Cognitive predictors of depression and suicide ideation

A total of 136 adult subjects who met the Research Diagnostic Criteria for major (unipolar) depression were assessed for intensity of depressive symptomatology (using the Hamilton Rating Scale for Depression and the Beck Depression Inventory) and for lethality of current suicide ideation (using the Scale for Suicide Ideation). In addition, they were administered a variety of questionnaires assessing cognitive variables presumed to mediate depression and suicidality. Multiple regression analyses indicated that depressive symptomatology was best predicted by Beck's Hopelessness Scale in combination with the Detachment factor of the Crandell Cognitions Inventory. In addition, suicidality was significantly predicted by the Selective Abstraction and Overgeneralization factors of Lefebvre's Cognitive Error Questionnaire, when the effects of the Beck Depression Inventory were partialed out. The practical implications of these findings for discriminating suicidal from nonsuicidal depressives are discussed.     

Event-specific attributions and daily life events as predictors of depression symptom change

A prospective study was conducted to investigate whether event-specific attributions, either alone or in interaction with daily life events predict depression symptom change, and whether this is affected by systematic variation in intertest intervals. Baseline measures of attributional style, event-specific attributions, life events, and depression were administered to 96 adults enrolled in a cigarette-smoking cessation program who were readministered the event-specific attributions, life events, and depression measures 2, 4, 6, and 8 weeks later. Results indicated that (a) the interaction between event-specific attributions and life events was a better predictor of depression symptom change than were event-specific attributions alone; (b) event-specific attributions and life events demonstrated a tendency to predict depression symptom change over 2 and 4 weeks but not over 6 and 8 weeks; (c) the stability and globality of event-specific attributions was associated with the number of reported life events; and (d) baseline attributional style predicted event-specific attributions 2, 4, 6, and 8 weeks later.     

Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients' illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline--cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?相似文献   

Cognitive function and depression in symptom resolution in schizophrenia patients treated with an atypical antipsychotic

OBJECTIVE: To investigate which cognitive and affective features contribute most to responder/non-responder group separation during a switching trial with atypical antipsychotic. DESIGN: A prospective open trial with an atypical antipsychotic (olanzapine). PATIENTS: One hundred and thirty-four patients meeting diagnostic criteria for schizophrenia, schizophreniform or schizoaffective disorder began an 8-week open-label olanzapine treatment at a dose of 5 mg/day which was increased to 10 mg/day after one week. INTERVENTIONS: Olanzapine during 8 weeks. Patients were considered as responders if their BPRS score decreased of at least 20% (n = 96) and non-responders if it did not (n = 38). Neuropsychological assessments were carried out at baseline, at four and at eight weeks. RESULTS: Neurocognitive measures were analyzed for discriminate factors between responder and non-responder groups. A regression analysis was applied to explain the effects of depression on each cognitive variable. Depression was found to be a weak discriminant factor, however this finding could not firmly establish that depression is a potential factor in explaining deficits and improvements in cognition.     

Cognitive biases and depression

Compared symptomatically depressed, clinically remitted, and normal controls using cognitive measures designed to be traitlike and statelike in cross-sectional and longitudinal designs, respectively. Remitted depressives and normal subjects did not differ in their attributional biases, endorsement of dysfunctional attitudes, or interpretation of schema-relevant ambiguous events, but both groups differed from symptomatic depressives. Depressive episodes thus affect cognition, but cognitions measured by self-reports are more statelike than traitlike.     

Cognitive inhibition in depression

Cognitive inhibition is a key mechanism in the regulation of emotion. There is emerging evidence that depression is characterized by deficits in the inhibition of mood-congruent material. These deficits could result in prolonged processing of negative, goal-irrelevant aspects of presented information thereby hindering recovery from negative mood and leading to the sustained negative affect that characterizes depressive episodes. Indeed, it has been suggested that deficits in cognitive inhibition lie at the heart of memory and attention biases in depression, and set the stage for ruminative responses to negative events and negative mood states. A ruminative response style results in a heightened vulnerability to experience episodes of major depression. Recent research has demonstrated that deficient inhibition of negative material is associated with heightened rumination. In this article, we review the depression literature with a focus on studies that investigate cognitive inhibition in depressed participants and in participants who report a history of major depressive episodes. In addition, we summarize neurobiological findings that indicate a strong relation between depression and deficits in inhibition and we take a closer look at the relation of inhibition, rumination and mood regulation.     

