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.     

The future is here: A review of foresight systems in anxiety and depression

Cognitive models of anxiety and depression have long suggested a central role for future-oriented thinking in these disorders. Experimental studies suggest that anxiety and depression are characterised by distinct future-oriented thinking profiles, and that these profiles are markedly different from those of asymptomatic adults. In this paper, we review these profiles and propose two explanatory models marked by two different neurocognitive systems. The Reconstructive Memory Model emphasises a role for emotionally driven learning and retrieval in episodic foresight (i.e., the construction of future-oriented scenarios), and the Valuation Model proposes that an overweighing of risk and uncertainty estimates can be invoked to explain the future-oriented thought patterns. We consider the effectiveness of interventions aimed at altering such thought patterns. We suggest that future research aimed at elucidating the neurobiological underpinnings of future-oriented thinking in anxiety and depression can play an important role in advancing development of effective biological and psychosocial interventions for these disorders.     

Useful lies: The twisted rationality of denial

He who increases knowledge increases sorrow.

Ecclesiastes 1:18

The truth will set you free.

John 8:32

Denial, or the habit of treating a real problem as if it were a nonissue, has both rational and irrational features. The interplay between these is best captured by a utilitarian-rationalist framework stretched to its limits. When in denial, people follow what they feel to be in their best interest by minimizing the psychosocial cost of acknowledging their problems. At its core, denial is thus based on a self-interested rationale of pain avoidance and harm minimization. Depending on the characteristics of the issue at hand, some of the effects are deeply ironic. I demonstrate this by starting from the simplest and most beneficial form of denial, before moving on to cases that are more complex and harmful. I also show how people can be liberated from denial when the practice has become counterproductive. Most of the mystery surrounding denial disappears when we accept that it is premised on a twisted kind of rationality.     

The impact of depression and PTSD symptom severity on trauma memory

Posttraumatic stress disorder (PTSD) and depression frequently co-occur following a traumatic event. Differences in the processing of autobiographical memory have been observed in both disorders in the form of overgeneralised memories and negative intrusive memories. The current study examined how symptoms of PTSD and depression influence the phenomenological characteristics of trauma memories. Undergraduate students who had experienced a traumatic event (n?=?696) completed questionnaires online including measures of PTSD and depressive symptom severity. They rated their trauma memory on several phenomenological characteristics using the Memory Experiences Questionnaire [Sutin, A. R., &; Robins, R. W. (2007). Phenomenology of autobiographical memories: The memory experiences questionnaire. Memory.]. Moderated multiple regression was used to examine how PTSD and depressive symptom severity related to each phenomenological characteristic. Symptoms of PTSD and depression were related separately and uniquely to the phenomenological characteristics of the trauma memory. PTSD severity predicted trauma memories that were more negative, contained higher sensory detail, and were more vivid. In contrast, depressive symptom severity predicted trauma memories that were less accessible and less coherent. These findings suggest that depressive and PTSD symptomatology affect traumatic memory differently and support a distinction between these two disorders.     

I was like a wild wild person: Understanding feelings of anger using interpretative phenomenological analysis

This paper is concerned with illuminating how emotion (anger) and emotion‐related phenomena such as feelings, thoughts and expressions appear to the individual person. In particular, it focuses on the role of feelings in emotion experience. It does this through the qualitative analysis of interview material from a single person case study using interpretative phenomenological analysis. The paper examines how the participant feels and experiences anger, the defining characteristics of anger episodes, and how the typical pattern of these episodes is disrupted by life‐changes. The findings are examined in light of phenomenological ideas and the utility of these ideas for psychology's understanding of emotion argued for.     

Using Contextual Therapy to Treat Depression with Couples

Abstract

Though depression is one of the most common presenting problems treated by systemic therapists, there have been relatively few attempts to describe how specific systemic therapy models can be applied to treat couples dealing with depression. In this paper, we discuss how contextual therapy can be used to treat depression in couples therapy. We identify multidirected partiality as an intervention and as a characteristic. We introduce letter writing and internalized other interviewing as contextual interventions that help to facilitate partiality and understanding between clients. A clinical vignette illustrates our discussed concepts.     

