Search

Repetitive negative thinking (RNT)—such as worry and rumination—is an important transdiagnostic factor in the onset, course, and recurrence of depressive and anxiety disorders. This article describes a psychoeducational cognitive behavioral therapy (CBT)-based group intervention entitled "Drop It" that focuses exclusively on treating RNT in patients with major depressive disorder and/or generalized anxiety disorder. The theoretical concepts and treatment goals of the intervention are outlined. The organization and therapeutic processes of the different sessions are described and illustrated with statements of participants. Special attention is given to how the intervention capitalizes on the group structure and process to maximize the effectiveness of psychoeducation and CBT-based techniques. We also provide practical guidelines for clinicians treating patients with RNT. [ABSTRACT FROM AUTHOR]

Personality is a predictor of subjective well-being in older and younger adults, but less is known about the underlying mechanisms. One possible mechanism is psychological flexibility, which is the ability to keep an open mind-set in order to make flexible choices adapted to the situation at hand. We recruited 60 younger and 60 older adults and measured personality and well-being by questionnaires. To assess psychological flexibility we used questionnaires and a behavioral task assessing flexibility in information acquisition when making choices. Based on indirect effect analysis of the questionnaire data, in line with former research, our data show that in both age groups, the relationship between personality and well-being runs through psychological flexibility. This implies that training psychological flexibility may be a promising approach to increase well-being in both older and younger adults. This effect could not be demonstrated with our choice flexibility task, thus more research is needed to uncover why this could not be measured at the behavioral level. [ABSTRACT FROM AUTHOR]

Introduction: Despite several available evidence-based interventions for major depression relapse, rates remain high and relapse prevention programs are still scarce. To increase effectiveness, novel techniques that target underlying vulnerability factors may be a promising avenue. Depression is associated with impairments in executive functioning, which is in turn associated with poor psychosocial outcomes and more Repetitive Negative Thinking (RNT), a key vulnerability factor for relapse. This paper examines deficits in cognitive control as a potentially modifiable causal mechanism for depression. Areas covered: An overview of studies on the interplay between cognitive control and RNT is presented, assessing the potential of training cognitive control in depressed individuals. Cognitive Control Training (CCT), or other techniques aimed at remediating executive functioning, provides an interesting way to examine the causal status of executive functions in depression-related symptoms, such as emotion regulation and psychosocial functioning. The clinical utility of CCT is assessed. Expert commentary: There is emerging evidence for clinical utility of CCT but more large-scale, longitudinal studies are required. The section discusses how the adaptive Paced Auditory Serial Addition Test (PASAT) can be used as a technique that can be combined with psychological as well as biological interventions, to increase overall effectiveness of treatment for depression. [ABSTRACT FROM AUTHOR]

Objectives: Accelerated intermittent theta-burst stimulation (aiTBS) anti-depressive working mechanisms are still unclear. Because aiTBS may work through modulating the reward system and the level of anhedonia may influence this modulation, we investigated the effect of aiTBS on reward responsiveness in high and low anhedonic MDD patients. Methods: In this registered RCT (NCT01832805), 50 MDD patients were randomised to a sham-controlled cross-over aiTBS treatment protocol over the left dorsolateral prefrontal cortex (DLPFC). Patients performed a probabilistic learning task in fMRI before and after each week of stimulation. Results: Task performance analyses did not show any significant effects of aiTBS on reward responsiveness, nor differences between both groups of MDD patients. However, at baseline, low anhedonic patients displayed higher neural activity in the caudate and putamen. After the first week of aiTBS treatment, in low anhedonic patients we found a decreased neural activity within the reward system, in contrast to an increased activity observed in high anhedonic patients. No changes were observed in reward related neural regions after the first week of sham stimulation. Conclusions: Although both MDD groups showed no differences in task performance, our brain imaging findings suggest that left DLPFC aiTBS treatment modulates the reward system differently according to anhedonia severity. [ABSTRACT FROM AUTHOR]

