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Maladaptive mood repair responses distinguish young adults with early-onset depressive disorders and predict future depression outcomes

Published online by Cambridge University Press:  20 April 2009

M. Kovacs ,
J. Rottenberg  and
C. George
M. Kovacs*
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
J. Rottenberg
Affiliation:
University of South Florida, Tampa, FL, USA
C. George
Affiliation:
University of Pittsburgh Medical Center, Pittsburgh, PA, USA
*
*Address for correspondence: M. Kovacs, Ph.D., Western Psychiatric Institute and Clinic, 3811 O'Hara Street, 134 Webster Hall, Pittsburgh, PA 15213, USA. (Email: kovacs@pitt.edu)
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Abstract

Background

Clinical depression involves persistent dysphoria, implicating impaired affect regulation or mood repair failure. However, there is comparatively little information about the mood repair repertoires of individuals with histories of clinical depression, how their repertories differ from that of never-depressed people, and whether particular types of mood repair responses differentially contribute to depression risk.

Method

Adult probands who had childhood-onset depressive disorder (n=215) and controls with no history of major mental disorder (n=122) reported which specific (cognitive, behavioral, interpersonal and somatic-sensory) responses they typically deploy when experiencing sad affect, including responses known to appropriately attenuate dysphoria (‘adaptive’ responses) and those known to exacerbate dysphoria in the short or long run (‘maladaptive’ responses). Subjects were longitudinally followed and evaluated.

Results

Remitted probands and probands in depressive episodes both reported a greater number of maladaptive responses and fewer adaptive responses to their own sadness than did controls, although probands did not have an absolute deficiency of adaptive responses. Maladaptive (but not adaptive) mood repair responses predicted future increases in depression symptoms and an increased probability of a recurrent depressive episode among probands (even after controlling for several clinical predictors of course). Post-hoc analyses revealed that maladaptive non-cognitive and maladaptive cognitive mood repair response sets each predicted depression outcomes.

Conclusions

Individuals with past and present episodes of depressive disorder report an array of cognitive and non-cognitive responses to their own sadness that are likely to exacerbate that affect, and this pattern predicts a worse course of the disorder.

Keywords

Affect self-regulationdepressiondysphoriamood repairself-rated inventory
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 11 , November 2009 , pp. 1841 - 1854
Copyright
Copyright © Cambridge University Press 2009

