Focusing on situation‐specific expectations in major depression as basis for behavioural experiments – Development of the Depressive Expectations Scale

• DOI: 10.1111/papt.12114
• Publication Date: 2016-12-09T13:46:57Z
• Authors: Tobias Kube; Lisa D'Astolfo; Julia A. Glombiewski; Bettina K. Doering; Winfried Rief
• Keywords: Adult; Male; Psychiatric Status Rating Scales; 2. Zero hunger; Depressive Disorder, Major; Psychometrics; Reproducibility of Results; Middle Aged; Anticipation, Psychological; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female

ObjectivesDysfunctional expectations are considered to be core features of various mental disorders. The aim of the study was to develop the Depressive Expectations Scale (DES) as a depression‐specific measure for the assessment of dysfunctional expectations. Whereas previous research primarily focused on general cognitions and attitudes, the DES assesses 25 future‐directed expectations (originally 75 items) which are situation‐specific and falsifiable.Design and methodsTo evaluate the psychometric properties of the DES, the scale was completed by 175 participants with and without severe depressive symptoms in an online survey. Participants additionally completed the Patient Health Questionnaire modules for depression (PHQ‐9) and anxiety (GAD‐7). People experiencing depressive symptoms were informed about the study with the help of self‐help organizations.ResultsReliability analyses indicated excellent internal consistency of the scale. An exploratory factor analyses revealed four factors: social rejection, social support, mood regulation, and ability to perform. The DES sum score strongly correlated with the severity of depressive symptoms. The DES sum score also significantly correlated with symptoms of generalized anxiety.ConclusionThe DES was shown to have excellent reliability; validity analyses were promising. As the DES items are situation‐specific and falsifiable, they can be tested by the individual using behavioural experiments and may therefore facilitate cognitive restructuring. Thus, a structured assessment of patients’ expectation with help of the DES can provide a basis for interventions within cognitive–behavioural treatment of depression.Practitioner points

Assessing situation‐specific expectations in patients experiencing depressive symptoms can provide a basis for the conduction of behavioural experiments to test patients’ expectations. For the use of behavioural experiments, therapists should choose those dysfunctional expectations which a patient strongly agrees on. To modify patients’ expectations, they should be exposed to situations where the discrepancy between patients’ expectations and actual situational outcomes can be maximized. The Depressive Expectations Scale can be completed repeatedly to monitor a patient's progress within cognitive–behavioural treatment.