Attributional style and depression in schizophrenia.

OBJECTIVES: The literature implies that negative attributional style is a psychological correlate of depression. Recent evidence suggests that negative attributional style may be specific to depression. This study examines the association between level of depression and negative attributional style in a sample of individuals with schizophrenia. METHOD: One hundred and thirteen inpatients with schizophrenia were assessed with the Calgary Depression Scale for Schizophrenia and the Attributional Style Questionnaire. RESULTS: Attributions of negative events to internal and to global causes were significantly associated with depressive symptoms. Only the global dimension was significantly associated with positive symptoms. No attributional dimensions were significantly associated with negative symptoms. CONCLUSIONS: These results are consistent with the idea that negative attributional style may be specific to depression and not a general characteristic of psychopathology.     

Longitudinal Correlates of Depressive Symptoms and Positive and Negative Affects in Family Caregivers of People With Dementia

ObjectiveCaring for a relative with dementia is considered a chronically stressful role associated with negative consequences for psychological health such as higher levels of depression. However, the subjective experience of depressive symptomatology is complex as it relates to two unique domains: positive affect (PA) and negative affect (NA). The objective of this study was to analyze, through a longitudinal design, the associations of caregivers’ cognitive (avoidance coping, personal mastery, and coping self-efficacy) and behavioral (frequency of pleasant events) coping strategies with depressive symptoms, PA, and NA.MethodsA total of 111 caregivers of a spouse with dementia participated in this study. They were assessed yearly across 5 years. Mixed model regression analyses were conducted separately for depressive symptoms, PA, and NA, analyzing within and between-person associations of caregivers’ age, gender, role overload, sleep quality, and coping variables previously mentioned.ResultsThe results showed that different coping strategies were associated with different components of depressive symptomatology. While avoidant coping was associated with NA and depressive symptoms but not PA at both within- and between-person levels, frequency of pleasant events was associated only with NA and depressive symptoms at the within-person level, showing no effect at the between-person level. Personal mastery and coping self-efficacy were found to be more transversal variables, being associated with most of the mood outcomes in both within and between-person effects.ConclusionFindings support the concept of depressive mood as a complex construct and highlights the importance of analyzing different coping strategies when trying to comprehend the caregiving stress process.     

Early detection of bipolar disorder: a pilot familial high-risk study of parents with bipolar disorder and their adolescent children

OBJECTIVES: Disturbances in cognition, affect, sleep and activity have been identified in bipolar disorder (BD) but little is known about the possible role of these factors in the development of the condition. We studied these variables in a familial high-risk sample. METHODS: Twenty-five children (13-19 years) of bipolar parents were compared with 22 similar aged children of age- and sex-matched healthy controls. Participants were assessed using Schedule for Affective Disorders and Schizophrenia-Lifetime version (SADS-L) and completed self-report measures of dysfunctional attitudes, behavioural inhibition/activation, social rhythms, coping styles and subjective experience of sleep. Children completed a 7-day recording of actigraphy (sleep and activity) and a 7-day diary measuring self-esteem, positive and negative affect and reactions to positive and negative events. RESULTS: Fifty-six per cent of children of bipolar parents (CBP) reported mood symptoms compared to 9% of children of control parents (CC). The CBP group had coping styles and instability of self-esteem consistent with abnormal strategies for regulating affect. Both groups also differed on sleep measures. The majority of differences observed were between CBP with a current or past mood diagnosis and CC. BD parents reported dysfunctional coping styles and (to a lesser extent) disrupted activity patterns. CONCLUSIONS: A familial high-risk strategy for studying the role of psychological factors in BD is feasible and informative. This pilot study indicates that abnormal coping styles, instability of self-esteem and dysregulation of sleep may be early markers of bipolar illness. However, current findings need to be explored further in longitudinal studies to clarify which potential markers are truly predictive of BD.     

Cognitive coping and depressive symptoms in the elderly: a longitudinal study

The objective of the present longitudinal study was to examine the relationship between cognitive coping strategies and depressive symptoms at old age. At the two and a half year follow-up study, a community sample of 99 people aged 67 years and older filled out a self-report questionnaire comprising the Geriatric Depression Scale, the Cognitive Emotion Regulation Questionnaire and a negative life events checklist. Cognitive coping strategies seemed to play an important role in relation to depressive symptoms in late life. Elderly persons with more depressive symptoms reported to use acceptance, rumination and catastrophizing to a significantly higher extent and positive reappraisal to a significantly lower extent than those with lower depression scores. After controlling for negative life events and prior depressive symptoms, acceptance and positive reappraisal retained their significant relationship with current depressive symptoms. It is suggested that intervention programs should pay attention to these aspects by challenging the 'maladaptive' strategies, and by supplying the more 'adaptive' strategies. This could be linked to the well-established cognitive therapies.     

