Elevated Depressive Symptoms Research Articles

Older Bereaved Individuals’ Experiences of Cognitive-Behavioral Therapy for Complicated Grief Reactions: A Qualitative Multistage Focus Group Approach

Bereavement is particularly common in old age. A small proportion of bereaved people develop complicated grief reactions (CGR) characterized by elevated symptoms of depression, prolonged grief disorder, anxiety, and/or posttraumatic stress. Cognitive-behavioral therapy for CGR (CBTgrief) is found to be an effective treatment. Detailed knowledge about older adults’ experiences of CBTgrief is needed to optimize treatment and to give recommendations to practice. To explore older adults’ experience of CBTgrief to gain insight into elements that were helpful or less helpful. Four multistage focus group interviews were conducted with nine older adults who lost a partner and received CBTgrief and three researchers. Five participants received group therapy and four individual therapy (mean age = 69.67 years, 89% women). The participants found exposure exercises, psychoeducation in grief, and letter writing particularly helpful. The participants requested options for family sessions, a combined individual/group format, and follow-up sessions. Awareness of potential memory problems and adapting to new practical tasks should receive greater focus in therapy. This study gives important insights into older adults’ experiences of CBTgrief and evaluates the helpful and less helpful elements in grief therapy. This may guide improvements in the treatment of bereaved older adults with CGR.

The moderating role of diabetes distress on the effect of a randomized eHealth intervention on glycemic control in Black adolescents with type 1 diabetes.

Due to systemic inequities, Black adolescents with type 1 diabetes are more likely to have suboptimal glycemic control and high rates of diabetes distress, but tailored interventions for this population are lacking. In primary outcomes of a randomized clinical trial, a family-based eHealth intervention improved glycemic control in Black adolescents with type 1 diabetes and elevated depressive symptoms. The present study is a secondary analysis of these clinical trial data examining the moderating effect of diabetes distress on the efficacy of the intervention. Using secondary data from a multicenter randomized clinical trial (Clinicaltrials.gov [NCT03168867]), caregiver-adolescent dyads were randomly assigned to either up to three sessions of an eHealth parenting intervention (n = 75) or a standard medical care control group (n = 74). Black adolescents (10 years, 0 months to 14 years, 11 months old) with type 1 diabetes and a caregiver willing to participate were eligible. Adolescents reported their diabetes distress at baseline, and hemoglobin A1c (HbA1c) data were collected at baseline, 6-, 13-, and 18-month follow-up. No between-group contrasts emerged in a linear mixed-effects regression (p's > .09). Within-group contrasts emerged such that adolescents assigned to the intervention who reported high diabetes distress had lower HbA1c at the 18-month follow-up relative to baseline (p = .004); the 18-month decrease in HbA1c was -1.03%. Black adolescents with type 1 diabetes and high levels of diabetes distress showed significant decreases in HbA1c following a family-based eHealth intervention, suggesting diabetes distress may be a key moderator of intervention efficacy within this population.

Factors Associated with Fathers’ Mental Health Difficulties in an Australian Help-Seeking Sample

Fathers are at increased risk of mental health difficulties such as depression during the first postnatal year, however little is currently known about the extent to which fathers experience symptoms of anxiety and stress, and the factors associated with these symptoms. This study aimed to: (1) investigate the extent to which fathers accessing support to strengthen their coparenting relationship through a community health organisation experience depressive, anxiety and stress symptoms during the first postnatal year, and (2) examine associations between a broad range of individual, child, and family factors and fathers’ depressive, anxiety, and stress symptoms during the first postnatal year. This study involved secondary analysis of routinely collected data from 170 fathers of children aged 0–12 months who were enroled in a coparenting intervention programme delivered by a community health organisation in Melbourne, Australia. Elevated symptoms of stress were reported by ~28% of fathers, while elevated symptoms of depression and anxiety were reported by ~26% and 16% of fathers, respectively. Multiple regression analyses revealed evidence for associations between reduced parental self-efficacy and higher depressive and stress symptoms, while infant regulation difficulties and increased interparental conflict were associated with higher levels of stress. This study highlights that fathers are at risk of mental health difficulties during the first postnatal year. Findings demonstrate the importance of undertaking a broad assessment of fathers’ mental health during the first postnatal year and provide important insights into individual, child, and family factors that may represent optimal targets for prevention and early intervention.

