Depressive Experiences Questionnaire Research Articles

Vulnerability to depression and resolution in mothers of children with cerebral palsy

BackgroundThis study investigated associations between Self-Criticism and Dependency as factors of vulnerability to depression and maternal resolution. Resolution entails parental cognitive and emotional acceptance of the child's developmental disability. MethodsOur sample included 100 mothers whose children had a diagnosis of cerebral palsy. The Reaction to Diagnosis Interview, the Depressive Experiences Questionnaire and the Depression Scale were administered. ResultsThe results showed that unresolved mothers scored higher on the dimensions of Self-Criticism and Dependency compared to their resolved counterparts. The hierarchical cluster analysis yielded three maternal profiles based on the scores obtained on the dimensions of vulnerability to depression, regardless of maternal resolution status. The first profile was labeled Low Vulnerability and was characterized by low scores on Self-Criticism and Dependency. The second profile was labeled Dependent and it included mothers with higher scores on Dependency and lower scores on Self-Criticism. The third profile comprised mothers with higher scores on both Self-Criticism and Dependency. The smallest proportion of unresolved mothers belonged to the third, most vulnerable profile labeled Double Vulnerability. DiscussionWe discussed the implications of the obtained results in light of a need for psychotherapeutic interventions that would focus on individual differences when providing support to parental resolution.

Personality Functioning, Narcissism and Borderline Traits in the General Population Predict Deviations from the Optimal Time Perspective

Abstract The aim of this article is to clarify and describe the relationships between levels of personality functioning, pathological personality traits from the borderline and narcissistic functioning, and time perspective (TP). The study was conducted online, and 210 participants completed eight questionnaires: Inventory of Personality Organization, Boredom Proneness Scale, Rejection Sensitivity Questionnaire, Barratt Impulsiveness Scale, Hypersensitive Narcissism Scale, Narcissistic Admiration and Rivalry Questionnaire, Depressive Experience Questionnaire, and Zimbardo Time Perspective Inventory. The results reveal that the pathological personality functioning was consistently associated with a deviation on each dimension of TP and the Deviation from the Balanced Time Perspective (DBTP) while the higher functioning personality indicator was associated with a balanced time perspective. When accounting for all traits in the regression, pathological personality traits predicted variance of Past-Negative, Present-Hedonistic, Present-Fatalistic, and the DBTP. Borderline and narcissistic traits were associated with the DBTP but demonstrated different time perspective profiles. Borderline traits showed an overall negative TP with a tendency to seek quick and intense pleasure in the present with no regards toward the future. These results show that there can be TP profile differences between borderline personalities, depending on their specific trait profile. Impulsivity plays an important role in how borderline personalities cope with their negative temporalities. Vulnerable narcissism is characterized by a negative past with the ability to recruit the future, while grandiose narcissism denotes an overall more balanced time perspective than their vulnerable counterpart.

Investigating psychometric properties of short versions of the depressive experiences questionnaire: Findings from a representative large sample of Chinese adolescents

BackgroundAdolescence involves a period of swift change, including the development of personality vulnerabilities (i.e., dependency and self-criticism) that act as transdiagnostic factors to psychopathology. Over the past several decades, numerous short revisions have condensed the Depressive Experiences Questionnaire (DEQ) into more efficient measures of personality vulnerability. Prior research has investigated the psychometric properties of the short DEQs in adult and clinical samples. However, there has been insufficient exploration within adolescents, who are in addition marked by fluctuating personality vulnerabilities. MethodA representative large sample of adolescents and emerging adults in China aged 10 to 25 (N = 23,953) was administered five short DEQs, including the Revised DEQ (RevDEQ), Reconstructed DEQ (RecDEQ), Theoretical DEQ-21/12 (TDEQ-21/12) and adolescent DEQ (DEQ-A). The data was evaluated for internal consistency and criterion-related validity, while factor structure and measurement invariances across gender and age groups were analyzed by confirmatory factor analysis (CFA). A subset of the original sample (N = 2874) was retested after six months and analyzed for test-retest reliability and cross-time invariance. ResultCFA of the TDEQ-21/12 and RecDEQ supported the intended two-factor model. Good criterion-related validity, internal consistency and test-retest reliability for these three versions were found. Satisfying measurement invariances across gender, time, and age groups were established. LimitationThe study's scope was confined to non-clinical adolescent populations within China, highlighting a gap in cross-cultural and clinical applicability. ConclusionThe present study supports the use of the TDEQ-21/12 and RecDEQ as valid and concise instruments for measuring Chinese adolescent personality vulnerability.

