Unraveling how the adolescent brain deals with criticism using dynamic causal modeling.

Sensitivity to criticism, which can be defined as a negative evaluation that a person receives from someone else, is considered a risk factor for the development of psychiatric disorders in adolescents. They may be more vulnerable to social evaluation than adults and exhibit more inadequate emotion regulation strategies such as rumination. The neural network involved in dealing with criticism in adolescents may serve as a biomarker for vulnerability to depression. However, the directions of the functional interactions between the brain regions within this neural network in adolescents are still unclear. In this study, 64 healthy adolescents (aged 14 to 17 years) were asked to listen to a series of self-referential auditory segments, which included negative (critical), positive (praising), and neutral conditions, during fMRI scanning. Dynamic Causal Modeling (DCM) with Parametric Empirical Bayesian (PEB) analysis was performed to map the interactions within the neural network that was engaged during the processing of these segments. Three regions were identified to form the interaction network: the left pregenual anterior cingulate cortex (pgACC), the left dorsolateral prefrontal cortex (DLPFC), and the right precuneus (preCUN). We quantified the modulatory effects of exposure to criticism and praise on the effective connectivity between these brain regions. Being criticized was found to significantly inhibit the effective connectivity from the preCUN to the DLPFC. Adolescents who scored high on the Perceived Criticism Measure (PCM) showed less inhibition of the preCUN-to-DLPFC connectivity when being criticized, which may indicate that they required more engagement of the Central Executive Network (which includes the DLPFC) to sufficiently disengage from negative self-referential processing. Furthermore, the inhibitory connectivity from the DLPFC to the pgACC was strengthened by exposure to praise as well as criticism, suggesting a recruitment of cognitive control over emotional responses when dealing with positive and negative evaluative feedback. Our novel findings contribute to a more profound understanding of how criticism affects the adolescent brain and can help to identify potential biomarkers for vulnerability to develop mood disorders before or during adulthood.

Dose-dependent response of prefrontal transcranial direct current stimulation on the heart rate variability: An electric field modeling study.

Transcranial direct current stimulation (tDCS) of the prefrontal cortex (PFC) modulates the autonomic nervous system by activating deeper brain areas via top-down pathway. However, effects on the nervous system are heterogeneous and may depend on the amount of current that penetrates. Therefore, we aimed to investigate the variable effects of tDCS on heart rate variability (HRV), a measure of the functional state of the autonomic nervous system. Using three prefrontal tDCS protocols (1.5, 3 mA and sham), we associated the simulated individual electric field (E-field) magnitude in brain regions of interest with the HRV effects. This was a randomized, double-blinded, sham-controlled and within-subject trial, in which healthy young-adult participants received tDCS sessions separated by 2 weeks. The brain regions of interest were the dorsolateral PFC (DLPFC), anterior cingulate cortex, insula and amygdala. Overall, 37 participants were investigated, corresponding to a total of 111 tDCS sessions. The findings suggested that HRV, measured by root mean squared of successive differences (RMSSD) and high-frequency HRV (HF-HRV), were significantly increased by the 3.0 mA tDCS when compared to sham and 1.5 mA. No difference was found between sham and 1.5 mA. E-field analysis showed that all brain regions of interest were associated with the HRV outcomes. However, this significance was associated with the protocol intensity, rather than inter-individual brain structural variability. To conclude, our results suggest a dose-dependent effect of tDCS for HRV. Therefore, further research is warranted to investigate the optimal current dose to modulate HRV.

Parental criticism affects adolescents' mood and ruminative state: Self-perception appears to influence their mood response.

Feeling and/or being criticized is a known risk factor for various psychiatric disorders in adolescents. However, the link between the experience of social stressors and the development of psychopathological symptoms is not yet fully understood. Identifying which adolescent subgroups are more vulnerable to parental criticism could be of great clinical relevance. In this study, 90 nondepressed 14- to 17-year-old adolescents were exposed to a sequence of auditory segments with a positive, neutral, and finally negative valence, mirroring parental criticism. Their mood and ruminative states were assessed before and after exposure to criticism. We observed an overall increase in mood disturbance and ruminative thoughts. Self-perception appeared to influence these mood changes, whereas no significant influence by perceived criticism, self-worth, or the general tendency to ruminate was found. Emotional awareness seemed to account for some of the variance in positive mood state changes. These findings point to the importance of adolescent self-perception (and emotional awareness) in dealing with parental criticism.

