Dependent and Self-Critical Depressive Experiences among Inner-City Adolescents

ABSTRACT The Adolescent Depressive Experiences Questionnaire was administered to 142 inner-city ninth graders. Based on theory, several potential correlates of dependency and self-criticism were selected for study, including depression, aspects of anxiety, locus of control, and facets of social behavior. Self-criticism showed stronger associations with depression and concerns about losing others' approval, while dependency showed stronger associations with diffuse tension and worry and sensitivity to others' behavior. The two depressive tendencies had comparable associations with physiological anxiety and external locus of control. These findings are discussed in terms of current perspectives on the symptomatic heterogeneity of depressive experiences.     

Test–Retest Reliability of Dominic Anxiety and Depression Items Among Young Children

Assessing anxiety and depressive symptoms through direct interviewing of young children has been found to be particularly difficult utilizing standard interview methods. Test–retest reliability of selected anxiety and depression items from the revised Dominic (Valla, Bergeron, Bidaut-Russell, St-Georges, & Gaudet, 1997), a cartoon-based questionnaire based on DSM diagnostic criteria, was investigated among two geographically diverse samples (Los Angeles and St. Louis; N = 37). Overall, kappas were higher for the anxiety items than for the depression items. In both cities the sample included clinic and non-clinic cases of African-American, Hispanic/Latino, and Caucasian children age 6–8; kappas for the anxiety and depression items were higher among the clinic cases than for the community cases. Given the need for psychometrically sound measures for culturally diverse samples of children, this initial report suggests that the use of selected Dominic items holds promise as a cartoon-based assessment of young children.     

Anxiety,anger and depression: Relationships at the trait level

Abstract

The relationship between anxiety and depression has been extensively researched at the state and clinical syndrome levels. However, relatively few studies have directed their attention to the interrelations between the constructs at the trait level. The present two studies investigated the interrelationships between anxiety, anger and depression at the trait level in nonclinical, subclinical and clinical samples. The results showed anxiety and depression to be highly correlated in students, adults, medical and psychiatric in-patients. As to the relationship of anger with both anxiety and depression, results, especially between anxiety and anger, were likewise significant although much weaker than commonly reported at the affective state level. Moreover, partial correlations suggested the results on the anger-depression relationship to be mainly due to the mediating (causal) influence of anxiety. The results are discussed with reference to the discrepancy of distinctions commonly made between the constructs at the theoretical level and lack of such distinction found at the empirical level. The possible mediating role of both trait-anxiety and trait-anger-in in the development of a depressive disposition is offered as an alternative explanation for the interrelatedness of the three constructs at the trait level.     

Dimensionality of the hospital anxiety and depression scale (HADS) in cardiac patients: comparison of Mokken scale analysis and factor analysis

The hospital anxiety and depression scale (HADS) measures anxiety and depressive symptoms and is widely used in clinical and nonclinical populations. However, there is some debate about the number of dimensions represented by the HADS. In a sample of 534 Dutch cardiac patients, this study examined (a) the dimensionality of the HADS using Mokken scale analysis and factor analysis and (b) the scale properties of the HADS. Mokken scale analysis and factor analysis suggested that three dimensions adequately capture the structure of the HADS. Of the three corresponding scales, two scales of five items each were found to be structurally sound and reliable. These scales covered the two key attributes of anxiety and (anhedonic) depression. The findings suggest that the HADS may be reduced to a 10-item questionnaire comprising two 5-item scales measuring anxiety and depressive symptoms.     

Effects of age on symptoms of anxiety and depression in a sample of retired police officers

This study addressed the effects of age on anxiety and depressive symptoms. The analysis was based on the responses of 1,334 retired male Scottish police officers (34-94 years old) to the Hospital Anxiety and Depression Scale. Multiple regression analysis was used to determine the partialed linear and curvilinear effects of symptoms of, separately, anxiety and depression on age and retirement variables. Significant partialed effects of retirement type and present age were found. Early retirement was a vulnerability factor for both disorders. The authors found a consistent linear reduction in anxiety across age and a U-shaped function for depression across age. The differing profiles and independent effects of age on anxiety and depression are consistent with their status as separate entities. Respondents were increasingly susceptible to depression from the mid-50s onward, whereas susceptibility to anxiety was reduced with age.     

