Different Levels Of Depressive Symptoms Research Articles

Intentions and barriers to help-seeking in adolescents and young adults differing in depression severity: cross-sectional results from a school-based mental health project

BackgroundMental health problems, such as depression, have a high prevalence in young people. However, the majority of youths suffering from depression do not seek professional help. This study aimed to compare help-seeking behavior, intentions and perceived barriers between youthswith different levels of depressive symptoms.MethodsThis cross-sectional study is part of a large-scale, multi-center project. Participants were n = 9509 youths who were recruited in German schools and completed a baseline screening questionnaire. Based on their depressive symptoms, youths were allocated to the following three subgroups: (a) without depressive symptoms, (b) with subclinical symptoms, (c) with clinical symptoms (measured by PHQ-A). Quantitative analyses compared previous help-seeking behavior, help-seeking intentions and perceived barriers (Barriers questionnaire) between these subgroups. An additional exploratory qualitative content analysis examined text answers on other perceived barriers to help-seeking.ResultsParticipants were mostly female (n = 5575, 58.6%) and 12 to 24 years old (M = 15.09, SD 2.37). Participants with different levels of depressive symptoms differed significantly in help-seeking behavior, intentions and perceived barriers. Specifically, participants with clinical depressive symptoms reported more previous help-seeking, but lower intentions to seek help compared to participants without symptoms (all p < 0.05). Participants with subclinical depressive symptoms reported a similar frequency of previous help-seeking, but higher intentions to seek help compared to participants without symptoms (all p < 0.05). Perception of barriers was different across subgroups: participants with clinical and subclinical depressive symptoms perceived the majority of barriers such as stigma, difficulties in accessibility, and family-related barriers as more relevant than participants without depressive symptoms. Across all subgroups, participants frequently mentioned intrapersonal reasons, a high need for autonomy, and a lack of mental health literacy as barriers to help-seeking.ConclusionsYouths with higher levels of depressive symptoms are more reluctant to seek professional help and perceive higher barriers. This underlines the need for effective and low-threshold interventions to tackle barriers, increase help-seeking, and lower depressive symptoms in adolescents and young adults differing in depression severity.Trial registrationDRKS00014685.

Fatalistic and Optimistic Coping Strategies Predict Depression in Arab Muslim Patients With End-Stage Renal Disease.

Depression is one of the common psychological problems in patients on hemodialysis. We aimed to identify the predictors associated with depressive symptoms among patients on hemodialysis from a population under-represented in research and minoritized in countries like the United States. This cross-sectional study used a convenience sample of patients in Oman. Data were analyzed using linear multiple regression. A total of 157 patients on hemodialysis participated in the study, with 40.5% reporting different levels of depressive symptoms. Higher stress levels (β = .643; p < .01) and higher perceived effectiveness of the fatalistic coping style (β = .144; p < .05) were significant predictors of depressive symptoms. Patients with a higher optimistic coping style (β = -.182; p < .01) had lower levels of depressive symptoms. Arab Muslim hemodialysis patients have significant levels of depressive symptoms. Identifying predictors of depressive symptoms may help identify those at risk and provide culturally appropriate interventions.

Relationship Satisfaction Agreement and Depressive Symptom Similarities in Clinical Couples: An Intensive Longitudinal Analysis across Treatment

Despite being in the same relationship, partners may differ in their level of relationship satisfaction and may experience different levels of depressive symptoms. However, there has been limited research about the implications of the degree of relationship satisfaction agreement and similarities in depressive symptoms among partners in couple therapy. From a spousal discrepancy framework, we aimed to first examine the level of similarity between partners on relationship satisfaction and depressive symptoms. Second, we will examine partners’ previous week’s depressive symptom similarities predicting relationship satisfaction the following week, and partners’ previous week’s relationship satisfaction agreement predicting depressive symptoms the following week. We used data from partners receiving 15 wk of couple therapy for depression (n = 24 couples). Results revealed low to moderate levels of relationship satisfaction agreement and depressive symptom similarities between partners across treatment. Repeated measures multilevel analyses revealed that previous week’s relationship satisfaction agreement and depressive symptom similarities were not notable predictors of relationship satisfaction and depressive symptoms the following week. This suggests that each partner’s own reports of relationship satisfaction and depressive symptoms may be more important than the degree of similarity in relationship satisfaction and depressive symptoms between partners.

Pathways to Depressive Symptoms in a Digital Environment: The Role of Trait Affectivity and Mediation of Media Response Styles in Adolescence.

