Is it magic? An exploratory randomized controlled trial comparing imagery rescripting and cognitive restructuring in the treatment of depression.

BACKGROUND AND OBJECTIVES: To investigate whether working with intrusive images and the use of imagery processes would be beneficial to treating depression, an imagery-based intervention (imagery rescripting, IR) was compared with a more commonly used verbal-based technique (cognitive restructuring, CR). The study aimed not only to test the efficacy of IR as a brief modular treatment for depression, but to explore whether such experiential use of imagery would alleviate the abstract-evaluative, verbal processes of rumination and worry. METHODS: Forty-one participants diagnosed with clinical depression and who also reported intrusive images underwent one assessment session of imagery properties before they were randomly assigned to an IR group or to an active control group of CR. They then received three weekly sessions of treatment, and outcomes were measured before and after treatment, as well as at two-month follow-up. RESULTS: The results showed that IR was equally if not more effective than CR in alleviating depression. Significant differential reductions in rumination, worry and experiential avoidance between treatments added support to the technique's experiential nature, and possibly, a defusing out of an abstract-evaluative mode of processing. LIMITATIONS: Only self-report measures were used, with a small number of treatment sessions by one clinician. CONCLUSIONS: The findings support the therapeutic potential of imagery modalities in the treatment of depression, which compared to cognitive restructuring, appear to bring about more significant emotional change with time (clinical trial registered at the Joint CUHK-NTEC CREC Ref. No. 2015.458).

Factor analysis and validation of a self-report measure of impaired fear inhibition.

Difficulties with inhibiting fear have been associated with the emergence of anxiety problems and poor response to cognitive-behavioural treatment. Fear inhibition problems measured using experimental paradigms involving aversive stimuli may be inappropriate for vulnerable samples and may not capture fear inhibition problems evident in everyday life. We present the Fear Inhibition Questionnaire (FIQ), a self-report measure of fear inhibition abilities. We assess the FIQ's factor structure across two cultures and how well it correlates with fear inhibition indices derived experimentally. Adolescent participants from Hong Kong and England completed the FIQ, with the English participants also completing a conditioning and extinction task to assess fear inhibition problems. Across both cultures, the FIQ showed a single factor structure and low FIQ scores, or worse fear inhibition problems, were associated with self-reports of heightened anxiety. Correlation of FIQ scores with experimental indices, whilst controlling for anxious symptoms, suggests that the FIQ represents a valid and unique measure of fear inhibition abilities. The FIQ might be used to assess more ecologically valid fear inhibition problems particularly amongst people who have or who are at risk of anxiety diagnoses.

Parental Factors Associated with Rumination Related Metacognitive Beliefs in Adolescence.

An increasing number of research studies have suggested that metacognition is associated with individuals' mental health. Specifically, metacognitive beliefs about rumination was proposed to link to the onset and maintenance of depression according to the metacognitive model of depression. The current study aimed to serve as a pilot study exploring how parents' metacognitive beliefs and parenting characteristics are associated with rumination related metacognitive beliefs in adolescents. Eighty-five parent-youth dyads were invited to complete a set of questionnaires examining their metacognitive beliefs about rumination followed by a difficult puzzle task, in which parent-adolescent interaction patterns were recorded to examine the parenting style. Results found that parents' and adolescents' positive metacognitive beliefs about rumination were significantly associated with each other. In addition, parental negativity was significantly associated with adolescents' positive metacognitive beliefs of rumination and parental over-involvement was marginally associated with adolescents' negative metacognitive beliefs of rumination. The findings highlighted the association between parental factors and adolescents' metacognitive beliefs about rumination. Implications on the prevention of adolescent's depression were discussed.

Executive Control in Depressive Rumination: Backward Inhibition and Non-inhibitory Switching Performance in a Modified Mixed Antisaccade Task.

BACKGROUND AND OBJECTIVES: The present study examines backward inhibition (BI) and non-inhibitory switching performance among depressed and healthy participants in a modified mixed antisaccade task. Specifically, sad and neutral faces were incorporated in the design to examine executive control difficulties associated with brooding trait. METHODS: Thirty-nine participants took part in the study, including 19 depressed patients and 20 healthy control subjects. Participants completed a diagnostic interview and self-report questionnaires, including the Beck Depression Inventory and Ruminative Response Scale-Brooding Subscale. They were then instructed to complete prosaccade and antisaccade trials in the pure and mixed blocks whereby eye gazes were tracked to assess inhibition and switching efficiency. RESULTS: For the switching effects, a significant group × brooding × task type interaction was found as hypothesized when multilevel modeling analysis was employed. Switching deficits associated with brooding was found to be greatest when sad faces were presented to depressed group. No significant results in BI or error rates were observed. CONCLUSION: The patterns observed suggest that as opposed to BI, set shifting difficulty associated with brooding trait may be modulated by negative mood and cognition. In future research, emotional faces other than sad faces may be used to further explore if the observations could be generalized to other affective conditions.

Relationship of health locus of control with specific health behaviours and global health appraisal: a meta-analysis and effects of moderators.

Health locus of control (HLOC) refers to beliefs regarding how one's health is influenced by oneself, others, or fate. This meta-analysis investigated whether three HLOC dimensions (internality/I-HLOC, powerful others/P-HLOC, chance/C-HLOC) were related to both specific health behaviours and global health appraisal, and whether these relationships were moderated by gender and age compositions, individualism, and power distance. Three-level mixed-effects meta-analysis was performed on studies examining the associations of HLOC with specific health behaviour (k = 76, N = 76,580, 57% women, Mage = 43.75) and global health appraisal (k = 95, N = 12,068, 57% women, Mage = 45.44), respectively. For specific health behaviour, the averaged correlations with the HLOC dimensions were generally weak (r's = -.07 to .10). However, the links between P-HLOC and exercise were moderated by all four demographic moderators, and gender composition and individualism moderated the association between the HLOC dimensions and diet. For global health appraisal, all of the averaged correlations were statistically significant (r's = -.16 to .21), except that between P-HLOC and mental quality of life. The results further showed individualism and power distance to moderate the links between the HLOC dimensions and both mental and physical quality of life, and gender composition to moderate those between these dimensions and two indicators of emotional problems (depression and anxiety).

Brief mindfulness meditation improves mental state attribution and empathizing.

The ability to infer and understand the mental states of others (i.e., Theory of Mind) is a cornerstone of human interaction. While considerable efforts have focused on explicating when, why and for whom this fundamental psychological ability can go awry, considerably less is known about factors that may enhance theory of mind. Accordingly, the current study explored the possibility that mindfulness-based meditation may improve people's mindreading skills. Following a 5-minute mindfulness induction, participants with no prior meditation experience completed tests that assessed mindreading and empathic understanding. The results revealed that brief mindfulness meditation enhanced both mental state attribution and empathic concern, compared to participants in the control group. These findings suggest that mindfulness may be a powerful technique for facilitating core aspects of social-cognitive functioning.