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Kris Van den Broeck
                                    Psychologist / Behaviour Therapist / PhD student
                                    kris.vandenbroeck@ppw.kuleuven.be




                                    AUTOBIOGRAPHICAL MEMORY
                                    CHARACTERISTICS IN RELATION TO
                                    BORDERLINE COMPLAINTS
                                    In cooperation with Jasmin Reza, Loes Koolen, Prof. Dr. Guido
    7th Autobiographical Memory
  and Psychopathology Meeting,
June 13th, 2012, Aarhus, Denmark.   Pieters MD, Prof. Dr. Laurence Claes, and Prof. Dr. Filip Raes
Introduction: Observations
Autobiographical Memory Characteristic         In MDD/PTSD                      In BPD
• Overgeneral Memory (OGM)
 “Every time I play tennis” vs
                                                    Robust                 Inconsistent
 “That one set I broke my racquet in that            (e.g., …)

 thrilling tiebreak against my brother.”



• Cue Discrepancy                                                         Some evidence
                                             Some evidence                (e.g., Van den Broeck,
 “Happy” (HD) vs “Polite” (LD)               (e.g., Crane, Barnhofer, &
                                                                          Pieters, Claes, & Raes,
                                                   Williams, 2007)
                                                                                   2011)



• Vantage Point during Recall (VPR)
 Observer perspective vs Field perspective    More recently
                                              (e.g., Kuyken & Moulds,          No data
                                                       2009)
Introduction: Research Questions

1. What about …
          Overgeneral
            Memory

          Borderline
          Complaints




           Hypotheses

 r(BPD complaints, %Cat(HD)) > 0
Introduction: Research Questions

1. What about …

          Borderline
          Complaints

            Vantage
          Perspective
         during Recall

           Hypotheses

 r(BPD complaints, %Cat(HD)) > 0
 r(BPD complaints, %Obs(HD)) > 0
Introduction: Research Questions

1. What about …                       2. What about …
                                                • “The ability to inhibit a
          Overgeneral                             dominant response to perform
            Memory                                a subdominant response”
                                                  (Rothbart & Bates, 2006)


          Borderline           Effortful        • In general lower EC in
                                                  personality disorders (Claes et al.,
          Complaints           Control            2009)


                                                • Associated with social skills,
            Vantage                               conscience development,
          Perspective                             sympathy/empathy (Eisenberg et
                                                  al., 1996; Kochanska et al., 1996; Spinrad
         during Recall                            et al., 2007; Valiente et al., 2004).



           Hypotheses                              Exploration

 r(BPD complaints, %Cat(HD)) > 0           r(EC, BPD complaints) < 0 ?
                                               r(EC, %Cat(HD)) = ?
 r(BPD complaints, %Obs(HD)) > 0               r(EC, %Obs(HD)) = ?
Study 1: Set-up
Participants      Instruments
   N = 148          Autobiographical Memory Task            (Williams & Broadbent, 1986)

                        Written, minimal instructions
   Community
                        10 HD cues, 10 LD cues (Dicrep. ~ MDD)
   sample
   82 females       Borderline Syndrome Index          (Vertommen & Van de Wygaert, 1988)

