self-discrepancy monitoring and its impact on depressed mood: an experimental investigation

Self-discrepancy monitoring and its impact on depressed

mood: an experimental investigation

Chiara Manfredi1,4 ,Gabriele Caselli1,2, Alina Decsei-Radu3, Francesca Fiore1, Sara Querci1, Sara Sgambati1, Daniela Rebecchi1, Giovanni M. Ruggiero1

& Sandra Sassaroli1

1 Studi Cognitivi, Cognitive Psychotherapy School, Italy2 London South Bank University, UK3 University of Oradea, Romania 4 University of Pavia, Italy

Cognitive theories of depression• There is a greater risk for depression for

people who exhibit a dispositional negative style and dysfunctional attitudes (Abramson et al., 1989; Beck 1987)

• These dysfunctional attitudes can act as latent vulnerability factors for emotional and affective disorders (Mathews & MacLeod, 1994)

Three possible forms of these dysfunctional attitudes

• Selective attentional and interpretation biases

• Chronic and embedded pessimism

• Ruminative brooding


• Selective attentional and interpretation biases:



An active and conscious direction of attention to mood-

congruent information (Mathews et al., 1996)

STRATEGIC NATURE

The tendency to distort the interpretation of specific irrelevant events in terms of personal failure, and to generalize events that hold

any semblance of negative information about the self (Beck,

1964)



• Chronic and embedded pessimism: a generalized negative outcome expectancy (Armor & Taylor, 1998); a proximal predictor of adjustment (Scheier & Carver, 1985)





• Ruminative brooding: a mode of thinking that involves repetitive and passive focus on one’s depressive symptoms as well as their causes and consequences; a cognitive risk factor for depressive mood (Nolen-Hoeksema, 1991).





These dysfunctional attitudes have been conceptualized as a reaction to negative self-related information.

Positive stimuli in depression

Difference between depressed and non-depressed individuals in emotional response to positive stimuli:• Smaller electromyographic response (Schwartz et

al., 1976)•Rating hedonic images as less pleasant and less

arousing (Dunn et al., 2004; Sloan et al., 1997, 2001)

Diminished subjective emotional response in depression refers not only to negative stimuli

Self-Discrepancy• The basis of Self-Regulation theory (Caver et al., 1999)

discrepancies between ideal and actual selves as predictors for depression

• Different attention directed to detecting signals of discrepancies in different people

• Self Discrepancy Monitoring: a strategic and voluntary allocation of attentional resources towards the monitoring of possible discrepancies between ideal and actual selves, even in positive experiences (Higgins, 1987)

It may represent a relevant process in discriminating between usual and transitional self-discrepancy experiences and the sustained negative evaluation of the self, others and future typical of depressed patients

What can SDM lead to?

• The hindering of positive emotional experiences

• The re-orientation of attention towards the negative and even less important aspects of a situation

• The influences upon conscious interpretations (discounting positive ones)

• The enhancement of the frequency of negative triggers by focusing attention on negative content and, in turn, increasing the number of negative thoughts

Distinguishing SDM from other cognitive processes

Self Discrepancy Monitoring

Negative intrusive

thoughts and memories

- Voluntary and non intrusive nature (Wells, 2008)- Not directly associated with instrumental behavior employed to control or eliminate the outcomes that can result from it (Wegner, Eich & Bjork, 1994)

Brooding- Repetitiveness - Activating stimuli - “what” vs. “why”

Pessimism- Stability over time (Carver, Scheier & Segerstrom, 2010)- Global vision and negative expectancies vs. Intentional focus and search for elements of distance between current and ideal selves

Cognitive biases - Automatic interpretations

Hypotheses

• Inducing SDM when facing a positive situation would enhance negative mood

• The effect would be more significant between depressed individuals than healthy controls

• A change in ruminative brooding would in a certain degree mediate the relationship between SDM and negative mood in both the samples

Methods• Participants:

– Italian clinical sample: 28 outpatients (19 females) with a diagnosis of moderate depression (mean = 38.8 years; SD = 12.9; range = 18-64)

– Italian non-clinical sample: 28 non-depressed subjects (19 females) recruited from general population (mean= 39.3 years; SD = 13.9; range = 21-67)

– Romanian clinical sample: 30 inpatients (15 females) with a diagnosis of severe depression (mean = 39.6 years; SD = 10.9; range = 23-57)

– Romanian non-clinical sample: 30 non-depressed subjects (14 females) recruited from general population (mean = 34.0 years; SD = 8.7; range = 21-55)

• Measures: Depression (BDI), Rumination (RRS), Pessimism (LOT-R), Negative mood and thoughts measure (NMT), Current brooding (RRS modified)

Attentional manipulationTasks were adapted from Nolen-Hoeksema and Morrow’s (1993) distraction and rumination task

