 emotional cue words. Depending on the condition, they were punished with an aversive sound for the retrieval of specific or nonspecific memories in an operant conditioning procedure. Analyzes showed that the course of memory specificity significantly differed between conditions. After the procedure participants punished for nonspecific memories retrieved significantly more specific memories compared to participants punished for specific memories. However, whereas memory specificity significantly increased in participants punished for specific memories, it did not significantly decrease in participants punished for nonspecific memories. Thus, while our findings indicate that autobiographical memory retrieval can be brought under operant control, they do not support a functional avoidance view on OGM.
Memory 02/2013; · 2.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: According to the functional avoidance hypothesis, overgeneral autobiographical memory, the tendency to retrieve personal memories in a less specific format, might serve an affect-regulating function. Reducing the specificity of memories of negative events may prevent individuals from re-experiencing the associated painful emotions. This cognitive avoidance strategy might not only be employed by depressed and traumatized patients, but also by healthy individuals. In the present study we tested the hypothesis that the increase in memory overgenerality induced by an acute stressor is positively correlated with habitual (cognitive) avoidant coping. Participants (N = 32) were exposed to a Trier Social Stress Test. Cognitive avoidant coping was measured at the start of the experiment by means of the Mainz Coping Inventory. Before, immediately after, and 40 min after the Trier Social Stress Test, autobiographical memory specificity was assessed by means of the Autobiographical Memory Test. Cognitive avoidant coping was significantly correlated with an increase in categoric memories from pre to immediately post stressor, but not with change in overgeneral memories from pre to 40 min post stressor. The results of the present experiment provide further support for functional avoidance as one of the mechanisms underlying overgeneral memory.
Journal of behavior therapy and experimental psychiatry 12/2012; 43 Suppl 1:S37-42. · 2.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The goal of this chapter is to describe how a particular deficit in autobiographical memory, that is, a deficit in its specificity, may be implicated in occurrence and escalation of suicidal crises. We present findings in suicidal patients as well as other groups of patients to explore the processes that underlie these memory deficits. We then look at how these processes may relate to psychological mechanisms leading to suicidal behavior. First, we introduce the phenomenon of overgeneral memory. Second, we address the issue of etiology. Third, we consider what cognitive mechanisms underlie the phenomenon and how they may stabilize into a trait feature of some individuals. Fourth, we outline the evidence for the consequences of this memory deficit. Finally, we draw out the clinical implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
10/2012;
-
[show abstract]
[hide abstract]
ABSTRACT: Reduced autobiographical memory specificity, or overgeneral memory, is an important feature and vulnerability factor of depression (Williams, 1996) and is closely associated with a trauma or abuse history in childhood (Hermans et al., 2004). The present study examined the relation between autobiographical memory specificity and trauma in 28 patients with major depression. Trauma-related intrusive memories and efforts to avoid such memories were significantly related to reduced autobiographical memory specificity, whereas trauma itself was not. Moreover, this relationship could not be explained by a reduction in working memory capacity. Results further revealed rumination as a moderator of the relation between trauma and overgeneral memory. The results as a whole suggest that how one copes with trauma or abuse afterwards is of more importance for developing overgeneral memory following trauma, than mere trauma experience itself. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
10/2012;
-
[show abstract]
[hide abstract]
ABSTRACT: Objective: The efficacy and acceptability of existing psychological interventions for health anxiety (hypochondriasis) are limited. In the current study, the authors aimed to assess the impact of mindfulness-based cognitive therapy (MBCT) on health anxiety by comparing the impact of MBCT in addition to usual services (unrestricted services) with unrestricted services (US) alone. Method: The 74 participants were randomized to either MBCT in addition to US (n = 36) or US alone (n = 38). Participants were assessed prior to intervention (MBCT or US), immediately following the intervention, and 1 year postintervention. In addition to independent assessments of diagnostic status, standardized self-report measures and assessor ratings of severity and distress associated with the diagnosis of hypochondriasis were used. Results: In the intention-to-treat (ITT) analysis (N = 74), MBCT participants had significantly lower health anxiety than US participants, both immediately following the intervention (Cohen's d = 0.48) and at 1-year follow-up (d = 0.48). The per-protocol (PP) analysis (n = 68) between groups effect size was d = 0.49 at postintervention and d = 0.62 at 1-year follow-up. Mediational analysis showed that change in mindfulness mediated the group changes in health anxiety symptoms. Significantly fewer participants allocated to MBCT than to US met criteria for the diagnosis of hypochondriasis, both immediately following the intervention period (ITT 50.0% vs. 78.9%; PP 47.1% vs. 78.4%) and at 1-year follow-up (ITT 36.1% vs. 76.3%; PP 28.1% vs. 75.0%). Conclusions: MBCT may be a useful addition to usual services for patients with health anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Journal of Consulting and Clinical Psychology 06/2012; 80(5):817-28. · 4.85 Impact Factor
-
Mindfulness 04/2012; 2(2):142-142.
