Melancholy: An elusive dimension of depression?

Journal of Medical Humanities - This paper presents a view of melancholy based on Kierkegaard's insight of the self, showing that this dimension of depression is anticipatory of threat to...     

Mood-induction research—its implications for clinical depression

Mood-induction procedures (MIPs) are increasingly being used as laboratory analogues of clinical depression. Four methods of mood induction are described: reading depressing self-referent statements: remembering past unpleasant events; listening to a taped depressing story: and failure on a task. The effects of these MIPs on affect, behaviour and related variables and parallels between these effects and clinical deficits are reviewed. The implications of MIP research for clinical depression are discussed in the light of self-awareness theory, mood effects on memory, and the inter-relationship between cognitive and somatic variables in depression.     

Is depression taxonic,dimensional, or both?

The current investigation examines the potential importance of item selection in the ongoing discussion regarding the taxonicity of depression. Following J. C. Coyne (1994), we contrast the taxonicity of "distress" with the taxonicity of a syndrome more focused on somatic symptoms (i.e., the involuntary defeat syndrome). Using 4 samples of 984 undergraduates, we first replicate the J. Ruscio and A. M. Ruscio (2000) results by showing that distress item indicators are dimensional. We then demonstrate taxonicity using items focused on somatic symptoms and reflective of disruption of multiple homeostatic mechanisms. Results suggest that item selection is central to the determination of taxonicity in depression.     

Trauma,personality disorders and chronic depression – the role of the conversational model of psychodynamic psychotherapy in treatment resistant depression

Objective: To report preliminary data describing the interim treatment outcome of 44 patients referred with treatment-resistant depression (TRD), comorbid personality disorders and histories of early childhood trauma using the Conversational Model (CM) of psychodynamic psychotherapy. Method: Patients (N = 44), 13 males and 31 females with long histories of depression ranging from 2 to 30 years, resistant to multiple trials of treatment, were referred by mental health practitioners, including psychiatrists. They were treated with twice weekly CM psychotherapy by multidisciplinary trainees and supervised by experienced trained clinicians. Questionnaires were administered at assessment and at 12 months to assess symptoms, functioning, self-esteem, history of trauma, personality functioning and suicidality. In this preliminary study, there was no separate control group, and patients served as their own controls. Results: Patients with TRD were found to have comorbid severe personality disorders and histories of early childhood trauma. Significant improvement in symptoms, self-esteem, functioning and suicidality was noted after 12 months. Conclusion: Patients responded with symptomatic and functional improvement to twice weekly CM therapy.     

Postpartum depression and attachment: Is anybody here?

Abstract

The paper presents a developmental and dynamic multitheoretical overview of many dimensions of attachment-related processes activated under the conditions of maternal depression. The clinical vignette (from the analytic practice of Eva D. Papiasvili) of reconstructive anaytic work with an adult patient illustrates the profound impact of maternal depression on precocious early differentiation between the attachment styles, of the depressed parent and the substitute caregiver, at the root of early “counterdependent” self-sufficiency. Through reconstructive interpretive work, first with enactments and then dreams, pertaining to not-remembered, represented, or symbolized events of earliest infancy, the patient is able to make a series of developmentally transformative symbolic leaps, restoring the capacity for intimacy, hope, trust, and pleasure. This breaks the intergenerational mother–daughter transmission of postpartum depression and related problematic attachment.     

Is depression best viewed as a continuum or discrete category? A taxometric analysis of childhood and adolescent depression in a population-based sample

The authors examined the latent structure of depression in a population-based sample of children and adolescents. Youth's self-reports and parents' reports of the youth's Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) major depressive symptoms were assessed via a structured clinical interview. The authors used Meehl's (1995) taxometric procedures to discern whether youth depression is dimensional or categorical. Taxometric analyses that explicitly took into account the skewness of depressive symptoms suggested that depression is a dimensional, not categorical, construct. The dimensional structure of depression was obtained for all of the DSM-IV major depressive symptoms as well as for different domains of depression (emotional distress symptoms and vegetative, involuntary defeat symptoms), youth and parent reports, and different subsamples (i.e., boys vs. girls and younger vs. older youth).     

Mood-congruent memory in depression: emotional priming or elaboration?

We investigated whether mood-congruent memory (MCM) bias in depression is a function of implicit or explicit memory. Implicit memory is taken as a measure of ease of activation, whereas explicit memory also taps elaboration. As expected, MCM bias was found in the explicit memory task but not in the implicit memory task. We believe this finding supports the involvement of elaborative mechanisms in MCM. In addition, memory bias was found with words related to depression but not with words denoting physical threat. Thus, the MCM bias in explicit memory was found to be specific to information that was congruent with depression rather than to all negative information.     

