Intrusive images and memories in major depression

Individuals with current major depression were interviewed to investigate the prevalence of distressing intrusive mental imagery among depressed patients and study the phenomenology of these intrusions. Of the 39 currently depressed patients, 17 experienced some form of repetitive intrusive imagery (i.e., either an intrusive memory or image), with intrusive memories being more common than images. The intrusive imagery was experienced as highly uncontrollable and interfered significantly with patients' everyday lives. The intrusions were experienced with a sense of 'nowness', as well as physical and emotional re-experiencing. Despite high levels of re-experiencing, levels of dissociation were very low. The intrusive imagery was in some patients part of a wider network of key defining autobiographical memories, consistent with the idea that it is likely to play a significant role in maintaining the patient's depressive mood. Interventions targeting these intrusions could potentially result in a positive shift in depressed mood.     

Characteristics of intrusive memories in a community sample of depressed, recovered depressed and never-depressed individuals

An accumulating body of evidence has revealed that intrusive autobiographical memories of negative events play a role in depression. Despite increasing understanding of the phenomenological experience of these memories, previous research in this area has been conducted in either nonclinical samples, or in clinical samples without an adequate control group. This study aimed to replicate and extend findings with dysphoric samples by comparing the content and characteristics of intrusive memories in clinically depressed (n = 25), recovered (n = 30) and never-depressed (n = 30) participants. Participants completed mood measures, and a battery of self-report questionnaires that indexed intrusive memory frequency, avoidance and characteristics. Intrusive memories were common and shared strikingly similar characteristics across the three groups. The key finding was that depressed participants reported higher levels of intrusion-related distress, associated emotions (especially sadness and helplessness), interference as a result of the memories and memory vividness compared to the never-depressed group. Despite similar levels of intrusion, there were group differences in avoidance such that depressed participants reported higher levels of avoidance than the never-depressed group. These results provide further support for the proposal that clinical interventions for depression could usefully incorporate components that aim to reduce intrusive autobiographical memories and target avoidance strategies.     

Autobiographical memory characteristics in depression vulnerability: formerly depressed individuals recall less vivid positive memories

The differential activation hypothesis (DAH; Teasdale, 1988) proposes that individuals who are vulnerable to depression can be distinguished from non-vulnerable individuals by the degree to which negative thoughts and maladaptive cognitive processes are activated during sad mood. While retrieval of negative autobiographical memories is noted as one such process, the model does not articulate a role for deficits in recalling positive memories. Two studies were conducted to compare the autobiographical memory characteristics of never-depressed and formerly depressed individuals following a sad mood induction. In Study 1, features of negative memories of never-depressed and formerly depressed individuals did not differ, either in neutral or sad mood. For positive memories, groups did not differ in neutral mood, but following a sad mood induction, formerly depressed individuals rated their positive memories as less vivid than their never-depressed counterparts. Study 2 examined positive autobiographical memory features more comprehensively and replicated the finding that in a sad mood formerly depressed individuals recalled less vivid positive memories than never-depressed controls. These findings suggest that the phenomenological features of positive memories could represent an important factor in depressive vulnerability, and, more broadly, that depression may be associated with a deficit in the processing of positive material.     

Autobiographical memory characteristics in depression vulnerability: Formerly depressed individuals recall less vivid positive memories

The differential activation hypothesis (DAH; Teasdale, 1988) proposes that individuals who are vulnerable to depression can be distinguished from non-vulnerable individuals by the degree to which negative thoughts and maladaptive cognitive processes are activated during sad mood. While retrieval of negative autobiographical memories is noted as one such process, the model does not articulate a role for deficits in recalling positive memories. Two studies were conducted to compare the autobiographical memory characteristics of never-depressed and formerly depressed individuals following a sad mood induction. In Study 1, features of negative memories of never-depressed and formerly depressed individuals did not differ, either in neutral or sad mood. For positive memories, groups did not differ in neutral mood, but following a sad mood induction, formerly depressed individuals rated their positive memories as less vivid than their never-depressed counterparts. Study 2 examined positive autobiographical memory features more comprehensively and replicated the finding that in a sad mood formerly depressed individuals recalled less vivid positive memories than never-depressed controls. These findings suggest that the phenomenological features of positive memories could represent an important factor in depressive vulnerability, and, more broadly, that depression may be associated with a deficit in the processing of positive material.     

