Beck Depression Inventory-Second Edition Scores Research Articles

Cognitive Behavioral Therapy for Depression Integrating Malaysian Culture: A Case Illustration

This clinical case assessed the efficacy of cognitive behavioral therapy (CBT) in treating major depressive disorder in a 26-year-old female, Sara, attributing her depression to pregnancy, financial constraints, parental duties, and emotional stress. Sara had eight sessions of CBT, during which her symptoms were measured using the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory-Second Edition (BDI-II). Sara’s depressive symptoms dramatically decreased after the intervention, moving her HAM-D and BDI-II scores from moderate to mild depression and from clinically depressed to mild, respectively. The assessment showed improved interest, concentration, energy levels, and a more positive self-perception. Integrating Malaysian cultural elements into CBT, emphasizing family support, community engagement, and spirituality positively impacted Sara. This study emphasizes the value of culturally appropriate CBT for depression as it can help with symptom management, challenging negative thoughts, and bolstering self-esteem. This method identifies and addresses cultural impacts on mental health, recommending the incorporation of cultural aspects in therapy, enhancing relapse prevention and quality of life for Malaysians experiencing depression.

Effects of lactotripeptide ingestion and physical activity intervention on the fatigue status of middle-aged and older adults: a randomized controlled trial

This randomized controlled trial aimed to investigate the effects of eight weeks of lactotripeptide (LTP) ingestion, physical activity (PA) intervention, and combined intervention on the fatigue status of middle-aged and older adults. A total of 78 middle-aged and older adults (63 ± 8 years of age) were randomly assigned to four groups: placebo, LTP, placebo with PA intervention (placebo + PA), and LTP with PA intervention (LTP + PA). All participants ingested the placebo or LTP tablets daily (three tablets/day). The placebo + PA and LTP + PA groups participated in a weekly supervised exercise class and were instructed to increase their moderate- to vigorous-intensity PA at home. The visual analog scale, Brief Fatigue Inventory, Profile of Mood States second edition (POMS2), and Beck Depression Inventory second edition (BDI-II) were administered before and after the intervention. No significant interactions or main effects were observed between LTP ingestion and PA intervention on any of the fatigue scales. The main-effect analyses revealed that the PA intervention improved the total mood disturbance score of the POMS2 (F = 5.22, P = 0.03) and BDI-II score (F = 4.81, P = 0.03). After the post hoc paired comparisons, the total mood disturbance and BDI-II scores improved more with the combined intervention than with the PA intervention alone (percentage difference between the effect of combined intervention and PA intervention alone was 3.7% for total mood disturbance score and 13.7% for BDI-II score). The present study suggests that eight weeks of LTP ingestion and PA intervention did not have a significant effect on fatigue status. However, the PA intervention improved mood status and depressive symptoms, and these effects were enhanced by LTP ingestion.

Health-related quality of life in Japanese patients with multiple sclerosis.

Neurological disabilities, especially physical issues, can adversely affect the daily lives of people with multiple sclerosis (MS) and negatively impact their health-related quality of life (HRQOL). On the other hand, physical and psychiatric symptoms are variable in people with MS, and QOL can be influenced by cultural and educational background. This study aimed to evaluate the association of HRQOL with disabilities, fatigue, and depression in Japanese subjects with MS. Evaluation of HRQOL, fatigue, and depression was performed in 184 Japanese individuals with MS, using the Functional Assessment of MS (FAMS), Fatigue Severity Scale (FSS), and Beck Depression Inventory-Second Edition (BDI-II), respectively. Multiple linear regression analysis demonstrated negative correlations of the Expanded Disability Status Scale (EDSS) with scores on the FAMS subscales of mobility, symptoms, thinking and fatigue, total FAMS, and additional concerns. The FSS score had negative correlations with mobility, symptoms, emotional well-being, thinking and fatigue, total FAMS, and additional concerns. There were negative correlations between BDI-II scores and all items of FAMS. HRQOL had relatively close correlations with disabilities and fatigue, and depression had an especially close relationship with HRQOL.

