Imagery Rescripting : The Impact of Conceptual and Perceptual Changes on Aversive Autobiographical Memories

BACKGROUND: Imagery rescripting (ImRs) is a process by which aversive autobiographical memories are rendered less unpleasant or emotional. ImRs is thought only to be effective if a change in the meaning-relevant (semantic) content of the mental image is produced, according to a cognitive hypothesis of ImRs. We propose an additional hypothesis: that ImRs can also be effective by the manipulation of perceptual features of the memory, without explicitly targeting meaning-relevant content. METHODS: In two experiments using a within-subjects design (both N = 48, community samples), both Conceptual-ImRs-focusing on changing meaning-relevant content-and Perceptual-ImRs-focusing on changing perceptual features-were compared to Recall-only of aversive autobiographical image-based memories. An active control condition, Recall + Attentional Breathing (Recall+AB) was added in the first experiment. In the second experiment, a Positive-ImRs condition was added-changing the aversive image into a positive image that was unrelated to the aversive autobiographical memory. Effects on the aversive memory's unpleasantness, vividness and emotionality were investigated. RESULTS: In Experiment 1, compared to Recall-only, both Conceptual-ImRs and Perceptual-ImRs led to greater decreases in unpleasantness, and Perceptual-ImRs led to greater decreases in emotionality of memories. In Experiment 2, the effects on unpleasantness were not replicated, and both Conceptual-ImRs and Perceptual-ImRs led to greater decreases in emotionality, compared to Recall-only, as did Positive-ImRs. There were no effects on vividness, and the ImRs conditions did not differ significantly from Recall+AB. CONCLUSIONS: Results suggest that, in addition to traditional forms of ImRs, targeting the meaning-relevant content of an image during ImRs, relatively simple techniques focusing on perceptual aspects or positive imagery might also yield benefits. Findings require replication and extension to clinical samples

Acceptability of internet-based interventions for depression in Indonesia

Background: In Indonesia, internet-based interventions may represent a promising strategy to reduce the mental health gap given that the level of internet usage in the country continues to increase. To check the acceptability of internet-based interventions, this study investigates factors that contribute to the use of internet-based interventions for depression in Indonesia. Method: The survey was conducted online and had 904 participants recruited from specific social networks on mental health and general social media (Mean age = 27.07, 50.22% females). The three dependent variables were (1) behavioral intention to start using internet-based interventions for depression, (2) preference to use it as a substitute for regular treatments and (3) preference to use it to complement regular treatments. The predictor variables included sociodemographic characteristics, perceived mental health conditions, personal situational characteristics, personal innovativeness toward online services, and depression level. Results: A large majority reported to be open to using internet-based interventions for depression (73.7%), as well as to use it as a substitution (73.3%) or as a complementary (73%) to regular treatments. Personal innovativeness toward online services was the strongest significant predictor for all types of use, even when corrected for current depression level. When added to the analyses separately, depression level was the second strongest predictive factor for all dependent variables. Conclusion: The majority of Indonesians showed openness to use internet-based interventions for depression. To increase the adoption of internet-based interventions for depression, it is important to first promote internet usage to more people across the country, especially for those who are currently depressed

Psychological interventions for depression in Chinese university students:A systematic review and meta-analysis

Background: University students in China are vulnerable to depression with a high estimated prevalence. It is currently unknown which types of psychological interventions are being delivered to treat depression in this population and whether they are effective. Therefore, a systematic review was conducted to address this issue. Methods: We searched records in English and Chinese databases up to January 2019. Results: From 2,739 records, we identified 39 randomized controlled trails (RCTs) and 54 non-RCTs. A range of psychological interventions were identified including cognitive behaviour therapy, interpersonal therapy, and local interventions. Hedge's g pooled effect size of 23 comparisons from 21 RCTs (N =858) compared to a control group (N = 802) was 1.08 (95% CI: 0.72 to 1.45). Heterogeneity was moderate with I2 = 47 (95%CI: 14 to 68). Type of control group was significantly associated with the effect size (p =0.039). Comparisons between the intervention condition and the ‘no intervention’ condition yielded a higher effect size (Hedges’ g =1.38, 95% CI: 0.89 to 1.87) than comparisons between the intervention condition and the ‘usual care/control’ condition (Hedges’ g = 0.56, 95% CI 0.08 to 1.05). No other significant differences based on the study characteristics were observed. Limitations: Publication bias and quality of inclusions. Conclusions: Collectively, there is evidence that psychological interventions for depression in Chinese university students are effective as compared to control groups, although the effects merit further examination by research of higher quality. Innovations in treatment delivery could facilitate wider dissemination of evidence-based interventions

