Higher Rates Of Depressive Symptoms Research Articles

Anxiety symptoms preceding suicide: A Swedish nationwide record review

BackgroundThe literature on the relationship between anxiety and suicidal behaviors is limited and findings are mixed. This study sought to determine whether physicians noted anxiety symptoms and suicidality in their patients in the weeks and months before suicide. MethodsData were derived from a nationwide medical record review of confirmed suicides in Sweden in 2015. Individuals with at least one documented physician consultation in any health care setting during 12 months before suicide (N = 956) were included. Clinical characteristics were compared between decedents with and without a notation of anxiety symptoms. Odds ratios were calculated to estimate associations between anxiety symptoms and suicidality in relation to suicide proximity. ResultsAnxiety symptoms were noted in half of individuals 1 week before suicide. Patients with anxiety were characterized by high rates of depressive symptoms, ongoing substance use issues, sleeping difficulties, and fatigue. After adjustment for mood disorders, the odds of having a notation of elevated suicide risk 1 week before death were doubled in persons with anxiety symptoms. Associations were similar across time periods (12 months – 1 week). Two-thirds had been prescribed antidepressants at time of death. LimitationsData were based on physicians' notations which likely resulted in underreporting of anxiety depending on medical specialty. Records were not available for all decedents. ConclusionsAnxiety symptoms were common in the final week before suicide and were accompanied by increases in documented elevated suicide risk. Our findings can inform psychiatrists, non-psychiatric specialists, and GPs who meet and assess persons with anxiety symptoms.

Breaking the Silence: An Epidemiological Report on Asian American and Pacific Islander Youth Mental Health and Suicide (1999-2021).

Limited studies have focused on recent trends in Asian American and Pacific Islander (AAPI) youth suicide. This study aimed to evaluate epidemiological trends in AAPI youth suicide and reports of depressive symptoms among Asian and Pacific Islander youth in the USA. This cross-sectional study analyzed mortality data from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) and reports of depressive symptoms from the Youth Risk Behaviour Surveillance System (YRBSS). Data from 1999 to 2021 were analyzed for suicide rates and methods used among AAPI youth aged 5-24 years. YRBSS data from 1991 to 2021 were analyzed for depressive symptoms reported by Asian American (AA) 9th-12th graders. From 1999 to 2021, 4747 AAPI youth died by suicide in the USA. Rates of suicide doubled from 3.6 to 7.1 per 100,000 during 1999-2021, with an increasing trend observed from 2014 onwards. The most common methods of suicide deaths in this population were suffocation, firearms and poisoning. Rates of suicide were higher among AA males than females, although more AA females reported depressive symptoms, including suicidal planning and attempts. This study shows a concerning increase in suicide rates among AAPI youth over 1999-2021. Suffocation, firearms and poisoning were the most common methods used. While more AAPI males died by suicide, AA females reported higher rates of depressive symptoms. These findings highlight the urgent need for targeted prevention strategies and clinical interventions for this vulnerable population. The study also emphasizes the importance of addressing mental health stigma to improve reporting and support for Asian American, Native Hawaiian and Pacific Islander (AANHPI) youth.

Quality of sleep and depression in family caregivers of patients receiving palliative care

Introduction: This study aimed to evaluate the depression symptoms and quality of sleep of palliative care patients’ family caregivers. Methods: A total of 120 patients were hospitalized at the palliative care center and primary caregivers were included. Depression symptoms of caregivers was assessed by the Beck Depression Inventory (BDI) and quality of sleep with Pittsburgh Sleep Quality Index (PSQI). Results: The mean age of 120 caregivers included in the study was 47.2±12.8 years. The mean BDI score was 10.4±7.2, and the mean PSQI score was 4.6±2.9. Significantly higher rates of depression symptoms were observed in singles than in married people (p=0.037). The healthy sleep rate of the patients whose caregiving period was 6-10 years was significantly lower (p=0.018). While 78.5% of those who received support from their families had a healthy sleep, this rate was 52.4% in those who did not receive support from their families (p=0.034). A significant difference was found between PSQI and BDI categories (p=0.004). People with moderate depressive symptoms were more likely to have poor sleep quality and long-term sleep disorders. Conclusions: Family caregivers of patients receiving palliative care are at risk for poor sleep quality and depression symptoms. We think that the evaluation of these people in terms of the presence of depression symptoms and poor sleep quality may provide early intervention to alleviate the symptoms.

