Transient Autobiographical Memory Enhancement to Improve Everyday Cognitive Skills
Lead Research Organisation:
University of Cambridge
Department Name: MRC Cognition and Brain Sciences Unit
Abstract
Depression affects almost 20% of adults. If you don't experience depression yourself, it's likely that someone you care about does. The best psychological 'talking therapy' for depression is Cognitive Behavioural Therapy - commonly referred to as 'CBT'. Although CBT helps with depression, around half of people who complete a course of CBT still have depressive symptoms. This has a huge impact on the individuals' quality of life, their families, and the economy. It is therefore vitally important that we improve psychological therapies like CBT so that more people can beat depression.
One way of trying to improve CBT is to use experimental, cognitive psychology to find out what stops CBT working. Research has shown that certain styles of remembering or thinking about things interfere with how well people respond to CBT. If we can find a way to change these 'cognitive problems', then CBT should work better at shifting depression. One such cognitive problem occurs when people struggle to remember details about events from their past - what we call autobiographical memories. Being able to easily bring to mind detailed autobiographical memories is very important for a number of everyday mental skills essential to our psychological health. We need good access to detailed autobiographical memories to successfully solve everyday problems, to make accurate judgements about ourselves and the world around us, and to see both positive and negative things that might happen whenever we plan how to deal with a challenging experience (e.g., working hard to meet a deadline at work).
When someone experiences depression, the autobiographical memories they bring to mind are often very vague and broad and negative (e.g., my life has always been awful). People with depression find it very hard to reach those detailed autobiographical memories that they need to navigate everyday life, which keeps their depression going. How does this relate to CBT? Well, those everyday skills of problem-solving, sound judgement, and careful planning that require good access to autobiographical memories, are the very same skills we need in order to successfully engage with CBT. For instance, a common task in CBT for depression is to identify the negative thoughts that keep depression going (e.g., I never do well at anything) and then gather 'evidence' from the person's life to show that the thoughts aren't true (e.g. last week I cooked a nice meal). However, this evidence-gathering critically relies on being able to remember past events that contradict the thoughts. So, problems with autobiographical memory may not only keep depression going, but may also interfere with CBT that is designed to treat depression.
In this project we want to develop and test a new technique that can temporarily boosts people's ability to access their detailed autobiographical memories. We will then determine that improving autobiographical memory in this way then improves those problem-solving, judgement and planning skills that depend on autobiographical memories. Finally, we will test whether this booster technique improves depressed people's ability to do tasks that are similar to CBT, such as challenging negative thoughts. If our technique works, in the future we could provide depressed people a way to 'switch on' a detailed way of remembering things that they can use before a CBT session in order to get the most out of therapy. In this way, this project will use laboratory work with depressed volunteers to explore a new technique that could help to improve treatments for depression in the future.
Our key goals, then, are to: 1) Develop a technique to boost access to detailed autobiographical memories in depressed people; 2) Evaluate whether this memory booster technique improves both a) everyday mental skills like solving problems, and planning, and b) depressed people's ability to successfully complete the sorts of tasks that they would be asked to do in CBT.
One way of trying to improve CBT is to use experimental, cognitive psychology to find out what stops CBT working. Research has shown that certain styles of remembering or thinking about things interfere with how well people respond to CBT. If we can find a way to change these 'cognitive problems', then CBT should work better at shifting depression. One such cognitive problem occurs when people struggle to remember details about events from their past - what we call autobiographical memories. Being able to easily bring to mind detailed autobiographical memories is very important for a number of everyday mental skills essential to our psychological health. We need good access to detailed autobiographical memories to successfully solve everyday problems, to make accurate judgements about ourselves and the world around us, and to see both positive and negative things that might happen whenever we plan how to deal with a challenging experience (e.g., working hard to meet a deadline at work).
When someone experiences depression, the autobiographical memories they bring to mind are often very vague and broad and negative (e.g., my life has always been awful). People with depression find it very hard to reach those detailed autobiographical memories that they need to navigate everyday life, which keeps their depression going. How does this relate to CBT? Well, those everyday skills of problem-solving, sound judgement, and careful planning that require good access to autobiographical memories, are the very same skills we need in order to successfully engage with CBT. For instance, a common task in CBT for depression is to identify the negative thoughts that keep depression going (e.g., I never do well at anything) and then gather 'evidence' from the person's life to show that the thoughts aren't true (e.g. last week I cooked a nice meal). However, this evidence-gathering critically relies on being able to remember past events that contradict the thoughts. So, problems with autobiographical memory may not only keep depression going, but may also interfere with CBT that is designed to treat depression.
