How does dysfunctional thinking decrease during recovery from major depression?

Decreased dysfunctional thinking in recovering depressed patents could reflect predominantly (a). reduced access to dysfunctional schemas or (b). increased metacognitive monitoring of dysfunctional schematic products. Twenty acutely depressed patients, 20 partially remitted depressed patients, and 20 controls were compared on tasks primarily reflecting one or the other of these processes. On both tasks, acutely depressed patients differed significantly from controls. Partially remitted patients resembled acutely depressed patients on the task assessing dysfunctional schema access but resembled controls on the metacognitive monitoring task. Results suggest that reduced dysfunctional thinking associated with partial remission is mediated primarily by increased metacognitive monitoring of dysfunctional cognitive products rather than reduced access to dysfunctional schemas.     

Visual-perceptual abilities in healthy controls, depressed patients, and schizophrenia patients

Previous studies have suggested a right hemineglect in schizophrenia, however few assessed possible visual-perceptual implication in this lateralized anomaly. A manual line bisection without (i.e., lines presented on their own) or with a local cueing paradigm (i.e., a number placed at one or both ends of the line) and the Motor-free Visual Perceptual Test-Vertical format (MVPT-V) were used to assess the visual-perceptual abilities of healthy controls, schizophrenia and depressed patients. Whereas healthy controls and depressed patients showed a non-significant leftward bias in manual line bisection, schizophrenia patients bisected significantly to the left of the true centre of the line. Interestingly, the pattern of performances in response to the local cueing paradigm was similar in depressed and schizophrenia patients such that both groups demonstrated a significant change in their bisection performance only in response to a cue placed at the right extremity of the line (control performance was modified by cues at either end of the line). Finally, in the MVPT-V, schizophrenia patients were impaired relative to the other two groups, especially in the spatial working memory and visual closure categories. These results suggest that: 1/a deficit towards the right hemifield, consistent with a mild form of right hemineglect, can be observed in schizophrenia; 2/lateralized anomalies could also be observed in depression using an appropriate tool such as manual line bisection; 3/performances in the MVPT-V suggested that a simple visual-perceptual deficit could not explain the lateralized anomaly observed in the manual line bisection, as it is the case in the hemineglect syndrome.     

The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study

Depression is characterized by a large risk of relapse/recurrence. Mindfulness-based cognitive therapy (MBCT) is a recent non-drug psychotherapeutic intervention to prevent future depressive relapse/recurrence in remitted/recovered depressed patients. In this randomized controlled trial, the authors investigated the effects of MBCT on the relapse in depression and the time to first relapse since study participation, as well as on several mood states and the quality of life of the patients. 106 recovered depressed patients with a history of at least 3 depressive episodes continued either with their treatment as usual (TAU) or received MBCT in addition to TAU. The efficacy of MBCT was assessed over a study period of 56 weeks. At the end of the study period relapse/recurrence was significantly reduced and the time until first relapse increased in the MBCT plus TAU condition in comparison with TAU alone. The MBCT plus TAU group also showed a significant reduction in both short and longer-term depressive mood and better mood states and quality of the life. For patients with a history of at least three depressive episodes who are not acutely depressed, MBCT, added to TAU, may play an important role in the domain of relapse prevention in depression.     

Deployment of attention in clinical depression during symptom remission

The purpose of the current study was to investigate deployment of attention in clinically depressed patients during the process of symptom remission. Previous research indicates a non-depressed protective bias in attention whereas depressed individuals evidence no bias. A deployment-of-attention task based on negative, positive, and neutral adjectives was administered twice to 15 inpatients with major depression and 15 normal controls, at about 6 weeks apart. From test 1 to test 2, severity of patients' depressive symptoms improved significantly. Acutely depressed patients tended to show an attentional bias towards negative information whereas partially remitted patients manifested no attentional bias. Non-depressed individuals attended less to negative information than (acutely and partially remitted) depressed patients. Non-depressed participants but not depressed patients avoid negative information demonstrating a protective processing bias. Depressed patients are not characterized by a shift towards a pronounced protective pattern during symptom remission.     