Hostility in medication-resistant major depression and comorbid generalized anxiety disorder is related to increased hippocampal-amygdala 5-HT2A receptor density.

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are severe and difficult-to-treat psychiatric illnesses with high rates of comorbidity. Although both disorders are treated with serotonergic based psychotropic agents, little is known on the influence of the serotonergic neurotransmitter system on the occurrence of comorbid GAD when clinically depressed. To investigate this poorly understood clinical question, we examined the involvement of frontolimbic post-synaptic 5-HT2A receptors in 20 medication-resistant depressed (MRD) patients with half of them diagnosed with comorbid GAD with 123I-5-I-R91150 SPECT. To explore whether 5-HT2A receptor-binding indices (BI) associated with comorbid GAD could be related to distinct psychopathological symptoms, all were assessed with the symptom Checklist-90-Revised (SCL-90-R). MRD patients with comorbid GAD displayed significantly higher 5-HT2A receptor BI in the hippocampal-amygdala complex, compared to MRD patients without GAD. Correlation analyses revealed that the 5-HT2A receptor BI in these areas were significantly related to the SCL-90-R subscale hostility (HOS), especially for those MRD patients with comorbid GAD. Comorbid MRD-GAD may be characterized with increased hippocampal-amygdala 5-HT2A receptor BI which could represent enhanced levels in hostility in such kinds of patients. Adapted psychotherapeutic interventions may be warranted.

The link between resting heart rate variability and affective flexibility.

The neurovisceral integration model aims to account for the complex interplay between physiological, cognitive, and emotion regulation processes through their support by common cortico-subcortical neural circuits. According to the model, vagally mediated heart rate variability (HRV) serves as a peripheral index of the functioning of these circuits, with higher levels of resting HRV reflecting more optimal functioning, to support goal-directed behaviour and adaptability to environmental demands. Although increased cognitive flexibility has been related to higher resting HRV, this has not been assessed in the context of emotional information to examine the interplay between cognition and emotion. Therefore, we investigated (n = 109) the relationship between resting HRV and performance on a task-switching paradigm in which participants shift attention between affective and nonaffective aspects of emotional material. Resting HRV was not associated with flexibility in processing of positive material, but more efficient shifting of attention (greater flexibility) from affective to nonaffective aspects of negative information was related to lower resting HRV. The avoidance theory of worry and anxiety, as well as empirical evidence, links anxiety to attentional avoidance of negative information. Our findings therefore support the neurovisceral integration model such that when greater flexibility can facilitate attentional avoidance of negative information-as seen in anxiety-it is related to lower resting HRV.

Cortisol response to stress: The role of expectancy and anticipatory stress regulation.

An exacerbated physiological response to stress is associated with the development of stress-related disorders (e.g., depression and anxiety disorders). Recently, it has been proposed that individuals with high expectancies of being able to deal with stressful situations will activate regulatory mechanisms during the anticipation of the stressful event that would improve stress regulation. To test this hypothesis, 52 women in young adulthood (M = 21.06; SD = 2.58) anticipated and performed a laboratory-based stress task after receiving positive or negative bogus feedback on their abilities to deal with stressful events. Heart rate variability and salivary cortisol were assessed throughout the experimental protocol. Participants receiving positive bogus feedback (i.e., High Expectancy group) showed a more positive anticipatory cognitive stress appraisal (i.e., they anticipated the stress task as less threatening/challenging, and they perceived that they were more able to deal with it), and they showed a lower cortisol response to stress. Moreover, a more positive anticipatory cognitive stress appraisal was associated with better anticipatory stress regulation (indexed as less decrease in heart rate variability), leading to a lower cortisol response. Our results indicate that people with positive expectancy initiate mechanisms of anticipatory stress regulation that enhance the regulation of the physiological stress response. Expectancy and anticipatory stress regulation may be key mechanisms in the development and treatment of stress-related disorders.

The effect of HF-rTMS over the left DLPFC on stress regulation as measured by cortisol and heart rate variability.

