Biomedical subjects

Kate L Harkness

Publications and source records attributed to Kate L Harkness.

11 recordsLinked to original sources

PubMed2006

Severe melancholic depression is more vulnerable than non-melancholic depression to minor precipitating life events.

BACKGROUND: The present study examines the moderating role of global depression severity on the relation of melancholic versus non-melancholic depression to severe and non-severe levels of stress. METHOD: A community sample of 50 women with unipolar major depressive disorder, of which 54% met Research Diagnostic Criteria for melancholic depression, were interviewed regarding stressful life events experienced prior to onset. Events were coded as severe or non-severe based on the rigorous Bedford College contextual rating system. RESULTS: Greater severity of depression was related to a higher likelihood of a severely stressful event prior to onset only for women with non-melancholic major depression. By contrast, greater severity of depression was related to a higher likelihood of a non-severe, more minor, stressful event prior to onset only for women with melancholic major depression. LIMITATIONS: The present study was limited by its use of a female volunteer sample, which might not be entirely representative of the population of individuals with major depression. In addition, the study employed a cross-sectional design, which limits conclusions relating to the causal relation of stress to melancholic versus non-melancholic depression. CONCLUSIONS: Far from being autonomous of stress, individuals with severe melancholic depression may be especially sensitive to stress, such that their episodes are influenced by more minor stressors than those of individuals with non-melancholic depression.

Adolescent↗

PubMed2006

The role of childhood abuse and neglect in the sensitization to stressful life events in adolescent depression.

This study examined the role of childhood abuse and neglect in sensitizing adolescents to the effects of proximal stressful life events in a cross-sectional sample of 103 depressed and nondepressed adolescents. Consistent with hypotheses, adolescents with a history of childhood abuse and/or neglect reported a lower level of threat of stressful life events prior to episode onset than that reported by those without. This effect was specific to those on their 1st episode of depression and was specific to independent events (i.e., stressors outside of adolescents' control). Further, this effect was robust when controlling for level of chronic difficulties, which was higher in those with childhood abuse and/or neglect. The authors suggest that childhood abuse and/or neglect may be an important risk factor that sensitizes individuals to the effects of acute independent life events.

Adolescent↗

PubMed2006

Life stress and the long-term treatment course of recurrent depression: III. Nonsevere life events predict recurrence for medicated patients over 3 years.

Research has consistently documented the significance of severe life events for onset of major depression. Theory, however, suggests other forms of stress are relevant for depression's recurrence. Nonsevere life events were tested in relation to depression for 126 patients with recurrent depression in a 3-year randomized maintenance protocol. Life stress was assessed every 12 weeks and rated along dimensions of severity, focus, and independence. A significant interaction between specific types of nonsevere life events and medication was found. For medicated patients, subject-focused independent nonsevere life events predicted recurrence; for unmedicated patients, these events predicted fewer recurrences. Other nonsevere life events did not predict recurrence. The findings underscore the potential importance of specific stressors for triggering recurrences of depression.

Adult↗

PubMed2005

Mental state decoding abilities in clinical depression.

BACKGROUND: Depression is associated with profound impairments in social functioning. Past research and theory suggests that these impairments may be related to a difficulty in the ability of depressed individuals to identify and decode others' social cues. However, the nature of this difficulty is equivocal. This investigation is the first to adopt a theory-of-mind framework to examine unipolar depressed individuals' ability to identify complex mental states from eye expressions. METHODS: Women with unipolar clinical depression (N=52) and nondepressed controls (N=30) completed the "Reading the Mind in the Eyes Task" (). All participants also completed self-report measures assessing depressive and anxious symptoms. RESULTS: Depressed women were significantly impaired in their ability to identify mental states in the Eyes task compared to nondepressed participants. This difference remained after controlling for anxiety and was stronger for the affective than the somatic symptoms of depression. LIMITATIONS: The present study was limited by its sample size, resulting in low power for some comparisons. In addition, the study is limited by its use of a heterogeneous depressed sample, including outpatients and volunteers from the community, as well as its use of only female participants. CONCLUSIONS: Our results demonstrate that severely depressed individuals are significantly impaired in their ability to decode others' mental states. We suggest that strategies based on improving basic theory-of-mind reasoning could be incorporated into current therapeutic interventions for depressed individuals to ameliorate their understanding and interpretation of social information.

