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Background: Early neurodevelopmental deviations, such as abnormal cortical folding patterns, are candidate biomarkers of major depressive disorder (MDD). We aimed to investigate the association of MDD with the local gyrification index (LGI) in each cortical region at the whole-brain level, and the association of the LGI with clinical characteristics of MDD. Methods: We obtained T1-weighted images from 234 patients with MDD and 215 healthy controls (HCs). The LGI values from 66 cortical regions in the bilateral hemispheres were automatically calculated according to the Desikan–Killiany atlas. We compared the LGI values between the MDD and HC groups using analysis of covariance, including age, sex, and years of education as covariates. The association between the clinical characteristics and LGI values was investigated in the MDD group. Results: Compared with HCs, patients with MDD showed significantly decreased LGI values in the cortical regions, including the bilateral ventrolateral and dorsolateral prefrontal cortices, medial and lateral orbitofrontal cortices, insula, right rostral anterior cingulate cortex, and several temporal and parietal regions, with the largest effect size in the left pars triangularis (Cohen's f 2 = 0.361; p = 1.78 × 10−13). Regarding the association of clinical characteristics with LGIs within the MDD group, recurrence and longer illness duration were associated with increased gyrification in several occipital and temporal regions, which showed no significant difference in LGIs between the MDD and HC groups. Conclusions: These findings suggest that the LGI may be a relatively stable neuroimaging marker associated with MDD predisposition. [ABSTRACT FROM AUTHOR]

The Interpersonal-Psychological Theory of Suicidal Behavior (IPTS) posits that suicide stems from a motivation to die by suicide, emanating from perceived-burdensomeness and failed belongingness, and a capacity to kill oneself. We propose a bridge between IPTS and dissociation theory/research via a recent reformulation of Melanie Klein's notion of the depressive position, as comprised of three elements: Demeaning affect, compensatory affect-regulatory maneuvers, and mental representation of self-as-deficient and others as judgmental/punitive and at times seductive. This position is formed in childhood, proceeds to adulthood, and is projected into the future with the hope of finding respite from criticism. This hope is then thwarted by the sufferer's interpersonal action leading to interpersonal strife. We posit that, in the Basic Level, a trauma-based, dissociative structure is formed, whereby the reformulated depressive position disengages from benign and benevolent mental processes, in turn creating interpersonal havoc. In the Advanced Level, dissociative mechanisms are utilized to assist the now depressed-suicidal position to succeed in its mission: Killing the self. A chilling case illustration of this pattern is presented and discussed. Clinically, we recommend a routine measurement of both dissociation and suicide risk, and appraisal of the psychodynamic connecting dissociation and suicidality. [ABSTRACT FROM AUTHOR]

Objectives. Given the continuing COVID-19 pandemic and the associated prevention and control measures implemented, the psychological burden brought by the pandemic on citizens is expected to increase. This study is aimed at exploring the predictors of depressive symptoms among Hong Kong people during the epidemic, as well as factors that could potentially alleviate the negative effects of the epidemic. Methods. The third wave follow-up survey (December 2021 to January 2022) from a longitudinal prospective survey study conducted in Hong Kong was used for a cross-sectional analysis. The participants (n = 803) are adults aged 18 and above in Hong Kong. Logistic and linear regression were performed to test the predictors and moderating effects, respectively, with depression as the outcome variable. Results. With minimized confounding effects of demographic variables, higher levels of concern about infection, experience with COVID-19 infection and previous epidemics, hassles, and trust in authority increased the odds of being depressed, while a higher level of trust in medical professionals reduced the odds of depression. Moreover, greater trust in medical professionals, as a moderator, lessened the positive associations between the levels of depression and hassles and concern about infection. Conclusions. Even though the threats of COVID-19 seem to have lowered, this study shows that a few factors associated with the pandemic continue to threaten people's mental health. However, developing greater trust in medical experts may be an effective way to relieve psychological burden. [ABSTRACT FROM AUTHOR]

Depression and social anxiety are common disorders that have a profound impact on social functioning. The need for studying the neural substrates of social interactions in mental disorders using interactive tasks has been emphasized. The field of neuroeconomics, which combines neuroscience techniques and behavioral economics multiplayer tasks such as the Ultimatum Game (UG), can contribute in this direction. We assessed emotions, behavior, and Event‐Related Potentials in participants with depression and/or social anxiety symptoms (MD/SA, n = 63, 57 females) and healthy controls (n = 72, 67 females), while they played the UG. In this task, participants received fair, mid‐value, and unfair offers from other players. Mixed linear models were implemented to assess trial level changes in neural activity. The MD/SA group reported higher levels of sadness in response to mid‐value and unfair offers compared to controls. In controls, the Medial Frontal Negativity associated with fair offers increased over time, while this dynamic was not observed in the MD/SA group. The MD/SA group showed a decreased P3/LPP in all offers, compared to controls. These results indicate an enhanced negative emotional response to unfairness in the MD/SA group. Neural results reveal a blunted response over time to positive social stimuli in the MD/SA group. Moreover, between‐group differences in P3/LPP may relate to a reduced saliency of offers and/or to a reduced availability of resources for processing incoming stimuli in the MD/SA group. Findings may shed light into the neural substrates of social difficulties in these disorders. It is crucial to study the neural substrates of social interactions in mental health using interactive tasks that immerse the participant in a social context. The Ultimatum Game was used to assess ERPs to fair, mid‐value, and unfair offers from others in depressed and/or socially anxious volunteers. We found blunted neural responses over time to fair offers as well as reduced availability of resources for processing incoming social stimuli in depression and social anxiety. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a highly prevalent psychiatric condition, yet many patients do not receive adequate treatment. Novel and highly scalable interventions such as internet-based cognitive-behavioral-therapy (iCBT) may help to address this treatment gap. Anhedonia, a hallmark symptom of MDD that refers to diminished interest and ability to experience pleasure, has been associated with reduced reactivity in a neural reward circuit that includes medial prefrontal and striatal brain regions. Whether iCBT can reduce anhedonia severity in MDD patients, and whether these therapeutic effects are accompanied by enhanced reward circuit reactivity has yet to be examined. Methods: Fifty-two MDD patients were randomly assigned to either 10-week iCBT (n = 26) or monitored attention control (MAC, n = 26) programs. All patients completed pre- and post-treatment assessments of anhedonia (Snaith–Hamilton Pleasure Scale; SHAPS) and reward circuit reactivity [monetary incentive delay (MID) task during functional magnetic resonance imaging (fMRI)]. Healthy control participants (n = 42) also underwent two fMRI scans while completing the MID task 10 weeks apart. Results: Both iCBT and MAC groups exhibited a reduction in anhedonia severity post-treatment. Nevertheless, only the iCBT group exhibited enhanced nucleus accumbens (Nacc) and subgenual anterior cingulate cortex (sgACC) activation and functional connectivity from pre- to post-treatment in response to reward feedback. Enhanced Nacc and sgACC activations were associated with reduced anhedonia severity following iCBT treatment, with enhanced Nacc activation also mediating the reduction in anhedonia severity post-treatment. Conclusions: These findings suggest that increased reward circuit reactivity may contribute to a reduction in anhedonia severity following iCBT treatment for depression. [ABSTRACT FROM AUTHOR]

