williams et al 2000 ogm in mbct
Post on 13-Apr-2018
220 Views
Preview:
TRANSCRIPT
-
7/27/2019 Williams Et Al 2000 OGM in MBCT
1/6
Journal of Abnormal Psychology Copyright 2000 by the American Psychological Association, Inc.
2000, Vol. 109, No. 1, 150-155 0021-843X/00/ 5,00 DOI: 10.1037//0021-843X.109.1.150
M indfulness Based Co gnitive Therapy Re duces Overgeneral
Autobiographical M em ory in Form erly D epressed Patients
J M a r k G
Williams
U n i v e r s i t y o f W a l e s, B a n g o r
John D Teasdale
M e d i c a l R e s e a r c h C o u n c i l
Zindel V Segal
C l a r k e I n s t i t u t e o f P s y c h i a t r y
J u d i t h S o u l s b y
U n i v e r s i t y o f W a l e s , B a n g o r
Previous research on depressed and suicidal patients and those with posttraumatic stress disorder has
shown that patients' mem ory for the past is overgeneral (i.e., patients retrieve generic sum maries of past
events rather than specific events). This study investigated whether autobiographical memory could be
affected by psychological treatment. Recovered depressed patients were randomly allocated to receive
either treatment as usual o r treatment designed to reduce risk of relapse. W hereas control patients showed
no change in specificity of memories recalled in response to cue words, the treatment group showed a
significantly reduced number of generic memories. Although such a memory deficit may arise from
long-standing tendencies to encode and retrieve events generically, such a style is open to modification.
W h e n p e o p l e t r y t o r e t r i ev e s p e c i f i c e v e n t s f r o m t h e i r p a st , t h e y
f i r s t a c c e s s h ighe r l e ve l , ge ne ra l de sc r ip t ions , us ing the se a s in te r -
m e d i a t e s t e p s t o d e r i v e p o i n t e r s t o t h e l o w e r l e v e l , s p e c i f i c e v e n t
re pre se nta t io ns (Re i se r , B la c k , & Abe lson , 1985; s e e Rub in , 1996,
f o r a r e v i e w ) . C h a r a c t e r i z i n g a u t o b i o g r a p h i c a l m e m o r y a s a h i e r -
a r c h y , w i t h m o r e g e n e r a l i n f o r m a t i o n h i g h e r i n t h e h i e r a rc h y , a n d
m o r e d e t a i le d , s p e c i f i c i n f o r m a t i o n l o w e r i n t h e h i e ra r c h y , p e o p l e
a r e n o r m a l l y a b l e t o m o v e f l u e n t l y th r o u g h t h e h i e r a r c h y , s e l e c ti n g
t h e l e v e l o f s p e c i f i c i ty n e c e s s a r y t o r e s p o n d a p p r o p r i a t e l y t o t h e
g i v e n c o n t e x t.
H o w e v e r , s e v e r a l r e c e n t s t u d i e s s u g g e s t t h a t d e p r e s s e d p a t i e n ts
h a v e c o n s i d e r a b l e d i f f i c u l ti e s m o v i n g f l u e n t l y t h r o u g h t h e m e m o r y
h i e r a rc h y . T h e i r m e m o r y a p p e a r s t o a b o r t t h e s e a r c h f o r a s p e c i f ic
e v e n t p r e m a t u r e l y , w h e n o n l y t h e g e n e r a l d e s c r i p t i o n s t a g e h a s
b e e n r e a c h e d . F o r e x a m p l e , i n r e s p o n s e t o a w o r d c u e s u c h a s
kindness
s u c h a d e p r e s s e d p a t i e n t m a y r e s p o n d , M y g r a n d m o t h e r
w a s a l w a y s k i n d t o m e . S h e u s e d t o t a k e m e o u t w h e n m y f a t h e r
g o t c r o s s . I n th i s e x a m p l e , t h e p a t i e n t is re s p o n d i n g w i t h a
s u m m a r y d e s c r i p ti o n , a c a t e g o r y o f e v e n t s , r a t h er t h a n r e t r i e v i n g a
s p e c i f i c e v e n t t h a t h a p p e n e d a t a p a r t i c u l a r p l a c e a n d t i m e ( s e e
Wi l l i a m s , 1996, for a r e v ie w) .
J. Mark G. W illiams and Judith Soulsby, Institute of Medical and Social
Care Research, University of Wales, Bangor; John D. Teasdale, Cognition
and Brain Sciences Unit, Medical Research Council, Cambridge, England;
Zindel V. S egal, Clarke Institute of Psychiatry, Toronto, O ntario, Canada.
This research was funded by grants from the National Health Service
Wales O ffice of Research and Developm ent and fro m the National Institute
of Mental Health (Grant 53457). We thank Jess Eade, Valerie Ridgeway,
Susan Williams, Mark Lau, Neil Rector, Jon Kabat-Zinn, Ferris Ur-
banowsky, and Saki Santorelli for their help.
Correspondence concerning this article should be addressed to J. Mark
G. Williams, Institute of Medical and S ocial Care Research, University of
Wales, Bangor, LL57 2U W, United Kingd om. Electronic mail may be sent
to j.m.g.williams @ bangor.ac.uk.
150
O r i g i n a l l y d e s c r i b e d i n s u i c i d a l p a t ie n t s ( W i l l i a m s & B r o a d b e n t ,
1 9 8 6 ; W i l l i a m s & D r i t s c h e l , 1 9 8 8 ) , s u b s e q u e n t r e s e a r c h f o u n d
o v e r g e n e r a l m e m o r y t o b e a c h a r a c t e r i s ti c o f d e p r e s s i o n ( G o d d a r d ,
D r i t s c h e l , & B u r t o n , 1 9 9 6 ; K u y k e n & B r e w i n , 1 9 9 5 ; K u y k e n &
D a l g l e i s h , 1 9 9 5 ; M o o r e , W a t t s , & W i l l i a m s , 1 9 8 8 ; P u f f e t , J e h i n -
M a r c h o t , T i m s i t - B e r t h i e r , & T i m s i t , 1 9 9 1 ; W i l l i a m s & S c o t t ,
1 9 8 8 ) a n d p o s t t r a u m a t i c s t r e ss d i s o r d e r ( M c N a l l y , L a s k o , M a c k l i n ,
& Pi tm a n, 1995; Mc Na l ly , L i t z , Pra s sa s , Shin , & We a the r s , 1994) .
K u y k e n a n d B r e w i n ( 1 9 9 5 ) f o u n d t h a t o v e r g e n e r a l i t y i n m e m -
o r y i n d e p r e ss e d w o m e n w a s a s s o c ia t e d w i t h a h i g h e r n u m b e r o f
p r e v i o u s s u i c i d e a t t em p t s a n d e p i s o d e s o f d e p r e s s io n . I n a d d i t i o n ,
o v e r g e n e r a l m e m o r y w a s a s s o c i a t e d w i t h g r e a t e r f r e q u e n c y o f
i n t r u s io n s o f p a s t s t r es s f u l e v e n t s s u c h a s p h y s i c a l a n d s e x u a l
a b u s e , s u g g e s t i n g e i t h e r t h a t t h e e f f o r t i n v o l v e d i n s u p p r e s s i n g o r
a v o i d i n g u n p l e a s a n t m e m o r i e s d i s r u p t s t h e m e m o r y s e a r c h a t t h e
p o i n t w h e r e i t m o v e s f r o m g e n e r a l d e s c r i p t i o n s t o s p e c i f i c e v e n t s
o r t h a t s o m e i n d i v i d u a l s s t r a t e g i c a l l y a d o p t a n o v e r g e n e r a l r e -
t r i e v a l s t y l e a s a m e t h o d f o r d e a l i n g w i t h p o t e n t i a l l y e m o t i o n a l
m a t e r i a l . A l t h o u g h s u c h o v e r g e n e r a l r e t r i e v a l m a y t h u s a p p e a r t o
h a v e a n a d a p t i v e , a f f e c t r e g u l a t i o n f u n c t i o n , i t h a s a l s o b e c o m e
c l e a r th a t i t h as a n u m b e r o f m a l a d a p t i v e e f f e c t s . A l t h o u g h n o t a l l
p a t i e n ts s h o w t h i s d e f i c i t t o t h e s a m e e x t e n t , p a t i e n t s w h o a r e m o r e
o v e r g e n e r a l f o r n e g a t i v e e v e n t s i n t h e i r l i v e s ( a ) a r e a l s o m o r e
o v e r g e n e r a l f o r p o s i t i v e an d n e u t r a l e v e n t s ( W i l l i a m s , 1 9 9 6 ) ; ( b)
s h o w d e f i c i t s i n i n t e r p e r s o n a l p r o b l e m s o l v i n g ( E v a n s , W i l l i a m s ,
O ' L o u g h l i n , & H o w e l l s , 1 9 9 2 ; G o d d a r d e t al . , 19 9 6 ; S i d l e y , W h i t -
t a ke r , Ca la m , & W e l l s , 19 97) ; ( c ) f ind i t d i f f i c u l t to im a gine the
f u t u r e i n a s p e c i f i c w a y a n d a r e m o r e h o p e l e s s ( W i l l i a m s , 1 9 9 7 ;
W i l l i a m s e t a l . , 1 9 9 6 ) ; a n d ( d ) m a y t a k e l o n g e r t o r e c o v e r f r o m t h e
di sorde r (Br i t f l e ba nk, Sc ot t , Wi l l i a m s , & Fe r r i e r , 1993; Ha rve y ,
B r y a n t , & D a n g , 1 9 9 8 ; h o w e v e r , s e e B r e w i n , P h i l l i p s , C a r r o l l , &
Ta ta , 1998, for a nonre pl ic a f ion) .
