Do self-criticism and somatic symptoms play a key role in chronic depression? Exploring the factor structure of Beck depression inventory-II in a sample of chronically depressed inpatients.

Høstmælingen, Andreas; Ulvenes, Pål; Nissen‐Lie, Helene A.; Eielsen, Mikkel; Wampold, Bruce E.

doi:10.1016/j.jad.2021.01.066

Cited by 11 publications

(11 citation statements)

References 55 publications

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“…We examined the trajectories of symptom change on BDI-II, comparing patients using or not using ADM while undergoing treatment. Specifically, we compared outcomes for the two groups on items pertaining to self-criticism and a cluster of somatic items (sleep, appetite, and fatigue) previously identified as subfactors in the factor structure of BDI-II in the current sample (Høstmaelingen et al, 2021a).…”

Section: Methods Study Design and Participantsmentioning

confidence: 99%

“…Patients completed BDI-II at assessment, start of treatment, at termination, and at 1-year follow-up. A factor analysis of the BDI-II on the same sample (Høstmælingen et al, 2021a) found a bifactor model with one general factor and two specific subfactors labeled “self-criticism” and “somatic” provided best model fit. All items except for “changes in sleeping pattern” loaded on the general factor, accounting for 73.4% of the explained variance.…”

Section: Methodsmentioning

confidence: 99%

“…The "somatic" subfactor (consisting of items "changes in sleeping pattern," "changes in appetite," and "tiredness or fatigue") accounted for 13.5% of the explained variance. Hence, depression could best be explained by one global factor, but that symptoms pertaining to self-critical cognition and somatic symptoms specifically involving sleep problems, appetite, and fatigue played a special role in the depressive functioning of this sample (Høstmaelingen et al, 2021a). Hence, in the present study, we conducted comparisons of trajectories of symptom change between ADM users and nonmedicated patients on the total BDI-II as well as for these separate factors.…”

Section: Outcome Measurementioning

confidence: 97%

“…In a recent study (Høstmaelingen et al, 2021a), we conducted a factor analysis of BDI-II (Beck et al, 1996) in a sample of chronically depressed inpatients. We found a bifactor structure with one general depression factor, and two lower order factors indicating (a) self-criticism (i.e., "guilty feelings," "self-dislike," "self-criticism," and "worthlessness") and (b) somatic symptoms (i.e., "changes in sleeping pattern," "changes in appetite," "tiredness or fatigue") as specific subfactors of depression in this patient group.…”

mentioning

confidence: 99%

“…Thus, selfcriticism and symptoms pertaining to sleep, appetite, and fatigue might represent subfactors of CD that warrant further exploration in terms of a differential treatment response. Analyzing a subsample from the same patient sample as the abovementioned study (Høstmaelingen et al, 2021a), the aim of the present study was to examine potential differences in treatment response on the two factors labeled "self-criticism" and "somatic symptoms" depending on ADM use (i.e., whether patients were taking ADM while going through a 12-week inpatient psychotherapeutic treatment, or not). In line with previous research indicating ADM has an effect on somatic symptoms (e.g., Chekroud et al, 2017), we hypothesized that (a) patients using ADM would have more symptom reduction on the somatic factor than nonmedicated patients.…”

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confidence: 99%

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Trajectories of change in chronic depression: Differences in self-criticism and somatic symptoms between users of antidepressants and nonmedicated patients.

