Social and Behavioral Sciences Commons^™

Evaluating The Effectiveness Of A School-Based Cognitive Behavioral Youth Depression Prevention Program In Improving Life Satisfaction, Roshani Patel, Steven M. Brunwasser, Alissa Hochman

Rowan-Virtua Research Day

Depression is the leading cause of disability worldwide, known as the global burden of disease. Incident cases from 1990 to 2017 have increased by 49.86%. Additionally, rates have been seen to dramatically rise in adolescents aged 18-25 (17%) compared to rates in individuals aged 10-14 (1.1%). This makes it beneficial to have prevention programs for middle school aged children. The Penn Resiliency Program (PRP) is a youth depression prevention program focused on cultivating healthy thinking styles and behavioral coping skills. In our study, we used archival data from a randomized control trial of PRP to evaluate whether the program led …

Infant Hedonic/Anhedonic Processing Index (Hapi-Infant): Assessing Infant Anhedonia And Its Prospective Association With Adolescent Depressive Symptoms, Jessica L. Irwin, Elysia Poggi Davis, Curt A. Sandman, Tallie Z. Baram, Hal S. Stern, Laura M. Glynn

Psychology Faculty Articles and Research

Background

Anhedonia, an impairment in the motivation for or experience of pleasure, is a well-established transdiagnostic harbinger and core symptom of mental illness. Given increasing recognition of early life origins of mental illness, we posit that anhedonia should, and could, be recognized earlier if appropriate tools were available. However, reliable diagnostic instruments prior to childhood do not currently exist.

Methods

We developed an assessment instrument for anhedonia/reward processing in infancy, the Infant Hedonic/Anhedonic Processing Index (HAPI-Infant). Exploratory factor and psychometric analyses were conducted using data from 6- and 12-month-old infants from two cohorts (N = 188, N = 212). …

Mental Health Of Medical Students Regarding The Covid-19 Pandemic, Parth Patel, Richard Jermyn, Arvind Venkataraman

Rowan-Virtua Research Day

Mental health has taken a global priority as more realize that it is just as important as physical health in the overall health of a person. Medical students have faced mental health issues for decades and have been shown to suffer more than the general population. The recent COVID-19 pandemic has only deteriorated this issue. Many primary databases such as PubMed were used. The results indicate that medical students have extremely high rates of depression, burnout, anxiety, and stress that can affect their education but also carry over into their professions. Although many interventions increase mental wellness in medical school, …

Experiences Of Covid-19-Related Racism And Impact On Depression Trajectories Among Racially/Ethnically Minoritized Adolescents, Sabrina R. Liu, Elysia Poggi Davis, Anton M. Palma, Hal S. Stern, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Purpose

In 2020, racially/ethnically minoritized (REMD) youth faced the “dual pandemics” of COVID-19 and racism, both significant stressors with potential for adverse mental health effects. The current study tested whether short- and long-term trajectories of depressive symptoms from before to during the COVID-19 pandemic differed between REMD adolescents who did and did not endorse exposure to COVID-19-era-related racism (i.e., racism stemming from conditions created or exacerbated by the COVID-19 pandemic).

Methods

A community sample of 100 REMD adolescents enrolled in an ongoing longitudinal study of mental health was assessed before and during the COVID-19 pandemic. Participants were 51% girls, mean …

Interactions Of International Pilots' Stress, Fatigue, Symptoms Of Depression, Anxiety, Common Mental Disorders And Wellbeing, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

Objective

This study Investigates more dimensions than previous studies simultaneously: pilots’ duty rosters, stress, sleep difficulties, fatigue levels, wellbeing, symptoms of depression, anxiety, and common mental disorders (CMD), and how they are interrelated.

Background

Several scientific studies have confirmed that fatigue can pose a significant risk to flight safety. Other studies reported positive depression screening results for more pilots, compared with the general population.

Method

A cross-sectional online survey was completed by 406 international pilots, who reported their duty rosters of the last two months. Pilots also self-assessed their stress-levels, sleep problems, fatigue, wellbeing, and mental health.

