Attributional style of depressed chronic low back patients

This study used the Attributional Style Questionnaire to study the attributional styles of depressed and nondepressed chronic low back pain patients (N = 91) in order to test the Revised Learned Helplessness model's prediction of differences between the two. The results partly supported the hypothesis; an internal, stable, global style for negative events distinguished the depressed group from the nondepressed, but there were no differences in attributional style for positive events. The findings are consistent with recent reviews of the literature that have reported general support for the negative outcome style, but consistent failure to confirm the predictions associated with positive outcome style. In addition, the attributional style was not common to all subjects in the depressed group, which suggested that other factors may be involved in the development of different subtypes of depression. Implications for studying attributional aspects of depression and chronic low back pain are discussed.     

A Rorschach comparison of psychopathic and nonpsychopathic conduct disordered adolescents

Forty-eight male subjects who met the DSM-IV (APA, 1994) criteria for conduct disorder (CD) were assessed for psychopathy level using a modified version of the Psychopathy Checklist-Revised (PCL-R; Forth, Hart, & Hare, 1990). Rorschach variables associated with self-perception, affects, and object relations, early behavioral problems and history of violence were compared between psychopathic and nonpsychopathic CD adolescents. Psychopathic CD subjects were significantly more self-centered and violent than nonpsychopathic CD subjects. Decreased attachment and anxiety were found in both CD groups. Our study adds empirical support to the heterogeneity noted among CD adolescents (PCL-R), supports the utility of the Rorschach for detecting individual differences among CD subjects, and extends the empirical work of Gacono and Meloy (1994) to adolescent psychopathy. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53 : 289–300, 1997.     

MMPI profiles of depressed adolescents with and without conduct disorder

This study examined whether adolescents with depression would produce significantly different MMPI profiles from adolescents with depression and conduct disorder. Twenty-four adolescents who met DSM-III-R criteria for major depression or dysthymia were included in the study. Nine of these 24 subjects also met DSM-III-R criteria for Conduct Disorder. Results indicated that depressed only adolescents had significantly higher elevations on scales 2 and 0 while those with depression and conduct disorder had significantly higher elevations on scales F and 9. These findings suggest that the presence of conduct disorder in depressed adolescents may lead to a veiling of their affective symptoms, thus potentially causing clinicians to underdiagnose depression in such cases. © 1996 John Wiley & Sons, Inc.     

Effect of neuroticism,response style and information processing on depression severity in a clinically depressed sample

BACKGROUND: It is postulated that individuals who score high on neuroticism would ruminate when faced with stress. A ruminative response style to depression is associated with faulty attribution and higher dysfunctional beliefs, which in turn is associated with a higher level of depression and hopelessness. Distraction is associated with less severe depression. Evidence supporting these hypotheses mainly comes from a non-clinical population. Hence it is not clear if these theories apply to clinical depression. METHOD: One hundred and nine out-patients suffering from unipolar major depressive disorder were recruited to test these theories, using model-fitting analysis technique. RESULTS: Certain rumination responses to depression were associated with higher levels of depression and hopelessness, faulty attribution and dysfunctional attitudes when gender and the level of depression were controlled. Principal component analysis of the Rumination Scale yielded four factors: 'symptom-based rumination', 'isolation/introspection', 'self-blame' and 'analyse to understand'. Unlike the other factors, 'analyse to understand' did not correlate with the level of depression. Model fitting analysis, though not reflecting entirely the true model, captures most of the hypothesized relationships between important variables. Neuroticism was associated with stress. Rumination was associated with an increased level of dysfunctional beliefs and faulty attribution, which in turn was associated with increased severity of depression. Distraction, in contrast, was associated with lower levels of negative mood. CONCLUSION: The results of our study support the importance of teaching depressed patients to manage their depressive symptoms by avoiding rumination about their symptoms and engaging in distracting and pleasurable activities.     

Attributional style and perceived stress in endogenous and reactive depression

The depressive Attributional Style Questionnaire (Peterson et al., 1982) and the Hassles and Uplifts Questionnaire (Kanner et al., 1981) were administered to melancholic and non-melancholic depressed patients (matched for severity according to a doctors/nurses rating scale), and to non-depressed volunteers. Compared to the other two groups, melancholic patients had higher internality and stability scores for negative attributions, and reported a greater intensity of 'hassles' and a lower frequency of 'uplifts'. The intensity of 'uplifts' was reduced in both depressed groups. On all other cognitive measures, the reactive patients were indistinguishable from non-depressed volunteers. The results suggest that the 'depressive attributional style' may be specific to melancholic patients, and underline the importance of studying well-defined diagnostic subgroups.     

