Group Differences In Depression Research Articles

Psychosocial Well-Being Differences Between the Young Old, Old-Old, and Oldest Old: A Global Comparison.

We investigate global differences in psychosocial well-being between older adult age groups. Using multinomial logistic regression, we analyzed 2018 data (n = 93,663) from 9 countries/regions in the Health and Retirement Study international family of studies to compare age group differences in depression, loneliness, and happiness. Compared to the young old, the old-old reported more depression in Southern Europe, while the oldest old had higher risk in India and Southern Europe but lower risk in the United States. The old-old reported less loneliness in the United States but more in Southern Europe, while the oldest old had greater risk in Southern Europe. The old-old reported less happiness in Korea, while the oldest old had lower reports in Korea but higher reports in the United States. The psychosocial well-being of the oldest old is exceptionally good in the United States but exceptionally poor in Southern Europe.

A modified persian version of the self-stigma of depression scale among the Iranian population: a methodological study in 2023

IntroductionThis cross -sectional research evaluated the psychometric properties of the Self-Stigma of Depression Scale (SSDS) among Iranian people.MethodsThis methodological study was conducted among 881 people in 2023, Iran. The method of proportional stratified sampling was used to select participants. To evaluate the validity, face, content, construct, convergent, and discriminant were evaluated. The reliability of SSDS was assessed with the McDonald’s omega coefficient, Cronbach α coefficient, and test– retest (Intraclass Correlation Coefficient).ResultsIn confirmatory factor analysis, the factor loading of all items of SSDS was more than 0.5, and two items had low factor loading. After deleted these items, goodness of fit indexes (such as GFI = 0.945, RMSEA = 0.067, AGFI = 0.917, CFI = 0.941, RFI = 0.905) confirmed the final model with 14 items and four factors of social inadequacy (3 items), help-seeking inhibition (4 questions), self-blame (3 questions), and shame (4 questions). In the reliability phase, for all items of SSDS, Cronbach α coefficient was 0.850, the McDonald omega coefficient was 0.853, and the intraclass correlation coefficient was 0.903.ConclusionThe Persian form of SSDS was approved with 14 items and four factors: social inadequacy, help-seeking inhibition, self-blame, and shame. This tool can be used to check the status of self-stigmatization of depression in different groups.

Global, regional and national burdens of depression in adolescents and young adults aged 10-24 years, from 1990 to 2019: findings from the 2019 Global Burden of Disease study.

Depression is a significant mental health concern affecting the overall well-being of adolescents and young adults. Recently, the prevalence of depression has increased among young people. Nonetheless, there is little research delving into the longitudinal epidemiology of adolescent depression over time. To investigate the longitudinal epidemiology of depression among adolescents and young adults aged 10-24 years. Our research focused on young people (aged 10-24 years) with depression, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We explored the age-standardised prevalence, incidence and disability-adjusted life-years (DALYs) of depression in different groups, including various regions, ages, genders and sociodemographic indices, from 1990 to 2019. The prevalence, incidence and DALYs of depression in young people increased globally between 1990 and 2019. Regionally, higher-income regions like High-Income North America and Australasia recorded rising age-standardised prevalence and incidence rates, whereas low- or middle-income regions mostly saw reductions. Nationally, countries such as Greenland, the USA and Palestine reported the highest age-standardised prevalence and incidence rates in 2019, whereas Qatar witnessed the largest growth over time. The burden disproportionately affected females across age groups and world regions. The most prominent age effect on incidence and prevalence rates was in those aged 20-24 years. The depression burden showed an unfavourable trend in younger cohorts born after 1980, with females reporting a higher cohort risk than males. Between 1990 and 2019, the general pattern of depression among adolescents varied according to age, gender, time period and generational cohort, across regions and nations.