Results

Although pilots …

An Examination Of The Relationship Between Fear Of Evaluation, Social Anxiety, And Depression, Michelle Ingraffia

Masters Theses

This study explores fear of negative evaluation (FNE) and fear of positive evaluation (FPE) across social anxiety and depression. The following assessment tools were used to measure fear of positive evaluation, fear of negative evaluation, social anxiety, and depression: Fear of Positive Evaluation Scale, Brief Fear of Negative Evaluation - Straightforward, Liebowitz Social Anxiety Scale – Self Report, The Center for Epidemiological Studies Depression Scale – Revised. A sample of two hundred and thirty-one participants completed forms online via Amazon Mechanical Turk. Social anxiety was correlated positively with both FNE and FPE; likewise, depression was correlated positively with both FNE …

The Acute And Persisting Impact Of Covid-19 On Trajectories Of Adolescent Depression: Sex Differences And Social Connectedness, Sabrina R. Liu, Elyssia Poggi Davis, Anton M. Palma, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Background

The COVID-19 era is a time of unprecedented stress, and there is widespread concern regarding its short- and long-term mental health impact. Adolescence is a sensitive period for the emergence of latent psychopathology vulnerabilities, often activated by environmental stressors. The present study examined COVID-19′s impact on adolescent depression and possible influences of different domains of social connectedness (loneliness, social media use, social video game time, degree of social activity participation).

Methods

A community sample of 175 adolescents (51% boys, mean age = 16.01 years) completed questionnaires once before and twice during the COVID-19 pandemic. Piecewise growth modeling examined the …

Is Burnout A Depressive Condition? A 14-Sample Meta-Analytic And Bifactor Analytic Study, Renzo Bianchi, Jay Verkuilen, Irvin S. Schonfeld, Jari J. Hakanen, Markus Jansson-Fröjmark, Guadalupe Manzano-García, Eric Laurent, Laurenz L. Meier

Publications and Research

There is no consensus on whether burnout constitutes a depressive condition or an original entity requiring specific medical and legal recognition. In this study, we examined burnout–depression overlap using 14 samples of individuals from various countries and occupational domains (N = 12,417). Meta-analytically pooled disattenuated correlations indicated (a) that exhaustion—burnout’s core—is more closely associated with depressive symptoms than with the other putative dimensions of burnout (detachment and efficacy) and (b) that the exhaustion–depression association is problematically strong from a discriminant validity standpoint (r = .80). The overlap of burnout’s core dimension with depression was further illuminated in 14 exploratory structural …

Scope Of Attention Variation As A Function Of Anxiety And Depression, Kathleen O'Donnell

Electronic Theses, Projects, and Dissertations

As a social species, correct emotional perception is so vital, that the human brain has evolved a mechanism to control attentional choices by exerting a narrowed field of perception during danger, called the scope of attention (SoA). The SoA determines what information will be focused on or ignored by blocking the perception of non-relevant items and increasing selective focus on danger; even if danger is merely a sad-face. The emotional items blocked from perception cannot be remembered because they were never perceived. But, attention-control to emotional stimuli also varies with mood, as seen in mood-disorders. A mood-disorder’s effect upon the …

Analytic Hierarchy Process: An Innovative Technique For Culturally Tailoring Evidence-Based Interventions To Reduce Health Disparities, Jaime A. Corvin, Isabella Chan, Claudia X. Aguado, Ian Dollman, Junius Gonzales

Publications from Provost Junius J. Gonzales

Latinos in the United States represent a disproportionate burden of illness and disease and face barriers to accessing health care and related resources. Culturally tailored, evidence-based interventions hold promise in addressing many of these challenges. Yet, ensuring patient voice is vital in the successful development and implementation of such interventions. Thus, this paper examines the application of analytic hierarchy process (AHP) to inform the augmentation and implementation of an evidence-based chronic disease self-management programme for underserved Latinos living with both minor depression and chronic illness. The process of AHP allows for direct input from the individuals that would utilize such …

Relation Of Depression Symptoms To Sustained Reward And Loss Sensitivity, Michael P. Berry, Ema Tanovic, Jutta Joormann, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Investigating Prosodic Accommodation In Clinical Interviews With Depressed Patients, Brian Vaughan, Carolina De Pasquale, Lorna Wilson, Charlie Cullen, Brian Lawlor

Conference Papers

Six in-depth clinical interviews, involving six elderly female patients (aged 60+) and one female psychiatrist, were recorded and analysed for a number of prosodic accommodation variables.