Screening for depression and anxiety in lung cancer patients: A real-world study using GAD-7 and HADS.

The psychological well-being of lung cancer patients is critical in-patient care but frequently overlooked. This study, employing a cross-sectional, questionnaire-based design, aimed to elucidate the prevalence of depressive and anxiety symptoms among lung cancer patients and identify associated risk factors. Participants' demographic, medical history, disease stage, and pathology were systematically collected. Psychological assessment was conducted using the general anxiety disorder-7 (GAD-7), patient health questionnaire-9 (PHQ-9), and hospital anxiety and depression scale (HADS). Statistical analyses were performed using SPSS software (version 25.0). Out of 294 distributed questionnaires, 247 lung cancer patients were included in the final analysis, with an average completion time of 9.08 min. Notably, 32.4% exhibited depressive symptoms, while 30% displayed signs of anxiety. A significant correlation was found between both depressive and anxiety symptoms and a history of tobacco and alcohol consumption. Specifically, increased nicotine dependence and greater cumulative tobacco use were linked to higher rates of depressive symptoms, whereas cumulative alcohol consumption was associated with increased risks of anxiety symptoms. The study affirms the feasibility of GAD-7, PHQ-9, and HADS as screening tools for depressive and anxiety symptoms in lung cancer patients. It further highlights tobacco and alcohol consumption as significant risk factors for poor psychological health in this population.

Building stronger bonds: The impact of family support and communication on suicidal behaviors among Black men who have sex with men.

It has been well documented that men who identify with a sexual orientation other than heterosexual are at a greater risk for suicide-related outcomes. What is less known are the protective factors that can reduce such negative outcomes and contribute to their resilience. This study used data collected between December 1, 2021, and January 2022 to understand how family factors contribute to or prevent depression symptoms and suicide outcomes among young Black men who have sex with men (BMSM) ages 18 to 29 (N = 400). A path analysis was conducted to explore the direct and indirect effects of suicide attempts. Surprisingly, there were nuanced findings that showed having a family member or friend die by suicide was indirectly associated with suicide planning and suicide attempts. It was also unexpectedly noted that there was a positive relationship between higher rates of depressive symptoms and higher levels of support from family members. The population focused on in this study is understudied and has unique needs. Identifying familial support may not automatically reduce the thoughts and plans of young BMSM, which is an example of why their intersecting marginalized identities must be considered when conducting further research, creating interventions, and providing therapeutic services.

Impacts of the Early COVID-19 Pandemic on Depressive Symptoms and Mental Health Among Student-Athletes.

Social distancing protocols due to the COVID-19 pandemic resulted in premature ending of athletic seasons and cancellation of upcoming seasons, placing significant stress on young athletes. Inability to play or forced early retirement has significant consequences on athlete's mental health, as demonstrated by an extensive body of injury literature. We hypothesize that premature suspension and cancellation of athletic events due to the COVID-19 pandemic leads to higher incidence of depressive symptoms among high-school and collegiate athletes. Further, athletes who strongly derive their sense of self-worth centered around athletics would have higher rates of depressive symptoms. High school and collegiate athletes were evaluated for depressive symptoms, emotional health and athletic identity measures through validated assessment instruments from May 2020 through July 2020. The Patient-Reported Outcomes Measurement Information System Depression Computer Adaptive Test (PROMIS-10 Depression CAT), Veterans RAND-12 (VR-12), which comprises both a physical and mental health component, and Athletic Identity Measurement Scale (AIMS) were utilized. Mental health assessments were completed by 515 athletes (52.4% male, 47.6% female; .84.5% collegiate, 15.5% high school). Female athletes scored significantly worse than males on VR-12 mental health assessments, as well as PROMIS-10 Depression scores; however, males scored significantly lower than females on VR-12 physical health assessments, irrespective of education level. Athletes who had strong associations with athletics as central to their personal identity exhibited worse psychologic impact on VR-12 mental health and PROMIS-10 Depression measures and female athletes in this cohort reported greater depressive symptoms than males. Social distancing protocols due to the COVID-19 pandemic have limited athlete's ability to participate in sports at the training and competition level. Higher rates of depressive symptoms in high school and college athletes have resulted among female athletes and those who identify strongly as an athlete.

