15 research outputs found
Recommended from our members
Misremembrance of Things Past: Depression Is Associated With Difficulties in the Recollection of Both Specific and Categoric Autobiographical Memories.
Impaired retrieval of specific, autobiographical memories of personally experienced events is characteristic of major depressive disorder (MDD). However, findings in subclinical samples suggest that the reduced specificity phenomenon may reflect a broader impairment in the deliberate retrieval of all autobiographical memory types. This experiment (N = 68) explored this possibility by requiring individuals with and without MDD to complete a cued-recall task that required retrieval of specific, single-incident memories to a block of cues; retrieval of categoric, general memories to a block of cues; and to alternate between retrieval of specific and general memories for a block of cues. Results demonstrated that relative to never-depressed controls, individuals with MDD experience reduced recall of both specific (d = 0.48) and general memories (d = 1.00) along with reduced flexibility in alternating between specific and general memories (d = 0.90). Findings support further development of autobiographical memory-based interventions that target a range of retrieval deficits rather than specificity alone
Study protocol for a randomised, controlled platform trial estimating the effect of autobiographical Memory Flexibility training (MemFlex) on relapse of recurrent major depressive disorder.
INTRODUCTION: Major depressive disorder (MDD) is a chronic condition. Although current treatment approaches are effective in reducing acute depressive symptoms, rates of relapse are high. Chronic and inflexible retrieval of autobiographical memories, and in particular a bias towards negative and overgeneral memories, is a reliable predictor of relapse. This randomised controlled single-blind trial will determine whether a therapist-guided self-help intervention to ameliorate autobiographical memory biases using Memory Flexibility training (MemFlex) will increase the experience of depression-free days, relative to a psychoeducation control condition, in the 12 months following intervention. METHODS AND ANALYSIS: Individuals (aged 18 and above) with a diagnosis of recurrent MDD will be recruited when remitted from a major depressive episode. Participants will be randomly allocated to complete 4 weeks of a workbook providing either MemFlex training, or psychoeducation on factors that increase risk of relapse. Assessment of diagnostic status, self-report depressive symptoms, depression-free days and cognitive risk factors for depression will be completed post-intervention, and at 6 and 12 months follow-up. The cognitive target of MemFlex will be change in memory flexibility on the Autobiographical Memory Test- Alternating Instructions. The primary clinical endpoints will be the number of depression-free days in the 12 months following workbook completion, and time to depressive relapse. ETHICS AND DISSEMINATION: Ethics approval has been granted by the NHS National Research Ethics Committee (East of England, 11/H0305/1). Results from this study will provide a point-estimate of the effect of MemFlex on depressive relapse, which will be used to inform a fully powered trial evaluating the potential of MemFlex as an effective, low-cost and low-intensity option for reducing relapse of MDD. TRIAL REGISTRATION NUMBER: NCT02614326.This work is supported by a grant to TD from the UK Medical Research Council, grant number MC_US_A060_0019
A cluster randomized controlled platform trial comparing group MEmory specificity training (MEST) to group psychoeducation and supportive counselling (PSC) in the treatment of recurrent depression.
Impaired ability to recall specific autobiographical memories is characteristic of depression, which when reversed, may have therapeutic benefits. This cluster-randomized controlled pilot trial investigated efficacy and aspects of acceptability, and feasibility of MEmory Specificity Training (MEST) relative to Psychoeducation and Supportive Counselling (PSC) for Major Depressive Disorder (N = 62). A key aim of this study was to determine a range of effect size estimates to inform a later phase trial. Assessments were completed at baseline, post-treatment and 3-month follow-up. The cognitive process outcome was memory specificity. The primary clinical outcome was symptoms on the Beck Depression Inventory-II at 3-month follow-up. The MEST group demonstrated greater improvement in memory specificity relative to PSC at post-intervention (d = 0.88) and follow-up (d = 0.74), relative to PSC. Both groups experienced a reduction in depressive symptoms at 3-month follow-up (d = 0.67). However, there was no support for a greater improvement in depressive symptoms at 3 months following MEST relative to PSC (d = -0.04). Although MEST generated changes on memory specificity and improved depressive symptoms, results provide no indication that MEST is superior to PSC in the resolution of self-reported depressive symptoms. Implications for later-phase definitive trials of MEST are discussed
Recommended from our members
A randomised controlled trial of memory flexibility training (MemFlex) to enhance memory flexibility and reduce depressive symptomatology in individuals with major depressive disorder.
