Future Thinking and Depression

Sammanfattning: The ability to imagine negative or positive future events is associated with psychological well-being. The present thesis deals with depressed individual’s ability to imagine negative or positive future events. It consists of three quantitative studies (I-III) and one qualitative study (IV).Participants in studies I-III were assessed in connection with a randomized controlled trial of two ways to deliver Internet-based treatment for major depressive disorder (MDD). Their ages ranged between 19-65 years. In addition to receiving treatment participants completed the Controlled Word Association Test; the Autobiographical Memory test (AMT) and the Future Thinking Task (FTT). Participants in study IV were recruited from a psychiatric clinic in Sweden. The sample sizes varied between study I (N=40), II (N=88), III (N=47) and IV (N=15).The aim of the first study was to compare positive and negative future thinking in a group of depressed individuals (n=20) who were compared with a matched group of non-depressed persons (n=20). The results showed that depressed persons report lower scores regarding anticipated future positive events, but that they do not differ in terms of future negative events. The aim of the second study was to examine the association between FTT and AMT in a depressed sample. The results showed that positive future thinking was significantly correlated with retrieval of specific positive autobiographical memories (r = 0.23). The results only gave weak support for an association between FTT and AMT. The aim of the third study was to investigate if scores on the FTT would change following two forms of Internet-delivered cognitive behaviour therapy for major depression (guided self-help and e-mail therapy). A second aim was to study if changes in depression scores as measured by the Beck Depression Inventory would correlate with changes in future thinking. The results showed that FTT index scores for negative events were reduced after treatment. There was no increase for the positive events. Change scores for the FTT negative events and depression symptoms were significantly correlated. The aim of the fourth study was to investigate representations of the future in depressed individuals by using open-ended methodology inspired by grounded theory. The results showed that depressed individuals experienced a state of “ambivalence”. Ambivalence and its negative emotional and cognitive effects were substantially reduced in strength when participants were asked about their distant future.The conclusions drawn from these studies are that depressed persons report lower scores regarding anticipated future positive events (Study I). There is some support for a positive association between FTT and AMT, but the association is weak and only concern positive FTT and positive AMT (Study II). Negative future thinking may be reduced after Internet-delivered treatment, and changes in depressive symptoms correlate to some extent with reductions in negative future thinking (Study III). The concept of ambivalence may be an important feature of depression which deserves more attention from both a theoretical and clinical perspective (Study VI).