LovesCompany: evaluating the safety and feasibility of a mental health-focused online community for adolescents

Background: Adolescents are at risk for mental health (MH) disorders but are unlikely to seek services and may be reluctant to talk about their MH. An anonymous, online MH-focused community could help reduce suffering. However, online forums can also promote negative behaviours such as cyberbullying. This study aimed to evaluate the safety and feasibility of an online community – LovesCompany – to improve MH outcomes for adolescents. Methods: American adolescents (14–17 years) were recruited through social media. Eligible participants were randomised to LovesCompany or a placebo MH resource site. Outcomes were assessed every other week for six months, and at twelve months. Multilevel models assessed group differences in depression, anxiety, and suicidal ideation. A subgroup of participants participated in qualitative interviews. Results: Participants (N = 202) were mostly female (70%), White non-Hispanic (69%), and cisgender (80%). There were no instances of inappropriate behaviour such as bullying or posting explicit content. Symptoms for both groups improved over time. Participants appreciated hearing others’ experiences and valued the opportunity to offer support. Conclusion: Although adolescents are often resistant to MH treatment, they appear to be interested in anonymous, online, MH-focused conversation, and can benefit from giving and seeking support. Finding a balance between an appealing user experience, ethical considerations, and resource needs is challenging.

Engaging Black youth in depression and suicide prevention treatment within urban schools: study protocol for a randomized controlled pilot

BackgroundDepression continues to be an ongoing threat to adolescent well-being with Black adolescents being particularly vulnerable to greater burdens of depression as well as lower mental health service utilization. Black adolescents are likely to have untreated depression due to social network influences, varied perceptions of services and providers, or self-stigma associated with experiencing depressive symptoms. Furthermore, if or when treatment is initiated, low engagement and early termination are common. To address this gap, a trial is being conducted to preliminarily test the effectiveness of an engagement intervention targeting Black adolescents with depression in school mental health services in New York City.MethodsA total of 60 Black middle and high school adolescents displaying depressive symptoms are equally randomized (based on school site) to the treatment arms. Both trial arms deliver Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), a time-limited, evidence-based treatment for depression. Additionally, one arm pairs IPT-A with a brief, multi-level engagement intervention, the Making Connections Intervention (MCI), involving adolescents, caregivers, and clinicians. Outcomes of interest are group differences in depression and suicide ideation, adolescent and caregiver engagement, and mental health service use.DiscussionThis trial will serve as an efficacy assessment of the MCI among a sample of Black adolescent students with depressive symptoms. Clinical and implementation results will be used to inform future research to further test the MCI intervention in a larger sample.Trial registrationRegistered by ClinicalTrials.gov on May 3, 2019, identifier: NCT03940508.

Predictors of depression: lifestyle choices during the pandemic.

Our study intends to specify the impact of the singular pandemic stressors on the population and also quantify the contribution of different predictors of depression; some of them are stronger than others, and this research shows how the whole effect is divided into single items. This research included a structured online survey using data from 11,340 respondents from six European countries during the first months of the pandemic. The statistical analysis focused on how behavioural patterns appear in different groups of the population and how they mark the psychological wellbeing of these groups with regard to various factors. We targeted social media's role and analyzed the impact of its consumption on symptoms of depression in different groups divided by age and other characteristics. The analysis creates a mosaic of lifestyle choices and other characteristics that manifest different effects on depression inside selected groups whereas several groups generated by the cluster analysis are less vulnerable to their effect than others. Regarding our findings, the perceived reality through information sources and the manner of their processing seems to be more significant than the tangible reality (poor self-reported health correlated with depression more strongly than intrinsic health limitations).

Physical activity and mental health during the COVID-19 pandemic among individuals with amputation.

The isolating nature of various COVID-19 mandates may have reduced physical activity (PA) and increased mental health symptomology among individuals with amputation. However, an investigation of mental health across PA levels before and after the onset of COVID-19 among this group has not been conducted. Therefore, the objective of this study was to investigate group differences in depression, anxiety, and post-traumatic stress symptomology among individuals with amputation who reported being physically "active," "somewhat active," or "inactivate" before and during the pandemic. Individuals with an amputation at any level (n = 91; 51% female; age = 52.5±15.5) completed an online questionnaire to assess demographic information, PA levels, and mental health throughout the pandemic. Group differences in self-reported PA before and after COVID-19 onset were assessed by the PA Guidelines for Americans recommendations. The Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder (GAD-7), and Posttraumatic Stress Disorder Checklist (PCL-5) scales were used to assess group differences in mental health status. Before and after the onset of COVID-19, 33% and 42.9% of respondents reported that they were inactive, respectively. 58.2% of respondents reported decreased PA since the pandemic's onset. Prior to the pandemic, active individuals reported lower CES-D (14.21 vs. 19.07; Cohen's d: -0.414), GAD-7 (3.82 vs. 5.47; Cohen's d: -0.359), and PCL-5 (15.92 vs. 21.03; Cohen's d: -0.319) scores compared to inactive individuals. After the onset of COVID-19, scores remained lower for active respondents CES-D (12.67 vs. 20.03; Cohen's d: 0.-669), GAD-7 (3.17 vs. 5.87; Cohen's d: -0.598), and PCL-5 (13.39 vs. 19.90; Cohen's d: -0.430). Individuals with amputation reported decreased PA after the onset of COVID-19. Individuals reporting that they were "active" exhibited improved depression and anxiety symptomology scores compared to those reporting that they were "inactive."

