Intrusive Memories In Depression Research Articles

Alleviating distressing intrusive memories in depression: A comparison between computerised cognitive bias modification and cognitive behavioural education

Negative appraisals maintain intrusive memories and intrusion-distress in depression, but treatment is underdeveloped. This study compared the efficacy of computerised bias modification positive appraisal training (CBM) versus a therapist-delivered cognitive behavioural therapy session (CB-Education) that both aimed to target and alter negative appraisals of a negative intrusive autobiographical memory.Dysphoric participants (Mean BDI-II = 27.85; N = 60) completed baseline ratings of a negative intrusive memory, negative appraisals and the Impact of Event Scale, and were randomly allocated either one session of CBM, CB-Education, or a no intervention monitoring control condition (Control). Mood and intrusion symptoms were assessed at one week follow-up.For all groups, there were significant reductions over one week in mood (depression and anxiety), memory intrusiveness and negative appraisals. Groups differed in terms of intrusion-related distress, with the CB-Education group showing greatest reduction, followed by the CBM group.The study provides evidence for the link between maladaptive appraisals of intrusive memories and distress in depressed mood. Further, both a single session of CB-Education and (to a lesser degree) CBM are useful in reducing intrusion-related distress. This study may have been underpowered to detect differences and replication is needed with larger samples.

Souvenirs intrusifs au cours des troubles de l’humeur

AM retrieval is a reconstruction process that grounds the self by providing coherent narratives organized to elicit a sense of identity across the time. Major depression is associated with impairments of AM retrieval, combining a mood congruent recall, a lack of specificity, an increased prevalence of the third-person visual perspective and frequent intrusive memories, which are characterized by an involuntary, fast and effortless recall. Intrusive memories in depression relate to a broad range of negative life events and are usually vivid, distressful and associated with a poorer outcome as well as with typical depressogenic cognitive biases, especially with cognitive avoidance. To date, little is known about the neural bases of these memories. These bases are likely to partially mirror those of the depressive state, with a decreased cognitive control over unwanted thoughts by the prefrontal cortex and an increased amygdala activation.

Do Negative Appraisals and Avoidance of Intrusive Memories Predict Depression at Six Months?

Recent cross-sectional studies have found evidence of an important role for negative appraisals and avoidance of intrusive memories in depression. However, no studies to date have examined whether such appraisals predict depression over time. The role of negative appraisals and avoidance (in the form of suppression/distraction and rumination) was explored in the prediction of depression prospectively. At Time 1, a mixed sample of community participants (N = 85) were interviewed and completed self-report measures of depression symptoms and intrusive memories. At Time 2 (6 months later, N = 64), depression symptoms were re-assessed. For the subsample of participants who did not receive treatment between the baseline and follow-up assessments, baseline levels of negative appraisals of intrusions predicted follow-up depression, even after controlling for baseline depression symptoms. Unexpectedly, avoidance failed to predict depression in the subsample who did not receive treatment. These results provide furt...

Intrusive memories of negative events in depression: Is the centrality of the event important?

Background and ObjectivesFollowing stressful events, there is evidence that the degree to which the event is perceived as central to one’s identity and forms a reference point for the attribution of meaning to other events (i.e., “centrality of events”) is associated with depression symptoms. However, these findings have primarily come from cross-sectional studies of undergraduate samples, and no past study has investigated whether centrality predicts depression over time. We sought to further examine the role of centrality of negative autobiographical events that were the content of intrusive memories in depression. MethodsAt Time 1, participants (clinically depressed, recovered and never-depressed) were interviewed and completed self-report measures of depression symptoms, intrusive memories and features, centrality, and avoidance. At Time 2 (six months later), depression and anxiety symptoms were assessed. ResultsUnexpectedly, the three groups did not differ on centrality ratings. Centrality was not associated with concurrent depression symptoms and was not predictive of depression at follow-up. However, as expected, centrality ratings were positively correlated with important intrusive memory variables including memory intrusiveness, and rumination. LimitationsThe correlational nature of our design prevents us from establishing the causal direction of the relationships reported. ConclusionsThe degree to which intrusively recalled events are seen as central to identity might not play as important a role in depression as previously expected. Future centrality research needs to take memory frequency/intrusiveness into account before drawing conclusions about the role of this variable in depression.

Negative intrusive memories in depression: The role of maladaptive appraisals and safety behaviours

Background Evidence from non-clinical studies suggests that both negative appraisals of intrusive memories and the use of safety behaviours to manage these memories play a role in depression. This study extended this research by exploring its generalisability to a clinically depressed sample. Methods 85 participants (25 depressed, 30 recovered depressed, 30 never-depressed) were administered the SCID-I/NP (First et al., 1996), mood measures, and self-report questionnaires that indexed intrusive memory frequency and avoidance, appraisals and strategies used to manage the memories. Results Depressed participants endorsed higher ratings of negative appraisals of intrusive memories than the never-depressed group, with the recovered group reporting intermediate ratings across most appraisal themes. Depressed individuals reported more safety behaviours and passive strategies in response to their memories than the other two groups. Limitations The cross-sectional design of this study prevents conclusions regarding the causal role of both appraisals and safety behaviours. Conclusions These results highlight the importance of negative appraisals, safety behaviours and passive strategies that are used to manage intrusive memories in depression, and provide further support for the proposal that psychological interventions for depression could usefully incorporate components that aim to reduce intrusions and associated maintaining variables.

