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Why dysfunctional expectations in depression persist – Results from two experimental studies investigating cognitive immunization

Published online by Cambridge University Press:  22 August 2018

Tobias Kube ,
Winfried Rief ,
Mario Gollwitzer ,
Thomas Gärtner  and
Julia Anna Glombiewski
Tobias Kube*
Affiliation:
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
Winfried Rief
Affiliation:
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
Mario Gollwitzer
Affiliation:
Department of Psychological Methodology and Social Psychology, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
Thomas Gärtner
Affiliation:
Schön Klinik Bad Arolsen, Hofgarten 10, D-34454 Bad Arolsen, Germany
Julia Anna Glombiewski
Affiliation:
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
*
Author for correspondence: Tobias Kube, E-mail: tobikube@gmail.com
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Abstract

Background

Research has revealed that negative expectations impact depressive symptoms. However, research on the change of dysfunctional expectations in depression is lacking so far. Therefore, the present research aimed to fill this gap by testing the hypothesis that people with the major depressive disorder (MDD), contrary to healthy individuals, maintain their expectations despite experiences that positively disconfirm expectations. Further, it was hypothesized that cognitive immunization (a cognitive reappraisal of the disconfirming evidence) is a mechanism underlying the persistence of expectations.

Method

In Study 1, we compared individuals with MDD (N = 58) to healthy individuals (N = 59). Participants worked on the same performance test and received standardized feedback that either confirmed or disconfirmed their initial performance expectations. In Study 2, we investigated the effects of cognitive immunization on expectation change among 59 individuals reporting elevated levels of depression by varying the appraisal of expectation-disconfirming feedback.

Results

Results from Study 1 show that in the expectation-disconfirming condition, healthy individuals changed their expectations, whereas individuals with MDD did not. No such difference between the two groups was found for expectation-confirming feedback. Results from Study 2 indicated that varying cognitive immunization impacted expectation change, thus suggesting a crucial role of cognitive immunization in expectation change.

Conclusions

These two studies indicated that individuals suffering from depression have more difficulties in changing their expectations after disconfirming experiences than do healthy individuals, and cognitive immunization might be a core mechanism underlying expectation persistence. Therefore, psychotherapeutic interventions should aim to inhibit cognitive immunization processes to enhance expectation change.

Keywords

Behavioral experimentexpectationexpectation persistenceexpectancy violationimmunizationmajor depression.
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 9 , July 2019 , pp. 1532 - 1544
Copyright
Copyright © Cambridge University Press 2018 

