A multisample item response theory analysis of the Beck Depression Inventory-1A.

The widespread employment of the Beck Depression Inventory-1A ({bdi}-1{a}) has spawned a number of practices: (1) The employment of an unweighted total score as a measure of depression; (2) Its use in populations other than that in which it was normed; and (3) The employment of {bdi}-1{a} total scores in hypothesis tests about population differences in mean depression. A sequential procedure based on item response theory was employed to assess the validity of these practices for the case of 4 populations: clinical depressives (n?=?210), mixed nondepressed psychiatric patients (n?=?98), and students from 2 different universities (n?=?624). The findings suggest that the 1st practice was not justified for any of these populations, that the {bdi}-1{a} was employable only with clinical depressives and with 1 of the university populations, and that mean comparisons were not allowable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary early-onset dysthymia: Comparison with primary nonbipolar nonchronic major depression on demographic, clinical, familial, personality, and socioenvironmental characteristics and short-term outcome.

In order to explore the characteristics and validity of DSM-III-R primary early-onset dysthymia, we compared outpatients with primary early-onset dysthymia (n?=?32) and primary nonbipolar nonchronic major depression (n?=?35). Fifty-nine percent of the dysthymics were currently in a major depressive episode, and 97% had a history of major depression. Compared with the episodic major depressives, the early-onset dysthymics exhibited significantly higher rates of melancholia, greater global impairment, and an earlier age of onset of major depression; were more likely to have recurrent major depressive episodes; and had higher rates of personality and substance use disorders. In addition, significantly higher proportions of early-onset dysthymics than nonchronic major depressives had family histories of affective and antisocial personality disorders. The dysthymics also exhibited significantly higher levels of depressive personality traits and self-criticism, lower levels of extraversion and social support, and higher levels of chronic strain and perceived stress than did the major depressives. Finally, the early-onset dysthymics exhibited significantly greater depression and poorer social and global functioning over the course of a 6-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dependency and self-criticism in depression: Evaluation in a clinical population.

The validity of Blatt's (1974) model of depression was explored in a clinical population. Subjects included 63 female outpatients with major depression and 15 women with no lifetime history of psychopathology. All subjects received structured diagnostic and family history interviews and completed the Depressive Experiences Questionnaire (DEQ), which was developed to assess Blatt's concepts of anaclitic and introjective depression. In addition, the depressives received extensive follow-up assessments 6 months later. The depressives had significantly higher levels of anaclitic and introjective traits, respectively. Dependency and, to a lesser extent, self-criticism appeared to be influenced by clinical state, as recovered depressives' scores exhibited a greater decline between the initial and follow-up assessments than did nonrecovered patients' scores. Finally, analyses examining the relation between dependency and self-criticism and a broad range of clinical, family history, and short-term outcome variables provided little support for Blatt's (1974) model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Major depressive subtypes and treatment response

The purpose of this study was to investigate the relationships between depressive subtypes and response to fluoxetine treatment in a large cohort of outpatients. We studied 294 outpatients with major depressive disorder who were then treated with fluoxetine 20 mg/day for 8 weeks. Treatment outcome was evaluated with the Hamilton Depression Rating Scale (HDRS)-17, the Clinical Global Impressions-Severity, and with the HDRS-8; the latter is proposed to be a relatively more specific measure of depression severity than the HDRS-17. We assessed the relationships between degree of treatment response and several depressive subtypes (melancholic, atypical, hostile, and anxious depression, double depression, and depression with comorbid personality disorders), after adjusting for baseline depression severity. We found that nonanxious depressives (patients without any comorbid anxiety disorder) improved slightly but significantly more during treatment than anxious depressives on all outcome measures. Melancholic depression was associated with slightly less improvement on the HDRS-17 only, whereas the other subtypes of depression were not associated with differences in treatment outcome.     

Depression and causal attributions for success and failure.

Investigated the effects of depression on causal attributions for success and failure. From a pool of 340 female university students, 60 were separated into depressed and nondepressed groups on the basis of Costello-Comrey Depression Scale scores, and then received either 20, 55, or 80% reinforcement on a word association task. Following the task, attributions were made for outcome using the 4 factors of effort, ability, task difficulty, and luck. In accord with predictions generated from a self-serving biases hypothesis, nondepressives made internal (ability, effort) attributions for a successful outcome (80% reinforcement) and external attributions (luck, task difficulty) for a failure outcome (20% reinforcement). As predicted from consideration of the self-blame component of depression, the attributions made by depressives for a failure outcome were personal or internal. Contrary to expectations, depressives also made internal attributions for a successful outcome. The findings for depressives are discussed in relation to the recently revised learned helplessness model of depression, which incorporates causal attributions. For nondepressives, the findings are considered in terms of the self-serving biases hypothesis. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the Golden-Meehl indicators in the detection of schizoid-taxon membership.