Depression, anxiety and quality of life of hemodialysis patients before and during the COVID-19 pandemic

ObjectiveTo investigate the impact of the coronavirus pandemic on mental health in hemodialysis patients, we assessed depression, anxiety and quality of life with valid mental health measures before and after the start of the pandemic. MethodsData were used from 121 hemodialysis patients from the ongoing prospective multicenter DIVERS-II study. COVID-19 related stress was measured with the Perceived Stress Scale – 10, depression with the Beck Depression Inventory – second edition (BDI-II)), anxiety with the Beck Anxiety Inventory (BAI) and quality of life with the Short Form – 12 (SF-12). Scores during the first and second COVID-19 wave in the Netherlands were compared to data prior to the pandemic with linear mixed models. ResultsNo significant differences were found in BDI-II, BAI and SF-12 scores between before and during the pandemic. During the first wave, 33% of participants reported COVID-19 related stress and in the second wave 37%. These patients had higher stress levels (mean difference (MD) 4.7 (95%CI 1.5; 8.0), p = 0.005) and BDI-II scores (MD 4.9 (95%CI 0.7; 9.0), p = 0.021) and lower SF-12 mental component summary scores (MD -5.3 (95%CI -9.0, −1.6), p = 0.006) than patients who did not experienced COVID-19 stress. These differences were already present before the pandemic. ConclusionThe COVID-19 pandemic does not seem to influence mental health in hemodialysis patients. However, a substantial subgroup of patients with pre-existent mental health problems may be more susceptible to experience COVID-19 related stress.

Evaluation of the Psychometric Properties of the Persian Version of Children's Depression Inventory in Iranian Adolescents.

Objectives: Children's Depression Inventory (CDI) is a self-report tool for measuring depression in children and adolescents. In this study, the psychometric properties of the Persian version of CDI were investigated in an Iranian adolescent population. Methods: This study was conducted on a sample of 480 adolescent boys and girls in the age range of 12-18 years. The results showed that 23.6% of the study population were 11-13 years old, 62.1% were 14-16 years old, and 14.3% were 17-18 years old. Also, 48.5% of the sample were girls, and 51.5% were boys. To investigate the convergent and divergent validity, Beck's Depression Inventory-Second Edition (BDI-II) and Teenage Inventory of Social Skills were used, respectively. Results: The reliability coefficient of CDI, based on Cronbach's alpha, indicated the relatively high internal consistency of the items (0.907). The results of the exploratory factor analysis showed that CDI has a saturated factor, explaining 50.11% of the variance in the data. Also, goodness-of-fit indices of confirmatory factor analysis showed that the model is well suited for explaining depression. The present results also showed a negative correlation between children's depression and the social skills subscale and a positive correlation between children's depression and BDI-II score. Conclusions: The construct validity of the questionnaire was confirmed. It can be concluded that the Persian version of CDI has adequate reliability and validity. Therefore, it can be used as a useful tool for early screening of depression in adolescents due to its easy use and specific design for children and adolescents.

Improvement in social anxiety following a return-to-work intervention for patients with depression.

Purpose:To retrospectively examine depression and social anxiety improvement in patients on sick leave due to depression who participated in a return-to-work intervention (RTW-I) program.Methods:Patients visited a psychiatric outpatient clinic simulating workplaces to learn recurrence prevention skills through RTW-Is, including group cognitive behavioral therapy, from April 1, 2013, to September 30, 2017. The Beck Depression Inventory-Second Edition (BDI-II), Social Adaptation Self-Evaluation Scale (SASS), and Liebowitz Social Anxiety Scale (LSAS) scores of 112 patients were analyzed before and after the intervention program. Missing postprogram data were substituted using the last observation carried forward scores. Next, 45 patients who responded to the work continuity survey 1 year after RTW-I were categorized into Group A (patients who continued working: 37) and Group B (those who did not continue: 8).Results:The mean BDI-II scores significantly decreased from preintervention 19.4 to postintervention 7.9 (t = 13.303, P < .001). The mean SASS scores significantly increased from preintervention 31.9 to postintervention 36.0 (t = −5.953, P < .001). The mean LSAS scores significantly decreased from preintervention 54.7 to postintervention 37.0 (t = 8.682, P < .001), and all scores demonstrated an improvement. Patients who continued working showed improved depressive and social anxiety symptoms. The BDI-II and SASS scores showed no significant differences between the groups, but the postintervention LSAS scores were significantly different (P = .041). LSAS score changes: Group A = −26.2; Group B = −9.8; estimated difference: −17.920, 95% CI: −32.181 to −3.659, P = .015.Conclusions:The RTW-I program improved depressive and social anxiety symptoms. Patients with improved scores continued working for 1 year after the intervention.Trial registration: This trial was retrospectively registered with the UMIN Clinical Trial Registry (UMIN-CTR) (ID: UMIN000037662) on August 10, 2019.