Predictors of Depressive Symptoms in Autistic Youth-A Longitudinal Study From the Province of Ontario Neurodevelopmental Disorders (POND) Network: Prédicteurs des symptômes dépressifs chez les jeunes autistes-une étude longitudinale du Réseau des troubles neurodéveloppementaux de la province de l'Ontario (réseau POND).

The objective of this study was to identify longitudinal predictors of depressive symptoms in autistic children and youth. Participants were youth with a diagnosis of autism who were part of the Province of Ontario Neurodevelopmental Disorders Network longitudinal substudy. Depressive symptoms were assessed using the child behaviour checklist (CBCL) affective problems subscale. Univariate and multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between clinical and demographic characteristics at baseline (T1) and clinically elevated depressive symptoms (CEDS) approximately 4 years later (T2). The mean age of participants (n = 75) at T1 was 9.8 years (SD = 2.7) and at T2 was 14.1 years (SD = 2.8). A total of 37% and 35% of participants had CEDS at T1 and T2, respectively. Additionally, 24% of participants had CEDS at both T1 and T2. T1 characteristics associated with T2 CEDS were: loneliness (OR = 3.0, 95% CI, 1.1 to 8.8), self-harm (OR = 4.0, 95% CI, 1.1 to 16.9), suicidal ideation (OR = 3.9, 95% CI, 1.0 to 16.5), more social and adaptive skills (OR = 0.3, 95% CI, 0.1 to 0.9), elevated restricted and repetitive behaviours (OR = 3.8, 95% CI, 1.3 to 11.6), psychotropic medication use (OR = 3.0, 95% CI, 1.1 to 8.4), attention-deficient/hyperactivity disorder (OR = 2.8, 95% CI, 1.1 to 7.8), and T1 CEDS (OR = 8.8, 95% CI, 3.1 to 27.0) (uncorrected for multiple comparisons). Associations persisted after adjusting for age and intelligence quotient (IQ) differences. Age, sex, IQ, teasing/bullying on the CBCL, family psychiatric history and family income were not associated with T2 CEDS. Our results highlight both high prevalence and high potential for the persistence of depressive symptoms in autism and emphasize the importance of early support to address loneliness and social participation.

Prenatal determinants of anxiety symptoms in middle childhood. Evidence from Growing Up in New Zealand

BackgroundEarly life environments can have long-lasting impacts on future health and wellbeing. Maternal health during pregnancy, including experiencing stress or mood disorders, has been associated with psychopathology in later life. Anxiety disorders are one of the most prevalent mental health conditions, affecting approximately 7 % of children and adolescents globally, with a lifetime prevalence of 15–20 %. Identifying prenatal risk factors can support future and current public health interventions and maternity care. MethodsData were obtained from the Growing Up in New Zealand longitudinal study of child development. Prenatally, mothers provided sociodemographic information as well as data on their mental health, potential teratogens, and lifestyle factors such as supplement intake and exercise levels. At 8-years old, 4922 children self-completed the PROMIS-SF anxiety measure. Bivariate analyses and backward stepwise regression were used to determine the best multivariable model. ResultsSignificant prenatal predictors of anxiety symptoms at 8-years old included elevated maternal depression symptoms, body mass index in the overweight/obese range, exercise patterns, and paracetamol, anti-inflammatory and alcohol intake. LimitationsSample attrition from baseline to 8-year may have affected statistical power. To further untangle the effect of timing and duration of the exposures reported in this study, larger sample sizes would be required. ConclusionsPrenatal mental health and wellbeing was significantly associated with child anxiety symptoms at 8-years of age. This study highlights the importance of supporting expectant mothers' health and wellbeing during pregnancy to ensure children have the best opportunity to have good mental health.

Reducing intrusive suicidal mental images in patients with depressive symptoms through a dual-task add-on module: Results of a multicenter randomized clinical trial.