Objective: Previous research showed that individuals with eating disorders (EDs) can be subtyped by their levels of psychopathology and self‐regulation abilities. However, nothing is known about whether self‐regulation abilities are solely suited to depict the heterogeneity in ED and comorbid psychopathology in nonclinical samples. Therefore, this study sought to explore self‐regulation profiles and their ability to discriminate ED, depression and anxiety disorders, and personality dysfunction in the adult population. Methods: Within a German representative sample, N = 2391 adults (18–92 years) were examined using latent profile analysis to identify profiles based on established cognitive and emotional self‐regulation scales including attention control, cognitive reappraisal, and difficulties in identifying feelings. Profiles were validated with ED, depression, anxiety, and personality dysfunction measures. Results: The final solution selected as best balancing goodness of fit and interpretability included four profiles—High‐Functioning, Moderate‐Functioning, Dysregulated, and Alexithymic—with high explanatory power of R2 =.99. Profiles were characterized primarily by differences in difficulties in identifying feelings followed by differences in attention control and differed significantly regarding ED, depression and anxiety disorders, and personality dysfunction, with the Dysregulated profile showing the most unfavorable correlates. Conclusions: This study uniquely revealed that low cognitive and emotional self‐regulation were indicators for ED, depression, anxiety, and personality dysfunction in the adult population. Future research should investigate whether the identified profiles predict the development of ED and comorbid psychopathology longitudinally. Public Significance: Individuals with eating disorders present with difficulties in cognitive and emotional self‐regulation, likely maintaining their symptoms. This representative study in the German adult population sought to build profiles based on cognitive and emotional self‐regulation that differed in eating disorder and comorbid psychopathology. We discuss the potential to detect individuals with elevated eating disorder and comorbid psychopathology based on the identified profiles in nonclinical settings. [ABSTRACT FROM AUTHOR]

Depression is one of the most prevalent mental diseases characterized by distortions in the affective sphere. By using resting-state functional magnetic resonance imaging (rs-fMRI) technique, the current study aimed to investigate neural mechanisms associated with emotional sensitivity to reward, which represented the variation of emotional responsiveness as the degree of reward changing in individuals with depressive symptoms. We recruited 28 participants in elevated depressive symptoms (LD) group and 28 demographic-matched participants in low depressive symptoms (ED) group. After the rs-fMRI scan, participants were asked to complete a sequential risk-taking task, in which they might encounter both reward and loss. The resting-state functional connectivity (rs-FC) between ventral striatum (VS) and inferior frontal gyrus (IFG) was associated with the emotional sensitivity to reward in LD group. Compared with LD group, participants in ED group showed weaker emotional sensitivity to reward and stronger rs-FC between VS and prefrontal regions. The current study highlighted that the functional connectivity between VS and IFG in the resting state was related to the emotional sensitivity to reward in individuals with low depressive symptoms. However, individuals with elevated depressive symptoms exhibited altered functional connectivity between VS and IFG in the resting state, which might contribute to their weaker emotional sensitivity to reward. [ABSTRACT FROM AUTHOR]

Background: Reward dysfunction is a major dimension of depressive symptomatology, but it remains obscure if that dysfunction varies across different reward types. In this study, we focus on the abnormalities in anticipatory/consummatory processing of monetary and social reward associated with depressive symptoms. Methods: Forty participants with depressive symptoms and forty normal controls completed the monetary incentive delay (MID) and social incentive delay (SID) tasks with event-related potential (ERP) recording. Results: In the SID but not the MID task, both the behavioral hit rate and the ERP component contingent negative variation (CNV; indicating reward anticipation) were sensitive to the interaction between the grouping factor and reward magnitude; that is, the depressive group showed a lower hit rate and a smaller CNV to large-magnitude (but not small-magnitude) social reward cues compared to the control group. Further, these two indexes were correlated with each other. Meanwhile, the ERP components feedback-related negativity and P3 (indicating reward consumption) were sensitive to the main effect of depression across the MID and SID tasks, though this effect was more prominent in the SID task. Conclusions: Overall, we suggest that depressive symptoms are associated with deficits in both the reward anticipation and reward consumption stages, particularly for social rewards. These findings have a potential to characterize the profile of functional impairment that comprises and maintains depression. [ABSTRACT FROM AUTHOR]

Introduction: Depression is a significant, growing and prevalent issue, one of the chronic disorders and the leading cause of disability worldwide. Aim: The present study aimed to develop a psychological intervention protocol based on systemic theory in depressed individuals. Method: The research method was qualitative content analysis, and the statistical population included various data sources related to the present concepts and therapies in the field of systemic theory, such as Google Scholar, Scopus, Science Direct and …, within 1998 to 2020. The extracted data from these sources were analyzed; an individual systemic psychotherapy protocol was developed based on the obtained results. Then, the content validity of the protocol was determined using the opinions of eight experts in the field of clinical psychology. Sampling in this study was purposeful. The research tool included the written evidence and documents searched in the aforementioned databases, and the data analysis method was Sterling’s content analysis. Results: Therapeutic communication, questions, statements, guidelines, problem identification, problem sequence, types of constraints, and decision matrix, including planning frameworks at different levels, feedback, and feedforward, formed the primary themes of the individual systemic psychotherapy. The content of psychotherapy protocol sessions was adjusted based on the obtained components in 12 weekly sessions. Conclusion: The individual systemic psychotherapy protocol is a comprehensive psychological treatment that includes multiple factors affecting the individual’s system and is valid and efficient. It is recommended to use this protocol for individuals with depression. [ABSTRACT FROM AUTHOR]

Alterations in regional subcortical brain volumes have been investigated as part of the efforts of an international consortium, ENIGMA, to identify reliable neural correlates of major depressive disorder (MDD). Given that subcortical structures are comprised of distinct subfields, we sought to build significantly from prior work by precisely mapping localized MDD‐related differences in subcortical regions using shape analysis. In this meta‐analysis of subcortical shape from the ENIGMA‐MDD working group, we compared 1,781 patients with MDD and 2,953 healthy controls (CTL) on individual measures of shape metrics (thickness and surface area) on the surface of seven bilateral subcortical structures: nucleus accumbens, amygdala, caudate, hippocampus, pallidum, putamen, and thalamus. Harmonized data processing and statistical analyses were conducted locally at each site, and findings were aggregated by meta‐analysis. Relative to CTL, patients with adolescent‐onset MDD (≤ 21 years) had lower thickness and surface area of the subiculum, cornu ammonis (CA) 1 of the hippocampus and basolateral amygdala (Cohen's d = −0.164 to −0.180). Relative to first‐episode MDD, recurrent MDD patients had lower thickness and surface area in the CA1 of the hippocampus and the basolateral amygdala (Cohen's d = −0.173 to −0.184). Our results suggest that previously reported MDD‐associated volumetric differences may be localized to specific subfields of these structures that have been shown to be sensitive to the effects of stress, with important implications for mapping treatments to patients based on specific neural targets and key clinical features. [ABSTRACT FROM AUTHOR]

