Chronic stress and depressive disorders in older adults

Current and lifetime rates of Diagnostic and Statistical Manual (rev. 3rd ed.) disorders were compared in 86 older adults caring for a spouse with a progressive dementia and 86 sociodemographically matched control subjects. Dementia caregivers were significantly more dysphoric than non-care givers. The frequencies of depressive disorders did not differ between groups in the years before care giving, and there were no group differences in first-degree relatives' incidence of psychiatric disorder. During the years they had been providing care, 30% of care givers experienced a depressive disorder (major depression, dysthymia, or depression not otherwise specified) versus 1% of their matched controls in the same time period. Only two care givers who met criteria during care giving had met criteria for a depressive disorder before care giving, and family history was not even weakly related to the identification of at-risk care givers. In contrast to these group differences in depressive disorders, there were no significant differences in other Axis I disorders either before or during care giving. Thus, the chronic strains of care giving appear to be linked to the onset of depressive disorders in older adults with no prior evidence of vulnerability.     

Chronic stress,acute stress,and depressive symptoms

Although life events continue to be the major focus of stress research, recent studies suggest that chronic stress should be a more central focus. An evaluation of this issue is presented using data from a large community survey of married men (n = 819) and women (n = 936). Results show that chronic stresses are more strongly related to depressive symptoms than acute stresses in all but one life domain. The interaction patterns exhibited by chronic and acute stresses are predominantly associated with lower levels of depression than those predicted by a main effects model. This pattern suggests that chronic stresses may reduce the emotional effects of acute stresses. Although the processes through which this effect occurs are not clear, it is suggested that anticipation and reappraisal reduce the stressfulness of an event by making its meaning more benign. Implications for future research on chronic and acute stress effects are discussed.     

Chronic financial strain, social support, and depressive symptoms among older adults

The purpose of this study is twofold: one, to determine whether chronic financial strain is related to depressive symptoms among a random community sample of older adults, and two, to assess whether social support counterbalances or buffers the deleterious effects of financial strain. The findings suggest that elderly people suffering from financial strain are more likely to be depressed than are older adults with fewer financial problems. In addition, the data support the stress-buffering hypothesis, that is, that older people who have more informational support and who provide support to others, more often report fewer symptoms of depression as a result of financial strain than do elderly respondents who have less informational support and who do not provide support to others. Tangible and emotional support are found to be less effective coping resources when financial strain is present.     

Perceptions and possibilities

Not only do black students need assistance in solving the problems that are peculiar to them, but so do the school personnel with whom they come in daily contact. Counselors must realize how influential they are in helping youth form images of themselves and attitudes about their world. These students need help in channeling their energies toward constructive ends and in developing positive outlooks about life.     

Paradigms and possibilities

This paper is a excursus into a philosophy of science for deployment in the study of sport. It argues for the virtues of Thomas Kuhn's account of the philosophy of science, an argument conducted strategically by contrasting that account with one derived from views of Karl Popper. In particular, it stresses, first, that Kuhn's views have been widely misunderstood; second, that a rectified Kuhnianism can give due weight to truth in science, while recognising that social sciences differ in crucial ways from natural sciences. For, as Kuhn recognised, social sciences do not function in the paradigm-relative way characteristic of natural sciences. Yet there Kuhn's jargon, and especially misguided talk of ‘paradigms’, is almost ubiquitous.

These thoughts have relevance for three groups. First, as both sports scientists and exercise scientists come to grips with the claims to scientificity of their work, they will need increasingly to locate it within an epistemological framework provided by philosophy of science. So they must begin to take Kuhn's view seriously. Second, social scientists of sport – faced with the predominant scientism of colleagues in sport and exercise science – must also recognise alternatives to a postmodernist rejection of the concept of truth, where Kuhn's picture of natural science clarifies one such. Finally, philosophers writing on sport must not let antipathy to scientism close off the options they present or the terms in which they (we!) present them. And that may require debate among ourselves on abstract issues not immediately connected with sport.     

Ultimacy and alternative possibilities

I explore a key feature of Robert Kane’s libertarianism (about which I have been puzzled for some time). Kane claims that we should separate issues of alternative possibilities from issues of ultimacy, but he further argues that they are connected in a certain way. I call into question this connection, and I continue to argue for a strict separation of considerations pertaining to alternative possibilities and “actual-sequence” considerations.

Relevant possibilities

There are a number of relevant alternatives accounts of knowledge in the literature, including those by contextualists (like Lewis and Cohen), and invariantists (like Dretske). Despite widespread discussion of such views, an explication of the notion of relevance is conspicuously absent from the literature. Without a careful explication of that notion, relevant alternatives accounts resist evaluation. This paper attempts to aid in the evaluation of those accounts, by providing an account of relevance. The account rejects two common presuppositions about the notion of relevance. The account holds that worlds, rather than alternatives, are relevant, and that distant worlds can be relevant. Relevant worlds turn out to be those worlds at which an alternative to one’s belief obtains, and is such that one’s epistemic position (with respect to what one believes at the actual world) is worse than it is at the actual world.     

