Background: Postnatal depression (PND) follows 10-15% of deliveries. Postnatal blues occur in the first postpartum week and are thought to have little significance. Studies report links between them, PND and premenstrual symptomatology but are methodologically flawed. Hypotheses: Women with severe blues are more likely to become depressed in the 6 months after delivery and more likely to experience premenstrual symptomatology when menstruation resumes. Subjects: First-time mothers who were literate, English speaking, had a singleton pregnancy, no current severe mental illness and whose fetus was healthy. Method: Written informed consent was obtained in late pregnancy. Baseline data include the Eysenck Personality Questionnaire, Edinburgh Postnatal Depression Scale (EPDS), sociodemographic and obstetric details. The Blues Questionnaire was completed on postpartum days 3 & 5. Obstetric data were recorded. Subjects (scores >/75^th centile on the Blues Questionnaire) and controls (\<25^th centile) were matched for age, marital status and social class. All participants completed monthly postal EPDS. When menstruation returned, daily Menstrual Distress Questionnaires and visual analogue scales for premenstrual symptoms were completed for 2 cycles. At 6 months all women with EPDS scores >/9 at any time postpartum were interviewed using the Schedule for Affective Disorder and Schizophrenia (Lifetime version). Research Diagnostic Criteria diagnoses were made for current or past psychiatric disorder. 1 in 5 women with EPDS scores <9 were interviewed to exclude false negatives. Results: Women with severe blues were 3.8 times more likely to become depressed and to have a major rather than minor illness. Their depressions began sooner after delivery and lasted longer than those with no blues. They were more likely to experience premenstrual symptoms. Discussion: Results support the idea that these conditions are variants of affective disorder, severe blues acting as a marker of affective vulnerability. Clinical applications of the results and areas for further research are explored.

No description available.

5-hydroxytryptamin (5-HT) is biochemically derived from Tryptophan. Kynurenic acid and quinolinic acid are also known metabolites of tryptophan. 5-HT is considered to play a role in depression and today selective serotonin reuptake inhibitors (SSRIs) are used for treatment of depression. 5-HT may also play a role in pain perception. The aim of this study was to investigate whether a supplement of tryptophan may affect conditions such as depression and/or pain. Reviewed studies show that tryptophan deficiency leads to less availability of tryptophan in the brain, which reduces the synthesis of serotonin. Lowering of mood appears and seems to be linked to the decrease in serotonin synthesis. Supplements of tryptophan have in some studies been shown to have effects on social behaviour with reduced quarrelsome behaviour and increased dominant behaviour. Corresponding studies on the effects on pain provide a complex picture. Results indicate that in acute pain 5- HT seems to provide some pain relief but contradictory responses to 5-HT are seen in neuropathic and inflammatory pain. Comorbidity with both depression and pain occur, and has been linked to the increase in tryptophan metabolism through the kynurenine pathway. Enzymatic modifications have been detected which lead to elevated kynurenine/tryptophan ratios. This seems relevant to this comorbidity. Tryptophan as a supplement for effects on conditions such as depression and/or pain is very uncertain because of the complexity in physiological responses. More studies are needed. / Tryptofan är utgångsmaterial för syntesen av 5-hydroxytryptamin (5-HT) men metaboliseras även till andra metaboliter så som kynureninsyra och kinolinsyra. 5- HT anses ha betydelse vid depression och idag används selektiva serotoninåterupptagshämmare (SSRI) mot depression. 5-HT har eventuellt betydelse vid upplevelsen av smärta också. Syftet med studien var att undersöka om ett tillskott av tryptofan kan påverka sjukdomstillstånd som depression och/eller smärta. Granskade studier visar att tryptofanbrist leder till mindre tillgänglighet av tryptofan i hjärnan vilket minskar syntesen av serotonin. Förändrat stämningsläge visas och tycks vara kopplat till den minskade serotoninsyntesen. Tryptofantillskott har i vissa studier visats ha inverkan på socialt beteende med minskat stridslystet beteende samt ökat dominant beteende. Motsvarande studier för att studera effekten på smärta ger en komplex bild. Resultat visar på att vid akut smärta verkar 5-HT ha en viss smärtlindring och motsägelsefulla svar på 5-HT ses vid neuropatisk samt inflammatorisk smärta. Samsjuklighet med både depression och smärta förekommer och har kunnat kopplas till ökad tryptofanmetabolism via kynurenin -vägen. Enzymatiska förändringar har upptäckts och leder till förhöjt kynurenin /tryptofan förhållande. Detta förefaller av betydelse för denna samsjuklighet. Tryptofan som ett kosttillskott för inverkan på sjukdomstillstånd som depression och/eller smärta är väldigt osäkert då komplexiteten hur de fysiologiska svaren blir av ett tillskott är för stor och fler studier behövs göras.