I f t h is m e m o r y d e f i c i t h a s s u c h d e t r i m e n t a l e f f e c t s o n f u n c t i o n -
i n g , c a n i t b e m o d i f i e d ? O n e p o s s i b i l i ty i s t h a t s u c h a d e f i c i t a ri s e s
f r o m t h e s e v e r i t y o f m o o d d i s t u r b a n c e . I f so , th e n r e d u c i n g m o o d
-
7/27/2019 Williams Et Al 2000 OGM in MBCT
2/6
SHORT REPORTS 151
d i s t u r b a n c e w i l l r e d u c e t h e m e m o r y d e f i c i t . H o w e v e r , r e s e a r ch h a s
s u g g e s t e d t h a t , u n l i k e m a n y c o g n i t i v e b i a s e s a s s o c i a te d w i t h e m o -
t i o n a l d i s o r d e r s ( W i l l i a m s , W a t t s , M a c L e o d , & M a t h e w s , 1 9 9 7 ) ,
t h e p h e n o m e n o n o f o v e r g e n e r a l r e c a l l i s n o t m o o d - s t a t e d e p e n d e n t .
I n a c r o s s - s e c t i o n a l s t u d y , W i l l i a m s a n d D r i t s c h e l ( 1 9 8 8 ) t e s t e d a
g r o u p o f p r e v i o u s l y s u i c i d a l p a t i e n t s w h o h a d t a k e n a d r u g o v e r -
d o s e b e t w e e n 3 an d 1 4 m o n t h s b e f o r e a s s e ss m e n t . T h e y f o u n d t h a t
e x p a t i e n t s d i d n o t d i f f e r s i g n i f i c a n t l y f r o m c u r r e n t p a t ie n t s i n h o w
o v e r g e n e r a l t h e y w e r e i n t h e i r m e m o r i e s , b o t h o f t h e s e g r o u p s
b e i n g s i g n i f i c a n t l y m o r e i m p a i r e d t h a n c o n t r o l s . I n a l o n g i t u d i n a l
s t u d y , B r i t t l e b a n k e t a l . ( 1 9 9 3 ) t e s t e d d e p r e s s e d p a t i e n t s o n t h r e e
o c c a s i o n s : o n a d m i s s i o n , 3 m o n t h s l a t e r, a n d 7 m o n t h s l a t e r. T h e r e
w a s n o c h a n g e i n r e s p o n s e t o p o s i t i v e o r n e g a t i v e c u e s , e v e n i n
t h o s e p a t i e n t s w h o s e m o o d i m p r o v e d c o n s i d e r a b l y . S i m i l a r l y ,
K u y k e n a n d B r e w i n ( 1 9 9 5 ) f o u n d i n t h e i r s a m p l e o f d e p r e s s e d
w o m e n t h a t th e c o r r e l a t io n b e t w e e n l e v e l o f c u r re n t d e p r e s s i o n
( m e a s u r e d w i t h t h e B e c k D e p r e s s i o n I n v e n t o r y ) a n d o v e r g e n e r a l
m e m o r y w a s l o w an d n o n s i g n i fi c a n t, r( 5 4 ) = - 0 . 0 2 a n d - 0 . 0 6 f o r
p o s i t i v e a n d n e g a t i v e c u e s , r e s p e c t i v e l y .
T h e r e s u l t s f r o m o n l y o n e s t u d y h a v e s u g g e s t e d t h a t o v e r g e n -
e r a l i t y m i g h t n o r m a l i z e o n r e c o v e r y . K u y k e n a n d D a l g l e i s h ( 1 9 9 5 )
r e p l ic a t e d t h e o v e r g en e r a l m e m o r y p h e n o m e n o n i n a s a m p l e o f 3 3
d e p r e s s e d p a t i e n t s c o m p a r e d w i t h 3 3 m a t c h e d c o n t r o l s . H o w e v e r ,
t h e y n o t i c e d t h a t 1 4 o f t h e i r c o n t ro l s ( 4 2 % ) r e p o r t e d h a v i n g h a d
o n e o r m o r e e p i s o d e s o f d e p r e s s i o n i n t h e p a s t. T h e r e m a i n d e r h a d
n e v e r b e e n d e p r e s se d . I n a p o s t h o c a n a l y s is , t h e y c o m p a r e d t h e
p r e v i o u s l y d e p r e s s e d w i t h t h e n e v e r d e p r e s s e d g r o u p , f i n d i n g n o
d i f f e r e n c e b e t w e e n t h e m i n t h e i r t e n d e n c y t o r e t r i e v e g e n e r a l
m e m o r i e s . A s t h e a u t h o r s s t a t e d , h o w e v e r , n o s t r o n g c o n c l u s i o n s
c o u l d b e d r a w n f r o m t h i s a s p e c t o f t h e i r s t u d y . T h e r e w a s n o
i n f o r m a t io n a b o u t h o w m a n y o f t h e p r e v io u s l y d e p r e ss e d g r o u p
h a d r e c e i v e d p s y c h o t h e r a p y n o r a b o u t t h e n a t u r e o f t h e i r p r e v i o u s
d e p r e s s i o n . F u r t h e r m o r e , t h e d a t a w a s c r o s s - s e c t i o n a l , a n d a n
e x p l a n a t i o n i n t e r m s o f a l o n g - t e r m t r a i t r e m a i n s p o s s i b l e : S u b -
g r o u p s o f d e p r e s s e d p a t i e n t s w h o h a v e s e v e r e r e t r i e v a l p r o b l e m s
a n d a r e l e s s l i k e l y t o r e c o v e r ( B r i t t le b a n k e t a l ., 1 9 9 3 ) w i l l b e l e s s
l i k e l y t o a p p e a r i n t h e r e c o v e r e d g r o u p i n s u c h a s t u d y . O t h e r
s u b g r o u p s o f d e p r e s s e d p a t ie n t s w h o h a v e r e l a t i v e l y s p a r e d m e m -
o r y a r e m o r e l i k e l y t o r e c o v e r a n d t o b e p r e s e n t i n t h e r e c o v e r e d
s a m p l e .
O n t h e b a s i s o f t h e s e s t u d i e s , p r e v i o u s i n v e s t i g a t o r s h a v e c o n -
c l u d e d t h a t o v e r g e n e r a l m e m o r y i s a c o g n i t i v e s t y l e , a l o n g - t e r m ,
t r a i t - l i k e p h e n o m e n o n . F o r e x a m p l e , W i l l i a m s ' s r e v i e w ( 1 9 9 6 )
s u g g e s t e d t h a t s u c h a m e m o r y s t y l e s t a r t s e a r l y i n d e v e l o p m e n t ,
r e n d e r i n g p e o p l e v u l n e r a b l e t o d e p r e s s i v e b r e a k d o w n a n d t o p o s t -
t r a u m a t i c s t r e s s d i s o r d e r ( P T S D ) r e a c t i o n s i n t h e f a c e o f t r a u m a ,
a g r e e i n g w i t h B r i t t l e b a n k e t a l . ' s ( 1 9 9 3 ) c o n c l u s i o n t h a t o v e r g e n -
e r a l m e m o r y c o n s t i t u t e s a t r a it m a r k e r o f v u l n e r a b i l i t y ( p . 1 21 ).