A depressive symptom scale for the California Psychological Inventory: construct validation of the CPI-D

To facilitate life span research on depressive symptomatology, a depressive symptom scale for the California Psychological Inventory (CPI) is needed. The authors constructed such a scale (the CPI-D) and compared its psychometric properties with 2 widely used self-report depression scales: the Beck Depression Inventory and the Center for Epidemiological Studies Depression Scale. Construct validity of the CPI-D was examined in 3 studies. Study 1 established content validity, classifying CPI-D items into Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition depressive symptoms. Study 2 used 3 large samples to gather evidence for reliability and validity: correlational analyses demonstrated alpha reliability and convergent and discriminant validity; factor analysis provided evidence for discriminant validity with anxiety; and regression analyses demonstrated comparative validity with existing standard PI scales. Study 3 used clinician ratings of depression and anxiety as criteria for external validity.     

A simultaneous test of the relationship between identified psychosocial risk factors and recurrent events in coronary artery disease patients

Psychosocial factors are increasingly recognized as risk indicators for coronary artery disease (CAD) prognosis and they are likely interrelated. The objective of this study is to simultaneously test the relationship between key psychosocial constructs as independent factor scores and recurrent events in CAD patients. There were 1268 CAD outpatients of 97 cardiologists surveyed at two points. Recurrent events or hospitalization in the intervening nine months were reported. Factor analysis of items from the Hospital Anxiety and Depression Scale, Perceived Stress Scale, the ENRICHD Social Support Inventory, and Hostile Attitudes Scale was performed to generate orthogonal factor scores. With adjustment for prognostic variables, logistic regression analysis was performed to examine the relationship between these factor scores and recurrent events. Factor analysis resulted in a six-factor solution: hostility, stress, anxiety, depressive symptoms, support, and resilience. Logistic regression revealed that functional status and anxiety, with a trend for depressive symptoms, were related to experiencing a recurrent event. In this simultaneous test of psychosocial constructs hypothesized to relate to cardiac prognosis, anxiety may be a particularly hazardous psychosocial factor. While replication is warranted, efforts to investigate the potential benefits of screening and to investigate treatments are needed.     

Depressive experiences questionnaire: an empirical exploration of the underlying theory

This article addresses the theoretical conceptualization of depressive typology proposed by Blatt (1974) by analyzing selected items on the Depressive Experiences Questionnaire (DEQ) in a 21-item modified version. Items were selected by judges and by factor loading criteria to be most theoretically characteristic of the dimensions they are meant to represent: anaclitic and introjective depression. Two independent samples, a female inpatient sample and a female college sample, were used. Principal components analysis of these 21 items revealed only 5 anaclitic items and 7 introjective items that loaded on their respective factors for both samples. Inspection of these items suggests that the anaclitic depressive experience is characterized by discomfort with interpersonal separation, whereas the introjective experience is characterized by negative self-evaluation with respect to self-imposed standards. Other putative aspects of these two depressive dimensions were not supported by this study; particularly, guilt and self-blame were not associated with introjective depression.     

A longitudinal analysis of anxiety and depressive symptoms

The authors modeled depressive and anxiety symptom data from 1,391 participants in a longitudinal study of middle-aged and older Swedish twins (M age = 60.9 years, SD = 13.3). Although anxiety and depression were highly correlated, a model with distinct Anxiety and Depression factors fit the data better than models with Positive and Negative Affect factors or a single Mental Health factor. Lack of well-being was associated with anxiety rather than depression. Over two 3-year intervals, anxiety symptoms led to depressive symptoms, but the relationship was not reciprocal. Anxiety symptoms were more stable than depression. These findings provide additional support for the idea that anxiety symptoms may reflect a personality trait such as neuroticism more than do depressive symptoms and suggest that low positive affect may not be as specific to depression among older adults as in younger people.     

