Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT August 8, 2003 "The wise see knowledge and action as one; they see truly." - Bhagava Gita
LINKS Rocky Mountain Region
Disaster Mental Health Institute
CONFERENCES AND WORKSHOPS:
Extension Disaster Education Network (EDEN)
September 30 - October 4, 2003
CRITICAL INCIDENT STRESS MANAGEMENT
Rocky Mountain Region
Disaster Mental Health Institute
Dates & Locations:
Laramie, WY: November 12-15, 2003
Casper, WY: November 19-22, 2003
Contact: George W. Doherty
Laramie, WY 82073
The Australasian Critical Incident
Stress Association Conference
The Right Response in the
Location: Carlton Crest Hotel
Friday October 3, 2003 thru
Sunday October 5, 2003
For further information
please contact the conference organisers:
6th Annual Conference
The University of South Dakota
Disaster Mental Health Institute
"Innovations in Disaster Psychology:
Time for a New Paradigm?
Reflecting on the Past:
Looking to the Future"
Rapid City, SD
September 18-20, 2003
8TH International Conference on Family Violence
September 16 - 20, 2003
Location: San Diego, California, USA
Contact: "FV Conference 2003"
Attn: Lisa Conradi
6160 Cornerstone Court East
San Diego, CA 9212, USA
Phone: +1-858-623-2777 ext. 427
Middle East/North Africa Regional
Conference of Psychology
December 13 - 16, 2003
Location: Dubai, United Arab Emirates
Contact: Dr. Raymond H. Hamden
MENA RCP, PO Box 11806
Dubai, United Arab Emirates
Phone: +971-4- 331-4777
1st International Conference on
Psychophysiology of Panic Attacks
September 5 - 8 2003
Location: London, UNITED KINGDOM
European Society for Cognitive Psychology (ESCoP)
September 17 - 20, 2003
Location: Granada, SPAIN
Society for Judgment and
Decision Making Annual Meeting
November 10 - 11 2003
Location: Vancouver, CANADA
Society of Australasian
Social Psychologists 33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
27th National AACBT Conference
(Australian Association for
Cognitive and Behavior Therapy)
May 15 - 19, 2004
Location: Perth, Western Australia
FEMA Authorizes Funds To Help Fight Colorado Wildfire
The Federal Emergency Management Agency (FEMA) today authorized the use of federal funds to help Colorado fight the Cloudy Pass fire burning in Larimer County, about 15 miles northwest of Fort Collins. For the full story, go to: http://www.fema.gov/news/newsrelease.fema?id=3890
UN envoy condemns bomb attack on Jordanian mission in Iraq as ‘heinous act’
The top United Nations envoy in Iraq strongly condemned the deadly attack on the Jordanian diplomatic mission in Baghdad as a “heinous act” which resulted in the deaths of numerous innocent people and for which there could be no possible justification. For the full Story, go to: http://www.un.org/apps/news/story.asp?NewsID=7935&Cr=iraq&Cr1=
UN nuclear watchdog agency in talks with Iran on enhanced safeguards
The United Nations nuclear watchdog agency is holding a series of talks with senior governmental officials in Iran following its call last month for enhanced inspections to guarantee the peaceful nature of the country's nuclear programme after Tehran failed to disclose certain material and activities. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=7941&Cr=&Cr1=
ANTI-CATHOLICISM SPEECH, ACTIONS CONTRADICT U.S. SOCIETY OF TOLERANCE
While facing legitimate issues, the Catholic Church nonetheless is unfairly demonized by liberal political groups, who themselves commit hate speech and crimes against Catholicism, says a Penn State historian. "We see quick condemnation by community leaders when racist, anti-Semitic or anti-Muslim comments are made publicly," says Philip Jenkins, distinguished professor of religious studies and history. "But hostile or downright vulgar remarks about Catholics and the Church and outrageous demonstrations are conducted without repercussion. Many thought the election of John F. Kennedy, the first Catholic president, proved that anti-Catholicism in America was dead, but it is flourishing strongly and may be the 'thinking man's anti-Semitism.'" Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3688
LIVING TOGETHER BEFORE MARRIAGE: NOW COMMON BUT STILL RISKY
Even though more than half of couples now do it, compared with only 10 percent 30 years ago, living together before marriage still is linked to higher rates of troubled unions, divorce and separation, Penn State researchers have found. The Penn State team compared data on 1,425 people married between 1964 and 1980 when cohabitation was less common and between 1981 and 1997 when cohabitation was more common. They found that, in both groups, cohabiters reported less happiness and more marital conflict than noncohabiters. Also, in both groups, couples who lived together before marriage were more likely to divorce. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3682
Evaluating Treatment Decisions in Bipolar Depression