Does menopause hormone therapy improve symptoms of depression? Findings from a specialized menopause clinic.

Depressive symptoms are commonly reported during the perimenopause and in the early postmenopausal years. Although menopausal hormone therapy (MHT) is considered the most effective treatment option for vasomotor symptoms, its effect on mood-related symptoms is less established. This study aims to assess interval change in depressive symptoms after initiation of MHT treatment in women seeking care at a Canadian specialized menopause clinic. Women and female-presenting people attending the St. Joseph's Healthcare Menopause Clinic in Hamilton, Ontario, were invited to participate in this study. Participants (n = 170) completed a self-report questionnaire, which included their medical history as well as validated tools for bothersome symptoms at their initial visit. A shortened version was administered at the follow-up visit 3 to 12 months later with the same validated tools. We sought to examine interval changes on the Center for Epidemiological Studies Depression Scale based on type of treatment used and MHT dose, while controlling for relevant demographic variables (smoking, education level, age). There was a high rate of depressive symptoms in those seeking specialized menopause care (62%). MHT use was associated with significantly improved depressive symptoms, both alone and in addition to an antidepressant medication ( P < 0.001). Younger age, lower education attainment, and smoking were all associated with higher depression scores. This study supports the use of MHT to improve depressive symptoms experienced by those seeking specialized menopause care. Further investigation into timing of treatment initiation may facilitate a personalized treatment approach to improve quality of life of women in the peri- and postmenopausal years.

Brief Report: Convergence and Discrepancy Between Self- and Informant-Reported Depressive Symptoms in Young Autistic Adults.

Autistic individuals exhibit elevated rates of depression; however, assessment is complicated by clinical presentations and limited validation in this population. Recent work has demonstrated the utility of the Beck Depression Inventory (BDI-II) in screening for depression in ASD. The current study extends this work by examining the convergence and divergence of self- and informant-reported depression in autistic (n = 258) and non-autistic (n = 255) young adults. Participants completed the BDI-II as a self-report measure of depression; informants completed the Achenbach Adult Behavior Checklist. Analyses probed for between-group differences in rates of depression symptoms, convergence between self- and informant-reported depression, and discrepancy between self- and informant-reported depression. Results indicated significantly higher rates of depressive symptoms in the autistic group. Convergence was significant in both groups, with significantly greater agreement in the autistic group. There was differential divergence, with the autistic group reporting significantly lower scores relative to informants, and the non-autistic group reporting significantly higher scores relative to informants. Consistent with prior reports, results suggest that depression rates are elevated in autism. Additionally, while the BDI-II may be adequate for screening depressive symptoms in speaking autistic young adults, eliciting information from a close adult informant provides valuable diagnostic information, due to clinically critical concerns about underreporting in this population. Although controlled in analyses, between-group differences in gender, age, race, and informant identity, and a predominantly White and non-Latinx sample, limit the generalizability of these results.

Postpartum Mental Health and Perceptions of Discrimination Among Asian Fathers During the COVID-19 Pandemic.

