Preliminary clinical and cost effectiveness of augmented depression therapy versus cognitive behavioural therapy for the treatment of anhedonic depression (ADepT): a single-centre, open-label, parallel-group, pilot, randomised, controlled trial.

Background: Anhedonia (reduced interest/pleasure) symptoms and wellbeing deficits are core to depression and predict a poor prognosis. Current depression psychotherapies fail to target these features adequately, contributing to sub-optimal outcomes. Augmented Depression Therapy (ADepT) has been developed to target anhedonia and wellbeing. We aimed to establish clinical and economic proof of concept for ADepT and to examine feasibility of a future definitive trial comparing ADepT to Cognitive Behavioural Therapy (CBT). Methods: In this single-centre, open-label, parallel-group, pilot randomised controlled trial, adults meeting diagnostic criteria for a current major depressive episode, scoring ≥10 on the Patient Health Questionnaire (PHQ-9) and exhibiting anhedonic features (PHQ-9 item 1 ≥ 2) were recruited primarily from high intensity Improving Access to Psychological Therapy (IAPT) service waiting lists in Devon, UK. Participants were randomised to receive 20 sessions of CBT or ADepT, using a mimimisation algorithm to balance depression severity and antidepressant use between groups. Treatment was delivered in an out-patient university-based specialist mood disorder clinic. Researcher-blinded assessments were completed at intake and six, 12, and 18 months. Co-primary outcomes were depression (PHQ-9) and wellbeing (Warwick Edinburgh Mental Wellbeing Scale) at 6 months. Primary clinical proof-of-concept analyses were intention to treat. Feasibility (including safety) and health economic analyses used complete case data. This trial is registered at the ISRCTN registry, ISRCTN85278228. Findings: Between 3/29/2017 and 7/31/2018, 82 individuals were recruited (102% of target sample) and 41 individuals were allocated to each arm. A minimum adequate treatment dose was completed by 36/41 (88%) of CBT and 35/41 (85%) of ADepT participants. There were two serious adverse events in each arm (primarily suicide attempts; none of which were judged to be trial- or treatment-related), with no other evidence of harms. Intake and six-month primary outcome data was available for 37/41 (90%) CBT participants and 32/41 (78%) ADepT participants. Between-group effects favoured ADepT over CBT for depression (meanΔ = -1.35, 95% CI = -3.70, 1.00, d = 0.23) and wellbeing (meanΔ = 2.64, 95% CI = -1.71, 6.99, d = 0.27). At 18 months, the advantage of ADepT over CBT was preserved and ADepT had a >80% probability of cost-effectiveness. Interpretation: These findings provide proof of concept for ADepT and warrant continuation to definitive trial. Funding: NIHR Career Development Fellowship.

Daily relationships among maternal rumination, mood and bonding with infant.

There is little research examining the association between maternal maladaptive emotion regulation strategies such as rumination and perceived maternal bonding and mood. This study investigated the concurrent and prospective relationship of both trait and daily rumination with daily perceived maternal bonding and mood. Ninety-three mothers of infants aged between 3 and 14 months completed a ten-day diary study investigating the relationship between daily and trait ruminative self-focus, negative affect and perceived maternal bonding, or her perceived feelings of closeness with her infant. The majority of mothers reported mild to moderate depressive symptoms. The data were analysed using Hierarchical Linear Modelling. Baseline depressive symptoms and trait rumination were each positively associated with mean levels of daily ruminative self-focus and mood over the ten-day sampling period. Bonding with infant at baseline was not associated with mean levels of daily rumination, mood or bonding over the sampling period. Concurrently, daily rumination and daily bonding were negatively correlated, after accounting for daily mood. Prospectively, lower levels of daily bonding predicted increases in daily rumination and depressive mood on the subsequent day. Interestingly, daily rumination did not predict increases in depressive mood or bonding on the subsequent day, suggesting that rumination occurred in response to perceived disruptions in feelings of closeness with the infant, but did not lead to prospective decreases in these feelings of closeness. These findings hold important implications for understanding the relationship between the mother-infant relationship, and maternal rumination and depressive mood, suggesting that disruptions in the way mothers perceive they are bonding to their infants may contribute to depressongenic processes.

