The latent structure of analogue depression: should the Beck Depression Inventory be used to classify groups?

Research on depression is often conducted with analogue samples that have been divided into depressed and nondepressed groups using a cutoff score on the Beck Depression Inventory (BDI). Although the relative merits of different cut scores are frequently debated, no study has yet determined whether the use of any cut score is valid, that is, whether the latent structure of BDI depression is categorical or dimensional in analogue samples. The BDI responses of 2,260 college students were submitted to 3 taxometric procedures whose results were compared with those of simulated data sets with equivalent parameters. Analyses provided converging evidence for the dimensionality of analogue depression, arguing against the use of the BDI to classify analogue participants into groups. Analyses also illustrated the notable impact of pronounced skew on taxometric results and the value of using simulated comparison data as an interpretive aid.     

Association of fake-good MMPI-2 profiles with low Beck Depression Inventory scores

Seventy-nine adolescent mothers (mean age = 18.1 years) were administered the Beck Depression Inventory (BDI) and three validity scales (L, F, and K) of the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). The aim was to determine whether low-BDI mothers were "faking good," or denying their depression. The adolescent mothers were assigned to a low-BDI group (scores = 0, 1, 2), a nondepressed group (scores = 3-9), or a depressed group (scores > or = 13). The depressed group had higher F (Symptom) scale scores than did the nondepressed group, which in turn had higher scores than did the low-BDI group. The low-BDI group, in contrast, had more fake-good profiles than did the two other groups. Discriminant analyses indicated that 90% of the fake-good profiles could be classified correctly based on BDI and K (Defensiveness) scale scores. These data suggest the need for further assessment when individuals have extremely low BDI scores.     

Induction of depressive affect after prolonged exposure to a mildly depressed individual

Scores on the Beck Depression Inventory (BDI) were periodically obtained from the roommates of college students who exhibited a persistent mild depression over a 3-month period. For comparative purposes, BDI scores were also obtained from roommates of individuals who were transiently depressed and from subjects with nondepressed roommates. In comparison with control subjects, the roommates of persistently depressed persons displayed a progressive increase in BDI score over the course of the study.     

Schema congruence and depression: loss of objectivity in self- and other-inferences

Depressed and nondepressed students judged the plausibility of positive and negative inferences ostensibly made either by themselves or by others. Negative self-inferences were judged by depressed students as more plausible, and positive other-inferences as less plausible. The results were in accord with Beck's (1967) theory of schema-based distortion in depression, which proposes that persons vulnerable to the development of depression are prone to make erroneous negative inferences and to then regard those inferences as plausible and correct. The results also suggested that depressed persons responded differentially depending on whether they were instructed to consider the inferences as their own or another's, whereas nondepressed persons did not.     

Evaluating the continuity of symptomatology between depressed and nondepressed individuals

Debate is contentious concerning whether depression should be viewed as a distinct category or as a continuum including overlapping normal and clinical phenomena. A nonparametric item response model was used to evaluate whether the probability of expressing individual symptoms differed between nondepressed and clinically depressed adults experiencing similar levels of overall severity. Even though depressed and nondepressed individuals were equated in terms of overall severity, differences on specific symptoms emerged. Depressed mood, anhedonia, and suicidality were more likely to be expressed in depressed than in nondepressed individuals, whereas hypochondriasis and middle insomnia were more likely to be expressed in nondepressed individuals at similar levels of severity. Such differences are inconsistent with the view of depression as a simple continuum.     

Heightened subjective experience of depression in borderline personality disorder

