DEPRESSION IN MULTIPLE SCLEROSIS (MS): THE DISTINCTION BETWEEN MS AND DEPRESSIVE SYMPTOMATOLOGY AND UTILITY OF SELF-REPORT INSTRUMENTS

Open Access
Author:
Strober, Lauren Beth
Graduate Program:
Psychology
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
May 18, 2007
Committee Members:
  • Peter Andrew Arnett, Committee Chair
  • Thomas D Borkovec, Committee Member
  • Robert M Stern, Committee Member
  • Elizabeth Susman, Committee Member
Keywords:
  • Self-Report Measures
  • Assessment
  • Depression
  • Multiple Sclerosis
Abstract:
The long-term objective of the present investigation is to improve the detection of depression in primary care, specifically in Multiple sclerosis (MS) patients. Controversy exists regarding whether or not prevalence rates of depression in MS and the medical population in general, are inflated due to poor delineation of depressive symptoms from medical conditions and use of improper assessment tools. In particular, it has been hypothesized that the overlap of MS symptomatology and neurovegetative depression symptoms (e.g., fatigue, sleep disturbance, weight/appetite changes) on self-report questionnaires may lead to an over-diagnosis of depression in MS. Furthermore, assessment of depression in MS, or any medical sample, is problematic given the difficulty in ascertaining what is a suitable reaction and adequate adjustment to receiving a medical diagnosis and also the impact this has on mood and self-evaluation, both domains of depression as well. Self-report measures may not be the most sensitive tools in delineating these factors but are nonetheless widely used. Self-report measures may not be able to elucidate how patients interpret their medical symptoms or reactions to illness as depressive symptoms without being provided additional information beyond item endorsement. The proposed investigation attempts to explore this issue using a modification of the Beck Depression Inventory (BDI) that asks MS patients to further explain their endorsement of depressive symptoms and how their MS symptoms may contribute to such endorsement. Furthermore, the present investigation proposes to examine the utility of three common self-report instruments (Beck Depression Inventory-II, Beck Depression Inventory-Primary Care, Chicago Multiscale Depression Inventory) and resultant prevalence rates and recommended cutoffs when used with a MS sample.