Higher Depressive Symptomology Research Articles

Characterizing longitudinal change in accelerometry-based moderate-to-vigorous physical activity in the Hispanic Community Health Study/Study of Latinos and the Framingham Heart Study

BackgroundPhysical activity promotes health and is particularly important during middle and older age for decreasing morbidity and mortality. We assessed the correlates of changes over time in moderate-to-vigorous physical activity (MVPA) in Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL: mean [SD] age 49.2 y [11.5]) and compared them to a cohort of primarily White adults from the Framingham Heart Study (FHS: mean [SD] 46.9 y [9.2]).MethodsBetween 2008 and 2019, we assessed accelerometry-based MVPA at two time points with an average follow-up of: 7.6 y, SD 1.3 for HCHS/SOL, and 7.8 y, SD 0.7 for FHS. We used multinomial logistic regression to relate socio-demographic and health behaviors with changes in compliance with 2018 US recommendations for MVPA from time 1 to time 2 (remained active or inactive; became active or inactive) across the two cohorts.ResultsIn HCHS/SOL mean MVPA was 22.6 (SD, 23.8) minutes at time 1 and dropped to 16.7 (19.0) minutes at time 2. In FHS Mean MVPA was 21.7 min (SD, 17.7) at time 1 and dropped to 21.3 min (SD, 19.2) at time 2. Across both cohorts, odds of meeting MVPA guidelines over time were about 6% lower in individuals who had lower quality diets vs. higher, about half in older vs. younger adults, about three times lower in women vs. men, and 9% lower in individuals who had a higher vs. lower BMI at baseline. Cohorts differed in how age, gender, income, education, depressive symptoms, marital status and perception of general health and pain associated with changes in physical activity. High income older Hispanics/Latino adults were more likely to become inactive at the follow-up visit as were HCHS/SOL women who were retired and FHS participants who had lower levels of education and income. Higher depressive symptomology was associated with becoming active only in HCHS/SOL women. Being male and married was associated with becoming inactive in both cohorts. Higher perception of general health and lower perception of pain were associated with remaining active only in FHS adults.ConclusionsThese findings highlight potentially high-risk groups for targeted MVPA intervention.

Data-Driven Analyses of Longitudinal Hippocampal Imaging Trajectories: Discrimination and Biomarker Prediction of Change Classes.

Background:Hippocampal atrophy is a well-known biomarker of neurodegeneration, such as that observed in Alzheimer’s disease (AD). Although distributions of hippocampal volume trajectories for asymptomatic individuals often reveal substantial heterogeneity, it is unclear whether interpretable trajectory classes can be objectively detected and used for prediction analyses.Objective:To detect and predict hippocampal trajectory classes in a computationally competitive context using established AD-related risk factors/biomarkers.Methods:We used biomarker/risk factor and longitudinal MRI data in asymptomatic adults from the AD Neuroimaging Initiative (n = 351; Mean = 75 years; 48.7% female). First, we applied latent class growth analyses to left (LHC) and right (RHC) hippocampal trajectory distributions to identify distinct classes. Second, using random forest analyses, we tested 38 multi-modal biomarkers/risk factors for their relative importance in discriminating the lower (potentially elevated atrophy risk) from the higher (potentially reduced risk) class.Results:For both LHC and RHC trajectory distribution analyses, we observed three distinct trajectory classes. Three biomarkers/risk factors predicted membership in LHC and RHC lower classes: male sex, higher education, and lower plasma Aβ1–42. Four additional factors selectively predicted membership in the lower LHC class: lower plasma tau and Aβ1–40, higher depressive symptomology, and lower body mass index.Conclusion:Data-driven analyses of LHC and RHC trajectories detected three classes underlying the heterogeneous distributions. Machine learning analyses determined three common and four unique biomarkers/risk factors discriminating the higher and lower LHC/RHC classes. Our sequential analytic approach produced evidence that the dynamics of preclinical hippocampal trajectories can be predicted by AD-related biomarkers/risk factors from multiple modalities.

Pills, PrEP, and Pals: Adherence, Stigma, Resilience, Faith and the Need to Connect Among Minority Women With HIV/AIDS in a US HIV Epicenter

Background: Ending HIV/AIDS in the United States requires tailored interventions. This study is part of a larger investigation to design mCARES, a mobile technology-based, adherence intervention for ethnic minority women with HIV (MWH).Objective: To understand barriers and facilitators of care adherence (treatment and appointment) for ethnic MWH; examine the relationship between these factors across three ethnic groups; and, explore the role of mobile technologies in care adherence.Methods: Cross-sectional, mixed-methods data were collected from a cohort of African-American, Hispanic-American and Haitian-American participants. Qualitative data were collected through a focus group (n = 8) to assess barriers and facilitators to care adherence. Quantitative data (n = 48) surveyed women on depressive symptomology (PHQ-9), HIV-related stigma (HSS) and resiliency (CD-RISC25). We examined the relationships between these factors and adherence to treatment and care and across groups.Findings: Qualitative analyses revealed that barriers to treatment and appointment adherence were caregiver-related stressors (25%) and structural issues (25%); routinization (30%) and religion/spirituality (30%) promoted adherence to treatment and care. Caregiver role was both a hindrance (25%) and promoter (20%) of adherence to treatment and appointments. Quantitatively, HIV-related stigma differed by ethnic group; Haitian-Americans endorsed the highest levels while African-Americans endorsed the lowest. Depression correlated to stigma (R = 0.534; p < 0.001) and resiliency (R = −0.486; p < 0.001). Across ethnic groups, higher depressive symptomology and stigma were related to viral non-suppression (p < 0.05)—a treatment adherence marker; higher resiliency was related to viral suppression. Among Hispanic-Americans, viral non-suppression was related to depression (p < 0.05), and among African-Americans, viral suppression was related to increased resiliency (p < 0.04).Conclusion: Multiple interrelated barriers to adherence were identified. These findings on ethnic group-specific differences underscore the importance of implementing culturally-competent interventions. While privacy and confidentiality were of concern, participants suggested additional intervention features and endorsed the use of mCARES as a strategy to improve adherence to treatment and appointments.