Emerging ecophenotype: reward anticipation is linked to high-risk behaviours after sexual abuse.

Adolescents frequently engage in high-risk behaviours (HRB) following childhood sexual abuse (CSA). Aberrant reward processes are implicated in HRB, and their underlying fronto-striatal networks are vulnerable to neurodevelopmental changes during adversity representing a promising candidate for understanding links between CSA and HRB. We examined whether fronto-striatal responses during reward anticipation and feedback (i) are altered in depressed adolescents with CSA compared to depressed, non-abused peers and (ii) moderate the relationship between CSA and HRB irrespective of depression. Forty-eight female adolescents {14 with CSA and depression [CSA + major depressive disorder (MDD)]; 17 with MDD but no CSA (MDD); 17 healthy, non-abused controls} completed a monetary reward task during functional magnetic resonance imaging. No differences in fronto-striatal response to reward emerged between CSA + MDD and MDD. Critically, high left nucleus accumbens activation during reward anticipation was associated with greater HRB in CSA + MDD compared to MDD and controls. Low left putamen activation during reward feedback was associated with the absence of HRB in CSA + MDD compared to MDD. Striatal reward responses appear to play a key role in HRB for adolescents with CSA irrespective of depression, providing initial support for a CSA ecophenotype. Such information is pivotal to identify at-risk youth and prevent HRB in adolescents after CSA.

"If It Goes Horribly Wrong the Whole World Descends on You": The Influence of Fear, Vulnerability, and Powerlessness on Police Officers' Response to Victims of Head Injury in Domestic Violence.

Domestic violence (DV) victims face significant barriers to accessing healthcare. This is particularly concerning in cases of brain injury (BI), which is difficult to diagnose and risks severe long-term consequences for DV victims. Police may be able to identify head injury (HI) and signpost victims to healthcare. This research investigated potential barriers to police supporting victim health needs by exploring police attitudes towards DV and considering how police interpret and respond to stories of HI in DV victims. Individual interviews were conducted with 12 police officers from forces in South and Central England. This included the use of a clinical vignette. Thematic analysis highlighted three global themes: 'seesaw of emotions', 'police vulnerability', and 'head injury is fearful'. Police officers' vulnerability to external blame was the predominant influence in their responses to HI.

Working memory updating training reduces state repetitive negative thinking: Proof-of-concept for a novel cognitive control training.

Repetitive negative thinking (RNT) is a proximal risk factor implicated in the onset and maintenance of common mental health problems such as depression and anxiety. Adolescence may be a key developmental window in which to target RNT and prevent the emergence of such disorders. Impairments in updating the contents of working memory are hypothesised to causally contribute to RNT, and some theorists have suggested these difficulties may be specific to the manipulation of negative information. The present study compared the effects of computerised adaptive working memory updating training (in which the task becomes more difficult as performance improves) to a non-adaptive control task in reducing levels of RNT. 124 healthy young people were randomised to 20 sessions of (i) working memory updating training using neutral stimuli, (ii) working memory updating training using negative stimuli, or (iii) non-adaptive working memory updating training. Adaptive working memory updating training using neutral, but not negative, stimuli resulted in significant improvements to working memory updating for negative material, as assessed using an unpractised task, and significant reductions in susceptibility to state RNT. These findings demonstrate proof-of-concept that working memory updating training has the potential to reduce susceptibility to episodes of state RNT.

Self-Regulatory Goal Motivational Processes in Sustained New Year Resolution Pursuit and Mental Wellbeing.