Interleukin-18 (IL-18) is an inflammatory cytokine that has been linked to energy homeostasis and psychiatric symptoms such as depression and cognitive impairment. We previously revealed that deficiency in IL-18 led to hippocampal abnormalities and resulted in depression-like symptoms. However, the impact of IL-18 deficiency on other brain regions remains to be clarified. In this study, we first sought to confirm that IL-18 expression in neural cells can be found in human brain tissue. Subsequently, we examined the expression of genes in the prefrontal cortex of Il18−/− mice and compared it with gene expression in mice subjected to a chronic mild stress model of depression. Extracted genes were further analyzed using Ingenuity® Pathway Analysis, in which 18 genes common to both the chronic mild stressed model and Il18−/− mice were identified. Of those, 16 were significantly differentially expressed between Il18+/+ and Il18−/− mice. We additionally measured protein expression of α-2-HS-glycoprotein (AHSG) and transthyretin (TTR) in serum and the brain. In the prefrontal cortex of Il18−/− mice, TTR but not AHSG was significantly decreased. Conversely, in the serum of Il18−/− mice, AHSG was significantly increased but not TTR. Therefore, our results suggest that in IL-18-deficit conditions, TTR in the brain is one of the mediators causally related to depression, and AHSG in peripheral organs is one of the regulators inducing energy imbalance. Moreover, this study suggests a possible "signpost" to clarify the molecular mechanisms commonly underlying the immune system, energy metabolism, neural function, and depressive disorders. [ABSTRACT FROM AUTHOR]

Exposure to daily stressors specific to the COVID-19 pandemic (e.g., threat of infection) is associated with emotional distress, heightened stress reactivity, and increased depressive symptomology. Herein, we examined whether current depressive symptomology modulates the association between COVID-19-related daily stressor exposure and negative affective reactivity in young, otherwise healthy, college-aged adults. Fifty-eight adults (21 men; 22±3years) completed a daily web-based interview for eight consecutive days to assess COVID-19-related daily stress exposure and emotional responsiveness (September–November 2020). Depressive symptom severity was assessed using the Patient Health Questionnaire-9 (PHQ-9), and a score of ≥10 (range: 0–27) was used to define adults with a depressive episode (n =20). Participants reported at least one COVID-19-related stressor on 35.8% of interview days. Depressive symptomology did not predict the likelihood of exposure to a COVID-19-related stressor (p =0.46; OR=1.52; 95% CI: 0.492–4.718). However, negative affect (NA) was greater on days with an exposure to any COVID-19-specific daily stressor in adults with moderate-to-severe depressive symptoms (b =0.28, SE=0.093, p =0.003) but not in those without (b =0.009, SE=0.074, p =0.90), such that negative affective reactivity to COVID-19-related stressors was amplified in adults with a current depressive episode (p =0.019). Depressive symptomology did not moderate positive affective reactivity (p =0.686). Taken together, these data suggest that exposure to daily stressors related to COVID-19 further worsens NA in adults with a current depressive episode, potentially rendering them more susceptible to adverse mental health outcomes during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Growing evidence has indicated that right ventrolateral prefrontal cortex (RVLPFC) is critical in down-regulating emotional responses to social exclusion, and that depression is accompanied by social emotional dysregulation associated with reduced lateral prefrontal engagement. This study used anodal transcranial direct current stimulation (tDCS) to examine whether stimulating RVLPFC could improve emotional down-regulation of social exclusion in individuals with high depressive mood (DM). Methods: A total of 96 high and 94 low DM individuals received active or sham tDCS while viewing social exclusion or individual negative pictures under no-reappraisal (passive viewing) and reappraisal conditions. Participants rate their negative emotional experience following the presentation of each image. Pupil diameter and visual fixation duration were also recorded during the task. Results: It was found that tDCS-activated RVLPFC induced a stronger regulation effect on social exclusion than individual negative emotions. The effect of tDCS on regulation of social exclusion was more pronounced in low v. high DM individuals. Conclusions: These findings demonstrate the specific role of RVLPFC on social emotion regulation, which has implications for refining target areas for the treatment of social emotion dysregulation in depression. However the findings do not suggest that high DM individuals benefit from a single-tDCS session on the emotion regulation of social exclusion. Thus we suggest to use multiple tDCS sessions or transcranial magnetic stimulation to further explore the therapeutic proposal in the future. [ABSTRACT FROM AUTHOR]

Youths at high risk for depression have been shown to have problems in repairing their own sad mood. Given that sympathetic arousal has been implicated both in the experience and regulation of affect, an atypical pattern of arousal may be one of the factors that contribute to mood repair problems. In the current study, we measured sympathetic arousal of never‐depressed youths at high (n = 56) and low (n = 67) familial risk for depression during sad mood induction and instructed mood repair. Sympathetic arousal was indexed by skin conductance level (SCL) and cardiac pre‐ejection period (PEP); mood repair outcome was indexed by self‐rated affect. High‐risk youths demonstrated increased SCL during sadness induction, which persisted during mood repair; low‐risk youths evidenced increased SCL only during mood repair. Shortened PEP was evident only among high‐risk youths and only during mood repair. Furthermore, shortened PEP during mood induction predicted less successful mood repair in the low‐risk but not in the high‐risk group. The findings suggest that: (a) depression‐prone youths differ from control peers in patterns of sympathetic responses to emotional stimuli, which may impair their ability to relieve sadness, and (b) activation patterns differ across subsystems (SCL vs. PEP) of sympathetic activity, in conjunction with depression risk status. Difficulties in attenuating sadness (i.e., mood repair deficits) appear to be risk factors for depression. It is, therefore, important to understand better how physiological processes facilitate or hinder successful mood repair. In the present study, never‐depressed youths at high familial risk for depression and low‐risk control youths differed in sympathetic activation during sadness processing; sympathetic activation may, therefore, play a role in mood repair deficits. [ABSTRACT FROM AUTHOR]

Objective: Innovative treatments and outcome measures are needed for binge‐eating disorder (BED). This randomized controlled trial compared Integrative Cognitive‐Affective Therapy (ICAT‐BED), an individual psychotherapy targeting momentary behavioral and emotional precipitants of binge eating, with an established cognitive‐behavioral guided self‐help (CBTgsh) treatment using standard and ecological momentary assessment (EMA) outcome measures. Method: A total of 112 participants were randomized to 17 weeks of treatment (21 sessions for ICAT‐BED and 10 sessions for CBTgsh). Binge‐eating frequency was assessed with the Eating Disorder Examination (EDE) as well as EMA using cell phone‐based real‐time, naturalistic assessment at end of treatment (EOT) and 6‐month follow‐up. Hypothesized maintenance mechanisms were assessed using self‐report questionnaires. Results: Binge‐eating frequency as measured by the EDE and real‐time assessment showed significant reductions at EOT and follow‐up, with no significant differences between treatments. Hypothesized maintenance mechanisms, including emotion regulation, cognitive self‐discrepancy, self‐directed style, as well as measures of associated eating disorder psychopathology, depression, anxiety, impulsivity, and negative affect, showed similar improvement at EOT and follow‐up with no differences between treatments. Abstinence rates at EOT (ICAT‐BED: 57.1%; CBTgsh: 42.9%) and 6‐month follow‐up (ICAT‐BED: 46.4%; CBTgsh: 42.9%) were not significantly different. Treatment retention was significantly higher for ICAT‐BED (87.5%) than CBTgsh (71.4%). Discussion These findings suggest that ICAT‐BED and CBTgsh were associated with similar improvements in binge eating, psychopathology, and putative maintenance mechanisms as measured by traditional self‐report and momentary, naturalistic assessments and that these changes were generally sustained at 6‐month follow‐up. [ABSTRACT FROM AUTHOR]