Trait negative affectivity and trait extraversion/positive affectivity are predictive of both responses to affect and depressive symptoms in adolescence. Furthermore, differences in the use of responses to affect are associated with different levels of depressive symptoms. Despite the central role of media content in adolescents' daily lives, responses to affect have not yet been extended to affect in this media content. It is thus unclear whether trait affectivity is predictive of responses to affective media content, and whether such media response styles are predictive of depressive symptoms. A 3-wave longitudinal panel study with 3-month intervals among 318 adolescents (Mage = 16.5 years, SDage = 1.11, 72.5% boys) investigated the mediating role of media response styles in associations between trait affectivity and depressive symptoms. Trait negative affectivity predicted media rumination and media dampening, yet only media rumination predicted greater levels of depressive symptoms over time. Trait positive affectivity was associated with concurrent media distraction and media-enhancing. The media response styles did not mediate the associations between trait affectivity and depressive symptoms over time. These findings suggest that individuals higher in trait negative affectivity tend to engage in maladaptive emotion regulation strategies during sad media content consumption, whereas adolescents higher in trait positive affectivity turn to more adaptive strategies during sad or happy media content consumption. Yet, media response styles are not robustly associated with depressive symptoms over time.

The development of optimistic expectations in young children

Optimism, a bias to overestimate positive and underestimate negative outcomes, may shape how children learn, confront challenges, and overcome setbacks. Although approximately 80% of adults are optimistic, childhood optimism is understudied. A racially and socioeconomically diverse community sample of 152 three- to six-year-old children participated in two experiments (one story-based, one numeric probability-based) that assessed expectations of event outcomes when the likelihood of the outcome occurring either matched or conflicted with the most desirable outcome. The results systematically demonstrate that children are optimistic, even more optimistic for themselves than others, and increasingly integrate probabilistic information into their predictions with age. Differences in optimism were found in children from different socioeconomic backgrounds and those with different levels of depressive symptoms. These findings provide insight into how children reason about the future and elucidate key factors that impact optimistic predictions in childhood.

Depression Symptoms among Family Members of Nyaope Users in the City of Tshwane, South Africa.

Substance abuse brings major negative social and health impacts in South Africa. Nyaope, a cocktail drug commonly used in the Tshwane townships, has been well documented to be highly addictive and very difficult to quit. The resultant difficulties include financial, social, and mental, specifically depression and anxiety. This study aims to quantify the depression levels among family members with nyaope users in Tshwane, South Africa. The study used a quantitative cross-sectional design to collect data in nine Tshwane communities. The patient health questionnaire-9 (PHQ-9) screening tool and demographic data collection questionnaires were used to collect data from a sample of 390 male and female family members who included mothers, fathers, grandparents, aunts, uncles, partners, and siblings of nyaope users, and who share a home with them. The ages of the participants ranged from 18 to 87 years, with a mean age of 47 years, while the ages of the nyaope users ranged from 17 to 55 years, with a mean age of 30 years. Depression scores ranged from 0 to 27 with a mean of 7. Depressive symptoms, as measured by the PHQ-9 scores of 5 and above, were reported by 49% of the sample. The levels of depression symptoms ranged from mild to severe, and the severity was higher among female, unemployed, and single participants. As with many others, these participants were not diagnosed and therefore were not treated. The study, therefore, identified that living with nyaope users is associated with the development of different levels of depression symptoms and has resulted in reduced quality of life among family members. The study recommends interventions that intentionally focus on families who live with individuals who are addicted to nyaope. Those interventions should focus on screening and treatment of depression and other mental disorders.

The Biological Mechanism of Maternal Depression’s Negative Influences on Offspring Development: A Review

Maternal depression is a prevalent disorder among mothers: nearly 20% of women have experienced different levels of depressive symptoms during motherhood. The symptoms usually disappear by three years after their children were born, but some women experience them chronically. Maternal depression has been researched in terms of its negative influence on offspring since the 1960s. Children of chronically depressed mothers show delays in cognitive, emotional, and behavioral development. Moreover, they may even face mental health challenges themselves. How does maternal depression influence offspring? Previous studies have focused on the behaviors of mothers and found that mothers with depression interact with their children in a less engaging way. Recently, more researchers started to pay attention to the biological mechanism of this maternal depression’s negative influence. Cortisol, a hormone associated with stress, is regarded as a potential pathway of the transgenerational transmission of depression. Mothers with prenatal depression have elevated cortisol level during pregnancy, which is passed down to their children. After they are born, children of depressed mothers react to stress with more dramatic changes in cortisol level and compromised stress-coping abilities. Moreover, prenatal maternal depression also seems to shape the functional connectivity of amygdala, a brain area related to stress and emotions. For life situations like schooling, competing with peers or making significant decisions, children with decreased or abnormal stress-coping abilities will be in disadvantageous positions. Attenuated stress coping abilities brought by hormonal and neural changes may be a biological mechanism for children’s lower performance in cognitive and behavioral tasks.