-
[show abstract]
[hide abstract]
ABSTRACT: Most people believe that the future will bring them more good things than bad, and therefore have high hopes for the future
(MacLeod etal. Cogn Emot 10:69–85, 1996). However, many patients with mood disorders do not hold this positive belief about
the future. At the extreme, low expectations of positive outcomes in the future can lead to feelings of hopelessness (O’Connor
etal. Psychol Health Med 5:155–161, 2000). This paper aims to extend the literature on subjective probability of future events,
using a mood induction paradigm to examine the effects of transient mood change on perceived likelihood of future events in
a non-clinical community sample. Participants rated likelihood of future events from a standardized list and from their own
lives. Ratings were made in both normal and experimentally-induced positive or negative mood. Results show that self-generated
future events were perceived to be more likely than those from a standardized list, and that negative mood significantly biased
perceived likelihood of other-generated future events. Participants rating standardized list events saw positive outcomes
as less likely and negative outcomes as more likely in induced negative mood than they did in normal mood. Mood had no effect
on ratings of self-generated events. Possible directions for future research are discussed.
Journal of Happiness Studies 04/2012; 10(4):483-496. · 1.88 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Using a cross-sectional design, we examined the relationship between naturally occurring levels of mindfulness and rumination
in students (n = 164). As predicted, we found that, when controlling for current depressive symptoms and prior history of
depression, mindfulness was significantly negatively correlated with rumination, but it was only associated with the extent
to which rumination was experienced as uncontrollable, not with global levels of rumination. Furthermore, mindfulness moderated
the relationship between global levels of rumination and uncontrollability of rumination, consistent with the suggestion that
high dispositional mindfulness reduces the extent to which ruminative reactions tend to escalate into self-perpetuating and
uncontrollable ruminative cycles.
KeywordsMindfulness-Rumination-Depression
Mindfulness 04/2012; 1(4):199-203.
-
[show abstract]
[hide abstract]
ABSTRACT: Long-term vulnerability to depression is related to the presence of perceived discrepancies between the actual self and ideal
self-guides. This study examined the immediate effects of an 8-week course of Mindfulness-Based Cognitive Therapy (MBCT) on
self-discrepancies in individuals currently in recovery, with a history of affective disorder that included suicidal ideation
and behaviour. Results indicated significant time×group interactions for both ideal self similarity and ideal self likelihood ratings, primarily accounted for by increases in self-discrepancy
from pre-test to post-test in the waiting list group which were not seen in those receiving MBCT. Changes in self-discrepancy
were not associated with changes in residual depressive symptoms, but in the MBCT group there was a significant association
between increases in ideal self similarity and the adoption of more adaptive ideal self-guides post treatment. MBCT may protect
against increases in self-discrepancy in people vulnerable to relapse to depression and may also facilitate a shift in the
goals of self-regulation.
Cognitive Therapy and Research 04/2012; 32(6):775-787. · 1.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Although the Autobiographical Memory Test (AMT) is widely used its psychometric properties have rarely been investigated. This paper utilises data gathered from a 10-item written version of the AMT, completed by 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children, to examine the psychometric properties of the measure. The results show that the scale derived from responses to the AMT operates well over a wide range of scores, consistent with the aim of deriving a continuous measure of over-general memory. There was strong evidence of group differences in terms of gender, low negative mood, and IQ, and these were in agreement when comparing an item response theory (IRT) approach with that based on a sum score. One advantage of the IRT model is the ability to assess and consequently allow for differential item functioning. This additional analysis showed evidence of response bias for both gender and mood, resulting in attenuation in the mean differences in AMT across these groups. Implications of the findings for the use of the AMT measure in different samples are discussed.
Memory 02/2012; 20(3):300-20. · 2.09 Impact Factor
-
J Mark G Williams,
Thorsten Barnhofer,
Catherine Crane,
Danielle S Duggan,
Dhruvi Shah,
Kate Brennan,
Adele Krusche,
Rebecca Crane,
Catrin Eames,
Mariel Jones,
Sholto Radford,
Ian T Russell
[show abstract]
[hide abstract]
ABSTRACT: This report assesses the association between age of onset of major depression and later suicidality in a sample of 276 recurrently depressed patients recruited for the Oxford/Bangor Staying Well after Depression (SWAD) Trial, and interviewed when in remission.
The study enrolled adult patients with a history of at least three episodes of non-psychotic major depressive disorder from primary care and psychiatric care practices and through community advertisements. At study entry, all participants estimated the age of their first onset of a major depressive episode and completed both self-report and interview-based assessments of past and current suicidal ideation and behavior. Participants were divided into pre-adult and adult onset groups using a cut-off age of 18.
