Baseline Levels Of Depressive Symptoms Research Articles

Family Environment, Effortful Control, and Adjustment Among European American and Latino Early Adolescents

The present study examined the independent and interactive relations of effortful control and two family environment variables (parent-adolescent conflict and negative family relations) on the subsequent conduct problems and depressive symptoms of 459 European American and Latino adolescents between the ages of 10 and 14. Hierarchical regression analyses showed that even after baseline levels of conduct problems were taken into account, lower levels of effortful control and poorer family relations were uniquely predictive of more conduct problems 1 year later. A three-way interaction among effortful control, negative family relations, and ethnicity indicated that among European Americans only, effortful control moderated the negative family relations effect. High levels of effortful control protected European American adolescents living in homes characterized by negative family relations from elevated levels of subsequent conduct problems. Contrary to findings for the conduct problems outcome, only baseline levels of depressive symptoms predicted subsequent depressive symptoms.

Baseline Immune Activation as a Risk Factor for the Onset of Depression During Interferon-Alpha Treatment

Major depression has been associated cross-sectionally with increased cell-mediated immune activation but causality has been difficult to establish. This study prospectively investigated the hypothesis that baseline level of immune activation predicts the development of depression during interferon-alpha (IFN-alpha) treatment. Sixteen hepatitis C patients without psychiatric disorder underwent IFN-alpha treatment. Proinflammatory and anti-inflammatory cytokines were determined before starting treatment. Presence of a major depressive disorder (MDD) was assessed at baseline and several times during treatment. Baseline soluble interleukin-2 receptor (sIL-2r), interleukin-6 (IL-6), and interleukin-10 (IL-10) concentrations were significantly increased in the five subjects that developed MDD during treatment compared with those that did not, with standardized effect sizes of 1.08, 1.16, and 1.25, respectively, controlling for marijuana use, cigarette smoking, and baseline level of depressive symptoms. Results suggest that increased immune activation, rather than an epiphenomenon, is a causal risk factor for the development of MDD.

The Effect of a Task‐Oriented Walking Intervention on Improving Balance Self‐Efficacy Poststroke: A Randomized, Controlled Trial

To evaluate the efficacy of a task-oriented walking intervention in improving balance self-efficacy in persons with stroke and to determine whether effects were task-specific, influenced by baseline level of self-efficacy and associated with changes in walking and balance capacity. Secondary analysis of a two-center, observer-blinded, randomized, controlled trial. General community. Ninety-one individuals with a residual walking deficit within 1 year of a first or recurrent stroke. Task-oriented interventions targeting walking or upper extremity (UE) function were provided three times a week for 6 weeks. Activities-specific Balance Confidence Scale, Six-Minute Walk Test, 5-m walk, Berg Balance Scale, and Timed "Up and Go" administered at baseline and postintervention. The walking intervention was associated with a significantly greater average proportional change in balance self-efficacy than the UE intervention. Treatment effects were largest in persons with low self-efficacy at baseline and for activities relating to tasks practiced. In the walking group, change in balance self-efficacy correlated with change in functional walking capacity (correlation coefficient=0.45, 95% confidence interval=0.16-0.68). Results of multivariable modeling suggested effect modification by the baseline level of depressive symptoms and a prognostic influence of age, sex, comorbidity, time poststroke, and functional mobility on change in self-efficacy. Task-oriented walking retraining enhances balance self-efficacy in community-dwelling individuals with chronic stroke. Benefits may be partially the result of improvement in walking capacity. The influence of baseline level of self-efficacy, depressive symptoms, and prognostic variables on treatment effects are of clinical importance and must be verified in future studies.

Prospective study of new participants in a community-based mind-body training program.

Mind-body practices such as yoga are widely popular, but little is known about how such exercises impact health-related quality of life. To measure changes in health-related quality of life associated with 3 months of mind-body training as practiced in community-based settings. Prospective cohort study. Eight centers for practice of mind-body training. One hundred ninety-four English-speaking adults who had taken no more than 10 classes at the centers prior to enrollment in the study. One hundred seventy-one (88%) returned the 3-month follow-up questionnaire. Administration of the SF-36 questionnaire at the start of training and after 3 months. At baseline, new participants in mind-body training reported lower scores than U.S. norms for 7 of 8 domains of the SF-36: mental health, role emotional, social, vitality, general health, body pain, and role physical (P <.002 for all comparisons). After 3 months of training, within-patient change scores improved in all domains (P <.0001), including a change of +15.5 (standard deviation +/-21) in the mental health domain. In hierarchical regression analysis, younger age (P=.0003), baseline level of depressive symptoms (P=.01), and reporting a history of hypertension (P=.0054) were independent predictors of greater improvement in the SF-36 mental health score. Five participants (2.9%) reported a musculoskeletal injury. New participants in a community-based mind-body training program reported poor health-related quality of life at baseline and moderate improvements after 3 months of practice. Randomized trials are needed to determine whether benefits may be generalizable to physician-referred populations.

Apolipoprotein epsilon4 allele status, depressive symptoms, and cognitive decline in middle-aged and elderly persons without dementia.

