Helpful Links
Links for Depression
For University of Maine students:
| Links for Related Disorders
groups. NEDA is a support organization for individuals and their families who suffer from eating disorders.
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Sources
- Danchin, C.L., MacLeod, A.K., & Tata, P. (2010). Painful engagement in deliberate self-harm: The role of conditional goal setting. Behaviour Research and Therapy, 48, 915-920
- Hoff, E.R., & Muehlenkamp, J.J. (2009). Nonsuicidal self-injury in college students: The role of perfectionism and rumination. Suicide & Life-Threatening Behavior, 39(6), 576-587.
- Keller, M.B., Hirschfeld, R.M.A., & Hanks, D. (1997). Double depression: A distinctive subtype of unipolar depression. Journal of Affective Disorders, 45, 65-73.
- McNamara, P., Auerbach, S., Johnson, P., Harris, E., & Doros, G. (2010). Impact of REM sleep on distortions of self-concept, mood and memory in depressed/anxious participants. Journal of Affective Disorders, 122, 198-207.
- Nolen-Hoeksema, S. (2011). Abnormal psychology. New York, NY: McGraw-Hill.
- Nolen-Hoeksema, S., Fredrickson, B.L., Loftus, G., & Wagenaar, W.A. (Ed.). (2009). Atkinson & Hilgard's introduction to psychology. Canale, Italy: Wadsworth: CENGAGE Learning.
- STAR★D: Sequenced Treatment Alternatives to Relieve Depression
Annotated Bibliography: Summaries of Relevant Studies
- Hoff, E.R., & Muehlenkamp, J.J. (2009). Nonsuicidal self-injury in college students: The role of perfectionism and rumination. Suicide & Life-Threatening Behavior, 39(6), 576-587.
The purpose of this study was to determine the contribution of perfectionism, rumination, depression, and anxiety to nonsuicidal self-injury (NSSI). The escape theory of suicidality was applied to NSSI. In both instances, the person attributes a failure to personal faults, which leads to a depressed and anxious state. The person then ruminates on the failure until it becomes overwhelming, and a narrowing of problem-solving options occurs: this leads to NSSI being seen as the only possible solution to end/reduce the psychological distress. The rationale behind this study was that both a tendency towards perfectionism and rumination contribute to escapist acts such as self-injury and suicide attempts. A sample of 170 college students filled out a self-harm inventory, a depression scale, an anxiety inventory, a perfectionism inventory, and the Ruminative Responses Scale (RRS). Individuals who had engaged in NSSI scored significantly higher on rumination, depression, and anxiety scales than the control individuals. The two groups also scored differently on three perfectionism subscales: concern over mistakes, parental criticism, and organization. One limitation of this study was that it put people who engaged in chronic NSSI and people who had only engaged in a single episode of NSSI into one group. The results of the study would have most likely been different if the NSSI group only included chronic engagers. However, this study did well explaining the relation between the two personality traits (perfectionism and rumination) and depression and anxiety disorders. This study is particularly relevant to the Could I Have Depression? (CIHD) website because it consisted entirely of college students. NSSI is also closely related to depression and can be seen as a highly indicative symptom (although it can also be a symptom of other disorders).
- Keller, M.B., Hirschfeld, R.M.A., & Hanks, D. (1997). Double depression: A distinctive subtype of unipolar depression. Journal of Affective Disorders, 45, 65-73.
