Childhood depression and conduct disorder: I. Behavioral, affective, and cognitive aspects of family problem-solving interactions.

We assessed the family interactions of depressed, conduct-disordered, mixed depressed-conduct-disordered, and nonclinic children, ages 7-14 years, during a standardized family problem-solving discussion in the clinic. The child's and the mother's problem-solving proficiency, aversive behavior, and associated affective behavior (depressed and angry-hostile) were observed. The child and mother also rated each other's affect during the interaction for the dimensions sad, angry, critical, and happy on Likert-type scales. The child's and mother's cognitive constructions about the interaction were assessed using video-mediated recall. Although all clinic groups had lower levels of effective problem solving than did nonclinic children, their deficiencies were somewhat different. Mixed and depressed children displayed high levels of depressed affect and low levels of angry affect, whereas conduct-disordered children displayed both angry and depressed affect. In addition, conduct-disordered children had lower levels of positive problem solving and higher levels of aversive content than did non-conduct-disordered children. Depressed and conduct-disordered children had higher levels of self-referent negative cognitions than did mixed and comparison children, and depressed children also had higher other-referent negative cognitions than did all other groups. The study provides support for theories and treatment that stress the importance of family problem-solving and conflict resolution skills in child psychopathology.     

Social problem-solving among adolescents treated for depression

Studies suggest that deficits in social problem-solving may be associated with increased risk of depression and suicidality in children and adolescents. It is unclear, however, which specific dimensions of social problem-solving are related to depression and suicidality among youth. Moreover, rational problem-solving strategies and problem-solving motivation may moderate or predict change in depression and suicidality among children and adolescents receiving treatment. The effect of social problem-solving on acute treatment outcomes were explored in a randomized controlled trial of 439 clinically depressed adolescents enrolled in the Treatment for Adolescents with Depression Study (TADS). Measures included the Children's Depression Rating Scale-Revised (CDRS-R), the Suicidal Ideation Questionnaire - Grades 7-9 (SIQ-Jr), and the Social Problem-Solving Inventory-Revised (SPSI-R). A random coefficients regression model was conducted to examine main and interaction effects of treatment and SPSI-R subscale scores on outcomes during the 12-week acute treatment stage. Negative problem orientation, positive problem orientation, and avoidant problem-solving style were non-specific predictors of depression severity. In terms of suicidality, avoidant problem-solving style and impulsiveness/carelessness style were predictors, whereas negative problem orientation and positive problem orientation were moderators of treatment outcome. Implications of these findings, limitations, and directions for future research are discussed.     

Social problem solving in adolescents with suicidal behavior: a systematic review

There is an increasing focus on deficiencies in problem solving as a vulnerability factor for suicidal behavior in general and hence a target for treatment in suicide attempters. In view of the uncertainty of evidence for this in adolescents we conducted a systematic review of the international research literature examining the possible relationship between deficiencies in social problem-solving skills and suicidal behavior in this population. This was based on searching two electronic databases: Medline 1966 to September 2003 and PsychInfo 1887 to September 2003. Twenty-two studies of social problem-solving skills in adolescents with suicidal behavior were found. Most of these studies, which compared adolescent patients with suicide attempts versus either nonsuicidal psychiatric or normal controls, found evidence for problem-solving deficits in the attempters; however, few of the differences remain after controlling for depression and/or hopelessness. Because most of the studies are cross-sectional, it is difficult to differentiate between the possibilities that deficiencies in problem-solving skills lead to depression when adolescents are faced by adversity and hence to suicidal behavior, or whether depression is the main factor which undermines problem-solving skills. Future research, preferably with longitudinal research designs, is required to determine the nature of the association between problem-solving skills and suicidal behavior in adolescents. This has important implications for therapeutic interventions.     