Teachers’ burnout, depression, role ambiguity and conflict

The present study investigates issues associated with teachers’ burnout in primary education as related to depression and role conflict–ambiguity. At the time of the study the participants (562 teachers) were working in seventy nine (79) Primary Education State Schools in Greece (Athens and two prefectures in the southern part of the country). The results showed that of the three factors comprising the Burnout inventory (MBI, Maslach and Jackson, MBI: Maslach Burnout Inventory; manual research edition, 1986), (i.e., Emotional exhaustion, Personal accomplishment, Depersonalization) Emotional Exhaustion showed a statistically significant (positive) correlation with the factors that comprise: (a) the Scale of Depression (CES-D: Ensel, in: Lin et al. (eds.) Social support, life events and depression, 1986; Radloff, Applied Psychological Measurement 1: 385–401, 1977) such as Depressed affect, Somatic retarded activity and (b) Degree of Role Conflict (Role Conflict and Role Ambiguity Scale, Rizzo et al., Administrative Science Quarterly, 15:150–163, 1970, adapted in Greek by Koustelios and Kousteliou, Psychological Reports, 82:131–136, 1998); similarly, Positive affect (CES-D) and Degree of Role Clarity (Role Conflict and Role Ambiguity Scale) showed a statistically significant (negative) correlation with the same factor (Emotional exhaustion). Furthermore, a regression analysis performed with Personal accomplishment as the dependent variable showed that the (combined) factors of Role Ambiguity, Positive Affect and Somatic Retarded Activity contributed significantly to the prediction of the dependent variable; A third regression analysis performed with Depersonalization as dependent variable showed that Somatic Retarded Activity, Role Conflict, Positive Affect, Interpersonal Affect and Role Ambiguity contributed significantly to the prediction of this variable. Overall, the results showed that Greek teachers experience low-moderate levels of Burnout, Depression, Role conflict and Role ambiguity.     

‘What do you mean by depression?’—A study of the relationship between antidepressive activity and personal concepts of depression

This study explores the relationship between a subject's concept of depression and his reported antidepressive activities. A pilot study is reported which was used to develop a method of classification of subjects' concepts of depression in terms of depth of depression and degree of external causality perceived. The majority of the subjects studied fitted into a group who see depression as a major disturbance of mood unrelated to external events; this was true for both the pilot and main studies. The main study applied the depressive classification method to an investigation of the relationship between depressive concept group and qualitative and quantitative aspects of reported repertoires for coping with depression. A major concept of depression was shown to be associated with a high frequency of reported antidepressive activity, but ANOVAR revealed no other significant main effect on quantitative analysis. Various complex interactions of sex. depth of concept and locus of concept were observed. A group of psychiatric inpatients were seen to differ in quantitative and qualitative aspects of reported antidepressive behaviour from the remainder of the population studied; the implications of these findings for further research are discussed.     

Subclinical and clinical depression: Are analogue studies justifiable?

A group of subclinically depressed students SS (N = 36) was compared with a group of mildly depressed patients MP (N = 48) and a group of severely depressed patients SP (N = 33) on 21 raw symptom severity scores in the Beck Depression Inventory (BDI). Stepwise discriminant function analysis yielded two significant functions, the first representing severity in core symptoms of depression. Symptom severity scores were then adjusted to allow for differences in total BDI scores among the groups and the adjusted scores were reanalysed. Two significant functions were again found, the first representing severity in only three of the core symptoms defining depression according to DSM III. The adjusted scores were further adjusted to equate the groups for differences in score variance and the discriminant analysis was repeated. Again two significant functions were found. The first, clearly representing a dimension of subclinical-clinical depression, was defined by a set of core symptoms smaller than that specified in the DSM III definition of major depression. It is argued that clinical and subclinical depression differ mainly in the absolute severity of the core symptoms defining depression but that subclinical shows a relative emphasis of some, and a relative de-emphasis of other core symptoms. It is concluded that subclinical depression in students offers a fairly accurate ‘model’ of clinical depression and that analogue studies are, to a reasonable extent, justifiable.     

Do intrusive memory characteristics predict depression at 6 months?