Objective: The present research aimed to better understand deficits in emotion differentiation that accompany depressive symptoms. Depressive symptoms have been associated with more undifferentiated negative emotion experiences-experiencing multiple negative emotions simultaneously. We extend previous research by asking: (a) Are depressive symptoms and negative and positive emotion differentiation related above and beyond emotion intensity? (b) Are deficits in negative emotion differentiation specific to distinct categories of negative emotions (sadness, guilt, anger, and anxiety)? and (c) Do age or gender predict emotion differentiation or its associations with depressive symptoms?Method: In 220 community participants (59% female; 21-60 years), we assessed depressive symptoms using surveys and emotion differentiation using daily diary emotion ratings in response to daily stressful events.Results: Greater depressive symptoms were associated with lower negative, but not positive, emotion differentiation, above and beyond emotion intensity. Depressive symptoms were specifically related to lower differentiation among sadness-related emotions, and this sadness-specific deficit accounted for the deficit in negative emotion differentiation. Age and gender did not predict or moderate associations with emotion differentiation.Conclusion: Depressive symptoms are associated with undifferentiated negative emotions above and beyond emotion intensity, and this association appears to be driven by undifferentiated sadness-related emotions, across gender and age. [ABSTRACT FROM AUTHOR]

Behavioral Activation (BA) is a contemporary third-wave psychosocial treatment approach that emphasizes helping individuals become more active in ways that are meaningful to them as a means of improving mood and quality of life. BA has been designated as a well-established, validated treatment for depression by the American Psychological Association following several decades of accumulated empirical support demonstrating that BA techniques successfully reduce depression symptoms and produce other desirable outcomes across a variety of populations and contexts. The purported mechanism of change underlying BA treatment lies in increasing activation, which in turn increases contact with positive reinforcement thereby reversing the cycle of depression. Current studies are further investigating how increasing activation and subsequent contact with mood reinforcers can influence mood and behavior. Specifically, there is growing evidence that BA modifies function of reward-related networks in the brain, and that these changes are associated with clinical improvement. Herein, we provide a brief history of BA, describe the primary components of BA treatment, and describe BA's purported mechanisms of change at behavioral, neural, and subjective activation levels. We present limitations as well as gaps in the current state of knowledge regarding mechanisms of action of BA. [ABSTRACT FROM AUTHOR]

We review theory and research pertaining to psychodynamic, social, humanistic, and ethological models of the self and depression and examine research into the neurobiological bases of the self and depression. We provide a narrative review of classic and recent empirical evidence pertaining to these four models of the relation of the self to depression as well as exemplar relevant neurobiological research. Evidence stemming from each of the four theories reviewed here shows a robust relationship between deficits in the sense of self and depressive symptoms, as well as increases in depressive symptoms over time. A smaller body of literature has linked one's sense of self to onsets of depressive episodes. A growing body of literature has linked self-relevant variables to functioning in various prefrontal and cortical midline brain regions as well as emotion and reward processing brain regions which have in turn been linked to depression. Evidence has therefore converged across all four theories and confirmed that a deficit in one's sense of self confers risk for depression and that there is substantial overlap in the brain areas associated with one's sense of self and depression. [ABSTRACT FROM AUTHOR]

Reward deficits and associated striatal circuitry disturbances have been implicated in the onset and progression of major depressive disorder (MDD). However, no studies have been conducted to investigate how the striatal circuitry changes during standard antidepressant, which is important for development of novel and targeted treatments for MDD. We examined the seed‐to‐whole‐brain functional connectivity (FC) for six striatal subregions based on resting‐state fMRI data of 23 MDD patients before and after 8‐week duloxetine, a serotonin, and noradrenaline reuptake inhibitor. Twenty‐three healthy controls (HCs) were also scanned twice with an 8‐week interval. After the analysis of covariance, we observed significant group‐by‐time interaction on FC of the dorsal caudate (DC), ventral striatum (VS), and putamen seeds. Post hoc analyses revealed that the FC between several right striatal seeds and left superior frontal gyrus (SFG), between right DC and left precuneus, between right superior VS and left inferior parietal lobe, were significantly higher in MDD patients compared to HCs at baseline and were reduced after treatment. Conversely, the FC between right inferior VS and left cerebellum was lower in MDD patients and was increased after treatment. Patients with larger reduction in right superior VS—left SFG FC exhibited larger alleviation of rumination. These findings suggest that duloxetine modulates the striatal FC with dorsolateral prefrontal cortex, posterior default mode network, and cerebellum, and partly, these changes underlie symptomatic improvement. This study adds to our understanding of antidepressant mechanism and future therapeutic development might benefit from considering these striatal circuitry as potential targets. [ABSTRACT FROM AUTHOR]

The World Health Organization has defined health as "complete physical, mental and social well-being and not merely the absence of disease or infirmity" (World Health Organization, 1948). An increasing number of studies have therefore started to investigate "the good life." However, the underlying variation in brain activity has rarely been examined. The goal of this study was to assess differences in resting state functional connectivity (RSFC) between regular healthy individuals and healthy individuals with a high occurrence of flourishing and subjective vitality. Together, flourishing, a broad measure of psycho-social functioning and subjective vitality, an organismic marker of subjective well-being comprise the phenomenological opposite of a major depressive disorder. Out of a group of 43 participants, 20 high-flourishing (highFl) and 18 high-vital (highSV) individuals underwent a 7-min resting state period, where cortical activity in posterior brain areas was assessed using functional near-infrared spectroscopy (fNIRS). Network-based statistics (NBS) of FC yielded significantly different FC patterns for the highFl and highSV individuals compared to their healthy comparison group. The networks converged at areas of the posterior default mode network and differed in hub nodes in the left middle temporal/fusiform gyrus (flourishing) and the left primary/secondary somatosensory cortex (subjective vitality). The attained networks are discussed with regard to recent neuroscientific findings for other well-being measures and potential mechanisms of action based on social information processing and body-related self-perception. [ABSTRACT FROM AUTHOR]

Despite evidence documenting relationships between eating disorder (ED) psychopathology, depression, and anxiety, little is known regarding how social anxiety is related to ED symptoms in treatment. Therefore this study examined associations between depression, general anxiety, social anxiety, and ED psychopathology at the beginning and end of treatment (EOT) among patients (N = 380) treated in a residential ED program. Participants completed measures of ED psychopathology and affective variables. Higher depression and general anxiety, but not social anxiety, were related to higher ED psychopathology at baseline. However, social anxiety emerged as a unique predictor of ED psychopathology at EOT such that participants with higher social anxiety evidenced less improvement in ED psychopathology. Findings suggest that social anxiety has specific relevance to treatment in EDs, which may reflect shared mechanisms and underlying deficits in emotion regulation. [ABSTRACT FROM PUBLISHER]

Reduced self-esteem is a core symptom of depression, but few studies have investigated within-treatment change of self-esteem as a predictor of long-term outcome in depression. This study investigated change in self-esteem during 8 weeks of multimodal, psychodynamically oriented psychotherapy for 40 depressed patients and tested whether it would predict outcome 6 months after termination. Data was drawn from a randomized clinical pilot trial on day-clinic versus inpatient psychotherapy for depression. Findings supported the association between change in self-esteem and follow-up depression severity, even when controlling for within-treatment symptom change. Change in self-esteem was not related to overall symptoms and interpersonal problems at follow-up. Thus, change in self-esteem may be an important variable in preventing relapse for depression. Key Practitioner Message Self-esteem is related to depressive symptoms and interpersonal problems., Improvement of self-esteem during psychotherapy correlates with improvements of symptoms and interpersonal problems., Change of self-esteem during psychotherapy predicts depressive symptoms 6 months after termination of therapy., When treating depressed patients, psychotherapists should work towards an improvement of self-esteem in order to prevent relapse. [ABSTRACT FROM AUTHOR]

