Dimensions of perfectionism in unipolar depression.

We tested the hypothesis that self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism are related differentially to unipolar depression. The Multidimensional Perfectionism Scale was administered along with measures of depression and anxiety to 22 depressed patients, 22 matched normal control Ss, and 13 anxiety patients. It was found that the depressed patients had higher levels of self-oriented perfectionism than did either the psychiatric or normal control Ss. In addition, depressed patients and anxious patients reported higher levels of socially prescribed perfectionism than did the normal control Ss. The results suggest that various dimensions of perfectionism may play an important role in clinical depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism dimensions, perfectionistic attitudes, dependent attitudes, and depression in psychiatric patients and university students.

P. L. Hewitt and G. L. Flett's (1991b) model of perfectionism dimensions (i.e., self-oriented, other-oriented, and socially prescribed perfectionism) was compared with A. T. Beck's model (G. P. Brown & A.T. Beck, 2002) of dysfunctional attitudes (i.e., perfectionistic attitudes [PA] and dependent attitudes [DA]) in predicting depression in 70 psychiatric patients and 280 university students. Socially prescribed perfectionism uniquely predicted both PA and DA. Dysfunctional attitudes failed to consistently predict additional variance in depression beyond perfectionism dimensions (and vice versa). Evidence for Hewitt and Flett's specific vulnerability hypothesis and Beck's specific cognitive vulnerability hypothesis was equivocal. Beck's conceptualization of perfectionism as a unitary cognitive style obscures important information by overlooking the distinction between the self-related and socially based features of perfectionism. Hewitt and Flett's conceptualization of perfectionism as 3 distinct personality traits allows for precise conclusions by recognizing the differential contribution of the self-related and socially based features of perfectionism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of perfectionism, daily stress, and depression: A test of the specific vulnerability hypothesis.

Tested whether perfectionism dimensions interact with specific stressors to predict depression. A depressed patient sample (N?=?51) and a general psychiatric sample (N?=?94) completed measures of perfectionism, hassles, and depression. Ss in Sample 2 also completed other personality measures to assess the amount of unique variance in depression. Partial support was obtained: In both samples, self-oriented perfectionism interacted only with achievement stressors to predict depression. Socially prescribed perfectionism interacted with interpersonal stress in Sample 1 and with achievement stress in Sample 2 to predict depression. Several personality variables, including socially prescribed perfectionism, accounted for unique variance in depression. The results suggest that perfectionism dimensions are associated with depression and may constitute specific vulnerability factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism and relationship adjustment in pain patients and their spouses.

The authors assessed whether social facets of perfectionism were associated with indexes of dyadic and family adjustment. A sample of 83 pain patients and their spouses completed the Multidimensional Perfectionism Scale, Dyadic Adjustment Scale, Family Assessment Device, Beck Depression Inventory, and Multiaxial Pain Inventory. After controlling for depression, the authors found that pain patients' relationship adjustments were associated with their spouses' other-oriented perfectionism. Also, pain patients rated their other-oriented perfectionistic spouses as less supportive. Spouses' reports of poor dyadic and family adjustment were associated with their own socially prescribed perfectionism. The findings suggest that social aspects of perfectionism contribute to poor family adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative stability of dimensions of perfectionism in depression.

Investigated the degree of absolute change, affective state dependence, and relative trait stability of several dimensions of perfectionism assessed by two popular, multidimensional measures. The study sample was 105 adult outpatients from a university hospital mood disorders program who met diagnostic criteria for major depressive episode at Time 1 and did not meet criteria for major depressive episode one year later (Time 2). Mean total scores on the Beck Depression Inventory decreased by almost 50% (from 28 to 15). Absolute change on perfectionism indices was smaller but significant for some maladaptive dimensions. Correlational, regression, and path analyses all indicated the presence of affective state dependence for several maladaptive dimensions of perfectionism (e.g., concern over mistakes, socially prescribed perfectionism). However, in all cases strong evidence was also found for the enduring trait stability of these dimensions. The results support a state-trait conceptualization of maladaptive perfectionism dimensions, which denotes stable individual difference variables that are elevated in the depressive state. Adaptive aspects of perfectionism showed little or no evidence of affective state dependence, consistent with findings from other research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-sectional and longitudinal comparisons of bipolar and unipolar depressed groups on the MMPI.

