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Biomedical subjects

P Rohde

Publications and source records attributed to P Rohde.

At least 55 records · Page 3Linked to original sources
PubMed1995

The life attitudes schedule: a scale to assess adolescent life-enhancing and life-threatening behaviors.

The purpose of this study was to develop a questionnaire to measure suicidal and other risk-taking behaviors, the Life Attitudes Schedule (LAS), and to test a theoretical model that postulates a single domain of behaviors to which all life-threatening and life-enhancing behaviors belong. The LAS was developed and piloted on 1539 high school students and young adults. The schedule measures four different content categories: death related, health related, injury related, and self-related. Each content category includes an equal number of items designed to assess actions, thoughts, and feelings. Consistent with the theoretical model, the LAS includes positive (life-enhancing) and negative (life-threatening) behaviors. In this paper we present psychometric information for the LAS. The results are interpreted as providing support for a broad, bipolar conceptualization of suicidal and other risk-taking behavior that encompasses life-threatening and life-enhancing behaviors.

Adolescent↗
PubMed1994

Adolescent psychopathology: II. Psychosocial risk factors for depression.

In a prospective study of adolescent depression, adolescents (N = 1,508) were assessed at Time 1 and after 1 year (Time 2) on psychosocial variables hypothesized to be associated with depression. Most psychosocial variables were associated with current (n = 45) depression. Formerly depressed adolescents (n = 217) continued to differ from never depressed controls on many of the psychosocial variables. Many of the depression-related measures also acted as risk factors for future depression (n = 112), especially past depression, current other mental disorders, past suicide attempt, internalizing behavior problems, and physical symptoms. Young women were more likely to be, to become, and to have been depressed. Controlling for the psychosocial variables eliminated the gender difference for current and future but not for past depression.

Adolescent↗
PubMed1994

Psychosocial risk factors for future adolescent suicide attempts.

An array of psychosocial risk factors for making a suicide attempt were examined in a representative sample of 1,508 older (14- to 18-year-old) high school students, 26 of whom made a suicide attempt during the year following entry into the study. Strongest predictors of future suicide attempt were history of past attempt, current suicidal ideation and depression, recent attempt by a friend, low self-esteem, and having been born to a teenage mother. The results suggest that adolescents who are depressed and those who attempt suicide share many psychosocial risk factors. The efficacy of two screeners (one consisting of 4 items and the other of 6 variables) is reported. Potential usefulness for research and communitywide prevention is discussed.

Adolescent↗
PubMed1994

Response of depressed adolescents to cognitive-behavioral treatment: do differences in initial severity clarify the comparison of treatments?

This study evaluated the impact of pretreatment depression severity and functional impairment on the response of 2 samples of older depressed adolescents to 2 group cognitive-behavioral treatments. Differences between the 2 active treatments and between active treatment and a waiting-list control condition were expected to be greater in the more severely depressed-impaired group. Variables assessing severity and impairment appeared to be best conceptualized as measures of a single factor. Improvement for the 2 active treatments in comparison to the control condition was greater in the more severely depressed group in one of the samples but not the other. The prediction that the relative effectiveness of the 2 treatments would be accentuated in the more severely depressed adolescents received no support in either sample. Implications of these findings for future psychotherapy research are discussed.

Adolescent↗
PubMed1994

The social competition hypothesis of depression.

Depressive personality and depressive illness are examined from an evolutionary adaptationist standpoint. It is postulated that the depressive state evolved in relation to social competition, as an unconscious, involuntary losing strategy, enabling the individual to accept defeat in ritual agonistic encounters and to accommodate to what would otherwise be unacceptably low social rank.

Cognitive Behavioral Therapy↗
PubMed1993

Age-cohort changes in the lifetime occurrence of depression and other mental disorders.

Data from three samples of adults (Ns = 571, 472, and 989) and a sample of adolescents (N = 1,710) supported the possibility that the prevalence of major depression has been increasing in recent birth cohorts, a phenomenon labeled the age-cohort effect (ACE). A significant ACE for relapse was also found in 1 of the adult samples. In addition, early onset age in the adults (prior to age 25) tended to be associated with relapse. Adults in recent birth cohorts were also found to show an elevated prevalence of other disorders. We examined the power of 4 variables (current mood state, social desirability response bias, labeling, and time interval between the episode and the diagnostic interview) to produce these results without an actual increase in the rate of mental disorder. With 1 exception (labeling), the variables were significantly associated with reports of past episodes of disorder and with birth cohort. Controlling for their influence, however, did not reduce the ACE.

