Learned helplessness, test anxiety, and acknowledgment of contingencies.

72 undergraduates designated as high or low test anxious (Test Anxiety Questionnaire) received either controllable of uncontrollable noise in a typical helplessness induction. Half of them subsequently received an acknowledgment of contingencies in the induction task, and the other half did not. An anagram task was then administered. Test anxiety theory successfully predicted group differences in anagram performance: Only high-test-anxious Ss were debilitated by the helplessness induction. The effects of providing acknowledgment of contingencies proved ambiguous, but this may have been due to the wording of the acknowledgment and the susceptibility of high-test-anxious Ss to social dimensions of the task situation. Because of differences in terminology, learned helplessness theory has failed to take into account a large body of literature that has similarly employed experimenter-induced failure, and there are numerous competing explanations for impairments following a helplessness induction. Test anxiety theory suggests that the deficits underlying impaired performance are likely to be attentional in nature. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned helplessness, depression, and the illusion of control.

Do people previously exposed to uncontrollable aversive events, like naturally depressed people, fail to succumb to an illusion of control in a situation in which events occur noncontingently but are associated with success? 120 depressed and nondepressed undergraduates (as determined by Beck Depression Inventory and Multiple Affect Adjective Check List) were assigned to 1 of 3 groups that make up the typical triad used in studies of learned helplessness: controllable noises, uncontrollable noises, or no noises. Following pretreatment, Ss judged how much control they had in a noncontingency learning problem. For half of the Ss, events were noncontingent and associated with failure; for the remaining Ss, events were noncontingent but associated with success. Contrary to the predictions of learned helplessness theory, nondepressed Ss previously exposed to uncontrollable noises showed a robust illusion of control in the condition in which events were noncontingent but associated with success; nondepressed Ss previously exposed to controllable noises judged control accurately. Depressed Ss also judged control accurately regardless of their previous noise experience. Results are interpreted as consistent with the egotism hypothesis. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis.

Evaluated the relationship between pain and sleep problems, and the role of pain and sleep problems in depression, in a sample of 242 patients who had been diagnosed with definite or classical rheumatoid arthritis (RA). Patients completed the Pain scale of the Arthritis Impact Measurement Scales, the Center for Epidemiological Studies Depression Scale, and self-reports of sleep disturbance at 2 data waves over a 2-yr interval. Cross-sectional multiple regression analysis revealed that the sleep problems variable was independently associated with depression at Time 1. Longitudinal multiple regression analyses demonstrated that prior pain predicted subsequent adverse changes in sleep problems, whereas sleep problems did not affect pain over time, and prior pain and the interaction of high pain and high sleep problems were independently associated with depression from Time 1 to Time 2. These data suggest that pain may exacerbate sleeping difficulty in RA patients and that both may contribute to depression over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned helplessness, attributional style, and depression in epilepsy. Bozeman Epilepsy Surgery Consortium

PURPOSE: We wished to examine the relevance of the theory of learned helplessness in general, and attributional style in particular, to the understanding of depression among patients with epilepsy. METHODS: Patients with lateralized temporal lobe epilepsy (TLE) (right = 73, left = 70) were administered two self-report depression inventories [Beck Depression Inventory (BDI), Center for Epidemiological Studies-Depression scale (CES-D)]. Depression scores were examined in relation to a key component of the revised theory of learned helplessness (attributional style) using the Optimism/Pessimism Scale. RESULTS: Attributional style was significantly associated with increased self-reported depression and remained significant when the effects of several confounding variables were controlled [age, age at onset, laterality of TLE, sex, and method variance]. CONCLUSIONS: The results indicate that the concept of learned helplessness in general, and attributional style in particular, are related to the genesis of depression in epilepsy. Because they are known to be related to depression in the general population, and because specific techniques for intervention and prevention are available, greater consideration of learned helplessness and attributional style in the genesis of depression in epilepsy may be worthwhile.     

Learned helplessness in children: A longitudinal study of depression, achievement, and explanatory style.

Assessed the depressive symptoms, life events, and explanatory styles of 168 8–11 yr olds 5 times over a 1-yr period to test the prediction that the maladaptive explanatory style would be associated with higher levels of depression, lower school achievement, and higher incidences of helpless behaviors in the classroom. Ss completed the Children's Depression Inventory, the Children's Attributional Style Questionnaire, and a life events questionnaire. Measures of school achievement (the California Achievement Tests) were obtained once during the year. Depressive symptoms and explanatory styles were found to be stable over the year. As predicted by the reformulated learned helplessness theory, explanatory style both correlated with concurrent levels of depression and school achievement and predicted later changes in depression during the year. Depression also predicted later explanatory styles. Implications for intervention with children with depressive symptoms or school achievement problems are discussed. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helplessness and depression in rheumatoid arthritis.

