Elevated Depressive Symptomatology Research Articles

Young Mothers and Dating Violence: An Examination of Depressive Symptomatology and Interpersonal Competency

Abstract Purpose Young mothers are an understudied group at high risk for dating violence (DV) victimization and perpetration. Prior research has investigated depressive symptomatology as a predictor of DV in female adolescents and young women; however, minimal research focuses on young mothers, and the specific mechanisms influencing the relationship between depressive symptomatology and DV for young mothers remain elusive. Interpersonal competency is one potential mechanism given its role in creating healthy foundations for romantic relationships. The present study examined interpersonal competency as a potential mechanism linking depressive symptomatology and DV victimization and perpetration in a sample of young mothers. We hypothesized young mothers with elevated depressive symptomatology would report higher rates of DV victimization and perpetration, and that these associations would be mediated by interpersonal competence. Methods Young mothers ages 18–21 in the United States (n = 238) completed questionnaires pertaining to our primary variables of interest via an online, cross-sectional survey. We conducted a mediation analysis to examine the average causal mediation and average direct effects. Results DV experiences were related to depressive symptomatology and interpersonal competency. Interpersonal competency was not a mediator; however, direct effects were present between depressive symptomatology and DV victimization and perpetration. Conclusions Our results suggest that prevention interventions should target depressive symptomatology (i.e., hopelessness, feeling easily bothered, social isolation) and interpersonal competency (i.e., initiation, disclosure, emotional support) to reduce young mothers’ DV experiences.

Depression-Mediating Pathways From Household Adversity to Antiretroviral Therapy Nonadherence Among Children and Adolescents Living With HIV in Zambia: A Structural Equation Modeling Approach.

In Zambia, half of children and adolescents living with HIV (CALWH) on antiretroviral therapy (ART) are virologically unsuppressed. Depressive symptoms are associated with ART nonadherence but have received insufficient attention as mediating factors in the relationship between HIV self-management and household-level adversities. We aimed to quantify theorized pathways from indicators of household adversity to ART adherence, partially mediated by depressive symptoms, among CALWH in 2 Zambian provinces. In July-September 2017, we enrolled 544 CALWH aged 5-17 years and their adult caregivers into a year-long prospective cohort study. At baseline, CALWH-caregiver dyads completed an interviewer-administered questionnaire, which included validated measures of recent (past 6 months) depressive symptomatology and self-reported past-month ART adherence (never versus sometimes or often missing medication doses). We used structural equation modeling with theta parameterization to identify statistically significant ( P < 0.05) pathways from household adversities (past-month food insecurity and caregiver self-reported health) to depression (modeled latently), ART adherence, and poor physical health in the past 2 weeks. Most CALWH (mean age: 11 years, 59% female) exhibited depressive symptomatology (81%). In our structural equation model, food insecurity significantly predicted elevated depressive symptomatology ( ß = 0.128), which was associated inversely with daily ART adherence ( ß = -0.249) and positively with poor physical health ( ß = 0.359). Neither food insecurity nor poor caregiver health was directly associated with ART nonadherence or poor physical health. Using structural equation modeling, we found that depressive symptomatology fully mediated the relationship between food insecurity, ART nonadherence, and poor health among CALWH.

Combatting negative bias: a mental contrasting and implementation intentions online intervention to increase help-seeking among individuals with elevated depressive symptomatology.

There are many reasons why individuals with depression may not seek help. Among those with elevated depressive symptomatology, some previous interventions aimed at increasing help-seeking have unintentionally decreased help-seeking intentions. Beck's cognitive theory of depression posits that individuals with elevated depressive symptomatology process information differently from those without depression (i.e., increased cognitive errors, negative bias); potentially explaining the iatrogenic results of previous interventions. Mental contrasting and implementation intentions (MCII; a self-regulatory strategy) interventions have successfully influenced physical and mental health behaviors. However, MCII has not been used specifically for initiating help-seeking for depression. The goal of this research was to ascertain whether an online MCII intervention could increase actual help-seeking or the intention to seek help for depression. Two online randomized pre-post experiments were conducted to measure the primary outcome measures 2 weeks post-intervention (Study 1 collected Summer 2019: information-only control ["C"], help-seeking MCII intervention ["HS"], and comparison MCII intervention ["E"]; Study 2 collected Winter 2020: "C" and "HS"). At Time 1, adults recruited from MTurk had a minimum Beck Depression Inventory (BDI-II) score of 14 (mild depressive symptoms) and were not seeking professional help. Study 1 (N = 74) indicated that the intervention was feasible, provided preliminary support, and clarified intervention components for Study 2. Study 2 (N = 224) indicated that the HS group reported greater intentions to seek help and actual help-seeking than the C group. Proportionally, actual help-seeking was more likely among individuals who received the HS intervention and either did not perceive themselves as depressed at Time 2 or had BDI-II scores indicating that their depressive symptomatology decreased from Time 1. Participation was limited to US residents who self-reported data. These studies indicate that a brief online MCII intervention to encourage help-seeking is feasible and preliminarily successful. Future studies should consider using ecological momentary assessment measurements to establish the temporal precedence of intervention effects and whether MCII is effective for encouraging help-seeking among individuals prone to experiencing cognitive errors who may not be experiencing negative bias (e.g., bipolar disorder or anxiety). Clinicians may find this method successful in encouraging ongoing treatment engagement.