Internet-based treatment for depressive symptoms in hemodialysis patients: A cluster randomized controlled trial

ObjectiveTo investigate the effectiveness of a guided internet-based self-help intervention for hemodialysis patients with depressive symptoms. MethodChronic hemodialysis patients from nine Dutch hospitals with a depression score on the Beck Depression Inventory – second edition (BDI-II) of ≥10, were cluster-randomized into a five modules guided internet-based self-help problem solving therapy intervention or a parallel care-as-usual control group. Clusters were based on hemodialysis shift. The primary outcome depression was measured with the BDI-II. Analysis was performed with linear mixed models. ResultsA total of 190 hemodialysis patients were cluster-randomized to the intervention (n = 89) or control group (n = 101). Post-intervention measurement was completed by 127 patients (67%) and more than half of the patients (54%) completed the intervention. No significant differences were found on the BDI-II score between the groups (mean difference − 0.1, 95%CI -3.0; 2.7, p = 0.94). Per protocol sensitivity analysis showed comparable results. No significant differences in secondary outcomes were observed between groups. ConclusionsGuided internet-based self-help problem solving therapy for hemodialysis patients with depressive symptoms does not seem to be effective in reducing these symptoms as compared to usual care. Future research should examine how to best design content and accessibility of an intervention for depressive symptoms in hemodialysis patients. Trial registrationDutch Trial Register: Trial NL6648 (NTR6834) (prospectively registered 13th November 2017).

Correlation of the symbol digit modalities test with the quality of life and depression in Japanese patients with multiple sclerosis

Background: This study aimed to evaluate the association between cognitive impairment and health-related quality of life (HRQOL), fatigue, and depression in Japanese patients with multiple sclerosis (MS). Methods: The Brief International Cognitive Assessment for MS (BICAMS) was performed in 184 Japanese patients with MS. The Functional Assessment of MS (FAMS), Fatigue Severity Scale (FSS), and Beck Depression Inventory-Second Edition (BDI-II) were used to evaluate HRQOL, fatigue, and depression, respectively. Results: Multiple linear regression analysis demonstrated positive correlations of the Symbol Digit Modalities Test (SDMT) with the scores on the FAMS subscales of mobility, symptoms, emotional well-being, and additional concerns and with the total FAMS score even after controlling for the Expanded Disability Status Scale score, age at examination, and duration of education. The SDMT score in the BICAMS battery had negative correlations with the BDI-II score, as revealed by multiple linear regression analysis. None of the three tests in the BICAMS had any correlation with the FSS score. Conclusion: The SDMT has a significant relationship with HRQOL and depression in Japanese patients with MS.

Predictors of Health-Related Quality of Life in Patients with Ankylosing Spondylitis in Southwest China.

PurposeThe purpose of this study was to evaluate health-related quality of life (QoL) and explore its predictors in patients with ankylosing spondylitis (AS) in Southwest China.Patients and MethodsWe recruited AS patients from a tertiary hospital in Chengdu, China. Data were collected by self-reported questionnaires, including sociodemographic and disease-related variables, the Medical Outcomes Study 36-Item Short Form (SF-36), Beck Depression Inventory-Second Edition (BDI-II), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global score (BAS-G). Stepwise multiple linear regression analysis was used to determine the factors affecting physical component summary (PCS) and mental component summary (MCS) of SF-36.ResultsA total of 125 patients with AS were included in the current study. The PCS, MCS scores of SF-36 were 41.06±9.12, 47.82±9.84, respectively. Stepwise multiple linear regression analysis showed that higher educational level (β=0.237, P<0.001) and income (β=0.141, P=0.017), lower BASDAI (β=−0.195, P=0.006), BASFI (β=−0.317, P<0.001) and BAS-G (β=−0.288, P<0.001) scores were associated with higher PCS scores of SF-36. Higher BDI-II (β=−0.444, P<0.001) and fatigue (β=−0.293, P<0.001) scores were associated with worse MCS scores of SF-36.ConclusionAS patients in Southwest China had impaired health-related QoL. Healthcare providers should take effective strategies to modify the factors affecting health-related QoL, which may prompt disease management and increase QoL.

