Relative memory deficits in recurrent versus first-episode major depression on a word-list learning task.

Although memory deficits are associated with major depressive disorder, few studies have identified which patient characteristics predict impairment. Because recurrent depression appears related to more severe cerebral dysfunction, the present study tested whether recurrent depressed individuals have worse memory function than first-episode depressed individuals. Two groups of young-adult, nonpsychotic, depressed inpatients (20 single episode [SE] and 46 recurrent episode [RE]) were administered the California Verbal Learning Test within a broader battery of neuropsychological tests. The groups were equivalent in age, education, estimated IQ, severity of depression, and demographic composition. The RE group demonstrated memory deficits relative to both the SE group and published norms, but no other significant difference was found across the battery. Data indicate that abnormal memory performance is associated with recurrent depression, whereas memory deficits are not prominent in first-episode depressed individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implicit memory for spatial context in depression and schizophrenia.

Deficits in explicit spatial memory, as well as abnormalities of the hippocampus and neighboring medial temporal structures, have been documented in schizophrenia and depression. Recent evidence relying on the contextual cueing paradigm has shown that integrity of these structures is crucial not only for explicit memory but also for implicit spatial memory. Using this paradigm, the authors show that implicit memory for spatial context is severely impaired in clinically depressed patients but reaches a normal level in schizophrenia patients, although in these patients, acquisition is slower than in controls. By contrast, implicit memory for isolated locations and colors is normal in both schizophrenia and depressed patients. These findings suggest an implicit memory impairment specific to spatial context in depression. The implications for research on the differences between schizophrenia and depression in abnormalities of the hippocampal system and for research on the neural correlates of contextual cueing are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory complaint and memory performance in the depressed elderly.

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

Marital distress, depression, and attributions: Is the marital distress-attribution association an artifact of depression?

We examined whether the association between marital distress and attributions is an artifact of depression. Study 1 showed that the attributions of 40 wives recruited from the community accounted for variance in their marital satisfaction after the effects of depression had been taken into account. Study 2 compared the attributions of 20 clinically depressed and maritally distressed wives (respondents to an advertisement offering therapy for depression and marital problems), 20 nondepressed but distressed wives (clients seeking marital therapy at a clinic), and a control group of 20 nondepressed and nondistressed wives (respondents to an advertisement for participants in a research project). The first two groups did not differ in attributions, but the attributions of both groups differed from those of the control group. Both studies therefore suggest that the association between attributions and marital satisfaction is not due to depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unconscious mood-congruent memory bias in depression.

The purpose of this study was to investigate an unconscious or implicit mood-congruent memory (MCM) bias in clinical depression. Many studies have shown an explicit memory bias, but no study has yet found an implicit MCM bias in clinical depression. The authors compared depressed and control group participants on a conceptually driven implicit memory test. After studying words of positive, neutral, and negative affective valences, participants produced free associations to various cues. Implicit memory or priming was demonstrated by the production of more studied than unstudied words to the association cues. Depressed participants showed more priming of negative words, whereas controls showed more priming of positive words, thus supporting the MCM pattern. Also, no implicit memory deficit was found in depressed participants. These findings are discussed in the context of several prominent theories of cognition and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of autobiographical memory in social problem solving and depression.

Depressed patients frequently exhibit deficiencies in social problem solving (SPS). A possible cause of this deficit is an impairment in patients' ability to retrieve specific autobiographical memories. A clinically depressed group and a hospital control group performed the Means-End Problem-Solving (MEPS; J. J. Platt & G. Spivack, 1975a) task, during which they were required to attend to the memories retrieved during solution generation. Memories were categorized according to whether they were specific, categoric, or extended and whether the valence of the memories was positive or negative. Results support the general hypothesis that SPS skill is a function of autobiographical memory retrieval as measured by a cuing task and by the types of memories retrieved during the MEPS. However, the dysfunctional nature of categoric memories in SPS, rather than the importance of specific memories, was highlighted in the depressed group. Valence proved to be an unimportant variable in SPS ability. The cyclical links among autobiographical memory retrieval, SPS skills, and depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic investigation of neurocognitive deficits in bipolar illness: Profile and effects of clinical state.

