Evaluating the continuity of symptomatology between depressed and nondepressed individuals.

Debate is contentious concerning whether depression should be viewed as a distinct category or as a continuum including overlapping normal and clinical phenomena. A nonparametric item response model was used to evaluate whether the probability of expressing individual symptoms differed between nondepressed and clinically depressed adults experiencing similar levels of overall severity. Even though depressed and nondepressed individuals were equated in terms of overall severity, differences on specific symptoms emerged. Depressed mood, anhedonia, and suicidality were more likely to be expressed in depressed than in nondepressed individuals, whereas hypochondriasis and middle insomnia were more likely to be expressed in nondepressed individuals at similar levels of severity. Such differences are inconsistent with the view of depression as a simple continuum.

Examining symptom expression as a function of symptom severity: item performance on the Hamilton Rating Scale for Depression.

Despite widespread use of the Hamilton Rating Scale for Depression (HRSD; M. Hamilton, 1960), questions have been raised concerning its psychometric properties. A nonparametric item response model was used to examine how the probability of observing a specific symptom of depression changes with increases in depressive severity in a sample of depressed adults. Results showed that options from a number of items on the HRSD did not vary as a function of severity and therefore should not be viewed as indicators of depressive severity. The extent to which symptoms are expressed as a function of depressive severity carries important implications for the use of the HRSD as a measure of severity and for the debate concerning construction of depression as a continuum. Results argue against viewing depression as a simple continuum.

Open trial of interpersonal therapy in adolescents with moderate to severe major depression: effectiveness of novice IPT therapists.

OBJECTIVE: To evaluate the effectiveness of interpersonal therapy (IPT) implemented by well-supervised, novice IPT therapists in treating adolescents with moderate to severe mood disorders of lengthy duration. METHOD: Twenty-five adolescents with moderate to severe major depression, lasting an average of 8 months, received 12 weeks of IPT. All participants were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HRSD), and the Children's Global Assessment Scale (C-GAS) at baseline and follow-up. RESULTS: The majority of participants improved substantially on the BDI, the HRSD, and the C-GAS; 84% met remission criteria on the HRSD (score < 7); and 80% met remission criteria on the BDI (score < 10). CONCLUSIONS: Results demonstrate that IPT is effective in treating moderately to severely depressed adolescents, that IPT is effective with depression lasting several months, and that IPT can be effectively implemented by well-supervised clinicians with no prior training in IPT.

Garnering the interest of others: mediating the effects among physical attractiveness, self-worth and dominance.

OBJECTIVES: Evolutionary psychologists emphasize that self-worth and well-being are largely determined by the degree to which individuals garner and hold the interest of others. Personal attributes, such as physical attractiveness, are viewed as resources which serve as signals to others to pay attention to us. DESIGN AND METHOD: This study examined (a) the degree to which participant appraisals (N = 75) of self-worth were related to appraisals of how interested others were in them; and (b) the extent to which interest ratings account for the relation among self-worth, dominance and attractiveness ratings. RESULTS: The main findings of the present study showed (a) that the degree to which individuals derive self-worth from various attributes was strongly related to the degree to which individuals believed others were interested in them; and (b) that the amount of interest one believes others show in them mediated the relation between physical attractiveness and social self-worth. CONCLUSION: Results have a number of implications concerning the nature of self-worth and the utility of psychological theories that emphasize evolutionary principles.

Somatic complaints disproportionately contribute to Beck Depression Inventory estimates of depression severity in individuals with multiple chemical sensitivity.

A number of individuals with multiple chemical sensitivity (MCS) are also diagnosed with depression. However, there is content overlap in MCS and symptoms of depression with respect to somatic complaints. The Beck Depression Inventory (BDI) was used to document severity of depressive symptomatology in 42 individuals with MCS. The purpose was to determine the extent to which somatic complaints contributed to the total BDI score. Analysis of cognitive-affective and somatic-performance complaints subscale indicated a significantly higher mean item score on somatic-performance items, relative to cognitive-affective items (t = 6.43, P < 0.05). Consequently, the total BDI score classified a greater percentage (43%) of the sample as moderately depressed than did the cognitive-affective subscale score (29%). An item analysis of the BDI revealed that individuals with MCS tended to endorse more somatic-performance items than did a sample of depressed outpatients. Two alternative interpretations are possible: (a) the BDI total score overestimated severity of depressive symptomatology in this sample, and/or (b) individuals with MCS tended to express depressive symptomatology in terms of somatic complaints. It was recommended that until the etiology of MCS is better understood, caution be used when estimating severity of depressive symptomatology in individuals with MCS when measures include somatic items.

Interpersonal responses to threats to status and interpersonal relatedness: effects of dependency and self-criticism.

