Vulnerability Factor For Depression Research Articles

INTERPERSONAL RELATEDNESS AND SELF-DEFINITION IN LATE ADULTHOOD DEPRESSION: PERSONALITY PREDISPOSITIONS, AND PROTECTIVE FACTORS

This study addresses depression in late adulthood within the context of Blatt's (1974; 1991) theory of development and vulnerabilities to depression. Participants were a sample of 237 Israeli community-dwelling old adults (age 65–75) in good health and functioning well. The authors assumed that in this developmental period, normally beset with questions about self-identity and interpersonal relatedness, the associations among Self-criticism, the Neediness component of dependency, and depressive symptomatology are moderated by participants' perceived social support as well as by their fear of death. As expected, the correlational results confirmed that depression in late adulthood is associated with Self-criticism, Neediness, fear of death, and low perceived social support. Additional results illustrated the protective role of Efficacy and Connectedness, as well as the buffering roles of social support and low fear of death in the relation between vulnerabilities to depression and depressive symptoms in late adulthood. The overall findings highlight the relevance of personality vulnerability factors in depression in late adulthood and the need to consider a range of moderating factors that may serve to protectively buffer or exacerbate the impact of personality vulnerability factors.

Frequency and duration of mood fluctuations: effects of dependency, self-criticism, and negative events

Few studies have examined the relation between depressive vulnerability factors and the duration of symptom disturbance, defined as the length of time during which mood states are elevated above a certain threshold. We examined the duration of mood disturbances in male ( N=31) and female ( N=71) college-aged individuals who completed mood checklists twice weekly for 10 weeks. Results showed that dependency and self-criticism were related to the mean severity of ratings across all checklists and the mean duration of disturbances, as well as the number of disturbances lasting at least 7 or 14 days. Some evidence for the congruency model was found. Dependency and self-criticism moderated the relation between vulnerability congruent hassles and mood. Sensitivity analyses showed that altering the threshold at which symptom scores were designated as symptom disturbances did not affect the pattern of results for dependency and self-criticism. Results have implications for the debate concerning the relation between vulnerability factors and depressive severity.

Affective Reactivity to Daily Interpersonal Stressors as a Prospective Predictor of Depressive Symptoms

Abstract We conceptualized affective reactivity to daily interpersonal stressors as an index of interpersonal sensitivity and evaluated it as a vulnerability factor for depression. College students completed an initial measure of depression (Time 1). Then, at the end of each day for two weeks, they completed a checklist of daily stressors and measures of state affect. Two months later (Time 2), students completed the depression measure again as well as a questionnaire that assessed life events for the intervening two months. We conducted regression analyses to predict Time 1-Time 2 changes in depressive symptoms. Our major predictions were positive main effects for Time 1 affective reactivity to daily interpersonal stressors and Time 2 negative interpersonal events, and a significant effect for the reactivity × Time 2 events interaction. Significant results were obtained for the two main effects, but not for the interaction. The results suggest that affective reactivity to daily interpersonal stressors is...

BIS/BAS Levels and Psychiatric Disorder: An Epidemiological Study

Behavioral inhibition and behavioral activation levels have been theorized to relate to a broad range of psychopathologies. To date, however, studies have focused on a single diagnosis, and the measures used to assess different psychopathologies have varied greatly. This study assessed how levels of behavioral inhibition and behavioral activation relate to lifetime diagnoses of depression, anxiety, drug abuse and dependence, alcohol abuseand dependence, attention deficit hyperactivity disorder, and conduct disorder. A representative community sample of 1,803 individuals between the ages of 19 and 21 in the Miami area was surveyed with the Composite International Diagnostic Interview and the Behavioral Inhibition and Behavioral Activation Scales (BIS/BAS; C. S. Carver & T. White, 1994). Results supported the role of BIS as a vulnerability factor for depression and anxiety and of BAS Fun Seeking for drug abuse and noncomorbid alcohol diagnoses. Other models were not supported. Goals in understanding BIS and BAS are described, including the need for prospective studies with a broader array of behavioral indices.

