Higher Levels Of Dysfunctional Attitudes Research Articles

Self-Compassion Mediates the Relationships Between University Students’ Mindfulness, Dysfunctional Attitudes, and Various Distress and Well-Being Indicators

Objective. The current study intended to model the relationships between mindfulness, dysfunctional attitudes, and self-compassion in predicting university students’ various indicators of emotional distress and well-being of university students. We aimed to examine the mediative role of self-compassion and the mediative roles of self-coldness and self-warmth in these relationships. Methods. Applying a correlational design, validated instruments were used to measure mindfulness, dysfunctional attitudes, self-compassion (and its two main components: self-warmth and self-coldness), various indicators of emotional distress (i.e., negative affect, depression, anxiety, stress), and well-being (i.e., soothing positive affect, activating positive affect, satisfaction with life). The final sample consisted of N = 176 university students. The proposed models were tested by SEM (structural equation modeling) using SPSS AMOS 20. Results. The main results obtained were consistent with the hypotheses. As expected, higher levels of mindfulness led to higher well-being and lower emotional distress through increased self-compassion, and higher levels of dysfunctional attitudes led to lower well-being and higher emotional distress through decreased self-compassion. However, the results also indicated that self-coldness was more important than self-warmth in all of these relationships. Conclusion. The results of the proposed current study supported the models for the relationships between dysfunctional attitudes, mindfulness, and self-compassion (and its positive and negative components) in predicting the various indicators of emotional distress and well-being of university students. These findings support the use of self-compassion interventions, particularly those aimed at reducing self-coldness, to improve well-being and reduce distress among university students.

T27. DYSFUNCTIONAL ATTITUDES IN ADOLESCENTS WITH EARLY-ONSET PSYCHOSIS: PRELIMINARY RESULTS

BackgroundDysfunctional attitudes such as defeatist performance beliefs (DPB) and asocial beliefs (AB) have been linked to negative symptoms and functional outcome in chronic schizophrenia (Campellone et al., 2016; Grant and Beck, 2010) and in adults with recent onset schizophrenia (Ventura et al., 2014). Adolescents with early-onset psychosis (EOP) are at major risk of having persistent negative symptoms (Puig et al., 2017) but no previous study has examined dysfunctional attitudes in this population. We aimed: (1) to examine if more DPB and AB were present in adolescents with EOP compared with normal controls, and (2) to study the relationships between DPB and AB with symptoms and functioning.MethodsSample: 15 adolescents with EOP (11♀, age=15.33 ± 1.23) and 10 healthy controls (8♀, age=15.60 ± 1.51), participants in a trial about cognitive and behavioral social skills treatment in EOP developing in Hospital Clínic of Barcelona (baseline data). Patients were under antipsychotic meds. Inclusion criteria: having an early-onset schizophrenia spectrum disorder diagnosed between 9–18 years-old (schizophrenia, schizoaffective disorder, psychosis n.o.s.); being within the 5 first years after the disease onset; clinical stability. Exclusion criteria: IQ<70; comorbid substance dependence disorder; neurological disorders. Instruments: PANSS (Kay et al., 1987), Calgary Depression Scale (CDS, Addington et al., 1990), Children’s Global Assessment Scale (C-GAS, Shaffer et al., 1983), Social and Role Functioning Scales (GF:S, GF:R, Cornblatt et al., 2007), Life Skills Profile - Adolescent version (Puig et al., 2013), Dysfunctional Attitudes Scale - Spanish version (DAS, Sanz et al., 1993); Asocial Beliefs Scale (Grant and Beck, 2010). DPB was extracted from the DAS scale following Beck et al. (2013). Groups were compared with T-test or Chi-square tests. Pearson correlations were computed for examining relationships between variables.ResultsEOP and control groups were homogeneous in age (t=-0.49, p=0.632) and sex (X2=0.15, p=0.702). All subjects were living with their parents. Family SES was lower in EOP group (X2=10.69, p=0.030). All subjects but one patient were studying although patients had repeated more courses (t=4.00, p=0.001). EOP subjects had a predominance of negative symptoms (positive symptoms=14.07 ± 3.85; negative symptoms=23.50 ± 13.79; general symptoms=31.86 ± 7.28). Mean score of CDS in EOP was low (3.77 ± 4.76). EOP group had lower scores in all functional measures than controls (C-GAS: 51.14 ± 9.38 vs 93.70 ± 4.45, GF:S: 5.71 ± 1.07 vs 9.00 ± 0.47, GF:R: 5.21 ± 1.12 vs 8.80 ± 0.42, LSP: 67.64 ± 12.30 vs 44.13 ± 3.60; t>6.67, p<0.001). Regarding dysfunctional attitudes, EOP group had higher scores in dysfunctional attitudes scales than healthy controls (DPB: 55.60 ± 19.57 vs 33.00 ± 9.37, AB: 6.67 ± 3.42 vs 3.00 ± 2.11; t>3.02, p<0.006). In EOP, DPB and AB scores were negatively correlated with functioning (DPB: C-GAS r=-0.60, GF:S r=-0.66, GF:R r=-0.66, LSP r=0.65; p<0.002; AB: C-GAS r=-0.45, GF:S r=-0.55, GF:R r=-0.49, LSP r=0.53; p<0.029). No significant correlation were found between dysfunctional attitudes and negative symptoms in EOP.DiscussionThese preliminary results showed that adolescents with EOP had higher levels of dysfunctional attitudes than controls. Accordantly to recent literature, defeatists performance beliefs and asocial beliefs were correlated with poorer functioning. However, dysfunctional attitudes were not associated with negative symptoms. It might be that dysfunctional attitudes do not contribute to negative symptoms but in functional outcome in youngs with EOP although larger samples are required. Acknowledgments: Fundación Alicia Kolplowitz.

