Table 5. Studies of DBS in Depression.
| Author & Year | Sample | Gender | Age | DBS Measure | Depression Measure | Result |
|---|---|---|---|---|---|---|
| Self-Report and Observational Findings | ||||||
|
| ||||||
| *Allan & Gilbert (1997) | Study 1: 332 undergraduates and 136 psychiatric outpatients Study 2: 154 undergraduates |
Both | Study 1: Student M =22.9 and Clinical M =39.7 Study 2: M =23.5 |
SBS | Study 1: SCL-90-R Depression Score Study 2: CESD |
Submissive behavior correlated with the SCL-90-R Depression among students, r =.48, and patients, r =.53, and with the CESD among students, r =.30. |
| Andrews (1995) | 101 community members | Female | 32-56 | Bodily Shame interview | PSE Depression diagnoses at baseline and over 8-year follow-up | Bodily shame was elevated among those with recurrent and chronic depression compared to those with a single episode or no depression. |
| Gilbert & Allan (1998) | 302 students and 90 depressed outpatients | Both | M =22.9 | SCS, SBS | CESD, BDI | Submissiveness (SBS) and low perceived social comparison (SCS) uniquely related to depression in both samples. |
| Gilbert, Allan, & Goss (1996) | 90 university and graduate students | Female | M =24.6 | Four items to capture childhood experiences of parental put-downs and shaming, rated separately for mothers and fathers. | GHQ-28 Depression scale | Experiences of maternal, r =.29, and paternal shaming, r =.22, correlated with depression. |
| Gilbert et al. (1995) | 50 college and nursing students; 29 people who met criteria for neurotic depression | 25% male | M =32 | SBS, SCS | BDI | Submissive behavior (SBS) and low social comparison (SCS) correlated with depression in both samples, all rs > |.47|. |
| *Gilbert, Broomhead et al. (2007) | 207 outpatients diagnosed with depression | 13% male | M =21.77 | SAIS, HCA, SCS, SBS | DASS21 | DBS indices accounted for 34% of the variance in depression. In a regression model, SBS, SAIS, and SCS were most strongly related to depression. |
| Gilbert et al. (2003) | 225 undergraduates | 24% male | M =24.53 | SCS, OAS; ELES developed in this study to measure childhood threat, submissiveness and being devalued | CESD | Shame (OAS) and childhood submissiveness (ELES) correlated with depression. In a regression model of multiple scales covering childhood experiences, only childhood submissiveness (ELES) uniquely predicted depression. |
| *Gilbert, McEwan, Bellew et al. (2009) | 45 outpatients and 17 inpatients | 42% male | M =44.32 | SAIS, SCS, SBS, OAS | DASS21 | Depression correlated with more striving to avoid inferiority (SAIS), r =.52, submissive behavior (SBS), r =.42, shame (OAS), r =.54, and lower social comparison (SCS), r =-.45. |
| *Harder, Cutler, Rockart (1992) | 71 undergraduates | Both | College aged | ASGS Shame | SCL-90-R Depression | Shame proneness correlated with depression, r =.38. |
| *Harder & Lewis (1987) | 120 undergraduates | Both | College aged | Single item rating of shame-proneness (and other shame measures with poor psychometric characteristics) | BDI | Shame proneness correlated with depression, r =.50 |
| *Harder & Zalma (1990) | 63 undergraduates | 59% male | M =18.46 | ASQS Shame Proneness, PFQ-2 Shame | BDI | Depression correlated with ASGS Shame, r =.39 and PFQ2 Shame, r =.41. Shame was more closely related to depression than was guilt. |
| Hoblitzelle (1987) | Undergraduates Study 1 n =71 Study 2 n =124 |
Both | College aged | ASGS Shame | Study 1: SDS Study 2: SDS, BDI |
Study 1: Shame correlated with depression, r =.42 Study 2: Shame correlated with depression (SDS r =.57, BDI r =.44). |
| *Horowitz et al. (1988) | 103 outpatients | 14% male | 20-64; M=32.7 | IIP | SCL-90-R Depression | Submissiveness correlated with depression, r =.35, but submissiveness was not more elevated than other interpersonal problems on the IIP. |
| *Kasser & Ryan (1993), Study 2 | 198 students | Both | M =20 | Aspiration Index | CESD | High aspirations for financial success, r =.24, and low aspirations for affiliation, r =-.21, were related to higher depression. |