Digital communities of practice: Investigation of actionable knowledge for local information networks

The article explores integration of knowledge-enabling digital technology into community functions through the development of local Digital Communities of Practice. This analysis includes both general considerations—in terms of domain, community, and practice dimensions—as well as results from an exploratory research project in Minnesota. The domain is described as integrated deployment of virtual services (education, human services, government) in local communities; the community is comprised of the local stakeholders and residents that would use or benefit from such services; and the practice is considered as a decision-making processes for designing and deploying these services. The paper concludes with research and policy considerations for providing an enduring source of knowledge about local virtual services, needs, and solutions. His research focuses on the evaluation of information technologies as they are planned and deployed in infrastructures, organizations and community systems. This research has been reported in Information Systems Frontiers, Communications of the ACM, Journal of Urban Technology, and Policy Studies Journal. Dr. Horan has also written two books, Digital Places (2000) and Digital Infrastructures (2004, co-edited with Rae Zimmerman). He has both his Masters and Doctorate degrees from the Claremont Graduate University and has held visiting scholar positions at MIT, Harvard, UCLA, and University of Minnesota. Kimberly Wells is an organizational psychologist currently working as an independent consultant. Since 1996 her research and work have converged upon issues involved with assessing the influence of technology in organizational and community settings. Ms. Wells is presently completing her doctorate at Claremont Graduate University, California. Her dissertation explores processes for improving the knowledge-creating capacity of virtual teams. Ms. Wells has a Masters degree in Organizational Behavior, Claremont Graduate University, and a Masters degree in Anthropology from the College of William and Mary, Virginia.     

Maternal depression and child adjustment: a longitudinal analysis

This study examined the relation between maternal depression and child adjustment. Two major issues were addressed. First, to assess the specificity to depression of observed child adjustment difficulties, four groups of female subjects were included: clinically depressed psychiatric patients, nondepressed psychiatric patients, nondepressed medical patients, and nondepressed nonpatients. Second, to assess the stability of the observed effects, data were collected early in the patients' treatment and again approximately 8 weeks later. The results indicated that the depressed mothers described their children as having various behavior problems; interestingly, interviewers also rated these children as demonstrating disturbed behavior. Although the offspring of the depressed mothers were the most impaired children in the sample, the lack of significant differences between children of the depressed and the nondepressed psychiatric patients suggests that child adjustment is more strongly related to the presence of maternal psychopathology than it is to diagnostic status. Finally, children of the psychiatric patients continued to demonstrate problems at the second assessment. Implications of these results for models of depression are discussed, and directions for future research are offered.     

An interpersonal perspective on depression: the role of marital adjustment, conflict communication, attributions, and attachment within a clinical sample

Previous studies have focused on the difficulties in psychosocial functioning in depressed persons, underscoring the distress experienced by both spouses. We selected conflict communication, attribution, and attachment as important domains of depression in the context of marital adjustment, and we analyzed two hypotheses in one single study. First, we analyzed whether a clinical sample of couples with a depressed patient would differ significantly from a control group on these variables. Second, we explored to what degree these variables mediate/moderate the relationship between depressive symptoms and marital adjustment. The perspectives of both spouses were taken into account, as well as gender differences. In total, 69 clinical and 69 control couples were recruited, and a series of multivariate analyses of variance and regression analyses were conducted to test both hypotheses. Results indicated that both patients and their partners reported less marital adjustment associated with more negative perceptions on conflict communication, causal attributions, and insecure attachment. In addition, conflict communication and causal attributions were significant mediators of the association between depressive symptoms and marital adjustment for both depressed men and women, and causal attributions also moderated this link. Ambivalent attachment was a significant mediator only for the female identified patients. Several sex differences and clinical implications are discussed.     

Contextualizing psychotherapy as a healing practice: Culture,history, and methods

The histories of modern medicine and psychotherapy are examined to situate psychotherapy in the array of healing practices. Although modern medicine relies on specificity as its central organizing concept, psychotherapy has consistently produced results that are not consistent with a medical model. Moreover, the development of research methodologies used to validate treatments, although useful in the medical context, ignores the experience of the patients as well as the provider of services. It is demonstrated that psychotherapy is a culturally imbedded healing practice and shares similarities with healing practices other than modern medicine. Psychotherapy shares one important feature with modern medicine, however: empirical support for efficacy. Various theories of placebo effects are examined to propose explanations for the effects of psychotherapy. Finally, issues and paradoxes are presented for future consideration.     