Transdiagnostic clustering of self-schema from self-referential judgements identifies subtypes of healthy personality and depression.

The heterogeneity of depressive and anxiety disorders complicates clinical management as it may account for differences in trajectory and treatment response. Self-schemas, which can be determined by Self-Referential Judgements (SRJs), are heterogeneous yet stable. SRJs have been used to characterize personality in the general population and shown to be prognostic in depressive and anxiety disorders. In this study, we used SRJs from a Self-Referential Encoding Task (SRET) to identify clusters from a clinical sample of 119 patients recruited from the Institute of Mental Health presenting with depressive or anxiety symptoms and a non-clinical sample of 115 healthy adults. The generated clusters were examined in terms of most endorsed words, cross-sample correspondence, association with depressive symptoms and the Depressive Experiences Questionnaire and diagnostic category. We identify a 5-cluster solution in each sample and a 7-cluster solution in the combined sample. When perturbed, metrics such as optimum cluster number, criterion value, likelihood, DBI and CHI remained stable and cluster centers appeared stable when using BIC or ICL as criteria. Top endorsed words in clusters were meaningful across theoretical frameworks from personality, psychodynamic concepts of relatedness and self-definition, and valence in self-referential processing. The clinical clusters were labeled "Neurotic" (C1), "Extraverted" (C2), "Anxious to please" (C3), "Self-critical" (C4), "Conscientious" (C5). The non-clinical clusters were labeled "Self-confident" (N1), "Low endorsement" (N2), "Non-neurotic" (N3), "Neurotic" (N4), "High endorsement" (N5). The combined clusters were labeled "Self-confident" (NC1), "Externalising" (NC2), "Neurotic" (NC3), "Secure" (NC4), "Low endorsement" (NC5), "High endorsement" (NC6), "Self-critical" (NC7). Cluster differences were observed in endorsement of positive and negative words, latency biases, recall biases, depressive symptoms, frequency of depressive disorders and self-criticism. Overall, clusters endorsing more negative words tended to endorse fewer positive words, showed more negative biases in reaction time and negative recall bias, reported more severe depressive symptoms and a higher frequency of depressive disorders and more self-criticism in the clinical population. SRJ-based clustering represents a novel transdiagnostic framework for subgrouping patients with depressive and anxiety symptoms that may support the future translation of the science of self-referential processing, personality and psychodynamic concepts of self-definition to clinical applications.

Exploring the Relationship Between Instagram Use and Self-Criticism, Self-Compassion, and Body Dissatisfaction in the Spanish Population: Observational Study.

The widespread use of online social networks, particularly among the younger demographic, has catalyzed a growing interest in exploring their influence on users' psychological well-being. Instagram (Meta), a visually oriented platform, has garnered significant attention. Prior research has consistently indicated that Instagram usage correlates with heightened levels of perfectionism, body dissatisfaction, and diminished self-esteem. Perfectionism is closely linked to self-criticism, which entails an intense self-scrutiny and is often associated with various psychopathologies. Conversely, self-compassion has been linked to reduced levels of perfectionism and stress, while fostering greater positive affect and overall life satisfaction. This study investigates the relationship between Instagram usage (time of use and content exposure) and users' levels of self-compassion, self-criticism, and body dissatisfaction. This study comprised 1051 adult participants aged between 18 and 50 years, either native to Spain or residing in the country for at least a decade. Each participant completed a tailored questionnaire on Instagram usage, along with abbreviated versions of the Self-Compassion Scale, the Body Shape Questionnaire, and the Depressive Experiences Questionnaire, spanning from January 23 to February 25, 2022. A positive correlation was observed between daily Instagram usage and self-criticism scores. Participants of all age groups who spent over 3 hours per day on Instagram exhibited higher self-criticism scores than users who spent less than 1 hour or between 1 and 3 hours per day. Contrary to previous findings, no significant relationship was detected between Instagram usage time and levels of self-compassion or body dissatisfaction. Furthermore, content centered around physical appearance exhibited a positive correlation with self-criticism and body dissatisfaction scores. Among younger participants (aged 18-35 years), those who primarily viewed beauty or fashion content reported higher self-criticism scores than those consuming science-related content. However, this association was not significant for participants aged 35-50 years. Conversely, individuals who predominantly engaged with sports or fitness or family or friends content exhibited higher levels of body dissatisfaction than those focusing on science-related content. No significant associations were observed between self-compassion scores and daily Instagram usage or most-viewed content categories. The findings of this study underscore the considerable impact of Instagram usage on self-criticism and body dissatisfaction-2 variables known to influence users' psychological well-being and be associated with various symptoms and psychological disorders.