Does knowledge of diagnosis really affect rates of depression in cancer patients?

The major objective of the present study was to investigate potential demographic and intrapersonal moderators of the relationship between knowing the cancer diagnosis and the level of depression experienced. The present research has a transversal comparative repeated cross-sectional design (2006-2014), sampling following the proportional quota method. Research was conducted in the four major oncological institutes in Romania, obtaining a national sample of cancer patients, maintaining gender and ethnic rates, and permitting the investigation of the stability of the results from one assessment to the other. Results indicate that in the Romanian context, knowing the diagnosis is associated with a lower level of depression than not knowing the diagnosis, the results being similar in both assessments (2006-2014). Furthermore, from the explored demographic factors (gender, residence, age, and education), only age has a main effect upon depression (depression increasing with age), while education is the only factor from those analyzed, which has a moderator effect. Regarding the analyzed intra-individual variables, only dysfunctional attitudes, emotion-focused coping, and lack of emotional support from the family (loneliness) have main effects upon the level of depression (i.e., higher levels of dysfunctional attitudes, emotion-focused coping, and loneliness are associated with higher levels of depression), while neither of them has a moderator effect on the relationship between knowing the diagnosis and depression. These results are important in the improvement of the doctor-patient relationship, the management of cancer-related distress, and implicitly for the course of illness. Copyright © 2016 John Wiley & Sons, Ltd.

The Relationship of Attitudinal Beliefs to Negative Symptoms, Neurocognition, and Daily Functioning in Recent-Onset Schizophrenia

In the early course of schizophrenia, premorbid functioning, negative symptoms, and neurocognition have been robustly associated with several domains of daily functioning. Research with chronic schizophrenia patients suggests that attitudinal beliefs may influence daily functioning. However, these relationships have not been examined in recent-onset schizophrenia patients. The sample consisted of recent-onset schizophrenia outpatients (n = 71) who were on average 21.7 (SD = 3.3) years old, had 12.5 (SD = 1.8) years of education, and 5.9 (SD = 6.3) months since psychosis onset. Patients were assessed for premorbid adjustment, positive and negative symptoms, neurocognition, attitudinal beliefs, and daily functioning. Normal controls (n = 20) were screened for psychopathology and demographically matched to the patients. Comparisons indicated that recent-onset patients had higher levels of dysfunctional attitudes and lower self-efficacy compared to healthy controls (t = 3.35, P < .01; t = -4.1, P < .01, respectively). Dysfunctional attitudes (r = -.34) and self-efficacy (r = .36) were significantly correlated with daily functioning. Negative symptoms were found to mediate the relationship between self-efficacy and daily functioning (Sobel test, P < .01), as well as between dysfunctional attitudes and daily functioning (Sobel test, P < .05). Neurocognition was a significant mediator of the relationship between self-efficacy and daily functioning (Sobel test, P < .05). Early course schizophrenia patients have significantly more dysfunctional attitudes and lower self-efficacy than healthy subjects. Both self-efficacy and dysfunctional attitudes partially contribute to negative symptoms, which in turn influence daily functioning. In addition, self-efficacy partially contributes to neurocognition, which in turn influences daily functioning.