Recent research suggests people typically "give up" pursuing their New Year resolutions within the first month. The present study investigated goal features proposed to be implicated in promoting both mental wellbeing and sustained New Year resolution pursuit. Australian and UK participants (n = 182) took part in an online longitudinal study, including four timepoints over a two-month period. At baseline, participants listed the New Year resolution to which they were most committed, and completed self-report measures to assess mental wellbeing, goal flexibility and tenacity. At the follow-up surveys, participants completed the wellbeing measure and their New Year resolution commitment, effort and stickability. As predicted, flexibility predicted wellbeing across time, however, tenacity did not. Counter to prediction, neither flexibility nor tenacity reported at baseline predicted "sticking" with one's New Year resolution. The predicted interaction between flexibility and tenacity was not significant. New Year resolutions focused predominantly on "diet" and "exercise" were predominantly the same resolutions previously pursued and tended to be relatively abstract. Although goal flexibility predicted greater wellbeing, the findings overall tend to support the view that people are not particularly good at sticking with their New Year resolutions. Implications of the findings are discussed.

Short-term affective consequences of specificity of rumination about unresolved personal goals.

BACKGROUND AND OBJECTIVES: Rumination is a form of repetitive thinking that has been associated with both helpful and unhelpful consequences for mood and self-regulation. It has been suggested that the specificity of ruminative thought content may be one factor that determines whether state rumination about personal goals is adaptive. The present study tested the hypothesis that state rumination about unresolved personal goals is associated with unhelpful affective consequences only when rumination is low in specificity. METHODS: We measured the extent and specificity of uninstructed rumination following the cueing of resolved and unresolved personal goals using a 30-min go/no-go task with thought probes. Changes in state positive and negative affect from before to after cueing goals, and before to after rumination during the go/no-go task were assessed. RESULTS: Cueing unresolved goals resulted in a significant increase in negative affect, and subsequent affective recovery during the go/no-go task. Cueing unresolved goals resulted in more goal-focused rumination than cueing resolved goals. When ruminative thoughts were low in specificity, rumination mediated the association between goal discrepancies and negative affect: greater rumination about unresolved goals significantly impaired affective recovery and perpetuated negative affect. LIMITATIONS: The findings await replication in clinical populations, where rumination is more commonly associated with unhelpful outcomes. CONCLUSIONS: Greater levels of goal-focused rumination were associated with unhelpful affective consequences only when rumination was low in specificity. Specificity of thought content may be an important determinant of whether goal-focused rumination has helpful or unhelpful effects.

Evaluating Augmented Depression Therapy (ADepT): study protocol for a pilot randomised controlled trial.

BACKGROUND: While existing psychological treatments for depression are effective for many, a significant proportion of depressed individuals do not respond to current approaches and few remain well over the long-term. Anhedonia (a loss of interest or pleasure) is a core symptom of depression which predicts a poor prognosis but has been neglected by existing treatments. Augmented Depression Therapy (ADepT) has been co-designed with service users to better target anhedonia alongside other features of depression. This mixed methods pilot trial aims to establish proof of concept for ADepT and to examine the feasibility and acceptability of a future definitive trial evaluating the clinical and cost-effectiveness of ADepT, compared to an evidence-based mainstream therapy (Cognitive Behavioural Therapy; CBT) in the acute treatment of depression, the prevention of subsequent depressive relapse, and the enhancement of wellbeing. METHODS: We aim to recruit 80 depressed participants and randomise them 1:1 to receive ADepT (15 weekly acute and 5 booster sessions in following year) or CBT (20 weekly acute sessions). Clinical and health economic assessments will take place at intake and at 6-, 12-, and 18-month follow-up. Reductions in PHQ-9 depression severity and increases in WEMWBS wellbeing at 6-month assessment (when acute treatment should be completed) are the co-primary outcomes. Quantitative and qualitative process evaluation will assess mechanism of action, implementation issues, and contextual moderating factors. To evaluate proof of concept, intake-post effect sizes and the proportion of individuals showing reliable and clinically significant change on outcome measures in each arm at each follow-up will be reported. To evaluate feasibility and acceptability, we will examine recruitment, retention, treatment completion, and data completeness rates and feedback from patients and therapists about their experience of study participation and therapy. Additionally, we will establish the cost of delivery of ADepT. DISCUSSION: We will proceed to definitive trial if any concerns about the safety, acceptability, feasibility, and proof of concept of ADepT and trial procedures can be rectified, and we recruit, retain, and collect follow-up data on at least 60% of the target sample. TRIAL REGISTRATION: ISCRTN85278228, registered 27/03/2017.