                        52 items, yes/no
   17-30 years
                        4 factors:
   (M = 21.32;
                            Failing Social Skills (FSS)
   SD = 3.22)
                            Difficult Interpersonal Relationships (DIR)
   76% finished             Negative Self-Concept (NSC)
   higher                   Anxiety (ANX)
   education
                    Effortful Control scale of Adult Temperament Questionnaire                 (Hartman
                    & Rothbart, 2001)
                        19 items, 8-point Likert scale
                        3 factors:
                            Attentional Control (ATT): the ability to change / focus attention when
                            desired
                            Activation Control (ACT): the ability to perform an action when there is a
                            strong tendency not to / to avoid it
                            Inhibitory Control (INH): the ability to suppress inadequate behaviour
Study 1: Results
          Results
          %catHD   %catLD   %obs   %obsHD   %obsLD   BSI-tot   BSI-FSS   BSI-DIR     BSI-NSC    BSI-ANX
%cat      .86**    .85**    -.05   -.08     -.03     .07       .11       -.03        .01        .10
%catHD             .47**    -.07   -.11     -.03     .10       .13       .01         .05        .12
%catLD                      -.01   -.02     -.02     .02       .06       -.06        -.02       .04
%obs                               .90**    .88**    .14       .17*      .14         .04        .11
%obsHD                                      .60**    .16       .20*      .19*        .06        .10
%obsLD                                               .07       .09       .06         .00        .09
BSI-tot                                                        .79**     .77**       .90**      .84**
BSI-FSS                                                                  .51**       .62**      .53**
BSI-DIR                                                                              .64**      .49**
BSI-NSC                                                                                         .67**
BSI-ANX
                                                                 Controlled for depression severity and age

          No associations between OGM and BPD complaints!
          VPR following HD cues associated with social BPD complaints!
Study 1: Results
  Results (exploration EC)
          EC-ATT   EC-ACT   EC-INH   %obsHD   BSI-tot   BSI-FSS   BSI-DIR     BSI-NSC    BSI-ANX
EC-tot    .79**    .79**    .72**    -.18*    -.43**    -.40**    -.34**      -.30**     -.36**
EC-ATT             .53**    .39**    -.18*    -.51**    -.47**    -.37**      -.41**     -.44**
EC-ACT                      .24**    -.22**   -.38**    -.40**    -.36**      -.25**     -.25**
EC-INH                               -.05     -.19*     -.13      -.10        -.16       -.23**
%obsHD                                        -.15      .06       .19*        .19*       .09
BSI-tot                                                 .90**     .77**       .79**      .84**
BSI-FSS                                                           .65**       .62**      .67**
BSI-DIR                                                                       .51**      .49**
BSI-NSC                                                                                  .54**
BSI-ANX
                                                          Controlled for depression severity and age

  EC negatively associated with BPD symptoms (not INH) = replication
  EC negatively associated with VPR (observer) (not INH)
  Mediation of EC between BPD symptoms and VPR?
Study 1: Results
Results (exploration EC)
  Preacher & Hayes bootstrapping
  5000 resamples
  .0006 < c-c’ < .0049 (90% CI)
  Yes, mediation
                       Interpersonal      c’ = .00
                         Borderline                     Observer
                         symptoms                      perspective



                           a = -.05**                b = -.04**

                                        Activation
                                         control
Study 1: Conclusions
No associations between BPD complaints and OGM
   Due to set of cues?

Given the association between BPD symptoms and observer
perspective during retrieval:
   VPR especially associated with interpersonal problems: what is the role of field perspective
   in interpersonal relationships? Field perspective necessary to build / maintain stable
   interpersonal relations?
   Cluster empathy / effortful control / vantage perspective (during recall) / interpersonal
   difficulties?

EC mediates relationship between BPD symptoms and VPR
   Therapeutic strategies that enlarge EC and diminish avoidance (MBT / MBCT / ACT /
   exposure) may work in BPD patients

Note: community sample!

Van den Broeck, Reza, Nelis, Claes, Pieters, & Raes (in prep). Effortful Control
   mediates between Borderline Symptoms and Vantage Perspective during
   Autobiographical Memory Retrieval.
Study 2: Set-up
Participants    Instruments
  N = 120         Autobiographical Memory Task       (Williams & Broadbent, 1986)
  Community          Written, minimal instructions
  sample             8 HD cues + 8 LD cues (Discrep. ~ BPD)
  55 females
  17-30 years     Borderline Syndrome Index (Vertommen & Van de Wygaert, 1988)
  (M = 21.19;
  SD = 1.60)
                  Effortful Control scale of Adult Temperament Questionnaire
                  (Hartman & Rothbart, 2001)
Study 2: Results
          Results
          %catHD   %catLD   %obs   %obsHD   %obsLD   BSI-tot   BSI-FSS   BSI-DIR     BSI-NSC    BSI-ANX
%cat      .84**    .88**    -.07   -.01     -.12     .01       -.05      .06         .12        -.09
%catHD             .48**    -.13   -.05     -.17     .12       .02       .18~        .18*       -.04
%catLD                      -.01   .03      -.04     -.08      -.09      -.06        .04        -.11
%obs                               .87**    .88**    -.08      -.12      -.05        -.09       .04
%obsHD                                      .54**    .01       .11       .03         -.01       .12
%obsLD                                               -.15      -.10      -.10        -.15       -.05
BSI-tot                                                        .69**     .73**       .78**      .68**
BSI-FSS                                                                  .33**       .42**      .24**
BSI-DIR                                                                              .66**      .30**
BSI-NSC                                                                                         .30**
BSI-ANX
                                                                         Controlled for depression severity

