Greater Increases In Depressive Symptoms Research Articles

The impact of stress on depressive symptoms is moderated by social support in Chinese adolescents with subthreshold depression: A multi-wave longitudinal study

Background Most studies have shown that negative life events and social support are important factors in the development and outcome of depression. It is unknown if these factors are important in adolescents with subthreshold depression. Thus, the current study examined whether high levels of social support from peers buffer adolescents exhibiting subthreshold depressive symptoms against experiencing further increases in such symptoms following the occurrence of negative events. Methods Participants included 143 adolescents (aged 14 to 18; M = 16.07, SD = .66) in Hunan Province China who were selected because they were exhibiting subthreshold depressive symptoms at the time of initial assessment. During an initial assessment, participants completed measures assessing social support from peers and depressive symptoms. Participants subsequently completed measures assessing depressive symptoms and the occurrence of negative events once every three months for the subsequent fifteen months. Results The prevalence of lifetime subthreshold depression in Hunan was 22.9% ( n = 143). The results of hierarchical linear modeling analyses indicated that lower levels of social support from peers was associated with greater increases in depressive symptoms following the occurrence of negative events. Conclusions The results suggested that the association between the occurrence of negative events and increased depressive symptoms is moderated by social support from peers in adolescents with subthreshold depression in mainland China, in line with the buffering hypothesis. Limitations The adolescent sample used in the current study was from Hunan, China, which could limit the generalizability of our results to other populations. In addition, given that it is possible that cultural context shapes symptom manifestation, future research should assess a broader array of symptom outcomes.

A Prospective Cohort Study Investigating Factors Associated With Depression During Medical Internship

Although the prevalence of depression among medical interns substantially exceeds that of the general population, the specific factors responsible are not well understood. Recent reports of a moderating effect of a genetic polymorphism (5-HTTLPR) in the serotonin transporter protein gene on the likelihood that life stress will precipitate depression may help to understand the development of mood symptoms in medical interns. To identify psychological, demographic, and residency program factors that are associated with depression among interns and to use medical internship as a model to study the moderating effects of this polymorphism. A prospective cohort study. Thirteen US hospitals. Seven hundred forty interns entering participating residency programs. Subjects were assessed for depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9), a series of psychological traits, and the 5-HTTLPR genotype prior to internship and then assessed for depressive symptoms and potential stressors at 3-month intervals during internship. The PHQ-9 depression score increased from 2.4 prior to internship to a mean of 6.4 during internship (P < .001). The proportion of participants who met PHQ-9 criteria for depression increased from 3.9% prior to internship to a mean of 25.7% during internship (P < .001). A series of factors measured prior to internship (female sex, US medical education, difficult early family environment, history of major depression, lower baseline depressive symptom score, and higher neuroticism) and during internship (increased work hours, perceived medical errors, and stressful life events) was associated with a greater increase in depressive symptoms during internship. In addition, subjects with at least 1 copy of a less-transcribed 5-HTTLPR allele reported a greater increase in depressive symptoms under the stress of internship (P = .002). There is a marked increase in depressive symptoms during medical internship. Specific individual, internship, and genetic factors are associated with the increase in depressive symptoms.

Excessive Reassurance Seeking, Self–Esteem, and Depressive Symptoms in Children of Affectively Ill Parents: An Experience Sampling Analysis

The current study examined whether excessive reassurance seeking serves as a vulnerability factor to depressive symptoms in a sample of children of affectively ill parents using a multiwave longitudinal design and experience sampling methodology. In addition, we examined whether self–esteem moderates the association between excessive reassurance seeking and increases in depressive symptoms following increases in negative events. At Time 1, 56 children (ages 7–14) completed measures assessing excessive reassurance seeking, low self–esteem, and depressive symptoms. Subsequently, children were given a handheld personal computer (HP Jornada 690), which signaled them to complete measures assessing depressive symptoms and negative events at six randomly selected times over an 8–week follow–up interval. In line with hypotheses, higher levels of reassurance seeking were associated with greater increases in depressive symptoms following increases in negative events. Contrary to hypotheses, however, the strength of this association was not moderated by self–esteem.

Depression and Next-day Spillover of Negative Mood and Depressive Cognitions Following Interpersonal Stress

We hypothesized that individuals high in depression would experience a greater increase in depressive symptoms following daily interpersonal stress, as compared with their symptoms following noninterpersonal stress. Forty-six adult outpatients completed seven consecutive daily assessments of stressful events, appraisals of those events, depressive cognitions, and negative affect at the beginning of treatment. Although there were no same-day differences in reactions to interpersonal and noninterpersonal stressors, there was significant “spillover” of negative thoughts and affect following interpersonal stressors for those high in depression. In other words, for those high in depression, negative thoughts and affect increased to a greater degree on days following an interpersonal stressor, as compared to days following a noninterpersonal stressor. These findings suggest that delayed recovery from daily interpersonal stress might contribute to the maintenance of depressive symptoms.