Can Imaginal Exposure Reduce Intrusive Memories in Depression? A Case Study

The presence of intrusive memories as an overlapping feature of depression and posttraumatic stress disorder (PTSD) raises the possibility that common therapeutic approaches may be effective. Imaginal exposure (IE) is the gold‐standard treatment for PTSD and directly reduces both PTSD and depression symptoms in traumatized individuals. The objective of this pilot study was to use a single‐case design to trial the use of IE to target intrusive memories of a negative life event as a treatment for major depression. The participant was experiencing depression after a relationship breakup. Pre–posttreatment measures (clinical interview and self‐report) showed a decrease in frequency of intrusive memories and improved mood, such that the participant no longer met diagnostic criteria for major depression at posttreatment or at 6‐month follow‐up. This case is an important first step in demonstrating the possible value of IE as an inclusion in therapy to reduce intrusive memories in patients whose depressive episode is precipitated by a stressor. Further application of IE to additional depressed clients in the context of a case series is needed to provide preliminary evidence of its efficacy as a treatment for depressive disorders.

The use of safety behaviours to manage intrusive memories in depression

Cognitive models of clinical disorders conceptualise cognitive and behavioural safety-seeking behaviours as central to symptom persistence because they prevent disconfirmation of key maintaining beliefs. Despite growing evidence of the role of negative beliefs about intrusive memories in depression, it remains unclear why such beliefs persist. Accordingly, we examined whether safety behaviours in response to unhelpful beliefs about intrusive memories might play a role in their maintenance. Eighteen high dysphoric (i.e., BDI-II⩾12) individuals who reported an intrusive negative autobiographical memory in the past week completed a battery of measures about their memory, associated negative beliefs and safety behaviours adopted in response to their beliefs. The most commonly endorsed beliefs reflected themes of wanting to control memories (e.g., ‘I should be able to rid my mind of this memory’) and self-deprecation about experiencing them (e.g., ‘Because I can’t control this memory, I am a weak person’). The beliefs prompted a range of safety behaviours, with cognitive distraction being the most common. The findings demonstrate that safety behaviours are common in response to maladaptive beliefs about intrusive memories. Treatment developments in this area are needed, and should incorporate strategies to challenge beliefs about memories, reduce the use of safety behaviours, and promote processing of intrusive memories.

Negative appraisals and cognitive avoidance of intrusive memories in depression: a replication and extension

Recent research has demonstrated that intrusive negative autobiographical memories represent a shared phenomenological feature of posttraumatic stress disorder (PTSD) and depression. A preliminary investigation (Starr and Moulds, 2006) successfully applied a cognitive appraisal model of PTSD to the maintenance of intrusive memories in depression. The current investigation sought to replicate and extend these findings. Two hundred and fifty first-year undergraduate students were interviewed to assess for the presence of a negative autobiographical memory that had spontaneously intruded in the past week. Participants completed self-report inventories assessing trait and situational employment of cognitive avoidance mechanisms in response to these memories. Consistent with Starr and Moulds, intrusion-related distress correlated with dysphoria, irrespective of intrusion frequency. Assigning negative appraisals to one's intrusive memory and attempts to control the memory were positively associated with intrusion-related distress, level of depression, and cognitive avoidance mechanisms. Additionally, negative appraisals and control influenced the employment rumination as an avoidant response to a greater degree than the corresponding trait tendency. Finally, negative appraisals and the use of cognitive mechanisms were predictive of depression concurrently. The results support the validity of borrowing from PTSD models to elucidate the cognitive mechanisms that maintain intrusive memories in depressed samples.

An investigation of the cognitive and experiential features of intrusive memories in depression

Intrusive autobiographical memories of negative past events are a clinical feature common to post-traumatic stress disorder (PTSD) and depression. Recent investigations provide increasing evidence that shared cognitive processes are linked to the maintenance of intrusive memories in both conditions. Still absent from the existing literature, however, is a systematic examination of the basic content and defining characteristics of intrusive memories in depression. This study sought to: (i) outline the content and features of intrusive memories in depression, and (ii) investigate whether intrusion characteristics linked to the persistence of intrusive memories in PTSD are also characteristic of intrusive memories in depression. A sample of undergraduate students (n=250) were interviewed and assessed for the presence of an intrusive memory in the past week, and completed a battery of measures that indexed cognitive and affective responses to the memory. Consistent with prediction, intrusive memories contained high levels of sensory experience and were marked by a sense of “nowness”. In accord with studies with PTSD samples, sensory features accounted for unique variance in the prediction of depression severity, over and above that accounted for by intrusion frequency. This pattern of findings was replicated in a dysphoric (BDI-II≥12) sub-sample of participants. Our results underscore the value of drawing on theoretical conceptualisations and empirical findings from the post-traumatic stress literature to extend our understanding of intrusive memories in depression.