In this project we want to develop and test a new technique that can temporarily boosts people's ability to access their detailed autobiographical memories. We will then determine that improving autobiographical memory in this way then improves those problem-solving, judgement and planning skills that depend on autobiographical memories. Finally, we will test whether this booster technique improves depressed people's ability to do tasks that are similar to CBT, such as challenging negative thoughts. If our technique works, in the future we could provide depressed people a way to 'switch on' a detailed way of remembering things that they can use before a CBT session in order to get the most out of therapy. In this way, this project will use laboratory work with depressed volunteers to explore a new technique that could help to improve treatments for depression in the future.
Our key goals, then, are to: 1) Develop a technique to boost access to detailed autobiographical memories in depressed people; 2) Evaluate whether this memory booster technique improves both a) everyday mental skills like solving problems, and planning, and b) depressed people's ability to successfully complete the sorts of tasks that they would be asked to do in CBT.
Planned Impact
As this project is at the interface between experimental and clinical psychology, the findings will be of wide interest with implications for those with mental health disorders and the practitioners and systems which aim to mitigate the effect of mental illness on individuals, society, and the economy. An extensive programme of impact activities has been planned to ensure maximum impact.
INDIVIDUALS WITH DEPRESSION: Approximately 50% of individuals with mental health disorders begin cognitive therapy and are disheartened to realise that the treatment is not working for them. The results of this project will offer an explanation as to why cognitive therapy can feel so hard. More broadly, the results will demonstrate the role of memory in why individuals might find it hard to solve problems or to come up with explanations that differ from their usual, unhelpful way of seeing things. Understanding the cause of these difficulties is likely to empower individuals and improve hope in the effectiveness of psychological-based intervention. Extensive dissemination has been planned to ensure that the results reach as many depressed individuals as possible. To ensure co-production of knowledge, individuals with lived experience of depression have been involved in planning this research, and will co-facilitate dissemination of results. Ultimately, the aim of this project is to use experimental psychology to take early but vitally important steps toward improving the efficacy of psychological treatment, and thereby quality of life for the one in four individuals affected by mental illness around the world.
COMMUNITY: The results are likely to also be of interest to the families and friends of those affected by depression. In particular, further knowledge of the cognitive difficulties that depressed individuals experience will increase understanding of how their daily functioning is reduced by depression. A public Q&A session co-facilitated by individuals with loved ones with depression will enhance impact in this area.
MENTAL HEALTH CARE PRACTITIONERS: Clinicians providing psychological treatment in public, private, and not-for-profit organisations will benefit from the increased understanding that this project will provide regarding why some individuals struggle to complete cognitive-based therapy. Demonstrating the role that autobiographical memory plays in the completion of cognitive-based tasks, and in predicting psychological treatment response, will allow recommendations to be made regarding how a clinician can refine their delivery of cognitive therapy (e.g., by supplementing therapy with memory-based techniques). This will improve patient engagement, and thereby treatment response. Two training workshops for clinicians have been included in the programme of impact activities to ensure that the findings are used to this effect.
PUBLIC HEALTH SYSTEMS AND POLICY MAKERS: Improving treatment of mental health issues is a key priority for the UK government and health organisations around the world. Identifying cognitive barriers to treatment effects, and using experimental psychology to elicit the mechanisms through which these barriers impact treatment, is important if we are to improve and advance psychological intervention. In this way, this project will indicate the utility of using autobiographical memory to inform a personalised treatment approach. In such an approach, those individuals experiencing trouble with autobiographical memory retrieval could be offered adjunctive treatment techniques that can be combined with current evidence-based practice to improve treatment effects for the individual. Importantly, autobiographical memory-based techniques would offer a low-cost and low-resource addition to treatment. This work will therefore offer important implications for the role that experimental psychology can play in innovating and improving care options.