Predicting prognosis for adults with depression using individual symptom data: a comparison of modelling approaches.

This study aimed to develop, validate and compare the performance of models predicting post-treatment outcomes for depressed adults based on pre-treatment data. Individual patient data from all six eligible randomised controlled trials were used to develop (k = 3, n = 1722) and test (k = 3, n = 918) nine models. Predictors included depressive and anxiety symptoms, social support, life events and alcohol use. Weighted sum scores were developed using coefficient weights derived from network centrality statistics (models 1-3) and factor loadings from a confirmatory factor analysis (model 4). Unweighted sum score models were tested using elastic net regularised (ENR) and ordinary least squares (OLS) regression (models 5 and 6). Individual items were then included in ENR and OLS (models 7 and 8). All models were compared to one another and to a null model (mean post-baseline Beck Depression Inventory Second Edition (BDI-II) score in the training data: model 9). Primary outcome: BDI-II scores at 3-4 months. Models 1-7 all outperformed the null model and model 8. Model performance was very similar across models 1-6, meaning that differential weights applied to the baseline sum scores had little impact. Any of the modelling techniques (models 1-7) could be used to inform prognostic predictions for depressed adults with differences in the proportions of patients reaching remission based on the predicted severity of depressive symptoms post-treatment. However, the majority of variance in prognosis remained unexplained. It may be necessary to include a broader range of biopsychosocial variables to better adjudicate between competing models, and to derive models with greater clinical utility for treatment-seeking adults with depression.

Evaluation of factors affecting health-related quality of life in patients treated for oral cancer

This study aimed to clarify the health-related quality of life (HRQOL) of patients with oral cancer and elucidate the factors that affect HRQOL. The participants were 14 male and 10 female patients who underwent definitive surgery. The patients' mean age was 68.2 years. A total of 21 oral cancer cases (87.5%) were in the early stages (stages 0-II), and 15 (62.5%) to tongue cancer. This study's assessments were conducted using HRQOL questionnaires (e.g., the SF-8 and EORTC QLQ Head&Neck35(QLQ-H&N35)) and the Beck Depression Inventory—second edition (BDI-II) along with evaluations of speech, mastication, and swallowing function. The evaluations were performed before surgery and one month, three months, and six months after surgery. There was no significant change in the SF-8 and BDI-II scores during the study period. However, the scores for pain, speech problems, social contact, and coughing within the QLQ-H&N35 significantly increased post-surgery. Furthermore, significant correlations were observed between almost all SF-8 scores and some QLQ-H&N35 scores. Speech intelligibility and masticatory and swallowing functions were significantly correlated with speech problems, social eating, and swallowing within the QLQ-H&N35. These results indicate that disease-specific and site-specific HRQOL decline as a result of oral dysfunction.

Predicting mood decline following temporal lobe epilepsy surgery in adults.

To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy. Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was requested from four epilepsy surgery centers across North America (n=100). All data were combined to develop a final model to predict postoperative mood decline (N=592). Internal validation with bootstrap resampling was performed. A clinically significant increase in depressive symptoms was defined as a 15% increase in Beck Depression Inventory-Second Edition score and a postoperative raw score>11. Fourteen percent of patients in the Cleveland Clinic cohort and 22% of patients in the external cohort experienced clinically significant increases in depressive symptoms following surgery. The final prediction model included six predictor variables: psychiatric history, resection side, relationship status, verbal fluency score, age at preoperative testing, and presence/absence of malformation of cortical development on magnetic resonance imaging. The model had an optimism-adjusted c-statistic of .70 and good calibration, with slight probability overestimation in higher risk patients. Clinicians can utilize our nomogram via a paper tool or online calculator to estimate the risk of postoperative mood decline for individual patients prior to temporal lobe epilepsy surgery.

A Cross-sectional Study of Attention Bias for Facial Expression Stimulation in Patients with Stroke at the Convalescence Stage.