Mood stability versus mood instability in bipolar disorder: a possible role for emotional mental imagery

A cognitive model of bipolar disorder suggests that mental imagery acts as an emotional amplifier of mood and may be heightened in bipolar disorder. First, we tested whether patients with bipolar disorder would score higher on mental imagery measures than a matched healthy control group. Second, we examined differences in imagery between patients divided into groups according to their level of mood stability. Mood ratings over approximately 6-months, made using a mobile phone messaging system, were used to divide patients into stable or unstable groups. Clinician decisions of mood stability were corroborated with statistical analysis. Results showed (I) compared to healthy controls, patients with bipolar disorder had significantly higher scores for general mental imagery use, more vivid imagery of future events, higher levels of intrusive prospective imagery, and more extreme imagery-based interpretation bias; (II) compared to patients with stable mood, patients with unstable mood had higher levels of intrusive prospective imagery, and this correlated highly with their current levels of anxiety and depression. The findings were consistent with predictions. Further investigation of imagery in bipolar disorder appears warranted as it may highlight processes that contribute to mood instability with relevance for cognitive behaviour therapy.     

Positive memory enhancement training for individuals with major depressive disorder

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.     

Mood repair and processing mode in depression

Recalling positive autobiographical memories is a powerful emotion regulation strategy that can be used to repair low mood and alleviate negative affect. Unlike healthy individuals, those with current or past depression do not experience an improvement in mood as a consequence of recalling positive memories. We tested whether differences in processing mode might account for this impairment. Following mood induction procedures designed to ensure equivalence of mood state, depressed (n = 35) and recovered depressed (n = 33) participants were instructed to recall a positive memory and focus on it while adopting either an abstract or a concrete mode of processing. Participants in the abstract processing condition experienced no change in mood, while those in the concrete processing condition showed improved mood after memory recall. This research illustrates that the process by which positive autobiographical memories are recalled is important in determining their emotional impact and suggests that psychological interventions for depression may be improved by explicitly targeting processing mode.     

Involuntary autobiographical memories in dysphoric mood: A laboratory study

The frequency and characteristics of involuntary autobiographical memories were compared in 25 stable dysphoric and 28 non-dysphoric participants, using a new laboratory-based task (Schlagman & Kvavilashvili, 2008). Participants detected infrequent target stimuli (vertical lines) in a simple vigilance task and recorded any involuntary autobiographical memories that came to mind, mostly in response to irrelevant words presented on the screen. Dysphoric participants reported involuntary memories as frequently and as quickly as non-dysphoric participants and their memories were not repetitive intrusive memories of negative or traumatic events. Additional content analysis showed that dysphoric participants did not recall more memories of objectively negative events (e.g., accidents, illnesses, deaths) than non-dysphoric participants. However, significant group differences emerged in terms of a mood congruency effect whereby dysphoric participants rated their memories as more negative than non-dysphoric participants. Moreover, the proportion of negatively rated involuntary memories was related to lower mood ratings at the end of the session in the dysphoric but not in the non-dysphoric group. Finally, groups did not differ on several memory characteristics such as vividness, specificity (high in both groups) and rates of rehearsal (low in both groups). Theoretical and practical implications of these findings for research on depression and autobiographical memory are discussed.     

Involuntary autobiographical memories in dysphoric mood: a laboratory study

The frequency and characteristics of involuntary autobiographical memories were compared in 25 stable dysphoric and 28 non-dysphoric participants, using a new laboratory-based task (Schlagman & Kvavilashvili, 2008). Participants detected infrequent target stimuli (vertical lines) in a simple vigilance task and recorded any involuntary autobiographical memories that came to mind, mostly in response to irrelevant words presented on the screen. Dysphoric participants reported involuntary memories as frequently and as quickly as non-dysphoric participants and their memories were not repetitive intrusive memories of negative or traumatic events. Additional content analysis showed that dysphoric participants did not recall more memories of objectively negative events (e.g., accidents, illnesses, deaths) than non-dysphoric participants. However, significant group differences emerged in terms of a mood congruency effect whereby dysphoric participants rated their memories as more negative than non-dysphoric participants. Moreover, the proportion of negatively rated involuntary memories was related to lower mood ratings at the end of the session in the dysphoric but not in the non-dysphoric group. Finally, groups did not differ on several memory characteristics such as vividness, specificity (high in both groups) and rates of rehearsal (low in both groups). Theoretical and practical implications of these findings for research on depression and autobiographical memory are discussed.     

Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure

High (n = 41) and low (n = 39) socially anxious (SA) participants completed the Waterloo Images and Memories Interview (WIMI), a new assessment tool that measures the accessibility and properties of mental images and associated autobiographical memories that individuals may experience across both anxiety-provoking (negative) and non-anxiety-provoking (positive) social situations. Results indicated that both high and low SA individuals experience negative images and associated autobiographical memories in anxiety-provoking social situations, but the rates of endorsement of such images and memories among high SA participants were substantially lower than those reported in recent studies. Moreover, whereas low SA individuals were capable of accessing a relatively balanced array of both negative and positive self-representations that were rich in episodic detail, high SA individuals retrieved a higher, more unbalanced ratio of negative-to-positive images and memories, as well as impoverished positive images that were significantly degraded in episodic detail. Finally, negative images influenced the two groups differently, with high SA individuals experiencing more negative emotional and cognitive consequences associated with bringing such images to mind. These results are discussed in relation to theoretical models of learning and memory within the context of contemporary cognitive behavioral models of social anxiety.     

Activating attachment representations impact how we retrieve autobiographical memories

Although much research indicates that proximity to attachment figures confers many psychological benefits, there is little evidence pertaining to how attachment activation may impact autobiographical memory retrieval. Following a negative mood induction to elicit overgeneral autobiographical retrieval, participants (N?=?70) were administered an induction in which they imagined a person who is a strong attachment figure or an acquaintance. Participants then completed an autobiographical memory task to retrieve memories in response to neutral and negative cue words. Attachment priming resulted in less distress, increased retrieval of specific memories, and reduced retrieval of categoric memories. These findings indicate that activation of mental representations of attachment figures can impact on the specificity of autobiographical memory retrieval, and extends prevailing models of autobiographical memory by integrating them with attachment theory.     

Depressed mood mediates the relationship between rumination and intrusions

Research suggests that rumination is a causal factor for intrusive memories. These are disturbing autobiographical memories that pop into one's mind involuntarily, spontaneously, and repetitively. A three‐wave longitudinal study was conducted to replicate this finding and to test whether one route via which rumination leads to (an increase in) intrusive memories is via depressed affect. Secondary school students (n = 72) filled out self‐report questionnaires measuring their level of rumination, depressive symptoms (DS), and intrusive memories. These were administered at three different points, with 3 weeks in between each measurement. Two types of rumination were measured, that is, depressive rumination and rumination in response to intrusions. Both bootstrapping analyses and cross‐lagged analyses yielded evidence for DS as a partial mediator of the relationship between rumination and intrusion frequency. Both depressive rumination and rumination about the content of intrusive memories seemed to be maladaptive: They may exacerbate negative emotions, which in turn trigger intrusive memories. Ruminative thinking also directly led to (an increase in) intrusive memories. These findings might suggest that people suffering from intrusive memories may benefit not only from therapies directly aimed at reducing intrusions but also from therapies aimed at reducing rumination and DS.     

The Interaction of Mood and Rumination in Depression: Effects on Mood Maintenance and Mood-Congruent Autobiographical Memory

Rumination is a response to distress in which individuals focus repetitively on their feelings and the causes and consequences of those feelings. When induced to ruminate, dysphorics exhibit more negative mood and recall more negative memories, but these effects are not seen in nondysphorics. This pattern of results could be due to trait-like differences between dysphoric and nondysphoric individuals, or to the high levels of negative affect that dysphorics are experiencing at the time of rumination. The purpose of this study was to evaluate the effects of pre-rumination mood on post-rumination mood and subsequent memory. Participants scoring high or low in depressive symptoms were assigned to either a positive or negative emotion induction prior to ruminating and completing an autobiographical memory task. Analysis of self-reported mood indicates that both emotion inductions were effective. Surprisingly, all participants returned to baseline mood levels following the rumination induction, and emotion induction had no effect on the negativity of the memories recalled. Dysphorics recalled significantly more negative memories than nondysphorics, regardless of whether positive, neutral, or negative memories were specifically prompted. Our results indicated that the prolonged experience of dysphoria may have greater effects on post-rumination mood and memory than the transitory experience of sadness.     