Cognitive theories emphasize the importance of attentional biases in the development and maintenance of depression. Noteworthy, recent studies indicate that depression-related biases only occur in later stages of attentional processing. This is consistent with the idea that attention is a multicomponent process, consisting of at least two mechanisms: selection and inhibition. Therefore, this study aims to investigate interference and inhibition toward angry and happy stimuli in dysphoric adolescents compared to nondysphoric adolescents. To examine interference and inhibition of emotional information in 21 dysphoric (17 girls) and 28 nondysphoric adolescents (17 girls), 10-16 years of age, a Negative Affective Priming task was used. In this task, a target has to be evaluated as positive or negative while ignoring a distractor. As expected, dysphoric adolescents showed both higher interference from and higher inhibition of angry stimuli relative to nondysphoric adolescents. In contrast, happy stimuli did not lead to interference and consequently did not have to be inhibited in either group. Finally, a positive relation was found between interference and the subsequent inhibition of emotional stimuli. These observations confirm the existence of a bias toward angry faces in dysphoric adolescents and indicate a higher inhibition of angry faces in dysphoric adolescents compared to nondysphoric adolescents. The obtained results are different from those of similar previous studies in depressed or dysphoric adults using sad faces or negatively valenced words and might reveal important emotion-specific or age-specific inhibitory biases. [ABSTRACT FROM AUTHOR]

When in a negative mood state, individuals with major depressive disorder (MDD) may have difficulties recalling positive autobiographical memories in a manner that repairs that negative mood. Using cognitive bias modification techniques, investigators have successfully altered different aspects of cognition among individuals with MDD. However, little has been done to investigate the modification of positive autobiographical memory recall. This study examined the impact of a novel positive memory enhancement training (PMET) on the memories and subjective affective experiences of individuals with MDD (N= 27). Across a series of trials, participants first recalled a sad memory to elicit a negative mood state. They then recalled a happy memory and completed procedures to elicit a vivid, here-and-now quality of the memory. PMET procedures were hypothesized to promote mood repair via the recall of increasingly vivid and specific positive memories. PMET participants demonstrated improved memory specificity and greater perceived ability to “relive” positive memories. The procedures also repaired mood; PMET participants’ affect following recall of positive memories did not differ from control participants’ affect following recall of neutral memories. Results provide preliminary support for PMET as a method to improve the quality of positive memories and facilitate emotion regulation in MDD. [ABSTRACT FROM AUTHOR]

The broaden-and-build theory relates positive emotions to resilience and cognitive broadening. The theory proposes that the broadening effects underly the relation between positive emotions and resilience, suggesting that resilient people can benefit more from positive emotions at the level of cognitive functioning. Research has investigated the influence of positive emotions on attentional broadening, but the stimulus in the target of attention may also influence attentional breadth, depending on affective stimulus evaluation. Surprised faces are particularly interesting as they are valence ambiguous, therefore, we investigated the relation between affective evaluation—using an affective priming task—and attentional breadth for surprised faces, and how this relation is influenced by resilience. Results show that more positive evaluations are related to more attentional broadening at high levels of resilience, while this relation is reversed at low levels. This indicates that resilient individuals can benefit more from attending to positively evaluated stimuli at the level of attentional broadening. [ABSTRACT FROM AUTHOR]

The anger superiority effect shows that an angry face is detected more efficiently than a happy face. However, it is still controversial whether attentional allocation to angry faces is a bottom-up process or not. We investigated whether the anger superiority effect is influenced by top-down control, especially working memory (WM). Participants remembered a colour and then searched for differently coloured facial expressions. Just holding the colour information in WM did not modulate the anger superiority effect. However, when increasing the probabilities of trials in which the colour of a target face matched the colour held in WM, participants were inclined to direct attention to the target face regardless of the facial expression. Moreover, the knowledge of high probability of valid trials eliminated the anger superiority effect. These results suggest that the anger superiority effect is modulated by top-down effects of WM, the probability of events and expectancy about these probabilities. [ABSTRACT FROM PUBLISHER]

