Dependency Subscale Research Articles

Rehabilitation Methods for Patients with Geographic Atrophy due to Age-Related Macular Degeneration and Effects of Rehabilitation on Quality of Life.

The purpose of the study is to evaluate the low vision rehabilitation methods and to investigate the effect of visual rehabilitation on quality of life in patients with low vision due to geographic atrophy from age-related macular degeneration (ARMD). The better-seeing eye of 78 patients with geographic atrophy due to ARMD were included in the study. Sociodemographic characteristics, ophthalmological examination findings, and preferred low vision aids for near and distant were recorded. Fifty-seven patients who preferred to use a low vision aid device in daily life were considered as a rehabilitation group, whereas 21 patients who did not use any device were considered as a control group. The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was applied to all patients at the initial examination and at least 6 months after the initial examination. In the rehabilitation group, statistically significant increases were found in the overall composite score, and general vision, near and distance activities, social functioning, mental health, role difficulties, and dependency subscale scores of the NEI-VFQ-25 quality of life scale after low vision rehabilitation (p=0.009 for general vision, p < 0.001; for others). In the control group, there was no statistically significant change in any of the subscale scores or the overall score of the scale (p > 0.05). All patients (n = 78) were recommended to use at least one low vision aid for near vision. Hyperocular glasses were recommended for 77 patients (98.72%), magnifiers for 15 patients (19.23%), electro-optical devices for 2 patients (2.56%), and telemicroscope for one patient (1.28%). Furthermore, 17 patients (21.8%) were prescribed more than one low vision aids. However, for distance vision, only 29 patients (37.18%) received a recommendation for a low vision aid. Low vision patients with ARMD-related geographic atrophy should meet with low vision aids as soon as possible and should be included in low vision rehabilitation programs.

Vision-Related Quality of Life and Its Sociodemographic Correlates Among Individuals With Visual Impairments

Introduction: Visual impairment is an important public health concern worldwide that negatively affects quality of life (QOL). We aimed to assess the vision-related QOL and determine its sociodemographic correlates among individuals with visual impairments. Methods: We carried out a cross-sectional study during the years 2016–2017 among 201 individuals with visual impairments aged ≥ 40 years. After obtaining informed consent, we collected relevant information regarding sociodemographic characteristics using a pretested questionnaire and assessed vision-related QOL using the National Eye Institute Visual Function Questionnaire (VFQ-25). An ophthalmologist conducted comprehensive ophthalmic examinations of all the eligible study participants. Results: The mean VFQ-25 composite score was 52.91 + 7.61. The subscale score was highest for color vision (72.39 + 21.71) and worst in the dependency subscale (31.43 + 25.2). Multivariable ordinal regression revealed that variables such as gender, place of residence, household overcrowding, dietary habits, practicing exercise or yoga, and type of eye disorder were significantly ( p&lt; .05) associated with the QOL of individuals with visual impairments. Discussion: The QOL among individuals with visual impairments was poor in our study. Further research is needed to establish associations of various factors with the QOL. Implications for practitioners: Incorporating these determinants of vision-related QOL in the existing strategies could be useful for health care providers and social service providers in promoting the well-being of individuals with visual impairments.

Examining the Reliability of Various Interpersonal Acceptance-Rejection Theory (IPARTheory) Measures in Vietnamese Adolescents

Perceiving one’s self as accepted by important others, such as parents, is fundamental and crucial for the well-being of each individual. One major aspect of interpersonal acceptance-rejection theory (IPARTheory) is examining how parental acceptance-rejection affects people’s psychological adjustment. This theory has been validated in many countries and cultural groups around the world, but has not been utilized in the Vietnamese context. This research aims to assess the reliability of IPARTheory measures in Vietnam and applicability of the theory itself among a Vietnamese sample. Participants included 162 students from a high school in Hanoi (Mage = 15.58 years; 69.8% female). Materials consisted of Vietnamese versions of various IPARTheory measures: Parental Acceptance-Rejection Questionnaire, Personality Assessment Questionnaire, Interpersonal Relationship Anxiety Questionnaire, and a demographics form designed specifically for this research. Analyses show that psychological maladjustment significantly correlated with perceived paternal rejection, maternal rejection, and their subscales. Cronbach’s alphas were strong, ranging from .73 to .97, except for the dependency subscale and hostility subscale of the Personality Assessment Questionnaire. Thus, the results provide evidence for the reliability of various IPARTheory measures in Vietnam. The relationships found in this study have implications for parents, teachers, and psychologists to employ in order to provide adolescents with appropriate guidance and intervention based on the importance of perceived parental acceptance-rejection.