Found that scores on a measure of helplessness mediated the relationship between severe, disabling rheumatoid arthritis (RA) and depression in 106 RA patients (aged 23–81 yrs). This association was independent of a previously demonstrated correlation between cognitive distortion and depression in RA patients. However, the association between disease severity and depression was mediated by Ss' views of their ability to control or cope with their disease. Both helplessness and cognitive distortion may be important factors in the development and treatment of depression among RA patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive distortion, helplessness, and depressed mood in rheumatoid arthritis: A four-year longitudinal analysis.

Cognitive models of depression have been invoked to explain the development of depressive symptoms and disorders in patients with chronic pain. However, few long-term, prospective studies have examined A. T. Beck's (1967, 1987) model in this context. 72 patients with rheumatoid arthritis completed the Beck Depression Inventory, the Cognitive Errors Questionnaire, and the Arthritis Helplessness Index during an initial assessment and again 4 yrs later. Initial levels of cognitive distortion were significantly related to follow-up levels of depressed mood, controlling for initial depression levels. This was also true for perceptions of helplessness. In contrast, initial depression levels did not predict changes in these cognitive processes. Results suggest that cognitive distortion and helplessness contribute to depressed mood among patients with arthritis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned helplessness and depression in a clinical population: A test of two behavioral hypotheses.

Conducted a study to extend the learned helplessness phenomenon to a clinical population and to test the competing hypotheses of M. E. Seligman (1975) and P. M. Lewinsohn (1974). 96 male hospitalized psychiatric and medical patients were divided into 3 levels of depression according to their scores on the Short Form of the Beck Depression Inventory. Ss were randomly assigned to 1 of 4 experimental conditions: (a) One group was treated with an 80-db tone, which could be terminated by making an active response; (b) a 2nd group was treated with the tone with a passive escape contingency; (c) a 3rd group was treated with an inescapable tone; and (d) a no-noise group served as a control. After treatment, Ss were tested on an anagram-solving task. Inescapable noise produced as much deficit in the low-depressed Ss as was present in the depressed no-noise control Ss. Passive escape Ss did as well as active escape Ss. Results replicate the learned helplessness phenomenon in a group of clinical depressives and support Seligman's model of depression. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned helplessness as experimenter-induced failure and its alleviation with attentional redeployment.

When it is recognized that laboratory studies of learned helplessness with human Ss are basically studies of experimenter-induced failure, the relevance of numerous studies of failure induction and of the theoretical models that generated them becomes apparent. The present study with 108 undergraduates adopted the assumption that cognitive interference associated with anxiety is the source of the performance decrements observed in helplessness studies. For susceptible Ss, failure experiences elicit a task-irrelevant, negative focus on self. As predicted from such a model, attentional redeployment in the form of an imagination exercise eliminated the impairment of performance that typically follows a helplessness induction. However, it was found that the effectiveness of the exercise depended on provision of a rationale to Ss. As predicted, it was found that Ss who received the exercise and rationale in the absence of a failure induction became debilitated, although this effect was only marginally significant. Results are discussed in terms of a cognitive-attentional interpretation of learned helplessness studies, and the likely role of demand characteristics is noted. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned helplessness in humans: Critique and reformulation.

Criticizes and reformulates the learned helplessness hypothesis. It is considered that the old hypothesis, when applied to learned helplessness in humans, has 2 major problems: (a) It does not distinguish between cases in which outcomes are uncontrollable for all people and cases in which they are uncontrollable only for some people (universal vs personal helplessness), and (b) it does not explain when helplessness is general and when specific, or when chronic and when acute. A reformulation based on a revision of attribution theory is proposed to resolve these inadequacies. According to the reformulation, once people perceive noncontingency, they attribute their helplessness to a cause. This cause can be stable or unstable, global or specific, and internal or external. The attribution chosen influences whether expectation of future helplessness will be chronic or acute, broad or narrow, and whether helplessness will lower self-esteem or not. The implications of this reformulation of human helplessness for the learned helplessness model of depression are outlined. (92 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Workshop on chronic pain, pain control, and patient outcomes in rheumatoid arthritis and osteoarthritis

