Papers by Gregory L Garamoni
Affect intensity and phasic REM sleep in depressed men before and after treatment with cognitive-behavioral therapy
Journal of Consulting and Clinical Psychology, 1994
This article explored the relationship between daytime affect and REM sleep in 45 depressed men b... more This article explored the relationship between daytime affect and REM sleep in 45 depressed men before and after treatment with cognitive-behavioral therapy and in a control group of 43 healthy subjects. The intensity of daytime affect (as measured by the sum of positive and negative affects) in depressed men correlated significantly and positively with phasic REM sleep measures at both pre- and posttreatment. This relationship was not found in healthy control subjects. In depressed men, both affect intensity and phasic REM sleep measures decreased over the course of treatment. The results suggest a relationship between phasic REM sleep and intensity of affect reported by depressed men. On the basis of this preliminary observation, it was hypothesized that abnormalities in phasic REM sleep in depressed patients are related, in part, to fundamental alterations in the intensity of their affective experience.
Journal of Psychopathology and Behavioral Assessment, Sep 1, 1986
Clarifying methodological and assessment issues is fundamental to the further development of cogn... more Clarifying methodological and assessment issues is fundamental to the further development of cognitive-behavioral approaches. The present work examines potential method confounds in several cognitive assessment techniques (e.g., self-statement inventories, postperformance videotape reconstruction) in light of social psychological research on objective self-awareness. On the basis of this analysis, a conceptual framework is proposed to organize research on the assessment of clinical cognition.
Type a behavior pattern and compulsive personality: Toward a psychodynamicbehavioral integration
Clinical Psychology Review, 1986
The present review outlines conceptual and empirically-based similarities between Type A Behavior... more The present review outlines conceptual and empirically-based similarities between Type A Behavior Pattern (TABP) and Compulsive Personality (CP), a correspondence that suggests avenues for further theoretical development and research. Both clinical description and ...
Shifts in affective balance during cognitive therapy of major depression
Journal of Consulting and Clinical Psychology, 1992
... Gregory L. Garamoni, Charles F. Reynolds III, Michael E. Thase, Ellen Frank, and Amy L. Fasic... more ... Gregory L. Garamoni, Charles F. Reynolds III, Michael E. Thase, Ellen Frank, and Amy L. Fasiczka Department of Psychiatry, University ... and confidence interval estimation procedures yielded results consistent with hypotheses derived from the states-of-mind (SOM; Schwartz & ...
Diminished nocturnal penile tumescence in depression: A replication study
Biological Psychiatry, Jun 1, 1992
A descriptive study was conducted in a new sample of 51 men with DSM-III-R research diagnostic cr... more A descriptive study was conducted in a new sample of 51 men with DSM-III-R research diagnostic criteria (RDC) major depression in order to replicate earlier observations that measures of nocturnal penile tumescence (NPT) and penile rigidity are disturbed in depressive states. When compared to both the age-equated patient (n = 34) and normal control (n = 28) groups reported in our 1988 study, the new sample manifested significant abnormalities of NPT and diminished penile rigidity. Such disturbances were not, however, significantly correlated with psychobiological indicators of severe or endogenous depression.
