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.Importantly, at the first assessment theinvestigators determined whether the students were cognitively vulnerable todeveloping depression or not on the basis of their scores on questionnaires thatmeasure dysfunctional attitudes and hopelessness attributions.In an initial report(Alloy et al., 2000), students at high risk because of dysfunctional attitudes reportedhigher rates of depression in the past compared with the low-risk group.But the reallyimportant results come from the prospective portion of the study.Preliminary resultsfrom the first 2.5 years of follow-up suggest that negative cognitive styles do indicatea vulnerability to later depression.Even if participants had never suffered fromdepression before, high-risk participants (who scored high on the measures ofcognitive vulnerability) were far more likely than low-risk participants to experience amajor depressive episode or at least depressive symptoms.Seventeen percent of thehigh-risk subjects versus only 1% of the low-risk subjects experienced majordepressive episodes, and 39% versus 6% experienced minor depressive symptoms(Gotlib & Abramson, 1999).This study is not perfect because even though subjectsdid not meet diagnostic criteria for depression at the initial assessment, they mighthave had minor depressive symptoms (Solomon & Haaga, 2003), and we must awaitthe final results of this study.Nevertheless, preliminary data are suggestive thatcognitive vulnerabilities to developing depression do exist and, when combined withbiological vulnerabilities, create a slippery path to depression.learned helplessness theory of depression Seligman s theory that people becomeanxious and depressed when they make an attribution that they have no control overthe stress in their lives (whether in reality they do or not).Durand 6-78depressive cognitive triad Thinking errors in depressed people negatively focusedin three areas: themselves, their immediate world, and their future.Social and Cultural DimensionsA number of social and cultural factors contribute to the onset or maintenance ofdepression.Among these, marital relationships, gender, and social support are mostprominent.Marital RelationsMarital dissatisfaction and depression are strongly related, as suggested previouslywhen it was noted that disruptions in relationships often lead to depression.Findingsfrom a number of studies also indicate that marital disruption often precedesdepression.Bruce and Kim (1992) collected data on 695 women and 530 men andthen reinterviewed them up to 1 year later.During this period a number of participantsseparated from or divorced their spouses, though the majority reported stablemarriages.Approximately 21% of the women who reported a marital split during thestudy experienced severe depression, a rate three times higher than that for womenwho remained married.Nearly 17% of the men who reported a marital split developedsevere depression, a rate nine times higher than that for men who remained married.However, when the researchers considered only those participants with no history ofsevere depression, 14% of the men who separated or divorced during the periodexperienced severe depression, as did approximately 5% of the women.In otherwords, only the men faced a heightened risk of developing a mood disorder for thefirst time immediately following a marital split.Is remaining married more importantto men than to women? It would seem so.Durand 6-79Monroe, Bromet, Connell, and Steiner (1986), as well as O Hara (1986), alsoimplicated factors in the marital relationship as predicting the later onset ofdepression.Important findings from the Monroe group s (1986) study emphasize thenecessity of separating marital conflict from marital support.In other words, it ispossible that high marital conflict and strong marital social support may both bepresent at the same time or may both be absent.High conflict, low support, or bothare particularly important in generating depression (Barnett & Gotlib, 1988; Gotlib &Beach, 1995).Another finding with considerable support is that depression, particularly if itcontinues, may lead to substantial deterioration in marital relationships (Beach,Sandeen, & O Leary, 1990; Coyne, 1976; Gotlib & Beach, 1995; Hokanson, Rubert,Welker, Hollander, & Hedeen, 1989; Paykel & Weissman, 1973; Whiffen & Gotlib,1989).It is not hard to figure out why.Being around someone who is continuallynegative, ill tempered, and pessimistic becomes tiring after a while.Because emotionsare contagious, the spouse probably begins to feel bad also.These kinds ofinteractions precipitate arguments or, worse, make the nondepressed spouse want toleave (Biglan et al., 1985).But conflict within a marriage seems to have different effects on men and women.Depression seems to cause men to withdraw or otherwise disrupt the relationship.Forwomen, on the other hand, problems in the relationship most often cause depression.Thus, for both men and women, depression and problems in marital relations areassociated, but the causal direction is different (Fincham, Beach, Harold, & Osborne,1997), a result also found by Spangler, Simons, Monroe, and Thase (1996).Giventhese factors, Beach et al.(1990) suggest that therapists treat disturbed maritalDurand 6-80relationships at the same time as the mood disorder to ensure the highest level ofsuccess for the patient and the best chance of preventing future relapses.Mood Disorders in WomenData on the prevalence of mood disorders indicate dramatic gender imbalances.Although bipolar disorder is evenly divided between men and women, almost 70% ofthe individuals with major depressive disorder and dysthymia are women (Bland,1997; Hankin & Abramson, 2001; Nolen-Hoeksema, 1987; Weissman et al., 1991).What is particularly striking is that this gender imbalance is constant around theworld, even though overall rates of disorder may vary from country to country(Weissman & Olfson, 1995) (see Figure 6.5).Often overlooked is the similar ratio formost anxiety disorders, particularly panic disorder and generalized anxiety disorder.Women represent an even greater proportion of specific phobias, as we noted inChapter 2.What could account for this?[Figures 6.5 goes here]It may be that gender differences in the development of emotional disorders arestrongly influenced by perceptions of uncontrollability (Barlow, 1988, 2002) [ Pobierz całość w formacie PDF ]