Biomedical subjects

Clive J Robins

Publications and source records attributed to Clive J Robins.

4 recordsLinked to original sources

PubMed2005

Personality--life event congruence effects in late-life depression.

BACKGROUND: This study examined whether specific interactions of personality and life events predicted increases in depressive symptoms over time in a late-life sample. METHOD: Participants (n=55) who were in remission from a recent episode of major depression completed a depression symptom interview and a questionnaire assessing the personality constructs sociotropy and autonomy. Six months later, they completed the same personality questionnaire and a checklist of life events experienced during the past 6 months. RESULTS: As predicted, increases in depressive symptoms were significantly predicted by the congruent interaction of sociotropy with negative interpersonal events and by the congruent interaction of autonomy with negative autonomy events, but not by either of the non-congruent interactions. LIMITATIONS: A small sample prevented examinations of important depressive subtypes based on age of depression onset and vascular status. CONCLUSIONS: These findings strongly support the personality-life event congruence model of depression in a late-life sample. Clinical implications include attending to stressful events that match an older adult's personality style, to help the older adult cope with those events that are more likely to increase his or her depression.

Age of Onset↗

PubMed2004

Dialectical behavior therapy: current status, recent developments, and future directions.

Dialectical behavior therapy (DBT) was developed as a treatment for parasuicidal women with borderline personality disorder and has been adapted for several other populations. This article describes standard DBT and several adaptations of it and reviews outcome studies with borderline patients in outpatient, inpatient, and crisis intervention settings, borderline patients with substance use disorders, suicidal adolescents, patients with eating disorders, inmates in correctional settings, depressed elders, and adults with attention-deficit/hyperactivity disorder. This treatment outcome review is followed by discussion of predictors of change in DBT, possible mechanisms of change, and current developments in theory, practice, and research.

Behavior Therapy↗

PubMed2002

Sociotropy, autonomy, and personality disorder criteria in psychiatric patients.

Sociotropy and autonomy (Beck, 1983) are sets of beliefs, concerns, and behavioral tendencies that are proposed to create vulnerability to depression and other psychopathology and to influence its manifestation and treatment response. Other theoretical frameworks (Blatt, 1974) have made similar suggestions. We investigated the differential relations of sociotropy and autonomy to dimensional scores for each DSM-III-R personality disorder (PD) in a sample of 188 psychiatric patients, controlling for the other set of characteristics and for the other PDs. Histrionic and dependent PD traits were related specifically to sociotropy. Paranoid, schizoid, schizotypal, and passive-aggressive PD traits were related specifically to autonomy. Borderline, narcissistic, avoidant, and self-defeating PD traits were related significantly and about equally to both sociotropy and autonomy. Obsessive-compulsive PD traits were not related consistently to either. Results were mostly as predicted and suggest that sociotropy and autonomy may be useful constructs for understanding and treating PDs.

Adolescent↗

PubMedDate not supplied

Dialectical behavior therapy for depressed older adults: a randomized pilot study.

OBJECTIVE: Although there is evidence for the efficacy of antidepressants and for some individual and group psychotherapy interventions for depressed older adults, a significant number of these do not respond to treatment. Authors assessed the benefits of augmenting medication with group psychotherapy. METHODS: They randomly assigned 34 (largely chronically) depressed individuals age 60 and older to receive 28 weeks of antidepressant medication plus clinical management, either alone (MED) or with the addition of dialectical behavior therapy skills-training and scheduled telephone coaching sessions (MED+DBT). RESULTS: Only MED+DBT showed significant decreases on mean self-rated depression scores, and both treatment groups demonstrated significant and roughly equivalent decreases on interviewer-rated depression scores. However, on interviewer-rated depression, 71% of MED+DBT patients were in remission at post-treatment, in contrast to 47% of MED patients. At a 6-month follow-up, 75% of MED+DBT patients were in remission, compared with only 31% of MED patients, a significant difference. Only patients receiving MED+DBT showed significant improvements from pre- to post-treatment on dependency and adaptive coping that are proposed to create vulnerability to depression. CONCLUSION: Results from this pilot study suggest that DBT skills training and telephone coaching may offer promise to effectively augment the effects of antidepressant medication in depressed older adults.

Adaptation, Psychological↗