Post-stroke depression increases the likelihood of adverse physical symptoms. Attentional bias (AB) for negative stimuli is important in depression onset, maintenance, and remission. Stroke is more likely in older adults, who can have reduced cognitive function. Individuals with mild cognitive impairment (MCI) can have delayed reaction times (RTs). We hypothesized that RT to select neutral facial expression is affected by depressive symptoms and cognitive function in patients with stroke. This study analyzed 61 patients with stroke. Beck Depression Inventory-Second Edition (BDI-II) and Profile of Mood States (short version) scores were determined. Task stimuli comprised eight pairs of facial expressions containing affective (angry) and neutral faces. AB was measured as the RT to select the neutral face in two simultaneously presented images using attention bias modification (ABM) software. Patients were grouped according to depressive symptoms using BDI-II scores. Between-subject factors of depressive symptoms and cognitive function were determined by ANCOVA. No significant interaction was found between depressive symptoms and cognitive function on RT. There was a main effect of cognitive function, but not depressive symptoms. In patients with hemiparesis and depressive symptoms, RT was significantly shorter in patients without MCI compared with patients with MCI. People with stroke and elevated depression symptoms with hemiparesis but without MCI quickly selected neutral facial expressions from neutral and aversive expressions, and thus do not need ABM to escape aversive stimuli. ABM in response to aversive stimuli may be useful in evaluating negative emotions in individuals with post-stroke depression without MCI.

P0939THE ASSOCIATION BETWEEN MUSCULAR STRENGTH, MUSCLE MASS AND DEPRESSION IN KIDNEY TRANSPLANT RECIPIENTS: A CROSS-SECTIONAL ANALYSIS

Abstract Background and Aims While kidney transplantation (Ktx) offers several advantages in terms of improved clinical outcomes and quality of life compared to dialysis modalities, depressive symptoms are still present in approximately 25% of patients, rates comparable to that of the hemodialysis population. Correlates of depressive symptoms include marital status, income, and kidney function, history of affective illness, malnutrition, and inflammation. The aim of this study was to evaluate possible correlations between nutritional status evaluated through body mass composition parameters, muscle strength and depression in kidney transplant recipients (KtR). Method 115 KtR, 61 (53 %) men and 54 (47 %) women, aged 59.3 (range 25 - 83) years were included. For each patient data about duration after Ktx, duration of dialysis before Ktx, age, gender, body weight and height were collected and body mass index (BMI) was calculated. Tanita MC780 Multi Frequency segmental body composition analyser was used to measure content of body fat, muscle mass, and visceral fat each study subject measured in kilograms (kg) and percentage (%.) Peripheral muscle strength of KtR was measured by using a standardized handgrip dynamometry protocol. The Beck Depression Inventory-Second Edition (BDI-II) was used as an indicator of the severity of depression. Results Out of all 115 KtR patients, according BDI-II score 25 (21.7 %) were depressed; 15 (13 %) had mild, 6 (5.2 %) moderate and 4 (3.5 %) severe depression. Significantly negative correlations between BDI-II scores (higher score – more depressive symptoms) and muscle mass (kg and %) was found (R=-0.205, P=0.032), (R=-0.278, P=0.003), respectively. Therefore, significantly positive correlations between BDI-II scores (higher score – more depressive symptoms), fat mass (%) and age was found (R=-0.24, P=0.012), (R=-0.231, P=0.013), respectively. Those KtR patients with more depressive symptoms (higher BDI-II score) had statistically lower muscle strength (R=-0.205, P=0.032). Significantly correlation between duration after Ktx and duration of dialysis before Ktx with BDI-II score was not found. Conclusion Prevalence rates for depression in this study is similar with previous reports and results have shown that depressive KtR patients were older and had significantly lower muscle mass and muscle strength and significantly higher fat mass content. Possible explanation for this findings might be that depression in KtR is associated with unhealthy behaviours including lower activity levels and worse dietary habits, which may in turn impact body mass composition parameters and upon transplant-related outcomes. Efforts to detect and treat depression should be a priority if one is to improve treatment and dietary adherence, quality of life, and outcomes in KtR.

