Reduced specificity of personal goals and explanations for goal attainment in major depression.

Published onlineJournal ArticleOBJECTIVES: Overgeneralization has been investigated across many domains of cognitive functioning in major depression, including the imagination of future events. However, it is unknown whether this phenomenon extends to representations of personal goals, which are important in structuring long-term behaviour and providing meaning in life. Furthermore, it is not clear whether depressed individuals provide less specific explanations for and against goal attainment. METHOD: Clinically depressed individuals and controls generated personally important approach and avoidance goals, and then generated explanations why they would and would not achieve these goals. Goals and causal explanations were subsequently coded as either specific or general. RESULTS: Compared to controls, depressed individuals did not generate significantly fewer goals or causal explanations for or against goal attainment. However, compared to controls, depressed individuals generated less specific goals, less specific explanations for approach (but not avoidance) goal attainment, and less specific explanations for goal nonattainment. SIGNIFICANCE: Our results suggest that motivational deficits in depression may stem partly from a reduction in the specificity of personal goal representations and related cognitions that support goal-directed behaviour. Importantly, the findings have the potential to inform the ongoing development of psychotherapeutic approaches in the treatment of depression

Ruminative Self-Focus and Negative Affect: An Experience Sampling Study

The authors conducted an experience sampling study to investigate the relationship between momentary ruminative self-focus and negative affect. Ninety-three adults recorded these variables at quasi-random intervals 8 times daily for 1 week. Scores on questionnaire measures of dispositional rumination were associated with mean levels of momentary ruminative self-focus over the experience sampling week. Concurrently, momentary ruminative self-focus was positively associated with negative affect. Cross-lagged analyses revealed that whereas ruminative self-focus predicted negative affect at a subsequent occasion, negative affect also predicted ruminative self-focus at a subsequent occasion. Decomposition of the dispositional rumination measure suggested that brooding, but not reflective pondering, was associated with higher mean levels of negative affect. Though broadly consistent with Nolen-Hoeksema's (1991) response styles theory, these results suggest that a reciprocal relationship exists between ruminative self-focus and negative affect

When the ends outweigh the means: mood and level of identification in depression.

Journal ArticleResearch Support, Non-U.S. Gov'tCopyright © 2011 Psychology Press, an imprint of the Taylor & Francis Group, an Informa businessResearch in healthy controls has found that mood influences cognitive processing via level of action identification: happy moods are associated with global and abstract processing; sad moods are associated with local and concrete processing. However, this pattern seems inconsistent with the high level of abstract processing observed in depressed patients, leading Watkins (2008, 2010) to hypothesise that the association between mood and level of goal/action identification is impaired in depression. We tested this hypothesis by measuring level of identification on the Behavioural Identification Form after happy and sad mood inductions in never-depressed controls and currently depressed patients. Participants used increasingly concrete action identifications as they became sadder and less happy, but this effect was moderated by depression status. Consistent with Watkins' (2008) hypothesis, increases in sad mood and decreases in happiness were associated with shifts towards the use of more concrete action identifications in never-depressed individuals, but not in depressed patients. These findings suggest that the putatively adaptive association between mood and level of identification is impaired in major depression

Processing mode causally influences emotional reactivity: distinct effects of abstract versus concrete construal on emotional response.

addresses: Mood Disorders Centre, School of Psychology, University of Exeter, UK. [email protected]: PMCID: PMC2672048types: Journal Article; Research Support, Non-U.S. Gov'tThis is a postprint of an article published in Emotion © 2008 copyright American Psychological Association. 'This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.' Emotion is available online at: http://www.apa.org/pubs/journals/emo/index.aspxThree studies are reported showing that emotional responses to stress can be modified by systematic prior practice in adopting particular processing modes. Participants were induced to think about positive and negative scenarios in a mode either characteristic of or inconsistent with the abstract-evaluative mind-set observed in depressive rumination, via explicit instructions (Experiments 1 and 2) and via implicit induction of interpretative biases (Experiment 3), before being exposed to a failure experience. In all three studies, participants trained into the mode antithetical to depressive rumination demonstrated less emotional reactivity following failure than participants trained into the mode consistent with depressive rumination. These findings provide evidence consistent with the hypothesis that processing mode modifies emotional reactivity and support the processing-mode theory of rumination

Depressed people are not less motivated by personal goals but are more pessimistic about attaining them