Two prospective studies have investigated whether the presence, intrusion, and avoidance of negative intrusive memories predict depression, and have reported conflicting findings. We aimed to replicate and extend these investigations by exploring the role of intrusion and avoidance of intrusive memories, as well as memory characteristics, in the prediction of depression prospectively. At Time 1 a mixed sample of community participants (N=85) were interviewed and completed self-report measures of depression, anxiety, and intrusive memory features. At Time 2 (6 months later, N=64) depression and anxiety symptoms were reassessed. Results were partly consistent with hypotheses for the sub-sample of participants who did not receive treatment between the baseline and follow-up assessments. Baseline levels of intrusion and some memory features (uncontrollability, distress, interference, numbness, detachment) predicted follow-up depression, controlling for baseline depression symptoms. Unexpectedly, avoidance of intrusive memories and other features (e.g., here and now quality) did not predict depression. Levels of intrusion and avoidance did not predict anxiety at follow-up. These results provide further evidence that intrusive memories are not simply an epiphenomenon of depression, but predict depression prospectively. Our results suggest that novel, depression-specific theories that emphasise the role of memory disturbances in the maintenance of depression are needed.     

Maternal depression and the timing of mother–child dialogue

Turn-taking in dialogue is an essential part of communication and early language experience. The prevalence of utterances and the timing of responses in dialogue were examined at 14 and 36 months of age in 104 mother–child dyads from the Early Head Start Research and Evaluation Project (EHSREP). Mothers varied in their level of depression risk (measured with the Center for Epidemiological Studies-Depression scale; CES-D). Although maternal utterance rate did not vary significantly across any factors, the latency of mothers' responses to their children decreased with development (12 ms/month) and was significantly related to that of their own children (i.e., slow-responding children had slow-responding mothers). Mothers with higher levels of depressive symptoms were 11% slower in responding to their children than mothers with low depression risk, suggesting that the interactive timing of speech to children may be particularly sensitive to maternal depression, modifying the contingent properties of children's early language experience.     

Attributions and depression: why is the literature so inconsistent?

A large body of literature examining the relations between depression and causal attributions has produced inconsistent findings. Many studies have clearly had inadequate statistical power, however, so that negative findings cannot be readily interpreted. In this review, statistical power was computed for all published analyses relating depression to attributions to any of the following: internal, stable, or global causes, or their composite, ability/character, effort/behavior, luck, or task difficulty. On average, the power of these analyses was very poor. For example, only 8 of the 87 analyses had a probability of .80 or better of detecting a small-medium true population effect (e.g., r = .20). Separating studies by levels of power helped to clarify the inconsistencies in the literature. Whereas across all published studies depression was fairly consistently related only to the composite of internal, stable, and global attributions, those few studies with fairly high power all reported significant relations of depression to stable and global attributions as well as to the composite. It is suggested that increased attention be paid to the power of statistical analyses in planning studies and in drawing conclusions from completed studies.     

Associations of social relationships with consultation for symptoms of depression: a community study of depression in older men and women in Québec

To assess associations between social relationships and consultation for symptoms of depression, data from a representative sample of 2,811 French-speaking community-dwelling older adults in Québec were used. Less than half of the older adults meeting DSM criteria for depression (N = 379; 47.1%) had sought consultation about their depression-relevant symptoms in the preceding 12 months. Having a cohabitant partner or having children were not associated with frequency of consultation for women. Men without a partner tended to consult more frequently than men with a cohabiting partner (OR = 2.5; 95% CI = 0.81, 7.88). None of the men without a confidant had consulted. Among the 67 men with a confidant, consultation was more frequent among those not cohabiting with a partner (70%) than among those with a cohabiting partner (46%). The influence of social relationships on consultation for depression differed in men and women in this population of depressed elderly people in Québec.     

Detention conditions’ impact on anxiety and depression levels of prisoners

IntroductionThe mortality rate in Portuguese prisons is the highest of the European Community. Two thirds of these deaths concern individuals in preventive detention, who have not yet faced trial.ObjectiveOur objective is to examine the impact of different detention conditions on the anxiety and depression rates of inmates. We predict that the anxiety and depression rates would be higher for inmates in preventive detention.ResultsResults have shown that the depression rates of inmates in open detention were the lowest. Depression rates were highest among inmates in preventive detention.DiscussionThe results do not allow us to confirm our hypothesis regarding anxiety rates. Considering our results, inmates in preventive detention seem to represent the most vulnerable population of the prison in relation to the two other groups.     

How are depression and autobiographical memory retrieval related to culture?

This study investigated how culture influences the association between autobiographical memory retrieval and depression. Thirty clinically depressed patients and 30 controls, 15 each from Britain and Taiwan, completed the English and Chinese versions of the Autobiographical Memory Cueing Task (AMT). Overall, the depressed individuals from both cultural groups retrieved significantly fewer specific and more categoric autobiographical memories than their matched, nondepressed controls. Within the control groups, the British participants retrieved significantly more specific autobiographical memories and fewer categoric memories than their Taiwanese counterparts. These results suggest that difficulty in retrieving specific autobiographical memories typical of depression may be a cognitive bias that occurs across cultures.