Factor structure and gender invariance of the Beck Depression Inventory – second edition (BDI-II) in a community-dwelling sample of adults

ABSTRACT Objective: The main purpose of this study was to investigate the factor structure of the Beck Depression Inventory – Second Edition (BDI-II) in a sample of adults. Specifically, we evaluated the BDI-II based on confirmatory factor analysis of different measurement models, and compared the optimal factor structure of the BDI-II by gender using measurement invariance analysis. Method: A cross-sectional survey with 717 community-dwelling adults was conducted. The Brazilian Portuguese version of the BDI-II was administered. Seven different models (one-, two-, three-factor models and their bifactor structures) were tested through CFA. CFA and multigroup analysis were executed with the software MPLUS (Weighted Least Squares Estimator – WLSMV). Results: Four bifactor models reached acceptable fit indices. A bifactor model with two specific factors (Cognitive–Affective, and Somatic-Affective) provided the best fit to the data. The multigroup analysis of this model demonstrated invariance by gender. Conclusions: Our findings support the use of the total BDI-II score to identify depressive symptoms, including gender comparisons. Since a bifactor structure fit the data better, the scores of the specific factors should not be used as the first choice, or at least should be used with caution. The analysis of the severity of depression, based on a total score, seems to be the most appropriate option.

Early Maladaptive Schemas, Depression Severity, and Risk Factors for Persistent Depressive Disorder: a Cross-sectional Study.

To investigate associations of the five early maladaptive schemas (EMS) domains with depression severity by comparing patients with persistent depressive disorder (PDD), patients with major depressive disorder (MDD), and controls with no psychiatric disorders. Patients with PDD (n = 30), patients with MDD (n = 24), and controls with no psychiatric disorders (n = 30) were recruited. Participants were assessed using the Mini-International Neuropsychiatric Interview 5.0 version (MINI), the Beck Depression Inventory-Second Edition (BDI-II), and the Young Schema Questionnaire-3rd Edition Short Form (YSQ-S3). The five EMS domains (YSQ-S3 score) significantly correlated with depression severity (BDI-II score), with correlation coefficients ranging from 0.583 to 0.788. After controlling for age, education, and sex, the two best predictors of depression severity were domains 'over-vigilance and inhibition' and 'disconnection and rejection'. For domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition, the total YSQ-S3 score was significantly higher in the PDD group than both the MDD and control groups. For the domain of impaired limits, the total YSQ-S3 score was significantly higher in both the PDD and MDD groups than the control group. All five EMS domains correlated significantly with depression severity. PDD and MDD differed in psychopathology. The EMS domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition may be specific risk factors for PDD.

Association of daily physical activity with cognition and mood disorders in treatment-naive patients with early-stage Parkinson's disease.

To determine the association of daily physical activity with cognition, mood disorders, and olfactory function in treatment-naive patients with early-stage Parkinson's disease (PD). The study subjects were 52 treatment-naive patients with early-stage PD (< 80years). Daily physical activity was measured using a wearable sensor with a built-in triaxial accelerometer, and its association with cognition [mini-mental state examination (MMSE), clock-drawing test (CDT), frontal assessment battery (FAB), and behavioral assessment of the dysexecutive syndrome (BADS)], depressive symptoms [Beck Depression Inventory-Second Edition (BDI-II)], apathy [Starkstein Apathy Scale (AS)], and olfactory function [Odor Stick Identification Test for the Japanese (OSIT-J)] was analyzed using multiple linear regression after adjustment for age, sex, and education status. The daily physical activity (0.42 ± 0.11m/s2) of the PD group was significantly lower than that of healthy controls (p < 0.001). Moreover, the daily physical activity of the PD group was significantly associated with FAB (β = 0.337, p = 0.027) and BADS (β = 0.374, p = 0.017) scores, but not with MMSE, CDT, BDI-II, AS, and OSIT-J scores. The daily physical activity is significantly reduced in treatment-naive patients with early-stage PD, and the low activity correlates with frontal/executive function.

