Literature Review

Depressive realism: A meta-analytic review

Article· Literature ReviewinClinical psychology review 32(6):496-509 · May 2012with 3,364 Reads
DOI: 10.1016/j.cpr.2012.05.004 · Source: PubMed
Abstract
The current investigation represents the first meta-analysis of the depressive realism literature. A search of this literature revealed 75 relevant studies representing 7305 participants from across the US and Canada, as well as from England, Spain, and Israel. Results generally indicated a small overall depressive realism effect (Cohen's d=-.07). Overall, however, both dysphoric/depressed individuals (d=.14) and nondysphoric/nondepressed individuals evidenced a substantial positive bias (d=.29), with this bias being larger in nondysphoric/nondepressed individuals. Examination of potential moderator variables indicated that studies lacking an objective standard of reality (d=-.15 versus -.03, for studies possessing such a standard) and that utilize self-report measures to measure symptoms of depression (d=.16 versus -.04, for studies which utilize structured interviews) were more likely to find depressive realism effects. Methodological paradigm was also found to influence whether results consistent with depressive realism were found (d's ranged from -.09 to .14).

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  • Thesis
    This thesis argues that we have a distinctive way of knowing why we have our attitudes and perform actions. It is often thought that we have no special access of this sort, even if we have privileged access to other facts about ourselves, like what attitudes we hold. I argue that this orthodoxy fails. Rather, we do have a privileged first-person access to a key explanation of our attitudes and actions – the reasons for which we hold/perform them (i.e. our motivating reasons). In providing an account of this, I draw on insights from cognitive science and appeal to both the personal level, where we can talk of the subject herself, and that of low-level processing. I argue that at the low level, self-knowledge indeed resembles other-knowledge. But regarding how the subject herself learns of her motivating reasons, I argue that we use a ‘transparency method’. We learn of what our reason is for believing p, say, by considering what justifies believing p. We look out into the world and consider the good reasons in favour of having that belief. This then allows us to self-ascribe our motivating reason. The final substantive chapter builds on the foregoing to argue that self-knowledge of motivating reasons is distinctive in a further, perhaps surprising, way. Our motivating reasons self-intimate – if we have a motivating reason, then necessarily we will be in a position to know that we have it. Indeed, this is the case even though we can hold attitudes that we are not in a position to know that we hold. Therefore, self-knowledge of motivating reasons not only differs significantly from other-knowledge, but from self-knowledge of attitudes as well.
  • Article
    Depression is the most common mental disorder in pregnancy. An important risk factor in the development of prenatal depression is lifetime history of abuse. The current review quantitatively synthesized research on the association between history of abuse and prenatal depressive symptoms using a meta-analytic technique. A total of 3322 articles were identified through electronic searches of the following databases: PsycINFO, PubMed, CINAHL, and EMBASE Cochrane Collaboration databases between the years of 1980 and 2016. All were independently screened against the following inclusion criteria: articles reporting on original data that included measures of prenatal depression and abuse. Data were extracted by the first and second authors. Descriptive analyses were conducted using Excel version 15.32, and all analyses involving effect sizes were conducted using comprehensive meta-analysis (CMA) version 3.0. Seventy articles met the inclusion criteria and were included in the meta-analyses. Meta-bias detected no publication bias. Abuse had a significant positive relation with prenatal depressive symptoms, with effect sizes in the moderate range for any abuse (r¯ = 0.287), physical abuse (r¯ = 0.271), sexual abuse (r¯ = 0.259), and emotional abuse (r¯ = 0.340; Cohen 1969. Statistical power analysis for the behavioral sciences. Academic Press, New York). The meta-analyses found a robust relation between abuse and prenatal depressive symptoms holding across a variety of demographic and study design characteristics. These results reinforce the established association between trauma victimization and subsequent psychopathology, extending current knowledge to specifically address the under-studied area of prenatal depression. These findings highlight the need for women who have survived child or adulthood abuse to receive appropriate referral and psychological treatment to mitigate their risk for prenatal depression.
  • Chapter
    The existence of keeper last-line defenses, psychopathologies which themselves incur severe fitness costs, points to the likelihood that a front line of defenses, fenders, would also have evolved. Pain-type fender systems, it is argued, would actively moderate the experiencing of negative affect in order to avoid the costly activation of keepers: they may be observed in the maintenance of subjective well-being – the homeostasis of affect at an above-neutral resting point; the phenomena of self-serving self-deception, optimism bias, and psychodynamic defenses; the pursuit of pleasurable interests and activities that apparently serve no direct biological purpose; and the selection and defense of benign mental models of the world, which may often be religious. The Jungian idea of God is posited to constitute a pain-type fender. Adaptive belief in a moral universe may help to explain the human capacity for true altruism.