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References

Abramson, LY, Alloy, LB and Metalsky, GI (1989) Hopelessness depression – a theory-based subtype of depression. Psychological Review 96, 358–372.Google Scholar
Backenstrass, M, Schwarz, T, Fiedler, P, Joest, K, Reck, C, Mundt, C and Kronmueller, KT (2006) Negative mood regulation expectancies, self-efficacy beliefs, and locus of control orientation: moderators or mediators of change in the treatment of depression? Psychotherapy Research 16, 250–258.Google Scholar
Beck, AT (1963) Thinking and Depression I: idiosyncratic content and cognitive distortions. Archives of General Psychiatry 9, 324–333.Google Scholar
Beck, AT (1964) Thinking and Depression II: theory and therapy. Archives of General Psychiatry 10, 561–571.Google Scholar
Beck, JS (2011) Cognitive Behavior Therapy: Basics and Beyond. New York: Guilford Press.Google Scholar
Beck, AT, Rush, A, Shaw, B and Emery, G (1979) Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Beck, AT, Steer, RA, Ball, R and Ranieri, WF (1996) Comparison of Beck depression inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment 67, 588–597.Google Scholar
Bridges, KR and Harnish, RJ (2010) Role of irrational beliefs in depression and anxiety: a review. HEALTH 2, 862–877.Google Scholar
Brose, A, Schmiedek, F, Koval, P and Kuppens, P (2015) Emotional inertia contributes to depressive symptoms beyond perseverative thinking. Cognition and Emotion 29, 527–538.Google Scholar
Cane, DB and Gotlib, IH (1985) Depression and the effects of positive and negative feedback on expectations, evaluations, and performance. Cognitive Therapy and Research 9, 145–160.Google Scholar
Catanzaro, SJ and Mearns, J (1990) Measuring generalized expectancies for negative mood regulation: initial scale development and implications. Journal of Personality Assessment 54, 546–563.Google Scholar
Cohen, J, Cohen, P, West, SG and Aiken, LS (2003) Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Mahawah, NJ: Erlbaum.Google Scholar
Connor, MJ and Walton, JA (2011) Demoralization and remoralization: a review of these constructs in the healthcare literature. Nursing Inquiry 18, 2–11.Google Scholar
Corsi, N and Colloca, L (2017) Placebo and Nocebo effects: the advantage of measuring expectations and psychological factors. Frontiers in Psychology 8, 1–7.Google Scholar
Deusinger, IM (1986) Frankfurter Selbstkonzeptskalen (FSKN). Göttingen: Hogrege.Google Scholar
Dobson, KS and Hamilton, KE (2003) Cognitive restructuring: behavioral tests of negative cognitions. In O'Donohue, JEFW and Hayes, SC (eds) Cognitive Behavior Therapy: Applying Empirically Supported Techniques in your Practice. New York: Wiley, pp. 84–88.Google Scholar
Eshel, N and Roiser, JP (2010) Reward and punishment processing in depression. Biological Psychiatry 68, 118–124.Google Scholar
Frank, JD (1973) Persuasion and Healing. Baltimore: The Johns Hopkins University Press.Google Scholar
Frank, JD (1974) Psychotherapy: the restoration of morale. American Journal of Psychiatry 131, 271–274.Google Scholar
Frank, JD and Frank, JB (1991) Persuasion and Healing: A Comparative Study of Psychotherapy. Baltimore: Johns Hopkins University Press.Google Scholar
Frost, RO, Marten, P, Lahart, C and Rosenblate, R (1990) The dimensions of perfectionism. Cognitive Therapy and Research 14, 449–468.Google Scholar
Gopinath, S, Katon, WJ, Russo, JE and Ludman, EJ (2007) Clinical factors associated with relapse in primary care patients with chronic or recurrent depression. Journal of Affective Disorders 101, 57–63.Google Scholar
Gordon, MS, Tonge, B and Melvin, GA (2011) Outcome of adolescent depression: 6 months after treatment. Australian and New Zealand Journal of Psychiatry 45, 232–239.Google Scholar
Hammen, C and Krantz, S (1976) Effect of success and failure on depressive cognitions. Journal of Abnormal Psychology 85, 577–586.Google Scholar
Holm, S (1979) A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics 6, 65–70.Google Scholar
Horwitz, AG, Berona, J, Czyz, EK, Yeguez, CE and King, CA (2017) Positive and negative expectations of hopelessness as longitudinal predictors of depression, suicidal ideation, and suicidal behavior in high-risk adolescents. Suicide and Life-Threatening Behavior 47, 168–176.Google Scholar
Jacoby, J and Sassenberg, K (2011) Interactions do not only tell us when, but can also tell us how: testing process hypotheses by interaction. European Journal of Social Psychology 41, 180–190.Google Scholar
Kashdan, TB and Rottenberg, J (2010) Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review 30, 865–878.Google Scholar
Kline, RB (2005) Principles and Practice of Structural Equation Modeling. New York: Guilford.Google Scholar
Korn, CW, Sharot, T, Walter, H, Heekeren, HR and Dolan, RJ (2014) Depression is related to an absence of optimistically biased belief updating about future life events. Psychological Medicine 44, 579–592.Google Scholar
Kube, T, D'Astolfo, L, Glombiewski, JA, Doering, BK and Rief, W (2017 a). Focusing on situation-specific expectations in major depression as the basis for behavioural experiments–development of the depressive expectations scale. Psychology and Psychotherapy: Theory, Research and Practice 90, 336–352.Google Scholar
Kube, T, Rief, W and Glombiewski, JA (2017 b) On the maintenance of expectations in major depression–investigating a neglected phenomenon. Frontiers in Psychology 8, 1–7.Google Scholar
Kube, T, Rief, W, Gollwitzer, M and Glombiewski, JA (2018 a) Introducing an Experimental Paradigm to Investigate Expectation Change (EXPEC). Journal of Behavior Therapy and Experimental Psychiatry 59, 92–99.Google Scholar
Kube, T, Siebers, VHA, Herzog, P, Glombiewski, JA, Doering, BK and Rief, W (2018 b) Integrating situation-specific dysfunctional expectations and dispositional optimism into the cognitive model of depression – A path-analytic approach. Journal of Affective Disorders 229C, 199–205.Google Scholar