Høstmælingen¹,

Ulvenes²,

Nissen‐Lie³

et al. 2022

Journal of Counseling Psychology

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Objective: Depression is typically seen as composed of several factors (i.e., cognitive, affective, somatic) which may be targeted by different interventions (i.e., pharmacotherapy, psychotherapy, or combination treatment). Successfully targeting these factors may contribute to improved treatment response in depression. A previous study identified two subfactors on Beck Depression Inventory-II (BDI-II) in a sample of chronically depressed patients: (a) self-criticism and (b) somatic symptoms (sleep disturbance, fatigue, changes in appetite). Prior research indicates that these symptoms may respond differently to psychotherapy and pharmacotherapy. In this study, we examined whether patients who were on antidepressant medication (ADM) had different outcomes on these factors than patients not using medication while undergoing intensive inpatient psychotherapeutic treatment. Method: After adjusting for baseline difference with propensity score matching, a total of 238 patients with chronic depression were included in the analysis of which 119 patients were using ADM during treatment while 119 were not. We analyzed whether the two groups had different trajectories of change on the factors "self-criticism" and "somatic symptoms" using multilevel growth curve modeling. Results: Patients not using medication during treatment had significantly larger symptom reduction than ADM users on the self-criticism factor, while there was no difference between groups on the somatic factor. Conclusion: There seems to be a difference in outcomes on selfcriticism depending on the use of ADM for this patient group. This may suggest that the simultaneous use of ADM while in psychotherapy could make patients less accessible to the effects of psychotherapeutic interventions on this factor. Public Significance StatementSelf-criticism may play a key role in maintaining chronic depression. This study suggests that chronically depressed patients not using antidepressant medication (ADM) while in psychotherapy reduce self-critical thought content more than patients using ADM. It is possible that patients using ADM experience emotional blunting which make them less accessible to psychotherapeutic interventions addressing dysfunctional rumination or emotional processing.

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Section: Methods Study Design and Participantsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Outcome Measurementioning

confidence: 97%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Trajectories of change in chronic depression: Differences in self-criticism and somatic symptoms between users of antidepressants and nonmedicated patients.

Høstmælingen¹,

Ulvenes²,

Nissen‐Lie³

et al. 2022

Journal of Counseling Psychology

Self Cite

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Further validation of the Multidimensional Version of the Fear‐of‐Self Questionnaire in a Persian non‐clinical and clinical obsessive–compulsive disorder sample

Bastan

Aardema

Khosravani

et al. 2023

Clin Psychology and Psychoth

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Previous research has shown that vulnerable self‐themes and feared self‐perceptions may play an important role in the development and maintenance of obsessive–compulsive disorder (OCD). In particular, the recently validated Multidimensional Version of the Fear‐of‐Self Questionnaire (FSQ‐MV) has shown strong relationships with OCD symptoms independent of cognitive constructs and negative mood in non‐clinical samples. The current study aimed to further evaluate the validity and reliability of a Persian version of the FSQ‐MV in OCD patients (N = 300), as well as non‐clinical individuals (N = 300). Participants completed a set of scales evaluating feared self‐perceptions and OCD‐related symptoms/conditions. The results showed that the Persian version of the FSQ‐MV replicated the three‐factor structure of the original scale in non‐clinical and OCD patients. The FSQ‐MV and its subscales had excellent reliability. Additionally, the FSQ‐MV was significantly associated with related cognitive constructs, as well as OCD symptoms and their severity, in both samples. The feared self, especially the corrupted feared self, was a significant unique predictor of OC symptomology, especially for repugnant obsessions, and OCD severity. The study confirmed the validity and reliability of the Persian version of the FSQ‐MV. Moreover, cognitive conceptualizations may benefit from a consideration of the feared self in OCD, which may play an important role in its development, maintenance and severity.

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Mechanisms of Mindfulness: A Longitudinal Study of a Mindfulness-Based Stress Reduction Program

Davis,

Wojcik,

Baillie

et al. 2024

Mindfulness

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Do self-criticism and somatic symptoms play a key role in chronic depression? Exploring the factor structure of Beck depression inventory-II in a sample of chronically depressed inpatients.

Cited by 11 publications

References 55 publications

Trajectories of change in chronic depression: Differences in self-criticism and somatic symptoms between users of antidepressants and nonmedicated patients.

Trajectories of change in chronic depression: Differences in self-criticism and somatic symptoms between users of antidepressants and nonmedicated patients.

Further validation of the Multidimensional Version of the Fear‐of‐Self Questionnaire in a Persian non‐clinical and clinical obsessive–compulsive disorder sample

Mechanisms of Mindfulness: A Longitudinal Study of a Mindfulness-Based Stress Reduction Program

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