| *Mehrabian & Bernath (1991) | Undergraduates Study 1 n =124 Study 2 n =129 |
Both | College aged | PAD Do | 29 measures of depression and anxiety | Submissiveness was related to depression in both samples. |
| Sturman & Mongrain (2008) | 146 graduate students with a history of major depression | 28% male | Median =28 | SCS | SCID diagnoses of major depressive disorder telephone interviews at 16 month follow-up to assess depressive recurrence | Low perceptions of social comparison were related to more previous depressive episodes (SCID), r =-.30, but did not predict depressive recurrence at follow-up. |
| *Tangney et al. (1992) | Undergraduates Study 1 n =245 Study 2 n =234 |
Both | College aged | SCAAI, TOSCA | SCL-90 Depression scale, BDI | Shame proneness (SCAAI, TOSCA) related to depression (SCL-90, BDI). |
| Troop & Baker (2008) | 74 white-color office personnel | Females | M =24.6 | SCS, SBS | BDI-II | Depression correlated with submissive behavior (SBS), r =.58 and perceptions of poor social comparison (SCS), r =-.55. |
| Vittengl et al. (2003) | 118 patients with major depressive disorder | 25.4% male | M =42.73 | IIP | Baseline clinical diagnosis of major depressive episode | Most IIP subscales were elevated at baseline; after recovery from depression, only Submissiveness remained elevated. |
| *Wright et al. (1989) | 100 undergraduates | 38% male | College aged | ASGS Shame | SDS | Shame correlated with depression, r =.48 |
| Wyatt & Gilbert (1998) | 113 undergraduate students | 22% male | M =24.88 | OAS, SCS, SBS | CESD | Depression correlated with submissive behavior (SBS), r =.35, shame (OAS), r =.54, and low perceived social comparison (SCS), r =-.48. |
| Biological Findings in Males | ||||||
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| Barrett-Connor, von Mühlen, & Kritz-Silverstein (1999) | 856 community residents | Males | 50-89 | Serum available T | BDI | Men with high depression scores had T levels 17% lower than those with lower depression scores. |
| *Booth et al. (2003) | 315 boys in working and middle class families | Males | 6-18; M =13 | AM saliva total T, adjusted for sampling time variability, pubertal status | Adolescents: CESD Children: CDI | Lower T related to depression only among boys with poor parent relationships. |
| *Booth et al. (1999) | 4,393 military veterans | Males | M =37 | AM serum T | DIS | In the lower range of T (< 590), deficits in T were related to higher depression rates. |
| Colangelo et al. (2007) | 1246 community residents (525 black; 721 white) | Males | < 40; M =35 | AM serum T; CAG, a gene encoding for androgen receptor function | CESD | No main effects of T. Among African American men only, low T related to depression among those with a polymorphism of the CAG gene. |
| *Dabbs et al. (1990) | 5236 US military veterans | Males | M =37 | Serum T | DIS number of depressive symptoms | T was unrelated to depression. |
| Delhez, Hansenne, & Legros (2003) | 153 community members | Males | 50-70 | AM serum free T | CRS | T was correlated with lower depression, r =-.17. |
| *Granger et al. (2003) | 106 students | Males | M =13.66 | Saliva T gathered three times per day on multiple days to model latent constructs for mean T level and diurnal variation | Anxiety-depression score derived from CBCL, YSR, and DISC | Lower T and T that decreased more slowly across the day were related to higher anxiety–depression among boys. |
| Loizides et al. (2004) | 638 hypogonadal men | Males | M =52.7 | Testim T replacement tmt for 30 days | Daily ratings of positive and negative mood | T was related to less negative mood and more positive mood over time. |
| McNicholas et al. (2003) | 208 hypogonadal men | Males | 31-80 | Testim T replacement tmt compared low dose T patch | Self-ratings of positive and negative mood | Although tmt groups did not differ in mood at the end of treatment, only Testim produced significant increases in positive mood and decreases in negative mood. |
