Induced mood change and dysfunctional attitudes in remitted bipolar I affective disorder

This study investigated the possibility that, in remitted bipolar I affective disorder, dysfunctional attitudes are mood-state dependent. Participants were 120 individuals with remitted bipolar I disorder, remitted unipolar depression, or no history of affective disorder. The Dysfunctional Attitudes Scale (DAS; Weissman, 1979) was completed before and after positive or negative mood challenge. Following mood increase, the bipolar group changed significantly less in DAS total score than did the other 2 groups, and in goal-striving and achievement attitudes relative to the unipolar group. These findings did not provide clear support for the mood-state dependency theory in bipolar disorder, arguing instead for the presence in bipolar I disorder of dysfunctional cognitions that show characteristic resilience in the face of minor positive mood increase.     

Efficiently assessing negative cognition in depression: an item response theory analysis of the Dysfunctional Attitude Scale

Despite a central role for dysfunctional attitudes in cognitive theories of depression and the widespread use of the Dysfunctional Attitude Scale, form A (DAS-A; A. Weissman, 1979), the psychometric development of the DAS-A has been relatively limited. The authors used nonparametric item response theory methods to examine the DAS-A items and develop a briefer version of the scale. Using DAS-A data obtained from depressed participants enrolled in 2 large depression treatment studies (N=367), the authors developed a 9-item DAS form (DAS-SF1). In addition, because 2 versions of the DAS are needed for certain study designs, they also developed a 2nd short version (DAS-SF2). These short forms were highly correlated with the original 40-item DAS-A (rs ranged from .91 to .93), exhibited change similar to that of the DAS-A over the course of treatment, were moderately correlated with related self-report assessments, predicted concurrent depression severity, and predicted change in depression from before to after treatment. Taken together, the authors believe the DAS-SF1 and DAS-SF2 provide an efficient and accurate assessment of dysfunctional attitudes among depressed individuals.     

Dysfunctional attitudes in seasonal affective disorder

Research examining dysfunctional attitudes in Seasonal Affective Disorder (SAD) has produced contrasting results. The present study sought to resolve this contradiction by addressing some methodological problems of the previous studies. The study examined dysfunctional attitudes using the Dysfunctional Attitudes Scale (DAS) in individuals with SAD and never-depressed controls. The SAD group were tested both when depressed in the winter (Time 1) and during their remission period (Time 2). At Time 1 the SAD group displayed a relatively elevated DAS compared to controls and to their Time 2 scores. These data therefore provide potential support for a view that SAD is characterized by underlying dysfunctional attitudes.     

青少年抑郁综合认知模型及其性别差异

Beck抑郁认知理论认为功能失调性态度和自动思维对抑郁的形成和发展有着重要的影响, 但是不同水平的认知因素在青少年抑郁中起什么样的作用还有待于进一步的研究。根据Oei和Kwon (2007)综合认知模型(ICM), 我们假设在青少年负性生活事件和抑郁症状间功能失调性态度是调节变量, 而自动思维是中介变量。研究采用开学初和临近期末间隔近四个月两个时间点的纵向数据搜集方式, 对613名初中生施以青少年生活事件量表(ASLEC)、功能失调性态度问卷(DAS)、自动思维问卷(ATQ)以及流调中心用抑郁量表(CES-D), 然后通过路径分析对模型进行了拟合度和性别差异检验, 结果表明：(1)各变量显著相关(p<0.01), 且各变量间隔四个月两个时间点的分数差异显著(p<0.01); (2)修正后的青少年抑郁综合认知模型较好地拟了数据, 且功能失调性态度与负性生活事件的交互作用对自动思维的影响上女生的路径系数显著大于男生。结论：功能失调性态度在负性生活事件和青少年抑郁症状间起调节作用, 而自动思维从中起到了认知中介的作用, 且该模型性别差异显著。     

Testing the Effectiveness of Brief Behavioral Activation Treatment for Depression—Revised: Changes in Depression,Anxiety, Dysfunctional Attitudes,and Mindfulness

We tested the effectiveness of Brief Behavioral Activation Treatment for Depression-Revised (BATD-R), and its impact on secondary outcomes: anxiety, dysfunctional attitudes, and mindfulness. It was expected that individuals who completed BATD-R would exhibit decreased depression, anxiety, and dysfunctional attitudes, as well as increased mindfulness. A sample of adults with depression (n?=?42) was recruited to complete the 10-week treatment. A healthy control group (n?=?38) was included for comparison. Outcomes (depression, anxiety, dysfunctional attitudes, and mindfulness) were assessed at pre-treatment, post-treatment or 10 weeks for the healthy control group, and three-month follow-up. At pre-treatment, the clinical group reported greater depression, anxiety, and dysfunctional attitudes, and less mindfulness than the healthy control group. At post-treatment, the clinical group reported decreased depressive symptoms, trait anxiety, and dysfunctional attitudes, and increased mindfulness, compared to pre-treatment. The control group did not exhibit changes across the 10 weeks. Clinical and healthy control group post-treatment scores did not differ. At three-month follow-up, the clinical group reported a slight increase in depressive symptoms from post-treatment, but still maintained lower depressive symptoms than pre-treatment. The clinical group maintained treatment gains in dysfunctional attitudes, and mindfulness. Results support the effectiveness of BATD-R and suggest BATD-R may influence dysfunctional attitudes and mindfulness.