Early adverse stress and depression severity: A pilot exploration of mediating psychological mechanisms.

To explore the associations between early adverse stress, attachment insecurity in adulthood (anxious and avoidant), pathological personality styles (self-criticism and dependency), difficulties in emotion regulation, and depression severity. Cross-sectional study of 178 outpatients diagnosed with major depression in Santiago, Chile. Participants filled the Childhood Trauma Questionnaire Short Form, the Experience in Close Relationships Scale, the Depressive Experience Questionnaire, the Difficulties in Emotion Regulation Scale, and the Patient Health Questionnaire-9 item. Full-information maximum likelihood path analyses with bias-corrected bootstrapped confidence intervals were conducted. Anxious attachment in adulthood and self-criticism mediated the association between early adverse stress and depression severity through their effects on difficulties in emotion regulation. Early adverse stress was not associated with avoidant attachment in adulthood and dependency; these variables were indirectly associated with depression severity. Difficulties in emotion regulation were exclusively directly related to depression severity, mediating the effects of the preceding variables. Our findings propose an integrative model for psychological mechanisms mediating between early adverse stress and depression. Difficulties in emotion regulation should be considered when treating adults with depression exposed to early adverse stress. The contribution of specific types of early adverse stressors and difficulties in emotion regulation should be further explored.

Correlates of Perceived Discrimination Related to Substance Use Disorders Among Patients in Methadone Maintenance Treatment

ABSTRACT This study sought to examine demographic, treatment-related, and diagnosis-related correlates of substance use disorder (SUD)-related perceived discrimination among patients receiving methadone maintenance treatment (MMT). Participants were 164 patients at nonprofit, low-barrier-to-treatment-access MMT programs. Participants completed measures of demographics, diagnosis-related characteristics (Brief Symptom Inventory (BSI-18) and Depressive Experiences Questionnaire (DEQ)), and treatment-related characteristics. Perceived discrimination was measured on a seven-point Likert-type scale ranging from 1 (“Not at all”) to 7 (“Extremely”) in response to the item: “I often feel discriminated against because of my substance abuse.” Given the variable’s distribution, a median split was used to categorize participants into “high” and “low” discrimination groups. Correlates of high and low discrimination were analyzed with bivariate and logistic regression models. Ninety-four participants (57%) reported high SUD-related perceived discrimination. Bivariate analyses identified six statistically significant correlates of SUD-related perceived discrimination (P < .05): age, race, age of onset of opioid use disorder, BSI-18 Depression, DEQ Dependency, and DEQ Self-Criticism. In the final logistic regression model, those with high (versus low) SUD-related perceived discrimination were more likely to report depressive symptoms and be self-critical. Patients in MMT with high compared to low SUD-related perceived discrimination may be more likely to report being depressed and self-critical.

Exploring Working Memory, Self-Criticism, and Rumination as Factors Related to Self-Harm.

The prevalence of self-harm and the relative emotional influences are well understood, but certain cognitive factors such as working memory, rumination, and self-criticism are not fully explored. The aim of the current study is to examine specific aspects of cognition to explore their influence on self-harming behaviors. Participants included 101 undergraduates from a British University. Factors were measured using the Center for Epidemiological Studies Depression Scale, the Depressive Experiences Questionnaire, Ruminative Response Scale, and the Automated Working Memory Assessment. Findings indicated a greater incidence of self-harming behaviors among those who demonstrated higher depressive symptoms, but depression scores were not significantly related to self-harm. Additionally, a binary logistic regression indicated that self-criticism was associated with the presence of self-harming behavior, and a Classification and Regression Trees found that the single strongest predictor of self-harming behavior was a belief that love needs to be continually earned from others. Incorporating treatments that reduce self-criticism, such as improving self-compassion with Compassionate Mind Training, may address underlying mechanisms that trigger self-harm behavior.

