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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
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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

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