Psychopathological Assessment and Diagnosis

Ahrens, B.; Stieglitz, R. D.

doi:10.1159/000066237

Cited by 2 publications

(1 citation statement)

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“…Here, we investigated the following hypotheses derived from the revised learned helplessness model: (1) The feeling of inadequacy/worthlessness is a consistent symptom of MDD and co-occurs with other core symptoms when assessed using an instrument designed to assess individual symptoms (AMDP, ( Ahrens and Stieglitz, 1998 ; Busch et al, 1980 )) rather than those used in DSM validation studies. (2) The type of self-blaming emotion experienced during depressive episodes differs between patients and is not restricted to guilt.…”

Section: Introductionmentioning

confidence: 99%

The role of self-blame and worthlessness in the psychopathology of major depressive disorder

Zahn

Lythe

Gethin

et al. 2015

Journal of Affective Disorders

141

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BackgroundCognitive models predict that vulnerability to major depressive disorder (MDD) is due to a bias to blame oneself for failure in a global way resulting in excessive self-blaming emotions, decreased self-worth, hopelessness and depressed mood. Clinical studies comparing the consistency and coherence of these symptoms in order to probe the predictions of the model are lacking.Methods132 patients with remitted MDD and no relevant lifetime co-morbid axis-I disorders were assessed using a phenomenological psychopathology-based interview (AMDP) including novel items to assess moral emotions (n=94 patients) and the structured clinical interview-I for DSM-IV-TR. Cluster analysis was employed to identify symptom coherence for the most severe episode.ResultsFeelings of inadequacy, depressed mood, and hopelessness emerged as the most closely co-occurring and consistent symptoms (≥90% of patients). Self-blaming emotions occurred in most patients (>80%) with self-disgust/contempt being more frequent than guilt, followed by shame. Anger or disgust towards others was experienced by only 26% of patients. 85% of patients reported feelings of inadequacy and self-blaming emotions as the most bothering symptoms compared with 10% being more distressed by negative emotions towards others.LimitationsSymptom assessment was retrospective, but this is unlikely to have biased patients towards particular emotions relative to others.ConclusionsAs predicted, feelings of inadequacy and hopelessness were part of the core depressive syndrome, closely co-occurring with depressed mood. Self-blaming emotions were highly frequent and bothering but not restricted to guilt. This calls for a refined assessment of self-blaming emotions to improve the diagnosis and stratification of MDD.

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Section: Introductionmentioning

confidence: 99%