Proximal Effects of Dependency and Self-Criticism: Conceptual and Methodological Challenges for Depressive Vulnerability Research

Research and theorizing on vulnerability to depression has expanded considerably in the past 40 years. However, there are a number of challenges and opportunities that cannot be adequately resolved or fully exploited within models of vulnerability that are typically investigated. Continued progress in understanding the link between vulnerability factors and mood depends on a fuller understanding of depressive vulnerability factors themselves. Understanding the proximal effects of vulnerability factors on both mood and behaviour requires methods and analytic models capable of examining moment to moment changes as well as an understanding of what underlying needs stressful life events and difficulties may threaten. Conceptualizing vulnerability factors more broadly in terms of ethological models focusing on social rank and attachment offers a number of useful avenues along which vulnerability theory may be expanded.

Personality and vulnerability to depression in stroke patients: a 1-year prospective follow-up study.

Depression is a frequent sequela of stroke that negatively interferes with rehabilitation outcome. Personality traits have been neglected as potential vulnerability factors for poststroke depression (PSD). In a 1-year prospective study, the influence of the 5 main personality traits (ie, neuroticism, extraversion, openness, agreeableness, and conscientiousness) on the development of PSD was studied. One month after stroke, 190 consecutive patients with a first-ever supratentorial infarct were asked to complete a personality inventory, the NEO-Five Factor Inventory, which is based on the Five Factor Model of personality. Depressive symptoms were assessed 1, 3, 6, 9, and 12 months after stroke with 3 self-rating questionnaires as screening instruments for depression. PSD was diagnosed as major or minor depression through the use of the Structured Clinical Interview from the Diagnostic and Statistical Manual of Mental Disorders. The 1-year cumulative incidence of depression was 38.7%. Cox regression analysis showed that patients with high neuroticism scores had a 4.6-times-higher risk of developing PSD than patients with low neuroticism scores (P=0.001) regardless of lesion location. Level of handicap was the only other factor that showed an independent effect on the occurrence of PSD. Neuroticism is an important predictor of PSD, a finding that emphasizes the need to take personality into account as a potential vulnerability factor for depression in stroke patients. Research on PSD should aim at delineating the interplay between neurological and psychological factors in the development of PSD.

Dimensions of temperament as vulnerability factors in depression.

In order to evaluate the hypothesis that one set of genetic risk factors may be common to disorders and dimensions of temperament, whereas environmental risk factors are disorder specific, we have conducted a genetic analysis of dimensions of temperament and symptoms of depression in about 201 pairs of monozygotic and dizygotic twins. Dimensions of temperament associated with novelty seeking, harm avoidance, reward dependence, and persistence were measured by using the Temperament and Character Instruments developed by Cloninger, and depressive symptoms were measured using the Hospital Anxiety and Depression Scale. Differences among individuals on these measures can be explained by differences in their genes and in their environmental experiences. There are no differences between the sexes in gene action affecting temperament. Each dimension of temperament is genetically dependent, and genetic variations in symptoms of depression are largely dependent on the same factors that affect the temperament. Temperament is closely associated with vulnerability to depressive symptoms.

Depressogenic attributional style: evidence of trait-like nature in youth psychiatric inpatients

The hopelessness theory of depression (1989) proposes that a negative style of thinking, termed “depressogenic attributional style”, is a stable vulnerability factor for depression. Much past research has examined the stability of this negative style of thinking, with mixed results. The present study presents data supporting the “trait-like” nature of depressogenic attributional style, as defined by hopelessness theory, in a sample of 100 psychiatric child and adolescent inpatients by examining patterns in attributional style and depressive symptomatology upon admission to the hospital and again at discharge.