In recent years, there has been a much-needed resurgence of interest in the treatment of bipolar depression. This renewed interest has been driven, in part, by research indicating that depressive symptoms and episodes account for greater morbidity and disability than previously appreciated, and by pharmacologic and psychotherapeutic treatment advances. Moreover, other studies indicate that bipolar depression continues to be underrecognized and frequently misdiagnosed, leading to inadequate or improper treatment. In this review, new data regarding the recognition, diagnosis, and treatment of bipolar depression that bear on treatment decisions for bipolar depression are discussed. For the full article, go to: http://www.medscape.com/viewprogram/2571?mpid=16781
THE MEDICAL MINUTE: ROLE OF TRANQUILIZERS FOR ANXIETY DISORDERS SCRUTINIZED
Last week there was an important birthday -- Valium turned 40. According to the latest edition of the Medical Minute, a service of Penn State Milton S. Hershey Medical Center, if there had been a party, not all the guests would have been pleased. Benzodiazepines, the class of drug in which Valium is a member, have helped millions with disabling anxiety by providing relief more safely than previously available medications. Since its development, tranquilizer research has revealed much about normal and abnormal moods, but some people see Valium, Ativan, Xanax and others as dangerous drugs. Once known as "mother's little helper," Valium is an icon in the "pill for every ill" mentality. Read the full story at http://live.psu.edu/index.php?cmd=vs&story=3697
Long-term Treatment of ADHD
ADHD is a chronic condition that requires long-term treatment. Several studies show that treatments do indeed provide sustained benefit in both adult and pediatric populations over the long term. For the full article, go to: http://www.medscape.com/viewarticle/457174
ADHD in Adults: New Perspectives and Treatments
The adult with ADHD may present with a variety of emotional, behavioral, or interpersonal problems. For the full article, go to: http://www.medscape.com/viewarticle/457175
SELF-CONTROL AND DEPRESSION
A model should provide a framework for hypotheses about causes of depression and should serve as a heurestic device for the development of means of treating the disordered behavior. Behavioral and cognitive models proposed by Lewinsohn (1974a, 1974b), Seligman (1974) and Beck (1974) have been prominent and influential in behavioral research and clinical application.
Rehm (1977) outlined a behavioral self-control model which can be used for the study of depression. He stated that depression has certain properties which make the development of a model particularly difficult. This is primarily because most models tend to focus on different subsets of depressive phenomena. The self- control model suggested by Rehm organizes and relates these phenomena. As such, it has its own implications for symptomatology, etiology and therapy.
Self-control has been an important focus of behavioral research for some time (Thoresen & Mahoney, 1974); Mahoney & Thoresen, 1974; Goldfried & Merbaum, 1973). The model described by Rehm (1977) is a slight modification of one described by Kanfer (1970, 1971; Kanfer & Karoly, 1972). In the Kanfer model, self-control is seen as those processes by which an individual alters the probability of a response in the relative absence of immediate external supports. Kanfer's model postulates three processes in a feedback loop model. These are:
Self-monitoring involves observations of one's own behavior along with its situational antecedents and its consequences. Self-monitoring involves not only a passive perceptual awareness of events, but also a selective attention to certain classes of events and the ability to make accurate discriminations. Specific deficits in self-monitoring behavior represent one potential form of maladjustive self-control.
Self-evaluation refers to a comparison between an estimate of performance (derived from self-monitoring) and an internal criterion or standard. Criteria may or may not be realistic. Inappropriately selected internal criteria may represent another specific type of deficit in self-control behavior.
Self-attribution and self-evaluation attributional processes play a role in self-evaluation, and are incorporated into Kanfer's model. Positive or negative self-evaluation implies more than a comparison of performance to criteria of success or failure. Efforts to control one's behavior are premised on at least the perception of internal control. Self-evaluation is considered to be the comparison of internally attributed performance to a standard criterion. Because individual differences in making internal attributions exist, self-attributional deficits are another potential type of maladaptive self-control behavior.