The purpose of this study was twofold: (1) to examine the prevalence of postpartum depression and anxiety symptomatology among fathers of Asian descent living in North America during the COVID-19 pandemic, and (2) to identify the occurrences of online racial discrimination. Using a cross-sectional design and convenience sampling methods, we recruited fathers online via social media sites (Facebook, Instagram) between March 12 and July 31, 2022. The Edinburgh Postnatal Depression Scale, General Anxiety Scale, and the Online Victimization Scale assessed mental health well-being and discrimination outcomes. Data were analyzed using descriptive statistics, two sample t-test, chi-square test of independence, and Pearson's correlation analysis. Our sample included 61 fathers within 6 months postpartum living in the United States and Canada. Participants were on average 34 years old, married, and represented 17 Asian ethnic groups, including Asian Indian (41%), Filipino (11.3%), and Korean (8.1%). One-third of our participants (31.1%, n = 19) were at high risk of developing postpartum depression and scores of three (4.9%) fathers indicated they had clinically significant anxiety. Overall, 26.3% reported experiencing direct online racial discrimination and 65% reported occurrences of indirect online racial discrimination. There was a high rate of depressive symptoms and occurrences of online racial discrimination among fathers of Asian descent living in North America. These rates are higher than the general perinatal population and further research is warranted to examine risk factors and preventive strategies among this unique paternal ethnic group.

“It’s a lonely journey”: Personal experiences and psychosocial distress among Chinese American dementia family caregivers

AbstractBackgroundChinese American dementia caregivers are a growing but understudied population. Prior survey studies suggest they experience high rates of depressive symptoms and adverse health outcomes, but data are limited on their caregiving experiences, distress processes, and related contextual factors. The current study aims to address the literature gap with a qualitative investigation.MethodIn‐depth interviews were conducted with 18 Chinese American dementia caregivers. An interview guide was developed priori based on literature on family dementia caregivers and stress process theories. All interviews were transcribed verbatim, thematic content analysis was conducted.ResultParticipants’ ages ranged from 39 to 85 with a median age of 60 years. 70% were female, and 64% had limited English proficiency. A conceptual framework of caregiving distress process was developed based on the interview guide and major themes emerged from the data. Caregiving stress stems from a complex interaction of care‐recipients’ and caregivers’ characteristics; stress leads high levels psychosocial distress, including poor sleep, depression and anxiety, and chronic conditions. The distress process is attenuated by caregivers’ help‐ seeking, social support, and use of formal services; it is also negatively influenced by caregivers’ poor self‐care, social isolation, and self‐perceived poor mastery of caregiving. The distress experienced by Chinese American dementia caregivers is a dynamic process in the caregiving context at multiple levels, including their social networks, available health and social services, immigration policies, and social norms. Participants described their caregiving experience as a “lonely journey”, reflecting their isolation and limited social support.ConclusionOur data suggest that Chinese American dementia caregivers, especially those with limited English proficiency, experience elevated psychosocial distress. They face daunting barriers to social support and health services due to their immigrant and minority status. Culturally appropriate targeted intervention is urgently needed for this underserved and vulnerable population.

Cognitive and Socio‐Demographic Factors Related to Subjective Cognitive Decline in Native Americans

AbstractBackgroundSubjective cognitive decline (SCD) is commonly reported in neuropsychological evaluation, but self‐reported SCD can be influenced by anosognosia and depressed mood. Cognitive decline reported by a close informant, such as a spouse, may be more predictive of objective cognitive decline than a patient’s self‐report (Bellaali et al., 2021). Recent research comparing how racial and ethnic groups report SCD found strong evidence that Native Americans and their close informants reported SCD more frequently than White and Black Americans (Dixon &amp; Woodard, N.D.). This study investigates whether unique socio‐demographic or cognitive variables could account for this phenomenon.MethodParticipants were selected from the National Alzheimer’s Coordinating Center (NACC) database. Participants were cognitively healthy at baseline, at least 65 years of age, and had an informant who lived with or visited the participant weekly (N = 9355). Participant racial groups included White Americans (n = 7770), Black Americans (n = 1517), and Native Americans/Alaskans (n = 68). Pairwise comparisons compared objective cognitive performance on the Mini‐Mental State Examination (MMSE), clinician‐determined functional decline, level of independence, educational attainment, self‐reported anxiety, Geriatric Depression Scale (GDS), and history of tobacco and substance abuse between each racial group using Bayesian contingency tables and t‐tests to find reliable evidence supporting the null or alternative hypothesis.ResultGroup comparisons indicated no reliable differences between Native Americans and the other racial groups on clinician‐determined functional decline, level of independence, self‐reported anxiety, tobacco use, and substance abuse (BF10 &lt; 3). White Americans had significantly higher educational attainment and performed better on the MMSE (BF10 &gt; 100) than Black and Native Americans. Native Americans exhibited reliably higher GDS scores than White (BF10 = 5.5) and Black (BF10 = 10.4) Americans.ConclusionThe greater rate of SCD reported by Native Americans and their close informants compared with White and Black Americans may be related to significantly higher rates of depressive symptoms reported by Native Americans/Alaskans. Careful evaluation of mood symptoms may be particularly important for clinicians working with Native American/Alaskan patients to differentiate between SCD and objective cognitive impairment.

