In this thesis four studies assessing putative pathways implicated in cognitive models of depression are presented and discussed. In two initial studies the possibility to manipulate attention... Show moreIn this thesis four studies assessing putative pathways implicated in cognitive models of depression are presented and discussed. In two initial studies the possibility to manipulate attention allocation bias using two types of attention bias modification (ABM) procedures was explored. Neither method successfully or consistently modified attention allocation bias in dysphoric individuals. Putative interactions between 5-HTTLPR genotype and life stress were studied in the third study. Adopting an endophenotype approach, effects on measures of biased information processing were assessed. S-allele carriers showed increased recognition of negative mood state as a function of recent negative life events. Hypothesized interactions with childhood emotional abuse or affection attention allocation bias were found non-significant. A main effect of 5-HTTLPR was observed such that s- allele carriers selectively oriented attention towards negative information. In the fourth study the predictive value of cognitive reactivity to sad mood (measured with the LEIDS-r questionnaire) for the first onset of depression was assessed. Among 834 never previously depressed participants, cognitive reactivity predicted first onset of depression over the subsequent two years, even when various other factors, including baseline symptoms and negative life events, were statistically controlled for. Finally, these findings are discussed and related to the existing literature Show less
We investigated the effects of two novel treatments for posttraumatic stress disorder (PTSD). The first treatment is Attentional Bias Modification (ABM). This treatment for anxiety disorders has... Show moreWe investigated the effects of two novel treatments for posttraumatic stress disorder (PTSD). The first treatment is Attentional Bias Modification (ABM). This treatment for anxiety disorders has become quite popular in a relatively short time and was featured in recent articles in the New York Times and The Economist. ABM is a brief, computerized treatment in which patients are trained to keep their attention away from the threatening stimuli from which they automatically attend. Since attentional bias (AB) is considered an important feature of PTSD, we tested ABM in a randomized controlled trial. ABM did not effect PTSD, nor did it change AB. We also investigated an individualized version of ABM in a case series and saw no therapeutic effects. Since the current popularity of ABM is based on smaller studies than our RCT, dissemination efforts may have to be reconsidered. Next, we explored the usefulness of a 8-week course of mindfulness-based cognitive therapy (MBCT) in a pilot study with patients with chronic PTSD. No adverse effects were observed and patients evaluated the course positively. About half of the patients who finished MBCT demonstrated positive clinical effects. However, considering the early dropout rate, different formats may have to be developed to increase its acceptability in this group. Show less
Drost, J.; Does, A.J.W. van der; Antypa, N.; Zitman, F.G.; Dyck, R. van; Spinhoven, P. 2012
