Symptoms of Depression and Anxiety in Children: Specificity of the Hopelessness Theory

The common etiology hypothesis proposes that depression and anxiety commonly co-occur because they share etiological factors. This study examined the specificity of the hopelessness theory in the development of depressive and anxious symptoms in children. Students in Grades 3 through 6 (N = 418, 47% boys) completed measures assessing inferential styles about causes, consequences, and the self, depressive symptoms, and anxious symptoms. Six weeks later, children completed measures of depressive symptoms, anxious symptoms, and hassles. All 3 inferential styles interacted with hassles to predict increases in depressive symptoms, although this relation only held for children with low levels of initial symptoms. Inferential styles about consequences and the self also predicted increases in anxious symptoms. Consistent with the common etiology hypothesis, after controlling for the association between depressive and anxious symptoms, the effects of inferential styles about consequences and the self persisted.     

大学生抑郁情绪与归因方式和自尊的关系

目的：探讨抑郁的无望感／自尊理论在中国大学生被试中的应用。方法：对大学生进行Beck抑郁量表（BDI）、归因方式问卷（ASQ）和白尊量表（SES）的测定。结果：不同抑郁水平大学生之间归因方式有显著差异，但在正性事件和内外维度上关系不稳定。抑郁与自尊有显著相关，不同自尊水平大学生之间的抑郁有显著差异，低自尊大学生的抑郁和归因方式的关系明显，高自尊大学生不明显。结论：本研究总体上验证了抑郁的无望感／自尊理论，中国大学生抑郁者具有对负性事件宿命性、普遍性和持续性归因、无望感和低自尊的特点。     

The Hopelessness Theory of Depression: A Quarter‐Century in Review

Since the formulation of the hopelessness theory of depression (Psychological Review, 96, 1989, 358) a quarter‐century ago, it has garnered considerable interest. The current article presents a systematic review of this theory, including its subsequent elaborations (Rose and Abramson's [Rochester Symposium of Developmental Psychopathology, 1992, University of Rochester Press, Rochester, NY] developmental elaboration; Abela and Sarin's [Cognitive Therapy and Research, 26, 2002, 811] weakest link approach; Panzarella, Alloy and Whitehouse's [Cognitive Therapy and Research, 30, 2006, 307] expansion of the hopelessness theory; and the hopelessness theory of suicide (Suicide Science: Expanding Boundaries, 2000, Kluwer Academic, Boston]), followed by recommendations for future study. Although empirical support was consistently found for several major components of the hopelessness theory, further work is required assessing this theory in relation to clinically significant phenomena. Among the most significant hindrances to advancement in this area is the frequent conceptual confusion between the hopelessness theory and the reformulated learned helplessness theory.     

Chronic Obstructive Pulmonary Disease Assessment Test Can Predict Depression: A Prospective Multi-Center Study

This study was conducted to investigate the association between the chronic obstructive pulmonary disease (COPD) assessment test (CAT) and depression in COPD patients. The Korean versions of the CAT and patient health questionnaire-9 (PHQ-9) were used to assess COPD symptoms and depressive disorder, respectively. In total, 803 patients with COPD were enrolled from 32 hospitals and the prevalence of depression was 23.8%. The CAT score correlated well with the PHQ-9 score (r=0.631; P<0.001) and was significantly associated with the presence of depression (β±standard error, 0.452±0.020; P<0.001). There was a tendency toward increasing severity of depression in patients with higher CAT scores. By assessment groups based on the 2011 Global Initiative for Chronic Obstructive Lung Disease guidelines, the prevalence of depression was affected more by current symptoms than by airway limitation. The area under the receiver operating characteristic curve for the CAT was 0.849 for predicting depression, and CAT scores ≥21 had the highest accuracy rate (80.6%). Among the eight CAT items, energy score showed the best correlation and highest power of discrimination. CAT scores are significantly associated with the presence of depression and have good performance for predicting depression in COPD patients.     