Mood dependency of self-rated attachment style

Previous research has established an association between depressive symptoms and self-rated insecure adult attachment styles. In this project we evaluated whether this association is an artifact of mood-dependent negative self-ratings. In Study 1 (N = 95, nonclinical sample), depressive symptoms correlated positively with Preoccupied and Fearful attachment style self-ratings, negatively with Secure attachment style. In Study 2 (N = 50 nondepressed adults, one-half with a history of major depression), recovered depressed people exceeded never-depressed adults on Preoccupied and Fearful styles, whereas the never-depressed scored higher on Secure attachment style. In Study 3 (N = 129), an unselected adult sample was randomly assigned to either depressed or elated musical mood induction. The two groups did not differ significantly on 3 of 4 attachment styles; theonly significant difference was that those in the depressed-mood condition scored lower on Fearful attachment. Taken together, the results are consistent with the possibility that insecure (particularly Preoccupied and Fearful) attachment is a stable vulnerability factor for depression and do not support the view that reporting insecure attachment is an artifact of current sad mood.

Correlates of analogue and clinical depression: a further test of the phenomenological continuity hypothesis

Background: The use of college students with high scores on a depression rating scale as analogues for depression by psychological researchers has generated controversy. Critics of analogue research argue that depression is qualitatively different in analogue and clinical samples. Objective: To conduct a further comparison of the phenomenology of clinical and analogue depression to determine if the differences between these groups are best understood as quantitative (consistent with the continuity hypothesis) or whether these forms of depression are qualitatively distinct. Method: This study compared 161 outpatients with major depressive disorder to 148 ‘analogue’ subjects (college students with a Beck Depression Inventory score ≥9) and 141 non-distressed controls. Study measures included several proposed personality vulnerability factors for depression, a measure of developmental experiences that may confer vulnerability to adult depression, and family history of emotional disorders. Results: Most comparisons of personality vulnerability factors, developmental experiences and family history information followed a pattern of greatest risk in the clinical group, intermediate risk in the analogue group and lowest risk in the non-distressed group. Noteworthy exceptions included several aspects of perfectionism and a number of childhood experiences reflecting parental over-control, which appeared to be more strongly associated with analogue depression than clinical depression. Implications: Several personality and developmental variables could represent important areas of discontinuity between clinical and analogue depression. However, the overall results were consistent with a growing body of literature suggesting continuity between subthreshold depression symptoms and syndromal depression.

Excessive reassurance seeking: delineating a risk factor involved in the development of depressive symptoms.

Six studies investigated (a) the construct validity of reassurance seeking and (b) reassurance seeking as a specific vulnerability factor for depressive symptoms. Studies 1 and 2 demonstrated that reassurance seeking is a reasonably cohesive, replicable, and valid construct, discernible from related interpersonal variables. Study 3 demonstrated that reassurance seeking displayed diagnostic specificity to depression, whereas other interpersonal variables did not, in a sample of clinically diagnosed participants. Study 4 prospectively assessed a group of initially symptom-free participants, and showed that those who developed future depressive symptoms (as compared with those who remained symptom-free) obtained elevated reassurance-seeking scores at baseline, when all participants were symptom-free, but did not obtain elevated scores on other interpersonal variables. Studies 5 and 6 indicate that reassurance seeking predicts future depressive reactions to stress. Taken together, the six studies support the construct validity of reassurance seeking, as well as its potential role as a specific vulnerability factor for depression.

Protective and vulnerability factors of depression in normal adolescents

The present study investigated the role of various protective and vulnerability factors in the development of depressive symptoms. A sample of normal adolescents ( N=373) completed the Children’s Depression Inventory and measures of a negative attributional style, parental rearing behaviour, coping styles, and perceived self-efficacy. In addition to computing the correlations between depression and these protective and vulnerability factors, the present data were also subjected to structural equations modelling to examine the correlational structure of the data. Depression was accompanied by high levels of parental rejection, negative attributions, and passive coping, and by low levels of active coping and self-efficacy. Furthermore, a model in which negative parental rearing behaviour and a negative attributional style featured as the primary sources of depression, while coping styles and self-efficacy played a mediating role in the formation of depressive symptoms, provided a reasonable fit for the data.