Trajectories of Change in a Group Behavioral Activation Treatment for Severe, Recurrent Depression.

Depression is a common and costly problem. Behavioral Activation (BA) is an effective treatment for depression when delivered 1:1, but group treatments often do not perform as well as 1:1 treatments. One way to begin to understand how group treatments perform is to assess the process of change during treatment. This study examined trajectories of change across 10-session group BA for individuals with severe, chronic, or recurrent forms of depression. We also tested whether individuals who had associated sudden gains or depression spikes had better outcomes than those who did not have these change patterns. We examined psychological and sociodemographic predictors of the patterns of change. Participants were 104 individuals who met diagnostic criteria for major depressive disorder and participated in one of 10 BA groups, provided over a 2-year period. A linear, but not quadratic or cubic, rate of change fit the data and the effect size for the change in mood symptoms from baseline to posttreatment was large, Cohen's d = 1.25. Although 34% (26 of the 77 who provided outcome data) of individuals had a sudden gain and 10% (7/77) had a depression spike, neither sudden gains nor depression spikes predicted posttreatment outcomes. None of the demographic or psychological factors (rumination, behavioral activation) predicted the pattern of change. These results suggest that although group BA may help to reduce depressive symptoms in individuals with severe, recurrent, and/or chronic forms of depression, the overall linear pattern of change is different from quadratic patterns of change reported for 1:1 BA.

Children's emotion understanding in relation to attachment to mother and father.

Although attachment plays a key role in children's socio-emotional development, little attention has been paid to the role of children's attachment to their father. This study examined whether insecure attachment to each parent was associated with reduced emotion understanding in children and whether children showed consistent attachments to their mother and father. We measured children's attachment to each parent using the Manchester Child Attachment Story Task and child emotion understanding using the Test of Emotion Comprehension (children's Mage  = 5.64 years, SD = 0.84). The results indicated that insecure father-child attachment and insecure mother-child attachment were each associated with lower emotion understanding in children after controlling for parent's depressive symptoms and children's age. There was significant concordance of child attachment to mother and father. The findings provide support for convergence of children's attachment across parents and suggest that father-child attachment is an important factor to consider when examining children's emotion understanding. Statement of contribution What is already known on this subject Secure mother-child attachment is positively associated with children's emotional competence. Children form similar representations of attachment to their mother and father. What the present study adds Both mother-child and father-child attachment are associated with children's emotion understanding. The study's findings highlight the importance of father-child attachment in their children's emotion understanding. The study provides support for concordance of children's attachment across parents.

Parental depressive symptoms, children's emotional and behavioural problems, and parents' expressed emotion-Critical and positive comments.

This longitudinal study examined whether mothers' and fathers' depressive symptoms predict, independently and interactively, children's emotional and behavioural problems. It also examined bi-directional associations between parents' expressed emotion constituents (parents' child-directed positive and critical comments) and children's emotional and behavioural problems. At time 1, the sample consisted of 160 families in which 50 mothers and 40 fathers had depression according to the Structured Clinical Interview for DSM-IV. Children's mean age at Time 1 was 3.9 years (SD = 0.8). Families (n = 106) were followed up approximately 16 months later (Time 2). Expressed emotion constituents were assessed using the Preschool Five Minute Speech Sample. In total, 144 mothers and 158 fathers at Time 1 and 93 mothers and 105 fathers at Time 2 provided speech samples. Fathers' depressive symptoms were concurrently associated with more child emotional problems when mothers had higher levels of depressive symptoms. When controlling for important confounders (children's gender, baseline problems, mothers' depressive symptoms and parents' education and age), fathers' depressive symptoms independently predicted higher levels of emotional and behavioural problems in their children over time. There was limited evidence for a bi-directional relationship between fathers' positive comments and change in children's behavioural problems over time. Unexpectedly, there were no bi-directional associations between parents' critical comments and children's outcomes. We conclude that the study provides evidence to support a whole family approach to prevention and intervention strategies for children's mental health and parental depression.

