General Hospital Psychiatry.
(September-October 1999), 21,382-385
Could Implantable Cardioverter Defibrillators
Provide a Human Model Supporting the Learned Helplessness Theory
of Depression?
Mark Goodman, Ph.D. and Brian Hess, M.A.
Abstract: Affective symptoms were examined retrospectively
in 25 patients following placement of implantable cardioverter
defibrillators (ICD) which can produce intermittent shocks without
warning in response to cardiac ventricular arrhythmias. The
number if ICD random, uncontrollable discharge shocks and pre-ICD
history of psychological distress (i.e., depression and/or anxiety)
were documented in all patients using a demographics questionnaire
and a standardized behavioral/psychological symptoms questionnaire
(i.e., Symptom Checklist-90 Revised). ICD patients were dichotomized
into two groups: those without a history of psychological distress
prior to ICD (N=18) and those with a history of psychological
distress prior to ICD (N=7). In ICD patients without a prior
history, results indicated that quantity of ICD discharge shocks
was significantly predictive of current reported depression
(r = 0.45, p = 0.03) and current reported anxiety (r = 0.51,
p = 0.02). Conversely, in patients with a reported history of
psychological distress, there was no significant relationship
found between quantity of discharge shocks and current reported
depression or anxiety. This study may provide evidence in support
of a human model of learned helplessness in that it supports
the notion that exposure to an unavoidable and inescapable aversive
stimulus was found to be related to patients’ reported
depression. Further studies may wish to prospectively consider
a larger sample as well as a more comprehensive assessment of
premorbid psychological symptoms.
University of Medicine and Dentistry of New Jersey-SOM,
West Orange, New Jersey (M.G.) and Department
of Educational Psychology, Research and Measurement, The University
of Georgia, Athens, Georgia (B.H.).
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