A Randomised Controlled Clinical Trial of Memory Specificity Training (MEST) for Depression

Study Overview
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Brief Summary
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Depression involves the tendency to recall overgeneral personal memories, a phenomenon which has been linked to numerous adverse psychological outcomes. The purpose of this study is to investigate whether a group-based Memory Specificity Training (MEST) programme improves outcomes in depression, and how this compares to an education and support control group. The primary aim is to examine whether MEST, which involves repeated practice retrieving specific autobiographical memories reduces depressive symptoms immediately post-treatment, and whether this is maintained 3 months after treatment. The secondary objective of this trial is to examine the role of hypothesised cognitive processes (ie., rumination, executive control, cognitive avoidance) which may underlie improvements in depression and memory.

Official Title
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A Randomised Controlled Clinical Trial of Memory Specificity Training (MEST) for Depression

Conditions
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Major Depressive Disorder, Depressive Symptoms

Intervention / Treatment
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* Behavioral: Memory Specificity Training
* Behavioral: Education and Support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Principal diagnosis of Major Depressive Disorder History of more than one previous depressive episode Current diagnosis of a Major Depressive Episode Depressive symptoms rated in the mild-severe range (> 13 on the BDI-II) Memory specificity < .70 (as assessed on the AMT) Exclusion Criteria: Head trauma Organic brain damage Secondary diagnosis of another affective disorder Psychosis Current drug or alcohol abuse or dependence A diagnosed Axis II disorder

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Memory Specificity Training<br>Five weekly one-hour sessions of memory specificity training administered in groups of 5-8 participants. | Behavioral: Memory Specificity Training<br>* This intervention is a manualised, structured treatment delivered over 5 x 60 minute sessions to groups of 5-8 individuals. This treatment involves repeated practice of retrieving specific autobiographical memories in response to positive, negative and neutral cue words. There is a single psychoeducation component in the first session about memory difficulties common in depression which provides the rationale for this treatment. The training is supplemented by weekly homework practice.<br>|
| Active Comparator: Education and Support<br>Five weekly one-hour sessions of an education-and-discussion supportive intervention, administered in groups of 5-8 participants. | Behavioral: Education and Support<br>* The education-and-support comparison condition is matched with the experimental arm for length and format (ie., 5 x 60 minute weekly sessions in groups of 5-8 individuals). Groups receive a single psychoeducation component where information about depression is provided. This is followed by non-directive support where participants are encouraged to raise different kinds of events that occur each week for discussion in the group. The sessions are supplemented by a homework diary where participants will be invited to note down an event that occurs each day, which may be positive, negative, or benign and non-emotional in nature. This material will provide the basis for discussion in the weekly group meetings.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in depressive symptoms on the Beck Depression Inventory II (BDI-II) | Symptom severity score | Change from baseline to 3 months post-treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in depressive status according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - IV (SCID-IV) | Presence of a current Major Depressive Episode (MDE) | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment, and 6-months post-treatment (6-month follow-up for MEST group only) | 
| Change from baseline in autobiographical memory specificity on Autobiographical Memory Test (AMT) | Memory specificity level | Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment | 
| Change from baseline in depressive symptoms as measured on the BDI-II | Symptom severity score | Change from baseline to post-treatment (approximately 6-weeks) | 
| Depression free days following treatment according to the Longitudinal Follow-up Evaluation on the SCID-IV | Number of depression-free days | Post-treatment and 3-month and 6-month follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Memory specificity training, Autobiographical memory, Major depressive disorder