A RCT of a Psychological Health Promotion Program for Women with SCI:Examining Efficacy and Mechanisms

<h3>Research Objectives</h3> To examine the efficacy of a psychological health promotion group intervention for women with SCI and test mechanisms of change. <h3>Design</h3> Two-group (intervention vs. control) by three times of testing (pre, post, follow-up) randomized controlled trial. <h3>Setting</h3> Online virtual world of Second Life (SL). <h3>Participants</h3> A national sample of 175 women with traumatic SCI who were at least one year post-injury. <h3>Interventions</h3> The 10-week group-based Zest intervention was offered in a private parcel of land in SL. Zest participants, represented as avatars, met weekly for 10 weeks. The program featured didactic information, group discussion, action planning, homework activities, and relaxation training. <h3>Main Outcome Measures</h3> We proposed a model in which the effect of the intervention on primary outcomes (Rosenberg Self-esteem Scale, PHQ-8, and Satisfaction with Life Scale) at T3 (6 month follow-up) would be mediated by the effect of the intervention on proximal outcomes (Generalized Self-efficacy Scale, Perceived Stress Scale, MOS Social Support Scale) at T2 (post-test). <h3>Results</h3> Results of analyses with Zest program completers indicated that women in the Zest intervention group demonstrated greater improvements from T1 (baseline) to T2 (post-test) than control group participants on measures of self-efficacy, stress, self-esteem, depression, and life satisfaction with improvements maintained from T2 to T3. Intent-to-treat analyses produced similar findings, although group differences in depression were no longer significant. In testing our mediational model, we found self-efficacy fully mediated the effect of the intervention on self-esteem and life satisfaction, while perceived stress fully mediated the effect of the intervention on depression. <h3>Conclusions</h3> Group psychoeducational programs that specifically target self-efficacy enhancement and stress management hold promise for improving psychological health among women with SCI. <h3>Author(s) Disclosures</h3> None.

The physical activity profiles of patients with persecutory delusions

BackgroundSevere paranoia is likely to limit engagement in physical activities. In this study we set out to examine for the first time the activity profiles of patients with current persecutory delusions and the associations with psychiatric symptoms. MethodSeventy-five patients with persecutory delusions in the context of non-affective psychosis wore a pedometer for seven days. Participants completed measures of meaningful activity, mobility, and psychiatric symptoms. Latent class analysis was used to identify physical activity profiles. ResultsThree distinct activity profiles emerged: a mobile but inactive group (n = 47, 63%) (mean daily step count = 6453, SD = 3348), an immobile and inactive group (n = 20, 27%) (mean daily step count = 4205, SD = 2442), and a mobile and active group (n = 8, 11%) (mean daily stepcount = 18396, SD = 5715). The groups did not significantly differ in their levels of paranoia, anhedonia, psychological wellbeing, insomnia, beliefs about self or others, or safety-seeking behaviours. There were significant group differences in depression and number of physical health appointments, with the immobile and inactive group showing higher levels of both. There were indications of group differences in body mass index, hours worked, hallucinations, and worry. ConclusionThere are likely to be different physical activity profiles for patients with current psychotic experiences. The majority of people with persecutory delusions are physically inactive, but a small minority are highly active. In those patients who have low activity levels, there is a potentially important distinction in self-reported mobility, which warrants further investigation. Treatments designed to improve physical activity levels may need to tailor by activity profile.

