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)     

Role of perfectionism and personality disorder features in response to brief treatment for depression.

Using data from the Treatment of Depression Collaborative Research Program (TDCRP), the authors compared the role of patients' perfectionism and features of personality disorder (PD) in the outcome of brief treatment for depression. Data were extracted as to patients' intake levels of symptoms; perfectionism; and PD features, measured as continuous variables, as well as their symptoms at termination; their contribution to the therapeutic alliance; and their satisfaction with social relations. Poorer therapeutic outcome was demonstrated for patients with elevated levels of perfectionism and odd-eccentric and depressive PD features. Patients' contribution to therapeutic alliance and satisfaction with social relations were predicted by perfectionism but not by PD features. Results highlight the central role played by patients' personality in the course of brief treatment for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with outcome in major depression: a 6-month prospective study

A number of authors have indicated in recent years that the course of depression is not as favourable as previously expected. Research conducted in order to identify predictors of recovery has shown widely different results. In this paper a sample of 90 consecutive patients with non-chronic major depressive disorders (index episode < 6 months) attending four mental health centres in Madrid were followed up prospectively for 6 months, and clinical social and cognitive variables were studied. The patients were treated pharmacologically and controlled. The rate of recovery was measured according to the Hamilton Rating Scale for Depression (HAM-D). Other tools used were: Life Events and Chronic Difficulties, Global Assessment Functioning in the 6 months prior to the onset of episode, Brown Rating Scale for Self-Esteem and Mannheim Interview of Social Support. The results showed that 41 cases recovered (HAM-D score < 8), 29 cases achieved a partial remission, and major depressive disorder persisted in 17 cases (HAM-D score > or = 18). The presence of personality disorders, having suffered a previous episode, GAF score and some aspects of social support were the variables most associated with non full remission in the logistic regression analysis. Personality disorders and the initial HAM-D score were related to non-improvement. Some clinical and cognitive variables maintain a weak relation to outcome and are rejected in logistic regression. This study emphasizes the relationship of personality, and social variables such as social support and previous global functioning, with incomplete recovery in major depression.     

Pathways to childhood depressive symptoms: The role of social, cognitive, and genetic risk factors.

Childhood depressive conditions have been explored from multiple theoretical approaches but with few empirical attempts to address the interrelationships among these different domains and their combined effects. In the present study, the authors examined different pathways through which social, cognitive, and genetic risk factors may be expressed to influence depressive symptoms in 300 pairs of child twins from a longitudinal study. Path analysis supported several indirect routes. First, risks associated with living in a step- or single-parent family and punitive parenting did not directly influence depressive outcome but were instead mediated through maternal depressive symptoms and child negative attributional style. Second, the effects of negative attributional style on depressive outcome were greatly exacerbated in the presence of precipitating negative life events. Third, independent of these social and cognitive risk mechanisms, modest genetic effects were also implicated in symptoms, with some indication that these risks are expressed through exposure to negative stressors. Together, these routes accounted for approximately 13% of total phenotypic variance in depressive symptoms. Theoretical and analytical implications of these results are discussed in the context of several design-related caveats. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

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

Maternal depressive symptoms and depressive symptoms in adolescents

The relationship between maternal depressive symptoms and rates of adolescent (15-16 years) depressive symptoms was studied in a birth cohort of 934 New Zealand children. There was a clear correlation between maternal depressive symptoms and subsequent depressive symptoms in adolescent females (r = .44) but no association (r = -.01) between maternal depressive symptoms and depressive symptoms in adolescent males. Subsequent analysis suggested that the correlation between maternal depression and depressive symptoms in adolescent females was largely explained by the associations of both measures with a series of social and contextual factors including social disadvantage, marital discord and family adversity. It is concluded that maternal depression is only associated with depression in adolescence insofar as maternal depression is associated with social disadvantage, marital discord or family adversity.     

