Impairments in retrieving event-level, specific autobiographical memories, termed overgeneral memory (OGM), are recognised as a feature of clinical depression. A previous meta-analytic review assessing how OGM predicts the course of subsequent depressive symptoms showed small effects for correlations and regression analyses when baseline depressive symptoms were controlled for. We aimed to update this study and examine whether their findings replicate given the decade of research that has been published since. A systematic literature review using the same eligibility criteria as the previous meta-analysis led to a doubling of eligible studies (32 v. 15). The results provided more precise estimates of effect sizes, and largely support the finding that OGM predicts the course of depressive symptoms. The effects were generally small, but significantly larger among clinical samples, compared to studies with non-clinical samples. There was some evidence that higher age was associated with stronger effects, and longer follow-up was associated with weaker effects. The findings on other moderating variables that were analysed were mixed. Continued research into this modifiable cognitive process may help to provide an avenue to better understand and treat highly prevalent and impactful depressive disorders.

Impairments in retrieving event-level, specific autobiographical memories, termed overgeneral memory (OGM) are recognised as a feature of clinical depression. A previous meta-analytic review (Sumner, Griffith, & Mineka, 2010) assessing how OGM predicts the course of subsequent depressive symptoms showed small, but robust effects for correlations and regression analyses when baseline depressive symptoms were controlled for. We aimed to update this study and examine whether their findings replicate given the decade of research that has been published since. A systematic literature review using the same eligibility criteria as the previous meta-analysis lead to a doubling of eligible studies (31 vs. 15). The results provided more precise estimates of effect sizes, and largely support the finding that OGM predicts the course of depressive symptoms. The effects were generally small, but significantly larger among clinical samples, compared to studies with non-clinical samples. Higher age was associated with stronger effects, while longer follow-up with associated with weaker effects. The findings on other moderating variables that were analysed were mixed. Continued research into this modifiable cognitive process may help to provide an avenue to better understand and treat highly prevalent and impactful depressive disorders.

Background Improving future thinking, such as characteristics of specificity, detail, and use of mental imagery, may be one means to reduce anhedonia, particularly in a Major Depressive Episode (MDE) in which future thinking is impaired. The current study aimed to test this using a validated program, Future Event Specificity Training (FEST). Methods Participants (N = 177; 80.8% women; M age = 43.7, SD = 11.8) with a current depressive episode with anhedonia and high symptom severity were randomized to FEST or no FEST. Future thinking, anhedonia-related variables, and other clinical outcomes were assessed at baseline, one- and three-month follow-up. Results Relative to the control group, FEST was associated with significantly improved future thinking characteristics, a reduced likelihood of anhedonia (35.1% vs. 61.1%, p = .015), improvements on other anhedonia-related variables such as anticipatory (d = 0.63, p = .004) and anticipated pleasure for future events (d = 0.77, p < .001), and desirable clinical outcomes such as less people meeting criteria for an MDE (37.8% vs. 64.8%, p = .011), higher behavioural activation (d = 0.71, p = .001) and improved global functioning (d = 0.52, p = .017). Changes in future thinking were found to mediate the effect of FEST on anhedonia. Conclusion The quality of future thinking can be enhanced in Major Depression, and this leads to a substantially reduced likelihood of anhedonia, other significant clinical effects, and functional gains.

Difficulty in accessing specific memories, referred to as reduced memory specificity or overgeneral memory, has been established as a marker of clinical depression. However, it is not clear if this deficit persists following the remission of depressive episodes. The current study involved a systematic review and meta-analysis of empirical studies with the aim of establishing whether remitted depression was associated with retrieving fewer specific and more overgeneral autobiographical memories. Seventeen studies were identified as eligible.The results indicated that people with remitted depression recalled fewer specific memories (k = 15; g = -0.314, 95% CI[-0.543; -0.085], z = -2.69, p = .007) and more categoric memories (k = 9; g = 0.254, 95% CI[0.007; 0.501], z = 2.02, p = .043) compared to people who had never been depressed. Given that these deficits have elsewhere been shown to be prognostic of future depressive symptoms, these findings provide further evidence that reduced memory specificity/overgeneral memory appears to be a risk factor for future episodes of depression in those that are in remission. The findings are discussed in terms of how this knowledge might influence clinical understanding of relapse prevention and maintenance of remission in those with a history of depression.