| Morsink et al. (2007) | 1406 well-functioning elderly men who were not taking steroids | Males | 70-79 | Serum total and free T assessed after an overnight fast | CESD | Those with total T levels in the lower quartile had higher depressive symptoms. |
| *Nottelmann et al. 1987 | 56 students | Males | 9-14 | AM serum T | CBCL | T was unrelated to depression. |
| Okun et al. (2002) | 5 hypogonadal patients with Parkinson's disease | Males | 59-87 | T replacement tmt | Clinical interview after 1-4 months of treatment | T replacement tmt was related to improvement in depressed mood. |
| Schmidt et al. (2004) | 31 participants with no psychiatric history | Males | M =30.8 | All received Lupron, a medication that induces hypogonadalism. After 1 month, men were randomly assigned to receive T replacement tmt or placebo. | BDI | Among men taking Lupron, about 10% developed depressive symptoms. Within those prescribed Lupron, depression scores were significantly lower in the tmt group than the placebo group. |
| Seidman et al. (2001) | 1000 community residents | Males | 48-79; M =62.6 | Average of two AM serum total T assays; polymorphic CAG repeat region resides on exon 1 of the androgen receptor gene | CES-D | Lower T was associated with depression only among men with the shorter CAG RLs. Depression scores were particularly elevated for men in the lowest quintile of the T distribution. |
| Seidman et al. (2002) | Participants who met DSM-IV criteria for major depressive disorder (N=13) or dysthymic disorder (N=32) and a comparison group (N=175) from a community representative sample | Males | ≥ 60 | Average of two AM serum total T assays | SCID, CESD | The dysthymic disorder group had lower T levels (295 ng/dl) than the major depressive disorder (425 ng/dl) and no depression groups (423 ng/dl). |
| Seidman et al. (2009) | 23 men with dysthymic disorder and low T | Males | 40-65 | Randomly assigned to receive T replacement tmt or placebo for 40-48 days | HDRS 21 item version | Those receiving T replacement tmt had lower depression scores at 6 weeks than did those receiving placebo. |
| Shamlian & Cole (2006) | Review of androgen supplement trials in older men | Males | Older men | Wide range of androgen tmt | varied | Six of 8 open trials had positive results, and 5 of 12 randomized trials had positive results. |
| Shores et al. (2004) | 278 community members with no prior depressive disorder | Males | ≥ 50; M =62.6 | Total T < or ≥ 2.5ng/mL. Assay methods not described. | ICD-9 depression diagnoses | Hypogonadal men had an increased rate of depressive illness (18.5%) compared to men with normative T (10.4%) in the two years after baseline |
| Shores et al. (2005) | 748 men receiving medical care through the VA system with no prior depressive illness recorded | Males | ≥ 45; M =67.1 | 294 hypogonadal men compared to men with T in the normative range | ICD-9 depression diagnoses | Low T predicted higher rates of depressive diagnosis over the next two years (21.7%) compared to normative T levels (7.1%). |
| *Susman et al. (1991) | 56 students | Males | 10-15 | Serum T assays averaged across 3 samples | CBCL Internalizing Problem Behavior Scores, DISC number of depression symptoms | T was unrelated to depression. |
| T'Sjoen et al. (2005) | 283 community members | Males | 70-85 | AM serum total T; AR CAG repeat length | GDS measured over 4-year follow-up | Depression was unrelated to T at baseline or follow-up. |
| Wang et al. (2004) | 123 hypogonadal adults | Males | M =51.4 | T replacement tmt for 42 months | Diaries of mood | Positive and negative mood scores improved rapidly with T tmt, and mood gains were sustained for one year. |
| Zitzmann et al. (2006) | 434 andrological outpatients | Males | 50-86 | AM free and total T | Self-reported depression | Low total T was related to higher depression: 15% of men with total T levels < 10 reported depression symptoms. |
