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In psychiatric and clinical psychological literature much attention has been paid to subtyping the heterogeneous group of depressed patients. Perhaps best known are the dependent or sociotropic and the self-critical or autonomous subtypes of depression proposed by Sidney Blatt and Aaron Beck, derived from psychoanalytic and cognitive-behavioral theory. This poster concentrates on Blatt's theory.
From the 1970s on, Blatt formulated a theory that distinguishes the two subtypes (for an overview, see Blatt 1998, 2004). Dependent depressed patients are characterized by preoccupation with interpersonal issues such as trust, caring, intimacy, and sexuality; their depression is frequently triggered by object loss, and they often make suicidal gestures. Self-critical depressed patients are primarily preoccupied with establishing and maintaining a sense of self, issues of autonomy and control, and other- or self-directed aggression; the latter form of aggression is obvious in their focus on self-worth and failure and in their frequent serious suicide attempts. As Blatt (1998) notes, “Introjective patients are more concerned with establishing, protecting and maintaining a viable self-concept than they are about the quality of their interpersonal relations and achieving feelings of trust, warmth and affection” (p. 731). The strengths of this theory are its clinical roots (i.e., psychoanalytic case studies that illustrate the clinical relevance of distinguishing the two subtypes) and the fact that the theory has engendered a line of empirical research. This research provides evidence that documents the validity of the distinction, and has led to insights into depression that are of interest to scholars and clinicians outside of psychoanalysis. The instrument Blatt developed to assess dependency and self-criticism is the Depressive Experiences Questionnaire (DEQ). His theory has also elicited criticisms, one of which we address in this poster—the assertion that Blatt's categorical