Mood state dependency of dysfunctional attitudes in bipolar affective disorder

Introduction. Studies of cognitive styles among euthymic people with bipolar affective disorder (BAD) without use of mood induction techniques to access those cognitive styles give misleading impressions of normality of those cognitions. The aim of this study was to assess dysfunctional attitudes of participants with BAD, and control participants with no previous psychiatric histories, after mood inductions. Methods. Sad and happy moods were induced within 49 BAD and 37 controls. Dysfunctional attitudes were measured following mood inductions using the Dysfunctional Attitude Scale—short form (DAS-24), which has three subscales of achievement, interpersonal, and goal attainment. Results. It was hypothesised that within BAD the sad mood induction would help in accessing dysfunctional attitudes in all three domains relative to the happy mood induction. This was supported. It was also hypothesised that the mood inductions would not affect dysfunctional attitudes within controls. This was supported. When diagnosis was entered as a between group variable, achievement dysfunctional attitudes were significantly higher in BAD compared to controls after a happy induction. Conclusions Both sad and happy moods provoked higher levels of dysfunctional attitudes within BAD. Euphoria may be related to elevated achievement dysfunctional attitudes, raising risk for mania.

Early adversity in chronic depression: clinical correlates and response to pharmacotherapy

There is growing evidence suggesting that early adversity may be a marker for a distinct pathway to major depressive disorder (MDD). We examined associations between childhood adversity and a broad variety of clinical characteristics and response to pharmacotherapy in a large sample of patients with chronic forms of MDD. Subjects included 808 patients with chronic forms of MDD (chronic MDD, double depression, or recurrent MDD with incomplete recovery between episodes and a total continuous duration of >2 years) who were enrolled in a 12-week open-label trial of algorithm-guided pharmacotherapy. Baseline assessments included a semi-structured diagnostic interview, and clinician- and self-rated measures of depressive symptoms, social functioning, depressotypic cognitions, and personality traits, and childhood adversity. Patients were re-evaluated every 2 weeks. A longer duration of illness; earlier onset; greater number of episodes, symptom severity, self-rated functional impairment, suicidality, and comorbid anxiety disorder; and higher levels of dysfunctional attitudes and self-criticism were each associated with multiple forms of childhood adversity. A history of maternal overcontrol, paternal abuse, paternal indifference, sexual abuse, and an index of clinically significant abuse each predicted a lower probability of remission. Among patients completing the 12-week trial, 32% with a history of clinically significant abuse, compared to 44% without such a history, achieved remission. These findings indicate that a history of childhood adversity is associated with an especially chronic form of MDD that is less responsive to antidepressant pharmacotherapy.

Dysfunctional attitudes, self-esteem, and hassles: Cognitive vulnerability to depression in children of affectively ill parents

The current study tested the diathesis-stress component of Beck's [(1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row, (1983). Cognitive therapy of depression: New perspectives. In P.J. Clayton, J.E. Barnett (Eds.), Treatment of depression: Old controversies and new approaches (pp. 265–290). New York: Raven Press] cognitive theory of depression in a sample of children between the ages of 6 and 14. We also examined whether high self-esteem buffers cognitively vulnerable youth against experiencing increases in depressive symptoms following increases in hassles. To provide a effective test of hypotheses, an at-risk sample (children of parents with a history of major depressive episodes) and a multi-wave longitudinal design were used. At Time 1, children ( n=140) completed measures assessing dysfunctional attitudes, self-esteem, and depressive symptoms. Every 6 weeks for the next year, children completed measures assessing depressive symptoms and hassles. Hierarchical linear modeling analyses indicated that children possessing high levels of dysfunctional attitudes and low levels of self-esteem reported greater elevations in depressive symptoms following elevations in hassles than other children.

Increased 5-HT 2A Receptor Binding in Euthymic, Medication-Free Patients Recovered From Depression: A Positron Emission Study With [ 11 C]MDL 100,907

A previous positron emission tomography (PET) study reported increased serotonin 5-HT(2A) receptor binding in unmedicated depressed patients with high scores on the Dysfunctional Attitudes Scale. The purpose of the present study was to use the highly selective 5-HT(2A) receptor ligand [(11)C]MDL 100,907 in a PET imaging paradigm to assess 1) 5-HT(2A) receptor binding potential in euthymic subjects with a history of recurrent depression and 2) the relationship between receptor binding and scores on the Dysfunctional Attitudes Scale. Cortical 5-HT(2A) receptor binding was measured in 20 unmedicated, fully recovered unipolar depressed patients and 20 age- and gender-matched comparison subjects. Regional estimates of binding potential were obtained using a reversible plasma input function compartmental model and the cerebellum as a reference region to estimate the free and non-specifically bound [(11)C]MDL 100,907 in brain tissue. Relative to the comparison subjects, the recovered depressed patients demonstrated significantly higher 5-HT(2A) receptor binding potential in the frontal cortex (mean increase: 19%), parietal cortex (mean increase: 25%), and occipital cortex (mean increase: 19%). 5-HT(2A) receptor binding potential correlated negatively with age in both patients and comparison subjects and positively with the Dysfunctional Attitudes Scale in the recovered patients. These findings should be considered preliminary but suggest that recovered subjects with a history of recurrent major depression have elevated binding potential of cortical 5-HT(2A) receptors. The correlation of increased 5-HT(2A) receptor binding potential with increased scores on Dysfunctional Attitudes Scale supports earlier work suggesting that increased 5-HT(2A) receptor availability characterizes a group of depressed patients with high levels of dysfunctional attitudes.