1. Participants were asked to retrieve images of a positive life event for 3 minutes while keeping their eyes closed

2. Participants were asked to focus on one of two lists of audio recorded items that were presented with an interval of 20 seconds, for 8 minutes– In the experimental condition participants were asked to focus their attention

on what they felt was preventing their lives from being completely happy or satisfied in the actual moment (e.g. “focus on what is missing to fully reach your ideal goals”, “focus on what you think you should do to feel near your ideal”)

– In the control condition items suggested to focus attention on emotion, sensation and thoughts participants had in the contingent moment (e.g. “focus on what you are feeling right now”, “focus on your bodily sensations”)

Procedure• Written informed consent, SCID-II, BDI, RRS and LOT-R

AFTER ONE WEEK:

• Current brooding, negative mood and thoughts measure (Time 1)• 3 minutes of imagery retrieving and 8 minutes working through

their assigned attentional task• Current brooding, negative mood and thoughts measure (Time 2)• Open-ended question investigating what the participants thought

the study was testing • Debriefing

Results: Italian sampleResults of ANOVA

BDIGroup: F=248.06***

Group x Condition: F=.37

RRS-BGroup: F=71.83***


Current brooding

Group: F=59.00***Group x Condition: F=.93

LOT-RGroup: F=44.17***


Paired t-test for SDM condition: t(27)=-22.2; p<.05

ANCOVA between conditions with the change score of NMT between Time 1 and Time 2 as dependent variable, and change in current brooding between Time 1 and Time 2 as covariate.The effect of the conditions remained significant [F(1) = 4.90, p=.03] but change score for current brooding appeared to have a significant effect [F(1) = 9.21, p = .004], too.

The increase in depressed mood following SDM induction depended on both experimental condition and levels of current brooding.

Results of ANCOVA

NMT

Group: F=27.70***

Condition: F=10.84**

Time: F=.28

Condition x Group: F=.51

Time x Condition: F=6.91**

Time x Group: F=.40

Time x Condition x Group: F=1.86

Results: Romanian sampleResults of ANOVA

BDIGroup: F=245.24***


RRS-BGroup: F=66.93***


Current brooding

Group: F=68.05***


LOT-RGroup: F=152.98***

Group x Condition: F=2.54

Paired t-test was for the SDM condition: t(28) = -2.70, p = .01

ANCOVA between conditions with the change score of NMT between Time 1 and Time 2 as dependent variable, and change in current brooding between Time 1 and Time 2 as covariate. The effect of the conditions remained significant [F(1, 54) = 19.89, p < .001], while the impact of change score for current brooding appeared not significant.

Thus the increase in depressed mood following SDM induction was not purely dependent on the concurrent levels of brooding.

Results of ANCOVA

NMT

Group: F=5.27*

Condition: F=17.38***

Time: F=.734

Condition x Group: F=.30

Time x Condition: F=27.34***

Time x Group: F=2.42

Time x Condition x Group: F=2.34

Discussion

• SDM leads to a significant decrease in mood and to a significant increase in negative thoughts independently on the severity and presence of depressive symptoms and not purely dependently on the concurrent change in levels of brooding.

• These results may reflect the importance of the time spent in monitoring self-discrepancy, instead of the importance of the degree of discrepancy perceived by the person.

Possible SDM consequences• Direct effect: a frequent engagement in discrepancy monitoring may

lead to a reduction of positive reinforcement in everyday life, and to an impairment in self-reinforcement skills. As a consequence, even positive stimuli could become more and more perceived as triggers for a lowering of mood.

• Indirect effect: following a positive stimulus, individuals may re-orientate attention on the negative part of experience as an intermediate step for the resumption of negative attitudes (such as negative biased interpretations, pessimistic forecasts and ruminative brooding) which, in turn, can trigger negative thoughts or depressive sensations, worsening mood’s state.

• Hindering the degree of acceptance of alternative beliefs emerging from cognitive restructuring techniques. Functional beliefs could play the role of positive stimuli and act as a triggers for SDM.

Limitations

• Self-report data subject to errors in measurement

• NMT in assessing the dependent variable

• Lack of an independent check for the reliability of the SCID diagnosis

• The sampling strategy may have lead to different levels of motivation and engagement in the research process

Clinical implications

• Assessing SDM may be useful in identifying and socializing a potential maladaptive cognitive strategy that could have an impact on mood, even independently from the diagnosis of depression

• Address SDM may be beneficial for a reduction in negative emotion but also for enhancing the degree of acceptance of alternative beliefs emerging from cognitive restructuring techniques.

Future research• Deepen investigate both the SDM frequency of use

in depressed and non-depressed individuals, and the motivations or beliefs that lead people to undertake it

Understanding these aims, therapists will be able to call them into question and try to bring evidences of the maladaptive nature of SDMPatients would be able to learn how to manage the orientation of attention in a different way, and learn flexible control over it

Thank you for your attentionContact details

Dr.ssa Chiara Manfredi

Cognitive Psychotherapy School Studi Cognitivi, Modena, Italy

University of Pavia, Italy

[email protected]

[email protected]

self-discrepancy monitoring and its impact on depressed mood: an experimental investigation

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