Initial Depressive Symptoms Research Articles

Negative Inferential Style, Emotional Clarity, and Life Stress: Integrating Vulnerabilities to Depression in Adolescence

Negative inferential style and deficits in emotional clarity have been identified as vulnerability factors for depression in adolescence, particularly when individuals experience high levels of life stress. However, previous research has not integrated these characteristics when evaluating vulnerability to depression. In the present study, a racially diverse community sample of 256 early adolescents (ages 12 and 13) completed a baseline visit and a follow-up visit 9 months later. Inferential style, emotional clarity, and depressive symptoms were assessed at baseline, and intervening life events and depressive symptoms were assessed at follow-up. Hierarchical linear regressions indicated that there was a significant three-way interaction between adolescents' weakest-link negative inferential style, emotional clarity, and intervening life stress predicting depressive symptoms at follow-up, controlling for initial depressive symptoms. Adolescents with low emotional clarity and high negative inferential styles experienced the greatest increases in depressive symptoms following life stress. Emotional clarity buffered against the impact of life stress on depressive symptoms among adolescents with negative inferential styles. Similarly, negative inferential styles exacerbated the impact of life stress on depressive symptoms among adolescents with low emotional clarity. These results provide evidence of the utility of integrating inferential style and emotional clarity as constructs of vulnerability in combination with life stress in the identification of adolescents at risk for depression. They also suggest the enhancement of emotional clarity as a potential intervention technique to protect against the effects of negative inferential styles and life stress on depression in early adolescence.

Overgeneral autobiographical memory, emotional maltreatment, and depressive symptoms in adolescence: Evidence of a cognitive vulnerability–stress interaction

Overgeneral autobiographical memory (OGM) is associated with depression and may confer risk for the development of depressed mood, but few longitudinal studies have evaluated OGM as a predictor of depressive symptoms in early adolescence, particularly in the context of environmental stressors. We investigated whether OGM and emotional maltreatment would interact to predict prospective increases in depressive symptoms in early adolescents and whether these effects differed by race. Among 174 seventh-graders, OGM and familial emotional abuse interacted to predict depressive symptoms eight months later, controlling for initial depressive symptoms. Specifically, emotional abuse predicted increases in depressive symptoms among Caucasian adolescents with more OGM, but not among those with less OGM. This association was not significant for African American adolescents. These results provide support for a cognitive vulnerability–stress relationship between OGM and emotional abuse in early adolescence and suggest that these mechanisms of risk for depression may be specific to Caucasian adolescents.

A randomized controlled trial of a web‐based psychological intervention for patients under treatment for chronic HIV infection

Purpose of the studyOne of the most prevalent mental conditions in people with HIV is depression as uniquely characterized by low positive affect. This study examined the effect of a web‐based intervention (Avanti) on overall mood and depressive symptoms among patients with HIV infection.MethodsPatients treated with effective antiretroviral treatment were included in a two‐armed trial with substance abuse as an exclusion criterion and randomized to Avanti (n=36) or control (n=31). Patients were surveyed at baseline, as well as 1 and 3 months after the initiation of a 5‐week intervention period. Outcomes were Center for Epidemiological Studies‐Depression scale and the Positive and Negative Affect Schedule which was combined into an overall mood index. Changes within groups were tested by Wilcoxon matched pairs test and baseline differences between groups by chi‐square and Mann‐Whitney independent samples test.Summary of resultsBaseline scores for both groups were similar. However, patients in the intervention group had an improvement in median (M) overall mood from baseline (M=67.6) to 1 month (M=71, p=0.02) which was also maintained from 1 to 3 months (M=71.9). Moreover, these patients had a favorable reduction in negative affect from 1 (M=24) to 3 months (M=22, p=0.01) and a transient improvement in positive affect from baseline (M=31.7) to 1 month after intervention onset (M=35, p<0.01) which almost returned to baseline levels at month 3 (M=32, p=0.01). In contrast, no significant changes were observed within the control group, except for a reduction in negative affect from 1 (M=23) to 3 months (M=21.6, p=0.05). Notably, symptoms of depression at baseline were low in both the Avanti (M=13) and control (M=12) groups, possibly explaining why no further reduction in depression was observed from baseline to 3 months in either of the two groups.ConclusionsThe results of this study lend support to the promise of a web‐based psychological intervention among patients with HIV and its ability to improve overall mood with favorable intervention‐related changes in negative and positive affect. Avanti had no effect on depression but this was probably due to low initial symptoms of depression. The findings suggest that a prolonged web‐based intervention with regular contact could maintain the positive effects on mood seen in this study. If so, Avanti could potentially provide an easily accessible and cost‐effective adjunct to traditional psychotherapy.

