Relationship between dysfunctional cognitions and depressive subtypes

The relationship of dysfunctional attitudes to personality in depressed patients

AIM

To examine the relationship between dysfunctional attitudes and personality in depressed patients.

METHOD

One hundred depressed patients completed both the Dysfunctional Attitudes Scale (DAS) and the Temperament and Character Inventory (TCI).

RESULTS

Scores on the DAS correlated with duration of depression, age of onset of depression, age, harm avoidance and self-directedness. In a multiple regression analysis three measures explained 45% of the DAS score. These were duration of depression, reward dependence and self-directedness. In both the univariate analyses and multiple regression the strongest predictor of dysfunctional attitudes was the character dimension of self-directedness.

CONCLUSION

The character dimension of self-directedness in the TCI which assesses an individuals' self-concept, relates highly with the dysfunctional attitudes score on the DAS. Given that the TCI assesses personality within a broader framework of a psychobiologic and developmental model, self-directedness may have a wider application as a measure of self-concept than the DAS.

Dysfunctional attitudes and vulnerability to persistent depression

Forty-four patients who met criteria for major depressive disorder were assessed for presence of dysfunctional attitudes and negative self-schema on admission. After six weeks, of sixteen patients who had shown high dysfunctional attitudes, six (35%) had not recovered. By contrast, of seventeen patients who had been equally severely depressed at the outset, but had low dysfunctional attitudes, only one (6%) had not recovered. The rating by the patients of themselves, as opposed to their attitudes, did not however predict. Thirty-one patients were tested six months later. Twenty-one (68%) remained asymptomatic, ten patients had relapsed or not responded to treatment, but neither type of admission measure predicted the state at this point. This is consistent with previous evidence which suggests that vulnerable attitudes assessed when symptomatic predict recovery, but that for prediction of relapse, cognitive measures need to be used when the patient is asymptomatic.