Presented at EBACT 2012 Geneève, the research of italian scholar Chiara Manfredi.
Cognitive theories of depression
There is a greater risk for depression for people who exhibit a dispositional negative style and dysfunctional attitudes (Abramson et al., 1989; Beck 1987)
These dysfunctional attitudes can act as latent vulnerability factors for emotional and affective disorders (Mathews & MacLeod, 1994)
Analisi del contenuto delle autocaratterizzazioni degli allievi in formazione
Self-discrepancy monitoring and its impact on depressed mood: an experimental investigation
1. Self-discrepancy monitoring
and its impact on depressed
mood: an experimental
investigation
Chiara Manfredi1,4 ,Gabriele Caselli1,2, Alina Decsei-Radu3, Francesca Fiore1,
Sara Querci1, Sara Sgambati1, Daniela Rebecchi1, Giovanni M. Ruggiero1
& Sandra Sassaroli1
1 Studi Cognitivi, Cognitive Psychotherapy School, Italy
2 London South Bank University, UK
3 University of Oradea, Romania
4 University of Pavia, Italy
2. Cognitive theories of depression
• There is a greater risk for depression for
people who exhibit a dispositional negative
style and dysfunctional attitudes (Abramson
et al., 1989; Beck 1987)
• These dysfunctional attitudes can act as latent
vulnerability factors for emotional and
affective disorders (Mathews & MacLeod,
1994)
3. Three possible forms of these
dysfunctional attitudes
• Selective attentional and interpretation biases
• Chronic and embedded pessimism
• Ruminative brooding
4. Three possible forms of these
dysfunctional attitudes
• Selective attentional and interpretation biases:
An active and conscious The tendency to distort the
direction of attention to mood- interpretation of specific irrelevant
congruent information events in terms of personal
(Mathews et al., 1996) failure, and to generalize events that
hold any semblance of negative
information about the self
STRATEGIC NATURE (Beck, 1964)
• Chronic and embedded pessimism
• Ruminative brooding
5. Three possible forms of these
dysfunctional attitudes
• Selective attentional and interpretation biases
• Chronic and embedded pessimism: a
generalized negative outcome expectancy
(Armor & Taylor, 1998); a proximal predictor
of adjustment (Scheier & Carver, 1985)
• Ruminative brooding
6. Three possible forms of these
dysfunctional attitudes
• Selective attentional and interpretation biases
• Chronic and embedded pessimism
• Ruminative brooding: a mode of thinking that
involves repetitive and passive focus on one’s
depressive symptoms as well as their causes
and consequences; a cognitive risk factor for
depressive mood (Nolen-Hoeksema, 1991).
7. Three possible forms of these
dysfunctional attitudes
• Selective attentional and interpretation biases
• Chronic and embedded pessimism
• Ruminative brooding
These dysfunctional attitudes have been
conceptualized as a reaction to negative self-
related information.
8. Positive stimuli in depression
Difference between depressed and non-depressed
individuals in emotional response to positive
stimuli:
• Smaller electromyographic response (Schwartz et
al., 1976)
• Rating hedonic images as less pleasant and less
arousing (Dunn et al., 2004; Sloan et al., 1997,
2001)
Diminished subjective emotional response in
depression refers not only to negative stimuli
9. Self-Discrepancy
• The basis of Self-Regulation theory (Caver et al., 1999)
discrepancies between ideal and actual selves as predictors
for depression
• Different attention directed to detecting signals of
discrepancies in different people
• Self Discrepancy Monitoring: a strategic and voluntary
allocation of attentional resources towards the monitoring
of possible discrepancies between ideal and actual selves,
even in positive experiences (Higgins, 1987)
It may represent a relevant process in discriminating
between usual and transitional self-discrepancy
experiences and the sustained negative evaluation of the
self, others and future typical of depressed patients
10. What can SDM lead to?
• The hindering of positive emotional experiences
• The re-orientation of attention towards the negative
and even less important aspects of a situation
• The influences upon conscious interpretations
(discounting positive ones)
• The enhancement of the frequency of negative triggers
by focusing attention on negative content and, in turn,
increasing the number of negative thoughts
11. Distinguishing SDM from other cognitive
processes
Self Discrepancy Monitoring
Negative - Voluntary and non intrusive nature (Wells, 2008)
intrusive - Not directly associated with instrumental behavior
thoughts and employed to control or eliminate the outcomes that can
memories result from it (Wegner, Eich & Bjork, 1994)
Cognitive biases - Automatic interpretations
- Repetitiveness
Brooding - Activating stimuli
- “what” vs. “why”
- Stability over time (Carver, Scheier & Segerstrom, 2010)
- Global vision and negative expectancies vs. Intentional
Pessimism focus and search for elements of distance between current
and ideal selves
12. Hypotheses
• Inducing SDM when facing a positive situation
would enhance negative mood
• The effect would be more significant between
depressed individuals than healthy controls
• A change in ruminative brooding would in a
certain degree mediate the relationship between
SDM and negative mood in both the samples
13. Methods
• Participants:
– Italian clinical sample: 28 outpatients (19 females) with a
diagnosis of moderate depression (mean = 38.8 years; SD =
12.9; range = 18-64)
– Italian non-clinical sample: 28 non-depressed subjects (19
females) recruited from general population (mean= 39.3 years;
SD = 13.9; range = 21-67)
– Romanian clinical sample: 30 inpatients (15 females) with a
diagnosis of severe depression (mean = 39.6 years; SD = 10.9;
range = 23-57)
– Romanian non-clinical sample: 30 non-depressed subjects (14
females) recruited from general population (mean = 34.0 years;
SD = 8.7; range = 21-55)
• Measures: Depression (BDI), Rumination (RRS), Pessimism
