Assertive behavior and depression

Assertiveness Training for Clients with a Psychiatric Illness: A Pilot Study

The current literature documents a need for assertiveness training for clients with a psychiatric illness, in order to address this need, a programme was designed and implemented to provide clients with practical techniques to enable them to communicate in a more effective, assertive manner. The frames of reference for the programme were the model of human occupation and social teaming theory. Data were collected over a 2-year period from 33 clients with a psychiatric illness who participated in a 7-week training programme. The investigation incorporated a prospective one-group, pre-test/post-test design. The Rathus assertiveness schedule and the Rosenberg self-esteem scale were used to measure changes in assertiveness and self-esteem. A t-test analysis of the pre-test and post-test scores attained by group participants on both scales indicated a statistically significant increase in their level of assertive behaviour and self-esteem. A brief review of the pertinent literature and a description of the assertiveness training programme are provided. Programme evaluation results and recommendations for further research are also discussed.

Social Skills Deficits and Subsequent Depressed Mood in Students

A total of 65 undergraduate students were administered the Beck Depression Inventory and two measures of social skill: the College Self-Expression Scale and the Means-Ends-Problem-Solving Test. Two months later, depression was reassessed using the D30 Depression Scale. It was found that social skills measures were significantly correlated with currently assessed depression. It was also found that the best single predictor of future depression was current depression (r = .70). A stepwise regression analysis indicated that, after partialling out the influence of current depression scores, two measures of social skill, CSES assertiveness scores and relevancy ratio on the MEPS, provided incrementally significant contributions to the prediction of future depression scores. This provides modest correlational evidence for Lewinsohn's social skills deficit model of depression. That is, social skills, independent of current depression, significantly increased the predictability of future depression.

Relationship between Burnout and Communication Skill Training among Japanese Hospital Nurses: A Pilot Study

We investigated the relationship between burnout and communication skill training among Japanese hospital nurses to improve the mental health of human service workers. The subjects were forty-five registered nurses referred to a self-expression skill intervention program by their section superiors, with each superior choosing from two to five nurses. The hospital was located in the Kyushu area and staffed by about four hundred nurses. The subjects were divided into an intervention group (19 nurses) and a reference group (26 nurses). The intervention group received the communication skill training in July and August, 2001. The communication skill training was carried out in accordance with the assertiveness training (AsT) precepts of Anne Dickson. In June, 2001, we delivered a set of questionnaires including age, gender, working years, a burnout scale, and a communication skill check-list as a baseline survey. The baseline questionnaires were returned at the end of June, 2001. In January, 2002, we delivered the same questionnaire again to the two groups and collected them at the end of the month. Excluding the only male and insufficient answers, twenty-six nurses (58%) returned complete answers in the initial and subsequent surveys. We found that the personal accomplishment and the two communication skills such as "accepting valid criticisms" and "negotiation" of the intervention group had improved significantly five months after the training as compared with that of the reference. Our results implied that communication skill training might have a favorable effect on burnout among Japanese hospital nurses.

Components of assertiveness: their relationships with assertive rights and depressed mood among Chinese college students in Hong Kong

Components of assertiveness and depressive symptoms of 183 Chinese university undergraduate students were assessed in their responses to the Rathus Assertiveness Schedule and the Beck Depression Inventory. Three dimensions of assertiveness emerged: expressing, confronting and demanding responses. These components were found to relate differentially to the beliefs in specific assertive rights, although there was no evidence that nonassertive behaviors could arise from beliefs that one did not have the rights to act assertively. Nonassertive responses, especially in expressing and disclosing oneself, correlated with depressed mood. Implications for cross-cultural comparison and assertiveness training among the Chinese are discussed.

Depression and engagement in pleasant and unpleasant activities in normal children

This study investigated Lewinsohn's reinforcement model of depression by examining the relationship between depressive symptomatology and mood-related activities in normal children. Subjects were 138 children aged 8 to 14 years. Children and their parents rated the children's depression and engagement in pleasant and unpleasant activities. It was found that children's depression was correlated positively with increased engagement in unpleasant activities. However, the predicted negative correlation between children's depression and engagement in pleasant activities was supported only when children's mood was assessed by parental report, and not by children's self-report.

The relationship between situational stress and phantom limb pain: cross-lagged correlational data from six month pain logs

This study reports the results of the first investigation into the relationship between situational stress and phantom limb pain. Twenty-seven male amputees recorded their pain and overall stress levels daily for 180 days using a 1-10 rating scale. Three possible relationships into the etiology and/or maintenance of phantom limb pain were examined using cross-lagged correlational techniques: an isomorphic relationship (same time increases in pain lead to same time increases in stress and vice versa), a consequence relationship (increases in pain precede increases in stress), and a precursor relationship (increases in stress precede increases in pain). Thirty-seven per cent of subjects demonstrated some significant precursor relationship. Although support was found for all three hypotheses, the most frequently observed relationship was the isomorphic one. Seventy-four per cent of subjects demonstrated some significant stress-pain relationship. The results lend support to the psychological theory underlying the use of psychophysiological interventions such as biofeedback and relaxation therapy in amputees with phantom limb pain.

Assertiveness factors and depression in a sample of college women

This investigation examined the relationships between measures of depression and factors of assertiveness in college women and tested the moderating effects of anxiety and locus of control on these relationships. A factor analysis of the Rathus Assertiveness Schedule was done, and the factor scores were correlated with three depression scales. After controlling for possible moderator effects, only one factor, Inhibited Verbal Expression, was significantly related to depression scores. The relevance of these findings for social skills in depression and for assertiveness training in depression is discussed as is the desirability of replications with larger samples including men.

Social skills training: an effective treatment for unipolar non-psychotic depression?

In recent times, social skills training (SST) has been used in the treatment of unipolar non-psychotic depression. We outline the rationale for SST in such treatment, provide definitions of SST, and outline the assessment and training procedures. Published studies are reviewed and their shortcomings discussed. We examine four theoretical issues arising from the review, and guidelines for improvements in future studies are suggested.

The role of affect in the etiology of chronic headache

Three hypotheses regarding the possible etiological relationship between affect and headache activity were examined through the use of cross-lagged correlational analyses: (1) the relationship between headache activity and affect (anger, anxiety and depression) is isomorphic, that is, increased headache activity is associated with same day increases in emotionality; (2) increased affect precedes (and thus possibly causes) increased headache activity; and, (3) increased headache activity precedes (and thus possibly causes) increased affect. Only hypothesis one was supported in the present study, and the relationship was found to be weak and only to approach significance (r = 0.163, p less than 0.09). These findings cast serious doubt upon many psychological theories regarding the etiology of headache and on the relationship between affect and headache in general.