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Understanding the Functionality of Depression Among Australian Breast Cancer Patients: Implications for Cognitive and Behavioural Interventions

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Abstract

Background

Depression in breast cancer (BCa) patients can reduce quality of life, relationships and treatment compliance, thus constituting a major target for cognitive behavioural (CBT) interventions. Although CBT treatments, which are built upon consideration of the roles of antecedents and consequences for depressive behaviour, are effective, the nature of those antecedents which trigger depression among BCa patients has received relatively little attention.

Purpose

Hypotheses were (1) to determine if BCa patients were experiencing either or both of punishment type I and II and (2) to identify if these aspects of punishment were related to overall depression.

Method

Two hundred fifty-three BCa patients completed a standardised depression scale, and data were factor analysed. Components were interpreted for their relationship to punishment type I or II.

Results

Two major components emerged: (1) loss of previously available sources of personal or social reinforcement (i.e. punishment type II or negative punishment) and (2) behavioural, emotional and cognitive responses to those losses. These two components represent the total symptomatology of major depressive episode from DSM-IV-TR.

Conclusion

These findings support the application of a functional analytic model of depression within CBT assessment and treatment procedures with BCa patients.

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References

  1. DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton RC, Young PR, Salomon RM, et al. Cognitive therapy vs medications in the treatment of moderate to severe depression. Arch Gen Psychiatry. 2005;62:409–16.

    Article  PubMed  Google Scholar 

  2. O'Neill R, Horner R, Albin R, Sprague J, Storey K, Newton J. Functional assessment and program development for problem behavior: a practical handbook. Pacific Grove: Brooks/Cole; 1997.

    Google Scholar 

  3. Kohlenberg RJ, Tsai M. Functional analytic psychotherapy: creating intense and curative therapeutic relationships. New York: Plenum Press; 1991.

    Google Scholar 

  4. Wade T, Lee C. The impact of breast cancer on the lives of middle-aged women: results from the Australian longitudinal study of women's health. Health Psychol. 2005;24:246–51.

    Article  PubMed  Google Scholar 

  5. APA. Diagnostic and statistical manual of mental disorders. 4th ed. Washington: American Psychiatric Association; 2000. Text Revision.

    Google Scholar 

  6. Love A, Grabsch B, Clarke D, Bloch S, Kissane D. Screening for depression in women with metastatic breast cancer: a comparison of the Beck depression inventory short form and the hospital anxiety and depression scale. Aust NZ J Psychiatry. 2004;38:526–31.

    Article  Google Scholar 

  7. Colleoni M, Mandala M, Peruzzotti G, Robertson C, Bredart A, Goldhirsch A. Depression and degree of acceptance of adjuvant cytotoxic drugs. Lancet. 2000;356:1326–7.

    Article  PubMed  CAS  Google Scholar 

  8. Fallowfield L. Quality of life issues in relation to the aromatase inhibitor. J Steroid Biochem Mol Biol. 2007;106:168–72.

    Article  PubMed  CAS  Google Scholar 

  9. Day R. Quality of life and tamoxifen in a breast cancer prevention trial. Ann NY Acad Sci. 2001;949:143–50.

    Article  PubMed  CAS  Google Scholar 

  10. Somerset W, Stout S, Miller A, Musselman D. Breast cancer and depression. Oncology. 2004;18:1021–34.

    PubMed  Google Scholar 

  11. Watson M, Haviland J, Greer S, Davidson J, Bliss J. Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet. 1999;354:1331–6.

    Article  PubMed  CAS  Google Scholar 

  12. Kissane D, Grabsch B, Love A, Clarke D, Bloch S, Smith G. Psychiatric disorder in women with early stage and advanced breast cancer. Aust NZ J Psychiatry. 2004;38:320–6.

    Article  Google Scholar 

  13. Hersen M. Clinician's handbook of behavioral assessment. Amsterdam: Elsevier; 2006.

    Google Scholar 

  14. Sharpley C. Neurobiological pathways between chronic stress and depression. Clin Med: Psych. 2009;2:33–45.

    Google Scholar 

  15. Dougher MJ, Hackbert L. A behavior-analytic account of depression and a case report using acceptance-based procedures. Behav Anal. 1994;17(2):321–34.

    Google Scholar 

  16. Ferster CB. A functional analysis of depression. Am Psychol. 1973;28:857–70.

    Article  PubMed  CAS  Google Scholar 

  17. Kanter JW, Busch AM, Weeks CE, Landes SJ. The nature of clinical depression: symptoms, syndromes, and behavior analysis. Behav Anal. 2008;31(1):1–21.

    Google Scholar 

  18. Zung W. A self-rating depression scale. Arch Gen Psychiatry. 1965;12:63–70.

    PubMed  CAS  Google Scholar 

  19. DeJonge J, Baneke J. The Zung self-rating depression scale: a replication study on reliability, validity and prediction. Psychol Rep. 1989;64:833–4.

    Article  Google Scholar 

  20. Gabrys J, Peters K. Reliability, discriminant and predictive validity of the Zung self-rating depression scale. Psychol Rep. 1985;57:1091–6.

    Article  PubMed  CAS  Google Scholar 

  21. Sharpley CF, Christie DRH. ‘How I was then and how I am now’: current and retrospective self-reports of anxiety and depression in Australian women with breast cancer. Psycho-Oncol. 2007;16:752–62.

    Article  Google Scholar 

  22. Schaefer A, Brown J, Watson C, Plenel D, DeMotts J, Howard M, et al. Comparison of the validities of the Beck, Zung and MMPI depression scales. J Consult Clin Psychol. 1985;53:415–8.

    Article  PubMed  CAS  Google Scholar 

  23. Zung W. From art to science: the diagnosis and treatment of depression. Arch Gen Psychiatry. 1973;29:328–37.

    PubMed  CAS  Google Scholar 

  24. Tabachnick B, Fidell L. Using multivariate statistics. 4th ed. Boston: Allyn & Bacon; 2001.

    Google Scholar 

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Correspondence to Christopher F. Sharpley.

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Sharpley, C.F., Bitsika, V. & Christie, D.R.H. Understanding the Functionality of Depression Among Australian Breast Cancer Patients: Implications for Cognitive and Behavioural Interventions. Int.J. Behav. Med. 18, 319–324 (2011). https://doi.org/10.1007/s12529-010-9098-5

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  • DOI: https://doi.org/10.1007/s12529-010-9098-5

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