To examine the safety and efficacy of a brief cognitive dual-task (using eye movements) add-on module to treatment as usual (TAU) in reducing the severity and frequency of intrusive suicidal mental images and suicidal ideation. We conducted a single-blind, parallel multicenter randomized trial (No. NTR7563) among adult psychiatric outpatients (N = 91; Mage = 34.4, SD = 13.54; 68% female) with elevated depressive symptoms and experiencing distressing suicidal intrusions in the Netherlands. Primary outcome was the severity (Suicidal Intrusions Attributes Scale) and frequency (Clinical Interview for Suicidal Intrusions) of suicidal mental imagery intrusions at 1-week posttreatment and 3-month follow-up. Primary analysis was intention-to-treat. Between November 27, 2018 and September 13, 2021, 91 patients were included and randomly assigned to intervention group (Cognitive Dual Task Add-on + TAU) (n = 46) or TAU-only (n = 45). Cognitive Dual Task Add-on + TAU had greater reductions in severity (mean difference, -15.50, 95% CI [23.81, -7.19]; p < .001, d = 0.60), and frequency (geometric mean difference, 0.47, 95% CI [0.29, 0.79]; p = .004) of suicidal intrusions over time than TAU-alone. Cognitive Dual Task Add-on + TAU patients also showed lower suicidal ideation over time (p = .008, d = 0.42). There were no significant group differences in reductions in depressive symptoms, rumination, or hopelessness. Four serious adverse events occurred (three Cognitive Dual Task Add-on + TAU; one TAU-only); all unlikely attributable to intervention/trial. Findings provide support for the effectiveness of adding a cognitive dual-task module to the treatment of psychiatric outpatients with elevated depressive symptoms in reducing suicidal intrusions and ideation and can be executed safely. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Identifying Person-Specific Drivers of Depression in Adolescents: Protocol for a Smartphone-Based Ecological Momentary Assessment and Passive Sensing Study.

Adolescence is marked by an increasing risk of depression and is an optimal window for prevention and early intervention. Personalizing interventions may be one way to maximize therapeutic benefit, especially given the marked heterogeneity in depressive presentations. However, empirical evidence that can guide personalized intervention for youth is lacking. Identifying person-specific symptom drivers during adolescence could improve outcomes by accounting for both developmental and individual differences. This study leverages adolescents' everyday smartphone use to investigate person-specific drivers of depression and validate smartphone-based mobile sensing data against established ambulatory methods. We describe the methods of this study and provide an update on its status. After data collection is completed, we will address three specific aims: (1) identify idiographic drivers of dynamic variability in depressive symptoms, (2) test the validity of mobile sensing against ecological momentary assessment (EMA) and actigraphy for identifying these drivers, and (3) explore adolescent baseline characteristics as predictors of these drivers. A total of 50 adolescents with elevated symptoms of depression will participate in 28 days of (1) smartphone-based EMA assessing depressive symptoms, processes, affect, and sleep; (2) mobile sensing of mobility, physical activity, sleep, natural language use in typed interpersonal communication, screen-on time, and call frequency and duration using the Effortless Assessment of Risk States smartphone app; and (3) wrist actigraphy of physical activity and sleep. Adolescents and caregivers will complete developmental and clinical measures at baseline, as well as user feedback interviews at follow-up. Idiographic, within-subject networks of EMA symptoms will be modeled to identify each adolescent's person-specific drivers of depression. Correlations among EMA, mobile sensor, and actigraph measures of sleep, physical, and social activity will be used to assess the validity of mobile sensing for identifying person-specific drivers. Data-driven analyses of mobile sensor variables predicting core depressive symptoms (self-reported mood and anhedonia) will also be used to assess the validity of mobile sensing for identifying drivers. Finally, between-subject baseline characteristics will be explored as predictors of person-specific drivers. As of October 2023, 84 families were screened as eligible, of whom 70% (n=59) provided informed consent and 46% (n=39) met all inclusion criteria after completing baseline assessment. Of the 39 included families, 85% (n=33) completed the 28-day smartphone and actigraph data collection period and follow-up study visit. This study leverages depressed adolescents' everyday smartphone use to identify person-specific drivers of adolescent depression and to assess the validity of mobile sensing for identifying these drivers. The findings are expected to offer novel insights into the structure and dynamics of depressive symptomatology during a sensitive period of development and to inform future development of a scalable, low-burden smartphone-based tool that can guide personalized treatment decisions for depressed adolescents. DERR1-10.2196/43931.

