Baseline Levels Of Depressive Symptoms Research Articles

Moderating Effect of Depression on Glycemic Control in an eHealth Intervention Among Black Youth With Type 1 Diabetes: Findings From a Multicenter Randomized Controlled Trial.

Black adolescents with type 1 diabetes (T1D) are at increased risk for suboptimal diabetes health outcomes; however, evidence-based interventions for this population are lacking. Depression affects a high percentage of youth with T1D and increases the likelihood of health problems associated with diabetes. Our aim was to test whether baseline levels of depression moderate the effects of a brief eHealth parenting intervention delivered to caregivers of young Black adolescents with T1D on youths' glycemic control. We conducted a multicenter randomized controlled trial at 7 pediatric diabetes clinics located in 2 large US cities. Participants (N=149) were allocated to either the intervention group or a standard medical care control group. Up to 3 intervention sessions were delivered on a tablet computer during diabetes clinic visits over a 12-month period. In a linear mixed effects regression model, planned contrasts did not show significant reductions in hemoglobin A1c (HbA1c) for intervention adolescents compared to controls. However, adolescents with higher baseline levels of depressive symptoms who received the intervention had significantly greater improvements in HbA1c levels at 6-month follow-up (0.94%; P=.01) and 18-month follow-up (1.42%; P=.002) than those with lower levels of depression. Within the intervention group, adolescents had a statistically significant reduction in HbA1c levels from baseline at 6-month and 18-month follow-up. A brief, culturally tailored eHealth parenting intervention improved health outcomes among Black adolescents with T1D and depressive symptoms. ClinicalTrials.gov NCT03168867; https://clinicaltrials.gov/study/NCT03168867.

Estimating anticipatory, immediate, and delayed effects of disability registration on depressive symptoms.

This study examines (a) whether disability registration has anticipatory, immediate, and delayed effects on depressive symptoms and (b) how these effects differ by gender. Using data from the Korea Welfare Panel Study spanning over 16 waves between 2005 and 2020, this study employed the individual-level fixed effects models to estimate the trajectories of depressive symptoms before and after the registration of physical disability, for a cohort of 20,054 individuals. Furthermore, gender-stratified fixed effects models were used to examine gender differences. Compared to the preregistration reference period (i.e., 4 or more years before disability registration), there was a sustained rise in depressive symptoms leading up to the year of registration, indicating the presence of anticipatory effects. After disability registration, depressive symptoms consistently remained at a statistically higher level than during the initial reference period, with a gradual return to the baseline level of depressive symptoms over time. These anticipatory, immediate, and delayed effects of disability registration were notably more pronounced among men than women. To develop more effective mental health interventions for people with disability, policymakers should consider gendered trajectories of depressive symptoms before and after disability registration. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How Positive Activities Shape Emotional Exhaustion and Work-Life Balance: Effects of an Intervention via Positive Emotions and Boundary Management Strategies

AbstractThe positive-activity model (PAM) proposes how and for whom positive activity interventions work best. This article evaluates the effectiveness of a web-based self-regulation intervention that teaches participants positive activities. Over six weeks, participants engage in different positive activities to meet the particular challenges in flexible work designs (FWD) such as remote work or mobile work. In line with the PAM, we expected the intervention to decrease emotional exhaustion and increase satisfaction with work-life balance via increases in both positive emotions and boundary management. Moreover, individuals’ depressive symptoms were expected to moderate this relationship. In a randomized controlled trial, participants were assigned to a waitlist control group or an intervention group. Study participants received questionnaires before and after the intervention and at a four-week follow-up. The final sample included 288 participants (intervention group: n = 105; control group: n = 183). Results of mixed variance analyses were in line with our predictions. Findings indicate that the intervention is an effective tool for improving well-being and work-life balance for workers with FWD. Changes in positive emotions and boundary management explained intervention effects. The intervention was effective regardless of participants’ baseline level of depressive symptoms.

Baseline depressive symptoms do not moderate the association between baseline symptom severity and time to recovery in individuals with grade I-II whiplash-associated disorders: A secondary analysis of a randomised controlled trial.

