Comparison of postpartum and nonpostpartum depression: clinical presentation, psychiatric history, and psychosocial functioning

This study compared a sample of postpartum women diagnosed with depression with a nonpostpartum depressed group and 2 nondepressed control groups. Women's depressive episodes were compared to determine whether differences existed in symptomatology, previous history, or course. Results indicate that postpartum depression tends to be relatively mild. Both depressed groups had high rates of positive psychiatric history and were equally likely to have recovered at a 6-month follow-up. Groups were also compared on psychosocial variables known to covary with depression: interpersonal relations, stress, and coping. A series of multivariate analyses of covariance showed few differences between the depressed groups that were not attributable to symptom severity, although postpartum depressed women did report better marital relations than did the nonpostpartum depressed women. These findings suggest that there is little to distinguish postpartum from nonpostpartum depression beyond differences in symptom severity.     

Depression among chronic pain patients: Cognitive-behavioral analysis and effect on rehabilitation outcome.

This study addressed two issues concerning the theoretical and clinical relevance of depression to chronic pain: (a) whether reliable differences among depressed, mildly depressed, and nondepressed chronic pain patients could be identified and (b) whether depression influenced participation in or outcome following a rehabilitation program. To address the first issue, four theoretical constructs were measured by multiple scales. Multivariate analyses of each construct revealed significant differences between the three groups on instrumental activities and coping skills, with more depressed individuals reporting lower levels of functioning and less support. An analysis of the second issue revealed that depressed pain patients showed a greater tendency to drop out of treatment. Outcome did not vary with depression among treatment completers. The results reveal the need to consider a cognitive-behavioral model of depression secondary to chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal consequences of depression: Responses to men and women enacting a depressed role.

To investigate interpersonal consequences of depressed behavior, telephone interactions were conducted between same- and opposite-sex pairs of 62 male and 64 female undergraduates. In each pair, one person enacted a depressed or nondepressed role. The content of the 2 roles differed only in the presence or absence of characteristically depressive affect and attitudes. Ratings of interest in further contact, personal rejection, and perceived impairment of role functioning all revealed a similar pattern: Depressed persons were more strongly rejected than nondepressed persons, especially by persons of the opposite sex. Interactions with depressed persons elicited significantly more depression in the listener than did interactions with nondepressed persons. Moreover, significantly more feminine traits were attributed to depressed than nondepressed persons. The responses of others to depressed individuals are discussed with respect to their implications for conceptualizing and treating depression. The results also have implications for the understanding of sex differences in the epidemiology of depression. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Persistent high self-focus after failure and low self-focus after success: The depressive self-focusing style.

Assessed the spontaneous self-focusing tendencies of depressed and non-depressed individuals after success and failure. Based on a self-regulatory perseveration theory of depression, it was expected that depressed individuals would be especially high in self-focus after failure and low in self-focus after success. Ss (41 and 42 undergraduates in Exps I and II, respectively) were administered the Beck Depression Inventory and a measure of spontaneous self-focusing tendencies. Results of Exp I suggest that immediately after an outcome, both depressed and nondepressed Ss were more self-focused after failure than after success. This finding led the authors to hypothesize that differences between depressed and nondepressed individuals in self-focus following success and failure emerge over time. Specifically, immediately following an outcome, both types of individuals self-focus more after failure because of self-regulatory concerns. However, over time, depressed individuals persist in higher levels of self-focus after failure than after success, whereas nondepressed individuals shift to the opposite, more hedonically beneficial pattern. Results of Exp II provide clear support for these hypotheses. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Performance benefits of depression: Sequential decision making in a healthy sample and a clinically depressed sample.

Previous research reported conflicting results concerning the influence of depression on cognitive task performance. Whereas some studies reported that depression enhances performance, other studies reported negative or null effects. These discrepant findings appear to result from task variation, as well as the severity and treatment status of participant depression. To better understand these moderating factors, we study the performance of individuals—in a complex sequential decision task similar to the secretary problem—who are nondepressed, depressed, and recovering from a major depressive episode. We find that depressed individuals perform better than do nondepressed individuals. Formal modeling of participants' decision strategies suggested that acutely depressed participants had higher thresholds for accepting options and made better choices than either healthy participants or those recovering from depression. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Examining scale discriminability in the BDI and CES-D as a function of depressive severity.