Reliability and validity of depressive personality disorder

OBJECTIVE: Depressive personality disorder was introduced into DSM-IV's appendix amid controversy. While that disorder appears to be a reliable and valid one, the authors offer new data about its relationship to major depression, dysthymic disorder, and other personality disorders. METHOD: The authors assessed 54 subjects with early-onset, long-standing mild depressive features for depressive personality disorder, axis I and axis II disorders, family history, and treatment history; they conducted follow-up interviews 1 year after the baseline assessment. Subjects with (N=30) and without (N=24) depressive personality disorder were characterized and compared in terms of those variables. RESULTS: Although depressive personality disorder and dysthymia co-occurred in some subjects, 63% of subjects with depressive personality disorder did not have dysthymia, and 60% did not have current major depression. Although subjects with depressive personality disorder were more likely than the mood disorder comparison group to have another personality disorder, 40% had no such disorder. Contrary to study hypotheses, mood disorder was not more common in first-degree relatives of subjects with depressive personality disorder than in relatives of the comparison group. Subjects with and without depressive personality disorder had similar rates of past treatment with medication and psychotherapy; however, the duration of psychotherapy was significantly longer for subjects with than for those without depressive personality. The depressive personality diagnosis was relatively stable over the 1-year follow-up period. CONCLUSIONS: Depressive personality disorder appears to be a relatively stable condition with incomplete overlap with axis I mood disorders and personality disorders. Further studies are needed to better characterize its treatment response and relationship to axis I mood disorders.     

Sleep Deprivation in social phobia and generalized anxiety disorder

BACKGROUND: Sleep deprivation has been shown to improve depressive symptoms in some patients with major depressive disorder, but it has not been tested in patients with generalized anxiety disorder (GAD) or social phobia (SP). METHODS: To determine if sleep deprivation altered anxiety or depressive symptoms in patients with GAD (n = 7) or SP (n = 8), we sleep deprived patients and normal controls (n = 18) for one night. RESULTS: On one measure of anxiety, GAD patients improved compared with controls, but there were otherwise no significant change differences between controls and SP or GAD patients. CONCLUSIONS: The lack of benefit is consistent with previous findings that sleep deprivation provides no benefit to patients with other anxiety disorders. Sleep deprivation may be a biological intervention that distinguishes anxiety from affective disorders.     

Response to cognitive therapy in depression: The role of maladaptive beliefs and personality disorders.

This study examined whether personality disorder status and beliefs that characterize personality disorders affect response to cognitive therapy. In a naturalistic study, 162 depressed outpatients with and without a personality disorder were followed over the course of cognitive therapy. As would be hypothesized by cognitive theory (A. T. Beck & A. Freeman, 1990), it was not personality disorder status but rather maladaptive avoidant and paranoid beliefs that predicted variance in outcome. However, pre- to posttherapy comparisons suggested that although patients with or without comorbidity respond comparably to "real-world" cognitive therapy, they report more severe depressive symptomatology at intake and more residual symptoms at termination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reassurance seeking, stress generation, and depressive symptoms: An integrative model.

The purpose of this study was to examine a mechanism through which interpersonal vulnerability factors may be linked with depressive symptoms by integrating a stress-generation model with an interpersonal theory of depression. The proposed conceptual framework was tested with 267 college students in a prospective structural equation model with 3 assessments over a 5-week period. Results supported all hypotheses. Initial depressive symptoms and initial reassurance seeking style were positively associated, and initial depressive symptoms were positively related to the occurrence of subsequent minor social stressors. Finally, a reassurance-seeking style was positively related to outcome depressive symptoms indirectly through minor social stressors. As predicted, stress generation operated as a mediating mechanism linking an initial reassurance-seeking style to subsequent depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms among amphetamine and cocaine users before and after substance abuse treatment.