Guided Act and Feel Indonesia (GAF-ID) – Internet-based behavioral activation intervention for depression in Indonesia: study protocol for a randomized controlled trial

Background: Depression is a leading cause of disease burden across the world. However, in low-middle income countries (LMICs), access to mental health services is severely limited because of the insufficient number of mental health professionals available. The WHO initiated the Mental Health Gap Action Program (mhGAP) aiming to provide a coherent strategy for closing the gap between what is urgently needed and what is available in LMICs. Internet-based treatment is a promising strategy that can be made available to a large number of people now that Internet access is increasing rapidly throughout the world. The present study will investigate whether such an Internet-based treatment for depression is effective in Indonesia.  Methods: An Internet-based behavioral activation treatment, with support by lay counselors who will provide online feedback on the assignments and supportive phone contact to encourage participants to work in the program (Guided Act and Feel Indonesia/GAF-ID), is compared to an online-delivered minimal psychoeducation without any support (psychoeducation/PE). Initial assessment for inclusion is based on a Patient Health Questionnaire-9 (PHQ-9) score of at least 10 and meeting criteria for major depressive disorder or persistent depressive disorder as assessed using the Structured Clinical Interview for DSM-5 (SCID-5). Participants with depression (N=312) will be recruited and randomly assigned to GAF-ID or PE. Overall assessments will be done at baseline, post intervention (10 weeks from baseline) and follow-ups (3 months and 6 months from baseline). The primary outcome is the reduction of depression symptoms as measured by the PHQ-9 after 10 weeks from baseline.  Discussion: To our knowledge, this is the first study in Indonesia that examines the effectiveness of an Internet-based intervention for depression in a randomized controlled trial. The hope is that it can serve as a starting point for bridging the mental health gap in Indonesia and other LMICs. Trial registration: Nederlands Trial Register ( www.trialregister.nl ): NTR5920 , registered on 1 July 2016

Virtual reality for psycho-education on self-stigma in depression:Design of a randomised controlled trial

Background: Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducation for depression, might increase mutual understanding. Virtual reality (VR) offers the opportunity to experience the perspective of having or living with someone with a mental condition. For this study an immersive VR environment is developed. The main objective of this study is to test whether our VR psychoeducation intervention is more successful in reducing self-stigma than standard psychoeducation for MDD.Methods: In this randomised controlled trial (RCT), 80 couples of patients and their significant other will be included and randomly assigned to one of two conditions: the VR psychoeducation intervention and standard psychoeducation. Patients will be aged 18 to 65, diagnosed with MDD. The main study parameter is self-stigma, as measured by the Internalized Stigma of Mental Illness scale. Secondary parameters include depressive symptoms, loneliness and perceived social support for the patient and burden of care and quality of life for the significant other.Limitations: No control for nonspecific factors, limited individual adjustment, patients are not able to participate without a significant other.Conclusions: VR might open up the opportunity to reduce self-stigma and thereby improve the efficacy of psychoeducation in MDD.</p

Virtual reality for psycho-education on self-stigma in depression:Design of a randomised controlled trial

Background: Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducation for depression, might increase mutual understanding. Virtual reality (VR) offers the opportunity to experience the perspective of having or living with someone with a mental condition. For this study an immersive VR environment is developed. The main objective of this study is to test whether our VR psychoeducation intervention is more successful in reducing self-stigma than standard psychoeducation for MDD.Methods: In this randomised controlled trial (RCT), 80 couples of patients and their significant other will be included and randomly assigned to one of two conditions: the VR psychoeducation intervention and standard psychoeducation. Patients will be aged 18 to 65, diagnosed with MDD. The main study parameter is self-stigma, as measured by the Internalized Stigma of Mental Illness scale. Secondary parameters include depressive symptoms, loneliness and perceived social support for the patient and burden of care and quality of life for the significant other.Limitations: No control for nonspecific factors, limited individual adjustment, patients are not able to participate without a significant other.Conclusions: VR might open up the opportunity to reduce self-stigma and thereby improve the efficacy of psychoeducation in MDD.</p

Low socioeconomic status increases effects of negative life events on antenatal anxiety and depression