Perceived discrimination and depressive symptoms among Muslims in the United States

ABSTRACT Recent research documents extensive Islamophobia and discrimination against Muslims in the United States. The current study seeks to better understand the discrimination experienced by Muslims and its mental health consequences in comparison to that experienced within a general sample of Americans. Using data from an original national survey of 700 American adults and an oversample of 300 Muslims, our analyses indicate elevated levels of perceived discrimination among Muslims (both White and non-White), relative to White non-Muslims, and comparable to that experienced by non-Muslim racial/ethnic minorities. Furthermore, Muslims report higher rates of depressive symptoms than Christians and non-religious individuals, and this mental health disparity is fully explained by Muslims’ greater perceived discrimination. These findings suggest that the racialization of Muslims in the United States is a public health concern.

34 Neurocomputational Mechanisms of Social Reward Processing in Combat-Exposed Veterans

Objective:Combat exposure is associated with higher rates of depressive symptoms, including anhedonia (i.e., a reduced ability to seek and experience rewards) and feelings of social disconnectedness. While these symptoms are commonly documented in combat-exposed Veterans following deployment, the cognitive mechanisms underlying this pathology is less well understood. Computational modeling can provides detailed mechanistic insights into complex cognition, which may be particularly useful to understand how social reward processing is altered following combat exposure. Here, we use a Bayesian learning model framework to address this question.Participants and Methods:Thirty-three Operation Enduring Freedom (OEF)/ Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) Veterans (25 Male, 8 Female) between the ages of 18-65 years old (M = 41.61, SD = 10.49) participated in this study. In both classic/monetary and social reward conditions, participants completed a 2-arm bandit task, in which they must choose on each trial between two options (i.e., slot machine vs social partner) with unknown reward rates. While they received monetary outcomes in the classic condition, participants received compliments from different fictitious partners in the social condition. We first compared a learning-independent Win-stay/Lose-shift (WSLS) heuristic and either a Rescorla-Wagner Q-learning or a Bayesian learning model (Dynamic Belief Model/DBM) paired with a Softmax reward maximization policy. DBM+Softmax provided the best fit of the data for most participants (31/33). Individual DBM parameters of prior reward expectation, reward learning (i.e., perceived stability of reward rates), and Softmax reward maximization were estimated and compared across conditions.Results:Participants did not differ in their reward learning parameters across monetary and social conditions (t(30)= -0.70, p = 0.490), suggesting similar perception of reward stability in both modalities. However, higher Bayesian prior mean (i.e., initial belief of reward rate; t(30)= -2.31, p = 0.028, d=0.42) and greater reward maximization (i.e., Softmax parameter; t(30)= -2.26, p = 0.031, d=0.41) were observed in response to social vs monetary rewards. In the social reward condition, higher self-reported social connectedness was associated with greater model fit of our DBM model (i.e., smaller Bayesian Information Criterion/BIC; r = -0.38, p = 0.041). In this condition, those expecting higher reward rates when initiating reward exploration (those with higher DBM prior mean) endorsed lower self-esteem (Spearman's ρ = -0.43, p = 0.078) and lower positive affect (ρ = -0.32, p = 0.078).Conclusions:A Bayesian learning modeling framework can characterize mechanistic differences in the processing of social vs non-social reward among combat-exposed Veterans. Individuals with higher social connectedness were more model-based in their performance, consistent with the notion that they are more likely to estimate and anticipate how much social peers have to offer. Combat-exposed individuals with lower self-esteem and positive affect appear to have higher initial expectations of reward from unknown partners, which could reflect greater need for mood and/or self-esteem repair in those individuals. Overall, Bayesian modeling of social reward behavior provides a useful quantitative framework to predict clinically relevant construct of functional outcomes in military populations.