Scale discriminability is the ability of a measure to discriminate among individuals ordered along some continuum, such as depressive severity. We used a nonparametric item-response model to examine scale discriminability in the Beck Depression Inventory (BDI) and Center for Epidemiologic Studies Depression Scale (CES-D) in both college and depressed outpatient samples. In the college sample, the CES-D was more discriminating than the BDI, but a standard CES-D cutoff score of 16 overestimated the likely prevalence of depression (45%). The CES-D may be more effective than the BDI in detecting differences in depressive severity in college students but may be less specific. In the depressed outpatient sample, the CES-D was again more discriminating than the BDI. The superior scale discriminability of the CES-D offers one explanation for its poorer specificity in college samples. Endorsing many items that discriminate at low levels of depressive severity can result in scores that exceed a cutoff criterion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, self-focused attention, and expectancies for positive and negative future life events for self and others.

In two studies, we examined depressed and nondepressed persons' judgments of the probability of future positive and negative life events occurring to themselves and to others. Study 1 demonstrated that depressed subjects were generally less optimistic than their nondepressed counterparts: Although nondepressed subjects rated positive events as more likely to happen to themselves than negative events, depressed subjects did not. In addition, relative to nondepressed subjects, depressed subjects rated positive events as less likely to occur to themselves and more likely to occur to others and negative events as more likely to occur to both self and others. Study 2 investigated the role that differential levels of self-focused attention might play in mediating these differences. On the basis of prior findings that depressed persons generally engage in higher levels of self-focus than nondepressed persons do and the notion that self-focus activates one's self-schema, we hypothesized that inducing depressed subjects to focus externally would attenuate their pessimistic tendencies. Data from Study 2 supported the hypothesis that high levels of self-focus partially mediate depressive pessimism: Whereas self-focused depressed subjects were more pessimistic than nondepressed subjects, externally focused depressed subjects were not. The role of attentional focus in maintaining these and other depressive pessimistic tendencies was discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral activation and inhibition systems and the severity and course of depression.

Theorists have proposed that depression is associated with abnormalities in the behavioral activation (BAS) and behavioral inhibition (BIS) systems. In particular, depressed individuals are hypothesized to exhibit deficient BAS and overactive BIS functioning. Self-reported levels of BAS and BIS were examined in 62 depressed participants and 27 nondepressed controls. Clinical functioning was assessed at intake and at 8-month follow-up. Relative to nondepressed controls, depressed participants reported lower BAS levels and higher BIS levels. Within the depressed group, lower BAS levels were associated with greater concurrent depression severity and predicted worse 8-month outcome. Levels of both BIS and BAS showed considerable stability over time and clinical state. Overall, results suggest that BAS dysregulation exacerbates the presentation and course of depressive illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parameters of self-reinforcement and depression.

Assessed the levels of 3 components of self-reinforcement (self-expectation, self-evaluation, and self-reward) in 2 groups of 40 hospitalized psychiatric patients (clinically depressed and clinically nondepressed). Tasks included a word association measure, the WAIS Digit Symbol subtest, and a task involving decisions that would benefit the ward. The depressed group showed significantly lower levels on all 3 variables, which were significantly interrelated. Ss in the depressed group were significantly more reinforcing to others on all 3 variables than to themselves, as compared with the nondepressed group. Despite lower levels of self-reinforcement, there were no differences between the 2 groups' objective performances. The overall results suggest qualifications to a self-reinforcement theory of depression. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and pessimism for the future: Biased use of statistically relevant information in predictions for self versus others.

The cognitive theories of depression emphasize the role of pessimism about the future in the etiology and maintenance of depression. The present research was designed for two reasons: (a) to provide a clear demonstration that depressed individuals' predictions of the likelihood of future outcomes are more pessimistic than those of nondepressed individuals given identical information with which to make forecasts and identical conditions for forecasting, and (b) to test two additional hypotheses regarding possible mechanisms underlying depressives' relative pessimism in forecasting: a social-comparison and a differential attributional-style hypothesis. We used a modification of the cue-use paradigm developed by Ajzen (1977, Experiment 1) and examined depressed and nondepressed people's predictions of the likelihood of future positive and negative outcomes for themselves and for others. The results provided strong support for pessimism on the part of depressed individuals relative to nondepressed individuals in forecasts for both self and others. In addition, whereas nondepressives exhibited a self-enhancing bias in which they overestimated their probability of success and underestimated their probability of failure relative to that of similar others, depressives did not succumb to either positive or negative social comparison biases in prediction. Finally, in line with the attributional-style hypothesis, depressed–nondepressed differences in subjects' cue-use patterns were obtained, especially in forecasts for self. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distinguishing depressed from nondepressed individuals using energy and psychosocial variables.