Regional brain electrical asymmetries discriminate between previously depressed and healthy control subjects

Baseline resting electroencephalogram (EEG) activity was recorded from 6 normothymic depressives and 8 controls using three different reference montages. Power in all frequency bands was extracted by Fourier transformation. Significant Group X Region X Hemisphere interactions were found consistently for alpha band power only. Previously depressed subjects had less left-sided anterior and less right-sided posterior activation (i.e., more alpha activity) than did never depressed subjects. Previously depressed subjects had no history of pharmacological treatment and did not differ from controls in emotional state at the time of testing. The pattern of anterior and posterior asymmetry in the previously depressed subjects is similar to that found in acutely depressed subjects and suggests that this may be a state-independent marker for depression.     

Separate personality traits from states to predict depression

Results have been inconsistent regarding the ability of personality measures to predict future depression severity levels, leading some researchers to question the validity of personality assessment, especially when patients are acutely depressed. Using a combination of regression and factor analytic techniques, we separated the variance of personality measures into stable trait and variable state-affect components. Findings supported the hypotheses that depression severity measured at different time points would correlate with both stable trait and concurrent state-affect components in personality measures, whereas change in depression severity would correlate with state changes but not with stable trait scores. Thus, personality assessments tap both state affect and trait variance, with the state-affect variance masking the trait variance when patients are depressed.     

Contextual Themes in Career Decision Making of Female Clients Who Indicate Depression

Difficulties concerning female counseling center clients' career decision making were explored in this qualitative study. The authors reviewed counseling intake and progress notes of 18 female students who sought counseling services at a university counseling center and who presented career concerns and reported feeling depressed. Most women in this study described their career decision‐making difficulties in the context of relationships with their parents or significant others. Both external (i.e., family relationships, family and culture, and relationships with significant others) and internal (i.e., developmental, developmental and mental health issues, and skill deficits) conditions emerged as significantly affecting these women's career decision‐making process.     

Life events,social support and depression in haemodialysis patients

This study examined the effects of life events and social support on depression in 200 dialysis patients. The instruments used included the Beck Depression Inventory, a modified version of Sarason's Life Experiences Survey and a Social Support Inventory (SSI) constructed by the authors. The SSI consisted of five quantitative measures and three measures of perceived social support. These measures were found to be internally consistent and stable over time. Results showed that clinically depressed dialysis patients reported fewer positive life events and appraised life events more negatively than non‐depressed patients. The total number of life events and the number of negative life events were not found to differentiate between depressed and non‐depressed patients. With regard to social support variables, results showed that depressed patients reported less frequent actual contact and telephone contact with others and perceived a smaller amount and less availability of social support and less satisfaction with perceived social support along the functional dimensions of emotional, informational, appraisal and instrumental support and social companionship. The results were found to provide support for a main effect model of social support and not for a buffering model. Copyright © 1999 John Wiley & Sons, Ltd.     

Self-Compassion in Depression: Associations With Depressive Symptoms,Rumination, and Avoidance in Depressed Outpatients

Self-compassion involves being kind to oneself when challenged with personal weaknesses or hardship and has been claimed to be associated with resilience in various areas. So far, there are only a handful of studies that investigate self-compassion and its relation to clinical depression. Therefore, the principal goals of the present study were (a) to compare self-compassion in clinically depressed patients and never-depressed subjects, (b) to investigate self-compassion and its relation to cognitive-behavioral avoidance and rumination in depressed outpatients, and (c) to investigate rumination and avoidance as mediators of the relationship between self-compassion and depressive symptoms. One hundred and forty-two depressed outpatients and 120 never-depressed individuals from a community sample completed a self-report measure of self-compassion along with other measures. Results indicate that depressed patients showed lower levels of self-compassion than never-depressed individuals, even when controlled for depressive symptoms. In depressed outpatients, self-compassion was negatively related to depressive symptoms, symptom-focused rumination, as well as cognitive and behavioral avoidance. Additionally, symptom-focused rumination and cognitive and behavioral avoidance mediated the relationship between self-compassion and depressive symptoms. These findings extend previous research on self-compassion, its relation to depression, as well as processes mediating this relationship, and highlight the importance of self-compassion in clinically depressed patients. Since depressed patients seem to have difficulties adopting a self-compassionate attitude, psychotherapists are well advised to explore and address how depressed patients treat themselves.     