     

The Dysfunctional Attitude Scale: How well can it measure depressive thinking?

The Dysfunctional Attitude Scale (DAS) was designed to measure patterns of maladaptive thinking held by depressed individuals. Despite its wide use as a research and clinical tool, only a few studies to date were designed to examine its psychometric properties in a clinically depressed population. Moreover, problems of low sample size and limited tests of validity call these findings into question. The present study was designed to examine psychometric properties of the DAS in clinically depressed inpatients and in nondepressed clinical controls. Intertest correlations between the DAS parallel forms and between each form with total test scores ranged from r=.84 to r=.97. Intratest stability coefficients were r=.88 to r=.97. Support for the DAS as a valid measure of dysfunctional cognitions in depressed patients was also indicated. Of those scoring high on the DAS, 73% received an independent RDC diagnosis of clinical depression, while only 36% of those receiving low DAS scores were so diagnosed.     

Dysfunctional Attitudes and Suicidal Ideation in Psychiatric Outpatients

To determine if specific sets of dysfunctional attitudes were related to suicidal ideation, the 100-item Dysfunctional Attitude Scale (DAS) was administered to 908 psychiatric outpatients along with the Beck Depression Inventory (BDI), Hopelessness Scale (BHS), Self-Concept Test (BST), and Scale for Suicide Ideation (SSI). The SSI was used to classify the outpatients into 97 (10.7%) suicide ideators and 811 (89.3%) nonideators, and the DAS was scored for nine subscales described by Beck, Brown, Steer, and Weissman (1991) . None of the DAS subscales discriminated the ideators and nonideators or was significantly related to SSI total scores of the suicide ideators after controlling for sex, age, diagnosis of a mood or panic disorder, comorbidity, presence of a personality disorder, a history of a past suicide attempt, the BDI, the BHS, and the BST. The contributions of sets of dysfunctional attitudes for identifying and explaining suicidal ideation were overshadowed by a history of a past suicide attempt and hopelessness.     

The Effects of Dysphoria and Personality on Negative Self-Referent Attitudes and Perceptions of the Attitudes of Others

The cognitive model of depression posits that depressed individuals harbor more dysfunctional self-referent attitudes, but little is known about how depressed individuals perceive the attitudes and perceptions of others in their social arena. This study examined whether dysphoric individuals perceive others to hold equally negative attitudes about themselves, and whether such perceptions depend on sociotropic (i.e., highly invested in social approval and relationship success) and autonomous (i.e., highly invested in vocational or academic achievement and goal attainment) personality styles. A sample of undergraduate students (N = 197) was recruited, and after the assessment of their depression symptoms and personality style, participants read vignettes that described negative scenarios, and imagined that these scenarios occurred to themselves or the general university student. After reading each vignette, participants also rated their agreement with a number of statements that assessed dysfunctional attitudes. Results indicated that elevated dysphoria (i.e., showing signs of depression) scores were positively associated with dysfunctional self-referent attitudes. Further, moderational analyses examining the interaction of sociotropy and dysphoria did not support the hypothesis that individuals higher on dysphoria and sociotropy were less likely to perceive others as harboring negative attitudes about themselves in comparison to those with elevated dysphoria and lower levels of sociotropy. Last, individuals showing elevated dysphoria and higher scores on subdomains of autonomy were more likely to perceive others as exhibiting negative attitudes about themselves than those with low levels of the trait. These findings, their implications, and strengths and limitations of the current investigation are further discussed.     

Stability of cognitive vulnerabilities to depression: a short-term prospective multiwave study

The stability of 3 cognitive vulnerabilities--a negative cognitive style, dysfunctional attitudes, and rumination--as well as depressive symptoms as a benchmark were examined to investigate whether cognitive vulnerabilities are stable, enduring risks for depression. A sample of adolescents (6th-10th graders) completed measures of these 3 cognitive vulnerabilities and depressive symptoms every 5 weeks for 4 waves of data across 5 months. Mean-level and differential stability were examined for the sample overall and by age subgroups. A negative cognitive style exhibited mean-level stability, whereas rumination and dysfunctional attitudes showed some mean-level change. Absolute magnitudes of test-retest reliabilities were strong for depressive symptoms (mean r= .70), moderately high for a negative cognitive style (mean r= .52), and more modest for rumination (mean r= .28) and dysfunctional attitudes (mean r= .26). Structural equation modeling showed that primarily enduring processes, but not contextual forces, contributed to the patterning of these test-retest reliabilities over time for a negative cognitive style and dysfunctional attitudes, whereas both enduring and contextual dynamics appeared to underlie the stability for rumination. Theoretical and clinical implications of these findings are discussed.     

