Biomedical subjects

John D Teasdale

Publications and source records attributed to John D Teasdale.

7 recordsLinked to original sources

PubMed2004

Adaptive and maladaptive self-focus in depression.

BACKGROUND: Studies of rumination suggest that self-focused attention is maladaptive and perpetuates depression. Conversely, self-focused attention can be adaptive, facilitating self-knowledge and the development of the alternative functional interpretations of negative thoughts and feelings on which cognitive therapy of depression depends. Increasing evidence suggests there are distinct varieties of self-focus, each with distinct functional properties. This study tested the prediction that in depressed patients brief inductions of analytical versus experiential self-focus would differentially affect overgeneral autobiographical memory, a phenomenon associated with poor clinical course. It was predicted that, relative to analytical self-focus, experiential self-focus would reduce overgeneral memory. METHODS: 28 depressed patients either thought analytically about, or focused on their momentary experience of, identical symptom-focused induction items from [Cogn. Emotion 7 (1993) 561] rumination task. Participants completed the Autobiographical Memory Test [J. Abnorm. Psychol. 95 (1986) 144] before and after self-focus manipulations. RESULTS: Experiential self-focus reduced overgeneral memory compared to analytical self-focus. Analytical and experiential self-focus did not differ in their effects on mood. LIMITATIONS: In the absence of a reference condition, only conclusions concerning the relative effects of analytical and experiential self-focus can be made. CONCLUSIONS: Results (1) support the differentiation of self-focus into distinct modes of self-attention with distinct functional effects in depression; (2) provide further evidence for the modifiability of overgeneral memory; and (3) provide further evidence for the dissociation of overgeneral memory and depressed mood. Clinically, results support the usefulness of training recovered depressed patients in adaptive experiential forms of self-awareness, as in mindfulness-based cognitive therapy.

Adaptation, Psychological↗

PubMed2004

The development of the P-CAN, a measure to operationalize the pros and cons of anorexia nervosa.

OBJECTIVE: Research has suggested that a fundamental aspect of anorexia nervosa (AN) is its egosyntonic nature, the fact that it is often valued by individuals with the disorder. The current study describes the development of the P-CAN, a quantitative measure of both positive (valued) and negative aspects of AN. METHOD: Items were derived from a previous qualitative study (Serpell, Treasure, Teasdale, & Sullivan. 1999. International Journal of Eating Disorders, 25, 177-186). Data from 233 women with AN were subjected to a principal components analysis. RESULTS: Ten subscales were identified, six describing the pros of AN and four describing the cons of the illness. DISCUSSION: The P-CAN shows good psychometric properties and should prove a useful tool for the measurement of attitudes towards AN, as well as offer insights into the maintenance of the disorder.

Anorexia Nervosa↗

PubMed2004

How does dysfunctional thinking decrease during recovery from major depression?

Decreased dysfunctional thinking in recovering depressed patents could reflect predominantly (a). reduced access to dysfunctional schemas or (b). increased metacognitive monitoring of dysfunctional schematic products. Twenty acutely depressed patients, 20 partially remitted depressed patients, and 20 controls were compared on tasks primarily reflecting one or the other of these processes. On both tasks, acutely depressed patients differed significantly from controls. Partially remitted patients resembled acutely depressed patients on the task assessing dysfunctional schema access but resembled controls on the metacognitive monitoring task. Results suggest that reduced dysfunctional thinking associated with partial remission is mediated primarily by increased metacognitive monitoring of dysfunctional cognitive products rather than reduced access to dysfunctional schemas.

Adolescent↗

PubMed2004

Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects.

Recovered recurrently depressed patients were randomized to treatment as usual (TAU) or TAU plus mindfulness-based cognitive therapy (MBCT). Replicating previous findings, MBCT reduced relapse from 78% to 36% in 55 patients with 3 or more previous episodes; but in 18 patients with only 2 (recent) episodes corresponding figures were 20% and 50%. MBCT was most effective in preventing relapses not preceded by life events. Relapses were more often associated with significant life events in the 2-episode group. This group also reported less childhood adversity and later first depression onset than the 3-or-more-episode group, suggesting that these groups represented distinct populations. MBCT is an effective and efficient way to prevent relapse/recurrence in recovered depressed patients with 3 or more previous episodes.

Attitude to Health↗

PubMed2004

Neuropsychological processing associated with recovery from depression after stereotactic subcaudate tractotomy.

OBJECTIVE: The authors compared patients who underwent stereotactic subcaudate tractotomy for depression, who were still depressed or recovered from depression, to identify therapeutic mechanisms. METHOD: Ten depressed and eight recovered psychosurgery patients, along with nine never-depressed subjects and nine who had recovered from depression with medication, completed the Iowa Gambling Task, a measure of decision making in the face of feedback. Psychosurgery patients also completed general neuropsychological testing. RESULTS: Recovered psychosurgery patients exhibited insensitivity to negative feedback on the Iowa Gambling Task compared to the other three groups. This difference between the groups remained when general neuropsychological performance was covaried out. CONCLUSIONS: These findings suggest acquired relative insensitivity to negative information as a specific mechanism mediating the antidepressant effect of stereotactic subcaudate tractotomy. Such insensitivity is not secondary to deficits in general neuropsychological functioning and is not a function of recovery from depression per se.

Adult↗

PubMed2003

Neural abnormalities during cognitive generation of affect in treatment-resistant depression.

BACKGROUND: Dysfunctions in brain regions known to be involved in affect and mood states are thought to be implicated in depression and may have a role in determining the type and symptoms of this illness. METHODS: Functional magnetic resonance imaging was used to elucidate neural correlates of cognitive generation of affect, using a previously published paradigm of evoking affect with picture-caption pairs, in patients with unipolar, treatment-resistant depression. RESULTS: Compared with control participants, patients showed relatively decreased response in the anterior cingulate (rostral; right) with both negative and positive picture-caption pairs and in the medial frontal gyrus and hippocampus (all left) with positive picture-caption pairs. They demonstrated increased response in the inferior (right) and middle temporal gyri (left) with negative picture-caption pairs, and in the parahippocampal gyrus (right), inferior frontal gyrus (left), subgenual cingulate (right), striatum (right), and brain stem (left) with positive picture-caption pairs. CONCLUSIONS: Reduced medial/middle prefrontal and hippocampal activity may account for positive affect disturbances and temporal lobe hyperactivity for negative affect disturbances in treatment-resistant depression. The results also corroborate previous observations from resting positron emission tomography studies and further elucidate the association between hypoactive rostral cingulate and nonresponsiveness to treatment in depression.

Adult↗

PubMed2002

Metacognitive awareness and prevention of relapse in depression: empirical evidence.

Metacognitive awareness is a cognitive set in which negative thoughts/feelings are experienced as mental events, rather than as the self. The authors hypothesized that (a) reduced metacognitive awareness would be associated with vulnerability to depression and (b) cognitive therapy (CT) and mindfulness-based CT (MBCT) would reduce depressive relapse by increasing metacognitive awareness. They found (a) accessibility of metacognitive sets to depressive cues was less in a vulnerable group (residually depressed patients) than in nondepressed controls; (b) accessibility of metacognitive sets predicted relapse in residually depressed patients; (c) where CT reduced relapse in residually depressed patients, it increased accessibility of metacognitive sets; and (d) where MBCT reduced relapse in recovered depressed patients, it increased accessibility of metacognitive sets. CT and MBCT may reduce relapse by changing relationships to negative thoughts rather than by changing belief in thought content.

Adult↗