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Future Thinking and Depression
Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Framtidsorienterat tänkande och depression (Swedish)
Abstract [en]

The ability to imagine negative or positive future events is associated with psychological well-being. The present thesis deals with depressed individual’s ability to imagine negative or positive future events. It consists of three quantitative studies (I-III) and one qualitative study (IV).

Participants in studies I-III were assessed in connection with a randomized controlled trial of two ways to deliver Internet-based treatment for major depressive disorder (MDD). Their ages ranged between 19-65 years. In addition to receiving treatment participants completed the Controlled Word Association Test; the Autobiographical Memory test (AMT) and the Future Thinking Task (FTT). Participants in study IV were recruited from a psychiatric clinic in Sweden. The sample sizes varied between study I (N=40), II (N=88), III (N=47) and IV (N=15).

The aim of the first study was to compare positive and negative future thinking in a group of depressed individuals (n=20) who were compared with a matched group of non-depressed persons (n=20). The results showed that depressed persons report lower scores regarding anticipated future positive events, but that they do not differ in terms of future negative events. The aim of the second study was to examine the association between FTT and AMT in a depressed sample. The results showed that positive future thinking was significantly correlated with retrieval of specific positive autobiographical memories (r = 0.23). The results only gave weak support for an association between FTT and AMT. The aim of the third study was to investigate if scores on the FTT would change following two forms of Internet-delivered cognitive behaviour therapy for major depression (guided self-help and e-mail therapy). A second aim was to study if changes in depression scores as measured by the Beck Depression Inventory would correlate with changes in future thinking. The results showed that FTT index scores for negative events were reduced after treatment. There was no increase for the positive events. Change scores for the FTT negative events and depression symptoms were significantly correlated. The aim of the fourth study was to investigate representations of the future in depressed individuals by using open-ended methodology inspired by grounded theory. The results showed that depressed individuals experienced a state of “ambivalence”. Ambivalence and its negative emotional and cognitive effects were substantially reduced in strength when participants were asked about their distant future.

The conclusions drawn from these studies are that depressed persons report lower scores regarding anticipated future positive events (Study I). There is some support for a positive association between FTT and AMT, but the association is weak and only concern positive FTT and positive AMT (Study II). Negative future thinking may be reduced after Internet-delivered treatment, and changes in depressive symptoms correlate to some extent with reductions in negative future thinking (Study III). The concept of ambivalence may be an important feature of depression which deserves more attention from both a theoretical and clinical perspective (Study VI).

Abstract [sv]

Förmågan att föreställa sig negativa eller positiva framtida händelser är förknippad med vårt psykiska välbefinnande. Denna avhandling fokuserar deprimerade individers förmåga att föreställa sig negativa eller positiva framtida händelser. Den består av tre kvantitativa studier (I-III) och en kvalitativ studie (IV).

Deltagare i studie I-III rekryterades i samband med en randomiserad kontrollerad studie av två sätt att ge Internet-baserad behandling för egentlig depression (vägledd självhjälp och e-postterapi) . Deltagarnas ålder varierade mellan 19-65 år. Förutom att gå igenom behandling fick deltagarna genomföra olika tester ( Controlled Word Association Test (COWAT), Autobiographical Memory test (AMT) och Future Thinking Task (FTT)). Deltagarna i studie IV rekryterades från en vuxenpsykiatrisk klinik i Sverige. Sampelstorleken varierade mellan studie I (n = 40), II (n = 88), III (n = 47) och IV (n = 15).