Mobile Health Intervention Promoting Physical Activity in Adults Post Cardiac Rehabilitation: Pilot Randomized Controlled Trial.

BackgroundCardiac rehabilitation (CR) is an exercise-based program prescribed after cardiac events associated with improved physical, mental, and social functioning; however, many patients return to a sedentary lifestyle leading to deteriorating functional capacity after discharge from CR. Physical activity (PA) is critical to avoid recurrence of cardiac events and mortality and maintain functional capacity. Leveraging mobile health (mHealth) strategies to increase adherence to PA is a promising approach. Based on the social cognitive theory, we sought to determine whether mHealth strategies (Movn mobile app for self-monitoring, supportive push-through messages, and wearable activity tracker) would improve PA and functional capacity over 2 months.ObjectiveThe objectives of this pilot randomized controlled trial were to examine preliminary effects of an mHealth intervention on group differences in PA and functional capacity and group differences in depression and self-efficacy to maintain exercise after CR.MethodsDuring the final week of outpatient CR, patients were randomized 1:1 to the intervention group or usual care. The intervention group downloaded the Movn mobile app, received supportive push-through messages on motivation and educational messages related to cardiovascular disease (CVD) management 3 times per week, and wore a Charge 2 (Fitbit Inc) activity tracker to track step counts. Participants in the usual care group wore a pedometer and recorded their daily steps in a diary. Data from the 6-minute walk test (6MWT) and self-reported questionnaires were collected at baseline and 2 months.ResultsWe recruited 60 patients from 2 CR sites at a community hospital in Northern California. The mean age was 68.0 (SD 9.3) years, and 23% (14/60) were female; retention rate was 85% (51/60). Our results from 51 patients who completed follow-up showed the intervention group had a statistically significant higher mean daily step count compared with the control (8860 vs 6633; P=.02). There was no difference between groups for the 6MWT, depression, or self-efficacy to maintain exercise.ConclusionsThis intervention addresses a major public health initiative to examine the potential for mobile health strategies to promote PA in patients with CVD. Our technology-based pilot mHealth intervention provides promising results on a pragmatic and contemporary approach to promote PA by increasing daily step counts after completing CR.Trial RegistrationClinicalTrials.gov NCT03446313; https://clinicaltrials.gov/ct2/show/NCT03446313

FAMILIES CREATED THROUGH EGG DONATION: PARENTAL PSYCHOLOGICAL HEALTH IN EARLY CHILDHOOD

This study examined mothers’ and fathers’ psychological health in families who had conceived a child using egg donation (ED). Data are reported from phase two of a longitudinal study, when children were aged five. Cross-sectional design using standardized questionnaires. Questionnaire data were obtained from 66 families who had a child through egg donation, and a comparison group of 46 families who had a child through IVF with own-gametes. The average ages of mothers were 47.06 years (ED) and 42.24 years (IVF); fathers’ average ages were 48.08 years (ED) and 45.11 years (IVF). Questionnaires assessing parental psychological health (Trait Anxiety Index, Edinburgh Depression Scale), stress associated with parenting (Parenting Stress Index), marital quality (Golombok Rust Inventory of Marital State), social support (Multidimensional Scale of Perceived Social Support) and resilience (Brief Resilience Scale) were completed by mothers and fathers. Independent-samples t-tests and Mann-Whitney U-tests were used to analyse the data. Preliminary results found that mothers and fathers in both groups scored within the normal range for all questionnaire measures of psychological health. No significant differences were found between ED and IVF mothers in reported levels of anxiety, depression or resilience. ED mothers reported significantly lower couple relationship quality than IVF mothers (t(93) = 2.97, p=.004). However, when mother’s age was controlled for, the test was no longer significant. ED mothers reported significantly higher parenting stress than IVF mothers (U= 1070.5, p=.02) and significantly lower levels of perceived social support than IVF mothers (U= 1037, p=.007). No significant differences were found between ED and IVF fathers in reported levels of couple relationship quality, perceived social support or resilience. ED fathers reported significantly higher levels of parenting stress (U= 766.5, p=.01), anxiety (t(88.95)= 2.45, p=.016) and depression (U= 798.5, p=.03) than IVF fathers. However, group differences in depression were no longer significant after controlling for father’s age. Egg donation parents appear to be functioning within the normal range with regards to parental psychological health. However, egg donation mothers reported lower couple relationship quality, higher parenting stress and lower social support, and egg donation fathers experienced greater parenting stress, anxiety and depression, relative to their IVF counterparts. It is notable that ED mothers’ lower couple relationship quality and ED fathers’ higher levels of depression appear to be related to the older age of egg donation parents, rather than their use of egg donation per se. Possible explanations for the differences in psychological health between the ED and IVF parents will be discussed.