The prefrontal cortex, and especially the Dorsolateral Prefrontal Cortex (DLPFC), plays an inhibitory role in the regulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis under stressful situations. Moreover, recent evidence suggests that a sustained DLPFC activation is associated with adaptive stress regulation in anticipation of a stressful event, leading to a reduced stress-induced amygdala response, and facilitating the confrontation with the stressor. However, studies using experimental manipulation of the activity of the DLPFC before a stressor are scarce, and more research is needed to understand the specific role of this brain area in the stress-induced physiological response. This pre-registered study investigated the effect on stress regulation of a single excitatory high frequency (versus sham) repetitive transcranial magnetic stimulation (HF-rTMS) session over the left DLPFC applied before the Trier Social Stress Test in 75 healthy young women (M = 21.05, SD = 2.60). Heart rate variability (HRV) and salivary cortisol were assessed throughout the experimental protocol. The active HF-rTMS and the sham group showed a similar cognitive appraisal of the stress task. No differences in HRV were observed during both the anticipation and the actual confrontation with the stress task and therefore, our results did not reflect DLPFC-related adaptive anticipatory adjustments. Importantly, participants in the active HF-rTMS group showed a lower cortisol response to stress. The effect of left prefrontal HF-rTMS on the stress system provides further critical experimental evidence for the inhibitory role played by the DLPFC in the regulation of the HPA axis.

Bifrontal tDCS applied to the dorsolateral prefrontal cortex in heavy drinkers: Influence on reward-triggered approach bias and alcohol consumption.

Even though the ventromedial neural network (reward pathway) has been well documented to be a mediator for increased craving, the prefrontal cortex is receiving ever more attention for craving monitoring. In the current study, we examined whether causal modulation of the prefrontal cortex, and its associated neural network, diminishes reward-triggered approach bias (due to increased cognitive control), alcohol craving and consumption. Using a double-blind within-subjects design in a subclinical group of forty-five heavy drinkers, a single sham controlled session of bilateral transcranial direct current stimulation (tDCS) was applied to the dorsolateral prefrontal cortex (DLPFC). Following real and sham tDCS placing the anode over the right and cathode over the left DLPFC, a rewarded Go/NoGo paradigm was administrated to provoke behavioral biases (irrespective of the task goal) After the cognitive paradigm, alcohol consumption was examined using a beer taste test. Bifrontal tDCS resulted in a reduced reward-triggered approach bias and reduced alcohol consumption, but not self-reported craving. Interestingly, reward-triggered approach bias and alcohol consumption were reliably associated in the sham condition, but not in the tDCS condition. Reward-trigged approach biases might be a cognitive mechanism associated with alcohol prone behavior, and the role of the prefrontal network may be significant.

Cognitive remediation following electroconvulsive therapy in patients with treatment resistant depression: randomized controlled trail of an intervention for relapse prevention - study protocol.

BACKGROUND: Major depressive episode (MDE) is worldwide one of the most prevalent and disabling mental health conditions. In cases of persistent non-response to treatment, electroconvulsive therapy (ECT) is a safe and effective treatment strategy with high response rates. Unfortunately, longitudinal data show low sustained response rates with 6-month relapse rates as high as 50% using existing relapse prevention strategies. Cognitive side effects of ECT, even though transient, might trigger mechanisms that increase relapse in patients who initially responded to ECT. Among these side effects, reduced cognitive control is an important neurobiological driven vulnerability factor for depression. As such, cognitive control training (CCT) holds promise as a non-pharmacological strategy to improve long-term effects of ECT (i.e., increase remission, and reduce depression relapse). METHOD/DESIGN: Eighty-eight patients aged between 18 and 70 years with MDE who start CCT will be included in this randomized controlled trial (RCT). Following (partial) response to ECT treatment (at least a 25% reduction of clinical symptoms), patients will be randomly assigned to a computer based CCT or active placebo control. A first aim of this RCT is to assess the effects of CCT compared to an active placebo condition on depression symptomatology, cognitive complaints, and quality of life. Secondly, we will monitor patients every 2 weeks for a period of 6 months following CCT/active placebo, allowing the detection of potential relapse of depression. Thirdly, we will assess patient evaluation of the addition of cognitive remediation to ECT using qualitative interview methods (satisfaction, acceptability and appropriateness). Finally, in order to further advance our understanding of the mechanisms underlying effects of CCT, exploratory analyses will be conducted using video footage collected during the CCT/active control phase of the study. DISCUSSION: Cognitive remediation will be performed following response to ECT, and an extensive follow-up period will be employed. Positive findings would not only benefit patients by decreasing relapse, but also by increasing acceptability of ECT, reducing the burden of cognitive side-effects. TRIAL REGISTRATION: The study is registered with ClinicalTrials.gov . Study ID: NCT04383509 Trial registration date: 12.05.2020.

