BACKGROUND: Decades of research have investigated the impact of clinical depression on memory, which has revealed biases and in some cases impairments. However, little is understood about the effects of subclinical symptoms of depression on memory performance in the general population. METHODS: Here we report the effects of symptoms of depression on memory problems in a large population-derived cohort (N = 2544), 87% of whom reported at least one symptom of depression. Specifically, we investigate the impact of depressive symptoms on subjective memory complaints, objective memory performance on a standard neuropsychological task and, in a subsample (n = 288), objective memory in affective contexts. RESULTS: There was a dissociation between subjective and objective memory performance, with depressive symptoms showing a robust relationship with self-reports of memory complaints, even after adjusting for age, sex, general cognitive ability and symptoms of anxiety, but not with performance on the standardised measure of verbal memory. Contrary to our expectations, hippocampal volume (assessed in a subsample, n = 592) did not account for significant variance in subjective memory, objective memory or depressive symptoms. Nonetheless, depressive symptoms were related to poorer memory for pictures presented in negative contexts, even after adjusting for memory for pictures in neutral contexts. CONCLUSIONS: Thus the symptoms of depression, associated with subjective memory complaints, appear better assessed by memory performance in affective contexts, rather than standardised memory measures. We discuss the implications of these findings for understanding the impact of depressive symptoms on memory functioning in the general population.
BACKGROUND: Decades of research have investigated the impact of clinical depression on memory, which has revealed biases and in some cases impairments. However, little is understood about the effects of subclinical symptoms of depression on memory performance in the general population. METHODS: Here we report the effects of symptoms of depression on memory problems in a large population-derived cohort (N = 2544), 87% of whom reported at least one symptom of depression. Specifically, we investigate the impact of depressive symptoms on subjective memory complaints, objective memory performance on a standard neuropsychological task and, in a subsample (n = 288), objective memory in affective contexts. RESULTS: There was a dissociation between subjective and objective memory performance, with depressive symptoms showing a robust relationship with self-reports of memory complaints, even after adjusting for age, sex, general cognitive ability and symptoms of anxiety, but not with performance on the standardised measure of verbal memory. Contrary to our expectations, hippocampal volume (assessed in a subsample, n = 592) did not account for significant variance in subjective memory, objective memory or depressive symptoms. Nonetheless, depressive symptoms were related to poorer memory for pictures presented in negative contexts, even after adjusting for memory for pictures in neutral contexts. CONCLUSIONS: Thus the symptoms of depression, associated with subjective memory complaints, appear better assessed by memory performance in affective contexts, rather than standardised memory measures. We discuss the implications of these findings for understanding the impact of depressive symptoms on memory functioning in the general population.
Mood fluctuates throughout the day as well as the lifespan, though overall most individuals
feel ‘fine’ most of the time (Taquet et al.
2016). At one time or another, however, virtually
everyone will experience low mood that is significant enough to endorse one or more symptoms
of depression. In 24% of the cases, this will be severe enough to meet diagnostic criteria
for major depressive disorder (Kessler et al.
2005; Kessler & Bromet, 2013). Much needed research has been dedicated to the
affective, cognitive and neurobiological correlates of these major depressive episodes
(Davidson et al.
2002; Gotlib & Joormann, 2010; Menon, 2011). Less however is known about the cognitive effects of depressive symptoms
within the subclinical range commonly experienced by the general population. Here we explore
the impact of depressive symptoms on memory, as experienced by a population cohort of over
2500 adults that was specifically selected for being currently free of neuropsychiatric
disorders (the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) cohort; http://www.cam-can.org).
Importantly, these individuals were tested on a range of memory measures including
subjective memory complaints, performance on a standardized measure of memory, and
performance (in a subset of the cohort) on a task specifically designed to assess memory in
affective contexts.The findings from the clinical literature suggest the ability to recall relevant
information over time is reduced in individuals who experience depression (Burt et
al.
1995; Rock et al.
2014). One possible neurobiological mechanism for
these memory problems is prolonged exposure to elevated levels of corticosteroids, owing to
the heightened psychological stress experienced in a depressive episode (Lamers et
al.
2013; Baumeister et al.