This paper focused on the distinctions between major depression, dysthymia, and double depression. A meta-analysis of several studies was conducted to determine the distinguishing factors of these three disorders. Results of the studies indicated that those who relapsed after a major depressive episode had about a 20% chance of remaining chronically ill. Six course patterns for major depression were described: major depression can present as either a single episode or recurring episodes, with or without prior dysthymia, and, for recurring episodes, with or without full interepisode recovery. It was found that the majority of patients diagnosed with dysthymia later developed major depression. People who suffer from double depression also stay depressed for longer periods of time than those with major depression. It was also found that if a patient with double depression recovered from a major depressive episode but could not recover from their chronic dysthymia, they would relapse into another major affective episode. This study determined that clinical predictors of recovery and relapse from a major depression are not accurate when applied to patients with double depression. One flaw with this paper is that it does not discuss the possibility that the difference between major and double depression might lie in the DSM classification of major depression rather than the two being separate disorders. Overall, the meta-analysis was comprehensive and provided solid evidence for the distinction between the three types of unipolar depression. This study is very relevant to the CIHD website: the distinctions between dysthymia, major depression, and double depression are useful to know for people trying to classify their symptoms.
- Loas, G. (1996). Vulnerability to depression: A model centered on anhedonia. Journal of Affective Disorders, 41, 39-53.
This paper presented a vulnerability model of depression centered on anhedonia. The model suggests that a predisposition for anhedonia is present from birth due to a factor such as brain injury or a chemical imbalance in the womb, which increases the developing child’s capacity for displeasure. As the child grows older, the model suggests that their predisposition to anhedonia would result in the parents using more negative rather than positive reinforcement, because the child will not respond well to positive reinforcement. It then predicts that the child will become introverted, autonomous, pessimistic, low sensation-seeking, and have dysfunctional attitudes. In addition, the model predicts the child will have a marked interest in working activity, which can lead to perfectionism and obsessive-compulsive features. The result of these factors would be mild dysthymia, which, with the stresses of adolescence and adulthood, would most likely turn into a unipolar depression. Literature was reviewed to discover the strength of the model. Several twin studies have suggested that the ability to feel pleasure (hedonic capacity) is genetically determined. There was also a high positive correlation between anhedonia and capacity for displeasure, introversion, autonomy, and dysfunctional attitudes. This model seems promising as it reinforces the diathesis-stress model of depression: that an inherited vulnerability to depression plus environmental stress results in the disorder. The model also integrates biological, behavioral, and cognitive components. However, the relationship between low hedonic capacity and parental use of positive and negative reinforcement is not well explained, and the paper does not discuss the behavior of children with a low hedonic capacity in much detail. This model is relevant to the CIHD website because it proposes a genetic origin of dysthymia, which, combined with the stressors of college, could be enough to cause a more severe depression.
- McNamara, P., Auerbach, S., Johnson, P., Harris, E., & Doros, G. (2010). Impact of REM sleep on distortions of self-concept, mood and memory in depressed/anxious participants. Journal of Affective Disorders, 122, 198-207.
This study examined the relationship between REM sleep and the cognitive distortions of mood disorders. The pattern of prefrontal cortex activation that occurs naturally in REM sleep is associated with the selective consolidation of negative emotional memories and a more negative mood. Fifty-five participants were recruited and completed a variety of tests measuring personality, sleep, mood, and behavior before the experiment was conducted in the sleep lab. These preliminary tests functioned to separate participants into the healthy and depressed/ anxious groups. On the night of the experiment, participants completed four awakening tasks: one right before going to sleep, one when awoken from REM sleep, one when awoken from Stage II NREM sleep, and the last one right after being woken up in the morning. The task packet included the Positive and Negative Affect Scale (PANAS), an autobiographical memory recall, a self-other word recall task, and ratings of the self, other, and the dream self. Participants labeled depressed/anxious rated themselves significantly less positively after awakening from REM than NREM sleep. In both groups, negative memories were more likely to be retrieved after REM sleep. Depressed/anxious participants also had more aggressive dream content and experienced more negative emotions in their dreams. One limitation of this study is that it had a relatively small sample size, with only twenty individuals reporting symptoms of depression. None of these individuals had received clinical diagnoses of depression. However, the study provides an important link between REM sleep and depression, suggesting that REM sleep in fact contributes to the cognitive distortions present in depression. This study is highly relevant to the CIHD website because it contained a disproportionately large amount of college students and describes the cognitive distortions present in depression.