Summary and Future Directions On the basis of the aforementioned studies, the hopelessnesstheory appears promising However, further research is neededFor example, although powerful tests of the attributional diath-esis-stress component have been conducted, no one has exam-ined the cognitive diatheses of inferring negative consequencesor characteristics about the self or whether the cognitive stylediathesis-stress interaction predicts clinically significant de-pression Moreover, it is crucial to determine if this interactionpredicts the development of the hypothesized symptoms ofhopelessness depression More generally, an important short-coming of the prior work is that it has not focused on the symp-toms of hopelessness depression in particular and, instead, sim-ply has examined the symptoms of depression in general Fu-ture investigators need to test more fine-grained predictionsabout the hypothesized symptoms of hopelessness depressionThe issue of the stability of the cognitive diatheses has not beenresolved satisfactorily We have only begun, in a preliminaryway, to investigate the issues of specific vulnerability and media-tional processes Finally, further tests of the predictions aboutcourse, cure, and prevention are needed We eagerly await thisresearchDifficult methodological issues may arise in the search forhopelessness depression, however For example, the hopeless-ness theory is silent about the time lag between formation ofhopelessness and onset of the symptoms of hopelessness depres-sion If it is very short, then a major challenge will be to developmethods with sufficient temporal resolving power to determineif hopelessness indeed precedes the occurrence of the hypothe-sized symptoms of hopelessness depression (see Alloy, Hartlage,et al, 1988, for proposed methods for testing the hopelessnesstheory) The results of work to test the hopelessness theory willdetermine if the concept of hopelessness depression needs tobe revised For example, perhaps the statement of the causalpathway is correc t bu culminate n a differen se f symp-toms than those currently hypothesized to compose hopeless-ness depression In this case, the symptom—but not thecause—component of the hopelessness theory would need to bemodifiedIn discussing how to search for hopelessness depression, wenote the possibility that future work may not corroborate theexistence of hopelessness depression as a bona fide subtype withcharacteristic cause, symptoms, course, treatment, and preven-tion Instead, the etiological chain featured in the hopelessnesstheory may be one of many pathways to a final common out-come of depression In this case, it would be more compellingto speak of a hopelessness cause, as opposed to a hopelessnesssubtype, of depression

http://psycnet.apa.org/journals/rev/96/2/358.pdf

Hopelessness depression: A theory-based subtype of depression.

OBJECTIVE: Theories of human behavior from Plato to Freud have repeatedly emphasized links between emotion and reason, a relationship now commonly attributed to pathways connecting phylogenetically “old” and “new” brain regions. Expanding on this theory, this study examined functional interactions between specific limbic and neocortical regions accompanying normal and disease-associated shifts in negative mood state. METHOD: Regions of concordant functional change accompanying provocation of transient sadness in healthy volunteers and resolution of chronic dysphoric symptoms in depressed patients were examined with two positron emission tomography techniques: [15O]water and [18F]fluorodeoxyglucose, respectively. RESULTS: With sadness, increases in limbic-paralimbic blood flow (subgenual cingulate, anterior insula) and decreases in neocortical regions (right dorsolateral prefrontal, inferior parietal) were identified. With recovery from depression, the reverse pattern, involving the same regions, was seen—...

https://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.156.5.675

Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness

This article provides a critical review of the empirical literature on the role of depression and elation in biasing mnemonic processing. Two classes of effects—state dependence and mood congruence—are examined. The latter, which involves the enhanced encoding and/or retrieval of material the affect

Affect and Memory: A Review

Advances in the conceptualization and measurement of life stress in the past 2 decades raise several questions concerning traditional diathesis— stress theories of psychopathology. First, comprehensive measures of life stress force investigators to become more precise about the particular stressful circumstances hypothesized to interact with diatheses. Second, the influence of the diathesis on a person's life is typically ignored, which results in several types of possible bias in the assessment of life stress. Finally, information is available on diatheses and stress for specific disorders to provide a foundation for more empirically based hypotheses about diathesis—stress interactions. This possibility is outlined for depression. Such an approach provides the basis for developing broader, yet more specific, frameworks for investigating diathesis—stress theories of psychopathology in general and of depression in particular.

Diathesis-stress theories in the context of life stress research: Implications for the depressive disorders.

A working model of depression implicating failure of the coordinated interactions of a distributed network of limbic-cortical pathways is proposed. Resting state patterns of regional glucose metabolism in idiopathic depressed patients, changes in metabolism with antidepressant treatment, and blood flow changes with induced sadness in healthy subjects were used to test and refine this hypothesis. Dorsal neocortical decreases and ventral paralimbic increases characterize both healthy sadness and depressive illness; concurrent inhibition of overactive paralimbic regions and normalization of hypofunctioning dorsal cortical sites characterize disease remission. Normal functioning of the rostral anterior cingulate, with its direct connections to these dorsal and ventral areas, is postulated to be additionally required for the observed reciprocal compensatory changes, since pretreatment metabolism in this region uniquely predicts antidepressant treatment response. This model is offered as an adaptable framework to facilitate continued integration of clinical imaging findings with complementary neuroanatomical, neurochemical, and electrophysiological studies in the investigation of the pathogenesis of affective disorders.

https://neuro.psychiatryonline.org/doi/pdfplus/10.1176/jnp.9.3.471

Limbic-cortical dysregulation: a proposed model of depression.

During depressive episodes, patients show both qualitative and quantitative changes in how information is processed. Depressed patients appear to use weak or incomplete encoding strategies to organize and transform events to be remembered. This makes these events less memorable. If the depressed patient is provided organization and structure, then learning-memory deficits are not apparent. Disruptions in arousal-activation in depression can account for these cognitive impairments.

https://jamanetwork.com/journals/PSYCH/articlepdf/492461/archpsyc_38_1_004.pdf

Cheryl Gerdt

Papers

Cognitive processes in depression