This study was conducted to determine whether energy level can be used to distinguish depressed from nondepressed individuals and to assess the relative importance of energy level and psychosocial variables in making this distinction. Fifty-seven participants experiencing a current episode of major depression and a matched sample of nondepressed participants completed a self-report questionnaire containing measures of energy level and psychosocial variables. Discriminant analysis revealed that energy level correctly classified 93% as depressed or nondepressed, whereas psychosocial variables correctly classified 87%. Combining the energy and psychosocial variables did not increase the accuracy of classification over that achieved by using only the energy measures. The measure of exhaustion provided the greatest relative contribution to the overall discriminant function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Universal versus personal helplessness in depression: Belief in uncontrollability or incompetence?

The learned helplessness model of depression predicts that depressed individuals believe outcomes are more response independent than do nondepressed individuals in a skill situation. The present study assessed whether depressives' cognitive distortions are specific to their belief about their own skilled action or are a result of a general belief in uncontrollability in the world. Changes in expectancies following success and failure in skill and chance tasks were examined in 32 depressed and 32 nondepressed college students who either performed themselves or observed a confederate perform a pair of tasks. In the skill task, depressed Ss showed significantly smaller changes in expectancy than nondepressed Ss when estimating the probability of their own success. In contrast, depressed and nondepressed Ss did not differ when estimating the probability of another person's success on the identical skill task. It is inferred that depressed individuals view themselves as helpless in a skilled situation but do not view the situation itself as uncontrollable. Results are discussed in terms of the reformulated learned helplessness model. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and interpersonal attraction: The role of perceived similarity.

We hypothesized that depressed individuals are generally viewed as dissimilar and that this perceived dissimilarity contributes to negative reactions to the depressed. In addition, we hypothesized that if perceived similarity affects liking of depressed individuals, than nondepressed subjects should prefer nondepressed targets, but depressed subjects should not share this preference. To test these hypotheses, depressed and nondepressed subjects received information about two targets, both either depressed or nondepressed, one attitudinally dissimilar and one attitudinally similar. They were then asked to fill out an attraction measure and an interest in meeting measure for each target. The results clearly supported the primary hypotheses, demonstrating that nondepressed subjects preferred nondepressed targets and perceived them as more similar than depressed targets, and that this preference for nondepressed targets is not shared by depressed subjects. Tests of supplementary hypotheses also confirmed that depressed subjects perceive their best friends as being more depressed and more dissimilar than do nondepressed subjects. The implications of these findings for the social world of the depressed were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributional and social comparison processes in depression.

In this study we examined the consequences for depressed and nondepressed individuals of receiving comparison feedback regarding their causal understanding of an event. Specifically, the effects of similar, dissimilar, or no-comparison feedback on depressed and nondepressed subjects' evaluations of the comparison other and on their feelings about themselves were investigated. Because the reduction of uncertainty about one's conception of social reality is a major motive underlying social-comparison processes, we expected that depressed individuals, who are assumed to have experienced heightened uncertainty associated with frequent exposure to uncontrollable life events, would be more motivated to engage in social comparison and would be more sensitive to social-comparison feedback. Results generally were consistant with this reasoning. The implications of the results in terms of the development and maintenance of depression were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of depression on response to comedy: A dynamic facial coding analysis.

