Nondepressed Psychiatric Inpatients Research Articles

The effects of feedback on the behavior of depressed inpatients in two structured interactions.

This study examined the responsivity of depressives' behavior to contingent social feedback within the framework of Coyne's and Lewinsohn's models of depression. Subjects included 10 depressed inpatients, 8 nondepressed psychiatric inpatients, and 10 nondepressed individuals. Each subject participated in two structured interactions with an experimenter in baseline phases and phases in which ongoing contingent feedback was provided by a pair of observers. The results revealed that the behavior of all three subject groups was responsive to the feedback in both interactions. The results are consistent with past research demonstrating social skills problems among depressed individuals but do not support the notion of a social skill deficit in depression. The results are consistent with Coyne's model of depression and suggest that the problematic social behavior often associated with depression may be modifiable by immediate veridical feedback from others.

DST status and blood chemistries in prepubertal children

Cholesterol, sodium, potassium, and serum glucose were examined to determine if they could predict status on the dexamethasone suppression test (DST) in 59 depressed prepubertal psychiatric inpatients and 21 nondepressed psychiatric inpatients. Multivariate analyses found that none of these variables, alone or combined, were predictive of DST results.

Use of the dexamethasone suppression test in an inpatient setting: A replication and new findings

The dexamethasone suppression test (DST) was administered to 131 depressed and 109 nondepressed psychiatric inpatients. The depressed patients were categorized according to DSM-III as minor depression, major depression without melancholia, and major depression with melancholia and/or with psychotic features. The nondepressed patients were stratified over several DSM-III subcategories. DST nonsuppression was nonspecific for major depression: the mean post-dexamethasone cortisol value and the number of nonsuppressors were not significantly different between the major depressives and the nondepressed psychiatric controls. Within the depressive sample the DST was a significant ( p<0.01) discriminator between major and minor depression. Postdexamethasone plasma ≥3.5 μg/dl at 0800h was the most sensitive (39%) and specific (94%) criterion; cortisol values at 1600h and 2300h showed no significant discriminating power for major vs. minor depression. The diagnostic utility of the DST thus appears to be limited to confirming the diagnosis of major depression, once the clinical diagnosis of depression is made. There was no significant influence of age or gender on postdexamethasone cortisol values.

Self-esteem in depression: a controlled repertory grid investigation.

Repertory grids were used to investigate self-esteem and social perception in three groups: depressed in-patients, non-depressed psychiatric in-patients and a general hospital control group. Depression was measured by the Beck Depression Inventory. Depressives had significantly lower self-esteem and more negative social perception and negative feelings associated with 'actual self', as predicted by Beck's cognitive theory. Repertory grids are potentially useful tools for the development of cognitive theories of depression, and may also have a role in clinical practice using cognitive techniques.

Social skills deficits and self-evaluation among depressed and nondepressed psychiatric inpatients.

Depressed psychiatric inpatients, nondepressed psychiatric inpatients, and nonpsychiatric controls role-played responses to 28 standardized interpersonal situations. Judges blindly rated these responses on overall social skill and component measures, and subjects rated their own social skills. Judges rated depressed and nondepressed psychiatric patients as having significant problems in social skills compared to normals. No differences were found between the two patient groups in judges' ratings of social skill. Depressed patients rated their own recent interpersonal behavior and optimal social skills significantly lower than did subjects in the other groups. Results suggest that social skills deficits are not specific to depression and that depressives and other psychiatric groups may differ primarily in their self-appraisals of social competence.

Depression, psychopathology, and self-serving attributions.

Depressed and non-depressed psychiatric in-patients and non-depressed non-psychiatric controls classified their performance on a verbal recognition task as either a success or a failure, and made attributions about the causes of their perceived success or failure. In all three groups, subjects who classified their performance as a success attributed their outcome more to internal and less to external factors than did subjects who classified their performance as a failure. These results suggest that depression and attributional style may not necessarily be related. Discussion centres on the idea that individuals' expectations of success can affect their subsequent attributions.

Perception and recall of interpersonal feedback: Negative bias in depression

Recent research in depression has raised questions concerning the accuracy with which environmental information is processed. The present study was designed to address this issue by examining the perception and recall of evaluative feedback in clinically depressed psychiatric patients in an interpersonal situation. Depressed and nondepressed psychiatric inpatients and nondepressed hospital employees participated in dyadic interactions with age-matched opposite-sex strangers, discussing their responses to a variety of hypothetical situations. Following the interaction, each subject was given a sheet of paper containing ratings on 13 bipolar adjectives, ostensibly an evaluation of the subject completed by an assistant behind a one-way mirror. In fact, all subjects received identical rating sheets. Subjects were asked to indicate their reactions to this evaluation and were subsequently required to reproduce the evaluation from memory on a blank rating sheet. Although no group differences were obtained with respect to the perceived accuracy of the evaluation, the depressed patients considered the assessment to be less favorable overall than did subjects in either of the nondepressed groups. Furthermore, the depressed subjects, to a significantly greater extent than the nondepressed subjects, recalled the evaluation to be more negative than was actually the case. These results are discussed in terms of both cognitive and interpersonal models of depression, and directions for future research are advanced.

