Computerised Memory Specificity Training (c-MeST) for Major Depression: A Randomised Controlled Trial

Background: Given modest response and high relapse after treatment for Major Depressive Episodes (MDE), the development and refinement of treatments to target cognitive vulnerabilities is indicated. Memory Specificity Training (MeST) remediates deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial aimed to assess the efficacy of an online, computerised version of MeST (c-MeST) for MDE. Methods: Adults (N = 146, 89.7% female) aged 18 and over (M age = 46.1, SD = 13.3) with a current MDE were randomised to the c-MeST program or wait-list control group. Primary outcomes were diagnostic status of MDE and self-reported depressive symptoms at baseline, post-training, one-month, and three-month follow-up. Memory specificity was assessed, as well as other variables thought to contribute to reduced memory specificity, such as rumination and cognitive avoidance. Results: Significantly fewer participants in the c-MeST group, relative to control, met criteria for an MDE at one-month follow-up (35.7% c-MeST vs. 60.6% control), but not at other time-points. The c-MeST group scored significantly higher on memory specificity at all time-points following baseline (d = 0.51 – 0.97), and lower on depressive symptoms at one (d = 0.53) and three-month follow-up (d = 0.67). Changes in memory specificity mediated the effect of c-MeST on depressive symptoms at follow-up. Few differences were noted on secondary measures.Conclusion: c-MeST can improve memory specificity and depressive symptoms in people with a MDE, and may speed the rate of recovery. Future studies can further examine the mechanisms through which this occurs.