Reciprocal Prospective Effects of Momentary Cognitions and Affect in Daily Life and Mood Reactivity Toward Daily Events in Remitted Recurrent Depression

• Published in: Behavior therapy Vol. 54; no. 2; pp. 274 - 289
• Main Authors: Schricker, Isabelle Florence, Nayman, Sibel, Reinhard, Iris, Kuehner, Christine
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2023
• Subjects: Affect; Chronic Disease; Cognition; daily events; Depression; Depressive Disorder, Major; ecological momentary assessment; Humans; positive thoughts; remitted recurrent depression; rumination; positive thoughts; daily events; remitted recurrent depression; rumination; ecological momentary assessment
• ISSN: 0005-7894; 1878-1888
• DOI: 10.1016/j.beth.2022.09.001

•We ran an EMA study with remitted recurrently depressed patients (rMDD) and controls.•rMDD patients show heightened rumination and lowered mood in daily life.•rMDD patients show stronger prospective associations between rumination and affect.•rMDD patients show affective and cognitive brightening following positive daily events.•The present results support the upward spiral model. Major depressive disorder is a recurrent condition. Potential risk factors for future episodes are maladaptive cognitions, such as rumination and unfavorable reactivity toward negative daily events. Positive thoughts and positive daily events, in contrast, could act as a buffer against mood deterioration. The aim of the present study is to (a) examine differences in daily affect and cognitions in remitted depressed patients with a history of recurrent episodes (rMDD) and healthy controls, (b) analyze reciprocal prospective effects of momentary cognitions and affect, and (c) investigate effects of daily events on affect and cognitions in both groups. A sample of N = 102 participants underwent an ecological momentary assessment (EMA) phase of 5 consecutive days, where rMDD patients (n = 51) and healthy controls (n = 51) indicated their momentary rumination, positive thoughts, affect, and the occurrence of daily events 10 times per day. Via multilevel lag models, we found higher rumination to predict a decrease of positive affect (PA) in the rMDD group, but no effect of rumination on subsequent negative affect (NA) in either group. Higher positive thoughts predicted an increase in PA and a decrease in NA, similarly strong in both groups. Regarding daily events, rMDD patients reported a stronger increase in NA and rumination following negative daily events compared to controls, whereas an observed subsequent decrease of PA and positive thoughts was not moderated by group. Following positive daily events, rMDD patients showed a stronger increase in PA and positive thoughts and a stronger decrease in NA and rumination than controls. For interventions targeting relapse prevention, our results indicate the implementation of strategies fostering the responsiveness to positive events and the up-regulation of positive affect.