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

JOURNAL OF AFFECTIVE DISORDERS

卷:186

Article

Zahn, Roland¹  Lythe, Karen E.^2,3  Gethin, Jennifer A.^2,3  Green, Sophie^2,3  Deakin, John F. William^2,4  Young, Allan H.¹  Moll, Jorge⁵ 

[1] Kings Coll London, Dept Psychol Med, Ctr Affect Disorders, Inst Psychiat Psychol & Neurosci, London SE5 8AZ, England

[2] Univ Manchester, Manchester M13 9PL, Lancs, England

[3] Manchester Acad Hlth Sci Ctr, Sch Psychol Sci, Neurosci & Aphasia Res Unit, Manchester M13 9PL, Lancs, England

[4] Manchester Acad Hlth Sci Ctr, Inst Brain Behav & Mental Hlth, Neurosci & Psychiat Unit, Manchester M13 9PL, Lancs, England

[5] DOr Inst Res & Educ IDOR, Cognit & Behav Neurosci Unit, BR-22280080 Rio De Janeiro, RJ, Brazil

关键词: Moral emotions;    Attributional style;    Major depression;    Self-blame;    Symptoms;    Nosology;   

DOI  :  10.1016/j.jad.2015.08.001

来源: Elsevier

【 摘 要 】

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 MOD 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 DSMIV-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. Crown Copyright (C) 2015 Published by Elsevier B.V. All rights reserved.

【 授权许可】

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