A meta-analysis of neuropsychological studies of patients with bipolar disorder comprised of 42 studies of 1,197 patients in euthymia, 13 studies consisting of 314 patients in a manic/mixed phase of illness, and 5 studies of 96 patients in a depressed state. Cohen d values were calculated for each study as the mean difference between patient and control group score on each neuropsychological measure, expressed in pooled SD units. For euthymia, results revealed impairment across all neuropsychological domains, with d values in the moderate-to-large range (d = .5 ? .8) for the vast majority of measures. There was evidence of large effect-size impairment on measures of verbal learning (d = .81), and delayed verbal and nonverbal memory (d = .80 ? .92), while effect-size impairment on measures of visuospatial function was small-to-moderate (d ≤ .55). Patients tested during a manic/mixed or depressed phase of illness showed exaggerated impairment on measures of verbal learning, whereas patients tested during a depressed phase showed greater decrement on measures of phonemic fluency. These results suggest that bipolar illness during euthymia is characterized by generalized moderate level of neuropsychological impairment with particular marked impairment in verbal learning and memory. These results also show that a subset of these deficits moderately worsen during acute disease states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recall of parental behavior by acute depressives, remitted depressives, and nondepressives.

The goal of this study was to determine whether depressives' recall of parental behavior is a stable characteristic that persists even during asymptomatic periods. Recall of parental behavior was measured in a large community sample that was followed for one year. Four groups of subjects were formed according to their depression status: depressed, remitted depressed who had a history of depression but were not depressed during the study, cases who became depressed during the follow-up period, and never-depressed subjects. The results were generally consistent with the hypothesis that recalling one's parents as having been rejecting and unloving is not a stable personality characteristic of depression-prone persons. The currently depressed subjects differed as expected from the nondepressed subjects; however, the remitted depressed, regardless of how many past episodes of depression they had, did not differ from the nondepressed controls in their recall of parental behavior. The comparison of controls and cases resulted in an unexpected and difficult-to-interpret Sex?×?Group interaction. The implication of these findings for cognitive theories of depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal assessment of depression and cognitive impairment following stroke

Previous studies have demonstrated that patients with major depression following stroke have a greater degree of cognitive impairment than nondepressed patients with comparable lesions. The present study examined the longitudinal course of cognitive impairment related to depression. Patients were prospectively evaluated following an acute stroke (N = 309), using a structured psychiatric interview and the Mini-Mental State Examination. Longitudinal evaluations were obtained at 3, 6, 12, and 24 months follow-up in a subset of these patients. During the initial in-hospital evaluation, the frequency and severity of cognitive impairment was significantly greater in patients with major depression compared with nondepressed patients. This effect occurred predominantly in patients with major depression following left hemisphere stroke. The association of depression and cognitive function was strongest during the initial evaluation, but was present for up to 1 year. The year-long effect, however, was evident only in patients with left hemisphere stroke. Patients with both depression and cognitive impairment had a greater duration of depression than depressed patients without cognitive impairment. Depression with cognitive impairment appears to be a phenomenon produced by left hemisphere lesions. This suggests that left hemisphere stroke may produce depression through a different mechanism than lesions in other locations. In addition, the fact that the strongest influence of depression on cognitive function was seen during the initial evaluation suggests that this phenomenon may be mediated by acute or subacute physiological effects of the lesion.     

Short-term outcomes of detected and undetected depressed primary care patients and depressed psychiatric patients

The aims of this study were to determine whether detection of major depression in primary care was associated with improved outcome, and to compare the 4.5 month outcomes of detected and undetected depressed primary care patients and depressed psychiatric patients. Primary care patients with major depression were recruited from the practices of 50 family physicians in Southeastern Michigan using a two-stage selection procedure employing the Center for Epidemiologic Studies-Depression Scale (CES-D) and the Structured Clinical Interview for DSM-III-R (SCID); clinician detection of depression was ascertained by response to a direct query on a rating form. Depressed patients seeking treatment in an outpatient psychiatric setting also received the CES-D and the SCID. Data on patient demographics and clinical characteristics were obtained for both primary care and psychiatric patients. Initial and 4.5 month scores on the Hamilton Depression Rating Scale (HAM-D) were obtained for 34 undetected and 25 detected depressed primary care and 55 depressed psychiatric patients. Improvement in depression over time was assessed by the change in HAM-D scores over the 4.5 months. The three groups did not differ in initial severity. Both psychiatric and undetected primary care patients showed significant improvement at 4.5 months, whereas detected primary care patients did not improve. At 4.5 months there were no differences in mean HAM-D scores between undetected, depressed primary care patients and depressed psychiatric outpatients. This result did not change after controlling for age and severity of depression at initial presentation, nor did it change after exclusion of cases of mild depression to control for a possible "floor effect." However, differences among groups in the stage of depressive episodes may have affected this comparison. These findings suggest that an exclusive focus on increasing detection of depression in primary care patients is unlikely to improve outcomes, and that undetected depression among primary care patients does not necessarily represent poor quality of care. Although depressed psychiatric patients in this study had better outcomes than detected depressed primary care patients, the presence of unmeasured differences among groups in the stage of the depressive episode makes it impossible to determine whether treatment of depression by psychiatrists is superior to that provided by primary care physicians. These findings should stimulate efforts to examine a more comprehensive model for detection and treatment of depression in primary care.     

