Lower Levels Of Depression Research Articles

Factors Influencing Quality of Life in the Disabled: Focus on Household Members Mental Health

Abstract Background Household members of the disabled experience various difficulties such as social isolation and the burden of caregiving. These difficulties can lead to mental health problems, which in turn affect the quality of life(QoL) of the disabled. Research on the QoL of the disabled is ongoing, but there are few studies addressing the mental health of household members. We aimed to investigate the impact of household members’ mental health on the QoL of the disabled. Methods We used data from the 2021 Disability and Life Dynamics Panel(nationwide survey). On the base of Patrick’s model of disability health promotion, we analyzed the impact of household members’ mental health on the QoL of the disabled by using correlation analysis and multiple regression analysis adjusted for gender, age, income level, employment status, education level, activities of daily living, participation in social activities, type and severity of disability, presence of multiple disabilities, and health status. Results The level of depression(r=-.316, p<.0001) and self-esteem(r=.248, p<.0001) of household members were found to be significantly correlated with the QoL of the disabled. The level of depression of household members had a significant negative impact on the QoL of the disabled(β=-.153, p<.0001), while self-esteem had a significant positive impact(β=.144, p<.0001). It was found that the level of depression had a greater impact on QoL than self-esteem. Conclusions Lower levels of depression and higher levels of self-esteem of household members are associated with higher QoL for the disabled. Improving the mental health of household members is crucial in improving the QoL of the disabled, enabling them to interact more positively with society. Additionally, as 27% of household members experience depressive issues, enhancing their mental health positively impacts on the overall well-being of families with disabilities. Efforts to enhance household members’ mental health are crucial. Key messages • Household members’ mental health significantly influences the quality of life of the disabled. • To improve the quality of life of the disabled, strengthening programs for promoting the mental health of household members and policy improvements are necessary.

Comparative analysis and model development of working conditions and sociopsychological factors influencing job satisfaction among office workers

This study aimed to examine the impact of working conditions and sociopsychological factors on job satisfaction among office workers. Using data from the 2017–2018 Working Conditions Survey, exploring how workplace conditions and sociopsychological elements could impact job satisfaction. This study examined data from 9801 workers to explore the effects of working conditions and psychosocial environments on job enthusiasm, which subsequently impacts job satisfaction. Analyzing 1416 office workers, it found that fewer working hours, better work-life balance, improved work conditions, and lower depression levels enhance job enthusiasm, significantly affecting job satisfaction. The work environment had the most substantial impact, encompassing relationships with colleagues, task completion time, and confidence. Work-life imbalance and depression were also significant, with work-life balance being crucial for modern society, especially the younger generation. Poor working conditions and unstable psychosocial environments negatively affect job enthusiasm and satisfaction, with findings supporting previous research on job stress and turnover intentions in various industries. This study highlights the need for organizational policies that support these aspects to improve overall employee well-being and productivity.

Optimism mitigated impacts of pre-operative depression and anxiety on post-operative distress in cardiac patients

ABSTRACT Both anxiety and depression are comorbid mortality risks in middle-aged and older patients with heart diseases. Open-heart surgery (OHS), a life-altering procedure, can induce psychological distress that impedes postoperative recovery. Extensive research has shown the health benefit of optimism, an indicator of hope—a Character Strength in positive psychology. It predicts low mortality in cardiovascular disease—the number one killer of all Americans. Few studies, however, have explored whether that optimism mitigates the negative impact of preoperative depression and anxiety on postoperative general psychological distress. This interdisciplinary clinical study evaluated a hypothetical model of these relationships prior to and 1 month following OHS in 311 U.S. patients using a three-wave survey. Structural equation modeling (SEM) was performed to predict post-OHS general psychological distress. Optimism was indicated by two subscales in the Life Orientation Test (LOT). Based on the definition, general psychological distress was indicated by low symptom levels of somatization, depression, and anxiety as measured by the SCL-90 subscales. The final solution demonstrated a good fit. Optimism alleviates the negative effects of preoperative depression and anxiety, as indicators of poor mental health, on postoperative distress. Both older age and female gender were positively and directly associated with higher levels of post-OHS symptoms. The finding supports the beneficial role of optimism in mitigating the damage of poor mental health in the postoperative outcome of cardiac patients. The desirable function of character strength hope suggests that health providers should be attentive to and enhance inner strength for reducing the distress of cardiac patients in the postoperative recovery month.