T h e i m p l i c a t i o n o f t h e s e c o n c l u s i o n s a p p e a r e d t o b e t h a t s u c h a
c o g n i t i v e s t y l e w o u l d b e r e l a t i v e l y r e s i s t a n t t o c h a n g e .
T h i s c o n c l u s i o n w a s b a s e d o n t h e f i n d i n g t h a t o v e r g e n e r a l
m e m o r y w a s n o t m o o d - s t a t e d e p e n d e n t , s o t h at r e d u c i n g l e v e l s o f
e m o t i o n a l d i s tu r b a n c e w o u l d b e u n l i k e l y t o c h a n g e i t . H o w e v e r , n o
s t u d y h a d e x a m i n e d w h e t h e r o v e r g e n e r a l m e m o r y c o u l d b e
c h a n g e d b y t r e a t m e n t . A n o p p o r t u n i t y t o e x a m i n e t h e s e i s s u e s
a r o s e d u r i n g t h e c o u r s e o f a r a n d o m i z e d c o n t r o l l e d t ri a l o f
m i n d f u l n e s s - b a s e d c o g n i t i v e t h e r a p y ( M B C T ; T e a s d a l e , S e g a l , &
W i l l i a m s , 1 9 9 5 ). T h i s 8 - w e e k t r a i n in g w a s a d a p t e d f r o m t h e S t re s s
R e d u c t i o n a n d R e l a x a t io n P r o g r a m o f t h e U n i v e r s i t y o f M a s s a-
c h u s e t t s M e d i c a l C e n t e r d e v e l o p e d b y K a b a t - Z i n n ( K a b a t - Z i n n ,
1 9 9 0 ; K a b a t - Z i n n e t a l. , 1 9 9 2 ) . T h e g o a l o f t h i s p r o c e d u r e i s t o
i n c r e a s e p a t i e n t s ' a w a r e n e s s o f p r e s e n t, m o m e n t - t o - m o m e n t e x p e -
r i e n c e . P a t i en t s r e c e i v e e x t e n s i v e p r a c t i c e i n l e a r n i n g t o b r i n g t h e i r
a t t e n t i o n b a c k t o t h e p r e s e n t , u s i n g a f o c u s o n t h e b r e a t h a s a n
a n c h o r , w h e n e v e r t h e y n o t i c e t h a t a t t e n t i o n h a s b e e n d i v e r t e d t o
s t r e a m s o f t h o u g h t s , w o r r i e s , o r g e n e r a l l a c k o f a w a r e n e s s. M B C T
c o m b i n e s K a b a t - Z i n n ' s m i n d f u l n e s s t e c h n i q u e s w i t h s o m e t e c h -
n i q u e s d r a w n f r o m c o g n i t i v e t h e r a p y i n a c o m p r e h e n s i v e t r e a t m e n t
p a c k a g e s p e c i f i c a l ly t a i l o r e d t o t r a i n p a t i e n t s i n s k i l l s r e l e v a n t t o
t h e p r e v e n t i o n o f d e p r e s s i v e r e l a p s e .
W e w e r e i n t e r e s te d i n t h e e f f e c t o f th i s t r e a tm e n t o n a u t o b i o -
g r a p h i c a l m e m o r y b e c a u s e , f i r s t , i t i n c l u d e s a l a r g e n u m b e r o f
h o m e w o r k t a s k s t h a t t r a in p a t i e n t s t o n o t i c e t h e s p e c i f i c as p e c t s o f
t h e i r e n v i r o n m e n t , t h u s p o t e n t i a l l y re d u c i n g o v e r g e n e r i c e n c o d i n g .
( H i e r a r c h i c a l s ea r c h m o d e l s o f m e m o r y a s s u m e t h a t e n c o d i n g a n d
r e t r i e v a l s h a r e c o m m o n p r o c e s s e s s o t h a t m a k i n g e n c o d i n g m o r e
s p e c i f i c w i l l a ls o m a k e r e t r i e v a l m o r e s p e c i f i c. ) S e c o n d , t h e t r a in -
i n g e x p l i c i t l y f o c u s e s o n a l l o w i n g m e n t a l c o n t e n t s t o o c c u r w i t h o u t
j u d g i n g t h e m o r t r y i n g t o s u p p r e s s o r a v o i d t h e m , t h u s p o t e n t i a l l y
r e d u c i n g t h e t e n d e n c y t o t r u n c at e t h e m e m o r y r e t r i e v a l p r o c e s s a s
a m e a n s o f r e g u l a t i n g a f f e c t .
T o e x a m i n e t h i s q u e s t i o n , w e a d m i n i s t e r e d t h e s t a n d a r d A u t o -
b i o g r a p h i c a l M e m o r y T e s t ( B r i t t l e b a n k e t a l . , 1 9 9 3 ) a t o n e o f t h e
t h r e e s it e s i n v o l v t d ( B a n g o r , W a l e s ) . T h i s t a s k i n v o l v e d g i v i n g
p o s i t i v e , n e g a t i v e , a n d n e u t r a l c u e w o r d s , o n e a t a t i m e , t o p a t i e n t s
a n d a s k i n g t h e m t o r e s p o n d w i t h a s p e c i f i c e v e n t f r o m t h e i r p a s t
t h a t t h e w o r d r e m i n d e d t h e m o f . I t w a s a d m i n i s t e r e d b e f o r e t h e
s t a rt o f t h e 8 - w e e k s e r i e s o f c la s s e s , a n d a g a i n d u r i n g t h e 1 2 -
m o n t h s f o l l o w - u p p e r i o d . W e e x a m i n e d t h e s p e c i f i c i t y o f t h e
r e s p o n s e s t o d e t e r m i n e w h e t h e r o r n o t r e c o v e r e d d e p r e s s e d p a -
t i e n ts b e c a m e l e s s g e n e r i c f o l l o w i n g t h e t r e a t m e n t .
M e t h o d
P a r t i c i p a n t s
Forty-five patients were recruited from th e clinical services of the
Comm unity M ental Health Servic e in Bangor, North Wales and by adver-
tising in the local press for volunteers w ho had been d epressed in the past
but were n ow recovered. W hatever the sou rce of referral, each participant's
general practitioner (GP) was contacted for verification and permission to
assess the patient for the study. To take part in the study, participants
needed to have had a previous history of at least two episodes of unipolar
depression meeting DS M-III -R Diagnostic and Stat ist ical Manual for
Mental Disorders, 3rd ed., revised; American Psychiatric Association,
1987) criteria for major depressive disorder, and the most recent episode o f
depression needed to be within the previous 2 years. They needed to be
currently in remission and to have had a history of treatment with tricyclic
antidepressant medication but to b e free from antidepressants for at least 12
weeks before entering the study. All patients remained under outpatient
care or the care of GPs d uring the study. A structured clinical interview for
D S M - I I I - R (SCID) w as used to assess past and present d iagnostic status.
Current clinical remission was confirmed by a SCID indicating that the
patient had been asymptomatic for at least 8 weeks and had a current
17-item HRS-D score of 9 or less. Participants were excluded from the
study if (a) they suffered from the following comorbid psychiatric disor-
ders: bipolar affective disorder, active drug dependency or abuse, organic
mental disorders, schizophrenia, schizoaffective disorder, primary
obs essiv e-co mp ulsiv e disorder, or eating disorders; (b) they could not
complete measures due to illiteracy; (c) they were receiving additional
-
7/27/2019 Williams Et Al 2000 OGM in MBCT
3/6
52 SHORT RE PORT S
p s y c h o t ro p i c m e d i c a t i o n o t h e r t h a n b e n z o d i a z e p i n e o r o t h e r n i g h t s e d a t i o n
( e . g . l i t h i u m o r n e u r o l e p t ic s ) . A l l p a r t i c i p a n t s g a v e w r i t t e n i n f o r m e d
c o n s e n t .
T h e m e a n a g e o f t h e p a r t i c i p a n t s w a s 4 4 . 0 y e a r s (SD = 9 . 5 ) a n d t h e
m e a n n u m b e r o f y e a r s o f e d u c a t io n w a s 1 4. 5 (SD = 3 . 4 ) . T h e r e w e r e 3 3
w o m e n a n d 1 2 m e n . T h e m e d i a n n u m b e r o f p r e v i o u s e p i so d e s o f d e p r e s -
s i o n w a s 4 . 0 .
a t e r i a l s
Hamilton Rating Scale for Depression (17-item version, HRS-D; Ham-
ilton, 1960). T h i s i s a n i n t e r v i e w e r - a d m i n i s t e r e d r a t i n g s c a l e f o r m e a s u r -
i n g s e v e r i t y o f d e p r e s s i o n , w i d e l y u s e d i n c l i n i c a l t r i a l s , w i t h r e l i a b i l i t y
c o e f f i c i e n t s o f 0 . 8 4 - 0 . 9 0 . W e a d m i n i s t e r e d it a t e n t r y t o t h e t r i a l a n d a t
f o l l o w - u p .
