Depressive Symptoms, Major Depressive Disorder
Conditions
Keywords
Memory specificity training, Autobiographical memory, Major depressive disorder
Brief summary
Depression involves the tendency to recall overgeneral personal memories, a phenomenon which has been linked to numerous adverse psychological outcomes. The purpose of this study is to investigate whether a group-based Memory Specificity Training (MEST) programme improves outcomes in depression, and how this compares to an education and support control group. The primary aim is to examine whether MEST, which involves repeated practice retrieving specific autobiographical memories reduces depressive symptoms immediately post-treatment, and whether this is maintained 3 months after treatment. The secondary objective of this trial is to examine the role of hypothesised cognitive processes (ie., rumination, executive control, cognitive avoidance) which may underlie improvements in depression and memory.
Interventions
BEHAVIORALMemory Specificity Training
This intervention is a manualised, structured treatment delivered over 5 x 60 minute sessions to groups of 5-8 individuals. This treatment involves repeated practice of retrieving specific autobiographical memories in response to positive, negative and neutral cue words. There is a single psychoeducation component in the first session about memory difficulties common in depression which provides the rationale for this treatment. The training is supplemented by weekly homework practice.
BEHAVIORALEducation and Support
The education-and-support comparison condition is matched with the experimental arm for length and format (ie., 5 x 60 minute weekly sessions in groups of 5-8 individuals). Groups receive a single psychoeducation component where information about depression is provided. This is followed by non-directive support where participants are encouraged to raise different kinds of events that occur each week for discussion in the group. The sessions are supplemented by a homework diary where participants will be invited to note down an event that occurs each day, which may be positive, negative, or benign and non-emotional in nature. This material will provide the basis for discussion in the weekly group meetings.
Sponsors
KU Leuven
Medical Research Council
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Principal diagnosis of Major Depressive Disorder * History of more than one previous depressive episode * Current diagnosis of a Major Depressive Episode * Depressive symptoms rated in the mild-severe range (\> 13 on the BDI-II) * Memory specificity \< .70 (as assessed on the AMT)
Exclusion criteria
* Head trauma * Organic brain damage * Secondary diagnosis of another affective disorder * Psychosis * Current drug or alcohol abuse or dependence * A diagnosed Axis II disorder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in depressive symptoms on the Beck Depression Inventory II (BDI-II) | Change from baseline to 3 months post-treatment | Symptom severity score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in depressive status according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - IV (SCID-IV) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment, and 6-months post-treatment (6-month follow-up for MEST group only) | Presence of a current Major Depressive Episode (MDE) |
| Change from baseline in autobiographical memory specificity on Autobiographical Memory Test (AMT) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Memory specificity level |
| Change from baseline in depressive symptoms as measured on the BDI-II | Change from baseline to post-treatment (approximately 6-weeks) | Symptom severity score |
| Depression free days following treatment according to the Longitudinal Follow-up Evaluation on the SCID-IV | Post-treatment and 3-month and 6-month follow-up | Number of depression-free days |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in performance on Verbal Fluency Task | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Index of executive control |
| Change from baseline on the Beck Anxiety Inventory (BAI) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Symptom severity score |
| Change in baseline on performance on Digit Span Task | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Working memory index |
| Change from baseline on the Beck Hopelessness Scale (BHS) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Hopelessness score |
| Change from baseline on the Cognitive Avoidance Questionnaire (CAQ) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Tendency for avoidance score |
| Change in baseline on Rumination Response Scale (RRS) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Tendency to ruminate score |
| Change from baseline in performance on Means-Ends Problem Solving Task (MEPS) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | Problem solving effectiveness score |
Countries
Australia
Outcome results
None listed