Depressive attributional style and depression following childbirth.

The reformulated learned helplessness model posits that individuals who make internal, stable, and global attributions for undesired outcomes are more likely than others to become depressed when faced with important life events that are perceived as uncontrollable. Two questions arise from the reformulated learned helplessness model within the context of the event of childbirth. The 1st question is whether the relationship between depressive attributional style and concurrent depression found in college undergraduates can be extended to women anticipating the birth of their 1st child. The 2nd question is whether women's prenatal attributional style is predictive of depression in the 1st wk postpartum. 50 pregnant women (mean age 28.85 yrs) completed the Attributional Style Questionnaire and 3 measures of depression during the 3rd trimester of pregnancy and 3 days postpartum. The results provide negligible support for the notion of depressive attributional style as defined by the hypothesis. Depression of clinical severity was reported by 2–6% of Ss during the 3rd trimester and by 10–24% postpartum. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Construct of attributional style in depression and marital distress.

Although important theoretically, consistency in attribution responses or attributional style has rarely been investigated empirically. The responses of 150 couples were used to examine whether consistency of attribution responses within attribution dimensions and consistency in the pattern of responses across attribution dimensions were associated with adaptational outcomes. Replicating previous findings, mean attribution scores correlated with depression and with marital distress. Consistency of attribution responses was unrelated to either adaptational outcome, whereas (1) theoretically derived pessimistic and optimistic attribution patterns were related to depression scores and (2) benign and nonbenign marital attribution patterns were related to marital satisfaction scores. The implications of these findings for the level at which attributional style is best conceptualized are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of stressful life events and depression: A test of attributional models.

Tested the attributional models of depression proposed by L. Y. Abramson et al (see record 1979-00305-001), using 278 undergraduates who had recently experienced a stressful event and 51 55–79 yr old adults who sought treatment for problems with depression. Three questions were addressed: (a) the validity of the hypothesized independent and direction relation between each of the dimensions of internality, stability, controllability, intentionality, and globality and depression; (b) the causal relation between attributions and depression in a 2-mo prospective study; and (c) evaluation of the model on the 2 disparate samples. Ss were administered a battery of depression measures; students completed an attribution questionnaire, while adults completed a measure of life stress attributions. Causal modeling statistical procedures were applied to both the question of concurrent relations and causal relations between cognitions and depression. Results suggest minimal support for the attributional model: The dimensions were not each independently and directly associated with depression in the manner predicted, and the model that best fit the data was generally congruent for both the normal and clinical samples. In terms of direction of causality, the data were more consistent in indicating that depression causes cognitions than in indicating the reverse. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antidepressants and biochemical theories of depression.

Reviews recent biochemical and neurophysiological findings on depression. Early interest in amine uptake systems, notably serotonin and norepinephrine, which dominated the literature for many years, has now shifted to research on more complex amine receptor systems and the importance of amine receptor changes in depression. It is concluded that although much important work has been done, a singular or comprehensive theory of depression from the biological perspective has not yet been developed. There may be multiple biochemical and psychological pathways to depression. (101 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative attributional style in seasonal and nonseasonal depression

OBJECTIVE: There is a substantial relationship between dysfunctional cognitions and the clinical course of major depression. This study examined whether this association extends to patients with seasonal affective disorder. METHOD: A revised version of the Attributional Style Questionnaire was used to assess negative attributional style and predict response to treatment in a group of depressed outpatients, 26 with seasonal depression and 30 with nonseasonal, unipolar major depression. RESULTS: Pretreatment scores on negative attributional style did not differ between the patients with seasonal affective disorder and those with nonseasonal depression. Negative attributional style predicted poor response to pharmacotherapy in the nonseasonal depression group but did not predict response to light therapy in the group with seasonal affective disorder. CONCLUSIONS: Dysfunctional cognitions may play a lesser role in seasonal affective disorder than in nonseasonal depression.     

A review of the neurobiological effects of psychotherapy for depression.