Centrality of Self-Criticism in Depression and Anxiety Experienced by Breast Cancer Patients Undergoing Short-Term Psychodynamic Psychotherapy

Introduction Depression and anxiety are prevalent in women suffering from breast cancer. However, the determinants of depression and anxiety in this population are not well known, particularly in the context of psychotherapy. Drawing from Blatt’s theory, we examined the role of Depressive Personality Vulnerability (DPV) in depression and anxiety experienced in female sufferers of breast cancer treated for depression as part of a Randomized Clinical Trial. Methods Seventy-eight patients were treated by Short-Term Psychodynamic Psychotherapy and 79 patients by Treatment as Usual. Assessments were conducted pre-treatment, at termination, and at six-month follow-up. Main outcomes were the depression and anxiety subscales of the Hospital Depression and Anxiety Scale. Predictors were pre-treatment dependency, self-criticism, and self-efficacy, assessed via the Depressive Experiences Questionnaire. Analyses targeted associations of these dimensions with baseline levels, main effects on pretreatment-termination and pretreatment-follow-up changes in depression and anxiety, and DPV by treatment interactions. Results Consistent with our hypotheses, self-criticism – implicated in previous research as a serious dimension of vulnerability to psychopathology – predicted elevated levels, as well as pretreatment-follow-up changes, in both depression and anxiety. However, self-criticism also augmented the effect of STPP (compared with TAU) on depression in the pretreatment-termination period. Conclusions These findings highlight the centrality of self-criticism for both risk and resilience processes in breast cancer.

Factor structure and psychometric properties of the Greek version of the Reconstructed Depressive Experiences Questionnaire.

The Reconstructed Depressive Experiences Questionnaire-RDEQ is a self-report measure for assessing depressive experiences and in particular dependency and self-criticism, that is, vulnerability traits for depression. It constitutes a short version of the widely used DEQ that was constructed to detect the anaclitic and the introjective depressive characterological configurations. However, DEQ's validity has been questioned and several shortened versions have been constructed. RDEQ has been found to preserve the characteristics of the original scale and demonstrate the best psychometric qualities. The aim of this study was to evaluate the psychometric properties of the Greek version. RDEQ was translated and the final version was administered, along with questionnaires measuring depression (Beck Depression Inventory, BDI), attachment (Cartes de Modèles Individuels de Relations, CAMIR), and self-esteem (Rosenberg Self-Esteem Scale, RSES), to a clinical and a community sample of 714 individuals. Confirmatory factor analysis yielded a two-factors structure that represents the personality dimensions of dependency and self-criticism. Findings showed that this model fits well the data and has good internal consistency with Cronbach's alphas 0.84 and 0.87, respectively. The correlation between the two RDEQ factors demonstrated that the two scales are orthogonal and distinct. Moreover, the Greek version exhibited low to moderate significant correlations with BDI, CAMIR, and RSES and satisfactory convergent and divergent validity. RDEQ appears to be a suitable tool for research use and is expected to facilitate the examination of depressive personality dimensions in Greek speaking populations.

A longitudinal investigation of the mediating role of humor in the relationship between personality vulnerability factors and depressive symptoms

Cross-sectional findings indicated that humor mediated between personality vulnerability factors (self-criticism and dependency) and depressive symptoms, although the specific mechanisms may differ across different samples. To address the limitations associated with cross-sectional designs, the present study sought to examine the longitudinal relationship among personality vulnerability factors, humor styles, and depressive symptoms. Data on Depressive Experience Questionnaire (DEQ), Humor Style Questionnaire (HSQ), and Center of Epidemiological Study – Depression (CESD) were collected from 301 participants at both baseline (data previously presented in Lin et al., 2021) and 2-month follow-up. Results indicated that self-enhancing humor mediated the longitudinal relationship between both personality vulnerability factors (self-criticism and dependency) and depressive symptoms, while affiliative humor mediated the longitudinal relationship between self-criticism and depressive symptoms. In sum, benign humor, especially self-enhancing humor, appeared to play a significant mediating role in the longitudinal relationship between personality vulnerability factors and depressive symptoms. Relevant research and clinical implications are discussed.