There is growing evidence on the efficacy of positive psychology interventions (PPI) to treat clinical disorders. However, very few studies have addressed their acceptability. The present study aimed to analyse 2 key components of acceptability (i.e., client satisfaction and adherence to treatment) of a new PPI programme, the Integrative Positive Psychological Intervention for Depression (IPPI-D), in comparison to a standard cognitive behavioural therapy (CBT) programme in the treatment of clinical depression. One hundred twenty-eight women with a DSM-IV diagnosis of major depression or dysthymia were allocated to a 10-session IPPI-D or CBT group intervention condition. Results showed that both interventions were highly acceptable for participants. Attendance rates were high, and there were no significant differences between conditions. However, the IPPI-D condition showed significantly higher client satisfaction than the CBT condition. Moreover, acceptability did not differ based on participants' severity of symptoms, regardless of condition. These findings encourage further investigations of the applicability of PPI in clinical settings in order to broaden the range of acceptable and suitable therapies for depressed patients. [ABSTRACT FROM AUTHOR]

Depressive rumination has been strongly linked to the development and maintenance of depression; however, less attention has been paid to ruminative processes in response to positive affect, and fewer have examined these processes in daily life. The current study sought to address these gaps by exploring depressive rumination and two forms of responses to positive affect, dampening and positive rumination, under ecologically valid conditions using daily diary methodology. One hundred fifty-seven young adults completed 14-day end-of-day diaries assessing positive affect and depressive symptoms in relation to depressive rumination, responses to positive affect, and daily positive and negative events. Daily depressive rumination predicted stronger associations between negative events and daily depressive symptoms. Higher daily dampening was associated with higher daily depressive symptoms and decreased positive affect and predicted lower associations between daily positive events and improvements in mood (including reduced daily positive affect and increased daily depressive symptoms). Higher daily positive rumination was negatively associated with daily depressive symptoms and interacted with daily positive events such that positive rumination had a greater impact on depressed mood on days when positive experiences were low. Results indicate that both depressive rumination and responses to positive affect play a role in influencing daily mood and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to compare changes in emotional processing by women newly diagnosed with gynecological cancer enrolled in either a coping and communication skills intervention (CCI) or a supportive counseling (SC) intervention. We examined the association between in-session emotional processing and patient-rated therapeutic progress.Method: Three therapy sessions with 201 patients were rated for the depth of emotional processing (peak and mode) during emotion episodes (EEs) using the Experiencing Rating Scale (EXP). Participants completed measures of dispositional emotional expressivity, depressive symptoms, and cancer-related distress before treatment began, as well as ratings of perceived progress in therapy after each session.Results: Peak EXP ratings averaged between 2.7 and 3.1, indicating that women discussed events, their emotional reactions, and their private experiences in sessions. A small proportion of patients had high levels of processing, indicating deeper exploration of the meaning of their feelings and experiences. Women in SC were able to achieve a higher level of emotional processing during the middle and later sessions, and during cancer-related EEs in the later session. However, emotional processing was not significantly associated with a patient's perceived therapeutic progress with SC. In the CCI group, higher levels of emotional processing were associated with greater session progress, suggesting that it may play an important role in patient-rated treatment outcomes.Significance Of Results: Newly diagnosed gynecological cancer patients are able to attend to their emotions and personal experiences, particularly when discussing cancer-related issues during both short-term SC and prescriptive coping skills interventions. [ABSTRACT FROM AUTHOR]

Traditionally, treatments for depression have been primarily focused on reducing patients' symptoms or deficits and less concerned with building positive resources. This study aims to compare the efficacy of a manualized protocol of empirically-validated positive psychology interventions (PPI) with a cognitive-behavioral therapy (CBT) protocol. This controlled clinical trial included 96 adult women with a DSM-IV diagnosis of major depression or dysthymia. Participants were blindly allocated to a 10-session PPI ( n = 47) or CBT ( n = 49) group therapy condition. Intention to treat analysis showed that both interventions were effective in reducing clinical symptoms and increasing well-being. There were no significant differences between groups in either main outcomes (i.e., severity of depressive symptoms and clinical diagnosis) or secondary outcomes (e.g., positive and negative affect, and satisfaction with life). Even within the most severely depressed participants, no differences between PPI and CBT emerged. If further clinical studies confirm these results, this would widen treatment choice for both patients and professionals. [ABSTRACT FROM AUTHOR]

Experience sampling methodology (ESM) was used in a randomized controlled trial of short-term therapy to examine changes in daily affect and reactivity to daily event appraisals among depressed patients. Fifty-five depressed adults (mean age 37 years, 80 % female) were randomly assigned to one of two therapy conditions. Using an interactive voice response system, participants rated activities and emotional functioning eight times per day for 7 days. Twenty-nine participants completed treatment and repeated ESM at post-treatment. Broad improvements in mood, cognition, and physical functioning were similar across treatment conditions, with the largest improvements for markers of positive affect. Participants demonstrated increased resilience, i.e., diminished reactivity to stressors, at post-treatment. Changes in reactivity to positive daily situations were minimal. Findings underscore the utility of ESM in psychotherapy research and the importance of including measures of both positive and negative affect and experiences. [ABSTRACT FROM AUTHOR]

Objectives: To determine the role of flexible goal adjustment in the impact of informal caregiving on depressive symptoms, using a longitudinal approach.Method: Data were gathered from the German Ageing Survey. This is a population-based longitudinal study among community-dwelling individuals aged 40 and above in Germany. Data were derived from the second (2002), third (2008) and fourth (2011) wave, drawing on 10,994 observations. Flexible goal adjustment was assessed using a scale by Brandstädter and Renner. Informal caregiving was measured by asking the individuals whether they provide informal care. Depressive symptoms were quantified by using the Center for Epidemiological Studies Depression scale.Results: Adjusting for several potential confounders, fixed effects regressions showed that the onset of informal caregiving markedly increased depressive symptoms. Furthermore, regressions revealed that this effect was significantly moderated by flexible goal adjustment.Discussion: Our results highlight the importance of informal caregiving for depressive symptoms. Furthermore, the importance of flexible goal adjustment in the relation between informal caregiving and depressive symptoms should be emphasized. Efforts to increase flexible goal adjustment might be beneficial in reducing depressive symptoms among informal caregivers. [ABSTRACT FROM AUTHOR]

Blunted positive affect is characteristic of depression. Altered positive affect regulation may contribute to this blunting, and two regulation strategies, dampening positive affect and positive rumination, have been implicated in depression. However, the conditions under which these strategies impart risk/protective effects prior to onset of depression are unknown. The current study examined 81 healthy children (age 7-10) at low and high risk for depression on the basis of maternal history of depression and tested how dampening and positive rumination interacted with the experience of recent positive life events to predict depressive symptoms. Children at high and low risk did not differ in their use of dampening or positive rumination. However, elevated use of dampening in the context of many positive life events predicted current depressive symptoms, and specifically anhedonic symptoms, in children at low-risk for depression. These findings held when controlling for negative rumination and negative life events. Positive rumination did not interact with positive life events but was associated with higher depressive symptoms in high-risk children. Results indicate that prior to the onset of depression, positive life events may impart risk when dampening positive affect is utilized in this context, while positive rumination may increase risk for depressive symptoms. [ABSTRACT FROM AUTHOR]