This is a postprint of an article published in Journal of Abnormal Psychology © 2011 copyright American Psychological Association. 'This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.' Journal of Abnormal Psychology is available online at: http://www.apa.org/pubs/journals/abn/index.aspxDespite its theoretical importance, personal goal motivation has rarely been examined in clinical depression. Here we investigate whether clinically depressed persons (n = 23) differ from never-depressed persons (n = 26) on number of freely generated approach and avoidance goals, appraisals of these goals, and reasons why these goals would and would not be achieved. Participants listed approach and avoidance goals separately and generated explanations for why they would (pro) and would not (con) achieve their most important approach and avoidance goals, before rating the importance, likelihood, and perceived control of goal outcomes. Counter to hypothesis, depressed persons did not differ from never-depressed controls on number of approach or avoidance goals, or on the perceived importance of these goals. However, compared to never-depressed controls, depressed individuals gave lower likelihood judgments for desirable approach goal outcomes, tended to give higher likelihood judgments for undesirable to-be-avoided goal outcomes, and gave lower ratings of their control over goal outcomes. Furthermore, although controls generated significantly more pro than con reasons for goal achievement, depressed participants did not. These results suggest that depressed persons do not lack valued goals but are more pessimistic about their likelihood, controllability, and reasons for successful goal attainment

Cognitive bias modification training in children affects anxiety during anticipatory processing of social evaluation

AcceptedArticleInterpretation training programs have proven effective in altering anxiety-related cognitive biases in children and adults. The current study examined the effects of interpretation training on subsequent anticipatory processing of an anxiety-provoking event. A non-clinical sample of 89 children (10-12 years) was trained to interpret ambiguous social scenarios in either a benign or a negative way. After a single session of training, participants were also asked to engage in anticipatory processing and rated their state anxiety at various points during the experiment. The results indicate that the training was effective in inducing the intended group differences in interpretative bias. Moreover, participants who had previously been trained to make benign interpretations showed attenuated levels of state anxiety after but not before engaging in an anticipatory processing task, whereas participants trained to make negative interpretations showed maintained levels of state anxiety during this period. These results provide support for our hypothesis that manipulating interpretative bias may modify anxious responsivity during anticipatory processing of an anxiety-provoking event

Social anxiety, anticipatory processing and negative expectancies for an interpersonal task in middle childhood

Cognitive models assume that socially anxious individuals engage in negatively-biased anticipatory processing that enhances anxiety and exacerbates maladaptive cognitions. To date little is known about this anticipatory processing and its relationship with mood and predicted performance in socially anxious children. In the present study, a school sample of 181 children (aged 10-11 years) was instructed to either engage in anticipatory processing or perform a distraction task while preparing to give a speech in front of the class. Results showed that trait social anxiety was associated with more negative estimates of personal appearance and catastrophic thoughts relating to speech performance. Following the manipulation, children in the distraction condition showed significant reductions in state anxiety, but children in the anticipation condition did not. Furthermore, children in the anticipation condition gave more negative predictions of personal appearance during the speech task than children in the distraction condition. Crucially, trait social anxiety was 'more strongly associated with catastrophic thinking and negative expectations of their personal appearance when children were instructed to engage in anticipatory processing rather than distraction. The findings provide further support for the suggestion that anticipatory processing plays a role in maintaining childhood social anxiety

Negative affect and ruminative self-focus during everyday goal pursuit

Models of self-regulation propose that negative affect is generated when progress towards goals is perceived to be inadequate. Similarly, ruminative thinking is hypothesised to be triggered by unattained goals (Martin & Tesser, 1996). We conducted an experience-sampling study in which participants recorded their negative affect, ruminative self-focus, and goal appraisals eight times daily for one week. Negative affect and ruminative self-focus were each associated with low levels of goal success and (with the exception of sadness) high levels of goal importance. As predicted, the combination of low goal success and high goal importance was associated with the highest levels of negative affect, and this interaction was marginally significant for ruminative self-focus. Decomposition of the ruminative self-focus measure revealed that the success by importance interaction was significantly associated with focus on problems but not focus on feelings. Findings did not differ for individuals reporting high versus low levels of depressive symptoms or trait rumination. These results suggest that self-regulatory models of goal pursuit provide a useful explanatory framework for the study of affect and ruminative thinking in everyday life

Preliminary clinical and cost effectiveness of augmented depression therapy versus cognitive behavioural therapy for the treatment of anhedonic depression (ADepT): a single-centre, open-label, parallel-group, pilot, randomised, controlled trial