Anxiety and emotional-behavioral problems of adolescents in China: evidence for a serial mediation model of alexithymia and dependency

ABSTRACT High prevalence of emotional and behavioral problems among Chinese adolescence has been reported. This study seeks to investigate the mediating effect of alexithymia and dependency on anxiety and emotional-behavioral problems among adolescents. The study population included 519 adolescents. The assessments included the completion of standardized scales such as the Multidimensional Anxiety Scale (MASC), the Toronto Alexithymia Scale (TAS-20), the Depressive Experiences Questionnaire (DEQ), the Strengths and Difficulties Questionnaire (SDQ). Independent-sample t-tests, bivariate correlation, and serial mediation analyses were performed using SPSS23.0. Bivariate analyses revealed that anxiety, emotional-behavioral problem, alexithymia, and dependency were positively correlated. Alexithymia and dependency play a significant role in mediating the effect of multidimensional anxiety on emotional-behavioral problems. The effects of the two mediating paths were 69.86% and 7.81% for indirect effect through alexithymia, dependency, and specific indirect effect by alexithymia and dependency was 12.33%. Anxiety and emotional-behavioral problems mediate the relationship between alexithymia and dependency.

Interpersonal Relatedness and Non-suicidal Self-Injurious Behaviors in Female Adolescents With Borderline Personality Disorder.

Background: Psychopathological models of adolescent borderline personality disorder (BPD) suggest that non-suicidal self-injuring (NSSI)—a particularly frequent symptom in girls—may constitute a way of coping with distress resulting from interpersonal concerns they typically experience as a developmental psychopathological feature.Objectives: Our objective was to investigate the relationship in BPD female adolescents between NSSI and the Sidney Blatt two-polarities model of personality development, which focuses on the psychological processes of interpersonal relatedness and self-definition.Methods: The study was conducted within the European Research Network on Borderline Personality Disorder in Adolescence, using the Depressive Experience Questionnaire (DEQ).Results: BPD patients (n = 59; mean age = 16.6 ± 1.3) scored significantly higher than healthy controls on the two DEQ sub-factors assessing the more immature forms of Interpersonal Relatedness (Neediness) and Self-definition (Self-criticism) and significantly lower on the more mature form of Self-definition (Efficacy). BPD adolescents with NSSI showed significantly higher scores on both mature and immature forms of Interpersonal Relatedness (Neediness and Connectedness) compared to BPD adolescents without NSSI. A logistic regression analysis showed that the subfactor Neediness of the DEQ was the only significant predictor of the presence of NSSI among BPD adolescents.Conclusions: The preliminary results of this study suggests that NSSI in adolescents with BPD is developmentally linked to high developmental concerns in the domain of interpersonal relatedness, which may be taken into consideration in clinical practice. More studies are necessary to better understand the relationships between NSSI and developmental psychopathology in borderline adolescents.

Parental bonding, depressive experiences, and symptomology: An investigation among college students in Malaysia.

This study examined the perceptions of parental bonding, depressive experiences of self-criticism and dependency, and the current level of depressive symptomology among 212 college students from Sabah, Malaysia. The participants completed the brief version of the Parental Bonding Instrument, the Reconstructed Depressive Experiences Questionnaire, and the Patient Health Questionnaire. The results showed significant direct effects of maternal care, maternal overprotection, paternal care, self-criticism, and dependency on depressive symptomology. In contrast, the indirect effects of self-criticism and dependency on the relationship between parental bonding and depressive symptomology were not significant. These findings were in line with previous studies that have highlighted the significance of parent-child bonding, self-criticism, and dependency in the development of depressive symptomology. However, they contradicted previous results on the significant indirect effects of self-criticism and dependency. This study highlights the importance of parental care and overprotection, as they can predict the manifestation of depressive symptomology at a later stage in life.