Vulnerability to depression,mild depression,and degree of self-schema consolidation

The present study investigated the degree of consolidation of self-schema content in mildly depressed individuals, individuals cognitively vulnerable to depression (but currently nondepressed), and nonvulnerable-nondepressed controls. All three groups of subjects were presented with pairs of adjectives involving one depressed and one nondepressed content adjective, and were asked to decide which of the two adjectives described them the best (or least). Following this, subjects rated each adjective on a 9-point degree of self-reference scale. On the basis of these two types of self-referent judgments, a measure of decision inconsistency was computed for each subject. In accord with predictions generated from a self-schema model of depression, similar decision inconsistency scores were found for mildly depressed and vulnerable-nondepressed individuals. In turn, both of these groups revealed greater decision inconsistencies than normal controls (the nonvulnerable-nondepressed group). Using the inconsistency measure as an index of the degree of consolidation of self-schema content, these findings suggest that relatively poor consolidation of depressed and nondepressed self-schema content may relate to both the etiology and maintenance of depression.     

Psychologists' role in family-centered approach to practice, training, and research with young children

Family-centered, community-based, coordinated care for children with special needs is presented as the best practice model for providing services to children and families. Psychologists must learn to play an active role in this frame-work that both integrates psychology with other health and education disciplines and uses the broad spectrum of psychological knowledge about families, development, community organization, and intervention strategies. Key principles of family-centered child psychology affect practice research and training. The psychologist becomes part of a team created to support families as the primary care-givers of their children. Training programs must reorganize the types of experiences both in the classroom and the field to train new psychologists within this model. As mandates for family-centered care affect policies at the state and federal levels, research will remain a critical factor in understanding the effects of these policy shifts on child and family functioning and the delivery of services.     

Performance benefits of depression: sequential decision making in a healthy sample and a clinically depressed sample

Previous research reported conflicting results concerning the influence of depression on cognitive task performance. Whereas some studies reported that depression enhances performance, other studies reported negative or null effects. These discrepant findings appear to result from task variation, as well as the severity and treatment status of participant depression. To better understand these moderating factors, we study the performance of individuals-in a complex sequential decision task similar to the secretary problem-who are nondepressed, depressed, and recovering from a major depressive episode. We find that depressed individuals perform better than do nondepressed individuals. Formal modeling of participants' decision strategies suggested that acutely depressed participants had higher thresholds for accepting options and made better choices than either healthy participants or those recovering from depression.     

When depression breeds contempt: reassurance seeking, self-esteem, and rejection of depressed college students by their roommates.

To test Coyne's (1976b) theory of depression, students' levels of depressive symptoms, reassurance seeking, and self-esteem were assessed at Time 1, and their same-gender roommates' appraisals of them were assessed 5 weeks later. Mildly depressed students engaged in the type of reassurance seeking described by Coyne. Among men, but not women, mildly depressed students were rejected if they strongly sought reassurance and had low self-esteem but not if they did not seek reassurance or had high self-esteem. Although induction of depressed symptoms in roommates did occur, this contagion effect did not account for the depression-rejection relationship. The prediction that unsupportive, intolerant, or unempathic others would be particularly likely to respond with rejection to reassurance-seeking depressed students with low self-esteem received partial support. Implications for future work on the interpersonal aspects of depression are discussed.     

Rumination, distraction, and mindful self-focus in depressed patients

Rumination has been proposed as a cognitive risk factor for the onset and maintenance of depression. In parallel, mindfulness interventions have shown to reduce the risk for recurrence of depressive episodes. This study aimed to investigate effects of short periods of induced rumination, distraction, and mindful self-focus on sad mood in depressed patients and to assess possible moderator effects of habitual variables on respective mood changes. Seventy-six depressed patients 3.5 years after discharge from inpatient treatment were subjected to negative mood induction and subsequently randomly assigned to a rumination, distraction, or mindful self-focus induction. Habitual aspects of rumination, distraction, and mindfulness were assessed by questionnaires. Compared to rumination, the induction of a mindful self-focus and of distraction showed clear beneficial effects on the course of negative mood. While habitual distraction predicted better mood outcomes across all conditions, patients high in habitual mindfulness tended to show stronger negative mood reduction specifically after the induction of a mindful self-focus. This study indicates that - similar to distraction - an experimentally induced mindful self-focus is able to reduce negative mood in depressed patients. Implications regarding possible subgroups of patients who might particularly benefit from mindfulness-based interventions are discussed.