Teoría de la depresión por desesperanza : aportaciones recientes

La teoría de desesperanza de la depresión o teoría de la depresión por desesperanza, propuesta por Abramson, Metalsky y Alloy (Psychological Review, 96, 358-372,1989), establece que las personas que poseen estilos inferenclales negativos (l.e., vulnerabilidad cognitiva) son más propensas a desarrollar síntomas depresivos (más específicamente los síntomas del subtipo "depresión por desesperanza') cuando experimentan sucesos vitales negativos que las personas que no poseen dichos estilos. En el presente artículo resumimos nuevos hallazgos empíricos que apoyan dicha teoría, principalmente los provenientes del Temple-Wisconsln Cognitive Vulnerability to Depression Project, un proyecto en el que se utiliza prospectivamente la estrategia de alto riesgo conductual con la que se prueba la hipótesis de vulnerabilidad y de mediación causal de la teoría de desesperanza de la depresión. En concreto analizamos (1) resultados retrospectivos y prospectivos referidos al Eje I (trastornos depresivos, incluido el subtipo de depresión por desesperanza), (2) la vulnerabilidad cognitiva y los trastornos de personalidad concurrentes (Eje II), (3) los mecanismos mediante los cuales los estilos cognitivos incrementan la vulnerabilidad para la depresión, y (4) el maltrato infantil como posible factor causal de la vulnerabilidad cognitiva para la depresión. También se discute la evidencia relevante para la integración de la teoría de la desesperanza y la vulnerabilidad biológica para la depresión. Finalmente, se ponen de relieve posibles implicaciones para la prevención y tratamiento de la depresión

Investigating the interaction between sleep symptoms of arousal and acquired capability in predicting suicidality

Heightened arousal significantly interacts with acquired capability to predict suicidality. We explore this interaction with insomnia and nightmares independently of waking state arousal symptoms, and test predictions of the Interpersonal Theory of Suicide (IPTS) and Escape Theory in relation to these sleep arousal symptoms. Findings from our e-survey (n= 540) supported the IPTS over models of Suicide as Escape. Sleep-specific measurements of arousal (insomnia and nightmares) showed no main effect, yet interacted with acquired capability to predict increased suicidality. The explained variance in suicidality by the interaction (1-2%) using sleep specific measures were comparable to variance explained by interactions previously reported in the literature using measurements composed of a mix of waking and sleep state arousal symptoms. Similarly, when entrapment (inability to escape) was included in models, main effects of sleep symptoms arousal were not detected yet interacted with entrapment to predict suicidality. We discuss findings in relation to treatment options suggesting that sleep specific interventions be considered for the long term management of at risk individuals

Partner behavioral responses to pain mediate the relationship between partner pain cognitions and pain outcomes in women with provoked vestibulodynia

Partner behavioral responses to pain can have a significant impact on patient pain and depression, but little is known about why partners respond in specific ways. Using a cognitive-behavioral model, the present study examined whether partner cognitions were associated with partner behavioral responses, which prior work has found to predict patient pain and depressive symptoms. Participants were 354 women with provoked vestibulodynia and their partners. Partner pain-related cognitions were assessed using the partner versions of the Pain Catastrophizing Scale and Extended Attributional Style Questionnaire, whereas their behavioral responses to pain were assessed with the Multidimensional Pain Inventory. Patient pain was measured using a numeric rating scale, and depressive symptoms were assessed using the Beck Depression Inventory–II. Path analysis was used to examine the proposed model. Partner catastrophizing and negative attributions were associated with negative partner responses, which were associated with higher patient pain. It was also found that partner pain catastrophizing was associated with solicitous partner responses, which in turn were associated with higher patient pain and depressive symptoms. The effect of partner cognitions on patient outcomes was partially mediated by partner behavioral responses. Findings highlight the importance of assessing partner cognitions, both in research and as a target for intervention. Perspective The present study presents a cognitive-behavioral model to partially explain how significant others' thoughts about pain have an effect on patient pain and depressive symptoms. Findings may inform cognitive-behavioral therapy for couples coping with PVD

Evaluation of a Dutch school-based depression prevention program for youths in highrisk neighborhoods: study protocol of a two-armed randomized controlled trial