Family Influences on Hopelessness Among Children Early in the Cancer Experience

The present study examined the relationship between five aspectsof family functioning and feelings of hopelessness among childrenearly in the cancer experience. The Hopelessness Scale for Children(Kazdin, French, Unis, Esveldt-Dawson, & Sherick, 1983)as well as a variety of individual and fam ily measures wereadministered to 32 pediatric cancer patients (8 to 16 yearsold) and both of their parents at 3 months postdiagnosis. Datasuggest that more global or characteristic aspects offamilylife (e.g., family satisfaction, extent of interaction) maybe less important in a child's early response to cancer thanare the parents' coping behavior and, to a lesser degree, theirsubjective distress about the illness. Two patterns of copingbehavior for both mothers and fathers (fostering family integrationand maintaining self- stability) proved to be the major independentcontributors in accounting for the variance in hopelessnessscores. In addition, it appears that some of the parental copingbehaviors related to a sense of optimism in the child may bedifferent from the behaviors that impact on the parents' ownlevel of sub jective distress. The important role of both mothersand fathers in their children's cancer experience is addressed,and implications for psychosocial intervention and future researchare discussed.     

Suicidal Behavior,Depression, and Hopelessness in Child Psychiatric Inpatients: A Replication and Extension

Examination of 55 consecutively admitted 6-to 13-year-old psychiatric inpatients indicated that 58% reported suicidal ideation and 40% had attempted suicide. Suicidal ideation was significantly associated with self-reports of hopelessness. Suicide attempts were significantly associated with both hopelessness and a diagnosis of depressive disorder, particularly major depression. Hopelessness and depression were highly correlated, and associations between Suicide attempts, hopelessness, and depression were accounted for partly by a group of hopeless depressed children. Thirty-six percent of suicide attempters had made prior attempts. This group of repeat attempters were older and had the highest rate of depressive disorders (75%). Whereas older (11- to 13-year-old) children tended to contemplate and attempt the same method, younger children tended to think of one method and attempt another, usually less lethal, method.     

抑郁症患者前瞻性记忆的实验研究

目的:探讨抑郁症患者的前瞻性记忆是否与正常人不同.方法:采用类别判断作为背景任务并采用Einstein研究范式对抑郁组和对照组分别进行研究.结果:尽管抑郁组前瞻性记忆成绩比对照组稍低,但没有统计学意义,回溯性记忆成绩两组差别具有统计学意义,且回溯性记忆成绩和前瞻性记忆成绩无明显相关.抑郁组对前瞻性记忆任务的反应时明显长于正常组.结论:抑郁症患者前瞻性记忆没有显著损害,但回溯性记忆有显著损害.     

Hopelessness in the Analysis

The author has written a paper about her sense of hopelessness in working psychoanalytically with two female patients. She found that these feelings were reflected in supervision through the parallel process. She was greatly helped by Betty Joseph's paper, ‘Addiction to near death’, where she found many similarities between that author's patients and her own. Eventually, through consideration of other literature and reflecting on her own experiences, she reached the conclusion that until she could allow herself to be immersed in this sense of hopelessness, it was not possible to genuinely connect with her patients. Any hope to be found, had to be reached through an authentic interaction, which means that the sense of hopelessness had to be tolerated for long periods of time.     

大学生抑郁无望与自尊综合理论因果模型的追踪研究

目的阐明消极归因方式、负性生活事件和无望抑郁的关系,检验无望感的中介效应和自尊的调节作用,并尝试建立抑郁无望与自尊综合理论的因果模型。方法在问卷调查的基础上,以某高校学生269名为研究对象,采用潜变量增长曲线模型对多变量多次追踪数据进行分析。结果1消极归因方式(路径系数为0.127)、负性生活事件的初始状态(路径系数为0.235)和无望感(路径系数为0.455)对无望抑郁的初始状态有显著正向作用;2消极归因方式通过无望感对无望抑郁初始状态的部分中介效应为0.104。负性生活事件的初始状态对无望抑郁初始状态的部分中介效应为0.112;3消极归因方式和自尊的交互作用对无望抑郁的初始状态有显著的负向作用(路径系数为-0.165)。结论消极归因方式和负性生活事件共同作用预测了无望抑郁的产生,无望感在此过程中发挥部分中介作用,自尊发挥调节作用。     

A Prospective Study on the Safety of Immunotherapy in Children with Severe Asthma