Effect of healthy dietary intention-behavior (in)consistency on depression and anxiety in the process of behavior change.

Although an increasing number of people are now committed to pursuing a healthy diet, it remains unclear how mental health changes during this process. The present study aimed to examine the combined effect of healthy dietary intention and behavior on depression and anxiety across two sub-studies. This study consisted of two parts: a cross-sectional survey (Study 1) involving 1,433 college students and an 11-day daily diary study (Study 2) with 117 college students. Polynomial regression and response surface analysis indicated that in cases of congruence, individuals' intention and behavior align at a high level and were associated with lower levels of depression and anxiety in the motivational phase but were not found similar association in the volitional phase. In cases of incongruence, individuals with high intention-low behavior tend to experience lower levels of depression and anxiety in the motivational phase. However, individuals with high intention-low behavior tend to experience higherlevels of depression and anxiety in the volitional phase. These findings not only enrich the current understanding of diet and health but also contribute to the development of holistic strategies for promoting a healthy diet.

Impact of an mHealth intervention on parents' emotional health and on the neurodevelopment of high-risk infants.

We assess the prenatal and postnatal effect of the High-Risk Pregnancy and Baby Parenting programme, which is complemented with two mHealth (app-based) resources. The GLM Repeated Measures Model technique was used to explore differences in the emotional health of the participants and in their infants' neurodevelopment, comparing programme versus usual care groups, composed of 150 and 195 participants, respectively. The mothers presented lower levels of depression (mean difference 1.74, p = 0.04, 95% CI 0.07, 3.40) and higher levels of resilience (mean difference 4.09, p = 0.004, 95% CI 1.40, 6.78). For the fathers, positive effects on resilience were recorded (p < 0.001). A positive treatment effect was perceived in the infants' cognitive (p = 0.014), language (p < 0.001) and motor (p = 0.006) development. These findings suggest application of the programme can benefit maternal emotional health and infant neurodevelopment. M-Health technology could make this programme more accessible.

The Perceived Inclusivity of Sex Education Scale – 2: Sex Education Inclusivity and Health Outcomes Among Gender Diverse Individuals

Past research has documented a relationship between sex education inclusivity and health outcomes among sexually diverse youth (e.g., lesbian, gay, bisexual, queer). However, despite transgender and gender diverse (TGD) individuals also being regularly excluded from sex education, little research has explored this relationship among TGD people. In the current study, the Perceived Inclusivity of Sex Education Scale − 2 (PISES-2) was developed to better understand the associations between perceived sex education climate and both mental and behavioral health outcomes. TGD individuals (N = 162) were recruited to participate in an online survey to examine these associations. Results suggested that greater levels of perceived inclusivity of sex education were associated with lower levels of depression, anxiety, and suicidality in high school and post-high school. Additionally, greater levels of inclusivity of sex education were associated with increased sexual behaviors and less hesitancy toward sex in TGD individuals in high school and post-high school. These conclusions add to the growing literature highlighting the critical importance of inclusive and affirming sex education for the safety and well-being of TGD individuals.

Occurrence of Malnutrition among Seniors in Poland Depending on the Place of Residence: An Analysis of Socioeconomic and Health Risk Factors.

The aging population in Poland poses significant socioeconomic and health challenges, particularly regarding malnutrition among seniors. This study examines the impact of place of residence on the nutritional status and related health outcomes of older adults. Data were collected from 338 community-dwelling seniors and those in long-term care facilities. The results indicate that long-term care residents exhibited significantly higher frailty and depression levels and poorer nutritional status, functional fitness, gait, and balance compared to those in communities. Self-reported quality of life did not differ significantly between groups. Regardless of residence, having a family correlated with better nutritional status, quality of life, and functional fitness and lower frailty and depression levels. Malnutrition was significantly associated with reduced functional fitness across all residences, and well-nourished individuals in care facilities had lower functional fitness than those who were at home. Community-dwelling residents had significantly lower frailty levels, with frailty negatively correlating with nutritional status. Normal nutritional status was linked to higher balance and gait scores, indicating a lower fall risk, with the risk further reduced for those living in community settings. Additionally, normal nutritional status correlated with lower depression levels and higher quality of life, with malnourished individuals experiencing better quality of life in community-dwelling settings. These findings underscore the critical role of residence and family support in elderly nutrition and health outcomes.