Forty-eight percent of the sample reported a pre-adult age of onset. Pre-adult age of onset was significantly associated with suicidality, both from self-report and from interviewer assessment even when adjusting for differences in age, gender, employment status, length of the disorder and early adversity.
Relevant variables were all assessed through retrospective reports.
Pre-adult age of onset is closely associated with risk for and severity of later suicidality, replicating, in a sample of patients assessed when in remission, findings from studies that assessed patients when currently depressed. The association of pre-adult age of onset with suicidality is not due to differences in sociodemographic variables, length of the disorder and early adversity.
Journal of affective disorders 02/2012; 138(1-2):173-9. · 3.76 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Stress has been shown to have a number of negative effects on health over time. Mindfulness interventions have been shown to decrease perceived stress but access to interventions is limited. Therefore, the effectiveness of an online mindfulness course for perceived stress was investigated.
A preliminary evaluation of an online mindfulness course.
This sample consisted of 100 self-referrals to the online course. The average age of participants was 48 years and 74% were women.
The online programme consisted of modules taken from Mindfulness Based Stress Reduction and Mindfulness Based Cognitive Therapy and lasted for approximately 6 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants completed the Perceived Stress Scale (PSS) before the course, after the course and at 1-month follow-up. Completion of formal (eg, body scan, mindful movement) and informal (eg, mindful meal, noticing) mindfulness activities was self-reported each week.
Participation in the online mindfulness course significantly reduced perceived stress upon completion and remained stable at follow-up. The pre-post effect size was equivalent to levels found in other class-based mindfulness programmes. Furthermore, people who had higher PSS scores before the course reported engaging in significantly more mindfulness practice, which was in turn associated with greater decreases in PSS.
Because perceived stress significantly decreased with such limited exposure to mindfulness, there are implications for the accessibility of mindfulness therapies online. Future research needs to evaluate other health outcomes for which face-to-face mindfulness therapies have been shown to help, such as anxiety and depressive symptoms.
BMJ open. 01/2012; 2(3).
-
[show abstract]
[hide abstract]
ABSTRACT: According to the affect-regulation hypothesis (Williams et al., 2007), reduced autobiographical memory specificity (rAMS) or overgeneral memory (OGM) might be considered a cognitive avoidance strategy; that is, people learn to avoid the emotionally painful consequences associated with the retrieval of specific negative memories. Based on this hypothesis, one would predict significant negative associations between AMS and avoidant coping. However, studies investigating this prediction have led to equivocal results. In the present study we tested a possible explanation for these contradictory findings. It was hypothesized that rAMS (in part) reflects an avoidant coping strategy, which might only become apparent under certain conditions, that is, conditions that signal the possibility of 'danger.' To test this hypothesis, we assessed AMS and behavioral avoidance but experimentally manipulated the instructions. In the neutral condition, two parallel versions of the Autobiographical Memory Test (AMT) were presented under neutral instructions. In the threat condition, the first AMT was presented under neutral instructions, while the second AMT was presented under 'threat instructions.' Results showed no significant correlations between avoidance and OGM under neutral conditions but significant and markedly stronger correlations under threat conditions, with more avoidance being associated with fewer specific and more categoric memories. In addition, high avoiders showed a stronger reduction in AMS in the threat condition as compared with the neutral condition, while low avoiders showed no such difference between conditions. The data confirm that OGM can be considered as part of a broader avoidant coping style. However, more importantly, they show that, at least in nonclinical individuals, the activation of this coping style may depend on the context.
Emotion 12/2011; 11(6):1500-6. · 3.88 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study examined the relationship between health anxiety and searching for health information online, a phenomenon dubbed 'cyberchondria'. The majority of those with 'high' (n=46) and 'low' (n=36) levels of health anxiety reported seeking health information online. However, those with higher levels of health anxiety sought online health information more frequently, spent longer searching, and found searching more distressing and anxiety provoking. Furthermore, more responses in the high than low health anxiety group related to searching for information on diagnosed and undiagnosed medical conditions, descriptions of others' experiences of illnesses and using message boards/support groups, although the largest proportion of responses in both groups was accounted for by seeking information on symptoms. Linear regression (n=167) revealed significant relationships between health anxiety and the frequency, duration and distress and anxiety associated with searching for health information online. This preliminary data suggests that searching for health information online may exacerbate health anxiety.