The pain and depressive symptoms cascade: A bidirectional analysis of the Mexican Health and Aging Study 2012-2015.

The association of pain and depression has not been evaluated in low- and middle-income countries, which have a disproportionate burden of pain compared to high-income countries. Using data from the Mexican Health and Aging Study (baseline, 2012; follow-up, 2015), we examined the bidirectional relationship between pain and depressive symptoms and identified shared predictors among community-dwelling participants ≥60years (n=7237). Multivariable logistic regressions models evaluated the association between (1) baseline pain and incident elevated depressive symptoms and (2) baseline depressive symptoms and incident pain, adjusting for demographic, socioeconomic, and health-related factors. Models included inverse probability weights and evaluated interactions by gender. Participants (55.0% women) were on average 69.1years old. Over half reported no pain (60.7%) and low/no depressive symptoms (67.9%) in 2012, of which, 20.2% reported elevated depressive symptoms and 25.3% self-reported pain in 2015. Baseline pain was associated with higher odds of incident elevated depressive symptoms (aOR 1.65; 95% CI, 1.41-1.93). Baseline elevated depressive symptoms were associated with higher odds of developing pain (aOR 1.57; 95% CI, 1.32-1.87). Age, gender, self-rated health, and activity of daily living limitations were shared risk factors for pain and elevated depressive symptomatology onset. Although the incidence of elevated depressive symptoms and pain was higher in women, there were no statistically significant interactions. Older adults with pain or depression may be at risk for developing the other. These shared predictors could help identify patients in clinical settings, where pain and depression are often overlooked, reducing the cascading risk of this comorbidity.

Increasing help-seeking among people with depression by self-distancing using mental time-travel

Background Past research indicates that self-distancing through perspective-taking may increase help-seeking intentions among some people with depression. Aims The current pre-registered study tested the effect of self-distancing through mental time-travel on help-seeking attitudes, intentions, outcome expectations, and self-stigma. Methods Participants with elevated depressive symptomatology who had not yet sought help for current feelings of depression (n = 859) were randomly assigned to a self-distancing writing task, a self-immersive writing task, or a control condition. Results Help-seeking attitudes were significantly higher in the distancing condition than in the immersive or control conditions. Additionally, self-distancing through mental time-travel resulted in higher help-seeking intentions compared to the control condition but was not significantly different from the immersive condition. The immersive condition was not significantly different from the control for any outcomes. Interactions show that both self-distancing and the immersive task weakened the negative relationship between depression severity and help-seeking attitudes and intentions. Conclusion Extending scholarship investigating self-distancing and help-seeking intentions, results show that self-distancing through mental time-travel can result in more favorable help-seeking attitudes compared to a control.

A Comparison of Depressive Symptoms in Medical and Psychology Students in Germany – Associations with Potential Risk and Resilience Factors