OBJECTIVE: Coincident with a change in the physician staff in our pediatric intensive care unit (PICU), the frequency and duration of invasive monitoring were decreased. We examined the impact of this change on outcomes, complications, and hospital charges in infants admitted to the PICU with respiratory syncytial virus (RSV) infection. STUDY DESIGN: We reviewed medical records of all children less than 1 year of age who were admitted to the PICU from January 1989 to July 1993 with confirmed RSV infection. Patient characteristics, therapeutic interventions, outcomes, and hospital charges were extracted and compared. RESULTS: Seventy-eight patients were identified, 38 admitted from January 1989 through July 1991 (group 1) and 40 from July 1991 through July 1993 (group 2). The groups were well matched in age, preexisting disease, and cardiorespiratory status on admission. Group 1 had significantly greater use of invasive monitoring, pharmacologic paralysis, inotropes, blood products, antibiotics, and parenteral nutrition. Outcomes were not different, but group 1 patients had significantly longer stays, more complications, and higher hospital charges. CONCLUSIONS: Routine use of invasive monitoring of PICU patients with RSV disease was associated with increased laboratory testing, overtreatment, and significant increases in costs and morbidity without improvement in outcome.     

Day and night pain measurement in rheumatoid arthritis

OBJECTIVE: An attempt was made to see if rheumatoid arthritis (RA) patients can use visual analogue scales (VAS) to distinguish and grade the severity of pain at night, during rest, and on joint movement and to determine if discriminate measurement of these three pain components enhances the value of VAS estimation. METHODS: Two hundred and fifty two consecutive RA patients were evaluated by a single observer using 10 cm VAS for pain at night, at rest during the day, and on movement. Values were correlated against age, disease duration, joint tenderness, swollen joint count, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and Larsen x ray scores. RESULTS: Night pain was recorded by 71 (28%) and this component of pain was lower than VAS scores for daytime rest and movement. However, those with nocturnal pain had significantly more joint tenderness (p < 0.0001), swollen joints (p < 0.0001), and higher ESR and CRP. Age, disease duration, and radiographic scores were similar in those with and without night pain. Correlations of joint tenderness were apparent for all three pain scores but only nocturnal pain correlated with swollen joints (p < 0.001) and CRP (p < 0.005). Age, disease duration, and radiographic severity correlated with daytime rest or movement scores but not nocturnal pain. CONCLUSION: Patients were able to distinguish and estimate the severity of pain at rest, on movement, and at night. The occurrence of night pain characterised those with more active disease and night pain VAS measurement correlated best with measures of joint inflammation whereas daytime pain scores, both at rest and on movement, seemed influenced by the degree of permanent joint damage. Thus, discrete measurement of rest, movement, and nocturnal pain may provide useful information about RA disease status.     

Cognitive distortion in rheumatoid arthritis: Relation to depression and disability.

Rheumatoid arthritis (RA) is often accompanied by significant levels of depression and disability. Previous research has demonstrated that cognitive distortions are related to depression and disability in other chronic pain conditions. Our study tested the relevance of Beck's model to RA by examining the relation between cognitive distortion, as measured by the Cognitive Error Questionnaire, and both self-reported and interview-rated depression and disability in 92 RA patients. Even when disease severity was controlled, cognitive distortion was significantly associated with depression. Although cognitive distortion was also related to physical disability, this relation was smaller. The results are discussed in terms of the potential relevance of Beck's model to the treatment of depression and disability in RA patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence and depression degree in patients with rheumatoid arthritis

BACKGROUND: Study goals were: a) to know the existence and depressive level among a series of rheumatoid arthritis (RA) patients; b) to assess differences in depression levels of individuals with and without RA, and c) to identify the association of depression level with socioepidemiological, clinical, and prognostic characteristics in these patients. MATERIAL AND METHODS: Cross-sectional study that undertakes a 3 years period (July 1992-March 1995) and includes 221 patients diagnosed of RA according to the 1988 criteria of the American College of Rheumatology (ACR). Association of depression levels, assessed with the Self-Rating Depression Scale of Zung-Conde, with each one of the variables was evaluated using chi 2 tests (p < 0.05). A multivariate analysis type Automatic Interaction Detection (AID), based on the statistic r2, was applied to determine patient's profile with RA and depression. RESULTS: Depressive level was identified in 33.48% of patients. Odds ratio (OR) between "not depressive" and "depressive" levels was from 20.35 with 95% CI: 8.87-47.88 (p < 0.00001). Association was found with the variables sex (p < 0.0001), profession (p = 0.02), weight and height (p < 0.0001 in both variables), Ritchie index (p < 0.004), number of painful joints (p = 0.002), morning stiffness (p = 0.049) and secondary effects of the treatment (p = 0.034). Sex was the variable that most influenced in depressive level (p < 0.00001). In females group, the factor mainly related with depression was the number of painful joints (p < 0.0002) while in males, it was the self-rating pain valuation with a Likert scale (p < 0.0001). CONCLUSIONS: RA could causes depression in the patients. The factor with highest influence in the depression of these patients was the sex. The most influential factor in the females was the number of painful joints, while in the males was the self-rating of pain.     

