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Title

DEPRESSION AND ATTRIBUTIONS FOR DISTRESS

Creator

Hanson, Bjorn J.

Date

2013, 2013-07

Description

Distress caused by depressive symptoms includes both direct and mediated pathways. Attributions for distress in individuals suffering from...
Show moreDistress caused by depressive symptoms includes both direct and mediated pathways. Attributions for distress in individuals suffering from depressive symptoms represent indirect pathways that have a high potential to be modified by psychotherapeutic interventions; however, little research has focused on the content of these attributions. This study provides the first quantitative measurement of this reasons-for-distress paradigm. Specifically, we aim to describe the frequencies, intensities, and co-occurrence patterns of attributions for distress, as well as distinguish the attributions for distress paradigm from previous attributions for depression research. Furthermore, we seek to demonstrate the accuracy of an illness behavior model for conceptualizing distress caused by depressive symptoms by differentiating symptom severity from symptom distress. In addition to quantifying attributions for distress, this study also extends previous research regarding rumination, the severity of distress caused by cognitive and vegetative symptoms of depression, and the co-occurrence of specific symptoms and specific reasons for distress. Individuals currently suffering from depressive symptoms were recruited from web-based advertisements to participate in this cross-sectional, online self-report study. A total of 204 individuals qualified for the study and completed some portion of the Reasons for Distress Questionnaire-Depression (RDQ-D). Results demonstrated that all reasons provided as part of the RDQ-D represented common attributions for distress in depressed individuals. Reasons related to personalized reasons for distress (Other), long-term outcomes (Long-term Consequences), productivity impairment (Work and Productivity Impairment), and x existential distress (Lack of Purpose or Meaning) were rated as significantly more distressing when compared with all reasons for distress. Cluster analysis suggested that certain reasons tended to co-occur and that some attributions for distress are nearly universal amongst individuals suffering from significant depressive symptoms. The reason-for-distress paradigm was demonstrated to be related to, yet distinct from, the reason-for-depression paradigm (Addis, Truax, & Jacobson, 1995). Distress ratings were also found to be moderately positively correlated with some depressive symptoms, but not others, providing support for an illness behavior conceptualization of distress severity in depression. Expanding on prior research, results showed that rumination was equally distressing and frequent across gender. Also, cognitive/affective symptoms of depression were rated as more distressing than vegetative symptoms of depression. Additionally, participants demonstrated the capacity to endorse specific reasons for distress in association with specific symptoms. As predicted, the existential reason for distress Lack of Purpose or Meaning was endorsed more frequently in relation to cognitive/affective symptoms of depression as compared to vegetative symptoms of depression. By focusing on specific symptoms of depression, the RDQ-D provides a clinical assessment that has the ability to identify specific unhelpful responses to symptoms that may be causing distress in addition to that inherent in the experience of the symptom. These unhelpful responses can then be included in case conceptualization, treatment planning, and intervention selection.
PH.D in Psychology, July 2013
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