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PubMed1996

Perceptions of abuse: effects on adult psychological and social adjustment.

The present study examined perceptions of abuse (psychological, physical, and sexual) and later adult psychological and social adjustment in a nonclinical sample of 173 individuals. A subgroup of abused individuals were identified (Minimizers), who reported levels of abuse above the mean, but failed to acknowledge themselves as abused. Analyses of variance revealed that abused individuals, both Acknowledgers and Minimizers, consistently had more psychological and social adjustment problems than the Nonabused group. In addition, individuals who fell in the Minimizing subgroup had more detrimental outcome than the Abused (Acknowledgers) group in a few areas, suggesting that the perception of past events (abuse) may be an important factor in determining future psychological adjustment.

Adaptation, Psychological↗
PubMed1990

Perceived dysfunctional intimate relationships: a specific association with the non-melancholic depressive subtype.

Associations between perceptions of dysfunctional current intimate relationships and subtypes of depressive disorders were quantified in a sample of 136 patients, using the Intimate Bond Measure (IBM). Deficient care was two to three times more likely to be reported by patients with non-melancholic disorders than by matched subjects, but was no more likely to be reported by patients with melancholic disorders, suggesting a risk factor selective for depressive type. Patients who reported markedly deficient care in childhood were more likely to report very poor current intimate relationships. For the remaining patients, however, no evidence of continuity between a dysfunctional parental relationship and a current dysfunctional intimate relationship was found.

Adult↗
PubMed1990

Depression and situational helplessness/mastery in a sample selected to study childhood parental loss.

This paper continues the investigation of differential states of depression in a sample of 225 women selected for different experiences of parental loss in childhood by introducing a measure of the cognitive-behavioural set of situational helplessness/mastery which uses actual rather than hypothetical situations as the basis for scoring. The measure is also specifically designed to take account of differences according to the time of its completion (before, during or after a psychiatric episode). The relationship is explored between this attribute and, on the one hand, depressive disorder, and on the other, parental loss in childhood. Rates of current depression increased progressively with the degree of helplessness rated not only for the current period but also, in instances where there was a current depressive episode, for the time immediately prior to its onset. For those with depression the degree of helplessness was often found to be higher during the episode than just before it. A measure of helplessness in childhood was associated not only with current depression but with previous episodes. Continuity between childhood and adult helplessness was apparently considerable, and both were associated with loss of mother in childhood. A rating of helplessness shown in the past just before onset of a prior depressive episode suggested a similar raised rate compared to those never depressed. The failure to find an association between prior episodes of depression and current helplessness among those currently not depressed is discussed in terms of the likely durability of long-term cognitive-behavioural sets and the possibility that with improved social circumstances and relationships, helplessness may decrease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Extraction of depression scores in adolescents from a general-purpose behaviour checklist.

Using a clinical sample of adolescents (n = 207), an attempt was made to find whether a multi-purpose, multi-informant instrument which measures a number of symptom domains, such as the Child Behavior Checklist (CBCL)/Youth Self-Report (YSR), could be used to extract Children's Depression Inventory (CDI) scores. Using item analysis procedures, a cluster of 15 items was selected from the YSR, which yielded a correlation of 0.74 with the CDI. The internalising scale of the YSR also correlated highly (0.73) with the CDI score. The corresponding CBCL items and scales showed poor capacity in predicting CDI scores.

Adolescent↗
PubMed1990

Major depression with and without a coexisting anxiety disorder: social dysfunction, social integration, and personality features.

Twenty-two inpatients with an acute major depression without an additional lifetime DSM-III axis I diagnosis were compared with 20 inpatients suffering from an acute major depression with a coexistent anxiety disorder. The comparisons focused on social dysfunction, social support, and premorbid personality features. Characteristics of provoking life events and chronic conditions of life during the year before the index admission were analyzed exploratively. Major depressives with an anxiety disorder reported a higher number of abnormal premorbid personality traits such as neuroticism and a tendency towards social isolation; they had fewer confidants and lived alone more frequently than pure major depressives. Furthermore, pure major depressives reported more non-illness-related chronic burdening conditions during the year before the onset of depression than did major depressives with an anxiety disorder. However, there were no differences between the patient groups as to social dysfunction. The results point to fewer personal and social resources of the comorbidity group.

Adult↗
PubMed1991

Lifetime exit events and recent social and family adversities in anxious and depressed school-age children and adolescents--I.