The self-control model suggests that self-reinforcement supplements external reinforcement in controlling behavior. Bandura (1976) has argued that self- reinforcement must be conceptualized in a context of external reinforcement. Self-reinforcement has been a major focus of self-control research and many clinical uses of self-administered reward and punishment programs have been described (Thoresen & Mahoney, 1974).
Self-control may be maladaptive in terms of either self-reward or self-punishment patterns. Two ways in which the self-monitoring of depressed persons can be characterized are:
1. Depressed persons tend to attend selectively to negative events.
2. Depressed persons tend to attend selectively to immediate versus delayed outcomes of their behavior.
Beck (1970, 1972, 1974) evolved a cognitive model of depression which holds that depression consists of a primary triad of cognitive patterns or schema. These are:
1. A negative view of the world.
2. A negative view of the self.
3. A negative view of the future.
Beck sees these views as being maintained by distorted modes of cognition such as selective abstraction, arbitrary inference and overgeneralization.
Selective abstraction involves focusing on a detail taken out of a more salient context and using it as the basis for the conceptualization of an entire experience.
Arbitrary inference involves a personal interpretation of an ambiguous or personally irrelevant event.
The overt behavioral symptoms of depression follow from cognitive distortion. Therapy involves identification of the distortions and their confrontation with the evidence of objective experience.
The self-control model deals with the same phenomena as does Beck's. However, it does so in a way which specifies the distortion processes in operational terms, and places them in a theoretical context with other factors in depression. Beck's concepts of arbitrary inference and selective abstraction can be translated into the self-control concept of selective attention to negative events. The self- control model postulates specific relationships among covert cognitive processes and the overt symptomatology seen in depression.
Selective attention to immediate versus delayed outcomes is related to Lewinsohn's (1974a) concept that depressed behavior functions to elicit immediate reinforcement from the social environment at the expense of more important forms of delayed reinforcement.
Lewinsohn (1974a, 1974b) developed a clinical and research program which looked at depression as an extinction phenomenon. He viewed the etiology of depression as being the joint function of external environmental changes and individual differences in reinforcement potential and social skills. Therapy procedures are directed toward identifying potential sources of reinforcement in the individual's environment and developing strategies to increase their frequency of occurrence (Lewinsohn, 1976). Therapy also consists of isolating deficits in social interaction and training subjects in how to modify these social skill behaviors (Lewinsohn, Biglan and Zeiss, 1976).
The self-control model differs from Lewinsohn's model in three major respects:
1. It adds considerations of covert reinforcement processes.
2. The self-control model adds considerations of the role of punishment, overt or covert, in producing depressions.
3. The self-control model provides a means of differentiating cognitive symptoms and relating them systematically to the overt behavior changes observable in depression.
The self-control model has several implications which go beyond the Lewinsohn model. The major one is that intervention can be directly aimed at covert self-control processes as well as at overt behavior. Interventions which are aimed at modifying self-evaluation criteria also follow from the self-control model. The model suggests that behavior which produces external reinforcement can be increased through the modification of self-control mechanisms.
The phenomena on which Seligman's (1974) theory focuses are accounted for within the more comprehensive model of self-control. His model describes how non-contingent punishment produces inaccurate attributions of causality. These lead to a lessening of cues for self-reinforcement. This results in the passivity which Seligman has demonstrated. Individuals may be helpless either by:
1. Perceiving a non-contingent relationship between response and consequence, or by
2. Perceiving themselves incapable or unskilled in producing positive consequences in situations where contingencies actually exist.
Seligman (1974, 1975) proposed a model of depression which he based on a laboratory paradigm of learned helplessness. His model suggests that learned helplessness has the following properties which parallel the symptoms of depression:
1. Lowered response initiation (passivity).
2. Negative cognitive set (belief that one's actions are doomed to failure).
3. Dissipation over time.
4. Lack of aggression.
5. Loss of libido and appetite.
6. Norepinephrine depletion and cholinergic activity.
Seligman (1974) gives cognition a central position in his model. Klein and Seligman (1976) have demonstrated the reversibility of learned helplessness and depression following experience with solvable problems. However, this model has generated a limited number of therapy studies.
From an attributional viewpoint, a depressed person can be "helpless" in either of two ways:
1. The person makes excessive external attributions of causality and, as a result, generally believes there is a high degree of independence between performance and consequences.
