Depression

 

Denoma, J.M., Berlin, M.T., Fleck, M.P., & Joiner, T.E. (in press). Double Depression in Adult Psychiatric Outpatients in Brazil: Distinct from Major Depression? Psychiatry Research.

     This study examines whether distinct symptom profiles, patterns of comorbidity, and suicidal symptoms uniquely characterize individuals diagnosed with double depression (DD) by comparing Brazilians with DD to those with major depressive disorder (MDD). One hundred forty two psychiatric outpatients (ages 20-77 (M = 48.8, SD = 13.2); DD n=23; MDD n=119) participated in structured diagnostic interviews and completed self-report measures of depressive symptoms, suicidality, and family history of mental disorders. Patients with DD exhibited a more severe symptom profile than those with MDD, as evidenced by a higher number of depressive symptoms and more intense suicidal ideation. They also appeared to be qualitatively different that individuals with MDD, as evidenced by distinct comorbidity patterns, quality of life reports, and anhedonic features. These results may be important in understanding the phenomenology of DD in psychiatric outpatients by informing diagnostics, psychotherapy, and psychotherapeutic treatment of DD.

 

Joiner, Jr., T.E., Brown, J.S., Metalsky, G.I. (2003) A test of the tripartite model's prediction of anhedonia's specificity to depression: Patients with major depression versus patients with schizophrenia. Psychiatry Research, 119, 243-250.

    The tripartite model of depression and anxiety suggests that anhedonia represents a relatively specific marker of depression. A strong version of this view is that anhedonic symptoms would particularly characterize depressed patients, even when compared to another diagnostic group of schizophrenic patients for whom anhedonic symptoms represent a well-studied feature. This prediction was tested among 102 VA psychiatric inpatients (95men), ages 21-72 (M = 43.56; S.D.s 8.47), all of whom received diagnoses of either major depression (n = 50 ) or schizophrenia (n = 52) based on structured diagnostic interviews. As predicted, patients with major depression scored significantly higher on the anhedonic symptoms scale of the Beck Depression Inventory (BDI) than did patients with schizophrenia. However, there was no difference between the two groups on the BDI total score or the BDI non-anhedonic symptoms score. Consistent with the tripartite model, anhedonic symptoms were more related to depressive vs. schizophrenic diagnostic status, whereas non-anhedonic depressive symptoms were not. Within the study's limitations, results were interpreted as relatively strong support for the validity and extension of the tripartite model.

 

Joiner, T.E. Jr., Cook, J.M., Hersen, M., & Gordon, K.H. (in press). Double depression in older adult psychiatric outpatients: Hopelessness as a defining feature. Journal of Affective Disorders.

  Background: There is a paucity of research on the distinguishing features of double depression, particularly in older adults. Preliminary studies have revealed that individuals with double depression diagnoses tend to have more severe depression than individuals with major depression or dysthymia alone, but few other distinctions between the diagnostic categories have been found. Method: We examined the possibility that hopelessness particularly characterizes double depression, by comparing older adults with double depression, dysthymia alone, or major depression alone, on hopelessness, as well as on internal and external locus of control. The sample included 54 older psychiatric outpatients who completed a battery of cognitive and symptom measures, and underwent structured clinical interviews. Results: Double depressed patients showed high levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness. Low internal locus of control characterized both groups with a dysthymia diagnosis (dysthymia alone and double depression), and differentiated them from the group with major depression alone. Limitations: The sample size was modest, and the results may not generalize to older adults with different demographic characteristics. Conclusions: Hopelessness may be important in understanding the phenomenology of double depression in older adults, and may inform diagnostics and psychotherapeutics as well.

 

Joiner, T., Kistner, J., Stellrecht, N. & Merrill, K. (in press). On seeing clearly and thriving: Interpersonal perspicacity as adaptive (not depressive) realism (or where three theories meet). Journal of Social & Clinical Psychology.

  Does realism characterize good mental health or maladjustment? In this paper, it is argued that illusory views of social reality, even if self-enhancing, represent a feature of mental distress (not health). Two studies of unselected undergraduates and their same-sex roommates were reported. In Study 1, 466 undergraduates completed a measure of depressive symptoms, and provided global self-ratings; their roommates provided ratings
of them. A curvilinear relation between self-other discrepancies and depressive symptoms was detected, in which discrepancies of any kind (even if self-enhancing) were associated with higher depressive symptoms. Using a similar design, Study 2 (N = 143) replicated this finding and extended it to other symptoms and to longitudinal analyses. It is concluded that illusory views of interpersonal reality (even if self-enhancing), far from bolstering adjustment, represent a pattern of attitudes that typifies maladjustment.