Cognition and social adversity in the depressed elderly.
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Biomedical subjects
Publications and source records attributed to C R Brewin.
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It has been proposed that dependency and self-criticism are independent forms of depressive experience. This study was designed to investigate whether one or both experiences are associated with a depressive attributional style. Internal and global attributions for hypothetical negative outcomes were found to be associated with both dependency and self-criticism, but neither of these aspects of depression were related to attributions for positive outcomes.
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Severely handicapped psychiatric patients in long-term day care were questioned about their perceptions of their skills, motivation to perform a range of everyday tasks, current problems and coping strategies. Patients were found to respond reliably and consistently to these questions. It is argued that effective service planning must take account of patients' views of their difficulties and, in particular, of their subjective priorities.
Predictions made according to the attributional reformulation of learned helplessness theory concerning the cognitive determinants of low self-esteem and depression were tested in two samples of undergraduates; real and hypothetical life events were used. As predicted, internal attributions for hypothetical success and failure were correlated with self-esteem, but there was an unexpected correlation with global attributions for negative outcomes. Two "preattributional" variables, consensus and consistency judgments, were also related to self-esteem and depression. In contrast to learned helplessness theory, a path analysis indicated that these variables were not attributionally mediated. Consensus judgment was as strong a predictor of depression as the number of recent distressing life events that subjects had experienced. Other evidence that links depression to perceived low consensus is described, and a possible etiological role for this variable is outlined.
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A series of scales was designed to measure perceived control of diabetes and diabetes-related health beliefs with a view to predicting treatment preferences and individual differences in response to the treatments. Scale development is described and the psychometric properties examined with responses from 286 insulin requiring adult diabetic patients. Patients were significantly more likely (p less than 0.001) to attribute responsibility for their diabetes control to themselves rather than to their medical advisors or to other factors. For most of the patients the benefits of treatment were perceived substantially to outweight any barriers (p less than 0.001). Compared with their perceptions of vulnerability to disorders unrelated to diabetes, patients thought that they were more vulnerable to such diabetes related complications as eye, kidney and foot problems (p less than 0.001) but not to heart disease.
To test an attributional model of psychotropic drug prescription, medical students rated the controllability of life-events along with prescription probability. As predicted, students were more willing to prescribe for more uncontrollable events. This relationship could not be explained by differences in the amount of readjustment required by events.
A number of factors thought to influence psychological adjustment to multiple sclerosis were studied. Patients' knowledge about their disorder was assessed, but neither their knowledge, level of disability, nor demographic characteristics were related to adjustment. Better adjustment was however associated with having more contact with able-bodied people.
Social and psychological determinants of the time taken to return to work were investigated in a sample of male manual workers referred to an accident clinic with mostly minor industrial injuries. Patients who showed a rapid recovery relative to the severity of their injuries were more often married, had greater job satisfaction, were less likely to be receiving an income supplement from their employers, and blamed themselves more for their accidents. The findings also indicated that a poor recovery rate could be expected when the accident was due to some environmental fault or failure, and the implications for studies of compensation are discussed.
Women's ratings of their experience of childbirth were compared with midwives' ratings of the women's experience. The midwives' ratings were significantly different from those of their patients. Midwives presented a more positive picture of the woman's experience than did the woman herself. Furthermore, the women reported using psychoprophylactic techniques for controlling discomfort for significantly more of the time than the midwives reported that the women used such techniques. The results are discussed in the context of similar findings reported in the literature.