2. The person makes accurate or even excessively internal attributions of causality, but perceives himself or herself to be lacking in ability to obtain positive consequences.
The work on learned helplessness in depression supports one or the other type of inaccurate attribution. Stringent self-evaluative criteria as one characteristic of depression was previously suggested by Marston (1965) and Bandura (1971). Failure in one instance may be taken as failure in the entire class of behavior. For example, beck (1972) described overgeneralization as one of the primary mechanisms of cognitive distortion in depression.
Lazarus (1968, 1974) suggested that depressed persons also lose their future perspective. That is, they tend to attend to immediate outcomes instead. Wener and Rehm (1975) found that depressed persons were influenced to a greater extent by both high and low rates of immediate reinforcement.
The self-reinforcement phase of self-control is particularly important when accounting for depressive behavior. Low rates of self-reward are associated with the slowed rates of overt behavior typical of depression. Lower general activity level, few response initiations, longer latencies and less persistence result from low rates of self-reward.
Depression is accounted for in terms of six deficits in self-control behavior:
1. Selective monitoring of negative events
2. Selective monitoring of immediate as opposed to delayed consequences of behavior
3. Stringent self-evaluation criteria
4. Inaccurate attributions of responsibility
5. Insufficient self-reward
6. Excessive self-punishment
The diverse symptoms of depression in this model are accounted for as either direct or indirect reflections of self-control deficits. Reports of a lack of motivation and hopelessness about the future also reflect this deficit.
Stringent self-evaluative criteria are directly reflected in setting unrealistic goals and result in attitudes of lack of self-esteem and negative self-evaluation. Guilt is thought of as the internal attribution of responsibility for failure.
Lack of self-reward results in psychomotor retardation, lowered activity level and lack of initiative. These are all associated with depression. Excessive self- punishment is directly reflected in negative self-statements and other forms of self-directed hostility. It can also result in the suppression or inhibition of thoughts, speech and actions.
Depressed persons who show negative self-monitoring should also show a negative self-image and depressed overt behavior. However, depressed overt behavior does not necessarily imply negative monitoring. It may also result from attributional or evaluative deficits alone.
The model has a number of implications for psychotherapy with depression. Different behavior therapy techniques may focus on each of the separate self-control deficits. Selective attention to negative events can be modified by increasing the self- monitoring of positive events. Self-monitoring of pleasant events may have the effect of refocusing attention as a mechanism through which mood change can ultimately occur.
Deutsch (1978) appraises the self-control model, as applied to depression, as containing a number of conceptual problems related to behavioral self-control. Specifically, she maintains that the model establishes "self-control" as an intervening variable, views "control" as an operation rather than a functional relationship, and relies on the questionable notion of self-reinforcement.
Deutsch sees Rehm's (1977) approach to be a useful one with considerable potential for the area of behavior treatment. The difficulties with the model, as outlined by Deutsch (1978) underscore the need for more controlled research in the self-control paradigm. She sees as being particularly important, studies designed to isolate those aspects of the model crucial to the success of self-control procedures. She state that it is unlikely that depression can be explained in terms of any single deficiency or theoretical model. However, whatever approach is used, its basis must be logically sound and empirically testable. The heuristic value of Rehm's work should certainly be emphasized in the direction of encouraging research in self-control rather than research in depression (Deutsch, 1978).
Rehm (1978) views Deutsch's (1978) evaluation of self-control research and of models of self-control as being unduly pessimistic. Deutsch made comments directly related to self-control as a model of depression. She did not like the term deficit as a descriptive term applied to concepts of control. Rehm pointed out that the term was not intended to mean that self-control behaviors are totally absent in depressed persons, only that depressed persons display maladaptive (and therefore deficient) self-control behavior patterns or skills.
Deutsch also discussed the relationship between self-monitoring and negative self- evaluation. She maintained that the problem of accurately assessing level of self- monitoring makes it very difficult to determine the optimum degree of self-monitoring necessary in order to effect behavior change. She argues that depressed individuals must be self-reinforcing those behaviors which lead to the label of depression. Rehm points out that this is not entirely accurate because the diagnosis of depression is often made on the basis of behavioral deficits more than on the basis of behavioral excesses. Behavioral deficits in depression all represent reduced frequencies of behavior in certain classes (Ferster, 1973).
