Dimensions of Oppositional Defiant Disorder in Young Children: Heterotypic Continuity with Anxiety and Depression

There are distinct dimensions of Oppositional Defiant Disorder (ODD) that have been associated with symptoms of other disorders (heterotypic continuity). The present study compared the heterotypic continuity of a two-factor (Pitt-2) model and the three-factor model incorporated into DSM-5 with symptoms of anxiety and depression. Participants were a diverse community sample of 796 children (38.8 % minority, 49.1 % boys) assessed at ages 4, 5 and 6 years. Symptoms were assessed with the dimensional scales of the Diagnostic Interview Schedule for Children-Young Child version and the Child Symptom Inventory. Dimensions of both the two- and three-factor DSM-5 models were associated with later symptoms of anxiety and depression. The association, however, was weak when accounting for initial levels of internalizing symptoms: thus there was little evidence for the unique contributions of ODD dimensions to symptoms of subsequent internalizing disorders for either model.     

Depression and God: The Effects of Major Depressive Disorder on Theology and Religious Identity

Major depressive disorder (MDD) has deep roots in brain function. Recent physiological research ties brain areas involved with depression to areas that process emotions. Among the research surveyed, a link was found between the activity levels of the prefrontal cortex (PFC), the orbitofrontal cortex (OFC), and parts of the anterior cingulate cortex (ACC). These links prove to be useful in understanding how an individual might have problems processing emotional experiences. This relates directly to how a person interacts in a religious environment. Religious leaders should share the physicians’ mantra of primum non nocere, which means “first, do no harm.” Skewed views of God can emerge from "gaps in understanding" related to topics such as sin, substance abuse, divine intimacy, and end-of-life questions.     

Behavioral Activation for a Breast Cancer Patient with Major Depression and Coexistent Personality Disorder

Behavioral activation is an empirically validated treatment for depression, with recent applications toward other psychological and medical conditions. However, modification to the treatment protocol may be necessary when symptoms, environment, or personality necessitate. This feasibility study applied Behavioral Activation Treatment for Depression (BATD) in a case of a woman with recurrent major depression and obsessive–compulsive personality disorder (OCPD) undergoing breast cancer treatment. A quasi-experimental design was used, comparing supportive psychotherapy (while she received radiation therapy) followed by eight sessions of BATD. Treatment was designed in accordance with patient and therapist goals of increasing exercise, decreasing fatigue, and reducing interference due to perfectionistic behaviors. The patient exhibited resistance to initiation of BATD, related to symptoms of OCPD, which necessitated modification of treatment strategies and scheduling. Following BATD, the patient reported a significant reduction in depressive symptoms, physical problems, and role limitations—gains not observed following supportive therapy. In addition, she demonstrated less psychological rigidity and interference due to OCPD symptoms within the therapeutic relationship and other interpersonal relationships. Consistent with previous research, results indicate BATD may effectively treat individuals with complex clinical presentations that include personality disorder pathology. In addition, methods of modification to BATD are discussed, as well as future directions for research in this area.     

Suicidal Ideation, Depression, and Conduct Disorder in a Sample of Adolescent and Young Adult Twins

The co-occurrence of suicidal ideation, depression, and conduct disturbance is likely explained in part by correlated genetic and environmental risk factors. Little is known about the specific nature of these associations. Structured interviews on 2,814 twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and Young Adult Follow-Up (YAFU) yielded data on symptoms of depression, conduct disorder, and adolescent and young adult suicidal ideation. Univariate analyses revealed that the familial aggregation for each trait was explained by a combination of additive genetic and shared environmental effects. Suicidal ideation in adolescence was explained in part by genetic influences, but predominantly accounted for by environmental factors. A mixture of genetic and shared environmental influences explained ideation occurring in young adulthood. Multivariate analyses revealed that there are genetic and shared environmental effects common to suicidal ideation, depression, and conduct disorder. The association between adolescent suicidal ideation and CD was attributable to the same genetic and environmental risk factors for depression. These findings underscore that prevention and intervention strategies should reflect the different underlying mechanisms involving depression and conduct disorder to assist in identifying adolescents at suicidal risk.     

Dimensions of Perfectionism and Self-worth Contingencies in Depression

The current study investigated the role of contingent self-worth in perfectionism and depression. It was hypothesized that perfectionism is associated with depression because perfectionists base their self-worth on being successful and on the need to be actively working toward their goals. A sample of 170 female university students completed measures of conditional self-worth, perfectionism traits, perfectionism cognitions, and depressive symptoms. Structural equation modeling revealed that a factor interpreted as Evaluative Concerns Perfectionism was associated strongly with contingent self-worth, which was, in turn, related to depressive symptomatology. In addition, contingent self-worth mediated the association between perfectionism cognitions and depression. Other analyses revealed that measures of self-oriented perfectionism that are often viewed as highly similar actually differed in terms of their associations with contingent self-worth. The theoretical and practical implications of the associations between perfectionism and contingent self-worth are discussed.     

