Depressive Guilt Research Articles

Psychoanalyzing democracies: Antagonisms, paranoia, and the productivity of depression

Psychoanalyzing democracies: Antagonisms, paranoia, and the productivity of depression

The less I get, the more I punish: A moderated-mediation model of rejection sensitivity and guilt in depression

Depression is known to affect how individuals perceive social exchanges, either negative or positive ones. These difficulties are thought to partly arise from depression-related guilt and rejection sensitivity. Here, we examined whether individuals with elevated levels of depression reported more guilt after engaging in a series of controlled exchanges in the Ultimatum Game (UG) and if rejection sensitivity mediated this relationship in negative interactions. To this end, we utilized a multi-round, multi-shot UG in which participants (N = 72) were sequentially paired with (1) unfair and (2) altruistic allocators. State guilt and perceived fairness ratings were collected throughout the Ultimatum Game. Alternatively, we looked into perceived fairness of received offers and harm caused to the allocator as potential moderators of the mediation model. As expected, we found that rejection sensitivity partially mediated the relationship between depression and guilt. Interestingly, the effect of depression through rejection sensitivity on guilt was stronger when participants caused more harm to the allocator than when they perceived the allocator as extremely unfair. A path analysis was performed as well to check for goodness of fit of the moderated mediation model. Exploratory, we looked at how depression may interfere with the emotional and behavioral response in positive exchanges as well. Overall, our findings may contribute to the understanding of the dynamics in interpersonal transactions of depressed individuals with relevance for counseling and diagnosis. Theoretical implications and interpretive caveats are discussed.

A Discussion of “‘When Reparation Is Felt to Be Impossible’: Persecutory Guilt and Breakdowns in Thinking and Dialogue about Race”

Jane Caflisch’s discussion (this issue) of white liberal guilt is recognized as a bold and ground-breaking exploration of how the Kleinian concepts of paranoid-schizoid and depressive positions may shed light on the question of reparation for racial injustice. I suggest that, in addition to persecutory and depressive guilt, melancholic guilt also operates in racist mind-sets, and constitutes the more serious obstacle to reparation. Guilt of this sort prompts defensive repetition, thereby perpetuating racist mind-sets and acts and taking one further and further from the possibility of reparation. On the other hand, the more normal interplay between persecutory and depressive guilt, which is illustrated through a clinical vignette, is seen as opening up a path to reparation. Brief vignettes are offered illustrating points about melancholic guilt and how a culture of facing rather than evading persecutory guilt enabled an opportunity for reparation to be recognized and used.

The Other Within: White Shame, Native-American Genocide

In this article, the author asks about the genocidal history of the United States, and the forms of reparation and recognition that can be found in white racial shame and white racial guilt. Examining the history of white supremacy in the United States, the author queries the differential practices of twin racial regimes: African-American slavery and the extermination of Indigenous peoples. Because of these differential practices of persecution, the “vanished Indian” will enter white psychoanalysis through the evocation of “creative racial shame”; whereas African-American slavery has entered that psychoanalysis through depressive white guilt. Much as psychoanalysis has distinguished pathological guilt from the depressive guilt that leads to reparation and remorse, the author distinguishes pathological shame from a creative form of shame that allows us to see the Other whom whiteness has vanished.

English

Through the fantastic story told by Momik, grandson of Jews deported to a Nazi extermination camp, we will reflect about Nazi guilt, evidencing the contrast of the role of guilt in Freudian human civilization and Hitler's Nazi project. The double nature of guilt in psychoanalysis is shown using Leon Grinberg’s notions (persecutory guilt / depressive guilt) and we then reach the idea of a retroactive guilt. The article points to the figure of Adolf Eichmann, the man in charge of the Nazi final solution, the submissive employee revealed by Hanna Arendt, who here finds psychoanalytic meaning.

Correction of cardiovascular disorders in diabetic patients with depressive simptoms

We studied the influence of mexidol and a-lipoic acid on cardiovascular and affective disorders' severity in patients with diabetes. 14-day administration of mexidol (300 mg/day) and a-lipoic acid (600 mg/day) had a positive impact on depressive guilt dinamics in association with a decrease in QTn-interval duration. Moreover, mexidol decreased patients' propencity to postural hypotension, and alfa-lipoic acid corrected myocardial diastolic function, pulmonary blood flow and circadian glycemia.

