Charles G. Costello

Measuring depressive symptoms in illness populations: Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) Scale

Abstract Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) scale were examined among five groups that vaned in physical health and illness. Participants included 175 healthy undergraduates, 176 individuals attending family physicians, 107 progressive renal disease, 135 end-stage renal disease, and 120 cancer patients. Individual item and total CES-D scores were relatively symmetrically distributed and varied across the entire range of potentially obtainable scores. Reliability analyses yielded internal consistency (alpha) coefficients ranging from 0.63 to 0.93 across the groups. Test-retest reliability (3-month lag) was 0.61. The CES-Ds factorial composition was highly similar to that observed among community volunteers. Varimax-rotated principal-components analyses extracted four factors, corresponding to “depressive affect”, “positive affect”, “somatic and retarded activity”, and “interpersonal”. Moreover, this pattern did not change despite differences in physical heal...

Restless sleep, illness intrusiveness, and depressive symptoms in three chronic illness conditions: Rheumatoid arthritis, end-stage renal disease, and multiple sclerosis

Restless sleep was compared across 110 out-patients with rheumatoid arthritis (RA), 101 with end-stage renal disease (ESRD), 94 with multiple sclerosis (MS), and an unselected control group of 176 individuals attending their family practitioners (FP). It was also investigated in the three chronic illness groups as a contributor to illness intrusiveness--the extent to which ones illness and/or its treatment interfere with continued involvements in valued activities and interests--a determinant of depression and emotional distress in chronic conditions. Reported frequencies of restless sleep were highest in RA, lower in ESRD, and lowest in MS; FP patients reported frequencies that were similar, overall, to those observed in MS. These differences were evident among nondepressed, (chi 2 9, N = 309, p < 0.0001), but not depressed, individuals. The occurrence of restless sleep correlated significantly with increased illness intrusiveness, r (279) = 0.31, p < 0.001, in RA, ESRD, and MS. Results supported the hypothesis that the relation between restless sleep and emotional distress is mediated by illness intrusiveness. Treatment of restless sleep may offer the added benefit of diminishing illness intrusiveness and may, thereby, enhance quality of life in chronic physical illness.

Do confidants of depressed women provide less social support than confidants of nondepressed women

The prediction was tested that during a simulated telephone conversation, the confidants of depressed women would provide less social support than the confidants of nondepressed psychiatric and nonpsychiatric control women. The coded speech of subjects and their confidants indicated that (a) confidants echoed the positive or negative valence of the statements made by subjects; (b) depressed women exhibited more depressotypic speech than women in both control groups; (c) confidants of depressed women also made more depressotypic statements, possibly due to the echoing phenomenon; (d) contrary to prediction, there were no significant group differences in the sequential dependencies of responses that confidants made to depressotypic or antidepressotypic subject statements; (e) contrary to prediction, the affect of depressed womens confidants was not more negative.

Two dimensional views of psychopathology

Two dimensional views of adult psychopathology are discussed: (a) the phenomenological view according to which symptoms of psychopathology can occur in normal people in less intense, persistent and debilitating, but not qualitatively different forms; and (b) the vulnerability view according to which the degree to which a person possesses the apparent normal counterparts of the symptoms of a psychopathological disorder is an index of that persons vulnerability for the disorder. Examples of research using questionnaires designed by two prominent advocates of these dimensional views, namely, H. J. Eysenck and L. J. Chapman, are reviewed. It is concluded that the research strategies to date do not provide adequate tests of the phenomenological view and provide only weak support for the vulnerability view. Alternative, more direct, research strategies are proposed.

Conceptual problems in current research on cognitive vulnerability to psychopathology

Four problems with the concepts used in research on the role of cognitions in psychopathological conditions are identified. The concepts are too intricate or too isolated, are too indistinguishable, and are too incontrovertible. The difficulties presented to the researcher by the use of such concepts are described and alternative approaches are recommended.

The prevalence of fears, phobias and anxiety disorders and their relationship with depression in women attending family physicians

Abstract An investigation of 437 women, who were attending their family physicians and who had moderately high scores on a self-report scale of depression, indicated high 1-month prevalences of fears, phobias and anxiety disorders. For instance, 20.6% reported phobias (i.e. intense fear with some avoidance) and 7.6% reported mild generalized anxiety . More severe forms of these disorders were less common: e.g. 2.3% reported severe phobias with generalized avoidance, and 1% reported intense generalized anxiety . Women with separation or nature fears, separation, social, animal or nature phobias. mild or intense generalized anxiety or panic attacks, whether infrequent or frequent, also showed a greater likelihood of depression when compared with women who did not have the fear, phobia or anxiety disorder. The implications of these findings for clinical and research psychopathologists are discussed.

Primary and secondary depression : a review

The literature on the distinction between primary and secondary depression is reviewed. The research data indicate that less severe, non life-threatening suicidal thoughts and behaviours occur more often in patients with secondary depression than in those with primary depression and that the prognosis for secondary depression after somatic forms of therapy is poorer than that for primary depression. The data also suggest that secondary depressives, unlike primary depressives, suffer from chronic dysphoria. It is concluded that, because the available evidence suggests that there are no qualitative differences between the episodes of primary and secondary depression, future research should concentrate on investigating the characteristics of different groups of patients with secondary depression rather than on comparisons between primary and secondary depression in general.

Anxiety, intelligence, and discrimination.

Kerrick (1956) found no relationship between anxiety as measured by the Taylor Manifest Anxiety scale (Taylor, 19S3) and discrimination among concepts on the semantic differential (Osgood, Suci, & Tannenbaum, 1957). He found a positive relationship between intelligence and discrimination. On the other hand, Ware (as reported by Osgood, 1962) and Brod, Kernoff, and Terwilliger (1964) found no relationship between intelligence and discrimination on the semantic differential, and the latter group of investigators found a positive relationship between anxiety and discrimination. In view of these conflicting results, it was decided to conduct a further investigation into these relationships.