OBJECTIVES: Previous research investigating the interpersonal environments of dependent and self-critical individuals has focused primarily on attachment issues, such as relationship satisfaction. DESIGN: In the present study, we examined how dependent and self-critical individuals respond to experimentally manipulated events that threaten or bolster self-worth and status. METHOD: Forty pairs of female college students were allowed to believe, first, that they outperformed a close friend or were outperformed by a close friend on 14 trials of a behaviour detection task and, second, that friends generally agreed or disagreed with them on a second 14 trials, in which participants informed friends who had the better response. RESULTS: Dependent women were more concerned with maintaining interpersonal relatedness, whereas self-critical women were more concerned with preserving self-worth and status. Dependent women adopted the responses of friends they outperformed, praised friends even when friends disagreed, and minimized disagreement with disagreeing friends. In contrast, self-critical individuals contested threats to status and self-worth, withheld praise from friends who challenged them, and did not minimize disagreement with disagreeing friends. CONCLUSIONS: Results support the utility of an interactional framework in which depressive personality styles, such as dependency and self-criticism, and situational events interact to regulate interpersonal behaviour.

Analysis and revision of the Depressive Experiences Questionnaire: examining scale performance as a function of scale length.

Revisions of the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976) have failed to replicate the degree of orthogonality routinely observed with the original Dependency and Self-Criticism scales. Item performance on the DEQ was examined by computing correlation coefficients between factor-derived scores and unit-weighted composite scores for Dependency and Self-Criticism as a function of (a) the importance of individual items in predicting factor-derived Dependency and Self-Criticism scores and (b) scale length. Analyses identified sets of unit-weighted items that optimally preserve the psychometric properties of the original DEQ scales, including between-scale orthogonality, while reducing the number of items used to measure Dependency and Self-Criticism. Findings were replicated in college (N = 172) and clinical (N = 83) samples. Limitations of exploratory principal components and confirmatory factor analysis as tools for revising scales are discussed.

Validating the McGill revision of the Depressive Experiences Questionnaire.

Research has identified important psychometric differences between the original Depressive Experiences Questionnaire (DEQ; Blatt, D'Affliti, & Quinlan, 1976) and two of its most widely used revisions, which have failed to preserve the degree of between-scale orthogonality routinely observed with the original Dependency and Self-Criticism scales. The purpose of this study was (a) to examine construct validity for the recently developed McGill revision of the DEQ (Santor, Zuroff, & Fielding, this issue), which preserves between-scale orthogonality; (b) to compare the McGill revision of the DEQ with other existing revisions with respect to measures of personality, motivation, and interpersonal relatedness; and (c) to explore the correlates of items that appear to be responsible for maintaining the degree of orthogonality between measures of Dependency and Self-Criticism. Results suggest that (a) the McGill revision of the DEQ offers more valid estimates of the relations among dependency, self-criticism, and other theoretically relevant constructs, such as depressed mood and agreeableness, than other existing revisions and (b) items differentiating Dependency and Self-Criticism assess broad interpersonal orientations that can be characterized as communal or agentic. Results validate the newer McGill scales, further support the utility of the methods used in their development, and provide insights into the differences between Dependency and Self-Criticism.

Evaluating stability and change in personality and depression.

Critics have argued that personality factors believed to represent a vulnerability to depression are not stable and are therefore state dependent. However, conclusions regarding the stability of personality and the relation between personality and depression have been drawn (a) without differentiating relative stability among individual differences from absolute stability of change scores and (b) without explicitly modeling change in personality as a function of change in depression. The relation between neuroticism and depression was examined in a sample of depressed outpatients (N = 71) receiving a 5-week trial of pharmacotherapy. Measures of neuroticism and extraversion demonstrated both relative stability and absolute change, and changes in neuroticism and extraversion scores were modestly or not at all accounted for by changes in depression scores. Claims that personality scores are not stable and are state dependent must be reconsidered.

Depressive symptoms: effects of negative affectivity and failing to accept the past.

Conceptual problems with existing measures of Erikson's ego-integrity construct were identified. It was hypothesized that a core component of ego-integrity involves how individuals evaluate and reflect on past experiences. Accepting the past was formally defined and operationalized and was conceptualized as one source of self-worth central to many formulations of depression. Findings demonstrate that accepting the past was related to a measure of ego-integrity in an elderly community sample, demonstrated superior predictive and incremental validity than ego-integrity in predicting concurrent depressive symptoms, and was unrelated to reminiscing about the past. Failing to accept the past was related to depressive symptoms even after accounting for effects due to age, sex, and physical symptoms. However, accepting the past was moderated by trait negative affectivity. Accepting the past predicted depressive symptoms only in individuals reporting high negative affectivity.