Sevcikova Marcela, Maslej Marta M, Stipl Jiri, Andrews Paul W, Pastrnak Martin, Vechetova Gabriela, Bartoskova Magda, Preiss Marek
National Institute of Mental Health, Klecany, Czechia.
First Faculty of Medicine, Charles University, Prague, Czechia.
Front Psychol. 2020 Jul 2;11:1344. doi: 10.3389/fpsyg.2020.01344. eCollection 2020.
Depression is a mental health condition for which individuals commonly seek treatment. However, depressive episodes often resolve on their own, even without treatment. One evolutionary perspective, the analytical rumination hypothesis (ARH), suggests that depression occurs in response to complex problems. According to this perspective, depressive symptoms promote analytical rumination, i.e., distraction-resistant thoughts about the causes of problems [causal analysis (CA)] and how they can be solved [problem-solving analysis (PSA)]. By helping individuals solve complex problems, analytical rumination may contribute to remission from depression. The aim of this study was to investigate (1) whether clinically-depressed individuals have more complex problems and engage in more CA and PSA than non-depressed and (2) the effects of CA and PSA on decreases in problem complexity, depressive symptoms, and remission from the depression. Samples of 85 patients were treated for depression with antidepressants and psychotherapy, and 49 healthy subjects were assessed three times over a 4-month period (at Weeks 1, 5, and 16). At each assessment, they completed measures of depression, analytical rumination, and problem complexity. Depressed individuals reported having more complex problems and engaging in more CA than non-depressed participants. The two groups engaged in a similar degree of PSA. Findings from a multiple regression suggested that more PSA at Week 1 was related to a decrease in depressive symptoms at Week 5, even after controlling for baseline depression, problem number, and complexity. PSA at Week 1 did not predict the remission after hospitalization or at follow-up; however, having less complex problems at the baseline made it more likely that a patient would later remit. Engaging in more CA or PSA at Week 1 did not affect perceived problem complexity at Week 5 or at follow-up. However, these findings were not statistically significant when influential observations (or outliers) were included in the analysis. Our findings suggest that PSA may contribute to a decrease in symptoms of depression over time. However, alleviations in problem complexity and remission might only be achieved if problems are initially less complex. Future directions involve exploring how PSA might contribute to decreases in depressive symptoms and other mechanisms underlying remission from depression.
抑郁症是一种人们通常会寻求治疗的心理健康状况。然而,抑郁发作常常会自行缓解,即使未经治疗也是如此。一种进化观点,即分析性沉思假说(ARH)认为,抑郁症是对复杂问题的反应而产生的。根据这一观点,抑郁症状会促进分析性沉思,即对问题原因[因果分析(CA)]以及如何解决这些问题[解决问题分析(PSA)]的抗干扰性思考。通过帮助个体解决复杂问题,分析性沉思可能有助于抑郁症的缓解。本研究的目的是调查:(1)临床抑郁症患者是否比非抑郁症患者有更多复杂问题,以及是否进行更多的因果分析和解决问题分析;(2)因果分析和解决问题分析对问题复杂性降低、抑郁症状减轻以及抑郁症缓解的影响。85名抑郁症患者接受了抗抑郁药物和心理治疗,49名健康受试者在4个月内(第1周、第5周和第16周)接受了三次评估。每次评估时,他们都完成了抑郁、分析性沉思和问题复杂性的测量。抑郁症患者报告称,与非抑郁症参与者相比,他们有更多复杂问题,且进行更多的因果分析。两组进行的解决问题分析程度相似。多元回归分析结果表明,即使在控制了基线抑郁、问题数量和复杂性之后,第1周进行更多的解决问题分析与第5周抑郁症状的减轻有关。第1周的解决问题分析并不能预测住院后或随访时的缓解情况;然而,基线时问题复杂性较低使患者更有可能随后缓解。第1周进行更多因果分析或解决问题分析对第5周或随访时感知到的问题复杂性没有影响。然而,当分析中纳入有影响力的观察值(或异常值)时,这些结果没有统计学意义。我们的研究结果表明,随着时间的推移,解决问题分析可能有助于减轻抑郁症状。然而,只有当问题最初不太复杂时,问题复杂性的减轻和缓解才可能实现。未来的方向包括探索解决问题分析如何可能有助于减轻抑郁症状以及抑郁症缓解的其他潜在机制。