Searching for Specificity Between Cognitive Vulnerabilities and Mood and Anxiety Symptoms

Using two large nonclinical samples (N = 725), relations between five targeted cognitive variables [intolerance of uncertainty, negative problem orientation, perfectionism/certainty, responsibility/threat estimation, and importance/control of thoughts] and mood [depression] and anxiety [social anxiety, generalized anxiety, and obsessive–compulsive] symptoms were examined. Analyses provided multiple levels of specificity, including zero-order correlations, partial correlations controlling for the effects of positive and negative affect, regression analyses, and hierarchical structural modeling. Results were that (a) intolerance of uncertainty showed relative specificity to anxiety versus depression symptoms and (b) negative problem orientation was common to mood and anxiety symptoms. Although certain analyses suggested that (c) perfectionism/certainty specifically predicted generalized anxiety and (d) both responsibility/threat estimation and importance/control of thoughts were unique predictors of obsessive–compulsive symptoms, these three cognitive variables inconsistently predicted symptom scores across the two studies. Conceptual and therapeutic implications are discussed.     

Predicting global and topic‐specific certainty beliefs: Domain‐specificity and the role of the academic environment

Background. Epistemological beliefs are subjective theories of the structure and acquisition of knowledge. The instruments used to measure epistemological beliefs in educational psychology (see Duell & Schommer‐Aikins, 2001 ) typically consist of questionnaires tapping general, decontextualized beliefs about knowledge or knowledge acquisition in a specific field or in general. Aims. Using specific theories as stimuli, we determine the degree of topic‐specificity of certainty beliefs as well as the association between certainty beliefs and the learning environment. Sample. Participants were 662 upper secondary school students (Study 1) and 211 college students (Study 2). Method. A global instrument and a topic‐specific instrument were used to collect responses to up to 10 stimulus theories. Factor analysis, multiple regression analysis and multi‐level modelling were carried out. Results. Students' topic‐specific certainty beliefs varied markedly across the stimulus theories. Furthermore, students in different academic environments differed more strongly on global certainty beliefs than on topic‐specific certainty beliefs, and global certainty beliefs were only loosely connected to topic‐specific certainty beliefs. Conclusion. Researchers should critically assess the validity of decontextualized global questionnaires for assessing certainty beliefs. If possible, global measures should be complemented by topic‐specific measures.     

Utility of the SCL-90-R with depressed and conduct-disordered adolescent inpatients.

We assessed the diagnostic utility of the Symptom Checklist-90-Revised (SCL-90-R) in a sample of adolescent inpatients. In Part 1 (n = 79), convergent and discriminant validity were demonstrated for SCL-90-R scales measuring depression and paranoid ideation. Canonical correlation showed that SCL-90-R scales tapped two dimensions of adolescent psychopathology, a primary dimension of dysphoria and a secondary dimension of anger and mistrust. In Part 2 (n = 50), adolescents diagnosed as having major depression showed significant elevations on scales measuring depression, anxiety, and obsessive-compulsive features. Although several scales had high diagnostic specificity for major depression and conduct disorder, sensitivity was low.     

Cognitive content-specificity in future expectancies: role of hopelessness and intolerance of uncertainty in depression and GAD symptoms

The present study examined cognitive content-specificity in future-event predictions associated with symptoms of depression and generalized anxiety disorder (GAD). College undergraduates (N=284) completed measures of depression, GAD, and rated their certainty that a given set of positive and negative outcomes were or were not likely to happen in their future. Participants also completed measures of hopelessness and intolerance of uncertainty (IU). Individuals (N=263) completed the same measures again 6 weeks later. Certainty in an absence of positive future outcomes was associated with symptoms of depression but not GAD, and hopelessness mediated this relationship - concurrently and when examining change scores over 6 weeks. Certainty in negative outcomes was concurrently associated with both symptoms of depression and GAD, and hopelessness partially mediated these relationships. IU predicted concurrent increases in depression and GAD symptoms, and negative-outcome certainty partially mediated the IU-depression but not the IU-GAD symptom relationship. Change in certainty did not mediate the relationship between changes in IU and GAD symptoms but partially mediated the relationship between change in IU and depression symptoms over time. Hopelessness appears to play a unique role in the relationship between reduced anticipation of positive future outcomes and depression. Although less clearly suggested by the data, IU may contribute to both depression and GAD symptoms but may do so through different pathways.     