Belief and recollection of autobiographical memories

In three experiments, undergraduates rated autobiographical memories on scales derived from existing theories of memory. In multiple regression analyses, ratings of the degree to which subjects recollected (i.e., relived) their memories were predicted by visual imagery, auditory imagery, and emotions, whereas ratings of belief in the accuracy of their memories were predicted by knowledge of the setting. Recollection was predicted equally well in between- and within-subjects analyses, but belief consistently had smaller correlations and multiple regression predictions between subjects; individual differences in the cognitive scales that we measured could not account well for individual differences in belief. In contrast, measures of mood (Beck Depression Index) and dissociation (Dissociative Experience Scale) added predictive value for belief, but not for recollection. We also found that highly relived memories almost always had strong visual images and that remember/know judgments made on autobiographical memories were more closely related to belief than to recollection.     

Self appraisal and behavioural activation in the prediction of hypomanic personality and depressive symptoms

Hypomanic personality is characterised by increased positive mood and energy but also more depression and greater risk of bipolar disorder. It is linked with positive self-appraisals for hypomania-relevant events and Behavioural Activation System (BAS) sensitivity such that hypomanic individuals tend preferentially towards goal-related activities. This study investigated relationships between positive and negative self-appraisal and BAS functioning and hypomanic personality and depressive symptoms. Participants (N = 231) completed measures of hypomanic personality, mood symptoms, dysfunctional attitudes, self-appraisal and behavioural activation/inhibition.Positive but not negative self-appraisal contributed to prediction of hypomanic personality as did higher BAS fun seeking and lower Behavioural Inhibition System (BIS) scores. Conversely, negative self-appraisal was positively predictive of current depressive mood, whilst BAS reward responsiveness was negatively predictive. There are specific relationships between positive and negative appraisal styles and hypomanic personality and depressive mood, respectively. The findings of complimentary contributions from appraisal style, BAS and BIS to prediction of hypomanic personality are relevant to developing a better understanding of risk factors for bipolar disorder.     

Memory accessibility, mood regulation, and dysphoria: difficulties in repairing sad mood with happy memories?

Recent studies have suggested that mood-incongruency effects are due to mood-regulatory processes, in which people retrieve positive memories to repair negative moods. In Study 1, the authors investigated whether dysphoria influences the accessibility of autobiographical memories following a positive or a negative mood induction combined with subsequent rumination or distraction. The results showed a mood-repair effect for nondysphoric but not for dysphoric participants following rumination. In Study 2, participants were asked to either distract themselves or to recall positive autobiographical memories after a negative mood induction. Whereas nondysphoric participants' mood improved under both conditions, dysphoric participants' mood improved only after distraction. These results suggest that dysphoria is associated with a reduced ability to use mood-incongruent recall to repair sad moods.     

Reflecting on imagery: A clinical perspective and overview of the special issue of Memory on mental imagery and memory in psychopathology

The authors provide an overview of the papers in the special issue of Memory on mental imagery and memory in psychopathology. The papers address emotional, intrusive mental imagery across a range of psychological disorders including post‐traumatic stress disorder (PTSD), agoraphobia, body dysmorphic disorder, mood disorders, and psychosis. They include work on information processing issues including modelling cravings, conditioning, and aversions, as well as imagery qualities such as vividness and emotionality. The overview aims to place the articles in a broader context and draw out some exciting implications of this novel work. It provides a clinical context to the recent growth in this area from a cognitive behavioural therapy (CBT) perspective. We begin with PTSD, and consider links to imagery in other disorders. The clinical implications stemming from this empirical work and from autobiographical memory theory are discussed. These include consideration of a variety of techniques for eliminating troublesome imagery, and creating healthy, realistic alternatives.