Syftet med den första studien var att undersöka positiva och negativa framtidstankar hos deprimerade individer (n = 20) vilka jämfördes med en matchad grupp av icke-deprimerade individer (n = 20). Resultaten visade att deprimerade individer rapporterade färre förväntade framtida positiva händelser, men att de inte skiljer sig åt vad gäller framtida negativa händelser. Syftet med den andra studien var att undersöka sambandet mellan FTT och AMT hos deprimerade individer. Resultaten visade att positivt framtidstänkande var signifikant korrelerat med specifika positiva självbiografiska minnen (r = 0.23). Dock visade resultaten enbart ett svagt stöd för ett statistiskt signifikant samband mellan FTT och AMT. Syftet med den tredje studien var att undersöka om poäng på FTT ändrades som en följd av två former av Internetbaserad kognitiv beteendeterapi hos deprimerade individer. Ett andra syfte var att studera om förändringar i depressionspoäng mätt med Beck Depression Inventory skulle korrelera med förändringar i FTT. Resultaten visade att FTT indexpoäng för negativa händelser minskade efter behandling. Det fanns ingen ökning gällande positiva händelser. Ändrade poäng för FTT negativa händelser och depressionssymtom var signifikant korrelerade. Syftet med den fjärde studien var att undersöka representationer av framtiden hos deprimerade individer genom att använda en ”open-ended” metodik inspirerad av grundad teori. Resultaten visade att deprimerade individer upplevde ett tillstånd av "ambivalens". Ambivalensen och dess negativa emotionella och kognitiva effekter minskade betydligt i styrka när de tillfrågades om en mer avlägsen framtid.

Slutsatserna från dessa studier är att deprimerade individer rapporter färre förväntade framtida positiva händelser, men att de inte skiljer sig från en kontrollgrupp avseende antal negativa framtida händelser (Studie I). Det finns visst stöd för ett positivt samband mellan FTT och AMT, men sambandet är svag och avser endast positiva FTT och positiva AMT (Studie II). Negativt framtidstänkande kan reduceras efter Internetbaserad behandling, och förändringar i depressionssymtom korrelerar till viss del med minskning av negativt framtidstänkande (studie III). Koncepten ambivalens vid depression kan vara ett viktigt inslag av depression som förtjänar mer uppmärksamhet från både ett teoretiskt och kliniskt perspektiv (Studie VI).

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2011. , 55 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 548Linköping Studies in Behavioural Science, ISSN 1654-2029 ; 160
Keyword [en]
Future thinking, cognitive processing, depression, suicide, autobiographical memory, Internet treatment, cognitive behaviour therapy, ambivalence and time dimensions
Keyword [sv]
Framtidsorienterade tänkande, kognitiv bearbetning, depression, självmord, självbiografiskt minne, Internet, kognitiv beteendeterapi, ambivalens och tidsdimensioner
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-72214ISBN: 978-91-7393-020-8 (print)OAI: oai:DiVA.org:liu-72214DiVA: diva2:458333
Public defence
2011-12-02, I:101, I-huset, Campus Valla, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-11-22 Created: 2011-11-22 Last updated: 2014-11-28Bibliographically approved
List of papers
1. Less positive or more negative? Future-directed thinking in mild to moderate depression
Open this publication in new window or tab >>Less positive or more negative? Future-directed thinking in mild to moderate depression
2010 (English)In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 39, no 1, 37-45 p.Article in journal (Refereed) Published
Abstract [en]

Depressed patients have been found to generate fewer anticipated positive future events, but most previous studies have included patients who have either been severely depressed or expressed suicidal thoughts and intents or both. The aim of this study was to compare positive and negative future-directed thinking in persons with mild to moderate depression who did not express suicidal thoughts or intents (n = 20) with a matched group of nondepressed persons (n = 20). The two groups completed the Future-Thinking Task (FTT), in which they were asked to generate positive and negative anticipated future events for three upcoming time periods (1 week, 1 year, and 5-10 years). In the present version of the FTT, both quantitative and qualitative aspects were included (i.e. subjective likelihood and emotional valence). Results showed that depressed persons reported lower scores regarding anticipated future positive events but they did not differ in terms of future negative events. The results are consistent with previous research and further strengthen the notion that reduced anticipation of future positive events is a defining characteristic of depression, even in the absence of suicidal ideation.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-61257 (URN)10.1080/16506070902966926 (DOI)19714541 (PubMedID)
Available from: 2011-03-16 Created: 2010-11-08 Last updated: 2017-12-11Bibliographically approved
2. Links between Future Thinking and Autobiographical Memory Specificity in Major Depression
Open this publication in new window or tab >>Links between Future Thinking and Autobiographical Memory Specificity in Major Depression
2011 (English)In: Psychology, ISSN 2152-7180, E-ISSN 2152-7199, Vol. 2, no 3, 261-265 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to examine the association between autobiographical memory specificity and future thinking in a depressed sample. A total of 88 individuals who meet the DSM-IV criteria of major depression were included and completed the autobiographical memory test (AMT) and the future thinking task (FTT). The FTT was an index of number of future plausible events, rating of likelihood and emotional valence. The results showed that positive future thinking was significantly correlated with retrieval of specific positive autobio-graphical memories (r = 0.23). Moreover, correlational analyses showed that positive autobiographical memo-ries were negatively correlated with extended autobiographical memories, repeated autobiographical memories, semantic associations and non-responses on the AMT. Self-report measures of depression and anxiety were not correlated with either the FTT or the AMT. The results of this cross-sectional study only give weak support for an association between autobiographical memory specificity and future thinking.