Investigation of the indulgence cycles hypothesis of suppression on experimentally induced visual intrusions in dysphoria

Within the thought control literature, Wegner [(1989). White bears and other unwanted thoughts: Suppression, obsession, and the psychology of mental control. New York, NY, USA: Penguin Press.] referred to the combined initial suppression and expression phases of thought control as an indulgence cycle which results in the rebound effect typically observed in suppression studies. According to Ironic Process Theory [Wegner, (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.], this rebound leads to further attempts to suppress that are difficult due to the target thought's hyperaccessibility, resulting in a secondary rebound effect owing to a positive feedback system of indulgence cycles. The current study investigated (i) the effects of repeated suppression and opportunities for expression by using a method to index the frequency, duration, and associated levels of distress of an experimentally induced visual intrusion, and (ii) whether any observed effects were differentially linked to depressive symptomatology in an analogue sample of low and high dysphoric participants. Results supported a secondary rebound effect in those participants most successful at suppressing target intrusions. The findings offer an important extension to the emerging literature on the management of intrusive memories in depression.

Cognitive avoidance of intrusive memories: Recall vantage perspective and associations with depression

Although recent research demonstrates that intrusive memories represent an overlapping cognitive feature of depression and post-traumatic stress disorder (PTSD), there is still a general paucity of research investigating the prevalence and maintenance of intrusive memories in depression. The current study investigated the association between a range of cognitive avoidant mechanisms that characterize PTSD samples (i.e., suppression, rumination, emotional detachment, and an observer vantage perspective) and intrusive memories of negative autobiographical events in relation to dysphoria. Hypotheses were based on the proposition that employment of these cognitive mechanisms would hinder the emotional processing of the negative event, thus contributing to the maintenance of intrusions. Results supported an association between negative intrusive memories, dysphoria, and avoidant mechanisms. Significant differences were also found between field and observer memories and measures of emotional detachment and rumination. Implications relating to intrusive memory maintenance and treatment approaches are discussed.

The role of negative interpretations of intrusive memories in depression

BackgroundRecent investigations have shown that intrusive memories of negative past events, the hallmark symptom of posttraumatic stress disorder (PTSD), are also commonly experienced in depression. This study explored whether Ehlers and Steil's [Ehlers, A., Steil, R., 1995. Maintenance of intrusive memories in posttraumatic stress disorder: a cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 217–249] model of PTSD maintenance, which focuses on the role played by negative interpretations of intrusive symptoms in the persistence of PTSD, also describes processes that operate in depression. MethodsEighty-four undergraduate students were interviewed to identify the presence of intrusive memories in the previous week. Participants who reported an intrusive memory were administered self-report questionnaires that indexed cognitive and affective responses to the memory. ResultsNegative interpretations of intrusive memories were significantly correlated with cognitive avoidance (particularly rumination) and depression severity, after controlling for intrusion frequency and severity of memory content. Negative meaning was the strongest predictor of depression, explaining variance over and above intrusion frequency. Ruminative responses to intrusions were highly correlated with depression. LimitationsThe use of an unselected student sample. ConclusionsThe demonstrated utility of Ehlers and Steil's [Ehlers, A., Steil, R., 1995. Maintenance of intrusive memories in posttraumatic stress disorder: A cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 217–249] model of PTSD to account for one aspect of depression maintenance supports recent commentaries [Harvey, A.G., Watkins, E., Mansell, W., Shafran, R., 2004. Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. New York: Oxford University Press] that call for a transdiagnostic approach to understanding the cognitive and behavioural processes that underpin psychological disorders.

Intrusive memories in depression and posttraumatic stress disorder

This study compared the stressors and consequent intrusive memories reported by matched samples of patients with posttraumatic stress disorder (PTSD) and major depression. Although intrusive memories were slightly more common among PTSD patients, both quantitative and qualitative measures revealed few differences between the groups. PTSD patients were more likely to have experienced personal illness or assault, and depressed patients family deaths and illness, and interpersonal events. Factor analysis of the associated emotions and memory characteristics suggested the existence of specific links between fear and reliving, and helplessness and out-of-body experiences. Possible inhibitory relationships between fear and sadness, and between guilt and anger, were also noted.

Intrusive memories in depression: an index of schema activation?

A sample of 31 male and female depressed patients was interviewed to investigate spontaneous, intrusive memories of immediate and past life events. Previous findings that depressed patients experience high frequency intrusive memories were confirmed, as was an association between intrusive memories of childhood abuse and severity of depression. Patients reported intrusive memories for a variety of other events, particularly involving illness and death. Limited support was obtained for the hypotheses that the course of depression would be related to the activation of negative memories, and that immediate life events would trigger the activation of memories of similar events from the past.