          OGM following HD cues associated with negative self-concept!
          No associations between VPR and (social) BPD complaints!
          Again: EC was negatively associated with BPD complaints!
General Conclusions
Stable negative correlations between EC-scales and BPD
complaints, even when controlled for depression severity.


Both studies suggest that discrepancy is an important element,
thereby supporting the idea that high discrepant information leads
to a reallocation of resources towards the self (self-coherence), as
is suggested by models on autobiographical memory organisation.


Study 1: EC(ACT) mediates between BPD complaints and vantage
perspective, suggesting that BPD complaints will ameliorate from
therapeutic strategies as MBCT, ACT, MBT, and exposure.


Note: community sample! No data on trauma/medication/…
General Conclusions
But: VPR~BPD (study 1)                      OGM~BPD (study 2)!
 Sample differences?
 Different cues?
                   Study 1                                  Study 2
   Polite (LD), happy (HD), honest (LD),          Satisfied (HD), tired (LD),
    enjoying (HD), just (LD), optimistic           optimistic (LD), stressed
      (HD), respectful (LD), energetic          (LD), self-assured (HD), sad
     (HD), sincere (LD), satisfied (HD),            (HD), successful (HD),
     intelligent (LD), pleasurable (HD),
        neat (LD), self-assured (HD),
   sensitive (LD), relaxed (HD), grateful
                                            ?    clumsy (LD), creative (LD),
                                                 dissatisfied (LD), energetic
                                                (LD), unhappy (HD), relaxed
    (LD), successful (HD), reliable (LD),            (HD), insecure (HD),
               and active (HD)                  enjoying (LD), disappointed
             Schoofs et al. (2010)                           (HD)
 Other suggestions?
Ende
General Conclusions
Study 1: Conclusions

1. What about …                      2. What about …
                                           • “The ability to inhibit a
         Overgeneral                         dominant response to perform
           Memory                            a subdominant response”
                                             (Rothbart & Bates, 2006)


         Borderline           Effortful    • In general lower EC in
                                             personality disorders (Claes et al.,
         Complaints           Control        2009)


                                           • Associated with social skills,
           Vantage                           conscience development,
         Perspective                         sympathy/empathy (Eisenberg et
                                             al., 1996; Kochanska et al., 1996; Spinrad
        during Recall                        et al., 2007; Valiente et al., 2004).



            Results

r(BPD complaints, %Cat(HD)) = 0
Study 1: Conclusions

1. What about …                        2. What about …
                                                 • “The ability to inhibit a
          Overgeneral                              dominant response to perform
            Memory                                 a subdominant response”
                                                   (Rothbart & Bates, 2006)


           Borderline           Effortful        • In general lower EC in
                                                   personality disorders (Claes et al.,
           Complaints           Control            2009)


                                                 • Associated with social skills,
             Vantage                               conscience development,
           Perspective                             sympathy/empathy (Eisenberg et
                                                   al., 1996; Kochanska et al., 1996; Spinrad
          during Recall                            et al., 2007; Valiente et al., 2004).