Suicide attempts and clinical risk factors in patients with bipolar and unipolar affective disorders

BackgroundSuicide is an important clinical problem in psychiatric patients. The highest risk of suicide attempts is noted in affective disorders. ObjectiveThe aim of the study was to look for suicide risk factors among sociodemographic and clinical factors, family history and stressful life events in patients with diagnosis of unipolar and bipolar affective disorder (597 patients, 563 controls). MethodIn the study, the Structured Clinical Interview for DSM-IV Axis I Disorders and the Operational Criteria Diagnostic Checklist questionnaires, a questionnaire of family history, and a questionnaire of personality disorders and life events were used. ResultsIn the bipolar and unipolar affective disorders sample, we observed an association between suicidal attempts and the following: family history of psychiatric disorders, affective disorders and psychoactive substance abuse/dependence; inappropriate guilt in depression; chronic insomnia and early onset of unipolar disorder. The risk of suicide attempt differs in separate age brackets (it is greater in patients under 45 years old). No difference in family history of suicide and suicide attempts; marital status; offspring; living with family; psychotic symptoms and irritability; and coexistence of personality disorder, anxiety disorder or substance abuse/dependence with affective disorder was observed in the groups of patients with and without suicide attempt in lifetime history.

Defining guilt in depression: a comparison of subjects with major depression, chronic medical illness and healthy controls

Background: Although guilt is a widely accepted feature of depression, there is limited and inconsistent data defining the nature of this symptom. The purpose of the current study was to examine the specificity and nature of guilt in subjects with major depression as compared to patients with another chronic medical illness and healthy controls. Methods: Outpatients with current major depressive episode (MDE; n=34), past-MDE ( n=22), chronic cardiac illness ( n=20) and healthy controls ( n=59) were administered the following measures: The Guilt Inventory (GI), State Shame and Guilt Scale (SSGS), 17-item Hamilton Rating Scale for Depression (Ham-D) and the Structured Clinical Interview for DSM-IV. Results: Overall multivariate analysis of covariance comparing mean scores for the six guilt subscales [state-guilt, trait-guilt, moral standards (from the GI); state-guilt, -pride, and -shame (from the SSGS)] across the four groups was significant ( F=9.1, df=6:121, p<0.0001). Post-hoc analysis revealed the following differences (each at least p<0.01): for state-guilt (GI), current-MDE>past-MDE>cardiac=healthy controls; for trait-guilt (GI), current-MDE=past-MDE>cardiac=healthy controls; for state-shame, - guilt and - pride (SSGS), current-MDE>past-MDE, past-MDE=cardiac, past-MDE>healthy, cardiac=healthy controls. Among depressed patients, there was significant correlation between Ham-D score and all guilt sub-scales ( p<0.01), except moral standards. Limitations: The cardiac group may have less illness burden than currently depressed. Conclusions: State expression of guilt, shame and low pride distinguish acutely depressed from all other groups, and are highly influenced by severity of depression. Trait-guilt does not differentiate acute from past depressed. Data suggests guilt may represent both an enduring and fluctuating feature of depressive illness over its longitudinal course.

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This study investigated gender and age differences in children’s feelings of guilt and personal responsibility towards other people’s distress. Forty-eight children, aged between seven and eleven years, were randomly recruited from a state school in Kent, England. Children were presented with sets of cartoon stories depicting a variety of open-ended moral dilemmas. They were then asked to recount the story depicted, and to describe the thoughts, feelings, attitudes and motives of the characters portrayed. Children’s responses were analysed and scored in terms of psychoanalyst Melanie Klein’s theory of persecutory and depressive guilt. It was found that girls gave more depressive guilt responses than boys. Younger boys gave more persecutory guilt and less depressive guilt responses than girls and older boys. Responses indicating concern for the other out of consideration for moral principles increased with age and were more frequent in boys. These results are interpreted as indicating gender differences in children’s expression of moral concern for others. Implications for gender differences in emotional development are discussed.

Appetite disturbance and excessive guilt in major depression. Use of family study data to define depressive subtypes.

A post hoc analysis of the relationship between depression in first-degree family members (N = 810) and specific patterns of "endogenous" symptoms in 133 probands with nonbipolar major depression revealed that concomitant appetite disturbance and excessive guilt in the depressed probands was associated with increased rates of major depression among family members. The depressed, interviewed relatives of depressed probands with appetite disturbance and excessive guilt were found to be at a 2.5 greater risk for this same subtype compared with the depressed, interviewed relatives of the remaining depressed probands. These findings suggest that this subtype of depression may "breed true" within these families.