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"Rottenberg, Jonathan"
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The depths : the evolutionary origins of the depression epidemic /
\"Why are we losing the fight against depression? In this groundbreaking work, psychologist Jonathan Rottenberg explains that despite advances in pharmaceutical science, progress has been hampered by our fundamental misunderstanding of depression as a psychological or chemical defect. Instead, Rottenberg introduces a surprising alternative: that depression is a particularly severe outgrowth of our natural capacity for emotion; it is a low mood gone haywire. Drawing on recent developments in the science of mood-and his own harrowing depressive experience as a young adult-Rottenberg explains depression in evolutionary terms, showing how its dark pull arises from adaptations that evolved to help our ancestors ensure their survival. Weaving together experimental and epidemiological research, clinical observations, and the voices of people who have struggled with depression, The Depths offers a bold new account of why depression endures-and points the way toward new paths for treatment\"-- Provided by publisher.
Book
Predictive modeling of initiation and delayed mental health contact for depression
Background
Depression is prevalent among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, yet rates of Veteran mental health care utilization remain modest. The current study examined: factors in electronic health records (EHR) associated with lack of treatment initiation and treatment delay; the accuracy of regression and machine learning models to predict initiation of treatment.
Methods
We obtained data from the VA Corporate Data Warehouse (CDW). EHR data were extracted for 127,423 Veterans who deployed to Iraq/Afghanistan after 9/11 with a positive depression screen and a first depression diagnosis between 2001 and 2021. We also obtained 12-month pre-diagnosis and post-diagnosis patient data. Retrospective cohort analysis was employed to test if predictors can reliably differentiate patients who initiated, delayed, or received no mental health treatment associated with their depression diagnosis.
Results
108,457 Veterans with depression, initiated depression-related care (55,492 Veterans delayed treatment beyond one month). Those who were male, without VA disability benefits, with a mild depression diagnosis, and had a history of psychotherapy were less likely to initiate treatment. Among those who initiated care, those with single and mild depression episodes at baseline, with either PTSD or who lacked comorbidities were more likely to delay treatment for depression. A history of mental health treatment, of an anxiety disorder, and a positive depression screen were each related to faster treatment initiation. Classification of patients was modest (ROC AUC = 0.59 95%CI = 0.586–0.602; machine learning F-measure = 0.46).
Conclusions
Having VA disability benefits was the strongest predictor of treatment initiation after a depression diagnosis and a history of mental health treatment was the strongest predictor of delayed initiation of treatment. The complexity of the relationship between VA benefits and history of mental health care with treatment initiation after a depression diagnosis is further discussed. Modest classification accuracy with currently known predictors suggests the need to identify additional predictors of successful depression management.
Journal Article
Mood and Emotion in Major Depression
Nothing is more familiar to people than their moods and emotions. Oddly, however, it is not clear how these two kinds of affective processes are related. Intuitively, it makes sense that emotional reactions are stronger when they are congruent with a preexisting mood, an idea reinforced by contemporary emotion theory. Yet empirically, it is uncertain whether moods actually facilitate emotional reactivity to mood-congruent stimuli. One approach to the question of how moods affect emotions is to study mood-disturbed individuals. This review describes recent experimental studies of emotional reactivity conducted with individuals suffering from major depression. Counter to intuitions, major depression is associated with reduced emotional reactivity to sad contexts. A novel account of emotions in depression is advanced to assimilate these findings. Implications for the study of depression and normal mood variation are considered.
Journal Article
Affect valuations predict emotional response to satisfying and disappointing exam scores
Does what a person desires to feel (affect valuation) predict their future affective reaction to salient life events? We tested this idea in the context of an exam, a key achievement-oriented event for college students.
One to two weeks prior to taking an exam (at baseline), 177 university students rated their ideal affect, depression and anxiety symptom severities, and provided affective forecasts for how they would react if they did or did not achieve their expected exam scores. On the day when students received their exam scores, they rated their actual emotional response to the exam outcomes.
Higher levels of baseline ideal positive affect predicted greater positive affective responses to receiving satisfying exam scores. This prediction held even after controlling for affective forecasting, depression and anxiety levels, and the exam score itself. Higher levels of baseline ideal negative affect predicted greater negative affective reactions to receiving disappointing exam scores, but did not survive parallel statistical controls.
These findings suggest motivational functions for ideal affect, particularly for positive affective states.
Journal Article
Is Crying Beneficial?
Lay opinion and extensive survey data indicate that crying is a cathartic behavior that serves to relieve distress and reduce arousal. Yet laboratory data often indicate that crying exacerbates distress and increases autonomic arousal. In this article, we present a framework for explaining variations in the psychological effects of crying as a function of (a) how the effects of crying are measured, (b) conditions in the social environment, (c) personality traits of the crier, and (d) the affective state of the crier. Recognizing the heterogeneity of crying effects represents a step toward a more nuanced understanding of this behavior, including its implications for psychosocial adjustment.
