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)     

Cognitive distortion and cognitive errors in depressed psychiatric and low back pain patients.

Measured the tendency to make cognitive errors in 18 depressed psychiatric patients, 19 depressed low back pain (LBP) patients, 29 nondepressed LBP patients, and 23 nondepressed persons without LBP. Ss were administered 2 cognitive error questionnaires that focused in either general or LBP-related life experiences. These were designed to measure general cognitive distortion as well as 4 empirically derived dysphoric cognitive errors (catastrophizing, overgeneralization, personalization, and selective abstraction). Results indicate that all cognitive errors were endorsed significantly more strongly by depressed Ss with or without LBP. Although depressed LBP Ss made cognitive errors in interpreting many general experiences, they endorsed 3 out of 4 errors focused on LBP experiences significantly more strongly than depressed nonpain Ss. Findings suggest that depression in LBP patients is a function of both LBP and cognitive errors. Thus, cognitive therapy designed to correct cognitive errors may alleviate depression in LBP patients despite the persistence of pain. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-devaluation and depressed mood.

E. Velten's (1968) mood induction procedure (VMIP) has been used in a variety of studies to induce depressed moods. Its effectiveness has been attributed to the self-devaluative nature of its statements, and it has been used as support for cognitive self-evaluation theories of depression. An alternative hypothesis is that suggestions of somatic states characteristic of depression, which are found in nearly half of the VMIP depression statements, account for the effectiveness of the procedure. 60 female college students were randomly assigned to 5 groups: VMIP depression, VMIP elation, VMIP neutral, somatic suggestion, and self-devaluation. The VMIP depression statements were divided into those that suggest somatic states characteristic of depression, (e.g., fatigue and exhaustion) and those that are self-devaluative, (e.g., statements of low self-worth) to form the somatic suggestion and self-devaluation conditions. Somatic suggestion Ss reported more depressed mood than neutral Ss. Somatic suggestion Ss also reported more depressed mood than self-devaluation Ss on several measures. Results support a somatic suggestion hypothesis and offer no support for self-devaluative interpretations of VMIP effects. This limits the support VMIP studies offer to cognitive self-evaluation theories of depression. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned helplessness and its correlation to impairment, pain, anxiety and depression in rheumatoid arthritis

A Swedish version of the self-report instrument Arthritis Helplessness Index (AHI) is presented. Validity and reliability of the translation has been analyzed. 100 consecutive patients with rheumatoid arthritis (RA) were studied, 78 of which completed 2 self-administered questionnaires with AHI, impairment, pain, anxiety and depression. Furthermore 20 of the patients were interviewed with regard to AHI. Forty-two other patients with RA were analyzed for correlation between AHI and biochemical activity and Signals of Functional Impairment (SOFI). We conclude that the Swedish version of AHI has satisfactory validity and reliability. It correlates with age, physical impairment, pain, anxiety and depression but not with sex or disease activity. Five of the original 15 items could for various reasons be omitted, leaving a 10 statement instrument. AHI is promising as a variable in future outcome studies of RA.     

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)     

Social support, depressed mood, and adjustment to stress: A genetic epidemiologic investigation.

A survey of 821 same-sex female twin pairs from a population-based registry assessed 8 dimensions of social support and social integration. Twin analyses documented significant common environmental influences on 5 of these 8 measures and significant genetic influences on 5 of the 8. A decomposition of the multiplicative association between support and a measure of stressful life experiences in predicting depressed mood—an association typically interpreted as providing evidence for a stress-buffering effect of social support—shows clearly that it is the environmental and genetic factors that cause support, rather than support itself, that buffer the effects of stress on mood in most cases. The authors discuss the implications of this result for future research on the relationship between social support and psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Induction of depressed mood: A test of opponent-process theory.

To test whether R. L. Solomon's (see record 1980-26727-001) opponent-process theory of acquired motivation can be applied to the induction of depressed mood, 100 female undergraduates completed the Depression Adjective Check Lists before, during, and after a depression-induction procedure or 1 of 2 control conditions. Results are not totally consistent with the opponent-process interpretation, suggesting that this model may not be applicable to depressed mood. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Irrational beliefs and self-reported depressed mood.

30 undergraduates completed the Depression Adjective Check List daily for 14–28 days to evaluate differences in depressed mood level and variability across time among Ss grouped on the basis of irrational beliefs, as measured by the Idea Inventory. As hypothesized, high levels of irrational thinking were associated with greater intensity and variability of depressed mood. Data provide partial confirmation for A. Ellis's (1962) theory of emotional disturbance, which holds that persons whose thinking is more dominated by irrational beliefs are more influenced by unpleasant experiences. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations among mothers' expressivity, children's effortful control, and their problem behaviors: A four-year longitudinal study.