The Relative Specificity of Excessive Reassurance-Seeking to Depressive Symptoms and Diagnoses Among Clinical Samples of Adults and Youth

In addition to playing a role in the deterioration of depressed people's interpersonal environment, excessive reassurance-seeking may be implicated as a vulnerability factor for depression. If so, excessive reassurance-seeking should display relative specificity to depression versus other forms of psychopathology. Two studies of psychiatric inpatients (Study 1 on adults and Study 2 on children) tested this possibility. In Study 1 a Depressed group obtained higher reassurance-seeking scores than an Other Disorders group did. Similar findings were obtained in Study 2, such that depressed youth reported higher reassurance-seeking than nondepressed youth. Hence, these two studies of psychiatric inpatients provided reasonable support for the specificity of excessive reassurance-seeking to depression as compared to other forms of psychopathology.

People With External Preoccupation Are Vulnerable to Depression: A Longitudinal Study

External preoccupation, the tendency to maintain an external focus of attention on a specific object, is believed to be a vulnerability factor for depression. The present study is an investigation of this hypothesis in a longitudinal design. At Time 1, external preoccupation as well as depressive symptoms were assessed. At Time 2, 4 months later, life events experienced between Time 1 and Time 2 and depressive symptoms at Time 2 were assessed. Data from 195 undergraduates (147 men and 48 women) were analyzed. The results supported the hypothesis. Specifically, when reporting a greater number of negative life events, those who scored high on external preoccupation became more depressed than those who scored low on that tendency. When there was a smaller number of negative events, this difference disappeared.

COMMENTARIES

As reflected in the title of Coyne's (1976b) article Toward an Interactional Description of Depression, his formulation was meant as an incompletely theorized description of processes linking depression to its interpersonal context and not as a definitive fonnal model (Coyne, 1999). The past two decades have seen a burgeoning of empirical investigations adopting an interactional perspective in exploring the context of distress and depression. Joiner and his colleagues have provided the impetus for some of the most creative of this research, and we applaud the enthusiasm and the perseverance this group has shown in extending and refining Coyne's original theoretical statement. Coyne's initial test of hypotheses, derived from his interpersonal perspective (Coyne, 1 976a), failed to identify exactly what depressed persons did that led to rejection and mood induction in those with whom they interacted. In passing, Coyne offered some post hoc speculation that the nonreciprocal disclosure of intimate problems by depressed persons might be the source of these effects. He did not pursue this question further, but others reported mixed findings (Jacobson & Anderson, 1982; Lynn & Bates, 1985). This suggested that high disclosure was not solely responsible for the response of others. For a time, too much of the work that followed consisted of little more than cookie-cutter variations on the original Coyne (1976a) study. However, in recent years, Joiner and colleagues have promoted the notion that reassurance-seeking is responsible for the effects of distressed and depressed persons on others. In a series of studies, they tested Coyne's (1976b) initial hypothesis that depressed persons engage in supportseeking that leads to their rejection (e.g., Joiner, 1994; Joiner, Alfano, & Metalsky, 1992). Based on this research, the authors have been successful in establishing that reassurance-seeking is a discernible feature of the interpersonal behavior associated with distress and depression. In their target article, Joiner, Metalsky, Katz, and Beach (this issue) argue that reassurance-seeking can be viewed both as a vulnerability factor for depression and as an explanation of depression's consequences. Our commentary identifies some specific challenges to establishing reassurance-seeking in each of these two roles. With some open-minded skepticism, we raise several issues with an interest in opening a larger discussion of how an interpersonal description of depression can best be developed.