INDIVIDUALS WITH DEPRESSION: Approximately 50% of individuals with mental health disorders begin cognitive therapy and are disheartened to realise that the treatment is not working for them. The results of this project will offer an explanation as to why cognitive therapy can feel so hard. More broadly, the results will demonstrate the role of memory in why individuals might find it hard to solve problems or to come up with explanations that differ from their usual, unhelpful way of seeing things. Understanding the cause of these difficulties is likely to empower individuals and improve hope in the effectiveness of psychological-based intervention. Extensive dissemination has been planned to ensure that the results reach as many depressed individuals as possible. To ensure co-production of knowledge, individuals with lived experience of depression have been involved in planning this research, and will co-facilitate dissemination of results. Ultimately, the aim of this project is to use experimental psychology to take early but vitally important steps toward improving the efficacy of psychological treatment, and thereby quality of life for the one in four individuals affected by mental illness around the world.
COMMUNITY: The results are likely to also be of interest to the families and friends of those affected by depression. In particular, further knowledge of the cognitive difficulties that depressed individuals experience will increase understanding of how their daily functioning is reduced by depression. A public Q&A session co-facilitated by individuals with loved ones with depression will enhance impact in this area.
MENTAL HEALTH CARE PRACTITIONERS: Clinicians providing psychological treatment in public, private, and not-for-profit organisations will benefit from the increased understanding that this project will provide regarding why some individuals struggle to complete cognitive-based therapy. Demonstrating the role that autobiographical memory plays in the completion of cognitive-based tasks, and in predicting psychological treatment response, will allow recommendations to be made regarding how a clinician can refine their delivery of cognitive therapy (e.g., by supplementing therapy with memory-based techniques). This will improve patient engagement, and thereby treatment response. Two training workshops for clinicians have been included in the programme of impact activities to ensure that the findings are used to this effect.
PUBLIC HEALTH SYSTEMS AND POLICY MAKERS: Improving treatment of mental health issues is a key priority for the UK government and health organisations around the world. Identifying cognitive barriers to treatment effects, and using experimental psychology to elicit the mechanisms through which these barriers impact treatment, is important if we are to improve and advance psychological intervention. In this way, this project will indicate the utility of using autobiographical memory to inform a personalised treatment approach. In such an approach, those individuals experiencing trouble with autobiographical memory retrieval could be offered adjunctive treatment techniques that can be combined with current evidence-based practice to improve treatment effects for the individual. Importantly, autobiographical memory-based techniques would offer a low-cost and low-resource addition to treatment. This work will therefore offer important implications for the role that experimental psychology can play in innovating and improving care options.
Organisations
- University of Cambridge (Lead Research Organisation)
- UNIVERSITY OF OXFORD (Collaboration)
- University of Amsterdam (Collaboration)
- Surrey and Borders Partnership NHS Foundation Trust (Collaboration)
- Dorset Healthcare University NHS Foundation Trust (Collaboration)
- Ieso Digital Health Ltd (Collaboration)
- Ludwig Maximilian University of Munich (LMU Munich) (Collaboration)
- Medical Research Council (MRC) (Collaboration)
People |
ORCID iD |
Caitlin Hitchcock (Principal Investigator) |
Publications
Barry TJ
(2021)
The current state of memory Specificity Training (MeST) for emotional disorders.
in Current opinion in psychology
Clifford G
(2020)
Fractured Pasts: The Structure of the Life Story in Sexual-Trauma Survivors With Posttraumatic Stress Disorder.
in Clinical psychological science : a journal of the Association for Psychological Science
Clifford G
(2019)
Compartmentalization of self-representations in female survivors of sexual abuse and assault, with posttraumatic stress disorder (PTSD)
in Psychological Medicine
Clifford G
(2020)
Negative and positive emotional complexity in the autobiographical representations of sexual trauma survivors.
in Behaviour research and therapy
Clifford G
(2018)
Developing an Emotion- and Memory-Processing Group Intervention for PTSD with complex features: a group case series with survivors of repeated interpersonal trauma.
in European journal of psychotraumatology
Dalgleish T
(2023)
Transdiagnostic distortions in autobiographical memory recollection
in Nature Reviews Psychology
Elliott R
(2021)
Prevalence and predictive value of ICD-11 post-traumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single-event trauma.
