COGNITION AND EMOTION, 2003, 17 (3), 455±475
Contextual questions prevent mood primes from maintaining experimentally induced dysphoria Ed Watkins Institute of Psychiatry, London, UK
John D. Teasdale, MRC Cognition and Brain Sciences Unit, Cambridge, UK
Ruth M. Williams Institute of Psychiatry, London, UK We investigated the effects of questions designed to increase a wider awareness of the context in which moods occur on mood-maintaining primes in induced dysphoria. These questions were incorporated, with the primes (negative Velten mood induction statements) into a scrambled sentence task. In Study 1, contextual questions produced a significantly greater reduction in despondency compared to control questions. Study 2 replicated this finding and also demonstrated that contextual questions reduced corrugator EMG response to repeated despondencyinducing statements. The results indicate that contextual questions can prevent negative primes from maintaining depressed mood, consistent with Brewin's (1989) suggestion that one mechanism of psychotherapy is reducing the activation of situationally accessible negative representations.
This paper investigates the potential role of cognitive priming in the maintenance of mood states, and, in particular, whether cognitive manipulations can prevent primes from maintaining a sad mood. Cognitive priming refers to the activation of mental representations, for example, constructs, stereotypes or memories, by the presentation of a particular cue, such as contextual features relevant to the targeted representation, often without the subject's conscious
Correspondence should be addressed to Ed Watkins, Department of Psychology, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, England, SE5 8AF, UK; e-mail:
[email protected] This article is based on research carried out by the first author in partial fulfilment for the degree of Ph.D. at the University of London, under the supervision of the second and third authors. This Ph.D. was supported by a Medical Research Council (UK) Studentship grant. # 2003 Psychology Press Ltd http://www.tandf.co.uk/journals/pp/02699931.html DOI:10.1080/02699930244000020
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awareness that such activation has occurred (Higgins, Rholes, & Jones, 1977; Riskind & Rholes, 1984). For example, the presentation of words relating to the positive or negative interpretation of a personality trait (e.g., ``persistent'' or ``stubborn'') in a scrambled sentence task can influence the subsequent categorisation of an ambiguously described stimulus person in a direction consistent with the prime (Higgins, Bargh, & Lombardi, 1985). Primes have also been demonstrated to automatically activate changes in behaviour, for example, priming an elderly stereotype can increase the time taken to walk down a corridor (Bargh, Chen, & Burrows, 1996). Research suggests that primes can also influence mood states (Brewin, 1989; Higgins, Bond, Klein, & Strauman, 1986; Rholes, Riskind, & Lane, 1987). Cognitive priming has been suggested as a mediating mechanism in moodcongruent memory, that is, the recall of memories of the same valence as the mood state during recall (i.e., negative memories in a negative mood; Riskind, 1989; Rholes et al., 1987; Varner & Ellis, 1998). Riskind and colleagues argued that the cognitions accompanying an affective state can directly prime associated items in long-term memory, such as autobiographical memories, increasing their recall accessibility. Mood-congruent memory has been identified as important in the maintenance of depression (Teasdale, 1983): Recall of negative memories in a negative mood state can initiate a vicious circle, whereby negative memories exacerbate negative mood, which in turn leads to more recall of negative memories. The importance of priming effects in the development and maintenance of emotional disorders is further demonstrated by research within the framework of self-discrepancy theory (Higgins, 1987). Within self-discrepancy theory, people are assumed to have a self-concept, which represents how they actually perceive themselves to be and self-guides, which represent how they would ideally like to be (ideal self-guide) and how they ought to be (ought self-guide). Words reflecting mismatches between the self-concept and the ideal self-guide (e.g., the word ``intelligent'' in someone who perceives himself to be stupid but who would like to be intelligent) induce dysphoric mood and increase the accessibility of negative memories (Higgins et al., 1986; Strauman, 1989, 1992; Strauman & Higgins, 1987). Because the self-discrepancy words were unobtrusively presented within a nonself-related sentence-completion task, these results suggest that the words automatically activate cognitive structures that can induce emotional discomfort (i.e., act as primes). Higgins and Strauman have suggested that unintended activation of self-discrepancies in the process of selfevaluation represent a cognitive diathesis for negative affect, potentially culminating in emotional disorder. Consistent with this proposal, compared to controls, Strauman (1989) has found, respectively, elevated discrepancies between the actual self-concept and the ideal self-guide in depressed patients and elevated discrepancies between the actual self-concept and the ought selfguide in anxious patients.