Despite the frequent comorbidity of major depression and borderline personality disorder (BPD), limited research has examined what effect this comorbidity has on the severity, course, and presentation of depression. The purpose of this study was to examine whether the severity of major depressive disorder (MDD) in the context of comorbid borderline personality disorder (BPD) differs from MDD when comorbid BPD is not present and to determine whether different measures of depression yield convergent findings. Sixty patients diagnosed with DSM-IV MDD participated in this study. Twenty-nine were diagnosed with DSM-IV BPD, while the remaining 31 had no Axis II diagnosis. Depression was evaluated with both clinician (Hamilton Rating Scale for Depression) and self-report (Beck Depression Inventory) ratings. While the two groups were rated as similarly depressed by clinicians on the overall rating and the factor scores, the MDD/BPD group reported more severe depressive symptoms on the self-report measure. This difference was significant even after controlling for clinician-rated severity. Gender interacted with diagnosis, males in the BPD group showed the largest discrepancies between clinician ratings and self-reports. Posthoc analyses of HDRS factors with the BDI showed that the clinicianrated cognitive disturbance and retardation factors were correlated with self-rated severity overall. Within subgroups, only the retardation factor was correlated with the BDI. Our results suggest that while depressed individuals with and without BPD may be rated as similarly depressed when assessed with objective rating methods, the subjective experience of the depression may be rated as more intense or severe by patients with comorbid BPD. The mechanism underlying this effect remains unknown, and requires further research.     

Negative and positive cognition in depressed and nondepressed chronic-pain patients

Several studies have suggested that depressed pain patients evidence more cognitive distortion than nondepressed pain patients and healthy controls. Although these studies have generally supported notions relating cognitive distortion to depressive functioning, other aspects of dysfunctional cognition have not been assessed in the chronic-pain population. The present study examined negative and positive automatic thoughts and attributional style in depressed pain patients, nondepressed pain patients, and healthy controls. Depressed chronic-pain patients were found to exhibit significantly more negative automatic thoughts than nondepressed pain patients and healthy controls. Conversely, nondepressed chronic-pain patients reported significantly more positive automatic thoughts than did depressed patients and healthy controls. No significant differences were found for attributional style. These results suggest that different cognitive-behavioral interventions might be considered for depressed compared to nondepressed chronic-pain patients.     

A comparison of depressed and nondepressed disturbed children on measures of attributional style,hopelessness, life stress,and temperament

Upon admission to a hospital treatment program, clinically depressed and nondepressed children (aged 9–17 years) were assessed on measures of attributional style, hopelessness, depression, life stress, and child temperament. The depressed group tended to attribute positive events to specific and unstable factors when compared with the nondepressed sample. Group differences also were found on child temperament measures. However, no differences were reported between the diagnostic groups on self-reported depression, hopelessness, or life stress. The findings suggested that there may not be a unique constellation of cognitive characteristics in depressed children when compared with a nondepressed clinical sample. For both depressed and nondepressed groups, treatment did appear to affect self-reported depression and overall ratings of depressogenic attributional style.     

Behavior of depressed subjects in problem solving groups

This study investigated leadership selection in groups in relation to level of depression of group members. On the basis of MMPI-D and DACL scores 66 subjects were organized into groups of six to eight people consisting of all depressed, all nondepressed, or half depressed and half nondepressed subjects. Subjects performed a problem solving task alone and in groups and completed a questionnaire on leadership choice and group performance. Results indicate that nondepressed group members talked more frequently, were rated as more important contributors, and were selected as leaders more frequently than depressed members. In addition, mixed groups were perceived as more efficient and enjoyable by group members than the unmixed groups. There were no significant differences between depressed and nondepressed subjects on performance of the problem solving task whether working alone or in groups. Results were discussed in relation to other literature on the interpersonal behavior of depressed persons.     

Maternal depression and its relationship to life stress,perceptions of child behavior problems,parenting behaviors,and child conduct problems

This study examined the relationship of reported maternal depression to prior and current life stressors, and to mother perceptions of child adjustment, parenting behaviors, and child conduct problems. Forty-six depressed mothers and 49 nondepressed mothers and their clinic-referred children (aged 3-8 years) participated. Depressed mothers were more critical than nondepressed mothers, but the behavior of children of depressed and nondepressed mothers showed no significant differences. Depressed mothers were more likely to have experience child abuse, spouse abuse, or more negative life events than nondepressed mothers. Maternal reports of stress related to mother characteristics and to negative life events were the most potent variables discriminating depressed from nondepressed mother families.     

