Preoperational Thinking as a Measure of Social Cognition Is Associated With Long-Term Course of Depressive Symptoms. A Longitudinal Study Involving Patients With Depression and Healthy Controls

Sondermann, Stefan; Stahl, Jörg; Grave, Ulrike; Outzen, Janne; Moritz, Steffen; Klein, Jan Philipp

doi:10.3389/fpsyt.2020.00652

Cited by 10 publications

(8 citation statements)

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“…We were the first to demonstrate that improvements in preoperational thinking are associated with outcome as postulated by the CBASP model (11). Our present results extend the findings of Sondermann et al (22), who also suggest the implication of preoperational thinking in depressive symptom severity as they found a high degree of preoperational thinking to be associated with a higher severity of depressive symptoms over an observation period of 2 years. In line with previous research (33,34,39), patients treated with CBASP exhibited more friendly-dominant behaviors at the end of treatment.…”

Section: Comparison To Existing Studiessupporting

confidence: 91%

“…This global and prelogical way of thinking has been summarized in the words of one chronically depressed patient: "Whatever I do, nothing will ever change" (19). Utilizing the Luebeck Questionnaire for Recording Preoperational Thinking (LQPT) as a measure specifically developed to assess preoperational thinking (20), studies found higher levels of preoperational thinking in chronically depressed patients compared to episodically depressed patients and healthy controls (17,(19)(20)(21)(22). Further, preoperational thinking is associated with early emotional abuse and this association might be mediated by interpersonal fears (19).…”

Section: Introductionmentioning

confidence: 99%

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Change in Interpersonal and Metacognitive Skills During Treatment With Cognitive Behavioral Analysis System of Psychotherapy and Metacognitive Therapy: Results From an Observational Study

et al. 2021

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Background: Interpersonal skills deficits and dysfunctional metacognitive beliefs have been implicated in the etiology and maintenance of depression. This study aimed to investigate the association between changes in these skills deficits and change in depressive symptoms over the course of treatment with Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and Metacognitive Therapy (MCT).Methods: In this prospective, parallel group observational study, data was collected at baseline and after 8 weeks of an intensive day clinic psychotherapy program. Based on a shared decision between patients and clinicians, patients received either CBASP or MCT. Ninety patients were included in the analyses (CBASP: age M = 38.7, 40.5% female, MCT: age M = 44.7, 43.3% female). Interpersonal deficits were assessed with the short-form of the Luebeck Questionnaire for Recording Preoperational Thinking (LQPT-SF) and the Impact Message Inventory (IMI-R). Metacognitive beliefs were assessed with the Metacognition Questionnaire-30 (MCQ-30). The Quick Inventory of Depressive Symptomatology (QIDS-SR16) was utilized to assess depressive symptoms. A regression analysis was conducted to assess variables associated with outcome. ANCOVAs were utilized to investigate whether improvement in skills deficits is dependent on type of treatment received.Results: Improvements in preoperational thinking and increases in friendly-dominant behavior were associated with change in depressive symptoms. There was no association between reductions in dysfunctional metacognitive beliefs and a decrease in depressive symptoms. While both treatment groups showed significant improvements in interpersonal and metacognitive skills, there was no significant between-group difference in the change scores for either of these skills.Conclusion: Our findings suggest that changes in interpersonal skills seem to be of particular relevance in the treatment of depression. These results have to be replicated in a randomized-controlled design before firm conclusions can be drawn.

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Section: Comparison To Existing Studiessupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Change in Interpersonal and Metacognitive Skills During Treatment With Cognitive Behavioral Analysis System of Psychotherapy and Metacognitive Therapy: Results From an Observational Study

et al. 2021

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“…Constantino et al found that patients with PDD and ED did not differ in submissiveness, friendly-submissiveness, or hostile-submissiveness, but they differed in levels of hostility ( 27 ). A recent study also indicates higher levels of specific interpersonal skill deficits (peroperational thinking) in patients with PDD when compared with ED and an association between these deficits and depression severity over the course of 2 years ( 28 ).…”

Section: Introductionmentioning

confidence: 99%

Social Cognition and Interpersonal Problems in Persistent Depressive Disorder vs. Episodic Depression: The Role of Childhood Maltreatment