             Results                                   Results

 r(BPD complaints, %Cat(HD)) = 0            r(EC, BPD complaints) < 0

r(social complaints, %Obs(HD)) > 0
Study 1: Conclusions

1. What about …                        2. What about …
                                                 • “The ability to inhibit a
          Overgeneral                              dominant response to perform
            Memory                                 a subdominant response”
                                                   (Rothbart & Bates, 2006)


           Borderline           Effortful        • In general lower EC in
                                                   personality disorders (Claes et al.,
           Complaints           Control            2009)


                                                 • Associated with social skills,
             Vantage                               conscience development,
           Perspective                             sympathy/empathy (Eisenberg et
                                                   al., 1996; Kochanska et al., 1996; Spinrad
          during Recall                            et al., 2007; Valiente et al., 2004).



             Results                                   Results

 r(BPD complaints, %Cat(HD)) = 0            r(EC, BPD complaints) < 0
                                               r(EC, %Cat(HD)) = 0
r(social complaints, %Obs(HD)) > 0             r(EC, %Obs(HD)) < 0

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20120613 7th special interest meeting

  • 1. Kris Van den Broeck Psychologist / Behaviour Therapist / PhD student kris.vandenbroeck@ppw.kuleuven.be AUTOBIOGRAPHICAL MEMORY CHARACTERISTICS IN RELATION TO BORDERLINE COMPLAINTS In cooperation with Jasmin Reza, Loes Koolen, Prof. Dr. Guido 7th Autobiographical Memory and Psychopathology Meeting, June 13th, 2012, Aarhus, Denmark. Pieters MD, Prof. Dr. Laurence Claes, and Prof. Dr. Filip Raes
  • 2. Introduction: Observations Autobiographical Memory Characteristic In MDD/PTSD In BPD • Overgeneral Memory (OGM) “Every time I play tennis” vs Robust Inconsistent “That one set I broke my racquet in that (e.g., …) thrilling tiebreak against my brother.” • Cue Discrepancy Some evidence Some evidence (e.g., Van den Broeck, “Happy” (HD) vs “Polite” (LD) (e.g., Crane, Barnhofer, & Pieters, Claes, & Raes, Williams, 2007) 2011) • Vantage Point during Recall (VPR) Observer perspective vs Field perspective More recently (e.g., Kuyken & Moulds, No data 2009)
  • 3. Introduction: Research Questions 1. What about … Overgeneral Memory Borderline Complaints Hypotheses r(BPD complaints, %Cat(HD)) > 0
  • 4. Introduction: Research Questions 1. What about … Borderline Complaints Vantage Perspective during Recall Hypotheses r(BPD complaints, %Cat(HD)) > 0 r(BPD complaints, %Obs(HD)) > 0
  • 5. Introduction: Research Questions 1. What about … 2. What about … • “The ability to inhibit a Overgeneral dominant response to perform Memory a subdominant response” (Rothbart & Bates, 2006) Borderline Effortful • In general lower EC in personality disorders (Claes et al., Complaints Control 2009) • Associated with social skills, Vantage conscience development, Perspective sympathy/empathy (Eisenberg et al., 1996; Kochanska et al., 1996; Spinrad during Recall et al., 2007; Valiente et al., 2004). Hypotheses Exploration r(BPD complaints, %Cat(HD)) > 0 r(EC, BPD complaints) < 0 ? r(EC, %Cat(HD)) = ? r(BPD complaints, %Obs(HD)) > 0 r(EC, %Obs(HD)) = ?
