Reconciling a phenomenological with a functional approach to memory: narrative coherence and its social function.

To date, the phenomenological and functional aspects of autobiographical memory have by and large been studied separately. This is quite remarkable, given that both can inform each other, and that investigating their interaction can add to the understanding of the (in)adaptivity of certain memory characteristics for our well-being. In other words, examining how particular features of autobiographical memory are adept or inept at serving specific functions, could help us to better comprehend and explain relations between memory and psychological well-being. We discuss previous attempts to integrate phenomenology with functionality and formulate three main directions for future research based on the current state of the art. The directions concern (1) focusing on functionality (adaptivity) and not merely on the use of memories in phenomenological work, (2) attention for the bidirectionality of the relation between phenomenology and functionality, and (3) the addition of narrative constructs like coherence to the traditional range of phenomenological features. We will illustrate our directions for the reintegration of phenomenology with functionality through the social function of coherent autobiographical memories. This framework could help to stimulate future empirical studies and pave the road for new clinical interventions to improve psychological well-being.

Narrative coherence predicts emotional well-being during the COVID-19 pandemic: a two-year longitudinal study.

Prior research has shown that narrative coherence is associated with more positive emotional responses in the face of traumatic or stressful experiences. However, most of these studies only examined narrative coherence after the stressor had already occurred. Given the outbreak of the novel coronavirus disease COVID-19 in March 2020 in Belgium and the presence of data obtained two years before (February 2018), we could use our baseline narrative coherence data to predict emotional well-being and perceived social support in the midst of the pandemic. In a sample of emerging adults (NT1 = 278, NT2 = 198), higher baseline coherence of narratives about positive autobiographical experiences predicted relative increases in emotional well-being during the COVID-19 pandemic. Furthermore, the relation between the coherence of positive narratives and emotional well-being was partially mediated by perceived social support. These findings suggest that narrative coherence could be an enhancement factor for adaptive emotional coping with stressful situations, in part by evoking more supportive social reactions. This study demonstrates the importance of researching cognition (narrative coherence) and emotion (well-being) to shed light on pressing societal matters such as the global COVID-19 pandemic.

Be coherent and become heard: The multidimensional impact of narrative coherence on listeners' social responses.

Previous research has suggested that sharing autobiographical memories in a coherent manner has a beneficial impact on consequent social reactions of listeners. In this experimental study, we were able to replicate earlier findings by demonstrating that listeners (N = 107) showed significantly more willingness to interact with, more social support towards, and a more positive attitude towards coherent than incoherent narrators. Remarkably, these beneficial effects of coherence were observed only for narratives about positive memories. Results are explained in the light of the relevance of positive memories for the social bonding function of autobiographical memory. Furthermore, earlier work was extended and refined by investigating effects of the individual constituting dimensions of coherence (context, chronology, theme) on social responses. In line with our predictions, the dimensions of chronology and theme were most important in impacting social responses of listeners. Possibly a reduction of the attraction effect due to increased effortful processing and reduced credibility due to insufficient emotional elaboration might explain these results respectively. Furthermore, social responses were worse when narratives were incoherent with regard to more than one dimension, in line with the expected additive effect. Overall, fully incoherent narratives, which had had low scores on context, chronology, and theme, had the most adverse effect on listeners' social responses. This study adds significantly to the domain of memory and cognition by showing how cognitive psychological research would benefit from extending a merely intrapersonal perspective to include an interpersonal perspective that considers social implications of memory and cognition as well.

How am I going to tell you this? The relations between social anxiety and narrative coherence.

