Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-26T12:19:23.779Z Has data issue: false hasContentIssue false
  • English
  • Français

Specificity and Persistence of Cognitive-Dynamic Characteristics in Elderly Depression*

Published online by Cambridge University Press:  29 November 2010

Alexandra Bachelor
Alexandra Bachelor
Affiliation:
Université Laval
Get access Rights & Permissions [Opens in a new window]

Abstract

Given the lack of research in clinically depressed elders, and drawing on an integrative perspective, this study examined predictions of three prominent psychological models of depression (cognitive, learned helplessness, and psychodynamic theory) in a sample of elderly depressed patients. The hypothesized specificity to depression and stability of representative psychological characteristics were evaluated by comparing levels of 25 clinically depressed elders, 20 nondepressed psychiatric controls and 28 nondepressed medical controls, at hospitalization (Tl), discharge (T2) and five months later (T3). Also, the relative contribution of theory-based variables to depression severity at discharge and at follow-up was explored. While elderly depressed patients showed, overall, significantly higher levels of maladaptive cognitions, biased attributions, and selected depressogenic personality traits than medical controls, these variables did not discriminate among depressives and psychiatric controls, with the exception of negative automatic thinking, and pessimistic attributions in females. Positive attributional style and hedonism did not discriminate among subject groups. Support was found for the stability, in the depressed group, of purportedly traitlike characteristics through hospitalization to follow-up. Multiple regression analyses indicated that initial symptomatology level was the strongest predictor of both discharge and follow-up depression severity, whereas selected variables from each theoretical model contributed marginally, depending on the time of assessment.

Résumé

Étant donné le peu d'études chez les aîné(e)s souffrant de dépression clinique, et s'inspirant d'une perspective intégrative, cette recherche avait pour objet d'examiner les postulate théoriques de trois modèles psychologiques majeurs de la dépression (cognitif, de la résignation acquise, et psychodynamique) auprès d'un échantillon de patient(e)s âgé(e)s déprimé(e)s. La prétendue spécificité à la dépression ainsi que la stabilité de caractéristiques représentatives furent évaluées en comparant les niveaux de 25 aîné(e)s cliniquement déprimé(e)s, 20 patient(e)s psychiatriques non-déprimé(e)s, et 28 patient(e)s non psychiatriques, lors de l'hospitalisation, du congé de l'hôpital, et cinq mois plus tard. Aussi, la contribution relative des variables psychologiques à la gravité de la dépression au moment du congé de l'hôpital et cinq mois plus tard fût explorée. Bien que les aîné(e)s déprimé(e)s ont, sur l'ensemble des trois temps, démontré des niveaux significativement plus élevés de cognitions maladaptées, d'attributions biaisées, et de traits de personnalité dépressogéniques que les aîné(e)s non-psychiatriques, ces variables n'ont pas différencié les déprimé(e)s des patient(e)s psychiatriques non-déprimé(e)s, à l'exception des pensées négatives automatiques et, chez les femmes, des attributions pessimistes. Un style positif d'attribution et l'hédonisme n'ont pas différencié les trois groupes de patient(e)s entre eux. Les résultats ont confirmé chez les déprimé(e)s la stabilité, de l'hospitalisation au suivi, decaractéristiques censées représenter des traits. Enfin, par le biais d'analyses de régression, le niveau initial de symptomatologie s'est avéré le prédicteur le plus important de la gravité de la dépression tant au congé de l'hôpital qu'au suivi, alors que des variables spécifiques de chaque modèle théorique y ont apporté une contribution marginale, selon la phase de l'évaluation.

