Autobiographical memory specificity to attachment-related cues improves in major depression during initial...

Patients with depression tend to retrieve fewer specific autobiographical memories, a phenomenon linked to insecure attachment and emotion regulation. This study examined changes in autobiographical memory (AM) specificity in response to attachment-related cues during the initial phase of psychodynamic psychotherapy, as early change is predictive of later outcome and central psychodynamic processes occur at this stage.

Seventy-four outpatients with major depression were assessed twice during early psychodynamic psychotherapy (baseline and after M = 10.5 sessions, range = 7-21). A modified Autobiographical Memory Test with attachment-related cues was used alongside measures of depression (BDI-II), anxiety (STAI), perseverative thinking (PTQ), attachment (ECR), and emotion regulation (EAQ). Robust regression analysis examined variables associated with change in attachment-cued AM (AC-AM).

Patients recalled more specific AC-AMs after early treatment. Depression, anxiety, and perseverative thinking decreased. Higher baseline attachment anxiety was associated with less improvement in AC-AM specificity, whereas higher baseline attachment avoidance and greater reductions in affective suppression were associated with greater improvement.

During early psychodynamic treatment, patients with depression showed increased AC-AM specificity. Early gains appeared moderated by attachment style and affective suppression, suggesting that memory specificity improvement reflects emerging psychodynamic change processes related to attachment and affect regulation.