Identity Structure Analyses of Individuals with Clinical Depression

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Identity Structure Analyses of Individuals with
Clinical Depression Anxiety

• Presented by
• Alison McKenna BSc (Hons)

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Identity, Depression Anxiety

• Joiner, Coyne, Blalock, 19993
• By ignoring the intricacies of depressed
  persons involvement with other people one may
  attribute to depressed persons characteristics
  they do not possess and leave significant
  aspects of their experience unexplained.
• ISA self/identity distinction.

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Depression Anxiety

• Prolonged, unresolved periods of anxiety often
  precede depressive episodes (Wolpe, 1971 Bittner
  et al, 2004).
• Sloman, Farvolden, Gilbert, Price, 200698
• they have complex and important
  co-regulating influences on each other that may
  explain their high comorbidity

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Postulates Examined

• Participants biographical experiences within
  their social milieu are likely to be reflected by
  ISA through their modulation of identity indices
  with significant others.
• The psychological processes underlying
  comorbidity of depression and anxiety will be
  elucidated through examination of participants
  identifications with others across depressed and
  anxious selves.

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Method

• Participants all had depressive disorder and
  anxiety disorder.
• Semi-structured interview with each participant.
• Customization of ISA Identity Instrument.
• - Approx. 20 entities.
• - Inclusion Criteria
• Participants testimony.
• Investigation of a priori theoretically
  derived postulates.

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Entity List Excerpt
Me when I am going through a long lasting depression
Me when I am feeling anxious
Me when I am without depression
Me when I am without anxiety
A prejudiced person
My friend as he was before suicide
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Method ctd.

• - Same 20 constructs for each participant.
• - Constructs included for the examination of a
  priori theoretically derived postulates.
• - Terminology influenced by testimony given in
  interviews.

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Construct List Excerpt
wishes to keep to oneself wishes to enter fully into relationships with others, with minimal boundaries
feels that doing something well is the best way to help depression feels that care and affection from others is the most helpful way to remove depression
feels the world is full of danger, which must be protected against feels the world is generally safe and should be welcomed
feels depression is rather different from the feeling one has after a death in the family feels depression is very similar to the feeling one has after a death in the family
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Method ctd.

• Participants were asked to complete both their
  Identity Instrument as well as the Depression
  Anxiety Stress Scale (Lovibond Lovibond, 1995).

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Results

• Philip Biographical Factors
• Mixed anxiety depressive disorder (F41.2).
• He had endured numerous prejudicial attacks.
• Nevertheless, he held strong aspirations towards
  positive social relationships (SP99.69).
• Depression likened to loss related to loss of
  relationships due to prejudicial encounters.

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Results ctd.

• Philip Biographical Factors ctd.
• Idealized his well self states, thus inducing
  the retaliations of others and amplifying their
  prejudicial appraisals of him.

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Results ctd.

• Philip - Comorbidity
• Anxiety was revealed to involve engagement with
  the social world in spite of problematic
  conflicted identifications with others and high
  diffusion
• where conflicted idn refers to the
  multiplicative function of ones empathetic idn
  with another and ones contra-idn with that other

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Results ctd.

• Philip Comorbidity ctd.
• and diffusion refers to the overall dispersion
  and magnitude of ones conflicted idns with
  others.
• Depression, on the other hand, was entered as he
  endeavored to resolve his conflicted idns with
  others through social withdrawal.

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Results ctd.

• Philip Comorbidity ctd.
• Vicious Cycle Maintaining Comorbidity
• Once in depression, attempts to relieve it
  through re-engagement socially reinstates
  problematic conflicted idns, high diffusion and
  implicit anxiety.
• Thus, a vicious cycle ensues whereby anxiety is
  traded off against depression and vice versa.

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Results ctd.

• Gordon - Biographical Factors
• Recurrent Depressive Disorder (Current Episode
  Moderate) (F33.1) with prominent anxiety
  symptoms.
• He had separated from his wife and had lost a
  friend through suicide in recent years, and had
  lost his job immediately prior to his
  participation in the study.

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Results ctd.

• Gordon - Biographical Factors
• Strong aspirations towards feeling safe and
  secure and having positive social relationships.
• Defensively identified with his parents when
  appraising his childhood self and, more recently,
  with his wife.

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Results ctd.

• Gordon Comorbidity
• The same psychological dynamic where anxiety and
  depression inter-relate within the person that
  was in evidence for Philip resulted in
  Gordons case.

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Results ctd.

• Contrasting case Nancy
• Negative evaluations of others generally enabled
  her to feel closer to them through illness.
• This tendency related to her early negative
  experiences in the family context, where her
  appraisals indicated a problematic relationship
  with her then depressed parents which had
  infiltrated her current idns with them.
• Her results showed a coalescence of the anxious
  and depressive states in her mind, where on the
  affective level they had merged into an unitary
  state.

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Conclusion

• ISA revealed diverse and complex biographical and
  social factors feature in the aetiology of
  clinical depression and anxiety
• confirming the importance of examining the
  intricacies of depressed persons social
  involvement.

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Conclusion ctd.

• Furthermore, ISA enabled the discovery of a
  dynamic whereby anxiety and depression
  inter-relate and co-regulate one another.
• Anxiety is experienced through social interaction
  in spite of problematic conflicted idns with
  others and high diffusion, and depression enables
  partial resolution thereof, via social
  withdrawal.
• A cyclical process ensues where the two may be
  entered interchangeably.