Whereas in basic research, intuition has become a topic of great interest, clinical research and depression research in specific have not applied to the topic of intuition, yet. This is astonishing because a well-known phenomenon during depression is that patients have difficulties to judge and decide. In contrast to healthy individuals who take most daily life decisions intuitively (Kahneman, 2011), depressed individuals seem to have difficulties to come to fast and adaptive decisions. The current article pursues three goals. First, our aim is to establish the hypothesis that intuition is impaired in depression against the background of influential theoretical accounts as well as empirical evidence from basic and clinical research. The second aim of the current paper is to provide explanations for recent findings on the depression-intuition interplay and to present directions for future research that may help to broaden our understanding of decision difficulties in depression. Third, we seek to propose ideas on how therapeutic interventions can support depressed individuals in taking better decisions. Even though our knowledge regarding this topic is still limited, we will tentatively launch the idea that an important first step may be to enhance patients' access to intuitions. Overall, this paper seeks to introduce the topic of intuition to clinical research on depression and to hereby set the stage for upcoming theory and practice. [ABSTRACT FROM AUTHOR]

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Reduced capacity to experience pleasure, also known as anhedonia, is a key feature of the depressive state and is associated with poor disease prognosis and treatment outcome. Various behavioral readouts (e.g., reduced sucrose intake) have been employed in animal models of depression as a measure of anhedonia. However, several aspects of anhedonia are poorly represented within the repertoire of current preclinical assessments. We recently adopted the social defeat-induced persistent stress (SDPS) paradigm that models a maintained depressive-like state in the rat, including social withdrawal and deficits in short-term spatial memory. Here we investigated whether SDPS elicited persistent deficits in natural reward evaluation, as part of anhedonia. We examined cue-paired operant sucrose self-administration, enabling us to study acquisition, motivation, extinction, and relapse to sucrose seeking following SDPS. Furthermore, we addressed whether guanfacine, an β2-adrenergic agonist that reduces stress-triggered maladaptive behavioral responses to drugs of abuse, could relief from SDPS-induced anhedonia. SDPS, consisting of five social defeat episodes followed by prolonged (≥8 weeks) social isolation, did not affect sucrose consumption during acquisition of self-administration. However, it strongly enhanced the motivational drive to acquire a sucrose reward in progressive ratio training. Moreover, SDPS induced initial resilience to extinction and rendered animals more sensitive to cue-induced reinstatement of sucrose-seeking. Guanfacine treatment attenuated SDPS-induced motivational overdrive and limited reinstatement of sucrose seeking, normalizing behavior to control levels. Together, our data indicate that long after the termination of stress exposure, SDPS induces guanfacine-reversible deficits in evaluation of a natural reward. Importantly, the SDPS-triggered anhedonia reflects many aspects of the human phenotype, including impaired motivation and goal-directed conduct. [ABSTRACT FROM AUTHOR]

Reduced capacity to experience pleasure, also known as anhedonia, is a key feature of the depressive state and is associated with poor disease prognosis and treatment outcome. Various behavioral readouts (e.g., reduced sucrose intake) have been employed in animal models of depression as a measure of anhedonia. However, several aspects of anhedonia are poorly represented within the repertoire of current preclinical assessments. We recently adopted the social defeat-induced persistent stress (SDPS) paradigm that models a maintained depressive-like state in the rat, including social withdrawal and deficits in short-term spatial memory. Here we investigated whether SDPS elicited persistent deficits in natural reward evaluation, as part of anhedonia. We examined cue-paired operant sucrose self-administration, enabling us to study acquisition, motivation, extinction, and relapse to sucrose seeking following SDPS. Furthermore, we addressed whether guanfacine, an α2-adrenergic agonist that reduces stress-triggered maladaptive behavioral responses to drugs of abuse, could relief from SDPS-induced anhedonia. SDPS, consisting of five social defeat episodes followed by prolonged (≥8 weeks) social isolation, did not affect sucrose consumption during acquisition of self-administration. However, it strongly enhanced the motivational drive to acquire a sucrose reward in progressive ratio training. Moreover, SDPS induced initial resilience to extinction and rendered animals more sensitive to cue-induced reinstatement of sucrose-seeking. Guanfacine treatment attenuated SDPS-induced motivational overdrive and limited reinstatement of sucrose seeking, normalizing behavior to control levels. Together, our data indicate that long after the termination of stress exposure, SDPS induces guanfacine-reversible deficits in evaluation of a natural reward. Importantly, the SDPS-triggered anhedonia reflects many aspects of the human phenotype, including impaired motivation and goal-directed conduct. [ABSTRACT FROM AUTHOR]

Objective This study examined the relation between identity disturbance and emotion dysregulation in a cross-diagnostic sample. We assessed whether these constructs are related and relevant beyond borderline personality disorder (BPD). Method We recruited 127 participants who completed measures assessing identity disturbance, emotion dysregulation, anxiety, and depression. The sample included primarily depressed adults meeting criteria for multiple diagnoses as well as psychiatrically healthy participants. Results Identity disturbance was significantly higher among psychiatric participants with and without BPD compared to healthy controls. Emotion dysregulation was a significant predictor of identity disturbance, even when controlling for BPD diagnosis, depression, and anxiety. In particular, clarity in emotional situations and problems using emotion regulation strategies were most closely related to identity disturbance. Conclusion The results of this study suggest that future research should examine identity disturbance and its relation with emotion regulation transdiagnostically. [ABSTRACT FROM AUTHOR]

Self-discrepancy theory postulates that negative affective states (e.g., depression and anxiety) may be a consequence of discrepancies between individuals' goals and their self-perceptions. one theoretical construct that has been hypothesized to influence the magnitude of the association between self-discrepancies and negative affect is goal strength, or how cognitively accessible individuals' goals are. the current study employed a computerized lexical decision task to measure goal strength. we hypothesized that goal strength would moderate the discrepancy-negative affect association, even after controlling for general mental processing speed. over the course of two assessment sessions, participants ( N = 162) completed self-report measures assessing self-discrepancies, depression, and anxiety symptoms, and were administered a lexical decision task which assessed the strength, or accessibility, of their self-identified goals. Consistent with hypotheses, results suggest that goal strength is a moderator of the discrepancy-depression relationship, above and beyond what can be accounted for by general reaction times and mental processing speed. the implications of these results for the conceptualization of self-discrepancies and the emergence of depressive symptoms are discussed. [ABSTRACT FROM AUTHOR]

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Neuroimaging studies of major depressive disorder (MDD) have consistently observed functional and structural changes of the hippocampus (HP) and amygdale (AY). Thus, these brain regions appear to be critical elements of the pathophysiology of MDD. The HP and AY directly interact and show broad and overlapping intrinsic functional connectivity (iFC) to other brain regions. Therefore, we hypothesized the HP and AY would show a corresponding pattern of aberrant intrinsic connectivity in MDD. Resting-state functional MRI was acquired from 21 patients with MDD and 20 healthy controls. β-Maps of region-ofinterest- based FC for bilateral body of the HP and basolateral AY were used as surrogates for iFC of the HP and AY. Analysis of variance was used to compare β-maps between MDD and healthy control groups, and included covariates for age and gender as well as gray matter volume of the HP and AY. The HP and AY of MDD patient's showed an overlapping pattern of reduced FC to the dorsomedial-prefrontal cortex and fronto-insular operculum. Both of these regions are known to regulate the interactions among intrinsic networks (i.e., default mode, central executive, and salience networks) that are disrupted in MDD. These results provide the first evidence of overlapping aberrant HP and AY intrinsic connectivity in MDD. Our findings suggest that aberrant HP and AY connectivity may interact with dysfunctional intrinsic network activity in MDD. [ABSTRACT FROM AUTHOR]