2014; Hammen, 2015). The animal literature shows robust, well-replicated associations between
stress exposure, levels of corticosteroids and memory performance, specifically through the
neurodegenerative effect of corticosteroids on the hippocampus (for a review see: Kim
& Diamond, 2002), which is critical to the
consolidation of information into long-term memory (Bird & Burgess, 2008). Studies in human depression yield more equivocal
results, though evidence generally supports the theory of volumetric shrinkage of the
hippocampal complex in individuals suffering from depression (MacQueen & Frodl,
2011; Fried & Kievit, 2015). However, the field faces methodological
challenges, some of which are inherent to the population under investigation. For example,
comparing brain abnormalities across studies entails comparing across subtypes of
depression, different levels of chronicity, environmental factors and variations in exposure
to psychotropic medication (Fried et al.
2014). Moreover, little is known about how the
effects of clinical depression on memory relate to the effects of (subclinical) symptoms of
depression experienced in the general population. Building on the clinical literature, the
present study aims to address this gap. We predicted that symptoms of depression experienced
in the general population would be related to memory impairments (as assessed by a
standardized measure of memory), and that this relationship would be associated with smaller
hippocampal volumes.The association between depressive symptoms and subjective memory complaints has been the
focus of considerable previous research, especially in late adulthood (Jorm et al.
2001; Minett et al.
2008; Kim et al.
2013; Crumley et al.
2014; Yates et al.
2015). Research into the predictive utility of
subjective memory complaints for objective memory performance and dementia diagnoses in
older adults has revealed that subjective memory complaints may be better accounted for by
individuals’ levels of depressive symptomatology than their actual memory performance (e.g.
Schofield et al.
1997; Reid & MacLullich, 2006; Hülür et al.
2014; Yates et al.
2017). In line with these findings, we predicted
that subjective memory complaints would increase as a function of symptoms of depression.
Negative interpretative biases observed in those with clinical levels of depression, which
increase as a function of symptoms of depression in non-clinical populations, may partially
account for this finding (Mathews & MacLeod, 2005; Beck, 2008). Alternatively the
association between self-reported symptoms of depression and self-reported memory problems
may simply reflect a response tendency on measures assessing neuropsychiatric health
complaints. The current sample allowed a direct test of the latter hypothesis, by using the
Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983) to assess symptoms of depression. The two subscales of the HADS
assess symptoms of anxiety and depression, respectively. If increased memory complaints
reflect a simple response tendency, then symptoms of depression and anxiety should show the
same association with subjective memory complaints. In contrast, if the increase in
self-reported memory complaints is specific to depressive symptomatology, then subjective
memory complaints should be more reliably associated with symptoms of depression than
symptoms of anxiety.Previous work additionally suggests that altered cognitive and affective processing in
depression are associated with other changes in memory performance. For example, depressed
individuals exhibit a mood-congruency bias, which makes them able to recall more negative
memoranda compared with non-depressed individuals (Elliott et al.
2002). Another memory phenomenon observed in
individuals with depression is that their autobiographical memories lack specificity (i.e.
depressed individuals memories are typically overgeneral; Dalgleish &
Werner-Seidler, 2014; Dritschel et al.
2014). These deviations from typical memory
performance suggest an abnormality in basic memory operation and/or in the processing of
affective information. Research on memory for affective stimuli and events more broadly
shows that compared with neutral, affective information is better remembered (LaBar
& Cabeza, 2006). What remains
under-researched is the effect of affective context on memory performance. Henson et
al. (2016) have recently shown that, in
the same Cam-CAN cohort as is studied here, recognition memory for neutral objects varied as
a function of the affective valence (negative, positive or neutral) of the background
context against which those objects were originally presented. The increased affective
significance (cf. Pessoa, 2009) of negative
information to individuals who currently experience symptoms of depression is likely to
attract attentional resources towards negative backgrounds and away from neutral objects
superimposed on those backgrounds, thereby impairing the encoding into memory of those
objects. For this reason, memory for information presented in affective contexts may be more
sensitive to the influence of subclinical depressive symptoms than the more commonly used,
affect-neutral measures of memory.In summary, the present study investigated the hypotheses that depressive symptoms are
related to more subjective memory complaints (Hypothesis 1a) and worse
objective memory performance (Hypothesis 1b). This first pair of hypotheses
was investigated in all individuals from the Cam-CAN cohort who completed all measures of
interest during an interview assessment in participants’ homes (N = 2544).
