Understanding the Impairment Associated With Depressive SymptomsHanson, Bjorn PhD*†; Young, Michael A. PhD*The Journal of Nervous and Mental Disease: August 2017 - Volume 205 - Issue 8 - p 600–604 doi: 10.1097/NMD.0000000000000644 Original Articles Abstract Author Information Relatively little theory or research has addressed the mediating processes through which depressive symptoms lead to impairment. To conceptualize the nature of impairment in depression, we conducted semistructured interviews of 18 psychiatric patients experiencing depressive symptoms about how their depressive symptoms create impairment. Interviews were audio recorded and transcribed, and thematic analysis methods were used to identify content areas and themes. Three content areas were identified: domains of impairment (types of behavior that are impaired), experience of impairment (nature and severity of impairment), and pathways to impairment (processes connecting symptoms to impairment). Pathways included direct connections between symptom and impairment, as well as indirect pathways mediated by other symptoms and by cognitive responses to symptoms. Patients' examples of the impairment phenomena are presented. In addition, patterns of association were observed between particular pathways and symptom type (vegetative versus cognitive/affective). Increased understanding of clients' explanations for impairment may improve clinical intervention and assessments. *Department of Psychology, Illinois Institute of Technology, Chicago; and †University Health Services, University of Wisconsin-Madison. Send reprint requests to Michael A. Young, PhD, Department of Psychology, Illinois Institute of Technology, 3105 S. Dearborn Avenue, Room 252, Chicago, IL 60616. E-mail: firstname.lastname@example.org. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.