Flexibility as a Mediator between Personality and Well-Being in Older and Younger Adults: Findings from Questionnaire Data and a Behavioral Task.

BACKGROUND: Personality is a predictor of subjective well-being in older and younger adults, but less is known about the underlying mechanisms. One possible mechanism is psychological flexibility, which is the ability to keep an open mind-set in order to make flexible choices adapted to the situation at hand. METHODS: We recruited 60 younger and 60 older adults and measured personality and well-being by questionnaires. To assess psychological flexibility we used questionnaires and a behavioral task assessing flexibility in information acquisition when making choices. RESULTS: Based on indirect effect analysis of the questionnaire data, in line with former research, our data show that in both age groups, the relationship between personality and well-being runs through psychological flexibility. CONCLUSION: This implies that training psychological flexibility may be a promising approach to increase well-being in both older and younger adults. This effect could not be demonstrated with our choice flexibility task, thus more research is needed to uncover why this could not be measured at the behavioral level.

Abnormal approach-related motivation but spared reinforcement learning in MDD: Evidence from fronto-midline Theta oscillations and frontal Alpha asymmetry.

Major depression is characterized by abnormal reward processing and reinforcement learning (RL). This impairment might stem from deficient motivation processes, in addition to reduced reward sensitivity. In this study, we recorded 64-channel EEG in a large cohort of major depressive disorder (MDD) patients and matched healthy controls (HC) while they performed a standard RL task. Participants were asked to discover, by trial and error, several hidden stimulus-response associations having different reward probabilities, as enforced using evaluative feedback. We extracted induced fronto-midline Theta (FMT) power time-locked to the response and feedback as neurophysiological index of RL. Furthermore, we assessed approach-related motivation by measuring frontal alpha asymmetry concurrently. At the behavioral level, MDD patients and HCs showed comparable RL. At the EEG level, FMT power systematically varied as a function of reward probability, with opposing effects found at the response and feedback levels. Although this global pattern was spared in MDD, at the feedback level these patients showed however a steep FMT power decrease across trials when reward probability was low. Moreover, they showed impaired approach-related motivation during task execution, as reflected by frontal Alpha asymmetry. These results suggest a dissociation between (globally spared) RL and (impaired) approach motivation in MDD.

How is personality related to well-being in older and younger adults? The role of psychological flexibility.

OBJECTIVES: Personality is known to be a reliable predictor of well-being. However, it is rather difficult to influence the personality of individuals in order to improve their well-being. Therefore, it is important to examine possible underlying mechanisms or indirect effects. Consequently, the aim of the current study was to investigate whether psychological flexibility is a mechanism explaining the relationship between personality and well-being. Given the evidence that age-related differences exist in personality, flexibility, and well-being, we also investigated whether our indirect effects model differed in both older and younger adults. DESIGN: We used a cross-sectional design. SETTING: Participants were asked to fill in questionnaires at home. PARTICIPANTS: We recruited 138 younger (25-50 years) and 120 older (65+) adults from a community-dwelling population. MEASUREMENTS: Self-report questionnaires were used to assess (mal)adaptive personality traits (Big Five), psychological flexibility, and affective and general subjective well-being. RESULTS: Similar indirect effects were found in older and younger adults: Psychological flexibility is a mechanism explaining the link between personality and well-being. In nearly half of the models, psychological flexibility even fully accounted for the effect of personality on well-being. CONCLUSION: These results have important implications for clinical practice, since psychological flexibility, contrary to personality traits, is malleable. Interventions to increase psychological flexibility already exist and are validated in both older and younger samples. They may hold promise to improve well-being.

Attachment-related attention bias plays a causal role in trust in maternal support.

The current study was designed to test whether children's ability to flexibly shift their attention (from their mother during distress to peers during exploration and vice versa) causally increases children's trust in the mother's support. We trained attention flexibility using a gaze-contingent music reward design. A total of 85 children (9-13 years of age; 46% boys) were randomly assigned to this training or a comparable yoked control condition. Attentional preferences were measured via eye tracking. Before and after the manipulation, we measured self-reported trust. Results showed that the training condition increased children's attention flexibility. Training-related increased attentional focus on the mother during distress was linked with increased trust.

From trust in caregivers' support to exploration: The role of openness to negative affect and self-regulation.

