Decision-Making and Depressive Symptomatology

Yan Leykin, Carolyn Sewell Roberts, Robert J Derubeis, Yan Leykin, Carolyn Sewell Roberts, Robert J Derubeis

Abstract

Difficulty making decisions is a core symptom of depressive illness, but the nature of these difficulties has not been well characterized. The two studies presented herein use the same hypothetical scenarios that call for a decision. In Study 1, participants were asked to make and explain their decisions in a free-response format, as well as to describe their prior experiences with similar situations. The results suggest that those with more depressive symptoms make decisions that are less likely to further their interests. We also identified several interesting associations between features of decision-making and the presence of depressive symptoms. In Study 2, participants were guided through their decisions with simple decision tools to investigate whether the association between depressive symptoms and poor decisions is better accounted for by failure to use of good decision-making strategies, or by other factors, such as differences in priorities or goals. With this minimal intervention the quality of decisions no longer declined significantly as a function of depressive symptom severity. Moreover, few associations between depressive symptom severity and decision-related goals and priorities were evident, suggesting that the previously-exposed difficulties of depressed individuals with decision-making were largely the result of their failure to use effective decision-making techniques.

Figures

Fig. 1
Fig. 1
Regression slopes of BDI scores predicting productivity, grouped by study

References

    1. Abramson LY, Metalsky GI, Alloy LB. Hopelessness depression: A theory-based subtype of depression. Psychological Review. 1989;96:358–372. doi: 10.1037/0033-295X.96.2.358.
    1. Abramson LY, Seligman ME, Teasdale JD. Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology. 1978;87:49–74. doi: 10.1037/0021-843X.87.1.49.
    1. APA . Diagnostic and statistical manual of mental disorders (4th edition, Text Revision) Washington, DC: Author; 2000.
    1. Barber JP, DeRubeis RJ. The ways of responding: A scale to assess compensatory skills taught in cognitive therapy. Behavioral Assessment. 1989;14:93–115.
    1. Beck JS. Cognitive therapy: Basics and beyond. New York: Guilford; 1995.
    1. Beck AT, Steer RA, Brown GK. BDI-II manual. San Antonio: The Psychological Corporation; 1996.
    1. Bell D. Regret in decision making under uncertainty. Operations Research. 1982;30:961–981. doi: 10.1287/opre.30.5.961.
    1. Bell DE, Raiffa H, Tversky A, editors. Decision making: Descriptive, normative, and prescriptive interactions. New York: Cambridge University; 1988.
    1. Chambers CD, Johnson KA, Dick LM, Felix RJ, Jones KL. Birth outcomes in pregnant women taking fluoxetine. New England Journal of Medicine. 1996;335:1010–1015. doi: 10.1056/NEJM199610033351402.
    1. Doerfler LA, Mullins LL, Griffin NJ, Siegel LJ, Richards CS. Problem-solving deficits in depressed children, adolescents, and adults. Cognitive Therapy and Research. 1984;8:489–499. doi: 10.1007/BF01173286.
    1. Joffe RD, Dobson KS, Fine S, Marriage K, Haley G. Social problem-solving in depressed, conduct-disordered, and normal adolescents. Journal of Abnormal Child Psychology. 1990;18:565–575. doi: 10.1007/BF00911108.
    1. Kahneman D, Wakker P, Sarin R. Back to Bentham? Explorations of experienced utility. Quarterly Journal of Economics. 1997;112:375–406. doi: 10.1162/003355397555235.
    1. Klerman GL. Overview of affective disorders. In: Kaplan HI, Freedman AM, Sadock BJ, editors. Comprehensive textbook of psychiatry. 3. Baltimore: Willians & Wilkins; 1980.
    1. Kulin NA, Pastuszak A, Sage SR, Schick-Boschetto B, Spivey G, Feldkamp M, et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: A prospective controlled multicenter study. Journal of the American Medical Association. 1998;279:609–610. doi: 10.1001/jama.279.8.609.
    1. Leahy RL. Decision making and mania. Journal of Cognitive Psychotherapy. 1999;13:83–105.
    1. Leahy RL. Mood and decision making: Implications for bipolar disorder. Behavior Therapist. 2000;23:62–63.
    1. Leahy RL. Depressive decision making: Validation of the portfolio theory model. Journal of Cognitive Psychotherapy. 2001;15:341–362.
    1. Leahy RL. Decision making and personality disorders. Journal of Cognitive Psychotherapy. 2002;16:209–225. doi: 10.1891/jcop.16.2.209.63991.
    1. Loewenstein G, O’Donoghue T, Rabin M. Projection bias in predicting future utility. Quarterly Journal of Economics. 2003;118:1209–1248. doi: 10.1162/003355303322552784.
    1. Loomes G, Sudgen R. Regret theory: An alternative theory of rational choice under uncertainty. The Economic Journal. 1982;92:805–824. doi: 10.2307/2232669.
    1. Marx EM, Williams JMG, Claridge GC. Depression and social problem solving. Journal of Abnormal Psychology. 1992;101:78–86. doi: 10.1037/0021-843X.101.1.78.
    1. Monroe MR, Skowronski JJ, MacDonald W, Wood SE. The mildly depressed experience more post-decisional regret than the non-depressed. Journal of Social and Clinical Psychology. 2005;24:665–690. doi: 10.1521/jscp.2005.24.5.665.
    1. Murphy FC, Rubinsztein JS, Michael A, Rogers RD, Robbins TW, Paykel ES, et al. Decision-making cognition in mania and depression. Psychological Medicine. 2001;31:679–693. doi: 10.1017/S0033291701003804.
    1. Nezu AM, Nezu CM, D’Zurilla TJ. Solving life’s problems: A 5-step guide to enhanced well-being. New York: Springer Publishing Co; 2007.
    1. Nezu AM, Nezu CM, Perri MG. Problem solving therapy for depression: Theory, research and clinical guidelines. New York: Wiley; 1989.
    1. Nezu AM, Perri MG. Social problem-solving therapy for unipolar depression: An initial dismantling investigation. Journal of Consulting and Clinical Psychology. 1989;57:408–413. doi: 10.1037/0022-006X.57.3.408.
    1. Platt, J. J., & Spivack, G. (1975). Manual for the means-ends problem-solving procedure (MEPS): A measure of interpersonal cognitive problem-solving skill. Philadelphia: Hanhemann Community Mental Health/Mental Retardation Center. (Unpublished document).
    1. Ritov I, Baron J. Outcome knowledge, regret, and omission bias. Organizational Behavior and Human Decision Processes. 1995;64:119–127. doi: 10.1006/obhd.1995.1094.
    1. Schwartz B, Ward A, Monterosso J, Lyubomirsky S, White K, Lehman DR. Maximizing versus satisficing: Happiness is a matter of choice. Journal of Personality and Social Psychology. 2002;83:1178–1197. doi: 10.1037/0022-3514.83.5.1178.
    1. Suri R, Altshuler LA, Mintz J. Depression and the decision to abort. American Journal of Psychiatry. 2004;161:1502. doi: 10.1176/appi.ajp.161.8.1502.
    1. Wierzbicki M. Social skills deficits and subsequent depressed mood in students. Personality and Social Psychology Bulletin. 1984;10:605. doi: 10.1177/0146167284104014.
    1. Young HF, Bentall RP. Hypothesis testing in patients with persecutory delusions: Comparison with depressed and normal subjects. British Journal of Clinical Psychology. 1995;34(Pt 3):353–369.

Source: PubMed

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