Autobiographical Memory Test (AMT; Williams Broadbem, 1986).
P a r t i c i p a n t s w e r e r e q u i r e d t o r e c a l l e v e n t s t h a t h a d h a p p e n e d t o t h e m i n
r e s p o n s e t o c u e s . T h e t i m e p e r i o d f r o m w h i c h e v e n t s c o u l d b e r e c a ll e d w a s
n o t s p e c i f i e d , a n d p a r t i c i p a n t s w e r e t o l d t h a t t h e e v e n t c o u l d b e i m p o r t a n t
o r t r iv i a l . I t w a s e m p h a s i z e d t h a t t h e e v e n t s f r o m t h e p a s t s h o u l d b e s p e c i f i c
e v e n t s ( e v e n t s t h a t l a s t e d l e s s t h a n 1 d a y ) , a n d p r a c t i c e w a s g i v e n u n t i l
p a r t i c i p a n t s h a d b e e n s u c c e s s f u l i n r e t r ie v i n g a s p e c i f i c m e m o r y . F o r e a c h
m e m o r y r e s p o n s e , p a rt i ci p a n ts n o t e d h o w l o n g a g o t h e e v e n t h a d o c c u r r e d
(1 = less than I week, 2 = less than 1 month, 3 = less than 6 months, 4 =
less than 1 year, and 5 = over 1 year).
E i g h t e e n w o r d s w e r e u s e d a s c u e s w i t h w h i c h t o p r o m p t p a r t ic i p a n ts f o r
r e s p o n s e s , 6 n e u t r a l ( e . g . , grass, gigantic), 6 pos i t i ve (e .g . , happy, relieved)
a n d 6 n e g a t i v e ( e . g . ,
guilty, hopeless),
m a t c h e d f o r w o r d f r e q u e n c y . T h e
p o s i ti v e a n d n e g a t i v e w o r d s w e r e c h o s e n t o b e h i g h o n e m o t i o n a l it y , w i t h
t h e n e u t r a l w o r d s l o w o n e m o t i o n a l i t y ( J o h n , 1 9 8 8 ) . A n e q u i v a l e n t l i s t
o f 1 8 w o r d s w a s c o m p i l e d s o t h a t t w o m a t c h e d s e t s ( A a n d B ) w e r e
a v a i l a b l e . H a l f o f t h e p a r t ic i p a n t s w e r e g i v e n S e t A a t T i m e 1 a n d S e t B a t
T i m e 2 w i t h t h i s o r d e r b e i n g c o u n t e r b a l a n c e d . ( T h e f u l l l is t o f c u e w o r d s ,
i n s t r u c t i o n s , a n d p r o c e d u r e a r e a v a i l a b l e f r o m J . M a r k G . W i l l i a m s . )
Pro ced u r e
Allocation.
F o l l o w i n g a b a s e l i n e a s s e s s m e n t , w e r a n d o m l y a l lo c a t e d
t h e 4 5 p a t i e n t s t o r e c e i v e e i t h e r M B C T ( i n a d d i t i o n t o t r e a t m e n t a s u s u a l
[ T A U ] ) o r T A U a l o n e . ( T A U p a t i e n t s c o n t i n u e d u n d e r t h e c a r e o f t h e i r
p h y s i c i a n f o r t h e d u r a t i o n o f t h e t r i a l a n d w e r e i n s t r u c t e d t o u s e w h a t e v e r
s e r v i ce t h e y w o u l d n o r m a l l y u s e i n t h e e v e n t o f d e p r e s s i v e r e l a p se . ) T h e r e
w e r e n o d i f f e r e n c e s b e t w e e n t r e a t m e n t a n d c o n t r o l g r o u p s o n a n y p r e tr e a t-
m e n t v a r ia b l e s : a g e o f t h e p a r t ic i p a n t s ( M B C T , M = 4 2 . 5 y e a r s ;
SD = 1 1 . 2 ; T A U , M = 4 5 . 7 , SD = 7 . 0 ), n u m b e r o f y e a r s o f e d u c a ti o n
( M B C T , M = 1 4 .4 ,
SD
= 2 . 7 ; T A U , M = 1 4 . 5 ,
SD
= 4 . 1 ), o r n u m b e r o f
p r e v i o u s e p i s o d e s o f d e p r e s s io n ( M B C T , Mdn = 5 . 0 ; i n t e r q u a r t i l e r a n g e
[ I Q R ] = 6 . 8 ; T A U , Mdn = 3 . 0 ; I Q R = 5 . 0 ) . T h r e e p a t i e n t s f a il e d to
c o m p l e t e t h e m e m o r y m e a s u r e a t t h e s e c o n d t e s ti n g . A n o t h e r p a ti e n t w a s
i n a d v e r te n t l y g i v e n t h e s a m e l i st o f m e m o r y c u e s o n b o t h o c c a s i o n s , s o
t h e i r d a t a w e r e n o t i n c l u d e d . D a t a f o r t h e s e p a t i e n t s s h o w e d t h a t t h e y d i d
n o t d i f f e r f r o m t h e o t h e r p a t i e n t s i n a n y r e s p e c t , n e i t h e r i n t h e i r l e v e l o f
d e p r e s s i o n n o r t h e i r i n i t i a l a u t o b i o g r a p h i c a l m e m o r y p e r f o r m a n c e . T h e
n u m b e r s o f p a r t i c i p a n t s i n t h e p r e s e n t s t u d y w a s t h e r e f o r e 4 1 ( M B C T ,
n = 2 1 , 1 6 w o m e n , M a g e = 4 2 . 1 , SD = 1 1 .7 ; T A U , n = 2 0 , 1 4 w o m e n ,
M a g e = 4 5 . 6 , SD = 7 .2 ) .
A u t o b i o g r a p h ic a l m e m o r y w a s t e s te d o n t w o o c c a s i o n s , o n c e b e f o r e
a l l o c a t i o n t o M B C T o r T A U ( T i m e 1 ) , a n d a g a i n d u r i n g t h e 1 2 - m o n t h s
f o l l o w - u p p e r i o d ( T i m e 2 ). T h e m e a n t e s t - r e t e s t i n t e r v a l w a s a p p r o x i -
m a t e l y 6 m o n t h s ( 4 m o n t h s f o ll o w i n g t h e e n d o f t r e a t m e n t) a n d d i d n o t
d i f f e r b e t w e e n t h e g r ou p s ( M B C T , M = 1 92 d a y s , SD = 4 4 ; T A U , M =
1 9 5 d a y s , SD = 67 ; t [39 ] = .13 , ns). D e p r e s s i o n l e v e l ( m e a s u r e d b y
H R S - D ) w a s a s s e s s e d o n th e s a m e o c c a s i o n s a s t he m e m o r y t e s ti n g .
R e s u l t s
o o d
B e c a u s e t h e t r e a t m e n t w a s d e s i g n e d t o p r e v e n t f u t u r e d e p r e s s i v e
r e l a p s e i n p e o p l e w h o w e r e c u r r e n t l y i n r e m i s s i o n , n o s p e c i fi c
r e d u c t i o n i n m o o d s y m p t o m s w a s p r e d i c te d f o r t h e t r e a t m e n t ,
N e v e r t h e l e s s , w e c o u l d n o t r u le o u t t h e p o s s i b il i ty t h a t s o m e
c h a n g e i n d e p r e s s i o n d u e t o th e t r e a t m e n t m a y h a v e h a d a n e f f e c t
o n m e m o r y p e r f o r m a n c e , s o w e a n a l y z e d H R S - D s c o r e s f i rs t. A 2
( T i m e : 1 , 2 ) x 2 ( G r o u p : M B C T , T A U ) m i x e d a n a l y s i s o f v a r i a n c e
( A N O V A ) w a s c a r r i e d o u t . M e a n s a n d s t a n d a r d d e v i a ti o n s a r e
s h o w n i n T a b l e 1 . W e f o u n d n o s i g n i f ic a n t m a i n e f f e c t s f o r t i m e ,
F ( 1 , 3 9 ) = 1 . 8 2 , MSE = 1 3 . 5 3 , p = . 1 9 ] ; g r o u p , F ( 1 , 3 9 ) = 2 . 5 8 ,
MSE = 1 9 . 4 3 , p = . 1 2 , o r f o r t h e G r o u p T i m e in t e r a c t i o n , F ( 1 ,
3 9 ) = 1 . 2 4 ,
MSE
= 1 3 . 5 3 , p - = . 2 7 .
