Lecture 11 - Late life depression/stress

Question 1

Cognitive Theory - Dysfunctional Cognitions

Answer 1

Stable traits that predispose one to depression

BUT recovered depressed patients do not show any dysfunctional cognitions

Question 2

Differential activation hypothesis

Answer 2

Dysfunctional cognitions activated in depressed state

Therefore it is mood/state dependent

Question 3

Rumination

Answer 3

NOT same as worrying

• Mode of responding to emotional distress involving repetitively and passively focusing on the symptoms of distress or possible causes and consequences of these negative emotional experiences
• Prevent active problem solving to change circumstances surrounding these symptoms

Question 4

Response style theory of depression

Answer 4

When you’re vulnerable to depression, you tend to ruminate more on symptoms of depression (ex: repeatedly thinking about what mood you have, and what consequences they have on you)

Question 5

Aspects of Rumination

Answer 5

Passively dwelling on negative aspects (brooding)

Attempting to get more insight (reflective)

Question 6

Rumination and Depression

STUDY: Nolen-Hoeksema, 2000

Answer 6

• longitudinal sample; rumination predicted first episode of depression, but not recurrence
• Combination of negative attributional style and rumination predict the duration of depressive symptoms

Question 7

Rumination mediates between depression and factors that are correlated with depression such as:

Answer 7

• Neuroticism
• Negative attributional style
• Pessimism
• Self-criticism
• Dependency
• Neediness

Question 8

Gender and Rumination

Answer 8

• Women more likely to engage in rumination than men
• Mediate gender differences in depression in some studies
• STUDY: mood induction in both men and women then asked to engage in a task (choose either an emotional task or a neutral task that would distract); women tend to choose more emotional tasks and men more neutral

Question 9

Rumination causes inhibition of instrumental behaviour

Answer 9

• Dysphoric ruminators: recognized that pleasant,
  distracting activities would lift their mood, but they
  were unwilling to try them.
• Ruminators with breast cancer reported having
  delayed the presentation of their initial symptoms
  to a physician more than 2 months longer than did
  non-ruminator (Lyubomirsky et al., 2006)
• Rumination correlated with low compliance with a
  medical regiment among a diverse of cancer
  patients in Germany (Aymanns et al., 1995).

Question 10

Rumination and social support

Answer 10

• Bereaved ruminators more likely to reach out for social support after their loss
  o BUT: reported more social friction and less emotional support from others
• Ruminators reports that friends and family become frustrated with their continued need to talk about their loss and its meaning for their lives many months after the loss

Question 11

Rumination manipulation

Answer 11

When ruminated:

• Diminished concentration
• Increase time required for reading and test tasks
• Impaired work strategies and performance
• Impaired memory, cognitive control, difficulty inhibiting negative information

Question 12

Mechanism of rumination

Answer 12

• Enhanced effects of depressed mood on thinking
• Interfere with effective problem-solving
• Interfere with instrumental behaviour, leading to increases in stressful circumstances
• Erosion of social support resources

Question 13

How is rumination linked with anxiety and depression

Answer 13

• Rumination is a mediator b/w stressful life events and anxiety symptoms
• stressful life events predict rumination, and rumination predicts high anxiety

Question 14

How do we assess life Stress?

Answer 14

Life Events and Difficulties Schedule (LEDS)

Question 15

What facets are there on the LEDS

Answer 15

• Timing
• Duration
• Episodic vs. chronic
  •Episodic: beginning and an end; ex: divorce, school, health problem, loss of job
  •Chronic: no beginning or end date; ex: chronically ill
• Judge-rated severity
• Dependent vs. Independent events
  • Dependent: events influenced by individual; ex: drug addiction, work stress
  •Independent: events outside control of individual; ex: getting sick, natural disaster
• Interpersonal vs. non-interpersonal
  • Interpersonal is social context (ex: divorce)
  • Non-interpersonal is NOT social (ex: natural disaster)

Question 16

Stress Generation Hypothesis

Answer 16

• Individuals are active in shaping environment
• Depression contributed to the occurrence of stressful life events
• Individuals prone to depression are not solely responding to stressful events but are also more likely to create stressors

Question 17

Research on stress generation hypothesis

Answer 17

• Women with history of depression more likely to experience dependent interpersonal events
• Self-perpetuating cycle of depression and stress

Question 18

Factors associated with stress generation

Answer 18

• Low socioeconomic environment
• Adverse childhood events
• History of maternal depression
• Neuroticism
• Axis II symptomatology
• High levels of cognitive vulnerability
• At least in part, also genetically determined.

Question 19

Mechanisms of stress generation

Answer 19

• Poor interpersonal problem-solving skills
• Lower ability to provide emotional support to
  others
• Negative expectations of support from
  spouses
• Excessive reassurance seeking

Question 20

Twin Study on Stress generation

Answer 20

How much stress their non-depressed co-twin experienced

• MZ twins had more stress
• Genetic risk for MDD was associated with significantly increased risk for personal SLEs (stressful life events) and one network SLE (trouble getting along with relatives and friends). This effect was not due to SLEs occurring during depressive episodes

Question 21

Genetic (s/s, s/l, l/l) study on stressful life events

Answer 21

Those with s/s allele had many more interpersonal stressful life events than l/l

Question 22

STUDY: Child Abuse and Stress generation

Answer 22

• Adults with history of depression
• Individuals exposed to child abuse more like to have greater levels of stress generation; mediated by negative attribution style

Question 23

Late Life Depression - Prevalence

Answer 23

15-20%

Question 24

Differences b/w late life depression and earlier depression?

Answer 24

• Late life has higher heterogeneity

- Late life has more lack of interest, more apathy, more somatic symptoms (less obvious mood symptoms)

Question 25

Is late life depression risk factor for future dementia

Answer 25

late-life depression increases the risk of all-cause dementia and, more specifically, of both vascular dementia and Alzheimer’s