The number of lifetime exit events occurring over the lives of 7-16-year-old children was compared between cases with new onset episodes of anxiety and depression (n = 100) and community controls (n = 100). The reporting of events by adult responders appears reliable and not subject to distortions of recall. Overall the likelihood of experiencing exit events increases with age. A significant association was found between current disorder and two or more previous lifetime exit events. There is, however, a non-significant trend for those cases who experience multiple lifetime exits to be younger than the controls and to be female rather than male. These findings are uninfluenced by pubertal stage at time of onset of disorder or by diagnosis.

Adolescent↗
PubMed1991

Lifetime exit events and recent social and family adversities in anxious and depressed school-age children and adolescents--II.

The relative contribution made by three sets of social adversities preceding the onset of anxiety and depression in 8-16-year-olds is reported. These three sets of adversities are (i) lifetime exit events over the whole of the subject's life excluding those in the 12 months before onset of disorder in cases or day of interview for controls; (ii) recent family adversities; (iii) recent friendship difficulties and an absence of social achievements. Three cases compared with 35 controls experienced none of these sets of adverse social variables. Lifetime exit events exert significant independent effects on the likelihood of being a case in the presence or absence of the other two sets of factors. This suggests that the impact of multiple lifetime exits is not explained by the presence of recent adversities measured in this study. Twenty controls however experienced two or more of these sets of adversities with four experiencing all three. This suggests that some children appear protected from the pathological effects of these social adversities. The findings are not influenced by the sex or pubertal stage of the subjects and appear with equal likelihood in both anxious and depressive cases.

Achievement↗
PubMed1991

Parents, partners or personality? Risk factors for post-natal depression.

The relevance of three different interpersonal risk factors to post-natal depression was examined. One hundred and forty-nine non-depressed women completed the Parental Bonding Instrument (PBI), the Intimate Bond Measure (IBM) and the Interpersonal Sensitivity Measure (IPSM) antenatally. Post-natal depression was identified using the Edinburgh Post-natal Depression Scale (EPDS) at 1, 3 and 6 months post partum. Significantly increased risks for post-natal depression were found for the women whose spouses provided low care or were overcontrolling and for women with high interpersonal sensitivity. Low maternal care and paternal overprotection were additional predictors when multiple regression analyses were used. Importantly, the different risk factors had their impact at different times post partum. The implication of these findings is discussed.

Adult↗
PubMed1991

Models of stress, vulnerability and affective disorder.

The concept of vulnerability indicates predisposition to affective disorder; characterised by greater sensitivity to stress but with no added risk in its absence. Mastery, self-esteem and attributional style may be involved but exogenous factors can also act as markers of vulnerability. A follow-up study of a national cohort of 36-year-olds was used to identify endogenous and exogenous vulnerability factors. Financial hardship and childhood risk were implicated for women, and financial hardship and unemployment for men. However, low rates of symptoms for 'stress-free' vulnerable individuals were only observed when chronic cases were excluded from analysis. Two alternative models are suggested: (i) a conditional vulnerability effect with an additional component to account for inception of long-term disorders; (ii) an additive burden model with vulnerability represented as a continuum from 'resilience' to 'susceptibility'. Their differentiation will require greater attention to the measurement of vulnerability and a fuller consideration of the significance of chronic disorders.

Adult↗
PubMed1991

Adolescent offspring of endogenous unipolar depressive parents and of normal parents.

Ninety-six children aged 10-17 of unipolar endogenous depressive proband parents and 96 matched control children of well parents were investigated using DSM-IIIR diagnostic criteria. Both sets of parents were also studied. Although the rate of psychopathology was significantly higher in proband than in control children, adaptive functioning as a measure of the severity of the psychopathology did not differentiate the two groups of children. Among factors related to the mental status of the children were: severity and onset under 30 years of age of the parental depression and lifelong association of parental anxiety with depression. Personality measurements performed in children showed different personality structures in proband offspring. Data on adolescent psychopathology and personality showed little evidence of a homotypic relationship with the adult affective disorders.

Adolescent↗
PubMed1991

Can future suicidal behaviour in depressed patients be predicted?

The determinants of suicidal behaviour over 18 years were examined in a series of 89 depressed in-patients, using index data on clinical features, personality, and history of past loss. Seven variables were selected from univariate analyses and their relationship with (1) the presence or absence, (2) frequency, (3) intent, and (4) medical threat of suicidal behaviour was then explored by generalised linear modelling. Severe dysphoria, past alcoholism and chronic physical illness were most predictive of suicidal attempting; however, different variables predicted the frequency, degree of intent and severity of medical threat of subsequent suicidal attempts. Thus, our results suggest that different aspects of long-term suicidal behaviour have different determinants.

