Cognitive and serotonergic vulnerability to depression: convergent findings

Cognitive reactivity (CR) is a psychological vulnerability marker of depression, whereas response to acute tryptophan depletion (ATD; a serotonergic challenge procedure) is a biological vulnerability marker. The aim of this study was to investigate the relationship between these markers. Thirty-nine remitted depressed patients participated in 2 ATD sessions in a double-blind crossover design. CR, assessed prior to the ATD sessions, predicted depressive response to high-dose ATD. CR also diminished the effects of 2 known predictors of ATD response: gender and residual symptoms. Neuroticism and behavioral inhibition were unrelated to ATD response. CR is associated with an increased sensitivity to reductions of serotonin concentrations. These findings present a small step toward unifying cognitive and neurobiological theories of depression.     

A 3-Year follow-up of aggressive and withdrawn behavior in childhood: Preliminary findings

The school placement of 122 aggressive, 150 withdrawn, 182 aggressive-withdrawn, and 299 control children was determined 3 years following their original selection. Children identified by peers as aggressive-withdrawn or aggressive were more likely to have failed a grade or to be in a special class than were withdrawn children or controls. Older aggressive-withdrawn subjects and controls, but not aggressive subjects or withdrawn subjects, had higher rates of school failure and special class placement. Fewer boys than girls were in a regular class at the expected grade level. The results underline the importance of childhood aggression as a predictor of later academic adjustment. Implications of these findings for the interpretation of measures of behavioral stability are discussed.The research reported here was supported by Quebec Ministry of Social Affairs Grant RS 281 to Jane Ledingham and Alex Schwartzman. The authors would like to thank the Commission des Ecoles Catholiques de Montréal for their continuing cooperation in this project, and Debbie Moskowitz and Alastair Younger for their constructive comments on an earlier draft.     

Depression in child psychiatric inpatients: Cognitive and attributional patterns

Cognitive and learned helplessness models of depression view maladaptive cognitive and attributional patterns as core features of depressive disorders. This study examined cognitive and attributional patterns in depressed children, nondepressed children, and a subgroup of remitting depressives who had histories of depression but were not reporting depressive symptoms when evaluated during the first 2 weeks of hospitalization. When compared with nondepressed controls, depressed children reported significantly more hopelessness, more negative self-perceptions, and negative self-perceptions across a wider variety of domains, and they displayed more dysfunctional attributional styles. While 55% of depressed children displayed pervasive maladaptive cognitive patterns, the other 45% of depressed children scored more similarly to nondepressed children, suggesting that childhood depressive disorders may be heterogeneous with respect to cognitive patterns. Contrary to the notion of traitlike depressive cognitive and attributional patterns that persist after the remission of depressive episodes, children with remitting depressions scored similarly to nondepressed children.Partial support for this project was provided by a grant from the John D. and Catherine T. MacArthur Foundation as part of their Network on Risk and Protective Factors in the Major Mental Disorders. I wish to thank Donald Guthrie for providing statistical consultation, Gwen Gordon for her computer assistance, and Niels Mueller and Jean Keller for their help with data collection.     

Cognitive behavior therapy for driving fear: A pilot randomized controlled trial

Fear of driving is common in clinical practice, while its treatment programs are understudied. This is the first randomized controlled trial to evaluate a newly developed protocol for cognitive behavior therapy (CBT) for driving fear compared with a wait list and to use specific assessment scales. 34 participants (30 women, 4 men) in an outpatient psychotherapy clinic were randomly allocated to either 18 sessions of CBT or a wait list (n = 17 each). After treatment, CBT was significantly more efficacious than the wait list with large effect sizes on the Instrument for Fear of Driving (IFD) (Cohen’s d = 2.58) and on the Driving Cognitions Questionnaire (DCQ) (Cohen’s d = 2.14). Driving fear is a condition treatable by CBT and the suggested protocol is safe, feasible and acceptable. Further studies with larger samples and active controls (e.g., virtual reality therapy) are required to draw generalizable conclusions on effect sizes.     

Cognitive behavior therapy with Internet addicts: treatment outcomes and implications.

Research over the last decade has identified Internet addiction as a new and often unrecognized clinical disorder that impact a user's ability to control online use to the extent that it can cause relational, occupational, and social problems. While much of the literature explores the psychological and social factors underlying Internet addiction, little if any empirical evidence exists that examines specific treatment outcomes to deal with this new client population. Researchers have suggested using cognitive behavioral therapy (CBT) as the treatment of choice for Internet addiction, and addiction recovery in general has utilized CBT as part of treatment planning. To investigate the efficacy of using CBT with Internet addicts, this study investigated 114 clients who suffered from Internet addiction and received CBT at the Center for Online Addiction. This study employed a survey research design, and outcome variables such as client motivation, online time management, improved social relationships, improved sexual functioning, engagement in offline activities, and ability to abstain from problematic applications were evaluated on the 3rd, 8th, and 12th sessions and over a 6-month follow-up. Results suggested that Caucasian, middle-aged males with at least a 4-year degree were most likely to suffer from some form of Internet addiction. Preliminary analyses indicated that most clients were able to manage their presenting complaints by the eighth session, and symptom management was sustained upon a 6-month follow-up. As the field of Internet addiction continues to grow, such outcome data will be useful in treatment planning with evidenced-based protocols unique to this emergent client population.     

Preliminary study of reminiscence therapy on depression and self-esteem in cancer patients

The present study investigated use of life review, a form of reminiscence, on the depression and self-esteem in cancer patients. 15 cancer patients in the experimental group participated in individual reminiscence therapy. 21 patients in the comparison group received no therapy. All patients were measured on both depression and self-esteem scales during two testing periods. Analysis showed mean depression scores of the cancer patients decreased and mean self-esteem increased significandy after the life-review therapy sessions, while the scores of the comparison group did not change. Furthermore, patients' psychological states were improved, and they thought their problems had been addressed. These results suggest reminiscence therapy can be useful for cancer patients.