Adolescent↗
PubMed1993

Negative cognitions and attributional style in depressed adolescents: an examination of stability and specificity.

Despite recent findings that the prevalence of unipolar depression is as high in adolescents as it is in adults, relatively little is known about the applicability of cognitive theories of depression to adolescents. The present study examined the nature, specificity, and stability of cognitive dysfunction in male and female depressed, remitted, and psychiatric control adolescents. Factor analysis of a diverse set of measures yielded two factors, labelled Negative Cognitions and Attributional Style. Scores on both these factors were related to a current diagnosis of depression. Results also indicated that there may not be complete recovery of cognitive functioning (or of depressed mood) with diagnostic remission of depression. Finally, whereas elevated scores on the Negative Cognitions factor appeared to be specific to depression, the depressed and psychiatric control adolescents did not differ with respect to their scores on the Attributional Style factor.

Adolescent↗
PubMed1993

Psychosocial characteristics of adolescents with a history of suicide attempt.

The purpose of this study was to identify psychosocial risk factors uniquely associated with past suicide attempts. Data assessing a large number of variables were available from a representative sample of older adolescents (N = 1,710). Most independent variables were associated with past suicide attempts; variables that remained associated with past attempts after controlling for current depression level included externalizing and internalizing problem behaviors, past psychiatric disorders, depressotypic cognitions, coping, school problems, health problems, and gender. The probability of having made an attempt increased dramatically as a function of the number of risk factors. Females had more risk factors and showed a greater vulnerability to the factors than did males.

Achievement↗
PubMed1991

Age and depression: unique and shared effects.

The degree to which psychosocial variables associated with depression were also associated with age was examined in 3 samples of community residents 50 years of age or older (N = 4,617). Most of the expected concomitants of depression were found. With only a few exceptions, age was not correlated with depression-related psychosocial variables. Rather, age was most strongly associated with levels in neuropsychological and psychophysiological functioning. In addition, the magnitudes of the correlations in women compared with men and in young-old age groups compared with old-age groups were examined. A number of significant differences emerged, and their implications for theories of depression are noted.

Adaptation, Psychological↗
PubMed1991

Psychological Profile and Outcome in Patients Undergoing Gastroplasty for Morbid Obesity.

Eighteen out of 22 consecutive patients undergoing vertical banded gastroplasty were reviewed with regard to preoperative psychological assessment and postoperative outcome. Each patient was initially evaluated by a consultant liaison psychiatrist with regard to previous or ongoing psychological disturbance, and suitability for bariatric surgery. Patients could be grouped into three broad categories: Group A (seven patients) those with no psychiatric abnormality; Group B (six patients) those with minor psychiatric disorders such as sociopathic teenage behavior, outpatient treatment for depression; and Group C (five patients) those with a history of major psychiatric disturbance such as depressive psychosis and drug dependency. Psychiatric morbidity had no adverse effect in terms of postoperative outcome or weight loss. Mean weight loss of 26%, 30% and 33% was recorded in groups A, B and C respectively after a mean follow-up period of 33 months following gastroplasty. The occurrence of postoperative psychiatric problems correlated closely with none of seven patients in group A but in four of the five patients in Group C requiring psychiatric management. Our findings indicate that psychiatric illness is not associated with poor outcome following surgery for morbid obesity and such patients should not be excluded if psychiatric support is available before and after surgery.

Journal Article↗
PubMed1991

Comorbidity of unipolar depression: I. Major depression with dysthymia.

The degree of current and lifetime comorbidity between major depressive disorder (MDD) and dysthymia (DY) was examined in large community samples of older adolescents (n = 1,710) and adults (n = 2,060). DY was highly comorbid with MDD (lifetime odds ratio of 3.4 for adolescents and 1.6 for adults) and was more likely to precede than to follow MDD, especially in persons who became depressed early in life. MDD was by far the more frequent form of depression: Approximately 80% of the depressed persons experienced only MDD, 10% experienced only DY, and 10% experienced both MDD and DY. The large number of persons who had became depressed twice experienced MDD in the 2nd episode, regardless of the nature of the 1st depression. History of depression was associated with a greater probability for other mental disorders in both adolescents and adults; however, the rates of comorbidity for MDD did not differ from rates for DY or for both MDD and DY.

Adolescent↗
PubMed1991

Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults.