(LOT-R), Negative mood and thoughts measure (NMT),
Current brooding (RRS modified)
14. Attentional manipulation
Tasks were adapted from Nolen-Hoeksema and Morrow’s (1993)
distraction and rumination task
1. Participants were asked to retrieve images of a positive life event
for 3 minutes while keeping their eyes closed
2. Participants were asked to focus on one of two lists of audio
recorded items that were presented with an interval of 20
seconds, for 8 minutes
– In the experimental condition participants were asked to focus their
attention on what they felt was preventing their lives from being
completely happy or satisfied in the actual moment (e.g. “focus on
what is missing to fully reach your ideal goals”, “focus on what you
think you should do to feel near your ideal”)
– In the control condition items suggested to focus attention on
emotion, sensation and thoughts participants had in the contingent
moment (e.g. “focus on what you are feeling right now”, “focus on
your bodily sensations”)
15. Procedure
• Written informed consent, SCID-II, BDI, RRS and LOT-R
AFTER ONE WEEK:
• Current brooding, negative mood and thoughts measure
(Time 1)
• 3 minutes of imagery retrieving and 8 minutes working
through their assigned attentional task
• Current brooding, negative mood and thoughts measure
(Time 2)
• Open-ended question investigating what the participants
thought the study was testing
• Debriefing
16. Results: Italian sample
Results of ANOVA
Paired t-test for SDM condition: t(27)=-22.2; p<.05
Group: F=248.06***
BDI
Group x Condition: F=.37
Group: F=71.83*** ANCOVA between conditions with the change score of
RRS-B NMT between Time 1 and Time 2 as dependent
Group x Condition: F=.96
variable, and change in current brooding between Time
Current Group: F=59.00***
1 and Time 2 as covariate.
brooding Group x Condition: F=.93 The effect of the conditions remained significant [F(1) =
Group: F=44.17*** 4.90, p=.03] but change score for current brooding
LOT-R appeared to have a significant effect [F(1) = 9.21, p =
Group x Condition: F=.20
.004], too.
Results of ANCOVA
Group: F=27.70***
Condition: F=10.84** The increase in depressed mood following SDM
induction depended on both experimental condition
Time: F=.28
and levels of current brooding.
Condition x Group: F=.51
NMT
Time x Condition: F=6.91**
Time x Group: F=.40
Time x Condition x Group:
F=1.86
17. Results: Romanian sample
Results of ANOVA Paired t-test was for the SDM condition: t(28) = -
Group: F=245.24*** 2.70, p = .01
BDI
Group x Condition: F=.80
Group: F=66.93*** ANCOVA between conditions with the change
RRS-B
Group x Condition: F=.06 score of NMT between Time 1 and Time 2 as
Current Group: F=68.05*** dependent variable, and change in current
brooding Group x Condition: F=.17
brooding between Time 1 and Time 2 as
covariate.
Group: F=152.98*** The effect of the conditions remained significant
LOT-R
Group x Condition: F=2.54 [F(1, 54) = 19.89, p < .001], while the impact of
change score for current brooding appeared not
Results of ANCOVA
significant.
Group: F=5.27*
Condition: F=17.38***
Time: F=.734 Thus the increase in depressed mood following
SDM induction was not purely dependent on the
Condition x Group: F=.30
concurrent levels of brooding.
NMT
Time x Condition: F=27.34***
Time x Group: F=2.42
Time x Condition x Group: F=2.34
18. Discussion
• SDM leads to a significant decrease in mood and
to a significant increase in negative thoughts
independently on the severity and presence of
depressive symptoms and not purely
dependently on the concurrent change in levels
of brooding.
• These results may reflect the importance of the
time spent in monitoring self-discrepancy, instead
of the importance of the degree of discrepancy
perceived by the person.
19. Possible SDM consequences
• Direct effect: a frequent engagement in discrepancy monitoring may
lead to a reduction of positive reinforcement in everyday life, and to an
impairment in self-reinforcement skills. As a consequence, even
positive stimuli could become more and more perceived as triggers for
a lowering of mood.
• Indirect effect: following a positive stimulus, individuals may re-
orientate attention on the negative part of experience as an
intermediate step for the resumption of negative attitudes (such as
negative biased interpretations, pessimistic forecasts and ruminative
brooding) which, in turn, can trigger negative thoughts or depressive
sensations, worsening mood’s state.
• Hindering the degree of acceptance of alternative beliefs emerging
from cognitive restructuring techniques. Functional beliefs could play
the role of positive stimuli and act as a triggers for SDM.
20. Limitations
• Self-report data subject to errors in measurement
• NMT in assessing the dependent variable
• Lack of an independent check for the reliability of
the SCID diagnosis
• The sampling strategy may have lead to different
levels of motivation and engagement in the
research process
21. Clinical implications
• Assessing SDM may be useful in identifying and
socializing a potential maladaptive cognitive
strategy that could have an impact on mood,
even independently from the diagnosis of
depression
• Address SDM may be beneficial for a reduction in
negative emotion but also for enhancing the
degree of acceptance of alternative beliefs
emerging from cognitive restructuring
techniques.
22. Future research
• Deepen investigate both the SDM frequency of
use in depressed and non-depressed individuals,
and the motivations or beliefs that lead people to
undertake it
Understanding these aims, therapists will be able
to call them into question and try to bring
evidences of the maladaptive nature of SDM
Patients would be able to learn how to manage
the orientation of attention in a different way,
and learn flexible control over it
23. Thank you for your attention
Contact details
Dr.ssa Chiara Manfredi
Cognitive Psychotherapy School Studi Cognitivi, Modena, Italy
University of Pavia, Italy
c.manfredi@studicognitivi.net
chiara.manfredi@unipv.it