Assessment of cognitive distortion in a clinically depressed population

The Cognitive Bias Questionnaire, the Present State Examination, the Beck Depression Inventory, and an expectancy of success measure were administered to depressed and nondepressed psychiatric inpatients. The depressed subjects selected significantly more depressed distortions on the Cognitive Bias Questionnaire than did the nondepressed subjects. Results also revealed that depressed distortion scores from the Cognitive Bias Questionnaire correlated significantly with measures of cognitive distortion obtained from the Beck Depression Inventory, the Present State Examination, and an experimental task. Although primary and secondary depressed groups did not differ significantly in their responses to the Cognitive Bias Questionnaire, depressed subjects who endorsed high levels of depressed distortion revealed significantly more cognitive symptoms of depression on the Beck Depression Inventory and the Present State Examination, and evidenced a nonsignificant trend to expect less success prior to an experimental task. Implications of these results for future research in this area are discussed.

Self-reinforcement and recall: Differential deficits in depressed and nondepressed psychiatric inpatients.

Self-reinforcement and recall: Differential deficits in depressed and nondepressed psychiatric inpatients.

Self-reinforcement and recall: differential deficits in depressed and nondepressed psychiatric inpatients.

Self-reinforcement and recall: differential deficits in depressed and nondepressed psychiatric inpatients.

The utilization of positive and negative feedback in the self-evaluation responses of depressed and nondepressed psychiatric patients.

Utilization of positive and negative feedback was investigated in a sample of 20 depressed and 20 nondepressed psychiatric inpatients. Patients, selected on the basis of Minnesota Multiphasic Personality Inventory scores and clinical diagnoses, received primarily positive or negative feedback after completing a moral judgment task. Results suggest that depressed patients are likely to utilize positive, personally relevant information to enhance their low self-esteem, whereas nondepressed patients are more likely to counteract negative feedback that is inconsistent with their self-evaluations. The results fail to confirm the presence of memory deficits for positive feedback in depression, proposed by Kovacs and Beck (Am. J. Psychiatry, 135: 525-532, 1978), and are more consistent with the prediction of Mischel et al. (J. Consult. Clin. Psychiatry, 44: 92-103, 1976) that people tend to be cognitively biased toward success and toward perpetuating positive emotional states.

Expectancies, mood, and performance of depressed and nondepressed psychiatric inpatients on chance and skill tasks.

Expectancies, mood, and performance of depressed and nondepressed psychiatric inpatients on chance and skill tasks.

Neuroendocrine Identification of Depressed Patients

Recent studies of hypothalamo--pituitary--adrenal (HPA) suppression in depressed patients indicate that these subjects often show abnormal early escape of plasma cortisol levels following an initial suppression. Non-depressed psychiatric inpatients usually show normal sustained HPA suppression. The responses of 49 depressed and 30 non-depressed patients have been analysed to develop criteria which can make the dexamethasone suppression test suitable for outpatient studies. The cortisol levels measured in a 24-hour urine collection and a single blood sample post-dexamethasone were sufficient to enable 61% of the depressed patients to be identified correctly at a confidence level of 90%, on the basis of at least one abnormal cortisol value. When both cortisol values were abnormal 35% of the depressed patient were identified correctly at a confidence level of 100%. Patients with "endogenous" depressive profiles had the most abnormal results. A normal response to this test will not necessarily exclude the diagnosis of primary depressive illness. An abnormal response to the test may be of help in confirming the diagnosis. With the simplified procedure outpatient studies may become possible.

Effect of monetary incentive on concept attainment in depressed subjects.

An experiment was conducted to determine whether highly depressed and non-depressed psychiatric inpatients and non-patient normal controls react differently on a concept attainment task to different reinforcement contingencies. Specifically, it was hypothesized that: 1) Depressed and non-depressed psychiatric patients and normal controls would perform at approximately the same levels on a concept attainment task when they received informational feedback only. 2) Depressed patients would show less improvement than normals and non-depressed patients when positive reinforcement (money) was given in addition to informational feedback in a concept attainment task. 3) Depressed patients would show markedly poorer performance than non-depressed patients and normals when punishment was administered for incorrect responses according to certain deductions from Freud's theory, but would be predicted to perform as well or better according to Beck's theory. 4) Following Freud's theory, depressives might initially attain concepts because of the demands of their ‘duty morality’ but would subsequently give incorrect responses to avoid positive reinforcement and/or gain punishment, since they reject ‘pleasure morality.’ This wolld not be predicted by Beck's theory. 5) If, as Beck contends, depressives are more sensitive to fear and frustration than non-depressed persons, depressed patients should have greater response latencies under punishment conditions than non-depressed persons. A 3 x 4 factorial design was used with three diagnostic categories and four reinforcement conditions with four replications (4 Ss in each cell). The four reinforcement conditions were information feedback only, positive reinforcement only, punishment only, and positive reinforcement and punishment. The three diagnostic categories were high-depressed patients scoring greater than 24 on the Beck depression inventory (DI); low-depressed patients scoring less than 15 on the Beck DI; and normal controls. The results did not strongly support any of the five hypotheses. In general, effects attributable to the different reinforcement conditions were weak and did not interact with the diagnostic categories as required to . support the hypotheses. Normals tended to perform better than psychiatric patients, and punishment tended to be associated with longer response latencies than positive reinforcement. Implications of these findings are discussed.