Characteristics of resting-state electroencephalogram microstates in individuals with different levels of depressive symptoms

Characteristics of resting-state electroencephalogram microstates in individuals with different levels of depressive symptoms

The possible mediatory role of adipokines in the association between low carbohydrate diet and depressive symptoms among overweight and obese women.

BackgroundPrevious studies showed the possible association between obesity, dietary pattern, and depressive symptoms. Due to the lack of enough data to confirm the association of obesity and depression in the Middle East, here, we aimed to explore the possible mediatory role of adipokines Galectin-3, transforming growth factor-beta (TGF-β), and endothelial plasminogen activator inhibitor (PAI-1) in the association between low carbohydrate diet (LCD) and depressive symptoms.MethodsA total of 256 women aged 17–56 years old were grouped based on their LCD score. Depression anxiety stress scales-21 (DASS-21) self-administered questionnaire was used to evaluate the three negative emotional states of stress, depressive symptoms, and anxiety. Body composition and dietary intake were assessed. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of Galectin-3, TGF-β, and PAI-1.ResultsNo significant difference was observed regarding Galectin-3, TGF-β, and PAI-1 levels between the groups with dissimilar adherence to LCD or the groups with different levels of depressive symptoms (P>0.05). However, there was a negative association between LCD score as a covariant and depressive symptoms as an independent variable (P = 0.02) and remarkably, a regression model linear analysis using Galectin-3, TGF-β, and PAI-1 as confounding variables indicated the mediatory role of these adipokines in this association (P>0.05). In other words, adipokines eliminated the significance of the relationship between adherence to LCD and depressive symptoms.ConclusionIt seems that higher adherence to LCD is probably associated with a lower prevalence of depressive symptoms in obese adults through the mediatory role of adipokines.

The Prevalence of Depression among Undergraduates of a Selected Medical Faculty in Sri Lanka

Introduction: Depression is a common mental disorder which can lead to major problems such as suicidal attempts. It is well known that the demands and pressure on undergraduates in medical faculties create tremendous challenges which result in an extensive range of psychological ailments like depression. The objective of this study was to determine the prevalence of different levels of depression among undergraduates in a selected medical sciences faculty in Sri Lanka. Methods: A descriptive cross-sectional study was conducted using a convenient sampling technique among students in a selected medical faculty. The Depression Anxiety Stress Scale-21 (DASS-21) was used to assess depressive symptoms of the respondents. Descriptive analysis was done using SPSS version 23. Results: Mean age of the sample (n=397) was 24.1±2.5 years. The mean score obtained for depression was 10.5±8.3. Only 38.5% of the respondents had normal level of depressive symptoms while 7.1% and 4.0% of the respondents presented severe and extremely severe symptoms, respectively. Age (p=0.011) and academic year (p=0.001) showed a significant association with depression. Conclusions: The study demonstrates a considerable prevalence in different levels of depressive symptoms among undergraduates who are enrolled in medical and allied health sciences programmes. Therefore, it would be highly beneficial to reduce depressive symptoms by early identification. Studies to identify causes and interventional studies will contribute to implement measures to improve identification, and reduce the prevalence of depression among undergraduates.Keywords: Depression, Undergraduates, Mental disorder

Evaluation of emotional (depression) and behavioural (nutritional, physical activity and sleep) status of Turkish adults during the COVID-19 pandemic period.

