Major depression,chronic minor depression,and the five‐factor model of personality

Fifty‐eight outpatients with major depression completed the NEO Personality Inventory at intake (time 1) and after up to three months of anti‐depressant treatment (time 2). Within this group, 26 patients met additional Research Diagnostic Criteria for chronic minor depression. Repeated‐measures analyses revealed significant decreases in Neuroticism scores, and significant increases in Extraversion and Conscientiousness scores, from time 1 to time 2 for both patient groups. In addition, despite similar symptom severity at time 2, the patients with major depression+chronic minor depression scored significantly higher on the Angry Hostility facet of Neuroticism and significantly lower on Agreeableness than those with major depression alone. We suggest from these findings that Angry Hostility and low Agreeableness may represent a trait vulnerability in individuals with chronic minor depression that persists even following remission of the major depressive state, and that this may help to explain their high rates of relapse and recurrence. Copyright © 2002 John Wiley & Sons, Ltd.     

Optimism, self-mastery, and symptoms of depression in women professionals

The construct validity and predictive utility of dispositional optimism were examined in a sample of 192 women professionals. By using covariance structure modeling with latent variables, opotimism (Scheier & Carver, 1985) and self-mastery (Pearlin & Schooler, 1978) were found to be empirically distinct, although substantially correlated, constructs. Furthermore, although optimism and self-mastery were significant and negatively correlated with symptoms of depression, only self-mastery was independently associated with symptom levels. In addition, no evidence was found that optimism and self-mastery interact to influence depressive symptoms. These results suggest that the apparent predictive power of optimism may derive from its substantial overlap with self-mastery. Implications for the assessment and interpretation of optimism and self-mastery are discussed.     

Self-mutilation and symptoms of depression, anxiety, and borderline personality disorder

The goal of this study was to examine the relationship between self-mutilation and symptoms of depression and anxiety in a nonclinical population. Self-mutilators reported significantly more symptoms of depression and anxiety than did the control group. When the group of self-mutilators was divided into individuals who cut themselves and individuals who harm themselves in other ways, we found that the between-group differences were primarily due to individuals with a history of cutting. Yet when symptoms of borderline personality disorder (BPD) were statistically controlled, all significant between-group differences in depressive and anxious symptoms were reduced to nonsignificant. These findings highlight the importance of assessing symptoms of BPD in self-mutilators, regardless of diagnosis.     

The nature of clinical depression: symptoms, syndromes, and behavior analysis

In this article we discuss the traditional behavioral models of depression and some of the challenges analyzing a phenomenon with such complex and varied features. We present the traditional model and suggest that it does not capture the complexity of the phenomenon, nor do syndromal models of depression that dominate the mainstream conceptualization of depression. Instead, we emphasize ideographic analysis and present depression as a maladaptive dysregulation of an ultimately adaptive elicited emotional response. We emphasize environmental factors, specifically aversive control and private verbal events, in terms of relational frame theory, that may transform an adaptive response into a maladaptive disorder. We consider the role of negative thought processes and rumination, common and debilitating aspects of depression that have traditionally been neglected by behavior analysts.     

The association between stress,self‐esteem and depressive symptoms in adolescents

This cross‐sectional study investigated gender and age differences on domains of stress, self‐esteem and depressive symptoms, as well as the association between those domains using a sample of Norwegian adolescents (N = 1,239). The data was analysed using Pearson product moment correlation, t‐tests, and hierarchical multiple regression analyses. The results showed significant differences between genders. Girls scored higher on five of seven stressor domains comprising peer pressure, home life, school attendance, school/leisure conflict and school performance as well as depression, while boys scored significantly higher on self‐esteem. The hierarchical multiple regression analysis showed that higher stress from school performance and school attendance related significantly to more depressive symptoms in both genders. Additionally, stress of home life significantly related to more depressive symptoms in girls, whereas stress of peer pressure was significant in association with depressive symptoms in boys. A strong, inverse association was found between self‐esteem and depression controlled for stress, especially in girls. Self‐esteem was not found to be a moderator of any stressor‐depression interactions. In conclusion, the results give support for the significant role of stress and self‐esteem on the experience of depressive symptoms in adolescents.     