The Relationships Between Cognitive Reserve and Psychological Symptoms: A Cross-Sectional Study in Healthy Individuals

ObjectivesLow levels of cognitive reserve (CR), depressive symptomatology, and apathy are considered risk factors for cognitive decline. The aim of this study was to explore the relationships between these factors across the lifespan in healthy adults. MethodsThis study included 429 Italian participants with no cognitive impairment, divided in three age subgroups: young adults, adults, and elderly. Participants were categorized as having low- or high CR based on the median of the Cognitive Reserve Scale, a self-rated questionnaire evaluating engagement in several leisure and social activities. Depressive symptomatology and severity of apathy were assessed by the Beck Depression Inventory – second edition (BDI-II) and the Dimensional Apathy Scale (DAS), respectively. Analysis of variance and regression served to explore the association between CR, apathy, and depression in the whole sample and in the three age subgroups. ResultsThe analyses of variance and regression analyses revealed that DAS was associated with I-CRS scores in all age groups, as people with high levels of lifetime CR showed a lower level of apathy, whereas no association was found between BDI-II and I-CRS scores. ConclusionLifetime CR is associated with levels of apathy, but not of depressive symptomatology. Low CR is strongly associated with high levels of apathy and might indicate the need for psychoeducational interventions in order to prevent development of cognitive deterioration.

Role of coping with negative emotions in cognitive behavioral therapy for persistent somatoform pain disorder: Is it more important than pain catastrophizing?

Cognitive behavioral therapy (CBT) is known to be effective for patients with persistent somatoform pain disorder (PSPD). Improvement of negative emotions in interpersonal stressful situations has been reported to reduce PSPD-related clinical pain. However, these associations in CBT remain unclear. Therefore, we examined the relation between changes in negative emotions and clinical pain symptoms after CBT by using a multiple regression analysis that included pain catastrophizing. We analyzed negative emotional intensity scores in stressful situations of 38 patients with PSPD who had completed CBT treatment and all the daily worksheets. Negative emotional intensity scores were recorded in daily worksheets during 12 weekly CBT sessions. Scores for the Pain Catastrophizing Scale (PCS), Visual Analogue Scale (VAS) as clinical pain intensity, Beck Depression Inventory - Second Edition (BDI-II), and State-Trait Anxiety Inventory (STAI) were also obtained at pre- and post-treatment. A multiple regression analysis was conducted using changes in VAS scores after CBT as the dependent variable, and changes in negative emotional intensity, PCS, BDI-II, and STAI scores after CBT, age, and sex as independent variables. Negative emotional intensity scores decreased after CBT. In a multiple regression analysis, the emotional changes resulting from CBT depicted a modest positive relation with changes in VAS scores (β = 0.37; P < 0.05); however, there was no relation between changes in PCS scores after CBT and changes in VAS scores after CBT (β = 0.03). The results show that negative emotions play an important role in the treatment effects of CBT for PSPD.

Demographic, Cannabis Use, and Depressive Correlates of Cannabis Use Consequences in Regular Cannabis Users.

Regular cannabis users experience cannabis-related consequences across many domains of functioning. The present study examined demographic, cannabis use, and depressive correlates of cannabis consequences. We hypothesized that (1) earlier onset of use would predict greater psychological and functional consequences; and (2) women would endorse more psychological and withdrawal consequences. Data were collected from an urban sample of 184 adults who reported regular cannabis use. Seventeen items from a cannabis consequence checklist were grouped into three domains: Psychological Consequences, Cannabis Withdrawal, and Functional Consequences. Three multiple regressions were performed to explore demographic and cannabis use correlates of each domain. Correlations between domains and depressive symptoms were assessed using Pearson's r. Greater endorsement on the Psychological Consequence subgroup was predicted by female sex, lower educational attainment, and treatment-seeking history for cannabis abuse/dependence. Individuals with greater number of quit attempts or treatment-seeking history endorsed more items in the Cannabis Withdrawal domain. Although the model failed to reach significance for Functional Consequences, age at onset of regular and daily cannabis use were negatively associated with this domain. Correlational analyses demonstrated higher Beck Depression Inventory-Second Edition scores were related to greater endorsement of Psychological Consequence and Cannabis Withdrawal items. Regular cannabis users report consequences of use, which can be grouped into content-specific subgroups. Individual characteristics are differentially associated with these subgroups. Understanding which individual characteristics are related to cannabis use sequelae could help identify those at risk for greater consequences, thus leading to improved assessment and treatment interventions. (Am J Addict 2019;28:295-302).