UNLABELLED: Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval can thereby have a detrimental impact on mental health. This randomised controlled phase II exploratory trial (N = 60) evaluated the potential of a novel intervention drawn from basic science - an autobiographical Memory Flexibility (MemFlex) training programme - which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and diagnostic status at three-month follow-up. These effect sizes could subsequently be used to estimate sample size for a fully-powered trial. Results demonstrated small-moderate, though as expected statistically non-significant, effect sizes in favour of MemFlex for memory flexibility (d = 0.34, p = .20), and loss of diagnosis (OR = 0.65, p = .48), along with the secondary outcome of depression-free days (d = 0.36, p = .18). A smaller effect size was observed for between-group difference in self-reported depressive symptoms (d = 0.24, p = .35). Effect sizes in favour of MemFlex in this early-stage trial suggest that fully-powered evaluation of MemFlex may be warranted as an avenue to improving low-intensity treatment of depression. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier NCT02371291
Engenharia didática sobre o Programa Nacional de Acesso ao Ensino Técnico e Emprego na Educação de Jovens e Adultos no Sistema Prisional
Esta pesquisa relata uma vivência didática no Programa Nacional de Acesso ao Ensino Técnico e Emprego Prisional através da ministração do curso de qualificação profissional de Agente de Limpeza e Conservação. Foi observado que o sistema prisional abrange um cenário educacional resignificado na modalidade da Educação de Jovens e Adultos (EJA). De modo que isso permita a reintegração do preso à sociedade. Este trabalho teve o objetivo de descrever os obstáculos didáticos e cognitivos presentes na EJA do sistema prisional vislumbrando uma situação didática numa perspectiva metodológica ativa. Foi adotada a Engenharia Didática como percurso metodológico. Por fim, pode-se compreender, nesse contexto, a existência de obstáculos didáticos e cognitivos que, apesar de dificultar o processo de ensino e aprendizagem, não impede de realizar uma situação didática potencialmente significativa para os alunos, tal que se desenvolva uma aprendizagem que tenha relevância em sua vida fora do âmbito escolar
Engenharia didática sobre o Programa Nacional de Acesso ao Ensino Técnico e Emprego na Educação de Jovens e Adultos no Sistema Prisional
This research reports a didactic experience in the National Program for Access to Technical Education and Prison Employment through the professional qualification course of Cleaning and Conservation Agent. It was observed that the prison system encompasses a reframed educational scenario in the modality of Youth and Adult Education (EJA). So that allows the prisoner to reintegrate into society. This paper aimed to describe the didactic and cognitive obstacles present in the EJA of the prison system, envisaging a didactic situation from an active methodological perspective. Didactic Engineering was adopted as the methodological course. Finally, it is possible to understand, in this context, the existence of didactic and cognitive obstacles that, despite hindering the teaching and learning process, do not prevent the realization of a potentially significant didactic situation for the students, such that a learning that develops have relevance in your life outside of school.Esta pesquisa relata uma vivência didática no Programa Nacional de Acesso ao Ensino Técnico e Emprego Prisional através da ministração do curso de qualificação profissional de Agente de Limpeza e Conservação. Foi observado que o sistema prisional abrange um cenário educacional resignificado na modalidade da Educação de Jovens e Adultos (EJA). De modo que isso permita a reintegração do preso à sociedade. Este trabalho teve o objetivo de descrever os obstáculos didáticos e cognitivos presentes na EJA do sistema prisional vislumbrando uma situação didática numa perspectiva metodológica ativa. Foi adotada a Engenharia Didática como percurso metodológico. Por fim, pode-se compreender, nesse contexto, a existência de obstáculos didáticos e cognitivos que, apesar de dificultar o processo de ensino e aprendizagem, não impede de realizar uma situação didática potencialmente significativa para os alunos, tal que se desenvolva uma aprendizagem que tenha relevância em sua vida fora do âmbito escolar.Esta investigación reporta una experiencia didáctica en el Programa Nacional de Acceso a Educación Técnica y Empleo Penitenciario a través del curso de calificación profesional del Agente de Limpieza y Conservación. Se observó que el sistema penitenciario abarca un escenario educativo reformulado en la modalidad de Educación de Jóvenes y Adultos (EJA). Eso le permite al prisionero reintegrarse a la sociedad. Este artÃculo tuvo como objetivo describir los obstáculos didácticos y cognitivos presentes en la EJA del sistema penitenciario con una visión de una situación didáctica desde una perspectiva metodológica activa. La IngenierÃa Didáctica fue adoptada como el curso metodológico. Finalmente, es posible comprender, en este contexto, la existencia de obstáculos didácticos y cognitivos que, a pesar de obstaculizar el proceso de enseñanza y aprendizaje, no impiden la realización de una situación didáctica potencialmente significativa para los estudiantes, tal que se desarrolle un aprendizaje tener relevancia en tu vida fuera de la escuela