  • ... Research exists offering preliminary evidence that depression may alter aspects of perception (Gotlib & Joormann, 2010;Kornbrot, Msetfi, & Grimwood, 2013;Moore & Fresco, 2012), of which one particular aspect may be the mothers' perception of their own child. Numerous recent articles reveal the effects of depression on different areas of perception, such as its association with reduced olfactory sensitivity (Schablitzky & Pause, 2014) or its influence on auditory looming perception (Riskind, Kleiman, Seifritz, & Neuhoff, 2014). ...
    Article
    Objective: The purpose of this study was to investigate the impact of postpartum depressive and anxiety symptoms on maternal perception of the infant and the protective role of social support. Background: Adverse effects of perinatal depression on mother–child interaction are well documented; however, the role of maternal perception has not been examined. Methods: We used the data of 431 women enrolled in a prospective study in a single maternity unit. Depressive and anxiety symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), the State Trait Anxiety Inventory (STAI), and the mother’s perception of infant with the Mother’s Object Relation Scale (MORS). We used Multidimensional Scale of Perceived Social Support (MSPSS) in order to measure social support. Results: Depressive and anxiety symptoms were positively associated to less positive emotions and a more dominant attitude of child as perceived by mothers. This association was even more significant in the case of trait anxiety. Perceived social support has been found to be a protective factor which was able to reduce this tendency. Conclusion: The findings have potential implications for our understanding of the impact of maternal depressive and anxiety symptoms on the developing mother–infant relationship.
  • Article
    The depressive-realism effect refers to a phenomenon in which depressed individuals are more realistic at assessing the relationship between two events than non-depressed individuals. Recent evidence suggests that the depressive realism hypothesis is weaker than first thought. Thus, we sought evidence for depressive-realism under conditions that we hypothesised would maximise the effect. We tested a clinically depressed sample of participants who were administered a rumination induction. Twenty-eight clinically depressed and 39 non-depressed participants were randomly allocated to either a rumination condition (focused on the causes, consequences, and meaning of their mood) or a distraction condition (focused on external objects/events such as a classroom). Participants then completed a contingency task in which there was no relationship between their responses and an outcome, and they were asked to make a judgment of how much control they had over an outcome. Both groups and conditions did not differ in their judgments of control; participants in all conditions showed a non-normative judgment of control. The depressive-realism effect was not observed in this study, even when depressed participants were encouraged to ruminate. Rather, the present study clearly demonstrates the robustness of the illusion of control.
  • Article
    This paper argues that confabulation is motivated by the desire to have fulfilled a rational obligation to knowledgeably explain our attitudes by reference to motivating reasons. This account better explains confabulation than alternatives. My conclusion impacts two discussions. Primarily, it tells us something about confabulation – how it is brought about, which engenders lively debate in and of itself. A further upshot concerns self-knowledge. Contrary to popular assumption, confabulation cases give us reason to think we have distinctive access to why we have our attitudes.
  • Article
    Human beliefs have remarkable robustness in the face of disconfirmation. This robustness is often explained as the product of heuristics or motivated reasoning. However, robustness can also arise from purely rational principles when the reasoner has recourse to ad hoc auxiliary hypotheses. Auxiliary hypotheses primarily function as the linking assumptions connecting different beliefs to one another and to observational data, but they can also function as a “protective belt” that explains away disconfirmation by absorbing some of the blame. The present article traces the role of auxiliary hypotheses from philosophy of science to Bayesian models of cognition and a host of behavioral phenomena, demonstrating their wide-ranging implications.
  • ... Sur le plan empirique, le paradigme de contingence constitue la pierre angulaire du construit de réalisme dépressif. Par ailleurs, cette tâche demeure à ce jour l'unique paradigme de réalisme dépressif à inclure un standard de réalité objective (c.-à-d., degré objectif de contingence; Moore et Fresco, 2012). Bien que les résultats de l'étude d'Alloy et Abramson (1979) ainsi que ceux d'études de contingence subséquentes aient initié certains changements dans le propos cognitif-comportemental concernant les mécanismes de la dépression au cours des années 1990 (Beck, 1991;Haaga et Beck, 1994), il semble que les plus récents efforts théoriques à cet égard aient omis de considérer les notions liées au réalisme dépressif (Beck et Alford, 2009). ...
    ... Bien qu'une méta-analyse ait conclu à une précision supérieure des jugements de contingence chez les individus dépressifs (Moore et Fresco, 2012), celle-ci n'a pas donné lieu à une étude exhaustive des modérateurs de cet effet. Par ailleurs, cette méta-analyse, publiée en 2012, a recensé les études parues jusqu'en 2010. ...
