The effects of mindfulness-based cognitive therapy on affective memory recall dynamics in depression: a mechanistic model of rumination.
The effects of mindfulness-based cognitive therapy on affective memory recall dynamics in depression: a mechanistic model of rumination.
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DOI：
10.3389/fnhum.2012.00257
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发表时间：
2012
影响因子：
2.9
通讯作者：
Britton W
中科院分区：
文献类型：
--
作者：
van Vugt MK;Hitchcock P;Shahar B;Britton W
目的：趋同的研究表明正念训练通过减少反思冥想而对抑郁症起到治疗作用。从理论上讲，沉思是一个多方面的结构，它聚集了抑郁症的多个神经认知方面，包括糟糕的执行控制，负面和过度笼统的记忆偏见，以及负面心理状态的持久性或粘性。目前对冥想的测量，最常见的是自我报告，没有捕捉到冥想倾向的这些不同方面，因此在提供关于正念机制的详细信息方面受到限制。方法：基于自由回忆动力学的三个基于模型的度量标准，我们对沉思的潜在机制提出了新的见解。这三个量度反映了配价信息的记忆提取模式：代表初始情感偏向的首次回忆概率(PStart)，表示正或负联想网络强度的停留在同一价类而不是转换的概率(Pstay)，以及在给定的价位内停止或结束回忆的概率(Ptop)，表示心理状态的持续性或粘性。在一项随机对照试验中，我们比较了基于正念的认知疗法(N = 29)和等待名单对照(N = 23)对复发性抑郁症患者回忆动态的影响。参与者完成了标准的实验室应激源，Trier社会压力测试，以诱导负面情绪并激活反省倾向。随后，参与者完成了一项由三个单词列表组成的自由回忆任务。这项评估是在治疗或等待名单之前和之后进行的。结果：虽然MBCT参与者的PStart保持相对稳定，但对照组显示出与抑郁相关的恶化的多个迹象，倾向于更多的负面和较少的积极偏向。干预后，MBCT受试者维持消极词汇串的倾向降低，而维持积极词汇串的倾向增加。相反，控制组显示出相反的趋势：与干预前的分数相比，控制组在负面词汇序列中停留的时间更长，而在积极单词序列中停留的时间更短。MBCT参与者倾向于较少使用否定词来停止回忆，这表明消极配价的心理环境的持久性或粘性较低。结论：与对照组相比，MBCT参与者在所有三种类型的回忆动力(PStart、PStay和PStop)上表现出持续沉思的模式减少。MBCT可能会削弱自我维持的负面联想网络的力量，而这些负面联想网络是抑郁症中观察到的持续和“粘性”负面心理状态的罪魁祸首，而增加了抑郁症中缺乏的积极联想。这项研究还提供了一种新的、客观的方法来衡量反省倾向的几个指数，这些指数表明了反省的潜在机制。
Objectives: converging research suggests that mindfulness training exerts its therapeutic effects on depression by reducing rumination. Theoretically, rumination is a multifaceted construct that aggregates multiple neurocognitive aspects of depression, including poor executive control, negative and overgeneral memory bias, and persistence or stickiness of negative mind states. Current measures of rumination, most-often self-reports, do not capture these different aspects of ruminative tendencies, and therefore are limited in providing detailed information about the mechanisms of mindfulness. Methods: we developed new insight into the potential mechanisms of rumination, based on three model-based metrics of free recall dynamics. These three measures reflect the patterns of memory retrieval of valenced information: the probability of first recall (Pstart) which represents initial affective bias, the probability of staying with the same valence category rather than switching, which indicates strength of positive or negative association networks (Pstay), and probability of stopping (Pstop) or ending recall within a given valence, which indicates persistence or stickiness of a mind state. We investigated the effects of Mindfulness-Based Cognitive Therapy (MBCT; N = 29) vs. wait-list control (N = 23) on these recall dynamics in a randomized controlled trial in individuals with recurrent depression. Participants completed a standard laboratory stressor, the Trier Social Stress Test, to induce negative mood and activate ruminative tendencies. Following that, participants completed a free recall task consisting of three word lists. This assessment was conducted both before and after treatment or wait-list. Results: while MBCT participant’s Pstart remained relatively stable, controls showed multiple indications of depression-related deterioration toward more negative and less positive bias. Following the intervention, MBCT participants decreased in their tendency to sustain trains of negative words and increased their tendency to sustain trains of positive words. Conversely, controls showed the opposite tendency: controls stayed in trains of negative words for longer, and stayed in trains of positive words for less time relative to pre-intervention scores. MBCT participants tended to stop recall less often with negative words, which indicates less persistence or stickiness of negatively valenced mental context. Conclusion: MBCT participants showed a decrease in patterns that may perpetuate rumination on all three types of recall dynamics (Pstart, Pstay, and Pstop), compared to controls. MBCT may weaken the strength of self-perpetuating negative associations networks that are responsible for the persistent and “sticky” negative mind states observed in depression, and increase the positive associations that are lacking in depression. This study also offers a novel, objective method of measuring several indices of ruminative tendencies indicative of the underlying mechanisms of rumination.
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