A Randomised Controlled Clinical Trial of Memory Specificity Training (MEST) for Depression (MEST)

Depression involves the tendency to recall overgeneral personal memories, a phenomenon which has been linked to numerous adverse psychological outcomes. The purpose of this study is to investigate whether a group-based Memory Specificity Training (MEST) programme improves outcomes in depression, and how this compares to an education and support control group. The primary aim is to examine whether MEST, which involves repeated practice retrieving specific autobiographical memories reduces depressive symptoms immediately post-treatment, and whether this is maintained 3 months after treatment. The secondary objective of this trial is to examine the role of hypothesised cognitive processes (ie., rumination, executive control, cognitive avoidance) which may underlie improvements in depression and memory.

Five weekly one-hour sessions of memory specificity training administered in groups of 5-8 participants.

Five weekly one-hour sessions of an education-and-discussion supportive intervention, administered in groups of 5-8 participants.

This intervention is a manualised, structured treatment delivered over 5 x 60 minute sessions to groups of 5-8 individuals. This treatment involves repeated practice of retrieving specific autobiographical memories in response to positive, negative and neutral cue words. There is a single psychoeducation component in the first session about memory difficulties common in depression which provides the rationale for this treatment. The training is supplemented by weekly homework practice.

The education-and-support comparison condition is matched with the experimental arm for length and format (ie., 5 x 60 minute weekly sessions in groups of 5-8 individuals). Groups receive a single psychoeducation component where information about depression is provided. This is followed by non-directive support where participants are encouraged to raise different kinds of events that occur each week for discussion in the group. The sessions are supplemented by a homework diary where participants will be invited to note down an event that occurs each day, which may be positive, negative, or benign and non-emotional in nature. This material will provide the basis for discussion in the weekly group meetings.

Change in depressive status according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - IV (SCID-IV)

Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment, and 6-months post-treatment (6-month follow-up for MEST group only)

Depression free days following treatment according to the Longitudinal Follow-up Evaluation on the SCID-IV

Inclusion Criteria: Principal diagnosis of Major Depressive Disorder History of more than one previous depressive episode Current diagnosis of a Major Depressive Episode Depressive symptoms rated in the mild-severe range (> 13 on the BDI-II) Memory specificity < .70 (as assessed on the AMT) Exclusion Criteria: Head trauma Organic brain damage Secondary diagnosis of another affective disorder Psychosis Current drug or alcohol abuse or dependence A diagnosed Axis II disorder

Werner-Seidler A, Hitchcock C, Bevan A, McKinnon A, Gillard J, Dahm T, Chadwick I, Panesar I, Breakwell L, Mueller V, Rodrigues E, Rees C, Gormley S, Schweizer S, Watson P, Raes F, Jobson L, Dalgleish T. A cluster randomized controlled platform trial comparing group MEmory specificity training (MEST) to group psychoeducation and supportive counselling (PSC) in the treatment of recurrent depression. Behav Res Ther. 2018 Jun;105:1-9. doi: 10.1016/j.brat.2018.03.004. Epub 2018 Mar 15.

Dalgleish T, Bevan A, McKinnon A, Breakwell L, Mueller V, Chadwick I, Schweizer S, Hitchcock C, Watson P, Raes F, Jobson L, Werner-Seidler A. A comparison of MEmory Specificity Training (MEST) to education and support (ES) in the treatment of recurrent depression: study protocol for a cluster randomised controlled trial. Trials. 2014 Jul 22;15:293. doi: 10.1186/1745-6215-15-293.