Dimensions of alexithymia and their relationships to anxiety and depression

Investigators have suggested that alexithymia is a multidimensional construct and that it is responsive to situational stressors. We tested these hypotheses in a sample of 110 freshman medical students. We conducted factor analyses on the Toronto Alexithymia Scale (TAS), the Beck Depression Inventory (BDI), and the state portion of the State-Trait Anxiety Inventory (STAI) and then used LISREL to examine the relationships among the various factors. The results indicated that the TAS consists of several independent dimensions and that the dimensions associated with difficulties identifying and communicating feelings are positively related to depression and anxiety. Thus, the evidence now affirms that alexithymia (as measured by the TAS) is multidimensional and that certain dimensions are state dependent.     

The impact of maternal postnatal depression on men and their ways of fathering: an interpretative phenomenological analysis

Objectives: Postnatal depression affects approximately 15% of women in Western countries. There are conflicting findings about the effects on fathers as well as the extent to which fathers buffer against the negative effects of depression on children. This study sought to understand the ways in which maternal postnatal depression affects men and their ways of fathering.

Design: Narrative interviews were conducted with 14 British fathers (mean age?=?33.9?years) whose (ex)partners had experienced at least one episode of postnatal depression. Interviews explored how their partner’s depression affected them, the partner relationship, their children and their ways of fathering. Data were analysed with interpretative phenomenological analysis.

Results and Conclusions: Men felt that their partner’s depression led to significant physical and/or psychological maternal absence as well as a fracturing of the family unit, which had been an important ideological foundation for men’s fathering. Unequal divisions of labour, unfulfilled expectations, a thwarting of preferred ways of fathering and preoccupation with their partner’s depression took some men away from fathering. Others reported adaptation by accepting the loss of shared parenting and investing in an exclusive father–child relationship. Fathering appears to be particularly affected by the loss of a close adult relationship.     

Maternal representations: A clinical and subjective phenomenological view

The relationship — as represented — is proving to be of growing value in our thinking about clinical problems such as “intergenerational transfer.” It is also an extremely positive influence in our thinking about how the interpersonal world is remembered, abstracted, and lived. Yet, the nature of a “represented relationship” remains unclear. This paper is an attempt to clarify some of the problems and areas for needed study regarding this concept. The mother's representation of her infant and of the people in her own life who have played “maternal roles” will be taken as the model. First, we will explore the richness and complexity of these representations and conclude that, for clinical purposes, different models are used to simplify this richness and render it therapeutically useful. Three models will be discussed. The first is the disfortion model which measures the distance between the mother's subjective experience of her interaction or relationship with another and some objective, observable “reality.” The model of overdeter-mining themes is a second model, largely the inspiration of psychoanalysis but inclusive of Bowlby's theory of attachment. Here psychobiological and/or psychodynamic themes organize the clinical material. Finally, a coherence model is discussed. Here the motive is goodness of the narrative construction rather than the historical “truth.” A second issue discussed is the capacity to represent dyads vs. triads and actual vs. second-hand narrated relationships. These issues are crucial for notions not only about the nature of such representations but also their limitations in understanding family interactions and relationships, i.e., where many members are concerned. A third issue concerns the nature of the subjective experience for a mother when a representation of her infant or herself in relation to the infant is “activated.” There exists here an unknown typology of experience. Finally, we will discuss what all of the above have to contribute to our further understanding of the nature of represented relationships.     

Power in relationships of women with depression

To identify marital power difficulties specifically associated with depression, twenty couples in which the female partner was depressed were compared on a range of interpersonal power variables with twenty healthy control couples and also with twenty couples in which the female partner had a disorder other than depression (specifically panic disorder with agoraphobia (PDA)). Couples in the depressed group had two features that distinguished them from couples in both the PDA and control groups and which were independent of relationship dissatisfaction. In the depressed group, both partners reported more physical assault in the year prior to the study and depressed women were more dissatisfied with their control of surplus spending money. Couples in the depressed group had a series of features that distinguished them from couples in both the PDA and control groups but which were due in part to relationship dissatisfaction. Depressed women were less committed to their relationships. Both partners in depressed couples reported more demand–withdraw transactions and less mutual constructive communication within their relationships. Depressed women reported more dissatisfaction with decision-making and greater dissatisfaction in childcare task distribution.     