Recently, evidence has been increasing that individuals who are able to narrate coherently about their autobiographical memories, receive more positive social feedback, have higher-quality social relationships and are overall less likely to suffer from internalising psychopathology, like depression and anxiety. However, the relation between narrative coherence and social anxiety, in particular, has not been topic of research until now. This is remarkable, since the concern about negative evaluations by others in social situations is at the core of social anxiety. In the present experimental study (N = 68), we investigated in a two-by-two design how trait and state social anxiety are related to narrative coherence, as well as possible underlying mechanisms. In our study, neither trait nor state social anxiety, nor their interaction had the expected detrimental effect on narrative coherence. However, trait differences in the proposed mechanisms of social anxiety were in line with the literature. Results showed that trait social anxiety and thematic narrative coherence were indirectly negatively related, via the intervening effects of an increased internal focus on anxiety cues, an excessive external focus on negative social evaluation, larger working memory load, more rumination and more depressive symptoms. Limitations and recommendations for future research are addressed.

Generalisation of fear in PTSD related to prolonged childhood maltreatment: an experimental study.

BACKGROUND: Fear responses are particularly intense and persistent in post-traumatic stress disorder (PTSD), and can be evoked by unspecific cues that resemble the original traumatic event. Overgeneralisation of fear might be one of the underlying mechanisms. We investigated the generalisation and discrimination of fear in individuals with and without PTSD related to prolonged childhood maltreatment. METHODS: Sixty trauma-exposed women with (N = 30) and without (N = 30) PTSD and 30 healthy control participants (HC) underwent a fear conditioning and generalisation paradigm. In a contingency learning procedure, one of two circles of different sizes was associated with an electrical shock (danger cue), while the other circle represented a safety cue. During generalisation testing, online risk ratings, reaction times and fear-potentiated startle were measured in response to safety and danger cues as well as to eight generalisation stimuli, i.e. circles of parametrically varying size creating a continuum of similarity between the danger and safety cue. RESULTS: The increase in reaction times from the safety cue across the different generalisation classes to the danger cue was less pronounced in PTSD compared with HC. Moreover, PTSD participants expected higher risk of an aversive event independent of stimulus types and task. CONCLUSIONS: Alterations in generalisation constitute one part of fear memory alterations in PTSD. Neither the accuracy of a risk judgement nor the strength of the induced fear was affected. Instead, processing times as an index of uncertainty during risk judgements suggested a reduced differentiation between safety and threat in PTSD.

Meta-Analysis of the Association Between Autobiographical Memory Specificity and Exposure to Trauma.

Cognitive models of emotional disorders suggest that reduced autobiographical memory specificity that results from exposure to traumatic events may play an important role in the aetiology and maintenance of these disorders. However, there has yet to be a comprehensive meta-analysis of the association between trauma exposure and memory specificity, and the role of posttraumatic stress symptoms on this association. We searched PsycINFO and MEDLINE databases and extracted data from studies regarding the mean number or proportion of specific memories that participants with and without trauma exposure recalled on the Autobiographical Memory Test. We also extracted data on differences between groups in terms of posttraumatic stress and depressive symptoms, along with data on trauma timing and participants' ages at the time of assessment. The effect size of memory specificity between participants with and without exposure to trauma was large, d = 0.77, and differed significantly from zero, p < .001. In metaregression, trauma timing was a significant predictor of the heterogeneity in trauma-exposure specificity effect sizes, but posttraumatic stress and depressive symptoms were not. Compromised memory specificity represents an important cognitive consequence of trauma exposure that might have an important influence on risk for, and maintenance of, subsequent emotional pathologies.

Meta-analysis of the association between rumination and reduced autobiographical memory specificity.

The CaRFAX model, proposed by Williams J. M. G. (2006. Capture and rumination, functional avoidance, and executive control (CaRFAX): Three processes that underlie overgeneral memory. Cognition and Emotion, 20, 548-568. doi: 10.1080/02699930500450465 ; Williams, J. M. G., Barnhofer, T., Crane, C., Herman, D., Raes, F., Watkins, E., & Dalgleish, T. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133(1), 122-148. doi: 10.1037/0033-2909.133.1.122 ) posits that reduced autobiographical memory specificity, a key factor associated with the emergence and maintenance of emotional disorders, may result from heightened rumination. We provide the first meta-analysis of the relation between autobiographical memory specificity and trait rumination. PsycINFO, PsycARTICLES and MEDLINE databases were searched and the following were extracted: the correlation between the number of specific memories recalled in the Autobiographical Memory Test and self-reported trait rumination scores, and its sub-factors - brooding and reflection. The pooled effect size for the correlation between memory specificity and trait rumination was small (d = -.05) and did not differ significantly from zero (p = .09). The effect sizes for the correlation with brooding and reflection were not significantly different from zero. There is limited support for the association between trait rumination and memory specificity suggested in CaRFAX.