Efficacy and cost-effectiveness of intensive short-term dynamic psychotherapy for treatment resistant depression: 18-Month follow-up of the Halifax depression trial

BackgroundDepressed patients with chronic and complex health issues commonly relapse; therefore, examining longer-term outcomes is an important consideration. For treatment resistant depression (TRD), the post-treatment efficacy of time-limited Intensive Short-Term Dynamic Psychotherapy (ISTDP) has been demonstrated but longer-term outcomes and cost-effectiveness are unclear. MethodIn this superiority trial, 60 patients referred to Community Mental Health Teams (CMHT) were randomised to 2 groups (ISTDP=30 and CMHT=30). The primary outcome was Hamilton Depression Rating scale (HAM-D) scores at 18 months. Secondary outcomes included Patient Health Questionnaire (PHQ-9) depression scores and dichotomous measure remission. A health economic evaluation examined mental health costs with quality-adjusted life years (QALYs). ResultsStatistically significant treatment differences in depression previously found at 6 months favouring ISTDP were maintained at 18-month follow-up. Group differences in depression were in the moderate to large range on both the observer rated (Cohen's d = .64) and self-report measures (Cohen's d = .70). At 18 months follow-up the remission rate in ISTDP patients was 40.0%, and 23.4% had discontinued antidepressants. Health economic analysis suggests that ISTDP was more cost-effective than CMHT at 18 months. Probabilistic analysis suggests that there is a 64.5% probability of ISTDP being cost-effective at a willingness to pay for a QALY of $25,000 compared to CMHT at 18 months. LimitationsReplication of these findings is necessary in larger samples and future cost analyses should also consider indirect costs. ConclusionsISTDP demonstrates long-term efficacy and cost-effectiveness in TRD.

The impact of relocation stress on cognitively impaired and cognitively unimpaired long-term care residents

Objectives: The current aims were to explore the effects of relocation stress on depression and anxiety in long-term care residents and to investigate the moderating effect of cognitive status.Methods: The study used existing data from nursing home and congregate apartment residents. Self-reported measures of relocation stress, cognitive status, depression, and anxiety were examined. Exploratory analyses examined group differences in depression and anxiety within the full sample (n = 568) and the sample of first-year residents (n = 347). Main analyses were conducted in a subsample of 107 first-year residents who completed the measure of relocation stress.Results: Residents who had moved in the past year reported more anxiety but not depression than longer-term residents. Relocation stress significantly predicted depression but not anxiety in the subsample of first-year residents. There was no significant effect of cognitive status or the interaction of cognitive status and relocation stress on depression and anxiety.Conclusion: Findings suggest that cognitively impaired older adults are no more vulnerable to the negative effects of relocation stress than cognitively unimpaired older adults. Relocation stress should be regarded as a risk factor for depression in long-term care residents, regardless of cognitive status, in the first year after relocation.

Sleep spindle and psychopathology characteristics of frequent nightmare recallers