Compared MMPI admission and remission profiles in 34 patients (17 bipolar and 17 unipolar) hospitalized for depression. There were no significant demographic differences or difference in behaviorally rated depression between the bipolar and unipolar groups. Relatively normal profiles for the bipolar group and abnormal profiles for the unipolar group significantly differentiated the 2 groups at admission, but, with 1 exception, the differences dissipated at recovery. Thus, greater changes over time were found in the self-reported personality characteristics of unipolar Ss than in bipolar Ss. After recovery from the depressive episode, there was a significant shift within unipolar Ss from withdrawal and lack of interest in others to a greater concern for socially approved behavior. The implications of change in the unipolar group and stability in the bipolar group and the more enduring personality characteristics of the 2 groups are discussed. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive responses to failure and success relate uniquely to bipolar depression versus mania.

This project examined cognitive responses to failure and success and their association with depression and mania within bipolar disorder. Many cognitive variables that are associated with unipolar depression have been found to be involved in bipolar disorder, more specifically bipolar depression. This research was the first to examine tendencies to hold high standards, engage in self-criticism, and generalize from failure to an overall sense of self-worth. In Study 1, undergraduates were screened for risk of mood disorders and completed structured diagnostic interviews. History of bipolar spectrum disorders and history of depression had separate associations with negative generalization. The association of generalization with bipolar spectrum disorders was accounted for by current depressive symptoms. For Study 2, the authors developed a measure of the tendency to engage in positive generalization following success experiences. In a sample of 276 undergraduates, this measure related uniquely to risk for mania. Results of these 2 studies suggest that responses to failure are associated with a history of depression, whereas responses to success are associated with a risk for mania. Implications for future research and clinical work are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism as a predictor of subsequent adjustment: Evidence for a specific diathesis–stress mechanism among college students.

The relations among perfectionism, stress, subsequent psychological symptoms, and hopelessness were examined among 215 college students. Hierarchical regression analyses were conducted to determine whether dimensions of perfectionism (P. Hewitt & G. Flett, 1991) predicted psychological symptoms and hopelessness (1 month later), and the extent to which stress scores added incremental validity to these predictions. Results indicated that socially prescribed perfectionism was a significant predictor of both adjustment measures. In addition, stress accounted for a significant amount of additional variance in predicting adjustment beyond perfectionism. Consistent with a diathesis–stress model, a significant Perfectionism × Stress interaction was found in predicting scores on adjustment measures beyond perfectionism and stress. However, this interaction was only found for socially prescribed perfectionism. Results provide support for a specific diathesis–stress mechanism and important implications for developing specific interventions in working with perfectionistic college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism and depression: Longitudinal assessment of a specific vulnerability hypothesis.

The authors tested whether perfectionism dimensions interact with specific stress to predict depression over time. A sample of 103 current and former patients completed measures of perfectionism and depression at Time 1 and measures of stress and depression 4 months later. After controlling for Time 1 depression, self-oriented perfectionism interacted only with achievement stress to predict Time 2 depression. Socially prescribed perfectionism did not interact with achievement or social stress to predict Time 2 depression, but it did predict Time 2 depression as a main effect. The results provide support for the contention that perfectionism dimensions are involved in vulnerability to depression over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical characteristics of unipolar and bipolar depression

INTRODUCTION: In the last decades affective disorders were divided into unipolar and bipolar and this division has been generally accepted. The bipolar type is manifested by mania or by both mania and depression. On the other hand, unipolar affective disorders are manifested only by depression. In numerous investigations authors have noticed that there are very distinctive differences between these two types of depressive disorders such as: course of illness, personality disorders, sex, family history etc. Nevertheless, in practice it is often very difficult to make the right diagnosis. The bipolar type often starts with a few pure depressive episodes and sometimes mania occurs a few years later so only at that point the psychiatrist can make the right diagnosis and treat the patient correctly. MATERIAL AND METHODS: This investigation comprised 50 patients hospitalized at the Psychiatric Clinic in Novi Sad during 1992-1995. The experimental group consisted of 20 patients with a bipolar affective disorder (according to ICD-X), while the control group consisted of 30 patients with clinical diagnosis of unipolar depression (intensive, without psychiatric features). Both groups of patients were weekly evaluated by Hamilton Depression Rating Scale (HDRS), whereas the initial score for all patients had to be higher than 16. RESULTS: Patients suffering from unipolar depression were older than patients with bipolar depression and there were more females in this group. There were no differences in demographic characteristics (level of education, migration, etc.), but the experimental group had a greater genetic loading for affective disorders. Unipolar depressive patients had more agitation and they were more anxious than patients with bipolar depression. DISCUSSION AND CONCLUSION: The fact that unipolar depressive patients were older than bipolar is similar to most of the results gained in this kind of investigation. On the other hand, we did not find statistical differences in the intensity of disorders, and in the literature these results are contraindicating. Numerous investigators report that bipolar depressives had a stronger genetic loading for affective disorders and our study confirms the same. All these results can help us to make the right diagnosis of unipolar and bipolar affective disorders.     