The study further explored whether the relationship between memory performance and
depressive symptoms is related to reductions in hippocampal volumes (Hypothesis
2). This was investigated in a subsample (n = 592) for whom
volumetric data of the hippocampus were available from a more extensive neurocognitive
assessment including the acquisition of T1- and T2-weighted MRI scans. The third prediction
was that self-reported symptoms of depression would be more strongly related to a measure of
memory in negative contexts compared with a standard measure of memory (Hypothesis
3). This hypothesis was investigated in a second subsample
(n = 288) that completed a more specialized memory task.The nature of the study's sample also allowed for a number of additional explorations:
first, as outlined above, we tested whether H1a was specific to symptoms of depression. That
is, whether the relationship between depressive symptoms and self-reported memory complaints
reflected a general response tendency towards reporting more neuropsychiatric complaints and
would therefore show the same relationship with symptoms of anxiety. Next, given the
evidence suggesting that memory problems related to depressive symptoms may be a function of
general impairments in cognitive ability observed in individuals experiencing symptoms of
depression (Fossati et al.
2002; Elderkin-Thompson et al.
2007) the study investigated whether symptoms of
depression remained significantly related to the various types of memory after controlling
for general cognitive ability. Third, the study explored whether the relationships in
hypotheses 1–3 would remain after accounting for variations in memory, hippocampal volume
and depressive symptoms attributable to age (Jeste et al.
2013; Sutin et al.
2013; Schaakxs et al.
2017). And finally, because women tend to show
better verbal recall performance and more symptoms of depression, we investigated whether
sex differences contribute to the relationships predicted in hypotheses 1–3 (Piccinelli
& Wilkinson, 2000; Andreano &
Cahill, 2009).
Methods
Participants
The full sample included 2544 individuals from the CC3000 Cam-CAN sample (Shafto
et al.
2014). These participants (95% of the total
Cam-CAN sample) were included because they had completed all measures pertaining to our
first hypothesis. Structural imaging data was available for 592 participants from our
overall sample. Hypothesis 2 was tested on this subsample. Finally, 288 participants from
the total sample completed the valenced memory task and were included in the investigation
of our third hypothesis. See online Supplementary Table S1 for participant
characteristics.
Measures
Depressive symptoms
Symptoms of depression were assessed with the depression subscale of the HADS (Zigmond
& Snaith, 1983). The subscale consists
of seven items for which participants indicate how frequently they have felt them over
the past week on a scale form ‘0’ = ‘Not at all’ to ‘3’ = ‘Most of the time’. The scales
have been well validated for use in the general population (Olssøn et al.
2005). In the current sample Cronbach's
α was acceptable–good, а = 0.79 and similarly
McDonalds’ Ω hierarchical was 0.71.
Objective memory
Objective memory was assessed with a standard measure of memory, the delayed recall of
a story taken from the Wechsler Memory Scale Third UK edition (Wechsler, 1997).
Subjective memory
Participants were simply asked whether they experienced any memory problems or not: ‘Do
you feel you have problems with your memory? Yes/No.’.
Valenced memory
Memory for objects in positively and negatively valenced as well as valence neutral
contexts was assessed with a newly designed measure (Henson et al.
2016). The task consisted of a study and a test
phase. The study phase was divided into two 10 min blocks with a short break in between.
In each block participants were presented with 60 background images selected from the
International Affective Picture System (Lang et al.