抑郁和焦虑与心律失常

焦虑抑郁广泛存在于各种心血管疾病中已成共识。心律失常患者合并心理问题在临床上十分常见,焦虑抑郁导致的自主神经对心脏的调节失衡会进一步促使心律失常的发生与发展。对于非器质性心脏病,β受体阻滞剂与抗焦虑药物合用有很好的疗效;器质性心脏病患者并发心律失常时患者的焦虑抑郁会进一步加重,甚至导致恶性室性心律失常的发生,增加器质性心脏病患者的病死率;心律失常介入治疗引起的焦虑抑郁更为常见。临床上对焦虑抑郁症状要有充分的重视,积极识别并诊断,以期进一步提高心律失常患者的生活质量,减少病死率。     

Three Dimensions of Oppositionality in Autism Spectrum Disorder

In autism spectrum disorder (ASD), symptoms of oppositional defiant disorder (ODD) are common but poorly understood. DSM-5 has adopted a tripartite model of ODD, parsing its features into ‘angry and irritable symptoms’ (AIS), ‘argumentative and defiant behavior’ (ADB) and ‘vindictiveness’. This was based on findings in non-autistic populations that each of these dimensions of oppositionality has a distinct constellation of associations with internalising and externalising psychopathology. We applied the tripartite DSM-5 ODD model to ASD to test its generalisability beyond non-ASD populations; and to elucidate the nature of ODD symptoms in ASD. Participants were 216 verbally-fluent young people (mean age?=?9.6 years, range 3.0 to 16.2 years, 82 % male) with ASD. Cross-sectional parent-and teacher-report data were analysed using bootstrap multiple regression to test the following predictions, derived from studies of non-ASD young people: (1) AIS will be the main predictor of internalising problems; (2) ADB will be the main predictor of ADHD symptoms; (3) all ODD traits will independently predict conduct disorder symptoms; (4) vindictiveness will be the main predictor of aggressive conduct problems. Our findings using both parent and teacher data were consistent with the non-ASD ODD literature. AIS were associated with internalising but not externalising problems; ADB and vindictiveness were associated with externalising but not internalising problems; and vindictiveness was the main predictor of aggression. The DSM-5 tripartite model of ODD appears to be generalisable to ASD: for people with an autistic disorder, AIS, ADB and vindictive dimensions of oppositionality have distinct associations with concurrent psychopathology, suggesting the need to assess them as separate constructs.     

The Dimensions of Life Stress and the Specificity of Disorder

Stress and related concepts have long been associated with ideas about the genesis of mental and physical disorders. The concepts linking stress to disorder, however, have typically been very general in nature. The theme of the present paper is that such nonspecific principles may obscure more specific relations between relatively distinct forms of life stress and particular types of disorder outcome. The historical progression of ideas on this topic is traced and the assumptions behind specificity and nonspecificity models of disorder are outlined. The implications of these developments are next illustrated in regard to current conceptual and operational shortcomings. Recent research that has overcome these limitations and suggests the viability and importance of more specific linkages between particular forms of stress and disorders is selectively reviewed. Finally, the paper concludes with some speculative comments on the problems facing investigators interested in translating stress concepts into operational procedures.     

Self-Reported Symptoms of Depression by Changes in Sleeping Patterns and Appetites for Outpatients with a Major Depressive Disorder

To determine whether self-reported symptoms of depression are differentiated by changes in sleeping patterns or appetite, the Beck Depression Inventory-II (BDI-II; Beck et al. 1996) was administered to 1,250 outpatients diagnosed with a major depressive disorder. A series of focused contrasts supported the hypothesis that the mean BDI-II total scores and the majority of the symptom ratings of the outpatients who described increases or decreases in their sleeping patterns or appetites were comparable and higher than the mean BDI-II total scores and symptom ratings of the patients who reported no changes in their sleeping patterns or appetites. However, the patients who were sleeping less described themselves as being more agitated than those who were sleeping more. Decreases and increases in sleep or appetite were both discussed as indicating comparable levels of depressive symptomatology.

Life Stress and Major Depression

ABSTRACT— People have long believed that adversity and stress contribute to emotional problems in general and to depression in particular. A considerable body of research has supported this intuition, documenting a consistent association between major stressful life events and the onset of clinical depression. However, most individuals under stress do not become depressed, sometimes depression develops without prior stress, and distinguishing psychological distress from major depression can be diagnostically challenging. In varying forms and degrees, life stress may play multiple roles in relation to major depression. In this article, we outline the opportunities and obstacles associated with conceptualizing depression from a life-stress perspective and discuss the implications for future research.     

