A psychoanalytic perspective on depression

A correct understanding of the role of depressive affect in triggering psychic conflict leads to a reformulation of the origins and the psychodynamics of depression as a feature of mental illness. It also raises serious question about the validity of the diagnosis of depressive illness.     

Teenage pregnancy: a theoretical analysis of a social problem

This paper begins by contrasting the two basic ways of defining a social problem (i.e., as a "problem" in society or of society). The implications of these two definitions are discussed within the context of the various approaches which have emerged from each. A typology is then developed which allows these divergent approaches to be synthesized into three broad categories (Social Disorganizational, Social Definitional, and Social Organizational). This typology helps to further clarify the implications of isolating certain noxious conditions (whether personal or social) and conceptualizing them as social problems. These implications for the emergence, scope, and possible solution to the problem of teenage pregnancy are discussed. The paper concludes with a theoretical critique that leaves little room for optimism about the piecemeal solutions to teenage pregnancy offered by either the social disorganizational or the social definitional approaches, yet it recognizes the unlikely prospects that the holistic solution is likely to be adopted soon. The paper thus concludes that this problem is likely to be with us for some time to come, and the best that we can hope to do is to treat the symptoms.     

Teenage parenting and child development: a literature review

Research on teenage parenting together with medical and behavioral research related to child development is reviewed in an effort to determine causal factors related to reported developmental deficits among children of teenage parents. 4 general conclusions are suggested: 1) several researchers agree that children of teenage parents show poor social and intellectual competence when compared with children on non-teen parents. However, the amount of sound empirical data to support this view is minimal. For example, there are few published studies of the longterm effects of teenage parenting or of actual behavioral interactions of teenage mothers and their children. 2) It is unlikely that research along the lines of the "continuum of reproductive casualty" will lead to identification of causal factors sufficient to account for developmental deficits in children of teenage mothers. 3) Research along the lines of "the continuum of caretaking casualty" suggest numerous behavioral and environmental variables that may be related to the development of children of teenage mothers. 4) Research designs applied to the study of teenage parenting must shift from linear models to complex multivariate models that permit simultaneous analysis of organismic, environmental, and behavioral determinants of development. Finally, mental health specialists, government agencies, and researchers alike, must be willing to entertain the hypothesis that much of our knowledge of the childrearing skills of teenage mothers is based on myth rather than empirical fact. 1 such myth may be that below 19 years of age, maternal age in and of itself is an important determinant of infant development and parent-infant interaction. Poor social-economic status, family support systems, marital stability, nutrition and prenatal care may be far more important determinants of development for these children than the age of their mothers.     

Teenage Fathers: A Profile

In this century both the literature and social programs devoted to adolescent pregnancy have focused almost exclusively on the female. This article presents a profile of teenage fathers by reviewing the scant literature that is available. The authors make specific recommendations for counselors on the basis of this review.     

Description of a Teenage Pregnancy Program

The authors describe a teenage pregnancy program with three major components—medical care, education, and counseling. The services, particularly the counseling program, are discussed.     

A European perspective on depression in the community: the DEPRES study

Depression is one of the most prevalent disorders in the general population, causing personal and social disability and impairment. Major studies assessing the diagnosis and management of depression have shown that it is often underdiagnosed and undertreated. A pan-European study aimed at assessing the extent and consequences of depression in six different countries is reported in this article. Different types of depressive profiles are analyzed and their respective management has been compared. The importance of improving diagnosis and treatment of depression is underlined. Appropriate management of depression depends on the recognition of depressive symptoms by patients, their possibility of seeking care, and the ability of the primary care physician to recognize the disorder and prescribe the appropriate medicines. Improvement in all of these fields is necessary.     

The biology of visual perspective and depression: A reply to Sutin

A recent meta-analysis by Munafò, Durrant, Lewis, and Flint (2009) [Munafò, M. R., Durrant, C., Lewis, G., & Flint, J. (2009). Gene × environment interactions at the serotonin transporter locus. Biological Psychiatry, 65, 211–219] questioned the meaning of studies searching for endophenotypes associated with the serotonin-transporter-linked promoter region (5-HTTLPR) polymorphism, including our study on visual perspective during autobiographical memory retrieval. However, the association of 3rd person perspective with vulnerability for depression does not rely only on genetics. External consistency is provided by the influence of the 5-HTTLPR polymorphism on brain regions involved in emotion regulation and autobiographical memory retrieval (e.g. the medial prefrontal cortex). Internal consistency is provided by the increased prevalence of 3rd person perspective in both currently and previously depressed patients, as well as in depression-prone individuals. Further studies should examine therapeutic opportunities.     

