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