Does fathers' and mothers' rumination predict emotional symptoms in their children?

OBJECTIVES: Although rumination can have a negative influence on the family environment and the quality of parent-child interactions, there is little research on the role of parental rumination in predicting adverse child outcomes over time. This longitudinal study examined whether mothers' and fathers' brooding rumination would each uniquely predict emotional symptoms in preschool children. METHODS: The initial sample consisted of 160 families (including 50 mothers with past depression, 33 fathers with past depression, and 7 fathers with current depression according to the Structural Clinical Interview for DSM-IV). Families were seen at two times separated by 16 months. Children's mean age at the entry into the study was 3.9 years (SD = 0.8). Each parent independently completed the Ruminative Response Scale, the Child Behavior Checklist, the Patient Health Questionnaire, and the Dyadic Adjustment Scale. RESULTS: Fathers' brooding rumination significantly predicted children's emotional symptoms over 16 months when controlling for child emotional symptoms, couple adjustment, parents' depressive symptoms, mothers' brooding and reflective rumination, and fathers' reflective rumination at baseline. Unexpectedly, mothers' brooding rumination did not significantly predict child emotional symptoms over time. Correlational analyses showed significant associations between parents' rumination and lower levels of couple adjustment. CONCLUSIONS: Findings suggest that fathers' brooding rumination may play a unique role in their children's emotional outcomes. If these findings are replicated, studies should examine the processes by which these links occur and their implications for clinical interventions. PRACTITIONER POINTS: Rumination is prevalent among individuals with depression, but to date no studies have examined the possible role of mothers' and fathers' brooding rumination in predicting children's emotional symptoms. Fathers' brooding rumination was positively associated with children's emotional symptoms over time when controlling for mothers' rumination and other important characteristics. Parental rumination might be a promising target for both prevention and intervention strategies for parents with depression and their children. The findings of this study could inform parenting interventions (e.g., educate parents about the possible effects of rumination on family interactions and children's outcomes, help parents notice when they ruminate, teach them to replace rumination with more adaptive strategies). The findings should be interpreted with caution. The study relied on self-reports, and therefore, the data are subject to shared method variance which may have artificially inflated associations between parent and child outcomes. The sample consisted of well-educated parents, and therefore, the findings should be generalized to other populations with caution.

Goal Fluency, Pessimism and Disengagement in Depression.

Despite the development of prominent theoretical models of goal motivation and its importance in daily life, research has rarely examined goal dysregulation processes in clinical depression. Here we aimed to investigate problematic aspects of goal regulation in clinically depressed adults, relative to controls. Depressed participants (n = 42) were recruited from two Improving Access to Psychological Therapy clinics in north-west England. Control participants (n = 51) were recruited from the same region. Participants generated personal approach goals (e.g., improve my marathon time) and avoidance goals (e.g., avoid getting upset over little things) and completed self-report measures of goal attainment likelihood and depressive symptoms. Participants also completed a measure of ease of disengagement from unattainable goals and re-engagement with new goals. Compared to controls, depressed participants reported fewer approach goals (but not more avoidance goals), rated their approach goal (rewarding) outcomes as less likely to happen and avoidance goal (threatening) outcomes as more likely to happen. Depressed participants also reported greater ease of disengagement from unattainable goals and more difficulty re-engaging with new goals than controls. Our findings extend current knowledge of the psychopathology of depression from a goal regulation perspective, suggesting that pessimism around goal pursuit accompanies fewer approach goal pursuits and a general tendency to disengage when difficulties are encountered.

