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What You Can Change _. And What You Can't - Martin E. Seligman [145]

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and Harold Zullow. See J. Kuhl, “Motivational and Functional Helplessness: The Moderating Effect of State-Versus Action-Orientation,” Journal of Personality and Social Psychology 40 (1981): 155–70; H. Zullow, “The Interaction of Rumination and Explanatory Style in Depression.” Master’s thesis, University of Pennsylvania, 1984; and Nolen-Hoeksema, Sex Differences in Depression.

10. M. McCarthy, “The Thin Ideal, Depression, and Eating Disorders in Women,” Behaviour Research and Therapy 28 (1990): 205–15.

11. J. Girgus, S. Nolen-Hoeksema, M. Seligman, G. Paul, and H. Spears, “Why Do Girls Become More Depressed Than Boys in Early Adolescence?” Paper presented at the meeting of the American Psychological Association, San Francisco, August 1991.

12. S. Hollon, R. DeRubeis, and M. Evans, “Combined Cognitive Therapy and Pharmacotherapy in the Treatment of Depression,” in D. Manning and A. Frances, eds., Combined Pharmacotherapy and Psychotherapy in Depression (Washington, D.C.: American Psychiatric Press, 1990), 35–64. In one well-publicized study, eleven patients who responded well to imipramine took the drug continuously for five years, and only one became depressed. Of nine patients given a placebo, five became depressed. See D. Kupfer, E. Frank, J. Perel, et al., “Five-Year Outcome for Maintenance Therapies for Recurrent Depression,” Archives of General Psychiatry 49 (1992): 769–73. This suggests that if antidepressant drugs work for you and curtail depression, stay on them even when you’re feeling fine, to prevent recurrence.

13. For a review of the effectiveness of ECS, see M. Fink, Convulsive Therapy: Therapy and Practice (New York: Raven Press, 1979). There is now a whole journal, Convulsive Therapy, devoted to ECS. For a cautious view, see J. Taylor and J. Carroll, “Current Issues in Electroconvulsive Therapy,” Psychological Reports 60 (1987): 747–58. For recent findings, see D. Devanand, H. Sackeim, and J. Prudic, “Electro-convulsive Therapy in the Treatment-Resistant Patient,” Psychiatric Clinics of North America 14 (1991): 905–23.

14. A. Beck, Cognitive Therapy and the Emotional Disorders (New York: New American Library, 1976), 233–62.

15. The basic reference to the NIMH collaborative study is I. Elkin, M. Shea, J. Watkins, S. Imber, et al., “National Institute of Mental Health Treatment of Depression Collaborative Research Program: General Effectiveness of Treatments,” Archives of General Psychiatry 46 (1989): 971–82. The reader should be warned that this is still a guild “hot potato” and that even now the data are disputed and are in the process of being reanalyzed.

The latest findings are about recurrence: M. Shea, I. Elkin, S. Imber, et al., “Course of Depressive Symptoms over Follow-up,” Archives of General Psychiatry 49 (1992): 782–87; and M. Evans, S. Hollon, R. DeRubeis, et al., “Differential Relapse Following Cognitive Therapy and Pharmacotherapy for Depression,” Archives of General Psychiatry 49 (1992): 802–8. Both of these major studies find that cognitive therapy fares better than drug treatment (which is tapered off during follow-up) on preventing recurrence of depression. But there is still considerable recurrence even in the cognitive-therapy groups, with drugs showing about 50 percent recurrence over two years and cognitive therapy about 30 percent recurrence.

16. Elkin et al., “National Institute of Mental Health Treatment of Depression Collaborative Research Program,” 971–82.

17. G. Klerman, M. Weissman, B. Rounsaville, and E. Chevron, Interpersonal Psychotherapy of Depression (New York: Basic Books, 1984).


CHAPTER 9 The Angry Person

1. Developed by Charles Spielberger in collaboration with G. Jacobs, R. Crane, S. Russell, L. Westberry, L. Barker, E. Johnson, J. Knight, and E. Marks. I have selected the trait-anger questions, inverting some of the scoring of the negatively worded items for easy self-scoring.

2. R. Ardrey, The Territorial Imperative (New York: Atheneum, 1966).

3. J. Hokanson, “The Effects of Frustration and Anxiety on Aggression,” Journal of Abnormal Psychology 62 (1961):

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