Keywords

DepressionCognitionsAttributional StylePersonality Traits.Dépressioncognitionattributiontraits de personnalité.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 15 , Issue 2 , Été/Summer 1996 , pp. 198 - 225
Copyright
Copyright © Canadian Association on Gerontology 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abraham, K. (1960). The first pregenital stage of the libido. In Selected papers in psychoanalysis. New York: Basic Books (Original work published 1916).Google Scholar
Abramson, L.Y., Seligman, M.E.P., & Teasdale, J. (1978). Learned helplessness in humans: Critic and reformulation. Journal of Abnormal Psychology, 87, 49–74.Google Scholar
Akiskal, H., & McKinney, W. Jr, (1975). Overview of recent research in depression: Integration often conceptual models into a comprehensive clinical frame. Archives of General Psychiatry, 32, 285.Google Scholar
Alloy, L., Hartlage, S., & Abramson, L. (1988). Testing the cognitive diathesis-stress theories of depression: Issues of research design, conceptualization, and assessment. In Alloy, L.B. (Ed.), Cognitive processes in depression (pp. 31–68). New York: Guilford Press.Google Scholar
Altman, J., & Wittenborn, J. (1980). Depression-prone personality in women. Journal of Abnormal Psychology, 89, 303–309.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC.Google Scholar
Arieti, S., & Bemporad, J. (1978). Severe and mild depression: Thepsychotherapeutic approach. New York: Basic Books.Google Scholar
Arieti, S., & Bemporad, J. (1980). The psychological organization of depression. American Journal of Psychiatry, 137, 1360–1365.Google ScholarPubMed
Beck, A.T. (1967). Depression: Clinical, experimental and theoretical aspects. New York: Harper & Row.Google Scholar
Beck, A.T. (1976). Cognitive Therapy and the Emotional Disorders. New York: Harper & Row.Google Scholar
Beck, A.T., & Beamesderfer, A. (1974). Assessment of depression: The Depression Inventory. In Pinchot, P. (Ed.), Psychological measurement in pharmacopsy-chiatry (Vol. 7). Basel: Harger.Google Scholar
Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1974). Cognitive Therapy of Depression: A Treatment Manual. New York: Guilford.Google Scholar
Beck, A.T., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An Inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Billings, A., & Moss, R. (1982). Psychosocial theory and research on depression: An integrative framework and review. Clinical Psychology Review, 2, 213–237.Google Scholar
Birtchnell, J. (1984). Dependence and its relationship to depression. British Journal of Medical Psychology, 57, 215–225.CrossRefGoogle ScholarPubMed
Birtchnell, J., & Kennard, J. (1983). What does the Dependency Scale of the MMPI really measure? Journal of Clinical Psychology, 39, 532–543.Google Scholar
Blaney, P., Behar, V., & Head, R. (1980). Two measures of depressive cognitions: Their association with depression and with each other. Journal of Abnormal Psychology, 89, 678–682.Google Scholar
Blazer, D.G. (1982). Depression in late life. St. Louis, MO: Mosby.Google Scholar
Breslau, L. (1983). Exploring causal factors. In Breslau, L. & Haug, M. (Eds.), Depression and aging. New York: Springer.Google Scholar
Brown, J., & Silbershiatz, G. (1989). Dependency, self-criticism, and depressive attributional style. Journal of Abnormal Psychology, 98, 187–188.CrossRefGoogle ScholarPubMed
Butcher, J., Aldwin, C., Levenson, M., Ben-Porath, Y., Spiro, A., & Bossé, R. (1991). Personality and aging: A study of the MMPI-2 among older men. Personality and Aging, 6, 361–370.Google ScholarPubMed
Cappeliez, P. (1988). Quelques considérations sur la prévalence et I'étiologie des états dépressifs de la personne âgée. Canadian Journal on Aging, 7(4), 417–430.CrossRefGoogle Scholar