  • 6. Study 1: Set-up Participants Instruments N = 148 Autobiographical Memory Task (Williams & Broadbent, 1986) Written, minimal instructions Community 10 HD cues, 10 LD cues (Dicrep. ~ MDD) sample 82 females Borderline Syndrome Index (Vertommen & Van de Wygaert, 1988) 52 items, yes/no 17-30 years 4 factors: (M = 21.32; Failing Social Skills (FSS) SD = 3.22) Difficult Interpersonal Relationships (DIR) 76% finished Negative Self-Concept (NSC) higher Anxiety (ANX) education Effortful Control scale of Adult Temperament Questionnaire (Hartman & Rothbart, 2001) 19 items, 8-point Likert scale 3 factors: Attentional Control (ATT): the ability to change / focus attention when desired Activation Control (ACT): the ability to perform an action when there is a strong tendency not to / to avoid it Inhibitory Control (INH): the ability to suppress inadequate behaviour
  • 7. Study 1: Results Results %catHD %catLD %obs %obsHD %obsLD BSI-tot BSI-FSS BSI-DIR BSI-NSC BSI-ANX %cat .86** .85** -.05 -.08 -.03 .07 .11 -.03 .01 .10 %catHD .47** -.07 -.11 -.03 .10 .13 .01 .05 .12 %catLD -.01 -.02 -.02 .02 .06 -.06 -.02 .04 %obs .90** .88** .14 .17* .14 .04 .11 %obsHD .60** .16 .20* .19* .06 .10 %obsLD .07 .09 .06 .00 .09 BSI-tot .79** .77** .90** .84** BSI-FSS .51** .62** .53** BSI-DIR .64** .49** BSI-NSC .67** BSI-ANX Controlled for depression severity and age No associations between OGM and BPD complaints! VPR following HD cues associated with social BPD complaints!
  • 8. Study 1: Results Results (exploration EC) EC-ATT EC-ACT EC-INH %obsHD BSI-tot BSI-FSS BSI-DIR BSI-NSC BSI-ANX EC-tot .79** .79** .72** -.18* -.43** -.40** -.34** -.30** -.36** EC-ATT .53** .39** -.18* -.51** -.47** -.37** -.41** -.44** EC-ACT .24** -.22** -.38** -.40** -.36** -.25** -.25** EC-INH -.05 -.19* -.13 -.10 -.16 -.23** %obsHD -.15 .06 .19* .19* .09 BSI-tot .90** .77** .79** .84** BSI-FSS .65** .62** .67** BSI-DIR .51** .49** BSI-NSC .54** BSI-ANX Controlled for depression severity and age EC negatively associated with BPD symptoms (not INH) = replication EC negatively associated with VPR (observer) (not INH) Mediation of EC between BPD symptoms and VPR?
  • 9. Study 1: Results Results (exploration EC) Preacher & Hayes bootstrapping 5000 resamples .0006 < c-c’ < .0049 (90% CI) Yes, mediation Interpersonal c’ = .00 Borderline Observer symptoms perspective a = -.05** b = -.04** Activation control
  • 10. Study 1: Conclusions No associations between BPD complaints and OGM Due to set of cues? Given the association between BPD symptoms and observer perspective during retrieval: VPR especially associated with interpersonal problems: what is the role of field perspective in interpersonal relationships? Field perspective necessary to build / maintain stable interpersonal relations? Cluster empathy / effortful control / vantage perspective (during recall) / interpersonal difficulties? EC mediates relationship between BPD symptoms and VPR Therapeutic strategies that enlarge EC and diminish avoidance (MBT / MBCT / ACT / exposure) may work in BPD patients Note: community sample! Van den Broeck, Reza, Nelis, Claes, Pieters, & Raes (in prep). Effortful Control mediates between Borderline Symptoms and Vantage Perspective during Autobiographical Memory Retrieval.
  • 11. Study 2: Set-up Participants Instruments N = 120 Autobiographical Memory Task (Williams & Broadbent, 1986) Community Written, minimal instructions sample 8 HD cues + 8 LD cues (Discrep. ~ BPD) 55 females 17-30 years Borderline Syndrome Index (Vertommen & Van de Wygaert, 1988) (M = 21.19; SD = 1.60) Effortful Control scale of Adult Temperament Questionnaire (Hartman & Rothbart, 2001)