Misremembrance of things past: Depression is associated with difficulties in the recollection of both specific and categoric autobiographical memories
Impaired retrieval of specific, autobiographical memories of personally experienced events is a key characteristic of major depressive disorder (MDD). However, there are findings in subclinical samples which suggest that the reduced specificity phenomenon may be a reflection of a broader impairment in the deliberate retrieval of all autobiographical memory types. This experiment explored this possibility by requiring individuals with MDD (N=68) to complete a cued-recall task which required retrieval of specific memories to a block of cues, retrieval of categoric, general memories to a block of cues, and to alternate between retrieval of specific and general memories for a block of cues. Results demonstrated that relative to never-depressed controls, individuals with MDD experience reduced recall of both specific, single incident memories (d=0.48) and general memories (d=1.00), along with reduced flexibility in alternating between specific and general memories (d=0.90), a skill vital to restraining negative beliefs. Findings indicate that the flexibility of autobiographical retrieval is important for mental health and support further development of autobiographical memory-based interventions which target a range of retrieval deficits
Misremembrance of things past:depression is associated with difficulties in the recollection of both specific and categoric autobiographical memories
Impaired retrieval of specific, autobiographical memories of personally experienced events is characteristic of major depressive disorder (MDD). However, findings in subclinical samples suggest that the reduced specificity phenomenon may reflect a broader impairment in the deliberate retrieval of all autobiographical memory types. This experiment (N=68) explored this possibility by requiring individuals with and without MDD to complete a cued-recall task which required retrieval of specific, single-incident memories to a block of cues, retrieval of categoric, general memories to a block of cues, and to alternate between retrieval of specific and general memories for a block of cues. Results demonstrated that relative to never-depressed controls, individuals with MDD experience reduced recall of both specific (d=0.48) and general memories (d=1.00), along with reduced flexibility in alternating between specific and general memories (d=0.90). Findings support further development of autobiographical memory-based interventions which target a range of retrieval deficits, rather than specificity alone
Aetiology of Acute Lower Respiratory Infections among Children Under Five Years in Accra, Ghana
The study aimed to investigate the aetiological agents and clinical presentations associated with acute lower respiratory infections (ALRI) among children under five years old at the Korle-Bu Teaching Hospital in Ghana. This was a cross-sectional study carried from February to December 2001. Nasopharyngeal aspirates and venous blood specimens obtained from 108 children with features suggestive of ALRI, were cultured and the isolated bacterial organisms were identified biochemically. Nasopharyngeal aspirates were also tested for Respiratory Syncitial Virus (RSV) antigen using a commercial kit (Becton Dickinson Directigen RSV test kit). A multiplex reverse transcription-PCR (RT-PCR) was also used to detect and characterize RSV using extracted RNA. Socio-demographic and clinical data were also obtained from the study subjects. Bronchopneumonia (55.5%), bronchiolitis (25%), lobar pneumonia (10.2), non-specific ALRI (4.6%), TB, bronchitis and respiratory distress (0.67%) were diagnosed. The prevalence of septicaemia was 10% and bacteria isolated were Staphylococcus aureus, Streptococcus pneumoniae and enteric bacteria, including Salmonella spp., Enterobacter spp and Klebsiella spp, were isolated. Out of the 108 cases, 18% tested positive for RSV, with two cases having RSV as the only aetiological pathogen detected. The subtyping analysis of RSV strains by a multiplex RT-PCR showed that subgroups A and B circulated in the season of analysis
A randomised controlled trial of Memory Flexibility training (MemFlex) to enhance memory flexibility and reduce depressive symptomatology in individuals with Major Depressive Disorder
The published version of this paper is available through open access at https://doi.org/10.1016/j.brat.2018.08.008. Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval processes can thereby have a detrimental impact on mental health. This randomised controlled phase II trial (N=60) evaluated the potential of a novel, autobiographical memory-based intervention drawn from basic science – an autobiographical Memory Flexibility (MemFlex) training programme – which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and depression diagnostic status at three month follow-up, in preparation for a later phase trial. Results demonstrated small-moderate effect sizes in favour of MemFlex for memory flexibility (d=0.34), self-reported depressive symptoms (d=0.24), and loss of depression diagnosis (OR=0.65), along with the secondary outcome of depression-free days (d=0.36). These results suggest that further development and definitive evaluation of MemFlex is warranted as an avenue to improving the low-intensity treatment of depression