The structural model of positive and negative cognition derives from principles of information pr... more The structural model of positive and negative cognition derives from principles of information processing, intrapersonal comnunication, and cybernetic self-regulation. The model proposes five distinct states of mind quantitatively defined by the proportion of positive to total cognition. A positive dialogue with a set point proportion of .618 plus or minus .06 is considered a functionally optimal balance because of information processing properties that rendf.2r negative events maximally striking. States of mind that deviate from this optimal balance are associated with psychopathology. Specifically, mild dysfunction is characterized by an internal dialogue of conflict with a set point of .500 plus or minus .05 and moderate dysfunction by a negative dialogue with a set point of .382 plus or minus .06. Analyses of 27 studies of normal, anxious, and depressed subjects indicated that the model fit existing data. Insufficient data were available to evaluate the two extreme states of mind--positive monologue (greater than or equal to .69) and negative monologue (lesser than or equal to .31). The states of mind model provides a theoretical and empirical framework for the study of cognitive balance in development, psychopathology, and psychotherapy. (Data tables and graphs are included.) (Author)
Sleep, 1993
The study of nocturnal penile tumescence (NPT) is frequently used to evaluate male erectile dysfu... more The study of nocturnal penile tumescence (NPT) is frequently used to evaluate male erectile dysfunction. Buckling force, a measure of rigidity, is an important part of this evaluation, but its reliability is unknown. Accordingly, we studied the reliability of buckling force measurement and the stability of "maximum buckling force" between consecutive NPT series repeated in the same subject. For individual subjects, we correlated buckling forces for separate episodes of sleep-related tumescence that were of comparable fullness (0-100%) as rated by a technician's visual estimates. For healthy control subjects, test-retest correlations were >0.8 both within-night and across study series separated by an average of 70 weeks. In depressed men, correlations within nights were >0.9, but fell to 0.64 across study series separated by an average of 21 weeks. Despite the high reliability of buckling force measurement, we found little stability of "maximum buckling force" between NPT series for individual subjects. Considerable variability in the maximum degree of penile rigidity was seen over time despite a constant level of reported daytime erectile function. We conclude that although penile rigidity is one of the more important variables in the assessment of male erectile dysfunction and can be measured reliably, the instability of maximum rigidity during sleep-related erections suggests that it is, at best, an imprecise correlate of daytime erectile function.
American Journal of Psychiatry, 1994
Differentiation of stable, trait-like characteristics from more episodic or state-dependent distu... more Differentiation of stable, trait-like characteristics from more episodic or state-dependent disturbances will be helpful in gaining a better understanding of the pathophysiology of depression. However, research in this area has been complicated by artifactual and clinical problems associated with pharmacologic treatment. In this investigation the authors used EEG sleep studies to assess medication-free depressed male patients before and after cognitive behavioral therapy. Forty-five male patients with the diagnosis of major depression according to the DSM-III-R criteria and the Research Diagnostic Criteria underwent EEG sleep studies before and after 16 weeks of cognitive behavioral therapy, during which they were free of medication. In addition to the documentation of changes within these patients, the findings were compared with those for 47 healthy subjects, including 15 who were restudied 12-24 months after their baseline assessments. The EEG sleep profiles of the depressed patients showed a significant reduction in REM sleep density after treatment, suggesting "normalization" of an abnormal state-dependent process. By contrast, slow wave sleep and tonic REM measures, including reduced REM latency, were unchanged after treatment. These findings suggest that early in remission there is disaggregation of irreversible, trait-like correlates of depression (e.g., diminished slow wave sleep and reduced REM latency) from more reversible disturbances (e.g., increased REM density).
American Journal of Psychiatry, 1994
A great majority of the evidence pertaining to the effectiveness of the time-limited psychotherap... more A great majority of the evidence pertaining to the effectiveness of the time-limited psychotherapies as treatments of major depression are derived from studies of either predominantly or entirely female subject groups. Depressed men and women differ in a number of important respects that may alter the course of affective disorder, and as a result, they may also differ in their responses to psychotherapy. In this study the outcomes of 40 men and 44 women treated with cognitive behavior therapy were compared. The patients were interviewed with the Schedule for Affective Disorders and Schizophrenia and diagnosed according to the Research Diagnostic Criteria and DSM-III-R criteria. Subsequently, they were assessed every other week (with the Hamilton Depression Rating Scale, Beck Depression Inventory, and Global Assessment Scale) during a standardized, time-limited cognitive behavior therapy protocol. The outcomes of the men and women were compared by means of a series of analyses of variance and covariance and survival analyses. There were several significant pretreatment differences, and the men attended significantly fewer therapy sessions than the women. Although the men and women generally had comparable responses, patients with higher pretreatment levels of depressive symptoms, particularly women, had poorer outcomes. This study provides further evidence of gender-specific differences in depressed patients' symptoms and treatment utilization. Cognitive behavior therapy appears to be a comparably useful outpatient treatment for men and women. However, either more intensive cognitive behavior therapy or alternative methods of treatment may be warranted for patients with more severe syndromes.