Chaisson-Stewart, G. (1985). Depression in the Elderly: An inter-disciplinary approach. New York: J. Wiley & Sons.Google Scholar
Chodoff, P. (1972). The depressive personality: A critical review. International Journal of Psychiatry, 27, 196–217.Google ScholarPubMed
Cofer, D., & Wittenborn, J. (1980). Personality characteristics of formerly depressed women. Journal of Abnormal Psychology, 89, 309–314.CrossRefGoogle ScholarPubMed
Costa, P., McCrae, R., Zonderman, A., Barbano, H., Lebowitz, B., & Larson, D. (1986). Cross-sectional studies of personality in a national sample: 2. Stability in neuroticism, extraversion, and openness. Psychology and Aging, 2, 144–149.CrossRefGoogle Scholar
Coyne, E., & Gotlib, I. (1983). The role of cognition in depression: A critical appraisal. Psychological Bulletin, 94, 472–505.CrossRefGoogle ScholarPubMed
Craighead, W. (1980). Away from a unitary model of depression. Behavior Therapy, 11, 122–128.CrossRefGoogle Scholar
Depue, R.A., & Monroe, S.M. (1978). Learned helplessness in the perspective of the depressive disorders. Conceptual and definitional issues. Journal of Abnormal Psychology, 87, 3–21.CrossRefGoogle ScholarPubMed
Dobson, K.S., & Breiter, H.J. (1983). Cognitive assessment of depression: Reliability and validity of three measures. Journal of Abnormal Psychology, 92, 107–109.Google Scholar
Dobson, K.S., & Shaw, B.F. (1986). Cognitive assessment with major depressive disorders. Cognitive Therapy and Research, 10, 13–29.CrossRefGoogle Scholar
Dohr, K., Rush, J., & Bernstein, I. (1989). Cognitive biases and depression. Journal of Abnormal Psychology, 98, 263–267.CrossRefGoogle ScholarPubMed
Eaves, G., & Rush, A. (1984). Cognitive Patterns in symptomatic and remitted unipolar major depression. Journal of Abnormal Psychology, 93, 32–40.Google Scholar
Eusanio, A.M. (1977). Personality characteristics of depressed women. Unpublished dissertation, Rutgers University, University Microfilm No. 78–5075.Google Scholar
Form, A.J. (1987). Sex and age differences in depression: A quantitative synthesis of published research. Australian and New Zealand Journal of Psychiatry, 21, 46–53.Google Scholar
Fry, P.S., & Grover, S.C. (1982). Cognitive appraisals of life stress and depression in the elderly: A cross-cultural comparison of Asians and Caucasians. International Journal of Psychology, 17, 434–454.Google Scholar
Gallagher, D., Breckenridge, J., Steinmetz, J., & Thompson, L. (1983). The Beck Depression Inventory and Research Diagnostic Criteria: Congruence in an older population. Journal of Consulting and Clinical Psychology, 51, 945–946.CrossRefGoogle Scholar
Gallagher, D., Nies, G., & Thompson, L. (1982). Reliability of the Beck Depression Inventory with older adults. Journal of Consulting and Clinical Psychology, 51, 945–946.Google Scholar
Gauthier, J., Thériault, F., Morin, C., & Lawson, J. (1982). Adaptation française d'une mesure d'auto-évaluation de I'intensité de la dépression. Revue Canadienne des Sciences du Comportement, 13–27.Google Scholar
Golin, S., Sweeney, P.D., & Shaeffer, D.E. (1980). The causality of causal attributions in depression: A cross-lagged panel correlational analysis. Journal of Abnormal Psychology, 90, 14–22.CrossRefGoogle Scholar
Griffin, P., & Kogut, D. (1988). Validity of orally administered Beck and Zung depression scales in a state hospital setting. Journal of Clinical Psychology, 44, 756–759.3.0.CO;2-Z>CrossRefGoogle Scholar
Grosscup, S.J., & Lewinsohn, P.M. (1980). Unpleasant and pleasant events, and mood. Journal of Clinical Psychology, 36, 252–259.Google Scholar
Hamilton, E., & Abramson, L. (1983). Cognitive Patterns and Major Depressive Disorder: A longitudinal study in a hospital setting. Journal of Abnormal Psychology 92, 173–725.CrossRefGoogle ScholarPubMed