Emotion Dysregulation as a Moderator of the Association Between Relationship Dependency and Female-Perpetrated Dating Aggression.

The dependency-possessiveness model proposes that individuals who are highly dependent on their intimate partner and fear partner abandonment, particularly among those with emotion dysregulation problems, may be at heightened risk for intimate partner aggression (IPA) perpetration. Despite prior research establishing a link between relationship dependency and male IPA perpetration, it is unknown whether this association extends to female-perpetrated aggression, occurs in dating relationships, and is moderated by emotion dysregulation. Thus, the purpose of the current study was to investigate the association between relationship dependency and female-perpetrated dating aggression and determine if emotion dysregulation moderated this hypothesized relationship. Female undergraduate students (N = 119) completed measures assessing relationship dependency, emotion dysregulation, and female-perpetrated physical and psychological dating aggression as part of a larger study investigating the context of dating aggression episodes. Anxious attachment was significantly correlated with female-perpetrated psychological and physical dating aggression. Regression analyses indicated a significant interaction between the Spouse-Specific Dependency Scale [SSDS] Anxious Attachment subscale and emotion dysregulation predicting female-perpetrated physical dating aggression, suggesting moderation. There was a positive association between anxious attachment relationship dependency and female-perpetrated physical dating aggression at high levels of emotion dysregulation. A significant interaction was also found between the SSDS Emotional Dependency subscale and emotion dysregulation predicting female-perpetrated physical dating aggression, such that among those with low scores in emotion dysregulation, there was a positive relationship between emotional dependency and female-perpetrated physical dating aggression. Findings suggest that the ability to regulate emotions may play an important role in the association between relationship dependency and female-perpetrated dating aggression.

Psychotherapy of Dependent Personality Disorder: The Relationship of Patient–Therapist Interactions to Outcome

Objective So far, only a few studies have focused on psychotherapy for Dependent Personality Disorder (DPD). DPD is marked by a repetitive pattern of efforts aiming at maintaining close relationships, which may present as a lack of assertiveness and as a difficulty in making routine decisions. The present study aims at exploring processes of change taking place during the working phase of a clarification-oriented psychotherapy (COP) by focusing on the in-session patient–therapist interaction, as it changes during treatment and their links with treatment outcome. Methods: N = 74 patients with DPD were recruited in a naturalistic setting; they underwent long-term COP. Sessions 15, 20 and 25 were video- or audio-recorded and analyzed using the Process-Content-Relationship Scale, an observer-rated instrument that measures the quality of the interaction processes from patient’s and therapist’s perspectives. Therapy outcomes were assessed with the Personality Inventory – Dependency Subscale, Beck Depression Inventory, Inventory of Interpersonal Problems and Self-efficacy Scale at intake and discharge of therapy. Three-level Hierarchical Linear Modeling was applied to test the hypotheses. Results: Improvement in interaction processes was observed in all patient’s and therapist’s variables over the sessions 15, 20, 25. Overall, this increase in quality of interaction process was unrelated with outcome, but decrease in dependency traits was predicted by increase in therapist’s quality of relationship offer, understanding of content and directivity over the course of the working phase of COP. Conclusions: Studying interaction processes in DPD provides an initial understanding of differential roles of potential mechanisms of change in effective treatment.

Do Relational and Self-Definitional Traits Influence Deep Brain Stimulation Device Preference?