Impact of natural views on mental health during COVID-19 quarantine: A natural experiment

The COVID-19 pandemic has changed the daily lives of people, and countries worldwide have implemented public health measures that restricted social contact and interactions. Individuals in isolation displayed increased mental health issues, for whom windows are a crucial means of connecting with the outside world. However, few studies have discussed the effect of having a window view on the mental health of individuals in quarantine. This study uses a natural experiment to address this knowledge gap. Between January 27, 2022 and June 19, 2022, individuals in Taiwan who were assigned to quarantine hotel room with various window views were recruited through Facebook groups. Participants completed a baseline assessment at the beginning of their quarantine period that included room and window conditions and mental health conditions, followed by a posttest assessment of the same mental health measures. Questions related to window conditions included the proportions of natural and urban landscapes viewable from their hotel windows, human activities they could observe (flow of people), and their viewshed broadness. Subsequently, this study investigated how visual access to greenness influenced the positive mental health, depression, and stress of the participants before and during quarantine. In total, 81 participants participated. The results of this study indicated that viewing vegetation and the ratio of windows to walls were associated with improved mental health, reduced symptoms of depression, and reduced stress. Specifically, an open view in the room was associated with lower levels of depression (p < 0.001) and stress (p < 0.000). Additionally, viewing people through windows was associated with reduced depressive symptoms (p < 0.006). The results of this study can inform policies for pandemic containment, but also broadly for health care, hospitals, and other related fields.

Influence of Depression and Subjective Health Status on COVID-19 Vaccine Acceptance: Based on the 2021 Community Health Survey

Background: Coronavirus Disease 2019 (COVID-19) is a novel coronavirus identified in 2019 that exhibited an exceptionally rapid spread. Although the development and administration of COVID-19 vaccines progressed quickly, concerns about side effects and safety persisted. This study utilized data from the 2021 Community Health Survey to analyze the relationship between COVID-19 vaccination and psychosocial factors, including depression and subjective health status.Methods: Analysis included 203,449 individuals, excluding those who had not received or were ineligible for the COVID-19 vaccine, based on the 2021 Community Health Survey. The chi-square tests assessed sociodemographic and health status differences related to vaccination status. Subjective health status was categorized based on survey responses as ‘good’ or ‘poor,’ and depression was assessed using the self-reported Patient Health Questionnaire-9. The association between depression, subjective health status, and vaccination status was examined using chi-square tests, followed by multiple logistic regression to determine independent effects.Results: Vaccination rates were higher among the elderly, those with lower education, higher income, healthcare workers, and individuals with lower depression, higher subjective health, and chronic conditions like hypertension or diabetes. Significantly lower vaccination rates were observed in those with lower subjective health and Patient Health Questionnaire-9 scores ≥5 or ≥10. Among individuals with chronic illnesses, those with good subjective health had the lowest odds for non-vaccination (odds ratio=0.42; 95% confidence interval, 0.39-0.45), while those without chronic illnesses and poor subjective health had the highest odds (odds ratio=1.89; 95% confidence interval, 1.76-2.02).Conclusions: This study found significantly higher odds ratios for vaccine non-receipt among individuals with lower levels of depression and subjective health status. Incorporating psychosocial factors such as depression and subjective health status may be crucial in developing strategies to enhance vaccination rates during future outbreaks of novel infectious diseases.

Exploring the efficacy of memory specificity training on depression among Iranian adolescents: a comparative analysis of online vs. in-person delivery

Depression in adolescence is common worldwide, with the burden being highest in low- and middle-income countries. This study assessed the efficacy of in-person Memory Specificity Training (MeST) and computerized MeST (c-MeST) as cognitive training programs aimed at addressing depression among Iranian adolescents. A secondary aim was to evaluate the efficacy of MeST and c-MeST on autobiographical memory specificity, emotion regulation and cognitive control. Ninety Iranian male adolescents (aged 13–18 years) with depression were randomly assigned to three groups; MeST group (n = 30), c-MeST group (n = 30) and the non-active control group (n = 30). Participants completed the Beck Depression Inventory-II, Autobiographical Memory Test, Cognitive Emotion Regulation Questionnaire, Wisconsin Card Sorting Test and Stroop Color and Word Test. The groups underwent either MeST and c-MeST. All the assessments were re-conducted after the intervention (post-intervention) and at 1-month post-intervention (follow-up). The in-person MeST group exhibited significantly higher autobiographical memory specificity at post-intervention and follow-up compared to the c-MeST group. Both groups demonstrated significantly lower levels of depression at post-intervention and follow-up. Both groups showed improvements in emotion regulation and cognitive control, which were found to mediate improvements in depression symptomatology. c-MeST and MeST appear promising brief interventions for the treatment of depression among adolescents in Iran.

