Depression in a Cancer Patient Population

The main goal of this study was to examine depression and its components in cancer patients as compared with healthy control subjects and psychiatric inpatients. The participants were 54 cancer patients (28 females with breast cancer, 26 males with prostate cancer), 59 healthy controls (33 females, 26 males), and 75 psychiatric patients (27 females, 48 males). Participants were administered the Beck Depression Inventory (BDI) and the State Trait Personality Inventory (STPI) Depression scales. Cancer patients had higher overall depression scores than did healthy controls as measured by BDI, but the difference was due primarily to the significantly higher scores of the cancer patients on the BDI Somatic–Performance subscale. No differences were found on the BDI Cognitive–Affective subscale. Cancer patients also scored significantly higher than healthy controls on the State-Trait Personality Inventory (STPI) State Depression (S-Dep) scale because of higher Euthymia subscale scores. The psychiatric inpatients scored significantly higher than the other groups on all measures of depression. The findings of this study suggest that cancer patients may be erroneously labeled as depressed because of somatic–performance difficulties they may experience, which are similar to symptoms of depressed individuals. In addition, it is essential to delineate the various components of depression in evaluating cancer patients.     

Sex differences in the expression of depression in adolescents

The purpose of the present study is to examine the patterns of depressive response of adolescents on The Beck Depression Inventory (BDI). Subjects, who were registered at the Western Québec Regional School Board (Grades 7–12), completed the BDI in the context of intact classes. Out of 1015 subjects, 249 (152 females, 97 males) met the cut-off score of 15 and above on the BDI, and were retained for the study. Sixty-three percent were francophone and 37 percent were anglophone. Ages ranged from 12 to 17 years. Results did not reveal any difference in the BDI scores as a function of either sex, age, or language. However, a significant discriminant function was obtained from subjects' responses that correctly differentiates depressed males from depressed females in 67.8% of the cases. These differential patterns of depressive responding are compared with those observed in depressed college students and adult psychiatric patients, and discussed in light of the literature on adolescent depression.This is an extended version of a poster paper presented at the 48th annual meeting of the Canadian Psychological Association, Vancouver, June 1987.     

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.     

The role of coping, anxiety, and stress in depression post-acute coronary syndrome

Depressive symptoms are common and can affect prognosis following acute coronary syndromes (ACS). This study examined the psychological factors, coping, anxiety, and perceived stress associated with depression following ACS. Psychological variables were assessed in 15 females and 66 males (M = 57 years, SD = 12). Repeated measures at 2, 12, and 24 weeks post-ACS compared depression, anxiety, perceived stress, and coping resources as determined by the Cardiac Depression Scale, Beck Depression Inventory-II, State Trait Anxiety Inventory, Perceived Stress Scale, and Coping Resources Inventory. Depression, anxiety, and perceived stress remained high in the depressed group across time. Coping scores at 2 weeks post-ACS predicted depression scores at 24 weeks post-ACS. It appears that trait anxiety and coping resources are related to depressive symptoms post-ACS.     

Sex differences in problems related to depression

The study investigated possible sex differences in the types of problems that are correlated with Beck Depression Inventory (BDI) scores, using a sample of college students. Problems related to assertiveness and feeling ill at ease were positively correlated with BDI scores for males, but not for females. In contrast, conflicts with parents, feelings of being boxed in and of boredom, lack of money, and chronic physical complaints were positively related to BDI scores for females, but not for males.     

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.     

Gender differences in depression in college students

Although there is much evidence indicating that females report more depressive symptoms on the Beck Depression Inventory (BDI) relative to males, virtually no research has examined or reported gender differences on several other measures tapping negative affect—namely, the Expanded Attributional Styles Questionnaire (EASQ) and the Selves Questionnaire. Our first study examined gender differences on both the BDI and EASQ, and found that females reported more depressive symptoms and a more maladaptive attributional style than males. In our second study, the data revealed that, again, females were found to have a more maladaptive attributional style than males. In addition, on the Selves Questionnaire, there was a significant discrepancy between actual and ideal self for females, but not for males. When delineating most frequently used ideal categories, the data revealed that females were more likely than males to report greater strivings for ideal attributes relevant to interpersonal relationships and body image/attractiveness, whereas males reported more ideal strivings for intelligence. These data suggest some content areas in which females and males differ with regard to “traits” to which they aspire, and which may produce dejection and negative affect if not attained.     