Although randomized, controlled clinical trials have shown that different forms of psychotherapy may be efficacious for depression, psychotherapy has not been widely reported to have effects upon the neurobiological concomitants of depression in similar ways as medication. Neuroendocrinal changes that occur during depression (principally hypercortisolaemia) produce structural and functional alterations to the prefrontal cortex, hippocampus, and amygdala, plus the connectivity between these regions of the brain. This article reviews the evidence to date regarding the neurobiological effects of psychotherapy for depression and suggests a hypothetical pathway linking the nurturing effects of the therapist–patient “bond” and restoration of neuroendocrinal “balance.” This pathway may provide a neurobiological causal link between psychotherapy and alleviation of depression in the same way as that which exists for pharmacological treatments, and argues for a model of depression that includes both biological and psychological effects of psychotherapy when considering treatment choice and application. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A dialectic of experience: A radical empiricist approach to conflicting theories in psychotherapy.

Uses the radical empiricism of William James (e.g.,1890 [1981]), in combination with the work of G. A. Kelly (1963) and E. Husserl (1929 [1977], 1936 [1970]), in a dialectical exploration of the roots of the problem of psychotherapy theories. The convolutions and confusions that result from metaphysical pursuits are clarified, although no attempt is made to finalize any particular theory. The dialectic of experience, like a kind of cognitive therapy on psychotherapy theory itself, shows how differing sets of presuppositions have reframed and redefined primary experience to arrive at radically different, incompatible theories. The discussion leads to a common factor approach to psychotherapy research, practice, and theory that is cognizant of the dialectic of experience. The dialectic accommodates the insights of the various schools without sacrificing them in a superficial eclecticism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergences among psychoanalytic and cognitive-behavioral theories of depression.

Discusses 2 types of depression based on disruptions of (1) interpersonal relatedness or (2) self-esteem, and considers the nature, etiology, and treatment of depression based on the phenomenology of the issues that cause individuals to become depressed. The interpersonal perspective of S. Arieti and J. Bemporad (1980), the object relations perspective of J. Bowlby (see record 1988-16459-001), and the psychoanalytic ego psychology and cognitive developmental theory perspective of S. J. Blatt (1992) are compared and contrasted with each other and with the cognitive-behavioral perspective of A. T. Beck (1983). Areas of agreement and differences among these 4 theoretical positions are discussed in terms of their implications for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of psychotherapy for depression in children and adolescents: A meta-analysis.

Serious sequelae of youth depression, plus recent concerns over medication safety, prompt growing interest in the effects of youth psychotherapy. In previous meta-analyses, effect sizes (ESs) have averaged .99, well above conventional standards for a large effect and well above mean ES for other conditions. The authors applied rigorous analytic methods to the largest study sample to date and found a mean ES of .34, not superior but significantly inferior to mean ES for other conditions. Cognitive treatments (e.g., cognitive-behavioral therapy) fared no better than noncognitive approaches. Effects showed both generality (anxiety was reduced) and specificity (externalizing problems were not), plus short- but not long-term holding power. Youth depression treatments appear to produce effects that are significant but modest in their strength, breadth, and durability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting outcomes of psychotherapy: A comparison of predictions from two attitude theories.

Compared social judgment and dissonance theory in their ability to predict the outcomes of psychotherapy on the basis of patient-therapist attitudinal similarity. 65 mental health clinic outpatients of 16 therapists were given attitude questionnaires before and after approximately 12 therapy contacts. It was found that dissonance theory was better able than social judgment theory to predict both those attitude changes that took place and the amount of similarity that a patient perceived between himself and his therapist. On the other hand, certain concepts from social judgment theory did prove efficacious in predicting certain kinds of outcomes among certain therapy conditions, but not in the manner predicted. Finally, certain outcomes of psychotherapy were found to be unpredictable from either theory studied. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The contributions of attributional style, expectancies, depression, and self-esteem in a cognition-based depression model.

