Body Image and Depression in Women With Early and Late Onset Obesity

Three groups of women (N = 27 in each group) were compared: women of normal weight and asymptomatic for eating disorders (M = 125.5 lb); women with early onset obesity—before 13 years (M = 182.4 lb); and women with adult onset obesity—17 years or over (M = 172.4 lb). Subjects (M age = 40.7 years) were obtained through church and business groups. Body image and depression were assessed, respectively, by three scales of the Body-Self Relations Questionnaire (Winstead & Cash, 1983) and by the Beck Depression Inventory (Beck, 1967). The combined group of obese subjects rated their bodies as less fit than normal weight subjects (p<.01). However, there were no other significant differences between obese and normal weight subjects. Also, no significant differences were found between the early and late onset groups. Results showed that (a) there is a subpopulation of obese women who are relatively satisfied with their bodies and whose psychological adjustment is no different from that of other women, and that (b) an early onset of obesity does not necessarily have more serious psychological consequences than late onset.     

Depression and Openness to Experience

The relation between depression and Openness to Experience was examined. Self-report measures of personality traits (Revised NEO Personality inventory; Costa & McCrae, 1992a) and depression (Beck Depression Inventory; Beck, Rush, Shaw, & Emery, 1979; and Inventory to Diagnose Depression; Zimmerman, 1994) were administered to 143 undergraduate participants from the following 3 groups: current depression (n = 46), past depression (n = 50), and never-depressed controls (n = 47). Depressed participants exhibited significantly higher scores than nondepressed controls on two facets of Openness (Aesthetics and Feelings). Openness to Experience was also found to account for a significant proportion of the variance in depression scores, beyond the variance accounted for by Neuroticism and Extraversion. The facet of Openness to Aesthetics appeared to be most strongly related to depression scores, and the facet of Openness to Fantasy was implicated as a moderator of the relation between Extraversion and depression.     

Coaching Clients to Manage Depression

The author presents a system of behavioral techniques that permits clients to manage their own depression. By coaching clients through the sequence of self-management procedures identified by Kahn (1976) and using the strategies offered by Lewinsohn (1975), counselors have an effective set of techniques to lead clients to successful coping with depression. The sequence of self-observation, self-mediation, and self-reinforcement activities is based on Lewinsohn's (1975) work and is effective with moderately depressed clients. This comprehensive treatment program requires a minimum amount of counselor intervention for a maximum amount of client gain.     

Cognitive Vulnerability to Persistent Depression

Abstract

The account of cognitive vulnerability to depression offered by Beck's cognitive model is summarised. As this account currently lacks consistent empirical support, an alternative, related, account is presented. This proposes that, once a person is initially depressed, an important factor that determines whether their depression remains mild or transient, or becomes more severe and persistent, is the nature of the negative cognitive processes and constructs that become active and accessible in the depressed state. These interact with the nature of environmental difficulties, available social support, and biological factors, to determine whether a depression-maintaining cognitive-affective vicious cycle will be set up.

Results from studies specifically designed to test predictions from this account have yielded positive results. Findings consistent with the hypothesis have also been obtained in other prospective studies which have shown that cognitive measures, administered in the depressed state, predict the future course of depression independently of initial levels of depression.

The hypothesis is elaborated to incorporate the demonstrated relationship of elevated neuroticism to risk and persistence of depression. Recent views on the nature of sex differences in rates of depression, and on the relationship of attributional style to depression are also compatible with the hypothesis. It is concluded that the hypothesis has encouraging preliminary support.

SUMMARY

Two broad aspects of cognitive vulnerability to depression can be distinguished. The first is the tendency to evaluate certain types of life event in ways which will produce intense rather than mild depression. This is the aspect of vulnerability on which Beck's cognitive model appears to concentrate. There are considerable difficulties in assessing this aspect of Beck's model and it is not consistently supported by comparison of recovered depressed patients with control groups.