Social problem-solving skills in boys with conduct and oppositional defiant disorders

The current study compared the social problem-solving skills of a clinic-based sample of 30 boys diagnosed with conduct disorder (CD) and 25 boys diagnosed with oppositional defiant disorder (ODD). Past research has indicated that contextual factors influence children's social problem-solving; thus, three hypothetical conflict situations (i.e., child-child, teacher-child, and parent-child) and situations which differed by degree of negative intent of the provocateur (i.e., hostile vs. Ambiguous intent) were examined. Problem-solving strategies were aggregated into three broad dimensions: 1) aggressive/antisocial solutions; 2) nonverbal-nonaggressive solutions; and 3) verbal-nonaggressive solutions. Compared to ODD boys, CD boys proposed more aggressive/antisocial solutions in parent-child conflicts when parental intent was ambiguous and in teacher-child conflicts regardless of intent. Compared to ODD boys, CD boys proposed fewer verbal-nonaggressive solutions in child-child conflicts. The implications of these findings for treatment intervention with CD and ODD boys were discussed. Aggr. Behav. 23:457–469, 1997. © 1997 Wiley-Liss, Inc.     

Adolescents' emotion expectancies regarding aggressive and nonaggressive events: connections with behavior problems

A total of 50 behaviorally disruptive (conduct-disordered or oppositional defiant-disordered) adolescents and 50 comparison adolescents assessed how they expected to feel following both aggressive and nonaggressive situations. Compared with their peers, behaviorally disruptive adolescents expected fewer normative emotions and exhibited somewhat more of an anger emphasis in their nonaggressive emotion attributions, and they expected to feel happier following acts of instrumental/proactive aggression. These patterns of emotion expectancies were linked more closely with teacher ratings of adolescents' proactive aggression than with ratings of reactive aggression. Regression analyses indicated that both nonaggression emotion expectancies and proactive aggression happiness made independent contributions to predicting adolescents' externalizing tendencies. Discussion focused on the contributions of different types of self-attributed emotion expectancies to adolescents' social understanding and behavior.     

Situational social problem-solving skills and self-esteem of aggressive and nonaggressive boys

This study was designed to assess specific social problem-solving, perceived competence, and selfesteem characteristics of 20 aggressive and 18 nonaggressive boys. Significant behavioral differences existed between the groups. The problem-solving measure provided for qualitative assessment of specific problem solutions that children consider, varying according to the interpersonal context of conflicts with peers, teachers, and parents and to the level of others' intent in conflicts (ambiguous frustration and hostile provocation). In univariate analyses, aggressive children had poorer selfesteem, generated fewer verbal assertion solutions in peer conflicts and during hostile frustration, and employed more direct action solutions with teachers and during hostile frustration. Discriminant analyses significantly differentiated the two groups. Findings indicated that future research should consider the relative distribution of specific kinds of problem situations that children produce, and that situational factors in social problem-solving skills should be addressed.This paper is based on a presentation made at the American Psychological Association annual convention in Los Angeles, August 1985. Acknowledgment is made of the administrative support provided by the Durham County Schools and the Durham Community Guidance Clinic. This research was supported in part by grants from the National Institute of Mental Health and from the Research Branch of the North Carolina Division of Mental Health, Mental Retardation and Substance Abuse Services. Appreciation is expressed to the school counselors who assisted with the coordination of this research: Tom Gemmer, Patricia Kirkley, Kathy McSwain, and Geoff Wyckoff.     

Social problem solving: A moderator of the relation between negative life stress and depression symptoms in children

The social problem-solving skill of generating effective alternative solutions was tested as a moderator of the relation between negative life stress and depressed mood in children. Boys ( n= 25) and girls ( n= 25), ages 8 to 12 years, from inner-city, lower socioeconomic group families, completed measures of depression symptoms, negative impact of life events, and quantity and effectiveness of alternative solutions to social problems. Results indicated that the effectiveness of alternative solutions children generate in response to peer social problems moderates the relation between stress and depression. Children who experienced a high impact of negative life events, with less effective social problem-solving skills, reported higher levels of depression compared to children who experienced a high impact of negative life events but exhibited more effective social problem-solving skills. Results are discussed in terms of alternative theoretical models for the mechanisms whereby effective social problem-solving skills moderate stress-related depression.     