Using Self-Report Measures to Corroborate Theories of Depression: The Specificity Problem

Depression scales tend to correlate highly with measures of anxiety and other negative emotional states. If the same is true of scales measuring constructs from depression theories such as negative cognitions and anaclitic depression, it brings into question the specificity Of these models to depression. The overlap has been attributed to the common role of negative affect in depression and anxiety. Using a sample of college students, our study investigated the relationships among measures of depression, anxiety, positive and negative affect, and theory-relevant constructs. Theory-relevant scales related no more strongly to depression than anxiety measures. Furthermore, they related strongly either with negative or positive affect but usually not with both. These findings bring into question the specificity of depression models corroborated through the available self-report measures.     

Utility of the SCL-90-R With Depressed and Conduct-Disordered Adolescent Inpatients

We assessed the ciiagnosric utility of the Symptom Checklist-90-Revised (SCL-9O-R) in a sample of adolescent inpatients. In Part 1 (n = 73), convergent and discriminant validity were demonstrated for SCL-90-R scales measuring depression and paranoid ideation, Canonical correlation showed that SCL-90-R scales tapped two dimensions of adolescent psychopathology, a primary dimension of dysphoria and a secondary dimension of anger and mistrust. In Part 2 (n = 50), adolescents diagnosed as having major depression showed significant elevations on scales measuring depression, anxiety, an obsessive-compulsive features. Although several scales had high diagnostic specificity for major depression and conduct dsorder, sensitivity was low.     

Double Depression in Men: Does It Exist?

Differences between male veterans diagnosed with major depression alone and male veterans diagnosed with both major depression and dysthymia (double depression) were investigated. Assessment instruments included the Structured Clinical Interview for DSM-III-R, the Beck Depression Inventory (BDI), and the Symptom Checklist-90-R (SCL-90-R). Consistent with prior literature, it was hypothesized that male veterans diagnosed with both major depression and dysthymia display more severe depressive symptomatology and other forms of psychopathology than male veterans diagnosed with major depression alone. Results did not corroborate these hypotheses. Patients with double depression (n = 17) yielded BDI and SCL-90-R scores which did not differ significantly from those of patients with major depression alone (n = 14). Our results call into question the existence of double depression among men, a disorder whose existence has been demonstrated primarily among women.     

Bayes,time perception,and relativity: The central role of hopelessness

Time judgement and time experience are distinct elements of time perception. It is known that time experience tends to be slow, or dilated, when depressed, but there is less certainty or clarity concerning how depression affects time judgement. Here, we use a Bayesian Prediction Error Minimisation (PEM) framework called ‘distrusting the present’ as an explanatory and predictive model of both aspects of time perception. An interval production task was designed to probe and modulate the relationship between time perception and depression. Results showed that hopelessness, a symptom of severe depression, was associated with the ordering of interval lengths, reduced overall error, and dilated time experience. We propose that ‘distrusting the future’ is accompanied by ‘trusting the present’, leading to the experiences of time dilation when depressed or hopeless. Evidence was also found to support a relative difference model of how hopelessness dilates, and arousal accelerates, the rate of experienced time.     

Reduced specificity of autobiographical memory as a moderator of the relationship between daily hassles and depression

Autobiographical memory biases are potential cognitive vulnerability factors for depression, with recent research highlighting the potential importance of accompanying high levels of life stress. Using a prospective design, the current study examined the role of autobiographical memory performance, both reduced specificity and propensity towards categoric memories, as moderators of the relationship between life stress and depression in a non-clinical college sample. Findings suggest that an increased propensity towards categoric recall emerged as a vulnerability factor for future depressive symptoms, with this vulnerability not being dependent upon the presence of high levels of life stress. In contrast, while reduced autobiographical memory specificity did not emerge as a vulnerability factor alone, it did emerge as a moderator of the relationship between chronic daily hassles and depression. These findings highlight the potential importance of both propensity towards categoric recall and reduced specificity of autobiographical memory as vulnerability factors for the experience of future depressive symptoms.     