Our analysis focused on pitch, speaking time, and vowel-space ratio. Findings indicate that there is a dynamic manifestation of prosodic accommodation over the course of the interactions. There is clear adaptation on the part of the psychiatrist, even going so far as to have a reduced vowel-space ratio, mirroring a reduced vowel-space ratio in the depressed patients. Previous research has found a reduced vowel-space ratio to be associated with psychological distress; however, we suggest …

Relationship Of Optimism And Suicidal Ideation In Three Groups Of Patients At Varying Levels Of Suicide Risk, Jeff C. Huffman, Julia K. Boehm, Scott R. Beach, Eleanor E. Beale, Christina M. Dubois, Brian C. Healy

Psychology Faculty Articles and Research

Optimism has been associated with reduced suicidal ideation, but there have been few studies in patients at high suicide risk. We analyzed data from three study populations (total N=319) with elevated risk of suicide: (1) patients with a recent acute cardiovascular event, (2) patients hospitalized for heart disease who had depression or an anxiety disorder, and (3) patients psychiatrically hospitalized for suicidal ideation or following a suicide attempt. For each study we analyzed the association between optimism (measured by the Life-Orientation Test-Revised) and suicidal ideation, and then completed an exploratory random effects meta-analysis of the findings to synthesize this data. …

Personality Disorders Predict Relapse After Remission From An Episode Of Major Depressive Disorder: A 6-Year Prospective Study, Carlos M. Grilo, Robert L. Stout, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Andrew E. Skodol, Donna S. Bender, Anthony Pinto, M. Tracie Shea, Shirley Yen, John G. Gunderson, Leslie C. Morey, Christropher J. Hopwood, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine prospectively the course of major depressive disorder (MDD) and to test for the moderating effects of personality disorder (PD) comorbidity on relapse after remission from an episode of MDD.

Method: Participants were 303 patients (196 women and 107 men) with current DSM-IV diagnosed MDD at baseline enrollment in the Col­laborative Longitudinal Personality Disorders Study. Major depressive disorder and Axis I psychiatric disorders were assessed with the Structured Clinical Interview for DSM-IV, and Axis II PDs were assessed with the Diagnostic Interview for DSM-IV Personality Disorders. The course of MDD was assessed with the Longitudinal Interval Follow­up Evaluation …

State Effects Of Major Depression On The Assessment Of Personality And Personality Disorder, Leslie C. Morey, M. Tracie Shea, John C. Markowitz, Robert L. Stout, Christopher J. Hopwood, John G. Gunderson, Carlos M. Grilo, Thomas H. Mcglashan, Shirley Yen, Charles A. Sanislow, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

OBJECTIVE: The authors sought to determine whether personality disorders diagnosed during a depressive episode have long-term outcomes more typical of those of other patients with personality disorders or those of patients with noncomorbid major depression.

METHOD: The authors used 6-year outcome data collected from the multisite Collaborative Longitudinal Personality Disorders Study (CLPS). Diagnoses and personality measures gathered from the study cohort at the index assessment using interview and self-report methods were associated with symptomatic, functional, and personality measures at 6-year follow-up. Of 668 patients initially recruited to the CLPS, 522 were followed for 6 years. All participants had either a …

Help-Negation And Suicidal Ideation: The Role Of Depression, Anxiety And Hopelessness., Coralie J. Wilson

Frank Deane

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study is part of a larger multi-cite research program developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from friends, family and professional mental health sources in a sample of 302 Australian university students. Participants were 77.5% female and aged from 18-25 years old, with 85.4% aged 21 years or younger. Higher levels of suicidal ideation were related to lower help-seeking …

Help-Negation And Suicidal Ideation: The Role Of Depression, Anxiety And Hopelessness., Coralie J. Wilson

Coralie J Wilson

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study is part of a larger multi-cite research program developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from friends, family and professional mental health sources in a sample of 302 Australian university students. Participants were 77.5% female and aged from 18-25 years old, with 85.4% aged 21 years or younger. Higher levels of suicidal ideation were related to lower help-seeking …

Depressive Symptoms And Marital Satisfaction In The Context Of Chronic Disease: A Longitudinal Dyadic Analysis, Rachel Pruchno, Maureen Wilson-Genderson, Francine P Cartwright

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

These analyses examined the longitudinal relationships between depressive symptoms and marital satisfaction over a 2-year period as experienced by 315 patients with end-stage renal disease and their spouses. Using multilevel modeling, the authors examined both individual and cross-partner effects of depressive symptoms and marital satisfaction on patients and spouses, testing bidirectional causality. Results indicate that mean and time-varying depressive symptoms of both patients and spouses were associated with their own marital satisfaction. Although mean marital satisfaction was associated with own depressive symptoms for both patients and spouses, time-varying marital satisfaction did not affect depressive symptoms for either patients or spouses. …