2008) that appeared on the screen for 2 s
before an object was superimposed on the background image. The object and background
stayed on the screen for 7.5 s. Participants were asked to press the button as soon as
they had come up with a story to help them link the object and background together. They
were asked to keep elaborating on that story until the object and background
disappeared. There was a 0.5 interval second before the next trial started.Participants were advised that some images would be pleasant and others unpleasant, but
they were not informed that their memory for the items and their background would be
tested later. After participants completed the second block they were given a 10 min
break before the test phase. In the test phase they saw 160 trials that were split into
four 20 min blocks. The trials included 120 studied objects and 40 new objects. Each
test trial first presented participants with a masked (pixel noise) picture of an object
and participants had to name the object or respond ‘I don't know’ before pressing the
key to reveal the object. Memory for the object was then tested by asking participants
whether or not the object had been presented in the study phase. Participants then
indicated how confident they were of their response by pressing one of four keys: ‘sure
new’, ‘think new’, ‘sure studied’ or ‘think studied’. For trials on which participants
indicated ‘studied sure’ or ‘studied think’ their associative memory was tested. That
is, participants were asked to say out loud whether the object had been presented over a
positive, neutral or negative background or to respond ‘I don't know’, if they could not
remember the valence of the background. Finally, they were asked to describe the
background image. The priming, associative memory and qualitative data are not reported
as part of this study.Memory accuracy was computed as the d′ measure of discriminability
(Green & Swets, 1966):
d′ = Φ−1 (pH) − Φ−1 (pFA). The pH denotes the
proportion of hits, pFA the proportion of false alarms and Φ−1 the inverse
cumulative distribution function of the Normal distribution (d′ = 0 for
chance performance; extreme values of 0 or 1 for d′ were adjusted using
a log-linear approach).
General cognitive functioning
In the overall cohort, cognitive ability was assessed with the Addenbrooke's Cognitive
Examination – Revised assessment (ACE-R; Mioshi et al.
2006). The screening measure was devised to
detect signs of dementia and cognitive impairment assessing five domains of cognitive
functioning: orientation/attention, memory, verbal fluency, language and visuospatial
ability. The memory domain assess both immediate and delayed recall. As with our
assessment of objective memory, participants had to recall verbal information after a
delay interval. We therefore used the ACE-R sum score of all domains except memory. For
the neuroimaging and affective subsamples, the ACE-R was not an informative test of
cognitive ability due to participants scoring at ceiling. We therefore included the
Cattell's culture-free test of intelligence (Cattell, 1971), which was available in both subsamples (not the overall cohort). The
test requires participants to complete complex pattern matrices, and has previously
shown strong associations with behavioural and neural domains within the Cam-CAN cohort
(Kievit et al.
2014).
Structural MRI
Grey matter was estimated from the combined segmentation of 1 mm3, T1- and
T2-weighted MR images, followed by diffeomorphic registration of grey-matter segments from
all participants in Stage 2 of the Cam-CAN study in order to create a sample-specific
template. This template was then transformed into Montreal Neurological Institute (MNI)
space, and every participant's gray-matter image resliced to the same space, while being
modulated by the warping entailed. These stages were done in SPM12 (http://www.fil.ion.ucl.ac.uk/spm). For details of the MRI sequences, see (Shafto
et al.
2014) for further details of the MRI
preprocessing, see (Taylor et al.
2017). We estimated the mean grey matter volume
across voxels within the hippocampus, by modulating the grey matter density in each voxel
by the Jacobean of the warps used to transform to MNI space within the left and right
Hippocampal ROIs (regions of interest) from the Harvard-Oxford atlas (http://fsl.fmrib.ox.ac.uk/fsl/fslwiki/Atlases), as is standard in many previous
studies.
Statistical analyses
Given the non-normal distribution of depressive symptoms in the cohort (Fig. 1), we ran all analyses as non-parametric tests.
More specifically, we entered the HADS-scores into a non-parametric logistic regression
analyses based on ranks for the dichotomous outcome (i.e. subjective memory complaints)
and non-parametric regression for the continuous outcomes (i.e. standard and affective
memory measures). Given the directionality of our hypotheses, all significance testing of
our a priori hypotheses was one-tailed, whereas significance level for all exploratory
tests was two-tailed.
Fig. 1.
Neuroimaging cohort = individuals from the overall cohort for whom structural
neuroimaging data is available; Affective cohort = individuals from the overall
cohort who completed the valenced memory measure;
N/n = number of participants; Depressive
symptoms = number of self-reported symptoms of depression on the Hospital Anxiety
and Depression Scale (HADS) depression subscale (range 0–21, Zigmond &
Snaith, 1983).
Neuroimaging cohort = individuals from the overall cohort for whom structural
neuroimaging data is available; Affective cohort = individuals from the overall
cohort who completed the valenced memory measure;
N/n = number of participants; Depressive
symptoms = number of self-reported symptoms of depression on the Hospital Anxiety
and Depression Scale (HADS) depression subscale (range 0–21, Zigmond &
Snaith, 1983).