Association of both depressive symptoms scores and specific depressive symptoms with all-cause and cardiovascular disease mortality

BackgroundThe presence of depression related to an increased risk of all-cause and cardiovascular disease (CVD) mortality has been reported. However, studies conducted on certain specific depressive symptoms are scarce. Our purpose was to assess the effect of both depressive symptoms scores and certain specific depressive symptoms on all-cause and CVD mortality.MethodsIn the present cohort study, all participants, aged 18 years or older, were enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014. Depressive symptoms score was assessed using the validated 9-item Patient Health Questionnaire Depression Scale (PHQ-9), which ranges from 0 to 27, with a PHQ-9 score ≥ 10 diagnosed as depression. The outcome events were all-cause and CVD mortality, which were followed up from 2005 to 2014. The associations of both depressive symptoms score and certain specific depressive symptoms with all-cause and CVD mortality were examined by weighted multivariable proportional hazards models.ResultsA total of 26,028 participants aged ≥ 18 years were included in the statistical analysis, including 12,813 (49.2%) males and 13,215 (50.8%) females, with a mean (SD) age of 47.34 (18.86) years. During the 9.32 (3.20) years of mean (SD) follow-up, 3261 deaths were recorded, of which 826 were cardiovascular deaths. All-cause mortality was 16.87/1000 person-years in subjects with depression. In terms of CVD mortality, these figures were 4.53/1000 person-years. In the full model (model 3), elevated depressive symptoms scores were independently associated with an increased risk of all-cause mortality (Highest depression symptom score group: adjusted hazard ratio, 1.63; 95% CI 1.44–1.85) and CVD mortality (Highest depression symptom score group: adjusted hazard ratio, 1.73; 95% CI 1.34–2.24). All 9 specific depressive symptoms that make up the PHQ-9 were related to an increased risk of all-cause mortality. However, only 3 symptoms, including trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation, were no significantly associated with an increased risk of CVD mortality.ConclusionsThe elevated depressive symptoms scores were strongly associated with an increased risk of all-cause and CVD mortality in US adults. Furthermore, all 9 specific depressive symptoms were associated with high all-cause mortality. However, trouble sleeping or sleeping too much, poor appetite or overeating, and suicidal ideation might not increase the risk of CVD mortality.

Depressive symptoms predict cannabis vaping initiation among young adults

BackgroundYoung adults in the United States, including college students, have the highest prevalence of cannabis use compared with other age groups. Although cannabis vaping is increasingly prevalent during young adulthood, little is known about factors contributing to the onset of cannabis vaping during this developmental period. MethodsParticipants were 3085 cannabis vaping naïve young adults aged 18–25 years (M = 20.60; SD = 1.80), initially recruited from 24 Texas colleges and participating in a multi-wave, longitudinal study. A survival analysis was conducted to determine if participants reporting elevated depressive symptoms had an increased risk of onset of cannabis vaping over six follow-up waves from fall 2015 to spring 2019 compared to their peers with lower levels of depressive symptoms. Socio-demographic characteristics, time-varying past 30 day substance use, and time-varying peer nicotine vaping were included as covariates in the model. ResultsTwenty-five percent of participants initiated cannabis vaping during the four-year study period, with stable initiation rates from 2015 to 2017 but doubling from 2017 to 2019. Analyses, both unadjusted and adjusted for study covariates, indicated that elevated depressive symptoms were significantly associated with an increased risk of cannabis vaping initiation. ConclusionFindings indicate that initiation of cannabis vaping during young adulthood is common, and particularly more likely among those with greater depressive symptoms, thus underscoring the importance of prevention programs that include mental health support services tailored to young adults.

Effect of elevated depressive symptoms during adolescence on health-related quality of life in young adulthood-a six-year cohort study with repeated exposure measurements.