Because the apolipoprotein epsilon4 (APOE-epsilon4) allele or depressive symptoms may increase the risk for development of Alzheimer disease (AD), the authors assessed APOE-epsilon4 status, baseline level of depressive symptoms, and subsequent cognitive decline in middle-aged and older persons without dementia. The 49 subjects (age range: 51-85 years) included 20 with and 29 without APOE-epsilon4. Baseline and follow-up neuropsychological assessments determined the degree of cognitive decline. Baseline mild depressive symptoms were greater in APOE-epsilon4 carriers than in non-carriers. The subject groups demonstrated significant cognitive decline at follow-up. APOE-epsilon4 carriers showed a significantly greater rate of verbal memory decline than non-carriers. Baseline depressive symptoms, however, did not predict future cognitive decline. These results suggest that APOE-epsilon4 carriers may have a greater severity of depressive symptoms than non-carriers. The APOE-epsilon4 allele (but not baseline mild depressive symptoms) is associated with verbal memory decline in middle-aged and older persons. Because of the limited range of depression scores in our sample, these findings should be interpreted with caution and not be generalized to patients with syndromal depression.

Stressful Neighborhoods and Depression: A Prospective Study of the Impact of Neighborhood Disorder

Quantitative and qualitative research suggests that urban disadvantaged environments may be highly stressful to their inhabitants. Social disorganization may be deleterious to both physical and mental health. The relationships among perceptions of one's neighborhood, measures of social support and social integration, and level of subsequent depressive symptoms was examined with a community sample of 818 individuals screened for an HIV prevention intervention, most of whom were current or former drug users. After adjusting for baseline levels of depressive symptoms, perceptions of neighborhood characteristics (vandalism, litter or trash, vacant housing, teenagers hanging out, burglary, drug selling, and robbery) predicted depressive symptoms at a 9-month follow-up interview. Measures of social support and social integration, entered as interactions with neighborhood perceptions, did not buffer the effect of neighborhood perceptions. However, CES-D scores at follow-up for frequent church attendees were lower. The data support theories of social disorganization and social stress and suggest the need for structural intervention.

Depressive symptoms and smoking cessation among inner-city African Americans using the nicotine patch

This study examined the relationship between depressive symptoms and smoking cessation among a sample of inner-city African American smokers using the nicotine patch. Analyses were conducted on data from a previous randomized trial that tested the effects of culturally sensitive vs. standard self-help quitting materials. The study sample consisted of 498 African American smokers (mean age = 42.95, SD = 10.40; 60% female) recruited from a large hospital. Participants in both groups received 8 weeks of nicotine replacement therapy. Level of smoking, quit status, and depressive symptoms (Medical Outcomes Survey Short Depression Screen) were assessed at baseline, week 4 (mid-treatment), and 6-month follow-up. Analyses that controlled for randomization group generally did not support the hypothesis that baseline levels of depressive symptoms predict smoking at Week 4 or Month 6. Cross-sectional analyses at each time point indicated that depressive symptoms were positively associated with smoking level (both: beta = 0.24, p < .05). Changes (increases) in depressive symptoms from baseline to week 4 predicted higher smoking levels at follow-up (beta = 0.19, p < .05). Although the results indicated a significant association between depressive symptoms and level of smoking, they generally did not support the notion that depressive symptoms are associated with failure to quit.

Depressive symptoms and smoking cessation among inner-city African Americans using the nicotine patch

This study examined the relationship between depressive symptoms and smoking cessation among a sample of inner-city African American smokers using the nicotine patch. Analyses were conducted on data from a previous randomized trial that tested the effects of culturally sensitive vs. standard self-help quitting materials. The study sample consisted of 498 African American smokers (mean age = 42.95, SD = 10.40; 60% female) recruited from a large hospital. Participants in both groups received 8 weeks of nicotine replacement therapy. Level of smoking, quit status, and depressive symptoms (Medical Outcomes Survey Short Depression Screen) were assessed at baseline, week 4 (mid-treatment), and 6-month follow-up. Analyses that controlled for randomization group generally did not support the hypothesis that baseline levels of depressive symptoms predict smoking at Week 4 or Month 6. Cross-sectional analyses at each time point indicated that depressive symptoms were positively associated with smoking level (both: beta = 0.24, p < .05). Changes (increases) in depressive symptoms from baseline to week 4 predicted higher smoking levels at follow-up (beta = 0.19, p < .05). Although the results indicated a significant association between depressive symptoms and level of smoking, they generally did not support the notion that depressive symptoms are associated with failure to quit.

The role of rumination in depressive disorders and mixed anxiety/depressive symptoms.

Several studies have shown that people who engage in ruminative responses to depressive symptoms have higher levels of depressive symptoms over time, after accounting for baseline levels of depressive symptoms. The analyses reported here showed that rumination also predicted depressive disorders, including new onsets of depressive episodes. Rumination predicted chronicity of depressive disorders before accounting for the effects of baseline depressive symptoms but not after accounting for the effects of baseline depressive symptoms. Rumination also predicted anxiety symptoms and may be particularly characteristic of people with mixed anxiety/depressive symptoms.