Idiopathic nightmares are a common disturbance of rapid eye movement sleep (REM) sleep, but studies of comorbid pathologies and sleep architecture suggest that non-REM (NREM) sleep is also affected. Sleep spindles are a NREM sleep characteristic associated with both pathophysiology and sleep-dependent memory consolidation, yet they have not been evaluated in frequent nightmare recallers. The morning naps of 38 participants with frequent idiopathic nightmares (mean age: 23.7 ± 3.78 years) and 25 age- and sex-matched controls (23.9 ± 3.65 years) were recorded and their sleep evaluated. A custom spindle detector assessed NREM sleep stage 2 (N2) sleep spindles on six electroencephalogram (EEG) derivations (F3, F4, C3, C4, O1, and O2) for density (number spindles/N2 time), mean frequency, and amplitude. Total spindles (10–16 Hertz (Hz) range), slow spindles (10–12.79 Hz), and fast spindles (12.8–16 Hz) were all assessed separately. Compared with the Control group, the Nightmare group had longer N2 sleep latency and a marginally greater %N2 sleep. The Nightmare group also had a lower than normal density of slow spindles in most EEG derivations, a higher density of fast spindles in frontal derivations, and an elevated fast spindle oscillatory frequency—“faster fast” spindles—mainly in central derivations. These differences withstood controls for pre-existing group differences in depression. Correlational analyses demonstrated a further pattern of group differences by which higher pathology scores were associated with higher slow spindle densities and slower spindle frequencies for the Nightmare but not the Control group. A similar pattern was observed for some dream content measures, ie, the Nightmare group showed positive correlations of slow spindle density with dreamed fear and word count and negative correlations with dreamed positive emotion. Conversely, the Control group showed opposite trends. Results thus demonstrate abnormalities in the composition of N2 sleep—and especially in N2 spindles—among frequent nightmare recallers and link these abnormalities to both trait (psychopathology) and state (dream content) factors. Spindle findings for psychopathology resemble, but are not identical with, previous findings for patients with major depression, social anxiety, and schizophrenia and are thus consistent with an explanation implicating spindles as trait markers of psychopathology. Correlational analyses go beyond a trait explanation to suggest several possible state-based explanations involving memory consolidation mechanisms, specifically, the possibility that spindles index either emotional or verbal task-based processes.

Depression and discrimination in the lives of women, transgender and gender liminal people in Ontario, Canada.

This article uses an intersectionality lens to explore how experiences of race, gender, sexuality, class and their intersections are associated with depression and unmet need for mental healthcare in a population of 704 women and transgender/gender liminal people from Ontario, Canada. A survey collecting demographic information, information about mental health and use of mental healthcare services, and data for the Everyday Discrimination Scale and the PHQ-9 Questionnaire for Depression was completed by 704 people via Internet or pen-and-paper between June 2011 and June 2012. Bivariate and regression analyses were conducted to assess group differences in depression and discrimination experiences, and predictors of depression and unmet need for mental healthcare services. Analyses revealed that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet needs for mental healthcare. Use of interaction terms to model intersecting identities and exclusion contributed to explained variance in both outcome variables. Everyday discrimination was the strongest predictor of both depression and unmet need for mental healthcare. The results suggest lower income and intersections of race with other marginalised identities are associated with more depression and unmet need for mental healthcare; however, discrimination is the factor that contributes the most to those vulnerabilities. Future research can build on intersectionality theory by foregrounding the role of structural inequities and discrimination in promoting poor mental health and barriers to healthcare.

Prevention of Depression in At-Risk Adolescents: Moderators of Long-term Response.

In a randomized controlled trial, we found that a cognitive behavioral program (CBP) was significantly more effective than usual care (UC) in preventing the onset of depressive episodes, although not everyone benefitted from the CBP intervention. The present paper explored this heterogeneity of response. Participants were 316 adolescents (M age = 14.8, SD = 1.4) at risk for depression due to having had a prior depressive episode or having current subsyndromal depressive symptoms and having a parent with a history of depression. Using a recursive partitioning approach to baseline characteristics, we (Weersing et al. 2016) previously had identified distinct risk clusters within conditions that predicted depressive episodes through the end of the continuation phase (month 9). The present study used the same risk clusters that had been derived in the CBP group through month 9 to reclassify the UC group and then to examine group differences in depression through month 33. We found that in this overall very high-risk sample, the CBP program was superior to UC among youth in the low-risk cluster (n = 33), characterized by higher functioning, lower anxiety, and parents not depressed at baseline, but not in the middle (n = 95) and high-risk (n = 25) clusters. Across conditions, significantly more depression-free days were found for youth in the low-risk cluster (M = 951.9, SD = 138.8) as compared to youth in the high-risk cluster (M = 800.5, SD = 226.7). Identification of moderators, based on purely prognostic indices, allows for more efficient use of resources and suggests possible prevention targets so as to increase the power of the intervention.