Background: Previous studies have shown that medical students are more prone to suffer from symptoms related to depression than other students. Even though there is some evidence that psychology students also experience such symptoms, research concerning the mental health of future psychologists is scarce. Objective: The aims of this study were threefold: (a) to determine the prevalence of symptoms related to depression among medical and psychology students (b) to investigate risk factors, which may have a potential influence on the development of depressive symptoms and (c) to examine resilience factors in order to indicate possible approaches to improve the mental health of the students. Methods: A total of 673 medical and psychology students completed the Beck Depression Inventory-II (BDI-II) to assess depressive symptoms, a neuroticism scale, and a standardized questionnaire for 13 risk and eight resilience factors derived from the literature. Results: While the results of previous research concerning the prevalence of depressive symptoms could be replicated for medical students (22% exceeding the cut-off in the BDI-II), psychology students demonstrated an even higher prevalence (28%). Ten potential risk factors and five potential resilience factors could be identified, which also showed a cumulative effect: The more risk factors students reported, the more depressive symptoms they experienced; the inverse effect was observed for resilience factors. Conclusions: Not only medical but also psychology students show elevated depressive symptomatology. In the university context, notably, the pressure to perform represents a potential risk factor, whereas the presence of just two resilience factors such as emotional support and study satisfaction contribute to a decrease of symptoms.

Examination of risk factors for discontinuation of follow-up care in patients with head and neck cancer.

Little research has examined discontinuation of follow-up care in patients with head and neck cancer. This exploratory study sought to examine key demographic, disease, and behavioral factors as possible correlates of discontinuation (N=512). Cross-sectional study examined correlates of discontinuation of follow-up care within 1 year. The primary outcome was defined as a disease-free survivor not returning to cancer clinic for two consecutive follow-up appointments within the first year of care and not reentering oncologic care at any point thereafter. Demographic, disease, and behavioral factors were examined using multivariable logistic regression. One hundred twenty-six (24.6%) patients discontinued by 12-month follow-up. Being unmarried (OR=1.28, 95% CI=1.01-1.63, p=0.041) and having elevated depressive symptomatology (OR=1.04, 95% CI=1.01-1.07, p=0.034) were significantly associated with discontinuation. Receipt of a single (vs. multimodal) treatment approached significance (OR=1.71, 95% CI=0.96-3.07, p=0.071). Approximately one quarter of patients disengaged from important follow-up care within 1 year. Lack of social support, depressive symptomatology, and single treatment modality may be important correlates of discontinuation of care in patients with head and neck cancer. Additional studies of this outcome are needed. Improved understanding of correlates associated with discontinuation could facilitate the identification of at-risk patients and further development of interventions to keep patients engaged at a crucial time in the survivorship care trajectory.

Intergenerational Effects of Discrimination on Black American Children's Sleep Health.

Greater exposure to racial/ethnic discrimination among pregnant Black American women is associated with elevated prenatal depressive symptomatology, poorer prenatal sleep quality, and poorer child health outcomes. Given the transdiagnostic importance of early childhood sleep health, we examined associations between pregnant women’s lifetime exposure to racial/ethnic discrimination and their two-year-old children’s sleep health. We also examined women’s gendered racial stress as a predictor variable. In exploratory analyses, we examined prenatal sleep quality and prenatal depressive symptoms as potential mediators of the prior associations. We utilized data from a sample of Black American women and children (n = 205). Women self-reported their lifetime experiences of discrimination during early pregnancy, their sleep quality and depressive symptoms during mid-pregnancy, and their children’s sleep health at age two. Hierarchical linear multiple regression models were fit to examine direct associations between women’s experiences of discrimination and children’s sleep health. We tested our mediation hypotheses using a parallel mediator model. Higher levels of gendered racial stress, but not racial/ethnic discrimination, were directly associated with poorer sleep health in children. Higher levels of racial/ethnic discrimination were indirectly associated with poorer sleep health in children, via women’s prenatal depressive symptomatology, but not prenatal sleep quality. Clinical efforts to mitigate the effects of discrimination on Black American women may benefit women’s prenatal mental health and their children’s sleep health.

Toward a Typology of Transnational Communication among Venezuelan Immigrant Youth: Implications for Behavioral Health.

We identify subtypes of Venezuelan youth based on patterns of technology-based communication with friends in their receiving (US) and sending (Venezuela) countries and, in turn, examine the behavioral health characteristics among different "subtypes" of youth. Using data from 402 recently-arrived Venezuelan immigrant youth (ages 10-17), latent profile analysis and multinomial regression are employed to examine the relationships between technology-based communication and key outcomes. We identified a four-class solution: [#1] "Daily Contact in US, In Touch with Venezuela" (32%), [#2] "Daily Communication in Both Countries" (19%), [#3] "Weekly Contact: More Voice/Text Than Social Media" (35%), and [#4] "Infrequent Communication with US and Venezuela" (14%). Compared to Class #1, youth in Classes #2 and #3 report elevated depressive symptomatology and more permissive substance use views. Findings suggest that how youth navigate and maintain transnational connections varies substantially, and that technology-based communication is related to key post-migration outcomes.

