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    • Our findings indicate that memory cueing can modulate positi

    2018-11-14

    Our findings indicate that memory cueing can modulate positive interpretations of new ambiguous scenes, while it did not impact negative interpretations. In line with previous studies, the absence of an effect of cueing on negative interpretations coincided with a general tendency of these participants to interpret ambiguous scenes more positively than negatively (Mathews and Mackintosh, 2000; Yiend et al., 2005; Mackintosh et al., 2006). We speculate that psychologically healthy individuals evaluate a negative outcome of an ambiguous situation as less likely due to their stable positive mental schemas. Furthermore, this tendency is stable and cannot be modified by a single intervention, such as cueing a negatively resolved scene during sleep. In depression and anxiety disorders, the interpretation and memory for ambiguous situations have been found to be negatively biased (Clark and Wells, 1995; Whitney et al., 2012; Dalgleish and Werner-Seidler, 2014). Because of more negative and less positive mental schemas in depressed and anxious patients we would expect that cueing positive experiences will not lead to generalization whereas this should be the case when cueing negative experiences. This order W 54011 needs to be tested in future experiments. Our finding that cueing can benefit the stabilization and generalization of newly acquired outcomes of ambiguous situations opens new research directions for clinical psychology and intervention development. One major goal in cognitive therapy is to reduce negative interpretations of ambiguous situations by challenging the interpretation (i.e. identifying distortions in the interpretation; cognitive restructuring of interpretation) (Beck, 1976). More recent intervention development includes training positive interpretations of ambiguous situations to over-ride negative interpretations, through computer-based platforms that can augment traditional cognitive therapies by offering repetitive training and habit building (Holmes et al., 2008; Mathews et al., 2013). Importantly, initial studies even point towards the great potential of CBM-I to alter negative interpretation biases in children and adolescents suffering from anxiety disorders. However, the importance for future research to identify how to maximize this potential has been clearly pointed out (Salemink and Wiers, 2011; Lau, 2013). Our findings indicate that memory for the trained items is an essential factor that might determine how efficient such training is in modulating individual biases. Further issues in CBM-I are related to the generalizability of the training-induced interpretation bias and the persistence of effects. Considering memory cueing during sleep in this context might not only help to increase our understanding of the psychopathological mechanisms of mental disorders but also give implications on how to support interventions targeting memory-related distortions. Future research should investigate whether cueing is capable of (1) changing mood as reported in previous studies on CBM-I (Holmes et al., 2008; Mathews et al., 2013), (2) modulating emotional processing of ambiguous situations as indicated by the heart rate response or subjective measures of stress and (3) altering how people respond to real-life ambiguous situations. Cueing the content of cognitive bias modification trainings during post-intervention periods of sleep with audio recordings (i.e. the phrases that disambiguate initally ambiguous scenes in a positive way) might enhance the effects of CBM-I as a clinical intervention. The method of post-interventional cueing is already applied in imagery rescripting techniques. Here, traumatized patients are guided to imagine problematic imagery of a scene from their lives, rescript the circumstances in a positive way during the therapy session and are advised to listen to a audio recording of that session at home (Holmes et al., 2007). To date, such cueing procedures are conducted during wakefulness but moving such components of interventions into sleep might be even more efficient. Future studies that examine these memory cueing and consolidation processes in clinical populations may reveal opportunities to translate advances in the neuroscience of sleep into models of developmental psychopathology that directly influence clinical practice.