Adolescent↗
PubMed1992

The familial relation of personality disorders (DSM-II-R) to unipolar major depression.

Four hundred and fifty directly interviewed relatives of probands with non-psychotic unipolar major depression and 320 directly interviewed relatives of controls were compared by the prevalences of personality disorders (P.D.) as defined by DSM-III-R, in relation to presence or absence of the relatives' affective disorder. Overall, there was only a trend for an increased risk for P.D. in relatives of depressed patients. However, P.D. and unipolar major depression co-occurred more frequently in relatives than expected by chance. It is suggested that this association is mainly due to non-familial factors. Compared with other P.D., the relationship of borderline P.D. to major depression was not substantially stronger.

Adult↗
PubMed1994

The stability of depressed mood in young adolescents: a school-based survey.

To test the stability of self-reported depressed mood in a school-based sample of young adolescents, 268 schoolchildren completed two self-rating scales measuring depressed mood, the Depression Self Rating Scale and the Child Depression Inventory, at three timepoints over a period of 6 months. Depressed mood in the sample, as measured across the whole range of the scales, was reasonably stable. A subgroup of children was identified for whom the mean scores of both scales at all three timepoints was close to, or above, the cut-off points, representing a stably depressed mood similar to that found in clinical populations. The present findings indicate that depressed mood within a section of the general child population may be more stable and less transient than previously thought.

Adolescent↗
PubMed1995

Major depression and the risk of attempted suicide.

We examined the risk of attempted suicide in 100 inpatients during a major depressive episode. We hypothesized that patients who attempt suicide have a vulnerability for suicidal behavior independent of severity or duration of depression, manifested by suicide attempts early in the course of a depressive episode. The first 3 months after the onset of an MDE and the first 5 years after the lifetime onset of major depressive disorder represented the highest-risk period for attempted suicide, independent of the severity or duration of depression. Familial, genetic, early-life loss experiences and comorbid alcoholism may be causal factors.

Adolescent↗
PubMed1995

Parental divorce, self-esteem and depression: an intimate relationship as a protective factor in young adulthood.

This study investigated whether an intimate relationship in young adulthood protects young people from depression in the presence of risk factors (parental divorce, low self-esteem in adolescence). The data were drawn from a follow-up survey of adolescents from the age of 16-22 (n = 1656). The prevalence of depression was highest among persons from divorced families who had reported low self-esteem at the age of 16 and who in young adulthood lacked an intimate relationship. An intimate relationship was found to protect young adults with the risk factor of earlier low self-esteem from depression irrespective of family background. The pattern was similar in both sexes.

Adolescent↗
PubMed1995

The tridimensional personality questionnaire as a predictor of response to nefazodone treatment of depression.

Personality traits have emerged as the strongest identified predictors of response to antidepressant treatment of major depressive disorder (Peselow et al., 1992; Joyce et al., 1994). 18 subjects in the midst of a major depressive episode were treated with nefazodone in an open trial. All subjects completed Cloninger's tridimensional personality questionnaire (TPQ) before beginning treatment. A multiple regression analysis was performed in an attempt to replicate Joyce et al.'s (1994) finding that temperament type, as assessed by the TPQ, is a strong predictor of antidepressant response. A model involving TPQ reward dependence and harm avoidance scores, and their interaction, was found to significantly predict the response to nefazodone (r2 = 0.47, P < 0.027). When response was defined as a 50% decrease in HAM-D score at last visit, high reward dependence score alone significantly separated responders from nonresponders (Fisher's exact P = 0.050, df = 1). These results raise the intriguing possibility that TPQ scores may have direct clinical applications.

Adult↗
PubMed1995

Personality disorders and personality variations in relatives of patients with bipolar affective disorders.

Family studies may elucidate etiological relationships between two psychopathological conditions. This study explored the prevalences of personality disorders (DSM-III-R) and the variation of personality traits measured by the Munich Personality Test (MPT) in first-degree relatives of patients with bipolar disorder in comparison to control families recruited in the general population. Although the overall prevalence of having any personality disorder did not distinguish both groups of relatives we found significantly more compulsive personality disorders among relatives of probands with bipolar disorder. Relatives of patients with bipolar disorder also revealed significantly higher mean scores of "rigidity' (MPT); other personality traits, including neuroticism and extraversion, did not distinguish both groups. The observed differences in personality features between both groups of relatives are not mediated by current or previous axis I disorders. Therefore, they may reflect overlap of etiological factors of familial origin.

Adult↗