Social Problem Solving Deficit in Depression

There is clear evidence that poor SPS is a feature of depression. Much of this research has employed the MEPS to assess social problem-solving performance.

Gotlib and Asarnow (1979) found that depressed university students produced less relevant means on the MEPS than nondepressed students. Marx and Schulze (1991) found that depressed college students generated less effective solutions than their nondepressed counterparts. Marx et al. (1992) examined the association between SPS ability in patients with a diagnosis of major depressive disorder and patients with a diagnosis of anxiety disorder as well as a normal control group. Problem-solving ability was assessed with (1) the MEPS task, (2) the assessment of solutions to a personal problem generated by the participants themselves, and (3) the Problem-Solving Questionnaire (PSQ), a translation of the German Problemlosefragebogen (Konig, Otto, Holling, & Liepmann, 1980). Results showed that, as predicted, depressed participants suffered from a deficit in SPS on all three measures. The majority of these deficits were also displayed by the anxiety disorder patients group rather than being specific to a diagnosis of depression. However, on one key outcome measure, effectiveness of solutions on the MEPS, the depressed participants performed significantly poorer than both the normal group and the patients with a diagnosis of anxiety disorder.

The results also suggest that depressed and anxious patients may have difficulties at different stages of the problem-solving process, providing some support for the stage model of social problem-solving (Marx et al, 1992). For example, the depressed patients had difficulties in generating effective solutions to hypothetical problems where an earlier cognitive stage is involved. In contrast, the anxious patients showed impairment in implementing solutions, a later stage of problem-solving. Thus, Marx et al. (1992) provides clear evidence that an impaired cognitive style in producing effective SPS strategies is a feature of

depression. A final finding of interest was that depressed people also displayed more negative attitudes towards problems than their nonclinical controls. Specifically, the depressed patients manifested a more negative problem orientation and more disinclination to apply unconventional solutions to problems.

Other research examining the effects of depression on social problem-solving has investigated whether rumination and the ability to retrieve autobiographical memories are possible mechanisms involved in the social problem-solving process. Again most of this research has employed the MEPS. Consider first the research looking at rumination. Lyubomirsky and Nolen-Hoeksema (1995) investigated the effects of self-focused rumination on interpersonal problem-solving in dysphoric participants using the MEPS. The results indicated that dysphoric participants who ruminated generated less effective solutions on the MEPS than the dysphoric participants receiving a distraction manipulation and the non-depressed ruminators and distracters. In addition, the dysphoric ruminators were also more pessimistic towards their problem situations, such as offering more negative explanations to the social problems they had, than the other groups. Finally the dysphoric ruminators experienced greater negative mood than the dysphoric distracters. Considered together, the results demonstrated that rumination impairs SPS through the effect of negative mood in a dysphoric sample.

Another possible mechanism through which depression influences SPS is thinking style (rumination versus distraction). In contrast to the abstract self-focus which involves an abstract, conceptual and more general mode of thinking style

processing, the concrete self-focus encourages a processing style that focuses on a more concrete, direct and specific mode (Stöber, 1998; Teasdale, 1999; Watkins & Mould, 2005). It has been suggested that concrete self-focus is associated with improved social problem-solving performance, in contrast to abstract self-focusing. Watkins and Moulds (2005) further tested this hypothesis by looking at the influence of abstract versus concrete self-focus on problem-solving in depressed people. In an abstract self-focus condition, participants were given an instruction such as “Think about the way you feel inside”. In the concrete condition, participants were asked to “Focus your attention on your experience of the way you feel inside”. The items were adapted from the Nolen-Hoeksema and Morrow’s (1993) rumination task. As predicted, the concrete self-focus manipulation helped depressed people in solving the MEPS.

Thus research has demonstrated some preliminary finds that ruminative self-focus can be either helpful or detrimental depending on the nature of the self-focus. Originally derived from the concept of mindfulness, the experiential self-focus has proven to be associated with improvement in AM retrieval as well as social problem solving. More work is required to test this newly developed theory and to develop some treatment strategies based on this assumption.

The ability to retrieve AMs may be another mechanism underlying poor SPS performance in depression. Poor SPS performance on the MEPS has been found to be associated with the difficulty in retrieving specific AM in parasuicide patients (Evans, Williams, O’Loughlin, & Howells, 1992). Pollock and Williams (2001) investigated interpersonal problem-solving ability on the MEPS and AM

retrieval in suicide attempters. They found that, in contrast to the nonsuicidal psychiatric controls and normal controls, the suicide attempters were more overgeneral in their AM retrieval style and they also showed greater deficits in their interpersonal problem-solving ability. Moreover, the results demonstrated that effective interpersonal problem-solving performance in suicide attempters was associated with the ability to retrieve specific AM. Goddard, Dritschel, and Burton (1996, 1997, 1998, 2001) extended research looking at the relationship between AM retrieval and SPS by examining how AM retrieval during SPS, as well as AM retrieval on the AMT cueing task, may contribute to the quality of solutions produced in terms of the generation of relevant means and the effectiveness scores. Results supported the general hypothesis that SPS skill is a function of both AM retrieval as measured by the AMT cueing task and by the types of AMs retrieved during SPS in a clinically depressed sample. More specifically, the ability to retrieve specific AMs on the AMT cueing task was again found to be positively correlated with the successful SPS performance. Moreover, with respect to the AM retrieval during SPS, a strong association between categoric AM retrieval during SPS and poor SPS performance was demonstrated. Goddard et al. (1996) have argued that the categoric AM retrieval style facilitates ruminative thinking in depressed individuals in both positive and negative ways. When negative, this ruminative thinking style encourages poor problem-orientation towards problems. In contrast, a positive ruminative thinking style diminishes the desire to find new insight, perhaps in the form of unconventional solutions. Moreover, this ruminative thinking style limits the cognitive resources needed to successfully define and evaluative problems as well as to generate effective solutions due to a maladaptive preoccupation with the

past.

A subsequent study by Goddard et al. (2001) examined whether priming depressed individuals and matched controls to retrieve specific AMs prior to performing SPS would result in enhanced SPS performance. Priming increased the specific AM retrieval in both groups but did not improve their SPS performance. However, the priming did facilitate the ability of depressed people to retrieve memories that they subsequently rated as helpful.

Other research examining the association between depression and SPS has examined attitudes towards problem solving using self-report measures and found deficits. For example, there is some evidence suggesting that depressed people demonstrate a more negative problem orientation towards social problems (Chang & D’Zurilla, 1996; D’Zurilla, Chang, Nottingham, & Faccini, 1998; Dixon, 2000; Dixon, Heppner, Burnett, Anderson, & Wood, 1993) than their non-depressed counterparts. D’Zurilla et al. (1998) also examined the relationship between social problem-solving abilities (measured by the SPSI-R) and hopelessness, depression, and suicidal risk in college students and psychiatric inpatients. They found a significant positive association between depression level (as measured by the BDI) and NPO (the Negative Problem Orientation), the ICS (the Impulsivity/Carelessness Style), and the AS (the Avoidance Style) in both a college students sample and a depressed patients sample. In these samples, a significant negative association was also found between the depressed level and the PRO (the Positive Problem Orientation) (see Section 1.4.2.3 for the introduction of SPSI-R).