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

Background: The psychological literature concerned with the aetiology and maintenance 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 study aims to create a single framework of psychosocial depression concepts based on the opinions of key original theorists. Method: A quantitative integration of depression factors was conducted. Ninety-nine factors were identified from 27 theories. Fourteen of the original theorists sorted the factors into groups using a card sort task. Results: Thr re-way multidimensional scaling (MDS) produced a four-dimensional solution with high explained variance and low stress. Dimension one describes cognitions resulting in a lack of positive intrapersonal and interpersonal communication. Dimension two emphasises behaviours and the impact of environmental stressors. Dimension three describes the individual's pursuit of unrealistic goals and a perceived lack of control. Finally, Dimension four describes concepts relating to self-focus and self-reinforcement. Limitation: future research could examine clinicians and depressed individuals' understandings of the literature. Conclusions: the MDS solution identifies the original theorists' collective understanding of the literature. Clinicians could usefully employ the framework to identify the underlying psychosocial themes involved in depression. Moreover the study highlights the need for clinicians to consider the relationships between different conceptual areas in order to challenge the chronic nature of the depressive experience and the high rates of relapse. (C) 2001 Elsevier Science B.V. All rights reserved.