Is "Busy" Always Better? Time-Use Activities and Depressive Symptoms Among Older Mexican Adults.

Background and ObjectivesDepression among older Mexican adults is underrecognized and of increasing concern due to its association with comorbidities including cognitive and functional impairments. Prior studies have found an association between low involvement levels in social activities and depression. We aimed to examine the association of time-use activities and depressive symptomatology by sex.Research Design and MethodsWe used data from the 2012 and 2015 waves of the Mexican Health and Aging Study. Participants aged 60 and older who had low or no depressive symptoms in 2012 were included in these analyses (N = 4,309). Factor analysis was used to group activities and logistic regression models were used to assess the association of baseline time use with depressive symptomatology in 2015.ResultsAmong those with low or no depressive symptomatology in 2012, 21.0% reported elevated symptoms (5+) in 2015. Those with elevated depressive symptoms were more likely to be women, older, lower educated, and with at least one activity of daily living limitation. Four time-use domains emerged from the factor analysis including hobbies and indoor activities, volunteering, caregiving, and working. The hobbies and indoor activities domain was associated with lower odds of elevated symptoms for men and women (odds ratio [OR]: 0.76, 95% confidence interval [CI]: 0.61–0.96; and OR: 0.75, 95% CI: 0.61–0.91, respectively). Additionally, the volunteer and community activities domain was associated with lower odds of depressive symptoms for women (OR: 0.72, 95% CI: 0.58–0.89) and men (OR: 0.77, 95% CI: 0.60–0.99).Discussion and ImplicationsUnderstanding how older Mexicans distribute their time among different activities and its associations with depressive symptoms can help guide policy and sex-specific interventions for psychological well-being. Certain domains had lower odds for elevated depressive symptomatology; future work should examine this association in other countries as well as the context of the built environment.

Risk for depression and anxiety in long-term survivors of hematologic cancer.

An increasing number of hematologic cancer patients outlive 10 years past diagnosis. Nevertheless, few studies investigated psychological strain in this patient group beyond 5 years after diagnosis. We conducted a registry-based investigation of risk for depression and anxiety among long-term hematologic cancer survivors up to 26 years after diagnosis compared to the general population. In this cross-sectional postal survey, cancer survivors were recruited through 2 regional cancer registries in Germany. Depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) were assessed. Survivor data were compared to age- and gender-matched comparison groups (CG) randomly drawn from large representative samples (N > 5,000). Out of 2,001 eligible patients, 46% participated (n = 922). Survivors were significantly more likely than the CG to report elevated depressive (relative risk [RR] = 3.1; 95% confidence interval [CI]: 2.2-4.3) and anxious symptomatology (RR = 1.7; 95% CI: 1.2-2.3). Depression scores remained high even in the survivor Group 12-26 years after diagnosis. RR for anxiety decreased to values comparable to the CG. Younger and middle-aged survivors (≤65 years) were at highest relative and absolute risk to be psychologically impaired. This study shows that depression rather than anxiety is a prominent problem in long-term survivors of hematologic cancer. The results stress the importance of monitoring patients even years after diagnosing and supplying psychosocial support to patients in need. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Insomnia symptoms predict both future hypertension and depression

The prevalence of hypertension and depression is high in older populations. Moreover, their comorbidity may significantly increase morbidity and mortality. However, the risk factors contributing to both health conditions are not well understood. Older individuals are prone to insomnia; thus we hypothesized that having more insomnia symptoms increases risk for incident hypertension and depression over time.The sample consisted of a longitudinal population-based study of community-dwelling older individuals, from the 2008–2016 waves of the Health and Retirement Study, sampled across the United States.A total of 18,123 subjects, aged 50+, were stratified into three age groups, ages 50–60, 61–74, and 75 and older years. Subjects were excluded for reporting baseline hypertension or depression at the first wave 2008. Center for Epidemiologic Studies-Depression (CES-D) score ≥ 4 was the cutoff for elevated depressive symptomatology. Subjective insomnia symptoms were evaluated.Cox proportional hazards regression revealed that SBP (1.02[1.01, 1.02]) and more insomnia symptoms (1.11[1.01, 1.21]) were significant predictors of hypertension for all age groups. For depression, only insomnia symptoms were significant predictors (9.91[6.37, 15.41]). Kaplan-Meier curves revealed that 9.2% of the overall cohort had both hypertension and depression within 8 years and more insomnia symptoms predicted greater incidences of both conditions (p-values <0.001).In this older prospective cohort, insomnia symptoms are consistent predictors of future hypertension and depression in all age groups, who were not hypertensive and depressed at baseline. Insomnia may contribute to the etiology and comorbidity of hypertension and depression in older individuals.

