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Depression in adolescence is common worldwide, with the burden being highest in low- and middle-income countries. This study assessed the efficacy of in-person Memory Specificity Training (MeST) and computerized MeST (c-MeST) as cognitive training programs aimed at addressing depression among Iranian adolescents. A secondary aim was to evaluate the efficacy of MeST and c-MeST on autobiographical memory specificity, emotion regulation and cognitive control. Ninety Iranian male adolescents (aged 13–18 years) with depression were randomly assigned to three groups; MeST group ( n  = 30), c-MeST group ( n  = 30) and the non-active control group ( n  = 30). Participants completed the Beck Depression Inventory-II, Autobiographical Memory Test, Cognitive Emotion Regulation Questionnaire, Wisconsin Card Sorting Test and Stroop Color and Word Test. The groups underwent either MeST and c-MeST. All the assessments were re-conducted after the intervention (post-intervention) and at 1-month post-intervention (follow-up). The in-person MeST group exhibited significantly higher autobiographical memory specificity at post-intervention and follow-up compared to the c-MeST group. Both groups demonstrated significantly lower levels of depression at post-intervention and follow-up. Both groups showed improvements in emotion regulation and cognitive control, which were found to mediate improvements in depression symptomatology. c-MeST and MeST appear promising brief interventions for the treatment of depression among adolescents in Iran.

The ability to retrieve specific autobiographical memories decreases with cognitive aging. This decline is clinically relevant due to its association with impairments in problem solving, daily functioning, and depression. A therapist-delivered group training protocol, Memory Specificity Training (MeST), has been shown to enhance the retrieval of specific memories while ameliorating the impairments and negative outcomes associated with reduced specificity. The therapist-delivered nature of this intervention means it is relatively expensive to deliver and difficult for people with mobility impairments, such as older people, to receive. The objective of this study was to test if a novel, Web-based computerized version of a group training protocol called Memory Specificity Training, has the potential to increase autobiographical memory specificity and impact associated secondary psychological processes. A total of 21 participants (13 female; mean age 67.05, SD 6.55) who experienced a deficit in retrieving specific autobiographical memory were trained with c-MeST. We assessed memory specificity at preintervention and postintervention, as well as secondary processes such as depressive symptoms, rumination, and problem-solving skills. Memory specificity increased significantly after participants completed c-MeST (r=.57). Session-to-session scores indicated that autobiographical memory specificity improved most from the online baseline assessment to the first Web-based session. Symptoms or secondary processes such as problem-solving skills did not change significantly. A Web-based automated individual version of MeST is a feasible, low-cost intervention for reduced memory specificity in healthy older adults. Future studies should clarify the preventive impact of c-MeST in other at-risk sample populations with longer follow-up times.

Background There is an urgent need for psychological interventions that can target depression in late adolescence and prevent it from having lifelong implications. Schools have been identified as a promising setting to enhance access to interventions and offer support earlier. We have co-developed a novel intervention, IMAGINE, that targets key cognitive mechanisms implicated in depression across the lifespan. Depression has been associated with distressing negative mental images, a deficit in positive future images and overgeneral autobiographical memories. Interventions targeting these factors have shown clinical promise in adults. Here, we combine techniques targeting these cognitive processes into a novel, brief psychological intervention for adolescent depression. This Phase IIb randomised controlled trial will evaluate IMAGINE compared to an active psychological intervention. Methods/design One hundred sixty adolescents (aged 16–18) with high levels of depressive symptoms will be recruited from schools. Participants will be randomly allocated to IMAGINE or the active psychological control intervention, non-directive support (NDS). Assessment will take place at baseline, 8-, 16- and 24-week post randomisation. The primary objective is to establish whether IMAGINE reduces symptoms of depression, relative to NDS, at 8 weeks following randomisation. Secondary objectives include whether changes in depression are maintained at 16- and 24-week follow-up, the efficacy of IMAGINE on secondary clinical outcomes and key cognitive mechanisms and, finally, to assess outcomes around acceptability, safety and adherence. Discussion If IMAGINE is shown to be safe and clinically effective, an effectiveness-implementation hybrid RCT will be indicated. If rolled out as an intervention, IMAGINE would significantly extend the range of effective therapies available for adolescent depression. Trial registration ISRCTN, ISRCTN14015295. Registered 11 September 2023, https://doi.org/10.1186/ISRCTN14015295 .