The present study was designed to investigate the possible relationship between religiosity as cognitive variable and the occurrence and severity of nonpsychotic, reactive depression within the paradigm of cognitive theory. Religious orientation, religious belief content, and locus of control were investigated to assess their relationship to guilt tendencies and depression tendency. The basic cognitive elements of religiosity were used as predictor variables in multiple regression analyses of the criterion variables of guilt and depression tendencies. Pearson correlations were also performed to determine the strength of the relationships between religiosity variables and guilt and depression tendencies.

This thesis was designed to examine two issues concerning negative cognition in depression: whether a negative schema is a characteristic of depressed people, and if so, whether it is a temporary state or an enduring trait. Previous research has reported mixed findings on both issues. A negative schema was defined as the negativity of an individual's chronically accessible constructs. A positive relationship between negative construct accessibility and depression , and between negative construct accessibility and vulnerability to depression was predicted. The relationship between negative construct accessibility and vulnerability to depression controlling for depression was also examined. Subjects completed a construct accessibility measure, the Beck Depression Inventory, the Dysfunctional Attitude Scale, and the State-Trait Anxiety Inventory. The results indicated that the relationship between negative construct accessibility and depression was modified either by anxiety alone or by gender and vulnerability to depression. The relationship between negative construct accessibility and vulnerability to depression was modified by gender and depression. These results suggest that under certain conditions a negative schema is a temporary state in depressed individuals. Implications for future research are discussed. / Department of Psychological Science

This study explored the relationship between counterfactual thinking and depressive self-schemata. Specifically, the effect of depression on the focus, direction, and action versus inaction of counterfactual thoughts was studied. It was found that the positive and negative outcome events containing action resulted in a greater range of affect (regret and joy) for the depressed group, and positive and negative outcome events with inaction resulted in greater affect (regret and joy) for the nondepressed group. The depressed and nondepressed groups did not differ in their focus on the self or other within their counterfactual thoughts in response to a positive or negative eventAlso, no differences between the depressed and nondepressed groups use of upward and downward counterfactual thoughts were found. / Department of Counseling Psychology and Guidance Services