Investigated the ability of 7 MMPI items to identify schizoid-taxon membership as identified by R. R. Golden and P. E. Meehl (see record 1979-25088-001). 113 schizophrenics (mean age 26.9 yrs), 24 acute depressives (mean age 40 yrs), and 43 remitted depressives (mean age 45.4 yrs) participated. With a cutting score of 4 or more items answered in the schizoid direction, 53.1% of schizophrenics were identified as taxon members, whereas 70.9% of acutely depressed Ss were so identified. In contrast, 9.3% of remitted depressives were identified as taxon members. Only 33.3% of a subgroup of the schizophrenics were consistently identified as taxon members on 2 testings, whereas 37.8% of this group were consistently identified as nontaxon members. The correlation of the scores from Test 1 to Test 2 was .54. The sum of the standard scores for the depression (D), Psychasthenia (Pt), Schizophrenia (Sc), and Social Introversion (Si) scales was also unsuccessful in identifying taxon members regardless of the cutting score used, although it did differentiate the 2 groups of depressives. The 7 items and the sum of the D, Pt, Sc, and Si scales may be reasonable indicators of current psychopathology and emotional distress. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dexamethasone suppression and self-reinforcement correlates of clinical depression.

Neuroendocrine dysfunction and self-reinforcement deficits were evaluated in 45 individuals exhibiting symptoms of major depression. The dexamethasone suppression test (DST), Beck Depression Inventory (BDI), and Frequency of Self-Reinforcement Questionnaire (FSRQ) were administered to subjects who also were participating in a comparative antidepressant drug study. Subjects with low rates of self-reinforcement tended to exhibit normal DST responses, whereas high self-reinforcement could not be characterized as being significantly more or less dysfunctional on the DST. Only one third of this sample of depressives evidenced abnormal DSTs, which suggests that in these cases of depression with normal neuroendocrine functioning, a deficit in self-reinforcement could be related to depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal follow-up of unipolar depressives: An investigation of predictors of relapse.

Conducted longitudinal interval follow-up evaluations, using the method described by R. Shapiro and M. Keller (unpublished), with 113 19–60 yr old unipolar depressives who had completed a cognitive-behavioral intervention in an examination of 1- to 3-yr outcomes and risk factors for relapse. Ss were administered the Beck Depression Inventory, the Schedule for Affective Disorders and Schizophrenia, and a life satisfaction scale. 59, 28, and 26 Ss were assigned to major depressive, intermittent depressive, and double depressive categories, respectively, according to pretreatment symptomatology and the Research Diagnostic Criteria. Results indicate that the recovery rate of the major depressives (75%) was significantly higher than that of the intermittent depressives (43%) or that of the superimposed depressives (27%). Significant predictors of relapse, accounting for 38% of the variance, included the number of previous episodes of depression, family history, poor health, history of depression in 1st-degree relatives, dissatisfaction with major life roles, depression level at entry to the study, and age. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward depression among rehabilitation participants with acute stroke: Evidence of an age cohort effect.

Purpose/Objective: Depression is commonplace after acute stroke and is associated with increased morbidity and mortality. No data exist regarding attitudes about depression among older persons with acute stroke and their potential impact on self-report of depressive symptoms. The objective of this study was to determine if attitudes toward depression affect depression symptom reporting. Research Method/Design: Cross-sectional using data from an inpatient rehabilitation unit. Seventy-two people with acute stroke were surveyed regarding their attitudes toward depression as part of a larger battery assessing their cognitive and emotional functioning. Results: Both age and cognitive status were significant predictors of attitudes toward depression. Older participants expressed significantly more negative attitudes about depression and seeking professional help compared with younger participants. Those with higher cognitive scores held more positive attitudes. However, attitudes about depression were unrelated to participants' responses on self-report measures of depression. Conclusions/Implications: Participants with stroke who were older were more likely to report negative attitudes about depressive symptoms than were younger participants. However, these attitudes do not appear to represent a barrier to their ability to accurately report the presence and severity of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptual accuracy in schizophrenia, depression, and neurosis, and effects of amytal.

