Exploring the relation of depression and overt behavior with daily diaries

Behavioral models of depression highlight decreased response-contingent positive reinforcement as critical toward conceptualizing depressive affect, decreased reinforcement being caused by changes in the quantitative (i.e., number or intensity) or qualitative (i.e., type or function) aspects of reinforcing events, availability of reinforcement, inadequate instrumental behaviors, and/or an increased frequency of punishment [Lewinsohn, P. M. (1974). A behavioral approach to depression. In R. M. Friedman, & M. M. Katz (Eds.), The psychology of depression: Contemporary theory and research. New York: Wiley]. Building on previous research and addressing methodological limitations, this study utilized a daily diary method and behavioral coding system to directly assess whether qualitative aspects (or types) of human behavior differed as a function of depression level. Relative to non-depressed individuals, mildly depressed participants engaged less frequently in social, physical, and educational behaviors and more frequently in employment-related activities. These data support behavioral models of depression and have clinical relevance as highlighted with reference to behavioral activation interventions for depression.     

Anger, Spiritual Meaning and Support from the Religious Community in Dementia Caregiving

This study explores the relationships between spiritual meaning and social support from the religious community and problem behaviors, anger and depression in 128 dementia caregivers. The results suggest a mediating role of anger in the relationship between the appraisal of problem behaviors and depression. Support from the religious community is directly and negatively associated with anger, but the relationship between spiritual meaning and anger is mediated by caregivers’ appraisals of problem behaviors, suggesting that spiritual beliefs might help caregivers to find meaning in caregiving experiences and thus appraise care recipients’ behavioral problems as less stressful.     

Buffer effects and threshold effects: An alternative interpretation of nonlinearities in the relationship between social support,stress, and depression

The common interpretation of statistical interactions of global measures of social support and stress in their effects on depression (the "buffer effect" of social support) as reflecting interactive processes within individuals was examined. It was argued that its adequacy depends on incorrect assumptions about the distribution of depressive symptoms within individuals over time and/or different levels of psychosocial adversity. With hypothetical data sets generated under the assumption of a threshold effect in the development of depression and of additive, rather than interactive, effects of social support and stress, it was demonstrated that spurious "buffer effects" of social support can appear in analyses of cross-sectional data. Methodological and substantive implications are discussed, and strategies for study design and data analysis are proposed that allow to assess whether empirical deviations from linearity are more adequately interpreted as a buffer or as a threshold effect.     

Social Anxiety Disorder and Social Support Behavior in Friendships

Relationship quality is a strong predictor of health outcomes, and individuals with social anxiety disorder (SAD) report increased interpersonal impairment. However, there are few studies testing the effect of SAD on friendships and it is thus unclear whether there are behavioral differences that distinguish friendships in which a target individual has SAD from friendships in which the target individual does not have SAD. We tested for differences in the provision and receipt of support behaviors as a function of having a SAD diagnosis and accounting for comorbid depressive symptoms. Participants with SAD (n = 90) and their friends engaged in support conversations that were coded using the Social Support Interaction Coding System. Structural equation modeling revealed some differences between participants and friends when accounting for depression. Specifically, friends of participants with SAD and comorbid depression engaged in fewer positive helper behaviors than the friends of participants who did not have SAD or comorbid depression. Additionally, dyads in which the primary participant had SAD engaged in more off-task behaviors. Results suggest that SAD does not result in global interpersonal impairment, but that receipt of positive support behaviors from friends may differ as a function of SAD and comorbid depression. Interpersonal interventions aimed at increasing adaptive friendships and aspects of CBT that target subtle avoidance (e.g., safety behaviors) may be useful in facilitating more satisfactory relationships for these individuals.     