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References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychological Association: Washington, DC.Google Scholar
Arnow, BA, Spangler, D, Klein, DN, Burns, DD (2004). Rumination and distraction among chronic depressives in treatment: a structural equation analysis. Cognitive Therapy and Research 28, 67–83.CrossRefGoogle Scholar
Bagby, RM, Parker, JDA (2001). Relation of rumination and distraction with neuroticism and extraversion in s sample of patients with major depression. Cognitive Therapy and Research 25, 91–102.CrossRefGoogle Scholar
Bagby, RM, Rector, NA, Segal, ZV, Joffe, RT, Levitt, AJ, Kennedy, SH, Levitan, RD (1999). Rumination and distraction in major depression: assessing response to pharmacological treatment. Journal of Affective Disorders 55, 225–229.CrossRefGoogle ScholarPubMed
Bargh, JA, Chartrand, TL (1999). The unbearable automaticity of being. American Psychologist 54, 462–479.CrossRefGoogle Scholar
Beck, AT (1967). Depression: Clinical, Experimental and Theoretical Aspects. Harper & Row: New York.Google Scholar
Beck, AT, Steer, RA, Carbin, MG (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review 8, 77–100.CrossRefGoogle Scholar
Carstensen, LL, Pasupathi, M, Mayr, U, Nesselroade, JR (2000). Emotional experience in everyday life across the adult life span. Journal of Personality and Social Psychology 79, 644–655.CrossRefGoogle ScholarPubMed
Casey, BJ, Tottenham, N, Liston, C, Durston, S (2005). Imaging the developing brain: what have we learned about cognitive development? Trends in Cognitive Sciences 9, 104–110.Google Scholar
Cox, DR (1972). Regression models and life-tables. Journal of the Royal Statistical Society, Series B 34, 187–220.Google Scholar
Cunningham, MR (1988). What do you do when you're happy or blue? Mood, expectancies, and behavioral interest. Motivation and Emotion 12, 309–331.CrossRefGoogle Scholar
Davidson, RJ, Lewis, DA, Alloy, LB, Amaral, DG, Bush, G, Cohen, JD, Drevets, WC, Farah, MJ, Kagan, J, McClelland, JL, Nolen-Hoeksema, S, Peterson, BS (2002). Neural and behavioral substrates of mood and mood regulation. Biological Psychiatry 52, 478–502.CrossRefGoogle ScholarPubMed
Dimidjian, S, Hollon, SD, Dobson, KS, Schmaling, KB, Kohlenberg, RJ, Addis, ME, Gallop, R, McGlinchey, JB, Markley, DK, Gollan, JK, Atkins, DC, Dunner, DL, Jacobson, NS (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology 74, 658–670.CrossRefGoogle ScholarPubMed
Donaldson, C, Lam, D (2004). Rumination, mood and social problem-solving in major depression. Psychological Medicine 34, 1309–1318.CrossRefGoogle ScholarPubMed
Fichman, L, Koestner, R, Zuroff, DC, Gordon, L (1999). Depressive styles and the regulation of negative affect: a daily experience study. Cognitive Therapy and Research 23, 483–495.CrossRefGoogle Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1995). Structured Clinical Interview for DSM-IV Axis I Disorders – Patient Edition (SCID-I/P, Version 2.0). Biometrics Research Department, New York State Psychiatric Institute: New York.Google Scholar
Gross, JJ (1998). The emerging field of emotion regulation: an integrative review. Review of General Psychology 2, 271–299.CrossRefGoogle Scholar
Gross, JJ (2007). Handbook of Emotion Regulation. Guilford Press: New York.Google Scholar
Gross, JJ, Carstensen, LL, Pasupathi, M, Tsai, J, Skorpen, CG, Hsu, AYC (1997). Emotion and aging: experience, expression, and control. Psychology and Aging 12, 590–599.CrossRefGoogle ScholarPubMed
Hemenover, SH, Augustine, AA, Shulman, T, Tran, TQ, Barlett, CP (2008). Individual differences in negative affect repair. Emotion 8, 468–478.Google Scholar
Isen, AM (1985). Asymmetry of happiness and sadness in effects on memory in normal college students: comment on Hasher, Rose, Sacks, Sanft, and Doren. Journal of Experimental Psychology: General 114, 388–391.CrossRefGoogle Scholar
Joormann, J, Siemer, M, Gotlib, IH (2007). Mood regulation in depression: differential effects of distraction and recall of happy memories on sad mood. Journal of Abnormal Psychology 116, 484–490.CrossRefGoogle ScholarPubMed
Josephson, BR, Singer, JA, Salovey, P (1996). Mood regulation and memory: repairing sad moods with happy memories. Cognition and Emotion 10, 437–444.CrossRefGoogle Scholar
Kovacs, M, Joormann, J, Gotlib, IH (2008). Emotion (dys)regulation and links to depressive disorders. Child Development Perspectives 2, 149–155.CrossRefGoogle ScholarPubMed
Kovacs, M, Obrosky, DS, Gatsonis, C, Richards, C (1997). First-episode major depressive and dysthymic disorder in childhood: clinical and sociodemographic factors in recovery. Journal of the American Academy of Child and Adolescent Psychiatry 36, 777–784.CrossRefGoogle ScholarPubMed
Kovacs, M, Obrosky, S, Sherrill, JT (2003). Developmental changes in the phenomenology of depression in girls compared to boys from childhood onward. Journal of Affective Disorders 74, 33–48.CrossRefGoogle ScholarPubMed
Kraeplin, E (1921). Manic Depressive Insanity and Paranoia. E & S Livingston: Edinburgh.Google Scholar