Attributional style and locus of control in adults with epilepsy

Little agreement exists on how attributional style and locus of control relate to one another. Some consider the two to be interchangeable; others say that they overlap but are not identical. This study of the perceptions of control (conceptualized as attributional style and locus of control) of 144 adults with epilepsy, measured via a mailed survey, lends support to the latter notion. Attributional style for bad events, but not for good events, could be predicted by length of time that participants had been seizure free. Locus of control could not be predicted. Differences in the nature of the two concepts and how they develop within individuals are examined to explain how changes in seizure control would effect one but not the other. Implications for other medical conditions are discussed.     

Ruminative thought style and depressed mood

Recent research has suggested that the measure most commonly used to assess rumination, the Response Style Questionnaire (RSQ; L. D. Butler & S. Nolen‐Hoeksema, 1994), may be heavily biased by depressive symptoms, thereby restricting the scope of research exploring this construct. This article offers a broader conceptualization of rumination, which includes positive, negative, and neutral thoughts as well as past and future‐oriented thoughts. The first two studies describe the development and evaluation of the Ruminative Thought Style Questionnaire (RTS), a psychometrically sound measure of the general tendency to ruminate. Further, the scale is comprised of a single factor and shows high internal consistency, suggesting that rumination does encompasses the factors mentioned. The final study involved a longitudinal diary investigation of rumination and mood over time. Results suggest that the RTS assesses a related, but separate, construct than does the RSQ. RTS scores predicted future depressed mood beyond the variance accounted for by initial depressed mood whereas RSQ scores did not. The implications of these results and directions for future research are discussed. © 2008 Wiley Periodicals, Inc. J Clin Psychol 65:1–19, 2009.     

Attributional style and symptoms of depression in persons with multiple sclerosis

This study was designed to assess hypotheses derived from the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989), specifically that negative attributional style would be associated with depressive symptoms and that negative life events would interact with negative attributional style to explain depressive symptoms in a sample of persons with multiple sclerosis (MS). The research was cross sectional in design. Data was collected via survey from 495 persons with MS. Attributional style was positively associated with depressive symptoms across the whole sample. The proposition that negative life events would interact with negative attributional style to explain depressive symptoms was also supported, although only for global attributional style. Longitudinal studies would assist in determining the causal direction proposed by the hopelessness theory of depression in this population. It is also appropriate that clinicians consider attributional style in persons with MS whom they are treating for depression.     

Early maladaptive schemas,temperament and character traits in clinically depressed and previously depressed subjects

The Young Schema Questionnaire (YSQ) and the Temperament and Character Inventory (TCI) have been suggested as vulnerability markers for depression. One‐ hundred forty clinically depressed subjects(CD), previously depressed subjects(PD) and never depressed (ND) controls completed the YSQ, the TCI and the Beck Depression Inventory. Results showed that CD and PD differed significantly on early maladaptive schemas, temperament and character traits compared with ND. In accordance with previous research, higher levels of harm avoidance and lower levels of self‐directedness were found in CD and in recovered PD. Moreover, CD and PD showed substantial variability in the scores on the YSQ and the TCI when controlling for concurrent depression severity. In multiple regression analyses, YSQ domain scales of disconnection, impaired autonomy, restricted self‐expression and impaired limits emerged as significant predictors of depression severity. Likewise, as concerns TCI higher order scales, high harm avoidance, low self‐directedness and high persistence emerged as significant predictors of depression severity. Harm avoidance was positively related to several early maladaptive schemas (EMSs), whereas self‐directedness was negatively related to a majority of the EMSs. Our findings indicate the presence of maladaptive personality characteristics in CD and PD. Longitudinal studies are needed to establish their causal role in relation to first‐onset and recurrent depression. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: ? Early maladaptive schemas, high harm [correction made here after initial online publication] avoidance and low self‐directedness may be a part of vulnerability to depression. ? The finding of these personality characteristics in subjects recovered from depression indicates malfunctioning to some degree. ? Addressing such characteristics in therapy should be considered in order to prevent and treat depression from its relapsing and recurring course.     

Frontal-lobe cognitive dysfunction in conduct disorder adolescents

Behavioral similarities between antisocial behavior disorders and frontal-lobe cerebral impairment have led to suggestions that conduct disorders are attributable to disinhibition deficit associated with frontal-lobe cerebral functions. This study compared the performance of 21 conduct disorder adolescents on measures of cognitive processes associated with frontal-lobe functions with that of a matched comparison sample. Conduct disorder adolescents performed more poorly on measures sensitive to frontal-lobe dysfunction (conceptual perseveration, poorly sustained attention, impaired sequencing on memory and motor tasks), but not on non-frontal-lobe specific cognitive measures. Although the findings support a neurobehavioral explanation of antisocial behavior as a product of cerebral disinhibition, caution is urged in overinterpreting causal relationships through neurobehavioral data.     

Self-concept dimensions of clinically depressed and anxious outpatients.