Inherited Hypohedonia Leads to Learned Helplessness: A Conjecture Updated

The reformulated learned helplessness theory posits depressogenic explanatory style (DES) as a vulnerability factor in depression. Early-life adversity has been suggested as the source of DES, but this is contradicted by empirically established features of the learned helplessness phenomenon itself and by the evidence for human resilience in the face of adversity. This article extends a conjecture first advanced by P. E. Meehl (1975) and argues that an inherited defect in hedonic capacity would be sufficient to produce DES by causing intermittent schedules of reinforcement to be experienced as extinction schedules, resulting in a pervasive and unremitting sense of helplessness. This proposed hedonic defect also provides a means for integrating the original and reformulated versions of learned helplessness theory and for integrating learned helplessness with emerging research and theory on the biology of vulnerability to depression.

Biased information processing as a vulnerability factor for depression

Individuals who become clinically depressed once are more likely than are their never-depressed counterparts to experience a future episode of depression. This finding suggests that there is a stable vulnerability factor, or set of factors, that predisposes some individuals to become depressed repeatedly over the course of their lives. Cognitive theories of depression (e.g., Beck, 1967 , Beck, 1976 ) contend that negatively biased information processing may constitute such a vulnerability factor for the onset and/or maintenance of depression. In this paper, we review research using information-processing paradigms that examines depression-associated biases in attention to, and memory for, negative information. We conclude that there is strong evidence that depression is associated with concurrent information-processing biases. Moreover, based on the results of recent priming studies, we argue further that some aspects of cognitive functioning, particularly those involving memory processes, may indeed represent a vulnerability factor for depression. We conclude this paper with a discussion of implications of this line of research for the prevention and treatment of depression.

The role of biased information processing in depression: Evaluation and implications for treatment

Gotlib and Krasnoperova (1998) review research using information-processing methodologies to determine whether biases in attention and memory are a vulnerability factor in depression. They argue that some aspects of cognitive processing may represent a vulnerability factor for depression and propose treatment and prevention interventions based on this line of research. In this paper, we discuss the conceptual issues related to the role of vulnerability in psychopathology and attempt to identify where and why additional research is necessary in designing new prevention and treatment strategies. We stress the importance of having a well-specified theory of how a vulnerability factor leads to depression and we examine conceptual problems such as specificity of outcome, the measurement of depression, relative and attributable risk, and sensitivity and specificity of the vulnerability factor. We conclude by evaluating the prevention and treatment proposals derived from this line of research and emphasize that, while this is a promising direction, such interventions must themselves be evaluated.

Inherited hypohedonia leads to learned helplessness: A conjecture updated.

The reformulated learned helplessness theory posits depressogenic explanatory style (DES) as a vulnerability factor in depression. Early-life adversity has been suggested as the source of DES, but this is contradicted by empirically established features of the learned helplessness phenomenon itself and by the evidence for human resilience in the face of adversity. This article extends a conjecture first advanced by P. E. Meehl (1975) and argues that an inherited defect in hedonic capacity would be sufficient to produce DES by causing intermittent schedules of reinforcement to be experienced as extinction schedules, resulting in a pervasive and unremitting sense of helplessness. This proposed hedonic defect also provides a means for integrating the original and reformulated versions of learned helplessness theory and for integrating learned helplessness with emerging research and theory on the biology of vulnerability to depression.

Vulnerability factors in depression: The facets of sociotropy and autonomy

Sociotropy-autonomy (Beck, 1983) describes a set of personality dimensions that relate to an individual's vulnerability to depression. Two recently developed scales, the Sociotropy-Autonomy Scale (Clark & Beck, 1991) and the Personal Style Inventory (Robinset al., 1994), have been developed in order to assess these personality dimensions. Typically, these measures are used in isolation and little published information is available concerning their interrelationship. The present study examined the relationship between the two scales and specified the various factors that emerge when the items of the two scales are integrated. Six hundred fifty-two participants responded to the Personal Style Inventory (Robinset al, 1994) and the Sociotropy-Autonomy Scale (Clark & Beck, 1991). A factor analysis on all of the items of the two scales revealed a five-factor structure (two sociotropy, two autonomy, and one achievement factor). The relationships among depression, the five derived factors, and the original scales developed by Clark and Beck (1991) and Robinset al. (1994) were critically examined. The results are discussed in the context of vulnerability to depression.