Stress generation research has historically examined the link between depression and stressful life events, particularly interpersonal events. Stress generation theory has rarely been applied to personality disorders, which are characterized by longstanding, pervasive, and often self-perpetuating interpersonal difficulties. In addition, there is little research on the specific types of interpersonal deficits associated with personality disorders. We examined the associations between symptoms of Avoidant Personality Disorder (AVPD), interpersonal competence, and daily stress generation. College students completed measures of personality disorder symptoms, interpersonal competence, and a 7-day diary of daily negative events. Multilevel mediation models showed that lower Conflict Management skills mediated the relation between AVPD symptoms and daily negative events. These results suggest that a daily model of stress generation might apply to these personality disorder symptoms and that interpersonal competence is an important mediator of the process of daily stress generation. [ABSTRACT FROM AUTHOR]

Objectives: converging research suggests that mindfulness training exerts its therapeutic effects on depression by reducing rumination. Theoretically, rumination is a multifaceted construct that aggregates multiple neurocognitive aspects of depression, including poor executive control, negative and overgeneral memory bias, and persistence or stickiness of negative mind states. Current measures of rumination, most-often self-reports, do not capture these different aspects of ruminative tendencies, and therefore are limited in providing detailed information about the mechanisms of mindfulness. Methods: we developed new insight into the potential mechanisms of rumination, based on three model-based metrics of free recall dynamics. These three measures reflect the patterns of memory retrieval of valenced information: the probability of first recall (Pstart) which represents initial affective bias, the probability of staying with the same valence category rather than switching, which indicates strength of positive or negative association networks (Pstay), and probability of stopping (Pstop) or ending recall within a given valence, which indicates persistence or stickiness of a mind state. We investigated the effects of Mindfulness-Based Cognitive Therapy (MBCT; N D29) vs. wait-list control (N D23) on these recall dynamics in a randomized controlled trial in individuals with recurrent depression. Participants completed a standard laboratory stressor, the Trier Social Stress Test, to induce negative mood and activate ruminative tendencies. Following that, participants completed a free recall task consisting of three word lists. This assessment was conducted both before and after treatment or wait-list. Results: while MBCT participant's Pstart remained relatively stable, controls showed multiple indications of depression-related deterioration toward more negative and less positive bias. Following the intervention, MBCT participants decreased in their tendency to sustain trains of negative words and increased their tendency to sustain trains of positive words. Conversely, controls showed the opposite tendency: controls stayed in trains of negative words for longer, and stayed in trains of positive words for less time relative to pre-intervention scores. MBCT participants tended to stop recall less often with negative words, which indicates less persistence or stickiness of negatively valenced mental context. Conclusion: MBCT participants showed a decrease in patterns that may perpetuate rumination on all three types of recall dynamics (Pstart, Pstay, and Pstop), compared to controls. MBCT may weaken the strength of self-perpetuating negative associations networks that are responsible for the persistent and "sticky" negative mind states observed in depression, and increase the positive associations that are lacking in depression. This study also offers a novel, objective method of measuring several indices of ruminative tendencies indicative of the underlying mechanisms of rumination. [ABSTRACT FROM AUTHOR]

The article discusses the importance of biology in context to cognitive model of depression and how the gaps in the model have been filled by genetic studies. It provides information that the cognitive theory and psychoanalytic approaches are work with similar phenomena. It reflects that the prototype cognitive model of depression is based on observations of depressed patients in psychotherapy, and depicts the putative role of the model which includes processing of emotionalstimuli.

There are obvious similarities between the cognitive constructs of Beck's cognitive theory, the hopelessness model, and the response styles theory. No single comprehensive model has yet integrated the core cognitive concepts of these theories, however. In order to develop such an integrative cognitive model, we conducted two independent studies with 588 and 606 participants, respectively, from a university population. Both studies support the idea that all cognitive constructs of the three models are distinct from each other. Furthermore, both studies provide evidence for the possibility an integration of the constructs in one cognitive model. If future studies replicate these findings, the integrated cognitive model can provide a theoretical framework to better understand how therapeutic techniques derived from one model influence cognitive variables from another model. This might even allow for improvements in the effectiveness of psychotherapies by theory-driven combinations of therapeutic techniques that are based on different models. [ABSTRACT FROM AUTHOR]

Positive affective functioning (PAF) is critical to the development, course and treatment of depressive symptoms. Targeting key features of PAF during treatment may provide a new angle through which to improve affective functioning and reduce symptoms. The current study was a treatment development trial for the Positive Affect Stimulation and Sustainment (PASS) Module. PASS is conceptualized as a means of capitalizing on positive events (e.g., planned through behavioral activation) by enhancing and sustaining positive affective states through savoring, and establishing positive attributions and expectancies. Participants were 27 female college students with dysphoric symptoms. There was a moderate effect of PASS on depressive symptoms. There was also a significant within session increase in positive affect from pre to post session among the PASS group, relative to active control; and a significant decrease in positive affect from pre (baseline) to post (follow-up) treatment among the control group, relative to PASS. Results provide preliminary evidence for the efficacy of the treatment module among young adults with depressed mood, and lay the foundation for future research. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapy Research is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although numerous EEG studies have shown that depression is associated with abnormal functional asymmetries in frontal cortex, fMRI and PET studies have largely failed to identify specific brain areas showing this effect. The present study tested the hypothesis that emotion processes are related to asymmetric patterns of fMRI activity, particularly within dorsolateral prefrontal cortex (DLPFC). Eleven depressed and 18 control participants identified the color in which pleasant, neutral, and unpleasant words were printed. Both groups showed a leftward lateralization for pleasant words in DLPFC. In a neighboring DLPFC area, the depression group showed more right-lateralized activation than controls, replicating EEG findings. These data confirm that emotional stimulus processing and trait depression are associated with asymmetric brain functions in distinct subregions of the DLPFC that may go undetected unless appropriate analytic procedures are used. [ABSTRACT FROM AUTHOR]

Long-term vulnerability to depression is related to the presence of perceived discrepancies between the actual self and ideal self-guides. This study examined the immediate effects of an 8-week course of Mindfulness-Based Cognitive Therapy (MBCT) on self-discrepancies in individuals currently in recovery, with a history of affective disorder that included suicidal ideation and behaviour. Results indicated significant time × group interactions for both ideal self similarity and ideal self likelihood ratings, primarily accounted for by increases in self-discrepancy from pre-test to post-test in the waiting list group which were not seen in those receiving MBCT. Changes in self-discrepancy were not associated with changes in residual depressive symptoms, but in the MBCT group there was a significant association between increases in ideal self similarity and the adoption of more adaptive ideal self-guides post treatment. MBCT may protect against increases in self-discrepancy in people vulnerable to relapse to depression and may also facilitate a shift in the goals of self-regulation. [ABSTRACT FROM AUTHOR]