Depression is a major contributor of young people's burden of disease. In this study we aim to estimate the effect of elevated depressive symptoms on physical health-related quality of life. We used self-reported information from the prospective BELLA cohort study, which included adolescents selected from the general population in Germany. The baseline assessment (2003-2006) and the 1-, 2-, and 6-year follow-up waves provide the data basis. The baseline study population consisted of 1,460 adolescents between the ages of 12 and 17 who, according to their caregivers, did not suffer from depression. The primary outcome, as measured by the physical component score (PCS) of the SF-36 at a 6-year follow-up (range: 0-100), is physical health-related quality of life. The exposure of interest is depressive symptoms, as measured by the Center for Epidemiological Studies Depression Scale for Children (CES-DC) at baseline, 1-year follow-up and 2-year follow-ups (range: 0-60). We dichotomized the exposure into subthreshold (≤15) and elevated depressive symptoms (>15). For the main analyses we considered a cumulative index for elevated depressive symptoms across the three time points (range: 0-3). Considered confounders are sex, age, socioeconomic status, migrant background, social support, anxiety symptoms, physical activity, chronic diseases, and sleeping problems. We used multiple imputation to account for missing values. Within each imputed dataset, we applied inverse probability weighting (IPW) to estimate the effect of the cumulative index for elevated depressive symptoms at baseline, 1- and 2-year follow-up on physical health-related quality of life at 6-year follow-up. We derived 95% confidence intervals by bootstrapping. After adjusting with IPW, the effect of the cumulative index per one unit increase of elevated depressive symptoms on the physical component score was -1.71 (95% CI: -3.51 to -0.04). The adjusted effect estimates of single exposure of elevated depressive symptoms on physical health-related quality of life were -0.83 (95% CI: -3.69 to 1.87) at baseline, -2.96 (95% CI: -4.94 to -0.52) at 1-year follow-up and -1.32 (95% CI: -3.85 to 1.15) at 2-year follow-up. Findings suggest that elevated depressive symptoms during adolescence decrease physical health-related quality of life in young adulthood.

Neuropathological implication of high blood bilirubin in patients and model rats with depression

PurposeElevated bilirubin levels have been associated with major depressive disorder (MDD); however, the exact impact of bilirubin on MDD and the underlying molecular mechanisms remain unclear. Here, we explored the influence of bilirubin on MDD and sought to identify the mechanisms via which bilirubin induces depressive-like behavior. Patients and methodsForty patients who were diagnosed with MDD and received treatment with selective serotonin reuptake inhibitors (SSRIs) were included, with 43 healthy volunteers serving as controls. Clinical symptoms were evaluated using Hamilton depression rating scale-24 (HAMD-24) and the Hamilton anxiety rating scale. Serum concentrations of total bilirubin (TBIL) and indirect bilirubin (IBIL) were measured at baseline and after treatment using an automated biochemical analyzer. The connection between clinical symptoms and TBIL or IBIL was examined using Pearson correlation. Chronic restraint stress (CRS) was employed to generate a rat model of depression. TBIL, IBIL in rat serum were measured by ELISA. Reactive oxygen species (ROS) contents in rat hippocampal tissues were quantified by flow cytometry. The levels of microglial markers and the extent of neuronal damage in the rat hippocampus were assessed by immunofluorescence and transmission electron microscopy, respectively. ResultsSerum TBIL and IBIL levels were higher in patients with MDD than in the healthy controls. After treatment with SSRIs, the serum levels of TBIL and IBIL in MDD patients were significantly reduced. The levels of TBIL and IBIL were associated with HAMD-24 in MDD patients. Compared with the controls, the serum levels of TBIL, IBIL and the hippocampal ROS contents were elevated in CRS-exposed rats. Fluoxetine lowered inflammatory factor levels, mitigated oxidative stress. ConclusionOur findings indicate a possible correlation between elevated serum bilirubin and depressive symptoms. Increases in ROS levels, along with neuronal damage, may represent pathological mechanisms underlying MDD.

Who Am I? Self-concept in Adults with Cystic Fibrosis: Association with Anxiety and Depression.

Cystic Fibrosis (CF) is a progressive condition resulting in reduced lung function and strongly associated with elevated anxiety and depression symptoms. Self-concept refers to an individual's overarching sense of identity, a positive level of which is widely associated with reduced anxiety and depression. There is a significant lack of self-concept research within CF. This study explores the association between self-concept and anxiety and depression in adults with CF. 64 adults living with CF in Western Australia completed validated online questionnaires (Generalised Anxiety Disorder-7, Patient Health Questionnaire-9, Tennessee Self-Concept Questionnaire 2: Short-Form) and consented to the collection of medical data. Descriptive, t-test, correlation and multiple regression analysis were undertaken. Higher levels of self-concept were associated with lower levels of anxiety and depression symptoms. Lower self-concept levels were a significant predictor of increased anxiety and depression symptoms after accounting for physical health status. Mean self-concept scores for those who required mental health intervention were significantly lower compared to those that did not. This study identifies a significant relationship between self-concept and anxiety and depression in adults with CF. Further research is required to establish causation and test the feasibility of self-concept interventions in reducing anxiety and depression symptoms.