Used structural equation modeling to examine the relations among attributional style (AS), outcome expectancies for future life-events, depression, and self-esteem among 195 college students. Ss completed questionnaires assessing AS, outcome expectancies, depression, and self esteem. Consistent with the hopelessness and self-regulation theories of depression, the 1st series of models illustrated that positive attributional styles (PAS) and negative attributional styles (NAS) had direct influences on expectancies, and that expectancies had a direct influence on depression. An NAS influenced depression independent of one's expectancies for the future. A 2nd series of models, which included the latent construct of self-esteem, showed that the previously modeled relations showing a PAS and an NAS having direct influence on expectancies and expectancies having a direct inverse effect on depression remained consistent. A PAS had an indirect positive influence on self-esteem via expectancies. A PAS also had a direct positive effect on self-esteem, an unexpected finding according to self-regulation theory. The final model also showed that self-esteem was inversely influenced by depression. A LISREL correlation matrix is appended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal psychotherapy for co-occurring depression and chronic pain.

Up to 37% of individuals experience chronic pain during their lifetimes. Approximately one fourth of primary care patients with chronic pain also meet criteria for major depression. Many of these individuals fail to receive psychotherapy or other treatment for their depression; moreover, when they do, physical pain is often not addressed directly. Women, socioeconomically disadvantaged individuals, African Americans, and Latinos all report higher rates of pain and depression compared with other groups. This article describes a version of interpersonal psychotherapy tailored for patients with comorbid depression and chronic pain, interpersonal psychotherapy for depression and pain (IPT-P). IPT-P potentially could be delivered to many patient populations in a range of clinical settings, but this article focuses on its delivery within primary care settings for socioeconomically disadvantaged women. Adaptations include a brief 8-session protocol that incorporates strategies for anticipating barriers to psychotherapy, accepting patients' conceptualization of their difficulties, encouraging patients to consider the impact of their pain on their roles and relationships, emphasizing self-care, incorporating pain management techniques, and flexible scheduling. In addition, IPT-P is designed as an adjunct to usual medical pain treatment, and seeks to engage non–treatment-seeking patients in psychotherapy by focusing on accessibility and relevance of the intervention to concerns common among patients with pain. Identifying patients with comorbid depression and chronic pain and offering IPT-P as a treatment option have the potential to improve clinical outcomes for individuals with depression and chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Applications of the psychotherapy phase model to clinically significant deterioration.

While previous research on deterioration has focused on identifying individuals at risk for negative outcomes, little is known about the nature or pattern by which deterioration occurs. The problem of deterioration is especially salient in training clinics; a setting in which higher deterioration rates have been reported. Two studies were designed to test the applicability of the phase model to deterioration in a training clinic and to replicate the model with a training clinic referral-base sample. In Study 1, the course of therapy was monitored for 135 clients. For the 38 clients who deteriorated during therapy, a model where increased symptoms (demediation) reliably preceded both decreased functioning (dehabilitation) and decreased well-being (demoralization) was found. In Study 2, the same three phases were prospectively monitored for 914 undergraduate students on a weekly basis throughout a single semester. For the 158 individuals who deteriorated during this time, a model where demediation reliably preceded dehabilitation, which preceded demoralization was found. These results have clinical implications for the use of tailored intervention strategies focusing on the deterioration phases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Liking versus loving: A comparative evaluation of theories.

In this article, I review and comparatively evaluate alternative theories of liking, loving, and their interrelations. The article opens with an introduction to some of the main issues and continues with three major parts. In the first, I review theories in which liking and loving are viewed as regions along a single continuum. In the second part, I discuss theories in which liking and loving are viewed as qualitatively distinct. This part is divided into three primary sections. The first section considers theories in which liking and loving are essentially disjoint sets. The second section considers theories in which liking and loving are viewed as overlapping sets. The third section considers theories in which liking is viewed as a subset of loving. In the final part, I present a framework that provides some coherence and integration of the various theories that have been discussed. It is concluded that most theories of liking and especially of loving have dealt with only part of each phenomenon and that better understanding is possible if these theories are viewed within a unifying framework that encompasses a broader view of liking and loving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of the adequacy of cognitive/behavioural theories for understanding depression in women.