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The relevance of cognitive priming to emotional disorders has also been stressed within Brewin's (1989) account of psychotherapy. Brewin (1989) proposed two types of memory representation: (1) verbally accessible memories (VAMs); and (2) situationally accessible memories (SAMs). Verbally accessible memories (VAMs) are voluntarily accessible, manipulable, and associated with the individual's conscious experience of an event. Situationally accessible memories (SAMs) are not voluntarily accessible, but rather are only accessed when the physical features or meaning of a situation matches aspects of the original emotional event. Brewin proposed that the situational activation of a SAM automatically activates representations of the details of the physical characteristics and of the verbal, physiological, and behavioural responses that occurred in the original situation. Because, for a negative SAM, these elements could include negative thoughts and intrusive images or flashbacks of the events, the activation of negative SAMs is hypothesised to contribute to the development or maintenance of an emotional disorder. Thus, the activation of a SAM can be conceptualised as the priming of a representation that includes cognitive, emotional, and behavioural information. It is noteworthy that Brewin (1989) suggested that SAMs can be activated by physical features and by the meaning of a situationÐthis conceptualisation extends the standard definition of the priming context from simply the situational features of the environment to include thoughts and feelings. For example, considering whether one was to blame for a negative outcome might access situational memories of other outcomes for which one had felt blame at the time, which in turn may lead to further negative mood. Within this account, Brewin suggests the activation of SAMs can lead to the maintenance and exacerbation of negative mood. Thus, an upsetting event that activates a negative SAM will produce longer and more severe negative mood than an upsetting event that lowers mood without activating a negative SAM. Furthermore, Brewin (1989) proposed that the initial activation of SAMs would produce negative automatic thoughts and images (as response elements of SAMs) which could access further SAMs, producing a feedback loop that would maintain the depressed mood. Consistent with this account, Brewin, Hunter, Carroll, and Tata (1996) found that involuntary intrusive memories are common in depression and can predict the course of depression. Brewin suggested that psychotherapy, and in particular, cognitivebehavioural therapy (CBT) could work in several different ways. First, therapy could work by correcting misinterpretations in the VAM system, for example by challenging inappropriate attributions that blame negative outcomes to the self. Second, therapy could work by modifying self-regulation and by teaching the use of more effective skills. Third, therapy could work by reducing access to negative, nonconscious situational memories. Brewin (1989) suggested that influencing the content of verbally accessible knowledge to reclassify the meaning of a situation into a new category could prevent the initial activation of
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a SAM or disrupt the feedback loop whereby SAMs act to access further SAMs. In particular, Brewin (1989, p. 388) suggested that the ``therapeutic task is to recreate a plausible context that will enable patients to encode subsequent experiences in a more discriminating way, rather than perceiving them as all indicating failure, rejection and so on''. For example, by altering the perspective or assumptions used to interpret the meaning of situations (e.g., recalling the positive as well as the negative aspects of a situation) the likelihood of accessing negative SAMs (e.g. SAMs associated with failure) will be reduced. In other words, increased awareness of physical features and of meanings, other than those aspects of the situation that match negative SAMs, reduces the likelihood of that situation activating negative SAMs. Within a priming framework, this effect can be conceptualised as increased awareness of the wider context relevant to the features and meaning of a potentially priming situation. Context, here, is operationalised as all the aspects of a situation, including the meaning of the situation, as well as sensory and response elements, which could be relevant to the activation of a mental representation. Thus, Brewin predicts that one way CBT may work is by reducing the priming effects of negative meanings on the activation of situationally accessible memories, by increasing awareness of the wider context relevant to the meaning of the situation. The aim of the current studies was to provide a preliminary investigation relevant to Brewin's (1989) contextual account of therapy, that is, to determine whether increasing awareness of context relevant to the meaning of a moodrelated cognitive prime can reduce the effect of that prime on mood. Study 1 examined whether awareness of context (using contextual questions) minimises the effects on mood of a prime (negative self-referent statements, Velten, 1968) known to both activate negative cognitive representations (i.e. SAMs) and induce negative mood (Rholes et al., 1987). The priming statements followed a voluntary mood induction because we wanted to test the hypothesis suggested by Brewin (1989) and Riskind and Rholes (1985) that cognitive primes can prolong a negative mood. The combination of an induced negative mood and self-evaluative negative thoughts was intended to be an experimental analogue to the negative mood and negative thinking found in depression. Study 2 tested whether contextual questions would limit the priming effects on mood of negative cues when the cues were repeated in the absence of the contextual questions. We assumed that the contextual questions produced new representations of the Velten primes that were less likely to activate negative constructs (e.g., negative SAMs). This account predicts that prior exposure to the contextual questions should limit the impact of the Velten statements even when repeated in the absence of the questions. Consistent with Brewin's (1989) account, we hypothesised that the contextual questions work by altering the meaning of the Velten statements such that rather than activating negative constructs and memories that would maintain the induced mood, the Velten statements prime less negative constructs and memories. In other words, the
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proposed mechanism for the contextual questions is that they prevent the negative Velten statements from matching with and, thereby, activating previous negative SAMs.