in Journal of child psychology and psychiatry, and allied disciplines
Description | This project sought to determine whether improving the specificity with which individuals remembered their past might help to improve the efficacy of everyday cognitive skills such as problem solving and cognitive reappraisal, and in turn, if this would improve their ability to cope with negative events. Although we were able to develop a short-term specificity induction with improved these cognitive skills, this did not affect thoughts or feelings about negative events. |
Exploitation Route | Our results have provided important insight into the best way to use memory specificity interventions to improve mental and emotional wellbeing. We have written a review and new theoretical model, drawing upon insights from this work, which will guide future research in this area. The data has also been used to produce a machine learning algorithm for scoring memories, which can be usedin future research, and facilitate the use of memory tasks in psychological practice. |
Sectors | Healthcare |
Description | British Psychological Society Workgroup on EMDR |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Description | Career Support Fund |
Amount | £4,950 (GBP) |
Organisation | University of Cambridge |
Sector | Academic/University |
Country | United Kingdom |
Start | 07/2021 |
End | 09/2021 |
Description | Discovery Early Career Researcher Award |
Amount | $426,970 (AUD) |
Organisation | University of Melbourne |
Sector | Academic/University |
Country | Australia |
Start | 12/2021 |
End | 12/2024 |
Description | The Galton Institute Small Research Grant |
Amount | £1,000 (GBP) |
Organisation | The Galton Institute |
Sector | Learned Society |
Country | United Kingdom |
Start | 09/2019 |
End | 02/2020 |
Title | Deep learning model to code specificity of autobiographical memory |
Description | As part of the project, we trained a deep learning model to score the specificity of text based autobiographical memories. |
Type Of Material | Physiological assessment or outcome measure |
Year Produced | 2021 |
Provided To Others? | Yes |
Impact | The model outperforms the current gold standard machine learning technique developed for this purpose. In using AI, we were able to dramatically increase the amount of data evaluated - over 11 million responses - than would have been possible using human evaluators. |
Title | Autobiographical memory style and clinical outcomes following mindfulness-based cognitive therapy (MBCT) |
Description | Dataset compiling memory and clinical outcome data from seven randomised controlled trials of MBCT. |
Type Of Material | Database/Collection of data |
Year Produced | 2022 |
Provided To Others? | Yes |
Impact | Freely available dataset and accompanying code to provide demonstration of how to use individual patient data meta-analysis to analyses moderators of psychological intervention. |
URL | https://www.sciencedirect.com/science/article/pii/S0005796722000195#appsec1 |
Description | Dorset |
Organisation | Dorset Healthcare University NHS Foundation Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | Design and management of research study. |
Collaborator Contribution | Recruitment of research participants from this site, with a local collaborator assisting the research. |
Impact | none as yet |
Start Year | 2020 |
Description | Ieso Digital Health |
Organisation | IESO Digital Health Ltd |
Country | United Kingdom |
Sector | Private |
PI Contribution | Identification of research question, design of study methods, obtaining ethics approval, leading write up of journal publication. |
Collaborator Contribution | Providing large dataset (N~14,000), leading creating of machine learning techniques for use in the study. |
Impact | Data analysis ongoing. Journal publication expected late 2020-early 2021. |
Start Year | 2020 |
Description | LMU |
Organisation | Ludwig Maximilian University of Munich (LMU Munich) |
Country | Germany |
Sector | Academic/University |
PI Contribution | Designed research study, obtaining ethics approval, leading data collection, leading data analysis and write up of publication. |
Collaborator Contribution | Providing expertise in machine learning for data work. |
Impact | A small grant application (Euro 15,000) currently under review. |
Start Year | 2019 |
Description | MRC Clinical Trials Unit, University College London |
Organisation | Medical Research Council (MRC) |
Department | MRC Clinical Trials Unit |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Expertise in memory and clinical psychology. |
Collaborator Contribution | Statistical expertise contributed by the partner to the funded project. |
Impact | Hitchcock et al (2022).Autobiographical memory style and clinical outcomes following mindfulness-based cognitive therapy (MBCT): An individual patient data meta-analysis. Behavior Research and Therapy. |
Start Year | 2021 |
Description | Oxford |
Organisation | University of Oxford |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Led project. |
Collaborator Contribution | Provided data. |
Impact | Hitchcock et al. (2022). Autobiographical memory style and clinical outcomes following mindfulness-based cognitive therapy (MBCT): An individual patient data meta-analysis. Behavior Research and Therapy. |