Objectives. Intensified repetitive transcranial magnetic stimulation (rTMS) applied to the left dorsolateral prefrontal cortex (DLPFC) may result in fast clinical responses in treatment resistant depression (TRD). In these kinds of patients, subgenual anterior cingulate cortex (sgACC) functional connectivity (FC) seems to be consistently disturbed. So far, no de novo data on the relationship between sgACC FC changes and clinical efficacy of accelerated rTMS were available. Methods. Twenty unipolar TRD patients, all at least stage III treatment resistant, were recruited in a randomized sham-controlled crossover high-frequency (HF)-rTMS treatment study. Resting-state (rs) functional MRI scans were collected at baseline and at the end of treatment. Results. HF-rTMS responders showed significantly stronger resting-state functional connectivity (rsFC) anti-correlation between the sgACC and parts of the left superior medial prefrontal cortex. After successful treatment an inverted relative strength of the anti-correlations was observed in the perigenual prefrontal cortex (pgPFC). No effects on sgACC rsFC were observed in non-responders. Conclusions. Strong rsFC anti-correlation between the sgACC and parts of the left prefrontal cortex could be indicative of a beneficial outcome. Accelerated HF-rTMS treatment designs have the potential to acutely adjust deregulated sgACC neuronal networks in TRD patients. [ABSTRACT FROM AUTHOR]

Although depression is characterised by low self-esteem as measured by questionnaires, research using implicit measures of self-esteem has failed to reveal the expected differences between depressed and non-depressed individuals. In this study, we used an implicit measure which enables the differentiation of ideal self- and actual self-esteem, through the introduction of propositions: “I am” versus “I want to be”. We measured implicit relational associations about actual and ideal self in low (N=27) versus high dysphoric (N=29) undergraduates. Our data revealed that dysphoric individuals have a higher ideal self-esteem, and lower actual self-esteem in comparison to healthy participants. The results underscore the need to go beyond simple associations and suggest that the use of individual–specific propositions could enhance our understanding of the implicit measurement of self-esteem. Furthermore, these results underscore the importance of actual versus ideal self-discrepancy theories, which might guide the content of therapeutic interventions. [ABSTRACT FROM PUBLISHER]

Although flight phobia is very common in the general population, knowledge of the underlying mechanisms is limited. The aim of the current study is to determine whether hypoxia is selectively associated with flight anxiety. We wanted to explore levels of oxygen saturation (SpO2) and the associated subjective somatic sensations in flight phobics and controls. The data collected in this study were obtained from 103 participants: 54 had flight phobia, 49 were controls. SpO2as well as a subjective report of somatic sensations and anxiety were measured during short haul flights, both at ground level and at cruising altitude. Results indicated that both flight phobics and controls showed a comparable clinical significant decrease in SpO2from sea level to cruising altitude. Next, at ground level the flight phobic group reported more somatic sensations, most likely due to the elevated levels of anxiety at that point. However, at cruising altitude the flight phobic group still reported more somatic sensations while the level of anxiety was no longer significantly different from controls. This finding points to altered symptom perception in flight phobia and stresses the importance of somatic sensations in this particular phobia. [ABSTRACT FROM AUTHOR]

Social stress has been related to both physiological and psychological responses. The recovery of stress is influenced by the way environmental information is processed, i.e., what information is attended to and how it is interpreted. The present study investigated the effect of attention modification training on physiological stress recovery following induced stress. A group of applicants preparing for a job interview were randomly allocated to an attention training condition versus a control condition. Afterwards, they were asked to give an artificial job interview to a real life jury while being videotaped. Participants in both conditions showed decreased heart rate variability during the job interview, which indicates an overall physiological stress response. However, during a 30-minute follow-up period after the training, indices of heart rate variability showed improved stress recovery only in the attention training condition. Attentional training is proposed as a promising strategy to prevent enduring stress reactions. [ABSTRACT FROM PUBLISHER]

Growing empirical evidence suggests that cognitive and affective problems in depression may be a reflection of cognitive control impairments. However, to date, the nature of such impairments is still poorly understood and further investigation of this topic is required to advance current knowledge on the underlying vulnerability factors for depression. Using a mixed antisaccade paradigm, the present study examined if depressive symptoms in general, and more specifically rumination, are related to impairments in cognitive control functions such as inhibition and switching. The results on antisaccade latency and error rates indicated that depressive symptoms in general were not related to impairments in inhibition and switching. However, rumination was associated with impaired inhibition such that high, compared to low, ruminators had slower antisaccade latencies. No group differences were observed on antisaccade error rates. Implications for understanding the underlying vulnerability factors for the development of depressive symptoms are discussed. [ABSTRACT FROM AUTHOR]