Continuous Participation in Voluntary Groups as a Protective Factor for the Psychological Well-Being of Adults Who Develop Functional Limitations: Evidence From the National Survey of Families and Households

Although previous studies have indicated that declining functional health is associated with individuals' poorer psychological well-being, few studies have examined factors that can protect adults from the loss of well-being following functional decline. Guided by continuity theory, this study investigated the extent to which continuous participation in voluntary groups (recreational, religious, and civic) buffers individuals against the harmful psychological effects of developing functional limitations. Longitudinal data came from 4,646 respondents aged 35 to 92 in the National Survey of Families and Households (1987-1993) who reported having no functional limitations at Time 1. Multivariate models controlling for sociodemographic factors, as well as psychological well-being at Time 1, indicated that developing functional limitations over a 5-year period was associated with greater increases in depressive symptoms and lower levels of personal growth. Increases in depressive symptoms, however, were less severe among men who were continuously involved in recreational groups than among men who were not continuously involved in recreational groups. Additionally, the association between developing functional limitations and lower levels of personal growth did not hold for men or women who continuously participated in religious groups. Findings suggest that continuous participation in certain types of voluntary groups can moderate the problematic effects of developing functional limitations on psychological well-being.

Transition to Caregiving, Marital Disagreement, and Psychological Well-Being

Guided by a life course perspective, this study investigated whether the psychological consequences of transitioning into a caregiver role for a biological parent, parent-in-law, spouse, other kin, or nonkin among married adults might be moderated by marital role quality. Using longitudinal data from a national sample of 1,842 married adults aged 35 years and older, this study estimated regression models examining whether marital disagreement prior to the transition to caregiving predicted differences in change in global happiness and depressive symptoms because of a transition into caregiving. Results indicated that, compared to noncaregivers, new caregivers for a biological parent or spouse experienced both a greater decline in happiness and a greater increase in depressive symptoms when they reported a higher level of marital disagreement. These findings suggest that the psychological effects of becoming a caregiver for a biological parent or spouse among married adults are contingent on marital role quality.

No Longer Intending: The Relationship Between Relinquished Fertility Intentions and Distress

We use data from both waves of the National Survey of Families and Households to assess whether relinquishing a serious intention to have (more) children leads to greater increases in depressive symptoms than continuing confidence in childbearing intentions. Our sample includes 2,200 individuals of childbearing age, men and women, all parities, and all marital statuses. Change score analysis shows that individuals who relinquished a serious intent to have children had elevated distress at Time 2 and that the association is conditioned by gender, health, and education. We find that fertility potential can be important to psychosocial well‐being and that closing the door on future fertility, especially for women, those in ill health, and the better educated, leads to increased distress.

Developmental trajectories of adolescents' depressive symptoms: Predictors of change.

In a sample of 240 adolescents assessed annually in Grades 6 through 11, the developmental trajectories of their depressive symptoms were examined using latent factor growth modeling. Growth in mother-reported adolescent depressive symptoms was quadratic; growth in adolescent-reported symptoms was linear. In the model with gender and maternal depression, girls reported a greater increase in depressive symptoms over time than boys, and adolescents of mothers with histories of mood disorders had higher initial levels of depressive symptoms than offspring of never-depressed mothers. After gender and maternal depression were controlled, initial levels of negative attributions and stressors significantly predicted initial levels of adolescent- and mother-reported depressive symptoms. Attributional styles that were increasingly negative across time were associated with significantly higher initial levels (mother reported) and increasing growth (adolescent reported) of depressive symptoms. Reciprocal models in which development of depressive symptoms predicted the development of attributions and stress also were examined.

Dysfunctional attitudes and vulnerability to depressive symptoms : A 14-week longitudinal study

Beck's acute-onset model of depression proposesthat initially asymptomatic individuals with high levelsof dysfunctional attitudes (DA) will become depressedwhen stressors occur. Using a large student sample (n = 275), we conducted a 14-weeklongitudinal study aimed at testing Beck's model as anacute-onset model. Consistent with past studies (Monroe,Bromet, Connell, & Steiner, 1986; Roberts & Monroe, 1992), a DA Stress interaction did notobtain when all subjects (both symptomatic andasymptomatic) were included in the data analyses.However, when analyses were restricted to initiallyasymptomatic subjects, the predicted DA Stress interactioneffect did obtain. Specifically, under conditions ofhigh stress, initially asymptomatic subjects with highlevels of dysfunctional attitudes showed greater increases in depressive symptoms than initiallyasymptomatic subjects with low levels of dysfunctionalattitudes. Follow-up analyses revealed that this DAStress interaction was specific to females and not males. Possible reasons for the female-specificeffect are discussed. In general, these findings callattention to the fact that subject selection proceduresmay affect a researcher's ability to predict future onset of depression.

Psychological distress and help seeking in rural America.

The implications of exposure to acute and chronic stressors, and seeking mental health care, for increased psychological distress are examined. Research on economic stress, psychological distress, and rural agrarian values each point to increasing variability within rural areas. Using data from a panel study of 1,487 adults, a model predicting changes in depressive symptoms was specified and tested. Results show effects by size of place for men but not for women. Men living in rural villages of under 2,500 or in small towns of 2,500 to 9,999 people had significantly greater increases in depressive symptoms than men living in the country or in larger towns or cities. Size of place was also related to level of stigma toward mental health care. Persons living in the most rural environments were more likely to hold stigmatized attitudes toward mental health care and these views were strongly predictive of willingness to seek care. The combination of increased risk and less willingness to seek assistance places men living in small towns and villages in particular jeopardy for continuing problems involving depressed mood.