Dependency: Self-Esteem—Clinical Depression

[This is one of a series of papers from the NIMH-Clinical Research Branch Collaborative Program on the Psychobiology of Depression, which deal with theoretical and methodologic issues in the study of the causes and nature of depression. The Collaborative Program was established in 1971 by the Institute to encourage the development of new theory and to enhance the pace of biological and clinical research on this important public health problem. The

1. * The authors constitute the membership of a task force on the relationship of personality to affective disorders, which is part of the National Institute of Mental Health, Clinical Research Branch, Collaborative Program on the Psychobiology of Depression.

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investigators currently involved in the planning of collaborative research are focusing on critical etiologic hypotheses and descriptive phenomenology, and specifically, on the roles of biochemistry, genetics, environment, and personality in the development and expression of the affective disorders. Because of the complexities of the “personality” issue in depression (i.e., competing schools and methodologies), a special task force was appointed to assess the state of theory in that field, and to evolve recommendations concerning promising research strategies. One facet of their work, based on an analysis of the current literature and their articulation of the critical concepts and methods, is presented in this paper.]

For over 50 years the role of dependency has dominated the discussion of the psychogenetic factors which predispose an individual to become clinically depressed. The theories that have attempted to explicate the relationship between dependency and depression have been based largely on the study of a single case or a few cases observed during the course of intensive psychotherapy. However, efforts to frame the relationship in the form of testable hypotheses applicable to larger populations have