Social problem-solving among adolescents treated for depression

Studies suggest that deficits in social problem-solving may be associated with increased risk of depression and suicidality in children and adolescents. It is unclear, however, which specific dimensions of social problem-solving are related to depression and suicidality among youth. Moreover, rational problem-solving strategies and problem-solving motivation may moderate or predict change in depression and suicidality among children and adolescents receiving treatment. The effect of social problem-solving on acute treatment outcomes were explored in a randomized controlled trial of 439 clinically depressed adolescents enrolled in the Treatment for Adolescents with Depression Study (TADS). Measures included the Children's Depression Rating Scale-Revised (CDRS-R), the Suicidal Ideation Questionnaire - Grades 7-9 (SIQ-Jr), and the Social Problem-Solving Inventory-Revised (SPSI-R). A random coefficients regression model was conducted to examine main and interaction effects of treatment and SPSI-R subscale scores on outcomes during the 12-week acute treatment stage. Negative problem orientation, positive problem orientation, and avoidant problem-solving style were non-specific predictors of depression severity. In terms of suicidality, avoidant problem-solving style and impulsiveness/carelessness style were predictors, whereas negative problem orientation and positive problem orientation were moderators of treatment outcome. Implications of these findings, limitations, and directions for future research are discussed.     

The social problem-solving abilities of people with borderline personality disorder

Interventions for people suffering from borderline personality disorder (BPD), such as dialectical behaviour therapy, often include a problem-solving component. However, there is an absence of published studies examining the problem-solving abilities of this client group. In this study, the social problem-solving (SPS) abilities of three groups of participants were assessed: a BPD group (n=25), a clinical control (CC) group (n=25) procedure and a non-clinical control (NCC) group (n=25). SPS ability was assessed using the means-end problem-solving (MEPS) procedure and the Social Problem-Solving Inventory-Revised (SPSI-R). The BPD group exhibited deficits in their SPS abilities, however the majority of these deficits were not specific to the BPD group but were also found in the CC group, indicating that a common factor between these two groups, such as negative affect, may account for these observed deficits. Specific SPS deficits were identified in the BPD group: they provided less specific solutions on the MEPS and reported higher levels of negative problem orientation and a more impulsive/carelessness style towards solving social problems. The results of this study provide empirical support for the use of problem-solving interventions with people suffering from BPD.     

Effects of cancer rehabilitation on problem-solving, anxiety and depression: a RCT comparing physical and cognitive-behavioural training versus physical training

We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in improvements in problem-solving (Social Problem-Solving Inventory-Revised (SPSI-R)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), and that more anxious and/or depressed participants would benefit most from adding CBT to PT. Cancer survivors (aged 48.8 ± 10.9 years, all cancer types, medical treatment completed) were randomly assigned to PT + CBT (n = 76) or PT (n = 71). Measurement occasions were: before and post-rehabilitation (12 weeks), 3- and 9-month follow-up. A non-randomised usual care comparison group (UCC) (n = 62) was measured at baseline and after 12 weeks. Longitudinal intention-to-treat analyses showed no differential pattern in change between PT + CBT and PT. Post-rehabilitation, participants in PT and PT + CBT reported within-group improvements in problem-solving (negative problem orientation; p < 0.01), anxiety (p < 0.001) and depression (p < 0.001), which were maintained at 3- and 9-month follow-up (p < 0.05). Compared with UCC post-rehabilitation, PT and PT + CBT only improved in anxiety (p < 0.05). CBT did not add to the effects of PT and had no extra benefits for higher distressed participants. PT was feasible and sufficient for durably reducing cancer survivors' anxiety.     

Depression and social problem solving.

Twenty depressed patients with major depressive disorder, 20 nondepressed matched control subjects, and 17 patients with anxiety disorders were compared in different measures of social problem solving. Problem solving was assessed with the Means-Ends Problem-Solving Test (Study 1), the solution of personal problems, and a problem-solving questionnaire (Study 2). Results showed that, as predicted, depressed subjects suffered from a deficit in problem solving in all three measures. The majority of these deficits were also displayed by the clinical control group rather than being specific to a diagnosis of depression. However, depressed subjects produced less effective solutions than did normal and clinical control subjects. The results suggest that depressed and anxious patients may have difficulties at different stages of the problem-solving process.     

