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.).