Cognitive aspects of chronic depression

Previous research on chronic depression has focused on its link with other mood disorders and Axis II personality disorders. However, there are few data examining whether the cognitive perspective applies to this condition. In this cross-sectional study, 42 outpatients with chronic depression were compared with 27 outpatients with nonchronic major depressive disorder and 24 never psychiatrically ill controls on cognitive variables thought to be related to vulnerability to depression (e.g., dysfunctional attitudes, attributional style, a ruminative response style, and maladaptive core beliefs). Both depressed groups were more elevated than a never-ill comparison group. However, chronically depressed individuals were generally more elevated on measures of cognitive variables than those with major depressive disorders even after controlling for mood state and personality disorder symptoms.     

Cultural differences in the predictors of depression

This study examined a number of psychosocial factors thought likely to contribute to depression among ethnic Korean and Caucasian students. As hypothesized, Koreans (n = 61) were more depressed than Caucasians (n = 69). Stepwise multiple regression analysis revealed different models for predicting depression in the two groups. Value orientations, a neglected element in the prevailing stress paradigm, contributed substantially to variation in depression, especially among Koreans. Two measures of parental values and three coping strategies accounted for a striking 44% of the variance in Korean youths' depression. Perceived parental traditionalism, the strongest predictor, was associated with higher depression; and perceived parental modernism, with lower depression. For Caucasians, in contrast, only 13% of the variance in depression could be accounted for; and the two significant predictors were academic stress and respondents' own modern values (the latter associated with fewer symptoms). The findings of this study argue for greater attention to the importance of values in studying adaptation to stress.     

Cognitive deficits in major depression

Major depression is a mood disorder that is often accompanied by the impairment of cognitive functions. Although suggestive, the large range of existing neuropsychological, neuropsychiatric, and, lately, neuroimaging investigations have not yet given a consistent picture of the psychological and biological disturbances involved in this psychiatric disorder. The present study of the cognitive functions in depression was part of an extensive investigation, including neuropsychological testing, psychiatric examination, and neuroimaging. A representative sample of 40 severely depressed hospitalized patients and a group of 49 closely matched control subjects were tested with an extensive neuropsychological test battery. Results, corrected for various confounding factors, confirmed the current notion that depressed patients suffer from wide-spread cognitive impairments. The group analysis did not allow any hypothesis on a possible pattern to the dysfunctions, but heterogeneity in the test performances calls for further analysis of the data in patient subgroups in relation to neuroimaging results.     

Attachment styles and personality disorders as predictors of symptom course.

Adult attachment styles and personality disorders (PDs) show some conceptual and empirical overlap and both may complicate the course of symptoms among psychiatric patients. In this naturalistic prospective study, 149 patients with affective, anxiety, substance use, and other disorders were interviewed shortly after entering treatment, which included psychotherapy, pharmacotherapy, or both. Follow-up interviews were conducted 6 and 12 months later. Attachment styles, DSM-III-R PDs, and symptoms were assessed using structured interviews and consensus ratings. At intake, borderline, avoidant, and dependent PD features correlated consistently with symptom severity and secure attachment correlated inversely with two of four symptom scales. Secure attachment was linked with greater relative improvement in global functioning and a more benign course of anxiety symptoms over 6 months. Borderline PD features predicted less relative improvement of depressive symptoms over 6 months. These findings clarify the relations between attachment styles and PD features and they point to potential mediators of treatment response.     

Cognitive and marital factors in depression

The current investigation examines three groups of wives: (1) a group of nondepressed, nondiscordant community wives; (2) a group of nondepressed, discordant clinic wives; and (3) a group of depressed, discordant clinic wives. Groups were formed on the basis of structured interview responses and responses to a self-report inventory of depressive symptomatology. To be classified as depressed, wives were required to meet DSM III criteria for depression according to interview data and to exceed a Beck Depression Inventory score of 14. Both clinic groups showed equal levels of marital discord. Both nondepressed groups showed equally few cognitive errors. Accordingly, comparisons of these three groups allow us to test current interpersonal and cognitive theories of depression. The level of closeness in the marriage differentiated the depressed, discordant from the nondepressed, discordant wives despite their equal levels of overall marital discord. The level of depressive symptomatology was greater for the nondepressed clinic wives than it was for the community wives despite their equal levels of cognitive errors. Both closeness in the marriage and cognitive errors accounted for the unique variance in level of depression. Implications for current interpersonal and cognitive accounts of depression are discussed.Support for this research came in part from NIMH Grant 38390-02. Portions of this paper were presented at the 25th Annual Convention of the American Association for the Advancement of Behavior Therapy.     

Deployment of attention in clinical depression during symptom remission

The purpose of the current study was to investigate deployment of attention in clinically depressed patients during the process of symptom remission. Previous research indicates a non-depressed protective bias in attention whereas depressed individuals evidence no bias. A deployment-of-attention task based on negative, positive, and neutral adjectives was administered twice to 15 inpatients with major depression and 15 normal controls, at about 6 weeks apart. From test 1 to test 2, severity of patients' depressive symptoms improved significantly. Acutely depressed patients tended to show an attentional bias towards negative information whereas partially remitted patients manifested no attentional bias. Non-depressed individuals attended less to negative information than (acutely and partially remitted) depressed patients. Non-depressed participants but not depressed patients avoid negative information demonstrating a protective processing bias. Depressed patients are not characterized by a shift towards a pronounced protective pattern during symptom remission.     