Intrusion-based reasoning and depression: Cross-sectional and prospective relationships

Intrusion-based reasoning refers to the tendency to form interpretations about oneself or a situation based on the occurrence of a negative intrusive autobiographical memory. Intrusion-based reasoning characterises post-traumatic stress disorder, but has not yet been investigated in depression. We report two studies that aimed to investigate this. In Study 1 both high (n = 42) and low (n = 28) dysphoric participants demonstrated intrusion-based reasoning. High-dysphoric individuals engaged in self-referent intrusion-based reasoning to a greater extent than did low-dysphoric participants. In Study 2 there were no significant differences in intrusion-based reasoning between currently depressed (n = 27) and non-depressed (n = 51) participants, and intrusion-based reasoning did not predict depressive symptoms at 6-month follow-up. Interestingly, previously (n = 26) but not currently (n = 27) depressed participants engaged in intrusion-based reasoning to a greater extent than never-depressed participants (n = 25), indicating the possibility that intrusion-based reasoning may serve as a “scar” from previous episodes. The implications of these findings are discussed.     

Spanish-language measures of mania and depression

Efforts to better understand bipolar spectrum disorders across ethnic groups are often hampered by the lack of commonly used self-report instruments to assess mania and depression in individuals who speak languages other than English. This article describes the translation into Spanish of 2 self-report measures of manic symptoms (i.e., the Internal State Scale and the Hypomanic Personality Scale) and 2 self-report measures of depression (i.e., the Inventory to Diagnose Depression and the Inventory to Diagnose Depression, Lifetime version). The authors translated these measures into Spanish and assessed their psychometric properties among bilingual college students (N = 88). Results suggest that the Spanish versions have psychometric properties comparable to the English versions of the instruments.     

The relationships among clinical depression, suicide, and other actions that may hasten death

Clinical depression and other psychological disorders have been associated with suicidal ideation, attempts, and deaths. Because of the link between suicide and mental illness, whenever discussion of "assisted suicide" arises, the possibility that major depression is affecting the decision arises. This article examines the literature on clinical depression as it relates to suicide, "assisted suicide," and other decisions that will hasten death (i.e. withholding and withdrawing treatment, terminal sedation, and voluntarily stopping eating and drinking). Ethical and legal considerations when working with individuals who are considering taking an action that would hasten death are also briefly reviewed. The article ends with practice and policy recommendations.     

Assessment of depression in adolescents: objective and projective measures

This study is a multimethod assessment of depressive features in a sample of 60 adolescent inpatients. The purpose of the study was to examine the relationship between self-report measures of depression and Rorschach variables commonly associated with depression. Patients represented a variety of diagnostic categories in order to determine whether information gathered through assessment instruments was related to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III], American Psychiatric Association, 1980) diagnoses of depression. Findings indicated that this sample of adolescents was highly defensive and emotionally constricted. There were several significant relationships between self-report measures and Rorschach indicators of depression. However, in general, the Rorschach variables were not strongly related to depression. The self-report measures were more accurate than Rorschach variables in discriminating between depressed and nondepressed subjects.     

Adolescents' relationships with their mothers and fathers: associations with depressive disorder and subdiagnostic symptomatology

Family relationships across 3 groups of adolescents were compared: (a) those with unipolar depressive disorders (n=82); (b) those with subdiagnostic depressive symptoms (n=78); and (c) those without emotional or behavioral difficulties (n=83). Results based on multisource, multimethod constructs indicated that depressed adolescents, as well as those with subdiagnostic symptomatology, experience less supportive and more conflictual relationships with each of their parents than do healthy adolescents. These findings are notable in demonstrating that adverse father-adolescent relationships are associated with depressive symptomatology in much the same way as mother-adolescent relationships. As well, the findings add to the emerging evidence that adolescents with subdiagnostic symptoms experience difficulties in social relationships similar to those experienced by adolescents with depressive disorder.     

Adolescents' relationships with mother and father and their links to the quality of romantic relationships: A classification approach

Adolescents' relationships with parents are considered to be a major learning source and emotional base for developing expectations and styles of behaviour in close relationships. Using a longitudinal sample of late adolescents from nuclear families drawn from the German Family Panel pairfam (N = 720; mean age: 18.6 years), we investigated how adolescents' relationships with both parents influenced their romantic relationship quality one year later. Bagged (Averaged) Binary Recursive Partitioning was used to compare features of adolescents' relationships with mother and father (relatedness, negative conflict, emotional insecurity, and parental dominance) in respect of their importance in predicting similar aspects of romantic relationship quality. Overall, our findings suggest some degree of domain-specific continuities in adolescents' relationships with parents and partner, particularly for negative conflict, as well as more global effects for most features of the parent–adolescent relationship. Emotional insecurity with mother was most broadly linked to all features of adolescents' romantic relationship. Overall, adolescents' relationship with mother was found to be more influential than their relationship with father. The findings are discussed with reference to a behavioural systems perspective and attachment theory.     