Former research demonstrated that depression is associated with dysfunctional attentional processing of emotional information. Most studies examined this bias by registration of response latencies. The present study employed an ecologically valid measurement of attentive processing, using eye-movement registration. Dysphoric and non-dysphoric participants viewed slides presenting sad, angry, happy and neutral facial expressions. For each type of expression, three components of visual attention were analysed: the relative fixation frequency, fixation time and glance duration. Attentional biases were also investigated for inverted facial expressions to ensure that they were not related to eye-catching facial features. Results indicated that non-dysphoric individuals were characterised by longer fixating and dwelling on happy faces. Dysphoric individuals demonstrated a longer dwelling on sad and neutral faces. These results were not found for inverted facial expressions. The present findings are in line with the assumption that depression is associated with a prolonged attentional elaboration on negative information. [ABSTRACT FROM AUTHOR]

Objectives: Identification of early Alzheimer's disease (AD) has become very important. Episodic memory tasks appear to have predictive power for indicating early AD. Deficits in encoding and storage processes that are characteristic of AD, however, must be distinguished from non-AD deficits that can also affect memory, including difficulties that may be present in depression. This pilot study was set up to ascertain whether a 10-word-list-learning task (delayed recognition and rate of forgetting) may be useful in making the differentiation between mild AD and depression. Method: A Dutch version of Rey's auditory verbal learning test was administered to 36 mild AD patients, 41 depressed patients, and 47 healthy controls. Data were analyzed in a cross-sectional manner. Results: Receiver operating characteristic analyses showed that for differentiating mild AD and depression, both delayed recognition and percentage of forgetting have sufficient diagnostic accuracy. Conclusion: Percentage of forgetting had the highest diagnostic accuracy for differentiating mild AD and depressed patients and may be useful in the early detection of AD. [ABSTRACT FROM AUTHOR]

Attentional bias to negative information has been considered as a vulnerability factor for depression, enhancing susceptibility and maintenance of this disorder. Biased attention has been studied in clinically as well as subclinically depressed samples. The present study examined the relationship between attentional bias, symptom severity, and specific components of depression (cognitive, affective, and somatic). We compared attentional bias, measured with a modified spatial cueing task, for positive and negative words presented for 1500 ms across three groups of individuals: (1) a group of healthy controls; (2) individuals with mild symptoms; and (3) individuals with moderate to severe depressive symptoms. Maintained attention to negative information was found in individuals with higher symptom severity and was specifically associated with the cognitive symptoms of depression. [ABSTRACT FROM AUTHOR]

Transcranial magnetic stimulation (TMS) is currently used as a non-invasive treatment for depression. In most clinical trials, the left dorsolateral prefrontal cortex (DLPFC) has been selected as the target site for TMS treatment and this region is commonly determined by a 'standard procedure', using a fixed position with respect to the motor cortex. In this study, to evaluate the relevance of using individual anatomical data during coil positioning, we used a more individualized localization method, based on three-dimensional magnetic resonance imaging of the head (3D-MRI). We wanted to examine the intra-individual variability of the localization of the stimulation area using a method taking into account individual brain anatomy by 3D-MRI, by comparing this method to the 'standard procedure'. As expected, even in a gender-controlled sample, our results demonstrate that the difference between the anatomical localization and the standard procedure of a well-defined part of the prefrontal cortex varies within subjects. Therefore, our results confirm the need for a TMS-coil positioning method which incorporates individual anatomical information. [ABSTRACT FROM AUTHOR]