"Three perceptual tests were given to four groups of hospitalized patients: chronic schizophrenics, early schizophrenics, depressives, and neurotics. The tests, Hands, Street Gestalt, and Rorschach, were administered first without then with intravenous sodium amytal and amphetamine sulphate. Without drugs, on the Hands test, the groups did not differ in accuracy. On Gestalt Completion, the CS and Dp groups gave fewer correct responses than the ES and Nt groups… . Beck's finding of lowered F + % in schizophrenia was confirmed. With drugs, on the Hands test, all groups were less accurate. On Gestalt Completion, all groups were more accurate and gave fewer rejections and unique responses. There was no change in Rorschach F + %." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knowledge about depression: Effects of depression and vulnerability levels on self and other perceptions.

275 depressed and nondepressed undergraduates (determined by the Beck Depression Inventory) provided estimates of the frequency, intensity, and duration parameters for themselves and the "average other." As expected for the self-referent condition, depressives displayed significantly higher frequency and intensity estimates than normals. In the case of average others, depressives did not provide higher estimates, as predicted from a self-based consensus bias position. Rather, the critical factor distinguishing the 2 groups was the relationship between self and average-other ratings, with depressives viewing themselves as worse than average, and normals viewing themselves as significantly better. Using the Dysfunctional Attitude Scale as a measure of vulnerability for depression, it was found that vulnerability level per se did not have a significant impact on Ss' estimates. This finding is discussed in relation to A. T. Beck's (1976) cognitive model of depression, with its emphasis on the etiological role of dysfunctional attitudes in depression. (French abstract) (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Semantic priming in major depressive state

We studied semantic priming in 20 major depressive subjects. The methodology used was a visual lexical decision task. Semantic priming is the facilitation of target word recognition (shortening of response time) by the prior presentation of a semantically related context (a prime word). It relies on semantic processing of words and context, facilitating early cognitive stages of response. Varying the temporal interval between prime and target words onset allows us to distinguish between two priming mechanisms, relying on more automatic (test 1) or more controlled (i.e. attention dependent) (test 2) information processing. We observe a significant retardation for words and pseudo-words in depressives (in relation to controls) in both tests. In spite of a general retardation and increase of response times in depressives, semantic priming is evident in both groups and both tests, and does not differ significantly between depressive and control groups in either automatic or controlled conditions. Theses results confirm that semantic processing is not impaired in depression, and are discussed with regard to the hypothesis of an effortful processing impairment in depression, and to depressive retardation.     

Induction of depressive affect after prolonged exposure to a mildly depressed individual.

Administered the Beck Depression Inventory (BDI) to 44 undergraduate roommate pairs during the 1st, 5th, and 11th wks of a 13-wk quarter. 22 pairs contained mildly or moderately depressed Ss; the other 22 pairs contained only nondepressed Ss (NSs). These mildly or moderately depressed Ss included 8 unremitted depressives and 14 transient-remitted depressives. Analyses indicated that after 5 wks and 11 wks of living together, the roommates of unremitted depressives had significantly higher BDI scores than NSs. Moreover, their BDI scores at 5 and 11 wks were significantly higher than they were at the 1st wk. Results also show that at 5 and 11 wks the BDI scores of the roommates of transient-remitted persons were significantly higher than scores of NSs. Possible causes for this induction of depressive affect include direct induction stemming from day-to-day contact, a modeling process, or increased dysphoria associated with an unhappy roommate relationship. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decline in self-reported dysphoria after treatment entry in inner-city cocaine addicts.

This study examined self-reported dysphoria in 82 consecutive admissions to intensive outpatient treatment for cocaine abuse on whom data for the Beck scales for depression, anxiety, and hopelessness were available for intake and 4 subsequent weeks with no more than 1 missing data point. Mean scores on the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) decreased significantly between intake and Week 1, with no further significant changes from Weeks 1–4. Similar drops in the rate of clinically significant BDI and BAI scores also were observed. Scores on the Beck Hopelessness Scale (BHS) showed no significant changes. By Week 4, rates of clinically significant depression, anxiety, and hopelessness were similar (17%, 13%, and 16%, respectively) . These findings suggest that assessing depression and anxiety using the BDI and BAI in this population should be postponed for at least 1 week after intake and that intake levels of self-reported mood may be inappropriate baseline measures for evaluating treatment effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Boundary disturbances in schizophrenia.