Mothers' representations of their relationships with their toddlers: links to adult attachment and observed mothering.

Mothers (N = 125) and their firstborn sons were studied over an 11-month period to examine relations between mothers' representations of their relationships with their children (measured at 15 months by using the Parent Development Interview [PDI]), adult representations of attachment (measured at 12 months by using the Adult Attachment Interview [AAI]), and observed mothering (measured at 15 and 21 months). Results indicate (a) that mothers classified as autonomous on the AAI scored highest on the joy-pleasure/coherence dimension of the PDI and mothers classified as dismissing on the AAI scored highest on the anger dimension of the PDI and (b) that mothers scoring higher on the joy-pleasure/coherence dimension of the PDI engaged in less negative and more positive mothering.     

The relationships of basic information processing measures with fluid and crystallized intelligence

The aim of the present research is to study the nature of Basic unit of Information Processing (BIP) by means of two related experiments. The first of these experiments uses structural equation models to attempt to confirm the relationships between these measures and crystallized intelligence proposed by Draycott and Kline (Personality and Individual Differences, 20, 201–210, 1994). The second attempts to find out more about the relationships between this and other Chronometrie measures both in computer and paper and pencil administration. Results seem to confirm the relationship between BIP and crystallized intelligence and it seems to be extensive to other paper and pencil measures such as the visual forms test. The relationships between task complexity and the size of the correlation between Chronometric measures and intelligence are also discussed.     

Dating couples and their relationships: intimacy and contraceptive use

Investigations of ineffective contraceptive use have generally focused on individualistic rather than dyadic factors. The present study used a sample of dating couples to investigate four intimacy dimensions in relation to contraceptive use. Fourteen consistent contraceptive use (CCU) couples and 16 inconsistent contraceptive use (ICU) couples participated. It was found that the two groups' expectations of intimacy did not differ significantly. However, the ICU couples reported experiencing significantly lower levels of emotional, social, and intellectual intimacy than did the CCU couples. Significant differences between realized and expected levels of intimacy were found only among ICU couples. The results indicate that partners with mutually dissatisfying levels of intimacy were more likely to use contraceptives inconsistently.     

Informed Outcomes: Self-rating measures and their use in psychodynamic therapy with adolescents

I am currently engaged in an A Space ¹ 1. A Space for Creative Learning and Support was set up as a research and development project in 1997 by The Glass-House Trust (a Sainsbury Family Charitable Trust), the Social Science Research Unit (Institute of Education, University of London) and Hackney Education. A core aim is to deliver psychodynamic therapies in the school setting, adapting and evolving current models of child and adolescent psychotherapy, where necessary, both in response to the educational context and to ensure that the needs of children and adolescents are best met. In 2010, A Space and The Centre for Psychoanalytic Studies, University of Essex, began a formal study into school-based therapy. Funded by The Glass-House Trust, this research will run through to 2013. A conference will be held in 2013, so that the findings can be more widely disseminated. /University of Essex research study looking at the ways in which psychodynamic counselling can best meet the needs of young people accessing therapy in the school setting. As part of the study, I have looked at the main outcome measures used in work with adolescents in clinics, the community and voluntary sector and in education settings. In this article, I look at the process of assessment, including the use of written self-rating outcome measures with young people. I critically review a selection of these and reflect on their application in practice. I go on to consider how collaborative written assessment procedures may be more appropriate for use by psychodynamic therapists working with school-based clients, given the challenges of delivering therapy in the education sector.     

Adult attachment styles and mothers' relationships with their young children

This research examined the relationship between adult attachment styles and mothers' feelings of closeness to their children, mothers' interaction styles in a teaching situation, individual differences in the desire to have children, and the concerns individuals have about their ability to relate to young children as parents. Investigation 1 revealed that more avoidant mothers did not feel as close to their preschool children as did more secure mothers, and they behaved less supportively toward their children during a laboratory teaching task. Anxious-ambivalence was also associated with feelings of less closeness, but the level of closeness achieved depended on marital quality. Investigation 2 showed that more avoidant college men and women, compared to secure ones, were more uncertain about their capacity to relate to young children and about whether they wanted to have children. Highly ambivalent men and women reported being more uncertain about their capacity to function well as parents, but ambivalence was not related to the strength of the desire to have children. These findings are discussed in the context of attachment theory.     