Unique associations between anxiety, depression and motives for approach and avoidance goal pursuit.

This study investigated the shared and distinct associations between depressive and anxious symptoms and motives for pursuing personal goals. One hundred and thirty-six undergraduates generated approach and avoidance goals and rated each on intrinsic, identified, introjected and external motives. Anxious and depressive symptoms showed significant unique associations with distinct motives. Specifically, depressive symptoms predicted significant unique variance in intrinsic motivation for approach goals (but not avoidance goals), whereas anxious symptoms predicted significant unique variance in introjected regulation for approach and avoidance goals. Some of these findings were moderated by gender. The findings broadly support the notion that depression is uniquely characterised by reduced enjoyment of approach goal pursuit whereas anxiety is uniquely characterised by pursuit of goals in order to avoid negative outcomes. We suggest that these findings are compatible with regulatory focus theory and suggest that motives for goal pursuit are important in understanding the relation between goals and specific mood disorder symptoms.

Reduced specificity of personal goals and explanations for goal attainment in major depression.

OBJECTIVES: Overgeneralization has been investigated across many domains of cognitive functioning in major depression, including the imagination of future events. However, it is unknown whether this phenomenon extends to representations of personal goals, which are important in structuring long-term behaviour and providing meaning in life. Furthermore, it is not clear whether depressed individuals provide less specific explanations for and against goal attainment. METHOD: Clinically depressed individuals and controls generated personally important approach and avoidance goals, and then generated explanations why they would and would not achieve these goals. Goals and causal explanations were subsequently coded as either specific or general. RESULTS: Compared to controls, depressed individuals did not generate significantly fewer goals or causal explanations for or against goal attainment. However, compared to controls, depressed individuals generated less specific goals, less specific explanations for approach (but not avoidance) goal attainment, and less specific explanations for goal nonattainment. SIGNIFICANCE: Our results suggest that motivational deficits in depression may stem partly from a reduction in the specificity of personal goal representations and related cognitions that support goal-directed behaviour. Importantly, the findings have the potential to inform the ongoing development of psychotherapeutic approaches in the treatment of depression.

Experimentally modifying interpretations for positive and negative social scenarios in children: a preliminary investigation.

BACKGROUND: Past research suggests that socially anxious individuals display a tendency to interpret ambiguous and clearly valenced information in a threatening way. Interpretation training programs, in which individuals are trained to endorse benign rather than negative interpretations of ambiguous social scenarios, have proven effective for reducing anxiety-related cognitive biases. However, it is not clear whether the same paradigms are effective in modifying interpretation biases for clearly valenced social information. METHOD: In this experiment, a group of unselected children (aged 10-13 years) was trained to endorse the more positive of two possible interpretations of mildly negative and positive social events. RESULTS: Data revealed that this group (n = 77) showed a decrease in catastrophic interpretations and an increase in neutral interpretations of mildly negative events compared to children in a no-training control group (n = 76). Furthermore, participants in the training condition showed an increase in positive interpretations and a trend for a decrease in discounting interpretations of positive events. However, training did not affect emotional ratings of mildly negative and positive events or trait social anxiety. CONCLUSIONS: Notwithstanding certain limitations of this pilot study, we believe that the results are promising with regard to modifying interpretative biases for clearly valenced vignettes, and that further study regarding the effects of training on mood is warranted.

Goal internalization and outcome expectancy in adolescent anxiety.

Anxiety has been conceptualized in terms of increased avoidance motivation and higher expectancies of undesirable outcomes. However, anxiety research has hitherto not examined an important qualitative aspect of motivation: the degree to which reasons for goal pursuit are experienced as controlling and originating outside the core self. We asked 70 adolescents (34 boys, 36 girls; aged 16-18 years) to list their important approach and avoidance goals, and rate the extent to which they pursued each goal for intrinsic, identified, introjected and external reasons. Participants also rated goal importance, expectancies for goal outcomes, and completed an anxious symptom measure. Broadly in line with predictions, anxiety was significantly associated with introjected reasons for pursuing approach goals and external reasons for pursuing avoidance goals but not with autonomous reasons for goal pursuit. As predicted, anxiety was significantly associated with heightened expectancies of undesirable avoidance goal outcomes, but not with expectancies for desirable approach goal outcomes. Results suggest that the salient role of avoidance-based motivation in anxiety extends to introjected reasons underlying approach goal pursuit. Our findings point to the theoretical and clinical importance of addressing controlled reasons for goal pursuit in adolescent anxiety.