Personality psychodynamics have been shown to influence individual responses to psychiatric treatments, including medication. Increasingly, neuromodulation therapies have become available for severe and treatment-resistant depression. This study aims to evaluate patient response to an implanted neurostimulator battery within the framework of relational versus self-definitional personality traits. Relational development is interpersonally oriented and disruptions along this pathway lead to dependency on others for a sense of security and self-worth. Self-definitional development is characterized by autonomy strivings and disruptions lead to self-critical feelings of failing to meet expectations. Patients drawn from a larger study of deep brain stimulation (DBS) for treatment-resistant depression were switched from a non-rechargeable to a rechargeable battery type to maintain stimulation therapy. This switch entailed taking greater personal responsibility for device maintenance and allowed for fewer battery replacement surgeries. Twenty-six patients completed the Depressive Experiences Questionnaire (DEQ) and a questionnaire surveying their preference for DBS battery type. Results show that the DEQ dependency subscale, and more specifically the neediness component of the subscale, is associated with patient preference for the non-rechargeable battery. This suggests that individuals with higher relational needs prefer treatment options that increase contact with and need for medical caregivers and may prioritize this aspect of an intervention over alternative considerations. In contrast, individuals with more self-critical personality traits did not have a battery type preference, indicating that self-definitional needs were not predictive of battery preference. The link between an individual's personality psychodynamics and response to biomedical interventions, including neuromodulation and treatments that incorporate medical devices, deserves further attention.

Psychopathology, health-related quality-of-life and parental attitudes in pediatric asthma

Objective: Considering that unknown psychopathology might play a role in the management of pediatric asthma, this study examines how self-esteem and psychosocial family environment (child-raising attitudes and parental coping strategies) influence the physical and psychosocial well-being of these children. Hence, this paper aims to predict psychosocial factors influencing health-related quality-of-life (HRQL) in children with asthma without a documented history of mental illness. Methods: 32 patients with asthma and 32 controls aged 8–18 years were included in the study. All participants were largely middle-income, Caucasian school-aged children. The child-raising attitudes examined were: dependency, egalitarianism/democratic attitude, rejection of the homemaking role, marital conflict, and strictness/authoritarianism. The parental coping strategies were; social support seeking, problem-solving attitude and avoidance. Results: Psychiatric comorbidity was present in 72% of asthma patients and 22% of the controls. The most common mental illness identified was generalized anxiety disorder; 32% vs 13%, respectively. Dependency was the only parental child-raising attitude that differed significantly between groups (47 ± 8 vs 41 ± 11, respectively. p = 0.035). There was a negative correlation between the PARI dependency subscale and the total HRQL score according to the parents (rp= −0.39, p = 0.027). The most influential factors connected with the total HRQL score in asthma were Rosenberg self-esteem scale score, presence of psychopathology and dependency according to the child. Conclusions: Simple ways to overcome emotional dependency and fortify self-esteem (exercises promoting self-awareness, opportunities cultivating decision-making, and a considerable freedom-of-choice to experience consequences) worth recommending to parents of children with asthma. Patients with suspected mental illness must be referred for psychiatric evaluations.

Evaluating the Student–Teacher Relationship Scale in the Greek educational setting: an item parcelling perspective

The Student–Teacher Relationship Scale (STRS) is one of the most extensively used instruments that evaluate the quality of teacher–child relationships. The STRS has a strong theoretical background based on attachment theory and research on parent–child and teacher–child relationships. The purpose of this study was to examine the dimensional structure of the adapted STRS proposed by Koomen et al. (2012) in the Greek educational settings. Another purpose was to examine the intercorrelations of the Dependency subscale with the Closeness and Conflict subscales of the adapted version of STRS, when applied in a cultural context different from the context, where it was developed originally. We applied confirmatory factor analyses with item parcelling in two independent samples (N1 = 118 teachers, 921 students and N2 = 118 teachers, 925 students). Findings provided evidence for the dimensional structure of the adapted STRS subscales and its validity. Results also showed that the Dependency subscale is positively correlated with Closeness in Greece as a background with more collectivistic characteristics. This finding suggests that the cultural universality of dependency can be challenged and that the possible socio-cultural influences in the nature and interpretation of dependent relationships needs to be further examined.

Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study

BackgroundWe evaluated cognitive function and factors associated with cognitive impairment in a cohort of older homeless adults. We hypothesized that substance use and a history of traumatic brain injury would be associated with cognitive impairment. MethodsWe recruited 350 homeless individuals aged ≥50 years using population-based sampling and conducted structured interviews and neuropsychological testing. We evaluated alcohol use with the Alcohol Use Disorder Identification Test, defining high-severity alcohol use as a total score ≥16 or ≥4 on the alcohol dependency sub-scale. We assessed global cognition with the Modified Mini-Mental State Test (3MS) and processing speed and executive function with the Trail Making Test (TMTB), defining impairment as performing 1.5 standard deviations below the standardized mean. We used multivariable logistic regression to examine the association between alcohol use and cognition. ResultsParticipants had a median age of 58 years [IQR 54–61], 76.7% were men, and 79.9% were African American. A quarter (25.1%) of participants met criteria for impairment on the 3MS; 32.9% met criteria for impairment on TMTB. In models adjusted for sociodemographic variables and health conditions, high-severity alcohol use was associated with global cognitive impairment (AOR 2.39, CI 1.19–4.79) and executive dysfunction (AOR 3.09, CI 1.61–5.92). ConclusionsOlder homeless adults displayed a prevalence of cognitive impairment 3–4 times higher than has been observed in general population adults aged 70 and older. Impaired cognition in older homeless adults could impact access to housing programs and the treatment of health conditions, including the treatment of alcohol use disorders.

Link of dysfunctional attitudes with the negative self-model.

BackgroundBeck’s cognitive theory postulates that dysfunctional attitudes predisposing to depression are formed by early negative experiences. Meanwhile, Bowlby’s attachment theory contends that distorted working models built through insecure attachment relationships lead to various psychopathologies such as depression. The present study examined the correlations of dysfunctional attitudes about achievement, dependency, and self-control with working models of the self and other, and tried to promote understanding of those dysfunctional attitudes from an attachment perspective.MethodsThe subjects were 591 Japanese healthy volunteers. Dysfunctional attitudes about achievement, dependency, and self-control were evaluated by the corresponding subscales of the 24-item Dysfunctional Attitude Scale, and working models of the self and other were assessed by the relationship scales questionnaire.ResultsThe scores of the achievement (β = −0.26, P < 0.001), dependency (β = −0.41, P < 0.001), and self-control (β = −0.14, P < 0.01) subscales had negative correlations with the self-model score, suggesting the connections of all clusters of dysfunctional attitudes with the negative self-model. The score of the dependency subscale (β = 0.21, P < 0.001) had a positive correlation with the other-model score, suggesting the connection of this cluster of dysfunctional attitudes with the positive other-model. Meanwhile, the scores of the achievement (β = −0.17, P < 0.001) and self-control (β = −0.13, P < 0.01) subscales had negative correlations with the other-model score, suggesting the connections of these clusters of dysfunctional attitudes with the negative other-model.ConclusionThe present study suggests that dysfunctional attitudes as a whole are linked with the negative self-model built through negative attachment experiences, while the content specificity of each cluster is related to the differential correlations with the other-model.Electronic supplementary materialThe online version of this article (doi:10.1186/s12991-016-0098-y) contains supplementary material, which is available to authorized users.