Longitudinal relations between mothers' expressivity, children's effortful control, and their problem behaviors were examined when children (N = 181) were 6.5-10 years old (T2) and again 2 (T3) and 4 (T4) years later. Mothers reported on their expression of positive and negative dominant emotion. Mothers and teachers reported on children's effortful control and externalizing and internalizing problem behaviors. In structural equation models, variables exhibited consistency over time. Further, the relation between mothers' expressivity (positive minus negative dominant emotion) at T2 and children's externalizing problems at T4 was mediated by T3 effortful control. The same process of mediation was significant for teacher- but not mother-reported internalizing problems. The results provide one explanation for how emotion-related socializing behaviors influence children's problem behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of stressful circumstances, illness symptoms, and depressed mood among adolescents.

This study assessed the relationship of stressful life circumstances to illness symptoms and depressed mood among adolescent girls (in the 7th through the 11th grades). At two times, respondents indicated whether each of 20 commonly experienced circumstances had occurred to them and whether they rated its occurrence as positive or negative. Additionally, they completed an illness symptoms checklist and a standard measure of depressed mood. Cross-sectional analyses showed that circumstances rated negatively were associated with poor physical and mental health. Perspective analyses, controlling for initial physical or mental health status, revealed that negative circumstances led to reports of greater illness symptoms or depressed mood only when positive circumstances were low. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rumination, negative cognition, and their interactive effects on depressed mood.

Response styles theory posits that rumination represents a trait vulnerability to depression. Recent evidence has suggested that rumination predicts changes in depression more strongly among individuals with high levels of negative cognition. Three studies evaluated this model of interactive vulnerabilities. Study 1 provided empirical support for the distinction between rumination and negative cognitive content. The next 2 studies investigated the interactive model in the laboratory. Study 2 randomly assigned participants to either ruminate or distract following a sad mood induction. This study found that rumination was more strongly associated with dysphoria among individuals who report high levels of negative cognition. Similarly, Study 3 found that rumination and negative cognition interact to predict changes in dysphoria across a no-task delay period following a sad mood induction. These studies provide support for an interactive model in which rumination amplifies the deleterious effects of negative cognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of life satisfaction after spinal cord injury: A four-year longitudinal approach.

Responses to a life situation questionnaire were obtained in 1985 and 1989 from 286 adults with spinal cord injury. Multidimensional personality questionnaires were obtained in 1989 only. Multiple regression was used to identify the optimal predictors of 1989 satisfaction from predictor variables taken in 1985 and 1989. Results suggest that the predictors accounted for a greater percentage of variation in General Satisfaction compared with Economic Satisfaction. As expected, concurrent prediction was superior to the 4-yr longitudinal prediction. Adjustment measures were better predictors of satisfaction than were demographic and injury-related predictors (e.g., age, injury severity). A different pattern of predictors was identified between the 2 satisfaction areas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concurrent and longitudinal patterns among sanctions, mood, and attributions.

Although some theorists claim that attributions are antecedents of mood changes, others argue that they are consequents. It is difficult to resolve this controversy satisfactorily because (a) the possibility that attributions are causally related to mood but mediated by another variable has not been considered fully, and (b) additional longitudinal research, particularly about how attributions are related to the offset of dysphoria, needs to be completed. We report a concurrent and longitudinal study addressing these issues. The concurrent study replicated and extended previous research, demonstrating that attributions for test performance were correlated with sanctions of affirmation and blame when they were correlated with mood. Furthermore, sanctions were more strongly associated with mood than were attributions. In the longitudinal study, sanctions decreased for subjects reporting decreased dysphoria and remained constant for those reporting stable mood. A similar consistency between the patternings of moods and attributions was not found. These results suggest that attributions are related to mood when their effects are mediated by sanctions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The long-term outcomes of rheumatoid arthritis: a 23-year prospective, longitudinal study of total joint replacement and its predictors in 1,600 patients with rheumatoid arthritis

OBJECTIVE: Although total joint arthroplasty (TJA) is a common procedure and an important outcome in rheumatoid arthritis (RA), little is known about its prevalence, failure rate, or predictors over the course of the illness. The current study evaluated these factors in 1,600 consecutive RA patients seen during a period of observation that extended 23 years. METHODS: Beginning in 1974, data from 34,040 RA patient visits were entered prospectively into a computer databank. Data consisted of laboratory, radiographic, physical examination, and self-report questionnaires. At each assessment, we also noted a complete surgical history. Patients were also followed up by questionnaires that were mailed at 6-month intervals. RESULTS: Kaplan-Meier life-table estimates indicated that 25% of RA patients will undergo total joint arthroplasty (TJA) within 21.8 years of disease onset. For patients with 1 TJA, 25% had a TJA in a different joint within 0.92 years and 50% within 7.0 years. Ten years after TJA, approximately 6% of implanted knees and 4% of implanted hips had been replaced with a second TJA, and 12% and 13% of the joints had either a second TJA or a TJA-related operation, respectively. In Cox regressions, a large series of clinical and laboratory variables, which primarily reflected disease activity, predicted TJA. Smoking, either past or present, had a protective effect. Patients with highly abnormal values on the Health Assessment Questionnaire Disability Scale, global severity, and erythrocyte sedimentation rate had a 3-6 times increased risk of TJA. CONCLUSION: TJA, a marker of joint failure and of RA outcome, is predicted by self-report assessments of severity and function, and by a series of laboratory, radiographic, and clinical variables. Prediction improves with the extent of observation, and 2-year observations approach full-study observations in their accuracy. Most TJAs survive for a long time in RA.     