Background Youth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning. Evidence-based treatments are available, but many young people do not respond or sufficiently recover with first-line options, and a significant proportion experience relapse. Consequently, there is clear scope to enhance intervention in this critical period of early-onset depression. Memory specificity training (MeST) is a low-intensity intervention for depression that targets reduced specificity when recalling memories of the past, a common cognitive vulnerability in depression. This randomised controlled trial will assess the efficacy of adding a computerised version of MeST (c-MeST) to usual care for youth depression. Methods/design Young people aged 15–25 years with a major depressive episode (MDE) will be recruited and randomised to have immediate access to the seven session online c-MeST program in addition to usual care, or to usual care and wait-list for c-MeST. The primary outcomes will be diagnostic status of an MDE and self-reported depressive symptoms assessed at baseline, 1-, 3- and 6-month intervals. Autobiographical memory specificity and other variables thought to contribute to the maintenance of reduced memory specificity and depression will be assessed as mediators of change. Discussion Online provision of c-MeST provides a simple, low-intensity option for targeting a cognitive vulnerability that predicts the persistence of depressive symptoms. If found to be efficacious as an adjunct to usual care for depressed youth, it could be suitable for broader roll-out, as c-MeST is highly accessible and implementation requires only minimal resources due to the online and automated nature of intervention. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000234112p . Registered on the 18 February 2019. All items from the WHO Trial Registration Data Set can be found within the protocol. Protocol version 1.0

Depression has a profound effect on quality of life (QoL) and is associated with rumination, hopelessness and social difficulties. It is important to explore novel intervention techniques that may reduce depression, and also improve rumination, hope and QoL. In this brief clinical report, we report the findings of two pilot randomized controlled trials examining the feasibility of a potentially important novel clinical technique (MEmory Specificity Training, MEST) on depression, social problem-solving (Study 1), rumination, hope and QoL (Study 2). In Study 1, Iranian women with depression (n = 24) completed the Beck Depression Inventory-II and Means-Ends Problem-Solving test at baseline, post-training and 2-month follow-up. In Study 2, female students with moderate depression (n = 24) completed the Ruminative Response Scale, Adult Hope Scale and Short-Form Health Survey at baseline and post-training. Assessors were blind to group allocation. In both studies participants were randomly assigned to MEST or a non-active control group. In both studies, MEST was found to be feasible and associated with low drop-out rates and high rates of self-reported patient and group facilitator satisfaction. There was preliminary evidence that MEST may bring about clinical benefit in terms of depression, social problem-solving (Study 1), QoL, rumination and hope (Study 2). MEST is a promising technique in the treatment of depression.

Objectives Reduced autobiographical memory specificity (rAMS) is a vulnerability factor found across unipolar depression (UD), posttraumatic stress disorder (PTSD), eating disorder, schizophrenia, and bipolar disorder (BD). A group delivered psychological therapy training called Memory Specificity Training (MeST) remediates rAMS in UD and PTSD, with additional downstream effects on related psychological processes and symptoms. Its impact in BD is unknown. In this case study, we examined the impact of a computerized version of MeST (c‐MeST) on improving AMS and related symptoms and processes in participant with rapid cycling type I BD. Method An experimental case study with an ABA design was used. During baseline (14 days, Phase A), the training phase (nine sessions across 17 days, Phase B), and a 1‐month follow‐up (Phase A), memory specificity, depressive symptoms, and related processes and symptoms were repeatedly measured. Results Memory specificity increased significantly after the participant completed c‐MeST. Session‐to‐session scores indicated that AMS improved most from the in‐person baseline assessment to the first online session. All other measures of processes and symptoms deteriorated during the training phase but regressed to baseline during follow‐up. Conclusion Memory specificity was improved as indicated by increased AMS from pre‐intervention measurement to 1‐month follow‐up. Other improvements in symptoms were not observed. Rather, some related maladaptive psychological processes and symptoms worsened during the training phase and regressed to baseline during follow‐up. In an experimental single case study autobiographical memory specificity was successfully remediated, from pre‐intervention measurement to 1‐month follow‐up, by using an online memory specificity training, in one person with rapid cycling Bipolar Disorder type I. Other improvements in symptoms were not observed. Rather, some related maladaptive psychological processes and symptoms worsened during the training phase and regressed to baseline during follow up.

IntroductionMajor depression is a prevalent and debilitating disorder, but many sufferers do not receive support or respond to current treatments. The development of easily accessible and low-intensity treatments that have clear cognitive mechanisms of change is indicated. Memory specificity training (MeST) is an intervention for depression that targets deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial will assess the efficacy of an online, computerised version of MeST (c-MeST).Methods and analysisAdults aged 18 and over with a current major depressive episode (MDE) will be recruited and randomised to have access to the seven session, online c-MeST programme for 2 weeks, or to a wait-list control group. The primary outcomes will be diagnostic status of MDE and self-reported depressive symptoms at postintervention. One-month and three-month follow-ups will be collected. Increases in autobiographical memory specificity will be assessed as a mediator of change, as well as other variables thought to contribute to reduced memory specificity, such as rumination and cognitive avoidance.Ethics and disseminationEthics approval has been granted by the Deakin University Human Research Ethics Committee to conduct the study (ID: 2017_168). The findings will be disseminated through scholarly publications and workshops and will inform future trials, such as with an active comparator or as an adjunct treatment.Trial registration numberACTRN12618000257268; Pre-results.