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Objective: Memory Specificity Training (MeST) improves the recall of past personal experiences, an impairment in Major Depressive Disorder (MDD). Extending on previous findings that computerised MeST (c-MeST) improves memory specificity and depressive symptoms in adults, this study aimed to answer two questions: 1) does c-MeST improve memory specificity and depressive symptoms in youth with MDD; and 2) does c-MeST improve memory specificity and depression in addition to other treatment? Methods: Participants aged 15-25 (N=359, 76.5% female; M age=19.2, SD=3.1), receiving predominantly psychological therapy or counselling (85%) and/or antidepressants (52.9%) were randomised to c-MeST or wait-list. Cognitive and clinical outcomes were assessed at baseline and at one, three, and six-month follow-ups. Results: The c-MeST group reported higher memory specificity at one-month (M change=1.13, 95%CI [0.16,2.10], d=.42, p=.022), but not other follow-ups. There was no significant group difference for Major Depressive Episode diagnosis at six-months (55.6% c-MeST vs. 68.8% control, odds ratio=0.56 95%CI [0.21,1.53], p=.266), but the c-MeST group did report lower depressive symptoms at one (M change=-1.84, 95%CI[-3.42,-0.25], d = .42, p = .023) and six-month follow-ups (M change=-3.91, 95%CI [-6.19,-1.63], d = .84, p = .001). Conclusions: c-MeST reduces symptoms in youth with MDD when provided alongside other treatments. There was some evidence that change in memory specificity drives these changes. Contrary to previous findings, specificity effects were not maintained, potentially due to the low intensity of c-MeST in this study. Further study is needed to understand more about co-occurring mechanisms that produce antidepressant effects.

Objective: Improving future thinking may be one means to reduce anhedonia, particularly in Major Depressive Disorder (MDD) in which future thinking is impaired. The current study therefore examined whether enhancing future thinking is a viable method of reducing anhedonia in MDD. Methods: Participants (N=177; 80.8% women; M age=43.7, SD=11.8) with a current depressive episode including anhedonia and high symptom severity were randomized to a Future Event Specificity Training (FEST) program or wait-list control. Future thinking characteristics, anhedonia-related variables, and other clinical outcomes were assessed at baseline, one- and three-month follow-up. Results: The FEST group showed significantly improved future thinking characteristics compared to the control group, as expected. Relative to the control group, FEST was also associated with a reduced likelihood of anhedonia (35.1% vs 61.1%, p = .015), improvements on other anhedonia-related variables such as anticipatory (d = 0.63, p = .004) and anticipated pleasure (d = 0.77, p &lt; .001), and desirable clinical outcomes such as less people meeting criteria for MDD (37.8% vs 64.8%, p = .011), lower symptom severity (d = 0.41, p = .048), higher behavioural activation (d = 0.71, p = .001) and improved global functioning (d = 0.52, p = .017). Changes in future thinking characteristics were found to mediate the effect of FEST on anhedonia.Conclusions: Future thinking can be enhanced in MDD, and this leads to a substantially reduced likelihood of anhedonia, other significant clinical effects and functional gains. Future research might examine FEST’s effects on other diagnostic groups with anhedonia and the utility of FEST as an adjunct to other treatments.

Importance: Suicide is a leading cause of preventable death. As a precursor to suicide attempts, disclosure of suicidal ideation provides opportunity for intervention and prevention. Objective: Meta-analyse available studies and estimate the prevalence of disclosure of suicidal ideation to others, and to whom people disclose. Data Sources: Multiple databases were searched for studies in English up to April 1st, 2022) using key word terms of ‘SUICID*’ AND ‘DISCLOS* OR NON-DISCLOSURE OR CONFESS* OR TALK* OR SHAR*’. Bibliographies were hand searched. Study Selection: Studies were included that reported a sample of people who had experienced suicidal thoughts or behaviours (including suicide decedents) and an indicator of whether they had disclosed this. Data Extraction and Synthesis: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines1. Two reviewers independently extracted data. Quality was assessed using the Joanna Briggs Institute Systematic Screening and Research Synthesis Checklist2. Data were pooled using random-effects models. Main Outcome(s) and Measure(s): The pre-registered main outcome was the proportion of people who disclosed suicidal ideation or behaviour to others. The proportion of disclosures to specific subgroups of confidants was also analysed. Results: Ninety-eight studies (N participants = 834,952) were included in analyses. Less than half of people disclosed suicidal ideation or behaviour: 46.3% (95%CI 42-50.7%, PI 10.9-84%; k=91). High heterogeneity, common to prevalence studies, was found (Q[90] = 113426, p &lt; .001; I2 = 99.9%). No publication bias was detected, and removing outliers did not affect this finding, but did produce smaller prediction intervals: 46.3% (95%CI 44-48.5%, PI 36.1-56.6%; k = 35). There was evidence that higher prevalence of psychiatric disorder in samples, female gender, and longer timeframe for disclosure were related to a higher prevalence of disclosure, while people who died by suicide disclosed less often relative to community samples. Disclosure, and proportions of disclosures, to family members, was numerically higher than to friends or health professionals, but could not be directly compared. Conclusions and Relevance: Between 50 and 60% of people do not disclose their suicidal ideation to other people. The suicidal thoughts and behaviours of many people remain unidentified and likely untreated.