Self-report measures of defeat and entrapment during a brief depressive mood induction

Recent studies have reported that depression is strongly associated with perceptions of defeat and entrapment, and have proposed that such perceptions are central features of depression. This study used experimental mood induction procedures to investigate the putative causal relationship between perceptions of defeat/entrapment and depressed mood. Two groups of female undergraduate volunteers (n = 16) completed visual analogue mood scales, as well as Defeat and Entrapment scales, before and after either a negative or a positive musical mood induction procedure (MIP). Scores on the Defeat and Entrapment Scales were significantly correlated with scores on the Beck Depression Inventory (BDI). The negative MIP caused a worsening of mood and significantly increased perceptions of defeat and entrapment, particularly internal entrapment. The positive MIP caused a small but significant improvement in mood, and significantly decreased defeat scores. Individuals with elevated BDI or internal entrapment scores prior to the negative MIP showed the greatest increases in internal entrapment after the negative mood induction. The results demonstrate that induction of a depressed mood increases perceptions of defeat and entrapment, and suggest that, in the case of internal entrapment, this effect increases with the initial level of depression or entrapment.     

Differential functioning of the Beck depression inventory in late-life patients: use of item response theory

The present analyses examined age-related measurement bias in responses to items on the revised Beck Depression Inventory (BDI) in depressed late-life patients versus midlife patients. Item response theory (IRT) models were used to equate the scale and to differentiate true-group differences from bias in measurement in the 2 samples. Baseline BDI data (218 late life and 613 midlife) were used for the present analysis. IRT results indicated that late-life patients tended to report fewer cognitive symptoms, especially at low to average levels of depression. Conversely, they tended to report more somatic symptoms, especially at higher levels of depression. Adjusted cutoff scores in the late-life group are provided, and possible reasons for age-related differences in the performance of the BDI are discussed.     

Processing of ambiguous and unambiguous feedback by depressed and nondepressed college students: schematic biases and their implications for depressive realism

Explored schematic processing as a mechanism for predicting (a) when depressed Ss would be negative relative to nondepressed Ss and (b) when depressed and nondepressed Ss would show biased or unbiased (i.e., "realistic") processing. Depressed and nondepressed Ss performed multiple trials of a task under conditions in which the two groups held either equivalent or different schemas regarding this task. Ss received either an unambiguous or objectively normed ambiguous feedback cue on each trial. In full support of schematic processing, depressed Ss showed negative encoding relative to nondepressed Ss only when their schemas were more negative, and both depressed and nondepressed Ss showed positively biased, negatively biased, and unbiased encoding depending on the relative feedback cue-to-schema match. Depressed and nondepressed Ss' response latencies to unambiguous feedback also supported the occurrence of schematic processing. We discuss the methodological, treatment, and "realism" implications of these findings and suggest a more precise formulation of Beck's schema theory of depression.     

Examining the world of the depressed: do depressed people prefer others who are depressed?

Two studies were conducted to examine the interpersonal world of the depressed person. In Study 1, depression levels and perceptions of depressed and nondepressed people and their best friend were assessed to test the hypothesis that depressed Ss have best friends who are themselves more depressed than the best friends of nondepressed Ss. The hypothesis was confirmed, suggesting that depressed persons may prefer others who also tend toward depression. To examine this possibility, in Study 2 depressed and nondepressed college students spoke with one another in either depressed-depressed, nondepressed-depressed, or nondepressed-nondepressed pairs. It was found that depressed Ss felt worse than nondepressed Ss after speaking with nondepressed targets, but not after speaking with depressed targets. There were no differences in liking or in perceived similarity between the groups. Implications for the social world of the depressed person are discussed.     

Depression and bulimia: the link between depression and bulimic cognitions

This study assessed the link between bulimic and depressive cognitions. Twenty-nine bulimics and 16 controls from the general population were first assessed on levels of depression using the Schedule for Affective Disorders and Schizophrenia-Change Version and the Beck Depression Inventory (BDI). Bulimics were significantly more depressed than controls. Bulimics differed significantly from controls on all cognitive measures associated with depression (Automatic Thoughts Questionnaire, Dysfunctional Attitude Scale, and Attributional Style Questionnaire), but differences on these measures were nonsignificant when depression, as measured by the BDI, was controlled. Bulimics differed from controls regardless of level of depression on the three scales of the Restraint Inventory, the Rationalization and All-or-None scales of the Thoughts About Eating Inventory, and most of the eight scales of the Eating Disorders Inventory. Bulimics showed more maladaptive thinking associated with depression, but these differences likely reflect the levels of depression for each group. The differences on the measures of cognitive and behavioral symptoms of bulimia remained when the level of depression was controlled statistically. This suggests that although depression can be frequently diagnosed in a bulimic sample, specific maladaptive cognitions and behaviors reflect a distinct disorder (bulimia) and are not simply the expression of an affective disorder.     