Differences in Internalizing Symptoms Across Specific Ethnic Minority Groups: An Analysis Across Chinese American,Filipino American,Japanese American,Native Hawaiian,and White Youth

Research to date on child and adolescent anxiety and depression have focused predominantly on major ethnic groups. Very few studies to date have been conducted on specific ethnic minority groups and the relatively few studies on these ethnic minority samples have produced mixed findings. The following question therefore still remains: Do specific ethnic subgroups differ with respect to their expression of anxiety and depression? And do these differences differ as a function of reporter type (i.e., youth versus parent)? If the expression of internalizing symptoms differs across specific ethnic subgroups, these differences could inform approaches to assessing and treating these populations. In the current study, we therefore examined ethnic differences in anxiety and depression symptoms in ethnic subgroups. A total of 629 children and adolescents from various public and private schools, aged 8–18 years (M = 12.37, SD = 2.8) and their caregivers completed anxiety and depression scales. Multiple indicators, multiple causes confirmatory factor analysis revealed that the following specific ethic subgroups were associated with significantly greater anxiety and depression relative to Caucasian youth: Chinese American, Filipino American, Japanese American, and Native Hawaiian. These results were found only among parent (but not youth) reports. Age and low SES status was also associated with more internalizing problems among Chinese, Filipino, and Japanese American youth. Implications related to ethnic minority subgroup differences and the role of multi-informant reports in understanding the relationship between anxiety, depression and ethnic minority subgroups are discussed.     

The Phenomenological Dimension of Meaning: Words,Vowels, Phonemes As Ways To Sing The World,To Celebrate The World,and To Live It

This is commentary on Cornejo’s Intersubjectivity as co-phenomenology: from the holism to the being-in-the-world-with-others, co-phenomenology, in which meaning is defined as a construal of phenomenological experience, it is not an individual creation, but rather an intersubjective one. In this paper the basic question is how language expresses the world and things and, consequently, what vision of the world is expressed by language and what relationship it creates with the real. Language is a set of differences between signs and meanings. It lives for and by this constant aspiration to say the inexpressible, to capture the elusive. Language tries to express the driving inner movement of the real through references and interlacing, by multiplying the relational threads of meanings. For example, the phonetic gesture performs for the speaker and his listener a certain structuring of experience, a certain modulation of existence. This is a communicative dimension in which meaning is always a process. It is the situation of co-feeling between subjects, in which understanding is achieved, as defined by Cornejo in his essay.

Psychophysiological Identification of Depression Subtypes in Older Adults: Problematic Diagnostic Heterogeneity in the DSM-III-R and DSM-IV

The DSM-IV does not subclassify patients with depression on the basis of anxiety level. Hence a significant confound may exist in all outcome studies that employ DSM definitions of depression. To establish that objectively identifiable anxious and nonanxious subtypes of depression do indeed exist, a psychophysiological assessment battery was used with 114 treatment-seeking older adults. Dichotomous criterion categorization as either Nonanxious Depressed or Anxious Depressed was based on (a) DSM-III-R/DSM-IV diagnosis, and (b) standardized questionnaires of psychopathology. Multivariate analyses revealed no differences between groups when DSM criteria were used to classify participants. However, identical analyses using phenomenological diagnostic criteria indicated that anxious and nonanxious depressed participants differed in their psychophysiological response to negative imagery. Although anxious and nonanxious depressed participants evince different psychophysiological response patterns, these differences unfortunately are obscured by the DSM. Consequently, a phenomenological classification system may be more appropriate with affective disorders.     

Auditory verbal hallucinations: Dialoguing between the cognitive sciences and phenomenology