The main objective of this study was to study the effectiveness of memory specificity training (MEST) on the symptoms of post-traumatic stress disorder (PTSD) of bereaved Afghan adolescents. Participants were bereaved Afghan adolescents with PTSD and depressive symptomatology and were randomly assigned into the MEST, trauma-focused cognitive behavioural therapy (TF-CBT) and a control group. In this study, a quasi-experimental design with pretest-post-test and follow-up with experimental and control groups was used. The instruments used were the Impact of Event Scale-Revised, Persian versions of the Mood and Feelings Questionnaire, clinical interview and demographic questionnaire. Post-intervention, the MEST and TF-CBT groups had significantly lower levels of PTSD symptoms compared with the control group. There was no significant difference between the MEST and TF-CBT groups. These effects were maintained at 12 weeks. Post-intervention, the MEST and TF-CBT groups also had significantly lower levels of depression symptoms compared with the control group.The findings of this small pilot study suggest that MEST is a promising intervention for the treatment of PTSD and a larger randomized controlled trial is warranted.

Background Depression is a debilitating mental health problem that tends to run a chronic, recurrent course. Even when effectively treated, relapse and recurrence rates remain high. Accordingly, interventions need to focus not only on symptom reduction, but also on reducing the risk of relapse by targeting depression-related disturbances that persist into remission. We are addressing this need by investigating the efficacy, acceptability and feasibility of a MEmory Specificity Training (MEST) programme, which directly targets an enduring cognitive marker of depression - reduced autobiographical memory specificity. Promising pilot data suggest that training memory specificity ameliorates this disturbance and reduces depressive symptoms. A larger, controlled trial is now needed to examine the efficacy of MEST. This trial compares MEST to an education and support (ES) group, with an embedded mechanism study. Methods/Design In a single blind, parallel cluster randomised controlled trial, 60 depressed individuals meeting diagnostic criteria for a current major depressive episode will be recruited from the community and clinical services. Using a block randomisation procedure, groups of 5 to 8 participants will receive five weekly sessions of MEST (n = 30) or education and support (n = 30). Participants will be assessed immediately post-treatment, and at 3- and 6-months post-treatment (MEST group only for 6-month follow-up). Depressive symptoms at 3-month follow-up will be the primary outcome. Secondary outcomes will be change in depressive status and memory specificity at post-treatment and 3-months. The 6-month follow-up of the MEST group will allow us to examine whether treatment gains are maintained. An explanatory question will examine variables mediating improvement in depression symptoms post-treatment and at 3-month follow-up. Discussion This trial will allow us to investigate the efficacy of MEST, whether treatment gains are maintained, and the mechanisms of change. Evidence will be gathered regarding whether this treatment is feasible and acceptable as a low-intensity intervention. If efficacy can be demonstrated, the results will support MEST as a treatment for depression and provide the foundation for a definitive trial. Trial registration NCT01882452 (ClinicalTrials.gov), registered on 18 June 2013.

Background Accumulating evidence shows that a cognitive factor associated with a worsening of depressive symptoms amongst people with and without diagnoses of depression – reduced Autobiographical Memory (rAMS) – can be ameliorated by a group cognitive training protocol referred to as Memory Specificity Training (MeST). When transporting interventions such as MeST from research to routine clinical practices (RCPs), modifications are inevitable, with potentially a decrease in effectiveness, so called voltage drop. We examined the transportability of MeST to RCPs as an add-on to treatment as usual with depressed in- and out- patients. Methods We examined whether 1) MeST was adaptable to local needs of RCPs by implementing MeST in a joint decision-making process in seven Belgian RCPs 2) without losing its effect on rAMS. The effectiveness of MeST was measured by pre- and post- intervention measurements of memory specificity. Results Adaptations were made to the MeST protocol to optimize the fit with RCPs. Local needs of RCPs were met by dismantling MeST into different subparts. By dismantling it in this way, we were able to address several challenges raised by clinicians. In particular, multidisciplinary teams could divide the workload across different team members and, for the open version of MeST, the intervention could be offered continuously with tailored dosing per patient. Both closed and open versions of MeST, with or without peripheral components, and delivered by health professionals with different backgrounds, resulted in a significant increase in memory specificity for depressed in- and out- patients in RCPs. Conclusions MeST is shown to be a transportable and adaptable add-on intervention which effectively maintains its core mechanism when delivered in RCPs. Trial registration ISRCTN registry, IDISRCTN10144349 , registered on January 22, 2019. Retrospectively registered.