Paul Eelen: Reflections on Life and Work.

This manuscript is part of a special issue to commemorate professor Paul Eelen, who passed away on August 21, 2016. Paul was a clinically oriented scientist, for whom learning principles (Pavlovian or operant) were more than salivary responses and lever presses. His expertise in learning psychology and his enthusiasm to translate this knowledge to clinical practice inspired many inside and outside academia. Several of his original writings were in the Dutch language. Instead of editing a special issue with contributions of colleagues and friends, we decided to translate a selection of his manuscripts to English to allow wide access to his original insights and opinions. Even though the manuscripts were written more than two decades ago, their content is surprisingly contemporary. This introductory article presents a reflection on Paul's career and legacy and introduces the selected manuscripts that are part of this special issue.

Generalisation of fear and avoidance along a semantic continuum.

Directly conditioned fear and avoidance readily generalises to dissimilar but conceptually related stimuli. Here, for the first time, we examined the conceptual/semantic generalisation of both fear and avoidance using real words (synonyms). Participants were first exposed to a differential fear conditioning procedure in which one word (e.g., "broth"; CS+) was followed with brief electric shock [unconditioned stimulus (US)] and another was not (e.g., "assist"; CS-). Next, an instrumental conditioning phase taught avoidance in the presence the CS+ but not the CS-. During generalisation testing, synonyms of the CS+ (e.g., "soup"; GCS+) and CS- (e.g., "help"; GCS-) were presented in the absence of shock. Conditioned fear and avoidance, measured via skin conductance responses, behavioural avoidance and US expectancy ratings, generalised to the semantically related, but not to the semantically unrelated, synonyms. Findings have implications for how natural language categories and concepts mediate the expansion of fear and avoidance repertoires in clinical contexts.

From bad to worse: Symbolic equivalence and opposition in fear generalisation.

The present study compared the impact of symbolic equivalence and opposition relations on fear generalisation. In a procedure using nonsense words, some stimuli became symbolically equivalent to an aversively conditioned stimulus while others were symbolically opposite. The generalisation of fear to symbolically related stimuli was then measured using behavioural avoidance, retrospective unconditioned stimulus expectancy and stimulus valence ratings. Equivalence relations facilitated fear generalisation while opposition relations constrained generalisation. The potential clinical implications of symbolic generalisation are discussed.

Post-extinction conditional stimulus valence predicts reinstatement fear: relevance for long-term outcomes of exposure therapy.

Exposure therapy for anxiety disorders is translated from fear conditioning and extinction. While exposure therapy is effective in treating anxiety, fear sometimes returns after exposure. One pathway for return of fear is reinstatement: unsignaled unconditional stimuli following completion of extinction. The present study investigated the extent to which valence of the conditional stimulus (CS+) after extinction predicts return of CS+ fear after reinstatement. Participants (N = 84) engaged in a differential fear conditioning paradigm and were randomised to reinstatement or non-reinstatement. We hypothesised that more negative post-extinction CS+ valence would predict higher CS+ fear after reinstatement relative to non-reinstatement and relative to extinction retest. Results supported the hypotheses and suggest that strategies designed to decrease negative valence of the CS+ may reduce the return of fear via reinstatement following exposure therapy.

Home nurses and patient depression. Attitudes, competences and the effects of a minimal intervention.

