Congratulations on a very nice study!  It's surprising to me that the choose your adventure story paradigm would be able to elicit perseveration thought.  This is not my area of expertise at all but II have known people who suffer from extreme versions of this related to OCD and they often do not show the same perseveration when talking about hypothetical situations.  It sometimes requires worry about a realistic plan or event that is imminent to elicit these thoughts.  However you were able to elicit PT in the general population so I imagine it would be moire robust in a clinical sample.  Were the frames all text or were there any illustrations.  More immersive graphics might also be helpful.   It's remarkable that participants found the stories vivid and stressful.  

This is novel study is very interesting. Similar to Dr. Brannon's comment above, I'm curious about how such hypothetical situations factor into perseveration. In particular, I could see this as potentially being very useful with children. Great job!

Thank you so much for your thoughtful comments, Dr. Brannon and Dr. Connolly!

Dr. Brannon-- You raise a very interesting point about how the mechanics of perseverative thought function differently within different disorders. It makes me think about ways in which the paradigm could be reshaped to serve OCD populations... But we were thrilled to see that the narrative elicited PT in our populations! As for images, I think in the end we decided that embedding images or sounds within the narrative would potentially distract the participant from the "flow" of the narrative and take them out of it, thus potentially decreasing the quality of our data. But it would be so interesting to see the levels of audio and visual immersion this story task could take on in the future. Thanks again for your comments!

Dr. Connolly-- As you and Dr. Brannon both mentioned, I think our study was limited in its ability to achieve true immersion because of its hypothetical nature, even though we tried to make it as simultaneously realistic and generalizable as possible, which is a challenge! A personal idea I had been mullling over throughout the study was creating a narrative using information supplied to us by a given participant and adjusting the story to include details of the participants own life, thus increasing potential immersion and more robust thought data...but achieving the mechanics of this idea would be a feat! Thanks also for your suggestion of the use of this study with children. I agree with you, and the prospect of potentially using this tool with children is very exciting! Thanks again for your thoughtful comments. :)

Hi Allison et al.

What an incredibly clever and novel paradigm for getting at negative thoughts!  I actually use a single hypothetical scenario with just about every new patient I see to to elicit their negative automatic thoughts and begin to explore core beliefs and negative schemas.  Using a standardized hypothetical scenario allows me to figure out a lot of things about each client very quickly.  (In the scenario, you image you are walking down the street and you see someone you know on the other side of the street walking the other way.  You wave, and the person does not wave back.  That's it.  But the range of responses I get is amazing, and how quickly (or whether) people are able to come up with the benign explanation that they other person just didn't see them is incredibly diagnostic.)  

So here's my question.  In this paradigm you are clearly eliciting variable negative (and maybe positive) thoughts in a standardized format that would be scoreable and might be very informative about a lot of things, especially with clinical populations.  (Plus it could be automated for distance applications and incorporated into digital health apps.  So cool.) BUT I'm not totally convinced that you are eliciting perseverative thought, which by definition must be intrusive and long lasting.  Is there anything in your paradigm that actually captures the persistence of the negative thoughts?  Or the way in which perseverative thought often both loops around on itself AND reminds people of other negative things that are thematically related?  

This is super important and creative research.  I love it!  I look forward to hearing your thoughts.

Cheers,

Dr. Hunt

Hi Dr. Hunt,

Thank you so much for your feedback! One of the ways we assessed the persistence of perseverative thought was through Pearson correlations between our composite trait PT variable and the mean change scores of thought ratings for each screen after a negative event (up to four screens). My original hypothesis was that individuals with higher trait PT would exhibit more inert thought ratings (less change) in the aftermath of negative events. Instead, our results indicated that higher trait PT was associated with slightly more change. We found small positive correlations between the two variables for each screen after a negative event. The correlations increased in size with distance from the negative event, and only the correlations on the third and fourth screens were statistically significant.

We wondered if our change score results might be due to the fact that a participant who reports more extremely negative thought ratings would therefore have more "room" to move toward a neutral or positive point on the thought rating scale. Since individuals with higher trait PT exhibited more negative thought ratings (particularly on negative screens), it could appear that these individuals showed a larger change following a negative event, simply because their thought ratings were more negative to begin with. In future analyses of the persistence of PT, we'd be interested in trying automatic regression or a similar test.

Hope this helps,

Isabella Schlact