Associations between interpersonal dependency and severity of prolonged grief disorder symptoms in bereaved surviving family members

BackgroundSeveral studies have shown that interpersonal dependency is a risk factor for prolonged grief disorder (PGD), a disorder that has been recently approved by the American Psychiatric Association Assembly for inclusion in the Diagnostic and Statistical Manual of Mental Disorders—5—Text Revision (DSM-5-TR). Nevertheless, it remains unclear whether this relationship is independent of depression, which may also be related to both loss and interpersonal dependency. Furthermore, anaclitic dependency (maladaptive and immature) compared to relatedness (more adaptive and mature) dependency, and the relationships between these types of dependency and PGD, have not been examined. The aim of the present study was to determine how anaclitic and relatedness dependency are associated with PGD symptom severity, controlling for depressive symptom severity, over and above potential sociodemographic and loss-related confounder variables. MethodsParticipants (N = 241) bereaved after the death of a family member from 0.5 to 8 years before the survey (M = 3.36, SD = 2.02) completed the Depressive Experiences Questionnaire, the Patient Health Questionnaire—9, and the Prolonged Grief Disorder—13 scale (PG-13). ResultsA hierarchical regression analysis confirmed that anaclitic dependency is positively associated with PGD symptom severity, even when controlling for depression severity and other potential confounder variables. There was no significant association between relatedness dependency and PGD. ConclusionsTo assess the risk of PGD in individuals bereaved after the death of a family member, it is important to assess anaclitic dependency.

Autocriticismo e tentativas de suicídio em indivíduos com experiência de doença mental

This research examined the role of self-criticism as a personality dimension in suicide risk, assessed through the presence of at least one suicide attempt. Ninety-two adults participated, ranging in age from 20 to 65 years (M = 42.73, SD = 12.95), divided into three groups: 22 individuals with a psychiatric disorder and who previously attempted suicide, 39 individuals with a psychiatric disorder without a prior suicide attempt and 31 individuals from the community. Participants answered the Depressive Experiences Questionnaire – Short form - and the Brief Symptom Inventory. The groups were compared using an ANOVA and an ANCOVA, considering psychopathology as a co-variable. Results indicate that individuals who have attempted suicide and individuals with a psychiatric disorder without previous suicide attempts presented significantly higher levels of self-criticism compared to community individuals. No significant differences were found between the clinical groups.

Depressogenic traits and depression: Are humor styles mediators?

Abstract Depressogenic traits are personality dispositions that put individuals at a higher risk for developing depression. Measured by the Depressive Experience Questionnaire (DEQ), self-criticism and dependency are two personality traits that are closely related to depression. The current study explored humor styles as potential mediating factors in the relationship between depressogenic traits and depression. Study 1: Given that the traditional Chinese version of the DEQ had not been validated psychometrically, we first conducted a confirmatory factor analysis to determine the most appropriate DEQ scoring system among the existing ones. The results indicated that the reconstructed DEQ had the best psychometric properties for the traditional Chinese version of the DEQ. Study 2: The potential mediating effect of humor styles in the relationship between depressogenic traits and depression was examined. Results showed that two benign humor styles, affiliative and self-enhancing humor styles, mediated the relationship between depressogenic traits (both self-criticism and dependency) and depression. The mediational strength was stronger for self-enhancing than for affiliative humor style. Malign humor styles, aggressive and self-defeating humor styles, did not emerge as mediators. Research and clinical implications for the findings were discussed.

Do Relational and Self-Definitional Traits Influence Deep Brain Stimulation Device Preference?

Personality psychodynamics have been shown to influence individual responses to psychiatric treatments, including medication. Increasingly, neuromodulation therapies have become available for severe and treatment-resistant depression. This study aims to evaluate patient response to an implanted neurostimulator battery within the framework of relational versus self-definitional personality traits. Relational development is interpersonally oriented and disruptions along this pathway lead to dependency on others for a sense of security and self-worth. Self-definitional development is characterized by autonomy strivings and disruptions lead to self-critical feelings of failing to meet expectations. Patients drawn from a larger study of deep brain stimulation (DBS) for treatment-resistant depression were switched from a non-rechargeable to a rechargeable battery type to maintain stimulation therapy. This switch entailed taking greater personal responsibility for device maintenance and allowed for fewer battery replacement surgeries. Twenty-six patients completed the Depressive Experiences Questionnaire (DEQ) and a questionnaire surveying their preference for DBS battery type. Results show that the DEQ dependency subscale, and more specifically the neediness component of the subscale, is associated with patient preference for the non-rechargeable battery. This suggests that individuals with higher relational needs prefer treatment options that increase contact with and need for medical caregivers and may prioritize this aspect of an intervention over alternative considerations. In contrast, individuals with more self-critical personality traits did not have a battery type preference, indicating that self-definitional needs were not predictive of battery preference. The link between an individual's personality psychodynamics and response to biomedical interventions, including neuromodulation and treatments that incorporate medical devices, deserves further attention.