Cognitive bias and irrational belief as predictors of avoidance

Cognitive bias, i.e. overestimates of subjective probability and cost of catastrophic events, and irrational belief were explored as predictors of avoidance. Three groups-anxiety disordered clients, a mixed group of clinic outpatients, and normals--were administered several self-report inventories. Multiple regression analyses were used to investigate a modified version of the Agoraphobic Cognitions Questionnaire, the Belief Scale, and the Body Sensations Questionnaire as predictors of avoidance, as measured by the Mobility Inventory. It was hypothesized that frequency x probability x cost of catastrophic cognitions (and the occurrence of the events they represent) would be a better predictor of avoidance than frequency alone. It was also hypothesized that irrational thinking would be a significant predictor of avoidance. The results generally supported the hypotheses, with subjective probability emerging as a particularly potent predictor of avoidance. Theoretical and clinical implications are discussed.     

Cognitive and affective predictors of academic achievement in schoolchildren

The ability of the theory of planned behaviour to predict objectively measured outcomes was tested in school‐age children. Study 1 (N=71) showed that the theory of planned behaviour accounted for significant proportions of the variance in intention and that the intentions predicted scores in a science test; study 2 (N=175) replicated these effects across a broader range of subjects. In addition, study 2 explored the mechanism by which intention was translated into action and demonstrated that intention stability moderated the intention‐academic achievement relationship. Moreover, controlling for a range of cognitive and affective variables, intention and positive affect were independent predictors of intention stability. These findings suggest that although positive affect did not influence intention directly, it did influence intention stability, the mechanism by which intentions are translated into action. Future educational interventions should therefore influence both cognitive and affective factors to promote sustained motivation.     

Cognitive and affective variables as predictors of life satisfaction

This work shows the association between personality variables, such as cognitive and affective variables, and psychological adjustment, such as life satisfaction and depressive symptoms. Accordingly, this study assessed the role of outcome expectancies (optimism and pessimism) and affectivity (positive and negative affect) as a predictors of life satisfaction and depressive symptoms. A total of 458 students from the University Rovira i Virgili completed the scales LOT-R, PANAS, the Satisfaction with Life Scale and BDI. Path analysis results suggest that affectivity variables are more important to predict life satisfaction and depressive symptoms than outcome expectancies. Implications for future research are discussed.     

Cognitive behavioural treatment for chronic fatigue syndrome in a rehabilitation setting: effectiveness and predictors of outcome

Cognitive behavioural therapy (CBT) was combined with graded exercise therapy (GET) for patients with chronic fatigue syndrome (CFS) in an uncontrolled implementation study of an inpatient multidisciplinary group therapy. During the intake procedure, 160 CFS patients completed a questionnaire on fatigue related measurements, physical impairment, depression, somatic and psychological attributions, somatic focus, and sense of control over symptoms. Pre-treatment physical activity level was measured with an actometer. At baseline, post-treatment and 6-month follow-up individual strength, subjective fatigue and physical impairment, were reassessed. Large effect sizes were found on subjective fatigue (1.2 post-treatment; 1.2 follow-up) and physical impairment (−.9 post-treatment; −.9 follow-up), Clinically significant improvement was found in 33.8% of the participants at post-treatment and 30.6% at follow-up. Individual strength at post-treatment was predicted by level of physical activity before treatment, and by sense of control over symptoms and physical activity at follow-up. Clinically significant improvement in subjective fatigue was predicted by not receiving a disablement insurance benefit, shorter duration of fatigue, higher sense of control over symptoms and, at follow-up by more pre-treatment physical activity. In conclusion, the intervention was effective for CFS patients. Cognitive behavioural factors that perpetuate fatigue symptoms are also predictors of treatment outcome.     

The MMPI-2 as a predictor of symptom change following treatment for posttraumatic stress disorder

This study sought to examine the impact of personality factors on symptom change following treatment for 141 Vietnam veterans with chronic combat-related posttraumatic stress disorder (PTSD) using the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). A series of partial correlation and linear multivariate regression analyses identified social alienation, associated with anger and substance use, as the most potent negative predictor of symptom change. Of the scales assessing personality disorder, Borderline Personality was identified as the strongest negative predictor of outcome. Regression analyses examining the most salient scales identified 5 items that contributed 14% of the variance in the prediction of change scores independently of the 21% accounted for by pretreatment PTSD severity.