Adult↗

PubMed2005

Life stress, the "kindling" hypothesis, and the recurrence of depression: considerations from a life stress perspective.

Major depression is frequently characterized by recurrent episodes over the life course. First lifetime episodes of depression, however, are typically more strongly associated with major life stress than are successive recurrences. A key theoretical issue involves how the role of major life stress changes from an initial episode over subsequent recurrences. The primary conceptual framework for research on life stress and recurrence of depression is the "kindling" hypothesis (R. M. Post, 1992). Despite the strengths of the kindling hypothesis, a review of the research literature reveals inconsistencies and confusion about life stress and its implications for the recurrence of depression. Adopting a life stress perspective, the authors introduce 3 major themes that resolve the inconsistencies in the current literature. They integrate these themes and extrapolate the ideas with available data to develop a preliminary framework for evaluating competing explanatory models and to guide research on life stress and the recurrence of depression.

Depression↗

PubMed2004

Neural correlates of mental state decoding in human adults: an event-related potential study.

Successful negotiation of human social interactions rests on having a theory of mind - an understanding of how others' behaviors can be understood in terms of internal mental states, such as beliefs, desires, intentions, and emotions. A core theory-of-mind skill is the ability to decode others' mental states on the basis of observable information, such as facial expressions. Although several recent studies have focused on the neural correlates of reasoning about mental states, no research has addressed the question of what neural systems underlie mental state decoding. We used dense-array event-related potentials (ERP) to show that decoding mental states from pictures of eyes is associated with an N270-400 component over inferior frontal and anterior temporal regions of the right hemisphere. Source estimation procedures suggest that orbitofrontal and medial temporal regions may underlie this ERP effect. These findings suggest that different components of everyday theory-of-mind skills may rely on dissociable neural mechanisms.

Analysis of Variance↗

PubMed2002

Life events, number of social relationships, and twelve-month naturalistic course of major depression in a community sample of women.

Research suggests that negative life events and social support are associated with the course of major depressive episodes. However, the manner in which these variables may be specifically interrelated remains unclear. The present study compared two models of the relation among life events, number of social relationships, and the naturalistic course of major depression in a community sample of women. The life event profiles of 32 women were assessed during their index episode of major depression (T1) and again 1 year later (T2). Measures included the Hamilton Depression Rating Scale, the Beck Depression Inventory, and the Life Events and Difficulties Schedule. Data analysis focused on whether life events and social relationships were independent predictors of depressive symptomatology (i.e., "main effects" model) or whether social relationships moderated the influence of life events on the naturalistic course of participants' major depressive episodes (i.e., "stress buffering" model). The results only partially supported the main effects model and failed to support the buffering model of the relation among life events, social relationships, and naturalistic depression course. In particular, the present findings indicated that number of social relationships was a significantly stronger predictor of naturalistic depression course than were life events. These findings suggest that insufficient social support is a particularly strong prospective predictor of elevated depressive symptomatology. Determining the quality of patients' social support networks should be a regular part of clinical assessment, and efforts should be made to help depressed patients establish supportive relationships both in the therapeutic environment and in their personal lives.

Adult↗

PubMed2002

Childhood adversity and anxiety versus dysthymia co-morbidity in major depression.