Perceived Mental Health and Quality of Life in Mothers of Children with Autism Spectrum Disorder in Armed Forces in a Tertiary Care Center of North India: A Cross-Sectional Study

Purpose: To explore the impact on mental health and quality of life among mothers following the diagnosis of mild or moderate autism in their child.Methods: The study included 100 consecutive mothers with a defence background, each having a child aged 3 to 10 years diagnosed with mild to moderate autism. Participants were briefed about the study, and informed consent was obtained. A quantitative experimental design was employed, utilising the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) and the World Health Organisation Quality of Life Scale-Brief (WHOQOL-Brief) to assess the mothers.Results: The results indicated that mothers experienced moderate levels of anxiety (mean±standard deviation, 10±6.4) and stress (19±6.7), but lower levels of depression (11±7.7), as measured by the DASS-21 questionnaire. The WHOQOL-Brief revealed a moderate decline in psychological health (transformative [T]-score=38) and social relationships (T-score=31). However, satisfaction with their environment (T-score=75) and physical health (T-score=63) was higher, potentially due to their defence background, which may provide easier access to healthcare and improved living conditions.Conclusion: Mothers of children with autism spectrum disorder experience moderate levels of stress and anxiety, and low levels of depression. Additionally, they face a decline in their quality of life.

Academic and non-academic predictors of common mental health difficulties among university students during the COVID-19 pandemic.

Public concern for the mental health of university students has been rising over recent years. Newly arising stressors associated with the COVID-19 pandemic could contribute to further mental health burden for students. This study aimed to understand the mental health status of university students at an early stage in the pandemic and to identify academic, non-academic, and COVID-19-related predictors of common mental health difficulties at this time. This study examined how academic and non-academic predictors relate to common mental health difficulties using a cross-sectional sample of university students (n = 3817). There were high levels of depression and anxiety during the pandemic, with more than 50% experiencing levels above the clinical cut offs. Academic stress, social isolation, intolerance of uncertainty, and more negative attitudes towards remote teaching and learning predicted higher levels of depression and anxiety. University identification predicted lower levels of depression whereas receiving a diagnosis of COVID-19 was associated with higher levels of depression. This study identified COVID-19-related factors that uniquely contributed to students' distress during the pandemic, over and above social connectivity variables. As COVID-19 factors, such as the uncertainty surrounding the pandemic, may have driven an increase in distress levels among students, these findings provide insights that could help universities and policymakers develop targeted interventions to support the mental health and well-being of university students during future crises.

A - 80 Moderating Effect of Age on the Relationship between Mood and Executive Functioning among South Asians

Abstract Objective This study investigated whether depression and anxiety are associated with executive functioning (EF) performance among South Asians living in the United States (US). Further, we explored whether age moderated this relationship. Method This retrospective chart analysis study included 28 South Asians referred for a neuropsychological evaluation within multiple northeast US-based outpatient clinics. Participants completed the Beck Depression Inventory-2nd edition (BDI-II), Beck Anxiety Inventory (BAI), Stroop Color Word Test- Color-Word Trial (SCWT-CW), and Verbal Fluency (FAS). Participants were dichotomized by age threshold (age 50 cut-off). Logistic regression analysis was used to determine the moderating effect of age on mood and EF. Results The sample comprised 13 younger adults and 15 older adults (50+), with 60.7% male (Meducation = 16.0, SD = 2.3). Regression analysis indicated a significant overall model between age, BDI-II, and SCWT-CW (F(1,25) = 3.01, p &amp;lt; 0.05, ΔR2 = 0.27). Further interaction analysis showed a stronger positive interaction effect between BDI-II and SCWT-CW (β = 5.39, F(1,24) = 4.91, p &amp;lt; 0.05, ΔR2 = 0.15) in the younger adult group. Conclusions Findings suggest that South Asian older adults with lower levels of depression have worse performance on EF than younger adults. This is one of the first studies to identify links between age, mood, and EF. Interpretation is challenging given that the mean scores of depression and SCWT-CW were in the mild range. Future studies are needed to understand how factors, such as English speaking proficiency and acculturation, may moderate the association and impact clinical relevance.