High-performance liquid chromatographic determination of midazolam in rat brain

The authors tested whether perfectionism dimensions interact with specific stress to predict depression over time. A sample of 103 current and former patients completed measures of perfectionism and depression at Time 1 and measures of stress and depression 4 months later. After controlling Time 1 depression, self-oriented perfectionism interacted only with achievement stress to predict Time 2 depression. Socially prescribed perfectionism did not interact with achievement or social stress to predict Time 2 depression, but it did predict Time 2 depression as a main effect. The results provide support for the contention that perfectionism dimensions are involved in vulnerability to depression over time.     

Children of depressed mothers: Maternal strain and symptom predictors of dysfunction.

Because of both methodological and theoretical limitations, previous studies of offspring of parents with affective disorders have rarely tested psychosocial models of depressive vulnerability. The current research is part of a longitudinal investigation of psychosocial risk for disorder in 8- to 16-year-old children of unipolar, bipolar, medically ill, and normal mothers. High rates of psychopathology, including depression, were found in children in the high-risk groups. The current study evaluated the separate contributions of maternal depressive history, current self-reported depressive symptoms (Beck Depression Inventory scores), and chronic strains to observe relations between these ordinarily confounded variables and children's psychiatric diagnoses and current functioning. Hierarchical regression analyses indicated that chronic strain added significantly to the prediction of several outcomes and that current depressive symptoms were more predictive of children's scores than was maternal history of affective disorder. Both chronic strains and current Beck Depression Inventory scores are viewed as concomitants of affective disorder but are not specific to it. Therefore studies of the risk to children conferred by parental disorder cannot assume that diagnostic status as such is a single risk factor and must attend to the effects of ongoing stressors and nonspecific symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identifying chronic affective disorders in outpatients: Validation of the General Behavior Inventory.

The validity of the General Behavior Inventory (GBI) in screening outpatients for chronic unipolar and bipolar affective conditions was evaluated. The GBI was administered to 492 consecutive patients at a university clinic and a community mental health center. Using a stratified random sampling plan, 167 patients were selected and administered blind structured diagnostic interviews. In addition, unipolar depressives were followed up 6 months after the initial evaluation. Overall, the GBI exhibited fair-to-good positive predictive power and good-to-excellent negative predictive power. In addition, GBI scores in the case range were consistently associated with poor outcome at the 6-month follow-up. These findings suggest that the GBI may provide an economical means of screening for chronic unipolar and bipolar affective conditions in outpatient settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between perfectionism and distress: Hassles, coping, and perceived social support as mediators and moderators.

This study of university students (136 men and 307 women) examined the roles of hassles, avoidant and active coping, and perceived available social support in the relation between evaluative concerns and personal standards perfectionism and distress symptoms (i.e., depression, anxiety). Confirmatory factor analysis supported the measurement model used in this study. Structural equation modeling results indicated that hassles, avoidant coping, and perceived social support are each unique mediators that can fully explain the strong relation between evaluative concerns perfectionism and distress. Personal standards perfectionism had a unique association with active coping only. Hassles and social support also moderated the relation between both dimensions of perfectionism and distress. Clinical implications of distinguishing between evaluative concerns and personal standards perfectionism are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.

It often is difficult clinically to differentiate bipolar disorder from other mental health conditions in young people. This study evaluated a parent report measure of depressive and hypomanic/biphasic symptoms. Parents of 196 youths, who were 5 to 17 years old and presented at an outpatient research center, completed an adapted General Behavior Inventory (GBI). Factor analyses suggested two dimensions, depression and biphasic/hypornania. Logistic regressions using these scales discriminated mood disorder versus disruptive behavior disorder or no diagnosis, unipolar versus bipolar disorder, and bipolar versus disruptive behavior disorder based on structured interviews. Classification rates exceeded 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative studies of the biological distinction between unipolar and bipolar depressions

Although unipolar depression and bipolar depression are considered distinct entities both by clinicians and researchers, it is not clear whether a pathophysiological distinction, which is the bridge between etiology and treatment, exists between these two conditions. The objective of this paper was to systematically review the studies that examined the biological differences between unipolar and bipolar depression. Using computerized Medline and manual searches, we located and reviewed studies that directly compared patients with unipolar depression with bipolar depressed patients on at least one biological variable. The results showed that patients with bipolar depression had lower levels of urinary NE and its metabolites and lower platelet MAO activity, and higher platelet free and stimulated intracellular calcium levels compared with unipolar depressed patients, but none of the variables examined appeared to differentiate the two groups consistently. We discuss some of the methodological flaws that might have contributed to this, and suggest that further studies should control for such confounding variables.     