Relationship Between Adherence to Remote Monitoring and Patient Characteristics: Observational Study in Women With Pregnancy-Induced Hypertension.

BackgroundPregnancy-induced hypertension (PIH) is associated with high levels of morbidity and mortality in mothers, fetuses, and newborns. New technologies, such as remote monitoring (RM), were introduced in 2015 into the care of patients at risk of PIH in Ziekenhuis Oost-Limburg (Genk, Belgium) to improve both maternal and neonatal outcomes. In developing new strategies for obstetric care in pregnant women, including RM, it is important to understand the psychosocial characteristics associated with adherence to RM to optimize care.ObjectiveThe aim of this study was to explore the role of patients’ psychosocial characteristics (severity of depression or anxiety, cognitive factors, attachment styles, and personality traits) in their adherence to RM.MethodsQuestionnaires were sent by email to 108 mothers the day after they entered an RM program for pregnant women at risk of PIH. The Generalized Anxiety Disorder Assessment-7 and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and the severity of depression, respectively; an adaptation of the Pain Catastrophizing Scale was used to assess cognitive factors; and attachment and personality were measured with the Experiences in Close Relationships-Revised Scale (ECR-R), the Depressive Experiences Questionnaire, and the Multidimensional Perfectionism Scale, respectively.ResultsThe moderate adherence group showed significantly higher levels of anxiety and depression, negative cognitions, and insecure attachment styles, especially compared with the over adherence group. The low adherence group scored significantly higher than the other groups on other-oriented perfectionism. There were no significant differences between the good and over adherence groups. Single linear regression showed that the answers on the PHQ-9 and ECR-R questionnaires were significantly related to the adherence rate.ConclusionsThis study demonstrates the relationships between adherence to RM and patient characteristics in women at risk of PIH. Alertness toward the group of women who show less than optimal adherence is essential. These findings call for further research on the management of PIH and the importance of individual tailoring of RM in this patient group.Trial RegistrationClinicalTrials.gov NCT03509272; https://clinicaltrials.gov/ct2/show/NCT03509272

Personality Trait Predictive Utility and Stability in Transcranial Magnetic Stimulation (rTMS) for Major Depression: Dissociation of Neuroticism and Self-Criticism: Utilité prédictive et stabilité des traits de personnalité dans la stimulation magnétique transcrânienne répétitive (SMTr) pour la dépression majeure : dissociation du neuroticisme et de l’autocritique

Background: Cost-efficient and non-invasive predictors of antidepressant response to repetitive transcranial magnetic stimulation (rTMS) are required. The personality vulnerabilities—neuroticism and self-criticism—are associated with antidepressant outcomes in other modalities; however, self-criticism has not been examined in response to rTMS, and the literature on neuroticism and rTMS is inconsistent. Methods: This naturalistic, 4-week study involved daily dorsolateral prefrontal cortex (DLFPC) rTMS for major depression (15 unipolar, 2 bipolar). Participants completed the Big Five Inventory (neuroticism) and the Depressive Experiences Questionnaire (self-criticism) at baseline and at the end of treatment. Changes in depressive symptoms, as rated by the clinician, were quantified using the 21-item Hamilton Depression Rating Scale. Given the inconsistencies in data regarding the stability of neuroticism in patients receiving rTMS, we performed a systematic review and quantitative meta-analysis of trials examining rTMS and neuroticism. Results: rTMS significantly improved depressive symptoms, and this was predicted by higher levels of self-criticism but not neuroticism. Self-criticism was stable over the 4 weeks of rTMS; however, neuroticism decreased, and this was not related to decreases in depressive symptoms. Our quantitative meta-analysis of 4 rTMS trials in major depression ( n = 52 patients) revealed decreases in neuroticism, with a moderate effect size. Limitations: Our results are limited by a small sample size, and the absence of a sham-rTMS group. Our meta-analysis included only 4 trials. Conclusion: Highly self-critical patients appear to benefit more from rTMS than less self-critical patients. Neuroticism, a conceptually similar but distinct personality domain, does not appear to predict antidepressant response, yet this vulnerability factor for depression decreases after rTMS.