Harrel, T.H., & Ryon, N.B. (1983). Cognitive — behavioral assessment of depression: Clinical validation of the Automatic Thoughts Questionnaire. Journal of Consulting and Clinical Psychology, 51, 721–725.Google Scholar
Harvey, D. (1981). Depression and attributional style: Interpretations of important personal events. Journal of Abnormal Psychology, 90, 134–142.CrossRefGoogle ScholarPubMed
Heimberg, R.G., Klosko, J., Dodge, C., Shadick, R., Becker, R., & Barlow, D. (1989). Anxiety disorders, depression, and attributional style: A further test of the specificity of depressive attributions. Cognitive Therapy and Research, 13, 21–36.CrossRefGoogle Scholar
Hirschfeld, R., Klerman, G., Clayton, P., Keller, M., McDonald-Scott, M., & Larkin, B. (1983). Assessing personality: Effects of the depressive state in trait measurement. American Journal of Psychiatry, 140, 695–699.Google Scholar
Hirschfeld, R., Klerman, G., Gough, H, Barrett, J., Korchin, S, & Chodoff, P. (1977). A Measure of Interpersonal Dependency. Journal of Personality Assessment, 41, 610–618.CrossRefGoogle ScholarPubMed
Hoffman, H. (1970). Personality patterns of depression and its relation to acquiescence. Psychological Reports, 26, 459–464.CrossRefGoogle Scholar
Hollon, S.D., & Kendall, P. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4, 383–397.Google Scholar
Hollon, S.O., Kendall, P.C., & Lumry, A. (1986). Specificity of depressotypic cognitions in clinical depression. Journal of Abnormal Psychology, 95, 52–59.CrossRefGoogle ScholarPubMed
Hussian, G. (1981). Geriatric Psychology. A Behavioral Perspective. New York: Van Nostrand.Google Scholar
Hyer, L., & Blount, J. (1984). Concurrent and discriminant validities of the Geriatric Depression Scales with older psychiatric inpatients. Psychological Reports, 54, 611–616.CrossRefGoogle ScholarPubMed
Isaacs, K., & Silver, R. (1980). Cognitive structure in depression. Paper presented at the meeting of the Association for Advancement of Behavior Therapy, New York.Google Scholar
Jackson, D. (1974). Personality Research Form Manual. New York: Research Psychologists Press, Inc.Google Scholar
Jackson, D. (1983). Questionnaire de recherche sur la personnalité. Formule E. London: Research Psychologists Press, Inc.Google Scholar
Jackson, D. (1984). Personality Research Form Manual (3rd ed.). Michigan: Sigma Assessment Systems Inc.Google Scholar
Johnson, J.E., Petzel, T.P., & Munic, D. (1986). An examination of the relative contribution of depression versus global psychopathology to depressive attributional style in a clinical population. Journal of Social and Clinical Psychology, 4, 107–113.Google Scholar
Keppel, G. (1982). Design and Analysis: A researcher's handbook (2nd ed.). Engle-wood Cliffs, NJ: Prentice Hall.Google Scholar
Kovacs, M., & Beck, A. (1978). Maladaptive cognitive structures in depression. American Journal of Psychiatry, 135, 525–533.Google ScholarPubMed
Lachman, M. (1990). When bad things happen to older people: Age differences in attributional style. Psychology and Aging, 5, 607–609.Google Scholar
Lam, D., Brewing, C., Woods, R., & Bebbington, P. (1987). Cognition and social adversity in the depressed elderly. Journal of Abnormal Psychology, 96, 23–26.Google Scholar
Leaf, P., Berkman, C., Weissman, M., Holzer, C., Tischer, C., & Myers, J. (1988). The epidemiology of late-life depression. In Brody, J.A. & Maddox, G.L. (Eds.), Epidemiology and Aging (pp. 117–133). New York: Springer.Google Scholar
Lewinsohn, P. (1974). A behavioral approach to depression. In Friedman, R.J. & Katz, M.M. (Eds.), The psychology to depression: Contemporary theory and research. New York: Wiley.Google Scholar
Lewinsohn, P.M., Rohde, P., Seeley, J., & Fischer, S. (1991). Age and depression: Unique and shared effects. Psychology and Aging, 6, 247–260.CrossRefGoogle ScholarPubMed