Struck

Gärtner²,

Kircher

et al. 2021

Front. Psychiatry

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Objective: Little is known about the specific psychological features that differentiate persistent depressive disorder (PDD) and episodic depression (ED). Thus, the present study aimed to investigate differences in social cognition and interpersonal problems between these two forms of depression and healthy controls. In addition, we aimed to examine childhood maltreatment (CM) as a possible origin of these alterations.Methods: In a cross-sectional study, adult patients with a current PDD (n = 34) or in a current episode of ED (n = 38), and healthy controls (n = 39) completed questionnaires about depression severity, empathy, interpersonal problems, and CM, as well as tests of affective theory of mind and facial emotion recognition.Results: Patients with PDD reported higher empathic distress than patients with ED and healthy controls. Both depressive groups recognized angry faces with higher accuracy and reported more interpersonal problems, with no differences between PDD and ED. Empathic distress and interpersonal problems mediated the link between CM and depression in the combined sample.Limitations: Patient groups were not drug-naïve and antidepressant intake might have influenced social-cognitive functions. Self-report measures of empathy and interpersonal problems are vulnerable to bias. The cross-sectional design does not allow causal conclusions.Conclusion: Depressed patients may not show deficits in decoding the affective states of others and in feeling with others. However, depressed individuals—in particular patients with PDD—may feel easily overwhelmed by emotionally tense situations, resulting in empathic distress and avoidant/submissive interpersonal behavior. Exposure to CM might be an origin of alterations in social cognition and interpersonal problems.

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“…Based on findings that patients with chronic depression experience lower social integration, less social support ( 61 ), and smaller social networks ( 62 ), it can be speculated that social connectedness and belongingness are particularly impaired in patients with chronic depression, as compared to episodic depression. As for depressed patients in general, reduced social connectedness may also correspond with reduced empathic response to positive affect ( 51 ), impaired social cognition ( 26 , 27 ), and social anhedonia ( 3 ). Psychological interventions for chronic depression should therefore target interpersonal problems.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies indicate, however, that chronic depression is characterized by a dysfunctional interpersonal style, as compared to patients with episodic depression ( 24 , 25 ). Impaired social cognition, either in terms of a mood-congruent interpretive bias ( 26 ) or in terms of preoperational thinking ( 27 ), has been highlighted as a risk factor for the development of depressive symptomatology. In this context, indirect evidence for a relationship between impaired social cognition and a hostile and overly submissive interpersonal style has been discussed ( 26 ).…”

Section: Introductionmentioning

confidence: 99%

Reduced Social Connectedness and Compassion Toward Close Others in Patients With Chronic Depression Compared to a Non-clinical Sample

et al. 2021

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Reduced social functioning in depression has been explained by different factors. Reduced social connectedness and prosocial motivation may contribute to interpersonal difficulties, particularly in chronic depression. In the present study, we tested whether social connectedness and prosocial motivation are reduced in chronic depression. Forty-seven patients with persistent depression and 49 healthy controls matched for age and gender completed the Inclusion of the Other in the Self Scale (IOS), the Compassionate Love Scale (CLS), the Beck Depression Inventory-II, and the Childhood Trauma Questionnaire. A Multivariate analysis of variance (MANOVA) with IOS and CLS as dependent variables revealed a highly significant difference between both groups. The IOS and the CLS-subscale Close Others were lower in persistent depression, whereas there was no difference in the CLS-subscale Strangers/Humanity. IOS and CLS-Close Others showed significant negative correlations with depressive symptoms. Connectedness to family members as measured by the IOS was negatively correlated with childhood trauma in patients with chronic depression. The results indicate that compassion and perceived social connection are reduced in depressed patients toward close others, but not to others in general. Implications for the treatment of depression are discussed.

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Preoperational Thinking as a Measure of Social Cognition Is Associated With Long-Term Course of Depressive Symptoms. A Longitudinal Study Involving Patients With Depression and Healthy Controls

Cited by 10 publications

References 42 publications

Change in Interpersonal and Metacognitive Skills During Treatment With Cognitive Behavioral Analysis System of Psychotherapy and Metacognitive Therapy: Results From an Observational Study

Change in Interpersonal and Metacognitive Skills During Treatment With Cognitive Behavioral Analysis System of Psychotherapy and Metacognitive Therapy: Results From an Observational Study

Social Cognition and Interpersonal Problems in Persistent Depressive Disorder vs. Episodic Depression: The Role of Childhood Maltreatment

Reduced Social Connectedness and Compassion Toward Close Others in Patients With Chronic Depression Compared to a Non-clinical Sample

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