Antidepressive behaviors and depression in a college student population

Abstract

ABSTRACT The study aimed to collect the antidepressive behaviors (ADB) in normal university population and taking into account their degree of helpfulness and difficulty, use them in an activity scheduling framework in the treatment of depression. The ABBs were obtained by asking subjects `what's the thing to do when you're feeling depressed` and found that a great proportion of the responses were consensual ly shared in the sample. The ADBs collected in this first study made up the Antidepressive Activity Questionnaire <AAQ). This questionnaire was used to obtain ratings on helpfulness and difficulty dimensions, by a new sample. As a second order agreement it was found that there existed a consensuality with regard to the degree of helpfulness and difficulty of ADBs. The sample was divided as high and low-depression groups. The ranking of the items in these two samples did not differ neither on the helpfulness nor on the difficulty. Thus, there existed also a consensuality in the perception of helpfulness and difficulty in low and high-depressed samples. However, depressed subjects perceived the ADBs overall as more difficult to engage in. According to the mean rating of helpfulness of ADBs by the second sample, the items of the AAQ were ranked. The most helpful 40 item were again ranked according to their mean ratings of difficulty. Consequently, those 40 helpful VlllADBs were grouped as `easy`, `moderately easy`, `moderately difficult` and `difficult` items. In the intervention study, 15 depressed subjects were randomly assigned to `Self-Selection Activity Increase`, `Forced-Choice Activity Increase`, and `Monitor-Control` groups. During the first week of the treatment, all groups monitored their 40 ADBs and mood. By the second week the `activity increase` was introduced in the two experimental groups. Results indicated that all groups decreased on depression score from pre to post-assessment. A significant interaction of Group x Time indicated that subjects in the experimental conditions decreased significantly on BDI by the end of treatment, whereas the control group's drop did not reach significance. Nevertheless, the pre to follow-up BDI change revealed only a significant Time effect and groups were equal at the follow-up. The analysis of the mood ratings did not parallel the above results. Despite the decrease on depression score evidenced by the measurement on BDI, the three weeks' mood ratings were not different from each other. These results suggest the alleviating impact of the coping activity scheduling on the depressed mood. Further analysis of the association between depressed mood and ADBs revealed that the antidepressive activity level was negatively correlated with the intensity of the depressed mood. However, the ADB frequency during the xr.treatment had a marginal association with the outcome of depression. The mood ratings appeared as less stable measurement. At the preassessment, the mood ratings were unrelated to the BDI scores. On the other hand, only the second and the third weeks' ratings were associated with each other and the last week's mood rating was significantly correlated with the post-assessment BDI scores. Subjects were divided to high and low-compliers according to their increase of ADBs during the treatment period. The high-compilers had a lower antidepressive activity baseline, and their increase of ADBs was significantly higher than the low-compliers. Thus, subjects having low ADB level complied most, but their outcome on depression was not better than the low compilers, nor was their depression intensity at the intake higher. As a result the compliance to treatment requirement did not seem to have a clear impact on the depressed mood. These results were discussed in terms of the limitations and weakness of the study.