Self-Criticism Versus Neuroticism In Predicting Depression And Psychosocial Impairment For 4 Years In A Clinical Sample, David M. Dunkley, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

The present study extended previous findings demonstrating self-criticism, assessed by the Dysfunctional Attitude Scale (DAS) (Weissman AN, Beck AT. Development and validation of the Dysfunctional Attitude Scale: a preliminary investigation. Paper presented at the 86th Annual Convention of the American Psychological Association, Toronto, Ontario, Canada, 1978), as a potentially important prospective predictor of depressive symptoms and psychosocial functional impairment over time. Using data from a prospective, 4-year study of a clinical sample, DAS self-criticism and neuroticism were associated with self-report depressive symptoms, interviewer-rated major depression, and global domains of psychosocial functional impairment 4 years later. Hierarchical multiple regression results indicated …

Ethnicity And Mental Health Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, John C. Markowitz, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Anthony Pinto, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson, Maria T. Daversa, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic …

Positive Childhood Experiences: Resilience And Recovery From Personality Disorder In Early Adulthood, Andrew E. Skodol, Donna S. Bender, Maria E. Pagano, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Carlos M. Grilo, Maria T. Daversa, Robert L. Stout, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.

METHOD: Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from …

Depressive Symptoms And Help-Seeking Intentions In Young People., Coralie J. Wilson

Coralie J Wilson

Whether the help-negation effect as demonstrated for suicidal thoughts was also evident for depressive symptoms was investigated in three studies of young people from diverse urban areas. The studies comprised a large sample of younger high school students (years 7-10), a sample of older high school students (years 8-12), and first year university students. A self-report questionnaire that measured help-seeking intentions, prior help-seeking experiences, and depression was administered. Results revealed the strongest inverse association between level of depressive symptoms was with intentions to seek help from parents across all three samples. There was a consistent trend for students to report …

Perfectionism And Depressive Symptoms 3 Years Later: Negative Social Interactions, Avoidant Coping, And Perceived Social Support As Mediators., David M. Dunkley, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Although research has demonstrated perfectionism to have a negative impact on the treatment of depression, little research has examined the mechanisms or processes through which perfectionism predicts subsequent depressive symptoms in clinical populations over time. Using data from a prospective, 3-year study of a clinical sample (N = 96), hierarchical regression analyses indicated that perfectionism, assessed by the Dysfunctional Attitude Scale (Weissman AN, Beck AT. Development and validation of the Dysfunctional Attitude Scale: a preliminary investigation. Paper presented at the 86th annual convention of the American Psychological Association, Toronto, Ontario, Canada; 1978), is distinguished from major depression and neuroticism for …

Preliminary Evidence For Medication Effects On Functional Abnormalities In The Amygdala And Anterior Cingulate In Bipolar Disorder, Hilary P. Blumberg, Nelson H. Donegan, Charles A. Sanislow, Susan Collins, Cheryl Lacadie, Pawel Skudlarski, Ralitza Gueorguieva, Robert K. Fulbright, Thomas H. Mcglashan, John C. Gore, John H. Krystal

Charles A. Sanislow, Ph.D.

RATIONALE: Abnormal amygdala and frontocortical responses to emotional stimuli are implicated in bipolar disorder (BD) and have been proposed as potential treatment targets.

OBJECTIVES: The aim of this study was to investigate amygdala and frontocortical responses to emotional face stimuli in BD and the influences of mood-stabilizing medications on these responses.

METHODS: Functional magnetic resonance imaging was performed while 17 BD participants (5 unmedicated) and 17 healthy comparison (HC) participants viewed faces with happy, sad, fearful, or neutral expressions.

RESULTS: The group by stimulus-condition interaction was significant (p<0.01) for amygdala activation, with the greatest effects in the happy face condition. Relative to HC, amygdala increases were greater in unmedicated BD, but lower in medicated BD. Rostral anterior cingulate (rAC) activation was decreased in unmedicated BD compared to HC; however, BD participants taking medication demonstrated rAC activation similar to HC participants.

CONCLUSIONS: Although the sample sizes were small, these preliminary results suggest that …

Longitudinal Comparison Of Depressive Personality Disorder And Dysthymic Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Hui Xie, Jianfeng Cheng, David J. Hellerstein, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: Few studies have compared the related diagnostic constructs of depressive personality disorder (DPD) and dysthymic disorder (DD). The authors attempted to replicate findings of Klein and Shih in longitudinally followed patients with personality disorder or major depressive disorder (MDD) in the Collaborative Longitudinal Personality Disorders Study.

