Yakov Barton, PhD, Samuel Barkin, MS, & Lisa Miller, PhD

'Deconstructing Depression' is an empirical article that evolved from my 5-year dissertation study. It examines unique subtypes of depression, some of which may be strengths-based, and suggests that depression can both debilitate us or prompt life-changing growth and insight. Have we made a longstanding mistake pathologizing all depression?

Abstract

The aim of the current investigation was to explore potential subtypes of depressive symptomatology from a phenomenological vantage point, focusing on dimensions of spirituality, positive human functioning, and character strengths. The study examines distinct presentational depressive symptom profiles in light of recent research on developmental depression—defined as depressive symptomatology that may characterize periods of major spiritual development, life transition, existential upheaval, and personal growth. Unique homogeneous profiles are inductively derived using depressive symptomatology domains and examined across spiritual and positive psychological variables within a large heterogeneous sample of 3,806 emerging adults (ages 18–25, M = 20.0, SD = 1.9). The present investigation utilizes latent profile analysis (LPA) interpreted in light of the developmental depression hypothesis. The LPA model produced contains three depressive symptomatology clusters, including mood, somatic, and cognitive areas of depressive functioning. Average scores on spiritual, existential, positive psychological, and relational covariate variables are examined across profiles. Results suggest that distinct subtypes of depression may exist throughout emerging adulthood. An interpretation of these results that supports the developmental depression hypothesis is proposed.

APA Journal of Spirituality and Clinical Practice - Article

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Yakov Barton, PhD & Lisa Miller, PhD

Abstract

We investigate the relationship between personal spirituality and positive psychology traits as potentially presented in multiple profiles, rather than monolithically across a full sample. A sample of 3966 adolescents and emerging adults (aged 18-25, mean = 20.19, SD = 2.08) and 2014 older adults (aged 26-82, mean = 38.41, SD = 11.26) completed a survey assessing daily spiritual experiences (relationship with a Higher Power and sense of a sacred world), forgiveness, gratitude, optimism, grit, and meaning. To assess the relative protective benefits of potential profiles, we also assessed the level of depressive symptoms and frequency of substance use (tobacco, marijuana, alcohol, and heavy alcohol use). Latent class analysis (LCA) was used to examine common subgroupings of study participants across report on personal spirituality and positive psychology scales in each age cohort, with potential difference between latent classes then tested in level of depressive symptoms and degree of substance use. LCA determined a four-class and a three-class best-fitting models for the younger and older cohorts, respectively. Level of personal spirituality and level of positive psychology traits were found to coincide in 83 % of adolescents and emerging adults and in 71 % of older adults, suggesting personal spirituality and positive psychology traits go hand in hand. A minority subgroup of "virtuous humanists" showed high levels of positive psychology traits but low levels of personal spirituality, across both age cohorts. Whereas level of depression was found to be inversely associated with positive psychology traits and personal spirituality, uniquely personal spirituality was protective against degree of substance use across both age cohorts. Overall interpretation of the study findings suggests that personal spirituality may be foundational to positive psychology traits in the majority of people.

Journal of religion and health - article

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Lisa Miller, PhD & Yakov Barton, PhD

Abstract

Diagnosis of depression has low reliability (kappa = 0.28) due to "covert heterogeneity," making the identification of sub-types a focus of research. Very high rates of moderate or sub-threshold depression among adolescents (35-45 % beyond the 20-25 % with MDD), prompt consideration of a potential sub-type of moderate sub-threshold depression, linked to adolescent development. Previously, developmental depression (DD) has been proposed as sub-type of moderate depression that is a normative developmental process of spiritual individuation, the integration of existential and spiritual experience. DD as a potential sub-type is supported both by clinical observation and by an emerging body of research identifying a common physiology to underlie both depression and spirituality (neurotransmitters, structural MRI and long-term clinical course), as well as research showing a surge of spirituality in adolescence (concomitant with window of risk of depression). We test for unique patterns of comorbidity and neural correlates as support for a sub-type. Based upon existing literature, we propose that DD will be (1) associated with the unique neural correlate of increased volume in the occipital region and (2) co-morbid with symptoms of affected regulation and processing. A sample of 125 adolescents (64 girls and 61 boys; ages 15-19 years) from the larger National Institute of Health Magnetic Resonance Imaging (MRI) Study of Normal Brain Development (Evans in Neuroimage 30(1):184-202, 2006) was assessed using the Cloninger Self-Transcendence Scale to examine correlates of sub-threshold mild to moderate symptoms of depression. Findings lend support to the possibility of a DD. Sub-threshold depression was associated with greater volume in the occipital region, as well as comorbidity with symptoms of affected regulation and processing (mania, ADHD, anxiety). By contrast, in adolescents with a low level of transcendence, sub-threshold depression was associated with conduct disorder and heavy substance use, both of which previous research have found to be associated with low levels of personal spirituality.

Journal of Religion and Health - Article

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Yakov Barton, PhD, Lisa Miller, PhD, Priya Wickramaratne, PhD, Marc Gameroff, PhD, & Myrna Weissmanb, PhD

Abstract

Background: Previous research has identified elevated social adjustment and frequent religious attendance as protective against depression. The present study aims to examine the association of frequency of religious services attendance with subsequent depression, while accounting for the effects of social adjustment. Method: Participants were 173 adult offspring of depressed and nondepressed parents, followed longitudinally over 25 years. Diagnosis was assessed with the Schedule for Affective Disorders and Schizophrenia—Lifetime Version. The Social Adjustment Scale—Self Report (SAS—SR) was used to assess social adjustment and frequency of religious services attendance was self-reported. In a logistic regression analysis, major depression at 20 years was used as the outcome measure and the frequency of religious services attendance and social adjustment variables at 10 years as predictors. Results: Frequent religious services attendance was found to protect against subsequent depression at a trend level. High functioning social adjustment was found to protect against subsequent depression, especially within the immediate and extended family. Adults without a depressed parent who reported attending religious services atleast once a month had a lower likelihood of subsequent depression. Among adults with a depressed parent, those with high functioning social adjustment had a lower likelihood of subsequent depression. Limitations: Measurement of social adjustment was non-specific to religious services. Conclusions: Frequent religious attendance may protect against major depression, independent from the effects of social adjustment. This protective quality may be attenuated in adults with a depressed parent. High functioning social adjustment may be protective only among offspring of depressed parents.

Journal of affective disorders - article

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