Cross-validation of the Mood Disorders Questionnaire, the Internal State Scale, and the Hypomanic Personality Scale

Previous research indicates that the Mood Disorder Questionnaire (MDQ), the Internal State Scale (ISS), and the Hypomanic Personality Scale (HPS) have the capacity to assess symptoms of bipolar spectrum disorders. The present study cross-validates these scales in a sample of 167 undergraduate students. Individuals were divided into high, medium and low likelihood of caseness (HLC, MLC and LLC) groups based on operationalised cut-off criteria on the MDQ. Scores on the ISS Perceived Conflict subscales were positively and proportionately associated with elevated likelihood of caseness. The HLC group was distinguished from the other two groups by high levels of ISS Depression, whereas the LLC group was distinguished from the other two groups by low levels of ISS Activation and hypomanic personality traits. The majority of individuals reported a history of isolated (hypo)manic experiences, and a quarter of the sample reached screening criteria for a bipolar spectrum disorder (Isometsae et al., 2003). The results are discussed in the context of the role of activation, depression, and interpersonal conflict in bipolar spectrum disorders.     

Predictors of suicidal thoughts: Mood instability versus neuroticism

The personality trait neuroticism predicts depression and suicidal thoughts. Neuroticism is also linked to mood instability (MI)¹ that is common in patients with depression. This study investigated (a) whether MI predicts suicidal thoughts in depressed patients and (b) the relationship of MI to neuroticism. All 129 patients with Major Depression (MINI interview) were assessed on MI (Affective Lability Scale), neuroticism (Short Eysenck Neuroticism Scale), depression (Beck Depression Inventory), and suicidal thoughts (Beck Scale for Suicidal Ideation). Participants also completed the Perceived Stress Scale, Mood Disorder Questionnaire and five clinical questions on MI. Factor analysis of the Eysenck Neuroticism Scale revealed unstable moods as one of three main factors. Only depression severity and MI predicted suicidal thoughts once other variables including neuroticism were controlled. Mediation analyses showed that MI mediated the relationship between neuroticism and suicidal thoughts. These results suggest that MI as measured by the Affective Lability Scale typifies the type of depression that predicts suicidal thoughts and that MI may be more directly associated with suicidal thoughts than neuroticism. This demonstrates the clinical value of assessing MI rather than neuroticism in the treatment of patients with depression with suicidal thoughts.     

Hopelessness,Depression, Suicidal Ideation,and Clinical Diagnosis of Depression

The relevance of a clinical diagnosis of depression for explaining the discrepant relationships of hopelessness and depression with suicidal ideation was studied. The Beck Depression Inventory (BDI), Hopelessness Scale (BHS), and the Scale for Suicide Ideation (SSI) were administered to 1,306 (72.8%) patients with at least one DSM-III-R mood disorder and 488 (27.3%) patients without any mood disorders. A multiple regression analysis was conducted, and hopelessness was 1.3 times more important than depression was for explaining suicidal ideation. The interactions of the BDI and BHS with diagnostic group were not significant.     

Dietary patterns are associated with the prevalence of alexithymia

Recent evidence supports the association between healthy dietary patterns and a reduced risk of depression. The objective was: (1) to examine the associations between dietary patterns and alexithymic features; and (2) investigate whether these possible associations are explained by depressive symptoms in a cross‐sectional study among the Finnish general population aged 25–65 years. The study population was a part of the population‐based Kuopio Depression Study (KUDEP) conducted in central‐eastern Finland (n = 1747). Dietary data were collected using a food frequency questionnaire and dietary patterns from 22 predefined food groups, which were extracted by factor analysis. Alexithymia was assessed using the 20‐item Toronto Alexithymia Scale (TAS‐20) and depression using the 21‐item Beck Depression Inventory (BDI‐21). Altogether, 173 of the study subjects (9.9%) were alexithymic. Three dietary patterns were identified: “prudent,” “Western” and “traditional.” Lower scores for a healthy prudent dietary pattern and higher scores for an unhealthy Western dietary pattern were associated with an increased likelihood of belonging to the alexithymic group among subjects with elevated depressive symptoms. Among subjects without depressive symptoms, alexithymia was associated with lower scores in the prudent dietary pattern, but also with higher scores in the traditional dietary pattern. General population subjects with alexithymic features may have unhealthier dietary patterns than non‐alexithymic subjects.     