Principal components analyses of the Beck Self-Concept Test (BST) were conducted independently for 288 women with primary mood disorders, 230 women with anxiety disorders, 236 men with mood disorders, and 161 men with anxiety disorders. Four self-concept dimensions that reflected (1) Intellectual Ability; (2) Work Efficacy; (3) Physical Attractiveness; and (4) Virtues/Vices occurred within the four samples. For 5-item subscales that represent these four dimensions, a two-way MANOVA found significant effects for sex and type of disorder. Women described themselves as having less intellectual ability than men did. Outpatients with mood disorders considered their physical appearance, work efficacy, and virtues/vices to be less acceptable than did those with anxiety disorders. Findings were discussed with respect to the cognitive content-specificity theory of psychopathology.     

Frontal lobe functioning in conduct disordered juveniles: preliminary findings.

This investigation assessed the hypothesis that conduct disordered juveniles may suffer from a maturational lag in the development of behaviors believed associated with the frontal cortex. Twenty conduct disorder (CD) juveniles and 20 normal comparison subjects were compared on nine Lurian tasks that measure behavior attributed to frontal lobe functioning. A three-way ANOVA, with gender, race, and group as factors of interest, revealed significant differences on the verbal conflict task, verbal retroactive inhibition task, and on a measure of receptive vocabulary. Using receptive vocabulary as a covariate, an ANCOVA showed no significant differences between the groups on any of the tasks. These findings appear to support the potential impact that language dysfunction can have in the development of disinhibitory behavior. Other interpretations of the findings are presented.     

Attributional style and defense mechanisms: a synthesis of cognitive and psychodynamic factors in depression

In a study involving 160 undergraduates, we tested the hypothesis that attributional style and defense style would have interactive effects on depressive symptoms. Consistent with this hypothesis, both negative attributional style and low defense maturity were associated with depressive symptoms, both as main effects and in interaction. Negative attributional style was associated with depressive symptoms primarily when accompanied by low defense maturity. The presence of a positive attributional style reduced the relation between low defense maturity and depressive symptoms, and the presence of high defense maturity reduced the relation between a negative attributional style and depressive symptoms. In addition, high defense immaturity was shown to be a possible mediator of the relation between negative attributional style and depressive symptoms. Clinical implications for psychotherapy integration are discussed.     

Evidence-based assessment of conduct problems in children and adolescents.

This article provides a summary of research in 4 areas that have direct and important implications for evidence-based assessment of children and adolescents with conduct problems (CP): (a) the heterogeneity in types and severity of CP, (b) common comorbid conditions, (c) multiple risk factors associated with CP, and (d) multiple developmental pathways to CP. For each of these domains, we discuss implications for evidence-based assessment, present examples of specific measures that can aid in such assessments, and provide recommendations for evidence-based assessment of CP in children and adolescents. We conclude that there is a need to (a) enhance the clinical utility of evidence-based measures for assessing CP; (b) increase attention to the sensitivity of such measures to change, for both treatment evaluation and monitoring; and (c) develop assessment methods that reliably and validly identify a child or adolescent's placement and progress on the various developmental pathways to CP.     

Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients

To ascertain the dimensions of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in clinically depressed outpatients, exploratory factor analyses were performed with the BDI-II responses of 210 adult (> or =18 years) outpatients who were diagnosed with DSM-IV depressive disorders. Two factors representing Somatic-Affective and Cognitive dimensions were found whose compositions were comparable to those previously reported by Beck, Steer, and Brown (1996) for psychiatric outpatients in general. A subsequent confirmatory factor analysis supported a model in which the BDI-II reflected one underlying second-order dimension of self-reported depression composed of two first-order factors representing cognitive and noncognitive symptoms. The clinical utility of using subscales based on these two latter first-order symptom dimensions was discussed.     

The conduct disordered child: An analysis of family problems

The purpose of this review was to examine the conduct disordered child and his/her family and determine how they differed from the “normal” or nonclinic family. Four areas were examined: child behavior, parent behavior, parent perceptions of child adjustment, and parental adjustment. Clinic-referred conduct disordered children were more deviant and less compliant than nonclinic children. Parents of the conducted disordered children issued more commands; emitted more negative, but not less positive, behavior toward their children; and perceived their children and themselves as less well adjusted than the parents in the nonclinic group. Why certain children are identified as conduct disordered and needing treatment is discussed as are the assessment and treatment implications of the findings.     

Growth hormone response to desmethylimipramine in depressed and suicidal adolescents

Desipramine 75 mg i.m. was given in the morning to 20 adolescents with major depressive disorder and 23 normal controls. Depressed adolescents secreted significantly less growth hormone (GH) over the next 2 h than did normal adolescents, although a substantial proportion of the differences were accounted for by the depressed adolescents who had a specific suicidal plan or attempt during the episode. Severity of depression or the presence of other depressive symptoms did not predict GH secretion within the depressed group. Age, sex and maturational factors in the control of GH are discussed. It is concluded that these differences in GH secretion probably reflect differences in CNS beta-adrenergic and/or serotonergic function. Suicidality and depression may have different psychobiological correlates in adolescents.