Autobiographica l Memory Responses
P a r t i c i p a n ts f i rs t r e s p o n s e s t o e a c h o f th e 1 8 c u e w o r d s p r e -
s e n t e d o n e a c h o c c a s i o n w e r e a n a l y z e d . I f p a t ie n t s d i d n o t r e s p o n d
w i t h i n 3 0 s f o r a n y c u e , t h is w a s s c o r e d a s a n o m i s s i o n ( s e e T a b l e
1 ). M e m o r y r e s p o n s e s w e r e t h e n c a t e g o r i z e d i n t o t h r e e t y pe s :
specific ( a m e m o r y f o r a p a r t i c u l a r e v e n t l a s t i n g 1 d a y o r l e s s , e . g ,,
g o i n g t o a c o n c e r t la s t s u m m e r ) , categoric ( a m e m o r y r e s p o n s e
t h a t s u m m a r i z e d a n u m b e r o r c a t e g o r y o f e v e n t s , e .g . , g o i n g to
T a b l e 1
Means a nd Standard Deviations fo r the Hamilton Depression Scale and Memory Variables
for MBCT and TAU Groups at Times 1 and 2
M B C T T A U
T i m e 1 T i m e 2 T i m e 1 T i m e 2
V a r i a b l e
M SD M SD M SD M SD
M o o d
H a m i l t o n 4 . 2 2 . 6 4 . 4 4 . 5 4 . 9 2 . 7 6 . 9 5 . 6
M e m o r y
No . o f om is s io ns 1 .9 1 .4 2 .3 1 .9 1 .6 1 .9 1 .8 1 .8
M e a n l a t e n c y ( s ) 9 . 4 2 . 9 9 . 6 2 . 2 1 0 .1 3 . 0 1 1 .3 3 . 4
M e m o r y a g e 4 . 1 2 . 4 3 . 0 2 . 4 3 . 9 2 . 4 2 . 7 2 . 3
Note. M B C T = m i n d f u l n e s s - b a s e d c o g n i t i v e t h e r a p y ; T A U = t r e a t m e n t a s u su a l .
-
7/27/2019 Williams Et Al 2000 OGM in MBCT
4/6
SH O R T R EPO R TS 1 5 3
c o n c e r t s a s a c h i l d ) , a n d e x t e n d e d ( a m e m o r y o f a p a r t i c u l a r t i m e
p e r i o d l a s t i n g l o n g e r t h a n a d a y , e . g . , m y 3 - w e e k h o l i d a y i n
F r a n c e ) . T h i s c a t e g o r i z a t io n w a s d o n e b y a n i n d e p e n d e n t r a t e r w h o
w a s u n a w a r e o f t r e a t m e n t a l l o c a t i o n a n d t i m e o f t e s t i n g o f t h e
m a t e r i a l b e i n g r a t e d . A r e l i a b i l i t y c h e c k o n d e g r e e o f s p e c i f i c i t y o f
r e s p o n s e s w a s c a r d e d o u t . F o l l o w i n g t h e m e t h o d o f B a d d e l e y a n d
W i l s o n ( 1 9 8 6 ) , w e s c o r e d m e m o r y r e s p o n s e s o n a s c a l e f r o m 3
t o 1 , h i g h e r s c o r e s r e f l e c t i n g g r e a t e r s p e c i f i c i ty . A s e c o n d i n d e -
p e n d e n t r a t e r w h o w a s a l s o u n a w a r e o f t r e a t m e n t c o n d i t io n a n d
t i m e o f t e s t i n g c a t e g o r i z e d a 1 2 s a m p l e o f t h e f i r s t r a t e r ' s
r e s p o n s e s ( N = 8 8 ). T h e P e a r s o n c o r r e l a t io n c o e f f ic i e n t b e t w e e n
t h e t w o s e t s o f r a t i n g s w a s 0 . 8 6 d f = 8 6 , p < .0 0 1 ) .
W e a n a l y z e d d a t a f o r t h e p r o p o r ti o n o f r e s p o n s e s t h a t w e r e o f
e a c h m e m o r y t y p e w i t h a se p a r a t e 2 (G r o u p : M B C T , T A U ) 2
( T i m e : p r e , p o s t ) x 3 ( V a l e n c e : p o s i t i v e , n e g a t i v e , n e u t r a l ) m i x e d
a na l~ cs is o f c o v a r i a n c e ( A N C O V A ) , c o v a r y i n g o u t H R S - D s c o r e s
a t T i m e 2 . M e a n s a n d s t a n d a r d d e v i a ti o n s a r e s h o w n i n T a b l e 2 .
N o n e o f t h e t y p e s o f m e m o r y y i e l d e d a s i g n i f i c an t v a l e n c e e ff e c t,
s o t h e d a t a a r e s h o w n c o l l a p s e d a c r o s s t h e p o s i t i v e , n e g a t i v e , a n d
n e u t r a l c u e s . T h e e x t e n d e d m e m o r y c a t e g o r y o f r e s p o n s e a p p e a r e d
r e l a t i v e l y r a r e l y ( o c c u r r i n g , o n a v e r a g e , i n r e s p o n s e t o o n l y 1 c u e
p e r p e r s o n ) s o w e r e n o t a n a l y z e d f u r t h e r . W e a n a l y z e d r e t r i e v a l
l a t e n c ie s t o c h e c k t h a t a n y d i f f e r e n c e s i n c a t e g o r ic m e m o r i e s w e r e
n o t m e r e l y d u e t o o v e r a l l i m p a i r e d p e r f o r m a n c e o n t h e t a s k ( s e e
T a b l e 1 ). W i t h r e g a r d to o m i s s io n s , a 2 2 A N C O V A s h o w e d n o
s i g n i f i c a n t m a i n e f f e c t s o r i n t e r a c t i o n s .
P r o p o r t i o n o f s p e c i fi c m e m o r i e s . T h e r e w a s a m a i n e f f e c t o f
t i m e , F ( 1 , 3 9 ) = 1 5 . 7 2 , M S E = 0 . 1 5 , p = . 0 0 0 5 , d u e t o a g e n e r a l
t e n d e n c y f o r b o t h g r o u p s t o r e c a l l a g r e a t e r p r o p o r t i o n o f s p e c i f i c
m e m o r i e s a t T i m e 2 ( 8 0 ) t h a n a t T i m e 1 ( 7 1 ) . T h e r e w a s n o
s i g n i f i c a n t e f f e c t o f g r o u p , F ( 1 , 3 8 ) = 2 . 5 6 , b u t t h e r e w a s a
s i g n i f ic a n t G r o u p T i m e i n t e r a c t io n , F ( 1 , 3 9 ) = 4 . 9 8 , M S E = 0 .0 5 ,
p = . 0 31 . P l a n n e d c o m p a r i s o n s s h o w e d t h i s i n te r a c t i o n t o b e d u e
t o t h e f a c t t h a t a t T i m e 1 t h e r e w a s n o s i g n i f i c a n t d i f f e r e n c e
b e t w e e n t h e g r o u p s i n t h e p r o p o r t i o n o f s p e c i fi c m e m o r i e s ( 7 2 i n
t h e M B C T , a n d 7 0 i n t h e T A U g r o u p ). A t T i m e 2 , h o w e v e r , t h e
M B C T g a v e s p e c if i c m e m o r i e s 8 5 o f t h e t i m e v e r s u s o n l y 7 4
f o r t h e T A U g r o u p , t ( 3 9 ) = 2 . 3 4 , p = 0 . 0 3 .
P r o p o r t i o n o f c a t e g o r i c m e m o r i e s T h e r e w a s a m a i n e f f e c t o f
t i m e , F ( 1 , 3 9 ) = 1 4 . 3 6 , M S E = 0 . 1 2 , p = . 0 0 1 , d u e t o a t e n d e n c y
f o r b o t h g r o u p s t o r e c a l l l e s s c a t e g o r ic m e m o r i e s a t T i m e 2 ( 1 5 )
t h a n a t T i m e 1 ( 2 3 ) . H o w e v e r , t h i s e f f e c t w a s q u a l i f i e d b y a
s i g n i f i c a n t G r o u p T i m e in t e r a c t i o n , F ( 1 , 3 9 ) = 8 . 4 2 ,
M S E = 0 . 0 7 , p = . 0 0 6 . P l a n n e d c o m p a r i s o n s s h o w e d t h i s i n t e r -
a c t i o n to b e d u e t o t h e f a c t t h a t i n t h e M B C T g r o u p t h e p r o p o r t i o n
o f c a t e g o r i c m e m o r i e s r e c a l le d f e l l f r o m 2 4 o f r e s p o n s e s a t
T i m e 1 t o 1 0 o f r e s p o n s e s a t T i m e 2 , e n d i n g s i g ni f i c a n tl y l o w e r
t h a n t h e p r o p o r t io n r e c a l l e d b y t h e T A U ( c o n t r ol ) g r o u p a t T i m e 2
(1 9 ) , t (3 9 ) = 2 .2 8 , p = .0 3 .