Differentiating anxious and depressive self-statements in youth: factor structure of the Negative Affect Self-Statement Questionnaire among youth referred to an anxiety disorders clinic

Conducted a factor analysis on the items from the Negative Affect Self-Statement Questionnaire (NASSQ; Ronan, Kendall, & Rowe, 1994). This analysis yielded 4 factors (Depressive Self-Statements, Anxiety/Somatic Self-Statements, Negative Affect Self-Statements, and Positive Affect Self-Statements) broadly consistent with both the content-specificity hypothesis (Beck & Clark, 1988) and L. A. Clark and Watson's (1991b) tripartite model of anxiety and depression. The association between children's self-talk and measures of trait anxiety and depression was also examined. Self-statements with content theoretically specific to depression were the best predictors of self-reported depressive symptoms, but the results were less clear for trait anxiety. Overall, these results provide evidence for the discriminability of anxious and depressive self-talk in youth and for the utility of the NASSQ as a cognitive assessment instrument.     

Anxiety, Depression, and Tension/Stress in Children

This study explored whether the structure of negative affect in children is similar to that previously found in adults (S. H. Lovibond & P. F. Lovibond, 1995). A sample of 577 7–14-year-old children completed a 76-item questionnaire designed to measure anxiety, depression, and tension/stress, comprising both exploratory items and the full item content of established measures of childhood anxiety and depression. Exploratory factor analyses indicated that several symptoms that were previously found to be nonspecific in adults also failed to differentiate between anxiety and depression in youth. Further, the core symptoms of depression were shown to be similar to those previously identified in adults. However, the hypothetical constructs of anxiety and tension/stress could not be differentiated. It is possible that these two distinct affective syndromes have not yet emerged in childhood. Alternatively, future refinements of the questionnaire's item content may lead to a more precise assessment of anxiety and tension/stress in children.     

On the Discriminant Validity of Burnout,Depression and Anxiety: A Re-examination of the Burnout Measure

We investigated the discriminant validity of the frequently used Burnout Measure (BM) (Pines et al ., 1981), in relation to depressive symptomatology and anxiety. Following Russell's (1980) work on the multidimensional space of affective states, BM's items were hypothesized to reside in three separate regions of that space, labeled anxiety, depression, and wornout, with wornout representing a combination of physical and emotional exhaustion. Respondents were 704 senior army officers, who completed a questionnaire that included BM items, standard measures of depression and anxiety, and measures of military-related stresses. Their responses to the BM items and to the depression and anxiety scales were subjected to multidimensional scaling analysis. Excepting an unexpected finding related to a fourth construct, loss of vigor, the results were supportive of the hypothesis and led to the construction of three unidimensional measures, respectively gauging anxiety, depression, and wornout. The correlations of the three measures with the stress measures supported their discriminant validity. We suggest that future research using the BM should focus on the set of items that were found to load on the dimension of wornout, to the exclusion of items tapping depression and anxiety.     

DS14 is more likely to measure depression rather than a personality disposition in patients with acute coronary syndrome

It has been suggested that Type D Personality is a risk factor for acute coronary syndrome (ACS) and the DS14 has been developed for its assessment. However, some of the items on the DS14 seem to evaluate depressive symptoms rather than personality features. Therefore, the present study aims to verify whether an overlap exists between the constructs of Type D Personality and depression. Three‐hundred‐and‐four consecutive patients who were both presenting their first ACS and had no history of major depression completed the Hospital Anxiety and Depression Scale (HADS) and the DS14 to assess Type D personality at baseline and have been re‐evaluated at 1, 2, 4, 6, 9 and 12‐month follow‐ups. Out of 304 subjects (80.6% males), 40 were diagnosed as depressed. An exploratory factor analysis of HADS and the DS14 in the second month revealed that four out of seven items on the depressive subscale of HADS (HADS‐D) and six out of seven items on the Negative Affectivity (NA) subscale of the DS14 segregated on the same factor. Results were verified by a Partial Confirmatory Factor Analysis performed at the twelfth month when most of the patients achieved complete remission from the depressive episode. Temporal stability was poor for NA and Type D Personality and these construct co‐vary with HADS‐D over time. Our data suggests that NA and depression are overlapping constructs, supporting the idea that the DS14 measures depressed features, rather than a personality disposition.     