Finding the self in metacognitive evaluations: Metamemory and agency in nondemented elders.

Objective: Metacognitive methodologies are used to examine the integrity of self-referential processing in healthy adults and have been implemented to study disorders of the self-concept in neurologic and psychiatric populations. However, the extent to which metacognitive evaluations assess a uniquely self-evaluative capacity that cannot be explained fully by primary cognitive functions, demographics, or mood is not clear. The objective of the current study was to examine whether metamemory and a metacognitive test of agency shared a self-referential association that would not be explained by cognition, demographics, or mood. Method: Thirty-eight nondemented older adults (Mini Mental State Examination [MMSE] ≥24 and mean age = 68.13) participated in metacognitive testing and completed cognitive testing and mood questionnaires. Bivariate correlations were used to evaluate the association between metamemory and agency, and to determine the cognitive (memory, attention, and executive functioning), demographic (age and education), and mood (anxiety and depression) correlates of each. Correlates of metamemory and agency were then entered into linear regression models to determine whether any association between metacognitive measures remained. Results: Metamemory was associated with agency judgments (n = 27), specifically those on self-controlled rather than computer-controlled trials (r = .41, p = .03). Regression results supported a role for agency in predicting metamemory, above and beyond memory and education (β = .39, p = .034). Metamemory was also an independent predictor of agency judgments (β = .36, p = .049). Conclusions: The interrelation between metamemory and agency judgments suggests that metacognitive testing captures an important aspect of self-referential processing not otherwise assessed in a standard cognitive evaluation and may provide unique information about self-evaluative capacities in clinical populations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Caregiver models of self and others, coping, and depression: Predictors of depression in children with chronic pain.

In a sample of 59 chronically ill pediatric patients and their maternal caregivers, both child-reported pain and caregiver-reported depression predicted child-reported depression. Results further suggested that the association between pain and depression in children is ameliorated by caregiver coping strategies and that how caregivers cope is a function of their attachment-related representations of the self and others. Caregivers with a negative model of the self were more depressed, and those with a negative model of others were more prone to use avoidant coping strategies, and, in turn, to be more depressed. However, the extent to which caregivers with negative models of self used more avoidant and less approach coping appeared to depend on whether they perceived that others were likely to respond to their needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

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

Memory for emotional trait adjectives in clinically depressed youth

An experiment was conducted to examine memory for emotional trait adjectives in depressed children and adolescents. Two groups of children and adolescents, clinically depressed participants and non-clinical controls, were compared on computerized versions of recall and recognition memory tasks. Three groups of words (positive trait adjectives, negative trait adjectives, and categorized neutral words) were used in the experiment. Results showed that the depressed group recalled significantly more negative adjectives than positive adjectives, whereas the control group recalled the same number of positive and negative adjectives. This effect was predicted by the association between age and level of depression, with the depression-related bias becoming stronger with age. Signal detection analysis revealed that the depressed group did not show any bias in the recognition task. The findings are discussed with respect to cognitive theories of depression with consideration of the developmental implications.     

Facial affect processing and depression susceptibility: Cognitive biases and cognitive neuroscience.

Facial affect processing is essential to social development and functioning and is particularly relevant to models of depression. Although cognitive and interpersonal theories have long described different pathways to depression, cognitive-interpersonal and evolutionary social risk models of depression focus on the interrelation of interpersonal experience, cognition, and social behavior. We therefore review the burgeoning depressive facial affect processing literature and examine its potential for integrating disciplines, theories, and research. In particular, we evaluate studies in which information processing or cognitive neuroscience paradigms were used to assess facial affect processing in depressed and depression-susceptible populations. Most studies have assessed and supported cognitive models. This research suggests that depressed and depression-vulnerable groups show abnormal facial affect interpretation, attention, and memory, although findings vary based on depression severity, comorbid anxiety, or length of time faces are viewed. Facial affect processing biases appear to correspond with distinct neural activity patterns and increased depressive emotion and thought. Biases typically emerge in depressed moods but are occasionally found in the absence of such moods. Indirect evidence suggests that childhood neglect might cultivate abnormal facial affect processing, which can impede social functioning in ways consistent with cognitive-interpersonal and interpersonal models. However, reviewed studies provide mixed support for the social risk model prediction that depressive states prompt cognitive hypervigilance to social threat information. We recommend prospective interdisciplinary research examining whether facial affect processing abnormalities promote—or are promoted by—depressogenic attachment experiences, negative thinking, and social dysfunction. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Headache--differential diagnosis and therapy]

