Mindfulness Based Cognitive Therapy (MBCT) Reduces Depression-Related Self- Referential Processing In Patients With Bipolar Disorder

Background: Negative self-referential processing has fruitfully been studied in unipolar depressed patients, but remarkably less in patients with bipolar disorder (BD). This study examines the relation between task-based self-referential processing and depressive symptoms in BD and their possible importance to the working mechanism of mindfulness-based cognitive therapy (MBCT) for BD.Methods: The study population consisted of a subsample of patients with BD (n = 49) participating in an RCT of MBCT for BD, who were assigned to MBCT+TAU (n = 23) or treatment as usual (TAU) (n = 26). Patients performed the self-referential encoding task (SRET), which measures (1) positive and (2) negative attributions to oneself as well as (3) negative self-referential memory bias, before and after MBCT. Results: At baseline all three SRET measures were significantly related to depressive symptoms in patients with BD. Moreover, repeated measures analyses of variance revealed that negative self-referential memory bias diminished over time in the MBCT+TAU group, compared with the TAU group. Conclusions: Task-based self-referential processing is related to depressive symptoms in BD. Moreover, the negative self-referential memory bias was specifically amenable to change through MBCT. Future research should explore the possibly mediating role of reduction of negative self-referential memory bias in preventing and treating depressive symptoms in BD through MBCT.

Myofascial Tissue and Depression

Background The myofascial system plays a fundamental role in the mechanics of the body, in body tension regulation and the etiology of pathological states like chronic pain. Moreover, it contains contractile elements and preliminary evidence suggests that its properties are linked to psychological factors. The aim of the present research was to investigate characteristics of the myofascial tissue in patients with Major Depressive Disorder (MDD) and to examine whether the state of the myofascial tissue causally affects pathopsychological processes in MDD. Methods In Study 1, stiffness and elasticity of the myofascial tissue of 40 inpatients suffering from MDD measured with a tissue compliance meter were compared with those of 40 matched never-depressed participants. In Study 2, 69 MDD patients were randomly assigned to single-session self-myofascial release intervention (SMRI) or a placebo intervention. Effects on memory bias and affect were investigated. Results Results showed that MDD patients displayed heightened stiffness and reduced elasticity of the myofascial tissue and that patients in the SMRI group showed a reduced negative memory bias and more positive affect compared to patients in the placebo condition. Conclusions The preliminary results of our studies indicate that the myofascial tissue might be part of a dysfunctional body-mind dynamic that maintains MDD.

Sensory suppression and increased neuromodulation during actions disrupt memory encoding of unpredictable self-initiated stimuli

Actions modulate sensory processing by attenuating responses to self- compared to externally-generated inputs, which is traditionally attributed to stimulus-specific motor predictions. Yet, suppression has been also found for stimuli merely coinciding with actions, pointing to unspecific processes that may be driven by neuromodulatory systems. Meanwhile, the differential processing for self-generated stimuli raises the possibility of producing effects also on memory for these stimuli, however, evidence remains mixed as to the direction of the effects. Here, we assessed the effects of actions on sensory processing and memory encoding of concomitant, but unpredictable sounds, using a combination of self-generation and memory recognition task concurrently with EEG and pupil recordings. At encoding, subjects performed button presses that half of the time generated a sound (motor-auditory; MA) and listened to passively presented sounds (auditory-only; A). At retrieval, two sounds were presented and participants had to respond which one was present before. We measured memory bias and memory performance by having sequences where either both or only one of the test sounds were presented at encoding, respectively. Results showed worse memory performance — but no differences in memory bias — and attenuated responses and larger pupil diameter for MA compared to A sounds. Critically, the larger the sensory attenuation and pupil diameter, the worse the memory performance for MA sounds. Nevertheless, sensory attenuation did not correlate with pupil dilation. Collectively, our findings suggest that sensory attenuation and neuromodulatory processes coexist during actions, and both relate to disrupted memory for concurrent, albeit unpredictable sounds.

Understanding mechanisms that may underlie the development and maintenance of anxiety in children and adolescents: Cognitive biases and parenting behaviours

<p>Anxiety is one of the most common forms of psychopathology in children and adolescents. Understanding the mechanisms that underlie the development and maintenance of this disorder is therefore critical. A variety of factors that interact with one another are likely to contribute to the risk and perpetuation of anxiety in young people. Moreover, risk and maintaining factors can occur at both an individual and environmental level. Cognitive biases are one such factor occurring at an individual level that are investigated in Study 1 and Study 2 of this thesis. Cognitive biases are also predicted to have associations with particular kinds of parenting behaviours, and Study 3 investigated these parenting behaviours. Study 3, therefore, provides a bridge between individual level cognitive mechanisms and possible environmental contexts that may contribute to the risk and maintenance of anxiety in young people. In Study 1, the relationships amongst anxiety, interpretation bias, and memory bias were investigated in children (M = 10.1 years, SD = 0.8). Children with higher levels of anxiety exhibit interpretation biases; a tendency to interpret ambiguous information in a negative manner. Moreover, interpretation biases are predicted to create negative memories for ambiguous information. In Study 1, 62 children heard ambiguous information about a novel animal and their interpretation and recall for this information was assessed. Interpretation bias was significantly associated with memory bias; children who interpreted the ambiguous information in a negative way also reported a greater number of negative memories for this information. Children with higher levels of anxiety also reported a greater number of negative memories. In Study 2 the relationship between interpretation bias and memory bias was investigated within an experimental paradigm, to understand whether there was evidence for a causal relationship between these cognitive biases. Children (M = 9.7 years, SD = 1.1) heard a series of ambiguous vignettes, and each vignette was followed by either a negative or a benign interpretation. Children were subsequently asked to recall the vignettes and children who had heard negative interpretations reported a greater number of negative memories. Children with higher levels of anxiety also reported a greater number of negative memories in their recall of the ambiguous vignettes. In Study 3, I investigated parental autonomy restriction and support in the context of parent-adolescent (M = 15.3 years, SD = 0.8) conversations, and their associations with anxiety, interpretation biases, and parental attributions. Higher levels of parental autonomy restriction may contribute to the risk and maintenance of anxiety in young people by signalling that the world is dangerous. Sixty-four mother-adolescent dyads were asked to discuss a recent conflict, and from this interaction maternal autonomy restriction and autonomy support were assessed. Adolescents with higher levels of anxiety and adolescents who exhibited interpretation biases to a greater extent, had mothers who demonstrated a greater amount of autonomy restriction within the conversations. Yet maternal variables were not significantly associated with either autonomy restriction or support. The results support predictions that these characteristics of young people may determine the extent of autonomy restriction parents engage in. In turn, autonomy restrictive parenting behaviours potentially play a role in the risk and maintenance of cognitive biases and anxiety. Overall this thesis contributes to an understanding of the complex and multiple relationships amongst factors that may be involved in the aetiology and perpetuation of anxiety in young people.</p>