Regulation of Negative Affect During Mother–Child Problem-Solving Interactions: Adolescent Depressive Status and Family Processes

Despite recent suggestions that depression can be conceptualized as a disorder of affect regulation, relatively little research has focused on affect regulation skills in depressed individuals. This paper investigated whether depressed adolescents (N = 25) differ from nondepressed adolescents (N 25) on two indices of affect regulation (i.e., duration of negative affective states and reciprocity of maternal negative affect) as well as whether these indices are related to microsocial family interactional processes. Analyses revealed that depressed teens differed from their nondepressed peers with regard to duration of negative affective states but not in their likelihood of reciprocating negative affect. Additionally, indices of adolescent affect regulation were related to family interactional processes. Duration of depressive affect was positively associated with maternal display of facilitative behavior contingent on adolescent depressive behavior. Duration of aggressive behavior was inversely related to maternal problem-solving responses to aggressive behavior. Finally, adolescent reciprocity of maternal depressive and aggressive behaviors was strongly associated with mothers' reciprocity of adolescents' negative affective behavior.     

青少年孤独感与抑郁症状:反应风格的中介作用以及性别的调节作用

基于反应风格理论,本研究探索反应风格在青少年孤独感与抑郁症状之间的中介效应。使用孤独感量表、儿童反应风格量表以及儿童抑郁量表对 795 名 青少年进行调查。结果发现：（1）青少年孤独感能显著预测抑郁症状。（2）青少年孤独感能通过反刍、问题解决间接预测抑郁症状。（3）反应风格整体（比率分数）中介青少年孤独感与抑郁症状之间的关系。本研究结果显示,反应风格能够解释青少年孤独感与抑郁症状之间的内在机制。     

青少年孤独感与抑郁症状:反应风格的中介作用以及性别的调节作用

基于反应风格理论,本研究探索反应风格在青少年孤独感与抑郁症状之间的中介效应。使用孤独感量表、儿童反应风格量表以及儿童抑郁量表对 795 名 青少年进行调查。结果发现：（1）青少年孤独感能显著预测抑郁症状。（2）青少年孤独感能通过反刍、问题解决间接预测抑郁症状。（3）反应风格整体（比率分数）中介青少年孤独感与抑郁症状之间的关系。本研究结果显示,反应风格能够解释青少年孤独感与抑郁症状之间的内在机制。     

Overgeneral autobiographical memory in depressed adolescents with, versus without, a reported history of trauma

Autobiographical memory retrieval is fundamental to the developing self-concept in adolescence, to emotion regulation, and to social problem solving and has been shown to be compromised in adolescents diagnosed with depression (R. J. Park, I. M. Goodyer, & J. D. Teasdale, 2002). The authors of the present study assessed autobiographical memory overgenerality in a sample of depressed adolescent participants with, versus without, a reported history of trauma and never-depressed control participants by using an emotion word-cueing paradigm. The authors' analyses showed for the first time that adolescents with major depression and with no reported history of trauma exhibited an overgeneral memory bias. They also revealed that depressed adolescents who reported a history of trauma retrieved fewer overgeneral memories than did depressed adolescents who reported no history of trauma. Among depressed adolescents who reported a history of trauma, more severe posttraumatic stress symptoms were associated with less overgenerality. Possible accounts of these findings are suggested.     