Handedness and depression in university students: a sex by handedness interaction

Previous research has indicated that there is an increased incidence of left-handedness in samples of depressed individuals. We administered the Beck Depression Inventory (BDI) to a sample of 541 undergraduate students. Left-handed males showed significant elevation of BDI scores. It is unlikely that this result is due to decreased right hemisphere activity or sex-role conflicts. However, one possibility is that known differences in male steroid hormones levels between right- and left-handers contributed to this effect. Press     

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.     

Depressive symptom manifestation and help‐seeking among Chinese college students in Taiwan

One longstanding hypothesis in the research of depression among Chinese populations is that they tend to express depressive symptoms in somatic terms, which, in turn, prevent them from seeking assistance from mental health services. This study aimed to examine the manifestation of depressive symptoms and its relationship to help‐seeking attitudes among Chinese college students. The Chinese Beck Depression Inventory‐II (BDI‐II; Beck, Steer, & Brown, 1996 ) and the Attitudes Toward Seeking Professional Psychological Help: Shortened Form (ATSPPH‐SF; Fischer & Farina, 1995 ) were administered to 1039 Chinese college students in a private university in Taiwan. Factor ratio scores analyses revealed that Chinese college students generally emphasized somatic complaints compared to cognitive‐affective complaints in expressing depressive symptoms. Probably‐depressed Chinese students (BDI‐II scores?16), however, placed significantly less emphasis on somatic symptoms than did nondepressed students. Additionally, multiple regression analyses showed that while Chinese students with elevated BDI‐II scores were less likely to seek professional psychological help, neither somatic nor cognitive‐affective symptoms were correlated with their attitudes toward seeking and avoiding professional psychological help. These findings seem to run counter to the common assumption that Chinese people tend to express depression in somatic terms and that somatic complaints help to explain their reluctance to seek professional psychological assistance. The current results suggest that Chinese students with elevated depressive symptoms readily acknowledged and expressed cognitive‐affective symptoms of depression and they were likely to distance themselves from professional psychological help. However, somatic symptoms did not explain their reluctance to utilize mental health services.     

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.     

Subclinical and clinical depression: Are analogue studies justifiable?

A group of subclinically depressed students SS (N = 36) was compared with a group of mildly depressed patients MP (N = 48) and a group of severely depressed patients SP (N = 33) on 21 raw symptom severity scores in the Beck Depression Inventory (BDI). Stepwise discriminant function analysis yielded two significant functions, the first representing severity in core symptoms of depression. Symptom severity scores were then adjusted to allow for differences in total BDI scores among the groups and the adjusted scores were reanalysed. Two significant functions were again found, the first representing severity in only three of the core symptoms defining depression according to DSM III. The adjusted scores were further adjusted to equate the groups for differences in score variance and the discriminant analysis was repeated. Again two significant functions were found. The first, clearly representing a dimension of subclinical-clinical depression, was defined by a set of core symptoms smaller than that specified in the DSM III definition of major depression. It is argued that clinical and subclinical depression differ mainly in the absolute severity of the core symptoms defining depression but that subclinical shows a relative emphasis of some, and a relative de-emphasis of other core symptoms. It is concluded that subclinical depression in students offers a fairly accurate ‘model’ of clinical depression and that analogue studies are, to a reasonable extent, justifiable.     

Gender differences in loneliness and depression of university students seeking counselling

Gender differences in loneliness and depression were examined among university students seeking counselling. The short-form UCLA Loneliness Scale (ULS-8) and the Beck Depression Inventory (BDI) were completed by 325 counselling seekers (107 males and 218 females) in Israel. Males were significantly higher in loneliness than females, while females were significantly higher in depression than males. The greater loneliness of male counselling-seekers than that of females is discussed, as well as the possibility of a response set. Implications for assessment and counselling are suggested.     

