Park R J, Goodyer I M, Teasdale J D
Department of Psychiatry, University of Oxford, Warneford Hospital, UK.
J Child Psychol Psychiatry. 2004 Jul;45(5):996-1006. doi: 10.1111/j.1469-7610.2004.t01-1-00291.x.
In adults there is evidence that the affective-cognitive processes of rumination and overgeneral autobiographical memory retrieval may play a part in maintaining depression. This study investigated the effects of induced rumination as compared to distraction on mood and categoric overgeneral memory in adolescents with first episode Major Depressive Disorder (MDD), and the specificity of any effects to MDD.
Three subject groups; adolescents with first episode MDD (N = 75), non-depressed psychiatric participants (N = 26) and community controls (N = 33) were recruited. An experimental design was used, with repeated measures of 'in the moment' depressed mood and categoric overgeneral memory before and after rumination and distraction, induced on separate occasions and counterbalanced in order across participants.
In adolescents with MDD, induced rumination as compared to distraction differentially increased depressed mood. There were no significant differences in this effect between full current MDD participants and those in partial remission. This differential effect was also seen in community controls but was absent in non-MDD psychiatric participants. In addition, rumination as compared to distraction increased overgeneral memories to negative cues in MDD participants, but this increase was not significantly related to mood change, and was specific to MDD, being absent in non-MDD psychiatric and community control groups.
Experimentally induced rumination as compared to distraction increases depressed mood and negative categoric memories in adolescents with first episode MDD. These results suggest that rumination has a deleterious effect on mood and memory retrieval processes in adolescents with first episode MDD. Increased negative overgeneral memories with rumination may be a process of particular importance for adolescents with MDD rather than psychiatric disorder in general. The findings imply that strategies to interrupt ruminative processes may be helpful in minimising persistence of first episode MDD in adolescence.
在成年人中,有证据表明沉思和过度概括性自传体记忆提取的情感认知过程可能在维持抑郁状态中起作用。本研究调查了与分心相比,诱导性沉思对首次发作的重度抑郁症(MDD)青少年的情绪和分类过度概括性记忆的影响,以及这些影响对MDD的特异性。
招募了三个受试者组;首次发作MDD的青少年(N = 75)、非抑郁的精神科参与者(N = 26)和社区对照组(N = 33)。采用实验设计,在沉思和分心前后分别对“当下”的抑郁情绪和分类过度概括性记忆进行重复测量,在不同场合诱导,并在参与者中进行平衡排序。
在患有MDD的青少年中,与分心相比,诱导性沉思会使抑郁情绪有差异地增加。当前完全处于MDD状态的参与者和部分缓解的参与者在这种影响上没有显著差异。这种差异效应在社区对照组中也可见,但在非MDD精神科参与者中不存在。此外,与分心相比,沉思会增加MDD参与者对负面线索的过度概括性记忆,但这种增加与情绪变化没有显著关系,并且是MDD特有的,在非MDD精神科和社区对照组中不存在。
与分心相比,实验诱导的沉思会增加首次发作MDD青少年的抑郁情绪和负面分类记忆。这些结果表明,沉思对首次发作MDD青少年的情绪和记忆提取过程有有害影响。沉思导致负面过度概括性记忆增加可能是MDD青少年而非一般精神疾病青少年特别重要的一个过程。研究结果表明,中断沉思过程的策略可能有助于减少青少年首次发作MDD的持续时间。