The second aspect of cognitive vulnerability relates to the cognitive processes and constructs that become active and accessible once a person is in a state of depression. Within this approach, vulnerability to onset and vulnerability to persistence of depression can be roughly distinguished, depending on whether the focus is on the period when the depression has been present for only a brief period, or is mild, or whether depression has already existed for some time and reached at least moderate severity. The account presented here proposes that a crucial factor determining whether an initially mild or transient depressed state remains mild or soon disappears, or becomes more severe and persistent, is whether a vicious cycle based on a reciprocally reinforcing relationship between depressed mood and negative cognitive processing can become established. The probability that this cycle will become established is, in turn, a function of a complex interaction between the environmental difficulties facing a person, the support available to them, their biological state, and the nature of the cognitive processes and constructs that are active and accessible in the depressed state. The kind of cognitive process and constructs that are most active and accessible in the depressed state will be a function both of the patterns of cognitive processing that are characteristic of the person in their normal mood state (such as those related to neuroticism), and of the patterns of cognitive processing that become active in the depressed state. It is on these latter that the differential activation hypothesis concentrates. It suggests that individual differences in the cognitive processes and constructs that become active and accessible in the depressed' state can make an important contribution to whether an initial state of depression becomes more intense, or fades away, and whether, once established, depression of moderate severity persists a long time or a short time. In particular, it is proposed that processes and constructs related to global negative characterological evaluations of the self or that, in other ways, lead to interpretations of experience as highly aversive and uncontrollable are likely to act to intensify and maintain depression.

Two investigations specifically designed to test predictions from the differential activation hypothesis yielded positive results. Further supportive evidence is available from a number of other studies which have examined the relationship between cognitive measures, administered in the depressed state, and the future course of depression. Such studies haverecurringly found that persistence or return of depression is associated with initially high scores on measures of negative cognition, and this association remains when the effects of initial depression level are partialled out.

In addition to this encouraging preliminary empirical support, the differential activation hypothesis has the further attraction that it can incorporate into this account the well established finding that neuroticism is associated with risk of becoming depressed, and of depression persisting. Further, it is quite consistent with recent proposals related to sex differences in rates of depression, and to the relationship of attributional style to depression.     

Onset capture requires attention

We studied exogenous cuing caused by an uninformative abrupt onset during a time when subjects were under the influence of the attentional blink. In two experiments, we found a reduced impact of exogenous cuing during the blink time of the attentional blink. The results indicate that involuntary orienting caused by abrupt onsets is sensitive to manipulation of available attentional resources. Thus, onset capture requires attention.     

A Holistic Approach to Postpartum Depression

No abstract available for this article.     

Depression and its relation to light deprivation

The absence or diminution of light is potentially an anxiety-arousing situation for, perhaps, all of us. Even a cursory look at the origin myths of many cultures reveals the chaotic, destructive, and dangerous aspects of darkness. Additionally, language reflects the same qualities metaphorically and symbolically. Developmentally, the arrival of the darkness of evening potentially signals object loss and ego regression. But factors other than ubiquitous references to a consideration of light and darkness are relevant. Can it be that we are all at least prone to depression due in part to this factor? Questions regarding possible biological causes of depression are perhaps unanswerable at this time. Is the seratonin level really associated with depression and light deprivation? Research is as yet inconclusive. If a relationship exists, another question must be asked: Will certain psychological situations affect a person's seratonin production? The answer to this question of how depression is associated with biological causes is certainly beyond the scope of this paper. Yet the preceding case history reveals at least some psychological causes of depression that were initially seen as biologically based. The SAD proponents would have treated Mr. B with light therapy. The quick solution of light therapy, based on a shaky theoretical base and lacking sturdy research, has too often replaced the psychoanalytic approach. In all too many situations psychoanalysts are being replaced by lightbulbs.     

Preadolescent Clues to Understanding Depression in Girls

Between the ages of 10 and 15, increases in depression among girls result in a rate that is twice as high as the rate of depression in boys. This sex difference remains throughout early and middle adulthood. Prior to early adolescence, there is essentially no sex difference in the rate of depression. The aim of the present review is to examine whether the preadolescent period is a time during which precursors to depression in girls can be identified. First, existing areas of research on explaining sex differences in depression, including cognitive and affiliative style and the socialization of emotion, are reviewed. Second, the hypothesis that for some girls, preadolescent precursors to depression take the form of excessive empathy, compliance and regulation of negative emotions is articulated. Third, ways of building on existing models by including the proposed preadolescent precursors are proposed. Finally, approaches to testing the hypotheses that individual differences in these domains during preadolescence may explain later individual differences in adolescent onset depression are explored.     

