Examining Autobiographical Memory Specificity, Expressed Emotional Arousal and Client Experiencing in Emotion - Focused and Client - Centered Treatments of Depression: A Process - Outcome Analysis

Abstract

Research has consistently demonstrated that clinical depression is associated with a propensity toward generic, nonspecific autobiographical memory (ABM) recall (for a review see Williams, Barnhofer, Crane, Hermans, Raes, Watkins, et al., 2007). A recent study demonstrated that although increasing degree of ABM specificity was not independently related to treatment outcome in experiential therapy for depression, a relationship between higher levels of expressed emotional arousal and more specific memory narratives existed in clients who demonstrated positive therapeutic outcome (Boritz, Angus, Monette, Hollis-Walker & Warwar, 2011). The purpose of the present study was to extend the research of Boritz et al. (2011) by examining the relation between expressed emotional arousal, ABM specificity, and client experiencing in a significantly larger depressed sample than was utilized in the original study. To this end, data from the York I & II Depression Studies of 72 depressed clients undergoing manualized psychotherapy treatment for depression was analyzed. Therapy transcripts from early, middle and late sessions were analyzed to evaluate ABM specificity, client experiencing (i.e. level of client self-reflection) and client expressed emotional arousal. Treatment outcome groups (Recovered, Unchanged) were classified based on the Beck Depression Inventory (BDI) using clinically significant change criteria identified by Jacobson and Truax (1991). Four primary findings were as follows: (1) increasing degree of ABM specificity with the progress of therapy did independently predict membership in the Recovered group at treatment end; (2) no relationship was evidenced between ABM specificity and expressed emotional arousal that distinguished clients who were Recovered vs. Unchanged; (3) there was no evidence found supporting a relationship between ABM specificity and client experiencing in predicting outcome; and (4) level of expressed emotional arousal and level of client experiencing were positively related in the Recovered group at all three phases of therapy. The findings hold clinical implications for the treatment of depression and theoretical implications for understanding the relationship between depression, memory, emotion and experiencing.