Predictors and Consequences of Cancer and Non-Cancer-Related Pain in Those Diagnosed with Primary and Metastatic Cancers.

The aims of the study were to (1) describe types of pain in cancer patients, (2) examine the predictors and consequences of pain, (3) investigate the association between type of pain and survival, and (4) examine potential biological mediators of pain and survival. This was a secondary analysis of baseline data from patients diagnosed with cancer. Patients answered questionnaires that assessed sociodemographic characteristics, pain, depression, sleep, and fatigue. Blood was collected and cytokine assays were performed. Analysis of variance, Kaplan-Meier, and Cox regression survival analyses were used to test the aims. Of the 779 patients diagnosed with cancer, the mean age was 63.5 years, 57.8% male, and 90.6% White. Of those who reported pain (total 70.3%), 46.5% stated their pain was cancer-related while 53.5% stated their pain was non-cancer-related. While both cancer and non-cancer-related pain was associated with depressive symptoms, fatigue, and sleep duration, those with cancer-related pain had significantly higher rates of depressive symptoms (F(1,516) = 21.217, p < 0.001) and fatigue (F(1,516) = 30.973, p < 0.001) but not poorer sleep (F(1,497) = 0.597, p = 0.440). After adjusting for sociodemographic, disease-related characteristics, depression, sleep duration, and morphine milligram equivalent, patient reports of cancer-related pain were significantly associated with poorer survival (HR = 0.646, 95% CI = 0.459-0.910, p = 0.012) compared to those with non-cancer-related pain, which was not associated with survival (HR = 1.022, 95% CI = 0.737-1.418, p = 0.896). Cytokines did not significantly mediate the link between pain and survival. While nearly half of the pain reported was cancer-related, both types of pain resulted in greater symptom burden, but only cancer-related pain was associated with survival.

The Link between Vulnerability to Poverty and Depression: Evidence from Vietnam

Vulnerability to poverty is a measure of the downside risk of falling into poverty. We examine the relationship between vulnerability to poverty and self-reported mental health, using a four-wave longitudinal panel from rural Vietnam. Our findings indicate that vulnerability to poverty has a significant and adverse connection with an index of depression. The impacts are not only statistically significant but also large. An increase in vulnerability to poverty from zero to one is associated with a 3.3 unit increase in the depression (CES-D) score (or 47.1 percent increase over the sample mean). Moreover, vulnerability to poverty also increases the probability of being severely mentally distressed. An increase in vulnerability to poverty of one standard deviation is associated on average with a 10.5 percentage point increase in the probability of severe mental distress. Risks of poverty that come from idiosyncratic shocks have stronger links to mental health than risks from covariate shocks. Vulnerability to poverty increases the likelihood of depressive symptoms more for men than for women and for the major ethnicity group compared to other ethnicities. Overall, we provide clear evidence that lives marked by greater downside risk are also blemished with higher rates of depressive symptoms.

The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety

BackgroundWith modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms.MethodsThis cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms.ResultsCompared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively).ConclusionsSleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.

Implementing youth participatory action research at a continuation high school.