Procedure
After providing informed written consent, participants completed the ‘Stage 1 –
Interview’ of the Cam-CAN study including computerised health and lifestyle questionnaires
as well as a core cognitive assessment (Shafto et al.
2014). The subset of measures included in the
present study are described below. A subset of the sample (subsamples selected to
investigate hypotheses 2 and 3, see above) were included in the ‘Stage 2 – Core Cognitive
Neuroscience’ phase of the Cam-CAN study. As part of the second stage of the study,
participants completed a series of cognitive task across three sessions. One of these
sessions also included core structural and functional MRI measures. This second stage also
included the valenced memory task. Given the time constraints across multiple sessions,
the Cam-CAN protocol included a subset of tasks, including the valenced memory tasks,
administered to only a randomized subset (50%) of participants. This study complied with
the Helsinki Declaration, and was approved by the Cambridgeshire 2 Research Ethics
Committee (reference: 10/H0308/50).
Results
Figure 1 shows the distribution of scores from the
depression subscale of the HADS, while online Supplementary Table S1 provides a
comprehensive overview of the characteristics of all three samples. We found that 87%
(n = 2211) of participants reported at least one symptom of depression,
and over 91% scored a total of seven points or less on the depression subscale (Zigmond
& Snaith, 1983), which is below the
commonly reported clinical cutoff of eight points for this subscale (Bjelland et al.
2002). This shows that symptoms of depression are
common in the general population, but typically do not reach clinically significant
levels†
.In the full cohort (N = 2544), more symptoms of depression were related to
more frequent self-report of memory complaints, β = 6.99−4,
s.d. = 5.94−5, [95% confidence interval (CI)
5.83−4–8.16−4], z = 11.76,
p ⩽ 0.001, R2Nagelkerke = 0.08 (H1a)
and poorer performance on a standardized measure of memory,
β = −1.00−3, s.d. = 1.32−4, (95% CI
−1.00−3 to −8.58−4), t (2542) = −8.44,
p ⩽ 0.001, R2 = 0.03 (H1b, Fig. 2a). However, only the relationship between
depressive symptoms and subjective memory survived adjustment for age, cognitive
ability
and sex
, β = 5.19−4, s.d. = 6.37−5, (95% CI
3.94−4–6.44−4), z = 8.15,
p ⩽ 0.001, R2Nagelkerke = 0.20; the
same was not true for the relationship with standardized memory performance,
β = −1.31−4, s.d. = 1.14−4, (95% CI
−1.00−3 to −8.58−4), t (2539) = −1.15,
p = 0.125, R2 = 0.33,
R2adj = 0.33 (Fig.
2b). The absence of a relationship was confirmed with Bayesian
analysis (JASP Team, 2016),
BF01 = 10.85. Moreover, exploratory analyses showed that the relationship between
symptoms of depression and subjective memory complaints did not appear to be due to
individuals who suffer from symptoms of depression simply reporting more neuropsychiatric
health complaints. That is, while symptoms of anxiety were related to subjective memory
complaints, β = 2.35−4, s.d. = 5.63−5, (95%
CI 1.24−4–3.45−4), z = 4.16,
p ⩽ 0.001, R2Nagelkerke = 0.01, the
relationship was no longer significant when accounting for depressive symptoms in the same
analyses, β = −5.63−5, s.d. = 6.30−5, (95%
CI −1.80−4 to 6.71−4), z = −0.89,
p = 0.372, R2Nagelkerke = 0.00,
whereas the relationship between depression and subjective memory complaints remained
significant after adjusting for symptoms of anxiety, β = 7.23−4,
s.d. = 6.52−5, (95% CI 5.96−4–8.51−4),
z = 11.09, p ⩽ 0.001,
R2Nagelkerke = 0.08.
Fig. 2.
The figure represents the relationships between: (a) depressive
symptoms and performance on the standard measure of objective memory;
(b) 2a, after adjustment for age, cognitive ability and sex; jitter
was added to the distribution for illustration purposes.