Individuals suffering from depression show diminished facial responses to positive stimuli. Recent cognitive research suggests that depressed individuals may appraise emotional stimuli differently than do nondepressed persons. Prior studies do not indicate whether depressed individuals respond differently when they encounter positive stimuli that are difficult to avoid. The authors investigated dynamic responses of individuals varying in both history of major depressive disorder (MDD) and current depressive symptomatology (N = 116) to robust positive stimuli. The Facial Action Coding System (Ekman & Friesen, 1978) was used to measure affect-related responses to a comedy clip. Participants reporting current depressive symptomatology were more likely to evince affect-related shifts in expression following the clip than were those without current symptomatology. This effect of current symptomatology emerged even when the contrast focused only on individuals with a history of MDD. Specifically, persons with current depressive symptomatology were more likely than those without current symptomatology to control their initial smiles with negative affect-related expressions. These findings suggest that integration of emotion science and social cognition may yield important advances for understanding depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and the perception of reinforcement.

Tested the prediction of the learned helplessness model of depression that depressed Ss tend to perceive reinforcement as more response-independent than do nondepressed Ss in skill tasks, but not in chance tasks. Changes in expectancies for success following reinforcement in chance and skill tasks were examined in 32 college students. The Rotter Internal-External Control Scale and Beck Depression Inventory were used to classify Ss into 4 groups: depressed high external, depressed low external, nondepressed high external, and nondepressed low external. The predictions were confirmed: nondepressed Ss showed greater expectancy changes than depressed Ss in skill, while the changes of depressed and nondepressed Ss were similar in chance. Externality had no significant effect on expectancy changes in chance or skill. Results indicate that depression entails a specific cognitive distortion of the consequences of skilled action. (27 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infants of postpartum depressed mothers: Temperament and cognitive status.

This study examined the association of postpartum depression with specific infant characteristics. Twenty-five diagnosed depressed and 25 nondepressed mothers and their 2-month-old infants participated in the study. The mothers completed measures of infant temperament and difficulty associated with infant care, and the infants were assessed using the Bayley Scales of Infant Development. Group comparisons indicated that, compared with the infants of the nondepressed mothers, the infants of the depressed women were less competent cognitively and expressed more negative emotions during the testing. The depressed mothers perceived their infants as more difficult to care for and more bothersome than did the nondepressed mothers, but did not attribute these difficulties to the temperament of their infants. These findings suggest that postpartum depression is associated with an identifiable pattern of infant behavior that may exacerbate depressed women's mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory complaint and memory performance in the depressed elderly.

Compared depressed and nondepressed elderly Ss recruited in the context of a large epidemiological study of health on measures of self-reported memory disturbance and an objective index of memory performance (free recall). Three groups were studied: (a) 26 Ss (mean age 71.56 yrs) meeting Research Diagnostic Criteria (RDC) for major depression, (b) 25 Ss (mean age 72.16 yrs) with high levels of self-reported depressive symptoms who did not meet RDC for major depression, and (c) 26 Ss (mean age 71.81 yrs) with low levels of self-reported depressive symptoms. Ss with high depression symptom levels reported significantly higher levels of memory complaint than did Ss with low symptom levels, but there were no differences in self-reported memory disturbance as a function of depression diagnosis. There were no significant differences between groups on the free-recall measure, either as a function of symptom level or diagnosis. It is argued that symptom severity rather than diagnosis of depression is important in determining impairment in depressed elderly people. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital interactions of depressed men and women.

This article examined marital interactions in 50 couples with a depressed husband, 41 couples with a depressed wife, and 50 nondepressed control couples. As expected, couples with a depressed partner evidenced more disturbed marital interaction than control couples. Furthermore, couples with a depressed wife demonstrated less positive communication than couples with a depressed husband, notwithstanding the fact the depressed husbands exhibited greater depression severity than depressed wives. Findings are integrated with recent research on gender differences in affective expression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive attributes of depression in children and adolescents.

This study explores whether cognitive attributes differentiate depressed children from those with other psychiatric disorders. The subjects were 108 children from 7 to 17 years of age. Forty-seven children were diagnosed as currently depressed, 30 as having had an episode of major depression within the last year (depressed-resolved), and 31 with diagnoses other than depression (nondepressed). The subjects completed the Piers-Harris Children's Self-Concept Scale, the Children's Hopelessness Scale, the Nowicki-Strickland Children's Locus of Control Scale, the Children's Attributional Styles Questionnaire, and the Children's Depression Inventory. The depressed children endorsed significantly lower self-esteem, more hopelessness, a more externalized locus of control, and a more depressive attributional style than the depressed-resolved or the nondepressed children. Thus, a depressive cognitive style can be documented in clinically depressed young people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)