Psychological Outcomes and Predictors of Initial Weight Loss Outcomes Among Severely Obese Adolescents Receiving Laparoscopic Adjustable Gastric Banding

Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery. The role of mental health providers in this population is not well defined, and the selection of candidates is often the result of clinical judgment alone. The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric banding (LAGB) by (1) examining changes in depressive symptoms and quality of life in the year following surgery; (2) evaluating the interaction between patterns of change in depression, quality of life, and weight postsurgery; and (3) identifying presurgical psychological predictors of initial weight change. Participants were 101 severely obese adolescents aged 14 to 18 years receiving LAGB at the Center for Adolescent Bariatric Surgery at the Morgan Stanley Children's Hospital of New York Presbyterian/Columbia University Medical Center between August 2006 and December 2009. Measures of height, weight, depressive symptoms, and quality of life were obtained in the first year following surgery. Changes in the Beck Depression Inventory (BDI), Pediatric Quality of Life Inventory (PedsQL), and body mass index were analyzed using latent growth curve modeling. Short-term changes in psychiatric symptoms and weight were analyzed using latent growth curve modeling. Significant changes in total BDI (βslope = -0.885, SE = 0.279, P < .01; βquadratic = 0.054, SE = 0.021, P < .001) and PedsQL (βslope = -0.885, SE = 0.279, P < .001) scores were observed following LAGB, and comparable postoperative changes between psychosocial variables and body mass index were also noted (BDI: covariance [COV] = 0.21, SE = 0.06, P < .001; PedsQL: COV = -0.41, SE = 0.10, P < .01). Two variables (family conflict/loss of control eating) were found to be significant predictors of weight change over the year following surgery (P < .05). Adolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB, and measures of preoperative binge eating and family conflict affected postsurgery body mass index among youth. ClinicalTrials.gov identifier: NCT01045499.

A longitudinal study of cortisol responses, sleep problems, and psychological well-being as the predictors of changes in depressive symptoms among breast cancer survivors

This study examined whether the changes in sleep problems, attachment styles, meaning in life, and salivary cortisol over the course of 14 months were the predictors of changes in depressive symptoms in women with breast cancer at post-treatment stage. The study included 76 participants who completed active breast cancer treatment with longitudinal data collected at five points, including baseline assessment (T0) and the four follow-ups after baseline: T1 (in the 2nd month), T2 (in the 5th month), T3 (in the 8th month), and T4 (in the 14th month). The self-reported questionnaires included the Medical Outcomes Study Sleep (MOS-Sleep) scale; the Beck Depression Inventory-II (BDI-II); the Experiences in Close Relationships-Revised (ECR-R) scale for measuring anxiety and avoidance dimensions of attachment style; and the Meaning in Life Questionnaire (MLQ), consisting of the MLQ-Presence scale and the MLQ-Search scale. The participants collected their salivary cortisol at home at six time points: upon waking, 30 and 45 min after waking, and at 1200 h, 1700 h, and 2100 h. Higher scores on for anxiety-related attachment style and the sleep problems index at baseline were associated with more severe initial depressive symptoms after the age, BMI, cancer, and treatment variables were controlled. The presence of meaning in life at baseline was negatively correlated with initial depressive symptoms. Moreover, the decreases in the presence of meaning in life over the course of 14 months predicted more severe depressive symptoms. In addition, the persistent increases of cortisol level at 2100 h across 14-month follow-ups predicted worsening depressive symptoms. Lacking presence of meaning in life as a predictor for severe depressive symptoms demonstrates that breast cancer survivors who lack psychological well-being are more likely to be depressed. The persistent elevation of cortisol levels at night also indicates breast cancer survivors to be at high risk of depression.