The Relevance of Age of Onset to the Psychopathology of Social Phobia

The present study aimed to examine the relevance of age of onset to the psychopathology of social phobia using a large clinical sample of 210 patients with social phobia. The two most common periods of onset were during adolescence (ages 14–17) and early childhood (prior to age 10). Structural regression modeling was used to test predictions that early onset social phobia would be associated with greater severity of the disorder, stronger current symptoms of depression and anxiety, greater functional impairment, and more pronounced levels of emotional disorder vulnerabilities (e.g., neuroticism/behavioral inhibition, extraversion, perceptions of control). Logistic regression was used to evaluate relationships between age of onset and the presence of acute and chronic stress at the time of onset. Results showed that earlier age of social phobia onset was associated with stronger current psychopathology, functional impairment, and emotional disorder vulnerabilities, and that later age of onset predicted the presence of an acutely stressful event around the time of disorder emergence. These results are discussed in regard to their clinical implications and congruence with prominent etiological models of the emotional disorders.     

Depression

Beck initially set out to test the Freudian notion that depression is a consequence of “anger turned inward” (rage directed the introjected parent for not gratifying infantile desires) but soon came to conclude that no such unconscious motivation existed and that instead depressed patients actually believe that they were unlovable or inadequate. He developed a treatment that he named cognitive therapy that is as efficacious as and more enduring than antidepressant medications. It stands as the most often tested and most widely practiced treatment for depression.     

Depression

Abstract— The theory of clinical depression presented here integrates etiological factors, changes in specific structural and cellular substrates, ensuing symptomatology, and treatment and prevention. According to this theory, important etiological factors, such as stress, can suppress the production of new neurons in the adult human brain, thereby precipitating or maintaining a depressive episode. Most current treatments for depression are known to elevate brain serotonin neurotransmission, and such increases in serotonin have been shown to significantly augment the ongoing rate of neurogenesis, providing the neural substrate for new cognitions to be formed, and thereby facilitating recovery from the depressive episode. This theory also points to treatments that augment neurogenesis as new therapeutic opportunities.     

Depression

Patients with myocardial infarction who suffer from a depression are at increased risk of dying of a subsequent heart attack or some other complication of coronary artery disease (CAD). A considerable body of research has provided evidence that a major depression, which is found in 16 to 23 percent of patients with CAD, but also subliminal depressive symptoms are independent risk factors for an unfavourable outcome of CAD. However, it is not yet clear whether depression is a causal risk factor having impact on the course of the heart disease or merely a prognostic marker that allows predicting the outcomes of interest, without any causal influence on them. Several pathways between depression and CAD have been discussed. These include behavioral mechanisms such as low compliance with both medical treatment and life style recommendations as well as neurobiological links. Much attention has been paid to the hypothalamic-pituitary-adrenocortical and sympathomedullary hyperactivity found in depression. Other possible links include diminished heart rate variability, stress-induced ischemia, platelet activation, and immunological dysregulation. To resolve the issue whether depression is a causal risk factor or only a prognostic marker, experimental studies are needed to evaluate interventions aimed at improving depression and test whether mortality is subsequently reduced. Such studies brought in the past mixed results. Whereas comprehensive intervention programs including risk factor management have produced a reduction in both coronary morbidity and mortality, a recent multicenter study providing either cognitive-behavioral therapy or usual care to depressed patients with CAD could not demonstrate a survival benefit among the participants of the intervention. Finally, results of evaluation studies regarding integrated disease management programs for patients with comorbid depression are presented.     

A Counselor's Guide to the Assessment of Depression

This article discusses various methods and procedures for assessing depression in clients. The following eight clinician rating and client self-report measures of depression are reviewed on the basis of their psychometric properties and applied pragmatic utility: the Hamilton Rating Scale for Depression, the Beck Depression Inventory, the Minnesota Multiphasic Personality Inventory-Scale 2 (Depression), the Depression Adjective Checklists, the Multiple Affect Adjective Checklist, the Zung Self-Rating Depression Scale, the Hopkins Symptom Checklist-90, and the Children's Depression Inventory.     

Discriminant Validity of the Inventory to Diagnose Depression

Measures of depression and anxiety correlate highly with one another. It has been hypothesized that this shared variance partly reflects poor discriminant validity, which could be improved by linking item content more closely to diagnostic criteria. We tested this speculation by comparing the Inventory to Diagnose Depression (Zimmerman, Coryell, Corenthai, & Wilson, 1986), developed to correspond with diagnostic criteria for major depression, with the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979) in terms of discriminant validity. These measures correlated more strongly with each other than with anxiety but did not differ in their relations with anxiety.