title: A comparison of MEmory Specificity Training (MEST) to education and support (ES) in the treatment of recurrent depression: study protocol for a cluster randomised controlled trial.
abstract: BACKGROUND
  Depression is a debilitating mental health problem that tends to run a chronic, recurrent course. Even when effectively treated, relapse and recurrence rates remain high. Accordingly, interventions need to focus not only on symptom reduction, but also on reducing the risk of relapse by targeting depression-related disturbances that persist into remission. We are addressing this need by investigating the efficacy, acceptability and feasibility of a MEmory Specificity Training (MEST) programme, which directly targets an enduring cognitive marker of depression - reduced autobiographical memory specificity. Promising pilot data suggest that training memory specificity ameliorates this disturbance and reduces depressive symptoms. A larger, controlled trial is now needed to examine the efficacy of MEST. This trial compares MEST to an education and support (ES) group, with an embedded mechanism study.
  
  
  METHODS
  In a single blind, parallel cluster randomised controlled trial, 60 depressed individuals meeting diagnostic criteria for a current major depressive episode will be recruited from the community and clinical services. Using a block randomisation procedure, groups of 5 to 8 participants will receive five weekly sessions of MEST (n = 30) or education and support (n = 30). Participants will be assessed immediately post-treatment, and at 3- and 6-months post-treatment (MEST group only for 6-month follow-up). Depressive symptoms at 3-month follow-up will be the primary outcome. Secondary outcomes will be change in depressive status and memory specificity at post-treatment and 3-months. The 6-month follow-up of the MEST group will allow us to examine whether treatment gains are maintained. An explanatory question will examine variables mediating improvement in depression symptoms post-treatment and at 3-month follow-up.
  
  
  CONCLUSIONS
  This trial will allow us to investigate the efficacy of MEST, whether treatment gains are maintained, and the mechanisms of change. Evidence will be gathered regarding whether this treatment is feasible and acceptable as a low-intensity intervention. If efficacy can be demonstrated, the results will support MEST as a treatment for depression and provide the foundation for a definitive trial.
  
  
  BACKGROUND
  NCT01882452 (ClinicalTrials.gov), registered on 18 June 2013.
authors: Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, UK. tim.dalgleish@mrc-cbu.cam.ac.uk.
authors: Tim
authors: T
authors: Dalgleish
authors: Anna
authors: A
authors: Bevan
authors: Anna
authors: A
authors: McKinnon
authors: Lauren
authors: L
authors: Breakwell
authors: Viola
authors: V
authors: Mueller
authors: Isobel
authors: I
authors: Chadwick
authors: Susanne
authors: S
authors: Schweizer
authors: Caitlin
authors: C
authors: Hitchcock
authors: Peter
authors: P
authors: Watson
authors: Filip
authors: F
authors: Raes
authors: Laura
authors: L
authors: Jobson
authors: Aliza
authors: A
authors: Werner-Seidler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D003863:Depression / Q000628:therapy*; D006801:Humans; D007858:Learning; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D012008:Recurrence; D016037:Single-Blind Method