Contains fulltext : 102517.pdf (publisher's version ) (Open Access)Background Research has indicated that depression prevention programs attenuate the development of symptoms of depression in adolescents. To implement these programs on a large scale, implementation in a school setting with teachers providing the programs is needed. In the present study, the effectiveness of the Dutch depression prevention program Op Volle Kracht (OVK) provided by school teachers during school hours with adolescents from high risk neighborhoods will be tested. The mediating effects of cognitive distortions and alexithymia will be evaluated as well. We hypothesize that the OVK program will prevent or decrease reported depressive symptoms, and that this association will be mediated by cognitive distortions and alexithymia. Methods/Design Schools with at least 30% of their pupils living in low income areas in the Netherlands are invited to participate in the study. Classes from vocational training up to pre-university level are eligible and 1324 adolescents (11-14 years) will be participating in the study. Randomisation will be done at class level, randomly assigning participants to an intervention group (OVK) and a control group (care as usual), stratifying by school level (high versus low). Trained school teachers will be delivering the program, which covers cognitive-behavioral and social problem-solving skills. Longitudinal data will be collected with self-report measurements administered in the school setting at baseline, post intervention and at two follow ups (at 6 and 12 months). Primary outcome is the level of depressive symptoms, and secondary outcomes include: cognitive errors, response style, attributional style, alexithymia, stressful life events, substance use, happiness, and school grades. Discussion If the OVK program proves to be effective when it is provided by school teachers, a structural implementation of the program in the school curriculum will enhance the quality of the lives of adolescents and their families and will reduce costs in health care. In addition, the results of the study advances current knowledge on the underlying mechanisms of the development of depression and may aid the improvement of depression prevention programs in general.7 p

Studying the role of cognition in depression: Well-trodden paths and cul-de-sacs

In their commentary on our earlier review (Coyne & Gotlib, 1983), Segal and Shaw minimize the problems faced by the cognitive approach to the study of depression. Their repeated references to cognitive processes that are latent and therefore not reported by subjects represent a substantial retreat from empiricism. In general, the notion of schema or schematic processing remains problematic. Published research does not support the existence of an identifiable cognitive vulnerability to depression. Other conceptual, methodological, and empirical difficulties are noted. We argue that the central defect in current cognitive approaches to depression is their inattention to the difficulties faced by depressed persons in their everyday environments, how they cope, and with what consequences.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44332/1/10608_2005_Article_BF01173755.pd

Narcissistic Features in Young Adolescents: Relations to Aggression and Internalizing Symptoms

Recent research and theory suggest narcissistic features contribute to aggression in adults. The present study examined the association of narcissistic features with aggression and internalizing symptoms in 233 students of 5th–8th grade at three inner-city schools. A factor analysis of the Narcissistic Personality Inventory in this sample revealed three factors: Adaptive Narcissism, Exploitativeness, and Exhibitionism. Regression analyses were used to predict the association of these three narcissistic features with self-, teacher-, and peer-reported aggression and self-reported internalizing symptoms. Results indicate narcissistic exploitativeness positively predicted self-reported proactive aggression, and narcissistic exhibitionism positively predicted internalizing symptoms. Narcissism and self-esteem interacted to predict teacher-reported aggression and self-reported internalizing symptoms. Results are discussed in the context of existing theories of narcissism, threatened egotism, and self-perception bias.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45298/1/10964_2004_Article_485227.pd

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

The relation of self-hatred and suicidality in people with schizophrenia-spectrum symptoms

It is well known that depressive symptoms represent a risk for suicidality in general. It is less clear, however, that general depressive symptoms comprise a definite suicide risk factor for people with schizophrenia. Based on this, as well as on the early writings of E. Bleuler (1911/1987), it was hypothesized that there may be a particular aspect of depressive symptoms that combines with schizophrenia to encourage suicidality. Specifically, schizophrenia may impart to self-concept a quality of self-hatred that encourages suicidality in schizophrenic people. If so, then an index of self-hatred should be more correlated with suicidality among people with schizophrenia-spectrum symptoms than among people with fewer such symptoms. Two studies evaluated this possibility. In Study 1 on 243 suicidal outpatients affiliated with the military, self-hate and suicidality were more correlated among people with schizotypal symptoms than among other patients. In Study 2 on 113 VA psychiatric inpatients, self-hate and suicidality were more correlated among people with a diagnosis of schizophrenia than among patients with a diagnosis of major depression. Study limitations were noted, and it was suggested that self-hatred be a focus of suicide risk assessment in schizophrenic people