Enduring deficits after remissions of depression: A test of the scar hypothesis

• Published in: Behaviour research and therapy 1988, Vol.26 (2), p.151-158
• Main Authors: Zeiss, Antonette M., Lewinsohn, Peter M.
• Format: Article
• Language: English
• Subjects: Behavior therapy. Cognitive therapy; Biological and medical sciences; Depressive Disorder - psychology; Depressive Disorder - therapy; Female; Humans; Interpersonal Relations; Male; Medical sciences; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recurrence; Self Concept; Treatments
• ISSN: 0005-7967; 1873-622X
• DOI: 10.1016/0005-7967(88)90114-3

People who have recovered from an episode of clinical depression have an elevated risk for developing a new episode of depression compared with those not previously depressed. One possible explanation for this finding is that depression may leave ‘scars’—enduring psychological changes resulting from depression. This hypothesis was examined for a set of interpersonal variables which measured self-perceptions, behavior observed in dyadic and group interactions, and ratings by peers and coders based on those interactions. The ‘scar’ pattern was defined as a deficit observed during depression which remained after the depressive episode ended. Data for 21 patients who improved during psychotherapy, 20 patients who did not improve, and 80 nondepressed participants were examined. No variables fit the ‘scar’ pattern. Seven variables were identified as concomitants of depression. Nine variables provided predictive information, in that patients who subsequently improved in treatment significantly differed at pre-test from patients who subsequently failed to improve. The failure to support the scar hypothesis is discussed, along with alternative explanation for the higher risk for a new depressive episode seen in the previously depressed. The importance of the finding that some measures of interpersonal behavior predict response to treatment is also discussed.