The figure represents the relationships between: (a) depressive
symptoms and performance on the standard measure of objective memory;
(b) 2a, after adjustment for age, cognitive ability and sex; jitter
was added to the distribution for illustration purposes.In the neuroimaging cohort (n = 592), multiple regression including total
intracranial volume (TIV) as a covariate showed that hippocampal volume was related to both
subjective memory, β = −4.64, s.d. = 1.71, (95% CI −8.02 to
−1.23), z = −2.71, p = 0.004,
R2Nagelkerke = 0.02, and the standardized objective
measure, β = 17.94, s.d. = 3.29, (95% CI 11.47–24.41),
t (589) = 5.45, p ⩽ 0.001,
R2 = 0.05, R2adj = 0.04
(Fig. 3a). However, neither the
relationship between hippocampal volume and subjective memory complaints,
β = 0.43, s.d. = 2.00, (95% CI −3.50 to −4.36),
z = 0.21, p = 0.416,
R2Nagelkerke = 0.07, nor relationship between
hippocampal volume and objective memory β = 0.22, s.d. = 3.40,
(95% CI −6.45 to 6.90), t (586) = 0.07, p = 0.474,
R2 = 0.25,
R2adj = 0.24, survived adjustment for age, cognitive
ability
and sex. Contrary to our expectations, there was no significant association between
depressive symptoms and hippocampal volume, β = −2.57,
s.d. = 2.01, (95% CI −6.51 to 1.38), t (589) = 1.28,
p = 0.100, R2 = 0.00 (Fig. 3b), which was again supported by a Bayes factor
of 6.87 in favour of the null hypothesis. Unsurprisingly therefore, the relationships
between depressive symptoms and both subjective β = 3.00−1,
s.d. = 5.59−4, (95% CI 2.00−1–4.00−1),
z = 5.04, p ⩽ 0.001,
R2Nagelkerke = 0.08 and objective
β = −2.00−1, s.d. = 1.00−1, (95% CI
−4.00−1 to 1.03−4), t (588) = −1.86,
p = 0.032, R2 = 0.05,
R2adj = 0.05 memory remained significant after
adjusting for hippocampal volume (and TIV). That is, there was no support for the hypothesis
that hippocampal volumes account in part for the relationship between depressive symptoms
and memory performance in this non-clinical population (H2).
Fig. 3.
The figure represents the relationships between: (a) hippocampal
volume and performance on the standard measure of memory; (b)
hippocampal volume and symptoms of depression; jitter was added to the distribution
for illustration purposes.
The figure represents the relationships between: (a) hippocampal
volume and performance on the standard measure of memory; (b)
hippocampal volume and symptoms of depression; jitter was added to the distribution
for illustration purposes.In the cohort that completed the measure of memory in affective contexts
(n = 288), we investigated whether depressive symptoms showed a
differential association with memory performance in affective contexts compared with a
standardized measure of memory (H3). As in the overall sample, the relationship between
depressive symptoms and performance on a standardized memory measure,
β = −5.00−1, s.d. = 3.00−1, (95% CI
−1.10−1 to 6.91−4), t (286) = −1.78,
p = 0.043, R2 = 0.01, did not survive
adjustment for age, cognitive ability
, and sex, β = −2.00−1,
s.d. = 3.00−1, (95% CI −7.00−1 to 3.00−1),
t (283) = −0.66, p = 0.509,
R2 = 0.23, R2adj = 0.21,
BF01 = 4.69. Symptoms of depression were, however, significantly related to
poorer memory performance in negative, β = −4.00−2,
s.d. = 1.00−2, (95% CI −6.00−2 to −1.00−2),
t (286) = −3.48, p ⩽ 0.001,
R2 = 0.04 and positive β = −2.00−2,
s.d. = 1.00−2, (95% CI −5.00−2 to −6.39−5),
t (286) = −2.52, p = 0.006,
R2 = 0.02 contexts (Fig.
