Chapter 11
Persistent Depressive Disorder (Dysthymia) and Its Treatment
James P. McCullough Jr.,
Sarah W. Clark,
James P. McCullough Jr.
Search for more papers by this authorSarah W. Clark
Search for more papers by this authorJames P. McCullough Jr.,
Sarah W. Clark,
James P. McCullough Jr.
Search for more papers by this authorSarah W. Clark
Search for more papers by this authorBook Editor(s):Dean McKay,
Jonathan S. Abramowitz,
Eric A. Storch,
Dean McKay
Search for more papers by this authorJonathan S. Abramowitz
Search for more papers by this authorEric A. Storch
Search for more papers by this authorSummary
Dysthymia was introduced in DSM-III as a form of chronic depression, while DSM-III-R added a second diagnostic category for chronic depression and labeled it chronic MD. Persistent depression disorder (PDD) is maintained by two pathological core problems the patient has not been able to resolve. First core problem is a pervasive fear avoidance state which stems from a history of early developmental maltreatment. Second core problem is the perceptual disconnection from the interpersonal environment patients brings to treatment, which suggests that others do not have any informing influence on the patient's behavior. One distinctive feature in the role of therapist of the cognitive behavioral analysis system of psychotherapy (CBASP) is disciplined personal involvement (DPI), a therapist role grounded in Kieslerian interpersonal theory. CBASP assumes that chronic depression is a lifetime disorder similar to diabetes and hypertension. In a manner similar to diabetes and hypertension, PDD can be managed as patients learn to control their chronic mood state.
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