Objectives: Research shows that aging often involves a decrease in the experience of negative affect and might even be associated with a stabilization or an increase in experience concerning positive affect. As it has been suggested that these changes could be related to the processing of emotional information, the aim of this study was to investigate interference and inhibition toward sad and happy faces in healthy elderly people compared to a younger population. Method: We used an affective modification of the negative priming task. If interference is related to enhanced inhibition, reduced interference from negative stimuli and a related weakened inhibition toward negative stimuli in the elderly group would be in line with the positivity hypothesis. Results: As expected, the results indicated that interference from negative stimuli was significantly lower in older adults as compared to younger adults, whereas this was not the case for positive stimuli. Moreover, at inhibitory level a significantly reduced processing of negative stimuli was observed only in the older adult group, whereas there was no such effect in the case of positive material. Conclusion: These observations are indicative for a decreased negative bias in older adults at information processing level. This provides new insights with regard to age-related differences in emotion processing. [ABSTRACT FROM AUTHOR]

Depression has been linked with impaired executive control and specific impairments in inhibition of negative material. To date, only a few studies have examined the relationship between depressive symptoms and executive functions in response to emotional information. Using a new paradigm, the Affective Shift Task (AST), the present study examined whether depressive symptoms in general, and rumination specifically, are related to impairments in inhibition and set shifting in response to emotional and non-emotional material. The main finding was that depressive symptoms in general were not related to inhibition. Set-shifting impairments were only observed in moderate to severely depressed individuals. Interestingly, rumination was related to inhibition impairments, specifically when processing negative information, as well as impaired set shifting as reflected in a larger shift cost. These results are discussed in relation to cognitive views on vulnerability for depression. [ABSTRACT FROM AUTHOR]

Previous studies in healthy volunteers reported a possible impact of high frequency repetitive transcranial magnetic stimulation (HF-rTMS) on stress hormones, like cortisol. In this sham-controlled, 'single blind', crossover study, we examined whether HF-rTMS had an effect on the hypothalamic-pituitary-adrenal (HPA) axis, by analysing salivary cortisol levels. Two studies were conducted. First, HF-rTMS on the left dorsolateral prefrontal cortex (DLPFC) was performed in 28 young healthy female volunteers. Second, in a comparable, but different group of 26 healthy females, HF-rTMS was performed on the right DLPFC. Salivary cortisol levels were assessed before, immediately after and 30 min after real and sham HF-rTMS. We found no support for the hypothesis that one single session of HF-rTMS on the left or the right DLPFC has an immediate or delayed impact on the HPA-axis, as measured by salivary cortisol. Although we controlled for several methodological problems in HF-rTMS research, the hypothesis that one single session of HF-rTMS on the left or on the right DLPFC can influence the HPA-axis in healthy volunteers was not supported. [ABSTRACT FROM AUTHOR]

Depressed patients are impaired in the ability to shift their focus of attention. This attentional control process is related to dysfunctions in the dorsolateral prefrontal cortex (DLPFC). It has been proposed that a dorsal circuit plays an important role in the interaction between emotional and attentional information processing. However, because the different emphasis of fundamental cognitive neuroscience research and clinical research of repetitive transcranial magnetic stimulation (rTMS) over the DLPFC, little research has been done on the effects of rTMS on cognitive functioning after a single stimulation session to explore the neural systems underlying depression. This study was conducted as a double-blind, placebo-controlled, crossover, within subjects design. Sixteen depressed patients performed a modified task switching paradigm, before and after receiving high frequency (HF) versus placebo rTMS over the left DLPFC. One session of HF- rTMS over the left DLPFC had a specific beneficial effect on task-switching performance, whereas mood remained stable. Antidepressant effects of rTMS could be related to the same neurochemical changes that underlie cognitive functioning. Therefore, task switching performance may provide a unique window into the extent of antidepressant effects which can be considered as second-order long-term effects possibly related to primary alternations in cognitive functioning. [ABSTRACT FROM AUTHOR]