Face Emotion Processing in Depressed Children and Adolescents with and without Comorbid Conduct Disorder

Studies of adults with depression point to characteristic neurocognitive deficits, including differences in processing facial expressions. Few studies have examined face processing in juvenile depression, or taken account of other comorbid disorders. Three groups were compared: depressed children and adolescents with conduct disorder (n = 23), depressed children and adolescents without conduct disorder (n = 29) and children and adolescents without disorder (n = 37). A novel face emotion processing experiment presented faces with ‘happy’, ‘sad’, ‘angry’, or ‘fearful’ expressions of varying emotional intensity using morphed stimuli. Those with depression showed no overall or specific deficits in facial expression recognition accuracy. Instead, they showed biases affecting processing of low-intensity expressions, more often perceiving these as sad. In contrast, non-depressed controls more often misperceived low intensity negative emotions as happy. There were no differences between depressed children and adolescents with and without conduct disorder, or between children with comorbid depression/conduct disorder and controls. Face emotion processing biases rather than deficits appear to distinguish depressed from non-depressed children and adolescents.     

Depression and social problem solving.

Twenty depressed patients with major depressive disorder, 20 nondepressed matched control subjects, and 17 patients with anxiety disorders were compared in different measures of social problem solving. Problem solving was assessed with the Means-Ends Problem-Solving Test (Study 1), the solution of personal problems, and a problem-solving questionnaire (Study 2). Results showed that, as predicted, depressed subjects suffered from a deficit in problem solving in all three measures. The majority of these deficits were also displayed by the clinical control group rather than being specific to a diagnosis of depression. However, depressed subjects produced less effective solutions than did normal and clinical control subjects. The results suggest that depressed and anxious patients may have difficulties at different stages of the problem-solving process.     

Self-image of emotionally disturbed adolescents

This study examined the ways in which normal, depressed, and conduct-disordered adolescents differ with regard to self-image. Normal and psychiatrically hospitalized adolescents completed the Offer Self Image Questionnaire for Adolescents (OSIQ). Patients were grouped on the basis of their DSM-III diagnoses, and their OSIQ scores were compared. Major depressive disorder, particularly the first episode, was associated with poor self-evaluation in multiple areas, while conduct disorder was associated with almost no specific self-image deficits. For younger (12- to 15-year-old) adolescents, a repeated episode of depression was associated with a poorer selfimage than was a diagnosis of dysthymic disorder or a typical depression, but a better self-image than a single episode of depression, suggesting that at this age, repeated episodes are met with internal adaptation rather than continued self-devaluation. Adolescents who received a diagnosis of both conduct disorder and major depression reported an overall level of self-image disturbance between those with either of these disorders alone, suggesting that acting-out behaviors may attenuate the self-devaluing experience of depression. Results are discussed in terms of current issues in adolescent development and developmental psychopathology.Portions of this article were presented at the annual meeting of the Midwestern Psychological Association, Chicago, 1986, and the annual meeting of the Association for the Advancement of Behavior Therapy, Chicago, 1986. The author wishes to express her appreciation to Kenneth I. Howard for his continued guidance throughout this project; to Lauren B. Alloy, Richard R. Bootzin, G. Daniel Lassiter, William Revelle, and two anonymous reviewers for helpful comments on an earlier draft; to Daniel Offer and Eric Ostrov for allowing use of their normative data; and to the staff of Charter Barclay and Riveredge Hospitals for their assistance in the data collection.     

An expanded etiological model for suicide behavior in adolescents: Evidence for its specificity relative to depression

This study tests both the stress/social support and the stress/problem-solving etiological models for suicidality while controlling for depression. To this end, a depressed, high-suicide-ideating sample (N=68) was compared to a depressed, low-suicide-ideating sample (N=64). Hierarchical multiple regression analyses were used to test the unique contributions of stress, problem-solving orientation, problem-solving skills, and perceived level of social support in predicting level of suicidality. Hierarchical regression analyses were also used to test the interactive contributions of problem-solving × stress and social support × stress in predicting level of suicidality. Regression models were generated separately for men, women, and the entire sample using all factors. The results clearly support the importance of social support as an independent predictor of suicidality for men, women, and the entire sample. Ability to generate alternatives to identified problems predicted suicidality, but only for women and the entire sample. Problem-solving orientation was not uniquely predictive of suicidality and may affect suicidal behavior via its relationship to depression.     