Hope and coping in family members of patients with obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) affects approximately 2-4% of the adult population. Despite the practical and emotional demands of having a family member with OCD, few systematic attempts have been made to assess the coping strategies used by relatives of individuals with such diagnoses. In this study we examined the relationships between hope, coping strategies, and depressive symptoms in a heterogeneous sample of 67 spouses/primary caregivers of individuals with a history of OCD. In support of our hypotheses, hope was negatively related to depressive symptoms, symptom severity, and denial disengagement coping strategies, and positively related to active reframing and social support coping strategies. Active, Reframing, Social Support, and Religiosity were negatively related to depressive symptoms. Denial/Disengagement was positively associated with depressive symptoms. Coping mediated the relationship between hope and depressive symptoms. Given the importance of family members in treatment, clinical implications of these findings are discussed.     

有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激的比较研究

目的:探讨有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激性生活事件的差异。方法:对143例抑郁症患者进行自编一般情况问卷、Beck抑郁自评量表(BDI)、认知情绪调节问卷中文版(CERQ-C)评定。结果:有自杀意念抑郁症发作患者BDI总分、婚姻家庭应激及社会生活应激分及CERQ-C适应性策略与不适应性策略总分显著高于无自杀意念抑郁症患者(P<0.05或P<0.01)。有自杀意念抑郁症患者抑郁总分与工作学习应激、婚姻家庭应激、社会生活应激及CERQ-C不适应性策略分呈显著正相关(r=0.569,0.470,0.341,0.303,P<0.05或P<0.01);无自杀意念抑郁症患者抑郁总分仅与婚姻家庭应激呈显著正相关(r=0.361,P<0.01)。结论:有自杀意念较无自杀意念抑郁症患者经历更多的负性生活事件,存在更严重的抑郁情绪,较多地采用认知应对策略。     

A longitudinal study of the associations among adolescent conflict resolution styles, depressive symptoms, and romantic relationship longevity

This study investigated whether adolescents' conflict resolution styles mediated between depressive symptoms and relationship longevity. Data were used from a sample of 80 couples aged 13-19 years old (Mage?=?15.48, SD?=?1.16). At Time 1 adolescents reported their depressive symptoms and conflict resolution styles. Additionally, time until break-up was assessed. Data were analyzed using actor-partner interdependence models. Results showed no support for conflict resolution styles as mediators. Girls' depressive symptoms were directly related to shorter relationships. Additionally, actor effects were found indicating that boys and girls with more depressive symptoms used negative resolution styles and were less likely to employ positive problems solving strategies. Finally, one partner effect was found: girls' depressive symptoms related to more positive problem solving in boys.     

The relationship between coping and psychological well-being among people with osteoarthritis: A problem-specific approach

We examined the strategies that people with osteoarthritis (OA) use to cope with illness-related problems in four areas: household activities, leisure activities, pain management, and social relationships. We also examined the relationship between the coping strategies participants reported using upon entry to the study (Time 1) and psychological well-being reported six months later. Three hundred people, aged 50 and over, with OA participated in the study. Data were collected via two mailed questionnaires, administered at six-month intervals. We found that two of the coping strategies examined, self-criticism and social withdrawal, were used more frequently for social relationship problems than for any of the other three types of problems. None of the other coping strategies (i.e. problem solving, cognitive restructuring, social support, emotional expression, problem avoidance, turning to religion, information seeking) were used differentially across problem areas. Multivariate analyses revealed that the coping strategies people used at Time 1 significantly predicted psychological well-being, as assessed by measures of positive affect, negative affect, and depressive symptoms, six months later. However, the specific strategies that predicted positive affect were different from those that predicted negative affect and depressive symptoms. Implications of these findings for future research on coping with chronic illness are discussed.     

“Sometimes we get it wrong but we keep on trying”: A cross-sectional study of coping with communication problems by informal carers of stroke survivors with aphasia

Background: The need to support carers of stroke survivors is widely recognised. However, research on which to base recommendations is scarce. Little research has focused on carers of stroke survivors with aphasia, and that which exists suffers from problems with sample size and methodology. More information is needed about methods used by carers to manage communication difficulties and about coping strategies that promote emotional wellbeing.

Aims: To assess the coping strategies used by informal carers of stroke survivors with aphasia to manage communication problems, and their association with depressive symptoms. To assess whether a problem-specific coping inventory offers an advantage over a generic coping questionnaire for this purpose.