Psychosocial profiles of adolescents from dissolved families: Differences in depressive symptoms in emerging adulthood

BackgroundWhen parents separate, on average, children are at greater risk for concurrent and subsequent depression; however, mean outcomes mask substantial variation in depressive risk. This study aimed to (1) identify multivariate risk profiles (classes) in adolescents from separated families and (2) prospectively estimate class risk for depressive symptoms in emerging adulthood. MethodsThe sample comprised 449 participants with separated parents from an Australian population based longitudinal cohort study established in 1983. Classes were explored using 17, theoretically germane, self- and parent-reported indicators of adolescent risk assessed at three points in adolescence (13–14, 15–16 and 17–18 years), spanning three domains of assessment: individual, relational, contextual. Distinct profiles of adolescents were identified using Latent Class Analysis. Class differences on depressive symptoms in emerging adult (19–20 years) were then examined. ResultsThree multivariate profiles, differentiated by patterns of risk severity, were observed: Adjusted (n = 253), Moderate Risk (n = 156), and High Risk (n = 40). Compared to the Adjusted class, participants in the Moderate Risk, but not High Risk class had notably elevated depressive symptomatology in emerging adulthood (d = 0.35). In contrast, High Risk class membership in adolescence predicted antisocial behavior in emerging adulthood. LimitationsRisk for depressive symptoms in emerging adulthood may be under-estimated due to a disproportionate loss of participants from low socio-economic backgrounds. ConclusionsWe found most adolescents from dissolved families to be well-adjusted. Differences between Moderate Risk and High Risk adolescents signal differentiated pathways to subsequent mental health problems. Our findings are relevant for targeted therapeutic strategies for adolescents from dissolved families.

A Self-Paced, Web-Based, Positive Emotion Skills Intervention for Reducing Symptoms of Depression: Protocol for Development and Pilot Testing of MARIGOLD.

BackgroundLiving with elevated symptoms of depression can have debilitating consequences for an individual’s psychosocial and physical functioning, quality of life, and health care utilization. A growing body of evidence demonstrates that skills for increasing positive emotion can be helpful to individuals with depression. Although Web-based interventions to reduce negative emotion in individuals with depression are available, these interventions frequently suffer from poor retention and adherence and do not capitalize on the potential benefits of increasing positive emotion.ObjectiveThe aim of this study was to develop and test a Web-based positive emotion skills intervention tailored for individuals living with elevated depressive symptoms, as well as to develop and test enhancement strategies for increasing retention and adherence to that intervention.MethodsThis study protocol describes the development and testing for Mobile Affect Regulation Intervention with the Goal of Lowering Depression (MARIGOLD), a Web-based positive emotion skills intervention, adapted for individuals with elevated depressive symptomatology. The intervention development is taking place in three phases. In phase 1, we are tailoring an existing positive emotion skills intervention for individuals with elevated symptoms of depression and are pilot testing the tailored version of the intervention in a randomized controlled trial with two control conditions (N=60). In phase 2, we are developing and testing three enhancements aimed at boosting retention and adherence to the Web-based intervention (N=75): facilitator contact, an online discussion board, and virtual badges. In phase 3, we are conducting a multifactorial, nine-arm pilot trial (N=600) to systematically test these enhancement strategies, individually and in combination. The primary outcome is depressive symptom severity. Secondary outcomes include positive and negative emotion, psychological well-being, and coping resources.ResultsThe project was funded in August 2014, and data collection was completed in May 2018. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2018.ConclusionsFindings from this investigation will enable us to develop an optimal package of intervention content and enhancement strategies for individuals with elevated symptoms of depression. If this intervention proves to be effective, it will provide a cost-effective, anonymous, appealing, and flexible approach for reducing symptoms of depression and improving psychological adjustment through increasing positive emotion.Trial RegistrationClinicalTrials.gov NCT01964820 (Phase 1); https://clinicaltrials.gov/ct2/show/NCT01964820 (Archived by WebCite at http://www.webcitation.org/6zpmKBcyX). ClinicalTrials.gov NCT02861755 (Phase 2); https://clinicaltrials.gov/ct2/show/NCT02861755 (Archived by WebCite at http://www.webcitation.org/6zpmLmy8k).Registered Report IdentifierRR1-10.2196/10494