Place, publisher, year, edition, pages
SciRes, 2011
Keyword
Depression, Prospective Cognitions, Autobiographical Memory, Future Thinking
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72211 (URN)10.4236/psych.2011.23041 (DOI)
Available from: 2011-11-22 Created: 2011-11-22 Last updated: 2017-12-08
3. Effects of Two Forms of Internet-Delivered Cognitive Behaviour Therapy for Depression on Future Thinking
Open this publication in new window or tab >>Effects of Two Forms of Internet-Delivered Cognitive Behaviour Therapy for Depression on Future Thinking
Show others...
2013 (English)In: Cognitive Therapy and Research, ISSN 0147-5916, E-ISSN 1573-2819, Vol. 37, no 1, 29-34 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to investigate if future thinking would change following two forms of Internet-delivered cognitive behavior therapy (ICBT) for major depression. A second aim was to study the association between pre-post changes in future thinking and prepost changes in depressive symptoms.

Background: Effects of psychological treatments are most often tested with self-report inventories and seldom with tests of cognitive function.

Method: We included data from 47 persons diagnosed with major depression who received either e-mail therapy or guided self-help during 8 weeks. Participants completed the future thinking task (FTT), in which they were asked to generate positive and negative events that they thought were going to happen in the future and rated the events in terms of emotion and likelihood. The FTT was completed before and after treatment. Data on depressive symptoms were also collected.

Results: FTT index scores for negative events were reduced after  treatment. There was no increase for the positive events. Change scores for the FTT negative events and depression symptoms were significantly correlated.

Conclusions: We conclude that ICBT may lead to decreased negative future thinking and that changes in depression symptoms correlate to some extent with reductions in negative future thinking.

Place, publisher, year, edition, pages
New York, USA: Springer-Verlag New York, 2013
Keyword
Future thinking task; Internet treatment; major depression; treatment effects
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72212 (URN)10.1007/s10608-012-9442-y (DOI)000314064400004 ()
Available from: 2011-11-22 Created: 2011-11-22 Last updated: 2017-12-08
4. Representations of the future in depression. A qualitative study
Open this publication in new window or tab >>Representations of the future in depression. A qualitative study
Show others...
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Previous studies indicate that the ability to imagine negative and positive future events affect psychological well-being and is a characteristic feature of depression. The aim of this study was to investigate how depressed individuals view their future along different time periods. A total of 15 individuals with a diagnosis of major depression were recruited from a psychiatry clinic and completed a semi-structured qualitative interview. Questions were asked about the situation right now, before becoming depressed, and the future (nearest time, within a year and the upcoming 5-10 years). Data were collected and analysed using open-ended methodology in line with the principles of grounded theory. The results showed that depressed individuals experienced a state of “ambivalence”, with negative cognitive, emotional, physical and socioeconomic consequences, when they were asked to think about their nearest future. Ambivalence and its negative emotional and cognitive effects were substantially reduced in strength when they were asked about their more distant future. We conclude that ambivalence in the present may be an important feature of depression which deserves more attention from both a theoretical and clinical perspective. The use of qualitative approaches in the study of depression is encouraged.

Keyword
Future thinking; depression; ambivalence, time horizons
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72213 (URN)
Available from: 2011-11-22 Created: 2011-11-22 Last updated: 2015-06-02Bibliographically approved

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