Information processing biases and panic disorder: relationships among cognitive and symptom measures

To test cognitive models of panic disorder, a range of information processing biases were examined among persons with panic disorder (N=43) and healthy control participants (N=38). Evidence for automatic associations in memory was assessed using the Implicit Association Test, interference effects related to attention biases were assessed using a modified supraliminal Stroop task, and interpretation biases were assessed using the Brief Body Sensations Interpretation Questionnaire. In addition, the relationship between information processing biases and clinical markers of panic (including affective, behavioral, and cognitive symptom measures) was investigated, along with the relationships among biases. Results indicated more threat biases among the panic (relative to control) group on each of the information processing measures, providing some of the first evidence for an implicit measure of panic associations. Further, structural equation modeling indicated that the information processing bias measures were each unique predictors of panic symptoms, but that the bias indicators did not relate to one another. These findings suggest that cognitive factors may independently predict panic symptoms, but not covary. Results are discussed in terms of their support for cognitive models of panic and the potential for automatic versus strategic processing differences across the tasks to explain the low relationships across the biases.     

Reducing depression in stroke survivors and their informal caregivers: A randomized clinical trial of a web-based intervention

Purpose/Objectives: To develop and test the efficacy of a Web-based intervention for alleviating depression in male stroke survivors (SSs) and their spousal caregivers (CGs) that blends both peer and professional support. Design and Methods: The research consisted of an intervention protocol evaluated by a focus group of rehabilitation professionals, a "think aloud" session conducted with female stroke CGs, and a usability test of the intervention's online features with 7 female stroke CGs. Efficacy of the final protocol was tested in a 2-group randomized clinical trial with a sample of 32 CG-SS dyads. The CGs in the intervention condition received an online group intervention. Intervention components were based on the Stress Process Model. Those CGs in a control condition received minimal support with individualized access to relevant online information. Measures of depression, as well as the secondary outcomes of mastery, self-esteem, and social support, were obtained from SSs and CGs at pretest, posttest, and 1-month later. Results: At posttest and 1 month later, CGs in the intervention condition reported significantly lower depression than CGs in the control condition with baseline depression controlled. There was no significant effect on depression among SSs. Although no significant treatment effects for either SSs or CGs were found on the secondary outcomes, posttreatment changes on some constructs were significantly correlated with change in depression. Conclusions/Implications: CGs benefit from Web-based programs that help them better understand both their emotional needs and those of the SS. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Suicidal ideation in adolescent psychiatric inpatients as associated with depression and attachment relationships

Examined suicidal ideation in adolescent psychiatric inpatients as associated with depressive symptoms and attachment to mother, father, and peers. Fifty-nine adolescent psychiatric inpatients (25 male, 34 female) completed self-report measures of suicidal ideation, depressive symptoms, and attachment. Attachment to mother accounted for significant variation in levels of depressive symptoms and suicidal ideation. In addition, attachment to peers accounted for significant variation in suicidal ideation and girls' (but not boys') depressive symptoms. However, after adjusting for depressive symptoms, attachment variables failed to contribute additional variance in suicidal ideation. Self-reported depressive symptomatology remained the strongest predictor of suicidal ideation, regardless of its order in the regression analyses. Prevention and treatment efforts may focus on mother-adolescent attachment and peer attachment (particularly in girls) to reduce risk for depression and suicidal ideation.     

Depressive realism and clinical depression

Depressive realism suggests that depressed individuals make more accurate judgments of control than their nondepressed counterparts. However, most studies demonstrating this phenomenon were conducted in nonclinical samples. In this study, psychiatric patients who met criteria for major depressive disorder underestimated control in a contingent situation and were consistently more negative in their judgments than were nondepressed controls. Depressed patients were less likely than their nondepressed counterparts to overestimate control in a noncontingent situation, but largely because they perceived receiving less reinforcement. Depressed patients were no more likely to use the appropriate logical heuristic to generate their judgments of control than their nondepressed counterparts and each appeared to rely on different primitive heuristics. Depressed patients were consistently more negative than their nondepressed counterparts and when they did appear to be more “accurate” in their judgments of control (as in the noncontingent situation) it was largely because they applied the wrong heuristic to less accurate information. These findings do not support the notion of depressive realism and suggest that depressed patients distort their judgments in a characteristically negative fashion.