L a t e n c y t o R e s p o n d
T o c h e c k t h a t t h e p a t t e rn o f r e s u l t s w a s n o t d u e t o g e n e r a l
s l u g g i s h n e s s i n r e s p o n d i n g t o t he c u e w o r d s , w e a n a l y z e d t h e m e a n
r e s p o n s e l a t e n c i e s ( s h o w n i n T a b l e 1 ) . R e s u l t s o f a 2 ( G r o u p :
M B C T , T A U ) 2 (T i m e : 1, 2 ) m i x e d A N O V A s h o w e d n o
s i g n i f i c a n t m a i n e f f e c t o f g r o u p , F ( 1 , 3 9 ) = 2 . 1 9 , M S E = 1 3 .1 4 ,
p = . 1 5 , o r o f t i m e , F ( 1 , 3 9 ) = 2 . 8 7 , M S E = 3 . 3 3 , p = . 1 0 , n e i t h e r
w a s t h e r e a s i g n i f i c a n t G r o u p T i m e i n t e r a c t i o n , F ( 1 , 3 9 ) = 1 . 1 7,
M S E = 3 .33 , p = .29 .
M e m o r y A g e
T h e r e d u c t i o n i n n u m b e r o f c a t e g o r ic m e m o r i e s f o l l o w i n g t r e at -
m e n t , d e s c r i b e d e a r li e r , m a y b e d u e t o t h e M B C T g r o u p r e t r i e v i n g
e v e n t s f r o m a m o r e r e c e n t t im e f r a m e t h a n t h e c o n t r o l p at i e nt s . F o r
e a c h m e m o r y r e s p o n s e , p a t i e n t s h a d n o t e d h o w l o n g a g o t h e e v e n t
h a d o c c u r r e d ( 1 =
l e s s than 1 we e k , 2 = le s s than 1 month , 3 =
le s s than 6 months , 4 = le s s than I y e ar , and 5 = ov e r I y e ar ) . F o r
e a c h p a t i e n t ' s s e t o f r e s p o n s es , t h e m o d a l t i m e s i n c e t h e r e t ri e v e d
e v e n t s h a d o c c u r r e d w a s r e c o r d e d ( u s i n g t h e m o d e b e c a u s e o f t h e
a b n o r m a l d i s t r i b u ti o n s o f e a c h i n d i v i d u a l ' s e v e n t a g e s) . M e a n
m e m o r y a g e s f o r e a c h g r o u p a r e s h o w n i n T a b l e 1 . A 2 ( G r o u p :
M B C T , T A U ) 2 ( T i m e : 1, 2 ) m i x e d A N O V A w a s ca r r ie d o u t.
W e f o u n d a s i g n i f i c a n t m a i n e f f e c t f o r t i m e : m o r e d i s t a n t e v e n t s
w e r e r e c a l l e d a t T i m e 1 ( M = 4 . 0 5 ,
S D
= 2 . 3 8) c o m p a r e d w i t h
T i m e 2 ( M = 2 . 8 3 , S D = 2 .3 4 ) , F (1 , 3 9 ) = 9 .0 7 , M S E = 3 . 3 7 , p =
. 0 0 5 . T h e r e w a s n o s i g n i f i c a n t m a i n e f f e c t f o r g r o u p , F ( 1 , 3 9 ) =
19, M S E = 8 . 0 2 , p = . 6 7 , n e i t h e r w a s t h e r e a s i g n i f i c a n t G r o u p
T i m e i n t e r a c t i o n , F ( 1 , 3 9 ) = . 0 4 , M S E = 3 .3 7 , p = .8 5 . In su m,
b o t h g r o u p s r e t r i e v e d m e m o r i e s f r o m m o r e r e c e n t t i m e p e r i o d s o n
t h e s e c o n d o c c a s i o n o f t e s t in g , b u t t h e r e w a s n o e v i d e n c e t h a t t h e
M B C T g r o u p d i d s o m o r e t h a n t h e c o n t r o l ( T A U ) g r o u p .
D i s c u s s i o n
T h e a i m o f t h e p r e s e n t s t u d y w a s t o e x a m i n e t h e s t a b il i ty o f t h e
t e n d e n c y t o b e o v e r g e n e r a l i n r e t r ie v a l o f a u t o b i o g r a p h i c a l m e m -
T a b l e
M e a n s a n d S t a n d a r d D e v i a t i o n s f o r t h e P r o p o r t i o n o f S p e ci f ic , C a t e g o ri c , a n d E x t e n d e d
M e m o r i e s R e c o r d e d a t T i m e s 1 a n d 2 f o r M B C T a n d T A U G r o u p s
M B C T T A U
Ti me 1 T i me 2 T i me 1 T i me 2
M e mo r i e s M S D M S D M S D M S D
Specific 0.72 0.14 0.85 0.13 0.70 0.16 0.74 0.17
Categoric 0.24 0.13 0.10 0.08 0.21 0.11 0.19 0.16
Extended 0 .04 0 .06 0 .05 0 .08 0 .09 0 .06 0.07 0 .06
Note. MB CT = mindfu lne ss-based cogni t ive therapy; TAU = t rea tment as usual.
-
7/27/2019 Williams Et Al 2000 OGM in MBCT
5/6
1 5 4 S H O R T R E P OR T S
t r y i n f o r m e r l y d e p r e s s e d p a ti e n t s. T h e b a l a n c e o f e v i d e n c e f r o m
p r e v i o u s s t u d i e s h a d s u g g e s t e d t h a t c a t e g o r i c m e m o r y w a s a l o n g -
t e r m c o g n i t i v e s ty l e p e r s is t i n g d e s p i t e s h o r t - t e r m c h a n g e s i n m o o d .
T h e f i n d i n g s o f t h i s st u d y s h o w t h a t w h e n r e c o v e r e d d e p r e s s e d
p a t i e n t s u n d e r g o t r a i n i n g t h a t i n c l u d e s i n s t r u c t i o n s t o f o c u s m o r e
c a r e f u l l y o n e v e r y d a y e v e n t s a n d t o a l l o w c o g n i t i o n s t o o c c u r
w i t h o u t t r y i n g t o a v o i d o r s u p p r e ss t h e m , t h e t e n d e n c y t o r e t r i e v e
e v e n t s i n a c a t e g o r i c s t y l e i s re d u c e d . F u r t h e r m o r e , c o n s i s t e n t w i t h
e a r l i e r st u d i e s s h o w i n g t h a t t h i s a s p e c t o f m e m o r y i s n o t m o o d -
s t a t e d e p e n d e n t , o v e r g e n e r a l i t y i n m e m o r y w a s r e d u c e d s i g n i f i -
c a n tl y i n t h e M B C T g r o u p d e s p it e t h e re b e i n g n o c h a n g e i n m o o d
s c o r e s o v e r t h i s i n t e r v a l : T h e m e m o r y c h a n g e s w e r e n o t m o o d
dr ive n .