Effects of enhanced caregiver training program on cancer caregiver’s self-efficacy, preparedness, and psychological well-being

We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients. We recruited adult patients in oncology units and their informal caregivers. We utilized a two-armed, randomized controlled trial design with data collected at baseline, post-training, and at 2 and 4 weeks after hospital discharge. Primary outcomes were self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving. Secondary outcomes were caregiver depression, anxiety, and burden. The education comparison (EDUC) group received information about community resources. We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group. We consented and randomized 138 dyads: Enhanced-CT = 68 and EDUC = 70. The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessments. There were no intervention group differences in depression, anxiety, and burden. An Enhanced-CT protocol resulted in short-term improvements in self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers' psychological well-being. The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge.

More similarities than differences between men and women with irritable bowel syndrome.

Differences regarding symptoms, coping abilities, and quality of life (QOL) between men and women with irritable bowel syndrome (IBS) have been reported but data are sparse and sometimes conflicting. The aim of present study was to investigate gender differences in gastrointestinal, extra-intestinal, and psychological symptoms, and sense of coherence (SOC) and QOL in a large group of patients diagnosed with IBS. We analyzed questionnaire data from 557 patients (152 men) diagnosed with IBS consecutively included in studies at an outpatient clinic for functional bowel disorders between 2002 and 2010. Following questionnaires were included: IBS severity scoring system (IBS-SSS), Hospital Anxiety and Depression Scale (HAD), IBSQOL Scale, Visceral Sensitivity Index (VSI), SOC Scale, Bristol Stool Form Scale (BSFS), and Patient Health Questionnaire (PHQ-15). Women had harder stools (FDR-adjusted p-value: q = 0.033), more severe bloating (q = 0.020), higher symptom severity (q = 0.042), higher total somatic symptom burden (q = 0.035), lower SOC (q = 0.042), and lower QOL. Women rated more general anxiety (q = 0.017) and gastrointestinal-specific anxiety (q = 0.042), but there were no group differences in depression, pain, stool frequency, impact on daily life, dissatisfaction with bowel habit, or extra-colonic symptoms. The differences found were small (effect sizes: r < 0.3). In this study, we demonstrated more similarities than differences between men and women with IBS. The largest difference were seen for QOL which might reflect certain structural stressors to which women in general are more exposed than men.

The Adolescent Response to Parental Illness: The Influence of Dispositional Gratitude

Existing literature suggests that the children of ill parents are susceptible to anxiety and depression. However, some may respond to threatening circumstances such as chronic illness or grief with positive emotions and finding benefits, including appreciation of life and greater emotional strength. We explored the college-age child response to parental illness by examining the relationship of dispositional gratitude, family variables, and characteristics of parental illness to college-age child depression and anxiety. College students completed self-report measures examining dispositional gratitude, family quality of life, depression, and anxiety. In comparison to the healthy parent group, the ill parent group experienced lower family quality of life. There were no significant between group differences in depression or anxiety levels. Dispositional gratitude moderated the relationship between parental health status and college-age child anxiety and depression. This suggests that dispositional gratitude may have served as a buffer against internalizing symptoms within the college-age children of ill parents.

Dieting in bulimia nervosa is associated with increased food restriction and psychopathology but decreased binge eating

The cognitive behavioral model of bulimia nervosa (BN) suggests that dieting is central to the maintenance of binge eating. However, correlational and experimental studies suggest that additional clarification is needed about the nature of this relationship. Dieting, weight, eating disorder psychopathology, and depression were assessed at admission among 166 patients with BN presenting for residential treatment. As in past research, a significant fraction (43%) of patients with BN reported not currently dieting. A comparison of weight loss dieters and non-dieters found greater food restriction and eating disorder psychopathology among weight loss dieters. However, dieters reported less frequent binge eating. There were no significant group differences in depression. Results suggest that 1) while many individuals with BN are attempting to restrict their food intake, the goal of losing weight fundamentally alters the effect of such restriction on binge eating, and 2) treatment may benefit from helping patients to establish a healthier approach to achieving long-term weight stability.