Major Depressive Disorder
Conditions
Keywords
Depression, Cognitive risk factors, Autobiographical memory, Cognitive bias, Relapse prevention
Brief summary
A wealth of research has demonstrated that they way in which the investigators recall our personal, autobiographical memories is influential in the course of depression. Biases in the recall of autobiographical memory occur in the midst of a depressive episode, and are shown to prolong symptoms, however these biases also remain when depression remits, and may predispose the individual towards relapse. A novel cognitive intervention, MemFlex, aims to train individuals to be flexible in their retrieval of autobiographical memories, and thereby reduce depressive relapse. Changes in memory bias may also have an effect on intermediate processes that increase risk of depression, such as rumination, impaired problem solving, and cognitive avoidance. This feasibility trial compares the effects of MemFlex and Psychoeducation in their ability to reduce memory bias and intermediate cognitive risk factors, and thereby depressive relapse, in individuals remitted from Major Depressive Disorder. Clinical outcome and process measures will be assessed immediately following completion of the intervention, at 6 months post-intervention, and at 12 months post-intervention. If encouraging, the results of this pilot trial may provide a foundation for a later phase trial.
Interventions
BEHAVIORALAutobiographical Memory Flexibility (MemFlex) training
As in experimental arm description
BEHAVIORALPsychoeducation
As in experimental arm description
Sponsors
Medical Research Council Cognition and Brain Sciences Unit
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Meets criteria for Major Depressive Disorder but is currently in remission, indexed on the Structured Clinical Interview for the DSM (SCID; First et al., 1996) * 18 years of age or older
Exclusion criteria
* Meets criteria for a current Major Depressive Episode, indexed on the SCID * Meets criteria for another mood disorder (e.g., Bipolar disorder), indexed on the SCID * Current alcohol or substance dependence, or currently experiencing psychotic symptoms, indexed on the SCID * Experience of intellectual disability, traumatic brain injury, or other neurological condition which may impact memory recall, assessed via self-report
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to depressive relapse | 12 months post-intervention | Length of time from post-intervention assessment to occurrence of any major depressive episode within the 12 month follow-up period |
| Number of depression free days at 12 month follow-up | 12 months post-intervention | Number of depression free days as indexed by the Longitudinal Interval Follow-up Evaluation (Keller et al., 1987) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Depressive status at 12 month follow-up | 12 months post-intervention | Presence of a Major Depressive Episode as indexed by the Longitudinal Interval Follow-up Evaluation (Keller et al., 1987) |
| Depression symptoms at 12 month follow-up | 12 months post-intervention | Score on the Beck Depression Inventory |
| Autobiographical memory retrieval | Measured within one week of completing the intervention | Scores for specific and alternating blocks of the alternating instructions autobiographical memory task (Dritschel et al., 2013) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Rumination | Measured within one week of completing the intervention, six months post-intervention and 12 months post-intervention | Total and sub-scale scores on the Rumination Response Scale (Treynor, Gonzalez, Nolen-Hoeksema, 2003) |
| Cognitive avoidance | Measured within one week of completing the intervention, six months post-intervention and 12 months post-intervention | Total score on the Cognitive Avoidance Questionnaire (Sexton & Dugas, 2008) |
| Problem solving | Measured within one week of completing the intervention, and six months post-intervention | The total number of means and total effectiveness scores on the abbreviated version of the Means-Ends Problem Solving task (Marx, Williams, & Claridge, 1992) |
| Anxiety symptoms | Measured within one week of completing the intervention, six months post-intervention and 12 months post-intervention | Total score on the Beck Anxiety Inventory (Beck & Steer, 1993) |
| Hopelessness | Measured within one week of completing the intervention, six months post-intervention and 12 months post-intervention | Total score on the Beck Hopelessness Scale (Beck, Weissman, Lester, & Trexler, 1974) |
Countries
United Kingdom
Outcome results
None listed