Journal of anxiety disorders 11/2011; 26(1):189-96. · 2.68 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE. Severe health anxiety (hypochondriasis) is a common and disabling condition for which existing psychological treatments have limited effects (Thomson & Page, 2007). Hence, it is a priority to examine both the efficacy and acceptability of new psychological treatments for health anxiety. The aim of this study was to explore the experiences of participants with severe health anxiety who received Mindfulness-based Cognitive Therapy (MBCT) as part of a randomized controlled trial. DESIGN. Semi-structured interviews were carried out 3 months after participants completed MBCT in order to explore their experiences of the course and subsequent self-managed practice. METHODS. Interpretative Phenomenological Analysis (Smith, 1996) was used to analyze interview transcripts from nine participants who had received MBCT. RESULTS. Two main themes emerged from the analysis: (1) My awareness of barriers to experiencing change through MBCT, and (2) Cultivation of a new approach to health anxiety and my life in general. CONCLUSIONS. The majority of participants considered MBCT to be an acceptable and beneficial treatment for health anxiety. Participants reported beneficial impacts of MBCT both on their health anxiety and on their broader functioning. Importantly, the focusing of attention upon bodily sensations required in MBCT practice did not exacerbate participants' health anxiety.
British Journal of Clinical Psychology 11/2011; 50(4):379-97. · 1.90 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Previous research suggests distinct modes of self-focus, each with distinct functional properties: Analytical self-focus appears maladaptive, with experiential self-focus having more adaptive effects on indices of cognitive-affective functioning (e.g., Watkins, Moberly, & Moulds, 2008). The authors applied this framework to eating disorder (ED) psychopathology and manipulated the mode of self-focus prior to exposure to a stressor (imagining eating a large meal; Shafran, Teachman, Kerry, & Rachman, 1999). Study 1 showed that students high in ED psychopathology reported lower post-stressor feelings of weight or shape change and less subsequent attempts to neutralise (e.g., imagining exercising) after experiential relative to analytical self-focus. Study 2 found that partially weight restored patients with anorexia nervosa had lower post-stressor estimates of their own weight and reported lower urge to cancel stressor effects following experiential compared to analytical self-focus. Experiential self-focus was also followed by less neutralisation than analytical self-focus. Results suggest that the mode of self-focus affects cognitive reactivity following a stressor in individuals with ED psychopathology. Examining the mode within which individuals with ED psychopathology focus on self and body may raise important implications for understanding of psychopathology and open new possibilities for augmenting current treatments.
Behaviour research and therapy 07/2011; 49(10):635-45. · 3.00 Impact Factor
-
06/2011: pages 401 - 418; , ISBN: 9781119998556
-
[show abstract]
[hide abstract]
ABSTRACT: Conditional goal setting (CGS, the tendency to regard high order goals such as happiness, as conditional upon the achievement of lower order goals) is observed in individuals with depression and recent research has suggested a link between levels of dispositional mindfulness and conditional goal setting in depressed patients. Since interventions which aim to increase mindfulness through training in meditation are used with patients suffering from depression it is of interest to examine whether such interventions might alter CGS. Study 1 examined the correlation between changes in dispositional mindfulness and changes in CGS over a 3-4 month period in patients participating in a pilot randomised controlled trial of Mindfulness-Based Cognitive Therapy (MBCT). Results indicated that increases in dispositional mindfulness were significantly associated with decreases in CGS, although this effect could not be attributed specifically to the group who had received training in meditation. Study 2 explored the impact of brief periods of either breathing or loving kindness meditation on CGS in 55 healthy participants. Contrary to expectation, a brief period of meditation increased CGS. Further analyses indicated that this effect was restricted to participants low in goal re-engagement ability who were allocated to loving kindness meditation. Longer term changes in dispositional mindfulness are associated with reductions in CGS in patients with depressed mood. However initial reactions to meditation, and in particular loving kindness meditation, may be counterintuitive and further research is required in order to determine the relationship between initial reactions and longer-term benefits of meditation practice.
Mindfulness 12/2010; 1(4):204-214.
-
[show abstract]
[hide abstract]
ABSTRACT: The majority of research in eating disorders (ED) has investigated the content of disorder-specific thoughts, while few studies have addressed underlying cognitive-affective processes. A better understanding of processes underpinning ED may have important implications for treatment development. Two studies were conducted that investigated levels of rumination, beliefs about rumination, experiential avoidance, and aspects of schematic thinking in individuals with eating pathology. The latter was assessed with a newly designed ED-Sentence Completion Task (ED-SCT). Study 1 (N = 177) examined relations between ED psychopathology and these variables in a student population. Extending this, Study 2 (N = 26) assessed differences between patients with anorexia nervosa and healthy control participants. The results showed that ED psychopathology was related to disorder-specific cognitions, experiential avoidance as well as ruminative brooding but not reflection. A follow-up of anorexia nervosa patients indicated that changes in ED psychopathology were associated with changes in dysfunctional attitudes and maladaptive cognitive-affective processes. These findings highlight cognitive processes that may play an important role in the maintenance of eating pathology.
Behaviour research and therapy 09/2010; 48(9):851-9. · 3.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group.
This trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter.
This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression--that in people who become suicidal when depressed.
BMC Psychiatry 03/2010; 10:23. · 2.55 Impact Factor