    ... Les analyses de modération indiquent toutefois que les individus dépressifs tendent à être plus précis lorsque l'occurrence d'un résultat est peu contrôlable. Une poursuite du travail de validation de l'hypothèse du réalisme dépressif -par des paradigmes de contingence ou non -est justifiée; les résultats de la présente étude et ceux d'une autre méta-analyse (Moore et Fresco, 2012) en sont des arguments à l'appui. Les implications d'un tel travail quant à la conceptualisation, l'évaluation et le traitement de l'humeur dépressive (Beck, 1967;Beck et Alford, 2009) sont importantes. ...
    Article
    The current study represents a meta-analysis focusing on depressed and nondepressed individuals’ judgments of contingencies. Specifically, it aimed: 1) to determine whether depressed individuals display more accurate judgments of contingencies than nondepressed individuals do, and; 2) to determine under which conditions this effect is statistically significant. A literature search revealed 16 studies representing 1167 participants. Results indicate that depressed individuals’ judgments of contingencies are more accurate than those of the nondepressed. This effect is moderated by the objective degree of contingency but not by sex, depression severity or other task characteristics. Results are discussed in regards to the optimal margin of illusion theory./Cette étude constitue une méta-analyse centrée sur les jugements de contingence chez les individus dépressifs et non dépressifs. Elle visait à déterminer si les dépressifs présentent des jugements de contingence plus précis que les non dépressifs et à déterminer la robustesse de cet effet en considérant différents modérateurs. Seize études représentant 1167 participants étaient disponibles. Les jugements de contingence sont significativement plus précis chez les dépressifs. Ce résultat varie selon le degré de contingence, mais pas selon le sexe, la sévérité de la dépression ou les autres caractéristiques expérimentales. Ces résultats sont discutés à la lumière de la théorie de la marge optimale d’illusion.
  • Chapter
    An account of sadness and grief is offered that focuses on their evolutionary function. Sadness and grief are distinct yet complementary adaptive responses to stress. Sadness is characterized by low physiological arousal, whereas grief is characterized by higher physiological arousal and a propensity to weep. Three general responses to stress are proposed: (1) an immune response, principally an energy-conserving state that is coordinated with enhanced immune activity; (2) a cognitive response, principally a reflective disposition characterized by more realistic situational appraisals, ultimately encouraging adaptive actions; and (3) a social response, minimally an appeal to halt aggression and, more broadly, an appeal for altruistic assistance.
  • ... A large number of social psychology studies have observed that healthy adults typically hold positive views of their own traits and behaviors which can be demon- strated via self-positivity biases in behavioral responses. Conversely, depression is character- ized by less positive views of the self and cognitive slowing [14,15,[52][53][54] and has been associated with reduced self-positivity biases [55,56]. During the Implicit Associations Task, our participants clearly exhibited faster identification of both positively valenced and self- related words (i.e. ...
    Article
    Full-text available
    Background In inflammatory bowel disease (IBD), immune activation with increased circulating TNF-α is linked to the intensity of gastrointestinal symptoms and depression or anxiety. A central feature of depression is cognitive biases linked to negative attributions about self, the world and the future. We aimed to assess the effects of anti-TNFα therapy on the central processing of self-attribution biases and visceral afferent information in patients with Crohn’s disease. Methods We examined 9 patients with Crohn’s disease (age 26.1±10.6. yrs, 5 female, 5 ileocolonic, 2 colonic and 2 ileal disease) during chronic anti-TNFα therapy (5 adalimumab, 4 infliximab). Patients were studied twice in randomized order before and after anti-TNFα administration. On each occasion patients underwent functional magnetic resonance imaging (fMRI) of the brain during a test of implicit attribution biases regarding sickness/health and undertook a standardized nutrient challenge. Results Following anti-TNFα treatment, ratings of ‘fullness’ following nutrient challenge reduced compared to pre-treatment ratings (p<0.05). Reaction times revealed improved processing of self-related and positive health words, consistent with improved implicit sense of wellbeing that correlated with improvements in sensory function after treatment (r = 0.67, p<0.05). Treatment-associated improvements in implicit processing were mirrored by alterations of prefrontal, amygdala, posterior cingulate and visual regions. Between patients, the degree of functional amygdala change was additionally explained by individual differences in attention regulation and body awareness rankings. Conclusion In patients with Crohn’s disease, anti-TNFα administration reduces visceral sensitivity and improves implicit cognitive-affective biases linked to alterations in limbic (amygdala) function.
