Gary Brown

Prediction of eventual suicide in psychiatric inpatients by clinical ratings of hopelessness

A 9-point clinical rating scale was used to assess the severity of hopelessness in 141 patients hospitalized with suicidal ideation. The patients were followed from 5 to 10 years, and 10 (7.1%) eventually committed suicide. The mean hopelessness rating for the patients committing suicide was significantly higher than that for the patients not committing suicide. A cutoff score of 6 or above successfully predicted 9 (90.0%) of those committing suicide. The results supported previous findings in which self-reported hopelessness on the Beck Hopelessness Scale was reported to predict suicide in both psychiatric outpatients and inpatients.

Taking the measure of anxiety and depression. Validity of the reconstructed Hamilton scales.

The ability of the Hamilton Psychiatric Rating Scale for Depression (HRSD) and the Hamilton Anxiety Rating Scale (HARS) to discriminate major depressive disorder (MDD) from generalized anxiety disorder (GAD) was studied in 120 psychiatric outpatients and cross-validated with another 71 outpatients. Factor and discriminant analyses were used to develop revised anxiety and depression scales that were less positively correlated with each other, showed greater internal consistency, and differentiated MDD and GAD better than the original scales. The recombined scales also displayed higher rates of correctly assigning the samples to these disorders than did the orginal scales.

Cognitive mediation in general psychiatric outpatients: a test of the content-specificity hypothesis.

We investigated the degree of content specificity evident in the negative cognitions associated with anxiety and depression in two large samples of general psychiatric outpatients. Standardized measures of affect and cognition were analyzed in a multiple regression design. As predicted by Becks (1967, 1976, 1987) cognitive theory of psychopathology, thoughts of loss and failure were specifically associated with depression, whereas cognitions of harm and danger were uniquely predictive of anxiety. In addition, hopelessness was specific to depression and not to anxiety. Dysfunctional beliefs showed no consistent association with either mood state. The implication of these results, as well as related findings, is discussed in terms of a cognitive perspective on the differentiation of emotional disorders. Also discussed are the methodological difficulties encountered in research on cognitive-affective relationships.

Psychiatric history and stress: Predictors of severity of unipolar depression.

Unipolar depression is frequently a recurrent or chronic disorder. In studies on predicting its course, outcomes are typically linked to either psychiatric features or stressful life events. In order to integrate the 2 approaches, 51 unipolar patients were assessed periodically over at least 1 year for symptoms, stressful events, and chronic stressors. It was hypothesized that adverse family history and early age of onset impair role functioning and coping capabilities, thereby contributing to stressful circumstances that predict severity of depressive reactions. Results of causal modeling analyses supported a model in which background factors were associated with severity of depressive outcomes as mediated by their effects on stress variables. Such a model implicates the self-perpetuating nature of clinical depression, both for the individual and across generations.

Relationships between the Beck Depression Inventory and the Hamilton Psychiatric Rating Scale for Depression in depressed outpatients

The Beck Depression Inventory (BDI) and the Hamilton Psychiatric Rating Scale for Depression (HRSD) were used with 300 outpatients diagnosed with DSM-III major depression disorders. A principal-components analysis was performed on the intercorrelations among the 21 BDI and 24 HRSD symptoms. Three orthogonal components were found and interpreted as reflecting differences in self-report and clinical rating methods for measuring the severity of depression. The importance of using both self-reports and clinical ratings for evaluating depression in psychiatric outpatients was discussed.

Levels of hopelessness in DSM-III disorders: A partial test of content specificity in depression

To determine the extent to which negativity about the future is specific to depression, the Hopelessness Scale (HS) scores of 199 patients diagnosed with major depressive disorder (MDD) were compared with those of 48 patients diagnosed with generalized anxiety disorder (GAD) and 76 psychiatric patients with mixed nonaffective, nonanxiety disorders. As predicted by the cognitive model, the MDD patients had higher mean HS scores than either the GAD or control patients. In addition, HS scores were more highly correlated with clinician-rated and self-report measures of depression than with measures of anxiety. Further, the positive relationships between the HS and measures of anxiety dropped to nonsignificant levels after the corresponding measures of depression were controlled for, while the HS remained correlated with depression after controlling for level of anxiety. The results were discussed as providing partial support for the content-specificity hypothesis (negative cognitive triad) of the cognitive model of depression.

Differentiation of Depressive Disorders from Generalized Anxiety by the Beck Depression Inventory.

The Beck Depression Inventory (BDI) was administered to 35 outpatients diagnosed according to the DSM-III as primary generalized anxiety disorders and 101 outpatients diagnosed as primary major-depression and dysthymic disorders. A backward stepwise-discriminant analysis revealed that Sadness and Loss of Libido were the only two symptoms that meaningfully distinguished between the two groups. The depressed patients were sadder and complained of more loss of libido than did the anxious patients. It was concluded that the BDI is a powerful tool for differentiating the depressive from generalized anxiety disorders.

Salience of weight‐related worries in adolescent males and females

The present study of high school sophmores assessed the prominence of weight concerns relative to other worries typical of adolescents. Subjects were 453 females and 355 males from a parochial school who indicated how much they worried about each of 15 items. Girls reported worrying most about looks, figure, weight, and popularity with and relationships with the opposite sex. Boys worried most about money, looks, and popularity and relationships with the opposite sex. Girls reported significantly greater worry than boys on nine of 15 items and scored significantly higher than boys on trait anxiety. Obese boys and girls reported worrying significantly more about weight and figure (physique) than did their non-obese peers, but being overweight was otherwise unrelated to trait anxiety or worry about other issues. The findings indicate that weight and figure are of primary concern to adolescent girls relative to other issues. Boys clearly were not weight-preoccupied but did share several of the principal worries reported by girls.

Beck Self-Concept Test.

The development and psychometric characteristics of the Beck Self-Concept Test (BST) are described. The BST is a 25-item self-report instrument that asks respondents to evaluate themselves in relation to other people whom they know

Counterfactual thinking and posttraumatic stress reactions.

Preoccupation with alternative outcomes (counterfactual thinking) is a central component of the ruminations of trauma victims. The questions investigated were whether such thinking should be distinguished from general rumination and whether elements of counterfactual thinking might relate to the process of adjustment. A sample of assault victims was interviewed. They completed a battery of self-report scales and thought-listing procedures. Frequency of counterfactual thinking was closely associated with continuing levels of posttraumatic distress. However, high availability of counterfactuals (as indexed by verbal fluency) was related to potentially adaptive outcomes, such as the generation of behavioral plans. In addition, as expected, levels of different aspects of counterfactual thinking were moderated by metacognitive control strategies as a function of time since the trauma.