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.

Study Overview

• Status: Completed
• Conditions: Depressive Symptoms; Major Depressive Disorder
• Intervention / Treatment: Behavioral: Memory Specificity Training; Behavioral: Education and Support

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Australia
  • Sydney, Australia, 2022
    • Aliza Werner-Seidler

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Memory Specificity Training; Five weekly one-hour sessions of memory specificity training administered in groups of 5-8 participants.	Behavioral: Memory Specificity Training; 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.
Active Comparator: Education and Support; Five weekly one-hour sessions of an education-and-discussion supportive intervention, administered in groups of 5-8 participants.	Behavioral: Education and Support; 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in depressive symptoms on the Beck Depression Inventory II (BDI-II)	Symptom severity score	Change from baseline to 3 months post-treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in depressive status according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - IV (SCID-IV)	Presence of a current Major Depressive Episode (MDE)	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)
Change from baseline in autobiographical memory specificity on Autobiographical Memory Test (AMT)	Memory specificity level	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment
Change from baseline in depressive symptoms as measured on the BDI-II	Symptom severity score	Change from baseline to post-treatment (approximately 6-weeks)
Depression free days following treatment according to the Longitudinal Follow-up Evaluation on the SCID-IV	Number of depression-free days	Post-treatment and 3-month and 6-month follow-up

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline on the Beck Anxiety Inventory (BAI)	Symptom severity score	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment
Change from baseline on the Beck Hopelessness Scale (BHS)	Hopelessness score	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment
Change from baseline on the Cognitive Avoidance Questionnaire (CAQ)	Tendency for avoidance score	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment
Change in baseline on Rumination Response Scale (RRS)	Tendency to ruminate score	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment
Change from baseline in performance on Means-Ends Problem Solving Task (MEPS)	Problem solving effectiveness score	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment
Change from baseline in performance on Verbal Fluency Task	Index of executive control	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment
Change in baseline on performance on Digit Span Task	Working memory index	Change from baseline at end of treatment (approximately 6 weeks) and 3 months post-treatment

Collaborators and Investigators

• Sponsor: Medical Research Council
• Collaborators: KU Leuven
• Investigators: Principal Investigator: Tim Dalgleish, PhD, Medical Research Council

Publications and helpful links

General Publications

• 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.

Study record dates

Study Major Dates

• Study Start: July 1, 2013
• Primary Completion (Actual): August 1, 2016
• Study Completion (Actual): October 1, 2016

Study Registration Dates

• First Submitted: June 18, 2013
• First Submitted That Met QC Criteria: June 18, 2013
• First Posted (Estimate): June 20, 2013

Study Record Updates

• Last Update Posted (Actual): March 22, 2018
• Last Update Submitted That Met QC Criteria: March 21, 2018
• Last Verified: March 1, 2018

More Information

Terms related to this study

• Keywords: Autobiographical memory; Major depressive disorder; Memory specificity training
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Mood Disorders; Depression; Depressive Disorder; Depressive Disorder, Major
• Other Study ID Numbers: MEST-UK