The current and lifetime comorbidity of depressive (i.e., major depressive disorder and dysthymia) with other common mental disorders was examined in community samples of older adolescents (n = 1,710) and adults (n = 2,060). Current and lifetime histories of depression in the adolescents were highly comorbid with several other mental disorders. The adults had a lower but statistically significant degree of comorbidity, primarily with substance use disorder. Depression in both groups was more likely to occur after the other disorder rather than to precede it. Comorbidity did not affect the duration or severity of depression. Comorbidity in the adolescents was associated with greater frequency of suicidal behavior and treatment seeking. The findings suggest that early-onset depression is associated with a greater degree of comorbidity and may represent a more serious form of the disorder.

Adolescent↗
PubMed1990

Are people changed by the experience of having an episode of depression? A further test of the scar hypothesis.

The purpose of this study was to identify characteristics of individuals before and after their first depressive episode. Subjects were 49 older persons assessed before and after their first depressive episode on depression-related psychosocial variables. The control group consisted of 351 never-depressed individuals. Consistent with previous findings, patients were more likely to be younger, female, and mildly depressed both before and after the episode. In addition, they were more likely to be employed. Following an episode of depression, the recovered patients described their social skills and health as poorer and their interpersonal dependency as greater than the controls. However, on an experiment-wise basis, the number of significant differences were no greater than expected by chance. The stress activation model was examined but did not appreciably enhance the results. Results suggest that most of the psychosocial variables associated with depression are state dependent.

Adaptation, Psychological↗
PubMed1990

Dimensionality of coping and its relation to depression.

The dimensionality of coping, as measured by 65 items from 3 commonly used instruments, and the relation of coping and stress to concurrent and future depression were studied in a community sample of 742 older (greater than or equal to 50 years old) adults. Measures of coping, stress, and depression were obtained at 2 time points over a 2-year period. Depression was assessed by symptom checklist and by diagnostic interview. Three coping factors--Cognitive Self-Control, Ineffective Escapism, and Solace Seeking--that had adequate psychometric properties and accounted for 25% of the total item variance were identified. Ineffective Escapism was associated with current depression and had a direct and interactive effect on future depression, exacerbating the negative impact of stress rather than acting as a buffer. Although Cognitive Self-Control was unrelated to either concurrent or future depression, Solace Seeking significantly buffered the effect of stress in predicting a future diagnosis of depression. Stress and initial depression level predicted both measures of future depression. Gender (being female) predicted the future diagnosis of depression but not the increase of depressive symptoms.

Adaptation, Psychological↗
PubMedDate not supplied

Personality assessment of substance-dependent patients in a therapeutic community.

The design and implementation of a personality assessment system for severely substance-dependent men in a therapeutic community (TC) are described. The system was designed from a treatment utility perspective (Hayes, Nelson, & Jarrett, 1987) and uses the Personality Research Form E (Jackson, 1984) to provide each patient with feedback (a) describing his normal personality traits, (b) predicting his probable pattern of adjustment to the treatment setting, and (c) prescribing specific actions he can take to address potentially problematic behaviors. Discussing the the results with the patient helps him cope with the TC. Reviewing the assessment results with the staff promotes their empathy for the patient as a person whose behavior can be understood as an interaction of his personality with the specific demands of the TC rather than seeing the patient in exclusively pathological terms. Specific suggestions for behavior change guide both the patient and the staff and are potentially useful in various treatment settings.

Case Management↗
PubMedDate not supplied

Major depression in community adolescents: age at onset, episode duration, and time to recurrence.

OBJECTIVE: This paper presents retrospective and prospective data regarding time course parameters of major depressive disorder (MDD) in community adolescents (14 to 18 years old): time to onset and recovery and, among those who recovered, time to recurrence. METHOD: Diagnostic interviews were conducted with 1,508 randomly selected high school students. Three hundred sixty-two had experienced at least one past or current episode of MDD. RESULTS: Mean age at onset of first episode was 14.9 (SD = 2.8). Early MDD onset was associated with female gender and suicidal ideation. MDD episode duration ranged from 2 to 520 weeks, with a mean of 26.4 weeks (SE = 3.3) and a median of 8.0 weeks. Longer episodes were observed in those whose depression occurred early (at or before age 15), whose depression had been accompanied by suicidal ideation, and for whom treatment was sought. Of the adolescents who recovered, 5% relapsed within 6 months, 12% within 1 year, and approximately 33% within 4 years. Shorter time to recurrence was associated with prior suicidal ideation and attempt and with later first onset. CONCLUSIONS: Risk of MDD is low in childhood, increasing substantially with adolescence. The majority of episodes in community adolescents are relatively brief, although the risk of recurrence is substantial. Suicidal behaviors are important mediators of episode duration and of recurrence.

Adolescent↗