This study investigated the moderating role of baseline depressive symptoms on the association between baseline pain severity and time to recovery in individuals with acute grade I-II whiplash-associated disorders (WAD). This is a secondary analysis of a randomised controlled trial investigating the effectiveness of a government-regulated rehabilitation guideline for the management of grade I-II WAD. Participants who completed baseline questionnaires for neck pain intensity and depressive symptoms and follow-up questionnaire on self-reported recovery were included in the analysis. Cox proportional hazards models were built, and hazard rate ratios were reported to describe the association between baseline neck pain intensity and time to self-reported recovery and to assess the effect modification of baseline depressive symptoms. 303 participants provided data for this study. Despite baseline level of depressive symptoms and neck pain intensity being independently associated with delayed recovery, the association between baseline neck pain intensity and time to recovery was not stronger for individuals with significant post-collision depressive symptoms (HRR = 0.91 (95%CI 0.79-1.04)) than for those without depressive symptoms (HRR = 0.92 (95%CI 0.83-1.02)). Baseline depressive symptoms are not an effect modifier of the association between baseline neck pain intensity and time to self-reported recovery in acute WAD.

Physical activity, sleep and affective wellbeing on the following day: An experience sampling study.

This study aims to investigate the temporal links between physical activity, sleep and affective wellbeing in young adults. In particular, the aim was to examine whether physical activity is associated with sleep indicators in subsequent nights and, in turn, whether sleep was associated with improved affective wellbeing the next morning. Relatedly, moderation by baseline levels of depressive symptoms, sleep quality, habitual physical activity and gender was analysed. One-hundred and forty-seven individuals (85.7% female) aged 18-25 years old participated in an experience sampling study over 14 consecutive days. Participants received seven prompts per day, and answered questions about their physical activity and affective states. Every morning, participants also reported their sleep. Physical activity throughout the day was not related to sleep during the following night or to affective wellbeing the next morning. An exception to that pattern was that physical activity before 14:00 hours was associated with longer subsequent sleep duration. Better subjective sleep quality predicted affective wellbeing the next morning. Associations of physical activity, sleep and affective wellbeing were not moderated by baseline depressive symptoms, sleep quality or habitual physical activity. However, investigation of gender as a moderator revealed that moderate physical activity was associated with better subsequent sleep quality for males, but not for females. Overall, we found that physical activity is associated with better subsequent sleep for males, but not for females. Also, our study provides further evidence that better sleep quality is associated with the next morning's affective wellbeing.

Temporal associations between objectively measured physical activity and depressive symptoms: An experience sampling study.

BackgroundThis study aimed to examine the relationship between the timing of physical activity and within-individual differences in depressive symptoms, positive affect, and negative affect in individuals with different baseline levels of depressive symptoms.MethodsExperience sampling methodology (ESM) was used to measure real-time depressive symptoms, positive affect, and negative affect in a convenience sample of 78 healthy adults (aged M = 25.46 years, SD = 6.18; 57 females) five times per day for 14 days. We measured physical activity throughout the 14 days by using activity sensors. Baseline levels of depressive symptoms were assessed with the PHQ-9 to build subgroups with low vs. mild-moderate depressive symptoms.ResultsPhysical activity predicted decreased depressive symptom levels, negative affect, and increased positive affect. Associations were stronger for individuals with higher baseline levels of depressive symptoms and for physical activity between 0 and 30 min compared to physical activity between 30 and 180 min before the mood rating. Conversely, levels of depressive symptoms, positive and negative affect did not predict physical activity.LimitationsThe convenience sample may not have been representative of the general population or people with depression. Accelerometers may not have detected some types of physical activities such as bicycling. Causality could not be inferred because of the observational study design.ConclusionIndividuals with higher levels of depressive symptoms may benefit from physical activity. While the effects were strongest for physical activity immediately before the mood ratings, the effects were in the same direction for up to 3 h before the mood ratings.

The Role of Delay Discounting in the Generation of Stressful Life Events Across Adolescence.