Neuroendocrine predictors of emotional and behavioral adjustment in boys: Longitudinal follow-up of a community sample

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been observed in adults and children with mood and anxiety disorders and is thought to be involved in the pathogenesis of these disorders. We recently studied a diverse community sample of boys and found associations of behavioral problems, including symptoms of depression and anxiety, with basal and stress-induced cortisol concentrations. Here we examine cortisol-emotional/behavioral associations at a two-year follow-up and test whether initial cortisol is predictive of worsening emotional/behavioral problems two years later. Seventy-eight 10-14-year-old boys and their mothers completed a battery of psychosocial assessments, provided morning and afternoon saliva samples, and participated in a home visit involving mildly stressful tasks and saliva collection for cortisol assay during a two-year follow-up assessment. Consistent with the findings from our time 1 assessment, greater declines in cortisol across the home-visit challenge task were significantly associated with internalizing and externalizing behaviors as well as attention problems and social problems at the two-year follow-up. In addition, morning and afternoon cortisol concentrations at the initial assessment were significant positive predictors of the later development of child depressive symptoms at follow-up after controlling for initial depressive symptoms. These findings demonstrate that children in the community with internalizing and externalizing behavior problems have altered patterns of HPA axis stress reactivity. In addition, our prospective findings suggest that elevated cortisol concentrations may influence the later development of emotional/behavioral problems in boys.

Negative Life Events and Substance Use Moderate Cognitive Behavioral Adolescent Depression Prevention Intervention

Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n = 173) in which adolescents (M age = 15.5, SD = 1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Results imply that high-risk adolescents with either high rates of major life stress or initial substance use may require specialized depression prevention efforts.

Progression along the bipolar spectrum: A longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders.

Little longitudinal research has examined progression to more severe bipolar disorders in individuals with "soft" bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a nonpatient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of "soft" bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts.

P-450 - Inaugural psychiatric presentation of sporadic Creutzfeldt-Jacob disease: case report

The case of a 72-year-old male patient with initial depressive symptoms and visual hallucinations, added to a progressive motor and cognitive neurological impairment, is presented. The patient died of pneumonia 7 weeks after the onset of the symptoms; the necropsy confirmed the diagnosis of Creutzfeldt-Jacob disease (CJD) suggested previously by complementary diagnostic tests (brain magnetic resonance imaging, electroencephalogram, 14-3-3 protein determination in the cerebrospinal fluid and study of the prionic protein gene). Discussion CJD is a rare dementia characterized by a rapidly progressive course. Psychiatric symptoms, including depression and personality change, occur early in the clinical course in about a third of patients, being estimated in some studies that 10% of patients are first admitted to psychiatric wards. Psychiatric symptoms associated with CJD have often lead to erroneous initial diagnoses of functional psychosis, depressive pseudodementia, or hysteria. Analysis of the psychiatric symptoms does not suggest specific features that rapidly allow the differentiation from more common psychiatric disorders, although the occurrence of associated persistent sensory symptoms may raise the possibility of this diagnosis. Later, the characteristic rapidly progressive neurological impairment is decisive in the affirmation of the diagnosis of CJD.

Mothers' Depressive Symptoms and Low Mother–Toddler Mutuality Both Predict Children's Maladjustment

The current study examined mothers' depressive symptoms and mother–child mutuality across children's early years and children's maladjustment in their first year of school. Mothers of 117 children (74 boys and 43 girls) each completed the Beck Depression Inventory at four time points, when their children were approximately aged 2, 3, 4 and 6 years. In addition, each mother–child dyad was filmed playing at the first time point and attempting an Etch‐a‐Sketch task at the last time point; here, teachers completed the Strengths and Difficulties Questionnaire. Modifications of confirmatory factor analytic techniques highlighted that the measurement of both mothers' depressive symptoms and mother–child mutuality were equivalent across time. A path analysis and a latent growth model demonstrated that individual differences in both mother–child mutuality and mothers' depressive symptoms were stable across the 4‐year period of the current study. Moreover, variation in both mothers' initial depressive symptoms and mother–toddler mutuality predicted individual differences in teachers' ratings of children's difficulties. These findings highlight the importance of children's early exposure to and experience of mothers' depressive symptoms and mother–child mutuality. Copyright © 2011 John Wiley &amp; Sons, Ltd.

The direct and interactive effects of neuroticism and life stress on the severity and longitudinal course of depressive symptoms.