Social problem-solving in depressed,conduct-disordered,and normal adolescents

Although past theory and research implicate social problem-solving deficits in both depression and aggressive disorders, research examining carefully diagnosed groups of adolescent depressed and conduct-disordered groups had not previously been conducted. In the current study three groups of adolescents (major depression, conduct-disordered, and normal) were studied using two social problem-solving measures. Both the Means-Ends Problem-Solving task (MEPS) and the Social Situations Analysis measure (SSA) failed to show social problem-solving problem deficits in the depressed group relative to their normal age peers, but did provide corroborative evidence for social problem-solving deficits in the conduct-disordered sample. Relative to the other two groups, the conduct-disordered adolescents were found to generate fewer means to a social end, to anticipate fewer obstacles in the pursuit of solutions to interpersonal situations, and to generate fewer assertive behavioral solutions to difficult social situations. The results are discussed in relation to other work with depressed and aggressive youth, and directions for future research are given.     

An expanded etiological model for suicide behavior in adolescents: Evidence for its specificity relative to depression

This study tests both the stress/social support and the stress/problem-solving etiological models for suicidality while controlling for depression. To this end, a depressed, high-suicide-ideating sample (N=68) was compared to a depressed, low-suicide-ideating sample (N=64). Hierarchical multiple regression analyses were used to test the unique contributions of stress, problem-solving orientation, problem-solving skills, and perceived level of social support in predicting level of suicidality. Hierarchical regression analyses were also used to test the interactive contributions of problem-solving × stress and social support × stress in predicting level of suicidality. Regression models were generated separately for men, women, and the entire sample using all factors. The results clearly support the importance of social support as an independent predictor of suicidality for men, women, and the entire sample. Ability to generate alternatives to identified problems predicted suicidality, but only for women and the entire sample. Problem-solving orientation was not uniquely predictive of suicidality and may affect suicidal behavior via its relationship to depression.     

Measuring social problem solving using the Spanish version for Hispanics of the Social Problem Solving Inventory-Revised

This study investigated the internal consistency, factor structure, and concurrent validity of the Social Problem Solving Inventory-Spanish Version for Hispanics (SPSI-R-Hispanic), a translation of the Social Problem Solving Inventory-Revised (SPSI-R; D'Zurilla, Nezu & Maydeu-Olivares, 2002), in a North American sample of 325 Spanish speaking Hispanics. The scales of the SPSI-R-Hispanic demonstrated good internal consistency reliability. The hypothesized factor model of the SPSI-R provided a good fit to the data. SPSI-R-Hispanic scores demonstrated concurrent validity in a multiple regression analysis, explaining 32% of incremental variability in psychological well-being scores. Gender differences were replicated, where men had higher positive problem orientation and rational problem solving scores and women had higher negative problem orientation scores.     

Wesleyan University Studies of Motion Sickness: V. Incidence of Sickness at Various Hours of the Day

Small groups lasting eight sessions each and aimed at improving patients' interpersonal problem-solving skills were conducted for a total of 41 hospitalized psychiatric patients. Forty control patients received the same pre and posttests but no training. Twenty-three patients participated in play-reading groups without problem-solving training (placebo condition). Three separate 3 by 2 repeated measures analyses of variance showed that hospitalization alone improved the patients' functioning on the criterion test of problem-solving, but that the problem-solving training groups advanced the improvement significantly. More disturbed patients made only slightly greater gains than less disturbed ones. The hospital stay was significantly shorter for the experimental and the placebo groups than for the control sample.     

Perfectionism,social problem-solving ability,and psychological distress

The present research examined the relation between dimensions of perfectionism and self-appraised problem-solving behaviors and attitudes. Specifically, in two separate studies, we tested the hypothesis that socially prescribed perfectionism (i.e., the perception that others demand perfection from the self) is associated with poorer social problem-solving ability. In addition, measures of psychological adjustment were included in Study 2 so that we could (1) examine whether socially prescribed perfectionism and poorer problem-solving ability were still associated after removing variance associated with psychological distress; and (2) compare depression and anxiety in terms of their respective associations with social problem-solving ability. Correlational analyses of the data from both studies confirmed that socially prescribed perfectionism is associated with more negative self-perceptions of problem-solving orientation, and that the link between socially prescribed perfectionism and negative perceptions of problem-solving orientation remains present after removing variance due to levels of negative affectivity. Both depression and anxiety were associated with a negative problem-solving orientation, but only depression was associated with more negative appraisals of actual problem-solving skills. The results suggest that perceived exposure to imposed standards of perfection undermines the problem-solving process and that individuals with high levels of socially prescribed perfectionism are particularly in need of counseling interventions designed to provide a more positive problem-solving orientation.This research was supported by grants #410-91-0856 and #410-93-1256 from the Social Sciences and Humanities Research Council of Canada. An earlier version of this paper was presented at the 1994 annual meeting of the Eastern Psychological Association in Providence, Rhode Island. The authors wish to thank Shawn Mosher for his assistance with the data collection.     