Methods & Procedures: Questionnaires were completed by 150 informal caregivers of stroke survivors with aphasia. The Centre for Epidemiologic Studies Depression Scale measured depressive symptoms. Coping was assessed with the Brief COPE and a problem-specific questionnaire on coping with communication difficulties. Level of social support was also assessed. Multiple regression analysis explored associations between coping and depressive symptoms. Mediation analysis assessed the significance of the indirect effect of coping between the level of communication impairment in the stroke survivor and the degree of depressive symptoms in the carer.

Outcomes & Results: Participants reported a wide range of coping strategies. Avoidant styles of coping were associated with increased depressive symptomatology. Coping by use of positive reframing was linked with fewer symptoms of depression. Anticipated level of social support was also associated with less depressive symptomology. The level of communication impairment of the stroke survivor was not predictive of depressive symptoms in carers after controlling for coping and social support. Limited support was found for a mediating model of coping. Inclusion of one subscale from the problem-specific questionnaire improved the amount of variance accounted for in depressive symptoms, above that explained by the Brief COPE.

Conclusions: The results verify that the impairment of the stroke survivor has less effect on carers' psychosocial functioning compared to coping. Assessment of coping can help to identify carers presenting with increased risk of depression. A traditional coping inventory provides an adequate assessment of the coping strategies used to manage communication problems, and can be supplemented by specific questions about avoidance. Interventions that develop some emotion-focused coping strategies in carers may support adaptation. Interventions should also aim to decrease the use of unhelpful coping strategies rather than solely focusing on increasing problem-focused forms of coping.     

Attributions and self-esteem in depression and chronic fatigue syndromes

There is considerable overlap in symptomatology between chronic fatigue syndrome (CFS) and affective disorder. We report a comparison of depressive phenomenology and attributional style between a group of CFS subjects seen in a specialized medical setting, which included a high proportion with depression diagnosed by Research Diagnostic Criteria (RDC) and depressed controls seen in a specialized psychiatric setting. Significant symptomatic differences between the depressed CFS group and depressed controls were observed for features such as self-esteem and guilt as well as attribution of illness. All the CFS groups tended to attribute their symptoms to external causes whereas the depressed controls experienced inward attribution. This may have resulted from differences in the severity of mood disorder between the samples, but it is also suggested that an outward style of attribution protects the depressed CFS patients from cognitive changes associated with low mood but at the expense of greater vulnerability towards somatic symptoms such as fatigue.     

Cobalamin level is related to self-reported and clinically rated mood and to syndromal depression in bereaved HIV-1(+) and HIV-1(-) homosexual men

OBJECTIVE: An examination of the relationship of plasma cobalamin (vitamin B(12)) level to overall psychological distress, specific mood states, and major depressive disorder was conducted in 159 bereaved men (90 HIV-1(+) and 69 HIV-1(-)). METHODS: The relationship of a continuous measure of cobalamin level to psychological distress was examined, while controlling for HIV-1 serostatus, life stressors, social support, and coping styles. RESULTS: Of this sample, 23.9% were either overtly or marginally cobalamin deficient; however, the deficiency rate was not significantly different by HIV-1 serostatus. Cobalamin level was inversely related to self-reported overall distress level and specifically to depression, anxiety, and confusion subscale scores, as well as to clinically rated depressed and anxious mood. Lower plasma cobalamin levels also were associated with the presence of symptoms consistent with major depressive disorder. CONCLUSION: These findings suggest that cobalamin level may be physiologically related to depressed and anxious mood level, as well as to syndromal depression.     

Do humor styles mediate or moderate the relationship between self-criticism and neediness and depressive symptoms?

This study examined whether, in a community sample of Israeli adults (N = 335), benign (i.e., affiliative and self-enhancing) and injurious (i.e., aggressive and self-defeating) humor styles mediated or moderated the relationship between self-criticism and neediness, two traits that confer vulnerability to depression, on the one hand, and levels of depressive symptoms, on the other. There was no evidence of any moderating effect of humor styles on the relationship between self-criticism and neediness and depressive symptoms. However, results indicated that the use of injurious styles of humor mediated the relationship between self-criticism and depressive symptoms as well as the relationship between neediness and depressive symptoms. Moreover, the relationship between neediness and depressive symptoms was also mediated by low levels of benign humor. These findings may have important implications for theories concerning vulnerability to depressive symptoms and intervention strategies.     