To evaluate emotional (depression) and behavioural (nutritional behaviours, physical activity status and sleep patterns) of Turkish adult individuals during the COVID-19 pandemic period. Cross-sectional online survey. The participants filled out a questionnaire (developed by using Google Forms) that contained descriptive characteristics, nutritional behaviours, sleep patterns, physical activity status, anthropometric measurements, COVID-19-related level of knowledge and the questions of the Center for Epidemiological Studies Depression Scale through e-mail or social media (WhatsApp). Turkey. Totally, 1120 adult individuals who completed an online survey between April and May 2020. It was determined that 29·1 % of the individuals showed mild, 34·2 % moderate and 23·4 % severe depression symptoms during the pandemic period. A significant relationship was found between gender, age and educational status, marital status and depression levels of the individuals, respectively (χ2 = 35·292, χ2 = 103·46, χ2 = 24·524 and χ2 = 86·208, P < 0·05). The top three foods consumed most during the pandemic period are tea and coffee (66·6 %), pastry (e.g. cake and cookie) (56·4 %) and desserts (49·6 %). During the pandemic period, 42·5 % of the individuals stated that they slept more and 40·2 % stated that there was no change in their sleep patterns. Daily physical activity durations were determined as 8·25 ± 1·77 h for sleep, 4·21 ± 2·68 h for lying down, 5·42 ± 2·64 h for sitting and 6·16 ± 4·82 h for standing activities. It was determined that the individuals showed different levels of depression symptoms during the pandemic period. Especially, carbohydrate food consumption increased, and physical activity status and sleep patterns changed due to the increased time spent sitting and lying.

Depressive symptoms and major adverse cardiovascular events: 12-month follow-up in patients undergoing angiography.

BACKGROUNDDepression is closely related to coronary artery disease (CAD). However, the association of depression before angiography with major adverse cardiovascular event (MACE) is still unknown.METHODSIn a prospective cohort study, 410 patients underwent angiography for the first time between 2016 and 2017 in Dr. Heshmat Hospital, Rasht, Iran. Demographic and medical information were collected and depressive symptoms were assessed using Beck Depression Inventory-II (BDI-II). The patients were followed for one year after angiography. Chi-square test and analysis of variance (ANOVA) were performed to compare demographic and clinical characteristics of patients between different levels of depressive symptoms. Multiple Cox regression analysis was performed to assess the association between depression symptoms before angiography and MACE rate controlled for the effect of confounders.RESULTSOf 410 patients, follow-up data were available for 380 (95%) patients. the MACE occurred in 134 (35%) patients. Depressive symptoms were observed in 42% of patients. Based on multivariable Cox regression analysis, adjusted for CAD severity, the risk of one-year MACE occurrence in patients with mild, moderate, and severe depressive symptoms was 1.96 [95% confidence interval (CI) for hazard ratio (HR): 1.30-2.94], 1.88 (95% CI for HR: 1.15-3.09), and 2.81 (95% CI for HR: 1.56-5.06) times that of patients without depressive symptoms, respectively. Depression in patients before angiography increased the risk of MACE up to 2.045 times.CONCLUSIONThe results showed that MACE in patients with depression was more than patients without depression. MACE in different levels of depression (mild, moderate, severe) was not significantly different.

The moderating role of spirituality on quality of life and depression among adolescents with spina bifida.

To investigate the relationships between spirituality, somatic symptom distress/severity, depressive symptoms and quality of life (QOL) for adolescents diagnosed with spina bifida (SB). Exploratory, cross-sectional design. Fifty-eight adolescents with SB in southern California were recruited during routine visits to a multidisciplinary clinic at a healthcare university from January 2016-January 2017. Each adolescent completed a series of self-report measures, including the System of Belief Inventory, Somatic Symptom Scale, Patient Health Questionnaire and Pediatric Quality of Life Inventory. Path analysis was performed to examine regression coefficients for each direct and indirect effect. The mediation-moderation analysis showed that depressive symptoms fully mediated the relationship between symptom distress and QOL (B=0.029 [0.014], CI [0.007, 0.061]) and higher levels of spirituality moderated the relationship between depressive symptoms and QOL (B=0.052, p=.018). Spirituality was higher for adolescents with greater symptom severity; including shunt status Welch's F(1, 53.689)=4.174, p=.046, level of lesion F(2,57)=3.382, p=.041, and ambulation status F(3, 57)=2.920, p=.042. Adolescents with SB who had greater levels of symptom distress experienced significantly higher levels of depressive symptoms and a lower QOL. Contrary to our expectations, adolescents with greater levels of spirituality had a lower QOL when depressive symptoms were mild/moderate, but no differences were noted when depressive symptoms were severe. This study examined the relationship between spirituality and quality of life (QOL) in adolescents with spina bifida, who were experiencing different levels of depressive symptoms and symptom distress/severity. Depressive symptoms appeared to have a more profound effect on QOL than spirituality. Accordingly, we recommend that healthcare professionals actively screen for depressive symptoms when assessing these adolescents and their physical symptoms/distress levels.

