Abstract
We investigated the role of attributional style in inpatients’ initial response to treatment, particularly to SSRIs, and explored possible psychological factors implicated in response to SSRIs. One hundred youth psychiatric inpatients completed questionnaires at admission and discharge on attributional style, hopelessness, self-esteem, and depressive symptoms; medication status was recorded. Change in depressive symptoms from admission to discharge varied depending on negative attributional style status and treatment group status. Patients with a relatively positive attributional style and who were on SSRI medicines experienced the largest decreases in depression from admission to discharge, as well as the lowest absolute depression level at discharge. Depression changes were less pronounced in other patients, including those on SSRIs with a negative attributional style. Psychological processes corresponding to these changes appeared to involve increased hope, not enhanced self-esteem. Attributional style may moderate initial SSRI treatment response, an effect that appears to correspond with increased hope.
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Abela, J. R. Z. (2001). The hopelessness theory of depression: A test of the diathesis-stress and causal mediation components in third and seventh grade children. Journal of Abnormal Child Psychology, 29, 241–254.
Abela, J. R. Z., & Sarin, S. (2002). Cognitive vulnerability to hopelessness depression: A chain is only as strong as its weakest link. Cognitive Therapy and Research, 26, 811–829.
Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96, 358–372.
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861–865.
Brent, D. A., Kolko, D. J., Birmaher, B., Baugher, M., Bridge, J., Roth, C., et al. (1998). Predictors of treatment efficacy in a clinical trial of three psychosocial treatments for adolescent depression. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 906–914.
Deakin, J. F. W. (1996). 5-HT, antidepressant drugs and the psychosocial origins of depression. Journal of Psychopharmacology, 10, 31–38.
Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218–226.
Hankin, B. L., Abramson, L. Y., & Siler, M. (2001). A prospective test of the hopelessness theory of depression in adolescence. Cognitive Therapy and Research, 25, 607–632.
Higley, J. D., King, S. T., Jr., Hasert, M. F., Champoux, M., Suomi, S. J., & Linnoila, M. (1996). Stability of interindividual differences in serotonin function and its relationship to severe aggression and competent social behavior in rhesus macaque females. Neuropsychopharmacology, 14, 67–76.
Joiner, T. E., Jr. (2000). A test of the hopelessness theory of depression among youth psychiatric inpatients. Journal of Clinical Child Psychology, 29, 167–176.
Joiner, T. E., & Rudd, M. D. (1996). Toward a categorization of depression-related psychological constructs. Cognitive Therapy and Research, 20, 51–68.
Joiner, T. E., Jr., & Wagner, K. D. (1995). Attributional style and depression in children and adolescents: A meta-analytic review. Clinical Psychology Review, 8, 777–798.
Kaslow, N. J., Tanenbaum, R. L., & Seligman, M. E. P. (1978). The Kastan-R: A children’s attributional style questionnaire. Pennsylvania: University of Pennsylvania.
Kazdin, A. E., French, N. H., Unis, A. S., Esveldt-Dawson, K., & Sherick, R. B. (1983). Hopelessness, depression, and suicidal intent among psychiatrically disturbed inpatient children. Journal of Consulting and Clinical Psychology, 51, 504–510.
Keller, M., McCullough, J., Klein, D., Arnow, B., Dunner, D., Gelenberg, A. J., et al. (2000). A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. New England Journal of Medicine, 342, 1462–1470.
Kovacs, M. (1992). Children’s depression inventory manual. Los Angeles: Western Psychological Services.
Kraemer, H. C., Wilson, T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883.
Kramer, P. (1993). Listening to prozac. New York: Penguin.
Lewinsohn, P. M., Joiner, T., & Rohde, P. (2001). Evaluation of cognitive diathesis-stress models in predicting major depressive disorder in adolescents. Journal of Abnormal Psychology, 110, 203–215.
Lewinsohn, P. M., Rohde, P., & Seely, J. R. (1998). Major depressive disorder in older adolescents: Prevalence, risk factors, and clinical implications. Clinical Psychology Review, 18, 765–794.
Longabaugh, R., Wirtz, P. W., DiClemente, C. C., & Litt, M. (1994). Issues in the development of client-treatment matching hypotheses. Journal of Studies on Alcohol, 12(Suppl), 46–59.
McCullough, J. P., Jr. (2000). Treatment for chronic depression: Cognitive behavioral analysis system of psychotherapy (CBASP). New York: Guilford.
Miller, I. W., Norman, W. H., & Keitner, G. I. (1990). Treatment response of high cognitive dysfunction depressed inpatients. Comprehensive Psychiatry, 31, 62–71.
Mufson, L. H., Moreau, D., Weissman, M. M., & Klerman, G. L. (1993). Interpersonal psychotherapy for adolescent depression. In G. Klerman and M. Weissman (Eds.), New applications of interpersonal psychotherapy (pp. 129–166). Washington, DC: American Psychiatric Press.
Needles, D., & Abramson, L. Y. (1990). Positive life events, attributional style, and hopefulness: Testing a model of recovery from depression. Journal of Abnormal Psychology, 99, 156–165.
Nierenberg, A., Farabaugh, A., Alpert, J., Gordon, J., Worthington, J., Rosenbaum, J., et al. (2000). Timing of onset of antidepressant response with fluoxetine treatment. American Journal of Psychiatry, 157, 1423–1428.
Nolen-Hoeksema, S., Girgus, J. S., & Seligman, M. E. P. (1992). Predictors and consequences of childhood depressive symptoms: A 5-year longitudinal study. Journal of Abnormal Psychology, 101, 405–422.
Pettit, J., Voelz, Z., & Joiner, T. (2001). Combined treatments for depression. In M. Sammons & N. B. Schmidt (Eds.), Combined treatments for mental disorders (pp. 131–160). Washington, DC: American Psychological Association.
Puig-Antich, J., Chambers, W. J., & Klein, R. G. (1993). Lifetime schedule for affective disorders and schizophrenia for adolescents. Pittsburgh, PA: University of Pittsburgh.
Reynolds, C. F., III, Frank, E., Perel, J. M., Imber, S. D., Cornes, C., Miller, M. D., et al. (1999). Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: A randomized controlled trial in patients older than 59 years. Journal of the American Medical Association, 281, 39–45.
Rosenberg, S. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.
Seligman, M. E. P., Peterson, C., Kaslow, N. J., Tanenbaum, R. L., Alloy, L. B., & Abramson, L. Y. (1984). Attributional style and depressive symptoms among children. Journal of Abnormal Child Psychology, 93, 235–238.
Spangler, D. L., Simons, A. D., Monroe, S. M., & Thase, M. E. (1997). Response to cognitive-behavioral therapy in depression: Effects of pretreatment cognitive dysfunction and life stress. Journal of Consulting and Clinical Psychology, 65, 568–575.
Wagner, K. D., Berenson, A., Harding, O., & Joiner, T. E., Jr. (1998). Attributional style and depression in pregnant teenagers. American Journal of Psychiatry, 155, 1227–1233.
Wagner, K. D., Rouleau, M., & Joiner, T. E., Jr. (2000). Cognitive factors related to suicidal ideation and resolution in psychiatrically hospitalized children and adolescents. American Journal of Psychiatry, 157, 2017–2021.
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Joiner, T.E., Brown, J.S., Gordon, K.H. et al. Attributional Style, Hope, and Initial Response to Selective Serotonin Reuptake Inhibitors Youth Psychiatric Inpatients. Cogn Ther Res 29, 691–704 (2005). https://doi.org/10.1007/s10608-005-9633-x
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DOI: https://doi.org/10.1007/s10608-005-9633-x