Problem: Low socioeconomic status and prior negative life events are documented risk factors for antenatal anxiety and depression, preterm birth and birth weight. We aimed to asses whether the adverse effects of prior negative life events increase with lower socioeconomic status and which aspects of socioeconomic status are most relevant. Methods: We performed a population-based cohort study in the Netherlands including 5398 women in their first trimester of pregnancy. We assessed the number of negative life events prior to pregnancy, aspects of paternal and maternal socio-economic position and symptoms of anxiety and depression. Associations of the number of prior negative life events with anxiety, depression, low birth weight and gestational age were quantified. Findings: The number of prior negative life events, particularly when they had occurred in the two years before pregnancy and maternal aspects of low socioeconomic status (educational level, unemployment and income) were associated with antenatal anxiety and depression. Furthermore, low socioeconomic status increased the adverse effects of prior negative life events. Obstetric outcomes showed similar trends, although mostly not statistically significant. Discussion: Low socioeconomic status and prior negative life events both have an adverse effect on antenatal anxiety and depression. Furthermore, low socioeconomic status increases the adverse impact of prior negative life events on anxiety and depressive symptoms in pregnancy. Conclusion: Interventions for anxiety and depression during pregnancy should be targeted particularly to unemployed, less-educated or low-income women who recently experienced negative life events

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OBJECTIVE: to investigate the association of life events during pregnancy with change in antenatal anxiety and depression symptoms. We distinguished pregnancy related and non-pregnancy related events and assessed specificity of these associations for depressive or anxious symptoms. In addition, we investigated whether the associations were affected by personality or childhood adversities. DESIGN: observational prospective cohort study SETTING: primary and secondary obstetric care centres in the Netherlands PARTICIPANTS: 1603 women during their first trimester of pregnancy between May 2010 and May 2012 MEASUREMENTS AND FINDINGS: we performed linear regression analyses to test the associations of pregnancy related, non-pregnancy related life events, childhood adversities and the personality traits neuroticism and extraversion with the change in symptoms of anxiety (State Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale) from week 12 to week 36. Life events during pregnancy were associated with increasing antenatal symptoms of anxiety and depression. Effect sizes associated with the highest numbers of events observed ranged from 0.59 to 1.31. Pregnancy related events were specifically associated with increasing symptoms of anxiety (p=0.009), whereas non-pregnancy related events were merely associated with an increase in symptoms of depression (p<0.001). Neither personality traits nor childhood trauma influenced the associations under study. KEY CONCLUSIONS: the most important finding is that pregnancy related life events during pregnancy increase levels of antenatal anxiety, whereas depression levels increase when women experience life events that are unrelated to pregnancy. Furthermore, non-pregnancy related events show stronger associations with increases in symptoms of anxiety or depression compared to pregnancy related events. IMPLICATIONS FOR PRACTICE: our findings may help midwives to tailor psychosocial care to the specific risks of the pregnant woman which may eventually have a positive impact on the health of mother and child

Virtual reality for psycho-education on self-stigma in depression:Design of a randomised controlled trial

Background: Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducation for depression, might increase mutual understanding. Virtual reality (VR) offers the opportunity to experience the perspective of having or living with someone with a mental condition. For this study an immersive VR environment is developed. The main objective of this study is to test whether our VR psychoeducation intervention is more successful in reducing self-stigma than standard psychoeducation for MDD.Methods: In this randomised controlled trial (RCT), 80 couples of patients and their significant other will be included and randomly assigned to one of two conditions: the VR psychoeducation intervention and standard psychoeducation. Patients will be aged 18 to 65, diagnosed with MDD. The main study parameter is self-stigma, as measured by the Internalized Stigma of Mental Illness scale. Secondary parameters include depressive symptoms, loneliness and perceived social support for the patient and burden of care and quality of life for the significant other.Limitations: No control for nonspecific factors, limited individual adjustment, patients are not able to participate without a significant other.Conclusions: VR might open up the opportunity to reduce self-stigma and thereby improve the efficacy of psychoeducation in MDD.</p

Virtual reality for psycho-education on self-stigma in depression:Design of a randomised controlled trial

Background: Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducation for depression, might increase mutual understanding. Virtual reality (VR) offers the opportunity to experience the perspective of having or living with someone with a mental condition. For this study an immersive VR environment is developed. The main objective of this study is to test whether our VR psychoeducation intervention is more successful in reducing self-stigma than standard psychoeducation for MDD.Methods: In this randomised controlled trial (RCT), 80 couples of patients and their significant other will be included and randomly assigned to one of two conditions: the VR psychoeducation intervention and standard psychoeducation. Patients will be aged 18 to 65, diagnosed with MDD. The main study parameter is self-stigma, as measured by the Internalized Stigma of Mental Illness scale. Secondary parameters include depressive symptoms, loneliness and perceived social support for the patient and burden of care and quality of life for the significant other.Limitations: No control for nonspecific factors, limited individual adjustment, patients are not able to participate without a significant other.Conclusions: VR might open up the opportunity to reduce self-stigma and thereby improve the efficacy of psychoeducation in MDD.</p