A l t h o u g h m o o d c h a n g e c o u l d n o t e x p l a i n t h i s e f f e c t , i t r e m a i n s
p o s s i b l e t h a t c h a n g e i n s o m e o t h e r , t h i r d v a r i a b l e w a s b e i n g
a f f e c t e d b y t h e M B C T t r e a t m e n t a n d t h e n a f f e c t i n g m e m o r y . F o r
e x a m p l e , i t i s p o s s i b le t h a t t r e a t m e n t s i m p l y a f f e c t s t h e a m o u n t o f
e n e r g y t h a t p a t i e n t s a r e p r e p a r e d t o p u t i n t o p s y c h o l o g i c a l t a s k s
suc h a s the se . A re la te d a r t i f a c tua l e xpla na t ion for the r e su l t s c ould
b e t h a t , f o l l o w i n g 8 w e e k s o f c o n t a c t w i t h a c l a s s - b a s e d i n s t r u c -
t i o n , p at i e n ts m a y h a v e b e e n m o r e u s e d t o r e c e i v i n g a n d a c t i n g o n
i n s t ru c t i o n s , a f f e c t i n g t h e i r a b i l i t y t o p e r f o r m t h e t a s k . I f t h a t w e r e
t h e c a s e , o n e m i g h t e x p e c t a n o v e r a l l b e t t e r p e r f o r m a n c e o n t h e
m e m o r y t a s k : T h e l a t e n c y t o r e s p o n d m i g h t b e f a s t e r f o r t h e
M B C T t r e a t m e n t g r o u p a t T i m e 2 o r t h e r e m i g h t b e f e w e r o m i s -
s i o n s a t T i m e 2 . T h e r e w e r e n o s u c h e f f e c t s , h o w e v e r . I n f a c t , i f
a n y t h i n g , t h e t r e n d w a s i n t h e o p p o s i t e d i r e c t i o n , w i t h s l i g h t l y
m o r e o m i s si o n s f o l l o w i n g M B C T t re a tm e n t , w h i c h , o n c e e x -
c l u d e d , m i g h t e x a g g e r a t e t h e a p p a re n t i m p a c t o f t h e t r e a t m e n t o n
t h e p r o p o r t i o n o f s p e c i f i c m e m o r i e s . O m i s s i o n s w e r e e x c l u d e d
b e f o r e a n a l y s is o f m e m o r y r e s p o n s e s b e c a u s e t h e y a r e a m b i g u o u s :
T h e y m a y m e a n t h at n o m e m o r y h a s b e e n r e tr i e v ed , o r a m e m o r y
h a s b e e n r e t r i e v e d t h a t t h e p e r s o n d o e s n o t w i s h t o r e p o r t , o r t h a t
t h e t r e a t m e n t h a s a l e r t e d t h e p a r t i ci p a n t t o t h e i n a p p r o p r i a t e n e s s o f
a c a t e g o r i c m e m o r y w h e n a s p e c i f i c m e m o r y i s u n a v a i l a b l e . T h e
l a t t e r p o s s i b i l i t y i s c o n s i s te n t w i t h p a r t i c i p a n t s b e i n g m o r e a w a r e
o f t h e i r r e t r i e v a l p r o c e s s e s , c o n s i s t e n t w i t h t h e a i m s o f t h e
t r e a tm e nt .
T h e f i n a l p o s s i b l e a r t i f a c t u a l e x p l a n a t i o n i s t h a t t h e t r e a t m e n t
g r o u p m i g h t h a v e s a m p l e d e v e n t s f r o m a m o r e r e c e n t t i m e f ra m e
f o l l o w i n g t r e a t m e n t . A n e x c e s s n u m b e r o f e v e n t s f r o m t h e p e r i o d
s i n c e t h e t r e a t m e n t s t a r te d m i g h t c h a n g e t h e p r o f i l e o f t h e r e t r i e v a l
p r o t o c o l s i n t h e M B C T g r o u p t o f a v o r , b y a c c i d e n t , m o r e r e c e n t
e v e n t s a n d t h e r e f o r e l e s s c a t e g o r i c m e m o r i e s . H o w e v e r , b o t h
g r o u p s s h o w e d a t e n d e n c y t o r e t r i e v e fr o m a m o r e r e c e n t p e r i o d o n
s e c o n d t i m e o f t e s t i n g , a n d t h e r e w a s n o d i f f e r e n c e b e t w e e n t h e
g r o u p s i n t h e t i m e e l a p s e d s i n c e t h e r e t r i e v e d e v e n t s t o o k p l a c e .
O f c o u r s e , t h e p r e s e n t d a t a c a n o n l y b e s e e n a s p r e l i m i n a r y f o r
t w o r e a s o n s . F i r s t , t h e r e w a s n o p l a c e b o c o n t r o l g r o u p , s o w e
c a n n o t d e f i n i t i v e l y a t t ri b u t e t h e c h a n g e s i n m e m o r y t o a s p e c i f i c
e f f e c t o f t h e M B C T . S e c o n d , t h e r e w a s n o i n d e p e n d e n t m e a s u r e
t a k e n d u r i n g t h e t r e a t m e n t t o c h e c k t h a t i n d i v i d u a l s w e r e i n f a c t
c h a n g i n g t h e i r c o g n i t i v e s t y l e i n t h e w a y p r e d i c t e d b y t h e t h e o r y .
N e v e r t h e l e s s , t h e m a i n i n t e n t io n o f t h is s t u d y w a s t o s e e w h e t h e r
o v e r g e n e r a l m e m o r y c o u l d b e m o d i f i e d . H o w s u c h c h a n g e o c c u r s
w i l l b e f o r f u t u r e r e s e a r c h t o d e t e r m i n e . T h e f i n d i n g t h a t i t c a n
c h a n g e h a s p o t e n t i a l l y i m p o r t a n t c l i n i c a l i m p l i c a t i o n s .
W i l l i a m s ( 1 9 9 6 ) r e v i e w e d e v i d e n c e s u g g e s t i n g t h a t s u c h a s t y l e
a r i s es e a r l y i n d e v e l o p m e n t . H y p e r s e n s i t i v i t y t o a f f e c t i v e l y t o n e d
a s p e c t s o f e v e n t s ( p o s i t i v e a n d n e g a t i v e ) , w h e t h e r p r e s e n t a s a n
a s p e c t o f t e m p e r a m e n t a l s t y l e o r d u e t o n e g a t i v e e x p e r i e n c e s , g i v e s
r i s e t o a t e n d e n c y t o e n c o d e s p e c i f i c a s p e c t s o f t h e e n v i r o n m e n t i n
t e r m s o f t h e i r m o r e g e n e r a l s c h e m a t i c a s p e c t s . T h i s l e a d s t o a
h a b i t u a l u s e o f e n c o d i n g a n d r e t r i e v a l s t r a t e g i e s i n w h i c h m o r e
g e n e r a l a s p e c t s o f e v e n t s ( i n t e r m e d i a t e g e n e r a l d e s c r i p t io n s ) a r e
r e p r e s e n t e d i n m e m o r y , w i t h p o o r e r s t r a t e g i c a c c e s s t o s p e c i f i c
e p i s o d i c e x e m p l a r s . T h i s s t y l e a f f e c t s t h e p r o c e s s i n g o f f u r t h e r
e v e n t s ( p o s i t i v e , n e g a t i v e , o r n e u t r a l ) b u t h a s p a r t i c u l a r i m p l i c a -
t i o n s f o r th e s a t i s fa c t o r y e m o t i o n a l p r o c e s s i n g o f a n y n e w n e g a t i v e
e ve nt tha t oc c ur s . F i r s t , suc h a r e t r i e va l s ty le m a ke s the s t r a te g ic
r e c o l l e c t i o n o f s p e c i f i c a s p e c t s o f s u c h e v e n t s ( n e c e s s a r y f o r
re c oding , r e a t t r ibu t ion , e tc . ) e f for t fu l a nd unl ike ly to be s a t i s f a c -
t o r i l y a c c o m p l i s h e d . S e c o n d , s p e c i f i c a s p e c ts o f e v e n t s w i l l c o m e
t o b e a s s o c i a t e d w i t h m o r e i n t e n s e a f f e c t a n d l e a d i n c r e a s i n g l y t o
a t t e m p t s t o a v o i d s p e c i f i c r e t ri e v a l .
M i n d f u l n e s s - b a s e d c o g n i t i v e th e r a p y a d d r e s s e s t h i s a v o i d a n t
m o d e o f p r o c e s s i n g b y e n c o u r a g i n g p a t i e n t s t o p r a c t i c e n o t i ci n g
e l e m e n t s o f t h e i r e x p e r i e n c e a n d t o d o s o i n a n o n j u d g m e n t a l w a y .
