Autobiographical narratives in major depression: changes in memory specificity during outpatient psychodynamic psychotherapy
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Background
Previous studies have shown that patients with depression recall fewer specific autobiographical memories, a phenomenon known as overgeneral autobiographical memory (OGM). OGM refers to the retrieval of categorical memories (repeated events) and extended memories (events lasting more than 24 h), rather than specific, single-event recollections. This pattern has been linked to dysfunctional emotion regulation and childhood trauma. While most research has used the Autobiographical Memory Test (AMT) to assess OGM, such standardized cue-word paradigms are limited in capturing how autobiographical memories unfold in real-life psychotherapeutic settings. This study introduces a novel methodology to assess autobiographical memories as they naturally emerge during videotaped psychodynamic psychotherapy sessions.
Methods
We analyzed videotapes of the first and 40th psychodynamic psychotherapy sessions of 55 patients with major depression. Therapist questions served as prompts for autobiographical narratives, which were rated for specificity and overgeneralization (extended, categorical). We also examined the role of adverse childhood experiences (ACEs) in changes to memory specificity during therapy.
Results
Linear regression analysis showed a significant time × memory-type × ACE interaction. No significant changes were observed for categorical or extended memories. In contrast, for specific memories, higher ACE scores predicted fewer specific memories at baseline but greater increases in specificity from session 1 to 40.
Conclusions
This study demonstrates the feasibility of assessing autobiographical memory specificity directly within psychodynamic psychotherapy sessions. The proposed methodology provides an ecologically valid alternative to traditional lab-based assessments of autobiographical memory and can be applied in the naturalistic context of real-life therapeutic interactions. Our findings suggest a potential improvement in autobiographical memory specificity during psychodynamic psychotherapy – particularly among individuals with higher ACE scores – that may be reliably assessed using this novel approach.
Clinical trial number
Not applicable.