Activity Level,Activity Enjoyment,and Weather as Mediators of Physical Health Risks in Seasonal and Nonseasonal Depression

Research suggests that depression has negative consequences on physical health. One of the mechanisms driving this link may be the decrease in physical activity characteristic of individuals before and during a depressive episode. However, the factors that influence changes in physical activity across the seasons remain unclear. For instance, weather has been proposed to play an important role in the frequency of activities and enjoyment derived from them. In addition, research has not investigated how weather variables influence activity levels across the seasons in individuals with seasonal versus nonseasonal depression. The present study compared patterns of activity level and enjoyment in samples of women with seasonal and nonseasonal depression and controls. Women with Major Depressive Disorder (MDD) and MDD with a seasonal pattern (Seasonal Affective Disorder, SAD) reported similar patterns of activity; engaging in less frequent activity and deriving less enjoyment from activities than controls across the entire year, most notably during the winter months. Women with SAD also reported being significantly impacted by the weather such that their mood and energy levels increased with warmer temperatures an increased sunshine. Results suggest that women with seasonal depression may be at similar health risks as women with nonseasonal depression and activity patterns may have implications for behavioral activation treatments for depression.     

Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial

Theorists posit that certain behaviors exhibited by depressed individuals (e.g., negative self-statements, dependency, reassurance seeking, inappropriate or premature disclosures, passivity, social withdrawal) reduce social support, yet there have been few experimental tests of this hypothesis. Using data from a randomized depression prevention trial (N = 253) involving adolescents (M age = 15.5, SD = 1.2), we tested whether a cognitive behavioral group intervention that significantly reduced depressive symptoms relative to bibliotherapy and educational brochure control conditions through 2-year follow-up produced improvements in perceived parental and friend social support and whether change in depressive symptoms mediated the effect on change in social support. Cognitive behavioral group participants showed significantly greater increases in perceived friend social support through 1-year follow-up relative to bibliotherapy and brochure controls, but there were no significant effects for perceived parental support. Further, change in depressive symptoms appeared to mediate the effects of the intervention on change in perceived friend support. Results provide experimental support for the theory that depressive symptoms are inversely related to perceived social support, but imply that this effect may be specific to friend vs. parental support for adolescents.     

抑郁个体对社会反馈的加工：研究现状及存在问题

抑郁症伴随着严重的社会功能障碍。本文以“社会反馈”这一重要社会性信息为切入点,综述了抑郁症患者及抑郁倾向人群对社会反馈的体验、期待及情绪调节障碍的研究现状,发现抑郁个体对社会奖赏存在快感缺失,对社会排斥、社会拒绝等负性反馈表现出过敏化,对社会奖赏的期待降低,且可能存在情绪调节困难。目前此领域存在社会与非社会反馈神经机制的异同不清楚、异常脑区与社会反馈加工障碍的因果关系难以确定以及无法排除抑郁症患者和抑郁倾向人群存在不同社会反馈加工模式的可能性等问题。     

CBT for Medication Adherence and Depression (CBT-AD) in HIV-Infected Patients Receiving Methadone Maintenance Therapy

For individuals with HIV who are current or former injection drug users, depression is a common, distressing condition that can interfere with a critical self-care behavior—adherence to antiretroviral therapy. The present study describes the feasibility and outcome, in a case series approach, of cognitive behavioral therapy to improve adherence and depression (CBT-AD) among individuals with HIV and depression undergoing methadone maintenance treatment for heroin dependence. CBT-AD integrates cognitive behavioral therapy for depression with our intervention for improving adherence to antiretroviral therapy for HIV (Life-Steps; [Safren, S. A., Otto, M. W., Worth, J., Salomon, E., Johnson, W., Mayer, K., et al. (2001). Two strategies to increase adherence to HIV antiretroviral medication: Life-Steps and medication monitoring. Behavioral Research and Therapy, 39, 1151–1162]). Specifically, in CBT-AD, patients first receive a cognitive behavioral intervention focusing on improving skills related to medication adherence. Each of the subsequent CBT modules (activity scheduling, cognitive restructuring, problem-solving training, and relaxation training/diaphragmatic breathing) is designed to address both self-care/adherence behaviors as well as depression. The process and outcome with 4 cases suggest that the treatment was feasible and acceptable and was generally associated with improvements. This case series provides an example of how cognitive behavioral therapists can integrate the treatment of depression with the enhancement of critical self-care behaviors in the context of highly complex, medical and psychiatric comorbidity.     