Complicated Grief and Depression in Young Adults

Young adults experience problematic responses to loss more often than is commonly recognized. Few empirical studies have examined the contribution of intrapersonal and interpersonal characteristics to grief and depression in bereaved young adults. This study investigated the association of dependency and quality of the relationship with the deceased (i.e., depth and conflict) with complicated grief (CG) and depression. Participants were 157 young adults aged 17 to 29 years who experienced loss of a family member or close friend within the past 3 years (mean = 1.74 years). Participants completed the Inventory of Complicated Grief, Beck Depression Inventory, Depth and Conflict subscales of the Quality of Relationships Inventory, and the Dependency subscale of the Depressive Experiences Questionnaire. Relationships among dependency and interpersonal depth and conflict and CG and depression were examined through analyses of covariance. Sixteen percent of participants met criteria for CG and 34% had mild to severe depression. Dependency and depth were independently related to CG and dependency was related to depression, but the pattern of associations was somewhat different for each outcome. Greater depth was associated with CG, at both high and low levels of dependency. High levels of dependency were related to more depressive symptoms. Interpretation of the findings is limited by the relatively small sample size and cross-sectional design. CG and depression are related but distinct responses to loss. Although dependency is associated with both CG and depression after loss, relationships between the bereaved and deceased that are characterized by high levels of depth are particularly related to the development of CG symptoms.

Relationship of the FKBP5 C/T polymorphism with dysfunctional attitudes predisposing to depression

FK506-binding protein 51 (FKBP5) is a co-chaperone of the glucocorticoid receptor, and plays an important role in the negative feedback regulation of the hypothalamic-pituitary-adrenal axis. The C/T single nucleotide polymorphism in the intron 2 of the FKBP5 gene affects cortisol secretion, and has been implicated in the pathophysiology of depression. In this study, the relationship of the FKBP5 C/T polymorphism with dysfunctional attitudes predisposing to depression was examined. The subjects were 300 healthy Japanese. The FKBP5 genotypes were determined by a real-time PCR and cycling probe technology for SNP typing. Dysfunctional attitudes were assessed by the 24-item version of the Dysfunctional Attitude Scale (DAS-24), which has the Achievement, Self-control, and Dependency subscales. DAS-24 total scores were significantly higher in the group with the T allele than in that without this allele (p=0.001). Regarding the subscales, scores of the Achievement (p=0.003) and Self-control (p=0.009) subscales, but not those of the Dependency subscale, were significantly higher in the former group than in the latter group. The present study suggests that the FKBP5 C/T polymorphism is implicated in formation of dysfunctional attitudes, especially those about achievement and self-control.

The Relations Between The Acceptance and Child-Rearing Attitudes of Parents of Children With Mental Disabilities

Problem Statement: The relationship between parent and child plays a fundamental role in the social and emotional development of the child. Parental acceptance-rejection behavior may be critical in shaping the quality of the affective bond between parent and child and is established within the specific contexts of the parent-child environment. Psychological, socioeconomic, and other difficulties introduced into family life by having a child with mental disability may affect parental acceptance-rejection levels. Difficulties resulting from the disability and related social pressures and expectations might also influence childrearing attitudes. Purpose of Study: To investigate the correlation between parents’ acceptance-rejection of their children with mental disability (7-12 years of age) and their child-rearing attitudes in relation to sociodemographic variables. Method: A total of 234 fathers and 129 mothers of children with mental disability (7-12 years of age) were included via a random sampling method in this relational screening modeled study. Data were collected via the Parental Acceptance-Rejection/Control Questionnaire (PARQ/C) and the Parental Attitude Research Instrument (PARI) to assess parental acceptance-rejection behavior and parents’ attitudes towards their children, respectively. Findings and Results: A positive correlation was found between the PARI dependency subscale and the PARQ/C subscales of warmth/affection and undifferentiated rejection and control. The PARI subscale of rejection of

The Three Dimensions of the Student–Teacher Relationship Scale

The validity of the Student–Teacher Relationship Scale (STRS) was examined in a preschool community sample ( N = 925) using confirmatory factor analysis (CFA). Factorial invariance across genders was also investigated as was concurrent and discriminant validity. Indicators of validity were teacher-rated social competence, problem behavior, and mental health, as well as the children’s score on the Peabody Picture Vocabulary Test. Results showed that the original three-dimensional model of the STRS was not satisfactorily confirmed. However, a slightly modified 25 items, 3-factor version of the STRS showed an acceptable fit. Model fit was acceptable for both boys and girls. The modified three-factor model evidenced good concurrent validity. The discriminant validity of the dependency versus the conflict subscale was somewhat unsatisfactory, mainly due to imperfections in the dependency subscale.

