Daily Stress, Coping, and Negative and Positive Affect in Depression: Complex Trigger and Maintenance Patterns☆
Section snippets
Complex Stress, Coping, and Affect Trigger and Maintenance Patterns
Although there are important differences between various cognitive (e.g., Beck, Rush, Shaw, & Emery, 1979), learning (e.g., Martell, Addis, & Jacobson, 2001), and emotion-focused (e.g., Gray, 1990) theories of depression, these theories recognize the importance of withdrawal and approach systems. All of these theories propose that effective treatment involves helping people with depression decrease inhibition and become more engaged with their environment, especially in ways that increase
The Present Study
As Dunkley et al. (2014) demonstrated their multilevel explanatory model in a sample of nondepressed adults, the generalizability of the complex trigger and maintenance patterns to depressed patients is unknown. In terms of within-person emotion dynamics, findings from experience sampling studies have suggested that affective reactivity to daily negative events may be either blunted (Peeters, Nicolson, Berkhof, Delespaul, & De Vries, 2003), comparable (Thompson et al., 2012), or intensified (
Participants
Participants were outpatient adults (between the ages of 18–65) who had a primary diagnosis of current unipolar MDD according to the Diagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV; American Psychiatric Association, 1994), and were referred for treatment based on clinical interview(s) at one of two teaching hospitals in a North American city from October 2007 to November 2010. In order to be eligible, participants did not have any changes in medications for at least 4
Participant characteristics
The 63 participants ranged from 20 to 61 years of age (M = 40.94 years, SD = 11.54). Of the 56 participants who reported their ethnicity, 80% (n = 45) self-identified as of European descent, 5% (n = 3) as African, 5% (n = 3) as West Indian, 4% (n = 2) as South American, 2% (n = 1) as Middle Eastern, 2% (n = 1) as East Indian, and 2% (n = 1) as Aboriginal. Eighty-three percent (n = 52) of participants reported taking psychiatric medication. The participants had a mean BDI score of 30.40 (SD =
Discussion
The present study was the first to use a daily diary method and MSEM to elucidate how specific stress appraisal and coping mechanisms work in combination to change and maintain daily negative affect and (lower) positive affect in depressed patients. Trigger patterns can be understood as time-proximal state-level (within-person) effects, whereas maintenance patterns are better understood as trait-level (between-persons) effects. Together with previous results (Thompson et al., 2012), our
Conclusion
Our use of a daily diary methodology and MSEM explicated two complex explanatory models that can help clinicians and their patients make more sense of what commonly triggers and maintains negative affect and (low) positive affect in depression. Our results demonstrate complex trigger patterns that shed light on how daily changes in mood are precipitated for the typical person with depression. We also showed how depressive mood is maintained for people with depression and higher self-critical
Conflict of Interest Statement
The authors declare that there are no conflicts of interest.
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2021, Personality and Individual DifferencesCitation Excerpt :This is noted in the results tables. The measurement model for PA and NA in our SEMs used an item parceling strategy previously employed with the PANAS (Dunkley et al., 2017; Dunkley, Ma, Lee, Preacher & Zuroff, 2014). Recent work has indicated that parceling has many psychometric benefits, including enhanced indicator reliability and the creation of indicators suitably continuous for maximum likelihood estimation (Little, Rhemtulla, Gibson & Schoemann, 2013).
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This research was supported by a Fonds de la Recherche en Santé du Québec Grant (DMD, DCZ, GM, RW), Bourses de Chercheurs-Boursiers (DMD), Douglas Utting Fellowships for Studies in Depression (ML, JEF), and a Canada Graduate Scholarships Master's Award (JB). Neither of the funding organizations had any role in the design and conduct of the study; in the collection or interpretation of the data; nor in the writing of the report or in the decision to submit it. The authors report no conflict of interest.
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Deceased (2013)