TY - JOUR
T1 - The Psychopathology of Worthlessness in Depression
AU - Harrison, Phillippa
AU - Lawrence, Andrew J
AU - Wang, Shu
AU - Liu, Sixun
AU - Xie, Guangrong
AU - Yang, Xinhua
AU - Zahn, Roland
N1 - Funding Information:
AL and RZ were funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. XY was funded by a King's College London–KC Wong Fellowship. PH's post was funded from the National Institute for Health Research (NIHR) research for patient benefit (RfPB, grant reference: PB-PG-0416- 20039).
Publisher Copyright:
Copyright © 2022 Harrison, Lawrence, Wang, Liu, Xie, Yang and Zahn.
PY - 2022/5/19
Y1 - 2022/5/19
N2 - Background: Despite common dissatisfaction with the syndromic heterogeneity of major depression, investigations into its symptom structure are scarce. Self-worthlessness/inadequacy is a distinctive and consistent symptom of major depression across cultures. Aims: We investigated whether self-worthlessness is associated with self-blaming attribution-related symptoms or is instead an expression of reduced positive feelings overall, as would be implied by reduced positive affect accounts of depression. Methods: 44,161 undergraduate students in Study 1, and 215 patients with current Major Depressive Disorder (MDD) and 237 age-matched healthy control participants in Study 2 completed the well-validated Symptom Check List-90. Depression-relevant items were used to construct regularized partial correlation networks with bootstrap estimates of network parameter variability. Results: Worthlessness co-occurred more strongly with other symptoms linked to self-blaming attributions (hopelessness, and self-blame), displaying a combined edge weight with these symptoms which was significantly stronger than the edge weight representing its connection with reduced positive emotion symptoms (such as reduced pleasure/interest/motivation, difference in edge weight sum in Study 1 = 2.95, in Study 2 = 1.64; 95% confidence intervals: Study 1: 2.6–3.4; Study 2: 0.02–3.5; Bonferroni-corrected p < 0.05). Conclusions: This confirms the prediction of the revised learned helplessness model that worthlessness is most strongly linked to hopelessness and self-blame. In contrast, we did not find a strong and direct link between anhedonia items and a reduction in self-worth in either study. This supports worthlessness as a primary symptom rather than resulting from reduced positive affect.
AB - Background: Despite common dissatisfaction with the syndromic heterogeneity of major depression, investigations into its symptom structure are scarce. Self-worthlessness/inadequacy is a distinctive and consistent symptom of major depression across cultures. Aims: We investigated whether self-worthlessness is associated with self-blaming attribution-related symptoms or is instead an expression of reduced positive feelings overall, as would be implied by reduced positive affect accounts of depression. Methods: 44,161 undergraduate students in Study 1, and 215 patients with current Major Depressive Disorder (MDD) and 237 age-matched healthy control participants in Study 2 completed the well-validated Symptom Check List-90. Depression-relevant items were used to construct regularized partial correlation networks with bootstrap estimates of network parameter variability. Results: Worthlessness co-occurred more strongly with other symptoms linked to self-blaming attributions (hopelessness, and self-blame), displaying a combined edge weight with these symptoms which was significantly stronger than the edge weight representing its connection with reduced positive emotion symptoms (such as reduced pleasure/interest/motivation, difference in edge weight sum in Study 1 = 2.95, in Study 2 = 1.64; 95% confidence intervals: Study 1: 2.6–3.4; Study 2: 0.02–3.5; Bonferroni-corrected p < 0.05). Conclusions: This confirms the prediction of the revised learned helplessness model that worthlessness is most strongly linked to hopelessness and self-blame. In contrast, we did not find a strong and direct link between anhedonia items and a reduction in self-worth in either study. This supports worthlessness as a primary symptom rather than resulting from reduced positive affect.
UR - http://www.scopus.com/inward/record.url?scp=85131750002&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2022.818542
DO - 10.3389/fpsyt.2022.818542
M3 - Article
C2 - 35664464
SN - 1664-0640
VL - 13
SP - 818542
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
M1 - 818542
ER -