On the Maintenance of Expectations in Major Depression – Investigating a Neglected Phenomenon

Kube, Tobias; Rief, Winfried; Glombiewski, Julia Anna

doi:10.3389/fpsyg.2017.00009

Cited by 42 publications

(39 citation statements)

References 75 publications

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“…This would be in line with memory research showing that depressed individuals recall overgeneralized autobiographical memories when asked about specific events (Williams et al, 2007). If this is the case, depressed individuals' expectation about their future mood might be relatively resistant to actual changes and improvements in mood (Kube, Rief, & Glombiewski, 2017), which may put them at increased risk for the recurrence of depressed mood states. In sum, the present results have important clinical implications and suggest that the modification of negatively distorted expectations and memories about depressed individuals' affective experiences should be a major target in psychotherapy.…”

Section: Discussionsupporting

confidence: 73%

Future expectations in clinical depression: Biased or realistic?

Zetsche¹,

Bürkner²,

Renneberg³

2019

Journal of Abnormal Psychology

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Negative expectations have been highlighted as a key mechanism in the maintenance and recurrence of depression. Nonetheless, no study has investigated depressed individuals' expectations about their future mood so far. This is surprising given that experiences of sustained negative mood and lack of positive mood are the hallmark symptoms of depression.The present study thus assessed depressed individuals' expectations about their future mood and examined whether these expectations are accurate or negatively biased.The study used experience sampling methodology (ESM) to contrast participants' expectations with their actually experienced sad and happy mood within a four-day period. At the end of this period, participants recalled their past mood. All variables were assessed in 30 clinically depressed individuals and 37 matched healthy controls, as well as in 56 undergraduate students with a wide range in depressive symptoms.Results revealed that clinically depressed individuals held negatively biased expectations about their future mood: they expected more sad and less happy mood than they actually experienced. In contrast, healthy individuals showed realistic expectations about their future mood. Depressed individuals also demonstrated a negative mood recall bias. Finally, individuals' expectations and memories were more closely linked to depression status than their actually experienced mood.Although negative mood is the hallmark symptom of depression, the expectations and memories of negative mood may be even more central for the understanding of depression.

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Section: Discussionsupporting

confidence: 73%

Future expectations in clinical depression: Biased or realistic?

Zetsche¹,

Bürkner²,

Renneberg³

2019

Journal of Abnormal Psychology

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“…It is also probable that activity and depression reduction interact in a bidirectional way as the more behavioural level (activity) and the more emotional level (depression) may be closely intertwined, a process that has been termed “reciprocal determinism” in cognitive–behavioural therapy (see, e.g., Craske, ). It is important to note, however, that potential third variables (such as improved outcome expectancies) may affect both activity and depressive mood (see, e.g., Kirsch, , for an introduction into response–expectancy theory and Kube, Rief, & Glombiewski, , for a modern conception of expectations in depression). For example, explaining the rationale of BA to the patient at the start of treatment in a motivating, easy‐to‐comprehend, and straightforward manner may not only enhance the willingness to test out new activity in the next week, but may also have a direct positive impact on depressive affect as it offers a simple agenda for counteracting depressogenic behaviours, fosters hope, and reduces helplessness.…”

Section: Discussionmentioning

confidence: 99%

Activity and subsequent depression levels: a causal analysis of behavioural activation group treatment with weekly assessments over 8 weeks

Hoyer

Hoefler

Wuellhorst

2020

Clin Psychology and Psychoth

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Research on behavioural activation (BA) for depression assumes that increasing the rate of rewarding activities leads to reduced depressive mood. Although the efficacy of BA treatment has been convincingly demonstrated, assumptions referring to the mechanisms underlying this effect have not been tested decisively yet. The Behavioural Activation Scale for Depression and the Beck Depression Inventory II were administered over 8 weeks in 161 reliably diagnosed patients with unipolar depression who underwent BA treatment in groups. Time-lagged associations between behavioural activity on depression at subsequent assessment (1 week later) and vice versa were modelled (a) with multilevel models and (b) dynamic panel models that eliminate shared constant factors and allow for reverse causation (e.g., depression affecting subsequent activation in the model for activation on depression). Both activation and depression changed significantly (model-based within effect sizes for activation = .70 and for depression = −.75). Higher activation and lower depression predict each other over time (mixed-effects, time-lagged model), but this association disappears in dynamic causal models. Change patterns were only analysed within a time frame of 1 week; smaller time intervals were not investigated. There were no objective observational data of activity patterns. In the present study, increased behavioural activity and reduced depressive mood co-occur on the week scale. They predict each other across time, but this may be due to shared causes only. K E Y W O R D S behavioural activation, change patterns, depression, group therapy

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“…The relevance of patients’ expectations for health outcomes has received increasing attention in recent years. Expectations play an important role in both physical ( Di Blasi et al, 2001 ; Mondloch et al, 2001 ) and mental health ( Constantino et al, 2011 ; Rief et al, 2015 ; Kube et al, 2017 ). Moreover, they are a key mechanism of the placebo and nocebo effect, a phenomenon according to which subjective and physiological changes emerge due to inert or non-specific treatment components ( Colloca and Miller, 2011b ; Enck et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Patients’ Expectations Regarding Medical Treatment: A Critical Review of Concepts and Their Assessment

et al. 2017

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Patients’ expectations in the context of medical treatment represent a growing area of research, with accumulating evidence suggesting their influence on health outcomes across a variety of medical conditions. However, the aggregation of evidence is complicated due to an inconsistent and disintegrated application of expectation constructs and the heterogeneity of assessment strategies. Therefore, based on current expectation concepts, this critical review provides an integrated model of patients’ expectations in medical treatment. Moreover, we review existing assessment tools in the context of the integrative model of expectations and provide recommendations for improving future assessment. The integrative model includes expectations regarding treatment and patients’ treatment-related behavior. Treatment and behavior outcome expectations can relate to aspects regarding benefits and side effects and can refer to internal (e.g., symptoms) and external outcomes (e.g., reactions of others). Furthermore, timeline, structural and process expectations are important aspects with respect to medical treatment. Additionally, generalized expectations such as generalized self-efficacy or optimism have to be considered. Several instruments assessing different aspects of expectations in medical treatment can be found in the literature. However, many were developed without conceptual standardization and psychometric evaluation. Moreover, they merely assess single aspects of expectations, thus impeding the integration of evidence regarding the differential aspects of expectations. As many instruments assess treatment-specific expectations, they are not comparable between different conditions. To generate a more comprehensive understanding of expectation effects in medical treatments, we recommend that future research should apply standardized, psychometrically evaluated measures, assessing multidimensional aspects of patients’ expectations that are applicable across various medical treatments. In the future, more research is needed on the interrelation of different expectation concepts as well as on factors influencing patients’ expectations of illness and treatment. Considering the importance of patients’ expectations for health outcomes across many medical conditions, an integrated understanding and assessment of such expectations might facilitate interventions aiming to optimize patients’ expectations in order to improve health outcomes.

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On the Maintenance of Expectations in Major Depression – Investigating a Neglected Phenomenon

Cited by 42 publications

References 75 publications

Future expectations in clinical depression: Biased or realistic?

Future expectations in clinical depression: Biased or realistic?

Activity and subsequent depression levels: a causal analysis of behavioural activation group treatment with weekly assessments over 8 weeks

Patients’ Expectations Regarding Medical Treatment: A Critical Review of Concepts and Their Assessment

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