Increased 5-HT&lt;char aid="99820963" id="sub"&gt;2A&lt;/char&gt; Receptor Binding in Euthymic, Medication-Free Patients Recovered From Depression: A Positron Emission Study With [&lt;char aid="99820964" id="sup"&gt;11&lt;/char&gt;C]MDL 100,907

Objective: A previous positron emission tomography (PET) study reported increased serotonin 5-HT 2A receptor binding in unmedicated depressed patients with high scores on the Dysfunctional Attitudes Scale. The purpose of the present study was to use the highly selective 5-HT 2A receptor ligand [ 11 C]MDL 100,907 in a PET imaging paradigm to assess 1) 5-HT 2A receptor binding potential in euthymic subjects with a history of recurrent depression and 2) the relationship between receptor binding and scores on the Dysfunctional Attitudes Scale. Method: Cortical 5-HT 2A receptor binding was measured in 20 unmedicated, fully recovered unipolar depressed patients and 20 age- and gender-matched comparison subjects. Regional estimates of binding potential were obtained using a reversible plasma input function compartmental model and the cerebellum as a reference region to estimate the free and non-specifically bound [ 11 C]MDL 100,907 in brain tissue. Results: Relative to the comparison subjects, the recovered depressed patients demonstrated significantly higher 5-HT 2A receptor binding potential in the frontal cortex (mean increase: 19%), parietal cortex (mean increase: 25%), and occipital cortex (mean increase: 19%). 5-HT 2A receptor binding potential correlated negatively with age in both patients and comparison subjects and positively with the Dysfunctional Attitudes Scale in the recovered patients. Conclusions: These findings should be considered preliminary but suggest that recovered subjects with a history of recurrent major depression have elevated binding potential of cortical 5-HT 2A receptors. The correlation of increased 5-HT 2A receptor binding potential with increased scores on Dysfunctional Attitudes Scale supports earlier work suggesting that increased 5-HT 2A receptor availability characterizes a group of depressed patients with high levels of dysfunctional attitudes.

Differential Predictors of Response to Preventive Cognitive Therapy in Recurrent Depression: A 2-Year Prospective Study

Background:Major depressive disorder is a recurrent disease. Brief cognitive therapy (CT), added to either regular care or medication, is helpful in preventing relapse/recurrence. Little is known which type of persons benefit from preventive CT, the so called ‘aptitude treatment interaction’ effect. Method:The present cohort included exclusively patients with at least two previous episodes remitted on various types of treatments (n = 172). They were assessed within a clinical trial comparing treatment as usual (TAU) with preventive CT added to TAU. Differential demographic, illness-related, psychological and biological risk factors in postponing recurrence by preventive CT were examined. Results:Significant aptitude-treatment-interaction effects were found for the number of previous episodes, daily hassles and life events, avoidant coping, gender, and morning cortisol levels. Preventive CT seemed ineffective in patients with life events (as more frequently reported by women in our study) and in patients with high episode number characterized by higher levels of avoidant coping. Generic predictors indicate that in CT, as in TAU, patients with more residual depressive symptomatology and higher levels of dysfunctional attitudes profit less from preventive CT. Conclusion:The finding that preventive CT protects against the influence of a consistently found risk factor of relapse/recurrence, i.e. the number of depressive episodes, underlines the potential of psychological preventive interventions. Preventive CT seemed to be especially effective in reducing presumably internally provoked, relapse/recurrence but may be quite ineffective in reducing externally provoked relapse/recurrence. CT possibly prevents either stress generation or disrupts kindling effects. Kindling effects probably cannot be disrupted in patients with higher levels of avoidant coping who experienced a high number of episodes, and patients who experienced life events.