The link between emotion regulation,social functioning,and depression in boys with ASD

PurposeSymptoms of depression are common in children and adolescents with an autism spectrum disorder (ASD), but information about underlying developmental factors is limited. Depression is often linked to aspects of emotional functioning such as coping strategies, but in children with ASD difficulties with social interactions are also a likely contributor to depressive symptoms.MethodologyWe examined several aspects of emotional coping (approach, avoidant, maladaptive) and social functioning (victimization, negative friendship interactions) and their relation to depression symptoms in children with ASD (N = 63) and typically developing (TD) peers (N = 57). Children completed a battery of self-report questionnaires.ResultsLess approach and avoidant, but more maladaptive coping strategies, and poor social functioning were uniquely associated with more symptoms of depression in children with ASD. Only less approach and more maladaptive coping were uniquely associated with depression severity in TD boys.ConclusionsUnlike TD boys, boys with ASD who report using avoidant strategies to deal with stressful situations report fewer symptoms of depression, suggesting that this may be an adaptive emotion regulation strategy. However, understanding the role of over-arousal in this process, inferences about long-term effects of this strategy, its causality and direction of effects will require additional research.     

Alternative approaches for conceptualizing children's attributional styles and their associations with depressive symptoms

This study examined whether two attribution frameworks relate to each other and to depressive symptoms in children. The first framework used a composite of stable/unstable, global/specific, and internal/external attributions for positive and negative events. The second framework used ability, effort, task difficulty, and luck attributions for positive and negative events. Participants were 185 elementary school children aged 8-12 years old. Results showed that the attribution approaches were significantly but modestly related, indicating that they are separate yet related constructs. Ability and task difficulty shared a high association, indicating that children may view them similarly. Results also showed that both approaches were significantly associated with depressive symptoms, even after taking the other into account. These findings suggest both attribution frameworks are useful for understanding childhood depression.     

Families of adolescents and adults with autism spectrum disorders in Taiwan: The role of social support and coping in family adaptation and maternal well-being

In this study we examined differences in social support and coping between mothers of adolescents and adults with an autism spectrum disorder (ASD) in Taiwan and the United States and to investigate the effects of social support and coping strategies on family adaptation and maternal well-being. Participants were 76 Taiwanese mothers who had at least one son or daughter with an ASD (10 years old and older), and a comparison group of 325 mothers in the United States matched on the age range of the child with an ASD. Mothers completed self-administered, written questionnaires and participated in an interview. Taiwanese mothers reported significantly greater use of problem-focused and emotion-focused coping strategies than did mothers in the United States. For Taiwanese families, greater use of problem-focused coping strategies was associated with lower levels of depressive symptoms and anxiety. Emotion-focused coping mediated the relationships between ethnicity/culture and several outcome measures: family adaptability, family cohesion, and maternal depressive symptoms. The higher levels of emotion-focused coping in Taiwanese mothers appeared to account for their lower levels of family adaptability and cohesion and higher levels of maternal depressive symptoms. The results from this cross-cultural study helped determine the role of social support and coping strategies in family adaptation and maternal well-being in families of individuals with an ASD in each culture. Implications for service delivery are discussed.     

Character Formation in the Evolution of the Acquisitive Society

The social rank and arrested defenses model for mood disorders bridges between animal and human models of psychopathology. There is increasing evidence that depression is associated with subordinated and loss of social rank, feeling inferior, shame, submissive behavior, and feeling defeated. These stressful states activate threat coping responses of fight and flight. If these are aroused but blocked, feelings of entrapment emerge with a negative impact on mood. The current study builds on previous studies and explores the association between depressive symptoms, social rank variables (of social comparison and submissive behavior), entrapment, and defeat in a sample of patients (n = 106) with major depression and in a sample of healthy controls (n = 116). Results showed that social rank variables, entrapment, and defeat were strongly associated with depressive symptoms in both samples. Entrapment and defeat showed significant association with other social rank variables. Logistic regression analysis revealed that defeat and internal entrapment were significant predictors of the belonging to the clinical or control groups. The present study extends previous research and supports the importance of defeat and external entrapment in clinical depression.     

Attachment insecurity and psychological resources associated with adjustment disorders

This study examined the adult attachment styles, interpersonal distance from potential attachment figures and strangers, coping strategies, perceived social support, and stress-related self-variables among patients diagnosed with adjustment disorders (AJD). Seventy patients at an outpatient clinic and 61 matched controls completed a battery of standardized questionnaires. Univariate and multivariate statistical analyses were used to evaluate the parameters of interest. Using attachment theory (J. Bowlby, 1988) and the dynamic stress-vulnerability model of depressive disorder (G. W. Brown & T. O. Harris, 1989) as the analytical frameworks, the authors hypothesized that participants with AJD would: (a) display more insecure attachment styles, (b) be less tolerant of close interpersonal proximity, (c) use more emotion-oriented coping strategies, (d) display lower self-efficacy and self-esteem, and (e) perceive less social support from family, friends, and significant others. We further hypothesized that these variables would be predictive of depressive symptoms. All of the hypotheses were confirmed. The results suggest that the insecure fearful-avoidant attachment style is associated with severe depressive symptoms in patients with AJD. However, other psychosocial factors, such as low self-esteem and poor social support from friends, were more predictive of AJD symptoms. The findings warrant further studies on the risk and protective effects of these factors in the development of AJD and other stress-induced disorders.     