P01-434 - The effect of cognitive flexibility on skill rehabilition training of schizophrenics in community

ObjectiveTo study the effect of cognitive flexibility on skill rehabilition training of schizophrenics in community.Methods150 schizophrenic outpatients in their rehabilitation stage were randomly divided into skills training group (100 cases) and control group (50 cases with five drop of). The training lasted for 24 weeks and the patients were followed up for 12 weeks. The assessing instruments included PANSS (positive and negative symptom scale), MRSS (morning. side rehabilitation stage scale) and cognitive flexibility (WCST, Stroop test and Trail making).Results133 subjects completed the trial. The scores of PANSS, the negative subscale, the General Psychopathology subscale in both groups decreased signifieantly after treatment (P &lt; 0.05∼P &lt; 0.01). The scores of MRSS, Dependency subscale, Inactivity subscale, effects of Current Symptoms and Deviant Behavior Subscale in the skills training group decreased significantly after treatment (P&lt; 0.05∼P &lt; 0.01); the reductions of PANSS, MRSS between two groups were not significant different; Relapse rate was lower in the skills training group than that in the control group, without a statistical significant. Within skills training group, the numbers of continuous error (WCST) and correct error in effective group was better than those in ineffective group.ConclusionCommunity reintegration skill is of benefit to rehabilitation of schizophrenics in decreasing symptoms, improving social function and decreasing defect. The cognitive flexibility and the effect of skill training rehabilitation in chronic schizophrenia patients has certain relations.

What Measure of Interpersonal Dependency Predicts Changes in Social Support?

One of the most intriguing characteristics of interpersonal dependency is its ability to predict elevated levels of social support. Yet studies of interpersonal dependency use various measures to assess this effect. In this study, I compared 3 commonly used measures of interpersonal dependency in terms of their prediction of social support: Hirschfield's Interpersonal Dependency Inventory (IDI; Hirschfeld et al., 1977), the dependency factor of the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976), and the Dependency subscale of the Personal Style Inventory (PSI; Robins et al., 1994). A total of 152 undergraduates were administered these measures as well as measures of depressive symptoms and social support a week prior to their first exam period and a week after this period (interval time = 8 weeks). DEQ–dependency predicted an increase in social support, whereas PSI–Dependency and IDI predicted a decrease in social support over time. DEQ–dependency appears to capture better than the other 2 measures the dialectic tension between risk and resilience in interpersonal dependency.

Applicability of the Student—Teacher Relationship Scale (STRS) in the Greek Educational Setting

The present study examined the applicability of the Student—Teacher Relationship Scale (STRS) within the Greek cultural context. Sixty-seven kindergarten teachers filled in a Greek version of the STRS concerning 403 kindergarten students. Exploratory factor analysis showed that a 26-item version of the STRS could be considered as a valid and reliable instrument to measure Closeness (α = .86), Conflict (α = .87) and Dependency (α = .79). Findings further indicated that teachers described young boys as having more conflictual relationships with their teachers and young girls as having closer and more dependent relationships with them. In contrast with previous studies, the Dependency subscale was positively correlated with the Closeness subscale ( r = .34) and did not associate with the Conflict subscale. These findings might be attributed to the different cultural background of the Greek kindergarten teachers or their differentiated interpretation of the notion of dependency.