Hammen's (1991) model of stress generation suggests that depressed individuals are more likely to behave in ways that bring about greater exposure to negative life events. More recent research suggests that adolescents with other types of psychological vulnerabilities, including those more likely to make impulsive choices, may also be predisposed to experience greater increases in stress over time. The current study examined whether delay discounting (DD), defined as the tendency to prefer smaller but immediately available rewards relative to larger, delayed rewards, predicts the generation of negative life events across adolescence and whether this is due to the association between DD and depressive symptoms. Participants (n = 213, Mage = 15, range 12-17) completed self-report measures of depressive symptoms and negative life events, as well as a behavioral measure assessing DD annually over four years. Results of latent growth models suggest that both independent and dependent negative life events increased across adolescence. Consistent with a stress generation framework, DD predicted the growth in dependent, but not independent, negative life events over this time period, controlling for baseline levels of depressive symptoms. Further exploratory analyses suggest that DD was associated with increases in depressive symptomology across adolescence, but that the relation between DD and changes in independent negative life events was not better accounted for by increases in depressive symptoms over time. Taken together, these findings suggest the importance of DD in predicting youths' exposure to dependent negative life events and point to potential avenues for clinical intervention.

Mentoring and depressive symptoms of youth: Examining prospective and interactive associations with mentoring relationship quality.

A significant body of research has demonstrated that mentoring relationships support positive youth development. The quality of the mentoring relationship has been identified as a predictor of positive youth outcomes. However, limited research has examined how engagement in a mentoring program may be related to youth depressive symptoms specifically. The current study utilized a sample of 2003 youth participating in mentoring programs across the country (Mage = 12.32, SD = 1.42, 55.1% female) from diverse racial and ethnic backgrounds (39.1% Black, 23.6% White, 22.1% Hispanic, 3.3% Native American or Alaskan Native, .4% Asian or Pacific Islander, 1.8% other, and 9.7% Multi-Ethnic) to investigate associations between youth depressive symptoms and mentoring relationship quality. Results revealed that: (1) mean depressive symptoms decreased after participation in a mentoring program; (2) several, but not all, relationship quality indicators predicted change in depressive symptoms; (3) baseline levels of depressive symptoms negatively predicted indicators of relationship quality; and (4) associations between several relationship quality indicators and follow-up depressive symptoms differed by baseline levels of depressive symptoms. These findings highlight the potential benefits of mentoring programs to youth and the need to provide mentors with support around building relationships with youth, especially those experiencing depressive symptoms.

Baseline depressive symptoms, personal control, and concern moderate the effects of preoperative psychological interventions: the randomized controlled PSY-HEART trial

This study examined whether baseline (3–14 days pre-surgery) levels of (i) depressive or (ii) anxiety symptoms and (iii) illness beliefs moderate the effects of additional preoperative interventions before coronary artery bypass graft surgery on (i) depressive or (ii) anxiety symptoms and (iii) illness beliefs 1 day before surgery, 1 week and 6 months after surgery. In the PSY-HEART trial, 115 patients were assessed. They were randomized into one of three groups: 1. receiving standard medical care only (SMC), additional psychological interventions: 2. aiming to optimize patients’ expectations (EXPECT), or 3. focusing on emotional support. Patients with a higher baseline level of depressive symptoms receiving a preoperative psychological intervention indicated lower depressive symptoms 6 months after surgery compared to SMC. EXPECT increased personal control and concern levels in patients with low baseline personal control/concern 1 day before surgery. Brief preoperative psychological interventions can improve psychological outcomes in heart surgery patients. Baseline status may moderate these effects. The study has been approved by the medical ethics committee of the Philipps University of Marburg and has been pre-registered at www.clinicaltrials.gov (NCT01407055) on August 1, 2011.

First Acute-Course Electroconvulsive Therapy for Moderate-to-Severe Depression Benefits Patients With or Without Accompanying Baseline Cognitive Impairment.