Cognitive specificity in emotional distress

Cognitive approaches to emotional distress posit that specific cognitive factors are critically linked to the etiology, course, or treatment of dysfunction. Although a number of empirical studies have assessed cognitive factors in emotional disorders such as depression and anxiety, research has yet to assess these variables simultaneously and with identical cognitive measures. Using depression and test anxiety as models of dysfunctional affective states, we examined cognitive specificity on measures of information processing, attributions, automatic thinking, and cognitive interference. Results indicated a pattern of specificity showing several differences and similarities in depression and anxiety. Specifically, "purely" depressed individuals showed evidence of selectively processing depressive information, making dysfunctional attributions, and engaging in more negative automatic thinking. "Purely" anxious individuals, on the other hand, showed evidence of selective anxious information processing and increased cognitive interference. Results are discussed in terms of a taxonomy for classifying depressive and anxious cognition.     

Parental death,depression and beck's theory of cognitive vulnerability: A critical appraisal and suggestions for research

An adequate model of depression should be able to (i) specify the origins of the disorder; (ii) explain the maintenance of depressive behaviour and (iii) result in effective therapy. The adequacy of Beck's cognitive theory of depression has been increasingly questioned (e.g. Alagaratnam, 1984; Alladin, 1985; Bebbington, 1985; Power & Champion (1986); Beidel & Turner (1986); Power (1987) and fundamental questions remain unexplored. In this paper, we focus on the assumption that early parental death results in the development of depressive schemas which constitute a cognitive vulnerability to depression. Bereavement is the most severe psychological trauma most people will encounter in the course of their lives (cf. Parkes & Weiss, 1983). Thus a most stringent test of Beck's hypothesis that depressive schemas are formed in early childhood by loss experiences such as parental death may be conducted by assessing the relationship between adult depression and parental death in childhood. In this paper the evidence will be considered briefly, within the context of Beck's theory of cognitive vulnerability. The specificity of parental loss to depression is questioned. Then, the role of schemas in cognitive theory is explored critically. Problems with Beck's idiosyncratic conceptualisation of depressive schemas are highlighted. A more adequate conceptualisation of the concept of loss is suggested. Finally, suggestions for future research into the origins of depression are offered.     

A test of interpersonal theory of depression in children and adolescents using a projective technique

Using a projective technique among child and adolescent psychiatric inpatients, we tested several hypotheses derived from Coyne's (1976b) interpersonal theory of depression. First, we predicted that depression would be associated with rejection, even controlling for the effects of aggression. Depression and rejection were associated only when aggression effects were covaried. Second, we hypothesized that the depression-rejection relation would display symptom specificity. Consistent with this hypothesis, we found that depression, but not anxiety, was related to rejection. Third, we assessed whether an index of interpersonal style—reliance on others—moderated the depression-rejection relation. Results suggested that depression and overreliance were both associated with high rejection scores, whereas the combination of low depression and low reliance on others was associated with low rejection scores. We found that results held across age groups. The implications of our findings for the interpersonal theory of depression in youngsters are discussed.     

Reduced autobiographical memory specificity and rumination in predicting the course of depression

Reduced autobiographical memory (AM) specificity is a known vulnerability factor for depression. AM specificity was investigated as a predictor of depression with the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986). When baseline depression scores were partialed, reduced AM specificity to negative cue words predicted higher levels of depression at 7-month follow-up. Once rumination was taken into account by means of the Rumination on Sadness Scale (M. Conway, P. A. R. Csank, S. L. Holm, & C. K. Blake, 2000), AM specificity no longer predicted depression, suggesting that the predictive value of AM specificity observed in previous studies might be--at least partly--explained as an effect of rumination. Further mediation analyses indeed revealed support for rumination as a mediator of the relation between reduced AM specificity and poor outcome of depression.     

Why the Wrongness of Killing Innocents is Not a Universal Moral Certainty

In this paper, I argue that the certainty about the wrongness of killing must not be considered as a universal, but as a local one. Initially, I show that there exist communities in which the wrongness of killing innocents is not a moral certainty and that this kind of case cannot be justified by arguing that such people are psychopaths. Lastly, I argue that universal certainties do not admit of exceptions: thus, the fact that some exceptional cases affect the certainty that killing innocents is wrong, leads me to conclude that it is a local certainty.     