The purpose of this study was to determine what effects a self-rewaard procedure involving the visualization of a pleasant scene had upon three operationally defined depressive behaviors. The three depressive behaviors were subjects' average self-confidence ratings, estimates of the rate of external reinforcement, and self-evaluations of their performance on a word association task. According to the self-reinforcement model of depression, a person becomes depressed as a result of a breakdown in any of the three stages, self-monitoring, self-evaluation, and self-reward of the self-reinforcement process. In an attempt to examine the role of self-rewards in modifying the three depressive behaviors, a high rate of self-rewarding behavior was used within a design previously utilized by Wener and Rehm (1975). Subjects in the self-reward treatment were hypothesized to manifest a statistical increase in the three depressive behaviors when compared to subjects in the no self-reward treatment. Furthermore, depressed subjects were hypothesized to be statistically lower on the three depressive behaviors than nondepressed subjects. Finally, no statistical difference on the three depressive behaviors was hypothesized when males were compared to females.Students in undergraduate psychology and general education courses at a Midwestern university were solicited as subjects for the study. A total of 380 students volunteered for the study and completed the Beck Depression Inventory (BDI). Based on their BDI scores, 96 subjects were selected with equal numbers of depressed and nondepressed, males and females. Just prior to the experimental procedure, subjects completed the BDI for a second time. Due to a shift in depression scores between initial and second presentations, 10 subjects were deleted from the study while another 11 subjects were deleted as a result of visualizing the self-rewarding scene when not requested thus changing the self-reward rate for the no self-reward treatment. The final sample size was 73.During the experimental procedure all subjects were asked to construct a pleasant scene based on their responses to the Reinforcement Survey Schedule while only the self-reward treatment subjects were requested to use the scene. After subjects gave a response to the cue word, they were asked how confident they were of their response. The other two dependent variables were obtained by asking, at the conclusion of the word association task, how well they felt they had done and how many times they were correct.Statistical processing of the data consisted of two, three-factor, non-orthogonal analyses of variance with the third factor (tester) blocked. All factors were reordered to determine their independent contribution. The first analysis eras multivariate in nature since both the average self-confidence rating and estimate of the rate of external reinforcement were used. The second analysis was univariate in nature since only self-evaluation was used. The use of a self-reward procedure involving the visualization of a pleasant scene was found to increase only subjects’ estimates of the rate of external reinforcement. No effects were found for average self-confidence ratings and self-evaluations. Thus, the self-reward procedure appeared to effect perceptions but not variables more centrally related to the self-concept, also, the self-reward procedure did not affect people in the same manner as external reinforcement. Depressed females had significantly lower self-confidence ratings and self-evaluations then nondepressed females, which lent support to the cognitive and self-reinforcement models of depression. Finally, as a result of a difference in depression levels between males and females, the validity of assuming males and females to express their depression in a similar manner was questioned.

Research provides evidence about the high levels of anxiety and depression in myocardial infarction (MI). This is because patients with MI face both an acute life-threatening illness and the potential for living with a major illness (Roebuck et al. 2001, Thornton 2001, Kim et al. 2000). Consequently, the patients' whole sense of meaning and purpose in life is at stake (Walton 1999, Burnard 1987, Simsen 1985). Research on spiritual coping and spiritual well being (SWB) in MI is still in its infancy. Therefore the aim of the study was to identify possible relationships between spiritual coping strategies (SCS) and anxiety, depression, SWB and personal characteristics of Maltese patients with MI, during hospitalisation and the first three months after discharge.The longitudinal descriptive correlational study recruited a homogenous systematic sample of seventy male (n=46) and female (n=24) patients with first MI, mean age of 61.9 years. The variables under investigation were assessed by the translated versions of the Hospital Anxiety and Depression (HAD) scale (Zigmond and Snaith 1983), JAREL------ SWB scale (Hungelmann et al.1985) and Helpfulness of Spiritual Coping Strategies (HSCS) scale designed for the study. The rationale for the perceived helpfulness of SCS was explored by the semi-structured face to face interview.The theoretical framework which guided the study incorporated the Cognitive Theory of Stress and Coping (Lazarus and Folkman 1984) and the Idea of the Holy (Otto 1950). Analysis of the qualitative data was guided by Burnard (1991) analysis model. Additionally, analysis of the quantitative data utilized both parametric and nonparametric statistical tests in order to identify differences between means of subgroups of the personal characteristics and correlations between SCS and anxiety, depression and SWB across time.The findings revealed a constant decline of anxiety and depression across time which is inconsistent with published research. However, the return of anxiety and depression to normal limits by the third month is congruent with research. In contrast, scores of SWB and SCS increased on discharge and remained stable across time.The qualitative data revealed that SCS, SWB and the Maltese culture, which promotes family support in illness, may have contributed towards the relief of anxiety and depression. The quantitative data exhibited a negative, significant relationship between SCS and anxiety and depression on the sixth week after discharge. Additionally, positive significant relationships were identified between SCS and SWB across time.The findings suggest that SWB may be a precursor to the relief of anxiety and depression. The minimal significant differences in SCS between the subgroups of personal characteristics propose the possible impact of the event of MI on spiritual coping and negative mood states. However these speculations may only be confirmed by further research as recommended in the study. Hopefully, the new knowledge produced by the study will be applied to the clinical practice and nursing education to promote patient care.

