Symposia
Cognitive Science/ Cognitive Processes
Garret Zieve, M.A.
Graduate Student
University of California, Berkeley
Oakland, California
Courtney Armstrong, MA
Doctoral Candidate
University of California Berkeley
Berkeley, California
Ian Richardson, BA
Research Assistant
University of California, Berkeley
Santa Cruz, California
Sydney Garcia, BA
Research Assistant
University of California, Berkeley
East Palo Alto, California
Allison G. Harvey, Ph.D.
Professor
University of California, Berkeley
BERKELEY, California
Background: Patient memory for psychological treatment contents is a promising transdiagnostic mechanism of change, but there is little consensus concerning its measurement. We conducted a pilot psychometric investigation of the Conceptualization Task, a novel measure of patient memory for treatment.
Methods: Data were from a trial comparing cognitive therapy-as-usual to cognitive therapy plus the Memory Support Intervention (MSI) for adults with depression (N = 171). The MSI is composed of eight memory support strategies that therapists use intensively in session to increase patient memory for treatment. For the Conceptualization Task, patients read clinical vignettes and provided written responses to three questions assessing different facets of conceptualization: identifying contributing factors to psychopathology, making intervention recommendations, and providing a rationale for recommendations. Higher scores were given to responses reflecting accurate memory for the theoretical model and change strategies used in treatment.
Results: The Conceptualization Task showed excellent inter-rater reliability and sensitivity to change during treatment, but only fair test-retest reliability. Internal consistency was low, so performance on each question from the task was analyzed separately instead of using a total score. Findings supported discriminant validity with measures of education, IQ, and general memory functioning, but not convergent validity with existing measures of patient memory for treatment. Criterion validity analyses showed that higher therapist use of memory support strategies, especially constructive memory support strategies, predicted better performance on some aspects of the Conceptualization Task. Additionally, patients who demonstrated better memory for change strategies on the Conceptualization Task showed some evidence of better treatment outcomes. However, findings were mixed, effect sizes were small, and some results did not remain statistically significant after correcting for multiple comparisons.
Conclusions: Internal consistency and convergent validity results suggest that patient memory for treatment is a multifaceted construct. Criterion validity findings provide some evidence that patient memory for change strategies may be more important for treatment outcome than patient memory for the underlying theoretical model used in treatment. Future versions of the Conceptualization Task may benefit from a narrower focus on memory for change strategies.