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The Black Dog is a Turn-Based Role-Playing Game (TBRPG) that uses story and a combat system to raise the players awareness about Major Depressive Disorder (MDD). According to the National Institute of Mental Health, MDD affects 6.7% of Americans as of 2016 [1]. The highest concentration of depressed Americans is between the age of 18-25. With depression being such a serious problem, creating engaging and effective methods to raise awareness of depression and its effects should be explored. Xia Wang’s looks at how educating about depression can be an effective tool to help recover from depression because of the impact of stigma on those suffering with depression [2]. To help inform students about MDD and other closely related forms of depression, Junfeng Guo, Sean Welch, Kyle Baker and Aaron Segal designed and created The Black Dog. The goal of The Black Dog is to raise awareness and create empathy in college students for the struggles depression causes and suggest some transferable strategies such as healthy eating and exercise, to assist with depression. The game attempts to provide information about depression through classroom dialog and character interaction, which the player will need to apply in combat. To assess the game's goals of raising awareness, thirty-five college students partook in a study. Overall, while most participants did learn from the game, the amount of learning and player engagement can be improved. The analysis of this data provides valuable information for future iterations of this game.

This thesis is a comparison of the change in MMPI performance following indoklon and electroconvulsive therapy.

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Objective To investigate men's experience of depression. Method A non-clinical sample of male teachers and students was recruited from a tertiary education institution to participate in a series of focus groups. Women were recruited from the same context to examine issues common to men. The men's data were analysed using a grounded theory approach to illuminate men's experience of depression. Theoretical sampling of biographical accounts of a small group who had experienced clinical depression (the 'clinical' group) was conducted to explicate the core category. Content analysis was then used to examine the women's data for similarities and contrasts and issues common to men. Standard measures of mood and dispositional optimism (together with sociodemographic and behavioural data) were collected to confirm the non-clinical status of the sample. Results The key results were as follows: (i) The non-clinical sample of men and women in this study reported all the symptoms of depression classified by the Diagnostic Statistical Manual of Mental Disorders (Version IV). (ii) In addition, men reported experiencing social withdrawal, and an escalation and intensification of negative emotion that may be triggered by negative thoughts or external events leading to anger and violence towards the self and others. (iii) The trajectory of emotional distress, conceptualised as the 'big build', links men's experience and expression of depression. (iv) 'Intensified constraint', illuminating the process of the 'big build', helps to explain the 'battle' between individual and social forces that influences hidden depression in men. (v) 'Intensified constraint' may be considered a state (emotional condition) characterising men or a symptom (subjective experience) of depression common to men. (vi) Non-resolution of problems, exacerbated by social conditioning of men to suppress emotion, leads to delayed help-seeking. (vii) The women's data were in concordance with the men's data that suggest that men and women experience depression similarly (with reference to DSM-IV criteria). (viii) The 'big build', as a trajectory of emotional distress and maladaptive strategies to ameliorate depressive symptoms, has salience for women. (ix) Gender differences in depression may be explained by the expression of depressive symptoms, and the time frame in which the symptoms are managed. Discussion This study arose out of the commonly held view that women report depressive symptoms at higher rates than men yet men demonstrate higher rates of drug and alcohol abuse and self-harm, referred to as 'depressive equivalents'. This generally accepted disparity of prevalence rates of depression in community samples makes certain assumptions about the mental health of men and women. Women are assumed to have a certain 'pathology' or vulnerability to depression while men are assumed to be either comparatively healthy or 'silent' to their experience. The perception of depression as a 'feminine' problem by men, exacerbated by social conditioning of men (by men and women) to suppress emotional distress and to hide signs of weakness, may influence men's reporting of depressive symptoms and may help to explain the gender disparity. The non-clinical group of men and women in this study has taken us to a point in their descriptions of depression as an objectified or reified 'it' that is something difficult to articulate but which is psychologically painful, to be avoided, numbed or from which to escape. The biographical accounts of a small group of people who have experienced clinical depression (the 'clinical' group) have explicated the meaning of depression even further. Depression, viewed by this articulate small group as 'beyond description', is elucidated by their use of metaphor. The data from the non-clinical group, informed by the 'clinical' group and the literature surrounding depression in men, is synthesised, analysed and interpreted. The findings inform three propositions - the 'big build', 'intensified constraint', and 'averting negative consequences' - that offer new ways of thinking about depression in men. Conclusion The inextricable link between the experience and expression of depression as described by men, confirmed by women and supported by the literature and clinicians' impressions, may explain the existing gap between the 'meaning', 'manifestation' and 'measurement' of depression in men. Questions that tap in to men's trajectory of emotional distress, incorporating a state or symptom of intensified constraint common to men, could narrow the gender differences in reported depressive symptoms. This has implications for the design of measurement instruments and approaches to depressed men in clinical practice.

Depression is one of the most important psychiatric disorders. It does not only affect the patients themselves but also influences their family members, friends, and society as a whole. The primary purpose of this paper is to discuss the general characteristics of depression in terms of the explanations provided by four major theoretical approaches. First, the biological approach considers the contributions to depression arising from distinct neural systems and their associated neurotransmitters. Second, the behavioral approach emphasizes learning processes, such as reinforcement and helplessness as causal to depressive behaviors. Third, the cognitive approach focuses on the causal role of distinctive patterns of cognition possessed by depressed patients. Finally, the sociological perspective considers the contributions arising from general forces within society, such as unemployment, social status, sex, and age. All of these approaches are very useful for understanding depression. However, depression is too complex to be fully explained by a single theory or two. It is necessary to integrate all the different approaches to understand and treat the illness in a better way. / Graduation date: 1996

Research indicates that cognitive and neuropsychological functions are adversely affected by symptoms of depression (Teeter & Semrud-Clikeman, 1997). In addition to deficits in attention and memory, depressive symptomatology may impact one’s executive functioning abilities. Over the last several decades, a number of studies have investigated the effects of internalizing symptoms on neurocognitive function in adults (e.g., Beats, Sahakian, & Levy, 1996; Channon & Green, 1999; Fossati, Coyette, Ergis, & Allilaire, 2002). However, little research is available confirming the presence of these adverse patterns in children and adolescents manifesting similar depressive symptoms. Although research suggests that children and adolescents who exhibit symptoms of depression often experience greater school and academic disruption (Mash & Barkley, 1996), it is unclear how symptoms of depression impair executive functioning skills in youth.

Research indicates that cognitive and neuropsychological functions are adversely affected by symptoms of depression (Teeter & Semrud-Clikeman, 1997). In addition to deficits in attention and memory, depressive symptomatology may impact one’s executive functioning abilities. Over the last several decades, a number of studies have investigated the effects of internalizing symptoms on neurocognitive function in adults (e.g., Beats, Sahakian, & Levy, 1996; Channon & Green, 1999; Fossati, Coyette, Ergis, & Allilaire, 2002). However, little research is available confirming the presence of these adverse patterns in children and adolescents manifesting similar depressive symptoms. Although research suggests that children and adolescents who exhibit symptoms of depression often experience greater school and academic disruption (Mash & Barkley, 1996), it is unclear how symptoms of depression impair executive functioning skills in youth.

Berlin, Freie Universität, Thesis (doctoral), 2000.