AIM: To explore attitudes and confidence in professional competence of home nurses concerning depression and to evaluate the capacity of a minimal intervention in helping home nurses to detect depression in patients and their family caregivers. BACKGROUND: Long-term ill patients have an elevated risk to develop comorbid depression, as do their family caregivers. However, most primary care providers have little training to detect patients at risk. A minimal intervention to help home nurses detect symptoms of depression was therefore evaluated. DESIGN: Quasi-experimental field study with pre-measures, postmeasures and follow-up measures. METHODS: From the Fall of 2012-Spring of 2013, home nurses (N = 92) in three regions in Antwerp (Belgium) were assigned to a 1-hour intervention (consisting of information, skill training and discussion; N = 63) or to a control condition (N = 29). The Depression Attitude Questionnaire and the Morris Confidence Scale were completed before the intervention and 3 and 7 months afterwards. For 3 months, the number of detections of depression in patients in each region was monitored. FINDINGS: No significant changes were found in attitude or confidence in professional competences, except for a decline in the role attitude for home nurses in the intervention group. Home nurses who followed the intervention did detect significantly more depressed patients compared with controls. CONCLUSION: These findings suggest that a minimal intervention can allow home nurses to be more responsive to symptoms of depression in patients and their family caregivers. The implications of these findings are discussed and suggestions for future research are made.

Psychometric properties of the multidimensional perfectionism scale of Hewitt in a dutch-speaking sample: associations with the big five personality traits.

We administered the Dutch Multidimensional Perfectionism Scale of Hewitt and Flett (1991, 2004) in a large student sample (N = 959) and performed a confirmatory factor analysis to test the factorial structure proposed by the original authors. The existence of a method factor referring to the negatively keyed items in the questionnaire was investigated by including it in the tested models. Next, we investigated how the 3 perfectionism dimensions are associated with the Five-factor model (FFM) of personality. The 3-factor structure originally observed by the authors was confirmed, at least when a method factor that refers to the negatively keyed items was included in the model. Self-oriented and socially prescribed perfectionism were both distinguished by low extraversion and low emotional stability. Self-oriented perfectionism's positive relationship with both conscientiousness and openness to experience differentiated the 2 perfectionism dimensions from each other. Other-oriented perfectionism was not well-characterized by the Big Five personality traits.

Positive appraisal style: The mental immune system?

Instead of converging to one, all-embracing resilience mechanism - that is, positive appraisal style - we encourage complementary research strategies, exploring both vulnerabilities and resilience factors, much like the biomedical sciences combine insights from pathophysiology and immunology. Furthermore, we argue that research with a strong focus on one central resilience mechanism may overlook or undervalue other processes that can aid in maintaining mental health.

A review on human reinstatement studies: an overview and methodological challenges.

In human research, studies of return of fear (ROF) phenomena, and reinstatement in particular, began only a decade ago and recently are more widely used, e.g., as outcome measures for fear/extinction memory manipulations (e.g., reconsolidation). As reinstatement research in humans is still in its infancy, providing an overview of its stability and boundary conditions and summarizing methodological challenges is timely to foster fruitful future research. As a translational endeavor, clarifying the circumstances under which (experimental) reinstatement occurs may offer a first step toward understanding relapse as a clinical phenomenon and pave the way for the development of new pharmacological or behavioral ways to prevent ROF. The current state of research does not yet allow pinpointing these circumstances in detail and we hope this review will aid the research field to advance in this direction. As an introduction, we begin with a synopsis of rodent work on reinstatement and theories that have been proposed to explain the findings. The review however mainly focuses on reinstatement in humans. We first describe details and variations of the experimental setup in reinstatement studies in humans and give a general overview of results. We continue with a compilation of possible experimental boundary conditions and end with the role of individual differences and behavioral and/or pharmacological manipulations. Furthermore, we compile important methodological and design details on the published studies in humans and end with open research questions and some important methodological and design recommendations as a guide for future research.

Operant conditioning of autobiographical memory retrieval.