Memantine Treatment in Patients With Moderate to Severe Alzheimer Disease Already Receiving Donepezil

Memantine is a low- to moderate-affinity, uncompetitive N-methyl-D-aspartate receptor antagonist. Controlled trials have demonstrated the safety and efficacy of memantine monotherapy for patients with moderate to severe Alzheimer disease (AD) but no controlled trials of memantine in patients receiving a cholinesterase inhibitor have been performed. To compare the efficacy and safety of memantine vs placebo in patients with moderate to severe AD already receiving stable treatment with donepezil. A randomized, double-blind, placebo-controlled clinical trial of 404 patients with moderate to severe AD and Mini-Mental State Examination scores of 5 to 14, who received stable doses of donepezil, conducted at 37 US sites between June 11, 2001, and June 3, 2002. A total of 322 patients (80%) completed the trial. Participants were randomized to receive memantine (starting dose 5 mg/d, increased to 20 mg/d, n = 203) or placebo (n = 201) for 24 weeks. Change from baseline on the Severe Impairment Battery (SIB), a measure of cognition, and on a modified 19-item AD Cooperative Study-Activities of Daily Living Inventory (ADCS-ADL19). Secondary outcomes included a Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-Plus), the Neuropsychiatric Inventory, and the Behavioral Rating Scale for Geriatric Patients (BGP Care Dependency Subscale). The change in total mean (SE) scores favored memantine vs placebo treatment for SIB (possible score range, 0-100), 0.9 (0.67) vs -2.5 (0.69), respectively (P<.001); ADCS-ADL19 (possible score range, 0-54), -2.0 (0.50) vs -3.4 (0.51), respectively (P =.03); and the CIBIC-Plus (possible score range, 1-7), 4.41 (0.074) vs 4.66 (0.075), respectively (P =.03). All other secondary measures showed significant benefits of memantine treatment. Treatment discontinuations because of adverse events for memantine vs placebo were 15 (7.4%) vs 25 (12.4%), respectively. In patients with moderate to severe AD receiving stable doses of donepezil, memantine resulted in significantly better outcomes than placebo on measures of cognition, activities of daily living, global outcome, and behavior and was well tolerated. These results, together with previous studies, suggest that memantine represents a new approach for the treatment of patients with moderate to severe AD.

The Cardiff Depression Study: a sib-pair study of dysfunctional attitudes in depressed probands and healthy control subjects.

Current cognitive theories propose that depression develops as a result of the interaction between dysfunctional cognitive schemata and environmental stressors. There is also consistent evidence of a substantial genetic contribution to depression. This study examines the familiality and stability of dysfunctional attitudes and attempts to distinguish whether they reflect trait vulnerability to depression or the state of being depressed. The 24-item Dysfunctional Attitude Scale (DAS-24) was completed by 108 depressed probands and their nearest-aged siblings and 105 healthy control probands and their nearest-age siblings, at the time of a semi-structured clinical interview and 10-12 months later. Subjects also completed self-report measures of depressed mood on both occasions. Measures of clinical depression were significantly correlated with DAS scores. At retest, DAS scores remained elevated despite improvement in mood, giving support for earlier findings, that dysfunctional attitudes remain active following recovery. The dependency subscale (DAS-D) of the DAS showed modest familiality, although there were no significant differences for DAS-D scores between the two groups of siblings. In a multiple regression analysis, current mood-state was the overwhelming predictor of DAS scores. However for DAS-D, gender as well as current mood influenced scores on this subscale. Although there was modest evidence for temporal stability and familiality for some DAS-24 subscale scores, dysfunctional attitudes were predominantly influenced by current low mood, and therefore reflect the state of being depressed rather than a familial vulnerability trait underpinning depression.

Are dependency and self-criticism risk factors for major depressive disorder?

To determine whether dependent and self-critical personality traits are associated with specific types of life events and whether these traits change with pharmacotherapy. Overall, 142 depressed outpatients completing 8 weeks of fluoxetine treatment were administered the Life Experiences Survey (LES) at baseline and the Dysfunctional Attitude Scale (DAS) and Hamilton Depression Rating Scale (HDRS) at baseline and endpoint. The DAS dependency subscale, but not the self-criticism subscale, showed significant correlations with life events regardless of congruency. Baseline HDRS scores were positively correlated with both DAS subscales and total score. The DAS subscales, the total DAS score, and the HDRS all improved significantly with treatment. These results confirm a growing body of research that has found an association between sociotropic or dependent personality traits and life events.