Four cognitive/behavioral theories (CBTs) of depression are evaluated against the criterion of their ability to account for the finding that rates of depression are higher in women than in men. A review of relevant research leads to the conclusion that CBTs as currently formulated are unable to account for the predominance of women among the depressed. In addition, because CBTs are implicitly male-biased in their assumptions about factors that increase vulnerability to depression, these theories, and the therapies derived from them, are inadequate for the purpose of furthering an understanding of depression in women. Models being developed by feminist theorists and therapists are considered potentially more promising for understanding depression in women. (French abstract) (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the deficits in deficit theories of depression.

Contends that J. M. Stoppard's (see record 1989-29654-001) assessment of the adequacy of cognitive/behavioral theories of depression is both warranted and overdue. It is noted that there may be a tendency to overdiagnose depression in women merely on the basis of a self-perpetuating statistical probability model. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A critical evaluation of the state-of-the-art in psychotherapy outcome research.

Results from recent large-scale psychotherapy outcome studies have prompted efforts to manualize clinical practice. To many, the use of empirically validated manualized treatments for clients with specific Diagnostic and Statistical Manual disorders represents the current state of the art in the field. Despite these efforts, it is argued that attempts to manualize clinical practice are premature. The current state of the art is reviewed, and the manualization movement is critiqued with a consideration of current clinical practices and recent findings from the field of psychotherapy process research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral and psychodynamic group psychotherapy in treatment of geriatric depression.

Assessed whether depressed geriatric patients would respond to group psychotherapy and, if so, whether they would respond differently to cognitive-behavioral and psychodynamic group psychotherapy. 33 55–78 yr olds entered the study, and 20 completed the 9-mo course of treatment. Ss in both types of groups showed statistically and clinically significant reductions on observer-rated measures of depression and anxiety (Hamilton Rating Scale for Depression and Hamilton Anxiety Scale), as well as on self-report measures of depression (Self-Rating Depression Scale and Beck Depression Inventory). There were no clinically significant differences, but a statistically significant difference between the types of groups was found for the Beck Depression Inventory, and this favored the cognitive-behavioral treatment. Limitations on interpretation of these results because of the lack of a control condition are discussed. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist competence and patient outcome in interpersonal psychotherapy of depression.

This article examines whether the therapist's level of competence in conducting interpersonal psychotherapy of depression (IPT) is associated with patient improvement. Data from 35 depressed outpatients treated for up to 16 sessions as part of the IPT training program for the National Institute of Mental Health Treatment of Depression Collaborative Research Program were used. Multiple regression analyses were performed to predict outcome from 4th-session ratings of therapist skill while controlling for important pretreatment patient characteristics including level of depression, social adjustment, and expectations of treatment outcome. The results showed that measures of therapist performance contributed significantly to the prediction of patient-rated change and change in the apathy associated with depression but not to measures of social adjustment at 16 weeks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between specific and general dimensions of the psychotherapy process in interpersonal psychotherapy of depression.

This article examines the relation between general dimensions of the psychotherapy process, rated with the Vanderbilt Psychotherapy Process Scale (VPPS), and a type of manual-guided psychotherapy, Short-Term Interpersonal Psychotherapy of Depression (IPT). With the use of data from a training program in IPT, two types of analyses were performed. First, VPPS factors were correlated with IPT therapist competence ratings. This analysis showed that all VPPS-rated dimensions of patient and therapist behaviors were significantly correlated with IPT competence ratings. Especially strong correlations occurred between IPT competence ratings and the VPPS therapist factors of (a) Exploration and (b) Warmth and Friendliness. Second, to evaluate whether the general process features that influenced IPT competence ratings were also related to the therapy's effectiveness, correlations between VPPS process dimensions and patient outcome were performed. This analysis indicated that VPPS-rated therapist behaviors were significantly predictive of patient outcome, whereas patient behaviors were generally not significantly related to outcome. Taken together, the findings indicate the importance of general aspects of the psychotherapy process in therapist evaluation and efficacy of manual-guided psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)