Beneficial effects of training in self-distancing and perspective broadening for people with a history of recurrent depression

Emma Travers-Hill,Barnaby D Dunn,Laura Hoppitt,Caitlin Hitchcock,Tim Dalgleish

doi:10.1016/j.brat.2017.05.008

Abstract

Cognitive training designed to recalibrate maladaptive aspects of cognitive-affective processing associated with the presence of emotional disorder can deliver clinical benefits. This study examined the ability of an integrated training in self-distancing and perspective broadening (SD-PB) with respect to distressing experiences to deliver such benefits in individuals with a history of recurrent depression (≥3 prior episodes), currently in remission. Relative to an overcoming avoidance (OA) control condition, SD-PB: a) reduced distress to upsetting memories and to newly encountered events, both during training when explicitly instructed to apply SD-PB techniques, and after-training in the absence of explicit instructions; b) enhanced capacity to self-distance from and broaden perspectives on participants' experiences; c) reduced residual symptoms of depression. These data provide initial support for SD-PB as a low-intensity cognitive training providing a spectrum of cognitive and affective benefits for those with recurrent depression who are at elevated risk of future episodes.

Highlights

Cognitive training designed to recalibrate maladaptive aspects of cognitive-affective processing associated with the presence of emotional disorder can deliver clinical benefits
In this study we evaluate a cognitive training protocol derived from two areas of basic science relevant to depression – self-distancing (Kross & Ayduk, 2011) and perspective broadening (Schartau, Dalgleish, & Dunn, 2009; Trope & Liberman, 2010)
We only included those with a recurrent course comprising at least three previous major depressive episodes as recurrent depression is most closely associated with heightened sensitivity to, and dysfunctional appraisals of, everyday negative events (Teasdale, 1988). This matches the inclusion criteria for trials of intensive preventive clinical interventions such as mindfulness-based cognitive therapy (MBCT) (Kuyken et al, 2016). We examined both the cognitive and affective effects of SD-Perspective Broadening (PB) training versus Overcoming Avoidance (OA) training, using standardized self-report measures of self-distancing and perspective broadening alongside targeted rating scales based on earlier work (Kross et al, 2012)

Summary

Introduction

Cognitive training designed to recalibrate maladaptive aspects of cognitive-affective processing associated with the presence of emotional disorder can deliver clinical benefits. Relative to an overcoming avoidance (OA) control condition, SD-PB: a) reduced distress to upsetting memories and to newly encountered events, both during training when explicitly instructed to apply SD-PB techniques, and after-training in the absence of explicit instructions; b) enhanced capacity to self-distance from and broaden perspectives on participants' experiences; c) reduced residual symptoms of depression These data provide initial support for SD-PB as a low-intensity cognitive training providing a spectrum of cognitive and affective benefits for those with recurrent depression who are at elevated risk of future episodes. A number of psychological interventions have been developed that can be used to target such cognitive change in remitted depressed individuals, most notably cognitive-behavior therapy (CBT; Vittengl, Clark, Dunn, & Jarrett, 2007) and mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2012) These interventions are complex, intensive and require specialized therapist training. Research in both domains focuses on cognitive and affective change across time, as opposed to mapping the nature of cognition-emotion interactions, providing a platform for cognitive intervention development

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