Group prevention of depression and anxiety symptoms

To prevent depression and anxiety, we delivered a brief, classroom-based cognitive-behavioral workshop along with ongoing Web-based materials and e-mail coaching to college students at risk for depression. At risk was defined as having mild to moderate depressive symptoms on a self-report measure of depression. Two hundred forty students were randomized into either an eight-week workshop that met in groups of 10, once per week for 2 h or into an assessment-only control group. We plan to track participants for 3 years after the workshop and here we report the 6 month preventive effects on depression and anxiety. The workshop group had significantly fewer depressive symptoms and anxiety symptoms than the control group, but there was no significant difference between the conditions on depression or anxiety episodes at 6 month follow up. The workshop group had significantly better well being than the control group, and the workshop group had significantly greater improvement in optimistic explanatory style than the control group. Improved explanatory style was a significant mediator of the prevention effects from pre- to post-workshop for depressive and anxiety symptoms, as well as for improved well being.     

Ambivalent sexism,attitudes towards menstruation and menstrual cycle‐related symptoms

The objective of the present study was to investigate the relationship between ambivalent sexism and beliefs and attitudes towards menstruation, and, in turn, to study the influence of these variables on menstrual cycle‐related symptoms. One hundred and six Mexican women completed the Ambivalent Sexism Inventory, the Beliefs about and Attitudes toward Menstruation Questionnaire and the Menstrual Distress Questionnaire. The higher scores on benevolent sexism were associated with the most positive attitudes towards menstruation and also with the belief that a menstruating woman should or should not do some activities and that menstruation keeps women from their daily activities. The higher scores on hostile sexism were associated with rejection of menstruation as well as with feelings of embarrassment about it. Beliefs about and attitudes towards menstruation predicted menstrual cycle‐related symptoms related to negative affect, impaired concentration and behavioural changes, but did not predict somatic symptoms. These results will be useful to health professionals and advocates who want to change the negative expectations and stereotypes of premenstrual and menstrual women and reduce the sexism and negative attitudes towards women that are evident in Mexican culture.     

The influence of depression symptoms on exploratory decision-making

People with symptoms of depression show impairments in decision-making. One explanation is that they have difficulty maintaining rich representations of the task environment. We test this hypothesis in the context of exploratory choice. We analyze depressive and non-depressive participants’ exploration strategies by comparing their choices to two computational models: (1) an “Ideal Actor” model that reflectively updates beliefs and plans ahead, employing a rich representation of the environment and (2) a “Naïve Reinforcement Learning” (RL) model that updates beliefs reflexively utilizing a minimal task representation. Relative to non-depressive participants, we find that depressive participants’ choices are better described by the simple RL model. Further, depressive participants were more exploratory than non-depressives in their decision-making. Depressive symptoms appear to influence basic mechanisms supporting choice behavior by reducing use of rich task representations and hindering performance during exploratory decision-making.     

On the links between self-discrepancies, rumination, metacognitions, and symptoms of depression in undergraduates

The present study aimed to test the central components of Papageorgiou and Wells' (2003) non-clinical metacognitive model of rumination and depression that is grounded on the Self-Regulatory Executive Function (S-REF) model of emotional disorders [Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove, UK: Lawrence Erlbaum.]. A second aim of this study was to extend the non-clinical model with the concept of self-discrepancy in line with the S-REF model. Data of the current study were collected in a large sample of non-clinical Dutch undergraduates (N=196), who completed a battery of questionnaires including measures of rumination, positive and negative metacognitions, depressive symptoms, and self-discrepancy (i.e., actual-ideal, actual-ought, and actual-feared discrepancies). Hypothesized relationships among these variables were tested by means of structural equation modelling. Following some theoretically consistent modifications, the model was an adequate fit to the data. With respect to the second aim of the study, self-discrepancies were directly linked to symptoms of depression as well as indirectly via the cognitive processes involved in the metacognitive model of rumination and depression. Evidence was found for positive beliefs about rumination to partially mediate the relation between self-discrepancy and rumination. Clinical implications of the findings, including implementation of a metacognitive-focused cognitive therapy of depression, and suggestions for future research are discussed.     