Researchers are increasingly investigating therapeutic response associated with new patient subgroups as a way to improve electroconvulsive therapy (ECT) treatment outcomes and reduce adverse events. This study is the first to examine baseline cognitive impairment status as a predictor of clinical outcome in first acute-course ECT patients. Baseline cognitive function at various thresholds and serial depressive symptom severity data from first-time ECT patients were examined using generalized linear mixed-effects models. Of 1345 patients who met the inclusion criteria, 617 had available data at their third assessment visit (~15th treatment visit). There was a robust improvement in depression symptoms over time (P < 0.0001), and cognitive function was not associated with baseline levels of depressive symptoms or serially measured change in self-reported symptom severity during acute-phase ECT. These results indicate that an acute course of ECT for the treatment of moderate-to-severe depression benefits patients with or without accompanying baseline cognitive impairment. These findings may be useful in informing shared decision-making discussions about ECT risks and expected benefits.

The longitudinal association of symptom-related and psychological factors with health-related quality of life in patients with chronic pelvic pain syndrome

ObjectiveTo analyze the course of symptom-related measures, psychological variables and health-related quality of life (HRQoL) over a 12-month period, and to longitudinally examine symptom-related and psychological factors as predictors for HRQoL in male and female patients with chronic pelvic pain syndrome (CPPS). MethodsData from 125 patients aged 19–83 years at baseline attending an interdisciplinary outpatient clinic for CPPS were analyzed. Participants completed a self-administered questionnaire on subjective health issues, and a postal follow-up survey was conducted 12 months later. We assessed physical and mental HRQoL, CPPS symptom severity, pain intensity, severity of somatic, depressive and anxiety symptoms, pain catastrophizing, and data on treatments during the follow-up period. Data were analyzed using multilevel linear modelling. ResultsCPPS symptom severity, pain intensity, and pain catastrophizing significantly decreased over time. HRQoL and levels of somatic symptoms, depressive symptoms and anxiety remained stable. Lower baseline levels of somatic symptoms were associated with an increase in physical HRQoL, and lower baseline levels of depressive symptoms, anxiety and pain catastrophizing were associated with an increase in mental HRQoL after 12 months. Treatment utilization was neither related to decrease in CPPS symptom severity, pain intensity and pain catastrophizing, nor to HRQoL after 12 months. ConclusionsOur data suggest that CPPS is related to persistently diminished HRQoL. Somatic symptoms and psychological factors are important determinants of HRQoL and potential therapeutic targets. To evaluate the efficacy and impact of treatment on CPPS-related outcomes, future large-scaled studies should systematically assess detailed data about therapies patients receive in routine care.

The negative impact of COVID-19 on sexual minority young adults: Demographic differences and prospective associations with depression.

Recent studies have demonstrated that the COVID-19 pandemic has contributed to increases in depression for sexual minority people. However, there has been limited attention to whether its negative impact differs across subgroups of sexual minority people or to whether its negative impact is prospectively associated with increases in depressive symptoms. To address these gaps, the present study examined demographic differences in the negative impact of COVID-19 on sexual minority people and whether the negative impact of COVID-19 was associated with increases in depressive symptoms one- and two-months later. A total of 695 sexual minority young adults completed surveys at three time points (baseline, one-month follow-up, and two-month follow-up). Results indicated that younger age, identifying as transgender/gender diverse or as a cisgender woman, and being a full-time student were associated with being more negatively impacted by the pandemic. Furthermore, the negative impact of COVID-19 was associated with higher levels of depressive symptoms at the two-month follow-up. However, this became nonsignificant after adjusting for baseline levels of depressive symptoms, likely due to its strong association with subsequent levels. Findings provide preliminary support for within-group heterogeneity in the negative impact of COVID-19 on sexual minority people and for the negative impact of COVID-19 on mental health in this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement Public Significance Statement-Among sexual minority people, certain groups (e.g., transgender/gender diverse, cisgender women, full-time students) have experienced a greater negative impact of the COVID-19 pandemic than others, and being negatively impacted by the pandemic is associated with worse mental health. Policies and interventions should prioritize minimizing the negative effects of the pandemic on the groups that are most negatively affected. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

The relationship between depression, anxiety, and pain interference with therapy referral and utilization among patients with hand conditions