Putative common pathways in therapeutic brain stimulation for affective disorders

Brain stimulation methods in the treatment of affective disorder are electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS). Clinically, ECT is considered the strongest remedy in the treatment of severe depression, especially depression with psychotic features, and in the elderly. TMS, despite positive reports, is somewhat more controversial. VNS has, so far, only been used in treatment-resistant depression with limited results. DBS may be of potential use in rare cases of treatment-resistant cases of affective disorder. This article highlights the similarities and differences between the four stimulation methods. The main difference is the seizures necessary in ECT. A stronger involvement of the hippocampus following experimental seizures compared with effects in that region induced by TMS and VNS might explain the consistent findings of the superiority of ECT in the most severe cases of affective disorder.     

Cognitive vulnerability to depression: The role of thought suppression and attitude certainty

Previous research indicates that dysfunctional attitudes wax and wane with shifts in mood, suggesting that they are more likely the result than the cause of depression. The present research examined the possibility that attitudinal precursors to depression exist but are difficult to detect because at-risk individuals are trying to suppress dysfunctional thinking. However, the lingering maladaptive beliefs should be reflected in attitude uncertainty. To test this idea, participants completed a measure of chronic thought suppression and the Dysfunctional Attitude Scale that was amended to include certainty ratings. Participants also reported current and past experiences with depression. The results indicated that although formerly depressed individuals—who are at high risk for relapse—reported relatively adaptive attitudes, they were more uncertain about those beliefs than were their never-depressed counterparts. Moreover, this greater uncertainty was associated with high levels of thought suppression that, in turn, were related to previous depression.     

Screening detoxifying inpatients with substance-related disorders for a major depressive disorder

The Beck Depression Inventory-Fast Screen for Medical Settings (BDI-FS; [Beck, Steer, & Brown, 2000]) and the Mood Module (MM) from the Primary Care Evaluation of Mental Disorders [Spitzer, Williams, Kroenke, Linzer, deGruy, III, Hahn, & Brody, 1995] were used to screen 100 inpatients detoxifying from alcohol, illicit substances, or both for a major depressive disorder (MDD). Receiver operating characteristic (ROC) analyses indicated that both tests were highly and comparably effective in differentiating patients who were and not diagnosed with a MDD; the ROC areas-under-curves for the BDI-FS and MM were, respectively, .87 and .84. A BDI-FS cut-off score of 10 and above had 90% sensitivity and 78% specificity rates, and a MM cut-off score of 7 and above had 90% sensitivity and 72% specificity rates for discriminating patients with and without a MDD. The clinical advantages and disadvantages of both instruments for rapidly screening detoxifying inpatients for clinical depression were discussed.     

Certainty,reasonableness and argumentation in law

This paper defends a position that parts ways with the positivist view of legal certainty and reasonableness. I start out with a reconstruction of this view and move on to argue that an adequate analysis of certainty and reasonableness calls for an alternative approach, one based on the acknowledgement that argumentation is key to determining the contents, structure, and boundaries of a legal system. Here I claim that by endorsing a dialectical notion of rationality this alternative account espouses an ambitious approach to reasoning in law and conceives of the theory of legal argumentation as the vantage point from which to analyze legal systems and tackle the main problems connected with their existence. Next, I look at what this alternative approach does for the way we should go about treating certainty and reasonableness, considered singularly as well as in their reciprocal relationship. I conclude on this basis that when argumentation receives its due emphasis in law we have to redefine certainty and reasonableness and recast their connection as non-conflictive.     

Evaluating the Effectiveness of Cognitive-Behavioral Teletherapy in Depressed Adults

Telephone psychotherapy is an emerging form of delivery of care that has recently demonstrated utility and efficacy for adult depression when provided as an adjunct to antidepressant treatment in primary care trials. This study constitutes one of the initial evaluations of cognitive behavioral therapy-telephone treatment (CBT-TT) as a stand-alone treatment for adult depression in specialty care. Thirty adults initiating psychotherapy for depression at a mental health clinic participated in the trial. The majority of participants (69%) were very satisfied with the 8-session CBT-TT, reduction in depression severity was significant over 3 and 6 months, and 42% of participants were considered recovered at termination. These outcomes closely parallel the findings from an earlier primary care trial, despite specialty care participants beginning treatment with more severe depression and without adjunctive antidepressant medication. These findings suggest that CBT-TT for adult depression is feasible and has potential as a stand-alone treatment. Implementation of this telephone-based delivery approach in primary and specialty care settings is discussed.