Background Anhedonia (reduced interest/pleasure) symptoms and wellbeing deficits are core to depression and predict a poor prognosis. Current depression psychotherapies fail to target these features adequately, contributing to sub-optimal outcomes. Augmented Depression Therapy (ADepT) has been developed to target anhedonia and wellbeing. We aimed to establish clinical and economic proof of concept for ADepT and to examine feasibility of a future definitive trial comparing ADepT to Cognitive Behavioural Therapy (CBT). Methods In this single-centre, open-label, parallel-group, pilot randomised controlled trial, adults meeting diagnostic criteria for a current major depressive episode, scoring ≥10 on the Patient Health Questionnaire (PHQ-9) and exhibiting anhedonic features (PHQ-9 item 1 ≥ 2) were recruited primarily from high intensity Improving Access to Psychological Therapy (IAPT) service waiting lists in Devon, UK. Participants were randomised to receive 20 sessions of CBT or ADepT, using a mimimisation algorithm to balance depression severity and antidepressant use between groups. Treatment was delivered in an out-patient university-based specialist mood disorder clinic. Researcher-blinded assessments were completed at intake and six, 12, and 18 months. Co-primary outcomes were depression (PHQ-9) and wellbeing (Warwick Edinburgh Mental Wellbeing Scale) at 6 months. Primary clinical proof-of-concept analyses were intention to treat. Feasibility (including safety) and health economic analyses used complete case data. This trial is registered at the ISRCTN registry, ISRCTN85278228. Findings Between 3/29/2017 and 7/31/2018, 82 individuals were recruited (102% of target sample) and 41 individuals were allocated to each arm. A minimum adequate treatment dose was completed by 36/41 (88%) of CBT and 35/41 (85%) of ADepT participants. There were two serious adverse events in each arm (primarily suicide attempts; none of which were judged to be trial- or treatment-related), with no other evidence of harms. Intake and six-month primary outcome data was available for 37/41 (90%) CBT participants and 32/41 (78%) ADepT participants. Between-group effects favoured ADepT over CBT for depression (meanΔ = −1.35, 95% CI = −3.70, 1.00, d = 0.23) and wellbeing (meanΔ = 2.64, 95% CI = −1.71, 6.99, d = 0.27). At 18 months, the advantage of ADepT over CBT was preserved and ADepT had a >80% probability of cost-effectiveness. Interpretation These findings provide proof of concept for ADepT and warrant continuation to definitive trial

Goal dysregulation in depression

Goal motivation is fundamental to human experience and well-being. Despite the development of prominent theoretical models of goal motivation and its importance in daily life, research has rarely examined goal dysregulation processes in clinical depression. This research presents data from two studies that aimed to investigate aspects of goal regulation in clinically depressed adults, relative to never depressed adults. In both studies, depressed participants were recruited from Improving Access to Psychological Therapy clinics in the north of England and control participants were recruited from the same region. In Studies 1 and 2, participants generated personally important approach goals (e.g., improve my marathon time) and avoidance goals (e.g., avoid getting upset over little things). In Study 1, participants generated explanations why they would and would not achieve these goals. Goals and causal explanations were subsequently coded as either specific or general. In Study 2, participants completed self-report measures of goal attainment, and the ease of disengagement from unattainable goals and re-engagement with new goals. Results, in Study 1, found that compared to controls, depressed individuals did not generate significantly fewer goals or causal explanations for, or against, goal achievement and valued their goals similarly. Compared to controls, however, depressed individuals generated less specific goals, less specific explanations for approach (but not avoidance) goal achievement, and less specific explanations for goal non-attainment. In Study 2, both groups (depressed and never depressed) reported a similar number of goals and valued their personal goals similarly. However, depressed participants reported fewer approach goals (but not more avoidance goals), rated their approach goal (rewarding) outcomes as less likely to happen and avoidance goal (threatening) outcomes as more likely to happen. Depressed individuals also reported greater ease of disengagement from unattainable goals and more difficulty re-engaging with new goals than controls. Overall, the results suggest that motivational deficits in depression may stem partly from a reduction in the specificity of personal goal representations, and related pessimistic cognitions that hinder goal-directed behaviour. Our findings extend current knowledge of the psychopathology of depression from a goal regulation perspective and may inform the development of more effective goal-based treatments for depression