Auditory verbal hallucinations (AVHs) are a highly complex and rich phenomena, and this has a number of important clinical, theoretical and methodological implications. However, until recently, this fact has not always been incorporated into the experimental designs and theoretical paradigms used by researchers within the cognitive sciences. In this paper, we will briefly outline two recent examples of phenomenologically informed approaches to the study of AVHs taken from a cognitive science perspective. In the first example, based on Larøi and Woodward (Harv Rev Psychiatry 15:109–117, 2007), it is argued that reality monitoring studies examining the cognitive underpinnings of hallucinations have not reflected the phenomenological complexity of AVHs in their experimental designs and theoretical framework. The second example, based on Jones (Schizophr Bull, in press, 2010), involves a critical examination of the phenomenology of AVHs in the context of two other prominent cognitive models: inner speech and intrusions from memory. It will be shown that, for both examples, the integration of a phenomenological analysis provides important improvements both on a methodological, theoretical and clinical level. This will be followed by insights and critiques from philosophy and clinical psychiatry—both of which offer a phenomenological alternative to the empiricist–rationalist conceptualisation of AVHs inherent to the cognitive sciences approach. Finally, the paper will conclude with ideas as to how the cognitive sciences may integrate these latter perspectives into their methodological and theoretical programmes.     

Kafka,paranoic doubles and the brain: hypnagogic vs. hyper-reflexive models of disrupted self in neuropsychiatric disorders and anomalous conscious states

Kafka's writings are frequently interpreted as representing the historical period of modernism in which he was writing. Little attention has been paid, however, to the possibility that his writings may reflect neural mechanisms in the processing of self during hypnagogic (i.e., between waking and sleep) states. Kafka suffered from dream-like, hypnagogic hallucinations during a sleep-deprived state while writing. This paper discusses reasons (phenomenological and neurobiological) why the self projects an imaginary double (autoscopy) in its spontaneous hallucinations and how Kafka's writings help to elucidate the underlying cognitive and neural mechanisms. I further discuss how the proposed mechanisms may be relevant to understanding paranoid delusions in schizophrenia. Literature documents and records cognitive and neural processes of self with an intimacy that may be otherwise unavailable to neuroscience. To elucidate this approach, I contrast it with the apparently popularizing view that the symptoms of schizophrenia result from what has been called an operative (i.e., pre-reflective) hyper-reflexivity. The latter approach claims that pre-reflective self-awareness (diminished in schizophrenia) pervades all conscious experience (however, in a manner that remains unverifiable for both phenomenological and experimental methods). This contribution argues the opposite: the "self" informs our hypnagogic imagery precisely to the extent that we are not self-aware.     

From <Emphasis Type="Italic">ego</Emphasis> to <Emphasis Type="Italic">alter ego</Emphasis>: Husserl,Merleau-Ponty and a layered approach to intersubjectivity

This article presents two different phenomenological paths leading from ego to alter ego: a Husserlian and a Merleau-Pontian way of thinking. These two phenomenological paths serve to disentangle the conceptual–philosophical underpinning of the mirror neurons system hypothesis, in which both ways of thinking are entwined. A Merleau-Pontian re-reading of the mirror neurons system theory is proposed, in which the characteristics of mirror neurons are effectively used in the explanation of action understanding and imitation. This proposal uncovers the remaining necessary presupposition of a minimalized version of the Husserlian concept of pairing and its recent and improved version in terms of the intermodal system. This leads to a layered approach to the constitution of intersubjectivity.     

Pseudodementia: A slow death

The clinical term pseudodementia has remained a permanent nosological entity in the literature for over 100 years. Indeed, recognition of the fact that clinical symptoms associated with reversible neuropsychiatric conditions can mimic irreversible disorders was known as early as the middle of the 19th century. The importance of the term lies in the inherent assumption that the presenting dementia is not real, or is at least reversible, and therefore treatable. Nonetheless, there continues to be controversy regarding the validity and appropriate clinical use of the term. This article reviews the evolution and clinical utility of the term pseudodementia and attempts to redirect investigative efforts toward an understanding of the neuroanatomical substrates that underlie depression and cognitive impairment in the elderly. Based on a critical analysis of the relevant literatures, a subcortical-frontal neuroanatomical substrate of late-life depression is supported. Further, the presence of leukoaraiosis, as measured by magnetic resonance imaging, is proposed as a potential neurobiological marker that contributes to the depressed mood, cognitive impairment, and later cognitive deterioration of some elderly depressed.     