Attachment theory assumes that trust in caregivers' support and exploration are closely related. Little research tried to investigate this link, nor focuses on mechanisms that might explain this association. The present studies examined whether trust is related to exploration through a serial indirect effect of openness to negative affect and self-regulation. In Study 1, 212 children, aged 8-13, completed questionnaires assessing trust, openness to negative affect, self-regulation and exploration. The results showed that trust predicted exploration, but only to the extent to which openness to negative affect and self-regulation were involved too. Study 2 refined these findings (n = 59, aged 9-12) using a behavioral measure of openness to negative affect and exploration, and with mother-reported self-regulation. Replicating this serial indirect effect of openness to negative affect and self-regulation with multiple informants and methods, the present studies advance our understanding of how trust might foster exploration in preadolescence.

Integration of reward with cost anticipation during performance monitoring revealed by ERPs and EEG spectral perturbations.

Effort expenditure has an aversive connotation and it can lower hedonic feelings. In this study, we explored the electrophysiological correlates of the complex interplay of reward processing with cost anticipation. To this aim, healthy adult participants performed a gambling task where the outcome (monetary reward vs. no-reward) and its expectancy were manipulated on a trial by trial basis while 64-channel EEG was recorded. Crucially, on some trials, the no-reward outcome could be transformed to a rewarding one, pending effort expenditure by means of an orthogonal dot clicking task, enabling us to compare at the electrophysiological level reward processing when cost was anticipated or not. We extracted and compared different markers of reward processing at the feedback level using both classical ERPs and EEG spectral perturbations in specific bands (theta, delta and beta-gamma). At the behavioral level, participants reported enhanced pleasure and relief when the outcome was rewarding but effort expenditure could be avoided, relative to a control condition where the outcome was rewarding but no extra effort was anticipated. In this condition, EEG results showed a larger Reward Positivity ERP component and increased power in the Delta and Beta-gamma bands. By comparison, cost anticipation did not influence the processing of the no-reward outcome at the FRN and frontal midline theta levels. All together, these neurophysiological results suggest that effort avoidance is associated with increased reward processing.

One MRI-compatible tDCS session attenuates ventromedial cortical perfusion when exposed to verbal criticism: The role of perceived criticism.

Transcranial direct current stimulation (tDCS) is a potential treatment strategy for mood and anxiety disorders, but how this application may influence emotional processes, and whether this is related to individual characteristics, is not well understood. It has been proposed that perceived criticism (PC) may represent a vulnerability factor for the development of such mental illnesses. To decipher whether neural mechanisms of action of tDCS potentially differ depending on PC status (low vs. high), we evaluated mood and brain perfusion before and after applying MRI-compatible tDCS, and after participants were exposed to verbal criticism in the scanner. Experimental design 30 healthy nondepressed females were included in a sham-controlled crossover MRI-compatible tDCS study. Brain perfusion was measured by means of arterial spin labeling (ASL) before and after tDCS applied to the left dorsolateral prefrontal cortex (DLPFC), and after hearing criticism. Before the experiment, all participants provided a rating of PC in their closest environment. Principal observations at the behavioral level, criticism made participants angrier. This was unrelated to the active or sham stimulation. After being criticized, females scoring high on PC had significantly decreased brain perfusion in the pregenual anterior cingulate cortex (pgACC) and medioprefrontal cortex (mPFC), after active tDCS but not sham. The decrease in pgACC/mPFC perfusion points to a significant impact of tDCS in brain areas related to stress responses and self-referential processes, especially in females scoring high on PC, which has been shown to be related to vulnerability for mood and anxiety disorders.

Neurocognitive mechanisms behind emotional attention: Inverse effects of anodal tDCS over the left and right DLPFC on gaze disengagement from emotional faces.

