Stephen S. Ilardi

Factor analysis of the Children's Depression Inventory in a community sample

The factor structure of the Childrens Depression Inventory (CDI; M. Kovacs, 1992) was evaluated in a large community sample of 1,777 children and 924 adolescents. There were 5 first-order factors (Externalizing, Dysphoria, Self-Deprecation, School Problems, and Social Problems) for the child group; the adolescent group yielded the same 5 factors plus a 6th factor (Biological Dysregulation). Confirmatory factor analyses supported the stability and replicability of the obtained factor structures. Both samples yielded 2 higher order factors-Internalizing and Externalizing. The factors were compared with previous CDI factors identified for clinical (B. Weiss et al., 1991) and community (M. Kovacs, 1992) samples. Other notable findings included more boys reporting high scores (17 and above) on the CDI among the child sample, whereas, among adolescents more girls reported high scores (17 and above) on the total CDI as well as higher scores on the biological dysregulation factor.

The Role of Hope in Cognitive-Behavior Therapies

A cognitive, two-component model of hope proposed by Snyder and colleagues is reviewed. Hope is defined as the perceived capability to (1) derive pathways to desired goals and (2) motivate oneself via agentic thinking to initiate and sustain movement along those pathways. The roles of these pathways and agency components of hope theory are described along with similarities and differences relative to other motivational and emotional theories, including optimism, self-efficacy, self-esteem, and problem solving. The goal focus, agentic thought, and pathways thought of hope theory are used as a framework for understanding the adaptive processes in the various phases of cognitive-behavior therapies, including relapse prevention. It is concluded that hope theory offers a valuable overarching framework for understanding common factors in behavior therapies.

Hemispheric asymmetry in the processing of emotional content in word meanings: the effect of current and past depression.

We examined hemispheric lateralization of emotion processing by comparing the performance of clinically depressed, previously depressed, and control individuals on a divided visual field task. Participants were asked to make affective valence judgments for each in a series of laterally presented person-descriptive adjectives. Study results suggest that the right cerebral hemisphere (RH) is preferentially sensitive to the affective context of language. Among targets presented to the RH, depressed and previously depressed participants were significantly faster and more accurate in their judgments of negative target words, while controls responded more quickly and accurately to positive target words. No such effects were observed for targets presented to the left hemisphere. It is hypothesized that affective sensitivity may result in differences in semantic network organization across individuals who vary in affective experience.

The right hemisphere's contribution to emotional word processing in currently depressed, remitted depressed, and never-depressed individuals

Abstract To examine how unipolar depression influences hemispheric processing of emotional stimuli, words with clear affective content were assessed by depressed, remitted depressed, and never depressed participants. Semantic stimuli were selected for both their valence (positive vs. negative) and for their ability to engender affective arousal (high vs. low). After completing a structured clinical interview to determine depression experience, participants were asked to make valence judgements for laterally presented emotional words. Study results suggest that the right hemisphere (RH) is particularly sensitive to the affective semantic content of emotional stimuli, furthermore, two interesting higher order interactions were observed in the RH. First, in a replication of recent findings by Atchley et al. [2003. Hemispheric asymmetry in the processing of emotional content in word meanings: The effect of current and past depression. Brain and Language , 84 , 105–119], individuals who have experienced depression (both currently depressed and remitted depressed groups) show an advantage when processing negatively valent words, while the never depressed individuals show an advantage for positive words. Also in the RH, affective arousal interacted with stimulus valence (but not diagnostic group), such that all participants exhibited an advantage when categorizing highly arousing negative information, while for positive words the low arousing stimuli were identified more accurately. These results are discussed in the context of models of depressive cognition and in regards to general models of hemispheric specialization for emotion processing.

Hope Theory and Cognitive—Behavioral Therapies

Publisher Summary Goal-directed thinking is the kind of thinking in which people appraise their capability to produce workable routes to goals (pathway thinking), along with their potential to initiate and sustain a movement via a pathway (agency thinking). The chapter explores the theoretical and clinical implications of hope theory regarding the broad class of interventions that are designated as cognitive-behavioral. Specifically, it examines cognitive-behavioral therapy (CBT) through the interpretive lens of hope theory, both as a means of explaining the impressive efficacy of CBT interventions and as a means of articulating recommendations for the optimal implementation of CBT procedures. In addition, the chapter discusses many of the theories and interventions developed within the diverse set of therapies that have been designated CBT. Based on this understanding, it identifies a number of core features that emerge from an analysis of various CBT approaches. These core features can be separated into factors specific to CBT and common factors that are characteristic of most therapies. It focuses on factors specific to CBT that relate to the hope theory. Finally, CBT interventions are characterized by an explicit commitment to the implementation of only the specific intervention procedures (pathways) that have been demonstrated through clinical research to be efficacious in promoting clinical goal attainment.

Disentangling Attentional Biases and Attentional Deficits in Depression: An Event-Related Potential P300 Analysis

Electroencephalographic event-related potentials (ERPs) were used to investigate maladaptive attentional processes in depression. Specifically, we measured the ERP P300 component—a waveform that reflects the real-time allocation of attention to stimuli of high informational salience—as it was elicited by neutral and negatively valent words among currently depressed, previously depressed, and never-depressed participants. The study design allowed us to clarify the degree to which the oft-reported attenuation of P300 response in depression should be regarded as evidence of: (a) a general, pervasive impairment in depressive attentional function; or (b) the operation of depressotypic attentional biases, which may give rise to attentional deficits only regarding stimuli of non-negative emotional valence. Consistent with the latter possibility, depressed individuals were observed in this study to experience, on average, a robust P300 response to negatively valent target words—a response of larger magnitude than that observed among previously depressed and never-depressed controls. This enhanced P300 response to negative stimuli in depression appears to be a statelike, rather than traitlike, phenomenon.