A study of the psychometric properties of the Beck Depression Inventory‐II,the Montgomery and Åsberg Depression Rating Scale,and the Hospital Anxiety and Depression Scale in a sample from a healthy population

The objective of this study is to evaluate internal consistency and psychometric properties of the Hospital Anxiety and Depression Scale (HADS), the Beck Depression inventory‐II (BDI‐II) and the Montgomery and Åsberg Depression Rating Scale (MADRS) for screening for major depressive episode (MDE) in a selected sample from a healthy population. Participants answered the BDI‐II and the HADS questionnaires and were interviewed with MADRS. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)‐IV Axis I Disorders‐Clinician Version (SCID‐CV) was used to diagnose MDE. Current MDE was diagnosed in 20 (6%) of the 357 participants. All three scales including the depression sub‐scale for HADS had high area under the receiver operating characteristics curve (ROC) (AUC) (0.84–0.87), and internal consistency was also high for all scales (0.75–0.89). Optimal cut‐off for MDE was ≥ 12 for BDI‐II, MADRS ≥ 8, HADS total ≥ 9, and HADS‐D ≥ 4, which all resulted in sensitivities = 85% and specificities > 78%. Diagnostic accuracy was low on all depression scales (Cohen's kappa = 0.20–0.40). Reports of the properties of depression scales in a healthy population are limited. We found BDI‐II, HADS and MADRS to be acceptable as screening instruments for MDE in a selected sample from healthy population with recommend cut‐offs as mentioned above.     

Couple Therapy for Depression Within a Naturalistic Setting in Finland: Factors Related to Change of the Patient and the Spouse

The study examined factors related to change in treatments for depression in couple therapy (CT; N = 29) and treatment-as-usual (TAU; N = 22). Treatments were adapted in accordance with the patient’s need. The patients’ depressive symptoms, general mental health and marital satisfaction were assessed at baseline and at 6 months post-baseline. The Hamilton Depression Rating Scale, the Beck Depression Inventory (BDI), the Symptom Check List-90, and the Dyadic Adjustment Scale (DAS) were used for the patients. The BDI and the DAS were used for the spouses. The couples in CT group assessed their subjective distress (SD) at every session by using the Outcome Rating Scale. The results showed that the spouses’ gender, the spouses’ depressive symptoms at baseline, and the number of therapy sessions were related to differing changes in the CT and TAU groups at the 6-month post-baseline assessment. The spouses in the CT group demonstrated a higher treatment response than those in the TAU group. In the CT group, the spouse’s benefit from the treatment was related to SD at the outset on the part of either the patient or the spouse or both. The change in the patient’s SD predicted the patient’s change in depressive symptoms, general mental health, and was associated with the patient’s change in marital satisfaction. The study emphasizes the importance of the spouse’s involvement in the treatment of depression, the provision of feedback on SD, and discussion of individual well-being and relational issues, in addition to the focus on depression.     

Association of fake-good MMPI-2 profiles with low Beck Depression Inventory scores

Seventy-nine adolescent mothers (mean age = 18.1 years) were administered the Beck Depression Inventory (BDI) and three validity scales (L, F, and K) of the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). The aim was to determine whether low-BDI mothers were "faking good," or denying their depression. The adolescent mothers were assigned to a low-BDI group (scores = 0, 1, 2), a nondepressed group (scores = 3-9), or a depressed group (scores > or = 13). The depressed group had higher F (Symptom) scale scores than did the nondepressed group, which in turn had higher scores than did the low-BDI group. The low-BDI group, in contrast, had more fake-good profiles than did the two other groups. Discriminant analyses indicated that 90% of the fake-good profiles could be classified correctly based on BDI and K (Defensiveness) scale scores. These data suggest the need for further assessment when individuals have extremely low BDI scores.     

THE SILENCING THE SELF SCALE: Schemas of Intimacy Associated With Depression in Women

The Silencing the Self Scale (STSS), derived from a longitudinal study of clinically depressed women, measures specific schemas about how to make and maintain intimacy hypothesized to be associated with depression in women. To assess its psychometric properties, the STSS was administered with the Beck Depression Inventory (BDI) to three samples of women: college students ( n = 63), residents in battered women's shelters ( n = 1401, and mothers ( n = 270) (of 4-month-old infants) who abused cocaine during pregnancy. The STSS had a high degree of internal consistency and test-retest reliability and was significantly correlated with the BDI in all three samples.     