Newborns of depressed mothers

Eighty-three newborns (M GA = 37 weeks) were assigned to depressed (N = 47) and nondepressed mother (N = 36) groups based on Beck Depression Inventory (BDI) scores. The Brazelton Neonatal Assessment Scale was administered to the infants within 24 hours after birth. Infants of depressed mothers demonstrated poorer performance on the orientation cluster. Further analysis of the orientation cluster items revealed inferior orientation to the inanimate stimuli. Infants of depressed mothers also showed less motor tone and activity and more irritability and less robustness and endurance (unavailability, lethargy, and stress behaviors) during the examination.     

Smiling, frowning, and autonomic activity in mildly depressed and nondepressed men in response to emotional imagery of social contexts

The study examined self-reported emotion and facial muscle and autonomic activity of depressed and nondepressed men in response to the social context of emotional situations. 20 university men, assessed on the Beck Depression Inventory, were asked to imagine happy and sad situations with and without visualizing other people. No differences were found between men classified as depressed and nondepressed on self-reported emotion and facial muscle activity. Smiling did not show differences between social contexts although self-reported happiness was increased during happy-social compared to happy-solitary imagery. Adjusting smiling for social context differences in happiness showed less smiling during happy-social than during happy-solitary imagery. In contrast, self-reported sadness and frowning were greater during sad-social compared to sad-solitary imagery. No differences between social contexts were found when frowning was adjusted for social context differences in sadness. Depressed-scoring men showed higher mean heart rate during sad-social than sad-solitary imagery whereas nondepressed-scoring men showed higher mean heart rate during happy social compared to happy-solitary imagery. The results indicate that men may frown more when sad but generally do not smile more during happy-social imagery, independent of depression. Depressed mood may affect heart rate during sad imagery but may not alter facial muscle activity and self:reported emotion in men.     

Interpersonal betrayal and cooperation: effects on self-evaluation in depression

Despite numerous studies demonstrating that depressed people are generally self-critical, little is known about interpersonal stressors that may activate or increase this negative self-evaluation. In this study, the effect of interpersonal betrayal and cooperative social interaction on self-evaluation processes in depressed and nondepressed women was assessed. Depressed subjects who experienced interpersonal betrayal were more critical of their performance on a subsequent task than were nondepressed subjects or depressed subjects who had experienced a cooperative interaction. Depressed subjects in the betrayal condition also behaved more aggressively toward their betraying partner than did nondepressed betrayed subjects. Depressed subjects were more critical of their own personality characteristics than were nondepressed subjects, regardless of condition. Results suggest that some negative cognitive schema among depressed persons may be altered by interpersonal factors, although it is not clear whether such effects are secondary to increases in self-criticism after conflict or to decreases in self-critical tendencies after positive interaction. Given the variability in results with different measures of self-evaluation, researchers are urged to use multiple, diverse measures of self-evaluation in future efforts to study variability in self-appraisal.     

Construct accessibility and depression: an examination of cognitive and affective factors

Two studies in which the parameters of construct accessibility in depression were examined are reported. In Experiment 1, depressed and nondepressed subjects were required to name the colors of tachistiscopically presented depressed-content, neutral-content, and manic-content words. Because of the predicted accessibility and interference effects of the depressed-content words, the depressed subjects were expected to demonstrate longer response latencies to these words than to the non-depressed-content words. This response pattern was found for the depressed subjects; the nondepressed subjects did not demonstrate differential response latencies. In Experiment 2, a mood-induction paradigm was used to investigate whether the interference effects obtained in Experiment 1 were due to temporary mood differences between the depressed and nondepressed subjects, or were a function of more stable depression-associated patterns of information processing. Although predicted group differences were obtained on a mood adjective checklist, no effects were found for task performance. These results suggest that transient mood is not a sufficient explanation for the results obtained in Experiment 1. The implications of the present findings for the understanding of both construct accessibility and depression are discussed, and directions for future research are suggested.