  • 12. Study 2: Results Results %catHD %catLD %obs %obsHD %obsLD BSI-tot BSI-FSS BSI-DIR BSI-NSC BSI-ANX %cat .84** .88** -.07 -.01 -.12 .01 -.05 .06 .12 -.09 %catHD .48** -.13 -.05 -.17 .12 .02 .18~ .18* -.04 %catLD -.01 .03 -.04 -.08 -.09 -.06 .04 -.11 %obs .87** .88** -.08 -.12 -.05 -.09 .04 %obsHD .54** .01 .11 .03 -.01 .12 %obsLD -.15 -.10 -.10 -.15 -.05 BSI-tot .69** .73** .78** .68** BSI-FSS .33** .42** .24** BSI-DIR .66** .30** BSI-NSC .30** BSI-ANX Controlled for depression severity OGM following HD cues associated with negative self-concept! No associations between VPR and (social) BPD complaints! Again: EC was negatively associated with BPD complaints!
  • 13. General Conclusions Stable negative correlations between EC-scales and BPD complaints, even when controlled for depression severity. Both studies suggest that discrepancy is an important element, thereby supporting the idea that high discrepant information leads to a reallocation of resources towards the self (self-coherence), as is suggested by models on autobiographical memory organisation. Study 1: EC(ACT) mediates between BPD complaints and vantage perspective, suggesting that BPD complaints will ameliorate from therapeutic strategies as MBCT, ACT, MBT, and exposure. Note: community sample! No data on trauma/medication/…
  • 14. General Conclusions But: VPR~BPD (study 1) OGM~BPD (study 2)! Sample differences? Different cues? Study 1 Study 2 Polite (LD), happy (HD), honest (LD), Satisfied (HD), tired (LD), enjoying (HD), just (LD), optimistic optimistic (LD), stressed (HD), respectful (LD), energetic (LD), self-assured (HD), sad (HD), sincere (LD), satisfied (HD), (HD), successful (HD), intelligent (LD), pleasurable (HD), neat (LD), self-assured (HD), sensitive (LD), relaxed (HD), grateful ? clumsy (LD), creative (LD), dissatisfied (LD), energetic (LD), unhappy (HD), relaxed (LD), successful (HD), reliable (LD), (HD), insecure (HD), and active (HD) enjoying (LD), disappointed Schoofs et al. (2010) (HD) Other suggestions?
  • 15. Ende
  • 17. Study 1: Conclusions 1. What about … 2. What about … • “The ability to inhibit a Overgeneral dominant response to perform Memory a subdominant response” (Rothbart & Bates, 2006) Borderline Effortful • In general lower EC in personality disorders (Claes et al., Complaints Control 2009) • Associated with social skills, Vantage conscience development, Perspective sympathy/empathy (Eisenberg et al., 1996; Kochanska et al., 1996; Spinrad during Recall et al., 2007; Valiente et al., 2004). Results r(BPD complaints, %Cat(HD)) = 0
  • 18. Study 1: Conclusions 1. What about … 2. What about … • “The ability to inhibit a Overgeneral dominant response to perform Memory a subdominant response” (Rothbart & Bates, 2006) Borderline Effortful • In general lower EC in personality disorders (Claes et al., Complaints Control 2009) • Associated with social skills, Vantage conscience development, Perspective sympathy/empathy (Eisenberg et al., 1996; Kochanska et al., 1996; Spinrad during Recall et al., 2007; Valiente et al., 2004). Results Results r(BPD complaints, %Cat(HD)) = 0 r(EC, BPD complaints) < 0 r(social complaints, %Obs(HD)) > 0
  • 19. Study 1: Conclusions 1. What about … 2. What about … • “The ability to inhibit a Overgeneral dominant response to perform Memory a subdominant response” (Rothbart & Bates, 2006) Borderline Effortful • In general lower EC in personality disorders (Claes et al., Complaints Control 2009) • Associated with social skills, Vantage conscience development, Perspective sympathy/empathy (Eisenberg et al., 1996; Kochanska et al., 1996; Spinrad during Recall et al., 2007; Valiente et al., 2004). Results Results r(BPD complaints, %Cat(HD)) = 0 r(EC, BPD complaints) < 0 r(EC, %Cat(HD)) = 0 r(social complaints, %Obs(HD)) > 0 r(EC, %Obs(HD)) < 0