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Why dysfunctional expectations in depression persist – Results from two experimental studies investigating cognitive immunization

Published online by Cambridge University Press:  22 August 2018

Tobias Kube ,
Winfried Rief ,
Mario Gollwitzer ,
Thomas Gärtner  and
Julia Anna Glombiewski
Tobias Kube*
Affiliation:
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
Winfried Rief
Affiliation:
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
Mario Gollwitzer
Affiliation:
Department of Psychological Methodology and Social Psychology, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
Thomas Gärtner
Affiliation:
Schön Klinik Bad Arolsen, Hofgarten 10, D-34454 Bad Arolsen, Germany
Julia Anna Glombiewski
Affiliation:
Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Gutenbergstraße 18, D-35032 Marburg, Germany
*
Author for correspondence: Tobias Kube, E-mail: [email protected]
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Abstract

Background

Research has revealed that negative expectations impact depressive symptoms. However, research on the change of dysfunctional expectations in depression is lacking so far. Therefore, the present research aimed to fill this gap by testing the hypothesis that people with the major depressive disorder (MDD), contrary to healthy individuals, maintain their expectations despite experiences that positively disconfirm expectations. Further, it was hypothesized that cognitive immunization (a cognitive reappraisal of the disconfirming evidence) is a mechanism underlying the persistence of expectations.

Method

In Study 1, we compared individuals with MDD (N = 58) to healthy individuals (N = 59). Participants worked on the same performance test and received standardized feedback that either confirmed or disconfirmed their initial performance expectations. In Study 2, we investigated the effects of cognitive immunization on expectation change among 59 individuals reporting elevated levels of depression by varying the appraisal of expectation-disconfirming feedback.

Results

Results from Study 1 show that in the expectation-disconfirming condition, healthy individuals changed their expectations, whereas individuals with MDD did not. No such difference between the two groups was found for expectation-confirming feedback. Results from Study 2 indicated that varying cognitive immunization impacted expectation change, thus suggesting a crucial role of cognitive immunization in expectation change.

Conclusions

These two studies indicated that individuals suffering from depression have more difficulties in changing their expectations after disconfirming experiences than do healthy individuals, and cognitive immunization might be a core mechanism underlying expectation persistence. Therefore, psychotherapeutic interventions should aim to inhibit cognitive immunization processes to enhance expectation change.

Keywords

Behavioral experimentexpectationexpectation persistenceexpectancy violationimmunizationmajor depression.
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 9 , July 2019 , pp. 1532 - 1544
Copyright
Copyright © Cambridge University Press 2018 

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