Cognitive and life stress predictors of relapse in remitted unipolar depressed patients: test of the congruency hypothesis.

Remitted depressed subjects (N = 59) were followed longitudinally to determine whether dependent or self-critical persons are more vulnerable to relapse after exposure to life events that have a bearing on interpersonal or achievement concerns. Regression analyses indicated that congruency effects, as measured by the occurrence of achievement-related adversity in the lives of self-critical subjects, accounted for a significant increment in relapse variance over each variable entered singly. When data from the 2 months just before relapse were analyzed, some evidence of congruency effects in dependent subjects experiencing interpersonal-related adversity was obtained. These findings highlight the dimensional qualities of life even impact and call for greater differentiation in modeling the activation of a diathesis and precipitation of depression after life stress.     

Severity of unipolar depression and choice of treatment.

The National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program (Elkin et al., Archives of General Psychiatry, 46, 971-982; 1989) reported treatment-by-severity interactions favouring pharmacotherapy for more depressed outpatients, on a minority of relevant comparisons. The present study reports secondary analyses from a similar, preexisting data set in which treatment-by-severity interactions are systematically investigated with depressed outpatients treated either with nondirective psychotherapy, behaviour therapy, pharmacotherapy, or relaxation/placebo. Despite multiple severity measures and variable severity cut scores, no treatment was differentially effective in improving more severely depressed patients. Also, there was little difference across symptom severity levels in the proportions of recovered patients between treatment groups. Finally, dynamic cluster analysis demonstrated that the proportion of pharmacotherapy nonresponders (20%) did not differ from the proportion of nonresponders in behaviour therapy or placebo groups. It is concluded that this failure to replicate the NIMH trial findings can not be attributed to treatment differences, populations or statistical power. The suggestion that pharmacotherapy be the treatment of choice for more severely depressed outpatients appears to be unjustified on the basis of available evidence.     

An experimental study of the effect of mood on body size perception.

The study presented is an experimental investigation of the effect of mood on body size perception. Female students estimated their body size and indicated their degree of dissatisfaction with their body size before and after the induction of a negative or positive mood state. Compared with women who received the positive induced mood, the induction of low mood led to greater disturbances in body size perception in the form of a tendency to overestimate their body size more and significantly greater dissatisfaction with their body size. Furthermore, among the women who received the negative mood condition, compared with those with little or no concern with their body shape, for those with such concerns the induction of low mood led to greater disturbances in body size perception in the form of overestimating their body size significantly more and a tendency towards greater dissatisfaction with their body size. These findings suggest that depressed mood may play an important role in determining the extent of disturbance in body size perception in clinical populations.     

A comparison of clinical features in trichotillomania and obsessive-compulsive disorder.

Trichotillomania (TM) recently has been conceptualized as a variant of obsessive-compulsive disorder (OCD). However, no systematic data have compared the clinical features of these two disorders. Here we report data from 8 TM and 13 OCD patients which suggest important clinical differences between groups. First, TM patients reported a significantly greater degree of pleasure during hair-pulling than OCD patients reported during performance of ritualistic behaviors. Second, TM was accompanied by significantly fewer associated obsessive-compulsive symptoms. Third, the groups differed with regard to other clinical features including anxiety, depression, and personality characteristics. We conclude that TM is not conceptualized best as a variant of OCD.     

Correlates of memory decline: a 4-year longitudinal study of older adults with memory complaints.

Change in memory performance and its correspondence to change in speed of performance and self-reported memory functioning were investigated longitudinally in 30 older adults with memory complaints. Subjects were assessed by self-report questionnaires and cognitive tests 3 times, at near 2-year intervals. A significant decline in word-recall scores was found, which was accompanied at the group level by significant self-reported decline in everyday memory functioning and nonsignificant decline in Wechsler Adult Intelligence Scale Digit Symbol scores (alpha = .05). The oldest subjects showed the most substantial declines in memory performance. At the individual level, however, memory change did not significantly correlate with either change in self-reports or change in Digit Symbol scores. Although these results do not support a cognitive slowing model of decline at the intraindividual level, they do have implications for intervention of age-related memory decline.     

Automatic phonological priming in visual word recognition

Theories of visual word recognition have proposed that a word’s phonological properties can be involved in reading visually presented words. Further, it is commonly supposed that this phonological information can be arrived at in at least two ways: (1) by looking it up after identifying the word visually (a lexical route) or (2) by rule-governed translating of the word’s orthographic code (a nonlexical route), Four experiments were conducted to examine whether phonological information is automatically accessed in visual word recognition, and, if so, how this occurs. A priming technique was used with a display sequence of mask, prime, target, mask. Subjects were asked to make written responses to any words that they thought were present, and prime identification was minimal. A facilitatory effect of phonological priming on target identification occurred when primes were homophones of targets. However, no similar facilitation occurred when the prime was a nonword homophone of the target. Further, the homophone priming effect was found irrespective of whether targets followed the spelling-to-sound rules of English. The results suggest that automatic access to phonology can occur in visual word recognition and that it operates by means of a lexical route.