Adolescent health behavior and conventionality-unconventionality: an extension of problem-behavior theory

Examined the relation of psychosocial and behavioral conventionality-unconventionality to health-related behavior in cross-sectional data from 1,588 male and female 7th to 12th graders. Conventionality-unconventionality was represented by personality, perceived social environment, and behavior variables selected from the social-psychological framework of problem-behavior theory (R. Jessor & S. L. Jessor, 1977). Greater psychosocial conventionality correlates with more regular involvement in health-related behavior (regular physical activity, adequate sleep, safety belt use, attention to healthy diet). Greater behavioral conventionality (less involvement in problem behaviors such as marijuana use, problem drinking, delinquent-type behavior, and greater involvement in conventional behaviors such as church attendance) was also associated with greater involvement in health-maintaining behavior. The overall findings provide support for the extension of problem-behavior theory to the domain of adolescent health behavior and for the relevance of the dimension of conventionality-unconventionality.     

Delayed Bedtimes Are Associated With More Severe Obsessive-Compulsive Symptoms in Intensive Residential Treatment

Delays in behavioral and biological circadian rhythms (e.g., sleep timing, melatonin secretion) are found more frequently in individuals with severe and treatment-resistant obsessive-compulsive disorder (OCD). In recent years, it has been documented that these delays in behavioral and biological circadian rhythms are associated with more severe OCD symptoms and poorer response to some OCD treatments. This study examined self-reported sleep behaviors in individuals taking part in an intensive treatment for OCD and the relations between these and OCD symptoms (both at admission to and discharge from the treatment program). Replicating previous findings in less severe populations, delayed sleep phases were relatively common in this group and later bedtimes were associated with more severe OCD symptoms at admission. Sleep onset latency and sleep duration were not associated with OCD symptom severity at admission. Later bedtimes were not associated with self-reported depression or worry symptom severity. There was no evidence of sleep behaviors affecting change in OCD symptoms from admission to discharge from treatment—however, later bedtimes at admission were associated with more severe OCD symptoms at admission and discharge from treatment. There was no evidence of sleep onset latency or sleep duration having a similar predictive effect. More severe OCD symptoms at admission were also associated with later bedtimes at admission and discharge from treatment. These bidirectional predictive relations between late bedtimes and OCD symptoms were of small effect size but support the potential value of evaluating sleep timing in individuals with severe and/or treatment-resistant OCD.     

Parental Representations and Support-Seeking Behaviors Related to Dependency and Self-Criticism

Cognitive and interpersonal models of depression were integrated by examining the links between parental representations and the interpersonal behaviors of individuals at risk for depression. Study 1 assessed the quantity and type of social support associated with Dependency and Self-Criticism. Study 2 examined the parental representations related to these personality styles, in an effort to document cognitive variables that might contribute to interpersonal behaviors. Self-critics were found to be more dysphoric over a 21-day, self-monitoring period, made fewer requests for social support, and showed lower perceptions of support. Peers did not report providing less support to self-critics, but found them less expressive and did not know them as well. Study 2 found pervasive, negative parental representations associated with Self-Criticism providing a cognitive underpinning to social distancing. Dependent participants reported higher levels of support, which was corroborated by the peer reports. Study 2 found Dependency to be related to favorable representation of parents for friendly and submissive, but not hostile, situations. The impact of cognitive representations for interpersonal functioning is highlighted, and reciprocal processes between the two are discussed.     