Kuehner, C, Weber, I (1999). Responses to depression in unipolar depressed patients: an investigation of Nolen-Hoeksema's response styles theory. Psychological Medicine 29, 1323–1333.CrossRefGoogle ScholarPubMed
Lam, D, Smith, N, Checkley, S, Rijsdijk, F, Sham, P (2003). Effect of neuroticism, response style and information processing on depression severity in a clinically depressed sample. Psychological Medicine 33, 469–479.CrossRefGoogle Scholar
Larsen, RJ (2000). Toward a science of mood regulation. Psychological Inquiry 11, 129–141.CrossRefGoogle Scholar
Lévesque, J, Eugène, F, Joanette, Y, Paquette, V, Mensour, B, Beaudoin, G, Leroux, J-M, Bourgouin, P, Beauregard, M (2003). Neural circuitry underlying voluntary suppression of sadness. Biological Psychiatry 53, 502–510.Google Scholar
Lewinsohn, PM, Graf, M (1973). Pleasant activities and depression. Journal of Consulting and Clinical Psychology 41, 261–268.Google Scholar
Lewinsohn, PM, Libet, J (1972). Pleasant events, activity schedules, and depressions. Journal of Abnormal Psychology 79, 291–295.CrossRefGoogle ScholarPubMed
Mauss, IB, Bunge, SA, Gross, JJ (2007). Automatic emotion regulation. Social and Personality Psychology Compass 1, 146–167.Google Scholar
Maziade, M, Roy, M-A, Fournier, J-P, Cliché, D, Merette, C, Caron, C, Garneau, Y, Montgrain, N, Shriqui, C, Dion, C, Nicole, L, Potvin, A, Lavallee, J-C, Pires, A, Raymond, V (1992). Reliability of best-estimate diagnosis in genetic linkage studies of major psychoses: results from the Quebec pedigree studies. American Journal of Psychiatry 149, 1674–1686.Google Scholar
Miller, A, Fox, NA, Cohn, JF, Forbes, EE, Sherrill, JT, Kovacs, M (2002). Regional patterns of brain activity in adults with a history of childhood-onset depression: gender differences and clinical variability. American Journal of Psychiatry 159, 934–940.CrossRefGoogle ScholarPubMed
Morris, WN, Reilly, NP (1987). Toward the self-regulation of mood: theory and research. Motivation and Emotion 11, 215–249.CrossRefGoogle Scholar
Morrow, J, Nolen-Hoeksema, S (1990). Effects of responses to depression on the remediation of depressive affect. Journal of Personality and Social Psychology 58, 519–527.Google Scholar
Nestler, EJ, Carlezon, WA Jr. (2006). The mesolimbic dopamine reward circuit in depression. Biological Psychiatry 59, 1151–1159.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S, Wisco, BE, Lyubomirsky, S (2008). Rethinking rumination. Perspectives on Psychological Science 3, 400–424.Google Scholar
Parkinson, B, Totterdell, P (1999). Classifying affect-regulation strategies. Cognition and Emotion 13, 277–303.Google Scholar
Rippere, V (1977). What's the thing to do when you're feeling depressed? – a pilot study. Behaviour Research and Therapy 15, 185–191.Google Scholar
Riso, LP, du Toit, PL, Blandino, JA, Penna, S, Dacey, S, Duin, JS, Pacoe, EM, Grant, MM, Ulmer, CS (2003). Cognitive aspects of chronic depression. Journal of Abnormal Psychology 112, 72–80.CrossRefGoogle ScholarPubMed
Rusting, CL, DeHart, T (2000). Retrieving positive memories to regulate negative mood: consequences for mood-congruent memory. Journal of Personality and Social Psychology 78, 737–752.Google Scholar
Scheier, MF, Carver, CS (1985). Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychology 4, 219–247.Google Scholar
Scheier, MF, Carver, CS, Bridges, MW (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a re-evaluation of the Life Orientation Test. Journal of Personality and Social Psychology 67, 1063–1078.CrossRefGoogle Scholar
Sherrill, JT, Kovacs, M (2000). Interview Schedule for Children and Adolescents (ISCA). Journal of the American Academy of Child and Adolescent Psychiatry 39, 67–75.CrossRefGoogle ScholarPubMed
Teasdale, JD (1988). Cognitive vulnerability to persistent depression. Cognition and Emotion 2, 247–274.CrossRefGoogle Scholar
Thayer, RE, Newman, JR, McClain, TM (1994). Self-regulation of mood: strategies for changing a bad mood, raising energy, and reducing tension. Journal of Personality and Social Psychology 67, 910–925.Google Scholar
Thomsen, DK (2006). The association between rumination and negative affect: a review. Cognition and Emotion 20, 1216–1235.CrossRefGoogle Scholar
Totterdell, P, Parkinson, B (1999). Use and effectiveness of self-regulation strategies for improving mood in a group of trainee teachers. Journal of Occupational Health Psychology 4, 219–232.Google Scholar
Tugade, MM, Fredrickson, BL (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of Personality and Social Psychology 86, 320–333.CrossRefGoogle ScholarPubMed
Watkins, ER (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin 134, 163–206.CrossRefGoogle ScholarPubMed
Westen, D, Muderrisoglu, S, Fowler, C, Shedler, J, Koren, D (1997). Affect regulation and affective experience: individual differences, group differences, and measurement using a Q-sort procedure. Journal of Consulting and Clinical Psychology 65, 429–439.CrossRefGoogle ScholarPubMed
Young, MA, Azam, OA (2003). Ruminative response style and the severity of seasonal affective disorder. Cognitive Therapy and Research 27, 223–232.CrossRefGoogle Scholar