Marital satisfaction, depression, and attributions: A longitudinal analysis.

Examined the longitudinal relation between causal attributions and marital satisfaction and tested rival hypotheses that might account for any longitudinal association found between these variables. Data on attributions for negative partner behaviors, marital satisfaction, depression, and self-esteem were provided by 130 couples at 2 points separated by 12 mo. To the extent that spouses made nonbenign attributions for negative partner behavior, their marital satisfaction was lower a year later. This finding was not due to depression, self-esteem, or initial level of marital satisfaction, and also emerged when persons reporting chronic individual or marital disorder were removed. Results support a possible causal relation between attributions and marital satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive complaints in elderly depressed and pseudodemented patients.

The cognitive complaints of 11 patients with depressive pseudodementia were compared with those of 22 patients with depression alone. Pseudodemented subjects were defined as depressed inpatients showing reversible cognitive impairment as measured by the Mini-Mental State Examination (MMSE); subjects with depression alone had no such impairment. For each group, cognitive complaints were highly correlated with depressive symptoms and were not related to MMSE scores. The pseudodemented group had significantly higher cognitive complaint scores, complaining more of difficulties with concentration and recent memory. Groups did not differ significantly in complaints of difficulties with remote memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The helplessness–hopelessness theory and daily mood experience: An idiographic and cross-situational perspective.

The experience sampling method was used to examine the helplessness–hopelessness theory as a model of normal mood fluctuations. Ninety-one participants were signaled 5 times daily for a 1-week period to provide reports of negative events, specific cognitions, and anxiety and depression. Attributional and perception of control styles did not explain anxious or depressed moods, but they were predictive of the causal attributions and perceptions of control made across diverse environmental contexts. Furthermore, idiographic analyses demonstrated that specific causal attributions about negative events explained fluctuations in depressed mood within the flow of daily life. In contrast to the theory, perceptions of event controllability were not related to fluctuations in anxious mood or to the later formulation of causal attributions. Implications for understanding normal mood experience and the helplessness–hopelessness theory are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in coping styles and implications for depressed mood.

Based on a sample of young adults in Miami-Dade County, Florida, this paper examined the extent to which there were sex differences in 3 coping style types: problem focused, emotion focused, and avoidance focused (Endler & Parker, 1990). Further examined were the extent to which sex differences in coping styles could be explained by sex differences in chronic strain; the extent to which sex differences in depressed mood could be explained by sex differences in coping style; and whether the effects of different coping style types on depressed mood varied by sex. Results suggested somewhat complex relationships among sex, coping, chronic strain, and depression. No sex differences in the use of problem-focused coping were observed when statistical controls for socioeconomic status were applied; however, women more often used avoidance-focused techniques. Although female respondents more often used emotion-oriented strategies compared to male respondents, such use did not prove to be fundamentally harmful for women. In fact, the effects of using emotion-focused strategies, such as the expression of feelings, reduced depressed mood for women, but not for men. Implications for practice and policy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cerebrovascular risk factors, activity limitations, and depressed mood in African American older adults.

This study investigated the association between cerebrovascular risk factors (CVRFs), physical activity limitations, and depressed mood. The 12-item Short-Form Health Survey (SF-12) was administered to 1,034 urban African American older adults. A chi-square analysis demonstrated that the prevalence of depressed mood among those with high CVRF burden (13.4%) was significantly higher than among those with low vascular burden (7.6%). Physical activity limitations also predicted depressed mood, but this relationship did not mediate the relationship between cerebrovascular burden and depression. These findings highlight the relationships among cerebrovascular burden, physical activity limitations, and depressed mood among African American older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A cognitive-behavioral treatment for rheumatoid arthritis.

Tested a cognitive-behavioral rheumatoid arthritis treatment designed to confer skills in managing stress, pain, and other symptoms of the disease. It was hypothesized that the treatment would reduce symptoms and possibly improve both immunologic competence and psychological functioning. 15 22–75 yr old women in the treatment group received instruction in self-relaxation, cognitive pain management, and goal setting. 15 similar controls received a widely available arthritis helpbook. Evidence of an enhancement of perceived self-efficacy, reduced pain and joint inflammation, and improved psychosocial functioning was found in the treated Ss based on their responses to an arthritis self-efficacy scale, the Zung Self-Rating Depression Scale, a perceived stress scale (developed by S. Cohen et al, 1983), and the UCLA Loneliness Scale. Magnitude of improvements was correlated with degree of self-efficacy enhancement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)