Lecture 11 - Late life depression/stress Flashcards
(25 cards)
Cognitive Theory - Dysfunctional Cognitions
Stable traits that predispose one to depression
BUT recovered depressed patients do not show any dysfunctional cognitions
Differential activation hypothesis
Dysfunctional cognitions activated in depressed state
Therefore it is mood/state dependent
Rumination
NOT same as worrying
- Mode of responding to emotional distress involving repetitively and passively focusing on the symptoms of distress or possible causes and consequences of these negative emotional experiences
- Prevent active problem solving to change circumstances surrounding these symptoms
Response style theory of depression
When you’re vulnerable to depression, you tend to ruminate more on symptoms of depression (ex: repeatedly thinking about what mood you have, and what consequences they have on you)
Aspects of Rumination
Passively dwelling on negative aspects (brooding)
Attempting to get more insight (reflective)
Rumination and Depression
STUDY: Nolen-Hoeksema, 2000
- longitudinal sample; rumination predicted first episode of depression, but not recurrence
- Combination of negative attributional style and rumination predict the duration of depressive symptoms
Rumination mediates between depression and factors that are correlated with depression such as:
- Neuroticism
- Negative attributional style
- Pessimism
- Self-criticism
- Dependency
- Neediness
Gender and Rumination
- Women more likely to engage in rumination than men
- Mediate gender differences in depression in some studies
- STUDY: mood induction in both men and women then asked to engage in a task (choose either an emotional task or a neutral task that would distract); women tend to choose more emotional tasks and men more neutral
Rumination causes inhibition of instrumental behaviour
- Dysphoric ruminators: recognized that pleasant,
distracting activities would lift their mood, but they
were unwilling to try them. - Ruminators with breast cancer reported having
delayed the presentation of their initial symptoms
to a physician more than 2 months longer than did
non-ruminator (Lyubomirsky et al., 2006) - Rumination correlated with low compliance with a
medical regiment among a diverse of cancer
patients in Germany (Aymanns et al., 1995).
Rumination and social support
- Bereaved ruminators more likely to reach out for social support after their loss
o BUT: reported more social friction and less emotional support from others - Ruminators reports that friends and family become frustrated with their continued need to talk about their loss and its meaning for their lives many months after the loss
Rumination manipulation
When ruminated:
- Diminished concentration
- Increase time required for reading and test tasks
- Impaired work strategies and performance
- Impaired memory, cognitive control, difficulty inhibiting negative information
Mechanism of rumination
- Enhanced effects of depressed mood on thinking
- Interfere with effective problem-solving
- Interfere with instrumental behaviour, leading to increases in stressful circumstances
- Erosion of social support resources
How is rumination linked with anxiety and depression
- Rumination is a mediator b/w stressful life events and anxiety symptoms
- stressful life events predict rumination, and rumination predicts high anxiety
How do we assess life Stress?
Life Events and Difficulties Schedule (LEDS)
What facets are there on the LEDS
- Timing
- Duration
- Episodic vs. chronic
•Episodic: beginning and an end; ex: divorce, school, health problem, loss of job
•Chronic: no beginning or end date; ex: chronically ill - Judge-rated severity
- Dependent vs. Independent events
• Dependent: events influenced by individual; ex: drug addiction, work stress
•Independent: events outside control of individual; ex: getting sick, natural disaster - Interpersonal vs. non-interpersonal
• Interpersonal is social context (ex: divorce)
• Non-interpersonal is NOT social (ex: natural disaster)
Stress Generation Hypothesis
- Individuals are active in shaping environment
- Depression contributed to the occurrence of stressful life events
- Individuals prone to depression are not solely responding to stressful events but are also more likely to create stressors
Research on stress generation hypothesis
- Women with history of depression more likely to experience dependent interpersonal events
- Self-perpetuating cycle of depression and stress
Factors associated with stress generation
- Low socioeconomic environment
- Adverse childhood events
- History of maternal depression
- Neuroticism
- Axis II symptomatology
- High levels of cognitive vulnerability
- At least in part, also genetically determined.
Mechanisms of stress generation
- Poor interpersonal problem-solving skills
- Lower ability to provide emotional support to
others - Negative expectations of support from
spouses - Excessive reassurance seeking
Twin Study on Stress generation
How much stress their non-depressed co-twin experienced
- MZ twins had more stress
- Genetic risk for MDD was associated with significantly increased risk for personal SLEs (stressful life events) and one network SLE (trouble getting along with relatives and friends). This effect was not due to SLEs occurring during depressive episodes
Genetic (s/s, s/l, l/l) study on stressful life events
Those with s/s allele had many more interpersonal stressful life events than l/l
STUDY: Child Abuse and Stress generation
- Adults with history of depression
- Individuals exposed to child abuse more like to have greater levels of stress generation; mediated by negative attribution style
Late Life Depression - Prevalence
15-20%
Differences b/w late life depression and earlier depression?
- Late life has higher heterogeneity
- Late life has more lack of interest, more apathy, more somatic symptoms (less obvious mood symptoms)
