Lecture plan

• Views on Depression and Marriage
• Causal Relationships for Men and Women
• Beach's Marital Depression Model
• Depression Screening


Views On Depression and Marriage

I. Concurrent association
 

A. 11 correlational studies (1977-1993)

B. 50% of couples seeking marital therapy have significant depression
 

C. Relative risk of major depression:

       25 fold increase for Mar. Distress

D. Based on 3,000 interview --
    Risk same for men and women, but 2 times more W than M
    classified as depressed

E. 1993 study: 328 newly marrieds
    MD spouse 10 times greater risk than NMD spouse for depression
    Same finding controlling for other spouse's MS and Depression

F. Improving depression not increase DAS

G. Treating depression does NOT improve relationship
 
 

II. Causal Role: Retrospective Studies
 
A. Marital negative events precede onset of depression
     Marital arguments & psychosocial stressors precede depression
     Lack of confiding relationship increases vulnerability for women

B. 1993 study of 50 women with recent significant negative
     marital events (NME) (abuse, affairs):
     Excluded W with prior major depressive episode:
     36% of the women with NME showed major depressive episode
     NOTE: 36% >> than point prevalence which is 7 - 8 %
     Also, >> self-reported attributions (between event and depression)


III. Causal Role: Prospective Findings

 
A. Monroe, et al (1986):
      For Non Dep/Non Marital Satified women with social support
      within the marriage -- DECREASED risk for depression 1 yr later

B. Beach & Nelson (1990):
     Measured MS, BDI, LE (life events)
     6-mths and 18-mths after marriage
     -Control for BDI & LE at Time 1, test for BDI at Time 2
     (Note: Want to keep Time 1 BDI out of Time 2 BDI!)
     --Found T-1 MS predicted BDI T-2
     (This means that lowered satisfaction --> Depression)
     --Cross-sectional r's between MS and Depression

             T-1: r = -.35           T-2: r = -.56

                             T-2 >> T-1

C. Different study:
     Weiss's MSI predicted BDI 2 years later, DAS did not!
     DAS predicted measures of anxiety
     Severe entrenched conflict predicts to BDI

D. Recent studies:
     Husband premarital dysphoria --> Marital Distress
     MD could be correlated with choice of an unreliable partner

E. Summary:
     Marital Distress ---> Depression
 

IV. Observational Studies:

      What do depressed couples DO, rather than what do they say

A. Base rate studies:
     W's: increased dysphoric affect & verbal
     W's: Lower positive affect and verbal
     C's: Increased hostility

B. Sequential Analyses:
     Does depressed W behavior reduce probability that H
     will respond aggressively?

     For Depressed-Distressed group --
     W depressive behavior --> REDUCTION of H aggressive
     behaviors BUT--- the suppression effect is a function of
     years married; true for briefer relationships, not for longer
     Long term marital discord is the key to depression!
 

V. Therapy
 
Studies show that marital therapy reduces MD when MD is relationship rleated
VI. Cognitive factors in Depression and MS
 
A. Beck's cognitive errors:
     Aaron Beck, noted for his cognitive theory of depression (and author
     of the Beck Depression Inventory -- BDI) has defined the following as
     fallacies of thinking associated with depression.The issue was whether
     these caused depression or were concomitants of depression (i.e.,
     whether this type of thinking leads to depression or whether it represents
     how, once depressed, people think). The evidence seems to favor the
     latter interpretation.

B. Specific Cognitive Errors:  MADOPS
     With depressed spouses one often sees evidence for these fallacies
     of thought:

     M  Magnification and minimization
           Event far more/less significant
     A  Arbitrary inference
          Specific conclusion no supporting facts
     D  Dichotomous thinking
          Either/or experience
     O  Over generalization
          General rule from single instance; applying it too broadly
     P  Personalization
         Attributing external events to self
  S  Selective abstraction
           Conceptualizing a situation on basis of detail taken out of context

      For an extended list of thinking errors, please visit  THINKING

C.  Attributional style dynamics (review)
               Internal-External

Specific-Global
Unstable-Stable

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Marital satisfaction and Depression: Different causal
         relationships for men and women

                       Fincham, Beach, Harold, and Osborne (1997) Psychological Science, 8, 351-357.

I. The Study

A. 150 recently married couples: Marital satisfaction (DAS) and
     depressive symptoms (BDI)

B. 18 mths later: 116 couples tested again

C. Stability: Time 1 to Time 2
     Satisfaction (DAS) and Depression (BDI) quite stable:
     DAS T1 to T2: .61 and .56 (H & W, respectively)
     BDI T1 to T2: .56 and .45 (H & W, respectively)

D. Concurrent: DAS vs. BDI
     Time 1 to 1: -.28 and .-45 (H & W, respectively)
     Time 2 to 2: -.48 and -.57 (H & W, respectively

E. Cross Lagged rs: Time 1 to Time 2 [ Not a causal model ]
 

SAT · DEP
Husbands : DAS · BDI -.33
Wives: DAS · BDI -.43
DEP · SAT
Husbands: BDI · DAS -.46
Wives: BDI · DAS -.23
F. Cross lagged analyses: Time 1 to Time 2 [ Causal model ]
     For Husbands --
         There was a significant Bi-directional influence –
         Both initial DAS and BDI predicted each other time 2 (BDI · DAS,
         and DAS · BDI)

     For Wives--
         Only uni-directional influence , their initial DAS predicted their
         subsequent BDI (DAS · BDI)

     And --
         Effect of BDI --> DAS STRONGER for Husbands than for Wives

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Beach's Marital Depression Model

    Beach, S. R. H., Sandeen E. E., & O'Leary, K. D. (1990).  Depression
        in Marriage: A Model Etiology and Treatment. NY: Guilford Press

    Steven Beach found empirical support in the literature for the following
    factors associated with depression in marriage:

    Absence of --

• Couple cohesion
• Acceptance of emotional expression
• Actual and perceived coping assistance
• Self-esteem support
• Spousal dependability
• Intimacy
    Presence of --
• Verbal & physical aggression
• Threat of separation or divorce
• Sever denigration, criticism, blame
• Disruption of scripted routines
• Major idiosyncratic marital stressors