Psychometric Properties of the Dutch Cognitive Avoidance Questionnaire.

Various psychological disorders, such as major depressive disorder and anxiety disorders, share cognitive avoidance as one of the main mechanisms underlying symptom severity and maintenance. A valid and reliable measure that covers a broad array of cognitive avoidance strategies is therefore instrumental, though currently greedily missing. The Questionnaire d'Évitement Cognitif (QEC) was developed as a comprehensive instrument measuring five cognitive avoidance strategies. The current study aimed to evaluate the psychometric properties of the Dutch Cognitive Avoidance Questionnaire (CAQ-NL) in three samples (N sample 1 = 607; N sample 2 = 357; N sample 3 = 448). Confirmatory factor analysis supported the hypothesized five-factor structure of the CAQ-NL. Reliability analysis showed good to excellent internal consistency for the CAQ-NL and its five subscales. Furthermore, Multi-Group CFA revealed that the CAQ-NL demonstrated configural and metric invariance across the three samples. Convergent validity of the CAQ-NL was supported by substantial correlations with brooding, with more cognitive avoidance being related to more brooding. In addition, cognitive avoidance was negatively associated with psychological well-being and positively with symptoms of depression and anxiety, which corroborates the instrument's concurrent validity. Moreover, the CAQ-NL was predictive of depressive symptoms six months later, supporting its predictive validity. In sum, results of the present study provide support for the validity and reliability of the CAQ-NL.

Cognitive Schemas in Placebo and Nocebo Responding: Role of Autobiographical Memories and Expectations.

PURPOSE: Placebo effects are presumed to be based on one's expectations and previous experience with regard to a specific treatment. The purpose of this study was to investigate the role of the specificity and valence of memories and expectations with regard to itch in experimentally induced placebo and nocebo itch responses. It was expected that cognitive schemas with more general and more negative memories and expectations with regard to itch contribute to less placebo itch responding. METHODS: Validated memory tasks (ie, the Autobiographical Memory Test and the Self-referential Endorsement and Recall Task) and expectation tasks (ie, Future Event Task and the Self-referential Endorsement and Recall Task) were modified for physical symptoms, including itch. Specificity and valence of memories and expectations were assessed prior to a placebo experiment in which expectations regarding electrical itch stimuli were induced in healthy participants. FINDINGS: Participants who were more specific in their memories regarding itch and who had lesser negative itch-related expectations for the future were more likely to be placebo itch responders. There were no significant differences in effects between the nocebo responders and nonresponders. IMPLICATIONS: The adapted tasks for assessing cognitive (memory and expectations) schemas on itch seem promising in explaining interindividual differences in placebo itch responding. Future research should investigate whether similar mechanisms apply to patients with chronic itch. This knowledge can be used for identifying patients who will benefit most from the placebo component of a treatment.

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.

Dysphoric students show higher use of the observer perspective in their retrieval of positive versus negative autobiographical memories.

Autobiographical memories are retrieved as images from either a field perspective or an observer perspective. The observer perspective is thought to dull emotion. Positive affect is blunted in depressed mood. Consequently, are positive events recalled from an observer perspective in depressed mood? We investigated the relationship between memory vantage perspective and depressive symptoms in a student sample. Participants completed the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986) and assessed the perspective accompanying each memory. The Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) and the Responses to Positive Affect questionnaire (RPA; Feldman, Joormann, & Johnson, 2008) were administered. The results showed a small positive association between depressive symptoms and the use of an observer perspective for positive autobiographical memories, but not for negative memories. Furthermore, comparing a subgroup with clinically significant symptom levels (dysphoric students) with non-dysphoric individuals revealed that dysphoric students used an observer perspective more for positive memories compared with negative memories. This was not the case for non-dysphoric students. The observer perspective in dysphorics was associated with a dampening cognitive style in response to positive experiences.

Current psychometric and methodological issues in the measurement of overgeneral autobiographical memory.

Autobiographical memory is a multifaceted construct that is related to psychopathology and other difficulties in functioning. Across many studies, a variety of methods have been used to study autobiographical memory. The relationship between overgeneral autobiographical memory (OGM) and psychopathology has been of particular interest, and many studies of this cognitive phenomenon rely on the Autobiographical Memory Test (AMT) to assess it. In this paper, we examine several methodological approaches to studying autobiographical memory, and focus primarily on methodological and psychometric considerations in OGM research. We pay particular attention to what is known about the reliability, validity, and methodological variations of the AMT. The AMT has adequate psychometric properties, but there is great variability in methodology across studies that use it. Methodological recommendations and suggestions for future studies are presented.

Relationship between cognitive avoidant coping and changes in overgeneral autobiographical memory retrieval following an acute stressor.