BACKGROUND: Attention to relevant emotional information in the environment is an important process related to vulnerability and resilience for mood and anxiety disorders. In the present study, the effects of left and right dorsolateral prefrontal cortex (i.e., DLPFC) stimulation on attentional mechanisms of emotional processing were tested and contrasted. METHODS: A sample of 54 healthy participants received 20 min of active and sham anodal transcranial direct current stimulation (i.e., tDCS) either of the left (n = 27) or of the right DLPFC (n = 27) on two separate days. The anode electrode was placed over the left or the right DLPFC, the cathode over the corresponding contra lateral supraorbital area. After each neurostimulation session, participants completed an eye-tracking task assessing direct processes of attentional engagement towards and attentional disengagement away from emotional faces (happy, disgusted, and sad expressions). RESULTS: Compared to sham, active tDCS over the left DLPFC led to faster gaze disengagement, whereas active tDCS over the right DLPFC led to slower gaze disengagement from emotional faces. Between-group comparisons showed that such inverse change patterns were significantly different and generalized for all types of emotion. CONCLUSIONS: Our findings support a lateralized role of left and right DLPFC activity in enhancing/worsening the top-down regulation of emotional attention processing. These results support the rationale of new therapies for affective disorders aimed to increase the activation of the left over the right DLPFC in combination with attentional control training, and identify specific target attention mechanisms to be trained.

Can training change attentional breadth? Failure to find transfer effects.

Recently, there is increasing interest in the causal relationship between attentional breadth and emotion regulation. To test this causal relationship, attentional breadth needs to be manipulated stringently. The aim of the current research was to establish whether visual attentional breadth could be manipulated through experimental training procedures. We conducted two single-session training experiments and one multiple-session training experiment, all of which contained pre- and post-training assessments to test the direct transfer effects of training on attentional breadth construed in different measures. For the first single-session training (Experiment 1), no training effects were found to transfer to the subsequent attentional breadth measures in terms of global-local processing preference. For the second single-session training (Experiment 2) and the 5-day training (Experiment 3) which combined both trainings from Experiment 1 and 2, there were some indications that attentional breadth can be decreased, but there was no evidence that it could be increased neither in terms of global-local processing preference nor in terms of scope of visual perception. Bayesian analysis confirmed the null hypothesis of no increase in attentional breadth through delivery of these training procedures. Therefore, our findings do not support the hypothesis that training variants of the Global-Local attentional breadth task or of the visuospatial attentional breadth task can stably alter attentional breadth in healthy students. Possible explanations and implications are discussed.

The Role of Interference and Inhibition Processes in Dysphoric Early Adolescents.

Cognitive theories emphasize the importance of attentional biases in the development and maintenance of depression. Noteworthy, recent studies indicate that depression-related biases only occur in later stages of attentional processing. This is consistent with the idea that attention is a multicomponent process, consisting of at least two mechanisms: selection and inhibition. Therefore, this study aims to investigate interference and inhibition toward angry and happy stimuli in dysphoric adolescents compared to nondysphoric adolescents. To examine interference and inhibition of emotional information in 21 dysphoric (17 girls) and 28 nondysphoric adolescents (17 girls), 10-16 years of age, a Negative Affective Priming task was used. In this task, a target has to be evaluated as positive or negative while ignoring a distractor. As expected, dysphoric adolescents showed both higher interference from and higher inhibition of angry stimuli relative to nondysphoric adolescents. In contrast, happy stimuli did not lead to interference and consequently did not have to be inhibited in either group. Finally, a positive relation was found between interference and the subsequent inhibition of emotional stimuli. These observations confirm the existence of a bias toward angry faces in dysphoric adolescents and indicate a higher inhibition of angry faces in dysphoric adolescents compared to nondysphoric adolescents. The obtained results are different from those of similar previous studies in depressed or dysphoric adults using sad faces or negatively valenced words and might reveal important emotion-specific or age-specific inhibitory biases.

Positive memory enhancement training for individuals with major depressive disorder.

When in a negative mood state, individuals with major depressive disorder (MDD) may have difficulties recalling positive autobiographical memories in a manner that repairs that negative mood. Using cognitive bias modification techniques, investigators have successfully altered different aspects of cognition among individuals with MDD. However, little has been done to investigate the modification of positive autobiographical memory recall. This study examined the impact of a novel positive memory enhancement training (PMET) on the memories and subjective affective experiences of individuals with MDD (N = 27). Across a series of trials, participants first recalled a sad memory to elicit a negative mood state. They then recalled a happy memory and completed procedures to elicit a vivid, here-and-now quality of the memory. PMET procedures were hypothesized to promote mood repair via the recall of increasingly vivid and specific positive memories. PMET participants demonstrated improved memory specificity and greater perceived ability to "relive" positive memories. The procedures also repaired mood; PMET participants' affect following recall of positive memories did not differ from control participants' affect following recall of neutral memories. Results provide preliminary support for PMET as a method to improve the quality of positive memories and facilitate emotion regulation in MDD.