Experiential avoidance in idiographic,autobiographical memories: Construct validity and links to social anxiety,depressive, and anger symptoms

Experiential avoidance, or attempts to alter or avoid undesirable thoughts and feelings, has been theorized to be relevant to the development of emotional disturbances, particularly anxiety problems. Prior work has relied on two methodologies: global self-report measures or laboratory manipulations. To better understand links between experiential avoidance and emotional disturbances, we measured experiential avoidance in the context of prominent anxious autobiographical events. Trained raters coded events for emotionality and reliance on experiential avoidance. Our interest was whether experiential avoidance could be measured as a memory characteristic and how it relates to social anxiety, depressive, and anger symptoms. As evidence of construct validity, experiential avoidance ratings were related to more intense negative emotions and coping difficulties during anxious events, memory vividness, and emotion suppression tendencies. Experiential avoidance was positively related to social anxiety and depressive symptoms and predicted an increase in social anxiety over a 3-month period; findings could not be attributed to the emotionality of memories. In contrast, no relations were found with inward or outward expressions of anger, or longitudinal change in depressive or anger symptoms. Results suggest that experiential avoidance is an important dimension of people's life narratives and particularly relevant to social anxiety problems.     

The role of interpersonal personality traits and reassurance seeking in eating disorder symptoms and depressive symptoms among women with bulimia nervosa

IntroductionThe role of interpersonal factors has been proposed in various models of eating disorder (ED) psychopathology and treatment. We examined the independent and interactive contributions of two interpersonal-focused personality traits (i.e., social avoidance and insecure attachment) and reassurance seeking in relation to global ED psychopathology and depressive symptoms among women with bulimia nervosa (BN).MethodParticipants were 204 adult women with full or subclinical BN who completed a battery of self-report questionnaires. Hierarchical multiple OLS regressions including main effects and interaction terms were used to analyze the data.ResultsMain effects were found for social avoidance and insecure attachment in association with global ED psychopathology and depressive symptoms. In addition, two-way interactions between social avoidance and reassurance seeking were observed for both global ED psychopathology and depressive symptoms. In general, reassurance seeking strengthened the association between social avoidance and global ED psychopathology and depressive symptoms.ConclusionThese results demonstrate the importance of reassurance seeking in psychopathology among women with BN who display personality features characterized by social avoidance.     

Predictors of depressive symptoms in primary caregivers of young children with or at risk for developmental delay

Background Despite extensive research with families raising children with or at risk for developmental delay (DD), it is not clear whether primary caregivers of these children are at increased risk for depressive symptoms. Discrepant findings in the literature may be owing to heterogeneity of child problems. More research is needed on child, parent and family variables that may increase risk for, or resilience to, caregiver depressive symptoms. Some studies have found that parental resources (e.g. social support and coping strategies) may buffer the effects of parental distress, while other studies have highlighted the role of parental self‐efficacy. Methods We examined Beck Depression Inventory (BDI) scores in 178 primary caregivers (mainly biological mothers) who had 2‐year‐old children with or at risk for DD owing to: (a) low birthweight, prematurity or multiple birth (n = 58), (b) other known reasons (e.g. Down syndrome, spina bifida) (n = 67), or (c) unknown reasons (n = 69). Results We found that 20% (n = 35) of the caregivers scored above the BDI clinical cut‐off for depression. Analysis of variance revealed that caregivers with elevated BDI scores had higher child behaviour problem and escape‐avoidance coping scores, and lower social support and parent self‐efficacy, compared with caregivers without depressive symptoms. Caregivers with children who had DD for unknown reasons had higher BDI scores than caregivers of the other two groups of children. Regression analyses showed that child behaviour problems, escape‐avoidance coping strategies and social support predicted caregiver BDI scores, but caregiver self‐efficacy only did so when entered independently of social support. Only social support mediated and (marginally) moderated the relationship between child behaviour problems and caregiver depressive symptoms. Conclusions These findings suggest that early intervention programmes should carefully consider the interaction of child characteristics (e.g. Diagnosis and behaviour problems), caregiver resources (e.g. coping strategies and social support), and parental mental health and mood when planning and tailoring services for families of children with or at risk for DD.