Phenomenology and Fallibility

If Husserl is correct, phenomenological inquiry produces knowledge with an extremely high level of epistemic warrant or justification. However, there are several good reasons to think that we are highly fallible at carrying out phenomenological inquiries. It is extremely difficult to engage in phenomenological investigations, and there are very few substantive phenomenological claims that command a widespread consensus. In what follows, I introduce a distinction between method-fallibility and agent-fallibility, and use it to argue that the fact that we are fallible phenomenologists does not undermine Husserl’s claims concerning the epistemic value of phenomenological inquiry. I will also defend my account against both internalist and externalist objections.

---

运动如何影响青少年抑郁：回顾与展望

近年来运动作为成人临床抑郁症治疗的替代疗法开始受到越来越多的关注,实证研究也支持运动对青少年抑郁症状具有积极影响作用,本文在此基础上系统梳理前人研究,分别对相关横纵向调查和实验干预研究进行回顾,分析总结了运动对青少年抑郁症状影响作用的研究进展。同时,我们对该作用现有的心理假说：自我效能、注意分散、自尊假说和神经生物假说包括神经内分泌、神经营养因子、氧化应激、炎症、皮质厚度和活性、表观遗传假说等分别进行了阐述,结合相关研究结果对这些假说进行了分析探讨。最后,我们认为,未来研究应不断完善相关设计,关注不同运动类型,并结合中国特色,深入探讨在青少年抑郁障碍群体中的最佳抗抑郁运动方案及其作用机制。     

Hope and social support utilisation among different age groups of women with breast cancer and their spouses

Objective: Social support and hope are considered positive, important contributors to psychological well-being for women with breast cancer and their spouses. Few studies examine the role of age in relation to these variables. The current study compares the relationship between social support, hope and depression among different age groups of women with advanced breast cancer and their healthy spouses.

Design: Cross-sectional sample of 150 women with advanced breast cancer and their spouses.

Main outcome measures: Social support, hope, depression and socio-demographic data. Analysis included comparison of these variables between groups of older and younger patients and their spouses. Structural equation modelling (SEM) was used to examine hope as a mediator of the relationship between social support and depression within each group (older and younger patients and spouses).

Results: Older patients and spouses reported lower levels of depression than younger ones. SEM showed that social support related directly to depression among younger women and older spouses, while hope was directly related to depression among older women and younger spouses and acted as a mediator between social support and depression.

Conclusions: Theoretical, empirical and clinical implications regarding the understanding of the role of age in coping with cancer are discussed.     

Altered Emotional Processing in Pediatric Anxiety,Depression, and Comorbid Anxiety-Depression

The goal of this study was to examine some of the mechanisms underlying emotion regulation in childhood affective disorders by examining the impact of distracting emotional information during performance on a working memory task (Emotional n-back or E-n-back). The sample included 75 children (38 girls and 37 boys) between 8 and 16 years of age meeting criteria for: Anxiety disorder (ANX, n = 17), Major depressive disorder (MDD, n = 16), Comorbid anxiety and depression (CAD, n = 24), or Low-risk normal control (LRNC, n = 18). Results showed that the MDD and CAD groups had significantly longer reaction times on negative emotional backgrounds compared to neutral backgrounds, whereas the LRNC group had significantly longer reaction times on positive backgrounds. These results suggest altered processing of emotional information particularly associated with depression. Because the E-n-back task engages higher-order cognitive processes, these results suggest that these alterations in processing emotional information also interfere with the cognitive processes that govern how attentional resources are allocated. Further, research is needed to replicate this study and delineate underlying neural mechanisms.     

A proposal for genetically modifying the project of “naturalizing” phenomenology

In this paper, we examine Shaun Gallagher’s project of “naturalizing” phenomenology with the cognitive sciences: front-loaded phenomenology (FLP). While we think it is a productive proposal, we argue that Gallagher does not employ genetic phenomenological methods in his execution of FLP. We show that without such methods, FLP’s attempt to locate neurological correlates of conscious experience is not yet adequate. We demonstrate this by analyzing Gallagher’s critique of cognitive neuropsychologist Christopher Frith’s functional explanation of schizophrenic symptoms. In “constraining” Gallagher’s FLP program, we discuss what genetic phenomenological method is and why FLP ought to embrace it. We also indicate what types of structures a genetically modified FLP will consider, and how such an approach would affect the manner in which potential neurological correlates of conscious experience are conceptually understood and experimentally investigated.