Gender and Sex Role Differences in Group Decision-Making Social Interactions: A Behavioral Analysis1

Sex role formulations assume relationships between role orientation and adjustive social behavior. However, few studies have examined behavioral differences with respect to both gender and sex role orientation in realistically complex social interactions. In the current study, groups composed of four male and four female “representatives” from each sex role category (masculine-typed, feminine-typed, androgynous, and undifferentiated) were presented with two group decision-making tasks. Group interactions were videotaped and subjects' behavior was rated on social skill variables. Analyses of variance revealed gender differences with males performing more actively than females, especially when the content of the decision-making task involved more historically male-oriented topics. However, when subjects' group behavior was examined in relation to their sex role orientation, androgynous and masculine-typed persons of both sexes performed in a more active, instrumental manner than feminine-typed or undifferentiated persons. Further, correlational analyses indicated that females' masculinity scores were substantially associated with ratings of effectiveness in the decision-making groups. Implications of these findings are discussed.     

Intrainformant agreement and family functioning in depressed and nondepressed parents and their children

Abstract

This investigation examined perceptions of family functioning, marital satisfaction, and parent-child bonding in 65 families (child, mother, father) with one or more depressed parents and 26 families with no depressed parent. Intrainformant agreement between offspring and their parents across family functioning measures was examined for the two proband groups. Results revealed more dysfunction in family adaptability, cohesiveness, and parent-child bonding and lower levels of marital satisfaction in the depressed as compared to the nondepressed proband group. Analyses of intrainformant data revealed no significant differences in levels of agreement between informants from the two proband groups for any of the raters. There was, however, significant agreement between informants in both proband groups. Thus, differential reports of family functioning are attributable to variations in perception of functioning, rather than to different levels of internal consistency in reporting across raters in depressed and nondepressed proband groups.     

The role of religious values in coping with cancer

The relationship between transcendent meaning attribution, religious orientation, and psychological well-being was studied in cancer and noncancer patients to test the hypotheses that intrinsic religious values and life meaning enhance coping and well-being during the course of the life-threatening illness. Subjects were 44 patients receiving medical treatment for cancer and noncancer medical conditions. In the cancer group, higher levels of attributed life meaning were positively linked with intrinsic religious orientation, and associated with lower levels of despiar, anger-hostility, and social isolation. Cancer patients scored higher than noncancer patients on depersonalization, suggesting the presence of psychic numbing in response to their illness. Noncancer group results were characterized by positive correlations between the two groups in coping styles and salience of life meaning attribution. A rationale for the observed differences in coping styles between the two groups is presented, highlighting perceived life threat as a key differentiating variable.     

Autobiographical Memory Retrieval and Problem-Solving Deficits of Iranian Depressed Patients Attempting Suicide

The underlying hypothesis was that suicide attempters tend to retrieve overgeneral autobiographical memories, with a considerable latency. Two cognitive measures (Autobiographical Memory Test and Means-Ends Problem-Solving Task, Persian versions) were used to assess 20 suicide patients who met DSM-IV criteria for depression, in comparison with a matched control group. The results showed that the suicide attempters produced more overgeneral memories and responded more slowly to positive than negative cue words, compared to the control participants. In the problem-solving task, the depressed patients evidenced less effective strategies, fewer and more irrelevant means, and took longer to respond to the task than the matched healthy participants. Moreover, there were significant correlations between autobiographical memory and problem-solving variables.     

Relation between social problem-solving ability and subsequent level of psychological stress in college students.