IntroductionPatients with upper extremity conditions may also experience symptoms of depression, anxiety, and pain that limit functional recovery. Purpose of the StudyThis study examined the impact of mental health and pain symptoms on referral rates to therapy and utilization of therapy services to achieve functional recovery among patients with common hand conditions. Study DesignThis is a retrospective cohort study of patients from one orthopedic center. MethodsData extraction provided demographics, the International Classification of Diseases, 10th revision diagnoses, therapy referral, therapy visit counts, treatment goal attainment, and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Pain Interference scores. The chi-square test, t-test, and logistic regression analyses assessed associations between baseline PROMIS depression, anxiety, and pain interference to therapy referral, the number of therapy visits, and goal attainment. ResultsForty-nine percent (172/351) of patients were referred to hand therapy. There was no relationship between three baseline PROMIS scores based on physician referral (t-test P values .32-.67) and no association between PROMIS scores and therapy utilization or goal attainment (Pearson correlation (r): 0.002 to 0.020, P > .05). Referral to therapy was most strongly associated with having a traumatic condition (P < .01). Patients with high depression, anxiety, and pain interference scores on average required one more therapy visit to achieve treatment goals (average visits: 3.7 vs 3.1; 4.1 vs 2.7; 3.4 vs 2.3, respectively). Fewer patients with high depression scores (50%) achieved their long-term goals than patients with low depression scores (69%, P = .20). ConclusionsPatients' baseline level of depressive symptoms and anxiety do not predict referrals to hand therapy by orthopedic hand surgeons. There is some indication that patients with increased depressive symptoms, anxiety, and pain interference require more therapy with fewer achieving all goals, suggesting that mental health status may affect response to therapy. Therapists may address mental health needs in treatment plans. Future studies should examine if nonreferred patients with depressive symptoms achieve maximal functional recovery.

Relationship between Caregiver Depressive Symptoms and Child Asthma Medication Adherence: A Multilevel Analysis

Abstract Asthma morbidity and mortality are disproportionately higher among African American children. Medication adherence is essential for reducing adverse asthma outcomes in this population. Depressive symptoms, prevalent among mothers of children with asthma, have been linked to medication nonadherence. This longitudinal, multilevel analysis used data from a randomized clinical trial evaluating the efficacy of an environmental control educational intervention to evaluate the relationship between caregiver depressive symptoms (Center for Epidemiologic Studies Depression Scale) and caregiver-reported medication adherence (Medication Adherence Report Scale) in urban African American children with uncontrolled asthma (N = 208) at baseline, in six months, and in 12 months. Nearly a third (31.7%) of caregivers (97% female) had clinically significant depressive symptoms at baseline. A random intercept model showed that the within-caregiver effect of depression predicted lower medication adherence (β = –.079, p = .002) as did time (β = –.413, p &amp;lt; .001); the between-caregiver effect of depression did not (β = –.007, p = .77). Changes in a caregiver’s baseline level of depressive symptoms appear to have a stronger influence on medication adherence than mean level of depressive symptoms. Policy, practice, and further research should address maternal mental health as a key element in the life course of African American children with asthma.

Effects of an intervention on internalized HIV-related stigma for individuals newly entering HIV care.

Considering the association between internalized HIV-related stigma and treatment adherence, an intervention addressing HIV treatment adherence may have the added benefit of reducing internalized stigma. The 'integrating ENGagement and Adherence Goals upon Entry' (iENGAGE) intervention was developed to facilitate adjustment to living with HIV among individuals newly engaged in HIV care. We evaluated the effects of this intervention on internalized stigma and examined whether the effect is moderated by depressive symptoms and coping styles. The iENGAGE intervention was tailored individually to improve information, motivation, and behavioral skills to promote treatment adherence and viral suppression. Three hundred and seventy-one participants initiating HIV care at four sites in the United States were randomly assigned to either the intervention receiving four face-to-face sessions or standard of care control arm. Baseline and 48-week follow-up assessments were conducted, which included validated measures of internalized HIV-related stigma, depressive symptoms, and coping mechanisms (behavioral disengagement and self-blame) as secondary outcomes. A repeated measures ANOVA evaluated the effect of the intervention on change in internalized HIV stigma. Furthermore, the moderating effects of depressive symptoms and coping mechanisms on the decrease in internalized stigma were examined. The decrease in internalized stigma from baseline to 48 weeks was significantly larger in the intervention arm compared with the control arm. This effect was significantly moderated by baseline levels of depressive symptoms and self-blame. The multifaceted iENGAGE intervention is effective in reducing internalized stigma for new-to-HIV care individuals, especially with higher depressive symptoms or when using higher levels of self-blame coping.