Development and validation of the penn state worry questionnaire

The present report describes the development of the Penn State Worry Questionnaire to measure the trait of worry. The 16-item instrument emerged from factor analysis of a large number of items and was found to possess high internal consistency and good test-retest reliability. The questionnaire correlates predictably with several psychological measures reasonably related to worry, and does not correlate with other measures more remote to the construct. Responses to the questionnaire are not influenced by social desirability. The measure was found to significantly discriminate college samples (a) who met all, some, or none of the DSM-III-R diagnostic criteria for generalized anxiety disorder and (b) who met criteria for GAD vs posttraumatic stress disorder. Among 34 GAD-diagnosed clinical subjects, the worry questionnaire was found not to correlate with other measures of anxiety or depression, indicating that it is tapping an independent construct with severely anxious individuals, and coping desensitization plus cognitive therapy was found to produce significantly greater reductions in the measure than did a nondirective therapy condition.     

Comorbidity of anxiety and depression in children and adolescents.

Anxiety and depression in children and adolescents are reviewed, including differential diagnosis, assessment of symptoms, family history data, developmental features, and clinical correlates. Findings indicate that 15.9% to 61.9% of children identified as anxious or depressed have comorbid anxiety and depressive disorders and that measures of anxiety and depression are highly correlated. Family history data are inconclusive. Differences emerged among children with anxiety, depression, or both disorders. Anxious children were distinguishable from the other 2 groups in that they showed less depressive symptomatology and tended to be younger. The concurrently depressed and anxious group tended to be older and more symptomatic. In this group, the anxiety symptoms tended to predate the depressive symptoms. Findings are discussed in the context of a proposed developmental sequence.     

Self‐compassion Is Best Measured as a Global Construct and Is Overlapping with but Distinct from Neuroticism: A Response to Pfattheicher,Geiger, Hartung,Weiss, and Schindler (2017)

Pfattheicher and colleagues recently published an article entitled ‘Old Wine in New Bottles? The Case of Self‐compassion and Neuroticism’ that argues the negative items of the Self‐compassion Scale (SCS), which represent reduced uncompassionate self‐responding, are redundant with neuroticism (especially its depression and anxiety facets) and do not evidence incremental validity in predicting life satisfaction. Using potentially problematic methods to examine the factor structure of the SCS (higher‐order confirmatory factor analysis), they suggest a total self‐compassion score should not be used and negative items should be dropped. In Study 1, we present a reanalysis of their data using what we argue are more theoretically appropriate methods (bifactor exploratory structural equation modelling) that support use of a global self‐compassion factor (explaining 94% of item variance) over separate factors representing compassionate and reduced uncompassionate self‐responding. While self‐compassion evidenced a large correlation with neuroticism and depression and a small correlation with anxiety, it explained meaningful incremental validity in life satisfaction compared with neuroticism, depression, and anxiety. Findings were replicated in Study 2, which examined emotion regulation. Study 3 established the incremental validity of negative items with multiple well‐being outcomes. We conclude that although self‐compassion overlaps with neuroticism, the two constructs are distinct. © 2018 European Association of Personality Psychology     

Coping-related expectancies and dispositions as prospective predictors of coping responses and symptoms

We used Rotter's (1954, 1982) social learning theory and Kirsch's (1985, 1999) response expectancy extension thereof to clarify distinctions between coping-related expectancies (beliefs about the outcomes of coping efforts) and coping dispositions (tendencies to use particular coping responses), specifically focusing on the role of generalized expectancies for negative mood regulation (NMR) as a predictor of individual differences in coping and well-being. Two studies using structural equation modeling provided support for direct and indirect associations between NMR expectancies and symptoms of depression. In Study 1 NMR expectancies predicted situational avoidance coping responses and symptoms of depression and anxiety, independent of dispositional avoidance coping tendencies. In Study 2, NMR expectancies were associated with depressive symptoms, concurrently and prospectively, independent of dispositional optimism and pessimism. Both studies indicated that NMR expectancies are more strongly associated with depressive symptoms than with symptoms of anxiety and physical illness. Results underscore the importance of distinguishing between expectancies and other personality variables related to coping.     