Investigations of microbiota composition and neuroactive pathways in association with symptoms of stress and depression in a cohort of healthy women.

Despite mounting evidence of gut-brain involvement in psychiatric conditions, functional data remain limited, and analyses of other microbial niches, such as the vaginal microbiota, are lacking in relation to mental health. This aim of this study was to investigate if the connections between the gut microbiome and mental health observed in populations with a clinical diagnosis of mental illness extend to healthy women experiencing stress and depressive symptoms. Additionally, this study examined the functional pathways of the gut microbiota according to the levels of psychological symptoms. Furthermore, the study aimed to explore potential correlations between the vaginal microbiome and mental health parameters in young women without psychiatric diagnoses. In this cross-sectional study, 160 healthy Danish women (aged 18-40 years) filled out questionnaires with validated scales measuring symptoms of stress and depression and frequency of dietary intake. Fecal and vaginal microbiota samples were collected at the beginning of the menstrual cycle and vaginal samples were also collected at cycle day 8-12 and 18-22. Shotgun metagenomic profiling of the gut and vaginal microbiome was performed. The Kyoto Encyclopedia of Genes and Genomes (KEGG) was used for functional profiling and 56 Gut Brain Modules were analyzed in the fecal samples. The relative abundance in the gut of the genera Escherichia, Parabacteroides, and Shigella was higher in women with elevated depressive symptoms. Women with high perceived stress showed a tendency of increased abundance of Escherichia, Shigella, and Blautia. Amongst others, the potentially pathogenic genera, Escherichia and Shigella correlate with alterations in the neuroactive pathways such as the glutamatergic, GABAeric, dopaminergic, and Kynurenine pathways. Vaginosis symptoms were more prevalent in women reporting high levels of stress and depressive symptoms. The findings of this study support the concept of a microbiota-associated effect on the neuroactive pathways even in healthy young women. This suggest, that targeting the gut microbiome could be a promising approach for future psychiatric interventions.

Characterizing Mental Health Status and Service Utilization in Chinese Americans With Type 2 Diabetes in New York City: Cross-Sectional Study.

Emerging evidence indicates that individuals with type 2 diabetes (T2D) are more prone to mental health issues than the general population; however, there is a significant lack of data concerning the mental health burden in Chinese Americans with T2D. The aim of this study was to explore the comorbid mental health status, health-seeking behaviors, and mental service utilization among Chinese Americans with T2D. A cross-sectional telephone survey was performed among 74 Chinese Americans with T2D in New York City. We used standardized questionnaires to assess mental health status and to gather data on mental health-seeking behaviors and service utilization. Descriptive statistics were applied for data analysis. A total of 74 Chinese Americans with T2D completed the survey. Most participants (mean age 56, SD 10 years) identified as female (42/74, 57%), were born outside the United States (73/74, 99%), and had limited English proficiency (71/74, 96%). Despite nearly half of the participants (34/74, 46%) reporting at least one mental health concern (elevated stress, depressive symptoms, and/or anxiety), only 3% (2/74) were currently using mental health services. Common reasons for not seeking care included no perceived need, lack of information about Chinese-speaking providers, cost, and time constraints. The cultural and language competence of the provider was ranked as the top factor related to seeking mental health care. Chinese Americans with T2D experience relatively high comorbid mental health concerns yet have low service utilization. Clinicians may consider team-based care to incorporate mental health screening and identify strategies to provide culturally and linguistically concordant mental health services to engage Chinese Americans with T2D.

'Who will I become?': possible selves and depression symptoms in adolescents.

Adolescence is an important period for the development of the possible self. It is also a time when depression is prevalent. The cognitive theory of depression proposes that a negative view of the future is a key feature of depression. Targeting these negative thoughts about the future during cognitive behavioural therapy may be helpful in depression. However, little is known about how adolescents envisage their future (i.e. possible) self, or if the content is associated with affect. The aim of this quantitative study is to describe how adolescents describe their 'possible self' and examine the relationship between the valence of the possible self and depression in adolescents. Adolescents (n = 584) aged 13-18 years were recruited via opportunity sampling via their schools and completed measures of depression symptoms (the Mood and Feelings Questionnaire) and the 'possible self' (a variant of the 'I Will Be' task). Possible selves were coded for content and valence. Despite depression severity, the most common possible selves generated by adolescents were positive and described interpersonal roles. The valence of the possible self was associated with depression severity but only accounted for 3.4% of the variance in severity. The results support the cognitive model of depression. However, adolescents with elevated symptoms of depression were able to generate positive, possible selves and therefore may remain somewhat 'hopeful' about their future despite clinically significant depression symptoms. Future-oriented treatment approaches such as cognitive behavioural therapy that focus on changing unhelpful negative future thinking may not be appropriate for this population.