The direct and interactive effects of neuroticism and stressful life events (chronic and episodic stressors) on the severity and temporal course of depression symptoms were examined in 826 outpatients with mood and anxiety disorders, assessed on 3 occasions over a 1-year period (intake and 6- and 12-month follow-ups). Neuroticism, chronic stress, and episodic stress were uniquely associated with intake depression symptom severity. A significant interaction effect indicated that the strength of the effect of neuroticism on initial depression severity increased as chronic stress increased. Although neuroticism did not have a significant direct effect on the temporal course of depression symptoms, chronic stress significantly moderated this relationship such that neuroticism had an increasingly deleterious effect on depression symptom improvement as the level of chronic stress over follow-up increased. In addition, chronic stress (but not episodic stress) over follow-up was uniquely predictive of less depression symptom improvement. Consistent with a stress generation framework, however, initial depression symptom severity was positively associated with chronic stress during follow-up. The results are discussed in regard to diathesis-stress conceptual models of emotional disorders and the various roles of stressful life events in the onset, severity, and maintenance of depressive psychopathology.

Progression along the bipolar spectrum: a longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders

Little longitudinal research has examined progression to more severe bipolar disorders in individuals with soft bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a nonpatient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of soft bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts.

Depressive symptoms in junior doctors: a follow-up study on work-related determinants

The study investigates the long-term effects of accumulated working conditions on depressive symptoms in junior doctors. Drawing on the Job Demand-Control-Support model, this study aims to identify personal and job-related determinants for self-reported depression in junior doctors-a professional group that is vulnerable to depression. We conducted a prospective cohort study with measures of work characteristics and depressive symptoms over three time-points among hospital doctors during postgraduate specialty training in Germany. Participants were 415 junior doctors with full-time contract (47.5% women; mean age, 30.5 years). The outcome was depressive symptoms assessed with the Spielberger State-Depression Scale. Odds ratios (OR) were computed to analyse the cumulative effect of initial depressive symptoms scores, demographic variables, and working characteristics across T1 and T2 on subsequent depressive symptoms at T3. The percentage of junior doctors reporting depressive symptoms scores above a critical value varied between 12.0% at T1, 10.4% at T2, and 13.3% at T3; N = 34 doctors (8.19%) were classified as incident cases during the observation period. Elevated depressive symptoms at T3 were positively predicted by depressive symptoms scores across T1 and T2 (OR: 1.37; 95% confidence interval: 1.25-1.50) and negatively by professional tenure (0.54; 0.31-0.96), free weekends (0.52; 0.28-0.97), and job autonomy (0.35; 0.18-0.65). After controlling for demographic and working time influences, findings suggest that junior doctors' perceived job autonomy is negatively associated with future depressive symptoms. Enhancing job control emerges as a promising strategy to lower the risk of depression during first years of professional practice.

The reciprocal relationship between menopausal symptoms and depressive symptoms: A 9-year longitudinal study of American women in midlife

Objectives The present study sought to examine: (a) the association between depressive symptoms among pre-menopausal and peri-menopausal women and subsequent difficulty with menopausal symptoms; and (b) the relationship between initial problems with menopausal symptoms and subsequent levels of depressive symptoms. Study design Prospective Longitudinal Regression Analysis ( n = 986) of survey data from a national sample of non-institutional women in midlife (mean age = 39.9 years at Time 1). Main outcome measures Menopausal symptoms and symptoms of depression. Results Initial levels of depressive symptoms predicted 9-year follow-up levels of menopausal symptoms controlling for initial menopausal symptoms and demographic covariates (beta = .074; t(980) = 2.425; p < .05). Initial levels of menopausal symptoms predicted follow-up levels of depressive symptoms controlling for initial depressive symptoms and demographic covariates (beta = 110; t(980) = 3.442; p < .001). Conclusions Women who have more symptoms of depression in their early 40's may be at heightened risk for problems with the menopausal transition. Conversely, efforts to address more severe symptoms of menopause may help to reduce the onset of depressive symptoms among middle aged women.