A prospective design was used to examine the relation between social problem-solving ability and later psychological stress in college students during the first semester of the academic year. A new social problem-solving inventory measured not only general ability, but also more specific components of the problem-solving process (e.g., problem orientation, problem-solving skills; D'Zurilla & Nezu, 1990). The results of a hierarchical multiple regression analysis showed that general problem-solving ability was negatively related to later stress, even after prior stress level and number of life problems were controlled. More specific analyses indicated that subjects' problem orientation was a better predictor of stress than their problem-solving skills. Results are discussed in terms of the possible stress-reducing effects of perceived control and successful problem resolution.     

Social problem solving: A moderator of the relation between negative life stress and depression symptoms in children

The social problem-solving skill of generating effective alternative solutions was tested as a moderator of the relation between negative life stress and depressed mood in children. Boys ( n= 25) and girls ( n= 25), ages 8 to 12 years, from inner-city, lower socioeconomic group families, completed measures of depression symptoms, negative impact of life events, and quantity and effectiveness of alternative solutions to social problems. Results indicated that the effectiveness of alternative solutions children generate in response to peer social problems moderates the relation between stress and depression. Children who experienced a high impact of negative life events, with less effective social problem-solving skills, reported higher levels of depression compared to children who experienced a high impact of negative life events but exhibited more effective social problem-solving skills. Results are discussed in terms of alternative theoretical models for the mechanisms whereby effective social problem-solving skills moderate stress-related depression.     

The Effects of Exploration on Preschoolers' Problem-Solving Ability

Specific contributions of exploration for divergent and convergent problem-solving ability in preschool children were investigated. Participants were identified as players or nonplayers based on naturalistic observations of free-play activities, and were assigned to either an exploration or nonexploration control condition prior to administration of two divergent and two convergent problem-solving tasks. No significant differences were found between the exploration and nonexploration groups on either divergent or convergent problem-solving tasks. Subjects in the exploration group, however, spent significantly less time in the related convergent problem-solving task than in the nonrelated convergent task. The player/nonplayer distinction was also nonsignificant.     

Relationship between two different measurements of field-dependence and athletic performance of adolescents

Two different measures were used to test field dependence-independence, Group Hidden Figures Test and Portable Rod and Frame Test. The purpose of the study was to compare the advantages of these two measures in differentiating among adolescents who are active in individual and team sports and those who are not. 94 adolescent boys and girls were divided into three groups, as follows: 33 in individual sports, 31 in team sports, and 30 nonathletes. No correlation was found between the two measures. The Portable Rod and Frame Test was the better instrument for distinguishing among the groups. This test requires use of visual vs proprioceptive information to perceive the body's spatial orientation. The Group Hidden Figures Test requires more analytical intelligence. Since there are relationships among awareness of the body, spatial orientation, and physical activity of athletes, the Portable Rod and Frame Test seems to be more applicable to the task of distinguishing between and among athletes and nonathletes.     

Psychometric properties of the Social Problem Solving Inventory (SPSI) with normal and emotionally disturbed adolescents

The factor structure of the Social Problem Solving Inventory (SPSI; D'Zurilla & Nezu, 1990) was evaluated with a sample of 708 normal adolescents. Confirmatory factor analysis supported the empirically derived five-factor model reported by D'Zurilla and Maydeu-Olivares (1994) using an adult sample, but not the theoretically derived seven-factor structure of the original SPSI. The psychometric properties of the original and revised inventories are reported for normal adolescents and psychiatrically hospitalized adolescents (n=63). Internal consistency and reliability estimates were adequate. Support for the validity of the revised SPSI was demonstrated by examining the relationship between social skills, depression, and social problem solving; in addition, differences between normal and inpatient adolescent samples were examined. The findings are discussed in terms of the utility of the inventories with adolescents.     

Treating boys with low school achievement and behavior problems: comparison of two kinds of intervention

Children with low school achievement frequently have behavior problems and interpersonal difficulties that pose a risk for psychosocial maladjustment. 39 boys were assessed and randomly assigned to one of two group treatment conditions: (a) interpersonal cognitive problem-solving for whom training was provided through oral and written language activities that met children's social and academic needs and (b) a language workshop, during which only academic difficulties were treated. Parents of children in both groups received group attention. Posttreatment assessments indicated that boys in both conditions showed significant improvements on school achievement and behavior problems, as they were measured by behavior scales reported by mothers and by an academic achievement test. Children in the problem-solving group improved significantly more than the other group on most measures. These results suggest that work with interpersonal cognitive problem-solving skills combined with reading and writing activities is a useful means to produce improvements in child behavior and school achievement.