Hierarchical model of vulnerabilities for anxiety: replication and extension with a clinical sample

This study served to replicate and extend our previously obtained hierarchical model of the relationships among general anxiety vulnerabilities, specific anxiety vulnerabilities and specific anxiety manifestations including panic symptoms, health anxiety, obsessive-compulsive symptoms and worry. Questionnaires assessing these variables, as well as positive affectivity and depressiveness, were administered to 125 outpatients seeking treatment for panic disorder, social anxiety disorder, obsessive-compulsive disorder, generalized anxiety disorder or major depressive disorder. The results, using a clinical sample, were highly consistent with the hierarchical model obtained in the previous study using a student sample. A more elaborate model, based on published theoretical and empirical evidence, was identified and tested, and similar results were obtained. Negative affectivity had expected direct positive effects on all of the specific anxiety and depression manifestations, with the exception of health anxiety, which showed a negative relationship, and OCD symptoms, which showed no relationship. Positive affectivity was found to be a specific risk factor for depression, while intolerance of uncertainty was found to be a specific risk factor for worry and depression. Finally, anxiety sensitivity appears to be a significant risk factor for panic and health anxiety.     

Self-Report Differentiation of Anxiety and Depression in a Mood Disorders Sample

Several lines of research suggest there is considerable overlap between anxiety and depression and that it is difficult to distinguish between these two constructs. However, a few studies utilizing factor analytic procedures have provided evidence that anxiety and depression can be differentiated when measures of these constructs are considered at the item level. In addition, there is some evidence that differentiation can be accomplished in samples experiencing high levels of anxiety (i.e., a clinically anxious sample; B. J. Cox, R. P. Swinson, L. Kuch, & J. Reichman, 1993). In the present study, this research strategy was extended to a sample of patients with high levels of depressed mood (i.e., a mood disorders sample; N = 378). Their responses to widely used measures of depression (i.e., Beck Depression Inventory; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) and anxiety (i.e., Spielberger State-Trait Anxiety Inventory—State subscale; C. D. Spielberger, R. L. Gorsuch, & R. E. Lushene, 1970) were entered into a principal-components analysis with oblique rotation. A 4-factor solution was retained. This solution was comprised of factors representing anxiety, anxiety absent (a reverse scored factor), cognitive symptoms of depression, and somatic/vegetative symptoms of depression. These findings indicated that anxiety and depression, as emotional states, can be differentiated within a mood disorders sample, using existing popular self-report measures. The clinical and research implications of these findings are briefly discussed.     

Does emotional reasoning change during cognitive behavioural therapy for anxiety?

Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world. It is a key interpretative bias in cognitive models of anxiety disorders and appears to be especially evident in individuals with anxiety disorders. However, the amenability of emotional reasoning to change during treatment has not yet been investigated. We sought to determine whether emotional reasoning tendencies change during a course of routine cognitive-behavioural therapy (CBT). Emotional reasoning tendencies were assessed in 36 individuals with a primary anxiety disorder who were seeking treatment at an outpatient clinic. Changes in anxiety and depressive symptoms as well as emotional reasoning tendencies after 12 sessions of CBT were examined in 25 individuals for whom there was complete data. Emotional reasoning tendencies were evident at pretreatment assessment. Although anxiety and depressive symptoms decreased during CBT, only one of six emotional reasoning interpretative styles (pertaining to conclusions that one is incompetent) changed significantly during the course of therapy. Attrition rates were high and there was not enough information regarding the extent to which therapy specifically focused on addressing emotional reasoning tendencies. Individuals seeking treatment for anxiety disorders appear to engage in emotional reasoning, however routine individual CBT does not appear to result in changes in emotional reasoning tendencies.