Pain coping strategies and depression in rheumatoid arthritis.

A study was conducted to examine the role of pain episodes and the role of active and passive pain coping strategies in depicting depression in 287 patients with rheumatoid arthritis (RA). The independent effects of pain and pain coping strategies, as well as the interaction effects between pain and pain coping strategies on depression, were evaluated cross-sectionally and prospectively over a 6-month interval. The cross-sectional findings revealed that pain, passive coping, and the interaction between pain and passive coping contributed independent variance, all accounting for higher depression. Of principal interest was the finding that the frequent use of passive pain coping strategies in the face of high pain contributed to the most severe level of depression over time. These results were obtained after controlling for the potentially confounding effects of prior depression, functional disability, and medication status. These data imply that there may be a potential benefit of developing techniques to reduce the use of passive pain coping strategies to deal with chronic arthritis pain in cognitive–behavioral pain management programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned helplessness in the rat: Time course, immunization, and reversibility.

Previous research has shown that rats, like dogs, fail to escape following exposure to inescapable shock. 3 experiments were conducted with a total of 121 male Sprague-Dawley rats to further explore parallels between rat and dog helplessness. The failure to escape did not dissipate in time; Ss failed to escape 5 min, 1 hr, 4 hrs, 24 hrs, and 1 wk after receiving inescapable shock. Ss that first learned to jump up to escape were not retarded later at barpressing to escape following inescapable shock. Failure to escape could be broken up by forcibly exposing the S to an escape contingency. Therefore, the effects of inescapable shock in the rat parallel learned helplessness effects in the dog. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal stress, depression, and disease activity in rheumatoid arthritis and osteoarthritis patients

The relationships among interpersonal stressors, depression, coping inefficiency, hormones (prolactin, cortisol, and estradiol), and disease activity were examined. The sample comprised 33 women with rheumatoid arthritis (RAs; age 37-78) and 37 women with osteoarthritis (OAs; age 47-91), who served as controls. In a regression analysis, interpersonal conflict events accounted for more than twice as much variance in depression in RAs than in OAs. In the RA patients, the immune-stimulating hormones prolactin and estradiol were significantly positively correlated with interpersonal conflicts, depression, coping inefficacy, and clinician ratings of disease activity, suggesting that RAs are more reactive to interpersonal stressors than are OAs, both psychologically and physiologically.     

Learned helplessness in the rat: Retention and immunization.

Conducted 3 experiments with 128 male albino Sprague-Dawley and Holtzman rats to determine (a) whether experience with uncontrollable trauma shortly after weaning interfered with an adaptive responding as an adult and (b) if early experience with controllable trauma protected adults against the helplessness-inducing effects of uncontrollable trauma received as an adult. Inescapable shock given to weanling rats produced large deficits in adult escape behavior. Therefore, helplessness learned as a weanling was retained in later life and interfered with adaptive instrumental responding. Experience with escapable shock while a weanling immunized the animal against the deficits produced by inescapable shock received as an adult. The implications of these findings for animal models of human depression are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hyperhaptoglobinemia and its significance in rheumatoid arthritis

Four patients with acquired ichthyosis are described and the results of histological, histometric, autoradiographic and enzyme histochemical studies reported. Three of the patients were found to have in addition the following underlying diseases--malnutrition, reticulum cell sarcoma and panhypopituitarism. The fourth patient did not have any systemic disorder and the provoking cause of his ichthyotic condition remains obscure. Clinically these patients demonstrated the skin changes of autosomal dominant ichthyosis although their condition tended to fluctuate in severity. The various studies performed indicated that the histological and metabolic changes tended to reflect the clinical state of the patients and that these parameters did not differ significantly from those observed in atuosomal dominant ichthyosis.     

Learned helplessness in humans: A review and attribution-theory model.

M. E. Seligman's (1973, 1974, 1975) theory of learned helplessness (LH) and the current status of the research literature are reviewed, with a focus on 5 issues of the LH phenomenon: nature, etiology, generalization, individual differences, and alleviation. Seligman's theory is seen as inadequate to account for present data in several areas, notably etiology and generalization. A revised model of LH in humans is presented that suggests that the individual's attributions of noncontingent failure experiences predict the degree and parameters of LH. (85 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)