Dysfunctional attitudes and episodes of major depression: Predictive validity and temporal stability in never-depressed, depressed, and recovered women

In a large, community-based sample of women (N = 750), the authors examined the nature of associations between dysfunctional attitudes and depression. Dysfunctional attitudes were evaluated both as a vulnerability factor for depression and as a consequence of depression. A link was found between past depression and baseline elevations in dysfunctional attitudes that was independent of current subsyndromal symptoms, but intensification of dysfunctional attitudes following prospectively evaluated episodes of depression (depressive "scarring") was not observed. Although baseline dysfunctional attitudes predicted an episode of major depression over 3 years of prospective study, this prediction, considered alone or in interaction with negative life events, was redundant with that offered by history of past depression. Further, no significant prediction was evident for the Dysfunctional Attitude Scale (A. N. Weissman & A. T. Beck, 1978) when the formerly depressed and never-depressed cohorts were considered separately. Implications for cognitive theories are discussed.     

A Direct Method of Assessing Underlying Cognitive Risk for Adolescent Depression

An enduring tendency towards negative thinking is thought to increase vulnerability for future depression. However, it has not been possible to assess this tendency in non-depressed mood states. We examined if response latency to endorse dysfunctional attitudes is associated with depressive outcomes in a longitudinal study. A sample of young people at familial risk of depression (N?=?252, aged 10–19, 56.3 % female) completed a computer-administered dysfunctional attitude scale. The main outcome measure was the difference in reaction time to agree versus disagree with dysfunctional attitudes. Cross-sectional differences between current and previous depression and no psychiatric disorder groups as well as longitudinal associations with depressive symptoms were examined. Young people with current and previous depression were quicker to agree with dysfunctional attitudes than those without disorder. In young people free from depressive disorder, faster agreements with dysfunctional attitudes were specifically associated with increased depressive symptoms over time. Self-reported dysfunctional attitudes did not differentiate the formerly depressed and no disorder groups and showed a longitudinal association with depressive symptoms for older adolescents only. Reaction time to endorse dysfunctional attitudes may indicate changes in affective processing that represent an early risk for future depression that is not indexed by self-report measures of negative thought.     

Decreased approach motivation in depression

The present study examined relations between choice preference and reaction time to emotionally valenced words, dysphoric symptoms (BDI), and dysfunctional attitudes (DAS) in clinically depressed (CD; n= 61), previously depressed (PD; n= 42), and never depressed controls (ND; n= 46). The results showed: (1) NDs and PDs exhibited a choice preference for the relatively more positive words and differed significantly from CDs; (2) PDs and CDs exhibited longer reaction time and differed significantly from NDs; and (3) BDI and DAS were positively associated with reaction time to positively valenced words, whereas no associations were found for reaction time to negatively valenced words. The increased reaction time, in PDs and CDs, is discussed as a possible vulnerability factor to depression, which may be related to decreased approach motivation.     

Evaluation of cognitive diathesis-stress models in predicting major depressive disorder in adolescents

Diathesis-stress predictions regarding the onset of adolescent major depression and nonmood disorders were tested. Adolescents (N = 1,507) were assessed for dysfunctional attitudes and negative attributional style, as well as current depressive symptoms, current depressive and nondepressive diagnoses, and past and family histories of psychopathology. Approximately 1 year later, participants were reassessed on all measures. Analyses supported A. T. Beck's (1976) theory of depression (at the level of a trend) but not the hopelessness theory of depression. Findings were suggestive of a threshold view of vulnerability to depression; for those who experienced negative life events, depressive onset was related to dysfunctional attitudes but only when dysfunctional attitudes exceeded a certain level (low = intermediate < high). For participants who scored either very high or very low on both dysfunctional attitudes and negative attributional style, nonsignificant findings were obtained.     

The relationship between personality pathology and dysfunctional cognitions in previously depressed adults

Multivariate and univariate regression models were used to examine the relationship between Axis II personality pathology and dysfunctional cognitions in a follow-up study of 40 formerly depressed inpatients. A dimensionalized measure of overall Axis II pathology was significantly and positively related to dysfunctional attitudes (Dysfunctional Attitudes Scale [DAS]) and maladaptive negative event attributions (Attributional Style Questionnaire-Negative Composite [ASQ-N]); the Axis II measure accounted for approximately 29% of the variance in DAS and 14% of the variance in ASQ-N, after controlling statistically for subsyndromal depressive symptoms (Beck Depression Inventory [BDI]). Axis II pathology was not significantly associated with positive event attributions, and no significant Axis II x BDI interaction effects were observed. A secondary canonical analysis of Axis II clusters was largely consistent with a hypothesized general personality pathology factor associated with dysfunctional cognitions, though a more specific association between Axis II Cluster C pathology and dysfunctional attitudes was also observed.     