Social engagement in late life may attenuate the burden of depressive symptoms due to financial strain in childhood

BackgroundIt remains poorly understood if childhood financial strain is associated with old-age depression and if active social life may mitigate this relationship. AimsTo investigate the association between childhood financial strain and depressive symptoms during aging; to examine whether late-life social engagement modifies this association. Method2884 dementia-free individuals (aged 60+) from the Swedish National study of Aging and Care-Kungsholmen were clinically examined over a 15-year follow-up. Presence of childhood financial strain was ascertained at baseline. Depressive symptoms were repeatedly assessed with the Montgomery–Åsberg Depression Rating Scale. Social engagement comprised information on baseline social network and leisure activities. Linear, logistic and mixed-effect models estimated baseline and longitudinal associations accounting for sociodemographic, clinical, and lifestyle factors. ResultsChildhood financial strain was independently associated with a higher baseline level of depressive symptoms (β = 0.37, 95%CI 0.10–0.65), but not with symptom change over time. Relative to those without financial strain and with active social engagement, depressive burden was increased in those without financial strain but with inactive social engagement (β = 0.43, 95%CI: 0.15–0.71), and in those with both financial strain and inactive engagement (β = 0.99, 95%CI: 0.59–1.40). Individuals with financial strain and active social engagement exhibited similar depressive burden as those without financial strain and with active social engagement. LimitationsRecall bias and reverse causality may affect study results, although sensitivity analyses suggest their limited effect. ConclusionsEarly-life financial strain may be of lasting importance for old-age depressive symptoms. Active social engagement in late-life may mitigate this association.

IS SOCIAL ENGAGEMENT RELATED TO FEWER HOSPITALIZATIONS IN COMMUNITY-DWELLING OLDER ADULTS?

We tested the hypothesis that more socially engaged older adults experience fewer hospitalizations. Data came from 1,153 older adults (72.4% female, mean age 80.8, 14.6 years education at baseline), enrolled in the Rush Memory and Aging Project, with survey data linked to Medicare claims records (mean 5.0 [SD=3.1] years of Medicare coverage after study baseline). Linear regression models were fit with annual rate of hospitalization as outcome with terms for age, sex, and education. Engaging in more social activities (est=-0.16, SE=0.05, p=0.002) and larger life space (est=-0.08, SE=0.03, p=0.005) were associated with a lower rate of hospitalization, while a higher level of loneliness (est=0.18, SE=0.06, p=0.002) was associated with greater rate of hospitalization; size of social networks (est=-0.01, SE=0.01, p=0.069) was not associated with hospitalization. When examined separately by admission type, the same significant associations were found for nonelective (emergency and urgent) hospitalizations, but not for elective hospitalizations. After further adjusting for marital status, baseline levels of depressive symptoms, chronic medical conditions, physical activity, and ADL disabilities, only social activities were significantly related to hospitalization rate (total and nonelective). Adjusting for disability attenuated these associations the most, indicating that functional status may confound the relationship between social engagement and hospitalization. More research is necessary to determine if social engagement in older age can proactively help to keep older adults out of the hospital, or alternatively whether level of social engagement is a marker for functional status or other health factor that is directly related to risk of hospitalization.