The association between acculturative stress and rule-breaking behaviors among Latinx adolescents in rural areas: A moderated mediation analysis.

The present study examined the association between acculturative stress and rule-breaking behaviors, with depressive symptoms as the mediator, and emotion regulation and parental behavioral involvement (i.e., time spent in shared activities between parents and adolescents) as the moderators among Latinx adolescents in rural areas. Using a sample of Latinx adolescents (N = 193; Mage = 15.90; 54.4% female) recruited from rural areas, a moderated mediation model was tested. Findings showed that the mediational pathways connecting acculturative stress, depressive symptoms, and rule-breaking behaviors were moderated by emotion regulation and parental behavioral involvement. Specifically, higher levels of acculturative stress were associated with higher levels of rule-breaking behaviors through elevated depressive symptoms only among adolescents who reported low levels of both emotion regulation and parental behavioral involvement. These findings underscore the importance of considering multiple contextual factors in understanding the development of internalizing and externalizing behaviors among Latinx adolescents in rural areas. The findings suggest intervention programs may target parental behavioral involvement and emotion regulation to help adolescents cope with acculturative stress and perhaps other minority stressors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Long-Term Depressive Symptom Trajectories and Midlife Cognition: The CARDIA Study.

The nature of associations between depressive symptoms and cognition early in the life course remains unclear, and racial differences in these associations are not well characterized. The aim of this study was to examine the relationship between trajectories of depressive symptom over 20 years, beginning in young adulthood, and cognitive functions in middle-age among Black and White adults. We used prospective data from participants of the Coronary Artery Risk Development in Young Adults Study. Depressive symptoms were measured at 5 study visits between 1990 and 2010 using the Center for Epidemiologic Studies Depression scale. We used latent class group-based modeling to identify 4 trajectories: "persistently low," "persistently medium," "medium decreasing," and "high increasing" depressive symptoms. In 2015, cognitive function was measured using the Digit Symbol Substitution Test (DSST), Stroop test (reverse coded), and Rey Auditory-Verbal Learning Test (RAVLT).We excluded participants who missed the cognitive battery or had no depressive symptoms measurements, resulting in a total of 3,117 participants. All cognitive tests were standardized, and linear regression was used to relate depressive trajectories with 2015 cognitive functions. The mean [SD] baseline age was 30.1 [3.6] years, and 57% were female. The associations between depressive symptoms and cognition significantly differed by race (p < 0.05). Among Black individuals, compared with having "persistently low," having "medium decreasing," "persistently medium," or "high increasing" depressive symptoms were associated with worse verbal memory, processing speed, and executive function scores (RAVLT persistently medium vs low: β = -0.30, 95% CI -0.48 to -0.12; and high increasing vs low: β = -0.49, 95% CI -0.70 to -0.27; DSST persistently medium vs low: β = -0.28, 95% CI -0.47 to -0.09; and high increasing vs low: β = -0.64, 95% CI -0.87 to -0.42; Stroop persistently medium vs low: β = -0.46, 95% CI -0.70 to -0.23; and high increasing vs low: β = -0.76, 95% CI -1.04 to -0.47). Associations were slightly weaker among White individuals, but we still found that having 'high increasing' depressive symptoms was associated with worse verbal memory and processing speed scores (high increasing vs low: β = -0.38, 95% CI -0.61 to -0.15; and β = -0.40, 95% CI -0.63 to -0.18, respectively). Prolonged exposure to elevated depressive symptoms beginning in young adulthood may result in worse cognitive function over midlife. This association was stronger among Black adults.