According to the functional avoidance hypothesis, overgeneral autobiographical memory, the tendency to retrieve personal memories in a less specific format, might serve an affect-regulating function. Reducing the specificity of memories of negative events may prevent individuals from re-experiencing the associated painful emotions. This cognitive avoidance strategy might not only be employed by depressed and traumatized patients, but also by healthy individuals. In the present study we tested the hypothesis that the increase in memory overgenerality induced by an acute stressor is positively correlated with habitual (cognitive) avoidant coping. Participants (N = 32) were exposed to a Trier Social Stress Test. Cognitive avoidant coping was measured at the start of the experiment by means of the Mainz Coping Inventory. Before, immediately after, and 40 min after the Trier Social Stress Test, autobiographical memory specificity was assessed by means of the Autobiographical Memory Test. Cognitive avoidant coping was significantly correlated with an increase in categoric memories from pre to immediately post stressor, but not with change in overgeneral memories from pre to 40 min post stressor. The results of the present experiment provide further support for functional avoidance as one of the mechanisms underlying overgeneral memory.

Context-dependent activation of reduced autobiographical memory specificity as an avoidant coping style.

According to the affect-regulation hypothesis (Williams et al., 2007), reduced autobiographical memory specificity (rAMS) or overgeneral memory (OGM) might be considered a cognitive avoidance strategy; that is, people learn to avoid the emotionally painful consequences associated with the retrieval of specific negative memories. Based on this hypothesis, one would predict significant negative associations between AMS and avoidant coping. However, studies investigating this prediction have led to equivocal results. In the present study we tested a possible explanation for these contradictory findings. It was hypothesized that rAMS (in part) reflects an avoidant coping strategy, which might only become apparent under certain conditions, that is, conditions that signal the possibility of 'danger.' To test this hypothesis, we assessed AMS and behavioral avoidance but experimentally manipulated the instructions. In the neutral condition, two parallel versions of the Autobiographical Memory Test (AMT) were presented under neutral instructions. In the threat condition, the first AMT was presented under neutral instructions, while the second AMT was presented under 'threat instructions.' Results showed no significant correlations between avoidance and OGM under neutral conditions but significant and markedly stronger correlations under threat conditions, with more avoidance being associated with fewer specific and more categoric memories. In addition, high avoiders showed a stronger reduction in AMS in the threat condition as compared with the neutral condition, while low avoiders showed no such difference between conditions. The data confirm that OGM can be considered as part of a broader avoidant coping style. However, more importantly, they show that, at least in nonclinical individuals, the activation of this coping style may depend on the context.

Associations between components of rumination and autobiographical memory specificity as measured by a Minimal Instructions Autobiographical Memory Test.

Clinical studies have shown that rumination functions as a mediator between overgeneral memory-the tendency to retrieve autobiographical memories in a non-specific format-and depression. Recently, rumination has been dismantled into two distinct subcomponents: reflection, which is more adaptive, and brooding, which is more maladaptive. In the present study we examined the differential relationships of these two rumination subcomponents with autobiographical memory specificity and their mediational role for the relationship between reduced memory specificity and depression in a non-clinical sample. In addition, we investigated the usefulness of a "minimal instructions" version of the Autobiographical Memory Test (AMT) to measure memory specificity in non-clinical populations. Results indicated that the use of minimal instructions can increase the AMT's sensitivity to detect reduced autobiographical memory specificity in non-clinical individuals. Further it was found that brooding, and not reflection, is significantly associated with reduced autobiographical memory specificity and functions as a mediator between reduced memory specificity and depression.

An item response theory/confirmatory factor analysis of the Autobiographical Memory Test.

The Autobiographical Memory Test (AMT) is used to assess the degree of specificity of autobiographical memory. The AMT usually contains cue words of both positive and negative valence, but it is unclear whether these valences form separate factors or not. Accordingly, confirmatory factor analysis assessed whether the AMT measures one overall factor, or whether different cue types are related to different factors. Results were consistent across three datasets (N = 333, N = 405, and N = 336). A one-factor model fitted each dataset well, which suggests that responses to positive and negative cues are related to the one construct. In addition, item response theory analyses showed that the AMT is most precise for people who score low on memory specificity. Implications for using the AMT with high-functioning samples are discussed.

Overgeneral autobiographical memory predicts diagnostic status in depression.

Major depressive disorder (MDD) is characterised by difficulties in retrieving specific autobiographical memories, with a significant propensity towards categoric memories (i.e. memories of a summary type). Previous studies have demonstrated that this overgeneral memory is a valid predictor of the course of depression, with reduced specificity being associated with worse outcome. Most of these studies have employed continuous measures of depression to assess the course of the symptoms. This study investigated whether overgeneral memory also predicts clinical status at follow-up (i.e. whether patients still meet criteria for depression). Patients who fulfilled criteria for major depressive disorder were tested shortly after admission to the hospital and were retested some weeks later. It was found that lower levels of specificity or a higher number of categoric memories were associated with a higher probability of still being diagnosed with MDD. These memory variables outperformed other relevant indices, such as depression severity, rumination, level of self-esteem and dysfunctional attitudes.