Gender differences in responses to depressed mood in a college sample

Two studies tested the hypothesis that women are more likely than men to focus on themselves and their mood when in a depressed mood, and that this leads them to experience longer periods of depressed mood. In both studies subjects were predominantly Caucasian college students. In our first study, a laboratory study, females chose to engage in an emotion-related task significantly more often than did males, even when this lead them to focus on an existing sad mood. In the second study, a prospective naturalistic study, females were more likely than males to evince an emotion-focused ruminative style of coping with their moods. A ruminative response style at Time 1 was a significant predictor of depression scores at Time 2, even after initial levels of depressed mood were taken into account. Furthermore, once rumination levels were controlled for, gender was no longer a potent predictor of depression outcome. The implications of these response styles for treatment are discussed.We thank Brandi Battistoni, Kim Bergquist, Rachel Carr, Lisa Lougee, and especially Ariel Lang for their invaluable help in data collection. We also thank Chuck Olson, Jannay Morrow, and Rose McDermott for their helpful comments on earlier drafts.     

New perspectives on child and adolescent depression

The Children's Depression Index (CDI) was administered to a group of 304 regular school students in Grades 3–12. It was found that 21% of the students reported mild to moderate levels and 7% reported severe levels of depression. Females reported more overall depression than did males. Specific CDI items selected more frequently by females than by males supports previous work suggesting that females tend to internalize difficulties whereas males are more likely to externalize problems. There were no age differences associated with overall depression; however, there were some developmental differences in specific items cited. Finally, “red flags” were identified that may be helpful in spotting children suffering from severe levels of depression.     

Suicide ideation and depression in university students in Botswana

The study aimed at exploring suicide ideation and its relationship to depression in university students in Botswana. Data were collected from 122 undergraduate students (68.9% females, 31.1% males) with a mean age of 20.02 years. Depressive symptoms were measured with an adapted version of Beck's Depression Inventory-II. In total, 47.5% of the respondents reported suicide ideation, 28.7% reported previous suicide attempts, and the mean depression score was 19.14. Suicide ideation correlated strongly with total depression scores. The level of depression severity was linearly related to suicide ideation but 14.3% of respondents who scored at the level of minimal depression and 53.8% of those who scored at the level of mild depression had also contemplated suicide. The level of education of respondents’ mothers had an inverse relationship with suicide ideation and with depression in that those whose mothers had a tertiary level education were less likely to engage in suicide ideation and had significantly lower depression scores. The results are discussed from within the specific social ecological context of Botswana.     

Femininity and work plans protect women against postpartum dysphoria

This study examined contributions of the following variables to postpartum depressive symptomatology: level of antepartum depression, loss of social reinforcement, assertiveness, sex-role orientation, and work plans. The Beck Depression Inventory (BDI), Pleasant Events Schedule (PES), Assertion Inventory, and Bem Sex Role Inventory (BSRI) were administered to 69 women during the eighth month of pregnancy. One month after delivery, subjects were administered the PES, postdelivery questionnaire, and BDI. A hierarchical regression analysis revealed that antepartum BDI scores predicted postpartum depressive symptomatology, and BSRI Femininity scores and work plans were significant negative predictors. A one-way analysis of variance of sex role orientation on postpartum BDI scores showed that undifferentiated women reported more depression than other sex role groups.     

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.     

Sex Differences on the Revised Beck Depression Inventory for Outpatients With Affective Disorders

The revised Beck Depression Inventory (BDI) was administered to 174 male and 276 female psychiatric outpatients diagnosed with affective disorders. The mean BDI scores, mean number of symptoms claimed, and corrected item-total correlations were comparable for both sexes, and the coefficients alpha for each sex was .88. Principal components analyses found four dimensions of depression underlying both sexes' BDI item-intercorrelation matrices. Although men and women had comparable dimensions with respect to weight loss, self-blame, and somatic-performance symptoms, men had affective and performance symptoms loading on the same factor, whereas women had affective and cognitive symptoms loading on the same dimension.     

Sex differences on the revised Beck Depression Inventory for outpatients with affective disorders

The revised Beck Depression Inventory (BDI) was administered to 174 male and 276 female psychiatric outpatients diagnosed with affective disorders. The mean BDI scores, mean number of symptoms claimed, and corrected item-total correlations were comparable for both sexes, and the coefficient alpha for each sex was .88. Principal components analyses found four dimensions of depression underlying both sexes' BDI item-intercorrelation matrices. Although men and women had comparable dimensions with respect to weight loss, self-blame, and somatic-performance symptoms, men had affective and performance symptoms loading on the same factor, whereas women had affective and cognitive symptoms loading on the same dimension.