Refining diathesis-stress models of depression or introducing ptolemaic epicycles? Commentary on Santor.
Work guided by diathesis-stress models of depression has not been as productive or clinically relevant as hoped. Santor (this issue) suggests some promising refinements of these theories. He proposes more of a contextual focus and addresses temporal instability in presumed diatheses. However, if carelessly applied, the innovations he proposes risk being so accommodating of diverse findings as to be unfalsifiable. Santor also suggests that the selection of coping strategies may be the means by which personality mediates between life events and subsequent depression; though reasonable, this elaboration too can lead to formulations immune to data. Other issues are raised concerning the distinction between fluctuations and disturbances in mood, the role of a history of depression, and operationalization of life events. One immediate solution to some of the problems inherent in this research may be intensive study of more select samples.
Coyne
James C
JC
Department of Psychiatry, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. jcoyne@mail.med.upenn.edu
Thompson
Richard
R