4). However, when adjusting for performance in neutral contexts only the relationship
between depressive symptoms and negative context remained significant,
β = −1.45−4, s.d. = 5.93−5, (95% CI
−2.61−4 to −2.79−5), t (285) = −2.44,
p = 0.015, R2 = 0.76,
R2adj = 0.76, even after adjusting for the same
covariates, β = −1.38−4, s.d. = 5.78−5, (95%
CI −2.51−4 to −2.40−5), t (285) = −2.38,
p = 0.018, R2 = 0.78,
R2adj = 0.78., but depressive symptoms were not
related to memory in positive contexts after adjusting for performance in neutral contexts,
β = −3.22−5, s.d. = 5.85−5, (95% CI
−1.47−4 to 8.32−5), t (285) = −0.55,
p = 0.584, R2 = 0.76,
R2adj = 0.75 and covariates,
β = −2.15−5, s.d. = 5.76−5, (95% CI
−1.00−3 to 9.19−5), t (282) = −0.37,
p = 0.709, R2 = 0.77,
R2adj = 0.76. Moreover, when controlling for memory
in positive contexts, depressive symptoms remained a significant predictor of memory in
negative contexts, β = −1.46−4,
s.d. = 5.52−5, (95% CI −2.54−4 to −3.75−5),
t (285) = −2.58, p = 0.010,
R2 = 0.79, R2adj = 0.79,
even after adjusting for the covariates, β = −1.39−4,
s.d. = 5.39−5, (95% CI −2.45−4 to −3.29−5),
t (285) = −2.58, p = 0.009,
R2 = 0.81, R2adj = 0.81.
Fig. 4.
The figure represents the relationships between: (a) depressive
symptoms and memory for objects presented in negative contexts; (b)
depressive symptoms and memory for objects presented in positive contexts; jitter was
added to the distribution for illustration purposes.
The figure represents the relationships between: (a) depressive
symptoms and memory for objects presented in negative contexts; (b)
depressive symptoms and memory for objects presented in positive contexts; jitter was
added to the distribution for illustration purposes.Furthermore, when directly comparing the size of the relationship of depressive symptoms
with memory for objects in negative contexts with that for objects in positive contexts, the
former was significantly higher, Williams’ t (285) = 3.07,
p = 0.002. There was a marginal relationship between symptoms of depression
and memory for objects presented in negative contexts to be stronger than their relationship
with memory on a standardized measure of memory, Williams’ t (285) = −1.70,
p = 0.045 (H3).Finally, we explored whether self-reported history of depression moderated any of the
associations between current symptoms of depression and memory performance (H1), memory
performance accounting for hippocampal volume (H2) or memory in affective contexts (H3).
Self-reported history of depression that required treatment did not moderate any of the
associations significantly, ts < 1, ps ⩾ 0.40.
Discussion
The present study examined the memory correlates of depressive symptoms in a large,
population-derived cohort. First, we showed that depressive symptoms were related to
self-reported memory problems, even after controlling for variations in age, cognitive
ability and sex. Moreover, the relationship was not simply due to individuals’ tendency to
report more mental health problems, as the relationship between depressive symptoms and
subjective memory remained after adjusting for symptoms of anxiety. One possibility is that
the association between symptoms of depression and subjective memory reflects a negative
interpretative bias. This notion, known as ‘depressive realism’, suggests that individuals
who report symptoms of depression show less positivity bias (Mezulis et al.
2004; Watson et al.
2007). Future research should therefore investigate
whether other types of self-reported cognitive functioning problems, for example attentional
control problems (Derryberry & Reed, 2002),
are also selectively associated with symptoms of depression but not other measures of mental
health functioning.A second set of findings showed that depressive symptoms were also related to performance
on a standardized test of memory, but in this case, we could not rule out the possibility
that this relationship was due to variations in memory as a function of age, cognitive
ability and/or sex (which were all significantly related to objective memory; see online
Supplementary Table S2). In line with Fried & Kievit (2015), we also found no evidence for a significant relationship between
depressive symptoms and hippocampal volume in this non-clinical cohort. Future research
could investigate alternative sources of brain alterations associated with commonly
experienced symptoms of depression (Hamilton et al.
2008). Alternatively, the lack of an association
between depressive symptoms and hippocampal volume may be because the current sample was a
non-clinical sample (i.e. participants reported no functional impairment form their
depressive symptoms). To date, hippocampal volume has been studied in the context of
clinical depression, and its association with subclinical symptoms of depression remains
under researched. There is some evidence pointing towards possible gender differences, with
men showing an association between subclinical symptoms of depression and hippocampal
volumes but not women (Hayakawa et al.