Comparing imagery and verbal instructions for the experimental modification of interpretation and judgmental bias in children.

BACKGROUND AND OBJECTIVES: Using an interpretation training paradigm, previous research has demonstrated that it is possible to modify interpretation biases in socially anxious children and that trained interpretation bias affects important aspects of social anxiety (Vassilopoulos, Banerjee, & Prantzalou, 2009). The current experiment was designed to replicate and extend the results reported by Vassilopoulos et al. (2009). METHODS: In a benign interpretation training paradigm, descriptions of ambiguous hypothetical events were presented in a form requiring participants to endorse the more benign of two interpretations. Ninety-four primary school children aged between 10 and 12 years were asked to either imagine these hypothetical events or to read the same descriptions while thinking about their verbal meaning. RESULTS: Participants in the verbal instructions condition showed greater decreases in negative interpretations and negative emotional consequences of ambiguous events from pre-training to post-training than did those in the imagery instructions condition. Additionally, children in the verbal instructions condition reported a significant decrease in trait social anxiety as well as in their self-reported tendency to discount positive information compared with children in the imagery instructions condition. LIMITATIONS: The results should be considered in the light of the exclusive use of self-report measures and the small effect sizes observed in some analyses. CONCLUSIONS: These findings suggest that interpretation training in children can be effective with verbal instructions and highlight the need for further investigation of how to optimize the effectiveness of interpretation training in children.

When the ends outweigh the means: mood and level of identification in depression.

Research in healthy controls has found that mood influences cognitive processing via level of action identification: happy moods are associated with global and abstract processing; sad moods are associated with local and concrete processing. However, this pattern seems inconsistent with the high level of abstract processing observed in depressed patients, leading Watkins (2008, 2010) to hypothesise that the association between mood and level of goal/action identification is impaired in depression. We tested this hypothesis by measuring level of identification on the Behavioural Identification Form after happy and sad mood inductions in never-depressed controls and currently depressed patients. Participants used increasingly concrete action identifications as they became sadder and less happy, but this effect was moderated by depression status. Consistent with Watkins' (2008) hypothesis, increases in sad mood and decreases in happiness were associated with shifts towards the use of more concrete action identifications in never-depressed individuals, but not in depressed patients. These findings suggest that the putatively adaptive association between mood and level of identification is impaired in major depression.

Depressed people are not less motivated by personal goals but are more pessimistic about attaining them.

Despite its theoretical importance, personal goal motivation has rarely been examined in clinical depression. Here we investigate whether clinically depressed persons (n = 23) differ from never-depressed persons (n = 26) on number of freely generated approach and avoidance goals, appraisals of these goals, and reasons why these goals would and would not be achieved. Participants listed approach and avoidance goals separately and generated explanations for why they would (pro) and would not (con) achieve their most important approach and avoidance goals, before rating the importance, likelihood, and perceived control of goal outcomes. Counter to hypothesis, depressed persons did not differ from never-depressed controls on number of approach or avoidance goals, or on the perceived importance of these goals. However, compared to never-depressed controls, depressed individuals gave lower likelihood judgments for desirable approach goal outcomes, tended to give higher likelihood judgments for undesirable to-be-avoided goal outcomes, and gave lower ratings of their control over goal outcomes. Furthermore, although controls generated significantly more pro than con reasons for goal achievement, depressed participants did not. These results suggest that depressed persons do not lack valued goals but are more pessimistic about their likelihood, controllability, and reasons for successful goal attainment.