This study examined whether higher rates of depressive symptoms among amphetamine compared with cocaine users result from amphetamine use itself, polydrug use, or experiencing a major lifetime depressive episode and whether depressive symptoms among amphetamine users are more likely to persist 12 months after treatment. The association between amphetamine use and depressive symptoms disappears when controlling for polydrug use and lifetime major depressive episode. Polydrug use and lifetime depressive episode are significantly related to depressive symptoms in the year preceding treatment. Amphetamine use at intake does not predict depressive symptoms among individuals who are abstinent at follow-up, and amphetamine users are no more likely than cocaine users to report depression at a 12-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In-vitro cytochrome P450 dependent metabolism of oxybutynin to N-deethyloxybutynin in humans

A functional polymorphism in the regulatory region of the serotonin transporter gene has been reported to be associated with anxiety-related personality traits. We attempted to replicate this finding in an association study involving 759 Caucasians selected from the general Australian population. We found no associations with personality traits (including neuroticism, negative affect and behavioral inhibition), anxiety and depressive symptoms, or alcohol misuse.     

Latent class analysis of lifetime depressive symptoms in the national comorbidity survey

OBJECTIVE: Although clinical trials have documented the importance of identifying individuals with major depression with atypical features, there are fewer epidemiological data. In a prior report, the authors used latent class analysis (LCA) to identify a distinctive atypical depressive subtype; they sought to replicate that finding in the current study. METHOD: Using the National Comorbidity Survey data, the authors applied LCA to 14 DSM-III-R major depressive symptoms in the participants' lifetime worst episodes (N=2,836). Validators of class membership included depressive disorder characteristics, syndrome consequences, demography, comorbidity, personality/attitudes, and parental psychiatric history. RESULTS: The best-fitting LCA solution had six classes. Four were combinations of atypicality and severity: severe atypical, mild atypical, severe typical, and mild typical. Syndrome severity (severe atypical and typical versus mild atypical and typical classes) was associated with a pronounced pattern of more and longer episodes, worse syndrome consequences, increased psychiatric comorbidity, more deviant personality and attitudes, and parental alcohol/drug use disorder. Syndrome atypicality (severe and mild atypical versus severe and mild typical classes) was associated with decreased syndrome consequences, comorbid conduct disorder and social phobia, higher interpersonal dependency and lower self-esteem, and parental alcohol/drug use disorder. CONCLUSIONS: As in prior reports, the atypical subtype of depression can be identified in epidemiological samples and, like typical depression, exists in mild and severe variants. Atypical depressive subtypes were characterized by several distinctive features. However, the correspondence between epidemiologically derived typologies of atypical depression and DSM-IV major depression with atypical features is not yet known.     

Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases?

Effects of psychosocial coping resources on depressive symptoms were examined and compared in older persons with no chronic disease or with recently symptomatic diabetes mellitus, lung disease, cardiac disease, arthritis, or cancer. The 719 persons without diseases reported less depressive symptoms than the chronically ill. Direct favorable effects on depressive symptoms were found for having a partner, having many close relationships, greater feelings of mastery, greater self-efficacy expectations, and high self-esteem. Buffer effects were observed for feelings of mastery, having many diffuse relationships, and receiving emotional support. Buffer effects were differential across diseases for emotional support (in cardiac disease and arthritis only) and for diffuse relationships (in lung disease). Receiving instrumental support was associated with more depressive symptoms, especially in diabetes patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: A randomized efficacy trial.

In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater reductions in depressive symptoms than did supportive-expressive, bibliotherapy, and assessment-only participants at posttest, though only the difference compared with assessment controls was significant at 6-month follow-up. CB participants showed significantly greater improvements in social adjustment and reductions in substance use at posttest and 6-month follow-up than did participants in all 3 other conditions. Supportive-expressive and bibliotherapy participants showed greater reductions in depressive symptoms than did assessment-only controls at certain follow-up assessments but produced no effects for social adjustment and substance use. CB, supportive-expressive, and bibliotherapy participants showed a significantly lower risk for major depression onset over the 6-month follow-up than did assessment-only controls. The evidence that this brief CB intervention reduced risk for future depression onset and outperformed alternative interventions for certain ecologically important outcomes suggests that this intervention may have clinical utility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in depressive self-schemata and depressive symptoms following cognitive therapy.

