Cognitive aspects of chronic depression

Department of Psychology, Georgia State University, Atlanta 30303, USA.
Journal of Abnormal Psychology (Impact Factor: 4.86). 03/2003; 112(1):72-80. DOI: 10.1037//0021-843X.112.1.72
Source: PubMed


Previous research on chronic depression has focused on its link with other mood disorders and Axis II personality disorders. However, there are few data examining whether the cognitive perspective applies to this condition. In this cross-sectional study, 42 outpatients with chronic depression were compared with 27 outpatients with nonchronic major depressive disorder and 24 never psychiatrically ill controls on cognitive variables thought to be related to vulnerability to depression (e.g., dysfunctional attitudes, attributional style, a ruminative response style, and maladaptive core beliefs). Both depressed groups were more elevated than a never-ill comparison group. However, chronically depressed individuals were generally more elevated on measures of cognitive variables than those with major depressive disorders even after controlling for mood state and personality disorder symptoms.


Available from: Lawrence P Riso, May 14, 2014
    • "However, the present study extends this previous work by differentiating chronic and episodic depression, a step that has rarely been undertaken so far. Previous comparisons of chronic and episodic depression found elevated childhood adversity (Brown and Moran, 1994; Lizardi et al., 1995), dysfunctional cognitions (Riso et al., 2003), and alexithymia (van Randenborgh et al., 2012) in chronically as compared to episodically depressed individuals. By demonstrating further differences between chronic and episodic depression, the present study lends support to the clinical distinction between chronic and non-chronic forms of depression that appears useful against the backdrop of their differences in psychopathology, etiological factors, treatment response, and burden of disease (Evans et al., 1996; Gilmer et al., 2005; Klein, 2008; Klein et al., 2000; Thase et al., 1994). "
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    ABSTRACT: Although chronic depression is associated with lower global functioning and poorer treatment response than episodic depression, little is known about the differences between these two forms of depression in terms of psychological factors. Thus, the present study aimed at differentiating chronic and episodic depression regarding cognitive-behavioral and emotional avoidance that have been proposed as important risk factors for depression and promising targets for the treatment of depression. Thirty patients with early onset chronic depression were compared with 30 patients with episodic depression and 30 healthy, never-depressed controls in terms of self-reported cognitive-behavioral (social and non-social) and emotional avoidance. Chronically depressed patients reported more avoidance than healthy controls in each of the measures. Moreover, they reported more cognitive-nonsocial and behavioral-nonsocial as well as behavioral-social and emotional avoidance (in the form of restricted emotional expression to others) than patients with episodic depression. This kind of emotional avoidance also separated best between chronically and episodically depressed patients. Furthermore, general emotion avoidance and behavioral-social avoidance were positively correlated with levels of depression in chronically depressed patients. The results are based on self-report data and should thus be interpreted with caution. Additionally, the cross-sectional design limits any causal conclusions. The findings underscore the relevance of cognitive-behavioral and emotional avoidance in differentiating chronic from episodic depression and healthy controls and advocate a stronger focus on maladaptive avoidance processes in the treatment of chronic depression. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 01/2015; 175C:418-423. DOI:10.1016/j.jad.2015.01.045 · 3.38 Impact Factor
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    • "Nur einige wenige Studien haben dysfunktionale Kognitionen bei chronisch depressiven Patienten auf der Ebene von Schemata erfasst. In einer Studie [Riso et al., 2003] wurde gezeigt , dass Patienten mit chronischen Depressionen stärker ausgeprägte EMS haben als Patienten mit nicht chronischen Depressionen, sogar nachdem in statistischen Analysen die Schwere der Symptome und Persönlichkeitsstörungen berücksichtigt wurde. Des Weiteren wurde gezeigt, dass bestimmte EMS charakteristisch sind für depressive Patienten (Versagen, emotionale Deprivation, Verlassenheit/Instabilität ) und dass diese Schemata während einer ambulanten, kognitiv-verhaltenstherapeutischen Behandlung relativ stabil bleiben [Renner et al., 2012a]. "
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    ABSTRACT: Schematherapie (ST) ist ein integrativer Therapieansatz zur Behandlung chronischer Probleme mit nachgewiesener Effektivität in der Behandlung von Persönlichkeitsstörungen. Dieser Artikel beschreibt die Anwendung der ST bei chronischer Depression. Dazu präsentieren wir eine Literaturübersicht zu Risikofaktoren, die chronischer Depression zugrunde liegen. Zudem wird ein Modell der chronischen Depression vorgestellt, in dem die Interaktion der empirisch nachgewiesenen Risikofaktoren (frühe negative Erfahrungen, kognitive Faktoren, Persönlichkeitspathologie, interpersonelle Faktoren) beschrieben wird. Schließlich stellen wir ein Protokoll zur Behandlung der chronischen Depression vor, das die Techniken beschreibt, die in der ST angewandt werden, um die zugrunde liegenden Risikofaktoren zu bearbeiten. Im Hinblick auf den heutigen Stand der empirischen Evidenz bezüglich der Risikofaktoren chronischer Depressionen scheint ST ein vielversprechender neuer Behandlungsansatz bei chronischer Depression zu sein, da er direkt an den Risikofaktoren ansetzt.
    Verhaltenstherapie 08/2014; 24(3):169-181. DOI:10.1159/000365472 · 0.48 Impact Factor
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    • "l information processing in a dysfunctional way , which gives rise to selective information processing that is congruent with its content and minimizes information that is not consistent with the schema . It has been suggested that EMS might be at the core of BPD and its co - occurring Axis I disorders such as depression ( Jovev & Jackson , 2004 ; Riso et al . , 2003 ; Sempertegui , Karreman , Arntz , & Bekker , 2013 ; Young et al . , 2003 ) . EMS are unconditional schema - level representations regarding attachment to others , autonomy , competence , sense of identity , ability to express valid needs and emotions , limit - setting capacity , and self - control that develop dur - ing childhood or ad"
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    ABSTRACT: Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD.
    Journal of Personality Disorders 06/2014; 29(2):1-18. DOI:10.1521/pedi_2014_28_146 · 2.31 Impact Factor
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