To date, only two studies have investigated implicit self-esteem in depressed individuals. Surprisingly, both studies found evidence not in line with the cognitive theory of depression. We wanted to test whether these findings are replicable by investigating implicit self-esteem using the Implicit Association Test in currently depressed (CD), never depressed controls (ND), and formerly depressed individuals (FD). The latter two groups were tested before and after a negative mood induction. The results are in line with the previous two studies suggesting no difference in implicit self-esteem between CD patients and ND controls. Moreover, before mood induction, FD individuals evidenced a higher implicit self-esteem as compared to the two other groups. Compared to ND participants, FD individuals showed a significant drop in implicit self-esteem after the negative mood induction procedure, but this was due to the higher implicit self-esteem of FD before the mood induction. These results are discussed in the light of new perspectives on implicit self-esteem and depression. [ABSTRACT FROM AUTHOR]

Although affective facial pictures are widely used in emotion research, standardised affective stimuli sets are rather scarce, and the existing sets have several limitations. We therefore conducted a validation study of 490 pictures of human facial expressions from the Karolinska Directed Emotional Faces database (KDEF). Pictures were evaluated on emotional content and were rated on an intensity and arousal scale. Results indicate that the database contains a valid set of affective facial pictures. Hit rates, intensity, and arousal of the 20 best KDEF pictures for each basic emotion are provided in an appendix. [ABSTRACT FROM AUTHOR]

Thought suppression is generally considered a maladaptive mental control strategy, leading to increased intrusions. In the experimental psychopathology literature, thought suppression is assigned a central role in anxiety and depression, disorders characterised by a high level of negative intrusive thoughts. We examined predictors of self-perceived and actual thought suppression ability in an undergraduate sample. It was found that self-perceived suppression ability was predicted by anxiety and depression scores, attentional control, and distraction strategies. Immediate and rebound effects of actual suppression were predicted by depression scores. Interestingly, higher levels of attentional control and distraction were related to more successful thought suppression on the questionnaires, yet were related to increased intrusions during suppression. [ABSTRACT FROM AUTHOR]

The internal working model of attachment can be conceptualized as a cognitive schema to provide testable hypotheses. Thus, this study predicts a relationship between attachment and attentional bias toward the mother using an emotional modification of the exogenous cueing task. The content of the cues (mother vs. unknown women) and the duration of the presentation of the cues (200 msec vs. 1,000 msec) were varied. The test was administered to 40 nonreferred children (9 to 13 years of age), divided into high- and low-secure attachment groups. As predicted, low-secure children directed their attention more quickly toward mother than toward unknown women at later stages of attentional processing (long presentation), Furthermore, low-secure children showed more maintained attention toward mother compared to unknown women and showed significantly more maintained attention toward mother compared with high-secure children. [ABSTRACT FROM AUTHOR]

Elderly people are often confronted with stressful events that threaten psychological homeostasis. Nevertheless, the lack of a general age-related drop in life satisfaction remains intriguing. The objective of this study was to analyze the basic mechanisms of perceived control and self-protective processes. Eighty-four elderly adults who underwent a fitness-to-drive evaluation were asked how they appraised their performance in a driving simulation task and were classified as over-estimators versus people who estimated their performance correctly and people who didn’t overestimate their performance. Decreased physical resources were related to self-serving appraisal and less depressive feelings. The results are in line with theories on self-immunizing processes and provide support for the use of cognitive therapies in dealing with age-related limitations. [ABSTRACT FROM AUTHOR]

Since fitness-to-drive evaluation of elderly drivers has become an important issue, we developed a short first-tier screening battery to evaluate the necessity for further referral to specialised centres. Our sample consisted of 84 subjects between 65 and 96 years who came to the Belgian Road Safety institute for a fitness-to-drive evaluation. Using cross-validated discriminant analyses, the predictive power of a battery consisting of the TRAIL Making Test, Part A, a visual acuity test, a clock drawing test, the Mini-Mental State Examination (MMSE) and age was analysed. The judgement by an independent driver instructor (fit-to-drive vs. not unconditional fit-to-drive), based on a real world road test was used as the dependent variable. Classification functions based on the significant discriminant function yielded a specificity score of 85% (subjects fit-to-drive correctly classified) and a sensitivity score of 80% (subjects as not unconditional fit-to-drive correctly classified). These results highlight the potential value of a short screening instrument that can be used in primary health care settings. This instrument may be useful as a first step in a multi-tier assessment procedure. [ABSTRACT FROM AUTHOR]