Studied 4 types of index associated with the concept of "boundary" with 171 psychiatric inpatients who were tested with the Rorschach and independently assessed on other aspects of psychopathology (e.g., measures of depersonalization, stimulus overinclusion, and derealization). Contaminations and fabulized combinations were correlated with indices of pathology from Rorschach and with other psychopathology measures. Penetration scores were related to some indices of psychopathology, while barrier scores were unrelated to pathology. Contaminations were more frequent in schizophrenics than in any other diagnostic group. Fabulized combinations were more frequent among schizophrenics and latent schizophrenics than in depressives. Penetration responses were less frequent in depressives than in any other group. Support was found for the hypothesis that schizophrenics give certain types of responses considered indicative of boundary disturbance such as contamination responses. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional adjustment 5 years after heart transplant: A multisite study.

Objective: To assess levels of and factors associated with depression and negative affect 5 years after heart transplant (HT). Participants: 370 adults 5 years post-HT. Outcome Measures: Cardiac Depression Scale and the Positive and Negative Affect Schedule (PANAS). Research Method: Stepwise multiple regression analyses were used to test 32 potential demographic, medical, functional, and psychosocial factors in adjustment. Results: Predictor variables accounted for 53% of the variance of depression scores and 45% of the variance of PANAS negative affect scores. The best predictors (p = .001) for depression were neurological symptoms, younger age, lower recreational functioning, and lower satisfaction with emotional support, and the best predictors for negative affect were neurological symptoms, lower mobility functioning, and perceived uncertainty about health. Depression scores were lower than norms for nontransplanted heart failure patients, and negative affect levels were comparable to those of the general population. Conclusions: The findings indicate normal long-term adjustment among HT recipients. Several factors associated with negative emotions, including younger age, have not been identified in previous research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Familial subtypes of depression: a clinical view

The clinical workup of 238 unipolar depressives were subdivided according to immediate family history. Pure depressives (with only depression in the family) typically have an illness involving more endogenous features and chronicity. Depression spectrum patients (with only alcoholism or sociopathy in first-degree relatives) have the mildest illness. Sporadic depression (with a negative family history) is associated with an intermediate severity. Premorbid unstable personality characteristics are more common to the spectrum patients. Sporadic patients have the least personality difficulties. While these differences are definite, they are not large enough to justify separation of unipolar depression into subsyndromes dependent on symptom differences. Rather, family history seems to exert its effect most strongly on the distinctive premorbid personality characteristics of the 3 groups.     

Manipulation of self-esteem as a determinant of mood of elated and depressed women.

Tested the theory that self-esteem is a determinant of elation-depression. Changes in self-esteem were induced by having Ss read positive or negative self-evaluative statements. 140 female college students were selected on the basis of extreme scores of characteristic elation and depression and on the basis of suggestibility and were assigned to 1 of 5 treatment or control groups. The induction of positive vs negative cognitions produced significant differences in elation-depression on multiple measures. Characteristically elated and depressed Ss were able to take on opposite mood states. This study suggests that a determinant of depression is evaluative self-statements, supports the utility of cognitive therapy for depressives, and demonstrates a potentially useful technique for inducing more appropriate self-evaluations. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and anxiety among Cambodian refugee women in France and the United States

This study reports on Cambodian refugee data related to signs symptomatic of depression and anxiety, the tendency to worry or ruminate over past events (a culture-bound syndrome called "Khoucherang"), and differences that might be influenced by social system and cultural practice. A sample consisting of 155 women of Cambodian national origin were interviewed in their homes in the USA and France. Answers to the research questions were collected by a focused interview to elicit demographic information, and the Hopkins Symptom Checklist (HSCL) in the Cambodian language to elicit depression and anxiety scores. Women residing in France (87%) were significantly more likely to show signs symptomatic of depression than women residing in the USA (65%). Women in the study reported about three times as much depression as the average American woman. Large numbers of women residing in both countries were symptomatic of anxiety (82% on average). Both groups experienced extreme symptoms of the culture-bound syndrome, "Khoucherang," and appeared to be strongly influenced by the different social systems of the two countries.     

Sexuality and the commission of physical violence to partners and non-partners by men and women.

In 2 studies of physical violence and sexuality among college students, more than 75% of men and more than 60% of women reported committing physical violence in the past year, including more women to partners and more men to non-partners. More than 90% of men who committed violence to partners were also violent to non-partners. In Study 1, among 193 men and 203 women, people who committed violence had higher scores on sexual depression and general depression than did people who were not violent. People violent to non-partners had more sexual preoccupation and more alcohol use problems than did other people. In Study 2, among 160 college men and 138 college women, people in 4 violence groups did not differ in total sexual fantasies or sexual functioning. The findings support the importance of differentiating between violence toward partners and toward non-partners among both men and women and suggest a role of depression in partner violence and antisocial features in violence toward non-partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)