Traits, States, and encoding speed: support for a top-down view of neuroticism/state relations

Recent theories suggest that trait neuroticism gains its pernicious power particularly among individuals less capable of making distinctions concerning present reality. Four studies, involving 272 undergraduates, sought to provide some basic, assessment-related support for such theories in the context of individual differences in choice reaction time, which reflect abilities to make distinctions at encoding. Studies 1-3 focused on somatic symptoms, whereas Study 4 focused on neurotic behaviors and negative affect. As predicted, neuroticism consistently interacted with categorization speed in predicting these dependent measures. Specifically, neuroticism/outcome relations were robust among individuals slow to make distinctions at encoding; by contrast, neuroticism did not predict the dependent measures among individuals fast to make distinctions. Such data reinforce suggestions that neuroticism is particularly pernicious among individuals less capable of making distinctions at encoding.     

Who's to blame? Narcissism and self‐serving attributions following feedback

The study examined the relationship between narcissism, performance attributions, and negative emotions following success or failure. As expected, narcissistic individuals showed more self‐serving attributions for their performance in an intelligence test than less narcissistic individuals: compared with less narcissistic individuals, narcissists revealed a stronger tendency to attribute success to ability and failure to task difficulty. In contrast to this, less narcissistic participants tended to show the opposite pattern by ascribing failure, but not success, to their ability. Additionally, anger and depression could be predicted by an interaction of performance feedback and performance attributions. Mediation analyses revealed that the attribution dimensions ‘task difficulty’ and ‘ability’ mediated the effect of narcissism on anger and depression following failure feedback. The results provide support for the theoretical assumption that attributional processes might, at least to some extent, explain the often reported relation between narcissism and negative emotions following failure. Copyright © 2003 John Wiley & Sons, Ltd.     

The Environmental Reward Observation Scale (EROS): development, validity, and reliability

Researchers acknowledge a strong association between the frequency and duration of environmental reward and affective mood states, particularly in relation to the etiology, assessment, and treatment of depression. Given behavioral theories that outline environmental reward as a strong mediator of affect and the unavailability of an efficient, reliable, and valid self-report measure of environmental reward, we developed the Environmental Reward Observation Scale (EROS) and examined its psychometric properties. In Experiment 1, exploratory factor analysis supported a unidimensional 10-item measure with strong internal consistency and test-retest reliability. When administered to a replication sample, confirmatory factor analysis suggested an excellent fit to the 1-factor model and convergent/discriminant validity data supported the construct validity of the EROS. In Experiment 2, further support for the convergent validity of the EROS was obtained via moderate correlations with the Pleasant Events Schedule (PES; MacPhillamy & Lewinsohn, 1976). In Experiment 3, hierarchical regression supported the ecological validity of the EROS toward predicting daily diary reports of time spent in highly rewarding behaviors and activities. Above and beyond variance accounted for by depressive symptoms (BDI), the EROS was associated with significant incremental variance in accounting for time spent in both low and high reward behaviors. The EROS may represent a brief, reliable and valid measure of environmental reward that may improve the psychological assessment of negative mood states such as clinical depression.     

Effects of occupational stress,job characteristics,coping, and attributional style on the mental health and job satisfaction of university employees

Well-being at work has been shown to be influenced by job characteristics and individual differences in coping styles. This study investigated the relationships between job demands, control, social support, efforts, rewards, coping, and attributional style in predicting anxiety, depression, and job satisfaction in a sample of 307 university employees from the UK. Results were compared to those from a sample of 120 members of the general population. Workplace demands, intrinsic and extrinsic effort, and negative coping and attributional behaviors were associated with high levels of depression and anxiety and low job satisfaction in university employees. Rewards, social support, job control, and positive coping and attributional behaviors were associated with lower levels of depression and anxiety and high job satisfaction. The study adds to the growing research on university samples by showing that a transactional approach should be adopted. This has implications for interventions and suggests that rather than just trying to change job characteristics one should identify at-risk individuals in this population and help them adopt appropriate positive coping styles.     