Correlates of depression in individuals with obsessive compulsive disorder

ABSTRACT The existing literature examining the correlates of depression in individuals with obsessive compulsive disorder (OCD) is characterized by inconsistent results. The aim of the current study was to replicate and extend the literature by exploring whether various clinical and demographic factors are related to the occurrence of depression in a large sample (N = 243) of individuals with OCD (M age = 33.00; SD = 12.47; 74% female). Individuals with OCD who had elevated comorbid depressive symptoms [Patient Health Questionnaire-9 item (PHQ-9) ≥10] scored significantly higher on all OCD symptom subtypes (p range < .001–.048), had greater obsessive and compulsive severity (ps < .001), scored higher on perfectionism (p < .001), and had higher disgust sensitivity and propensity scores (ps < .001) compared with individuals who did not have comorbid depressive symptoms (PHQ-9 < 10). Of these variables, obsession severity (β = 0.22, p = .004), OCD contamination subtype (β = 0.16, p = .032) and perfectionism (β = 0.25, p < .001) were found to be associated with depressive symptoms on the PHQ-9. The findings of this study contribute to the understanding of factors which are associated with depression comorbidity in individuals with OCD.

The circadian syndrome is a better predictor for psoriasis than the metabolic syndrome via an explainable machine learning method - the NHANES survey during 2005-2006 and 2009-2014.

To explore the association between circadian syndrome (CircS) and Metabolic Syndrome (MetS) with psoriasis. Compare the performance of MetS and CircS in predicting psoriasis. An observational study used data from the NHANES surveys conducted in 2005-2006 and 2009-2014. We constructed three multiple logistic regression models to investigate the relationship between MetS, CircS, and their components with psoriasis. The performance of MetS and CircS in predicting psoriasis was compared using five machine-learning algorithms, and the best-performing model was explained via SHAP. Then, bidirectional Mendelian randomization analyses with the inverse variance weighted (IVW) as the primary method were employed to determine the causal effects of each component. A total of 9,531 participants were eligible for the study. Both the MetS (OR = 1.53, 95%CI: 1.07-2.17, P = 0.02) and CircS (OR = 1.40, 95%CI: 1.02-1.91, P = 0.039) positively correlated with psoriasis. Each CircS algorithmic model performs better than MetS, with Categorical Features+Gradient Boosting for CircS (the area under the precision-recall curve = 0.969) having the best prediction effect on psoriasis. Among the components of CircS, elevated blood pressure, depression symptoms, elevated waist circumference (WC), and short sleep contributed more to predicting psoriasis. Under the IVW methods, there were significant causal relationships between WC (OR = 1.52, 95%CI: 1.34-1.73, P = 1.35e-10), hypertension (OR = 1.68, 95%CI: 1.19-2.37, P = 0.003), depression symptoms (OR = 1.39, 95%CI: 1.17-1.65, P = 1.51e-4), and short sleep (OR = 2.03, 95%CI: 1.21-3.39, p = 0.007) with psoriasis risk. CircS demonstrated superior predictive ability for prevalent psoriasis compared to MetS, with elevated blood pressure, depression symptoms, and elevated WC contributing more to the prediction.

Investigating physiological symptoms associated with mental health symptoms in youth with cerebral palsy: An observational study

Over 50 % of children and youth with cerebral palsy (CP) experience mental health challenges, with anxiety and depression most common. Youth with CP also experience several physiological symptoms such as fatigue, pain, sedentary lifestyle, and sleep disturbances that impact their daily living; however, little is known about the impact of these symptoms on mental health outcomes in these youth. This study addressed this gap and examined the individual and cumulative impacts of physiological symptoms on anxiety and depression symptoms in youth with CP. Forty youth with CP aged 8 to 18 years, and their caregiver, participated in this cross-sectional observational study. Pain, fatigue, anxiety, and depressive symptoms were measured using caregiver- and self-reported questionnaires and participants wore accelerometers for seven consecutive days, providing non-invasive physical activity and sleep pattern data. Youth with CP experienced substantial physiological symptoms and elevated anxiety and depression symptoms. Linear regression models determined that all physiological factors were predictive of caregiver-reported youth anxiety (R2 = 0.23) and youth depressive symptoms (R2 = 0.48). Fatigue, pain severity, sleep efficiency, and physical activity outcomes individually and cumulatively contributed to caregiver-reported youth anxiety and depression symptoms. These findings highlight the important role of physiological symptoms as potential risk factors and potential targets for intervention for mental health issues for in youth with CP.