The self-control model as applied to depression serves as a framework for analysis and integration and provides a framework for distinguishing among various depression symptoms, each of which can be logically associated with a particular aspect of self-control. It encompasses and integrates a range of behaviors which other available models focus on exclusively. It also suggests interrelationships among these behaviors. It specifies the relationships between covert, cognitive behavior and overt, motor behavior in depression.
Some parts of the model were only suggested in outline. They will require further refinement and validation (Rehm, 1978). There is a need for further research on basic issues in self-control. The model may have a wider applicability as a model of psychopathology.
There may be some limitations on the model as to causes and types of depression. Recent evidence in the fields of genetic and biochemical research on depression suggest a biological component in some forms of depression. For example, Akiskal and McKinney (1973, 1975) argue for a broad interaction model.
Akiskal, Hagop S. & McKinney, William T. (Mar 1975). Overview of recent research in depression: Integration of ten conceptual models into a comprehensive clinical frame. Archives of General Psychiatry, Vol 32(3), pp. 285-305. Journal URL: http://archpsyc.ama-assn.org/
Akiskal, Hagop S. & McKinney, William T. (Oct 1973). Depressive disorders: Toward a unified hypothesis. Science, Vol. 182(4107), pp. 20-29.
Bandura, Albert & Barab, Peter G. (Sep 1971). Conditions governing nonreinforced imitation. Developmental Psychology, Vol. 5(2), pp. 244-255. Journal URL: http://www.apa.org/journals/dev.html
Bandura, Albert (Fal 1976). Self-reinforcement: Theoretical and methodological considerations. Behaviorism, Vol 4(2), pp. 135-155.
Bandura, Albert, Mahoney, Michael J. & Dirks, Stanley J. (1976). Discriminative activation and maintenance of contingent self-reinforcement. Behaviour Research & Therapy, Vol 14(1), pp. 1-6. Journal URL: http://www.elsevier.com/inca/publications/store/2/6/5/
Beck, Aaron T. (1973). The diagnosis and management of depression. viii, 147 pp.
Beck, Aaron T., Weissman, Arlene, Lester, David & Trexler, Larry (Dec 1974). The measurement of pessimism: The Hopelessness Scale. Journal of Consulting & Clinical Psychology, Vol 42(6), pp. 861-865. Journal URL: http://www.apa.org/journals/ccp.html
Beck, Aaron T. (May 1970). Cognitive therapy: Nature and relation to behavior therapy. Behavior Therapy, Vol. 1(2), pp. 184-200.
Beck, Aaron T. (1970). Role of fantasies in psychotherapy and psychopathology. Journal of Nervous & Mental Disease, 150(1), pp. 3-17. Journal URL: http://www.jonmd.com/
Beck, Aaron T., Rial, William Y. & Rickels, Karl (Jun 1974). Short form of Depression Inventory: Cross-validation. Psychological Reports, Vol 34(3, Pt 2), pp. 1184-1186.
Beck, Aaron T. & Beamesderfer, Alice (1974). Assessment of depression: The depression inventory. In Pichot, P. (Ed); Olivier-Martin, R. (Ed); Psychological measurements in psychopharmacology. 267 pp.
Beck, Aaron (1974). Cognition, affect, and psychopathology. In London, Harvey (Ed); Nisbett, Richard E. (Ed) Thought and feeling: Cognitive alteration of feeling states. 239 pp.
Beck, Aaron T. (1974). The development of depression: A cognitive model. In Friedman, Raymond J. (Ed); Katz, Martin M. (Ed); The psychology of depression: Contemporary theory and research. xvii, 318 pp.
Braff, David L. & Beck, Aaron T. (Oct 1974). Thinking disorder in depression. Archives of General Psychiatry, Vol 31(4), pp. 456-459. Journal URL: http://archpsyc.ama-assn.org/
Deutsch, Anne-Marie (Jun 1978). Self-control and depression: An appraisal. Behavior Therapy, Vol 9(3), pp. 410-414.
Dorsey, Thomas E., Kanfer, Frederick H. & Duerfeldt, Pryse H. (Apr 1971). Task difficulty and noncontingent reinforcement scheduled as factors in self-reinforcement. Journal of General Psychology, Vol. 84(2), pp. 323-334. Journal URL: http://www.heldref.org/html/gen.html
Ferster, C. B. (Oct 1973). A functional analysis of depression. American Psychologist, Vol. 28(10), pp. 857-870. Journal URL: http://www.apa.org/journals/amp.html
Goldfried, Marvin R. & Merbaum, Michael (1973). Behavior change through self-control. x, 438 pp.