INCREMENTAL VALIDITY OF OPTIMISM AND PURPOSE FOR PREDICTING OLDER ADULTS’ DEPRESSIVE SYMPTOMS

After age 60, depressive symptoms tend to increase slowly over time on average across the population. However, individual trajectories vary, with some increasing more steeply, and others remaining stable. A broad array of psychological constructs have been demonstrated to predict depressive symptoms, including neuroticism, extraversion, optimism, and sense of purpose in life. It is important for psychologists to understand which among these factors are the strongest and most robust predictors. A substantial body of research demonstrates that Big Five personality traits are strongly associated with depressive symptoms (e.g., Hakulinen et al., 2015). Optimism and purpose are also associated with well-being (Carver et al., 2009; Pinquart, 2002), but it is not clear whether such associations could be accounted for by Big Five traits, which are also correlated with optimism and purpose. Using data from the Health and Retirement Study (N = 14,021), we tested the incremental validity of optimism and purpose for predicting older adults’ depressive symptoms, controlling for Big Five traits and demographics. A latent growth curve modeling approach allowed us to examine associations with trajectories of depressive symptoms over six waves (approximately 10 years). Results demonstrated that both optimism and purpose are significantly associated with baseline levels of depressive symptoms, over and above the Big Five. However, only Big Five traits were associated with linear and quadratic slope in depressive symptom trajectories. These findings suggest that optimism and purpose are not redundant with Big Five traits for predicting depressive symptoms, and may be valuable targets for intervention efforts.

Supplementary grandchild care, social integration, and depressive symptoms: longitudinal findings from Korea

Objectives Despite growing concerns about the heavy reliance on supplementary grandchild care in Korea, understanding of its longitudinal effects on the grandparents’ mental health has been limited. This study examined whether transition patterns of grandchild care among Korean grandparents were associated with changes in the grandparents’ depressive symptoms, directly or indirectly, through changes in two domains of social integration (intergenerational contact and social activities) after controlling for socioeconomic characteristics and baseline levels of depressive symptoms and social integration. Method Using the Korean Longitudinal Study of Aging (N = 4,362), a nationally representative multiwave survey, we examined four possible statuses of grandchild care over a three-year period: started (n = 64), continuous (n = 73), and discontinued (n = 103) caregiving, and non-caregiving (n = 4,121). The proposed mediation model was analyzed using structural equation modeling with non-caregivers as a reference group, and Wald tests were conducted to further examine differences in the effects across the three caregiving groups. Results The direct effects of grandchild care on depressive symptoms in Korean grandparents were not significant. Rather, those who started or continuously provided caregiving had significantly reduced depressive symptoms via increased intergenerational contact compared to the non-caregiving group. Conclusion These findings indicated beneficial effects of grandchild care on depressive symptoms in Korean grandparents through increased social integration within the family. Implications of the study findings were discussed.

Cognitive fusion and depressive symptoms in women with chronic pain: A longitudinal growth curve modelling study over 12 months

This study aims to (a) explore individual differences in women with chronic pain (CP) in regard to pain intensity, functional impairment, cognitive fusion, and depressive symptoms and (b) longitudinally test whether cognitive fusion is a significant predictor of depression symptoms, while controlling for pain intensity and functional impairment, over a 12-month period. This study follows a longitudinal design and was conducted in a sample of 86 women with CP who responded to an online battery of questionnaires in three equally spaced assessment moments. In order to explore the growth trajectory of variables of interest, latent growth curve models were examined. Also, correlation analyses were conducted between demographic and illness-related variables and depressive symptoms, as well as between all variables in all assessment moments. Cognitive fusion and functional impairment (but not pain intensity) were significantly associated with baseline levels of depressive symptoms. Cognitive fusion significantly predicted the growth trajectory of depressive symptoms, whereas pain intensity and functional impairment did not. No demographic (age, marital status, education, socio-economic) nor illness-related variables (number of CP diagnoses, duration of CP, taking medication) were associated with depressive symptoms at any point. These results suggest that the trajectory of depressive symptoms in women with CP is not predicted by the intensity of pain nor pain-related functional impairment, but rather by the tendency to get entangled with internal experiences (e.g., thoughts, emotions, and physical sensations), which may or may not be related to pain-specific contents. Clinical implications are discussed.