Lewinsohn, R., Hoberman, H., & Rosenbaum, M. (1988). A prospective study of risk factors for unipolar depression. Journal of Abnormal Psychology, 97, 251–264.CrossRefGoogle ScholarPubMed
Love, A. (1988). Attributional style of depressed chronic low back patients. Journal of Clinical Psychology, 44, 317–321.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
MacPhillamy, D.J., & Lewinsohn, P.J. (1974). Depression as a function of levels of desired and obtained pleasure. Journal of Abnormal Psychology, 83, 651–657.Google Scholar
McClelland, D.C. (1958). Methods of measuring human motivation. In Atkinson, J.W. (Ed.), Motives in fantasy, action, and society. Princeton, NJ: Van Nostrand-Reinhold.Google Scholar
Miller, D., & Moretti, M. (1988). The causal attributions of depressives: Self-serving or self-disserving? In Alloy, L.B. (Ed.), Cognitive processes in depression (pp. 266–286). New York: Guilford Press.Google Scholar
Miller, I.W., Klee, S.H., & Norman, W.H. (1982). Depressed and nondepressed inpatients' cognitions of hypothetical events, experimental tasks, and stressful life events. Journal of Abnormal Psychology, 91, 78–81.Google Scholar
Miller, I.W., & Norman, W.H. (1986). Persistence of depressive cognitions within a subgroup of depressed inpatients. Cognitive Therapy and Research, 10, 211–224.Google Scholar
Mollon, P., & Parry, G. (1984). The fragile self: Narcissistic disturbance and the protective function of depression. British Journal of Medical Psychology, 57, 137–145.Google Scholar
Newmann, J., Engel, R., & Jensen, J. (1991). Changes in depressive-symptom experiences among older women. Psychology and Aging, 6, 212–222.CrossRefGoogle ScholarPubMed
Norris, J.T., Gallagher, D., Wilson, A., & Winograd, C.H. (1987). Assessment of depression validity of two screening measures. Journal of the American Geriatrics Society, 35, 989–995.Google Scholar
O'Hara, M., Neunaber, D., & Zekoski, E. (1984). Prospective study of postpartum depression: Prevalence, course, and predictive factors. Journal of Abnormal Psychology, 93, 158–171.CrossRefGoogle ScholarPubMed
Oliver, J.M., & Baumgart, E.P. (1985). The Dysfunctional Attitude Scale: Psychometric properties and relation to depression in an unselected adult population. Cognitive Therapy and Research, 9, 161–168.Google Scholar
Persons, J.B., & Rao, P.A., (1985). Longitudinal study of cognitions, life events, and depression in psychiatric inpatients. Journal of abnormal psychology, 94, 51–63.Google Scholar
Peterson, C., & Seligman, M.T. (1984). Causal explanations as a risk factor for depression: Theory and evidence. Psychological Review, 91, 347–374.CrossRefGoogle ScholarPubMed
Peterson, C., Semmel, A., von Baeyer, C., Abramson, L., Metalsky, G., & Seligman, M. (1982). The Attributions Style Questionnaire. Cognitive Therapy and Research, 6, 287–299.CrossRefGoogle Scholar
Phifer, J., & Murrel, S. (1986). Etiologic factors in the onset of depressive symptoms in older adults. Journal of Abnormal Psychology, 95, 282–291.CrossRefGoogle ScholarPubMed
Power, M.J. (1987). The perception of life events in depressed inpatients and hospitalized controls. Journal of Clinical Psychology, 43, 206–211.Google Scholar
Rapp, S.T., Parisi, S., Walsh, D.A., & Wallace, C.E. (1988). Detecting depression in elderly medical inpatients. Journal of Consulting and Clinical Psychology, 56, 509–513.Google Scholar
Raps, C.W., Peterson, C., Reinhard, K.E., Abramson, L.Y., & Seligman, M.E. (1982). Attributional style among depressed patients. Journal of Abnormal Psychology, 91, 102–108.CrossRefGoogle ScholarPubMed
Rehm, L. (1976). Assessment of depression. In Hersen, M. & Bellack, A.S. (Eds.), Behavioral assessment: A practical handbook (1st ed.). New York: Pergamon.Google Scholar