Posttraumatic growth in breast cancer survivors: Are depressive symptoms really negative predictors?

Breast cancer (BC) diagnosis is a potentially traumatic event, the related challenges of which can trigger positive or negative reactions. Posttraumatic growth (PTG) is defined as a positive psychological change experienced as a result of the struggle. The present study aimed to shed light on the relationship between the evolution of depressive symptoms over time and PTG in a group of BC survivors. Depressive symptoms at the time of diagnosis (T0) and 2 years later (T1) were evaluated to investigate their potential impact on the level of PTG at T1. A total of 147 BC patients were recruited and divided into 4 groups according to the changes in depressive symptoms they experienced over time (patients who were never depressed, no longer depressed, still depressed, and depressed now). A One-way analysis of variance was run to compare the levels of PTG for the four groups. The One-way analysis of variance showed that PTG score was significantly different among groups with different levels of depressive symptoms (p = .008). Post hoc comparisons indicated that the PTG score was statistically significantly higher in the no longer depressed group compared with the still depressed and depressed now groups. The current results suggest that high levels of depressive symptoms, displayed at the time of cancer diagnosis, can be considered catalysts for PTG at follow-up, on condition that women experience elevated depressive symptoms only in the first period of the disease. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Are measures of marital satisfaction valid for women with depressive symptoms? The examination of factor structure and measurement invariance of the Couple Satisfaction Index‐4 across depression levels in Portuguese women

Marital satisfaction (MS) is a key indicator of mental and physical health. Factor structure of MS measures in individuals with clinical levels of depression as well as their measurement invariance across groups with different levels of depressive symptoms were not yet explored. The lack of evidence of measurement invariance might compromise valid comparisons between individuals with elevated and minimal depressive symptoms in MS. This study examined the factor structure of the Couple Satisfaction Index-4 (CSI-4) among women with clinical levels of depression, tested the CSI-4 measurement invariance across depression levels groups, and investigated CSI-4 convergent and divergent validity. Participants were 891 heterosexual married/cohabiting women who were assigned into one of two groups based on assessment of their levels of depressive symptoms. Participants completed the CSI-4 and self-reported measures used to examine convergent and divergent validity. Support was found for the factor structure of the CSI-4 for the total sample and both elevated depressive symptoms and minimal depressive symptoms groups. Subsequent multigroup confirmatory factor analyses supported the measurement invariance of the CSI-4 across depression levels groups. The CSI-4 revealed excellent values of internal consistency and convergent and divergent validity. Our findings suggest that CSI-4 produces comparable response patterns across depression groups and thus meaningful comparisons between groups can be performed.

Relationship between delay discounting and depression in cigarette smokers and non-smokers

BackgroundDelay discounting (DD) is a measure of impulsivity that describes the devaluation of reinforcers when delayed. Several studies have associated greater DD with drug dependence and certain mental disorders such as depression. The aim of the present study is to determine whether there are differences in DD rates between smokers and non-smokers with different levels of depressive symptoms. MethodsThe study included 200 individuals: smokers without depressive symptoms (n = 40), smokers with moderate depressive symptoms (n = 40), smokers with severe depressive symptoms (n = 40), non-smokers with moderate depressive symptoms (n = 40), and controls (n = 40). The Beck Depression Inventory-II (BDI-II) and the Structured Clinical Interview (SCID-I) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) were used to assess depressive symptoms and the presence of major depressive disorder. All participants completed a computerized DD task with hypothetical monetary values. ResultsThere was a significant correlation between AUC and BDI-II measures in non-smokers. There were statistically significant differences in DD between the comparison groups (p < .001). Controls were less impulsive than the other groups. ConclusionsSmoking and depression are related to high DD; however, there is no additive effect on impulsivity rates when both conditions appear together.

Korean Americans’ varying levels of depressive symptoms in relation to the ethnicities of their major interaction partners: Comparisons and explanations

ABSTRACTAfter conducting a survey study with cross-sectional data involving 377 Korean Americans, this study finds that (1) Korean Americans mainly interacting with European Americans report a lower level of depressive symptoms than those in frequent contact with African Americans or Latino/as; (2) a model involving the relationships between Korean Americans’ perceived ethnic distance, personal-relational and personal-enacted identity gaps, and level of depressive symptoms is tenable; and (3) comparisons of the model applied to three groups of Korean Americans who interact with different ethnic groups reveal that relationships between the perceived ethnic distance and the identity gaps are accentuated for Korean Americans who predominantly interact with African Americans and attenuated with those in frequent contact with European Americans. Possible explanations for the different levels of depressive symptoms according to the ethnicities of the Korean Americans’ major interaction partners are discussed.