Alternative possibilities and asymmetry

It has often been noted that many of our intuitive assessments of particular actions suggest that there is an asymmetry between blameworthy and praiseworthy actions with regard to the question of whether moral responsibility requires that the agent could have acted otherwise. It is a quite different question, though, whether such an asymmetry between good and bad cases can be supported by more systematic considerations. In this paper, I will develop a new argument for a restricted version of the asymmetry, by showing that in cases of praiseworthy actions responsibility cannot generally presuppose that the agent could have acted otherwise. This argument will be based on a distinction between two different kinds of roles that moral norms can play in determining whether an action is right and in guiding our deliberation. That agents can sometimes be responsible for their praiseworthy actions even though they cannot act otherwise is best seen as a reflection of the fact that moral norms can prohibit treating certain courses of action as genuine options at all.

     

Comorbid social anxiety disorder in clients with depressive disorders: predicting changes in depressive symptoms, therapeutic relationships, and focus of attention in group treatment

The current study examined whether depressed outpatients with comorbid SAD respond differently to a cognitive-behavioral group intervention and if so, how and why. Using growth curve modeling, we found evidence that depressed clients with comorbid SAD had rapid improvement in depressive symptoms over the course of treatment and generally did not differ from those without comorbidity in developing close therapeutic relationships and modifying the direction of attentional focus away from the self. Non-linear effects demonstrated that rates of change in depressive symptoms, relationship variables, and focus of attention, were most rapid early in treatment. In contrast to hypotheses, trajectories of change in therapeutic relationships and attentional focus did not mediate the effect of SAD on treatment improvement in depressive symptoms. These findings suggest that comorbid SAD does not have a detrimental effect on the course of depression treatment and group-based treatments can be as beneficial for depressed individuals with comorbid SAD. It may be that group-based treatments for depression provide explicit opportunity for emotional processing in social situations (i.e., exposure) and hence mimic efficacious therapies for SAD.     

Generating possibilities

Our knowledge of the most basic alternative possibilities can be thought of as generated recursively from what we know about the actual world. But what are the generating principles? According to one view, they are recombinational: roughly, alternative possibilities are generated by “patching together” parts of distinct worlds or “blotting out” parts of worlds to yield new worlds. I argue that this view is inadequate. It is difficult to state in a way that is true and non-trivial, and anyway fails to account for our knowledge that there might have been other things, properties, relations, and combinations of these than there actually are. I sketch and defend an alternative view based on the distinction between determinable and determinate properties: roughly, alternative possibilities are generated by “intra-determinable” variation, variation from one determinate to another of the same determinable.     

Hedonic possibilities and heritability statistics

Several influential psychologists have attempted to estimate to what extent human happiness levels are directly controlled by genes by comparing the happiness levels of identical twins raised apart. If we discover that the happiness levels of identical twins raised apart tend to be closer than the happiness levels of fraternal twins raised apart, this is taken as evidence that average happiness levels are largely controlled by genes. However, if it turns out that identical twins' happiness levels tend to be substantially different, as different as fraternal twins raised apart, it has been argued that this implies that the environment largely determines happiness levels. I contend that this interpretation of the data rests on a set of questionable, closely related assumptions: a) that pairs of identical twins raised apart are raised in substantially different environments; b) that genetically identical twins aren't identical in other pertinent ways; and c) that average levels of affect that are correlated with certain sets of genes in the environments the twin studies were conducted in will be correlated with those genes in other relevant environments because those genes govern average affect levels. In this paper, I will show that these assumptions are false and explain how to properly go about investigating the contingent causal links between genes and happiness. In the end, I argue that there is no good evidence that our genes delimit our hedonic potential and that the fact that this misinterpretation of the data has been widely disseminated is potentially harmful to human well-being.     

Aristotle's different possibilities

Marxism is often claimed to be incompatible with any kind of ethical theory, because of its assumptions of economic determinism, of the class character of morals, and of the subordination of morality to politics. But the author proposes that these assumptions can be interpreted in such a flexible way as not to rule out the freedom of choice and responsibility, die relative independence of morals from economic conditions and political ends, and concepts of universal human value and a specifically moral ideal. A humanist philosophy, centered in Marx's analysis of alienation, provides a sufficiently rich theoretical basis for the solution of both ethical and meta‐ethical’ problems.     

Omissions as possibilities

I present and develop the view that omissions are de re possibilities of actual events. Omissions do not literally fail to occur; rather, they possibly occur. An omission is a tripartite metaphysical entity composed of an actual event, a possible event, and a contextually specified counterpart relation between them. This view resolves ontological, causal, and semantic puzzles about omissions, and also accounts for important data about moral responsibility for outcomes resulting from omissions.