To describe the process of implementing a Youth Participatory Action Research (YPAR) project at a continuation high school (CHS) and share the results of a youth-designed research project that explores barriers to high school completion. YPAR was implemented across three cohorts at a CHS in the central coast of California from 2019 to 2022. Student survey respondents were enrolled CHS students between March and April 2021. A modified YPAR curriculum integrating research methodology and social justice topics was used to guide student-led research that resulted in a cross-sectional survey. Field notes maintained by the first author documented the process of implementing YPAR including the curriculum, conversations, and research decisions and procedures. A student-designed survey disseminated to all enrolled students resulted in 76 (66%) participant responses. The survey included 18 close-ended questions and three narrative responses. This study details how YPAR methodologies can be translated to a high school credit recovery program. For example, student cohorts were needed to maintain continuity over time. A student-designed survey revealed that 72% of student respondents reported taking care of family members and illuminated high rates of depression symptoms. This study offers a detailed description of how we implemented YPAR at a credit recovery program and provides student-driven perspectives on educational reform and evaluation. This project addresses the implementation and challenges of using YPAR to engage youth in transformational resistance to rapidly study and improve CHS' policy and practice.

Multiple Chronic Conditions and Disability among Vietnamese Older Adults: Results from the Vietnamese Aging and Care Survey (VACS).

Using data from Vietnamese-origin older immigrants/refugees in the Houston, Texas area, we assessed their overall health, chronic conditions, disability, depressive symptoms, and cognitive impairment, and examined the association between their chronic conditions and disability by comorbidity clusters. The mean age of the sample was 76years old. The majority were married in fair/poor health with several chronic conditions and disabilities and lived with families in low-income households. Hypertension and arthritis were the most common health conditions, but cognitive impairment had the most significant impact on their disability. They experienced similar health conditions to other older Americans but had higher rates of depressive symptoms and cognitive impairment possibly due to cultural factors that may have delayed mental health treatment. Culturally and linguistically tailored services created by policymakers, healthcare professionals, and local social service agencies are recommended for the well-being of immigrants/refugees who migrated to the U.S. for a better life.

Associations between social activities and depressive symptoms in adolescents and young adults with autism spectrum disorder: Testing the indirect effects of loneliness.

Previous studies have found that social activities and depressive symptoms in adolescents and young adults with autism spectrum disorder are related. To better understand the relationship between these issues, this study examined the frequency of various types of social activities as well as if the participants felt that the frequency of time spent in the activity met their personal needs. In addition, the role of loneliness was tested as a possible way to understand the relationship between activities and depressive symptoms. To test these ideas, 321 participants who were recruited from the Simons Foundation Powering Autism Research for Knowledge (SPARK) research match registry and completed online measures of social activities, depressive symptoms, and loneliness. While the specific pattern was different for individual activities, it was found that those who felt that their current frequency of activities did not meet their needs had higher rates of depressive symptoms than those who felt they did meet their needs. Also, loneliness helps to understand relationship between social activities and depressive symptoms. The findings were discussed in light of previous study findings, interpersonal theories of depression, and clinical implications.

The Relationship Between Chronic Pain, Depression, Psychosocial Factors, and Suicidality in Adolescents.

The objective of this study was to determine if depressive symptoms, peer victimization, and lack of fear of pain predict suicidality in adolescents with chronic pain. It was hypothesized that higher levels of depressive symptoms and peer victimization, and lower levels of fear of pain, would predict higher lifetime prevalence of suicidality. Participants consisted of 184 youth with primary chronic pain conditions (10-18y, M=14.27y). Measures included diagnostic clinical interviews assessing suicidality and self-report questionnaires assessing depressive symptoms, peer victimization, and fear of pain. Forty-two (22.8%) participants reported suicidality. Regression analyses demonstrated that the occurrence of suicidality was associated with higher rates of depressive symptoms (β=1.03, P=0.020, 95% CI [1.01, 1.06]) and peer victimization (β=2.23, P<0.05, 95% CI [1.07, 4.63]), though there was no association between lower fear of pain and suicidality. These results suggest that depressive symptoms and peer victimization are significant predictors of suicidality in adolescents with chronic pain; however, lower fear of pain was not shown to be a significant predictor. Given these findings, depression and peer victimization should be further explored and considered in the design and implementation of prevention and early intervention strategies that target chronic pain and suicidality in youth.