| Biological Findings in Females | ||||||
| *Booth et al. (2003) | 214 working and middle class participants | Females | 6-18; M =13 | AM saliva total T, adjusted for sampling time variability, pubertal status | CESD CDI | Low T was related to depression only among those girls ages 14-18 with poor father–daughter relationship quality. |
| Erdinçler et al. (2004) | 74 depressed and nondepressed outpatients | Females | > 60 | Serum T gathered without regard to time of day | GDS, clinical interview to assess DSM-IV depression | T was unrelated to depression. |
| *Granger et al. (2003) | 107 adolescents | Females | M =13.66 | AM saliva three times per day for three days to model latent constructs for T mean level and diurnal variation | Anxiety-depression scale based on latent modeling of CBCL, YSR, and DISC | T was unrelated to depression. |
| Haren et al. (2007) | 244 African Americans | Females | 45-69; M =56.9 | Serum total T | CESD | T was unrelated to depression. |
| Morsink et al. (2007) | 1449 well-functioning participants; those taking steroids or with total T >130 ng/dl were excluded. | Females | 70-79 | Free T assessed after an overnight fast | CESD | T correlated negatively with depression. |
| *Nottelmann et al. 1987 | 52 students | Females | 9-14 | AM serum T | CBCL | T was unrelated to depression. |
| Schmidt et al. (2002) | Community participants Study 1 n =42 Study 2 n =50 |
Females | 40-55; M =48 | Plasma samples gathered at various times of day for total T, free T | SCID, SADS-L, CESD to assess onset of minor or major depression after menopause | T was unrelated to depression. |
| *Susman et al. (1991) | 52 students | Females | 9-14 | Serum T assays averaged across 3 samples gathered in an hour | CBCL Internalizing scores, and DISC number of depression symptoms | T was unrelated to depression. |
Note. ASGS =Adapted Shame and Guilt Scale; BDI =Beck Depression Inventory; CBCL =Child Behavior Checklist; CDI =Children's Depression Inventory (Kovacs, 1981); CESD =Center for Epidemiological Studies Depression Scale; CRS =Carroll Rating Scale for Depression (Carroll, 1981); DASS21 =Depression, Anxiety and Stress Scale (Lovibond & Lovibond, 1995); DIS =Diagnostic Interview Schedule; DISC =Diagnostic Interview Schedule for Children; DSM-IV =Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (APA, 1994); ELES =Early Life Experiences Scale (Gilbert et al., 2003); GDS =Geriatric Depression Scale(Yesavage, 1991); GHQ-28 =General Health Questionnaire-28 item version (Goldberg & Hillier, 1979); GOI =Goal Orientation Inventory (Dykman, 1998); HCA =Hypercompetitive Attitudes Scale (Ryckman et al., 1990); HDRS=Hamilton Rating Scale for Depression (Hamilton, 1967); ICD-9-CM =International Classification of Diseases, 9th Revision, Clinical Modification (US US DHHS, 1991); IIP =Inventory of Interpersonal Problems; K-SADS =Schedule of Affective Disorders and Schizophrenia for School-Aged Children; OAS =Other as Shamer Scale (Allan, Gilbert, & Goss, 1994; Goss, Gilbert, & Allan, 1994); PAD Do =Pleasure-Arousal-Dominance Scales Dominance Subscale; PFQ-2 =Personal Feelings Questionnaire-Revised; PSE =Present State Examination (Cooper, 1977); SADS-L =Schedule of Affective Disorders and Schizophrenia-Lifetime Version (Spitzer & Endicott, 1979); SAIS =Striving to Avoid Inferiority Scale (Gilbert, Broomhead, et al., 2007); SBS =Submissive Behavior Scale; SCAAI =Self-Conscious Affect and Attribution Inventory (Tangney et al., 1988); SCID =Structured Clinical Interview for DSM Diagnoses; SCL-90 =Symptom Checklist-90 (Derogatis, Lipman, Rickels, & al, 1974); SCL-90-R =SCL-90-Revised (Derogatis & Lazarus, 1994); SCS =Social Comparison Scale; SDS =Self-Rating Depression Scale (Zung, 1965); SES =socioeconomic status; STAI =State-Trait Anxiety Inventory (Spielberger, Gorsuch, & Lushene, 1970); T =testosterone; tmt = treatment; TOSCA =Test of Self-Conscious Affect; YSR =Youth Self Report (Achenbach, 1991c).
*
Findings from this study are described in another table.