Literature and folk wisdom have long linked depression and death; however, only recently have scientific studies examined the relation between them. Beginning in the 1970s, investigators compared mortality among patients treated for major depression and the general population. Nine of ten studies found an increased mortality from cardiovascular disease among depressed patients. However, such studies confound the relation between depression and its treatment. Community surveys circumvent this difficulty, but as these studies began to appear, other investigations revealed the strong association between depression and cigarette smoking, which made obvious a need to control for smoking. The first study to do this appeared in 1993, and not only did a relation between depression and mortality persist, but a relation between depression and the development of ischemic disease was revealed. In the past 2 years, six more community surveys have followed populations initially free of disease, and five have observed an increased risk of ischemic heart disease among depressed persons. Another research strategy is to start with subjects who have preexisting cardiovascular disease. Here, too, depression has consistently been associated with a worse outcome. In one well-designed study, patients with depression in the period immediately after a myocardial infarction were 3.5 times more likely to die than nondepressed patients. The basis of this association remains speculative. However, it is likely that the changes in the autonomic nervous system and platelets that are seen in depression account for a substantial portion of the association.     

Temporal and spatial context memory in patients with focal frontal, temporal lobe, and diencephalic lesions

Patients with focal frontal, temporal lobe, or diencephalic lesions were investigated on measures of temporal (recency) and spatial (position) context memory, after manipulating exposure times to match recognition memory for targets (pictorial stimuli) as closely as possible. Patients with diencephalic lesions from an alcoholic Korsakoff syndrome showed significant impairment on the temporal context (recency) task, as did patients with frontal lesions penetrating the dorsolateral frontal cortex, according to MRI (and PET) evidence. Patients with temporal lobe lesions showed only a moderate (non-significant) impairment on this task, and patients with medial frontal lesions, or large frontal lesions not penetrating the dorsolateral cortical margins, performed as well as healthy controls at this task. On the spatial context memory task, patients with lesions in the temporal lobes showed significant impairment, and patients with right temporal lesions performed significantly worse than patients with left temporal lesions. Patients with diencephalic lesions showed only a modest (non-significant) impairment on this task, and the frontal lobe group performed normally. When a group of patients with temporal lobe lesions resulting from herpes encephalitis were examined separately, an identical pattern of results was obtained, the herpes group being significantly impaired on spatial memory and showing a trend towards impairment for temporal context memory. There were strong correlations between anterograde memory quotients and context memory performance (despite the use of an exposure time titration procedure) and a weak association in the frontal group with one frontal/executive task [corrected] (card-sorting perservations). It is predicted that correlations between temporal context memory and frontal/executive tasks will be greater in samples of patients all of whom have frontal lesions invading the dorsolateral cortical margin.     

A differential deficit in time- versus event-based prospective memory in Parkinson's disease.

Objective: The aim of the current study was to clarify the nature and extent of impairment in time- versus event-based prospective memory in Parkinson's disease (PD). Prospective memory is thought to involve cognitive processes that are mediated by prefrontal systems and are executive in nature. Given that individuals with PD frequently show executive dysfunction, it is important to determine whether these individuals may have deficits in prospective memory that could impact daily functions, such as taking medications. Although it has been reported that individuals with PD evidence impairment in prospective memory, it is still unclear whether they show a greater deficit for time- versus event-based cues. Method: Fifty-four individuals with PD and 34 demographically similar healthy adults were administered a standardized measure of prospective memory that allows for a direct comparison of time-based and event-based cues. In addition, participants were administered a series of standardized measures of retrospective memory and executive functions. Results: Individuals with PD demonstrated impaired prospective memory performance compared to the healthy adults, with a greater impairment demonstrated for the time-based tasks. Time-based prospective memory performance was moderately correlated with measures of executive functioning, but only the Stroop Neuropsychological Screening Test emerged as a unique predictor in a linear regression. Conclusions: Findings are interpreted within the context of McDaniel and Einstein's (2000) multiprocess theory to suggest that individuals with PD experience particular difficulty executing a future intention when the cue to execute the prescribed intention requires higher levels of executive control. (PsycINFO Database Record (c) 2011 APA, all rights reserved)