PROBLEM: Limited research on pharmacologic treatments for pediatric major depressive disorder (MDD) exists. METHODS: Prescription practices data for MDD from 1,209 American Academy of Child and Adolescent Psychiatry members collected in 1998 are compared to the current empirical support for this treatment approach. FINDINGS: Results indicated that psychiatrists have willingly used medication as a first-line treatment for MDD in children under age 7, despite a paucity of research support for this practice. CONCLUSIONS: Recent warnings regarding the use of selective serotonin reuptake inhibitors warrant the need to reexamine current prescription practices of psychiatric care providers for children diagnosed with MDD. [ABSTRACT FROM AUTHOR]

The promise of a new generation of therapies targeted to address neurobiological mechanisms thought to underlie psychological disorders, particularly depression, using cognitive and behavioral techniques is discussed. Relationships between such neurobehaviorally focused therapies and other psychological and rehabilitative interventions are also discussed. Their potential utility as adjuncts to conventional treatment, and the importance of multi-method assessment in their evaluation are emphasized. Finally, initial data from a neurobehavioral “cognitive control training” (CCT) adjunctive intervention for severe unipolar depression is presented as an extended example. These data suggest that CCT aids in reducing both physiological mechanisms underlying depression as well as depressive symptomatology. [ABSTRACT FROM AUTHOR]

Most psychotherapy outcome studies in the field of depression focus on changes in depressive symptoms and impairment of functioning. The present article reports on the General Life Functioning Scale (GLF), a measure of more positive aspects of a patient's experience, specifically the patient's sense of well-being and feeling that he or she can cope with problems that arise. The development of the GLF and psychometric data are presented, followed by outcome analyses and prediction of follow-up in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Although there were no significant outcome findings, the GLF at termination significantly predicted follow-up status, emphasizing the importance of considering the extent to which depressed patients make gains in positive aspects of experience.ZusammenfassungPositive Aspekte des Patientenzustandes: Ein Maß zur Einschätzung des Behandlungserfolges und zur Vorhersage von Befindlichkeiten von depressiven Patienten zum KatamnesezeitpunktDie meisten Psychotherapie-Ergebnisstudien zu Depression sind auf Veränderung von depressiven Symptomen und die Beeinträchtigung von Funktionsweisen ausgerichtet. Die vorliegende Untersuchung berichtet über die General Life Functioning Skala (GLF), einem Maß zu positiven Aspekten der Erfahrung eines Patienten, insbesondere dem Gefühl des Wohlergehens und dem Gefühl, aufkommende Probleme bewältigen zu können. Es wird über die Konstruktion der GLF berichtet und es werden psychometrische Daten dazu vorgelegt, gefolgt durch Ergebnisanalysen und Vorhersagen des Zustandes von Patienten zum Anamnesezeitpunkt im ‘National Institute of Mental Health Treatment of Depression Collaborative Research Program’. Obwohl es keine signifikanten Ergebnisdaten gab, sagte die zu Ende der Behandlungen erhobene GLF den Zustand zum Anamnesezeitpunkt signifikant vorher. Auf diese Art konnte die Wichtigkeit der Berücksichtigung des Ausmaßes, in dem depressive Patienten über das Ende der Behandlung hinaus weitere positive Erfahrungsgewinne verbuchen können, deutlich herausgestellt werden.RésuméLes aspects positifs de l’état du patient : une mesure pour évaluer le résultat et prédire la catamnèse dans le traitement de la dépressionLa plupart des études d'efficacité dans le domaine de la dépression focalisent sur les changements des symptômes dépressifs et l'handicap fonctionnel. Cet article parle de l'Echelle de Fonctionnement Général dans la Vie (GLF), une mesure d'aspects plus primitifs de l'expérience du patient, en particulier le sens de bien-être du patient et le sentiment qu'il arrive à gérer les problèmes qui surviennent. Nous présentons le développement et des données psychométriques de la GLF, ensuite des analyses d'efficacité et la prédiction de la catamnèse dans le Programme de Recherche en Collaboration de l'Institut National de Santé Mentale sur le Traitement de la Dépression. Malgré l'absence de résultats significatifs concernant l'efficacité, la GLF a prédit de façon significative à la fin du traitement l’état à la catamnèse, ce qui souligne l'importance de considérer la mesure dans laquelle des patients dépressifs font des progrès dans des aspects positifs de leur expérience.ResumenAspectos positivos del estado de los pacientes: una medida para estimar el resultado y predecir el seguimiento en el tratamiento de la depresiónLa mayoría de los estudios de resultado en psicoterapia de la depresión se centran en los cambios de los síntomas depresivos y de las dificultades de funcionamiento de estas personas. Este artículo informa sobre la Escala general del funcionamiento vital (GLF), una medida de los aspectos positivos de la experiencia del paciente, específicamente de su sensación de bienestar y del sentimiento de poder afrontar los problemas que le surgen. Se presenta el desarrollo de la GLF y los datos psicométricos, junto con análisis del resultado y la predicción del seguimiento en el Programa Colaborativo de Investigación de tratamiento de la depresión del Instituto Nacional de Salud Mental (Nacional Institute of Mental Health Treatment of Depression Collaborative Research Program. Si bien no se encontraron resultados significativos, la GLF aplicada al terminar predijo significativamente el estatuto del seguimiento, enfatizando la importancia de considerar el grado en que los pacientes depresivos mejoran en los aspectos positivos de su experiencia.ResumoAspectos positivos do estado do paciente: Uma medida para avaliação dos resultados e predição dofollow-uppara o tratamento da depressãoA maioria dos estudos de resultados terapêuticos na área da depressão foca-se nas mudanças dos sintomas depressivos e do comprometimento do funcionamento. O presente artigo descreve a Escala de Funcionamento Geral de Vida (General Life Functioning Scale, GLF), uma medida dos aspectos mais positivos da experiência do paciente, especificamente o sentido de bem-estar do paciente e o sentimento de que pode lidar com os problemas que surjam. É apresentado o desenvolvimento da GLF, bem como os dados psicométricos, seguidos pelas análises de resultados e predição do seguimento (follow up) no Programa Colaborativo de Investigação do Tratamento da Depressão do National Institute of Mental Health (NIMH Treatment of Depression Collaborative Research Program). Apesar de não existirem resultados finais significativos, a GLF, no final da terapia, predisse significativamente o estado no seguimento (follow up), enfatizando a importância de considerar até que ponto os pacientes depressivos obtém ganhos nos aspectos positivos da experiência.SommarioAspetti positivi dello stato dei pazienti: una misura per valutare i risultati e per aggiornare la predizione del trattamento per la depressioneLa maggior parte degli studi di esito in psicoterapia nel campo della depressione si focalizzano sui cambiamenti dei sintomi depressivi e nelle disfunzioni del funzionamento. Il presente articolo presenta una relazione sulla scala di funzionamento di vita generale (GLF), una misura degli aspetti positivi dell'esperienza del paziente, specificamente sul senso di benessere del paziente e dei sentimenti che lui o lei possono fronteggiare con i problemi che si presentano.Sono presentati gli sviluppi della GLF ed i dati psicometrici, seguiti dalle analisi di esito e dalle previsioni di follow-up del National Institute of Mental Health Treatment of Depression Collaborative Research Program. Sebbene non ci fossero risultati significativi di esito, la GLF ha predetto significativamente la condizione di follow-up, enfatizzando l'importanza di considerare il grado/il punto al quale i pazienti depressi dimostrano di acquistare esperienza negli aspetti positivi.Abstract [ABSTRACT FROM AUTHOR]