Effects of occupational stress, job characteristics, coping, and attributional style on the mental health and job satisfaction of university employees

Well-being at work has been shown to be influenced by job characteristics and individual differences in coping styles. This study investigated the relationships between job demands, control, social support, efforts, rewards, coping, and attributional style in predicting anxiety, depression, and job satisfaction in a sample of 307 university employees from the UK. Results were compared to those from a sample of 120 members of the general population. Workplace demands, intrinsic and extrinsic effort, and negative coping and attributional behaviors were associated with high levels of depression and anxiety and low job satisfaction in university employees. Rewards, social support, job control, and positive coping and attributional behaviors were associated with lower levels of depression and anxiety and high job satisfaction. The study adds to the growing research on university samples by showing that a transactional approach should be adopted. This has implications for interventions and suggests that rather than just trying to change job characteristics one should identify at-risk individuals in this population and help them adopt appropriate positive coping styles.     

Emotion context insensitivity in major depressive disorder

The present study tested 3 competing views of how depression alters emotional reactivity: positive attenuation (reduced positive), negative potentiation (increased negative), and emotion context insensitivity (ECI; reduced positive and negative). Normative and idiographic stimuli that elicited happy, sad, and neutral states were presented to currently depressed, formerly depressed, and healthy control individuals while experiential, behavioral, and autonomic responses were measured. Currently depressed individuals reported less sadness reactivity and less happiness experience across all conditions than did the other participants, and they exhibited a more dysphoric response to idiographic than to normative stimuli. Overall, data provide partial support for the positive attenuation and ECI views. Depression may produce mood-state-dependent changes in emotional reactivity that are most pronounced in emotion experience reports.     

Contributions of the functional analysis of behavior to the problem of AIDS

Epidemiological patterns in the spread of HIV infection and the potential role of psychologists in encouraging behavioral changes intended to reduce risks of infection are examined. The 1st great wave of AIDS cases in the industrialized countries occurred primarily in specific, fairly self-contained subgroups such as male homosexuals, hemophiliacs, and IV drug users. Large proportions in these groups are either infected or have adapted risk reduction behavior. The risk of infection for the general heterosexual population in industrialized countries is very low but likely to increase progressively unless measures are taken to reduce risks. Psychologists, who expend considerable effort researching and attempting to effect behavioral changes, thus have a potentially significant role in slowing the spread of the AIDS epidemic. The means of avoiding HIV infection in sexually active persons and drug users are known, but the means of motivating individuals to change to less risky behaviors are not as well understood. Several factors have been identified that appear to influence the vulnerability of the organism to HIV infection or to development of AIDS once infected. Several are capable of modification through behavioral changes, such as high-risk sexual practices, use of particular contraceptive methods, inadequate hygiene, poor nutrition, and self-administration of drugs. Several aspects of HIV infection and its spread are capable of producing psychological stress, including anxiety over possible infection and testing, reaction to diagnosis, fear of rejection by others, watching friends and relatives sicken and die of AIDS, encountering suspicious symptoms, and perceiving signs of physical deterioration. Psychological support in these situations can help to prolong life and improve its quality. Examples abound of individuals who continue to display a risk behavior despite being well informed of its risks; physicians who smoke are 1 such group. Information is a necessary but not sufficient condition for adapting preventive behaviors. Functional behavioral analysis suggests that immediate pleasure, ephemeral though it may be, outweighs the mere possibility of an unpleasant consequence at some hypothetical future date.     

“非典”流行期民众常见的心理应激反应与心理干预

该文介绍了传染性非典型性肺炎（严重的急性呼吸综合征,SARS）急性流行期我国民众较常见的心理应激反应,包括焦虑和恐惧、愤怒和怨恨以及抑郁等情绪反应,认知反应,自我防御反应和生理反应,描述了人们面对SARS威胁时的应对策略;探讨了当前影响民众心理反应的诸种因素,包括刺激事件或刺激情境的性质与特点,对事物的态度和认识评价,应对挑战的能力与应对方式,以及心理社会环境和人格特征等;指出了心理干预应当遵循的四个原则和多种形式,说明了6种心理干预的具体措施和方法。