Validity evidence of the Behavioral Activation for Depression Scale-Short Form among depressed smokers

Background/ObjectiveA measure of Behavioral Activation (BA) is highly recommended when evaluating BA treatment effects for smokers with depression. Recently, a short version of the Behavioral Activation for Depression scale (BADS-SF) has been developed as a means of assessing changes in activation and avoidance patterns. To date there is no validated version of this questionnaire in Spanish. This study sought to adapt the BADS-SF to a Spanish population of depressed smokers. Method A sample of 169 smokers (72.2% female) with elevated depressive symptomatology completed the BADS-SF. Results A bi-factorial structure was obtained: Activation and Avoidance. Results indicated an acceptable internal consistency for both the Activation (ω = .85) and the Avoidance subscales (ω =.70). Overall, convergent validity was obtained with Activation and Avoidance subscales being related to other depression-related measures such as depressive symptomatology (Activation r = −.29; Avoidance r = .35), environmental reward (Activation r = .40; Avoidance r = −.41) and, nicotine dependence (Avoidance r = .23). This latter variable was the only one not showing a statistically significant association with the Activation factor (r = −.12). Conclusions The Spanish BADS-SF can be considered as a reliable and valid instrument when assessing behavioral activation among clinically depressed smokers.

Positive Emotion Infusions: Can Savoring Increase Help-Seeking Intentions among People with Depression?

The current research effort used two experimental studies to assess whether a savoring-based, positive emotion infusion (PEI) could increase help-seeking intentions among individuals with elevated depressive symptomatology and whether this relationship would be mediated by positive emotion, arousal, and perceptions of personal control. In Study 1, participants with elevated depressive symptomatology, recruited from Amazon's Mechanical Turk (N = 135), were randomly assigned to complete a 6-minute savoring or control writing task followed by a help-seeking intentions scale. Study 2 participants (N = 136) were randomly assigned to the same tasks, but a scale assessing positive emotion, arousal, and personal control was added. Study 1 indicated a direct effect; those who savored reported greater help-seeking intentions compared to control participants. Study 2 revealed an indirect effect of savoring on help-seeking intentions through greater positive emotion but not through greater arousal or perceptions of personal control. Together, these results offer additional support for continued research on PEIs, and specifically, savoring-based PEIs. Although the experimental manipulations may be limited in regard to their ecological validity, for those seeking to create interventions, these studies offer a novel and efficacious approach for motivating individuals with elevated depressive symptomatology to seek help.

Increasing Help-Seeking Outcomes among People with Elevated Depressive Symptomatology with Public Service Announcements: An Examination of Functional Matching and Message Sidedness

The current experimental study assessed the utility, and potential harm, of depression public service announcements (D-PSAs) that were matched, moderately matched, or mismatched based on attitude function (i.e., social-adjustive or object-appraisal) and either one-sided or refutational two-sided. US adults (N = 567) with mild to severe depressive symptomatology were randomly assigned to view control messages or one set of D-PSAs. Results indicate that functionally matched D-PSAs, regardless of message sidedness, caused more favorable help-seeking outcome expectations, attitudes, and intentions compared to the control messages. Exposure to the mismatched D-PSAs, particularly refutational, led to less-favorable help-seeking outcome expectations, attitudes, and intentions compared with the control condition. Help-seeking outcomes among those exposed to the moderately matched messages were not significantly different from those exposed to the control messages, with the exception of those exposed to the one-sided moderately matched messages. The one-sided moderately matched messages resulted in lower help-seeking intentions than the control messages. Overall, results indicate that if messages can be tailored to match the recipients’ attitude functions, help-seeking outcomes among people with heightened depressive symptomatology can be increased. However, the results also indicate that some D-PSAs can have negative effects.

Modality of exercise influences rate of decrease in depression for cancer survivors with elevated depressive symptomatology.

