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The utility of care: Behavioral decision analysis and the development of depression

Published online by Cambridge University Press:  31 October 2008

Elizabeth J. Costello*
Duke University Medical Center
Address correspondence and reprint requests to: Elizabeth J. CostelloBox 3454, Duke University Medical Center, Durham, NC 27710.


The development of vulnerability to depression is examined from the point of view of one area of cognitive and affective functioning, the processing of information about the future. Drawing on research into how people make choices in an uncertain world, this article reviews how depression affects people's judgments about the relative utility, or subjective value, of different outcomes, and about the relative probability of those outcomes. A developmental model is proposed which suggests that children learn that some people are willing to incorporate into their own utility ordering for different outcomes the utility structure of the child–that is, to care about the child. The role of lack of perceived care in the development of depression is reviewed, and suggestions are made for applications of decision analytic methods to some critical questions concerning the role played by judgments about the future in the development of vulnerability to depression.

Research Article
Copyright © Cambridge University Press 1989

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