Cognitive influences on perceived change in social support,motivation, and symptoms of depression

In settings ranging from informal conversation to medical interviews and surveys, people are often asked to judge changes in subjective states that are important to them, such as perceived social support, motivation to cope with a negative life event, and symptoms of depression. How accurate are such reports, and are there theories of cognitive processes that can predict the most likely types of misperception? To address these questions, self-report survey data were collected from 224 recently unemployed adults. The measures assessed current subjective states of self and social environment at two times, separated by 4 months. Among the results, persons with high self-esteem were particularly likely to underestimate changes for the worse between the two survey waves–evidence of an optimistic response bias. When the dimension being judged was unstable and ambiguous, people were more likely to overestimate improvement–evidence of an optimistic response style. The findings were evaluated in terms of alternate theories of cognitive bias and in terms of implications for subsequent studies and application.     

Online self‐help: Developing a student‐focused website for depression

Many depressed people, young men in particular, do not seek professional help. This social constructionist action research project aimed to construct a comprehensive self‐help website for students. Its goal was to give a multi‐layered (‘thick’) account of depression to website users offering empowering perspectives and strategies while challenging barriers to help‐seeking. Thirteen student interviewees, representing diverse demographics and depression experiences, attended semi‐structured interviews to elicit ‘coping’ narratives. Ten of them then formed an ongoing e‐mail focus group. An evaluative action research spiral was used to analyse and act upon public health guidelines, student interviews and student focus group commentary. Triangulation was provided via the specifications and ongoing feedback from the other project stakeholders. These were the funding charity steering group (including heads of university counselling services); the university providing programme/ethical approval; and the expert group offering clinical validation. The final site at www.studentdepression.org has nearly 100 pages of information and self‐help resources cross‐referenced with personal narratives. It provides a rich, complex account of how depression may be tackled and resisted. Both student and expert groups were impressed with final site quality and usefulness. Collaborative development with user‐group representatives is likely to have produced a far richer, more accessible and more comprehensive resource than counsellor authorship alone. 1 ¹Formerly at the Counselling Service, Royal Holloway University of London, UK.
     

Burnout‐depression overlap: Nomological network examination and factor‐analytic approach

Burnout has been defined as a condition in which individuals are left exhausted by a long‐term confrontation with unmanageable job stressors. The question of whether burnout reflects anything other than depressive responses to unresolvable stress remains an object of debate. In this 911‐participant study (83% female; mean age: 42.36), we further addressed the issue of burnout‐depression overlap. Burnout was assessed with the exhaustion subscale of the Maslach Burnout Inventory‐General Survey (MBI ‐GS ) and depression with the PHQ ‐8. The relationships of burnout and depression with three job‐related variables – illegitimate work tasks, work‐nonwork interference, and job satisfaction – and three “context‐free” variables – social support, general health status, and trait anxiety – were examined. Burnout and depression were found to be strongly correlated, to cluster together, and to exhibit overlapping nomological networks. Remarkably, the average correlations of burnout and depression with job‐related variables were almost identical. A principal component analysis and a principal axis factor analysis both showed that the items of the MBI ‐GS and of the PHQ ‐8 loaded on a single dimension. All in all, our findings are consistent with the view that burnout is a depressive condition. The distinction between burnout and depression may be an instance of the jangle fallacy.     

Social problem‐solving,perceived stress,depression and life‐satisfaction in patients suffering from tension type and migraine headaches

This study aimed at investigating social problem solving, perceived stress, depression, and life‐satisfaction in patients with tension type and migraine headaches. Forty‐nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self‐report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T‐tests, chi‐square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life‐satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life‐satisfaction in patients suffering from primary headache.     