Perfectionism and bulimic symptoms in African American college women: Dimensions of perfectionism and their interactions with perceived weight status.

This study had 2 primary aims: (a) to examine the unique relations between maladaptive and adaptive dimensions of perfectionism and bulimic symptoms and (b) to test an interactive model of perfectionism and perceived weight status for bulimic symptoms in a sample of African American female undergraduates. The sample consisted of 97 women at Time 1 and 70 women at Time 2 about 5 months later, with bulimic symptoms assessed at both time points. Results showed that maladaptive perfectionism, but not adaptive perfectionism, was uniquely related to bulimic symptoms in cross-sectional analyses. Tests of interaction effects indicated that maladaptive perfectionism interacted with perceived weight status to identify elevated bulimic symptoms such that women with high levels of maladaptive perfectionism who felt overweight exhibited the highest levels of bulimic symptoms, both concurrently and prospectively after controlling for Time 1 levels of bulimic symptoms. This study highlights the relevance of maladaptive perfectionism to bulimic symptoms in African American college women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality, negative social interactions, and depressive symptoms.

Examined the associations among the frequency of negative social interactions, personality traits, and depressive symptoms in university students. 176 Ss completed measures of negative social interactions, sociotropy, autonomy, perfectionism, and depressive symptoms. It was found in the total sample that higher depression symptoms scores were correlated significantly with the frequency of negative social interactions, sociotropy, autonomy, and socially prescribed perfectionism. Additional results indicate that the frequency of negative social interactions accounted for unique variance in depressive symptoms over and above the variance predicted by personality traits, but it did not interact with these personality traits to predict unique variance in depressive symptoms. It was also found that the reported frequency of negative social interactions was correlated positively with socially prescribed perfectionism, sociotropy, and autonomy, especially among women. The current findings are discussed in terms of their implications for specific vulnerability and stress generation models of personality, life events, and depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

31P magnetic resonance spectroscopy in the frontal lobe of major depressed patients

Most research with 31P-magnetic resonance spectroscopy (31P-MRS) in affective disorders has been done in the field of bipolar disturbances. Reduced frontal and temporal lobe phosphomonoester (PME) concentrations were measured in the euthymic state, whereas increased values were found in the depressed state. In bipolar-II patients reduced phosphocreatine (PCr) concentrations were reported in the euthymic, depressed, and manic state. The aim of the present study was to explore whether PME and PCr were also altered in the frontal lobe of major depressed, unipolar patients. Therefore, we used 31P-MRS to investigate the relative phospholipid and high-energy phosphate concentrations in the frontal lobe of 14 unipolar patients, mostly medicated, and 8 age-matched controls. We found increased PME and decreased ATP values. Other 31P-MRS parameters were not different in both groups. Phosphomonoester percentages correlated negatively with the degree of depression. Thus, the main alterations found in bipolar depressed patients could also be demonstrated in unipolar depressed patients. The results are discussed with regard to disturbed phospholipid and intracellular high-energy phosphate metabolism in depressed patients.     

State dependence and trait stability of perfectionism: A short-term longitudinal study.

The authors examined state dependency on depression, trait stability, and state-trait characteristics of perfectionism in a short-term longitudinal study of university students. Relative stability of perfectionism was assessed with test-retest correlations across 3 time points, and results showed higher rank order and relative stability for perfectionism scores compared with depression scores. Regression and path analyses to disentangle directions of effects revealed that initial maladaptive perfectionism scores remained robust predictors of later perfectionism scores, even after the authors controlled for prior and concurrent depression and other dimensions of perfectionism. Perfectionism proved to be quite stable and was a significant predictor of later depression. Perfectionism was also not meaningfully altered by state changes in depression. The overall findings indicate that perfectionism appears to have substantial relative stability, and perfectionistic discrepancy in particular is a clear vulnerability factor for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)