Body dissatisfaction,eating disorders,and depression: A developmental perspective

McCarthy (1990) contends that a cultural ideal of thinness (the thin ideal) causes depression and eating disorders to occur more frequently in women than men. She believes eating disorders are a way of coping with depression and hypothesizes that the thin ideal has its greatest impact during puberty when sexual attractiveness becomes important and changes in physical appearance increase the discrepancy between the adolescent girl's actual and ideal body image. The present study used a cross-sectional design of 5th, 8th, and 12th grade males and females (N = 599) to test several predictions from McCarthy's model. As expected, 8th and 12th grade females preferred a thinner than average body shape. They were more dissatisfied with their bodies than males and scored higher on measures of disordered eating. In contrast, before puberty (5th grade) boys were more depressed than their female peers but this pattern was reversed in 8th grade boys and girls. Paralleling changes in depression, disordered eating scores were highest in 8th and 12th grade girls. Both of these findings underscore the role of maturational factors in the onset of eating disorders. Although the sample was ethnically diverse and mainly from middle and low socioeconomic groups, there was a surprisingly high incidence of body dissatisfaction and symptoms of disordered eating. This illustrates the pervasiveness of thinness as a standard of feminine beauty in our society and the damaging effects it can have.     

Cognitive avoidance of intrusive memories: recall vantage perspective and associations with depression

Although recent research demonstrates that intrusive memories represent an overlapping cognitive feature of depression and post-traumatic stress disorder (PTSD), there is still a general paucity of research investigating the prevalence and maintenance of intrusive memories in depression. The current study investigated the association between a range of cognitive avoidant mechanisms that characterize PTSD samples (i.e., suppression, rumination, emotional detachment, and an observer vantage perspective) and intrusive memories of negative autobiographical events in relation to dysphoria. Hypotheses were based on the proposition that employment of these cognitive mechanisms would hinder the emotional processing of the negative event, thus contributing to the maintenance of intrusions. Results supported an association between negative intrusive memories, dysphoria, and avoidant mechanisms. Significant differences were also found between field and observer memories and measures of emotional detachment and rumination. Implications relating to intrusive memory maintenance and treatment approaches are discussed.     

Understanding vulnerability for depression from a cognitive neuroscience perspective: A reappraisal of attentional factors and a new conceptual framework

We propose a framework to understand increases in vulnerability for depression after recurrent episodes that links attention processes and schema activation to negative mood states, by integrating cognitive and neurobiological findings. Depression is characterized by a mood-congruent attentional bias at later stages of information processing. The basic idea of our framework is that decreased activity in prefrontal areas, mediated by the serotonin metabolism which the HPA axis controls, is associated with an impaired attenuation of subcortical regions, resulting in prolonged activation of the amygdala in response to stressors in the environment. Reduced prefrontal control in interaction with depressogenic schemas leads to impaired ability to exert attentional inhibitory control over negative elaborative processes such as rumination, leading in turn to sustained negative affect. These elaborative processes are triggered by the activation of negative schemas after confrontation with stressors. In our framework, attentional impairments are postulated as a crucial process in explaining the increasing vulnerability after depressive episodes, linking cognitive and biological vulnerability factors. We review the empirical data on the biological factors associated with the attentional impairments and detail how they are associated with rumination and mood regulation. The aim of our framework is to stimulate translational research.     

Teenage suicide in Zimbabwe

The teenage suicide rate in Zimbabwe did not change much during the 1970s, though the rate rose for female teenagers. Female teenagers used poison as a method of suicide more often than did adults, and self-immolation had increased in frequency among young women by the mid-1980s.     

Consciousness: a neurological perspective

Consciousness is a state so essentially entwined with human experience, yet so difficult to conceptually define and measure. In this article, we explore how a bidimensional model of consciousness involving both level of arousal and subjective awareness of the contents of consciousness can be used to differentiate a range of healthy and altered conscious states. These include the different sleep stages of healthy individuals and the altered states of consciousness associated with neurological conditions such as epilepsy, vegetative state and coma. In particular, we discuss how arousal and awareness are positively correlated in normal physiological states with the exception of REM sleep, while a disturbance in this relationship is characteristic of vegetative state, minimally conscious state, complex partial seizures and sleepwalking.     

Teenage pregnancy: Seeking patterns that promote family harmony

Survey data from the RELATE inventory (www.relate-institute.org) was gathered for married couples (N = 374) and was analyzed for effects of marital quality on perceptions of weight as a problem in the marriage, activity level, and eating habits. Results indicate that wife marital quality was positively associated with weight being a problem for wives, while husband marital quality was negatively associated with weight being a problem for both husbands and wives in the relationship. Wife marital quality was also positively associated with husband activity level, while husband marital quality was negatively associated with husband activity level. Implications for clinicians are discussed.     

Explaining delusions: a cognitive perspective

There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. This review considers those models that explain delusions as a breakdown of normal belief formation (belief-positive models), approaches that explain the pathology only (belief-negative models) and approaches that view delusions as one end of a distribution of anomalous mental phenomena (the continuum view). A cognitive theory that includes the 'pragmatic pathology' of delusions will be able to address both the phenomenology and the treatment of delusion-related distress.