Autobiographical Narratives in Major Depression: Changes in Overgeneralization During Outpatient Psychodynamic Psychotherapy

Background: Previous studies have shown that patients with depression recall less specific autobiographical memories, a phenomenon known as overgeneral autobiographical memory. This is often linked to dysfunctional emotion regulation and childhood trauma. Most research has used the Autobiographical Memory Test, but this study is the first to assess autobiographical memories directly evoked during psychotherapy. Methods: We analyzed videotapes of the first and 40th psychotherapy sessions of 55 patients with major depression. Therapist questions served as prompts for autobiographical narratives, which were rated for specificity and overgeneralization. We also examined the role of adverse childhood experiences in changes to memory specificity during therapy. Results: A significant decrease in categorical memories, a subtype of overgeneral autobiographical memories, was observed between the first and 40th sessions. Additionally, adverse childhood experiences were linked to greater improvement in overgeneral memory during therapy. Conclusions: This study is the first to assess autobiographical memory specificity directly within psychotherapy sessions. The findings suggest that psychotherapy leads to a reduction in overgeneral autobiographical memories, measurable with our new methodology. Further research is needed to confirm these results. Clinical trial number: not applicable.