A reformulation of the states of mind model and a related study of euthymic, depressed, and hypomanic states of mind in a nonclinical population
ABSTRACT
Response to cognitive behavior therapy in chronic depression
The Journal of psychotherapy practice and research
ABSTRACT
Abstract: The structural model of positive and negative cognition derives from principles of info... more Abstract: The structural model of positive and negative cognition derives from principles of information processing, intrapersonal communication, and cybernetic self-regulation. The model proposes five distinct states of mind quantitatively defined by the proportion of ...
Toward the standardization of life stress assessment: Definitional discrepancies and inconsistencies in methods
Stress Medicine, 1992
There has been considerable controversy about methods for assessing life stress. However, self‐re... more There has been considerable controversy about methods for assessing life stress. However, self‐report checklists and interview‐based measures (the predominant approaches used in current research) differ in several respects, ranging from basic definitions through theoretical assumptions. Most research comparing these two approaches has focused on global comparisons in predicting disorder, which fail to take into account more specific information on how the methods vary. The present article outlines three stages of assessment for life stress: definition, operationalization, and quantification. Detailed examination of these stages with a sample of depressed patients helps to demonstrate in an explicit manner how self‐report checklists and interview‐based methods differ at successive stages of the measurement process. Data are presented that indicate large endpoint discrepancies attributable to specific differences in the definitional and operational procedures used in the two assessmen...
Correlation of nocturnal penile tumescence and daytime affect intensity in depressed men
Psychiatry Research, 1993
Although depressed patients have been shown to have diminished nocturnal penile tumescence (NPT),... more Although depressed patients have been shown to have diminished nocturnal penile tumescence (NPT), there remains considerable variability of NPT in depression. We hypothesized that affective experience during the day accounts for some of this variability. Forty-five depressed men had assessments of affect intensity and affect balance, NPT, and daytime sexual function, both before and after treatment with Beck's cognitive behavior therapy (CBT). Forty-three normal control subjects were studied for comparison. Daytime affect intensity in depressed men, but not in control subjects, correlated significantly and positively with measures of NPT duration and rigidity both before and after treatment, regardless of the adequacy of daytime sexual function. When the effect of daytime affect on REM activity was controlled, the observed correlations became nonsignificant at pretreatment, but remained significant at posttreatment. Neuropharmacologically mediated changes in arousal responsivity associated with depression may underlie the observed relation between daytime affect intensity, rapid eye movement activity, and NPT.
The balance of positive and negative affects in major depression: A further test of the states of mind model
Psychiatry Research, 1991
The States of Mind (SOM) model provided a framework for assessing the balance between self-report... more The States of Mind (SOM) model provided a framework for assessing the balance between self-reported positive and negative affects in a sample of 39 outpatients with major depression and 43 healthy control subjects. The SOM model proposes that healthy functioning is characterized by an optimal balance of positive (P) and negative (N) cognitions or affects (P/(P + N) approximately 0.63), and that psychopathology is marked by deviations from the optimal balance. Research thus far has focused on the functional significance of cognitive rather than affective balance. Within this framework, we hypothesized that patients in untreated episodes of major depression would balance their positive and negative affects at the same level where depressed patients in other studies have balanced their positive and negative cognitions--namely, at P/(P + N) approximately 0.37. Points and confidence interval (CI) estimation procedures yielded results (mean = 0.35, 95% CI = 0.30 - 0.40) consistent with this hypothesis in a sample of 39 depressed male outpatients. Correlational analysis indicated that affect balance is inversely related to symptom severity as measured by self-report (Beck) and clinician-rating (Hamilton) scales.
Cognitive assessment: A multibehavior-multimethod-multiperspective approach
Journal of Psychopathology and Behavioral Assessment, 1986
Clarifying methodological and assessment issues is fundamental to the further development of cogn... more Clarifying methodological and assessment issues is fundamental to the further development of cognitive-behavioral approaches. The present work examines potential method confounds in several cognitive assessment techniques (e.g., self-statement inventories, postperformance videotape reconstruction) in light of social psychological research on objective self-awareness. On the basis of this analysis, a conceptual framework is proposed to organize research on the assessment of clinical cognition.
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Papers by Gregory L Garamoni