Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany; Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Ostbahnstr. 10, 76829 Landau, Germany.
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany; Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Ostbahnstr. 10, 76829 Landau, Germany.
J Affect Disord. 2019 May 1;250:231-240. doi: 10.1016/j.jad.2019.03.027. Epub 2019 Mar 6.
Research has shown that negative expectations in major depressive disorder (MDD) often persist despite positive disconfirming experiences. To explain this phenomenon, the concept of cognitive immunization has been introduced: that is, individuals with MDD reappraise disconfirming positive evidence in such a way that negative expectations are maintained. In this study, we examined whether it is possible to inhibit cognitive immunization to facilitate expectation update.
We examined 113 people with MDD being treated in an inpatient psychosomatic hospital. Using a previously validated paradigm, participants worked on a standardized performance test; we examined changes in negative performance-related expectations after positive expectation-disconfirming feedback. One experimental group received additional information increasing the value of the positive feedback ('INFORMATION'). Another group was instructed to recall the feedback after completing the task ('RECALL'). In a third group, participants' attention was shifted to potential expectation-disconfirming feedback ('ATTENTION'). In addition, a control group underwent the standard procedure of the paradigm.
The results showed significant group differences in the change in generalized performance expectations, with the largest changes in participants from the INFORMATION group. All experimental groups had lower values for cognitive immunization than the control group.
Given that this proof-of-concept study was the first to examine strategies to inhibit cognitive immunization, the findings need to be replicated in future studies.
The present study confirms that cognitive immunization in MDD can be inhibited, thus facilitating adjusting negative expectations. The most promising results were found for the INFORMATION group, providing information to emphasize the relevance of expectation-disconfirming information.
研究表明，尽管有积极的否定经验，重度抑郁症（MDD）患者的负面预期往往仍然存在。为了解释这一现象，引入了认知免疫的概念：即 MDD 患者以维持负面预期的方式重新评估否定的积极证据。在这项研究中，我们检验了是否有可能抑制认知免疫以促进预期更新。
我们检查了 113 名在身心医院住院治疗的 MDD 患者。使用以前验证的范式，参与者在标准化的表现测试上工作；我们检查了积极的预期否定反馈后的负面表现相关预期的变化。一个实验组收到了增加积极反馈价值的附加信息（“信息”）。另一个组被指示在完成任务后回忆反馈（“回忆”）。在第三个组中，参与者的注意力被转移到潜在的预期否定反馈上（“注意力”）。此外，对照组接受了范式的标准程序。
结果显示，在一般表现预期的变化方面，各组之间存在显著差异，信息组的参与者变化最大。与对照组相比，所有实验组的认知免疫水平都较低。
鉴于这项概念验证研究是首次检验抑制认知免疫的策略，因此需要在未来的研究中复制这些发现。
本研究证实，MDD 中的认知免疫可以被抑制，从而促进负面预期的调整。信息组的结果最有希望，提供信息强调了预期否定信息的相关性。
