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The structure of the depressive response to stress.

The psychiatric literature dealing with the significance of stress in the causation of depression is reviewed. Definitive studies await the indispensable conceptual tools of a comprehensive theory. The author suggests criteria for distinguishing normal from abnormal despondency, pathogenic from nonpathogenic losses, and stress-induced lowering of self-esteem from stress-released despair of self. These criteria define a structure for coordinating and classifying despondent states in their relationship to stress. The clinical and research utility of the model are suggested.