Dataset Information

The role of self-blame and worthlessness in the psychopathology of major depressive disorder.

ABSTRACT:

Background

Cognitive models predict that vulnerability to major depressive disorder (MDD) is due to a bias to blame oneself for failure in a global way resulting in excessive self-blaming emotions, decreased self-worth, hopelessness and depressed mood. Clinical studies comparing the consistency and coherence of these symptoms in order to probe the predictions of the model are lacking.

Methods

132 patients with remitted MDD and no relevant lifetime co-morbid axis-I disorders were assessed using a phenomenological psychopathology-based interview (AMDP) including novel items to assess moral emotions (n=94 patients) and the structured clinical interview-I for DSM-IV-TR. Cluster analysis was employed to identify symptom coherence for the most severe episode.

Results

Feelings of inadequacy, depressed mood, and hopelessness emerged as the most closely co-occurring and consistent symptoms (?90% of patients). Self-blaming emotions occurred in most patients (>80%) with self-disgust/contempt being more frequent than guilt, followed by shame. Anger or disgust towards others was experienced by only 26% of patients. 85% of patients reported feelings of inadequacy and self-blaming emotions as the most bothering symptoms compared with 10% being more distressed by negative emotions towards others.

Limitations

Symptom assessment was retrospective, but this is unlikely to have biased patients towards particular emotions relative to others.

Conclusions

As predicted, feelings of inadequacy and hopelessness were part of the core depressive syndrome, closely co-occurring with depressed mood. Self-blaming emotions were highly frequent and bothering but not restricted to guilt. This calls for a refined assessment of self-blaming emotions to improve the diagnosis and stratification of MDD.

SUBMITTER: Zahn R

PROVIDER: S-EPMC4573463 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Publications

The role of self-blame and worthlessness in the psychopathology of major depressive disorder.

Zahn Roland R Lythe Karen E KE Gethin Jennifer A JA Green Sophie S Deakin John F William JF Young Allan H AH Moll Jorge J

Journal of affective disorders 20150805

<h4>Background</h4>Cognitive models predict that vulnerability to major depressive disorder (MDD) is due to a bias to blame oneself for failure in a global way resulting in excessive self-blaming emotions, decreased self-worth, hopelessness and depressed mood. Clinical studies comparing the consistency and coherence of these symptoms in order to probe the predictions of the model are lacking.<h4>Methods</h4>132 patients with remitted MDD and no relevant lifetime co-morbid axis-I disorders were a ...[more]

PMID: 26277271

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Project description:BackgroundIn major depressive disorder (MDD), self-blame-related fMRI measures have shown the potential to be used as prognostic markers for recurrence risk. Like most potential fMRI markers, however, their reliability is unclear. Here, we probed the internal reliability of self-blame-related fMRI measures, as well as the impact of different modelling approaches on reliability metrics and validity.MethodsInternal consistency (i.e. split-half reliability) was calculated for blood oxygen level-dependent (BOLD) responses and psychophysiological interactions (PPI) related to self-blame-related biases in medication-free remitted MDD participants (n = 81) and healthy controls (n = 41). Trial-length was modelled using three durations (0, 2 and 5 s), which was convolved with the haemodynamic response function (HRF) with and without time and dispersion derivatives. Intraclass correlation coefficients (ICCs) were calculated for simple contrasts examining activation to self-blaming emotions and other-blaming emotions and the more complex contrast of the subtraction-based difference between self- and other-blaming emotions within the following a priori ROIs: right superior anterior temporal lobe seed region, anterior subgenual cingulate cortex, posterior subgenual cortex and right striatum / pallidum.ResultsAcross ROIs, we obtained fair reliability (ICC ≥ 0.40) for simple, but poor reliability (ICC < 0.40) for more complex fMRI measures related to self-blame. Despite this low internal consistency of complex measures at the individual level, we observed robust activation at the group-level, reproducing previously published results.ConclusionsWhile simple BOLD contrasts had fair reliability, previously employed PPI models had poor reliability and simple connectivity measures lacked predictive validity. This calls for the development of functional connectivity measures that strike a better balance between reliability and validity for future clinical applications, which require robust measures at the individual rather than group-level.

Project description:Background: Major Depressive Disorder (MDD) is a moderately heritable disorder with a high lifetime prevalence. At present, laboratory blood tests to support MDD diagnosis are not available. Methods: We used a classifier approach on blood gene expression profiles of a unique set of non-medicated subjects (MDD patients and controls) to select genes of which expression is predictive for disease status. To reveal blood gene expression changes related to MDD disease, we applied a powerful ex vivo stimulus to the blood, i.e. incubation with lipopolysaccharide (LPS; 10 ng/ml blood). Results: Based on LPS-stimulated blood gene expression using whole-genome microarrays in 42 subjects (primary cohort; 21 MDD patients (mean age 42.3 years), 21 healthy controls (mean age 41.9 years)), we identified a set of genes (CAPRIN1, CLEC4A, KRT23, MLC1, PLSCR1, PROK2, ZBTB16) that serves as a molecular signature of MDD. These findings were validated for the primary cohort using an independent quantitative PCR method (P = 0.007). The difference between depressive patients and controls was confirmed (P = 0.019) in a replication cohort of 13 patients with MDD (mean age 42.8 years) and 14 controls (mean age 45.6 years). The MDD-signature score comprised of expression levels of 7 genes could discriminate depressive patients from controls with sensitivity of 76.9% and specificity of 71.8%. Conclusions: We show for the first time that molecular analysis of stimulated blood cells can be used as an endophenotype for MDD diagnosis, which is a milestone in establishing biomarkers for neuropsychiatric disorders with moderate heritability in general. Our results may provide a new entry point for following and predicting treatment outcome, as well as prediction of severity and recurrence of MDD. In total, 33 MDD patients and 34 healthy controls were analyzed using basal gene expression in whole blood, and gene expression from whole blood that was stimulated with LPS for 5-6 h, using microarrays. Patients were arbitrarily selected from all patients to serve as primary cohort (nMDD = 21 (MDD01-MDD21); nControls = 21 (Con01-Con21)), or replication cohort (nMDD = 12 (MDD22-MDD35); nControls = 13 (Con22-Con37)) using microarrays. This submission does not include Samples CON21_LPS or CON30_LPS.

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Dataset Information

The role of self-blame and worthlessness in the psychopathology of major depressive disorder.

Background

Methods

Results

Limitations

Conclusions

Publications

The role of self-blame and worthlessness in the psychopathology of major depressive disorder.

Similar Datasets

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