抑郁对社会决策的影响

从社会决策角度出发,依托博弈论的经典范式是研究抑郁症病人人际与社会功能障碍的一个切入点。Ruff和Fehr （2014）提出在社会决策中存在三类情境,即社会反馈、替代性评价、社会原则。我们从这个理论框架出发,发现抑郁症病人在社会反馈加工中存在社会性快感缺失,对社会拒绝的敏感性增强;在替代性评价过程中,共情和心理理论能力减弱;抑郁症病人对决策中的社会原则（公平、合作）存在适应不良现象,如过度利他性。未来的研究一方面可进一步探索抑郁症病人的社会性快感缺失现象,另一方面可采用经颅电/磁刺激与脑成像技术结合或超扫描技术,提高研究结果的解释力和生态效度。     

An evaluation of the effects of Rorschach EB style on the diagnostic utility of the Depression Index

Several empirical studies have found the Rorschach Depression Index (DEPI) to have questionable diagnostic utility. Studies using adolescent samples suggest that the DEPI has limited sensitivity and fails to differentiate effectively between adolescents with and without depression diagnoses. The present study was conducted to evaluate Viglione, Brager, and Haller's suggestion that the DEPI may have better discriminative ability for individuals with extratensive problem-solving styles, measured by the Rorschach EB (Erlebnistypus) variable, compared to those with introversive and ambitent styles. Comparisons were conducted between adolescents with depression-related diagnoses and adolescents with other diagnoses for each of the three EB groups. The results failed to support the hypothesized greater discriminative power of DEPI for depressed extratensives, and suggest caution in using the DEPI to evaluate adolescent depression.     

Social acceptance and the relationship between aggressive problem-solving strategies and aggressive behaviour in 14-year-old adolescents

This study examines the relationship between aggressive problem-solving strategies and aggressive behaviour, and the intervening role of social acceptance in that relationship. The subjects were 780 14-year-old adolescents (382 girls and 398 boys). They completed a questionnaire measuring social problem-solving strategies, while assessments of aggressive behaviour and social acceptance were obtained by peer ratings. The results showed that aggressive problem-solving strategies were only moderately related to aggressive behaviour, social acceptance playing an important role. Those who received incongruent social feedback, i.e. scored high on social acceptance even though they behaved aggressively, or low although they behaved non-aggressively, expressed aggressive problem-solving strategies which conflicted with their actual behaviour. Those who received congruent social feedback, on the other hand, i.e. scored high on social acceptance if they behaved non-aggressively, or low if they behaved aggressively, had strategies which were in line with their actual aggressive behaviour. Analyses of gender differences showed that aggressive problem-solving strategies were related to aggressive behaviour and social acceptance more among boys. The findings are discussed in terms of social information-processing models and social knowledge about the self.     

The social problem-solving abilities of people with borderline personality disorder

Interventions for people suffering from borderline personality disorder (BPD), such as dialectical behaviour therapy, often include a problem-solving component. However, there is an absence of published studies examining the problem-solving abilities of this client group. In this study, the social problem-solving (SPS) abilities of three groups of participants were assessed: a BPD group (n=25), a clinical control (CC) group (n=25) procedure and a non-clinical control (NCC) group (n=25). SPS ability was assessed using the means-end problem-solving (MEPS) procedure and the Social Problem-Solving Inventory-Revised (SPSI-R). The BPD group exhibited deficits in their SPS abilities, however the majority of these deficits were not specific to the BPD group but were also found in the CC group, indicating that a common factor between these two groups, such as negative affect, may account for these observed deficits. Specific SPS deficits were identified in the BPD group: they provided less specific solutions on the MEPS and reported higher levels of negative problem orientation and a more impulsive/carelessness style towards solving social problems. The results of this study provide empirical support for the use of problem-solving interventions with people suffering from BPD.