Pathways Linking School-Based Ethnic Discrimination to Latino/a Adolescents' Marijuana Approval and Use.

Latino/a adolescents are a growing part of U.S. public high schools, and many experience stressors related to their ethnicity within their schools that can contribute to risky behaviors such as drug use. Marijuana remains the most common illicit drug that Latino/a adolescents use. Using a sample of 121 Latino/a 9th grade students, the current study examined pathways linking perceived peer- and educator-perpetrated ethnic discrimination with marijuana approval and use. Findings revealed that perceived peer-perpetrated ethnic discrimination was linked with lower school belonging (βapproval model = -.21, p = .031; βuse model = -.18, p = .013), and lower school belonging was related to higher marijuana approval (β =-.22, p = .030), but not use. Additionally, those students with lower school belonging were more likely to experience greater depressive symptoms (βapproval model = -.45, p < .001, β use model = -.50, p < .001) and had more close friends who smoked marijuana (βapproval model = -.28, p = .002, βuse model = -.35, p < .001). Higher depressive symptomology was associated with more marijuana use (β = .32, p = .008). Having more substance-using friends was linked with higher marijuana approval (β = .24, p = .010) and use (β = .44, p < .001). Educator-perpetrated ethnic discrimination was not associated with any of the constructs under study. Findings highlight both internalizing and externalizing pathways through which peer-perpetrated ethnic discrimination may contribute to Latino/a adolescents' marijuana approval and use. Results have the potential to inform intervention efforts aimed at curtailing Latino/a adolescents' marijuana use.

Changes in depressive symptoms over age among older Americans: Differences by gender, race/ethnicity, education, and birth cohort.

Despite concerns about recent trends in the health and functioning of older Americans, little is known about dynamics of depression among recent cohorts of U.S. older adults and how these dynamics differ across sociodemographic groups. This study examined sociodemographic differences in mid- and late-life depressive symptoms over age, as well as changes over time. Using nationally representative data from the Health and Retirement Study (1994–2014), we estimated mixed effects models to generate depressive symptoms over age by gender, race/ethnicity, education, and birth cohort in 33,280 adults ages 51–90 years. Depressive symptoms were measured using the 8-item Center for Epidemiological Studies Depression scale. Women compared to men, low compared to high education groups, and racial/ethnic minorities compared to whites exhibited higher depressive symptoms. The largest disparity resulted from education, with those without high school degrees exhibiting over two more predicted depressive symptoms in midlife compared to those with college degrees. Importantly, war babies and baby boomers (born 1942–1959) exhibited slightly higher depressive symptoms with more decreasing symptoms over age than their predecessors (born 1931–1941) at ages 51–65. We additionally observed an age-as-leveler pattern by gender, whereby females compared to males had higher depressive symptomology from ages 51–85, but not at ages 86–90. Our findings have implication for gauging the aging population's overall well-being, for public health policies aimed at reducing health disparities, and for anticipating demand on an array of health and social services.

Mother-reported parental weight talk and adolescent girls' emotional health, weight control attempts, and disordered eating behaviors.

BackgroundThe aim of this paper is to explore the relationships between mothers’ report of parental weight talk about her daughter, herself, and others, and adolescent girls’ weight-related behaviors and cognitions among a socio-demographically diverse population of mothers and their adolescent daughters.MethodsData were drawn from the baseline assessment of 218 mother/adolescent daughter dyads. Mothers completed survey items regarding the frequency of weight talk by parents, and girls completed survey items assessing outcomes including body dissatisfaction, depressive symptomology, use of extreme weight control methods, and binge eating.ResultsMore frequent comments to daughters about their weight were associated with higher depressive symptomology (p = 0.041), greater prevalence of extreme weight control behaviors (p = 0.040), and greater prevalence of binge eating (p = 0.048) among girls after adjustment for socio-demographic characteristics and girls’ standardized body mass index (BMI). For example, among girls whose parents never commented on their weight, 4.2% reported use of any extreme weight control behaviors, while 23.2% of girls whose parents frequently commented on their weight reported use of any of these behaviors. Mothers’ more frequent talk about their own weight, shape, or size was associated with lower self-worth (p = 0.007) and higher depressive symptomology (p = 0.004) among girls.ConclusionsFrequent parental weight talk as perceived by mothers was associated with adolescent girls’ use of harmful weight control methods and poor psychological health, while no associations were found between weight talk and girls’ use of healthful weight control strategies. Interventions that help parents create a family environment that supports healthful activities while reducing weight-related talk may be particularly effective in decreasing the prevalence of harmful outcomes among adolescent girls.

Parental Overprotection, Cultural Value Conflict, and Psychological Adaptation among Asian Indian Women in America

The present study related generational status, marital status, parental overprotection (control), and cultural value conflict to self-esteem and depression among first and second-generation Asian Indian immigrant women in the south-midwestern United States. Self-report data from 73 community-dwelling women supported the hypotheses that unmarried and second-generation women would report greater maternal control and cultural value conflict than would married and first-generation women. Second-generational status, high maternal control, and high cultural value conflict correlated with higher depressive symptomology; being married, low maternal control, and low cultural value conflict were related to high self-esteem. Regression analyses indicated a mediating role for cultural value conflict for depression symptom predictors, but not for self-esteem predictors. Open-ended response data provided enriched understanding of these women’s cultural and family conflicts.