Reno, R., & Halaris, A. (1989). Dimensions of depression: A comparative longitudinal study. Cognitive Therapy Research, 13, 549–563.Google Scholar
Robins, C., & Block, P. (1989). Cognitive theories of depression viewed from a diathesis-stress perspective: Evaluations of the models of Beck and Abramson, Seligman, and Teasdale. Cognitive Therapy and Research, 13, 297–313.CrossRefGoogle Scholar
Sackheim, H., & Wegner, A. (1986). Attributional patterns in depression and enthy-mia. Archives of General Psychiatry, 43, 553–560.Google Scholar
Salamé, R. (1987). Évaluation psychométrique du Questionnaire de Recherche sur la Personnalité. Unpublished manuscript. Université Laval.Google Scholar
Segal, Z.V., & Shaw, B.F. (1986). Cognition in depression: A reappraisal of Coyne and Gotlib's critique. Cognitive Therapy Research, 10, 671–693.CrossRefGoogle Scholar
Seligman, M., Castellon, C., Cacciola, J., Schulman, P., Luborsky, L., Ollove, M., & Downing, R. (1988). Explanatory style change during cognitive therapy for unipolar depression. Journal of Abnormal Psychology, 97, 13–18.CrossRefGoogle ScholarPubMed
Seligman, M.E. (1975). Helplessness: On depression, development and death. San Francisco: Freeman.Google Scholar
Seligman, M.E., Abramson, L., Semmel, A., & von Baeyer, C. (1979). Depressive attributional style. Journal of Abnormal Psychology, 88, 242–247.Google Scholar
Solomon, K. (1981). The depressed patient: Social antecedents of psychopathological changes in the elderly. Journal of the American Geriatrics Society, 29, 14–18.Google Scholar
Steuer, J. (1982). Psychotherapy for depressed elders. In Blazer, D.H. (Ed.), Depression in Late Life. Missouri: C.V. Mosby.Google Scholar
Sweeney, P.D., Anderson, K., & Bailey, S. (1986). Attributional style in depression: A metaanalytic review. Journal of Personality and Social Psychology, 50, 974–991.CrossRefGoogle Scholar
Tabachnick, B.G., & Fidell, L.S. (1989). Using multivariate statistics (2nd ed.). New York: Harper & Row.Google Scholar
Taylor, E.B., & Klein, D.N. (1989). Assessing recovery in depression: Validity of symptom inventories. Cognitive Therapy and Research, 13, 1–8.Google Scholar
Thompson, L., Gallagher, D., & Steinmetz Breckenridge, J. (1987). Comparative effectiveness of psychotherapies for depressed elders. Journal of Consulting and Clinical Psychology, 55, 385–390.Google Scholar
Vézina, J., & Bourque, P. (1984). The relationship between cognitive structure and symptoms of depression in the elderly. Cognitive Therapy and Research, 8, 29–36.Google Scholar
Vézina, J., Laprise, R., Gourgue, M., Parenteau, P., & Fréchette, M. (1993). Comparaison de la performance diagnostique de I'lnventaire de Dépression de Beck et de I'Échelle de Dépression Gériatrique: Utilisation de courbes caractéristiques. Manuscript submitted for publication.Google Scholar
Vinokur, A., & Selzer, M. (1975). Desirable versus undesirable life events: Their relationship to stress and mental distress. Journal of Personality and Social Psychology, 32, 329–337.CrossRefGoogle ScholarPubMed
Watson, G., & Dyck, D. (1984). Depressive attributional style in psychiatric inpatients: Effects of reinforcement level and assessment procedure. Journal of Abnormal Psychology, 93, 312–320.Google Scholar
Weissman, A. (1979). The Dysfunctional Attitude Scale: A validation study. Unpublished dissertation, University of Pennsylvania. Dissertation Abstracts International, 40, 1389–1390B (University Microfilm No. 79–19, 533).Google Scholar
World Health Organization. (1979). Manual of the international statistical classification of diseases, injuries and causes of death (9th rev. ed.). Geneva, Switzerland: World Health Organization.Google Scholar