Functional avoidance is considered as one of the key mechanisms underlying overgeneral autobiographical memory (OGM). According to this view OGM is regarded as a learned cognitive avoidance strategy, based on principles of operant conditioning; i.e., individuals learn to avoid the emotionally painful consequences associated with the retrieval of specific negative memories. The aim of the present study was to test one of the basic assumptions of the functional avoidance account, namely that autobiographical memory retrieval can be brought under operant control. Here 41 students were instructed to retrieve personal memories in response to 60 emotional cue words. Depending on the condition, they were punished with an aversive sound for the retrieval of specific or nonspecific memories in an operant conditioning procedure. Analyzes showed that the course of memory specificity significantly differed between conditions. After the procedure participants punished for nonspecific memories retrieved significantly more specific memories compared to participants punished for specific memories. However, whereas memory specificity significantly increased in participants punished for specific memories, it did not significantly decrease in participants punished for nonspecific memories. Thus, while our findings indicate that autobiographical memory retrieval can be brought under operant control, they do not support a functional avoidance view on OGM.

Empowerment implementation: enhancing fidelity and adaptation in a psycho-educational intervention.

Implementation is an emerging research topic in the field of health promotion. Most of the implementation research adheres to one of two paradigms: implementing interventions with maximum fidelity or designing interventions that are responsive to the needs of a local community. While fidelity and adaptation are often considered as contradictory, they are both essential elements of preventive interventions. An innovative program design strategy is therefore to develop hybrid programs that 'build in' adaptation to enhance program fit, while also maximizing the implementation fidelity. The present article presents guidelines for this hybrid approach to program implementation and illustrates them with a concrete psycho-educational group intervention. The approach, which is referred to as 'empowerment implementation' on the analogy of empowerment evaluation, builds on theory of implementation fidelity and community-based participatory research. To demonstrate the use of these guidelines, a psycho-educational course aimed at stress reduction and the prevention of depression and anxiety was implemented according to these guidelines. The main focus lies on how an intervention can benefit from adaptations guided by local expertise, while maintaining the core program components and still respecting the implementation fidelity.

Overgeneral autobiographical memory predicts changes in depression in a community sample.

This study investigated whether overgeneral autobiographical memory (OGM) predicts the course of symptoms of depression and anxiety in a community sample, after 5, 6, 12 and 18 months. Participants (N=156) completed the Autobiographical Memory Test and the Depression Anxiety Stress Scales-21 (DASS-21) at baseline and were subsequently reassessed using the DASS-21 at four time points over a period of 18 months. Using latent growth curve modelling, we found that OGM was associated with a linear increase in depression. We were unable to detect changes over time in anxiety. OGM may be an important marker to identify people at risk for depression in the future, but more research is needed with anxiety.

Development of a stepped care intervention model of evidence-based interventions for the management of posttraumatic stress in the Belgian Police.

Background: Police officers are frequently exposed to a wide variety of potentially traumatic events (PTE) and are therefore at a considerable risk of developing posttraumatic stress disorder (PTSD). Previous research estimated the point prevalence of PTSD in Belgian police officers at 7.4%, significantly higher than in the general population. An effective organisational strategy to manage posttraumatic stress is essential.Objective: We aimed to develop a novel organisational approach regarding traumatic stress for Belgian police, combining evidence-based strategies for the prevention and treatment of posttraumatic stress in a stepped care intervention model.Method: In a broad development process, we combined scientific literature, case studies of best practices from other police organisations with insights gathered from a number of expert panels, thematic working groups and feedback groups.Results: A comprehensive stepped care intervention model was developed, consisting of evidence-based interventions for the prevention and treatment of posttraumatic stress.Conclusions: The intervention model is a promising organisational strategy for the management of posttraumatic stress in police organisations based on evidence-based interventions. Its effectiveness will be studied in the coming years.

Police officers are at considerable risk of developing PTSD as they are consistently exposed to a wide array of PTE.An adequate organisational response to manage the consequences of this exposure as much as possible is essential.We developed a comprehensive stepped care intervention model consisting of evidence-based interventions, based on scientific literature, best practices in other police organisations, and thorough expert review.