Relationships between the Beck Depression Inventory and the Hamilton Psychiatric Rating Scale for Depression in depressed outpatients

The Beck Depression Inventory (BDI) and the Hamilton Psychiatric Rating Scale for Depression (HRSD) were used with 300 outpatients diagnosed with DSM-III major depression disorders. A principal-components analysis was performed on the intercorrelations among the 21 BDI and 24 HRSD symptoms. Three orthogonal components were found and interpreted as reflecting differences in self-report and clinical rating methods for measuring the severity of depression. The importance of using both self-reports and clinical ratings for evaluating depression in psychiatric outpatients was discussed.     

Clinical Correlates of MMPI Depression Scales

We investigated whether Scale 2 (Depression [D]) and the Wiggins Content Scale of Depression (DEP) of the Minnesota Multiphasic Personality Inventory (MMPI) have different clinical correlates when only one of these two scales is elevated. According, a group of patients who elevated DEP higher than Scale 2 (DEP > 2) were compared with a group of patients who elevated Scale 2 higher than DEP (2 > DEP). The patients with DEP > 2 were rated as being less severe than the patients with 2 > DEP on the following Brief Psychiatric Rating Scales: Somatic Concern (SOM), Emotional Withdrawal (WDRA), Depressive Mood (DEP), and Blunted Affect (AFF). The patients with DEP > 2 were rated as more severe on Excitement (EXC). The patients with DEP > 2 were more likely to receive the Axis I diagnoses of: bipolar disorder, manic, and alcohol abuse. Schizophrenia was equally probable for patients in the two groups. It appears that these two MMPI scales of depression have different clinical correlates when either one scale or the other is elevated.     

The latent structure of analogue depression: should the Beck Depression Inventory be used to classify groups?

Research on depression is often conducted with analogue samples that have been divided into depressed and nondepressed groups using a cutoff score on the Beck Depression Inventory (BDI). Although the relative merits of different cut scores are frequently debated, no study has yet determined whether the use of any cut score is valid, that is, whether the latent structure of BDI depression is categorical or dimensional in analogue samples. The BDI responses of 2,260 college students were submitted to 3 taxometric procedures whose results were compared with those of simulated data sets with equivalent parameters. Analyses provided converging evidence for the dimensionality of analogue depression, arguing against the use of the BDI to classify analogue participants into groups. Analyses also illustrated the notable impact of pronounced skew on taxometric results and the value of using simulated comparison data as an interpretive aid.     

Depression and cognitive change among institutionalized aged.

Interrelations between depression (Geriatric Depression Scale) and cognitive impairment (Blessed test) were examined among 201 nursing home and congregate apartment residents in a 2-year, 3-wave study. In structural equations models that controlled autocorrelations and within-occasion correlated residuals, introducing paths from depression to subsequent cognitive status significantly reduced unexplained variance, whereas paths from cognitive status to subsequent depression did not. Subsidiary analyses indicated that the relation of depression to subsequent cognitive status was strongest among persons with borderline (vs. impaired or intact) cognitive status, but only for the first time interval. Discussion addresses explanations for obtained results and implications for monitoring and treating depression among elderly long-term care residents.     

Low-End Specificity of Four Depression Measures: Findings and Suggestions for the Research Use of Depression Tests

Past research has found that very low scorers on the Beck Depression Inventory (BDI) tend to respond in a fake-good manner on the Minnesota Multiphasic Personality Inventory (MMPI) validity scales. This finding was interpreted as evidence of poor low-end specificity. This study replicated and extended this work by evaluating the low-end specificity of four popular depression measures. The evidence of problems with low-end specificity was strong for the BDI and marginal for the Profile of Mood States depression subscale. Interestingly, MMPI scores in the normal range were associated with fake-good responding, whereas very low and high scores were not. There was no evidence of an association between fake-good responding and scores on Exner's Depression Index for the Rorschach. Implications of these findings and guidelines for dealing with problems with low-end specificity in research are discussed.     