Perfectionism and Interpersonal Sensitivity in Social Phobia: The Interpersonal Aspects of Perfectionism

We examined perfectionism, interpersonal sensitivity and dysfunctional cognitions in patients with Social Phobia (SP). The sample consisted of a clinical group with a diagnosis of SP (n?=?30) and a non clinical group (n?=?30), matched for age and gender. Both groups were assessed on Frost??s Multidimensional Perfectionism Scale (FMPS), Interpersonal Sensitivity Measure (IPSM), and Dysfunctional Attitudes Scale (DAS). The clinical sample was also assessed on Liebowitz Social Anxiety Scale (LSAS), Beck??s Depression Inventory-II, Eysenck??s Personality Inventory-Neuroticism sub-scale (EPI- N). The two groups were compared on FMPS, IPSM and DAS using t-test. Associations between FMPS, IPSM, DAS and predictors of social anxiety and depression were examined. The clinical group scored higher on perfectionism, interpersonal sensitivity and dysfunctional cognitions. There was no significant association between total scores on FMPS and IPSM. However subscales of IPSM and FMPS were correlated. Doubt about Actions was associated with Separation Anxiety (r?=?0.520) and Timidity (r?=?0.407). Organization was related to Interpersonal Awareness (r?=?0.371) and Separation Anxiety (r?=?0.407). Parental criticism was negatively associated with fragile inner self. DAS was positively correlated with FMPS and IPSM. Interpersonal sensitivity emerged as a significant predictor of social anxiety. Discriminant Functional Analysis indicated that concern over mistakes, organization, fragile inner self, separation anxiety discriminated between the clinical and non-clinical groups.     

Cognitive predictors of symptom return following depression treatment

This study tested whether poor cognitive change during depression treatment predicted time to return of depressive symptoms. Depressed participants (N = 121) completed assessments of dysfunctional attitudes and extreme thinking (i.e., number of totally agree and totally disagree responses) during hospitalization and again after 6 months of outpatient treatment. Participants then completed monthly depression assessments for 1 year. Survival analyses for time to symptom recurrence during follow-up were conducted among participants who reported 50% improvement in their depressive symptoms and were at least partially asymptomatic at the end of treatment (n = 53). Poor change in dysfunctional attitudes and poor change in extreme thinking both predicted shorter time to return of depressive symptoms.     

Examining the role of positive and negative metacognitive beliefs in depression

Many psychological models have been developed to explain the development and maintenance of depression. The most widely evaluated model is the cognitive model of depression, and it is against this model that emerging models should be compared. Accordingly, this cross‐sectional study examined whether metacognitive beliefs, as specified in the metacognitive model of depression, would explain additional variance in depressive symptoms over dysfunctional attitudes; the core feature of the cognitive model. Moreover, mediational relationships between metacognitive beliefs, rumination, and depressive symptoms, predicted by the metacognitive model were also explored, whilst controlling for dysfunctional attitudes. A sample of 715 students completed self‐report questionnaires measuring depressive symptoms, rumination, dysfunctional attitudes, and metacognitive beliefs. Regression analyses showed that metacognitive beliefs made a significant statistical contribution to depressive symptoms, after controlling for age, gender, rumination and dysfunctional attitudes. Furthermore, as predicted by the metacognitive model, the relationship between positive metacognitive beliefs and depressive symptoms was fully mediated by rumination, whilst the relationship between negative metacognitive beliefs about uncontrollability and danger and depressive symptoms was partially mediated by rumination. The results provide further empirical support for the metacognitive model of depression and indicate that positive and negative metacognitive beliefs play an integral role in the maintenance of depressive symptoms.     

The role of perceived social support and dysfunctional attitudes in predicting Taiwanese adolescents' depressive tendency

This study examined the moderating effect of perceived social support on the association of dysfunctional attitudes with depression among Taiwanese adolescents. Seventh graders (N = 458) completed the Dysfunctional Attitudes Scale (Weisman & Beck, 1978), Perceived Social Support from Family and Friends (Procidano & Heller, 1983), Stressful Life Events (Chiu, 1988), and Children's Depression Inventory (Kovacs, 1981). The results indicated that perceived social support from friends moderates the relationship between dysfunctional attitudes and depression, implying that as peer support increases, the positive relationship between dysfunctional attitudes and depression weakens.