One hundred and six of 503 (21%) consecutive children with asthma, who from 1979 to 1983 commenced hyposensitization therapy, were prospectively studied on the safety of immunotherapy. More than 80% of the patients completed therapy without side effects. Thirteen patients were withdrawn from hyposensitization due to moderate and predictable, but intolerable, side effects such as asthma/rhinitis, urticaria and subcutaneous nodules and hypersensitivity to aluminium. However, more alarming was the outcome in six children, who after an uneventful course of immunotherapy and after several months on maintenance therapy, suddenly, 5 to 20 min (mean 10 min) following an earlier tolerable allergen injection, developed severe, anaphylactic reactions, in three of them nearly fatal. Mould extracts were responsible for the most frequent and serious side effects (Alternaria iridis/alternata, 3 patients, Cladosporium herbarum, 8 patients). Furthermore, serious, but not immediately life-threatening, anaphylactic reactions occurred in two children treated with Phleum pratense. On the other hand, hyposensitization with Dermatophagoides pteronyssinus was very well tolerated.     

Assessment of Depression in Children with Cancer

An item analysis of the Children's Depression Index (CDI) wasconducted for 454 children and adolescents in order to examinedifferential reporting of depression by medically ill pediatricpatients. The samples compared were normal schoolchildren, inpatientsin a child and adolescent psychiatric hospital, and childrenwith cancer. Results indicated that the ill children reportedless depression than the psychiatric patients or normal controls.It is hypothesized that the children with cancer may be usingdenial as a coping mechanism. In addition, children with cancerendorsed a different pattern of items than did the normal childrenor psychiatric patients. In particular, somatic items and itemsconcerning self esteem did not discriminate between depressedand nondepressed children in the cancer groups. The resultsindicate that although the CDI is a valid measure of depressionin chronically ill children and adolescents, the test must beevaluated differently for this group.     

Depression and the Test of Memory Malingering

Research on the Test of Memory Malingering (TOMM) [Tombaugh, T. N., 1996. The Test of Memory Malingering. Toronto, Canada: Multi-Health Systems], has consistently shown that it is sensitive to exaggerated or deliberate faking of memory impairment, but it is relatively unaffected by a wide variety of neurological impairments causing genuine memory dysfunction. However, there is little research on the effects that affective disorders have on the TOMM. The current study examined how inpatients diagnosed with major depression performed on the TOMM. Results show that the TOMM is unaffected by affective state. These results, combined with those from previous research, provide converging evidence that performance on the TOMM below a cutoff score of 45 cannot be attributable to depression, neurological impairment, age or education.     

学龄儿童的抑郁

３２２名１０～１２岁小学五、六年级学生填写了Ｂｕｌｅｖｕｅ抑郁量表（ＢＩＤ）。抑郁症状的出现率３．４％～１１．５％，有自杀观念者５．９％。自杀观念与总分、心境恶劣、自卑和自杀、攻击性行为和社会交往４个因子的相关程度最高。３２２人中１０人（３．１％）为抑郁症检出者，临床表现与成人抑郁症相似，其中８人有自杀观念。结果提示抑郁情绪、自杀观念、抑郁症在学龄儿童中的出现率较高，应加强预防和治疗。     

网络受欺负对儿童抑郁的影响:一个有调节的中介模型

目的:探讨网络受欺负对小学生抑郁的影响及其作用机制。方法:采用网络受欺负问卷、一般自我知觉量表、内隐人格观量表和抑郁量表对453名3-6年级的小学生进行问卷调查。结果:(1)网络受欺负与抑郁显著正相关;(2)在控制性别和年龄后,网络受欺负不仅直接预测儿童抑郁,还通过自尊的中介作用间接预测抑郁;(3)自尊的中介作用受到内隐人格观的调节,相对于人格增长观儿童,倾向于持人格实体观的儿童的自尊对抑郁情绪的预测作用更大。结论:自尊在网络受欺负与儿童抑郁的关系中起部分中介作用,且自尊的中介作用受到内隐人格观的调节。     