BACKGROUND: Childhood adversity places individuals with major depression at risk for anxiety and dysthymia co-morbidity. The goal of the present paper is to broaden this area of research by examining specificity between the type of adversity (e.g. abuse versus neglect/indifference) and the resulting co-morbid disorder (e.g. anxiety versus dysthymia co-morbidity). METHOD: The volunteer sample consisted of 76 women meeting Diagnostic and Statistical Manual (DSM-IV) criteria for major depression. Of these, 28 were diagnosed with a co-morbid anxiety disorder and 21 were diagnosed with co-morbid dysthymia. Childhood physical abuse, sexual abuse, psychological abuse, antipathy and indifference were assessed using a contextual interview and rating system. RESULTS: Severe sexual abuse and psychological abuse were significantly and preferentially associated with co-morbid anxiety, while severe physical abuse was significantly and preferentially associated with co-morbid dysthymia. Indifference and antipathy were significantly associated with both co-morbid anxiety and dysthymia. Multivariate analyses revealed that severe sexual abuse was the adverse childhood experience most strongly associated with co-morbid anxiety. CONCLUSIONS: These results suggest that particular adverse experiences in childhood do set up specific vulnerabilities to the expression of anxiety versus dysthymia co-morbidity in adulthood major depression. Cognitive mediators of these associations are discussed as avenues of future research.

Adolescent↗

PubMed2002

Does interpersonal psychotherapy protect women from depression in the face of stressful life events?

The present study compared the role of life events in predicting time to index episode onset under conditions of no or variable treatment versus the role of life events in predicting time to recurrence during maintenance interpersonal psychotherapy (IPT). Eighty-three women with recurrent major depression participated in acute IPT treatment followed by 2 years of maintenance IPT. Life events were assessed using contextual interview and rating methods. Cox regression survival analyses indicated that, although severe life events were significantly associated with time to index episode onset, there was little evidence of an association between events experienced during maintenance treatment and time to recurrence. These results provide evidence that IPT may decrease the potency of life events in provoking recurrence.

Adult↗

PubMed2002

Childhood adversity and the endogenous versus nonendogenous distinction in women with major depression.

OBJECTIVE: Previous research has reported an association between childhood adversity and the nonendogenous subtype of depression. The present study sought to address this association by 1) investigating the relationship between depression subtype and different levels of childhood adversity and 2) examining the relative contribution of different types of childhood adversity to depression subtypes. METHOD: The authors conducted an investigator-based assessment of childhood adversity in a community group of 76 depressed women, 31 of whom met Research Diagnostic Criteria for endogenous depression. RESULTS: In contrast to previous studies, severe physical abuse, sexual abuse, antipathy, and neglect were significantly and preferentially associated with endogenous depression, as were both high and lax levels of supervision and discipline. In multivariate analyses, severe sexual abuse and a composite variable comprising antipathy and neglect were most strongly associated with endogenous depression. CONCLUSIONS: Implications of these findings in the context of the existing literature are discussed, and potential mediators of the relationship between childhood adversity and endogenous depression are presented as avenues for future research.

Adolescent↗

PubMed2002

Traumatic grief treatment: case histories of 4 patients.

BACKGROUND: Traumatic grief treatment is a newly developed intervention for a debilitating bereavement-related condition. Traumatic grief treatment uses imaginal and in vivo exposure techniques to target emotional distress and behavioral avoidance hypothesized to be core features of the syndrome, along with interpersonal psychotherapy techniques to engage patients and maintain rapport. The present report describes 4 case histories of patients treated in this way. METHOD: Each patient met our criterion for traumatic grief, defined as a score of at least 25 on the Inventory of Complicated Grief. Additionally, all 4 patients met DSM-IV criteria for a current episode of major depression and 1 patient for bipolar II disorder. The treatment course followed a direct replication design and ranged from 14 to 18 weekly 60- to 90-minute sessions. RESULTS: These 4 cases illustrate reduction in distress during exposure to painful emotional memories and avoided situations that was associated with decreased scores on measures of traumatic grief, depression, and anxiety and increased participation in and enjoyment of daily-life activities. CONCLUSION: Case histories of traumatic grief treatment suggest it is a promising treatment for individuals suffering from traumatic grief. It appears that imaginal relieving and in vivo exposure are effective in reducing grief intensity and lead to reduction in symptoms.

Aged↗