Harris T O, Brown G W, Bifulco A T
Department of Social Policy and Social Science, Royal Holloway and Bedford New College, University of London, U.K.
J Affect Disord. 1990 Sep;20(1):27-41. doi: 10.1016/0165-0327(90)90047-c.
This paper continues the investigation of differential states of depression in a sample of 225 women selected for different experiences of parental loss in childhood by introducing a measure of the cognitive-behavioural set of situational helplessness/mastery which uses actual rather than hypothetical situations as the basis for scoring. The measure is also specifically designed to take account of differences according to the time of its completion (before, during or after a psychiatric episode). The relationship is explored between this attribute and, on the one hand, depressive disorder, and on the other, parental loss in childhood. Rates of current depression increased progressively with the degree of helplessness rated not only for the current period but also, in instances where there was a current depressive episode, for the time immediately prior to its onset. For those with depression the degree of helplessness was often found to be higher during the episode than just before it. A measure of helplessness in childhood was associated not only with current depression but with previous episodes. Continuity between childhood and adult helplessness was apparently considerable, and both were associated with loss of mother in childhood. A rating of helplessness shown in the past just before onset of a prior depressive episode suggested a similar raised rate compared to those never depressed. The failure to find an association between prior episodes of depression and current helplessness among those currently not depressed is discussed in terms of the likely durability of long-term cognitive-behavioural sets and the possibility that with improved social circumstances and relationships, helplessness may decrease.(ABSTRACT TRUNCATED AT 250 WORDS)
本文通过引入一种基于实际而非假设情境进行评分的情境无助/掌控感的认知行为量表,继续对225名因童年时期父母丧失经历不同而被挑选出的女性样本中的抑郁差异状态进行研究。该量表还经过专门设计,以考虑根据其完成时间(在精神疾病发作之前、期间或之后)的差异。本文探讨了这一属性与一方面的抑郁症以及另一方面的童年时期父母丧失之间的关系。当前抑郁症的发病率不仅随着当前时期评定的无助程度逐渐增加,而且在当前存在抑郁发作的情况下,也随着发作前即刻的无助程度增加。对于患有抑郁症的人,往往发现在发作期间的无助程度高于发作前。童年时期的无助感不仅与当前的抑郁症有关,还与之前的发作有关。童年期与成年期无助感之间的连续性显然相当大,并且两者都与童年时期母亲的丧失有关。与从未患过抑郁症的人相比,在之前抑郁发作即将开始之前表现出的无助感评分显示出类似的较高发病率。对于当前未患抑郁症的人,未能发现之前的抑郁发作与当前无助感之间的关联,本文从长期认知行为模式可能的持久性以及随着社会环境和人际关系改善无助感可能降低的可能性方面进行了讨论。(摘要截选至250字)