Literature Review
  • Article
    We examined whether depressed persons' social skill deficits contribute to their negative cognitions and whether this contribution is independent of their negative schemata. Depressed (n = 60) and nondepressed (n = 60) subjects engaged in group discussions. We assessed subjects' social competence schemata with a questionnaire and subjects' actual level of social competence in the discussion through objective ratings made by codiscussants and outside observers. We found that independently of their negative schemata, depressed subjects' social skill deficits explained a significant portion of the variance in their more negative interpretation of feedback (relative to nondepressed subjects'). This suggests that real deficits in depressed persons' performance compound the effects of their negative schemata and further contribute to their negative cognitions. We also further explored findings by Dykman et al. (1989) and Lewinsohn et al. (1980).
  • Article
    The depressive realism effect is the paradoxical fact that persons suffering from depression sometimes have more accurate perceptions than individuals not experiencing depression. Relatively few previous studies in the depressive realism literature have attempted to achieve ecological validity through use of complex social stimuli. Depressed and nondepressed college students were given two measures of social information processing accuracy. In a videotape task, participants rated how actors expressing various behaviors in a videotaped interaction felt about each other. In a live interaction task, participants rated how a confederate displaying behaviors similar to those portrayed by the videotaped actors felt about them. On both the live and video tasks, both groups were accurate in identifying schema consistent information, but inaccurate when judging schema inconsistent information. The pattern of results supports schema based biases as an explanation for depressive realism phenomena and is inconsistent with several other cognitive or motivational hypotheses.
  • Article
    Full-text available
    Clinically depressed and nondepressed individuals completed a deployment-of-attention task developed by I. H. Gotlib, A. L. McLachlan, and A. N. Katz (1988). Results indicated that the clinically depressed individuals perform the task in an unbiased fashion, attending equally to positive-, negative-, and neutral-content stimuli. In contrast, the nondepressed individuals demonstrated a "protective" bias against the perception of negative stimuli by avoiding such material in favor of positive or neutral stimuli. Overall, the results of this study suggest that clinically depressed individuals do not show an attentional bias toward negative information, but rather, fail to demonstrate the positive or protective bias that is evident in nondepressed individuals. Language: en
  • Article
    The comorbidity of current and lifetime DSM-IV anxiety and mood disorders was examined in 1,127 outpatients who were assessed with the Anxiety Disorders Interview Schedule for DSM-IV :Lifetime version (ADIS-IV-L). The current and lifetime prevalence of additional Axis I disorders in principal anxiety and mood disorders was found to be 57% and 81%, respectively. The principal diagnostic categories associated with the highest comorbidity rates were mood disorders, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). A high rate of lifetime comorbidity was found between the anxiety and mood disorders; the lifetime association with mood disorders was particularly strong for PTSD, GAD, obsessive-compulsive disorder, and social phobia. The findings are discussed in regard to their implications for the classification of emotional disorders.
  • Article
    This volume considers the problem of quantitatively summarizing results from a stream of studies, each testing a common hypothesis. In the simplest case, each study yields a single estimate of the impact of some intervention. Such an estimate will deviate from the true effect size as a function of random error because each study uses a finite sample size. What is distinctive about this chapter is that the true effect size itself is regarded as a random variable taking on different values in different studies, based on the belief that differences between the studies generate differences in the true effect sizes. This approach is useful in quantifying the heterogeneity of effects across studies, incorporating such variation into confidence intervals, testing the adequacy of models that explain this variation, and producing accurate estimates of effect size in individual studies. After discussing the conceptual rationale for the random effects model, this chapter provides a general strategy for answering a series of questions that commonly arise in research synthesis: 1. Does a stream of research produce heterogeneous results? That is, do the true effect sizes vary? 2. If so, how large is this variation? 3. How can we make valid inferences about the average effect size when the true effect sizes vary? 4. Why do study effects vary? Specifically do observable differences between studies in their target populations, measurement approaches, definitions of the treatment, or historical contexts systematically predict the effect sizes? 5. How effective are such models in accounting for effect size variation? Specifically, how much variation in the true effect sizes does each model explain? 6. Given that the effect sizes do indeed vary, what is the best estimate of the effect in each study? I illustrate how to address these questions by re-analyzing data from a series of experiments on teacher expectancy effects on pupil's cognitive skill. My aim is to illustrate, in a comparatively simple setting, to a broad audience with a minimal background in applied statistics, the conceptual framework that guides analyses using random effects models and the practical steps typically needed to implement that framework. Although the conceptual framework guiding the analysis is straightforward, a number of technical issues must be addressed satisfactorily to ensure the validity the inferences. To review these issues and recent progress in solving them requires a somewhat more technical presentation. Appendix 16A considers alternative approaches to estimation theory, and appendix 16B considers alternative approaches to uncertainty estimation, that is, the estimation of standard errors, confidence intervals, and hypothesis tests. These appendices together provide re-analyses of the illustrative data under alternative approaches, knowledge of which is essential to those who give technical advice to analysts.