Identifying target groups for the prevention of depression among caregivers of dementia patients

Depression in informal caregivers of persons with dementia is a major, costly and growing problem. However, it is not yet clear which caregivers are at increased risk of developing depression. With this knowledge preventive strategies could focus on these groups to maximize health gain and minimize effort. The onset of clinically relevant depression was measured with the Center for Epidemiologic Studies - Depression Scale in 725 caregivers who were not depressed at baseline and who were providing care for a relative with dementia. Caregivers were followed over 18 months. The indices calculated to identify the most important risk indicators were: odds ratio, attributable fraction, exposure rate and number needing to be treated. The following significant indicators of depression onset were identified: increased initial depressive symptoms, poor self-rated health status and white or Hispanic race/ethnicity. The incidence of depression would decrease by 72.3% (attributive fraction) if these risk indicators together are targeted by a completely effective intervention. Race/ethnicity was not a significant predictor if caregivers of patients who died or were institutionalized were left out of the analyses. Detection of only a few characteristics makes it possible to identify high-risk groups in an efficient way. Focusing on these easy-to-assess characteristics might contribute to a cost-effective prevention of depression in caregivers.

The course of mental health disorders after a disaster: Predictors and comorbidity

Current longitudinal disaster studies usually focus only on posttraumatic stress disorder (PTSD), although some studies have shown that increased risks for other disorders and comorbidity is common. To obtain an insight into the course of postdisaster psychopathology, a community sample of survivors of the Enschede fireworks disaster was followed from 2-3 weeks to 4-years postdisaster. Diagnostic interviews (Composite International Diagnostic Interview [CIDI]; World Health Organization, 1997) and childhood stressor interviews were administered at 2-years postdisaster (n = 260); the CIDI was repeated at 4-years postdisaster (n = 201, response rate 77.3%). At 2-years postdisaster many survivors (40.6%) suffered from PTSD (21.8%), specific phobia (21.5%), and/or depression (16.1%). These disorders were highly comorbid. At 4-years postdisaster, prevalence significantly diminished. Instead of full recovery, diagnostic classifications shifted in several survivors over time. This resulted in low rates of PTSD but still elevated rates of depression and specific phobia. The course of the 3 entangled disorders of PTSD, depression, and specific phobia was further studied by constructing 4 groups of survivors based on the diagnostic status at 2- and 4-years postdisaster: healthy, recovered, chronic, and delayed-onset. Initial depressive symptoms, maternal dysfunction, childhood physical abuse, and disaster exposure were found to discriminate between the groups and predict long-term psychopathology.

Adverse Life Events and Depressive Symptoms in African American Youth: The Role of Control-Related Beliefs

The association between experiences of adverse life events and adolescent depressive symptoms has been well documented. However, this association is not consistently observed in urban and low income African American youth. In addition, mechanisms linking life event stress and African American adolescents' depressive symptoms have received little attention. This study examined past year violent and nonviolent life events assessed in 6th grade as predictors of 7th grade depressive symptoms among a community epidemiologically defined sample of 447 (47% girls) urban African American adolescents. Depressive symptoms were assessed twice, at a 1-year interval, and initial depressive symptoms were controlled in the analyses. Control-related beliefs were examined as mediators of the association between life events and depressive symptoms, and gender was examined as a moderator of the association between control-related beliefs and depressive symptoms. Associations among study variables were examined in a series of models, from general to more specific. A model in which nonviolent and violent life events were examined separately and control and contingency beliefs examined as one latent variable was the most informative about the etiology of depressive symptoms in a sample of urban, African American youth. Implications of the findings for preventive interventions and future research are discussed.