Examined the effects of 6–8 sessions of Beck's cognitive therapy on mildly and moderately depressed college students' depressive symptoms and depressive self-schemata. Participants were randomly assigned to either cognitive therapy (n?=?31) or no treatment (n?=?43). The Beck Depression Inventory was used to assess depressive symptoms, and self-referent judgment, recall, and reaction time (RT) measures were used to assess depressive self-schemata. Results support the efficacy of cognitive therapy in reducing depressive symptoms and depressive self-schemata, as measured by self-referent judgment and self-referent recall. The reduction in the recall of negative self-referent judgments may play a role in the outcome of cognitive therapy for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolutionary significance of depressive symptoms: Different adverse situations lead to different depressive symptom patterns.

Although much depression may be dysfunctional, the capacity to experience normal depressive symptoms in response to certain adverse situations appears to have been shaped by natural selection. If this is true, then different kinds of situations may evoke different patterns of depressive symptoms that are well suited to solving the adaptive challenges specific to each situation. The authors called this the situation-symptom congruence hypothesis. They tested this hypothesis by asking 445 participants to identify depressive symptoms that followed a recent adverse situation. Guilt, rumination, fatigue, and pessimism were prominent following failed efforts; crying, sadness, and desire for social support were prominent following social losses. These significant differences were replicated in an experiment in which 113 students were randomly assigned to visualize a major failure or the death of a loved one. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive aspects of chronic depression.

Previous research on chronic depression has focused on its link with other mood disorders and Axis II personality disorders. However, there are few data examining whether the cognitive perspective applies to this condition. In this cross-sectional study, 42 outpatients with chronic depression were compared with 27 outpatients with nonchronic major depressive disorder and 24 never psychiatrically ill controls on cognitive variables thought to be related to vulnerability to depression (e.g., dysfunctional attitudes, attributional style, a ruminative response style, and maladaptive core beliefs). Both depressed groups were more elevated than a never-ill comparison group. However, chronically depressed individuals were generally more elevated on measures of cognitive variables than those with major depressive disorders even after controlling for mood state and personality disorder symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association of social relationships with depressive symptoms: Testing an alternative to social support.

Low social support and expressed emotion have been associated with depression, but no studies examined their relative contributions. A self-report questionnaire was developed to measure family emotional involvement and perceived criticism to assess the main components of family expressed emotion. 83 family practice patients older than 40 yrs responded to a survey assessing depressive symptoms, social support, life events, and expressed emotion. Perceived criticism, intense emotional involvement, and negative life events were all independently associated with depressive symptoms. After controlling for expressed emotion, the association of low social support with depressive symptoms was no longer statistically significant. Results support the primacy of family interactions (with high perceived criticism and emotional involvement) over low social support in explaining the association between social relationships and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality disorder comorbidity with major depression and response to treatment with sertraline or citalopram

The purpose of this study was to investigate the frequency of DSM-III-R personality disorders in depressed patients treated in primary care, and to examine the effect of sertraline or citalopram on the diagnosis of personality disorders. A total of 308 patients with a major depressive disorder were assessed with the Swedish version of the Structured Clinical Interview for Personality Disorders (SCID) screen questionnaire, before and after 24 weeks double-blind treatment with sertraline (50-150 mg/day) or citalopram (20-60 mg/day). Following treatment, significant reductions in the frequency of paranoid, borderline, avoidant and dependent personality disorder diagnoses were seen in both treatment groups. When the personality disorders were analysed as continuous, dimensional personality traits significant reductions were seen for most personality categories. To elucidate if the observed reductions in personality disorder criteria could be explained by the improvement in depressive symptomatology, a series of multiple regressions were made. Reduction of depression scores was of some importance for the changes in most personality disorders. However, the multiple R never exceeded 0.24 (cluster C). Type of drug was of importance only as concerns obsessive-compulsive personality disorder. Overall, the results suggest that sertraline and citalopram may be beneficial in the treatment of certain personality disorder traits in patients with major depressive disorders.