The Acute Side Effects of Bright Light Therapy: A Placebo-Controlled Investigation

Despite the emergence of numerous clinical and non-clinical applications of bright light therapy (LT) in recent decades, the prevalence and severity of LT side effects have not yet been fully explicated. A few adverse LT effects—headache, eye strain, irritability, and nausea—have been consistently reported among depressed individuals and other psychiatric cohorts, but there exists little published evidence regarding LT side effects in non-clinical populations, who often undergo LT treatment of considerably briefer duration. Accordingly, in the present study we examined, in a randomized sample of healthy young adults, the acute side effects of exposure to a single 30-minute session of bright white light (10,000 lux) versus dim red light (< 500 lux). Across a broad range of potential side effects, repeated-measures analyses of variance revealed no significant group-by-time (Pre, Post) interactions. In other words, bright light exposure was not associated with a significantly higher incidence of any reported side effect than was the placebo control condition. Nevertheless, small but statistically significant increases in both eye strain and blurred vision were observed among both the LT and control groups. Overall, these results suggest that the relatively common occurrence of adverse side effects observed in the extant LT literature may not fully extend to non-clinical populations, especially for healthy young adults undergoing LT for a brief duration.

Word valence, attention, and hemispheric activity in depressed, remitted, and nondepressed controls.

Clinically depressed (n = 20), previously depressed (n = 28), and nondepressed control (n = 27) individuals, classified according to a structured clinical diagnostic interview, participated in a study employing a modified prior entry (Titchener, 1908) procedure to investigate interrelationships among word (adjective) valence, visual attention, and cerebral hemispheric activity. Overall, positive words were selected more quickly when presented to the right, versus left, visual field (RVF, LVF); the opposite pattern was observed for negative words. While there was no significant group X Valence X Visual Field interaction, planned comparisons revealed that the aforementioned Valence X Visual Field interaction was significant only for the nondepressed control group. Although the remitted group exhibited an overall pattern similar to the control group, the depressed group evinced a pattern in the opposite direction for positive words (i.e., quicker in the LVF than the RVF).

Depression reduces perceptual sensitivity for positive words and pictures

There is evidence of maladaptive attentional biases for lexical information (e.g., Atchley, Ilardi, & Enloe, 2003; Atchley, Stringer, Mathias, Ilardi, & Minatrea, 2007) and for pictographic stimuli (e.g., Gotlib, Krasnoperova, Yue, & Joormann, 2004) among patients with depression. The current research looks for depressotypic processing biases among depressed out-patients and non-clinical controls, using both verbal and pictorial stimuli. A d′ measure (sensitivity index) was used to examine each participants perceptual sensitivity threshold. Never-depressed controls evidenced a detection bias for positive picture stimuli, while depressed participants had no such bias. With verbal stimuli, depressed individuals showed specific decrements in the detection of positive person-referent words (WINNER), but not with positive non-person-referent words (SUNSHINE) or with negative words. Never-depressed participants showed no such differences across word types. In the current study, depression is characterised both by an absence of the normal positivistic biases seen in individuals without mood disorders (consistent with McCabe & Gotlib, 1995), and by a specific reduction in sensitivity for person-referent positive information that might be inconsistent with depressotypic self-schemas.

The Promise of Cognitive Neuroscience for Advancing Depression Research

How are the mind and the brain interconnected? What do the intricate workings of neural tissue have to do with the rich array of thoughts, feelings, and aspirations that make up our mental lives? For many centuries, such questions framed an impenetrable mystery, one more apt to be taken up by poets and philosophers than by practicing scientists. But the past several decades have witnessed a remarkable development on this front, as researchers from numerous distinct scientific disciplines—including neurobiology, psychology, psychiatry, computer science, cognitive science, neurology, and genetics—have begun working together to elucidate in ever-increasing detail the nature of the mind-brain relationship: specifically, how brain events give rise to mental events, and how the latter are reflected in the former (Wilson, 1998). This new interdisciplinary collaboration, most commonly referred to as cognitive neuroscience, has already witnessed a remarkable pace of scientific discovery during the few short decades of its existence (Albright, Kandel, & Posner, 2000). The cognitive neuroscience (CNS) enterprise, we believe, also carries with it the potential to facilitate important research advances across numerous domains of psychopathology, including major depressive disorder. Historically, of course, the depression research literature has been characterized by a considerable degree of conceptual fragmentation (Ilardi & Feldman, 2001; Ilardi, Karwoski, & Rand, 2006), as myriad distinct lines of investigation have typically focused, respectively, upon only limited sets of depression-linked phenomena—e.g., hopelessness, interpersonal deficits, negative automatic thoughts, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, serotonergic neurotransmission anomalies, etc. Attempts at meaningful integration across these disparate areas have been the laudable exception rather than the rule. CNS, however, provides an enormously useful heuristic for integrating the physiological and psychological levels of analysis. By regarding mental events as neurologically instantiated information-processing events (Pinker, 1997), the CNS approach allows depression researchers to recognize brain events and mental events as flip sides of the same