Journal Article
When is Crying Cathartic? An International Study
The idea that crying is a cathartic experience, leading to relief from distress, has deep roots. However, empirical evidence for catharsis after crying is mixed. One explanation for the inconsistent results is that variations in the social context of the crying situation determine whether or not crying-related catharsis occurs. To evaluate the role of social context and other contextual features in crying-related catharsis, self-report data were collected on characteristics of the most recent crying episode and its effects on mood in 2,181 male and 2,915 female students in 35 countries. It was hypothesized that the experience of catharsis after crying would be associated with social support during crying, reasons for crying, and characteristics of the situation where the crying occurred. Several contextual features of crying episodes were indeed predictive of crying-related catharsis. Specifically, the receipt of social support, experiencing a resolution to the event that caused the crying episode, and achieving a new understanding of the event were positively related to catharsis. Crying episodes that featured the suppression of crying or the experiencing of shame from crying were less likely to be cathartic. The data suggest that contextual factors may play an important role in shaping crying-related catharsis. [PUBLICATION ABSTRACT]
Journal Article
Atypical patterns of respiratory sinus arrhythmia index an endophenotype for depression
Can atypical patterns of parasympathetic nervous system activity serve as endophenotypes for depression? Using respiratory sinus arrhythmia (RSA) as an index of parasympathetic nervous system function, we examined this question in two studies: one involving mothers with and without depression histories and their offspring (at high and low risk for depression, respectively), and a further study of adolescent sibling pairs concordant and discordant for major depression. In both studies, subjects were exposed to sad mood induction; subjects' RSA was monitored during rest periods and in response to the mood induction. We used Gottesman and Gould's (2003) criteria for an endophenotype and a priori defined “atypical” and “normative” RSA patterns (combinations of resting RSA and RSA reactivity). We found that atypical RSA patterns (a) predicted current depressive episodes and remission status among women with histories of juvenile onset depression and healthy controls, (b) predicted longitudinal trajectories of depressive symptoms among high- and low-risk young offspring, (c) were concordant across mothers and their juvenile offspring, (d) were more prevalent among never-depressed youth at high risk for depression than their low-risk peers, and (e) were more concordant across adolescent sibling pairs in which both versus only one had a history of major depression. Thus, the results support atypical RSA patterns as an endophenotype for depression. Possible mechanisms by which RSA patterns increase depression risk and their genetic contributors are discussed.
Journal Article
The Curious Neglect of High Functioning After Psychopathology: The Case of Depression
We address a key issue at the intersection of emotion, psychopathology, and public health—the startling lack of attention to people who experience benign outcomes, and even flourish, after recovering from depression. A rereading of the epidemiological literature suggests that the orthodox view of depression as chronic, recurrent, and lifelong is overstated. A significant subset of people recover and thrive after depression, yet research on such individuals has been rare. To facilitate work on this topic, we present a generative research framework. This framework includes (a) a proposed definition of healthy end-state functioning that goes beyond a reduction in clinical symptoms, (b) recommendations for specific measures to assess high functioning, and (c) a road map for a research agenda aimed at discovering how and why people flourish after emotional disturbance. Given that depression remains the most burdensome health condition worldwide, focus on what makes these excellent outcomes possible has enormous significance for the public health.
Journal Article
REWARD LEARNING IN PEDIATRIC DEPRESSION AND ANXIETY: PRELIMINARY FINDINGS IN A HIGH-RISK SAMPLE
Background
Reward learning has been postulated as a critical component of hedonic functioning that predicts depression risk. Reward learning deficits have been established in adults with current depressive disorders, but no prior studies have examined the relationship of reward learning and depression in children. The present study investigated reward learning as a function of familial depression risk and current diagnostic status in a pediatric sample.
Method
The sample included 204 children of parents with a history of depression (n = 86 high‐risk offspring) or parents with no history of major mental disorder (n = 118 low‐risk offspring). Semistructured clinical interviews were used to establish current mental diagnoses in the children. A modified signal detection task was used for assessing reward learning. We tested whether reward learning was impaired in high‐risk offspring relative to low‐risk offspring. We also tested whether reward learning was impaired in children with current disorders known to blunt hedonic function (depression, social phobia, PTSD, GAD, n = 13) compared to children with no disorders and to a psychiatric comparison group with ADHD.
Results
High‐ and low‐risk youth did not differ in reward learning. However, youth with current anhedonic disorders (depression, social phobia, PTSD, GAD) exhibited blunted reward learning relative to nondisordered youth and those with ADHD.
Conclusions
Our results are a first demonstration that reward learning deficits are present among youth with disorders known to blunt anhedonic function and that these deficits have some degree of diagnostic specificity. We advocate for future studies to replicate and extend these preliminary findings.
Journal Article