Simon, Sarah (5/14) Enhancing the diagnosis of depression with interpersonal pathoplasticity (Lisa Wallner Samstag, Ph.D.; Nicole M. Cain, Ph.D.; Kevin B. Meehan, Ph.D.)
Categorical and context-free definitions of depression may not provide adequate descriptive or predictive ability. Research suggests that Major Depressive Disorder (MDD), Dysthymic Disorder (DD), and subthreshold depression (sD) represent various presentations of a single, continuous depressive process. Furthermore, interpersonal factors have been linked to depression in a mutually influencing, non-etiological pathoplastic relationship in which problems, like submissiveness, are related to symptom chronicity. The present study aimed to evaluate interpersonal pathoplasticity within MDD and a range of depressive psychopathology in an effort to enhance diagnostic utility. The study was conducted in two phases. One phase examined all 407 participants seeking psychotherapy in a clinical trial who met criteria for MDD, DD, or sD (Full Sample), while the other investigated only the 218 participants in the sample with an MDD diagnosis (MDD Subgroup). Latent profile analysis (LPA) identified five interpersonal groups (vindictive, intrusive, socially avoidant, exploitable, cold) and circular statistical profile analysis confirmed group interpersonal distinctiveness in both the Full Sample and MDD Subgroup. Generally, subtypes did not differ significantly in terms of demographic characteristics, psychiatric comorbidity, or intake depression severity in the Full Sample or MDD Subgroup. Subtypes did diverge, however, by rates of clinical depression in the Full Sample and treatment outcome in the MDD Subgroup. Interpersonal pathoplasticity in MDD as well as a spectrum of depressive psychopathology supports the argument that depression is a single disease process comprising interpersonally similar manifestations. Furthermore, interpersonal behavior is related to the expression and resolution of depressive symptoms.