Managing Depression During the Menopausal Transition

The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling implications for assessment, education, advocacy, and self-care are discussed. ********** Women are diagnosed with depression at nearly twice the rate as men are (American Psychiatric Association [APA], 2000), a trend that begins in puberty (APA, 2000) and levels off after menopause (Bebbington et al., 2003). Without question, rates of depression in women are higher during their reproductive years. Although the connections between depression and premenstrual syndrome and the postpartum period are recognized and included in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; APA, 2000), no such recognition exists for depression during the menopausal transition. Failing to recognize a potential biological component of a disorder and instead emphasizing psychosocial or intrapsychic factors can lead to treatment that is ineffective, if not harmful. Therefore, the purpose of this article is threefold: to discuss hormonally based factors associated with depression during the menopausal transition; to review the benefits and risks of hormone replacement therapy (HRT), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and complementary and alternative medicine (CAM) approaches to treat depression; and to offer strategies for assessment, advocacy, and intervention. THE MENOPAUSAL TRANSITION AND RISK OF DEPRESSION Efforts to understand possible relationships between depression and reproductive cycles in women consistently point to a strong connection between the menopausal transition and increased occurrences of depression. In a critical review of the research literature, Soares and Zitek (2008) concluded that the menopausal transition seems to present a unique period in which some women are more vulnerable to initial onset or recurrent depressive symptoms and major depressive episodes. Similarly, Schmidt (2005) affirmed that research studies indicate a relationship between perimenopause (the early and late stages of the menopausal transition) and the onset of depression, a relationship that did not extend to the postmenopausal stage. Deecher, Andree, Sloan, and Schechter (2008) likewise concluded that clinical studies show an increase in major depressive disorder during perimenopause compared with such occurrences during premenopause or postmenopause. The authors found that this increased risk was present even in perimenopausal women who had no prior history of major depressive disorder. Findings from longitudinal studies illustrate these conclusions. Results from the Seattle Midlife Women's Study, a prospective study that followed women for approximately fourteen years, showed that the late menopause transition stage was significantly related to depressed mood (Woods et al., 2008). Results were similar for cohorts from another prospective study, the Penn Ovarian Aging Study, an ongoing longitudinal study (as cited in E. W. Freeman et al., 2004). An examination of a 4-year cohort from this study showed that depressive symptoms increased during the menopausal transition and decreased in postmenopause (E. W. Freeman et al., 2004). E. W. Freeman, Sammel, Lin, and Nelson (2006) examined another cohort over an 8-year period from the Penn Ovarian Aging Study. They found that a woman was 4 times more likely to have high depression scores and 2 1/2 times more likely to be diagnosed with depressive disorder when she was in the menopausal transition compared with her premenopausal period. Although no direct associations have been identified in the research between depression during the menopausal transition and specific levels of hormones (e. …

Trajectories of Postpartum Maternal Depressive Symptoms and Children’s Social Skills

The vast majority of new mothers experience at least some depressive symptoms. Postpartum maternal depressive symptoms can greatly influence children’s outcomes (e.g., emotional, cognitive, language, and social development). However, there have been relatively few longitudinal studies of how maternal depressive symptoms may influence children’s social skills. The current study (n = 1363) examined the trajectory of maternal depressive symptoms (from 1 month to 36 months) and whether maternal depressive symptoms at 1 month postpartum and the change in symptoms over time (from 1 month to 3 years) predicted children’s parent- and teacher-rated social skills when they were 4.5 and 6.0 years old. A growth curve model indicated that, on average, maternal depressive symptoms declined over time in a nonlinear fashion. Further analyses indicated that after controlling for five demographic factors (child sex, family income, maternal age, mother’s marital status, and maternal education), initial maternal depressive symptoms significantly predicted children’s social skills as reported by mothers. The results support the notion that maternal depressive symptoms during children’s infancy can have long-term associations with children’s social skills. In addition, the results emphasize the importance of intervention and prevention efforts targeting maternal depressive symptoms during infancy, beginning immediately postpartum.

Components of interference control predict depressive symptoms and rumination cross-sectionally and at six months follow-up

Recent research has shown that depression is characterized by difficulties inhibiting irrelevant emotional material and that these difficulties are linked to rumination. The present study examined the relation among tasks that assess different aspects of interference control, depressive symptoms, and rumination, cross-sectionally and in a 6-months follow-up. 111 participants completed an emotional flanker task to assess individual differences in resolving interference from simultaneously presented irrelevant stimuli. In addition, participants completed two negative affective priming tasks using word and face stimuli to assess difficulty controlling interference from internal representations of previously rejected material. Six months after the initial session, depressive symptoms and rumination were re-assessed. Depressive symptoms at time 1 were related to individual differences in negative priming for verbal as well as pictorial material, but not to individual differences in interference resolution from simultaneously presented external stimuli in the flanker task. Individual differences in negative priming at time 1 further predicted depressive symptoms and rumination at time 2. These results suggest that depressive symptoms are related to impaired interference control for verbal and pictorial information and provide first evidence that individual differences in interference control predict the maintenance of depressive symptoms and rumination over a period of six months.