Understanding mechanisms that may underlie the development and maintenance of anxiety in children and adolescents: Cognitive biases and parenting behaviours

<p>Anxiety is one of the most common forms of psychopathology in children and adolescents. Understanding the mechanisms that underlie the development and maintenance of this disorder is therefore critical. A variety of factors that interact with one another are likely to contribute to the risk and perpetuation of anxiety in young people. Moreover, risk and maintaining factors can occur at both an individual and environmental level. Cognitive biases are one such factor occurring at an individual level that are investigated in Study 1 and Study 2 of this thesis. Cognitive biases are also predicted to have associations with particular kinds of parenting behaviours, and Study 3 investigated these parenting behaviours. Study 3, therefore, provides a bridge between individual level cognitive mechanisms and possible environmental contexts that may contribute to the risk and maintenance of anxiety in young people. In Study 1, the relationships amongst anxiety, interpretation bias, and memory bias were investigated in children (M = 10.1 years, SD = 0.8). Children with higher levels of anxiety exhibit interpretation biases; a tendency to interpret ambiguous information in a negative manner. Moreover, interpretation biases are predicted to create negative memories for ambiguous information. In Study 1, 62 children heard ambiguous information about a novel animal and their interpretation and recall for this information was assessed. Interpretation bias was significantly associated with memory bias; children who interpreted the ambiguous information in a negative way also reported a greater number of negative memories for this information. Children with higher levels of anxiety also reported a greater number of negative memories. In Study 2 the relationship between interpretation bias and memory bias was investigated within an experimental paradigm, to understand whether there was evidence for a causal relationship between these cognitive biases. Children (M = 9.7 years, SD = 1.1) heard a series of ambiguous vignettes, and each vignette was followed by either a negative or a benign interpretation. Children were subsequently asked to recall the vignettes and children who had heard negative interpretations reported a greater number of negative memories. Children with higher levels of anxiety also reported a greater number of negative memories in their recall of the ambiguous vignettes. In Study 3, I investigated parental autonomy restriction and support in the context of parent-adolescent (M = 15.3 years, SD = 0.8) conversations, and their associations with anxiety, interpretation biases, and parental attributions. Higher levels of parental autonomy restriction may contribute to the risk and maintenance of anxiety in young people by signalling that the world is dangerous. Sixty-four mother-adolescent dyads were asked to discuss a recent conflict, and from this interaction maternal autonomy restriction and autonomy support were assessed. Adolescents with higher levels of anxiety and adolescents who exhibited interpretation biases to a greater extent, had mothers who demonstrated a greater amount of autonomy restriction within the conversations. Yet maternal variables were not significantly associated with either autonomy restriction or support. The results support predictions that these characteristics of young people may determine the extent of autonomy restriction parents engage in. In turn, autonomy restrictive parenting behaviours potentially play a role in the risk and maintenance of cognitive biases and anxiety. Overall this thesis contributes to an understanding of the complex and multiple relationships amongst factors that may be involved in the aetiology and perpetuation of anxiety in young people.</p>

Somatization Symptoms Regulate Emotional Memory Bias in Adolescents With Major Depressive Disorder

Objective: Somatization symptoms are commonly comorbid with depression. Furthermore, people with depression and somatization have a negative memory bias. We investigated the differences in emotional memory among adolescent patients with depressive disorders, with and without functional somatization symptoms (FSS).Methods: We recruited 30 adolescents with depression and FSS, 38 adolescents with depression but without FSS, and 38 healthy participants. Emotional memory tasks were conducted to evaluate the emotional memory of the participants in the three groups. The clinical symptoms were evaluated using the Hamilton Depression Rating Scale (HDRS) and the Children's Somatization Inventory (CSI).Results: The valence ratings and recognition accuracy rates for positive and neutral images of adolescent patients were significantly lower than those of the control group (F = 12.208, P &lt; 0.001; F = 6.801, P &lt; 0.05; F = 14.536, P &lt; 0.001; F = 6.306, P &lt; 0.05, respectively); however, the recognition accuracy rate for negative images of adolescent patients of depression without FSS was significantly lower than that of patients with FSS and control group participants (F = 10.316, P &lt; 0.001). These differences persisted after controlling for HDRS scores. The within-group analysis revealed that patients of depression with FSS showed significantly higher recognition accuracy rates for negative images than the other types (F = 5.446, P &lt; 0.05). The recognition accuracy rate for negative images was positively correlated with CSI scores (r = 0.352, P &lt; 0.05).Conclusion: Therefore, emotional memory impairment exists in adolescent patients of depression and FSS are associated with negative emotional memory retention.