Affective Distress as a Central and Organizing Symptom in Depression: Psychological Mechanisms

As discussed in the Introduction of this volume, clinical depression presents as a multifaceted but coherent pattern of symptoms.1 This coherency is more than a construction in the minds of psychopathology researchers. Multivariate statistical procedures confirm that a general set of cognitive, affective, behavioral, and vegetative symptoms tend to cooccur as clusters in depressive episodes (Blashfield & Morey, 1979; Eaton, Dryman, Sorenson, & McCutcheon, 1989; Grove & Andreason, 1989). Experienced in isolation, each of these symptoms is capable of generating significant distress and dysfunction. However, when experienced in combination, their cumulative impact is felt as a maelstrom that soon spirals the depressed individual into feelings of futility and despair (Karp, 1996).