Exploring the relationship between different psychosocial determinants of depression: a multidimensional scaling analysis

Background: The psychological literature concerned with the aetiology and m aintenance of depression has generally been considered too diverse to allow for integration of concepts into a single comprehensive review. Moreover, there is little understanding of the original theorists' conceptualisation of the key themes underlying psychosocial theories of depression. This stud y aims to create a single framework of psychosocial depression concepts bas ed on the opinions of key original theorists. Method: A quantitative integr ation of depression factors was conducted. Ninety-nine factors were identif ied from 27 theories. Fourteen of the original theorists sorted the factors into groups using a card sort task. Results: Thr re-way multidimensional s caling (MDS) produced a four-dimensional solution with high explained varia nce and low stress. Dimension one describes cognitions resulting in a lack of positive intrapersonal and interpersonal communication. Dimension two em phasises behaviours and the impact of environmental stressors. Dimension th ree describes the individual's pursuit of unrealistic goals and a perceived lack of control. Finally, Dimension four describes concepts relating to se lf-focus and self-reinforcement. Limitation: future research could examine clinicians and depressed individuals' understandings of the literature. Con clusions: the MDS solution identifies the original theorists' collective un derstanding of the literature. Clinicians could usefully employ the framewo rk to identify the underlying psychosocial themes involved in depression. M oreover the study highlights the need for clinicians to consider the relati onships between different conceptual areas in order to challenge the chroni c nature of the depressive experience and the high rates of relapse. (C) 20 01 Elsevier Science B.V. All rights reserved.