Functional deficits in the self and depression in widows

Abstract

AbstractThis study addressed the role of deficits in the organization of the self, or narcissistic pathology, among widows who evidenced depressive outcomes following the loss of their husbands. The significance of object representations and self-regulatory capacities (introjects) within the self-representation in predicting psychiatric status in a sample of 77 widows 1 year after spousal loss was examined. In addition, the link between functional deficits within the self and observable state markers of such deficits as they related to depression was investigated. A combination of projective and self-report measures were used to assess self and object representation. The General Health Questionnaire (Goldberg & Hillier, 1979) and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) (Spitzer & Williams, 1985) were employed as measures of psychiatric disorder. Analyses revealed that functional aspects of self representations, or introjects, differentiated clinically depressed widows from those experiencing “normal” mourning. However, object representations were relatively weak predictors of depression following bereavement and evidenced little association with self representation. Observable markers of self-pathology were strongly related to functional impairments in the self but did not operate causally to predict depressive outcome. Theoretical and clinical implications of the linkage between functional deficits in the self and depression are discussed.