The symptoms of depression and those of accidie as described by the Desert Fathers overlap, in that feelings of despair, guilt, poor estimates of self-worth, lack of energy and self-absorption predominate. Tillich adds to these symptoms a sense of meaninglessness and purposelessness. A new model of depressed mood is proposed which incorporates a variety of different aetiological factors, integrating those from the body and the mind which are found in clinical practice, with others which have a spiritual origin. The need for reconciliation with God, the world and the self means that discernment of spiritual problems can be fundamental in finding an answer to disturbed mood. The psychological aspects of guilt and self-hatred and lethargy are explored through the work of Karen Homey, mainly in a discussion of the compulsions caused by an inflated ego-ideal. The work of Carl Jung emphasises the integration of the shadow, stressing the importance of reconciling polarities in the psyche so as to generate a creative tension which can replenish spiritual and mental energy. Many theologians, including Tillich, also emphasise that opposites must come together, so that God can be found at the centre of all things. Hans Urs von Balthasar is " outstanding because of his understanding of Christ's kenosis in balance with His plerosis These polarities point to the way in which Christ, through His Passion and Resurrection redeems us from godforsakermess, and also suggest a helpful way of understanding the Trinity as Love. Nicholas de Cusa and Ignatius of Loyola, from the fifteenth and sixteenth centuries, have a common strand of finding God in the midst of opposite and fragmenting influences. Miguel de Unamuno at the beginning of this century adds a dimension of God's involvement in tragedy and suffering, and Charles Williams stresses our co-inherence vyith God, and the need for forgiveness in bearing each other’s burdens. The convergence of psychological and theological insights concerning polarities is applied to a recovery model for depressed mood through cognitive therapy, art, and prayer - methods which search, respectively, for truth, beauty and goodness. The process of healing is part of redemption, in that the 'Fruits of the Spirit' are the antithesis of some of the symptoms of depression, such as guilt, anger, self-absorption and fear. We may feel helpless and vulnerable because of negative feelings, but in His total self-giving, Christ suffered the helplessness and agony of the Passion in order to transform our disorders and bring us to His Kingdom of service and praise.

Lifestyles, including alcohol consumption and illicit drug use in medical students were assessed using a self-completion questionnaire. Eight cohorts of secondy ear medical students were assessed consecutively between 1993-2000. The proportion of medical students in each cohort drinking excessively increased during this period. Illicit drug use stayed fairly stable with approximately half of each year group reporting having experimented with illicit drugs. Lifestyles in medical students were assessed in the second and final year of studies and one year after graduation. Alcohol consumption and illicit drug use had significantly increased over the 4 year period of the study. Two cohorts of medical and dental students were also compared in a similar study design. Although alcohol consumption in dental students was more than their medical student counterparts during the second year of the studies, it decreased one year after graduation. Illicit drug use was higher in medics than in dentists at all three time points. Nearly half of the fresher medical students reported to have been drinking excessively and using illicit drugs before beginning university life. Personality characteristics of the students were found to be related to their alcohol and illicit drug use. A significant proportion of pre-registration house officers suffered from stress and anxiety with more women than men having anxiety scores within the clinically significant range. Job satisfaction was low, with more pre-registration house officers being dissatisfied with the organisational processes of their jobs. Personality was significantly related to stress, anxiety, depression and job satisfaction. Education on alcohol and illicit drugs for young people may be needed at a much earlier age. Dealing with the problems of drink, drugs and stress among medical students and doctors may require a holistic approach which considers both the culture of medical education and work conditions.