A Test of Beck's Cognitive Diathesis-Stress Theory of Depression in Early Adolescents

The current study tested the diathesis-stress component of Beck's cognitive theory of depression in a sample of early adolescents. The study also examined whether high levels of social support and self-esteem buffer against depressive reactions in children with high levels of dysfunctional attitudes. At Time 1, 184 seventh graders completed measures assessing dysfunctional attitudes, social support, self-esteem, and depressive symptoms. Six weeks later, they completed measures assessing depressive symptoms and hassles. In support of Beck's theory, higher levels of dysfunctional attitudes were associated with higher levels of depressive symptoms. Contrary to hypotheses, however, dysfunctional attitudes served as a vulnerability to depressive reactions following negative events in children with high but not low levels of self-esteem. Similarly, contrary to hypotheses, dysfunctional attitudes served as a vulnerability to depressive reactions following negative events in children with high but not low levels of social support. Results are interpreted within a self-esteem lability framework.

Dysfunctional attitudes and vulnerability to depressive symptoms : A 14-week longitudinal study

Beck's acute-onset model of depression proposesthat initially asymptomatic individuals with high levelsof dysfunctional attitudes (DA) will become depressedwhen stressors occur. Using a large student sample (n = 275), we conducted a 14-weeklongitudinal study aimed at testing Beck's model as anacute-onset model. Consistent with past studies (Monroe,Bromet, Connell, & Steiner, 1986; Roberts & Monroe, 1992), a DA Stress interaction did notobtain when all subjects (both symptomatic andasymptomatic) were included in the data analyses.However, when analyses were restricted to initiallyasymptomatic subjects, the predicted DA Stress interactioneffect did obtain. Specifically, under conditions ofhigh stress, initially asymptomatic subjects with highlevels of dysfunctional attitudes showed greater increases in depressive symptoms than initiallyasymptomatic subjects with low levels of dysfunctionalattitudes. Follow-up analyses revealed that this DAStress interaction was specific to females and not males. Possible reasons for the female-specificeffect are discussed. In general, these findings callattention to the fact that subject selection proceduresmay affect a researcher's ability to predict future onset of depression.

The influence of cognitive variables on recovery in depressed inpatients

Forty two unipolar depressed inpatients were assessed on admission to hospital and again two years after the onset of the index episode. Fifty seven per cent of the sample ( n=24) fulfilled NIMH recovery criteria within this period. Older age, female gender, severity of index episode, median prior duration of episode, higher levels of dysfunctional attitudes and low self-esteem significantly predicted chronicity of depression. Backward stepwise logistic regression identified that three of these variables measured at the time of admission: severity of index depression, higher levels of dysfunctional attitudes related to the need for approval, and low self-esteem provided a robust logistic model for predicting outcome. However, the small sample size and statistical analysis employed means that replication of our research is required. Larger scale studies could also include a factor analysis so that the common elements within the different instruments may be detected. If the association between cognitive dysfunction and chronicity is confirmed, we would recommend that inpatient treatment strategies are revised to incorporate more overt psychosocial interventions.

Cognitive processes in delusional disorders.

Studies of schizophrenics with persecutory delusions have shown cognitive biases in subjects who are deluded. It has been suggested that their delusions defend against depression. This study challenges the assumption that delusional disorder (DD) patients are covertly depressed. Clinical and demographic data, and responses to questionnaires designed to assess schizotypy, depression, dysfunctional attitudes, attributional and attention biases were collected from 29 patients satisfying DSM-III-R criteria for DD. These were compared with 20 matched normal controls and results from published studies of schizophrenics. DD subjects did not show abnormal levels of overt or covert depression or schizotypy. They showed high levels of dysfunctional attitudes (P < 0.0001), a distinctive attributional style (P = 0.01), and increased attention to threat-related stimuli (P = 0.01). DD is a distinct disorder predicated upon sensitivity to threat and biases of attention and attribution. These findings may have implications for the cognitive therapy of these disorders.

Toward an integration of psychologic, social, and biologic factors in depression: effects on outcome and course of cognitive therapy.

The present study attempted to integrate key variables from 3 major domains of theory in depression (cognition, stress, and psychobiology) that are typically studied separately in analyses of course and response to cognitive therapy. Dysfunctional attitudes, negative life events, or sleep electroencephalogram were assessed in 53 outpatients before treatment with cognitive therapy. High levels of dysfunctional attitudes were found to be associated with poorer response to treatment but not for those patients who had experienced a severe negative life event. Examination of the length of time required to achieve remission revealed an effect for rapid eye movement (REM) latency as well as the interaction between REM latency and life events. These results are discussed in terms of the promise of integrative research in the study of depression and its treatment.