STUDY 1 Study 1 aimed to evaluate the effects of contextual questions embedded within a scrambled sentence task on recovery from an induced depressed mood. The independent variable was the nature of the questions embedded within the scrambled sentence task that followed the depressed mood induction. The dependent variables were self-report of mood and psychomotor speed. We used Velten sentences in a scrambled sentence task as the moodmaintaining primes. Riskind and Rholes (1985) proposed that cognitive priming provides the most parsimonious and coherent explanation of the effects of the Velten mood induction procedure on mood and memory, with the Velten statements hypothesised to prime negative constructs that independently influence mood and memory. Although the magnitude of the mood induced by Velten statements decreases when the statements are presented with a deceptive cover story and without explicit instructions to change mood (Larsen & Sinnett, 1991), the statements can still successfully influence mood. Thus, there seems to be both a voluntary, deliberative component and a more automatic, involuntary component to the negative Velten mood induction, with the involuntary effect consistent with the idea that Velten statements act as primes. Furthermore, the Velten mood induction was more effective in producing a dysphoric mood in subjects with more irrational beliefs (Cash, Rimm, & MacKinnon, 1986), consistent with the view that the statements work by priming preexisting negative schemas. We presented the Velten sentences in a scrambled sentence format similar to that used by Bargh et al., (1996), to reduce any demand effects in the response to the Velten statements (Polivy & Doyle, 1990), that is, there were no instructions to change mood, but only instructions to unscramble the sentences. We used the Velten inductions in preference to idiographically derived self-discrepancies so that we could control the content of the primes and therefore match the content of the contextual manipulation to the content of the primes. We assumed that contextual questions would only be useful in minimising priming effects if the content of the questions was relevant to the content of the situational primes triggering a negative emotional response. We used contextual questions designed to increase awareness of a wider temporal and personal context relevant to current mood (e.g., ``How long does any mood last?'' and ``How does this one moment fit into my whole life?''). We assumed that such questions would change the meaning of Velten primes referring to negative mood, causing them to prime alternative, less negative constructs (i.e., not activate such negative SAMs). For example, the statement
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``I feel very sad'' was expected to be less likely to match pre-existing memories of severe past sadness when incorporated into the wider context of awareness that moods pass, as prompted by the question, ``How long does any mood last?''. The control questions were matched for length and structure with the contextual questions, but did not refer to mood. Table 1 lists both control and contextual questions. We expected that the Velten statements encoded in the scrambled sentence task would be effective in influencing mood to the extent that they primed negative constructs and thereby triggered involuntary responses maintaining a sad mood. We preceded the mood priming with a voluntary mood induction to maximise the likelihood of the Velten statements priming negative mood-related constructs, as Blackburn, Cameron, and Deary (1990) found that the greater the frequency of recent negative events, the greater an individual's response to a Velten mood induction. We predicted that the scrambled Velten statements would act as a covert mood-maintaining prime in the control group, slowing the rapid fading away of mood normally observed following a depressed mood induction (Frost & Green, 1982; Isen & Gorgolione, 1983). However, in the contextual group, we predicted that the increased awareness of the temporal context would minimise the priming effects of the Velten statements. In other words, we predicted that the increased awareness of temporal context would prevent the Velten statements from activating constructs concerned with negative selfevaluation, which have a significant effect on maintaining negative mood. Therefore, we predicted that there would be a significantly greater decrease in self-ratings of despondency in the contextual group compared to the control group.
Method Participants A total of 56 volunteers meeting the following criteria were recruited by press advertisements: age 18±65; no evidence of DSM-IIIR (APA, 1987) diagnoses of present or past major depression or dysthymia, as revealed by a Structured Clinical Interview for Diagnosis (SCID; Spitzer, Williams, Gibbon, & First, 1990); and a Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) score