Clinical Supervision and Logotherapy: Discovering Meaning in the Supervisory Relationship

Upon review of the clinical supervision literature, the case is made for implementation of logotherapeutic principles within the context of the supervisory relationship. Logotherapy is a meaning-centered approach that may enhance existing supervision styles and models, especially their tendency to de-emphasize the supervisor-supervisee relationship and the inner experiencing factor of what occurs during the process of supervision. The utility of incorporating elements of logotherapy in clinical supervision is presented within the context of supervisor roles (i.e., mentor, teacher, and evaluator), as well as the content and process of effective supervision (e.g., enhancing knowledge, skills, attitudes, and interpersonal ability of supervisees). The importance of supervisor and supervisee personally meaningful values to the supervision process is then discussed, followed by specific avenues for research. Recommendations for incorporating logotherapy into supervision are offered.     

The Church Confronting Adult Depression: A Challenge

Local Protestant church leaders can confront the problem of depression by providing parishioners with information in three related areas: symptoms of and reasons for depression; distorted understandings and uses of biblical ideas about perfection, self-denial, surrender, and expression of anger and grief; and principles of parenting that encourage children's self-esteem, problem-solving abilities, and faith development—strong deterrents to depression.     

Borderline Personality Disorder in 3-D: Dimensions,Symptoms, and Measurement Challenges

Borderline personality disorder (BPD) is a pervasive pattern of psychopathology characterized by unstable affect, suicidal behaviors, and identity problems (Diagnostic and statistical manual of mental disorders. Washington, DC: Author; 2000). BPD is heterogeneous in nature, highly prevalent in clinical settings, and increasingly studied by clinical and social psychologists. This review highlights affective instability, impulsivity, and interpersonal hypersensitivity, the interaction of which we believe accounts for the symptoms of BPD, the BPD criteria most associated with these features, and the interrelationships among these underlying dimensions. We also discuss difficulties in measurement of these dimensions. Real-world assessment methods will assist in the measurement of time-dependent processes and identify causes, covariates, or consequences of these processes to determine how these features manifest themselves in real life.     

Meaning-Centered Couples Therapy: Logotherapy and Intimate Relationships

Viktor Frankl’s logotherapy posits that human life has purpose and that human beings are motivated to discover meaning in their lives. This paper’s objective is to present a case for incorporating meaning into couples therapy as a way of enhancing a clinician’s existing approach. Logotherapy is a potentially useful modality, regardless of the clinician’s theoretical orientation, given its collaborative nature and focus on the significance of meaning and values to the human condition. A logotherapeutic approach to couples therapy (i.e., meaning-centered couples therapy) would involve values clarification (individually and collectively) and emphasis on a love that is based on acceptance and self-transcendent growth. Logotherapy techniques are discussed, a composite illustration is presented, and recommendations for research are offered.     

Common Genetic and Environmental Influences on Major Depressive Disorder and Conduct Disorder

The evidence for common genetic and environmental influences on conduct disorder (CD) and major depressive disorder (MDD) in adolescents was examined. A sample of 570 monozygotic twin pairs, 592 dizygotic twin pairs, and 426 non-twin siblings, aged 12-18 years, was recruited from the Colorado Twin Registry. For the past year data, there was a significant correlation between the genetic influences on MDD and CD and, for the lifetime data, there was a significant correlation between the genetic influences on MDD and CD, and a significant correlation between the nonshared environmental influences on MDD and CD. Our results suggest that some genetic factors will increase an individual's vulnerability to both MDD and CD in adolescence.     

试论儒家的意义治疗思想

儒家学说中蕴涵着丰富的意义治疗思想。认为人要活得有意义,就必须成就自己的道德生命,成为具有道德的人;人只有通过自己的切身体验将外在的道德规范转化为一种道德信念,才能完成自己的道德使命,实践自己的道德人生;生与死一样,都是求"道"的工具和使命;而是否能够实现生命的意义、是否能够达到理想的人格,主要取决于其生命实践。     

试论儒家的意义治疗思想

儒家学说中蕴涵着丰富的意义治疗思想.认为人要活得有意义,就必须成就自己的道德生命,成为具有道德的人;人只有通过自己的切身体验将外在的道德规范转化为一种道德信念,才能完成自己的道德使命,实践自己的道德人生;生与死一样,都是求"道"的工具和使命;而是否能够实现生命的意义、是否能够达到理想的人格,主要取决于其生命实践.