Laferton, JAC, Kube, T, Salzmann, S, Auer, CJ and Shedden Mora, M (2017) Patients’ expectations regarding medical treatment: a critical review of concepts and their assessment. Frontiers in Psychology 8, 1–12.Google Scholar
Lefcourt, HM (1976) Locus of control and the response to aversive events. Canadian Psychological Review 17, 202–209.Google Scholar
Lefebvre, MF (1981) Cognitive distortion and cognitive errors in depressed psychiatric and low back pain patients. Journal of Consulting and Clinical Psychology 49, 517–525.Google Scholar
Lemmer, G and Gollwitzer, M (2017) The ‘true’ indirect effect won't (always) stand up: when and why reverse mediation testing fails. Journal of Experimental Social Psychology 69, 144–149.Google Scholar
Liknaitzky, P, Smillie, LD and Allen, NB (2017) Out-of-the-Blue: depressive symptoms are associated with deficits in processing inferential expectancy-violations using a novel cognitive rigidity task. Cognitive Therapy and Research 41, 757–776.Google Scholar
Loeb, A, Beck, AT and Diggory, J (1971) Differential effects of success and failure on depressed and nondepressed patients. The Journal of Nervous and Mental Disease 152, 106–114.Google Scholar
Ludman, E, Katon, W, Bush, T, Rutter, C, Lin, E, Simon, G, von Korff, M and Walker, E (2003) Behavioural factors associated with symptom outcomes in a primary care-based depression prevention intervention trial. Psychological Medicine 33, 1061–1070.Google Scholar
Miranda, R, Weierich, M, Khait, V, Jurska, J and Andersen, SM (2017) Induced optimism as mental rehearsal to decrease depressive predictive certainty. Behaviour Research and Therapy 90, 1–8.Google Scholar
Pechtel, P, Dutra, SJ, Goetz, EL and Pizzagalli, DA (2013) Blunted reward responsiveness in remitted depression. Journal of Psychiatric Research 47, 1864–1869.Google Scholar
Pizzagalli, DA, Iosifescu, D, Hallett, LA, Ratner, KG and Fava, M (2008) Reduced hedonic capacity in major depressive disorder: evidence from a probabilistic reward task. Journal of Psychiatric Research 43, 76–87.Google Scholar
Post, R, Lobitz, W and Gasparikova-Krasnec, M (1980) The utilization of positive and negative feedback in the self-evaluation responses of depressed and nondepressed psychiatric patients. The Journal of Nervous and Mental Disease 168, 481–486.Google Scholar
Rawal, A, Collishaw, S, Thapar, A and Rice, F (2013) ‘The risks of playing it safe’: a prospective longitudinal study of response to reward in the adolescent offspring of depressed parents. Psychological Medicine 43, 27–38.Google Scholar
Rief, W and Glombiewski, JA (2016) Expectation-Focused Psychological Interventions (EFPI). Verhaltenstherapie 26, 47–54.Google Scholar
Rief, W and Glombiewski, JA (2017) The role of expectations in mental disorders and their treatment. World Psychiatry 16, 210–211.Google Scholar
Rief, W, Glombiewski, JA, Gollwitzer, M, Schubo, A, Schwarting, R and Thorwart, A (2015) Expectancies as core features of mental disorders. Current Opinion in Psychiatry 28, 378–385.Google Scholar
Rotter, J (1966) Generalized expectancies for internal versus external control of reinforcement. Psychological monographs 80, 1–28.Google Scholar
Rotter, JB (1990) Internal versus external control of reinforcement. American Psychologist 45, 489–493.Google Scholar
Scheier, MF and Carver, CS (1985) Optimism, coping, and health – assessment and implications of generalized outcome expectancies. Health Psychology 4, 219–247.Google Scholar
Schmidt-Atzert, L and Buehner, M (2002) Development of a performance measure of Emotional Intelligence. In 43rd Congress of the German Psychological Society, Berlin.Google Scholar
Seligman, ME, Abramson, LY, Semmel, A and von Baeyer, C (1979) Depressive attributional style. Journal of Abnormal Psychology 88, 242–247.Google Scholar
Sergeant, S and Mongrain, M (2014) An online optimism intervention reduces depression in pessimistic individuals. Journal of Consulting and Clinical Psychology 82, 263–274.Google Scholar
Stange, JP, Alloy, LB and Fresco, DM (2017) Inflexibility as a vulnerability to depression: a systematic qualitative review. Clinical Psychology-Science and Practice 24, 245–276.Google Scholar
Stevens, J (2002) Applied Multivariate Statistics for the Social Sciences. Hillsdale, NJ: Erlbaum.Google Scholar
Strunk, DR, Lopez, H and DeRubeis, RJ (2006) Depressive symptoms are associated with unrealistic negative predictions of future life events. Behaviour Research and Therapy 44, 861–882.Google Scholar
Tabachnick, BG and Fidell, LS (2014) Using Multivariate Statistics. Harlow, England: Pearson.Google Scholar
Treadway, MT, Bossaller, NA, Shelton, RC and Zald, DH (2012) Effort-based decision-making in major depressive disorder: a translational model of motivational anhedonia. Journal of Abnormal Psychology 121, 553–558.Google Scholar
Vilhauer, JS, Young, S, Kealoha, C, Borrmann, J, IsHak, WW, Rapaport, MH, Hartoonian, N and Mirocha, J (2012) Treating major depression by creating positive expectations for the future: a pilot study for the effectiveness of Future-Directed Therapy (FDT) on symptom severity and quality of life. Cns Neuroscience & Therapeutics 18, 102–109.Google Scholar
Vrieze, E, Pizzagalli, DA, Demyttenaere, K, Hompes, T, Sienaert, P, de Boer, P, Schmidt, M and Claes, S (2013) Reduced reward learning predicts outcome in major depressive disorder. Biological Psychiatry 73, 639–645.Google Scholar
Wampold, BE (2015) How important are the common factors in psychotherapy? An update. World Psychiatry 14, 270–277.Google Scholar
Watkins, ER (2008) Constructive and unconstructive repetitive thought. Psychological Bulletin 134, 163–206.Google Scholar
Whitton, AE, Treadway, MT and Pizzagalli, DA (2015) Reward processing dysfunction in major depression, bipolar disorder and schizophrenia. Current Opinion in Psychiatry 28, 7–12.Google Scholar
Wittchen, HU, Wunderlich, U, Gruschwitz, S and Zaudig, M (1997) SCID: Structured Clinical Interview for DSM-IV Axis I Disorders. Göttingen: Hogrefe.Google Scholar
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