Heightened subjective experience of depression in borderline personality disorder

Despite the frequent comorbidity of major depression and borderline personality disorder (BPD), limited research has examined what effect this comorbidity has on the severity, course, and presentation of depression. The purpose of this study was to examine whether the severity of major depressive disorder (MDD) in the context of comorbid borderline personality disorder (BPD) differs from MDD when comorbid BPD is not present and to determine whether different measures of depression yield convergent findings. Sixty patients diagnosed with DSM-IV MDD participated in this study. Twenty-nine were diagnosed with DSM-IV BPD, while the remaining 31 had no Axis II diagnosis. Depression was evaluated with both clinician (Hamilton Rating Scale for Depression) and self-report (Beck Depression Inventory) ratings. While the two groups were rated as similarly depressed by clinicians on the overall rating and the factor scores, the MDD/BPD group reported more severe depressive symptoms on the self-report measure. This difference was significant even after controlling for clinician-rated severity. Gender interacted with diagnosis, males in the BPD group showed the largest discrepancies between clinician ratings and self-reports. Posthoc analyses of HDRS factors with the BDI showed that the clinicianrated cognitive disturbance and retardation factors were correlated with self-rated severity overall. Within subgroups, only the retardation factor was correlated with the BDI. Our results suggest that while depressed individuals with and without BPD may be rated as similarly depressed when assessed with objective rating methods, the subjective experience of the depression may be rated as more intense or severe by patients with comorbid BPD. The mechanism underlying this effect remains unknown, and requires further research.     

Symptoms of Depression and Psychological Distress in United States and Japanese College Students

Abstract

We compared United States and Japanese university students on self-report measures of depression (Beck Depression Inventory; BDI) and psychological distress (General Weil-Being Scale; GWB). In addition, we reassessed sex differences on these measures for students in the United States and examined sex differences for Japanese students. We found that (a) Japanese students had significantly higher scores than their U.S. counterparts on the BDI but not on the GWB scale and that (b) male and female college students in the U.S. and Japan did not differ in scores on the BDI or the GWB scale.     

Derivation and implications of MMPI cluster groups in clinically depressed inpatient females.

The purpose of this study was to subclassify clinically depressed patients based on a cluster-analytic examination of the MMPI. Subjects were 79 female inpatients with major depression. A cluster analysis of the MMPI validity and clinical scales resulted in three clusters labeled psychotic (287 MMPI profile), hostile (24 MMPI profile), and histrionic (32 MMPI profile) depression. The psychotic group exhibited the greatest depression as measured by the Beck Depression Inventory (BDI). The psychotic and hostile groups, however, did not differ on other associated aspects of depression, such as negative cognitions, nonassertiveness, or personality style. The hostile group reported the fewest physical difficulties and the most excessive alcohol use. The groups, however, did not differ on other aspects of depression history or presentation such as family history of depression or previous hospitalizations. A repeated measures ANOVA for the three cluster groups on the BDI at admission, discharge, and 6 months after discharge indicated that all groups showed improvement at discharge but that only the hostile depressive group continued to show improvement at the 6-month follow-up.     

Derivation and Implications of MMPI Cluster Groups in Clinically Depressed Inpatient Females

The purpose of this study was to subclassify clinically depressed patients based on a cluster-analytic examination of the MMPI. Subjects were 79 female inpatients with major depression. A cluster analysis of the MMPI validity and clinical scales resulted in three clusters labeled psychotic (287 MMPI profile), hostile (24 MMPI profile), and histrionic (32 MMPI profile) depression. The psychotic group exhibited the greatest depression as measured by the Beck Depression Inventory (BDI). The psychotic and hostile groups, however, did not differ on other associated aspects of depression, such as negative cognitions, nonassertiveness, or personality style. The hostile group reported the fewest physical difficulties and the most excessive alcohol use. The groups, however, did not differ on other aspects of depression history or presentation such as family history of depression or previous hospitalizations. A repeated measures ANOVA for the three cluster groups on the BDI at admission, discharge, and 6 months after discharge indicated that all groups showed improvement at discharge but that only the hostile depressive group continued to show improvement at the 6-month follow-up.     

Relationship between self-efficacy and changes in rated tension and depression for 9- to 12-yr.-old children enrolled in a 12-wk. after-school physical activity program

28 girls and 26 boys (93% African American) ages 9 to 12 years were enrolled in an after-school physical activity program for 12 wk. and completed measures of exercise self-efficacy, tension, and depression. Significant negative correlations were found between changes in ratings on Exercise Self-efficacy Scale for Children scores and Profile of Mood States Tension (r =-.44) and Depression (r =-.33) over 12 wk., indicating that as rated exercise Self-efficacy increased, rated Tension and Depression tended to decrease. Findings are consistent with behavioral explanations of the relationship between exercise and mood changes. Caution is appropriate as there was no control group, and familiarity might be an explanation of the findings.