METHODS: Subjects (N = 665) were evaluated at baseline and over 2 years (n = 546) by reliably trained clinical interviewers using semistructured interviews and self-report personality questionnaires.

RESULTS: Only 44 subjects (24.6% of 179 DPD and 49.4% of 89 early-onset dysthymic subjects) met criteria for both disorders at baseline. Depressive personality disorder …

Validity Of Das Perfectionism And Need For Approval In Relation To The Five-Factor Model Of Personality, David M. Dunkley, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

This study examined the validity of the perfectionism and need for approval scales of the Dysfunctional Attitude Scale (DAS; Weissman & Beck, 1978) by locating these measures within a comprehensive framework of personality, provided by the revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992), in a clinical sample (N ¼ 132). The results indicated that: (1) DAS perfectionism reflects the self-critical aspects of the broader perfectionism construct rather than the active achievement striving aspects; (2) DAS need for approval generally lacks an association with positive interpersonal traits and shares much in common with DAS perfectionism; and (3) with shared …

Correlates Of Suicide Risk In Juvenile Detainees And Adolescent Inpatients, Charles A. Sanislow, Carlos M. Grilo, Dwain C. Fehon, Seth R. Axelrod, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To compare correlates of risk for suicidal behavior in juvenile detainees with those in another high-risk group, adolescent psychiatric inpatients.

METHOD: Eighty-one adolescents in a short-term juvenile detention center were contrasted with a matched group of 81 adolescent psychiatric inpatients on a clinical assessment battery of established instruments including a measure for risk of suicidal behavior.

RESULTS: Juvenile detainees and adolescent psychiatric inpatients reported similar levels of distress on measures of suicide risk, depression, impulsivity, and drug abuse. After controlling for depression, impulsivity and drug abuse remained significantly associated with suicide risk scores in the juvenile detention group, but …

Relation Of Therapeutic Alliance And Perfectionism To Outcome In Brief Outpatient Treatment Of Depression, David C. Zuroff, Sidney J. Blatt, Stuart M. Sotsky, Janice L. Krupnick, Daniel J. Martin, Charles A. Sanislow, Sam Simmens

Charles A. Sanislow, Ph.D.

Prior analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program demonstrated that perfectionism was negatively related to outcome, whereas both the patient's perception of the quality of the therapeutic relationship and the patient contribution to the therapeutic alliance were positively related to outcome across treatment conditions (S. J. Blatt, D. C. Zuroff, D. M. Quinlan, & P. A. Pilkonis, 1996; J. L. Krupnick et al., 1996). New analyses examining the relations among perfectionism, perceived relationship quality, and the therapeutic alliance demonstrated that (a) the patient contribution to the alliance and the perceived quality of the …

Short And Long-Term Effects Of Medication And Psychotherapy In The Brief Treatment Of Depression: Further Analyses Of Data From The Nimh Tdcrp, Sidney J. Blatt, David C. Zuroff, Colin M. Bondi, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Prior analyses of data from the NIMH sponsored Treatment for Depression Collaborative Research Program (TDCRP; e.g., I. Elkin, 1994) indicated greater reduction of symptoms at midtreatment (8th wk) with Imipramine (IMI-CM) than with Cognitive-behavioral therapy (CBT) and Interpersonal therapy (IPT), but no significant differences in symptom reduction among these 3 active treatments at termination. Current analyses of previously unanalyzed data from ratings by therapists, clinical evaluators, and 162 patients (mean age 35 yrs) at termination and at 18-mo follow-up also indicated no significant differences among these treatments in symptom reduction or ratings of current clinical condition. But significant treatment differences …

Vulnerability To Depression: Reexamining State Dependence And Relative Stability, David C. Zuroff, Sidney J. Blatt, Charles A. Sanislow, Colin M. Bondi, Paul A. Pilkonis

Charles A. Sanislow, Ph.D.

Treatment-related decreases in Dysfunctional Attitudes Scale (DAS; Weissman & Beck, 1978) scores have been interpreted as evidence that dysfunctional attitudes are state-dependent concomitants of depression. Data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program were used to reexamine the stability of dysfunctional attitudes. Mean scores for Perfectionism, Need for Approval, and total DAS decreased after 16 weeks of treatment. However, test-retest correlations showed that the DAS variables displayed considerable relative stability. Structural equation models demonstrated that dysfunctional attitudes after treatment were significantly predicted by initial level of dysfunctional attitudes as well as by posttreatment depression. …