A comparison of two online cognitive‐behavioural interventions for symptoms of depression in a student population: The role of therapist responsiveness

Objectives: The study aimed to compare the efficacy of eight weekly sessions of a self‐administered online CBT treatment (cCBT; n=51) to a therapist‐assisted email CBT treatment (eCBT; n=50) in University students. Design: The design was a randomised parallel group trial. The study randomised participants with symptoms of depression to one of two available treatments. Method: Participants were offered eight weekly sessions of either cCBT or eCBT. Participants completed the Beck Depression Inventory‐II (BDI‐II) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) at pre‐and post‐treatment, at weeks 16 and 32 follow‐up. The Working Alliance Inventory‐Short Form (WAI‐SR) was completed at weeks 2, 4, and 6. Results: For both groups, pre‐post within group effect sizes reported were large for the BDI‐II and the CORE‐OM and these were maintained at follow‐up. Perceptions of working alliance were similar in each group, but Bond was significantly stronger for the eCBT condition. WAI scores correlated more positively with the outcome on BDI‐II for those in the eCBT condition than the cCBT condition, but not significantly. Conclusion: There were no significant differences between the two online treatments, both reduced depressive symptoms and improved general functioning. Similarly, at post‐treatment and follow‐up, clinical improvement and recovery was demonstrated for both groups equally. The study demonstrates the possibility for cCBT in a university setting that may contribute to addressing the shortcomings in meeting increasing demands that mental health services presently face.     

The association of anxiety,depression, and worry symptoms on cognitive performance in older adults

Emerging research suggests that a relationship exists between the cognitive aspects of anxiety (e.g. worry) and cognitive decline in older adults. The current study examined the association between anxiety, depressive, and worry symptoms on cognitive performance. Participants were 156 older adults enrolled in the Nathan Kline Institute-Rockland Sample Study (NKI-RS). Hierarchical linear regression analysis was used to determine the unique associations of anxiety, depressive, and worry symptoms on cognitive performance as measured by the Penn Computerized Neurocognitive Battery (Penn CNB), the Delis-Kaplan Executive Function System (D-KEFS), and the Rey Auditory Verbal Learning Test (RAVLT). Worry symptoms were a significant predictor of Penn CNB social cognition, complex cognition, executive function, and episodic memory performance as well as RAVLT immediate and short-delay recall, but not of D-KEFS performance or RAVLT long-delay recall. In contrast, anxiety and depressive symptoms had few unique associations with cognitive performance. Given that worry symptoms have a negative impact on many aspects of neurocognitive performance, they may have utility in predicting and preventing cognitive decline in older adults.     

The relationships among gratitude,self‐esteem,depression, and suicidal ideation among undergraduate students

The main purpose of this study was to examine the relationships among gratitude, self‐esteem, depression, and suicidal ideation. In total, 814 undergraduate participants (259 males and 555 females with mean age of 20.13 years) completed four inventories measuring the variables of interest. Analyses of structural equation modeling found that gratitude had direct effects on individuals' self‐esteem, depression, and suicidal ideation. In addition, gratitude had indirect effects on individuals' suicidal ideation via self‐esteem and depression, and self‐esteem had direct effects on individuals' depression. These results support the proposed model of suicidal ideation and contribute to the understanding of how gratitude influences individuals' suicidal ideation via psychological and physical variables.     

Insomnia in relation to depression and somatic symptoms

A sample of 358 Kuwaiti volunteer college students responded to the Insomnia Scale, the Somatic Symptoms Inventory, and the Center for Epidemiologic Studies-Depression Scale. The only significant sex difference was in somatic symptoms on which women had a higher mean score than the men. Correlations between scores on the Insomnia Scale and both Depression scales were .51 and .54 and for Somatic Symptoms were .53 and .61 (p < .01) among men and women, respectively. The factor analysis of the intercorrelations yielded a highly loaded general factor for Psychological Disorder in both samples.