This three-arm feasibility controlled trial examined whether different exercise modalities provide reductions in depression symptoms to cancer survivors with elevated depression. Thirty-two participants (58.9 ± 9.4years) were allocated to a 12-week supervised exercise group (EX; n = 10), a self-managed home-based exercise group (SMHB; n = 8), or a usual care control group (CONT; n = 14). EX performed two supervised resistance and aerobic sessions per week. SMHB were provided with printed material about benefits of exercise and encouraged to complete 150min of exercise weekly. CONT received no exercise or printed material and were encouraged to maintain usual activity. A group × time interaction was found for the primary outcome of depression scores, measured using the Hospital Anxiety and Depression Scale (HADS-D; p = .008). SMHB (6.4 ± 5.3 to 2.2 ± 2.9, p = .006) and EX (6.9 ± 4.2 to 4.0 ± 2.4, p = .021) interventions both effectively reduced HADS-D scores compared to CONT (7.2 ± 2.5 to 7.7 ± 3.6). SMHB decreased depression to a greater extent, and this occurred more rapidly with greatest changes noted at 6weeks (d = 0.50). Further favourable outcomes for exercise were also noted for several secondary outcome measures. The rate of exercise-related reduction in depression is influenced by the modality of exercise. However, increasing the duration of the programme appears to diminish the favourable short-term response to self-managed exercise with subsequent secondary outcomes of mental health favouring supervised exercise.

Poor Illness Perceptions Are a Risk Factor for Depressive and Anxious Symptomatology in Fibromyalgia Syndrome: A Longitudinal Cohort Study.

Patients with widespread pain, such as in fibromyalgia, are vulnerable for depression and anxiety, which composes a relevant public health problem. Identifying risk factors for the onset of depression and anxiety is therefore warranted. Objective of this study was to determine whether severe pain, maladaptive coping, and poor illness perceptions are associated with depressive and anxious symptomatology in fibromyalgia. Consecutive patients referred to an outpatient clinic completed sets of physical and psychological questionnaires at baseline and at 18-month follow-up. A total of 452 patients with fibromyalgia syndrome (FMS) were eligible for inclusion, and subsequently, 280 patients returned the baseline questionnaire. Depressive and anxious symptomatology was measured with the Hospital Anxiety and Depression Scale. To measure pain severity, coping style, and illness perceptions, the Fibromyalgia Impact Questionnaire, Pain Coping Inventory, and the Illness Perception Questionnaire-Revised (IPQ-R) were used, respectively. Multivariable logistic regression analyses, bootstrapping and calibration, were performed to examine the association of pain severity, pain coping, and illness perception with depressive and anxiety symptoms at follow-up, adjusted for sociodemographic variables. Initial level of depressive and anxiety symptoms was selected as covariates. Mean age was 42.6 years and 95.4% were female. At 18-month follow-up, 68 (of the 195) patients were depressed and 80 (of the 197) were anxious. Only the IPQ-R subscale "emotional representations" showed a significant positive association with depressive symptoms at follow-up (OR = 1.10), next to the initial level of depressive symptoms (OR = 1.30). In case of anxiety, only the IPQ-R subscale "treatment control" showed a significant negative association with anxiety symptoms at follow-up (OR = 0.87), next to the initial level of anxiety symptoms (OR = 1.45). Our data suggest that not pain severity or maladaptive coping, but poor illness perceptions are important in elevated depressive and anxious symptomatology. Patients with fibromyalgia who think their illness negatively affects their mental well-being are at increased risk for more depressive symptoms, and those who think treatment of their illness will not be effective are at increased risk for more anxiety symptoms. Strengthening illness beliefs and reducing catastrophic thinking, therefore, seem crucial factors in the treatment of patients with FMS.

Sintomatología depresiva elevada y uso de métodos anticonceptivos en estudiantes universitarios de la salud en la zona centro de México

La depresión es un problema de salud que afecta al 23% de universitarios predisponiéndolos a prácticas sexuales de riesgo. El objetivo de este estudio fue identificar la influencia existente entre la sintomatología depresiva elevada (SDE) en el uso de anticonceptivos y fallas al usarlos. Se realizó un estudio transversal no experimental a 1853 estudiantes de ambos sexos entre 18-24 años, del área de la salud de dos universidades públicas del centro de México. Se contrastaron SDE y uso de anticonceptivos por medio de χ2 y Odds Ratio ajustado por: sexo, edad, estado civil, con quién vive, múltiples parejas e inicio temprano de coito. Se encontró que la SDE es mayor en mujeres, la probabilidad de fallas en el uso anticonceptivos naturales y hormonales con SDE es 40%; y no usar condón 38%, (p &lt; 0.05), lo que aumenta el riesgo para embarazos no planeados y/o para la adquisición de infecciones de transmisión sexual.