I n t h i s w a y , i t e n c o u r a g e s n o t o n l y m o r e s p e c i f i c e n c o d i n g o f
e v e n t s b u t a l s o m o r e s p e c i f i c r e tr i e v a l o f p a s t e v e n t s b y r e d u c i n g
t h e t e n d e n c y f o r i n d i v i d u a l s t o a b o r t t h e s e a r c h p r o c e s s . F u r t h e r
r e s e a r c h w i l l b e n e e d e d t o e s t a b l i s h h o w m u c h o f t h e c h a n g e i n
m e m o r y c o m e s a b o u t a s a r e su l t o f th e M B C T ' s e f f e c t o n e n c o d i n g
v e r s u s r e t r i e v a l . N e v e r t h e l e s s , t h e f i n d i n g t h a t o v e r g e n e r a l m e m -
o r y s t y l e c a n b e c h a n g e d i s p o t e n t i a l l y i m p o r t a n t c l i n i c a l l y . F o r
e x a m p l e , t h e r e a r e n o w a n u m b e r o f s t u d i e s s h o w i n g t h a t p a t i e n t s
w h o h a v e d i f f i c u l t y i n b e i n g s p e c i f i c i n t h e i r m e m o r y h a v e p r o b -
l e m s i n f i n d i n g s u f f i c i e n t n u m b e r s o f s o l u t i o n s a n d s u f f i c i e n t l y
e f f e c t i v e s o l u t io n s t o c u r r e n t i n t e r p e r so n a l p r o b l e m s ( E v a n s e t a l . ,
1992; God da rd e t a l. , 1996; S id le y e t a l . , 1997). B e c a u se soc ia l
p r o b l e m - s o l v i n g d e f i c i t s a r e k n o w n t o b e a p r e v a l e n t f e a t u r e o f
d e p r e s s i o n ( N e z u & N e z u , 1 9 8 9 ) , i t is i m p o r t a n t t o k n o w t h a t o n e
o f t h e u n d e r l y i n g p r o c e s s e s t h a t c o n t r i b u t e s t o p o o r p r o b l e m
s o l v i n g - - o v e r g e n e r a l i t y i n a u t o b io g r a p h i ca l m e m o r y - - c a n b e
c h a n g e d b y t r e a t m e n t a n d t h a t s y s t e m a t i c i n s t ru c t i o n i n a t t e n t io n a l
c o n t r o l i s p r o m i s i n g a s a p r e l i m i n a r y m e t h o d b y w h i c h t o b r i n g
a b o u t s u c h c h a n g e .
R e f e r e n c e s
American Psychiatric Association. (1987 ).
Diagnost ic a nd s ta t i s t ica l man-
ual o f menta l d isorders (3rd ed., rev.). Washington, DC: Author.
Baddeley, A. D., & Wilson, B. (1986). Amnesia, autobiographical mem-
ory, and confabulation. In D . C. Rubin (Ed.), Autobiographica l memory
(pp. 225-252). Cambridge, England: Cambridge University Press.
Brewin, C . R., Phillips, E., Carroll, F., & Tata, P. (1 998 ). Intrusive
memories in depression.
Psyc holog ical Medicine 28
219-224.
Brittlebank, A. D., Scott, J., Williams, J. M. G., & Ferrier, I. N. (1993).
Autobiographical memory in depression: State or trait marker?
Bri t i sh
Journal o f Psychia try 162 118-121.
Evans, J. , Williams, J. M. G., O'Loughlin, S., & Howells, K. (1992).
Autobiographical m emo ry and problem-solving strategies of parasuicide
patients. Psychologica l Medic ine 22 3 9 9 - 4 0 5 .
Goddard, L., Dritschel, B., & Burton, A. (1996). R ole of autobiographical
memory in social problem solving and depression.
J o u rn a l o f Ab n o rm a l
Psychology 105 6 0 9 - 6 1 6 .
Hamilton, M . (1960). A rating scale for depression. Journal o f Neurology
Neurosurgery and Psychia try 12
5 6 - 6 2 .
Harvey, A. G., Bryant, R. A., & Dang, S. T. (1998). Autobiographical
-
7/27/2019 Williams Et Al 2000 OGM in MBCT
6/6
S H O R T R E P O R T S 1 5 5
memory in acute stress disorder. Journal of Consulting and Clinical
Psychology, 66, 5 0 0 - 5 0 6 .
John , C. H. (1988). Emot ional i ty ra t ings and associa t ion norms for 240
emot ional and nonemot ional words. Cognition Emotion, 2 , 4 9 -7 0 .
Kabat-Zinn, J. (1990).
Full catastrophe living.
New York: Delacorte.
Ka bat-Z inn, J., Massio, A. O., Kristeller, J., Peterson, L . G., Fletcher,
K. E., Pbert , L., Len derkin g, W. R., Santorelli , S. F. (1992). Effec -
t iveness of a medi ta t ion-based s t ress reduct ion program in the t rea tm ent
of anxiety disorders. American Journal o f Psychiatry, 149, 9 3 6 -9 4 3 .
Kuyken , W., Brewin , C. R. (1995). Autobiographical mem ory funct ion-
ing in depression and reports o f early abuse . Journal o f Abnormal
Psychology, 104, 5 8 5 -5 9 1 .
Kuyken , W., Dalg le ish , T. (1995). Autobiographical mem ory and de-
pression. British Journal of Clinical Psychology, 34, 8 9 - 9 2 .
Mc Na lly, R. J., Lasko, N. B., Ma cklin, M. L., Pitm an, R. K. (1995).
Autobiographical memory d is turbance in c0mbat -re la ted post t raumat ic
stress disorder. Behaviour Research and Therapy, 33, 6 1 9 - 6 3 0 .
McN al ly , R. J ., Li tz , B. T. , Prassas , A. , Sh in , L. M., Weathers , F. W.
(1994). Emot ional p riming of au tobiographical memory in post -
traumatic stress disorder.
Cognition and Emotion, 8,
3 5 1 -3 6 7 .
Moore, R. G., Watts, F. N., W illiams , J. M. G. (1988). The specificity
of persona l mem ories in depression. British Journal o f Clinical Psychol-
ogy, 27, 2 7 5 -2 7 6 .
Nezu, A., Nezu, C. (1989). Problem-solving therapy fo r depression:
Theory, research and clinical guidelines.
New York: Wiley .
Puffet , A., Jehin -M arch ot, D., Tim sit-Be rthier, M., Timsit , M. (1991).
Autobiographical memory and major depressive s ta tes . European Psy-
chiatry, 6, 141-145 .
Reiser, B. J., Blac k, J. B., Abe lson, R. P. (1985). Knowledge structures
in the organiza t ion and re t r ieval o f au tobiographical memories .
Cogni-
tive Psychology, 17, 8 9 -1 3 7 .
Rubin, D. (Ed.). (1996). Remembering our past: Studies in autobiograph-
ical memory. Cambridge , England: Cambridge Universi ty Press .
Sidley, G. L., W hitaker, K., Calam, R. M., W ells, A. (1997). The
re la t ionsh ip between problem-solv ing and au tobiographical memory in
parasuicide patients. Behavioural and Cognitive Psychotherapy, 25,
195-202 .
Teasdale, J. D., Segal, Z. V., W illiams, J. M. G. (1995). How does
cogni t ive therapy prevent depressive re lapse and why should a t ten t ional
cont ro l (m indfu lness) t ra in ing help? An informat ion processing analysis .
Behaviour Research Therapy, 33, 2 5 -3 9 .
Williams, J. M. G. (1996). Autobio graph ical me mo ry in depression. In D.
Rubin (Ed .) ,
Remembering our past: Studies in autobiographical mem-
ory (pp . 244-26 7). Camb ridge , England: Cambridge Universi ty Press.
Williams, J. M. G. (1997). Cry of pain: Understanding suicide and self
harm.
Harm ondsworth , Middlesex , England: Penguin Books.
Wil l iams, J . M. G., Broadben t , K. (1986). Autobiographical mem ory
in attempted suicide patients. Journal o f Abnormal Psychology, 95,
1 4 4 -1 4 9 .
Wil l iams, J. M. G. , Dri t schel , B. H. (1988). Emot ional d is turbance and
the specificity of autobiographical memory.
Cognition and Emotion, 2,
2 2 1 -2 3 4 .
W illiams , J. M. G., Ellis, N. C ., Tyers, C., Healy, H., Rose, G .,
MacLeod, A. K. (1996). The specificity of autobiographical me mo ry and
imageabi l i ty of the fu ture .
Memory Cognition, 24,
1 1 6 -1 2 5 .
Wil l iams, J . M. G. , Scot t, J . (1988). Autobiographical mem ory in
depression. Psychological Medicine, 18, 6 8 9 - 6 9 5 .
W illiams, J. M. G., W atts, F. N., MacLeod, C., Ma thew s, A. (1997).
Cognitive psychology and emo tional disorders
(2nd ed.). Chichester,
England: Wiley.
R e c e i v e d A u g u s t 1 7 , 1 9 9 8
R e v i s i o n r e c e i v e d A p r i l 3 0 , 1 9 9 9
A c c e p t e d M a y 5 , 1 9 9 9
top related