2013; Samplin et al.
2013; Spalletta et al.
2014)
.Finally, a third investigation showed that, while performance on a standard memory test may
be unaffected in individuals experiencing subclinical symptoms of depression, objective
memory impairments are found when the memoranda are encountered in negatively valenced
settings. More specifically, depressive symptoms were related to worse recognition memory
for visual objects presented against negative backgrounds, even when adjusting for age,
cognitive ability and sex. Importantly, this relationship remained even when further
adjusting for recognition memory for the same types of objects presented against neutral
backgrounds. This suggests that the relationship was specific to the valenced context,
rather than differences between the visual object recognition memory test and the
standardized verbal recall test, in terms of, for example, the nature of the memoranda or
retrieval demands. Furthermore, the relationship between depressive symptoms and recognition
memory for objects in positive contexts was no longer significant after the same adjustment
for memory in neutral contexts, and the size of the relationship between depressive symptoms
and recognition memory for objects in negative contexts was significantly greater than that
between depressive symptoms and memory in positive contexts. In other words, the sensitivity
of memory to depressive symptoms was selective to memory in negative contexts.The implication of this finding is that measures of memory in negatively valenced contexts
(e.g. Henson et al.
2016) may be particularly sensitive to subtle
differences in memory performance caused by current affective state. Importantly, the study
demonstrates that even subclinical depressive symptoms appear to have an impact on both
self-perceived and objective measures of memory functioning. Again it remains an open
question as to whether the impact of subclinical depressive symptoms in the general
population is limited to memory performance in negative contexts, or whether this extends to
other types of higher cognitive functions in negatively laden environments.When considering the implications of the findings from this large-scale population-based
study, a few limitations should be noted. First, subjective memory impairments were only
assessed with a single item, which may not be a sensitive measure of subjective concerns
about memory functioning. Moreover, inferences about subclinical levels of depression and
self-reported history of clinical episodes of major depression need to be drawn with caution
because they were assessed through a self-report questionnaire and retrospective recall,
respectively. These assessments may differ from clinician-rated levels of past and present
depressive symptomatology in the current sample.Future research should explore whether the association between depressive symptoms and the
different memory measures observed in the current sample will replicate in currently
depressed individuals, or whether they exhibit different memory profiles. Given the
impairment in autobiographical memory specificity that is characteristic of individuals in a
major depressive episode, the relation between performance on the affective memory measure
and the specificity of autobiographical memory should be assessed in healthy and currently
depressed individuals. Future research should also investigate whether the strength of the
association between individuals’ memory performance in negative contexts and their symptoms
of depression has predictive utility for the development of more severe clinical forms of
depressive disorders. That is, whether memory for neutral information in negative context
fits within a larger pattern of cognitive vulnerabilities to depression (Gotlib &
Joormann, 2010).In conclusion, these findings show that the frequency of self-reported memory problems
increases as a function of subclinical depressive symptoms. However, depressive symptoms are
not associated with memory performance on a standard objective memory measure, when
controlling for age, general cognitive ability and sex. Rather, depressive symptoms are
associated with poorer memory for objects presented in negative contexts. These results
suggest that memory for objects presented in negative contexts may be particularly sensitive
to the memory problems reported by those experiencing symptoms of depression.
Authors: Nikki L Hill; Jacqueline Mogle; Sakshi Bhargava; Emily Whitaker; Iris Bhang; Ana W Capuano; Zoe Arvanitakis; David A Bennett; Lisa L Barnes Journal: J Gerontol B Psychol Sci Soc Sci Date: 2020-03-09 Impact factor: 4.077
Authors: Laura de Nooij; Mathew A Harris; Mark J Adams; Toni-Kim Clarke; Xueyi Shen; Simon R Cox; Andrew M McIntosh; Heather C Whalley Journal: Eur Psychiatry Date: 2020-02-21 Impact factor: 5.361
Authors: Anya Topiwala; Sana Suri; Charlotte Allan; Enikő Zsoldos; Nicola Filippini; Claire E Sexton; Abda Mahmood; Archana Singh-Manoux; Clare E Mackay; Mika Kivimäki; Klaus P Ebmeier Journal: Am J Geriatr Psychiatry Date: 2020-07-07 Impact factor: 4.105