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- PMID: 26277271
- UKPMCID: 26277271
- DOI: 10.1016/j.jad.2015.08.001
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The role of self-blame and worthlessness in the psychopathology of major depressive disorder.
Zahn, Roland; Lythe, Karen E; Gethin, Jennifer A; Green, Sophie; Deakin, John F William; Young, Allan H; Moll, Jorge
Journal of affective disorders. 2015;186:337-41.
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Full-text held externally
- PMID: 26277271
- UKPMCID: 26277271
- DOI: 10.1016/j.jad.2015.08.001
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.
Keyword(s)
Attributional style; Major depression; Moral emotions; Nosology; Self-blame; Symptoms