Prevalence rates of arthritis among US older adults with varying degrees of depression: Findings from the 2011 to 2014 National Health and Nutrition Examination Survey.

Arthritis and depressive symptoms often interact and negatively influence one another to worsen mental and physical health outcomes. Better characterization of arthritis rates among older adults with different levels of depressive symptoms is an important step toward informing mental health professionals of the need to detect and respond to arthritis and related mental health complications. The primary objective is to determine arthritis rates among US older adults with varying degrees of depression. Using National Health and Nutrition Examination Survey 2011 to 2014 data (N=4792), we first identified participants aged ≥50years. Measures screened for depressive symptoms and self-reported doctor-diagnosed arthritis. Weighted logistic regression models were conducted. Prevalence of arthritis was 55.0%, 62.9%, and 67.8% in participants with minor, moderate, and severe depression, respectively. In both unadjusted and adjusted regression models, a significant association between moderate depression and arthritis persisted. There were also significant associations between minor and severe depression with arthritis. Arthritis is commonly reported in participants with varying degrees of depression. This study highlights the importance of screening for and treating arthritis-related pain in older adults with depressive symptoms and the need for future geriatric psychiatry research on developing integrated biopsychosocial interventions for these common conditions.

Does life story work improve psychosocial well-being for older adults in the community? A quasi-experimental study

BackgroundPrevious studies have demonstrated that life story work has positive effects when used on older adults. This study aimed to examine the effect of life story work on the general mental well-being, self-esteem, and life satisfaction of older adults by comparing two groups – one with and one without depressive symptoms.MethodsA quasi-experimental design was adopted in this study. One hundred and twenty-three adults aged 60 or above were recruited from community centers through convenience sampling. They were allocated into two groups based on their level of depressive symptomatology as measured by the Geriatric Depression Scale (GDS). The intervention was to produce a written life story with pictures and memorabilia in four to six semi-structured sessions facilitated by trained volunteers. The outcome measures included general mental well-being (General Health Questionnaire, GHQ), life satisfaction (Life Satisfaction Scale Index A, LSI-A), and self-esteem (Rosenberg’s Self-esteem Scale, RSES). Data were collected at baseline (T0), immediately post-intervention (T1), and at the 3-month follow-up (T2). Generalized estimating equations were used to examine the effect of the intervention on the outcomes.ResultsThere was a significant interaction effect between the two groups at T1 (β = 0.244, p < 0.05) with improvements in the GHQ observed in the group with depressive symptomology. No significant time and interaction effects were seen on the LSI-A and RSES. The Friedman test was also used to examine whether the intervention itself would have any effects on the GDS score, with two groups combined. A reduction in the mean GDS score was found to be close to reaching a level of significance (χ2 = 5.912, p = 0.052).ConclusionThe findings of this study provided some preliminary evidence that life story work was effective at improving the general mental well-being of community-dwelling older adults with depressive symptomology. Because older adults with different levels of depressive symptoms might respond differently to life story work interventions, our findings offer interesting directions for future studies – for instance, on what population would benefit the most from Life Story Work and what would be the mechanism that renders Life Story Work effective.

Examining the interplay between depression, motivation, and antiretroviral therapy adherence: a social cognitive approach

ABSTRACTA large body of research identifies depressive symptoms as a barrier to optimal antiretroviral therapy (ART) adherence, whereas treatment motivation has been characterized as a facilitator. There is evidence, however, that these patterns may not hold for some ART patients despite the widespread use of motivational techniques aimed at promoting adherence. Little is known about how the interplay between different levels of depressive symptoms and variations in the types and levels of motivation may influence ART adherence. The purpose of this study was to examine the relationship between depressive symptoms, two types of motivation, and adherence, with self-efficacy as a mediator. The sample consisted of 121 ART patients who reported various levels of depressive symptoms (mean age = 41 years; 84% African-American; and 68% female). Path analysis revealed that self-efficacy fully mediated the relationship between the three predictor variables (depressive symptoms, intrinsic motivation, and extrinsic motivation) and adherence, χ2(3, N = 121) = .78, RMSEA = .00, SRMR = .02, CFI = 1.00, NNFI = 1.06. Findings suggest that interventions using motivational techniques to build adherence among patients with varying levels of depressive symptoms should address the role of treatment self-efficacy to improve their effectiveness.