Haynes, Linda E. & Kanfer, Frederick H. (Jun 1971). Academic rank, task feedback and self-reinforcement in children. Psychological Reports, Vol. 28(3), pp. 967-974.
Kanfer, Frederick H. & Karoly, Paul (Jul 1972). Self-control: A behavioristic excursion into the lion's den. Behavior Therapy, Vol. 3(3). pp. 389-416.
Kanfer, Frederick H., Duerfeldt, Pryse H., Martin, Barbara & Dorsey, Thomas E. (Nov 1971). Effects of model reinforcement, expectation to perform, and task performance on model observation. Journal of Personality & Social Psychology, Vol. 20(2), pp. 214-217. Journal URL:http://www.apa.org/journals/psp.html
Kanfer, Frederick H. (Oct 1970). Self-monitoring: Methodological limitations and clinical applications. Journal of Consulting & Clinical Psychology, Vol. 35(2), pp. 148-152. Journal URL: http://www.apa.org/journals/ccp.html
Kanfer, Frederick H. & Phillips, Jeanne S. (1970). Learning foundations of behavior therapy. ix, 642 pp.
Klein, David C. & Seligman, Martin E. (Feb 1976). Reversal of performance deficits and perceptual deficits in learned helplessness and depression. Journal of Abnormal Psychology, Vol 85(1), pp. 11-26. Journal URL: http://www.apa.org/journals/abn.html
Kornblith, Sander J., Rehm, Lynn P., O'Hara, Michael W. & Lamparski, Danuta M. (Dec 1983). The contribution of self-reinforcement training and behavioral assignments to the efficacy of self-control therapy for depression. Cognitive Therapy & Research, Vol 7(6), pp. 499-528. Journal URL: http://www.wkap.nl/journalhome.htm/0147-5916
Lazarus, Arnold A. (1968). Aversion therapy and sensory modalities: Clinical impressions. Perceptual & Motor Skills, 27(1), pp. 178.
Lazarus, Arnold A. (1968). Science and service. Psychological Reports, 23(1), pp. 48.
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Wener, Albert E. & Rehm, Lynn P. (Jun 1975). Depressive affect: A test of behavioral hypothesis. Journal of Abnormal Psychology, Vol 84(3), . pp. 221-227. Journal URL: http://www.apa.org/journals/abn.html
To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
St. John's Wort, Prozac, psychotherapy, support groups--today's individual suffering from depression has a laundry list of treatments to choose from. For many, Paul Gilbert's self-help manual Overcoming Depression--based on the highly effective technique of cognitive behavioral therapy--will provide a lifeline to recovery and a better future, as a way to understand and thus resist the downward slide of depression, and as a resource to supplement therapy or medication. Cognitive behavioral therapy, which treats emotional disorders by changing negative thought-patterns, is now internationally established as a key method for overcoming conditions such as depression, anxiety, panic attacks, and eating disorders. The principle behind this form of therapy is that our thoughts have a major impact on our emotions: a person who goes through life thinking ""I am unlovable,"" or ""I'll never achieve anything,"" will find constant evidence to support his or her beliefs. In Overcoming Depression, Gilbert explains the many forms and causes of depression and lays out clinically proven techniques for dealing with this debilitating condition. This book will help people gain insight into problem areas such as perfectionism, shame, anger, and aggression, and how these areas can become exacerbated by depression. Overcoming Depression illustrates a systematic program of treatment by which people can monitor their thoughts, learn to recognize negative patterns, and challenge them. With step-by-step suggestions, case examples, thought-monitoring sheets, and practical ideas for gaining control over depression, Gilbert offers a course of action for those suffering from depression to change the way they think about themselves and their problems. The Second Edition of Overcoming Depression presents new statistics and findings from the last three years, and offers new chapters on causes for depression including ""Biology and Stress,"" ""How Evolution May Have Shaped Depression,"" and ""Early Life, Psychological and Social Aspects."" In a new chapter on guilt Gilbert differentiates between guilt and shame, and examines the relationship between guilt and depression and how to deal with those who make us feel guilty. Finally, a new preface and a new brief discussion of St. John's Wort complete the text.
Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Laramie, WY 82073-0786
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