Dysthymic disorder continues to present an enormous challenge for psychiatry. The factors related to the persistence of depression in dysthymic disorder and its inadequate response to treatment are poorly understood. One strategy for answering these questions has been to examine clinical variables in dysthymic disorder compared to episodic major depression. Thus, among the factors that most consistently distinguish dysthymic disorder from major depression, are variables related to early home environment. Subjects with dysthymic disorder consistently demonstrate poorer parental bonding, greater developmental object loss, and higher rates of sexual and physical abuse. What is not well understood, however, is how these early experiences contribute to dysthymic disorder. Jeffrey Young's schema theory was developed to link early experience to chronic psychiatric conditions, such as dysthymic disorder, by hypothesizing the existence of early maladaptive schemas (EMSs). In this investigation, we propose to evaluate the presence of EMSs in early-onset dysthymic disorder compared to non-chronic major depression. The relation of EMSs to various developmental variables will be examined. Findings that early maladaptive schemas are more prominent in dysthymic disorder will suggest the importance of these constructs in dysthymia and identify important points of intervention. Finding a relation between EMSs and early home environment would be consistent with Young's schema theory and support the notion that EMSs represent permissive factors for the development of the disorder. Future research will continue to refine the measurement of these constructs and examine the importance of EMSs in dysthymic disorder using high-risk research designs.
| Riso, Lawrence P; du Toit, P L; Blandino, Jaime A et al. (2003) Cognitive aspects of chronic depression. J Abnorm Psychol 112:72-80 |