Start Year | 2019 |
Description | SABP |
Organisation | Surrey and Borders Partnership NHS Foundation Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | Design and management of a research project. |
Collaborator Contribution | Recruitment of research participants from this site, with a local collaborator assisting the research. |
Impact | none as yet |
Start Year | 2020 |
Description | University of Amsterdam |
Organisation | University of Amsterdam |
Country | Netherlands |
Sector | Academic/University |
PI Contribution | Provided authorship on resulting publication. |
Collaborator Contribution | Contributed data to this project. |
Impact | Hitchcock et al. (2022). Autobiographical memory style and clinical outcomes following mindfulness-based cognitive therapy (MBCT): An individual patient data meta-analysis. Behavior Research and Therapy. |
Start Year | 2019 |
Description | Autobiographical Memory and Psychopathology Special Interest Meeting |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | he Special Interest Meeting in Autobiographical Memory and Psychopathology is a gathering of academics and students with an interest in how autobiographical memory is related to emotional and mental wellbeing. The conference will be held in Cambridge on the 5th and 6th of December 2019 at the MRC Cognition and Brain Sciences Unit, with a conference dinner planned on the 5th of December. This year, we are hoping to supplement the experimental, cognitive psychology research which has traditionally been presented with talks from those exploring biological or neural underpinnings of autobiographical memory. We hope this will help to integrate an understanding of autobiographical memory from biological to behavioural levels. To this end, Professor Brian Levine will make a keynote presentation on the neural correlates of autobiographical remembering, which will be followed by a short discussion session on Linking biological, psychological, and philosophical understanding of autobiographical memory. |
Year(s) Of Engagement Activity | 2019 |
URL | http://www.mrc-cbu.cam.ac.uk/conferences/simamp2019/ |
Description | Careers evening |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Undergraduate students |
Results and Impact | 40 students attended a panel discussion about careers in psychology, followed by a networking opportunity. |
Year(s) Of Engagement Activity | 2020,2021 |
Description | Departmental lecture |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Postgraduate students |
Results and Impact | 80 students and scientists attended a talk presenting my research, with an interactive Q&A for early career researchers afterwards. |
Year(s) Of Engagement Activity | 2020 |
Description | Discussion of role of memory in CBT at Ieso Digital Health |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Outlined my research and the role of autobiographical memory in CBT to clinical psychologists engaged in delivering CBT, along with NHS service leaders |
Year(s) Of Engagement Activity | 2019 |
Description | Invited lecture, Franklin Science Society |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Postgraduate students |
Results and Impact | 60 min presentation of my research to female students at the University of Cambridge |
Year(s) Of Engagement Activity | 2019 |
Description | Presentation at University of Hertfordshire |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Other audiences |
Results and Impact | 60 minute presentation of my research to clinical psychologists, trainees, and other researchers |
Year(s) Of Engagement Activity | 2019 |
Description | Presentation at the University of New South Wales (Australia) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Talk to 60 attendees in my ESRC funded research. Involved discussion after the talk, and discussion of future research collaboration. |
Year(s) Of Engagement Activity | 2020 |
Description | Public Discussion of researcher, clinicians, and service-users on the role of autobiographical memory in psychotherapy |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | This discussion session is part of an international meeting of the Autobiographical Memory and Psychopathology Special Interest Group. We would like to invite local clinicians to participate in (or observe) a conversation regarding the role of memory for personally experienced events in the therapeutic process. We will also explore how we can translate basic science towards improved clinical practice. Discussion will be led by a panel of researchers with expertise in memory and therapeutic practice, clinicians with experience treating affective disorders within the NHS, and an expert by lived experience who has completed both memory-based interventions and existing treatment options. Panel: Tim Dalgleish, Programme Leader, University of Cambridge Sarah Bateup, Clinical Director, Ieso Digital Health Melissa Black, Clinical Psychologist, NHS William Stringer, Expert by lived experience |
Year(s) Of Engagement Activity | 2019 |
Description | Seminar for postgrads |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Postgraduate students |
Results and Impact | Presentation of my research to postgraduate students |
Year(s) Of Engagement Activity | 2021 |