Depression Among Children with Chronic Medical Problems: A Meta-Analysis

Reviewed 60 studies of depressive symptoms among children andadolescents with chronic medical problems. Findings indicatethat children with a chronic medical problem are at slightlyelevated risk for depressive symptoms but that most are notclinically depressed. Although great variability in depressivesymptoms was found across children with the same disorder, childrenwith certain disorders (e.g., asthma, recurrent abdominal pain,sickle cell anemia) may be at greater risk than children withother disorders (e.g., cancer, cystic fibrosis, diabetes mellitus).Disorder severity was inconsistently related to depressive symptoms,while time since diagnosis, gender, and age were generally unrelatedto symptoms. Parent (vs. child) ratings and the use of community(vs. normative) control groups were associated with higher ratingsof depressive symptoms among children with a chronic medicalproblem     

抑郁症患者威斯康星卡片分类测验和连续操作测验的初步研究

目的 :通过与精神分裂症患者和正常对照的比较 ,探讨抑郁症患者的执行功能和注意功能。方法 :采用威斯康星卡片分类测验 (WCST)、连续操作测验 (CPT) ,对 66例精神分裂症患者、 42例抑郁症患者和 5 0名对照者的执行功能和注意功能进行评估。结果 :两组患者WCST中的总测验次数、持续错误数和随机错误数均明显多于对照组 (P <0 0 1) ;其中精神分裂症组WCST的三项成绩明显差于抑郁症组 (P <0 0 1) ;无干扰刺激时 ,精神分裂症组的认对数明显差于抑郁症组和对照组 (P <0 0 1) ,而抑郁症组与对照组之间的差异无显著性 (P >0 0 5 ) ;有干扰刺激时 ,精神分裂症组与对照组的差异有显著性 (P <0 0 1) ,抑郁症组与其它两组的差异均无显著性 (P >0 0 5 )。结论 :抑郁症组有执行功能障碍 ,介于精神分裂症组和对照组之间 ;在抑郁症组中没有发现有明显的注意障碍。     

农村留守儿童与非留守儿童房树人测验结果比较

目的:对比农村留守儿童与非留守儿童的心理健康状况的差异.方法:采用房树人测验对104例农村留守儿童和121例非留守儿童进行测试.结果:两组儿童在内向孤僻(t=11.049,P＜0.01)、自卑胆小(t=21.535,P＜0.01),紧张焦虑(t=21.454,P＜0.01)、抑郁(t=30.847,P＜0.01)、攻击性(t=7.701,P＜0.01)各维度均存在显著差异,且各心理维度之间显著相关(r=0.201～0.745,P＜0.01).结论:留守儿童的心理健康水平低于非留守儿童,需加强有效的干预.     

A Test of the Immunoreactive Theory of Selective Male Affliction

A survey of the charts of 576 children evaluated at the ChildStudy Center of the University of Arkansas for Medical Sciencesrevealed, as expected, the phenomenon of selective male afflictionin five common diagnostic groups. Evidence in support of Gualtieriand Hick's (1985) immunoreactive theory of selective male affliction(IMRT) was mixed. That is, the IMRT predicts that in diagnosticgroups where there is selective male affliction, male probandswill more frequently have antecedent brothers than female probands,which was not confirmed. However, males in diagnostic groupsimplicating primary cognitive dysfunction were found to haveantecedent brothers more frequently than males in diagnosticgroups showing behavioral and emotional adjustment disorders.Males with diagnoses of attention or anxiety/affective disorderswere more frequently firstborn than those with cognitive disorders.     

孤独症和正常儿童心理理论能力比较

目的考察孤独症儿童心理理论的特点,探讨孤独症心理理论缺失假说。方法18名3-15岁的孤独症儿童为实验组,30名3-16岁的正常儿童为对照组,接受了龚氏非文字智力测验以及“外表-真实任务”、“意外位置任务”和“意外内容任务”三个心理理论测验任务。结果⑴在龚氏非文字智力测验中,孤独症组IQ低于正常组(98.8±25.2/117.2±14.3,t=-2.760,P<0.05)。⑵所有被试在各项心理理论任务上的得分之间均存在显著正相关(r=0.612~1.000,P<0.01)。⑶孤独症组的外表-真实任务(247/927,u=-5.007,P<0.001)、位置错误信念问题(173/862,u=-5.661,P<0.001)、内容自我错误信念问题(178/725,u=-4.277,P<0.001)及内容他人错误信念问题(163.5/739.5,u=-4.639,P<0.001)得分均低于正常组。结论孤独症儿童心理理论发展水平远落后于同龄正常儿童,存在严重的心理理论缺损。