B - 67 Executive Functions as a Mediator between ADHD Symptoms and Anxiety and Depressive Symptoms in Emerging Adults

Abstract Objective Attention-deficit/hyperactivity disorder (ADHD) is associated with comorbid disorders such as anxiety and depression in emerging adults (Prevatt et al., 2012; Mochrie et al., 2020). However, there is limited research examining this association. This study explored the potential mediating role of executive functions in the relationship between ADHD symptoms and anxiety and depressive symptoms, respectively. Method A sample of 842 college students (mean age of 18.96 years) completed the Adult ADHD Self-Report Scale (ASRS-v1.1; Kessler et al., 2005), the Executive Function Index (EFI; Spinella, 2005), and the Depression Anxiety Stress Scale – 21 (DASS-21; Lovibond &amp; Lovibond, 1995). The sample was selected from a Psychology Research Program (PRP) pool of a southern university and consisted of 630 women (74.8%), 197 men (23.4%), 13 non-binary (1.5%), and 2 preferred not to answer (0.2%). Results PROCESS 4.2 (Hayes, 2022) model 4 was used with 5000 bootstrap resamples to examine indirect effects. The confidence interval for the indirect effect of ADHD symptoms through executive function was significant for depressive symptoms, B = 0.85, SE = 0.20, 95% CI [0.48, 1.26], as well as anxiety symptoms, B = 1.36, SE = 0.23, 95% CI [0.94, 1.85]. Conclusion ADHD symptoms in college students were associated with lower levels of depression and anxiety when students reported having stronger executive function skills. Given this association, future research could seek to clarify the role of executive functions in protecting individuals with ADHD from impairments associated with anxiety or depression, and whether treatment that builds executive functioning skills is of value in clinical populations.

B - 62 Cognitive Training Targeting Reward Responsiveness Promotes more Efficient Affective Processing in an Interference Go/NoGo Task

Abstract Objective Abnormalities in emotional processing are commonly seen in depression and anxiety, disorders also associated with decreased reward sensitivity i.e., anhedonia. We tested a noninvasive, cognitive training program aimed at boosting reward responsiveness and gaged if it may also improve affective processing efficiency. Methods Individuals (N = 50; 54% Female; 18–65 yo) with low hedonic tone (Positive and Negative Affect Scale/PANAS score &amp;lt; 25) and diagnostic levels of depression and/or anxiety (Patient Health Questionnaire-8/PHQ-8 or General Anxiety Disorder-7/GAD-7 score ≥ 10) who responded to community-posted flyers completed an affective go/no-go (AGN) task before and after completing an exploratory reward learning task, i.e., a multi-arm bandit (MAB). Participants were randomly assigned to a high-reward MAB training with either high variance (HV) or low variance (LV) in reward rates, HV being expected to boost reward maximization. In the AGN, participants saw negative and positive pictures and had to respond as fast as possible to pictures of a given target category (positive or negative). Results Following the HV vs LV training MAB, participants were more accurate (higher likelihood of hits), which was more evident in negative target blocks relative to positive target blocks (odds ratio/OR:0.61, 95% CI = [0.38,0.98]; z = −2.045, p = 0.041). Participants exhibited stronger decreases in hits response times following the HV vs LV training MAB, but across all target blocks (B:-37 ms, 95% CI = [−56,-18]; t = −3.806, p &amp;lt; 0.001). Conclusions A novel cognitive training program aimed at boosting reward sensitivity may help improve patients’ processing of emotionally taxing stimuli. Targeting reward sensitivity is a critical component of improving clinical outcomes in depressed and anxious patients..

SAÚDE MENTAL, ENFRENTAMENTO RESILIENTE E ESPERANÇA ENTRE RESIDENTES PAULISTANOS DURANTE O DISTANCIAMENTO SOCIAL DA COVID-19

The COVID-19 pandemic has globally impacted mental health. This study, conducted in Sao Paulo, investigated levels of anxiety, depression, resilient coping, and hope during the pandemic. The objective was to analyze the pandemic's effects on the mental health of São Paulo's population and explore coping strategies and hope. Data were collected among 1,434 adults between July 8 and August 8, 2020, using an online questionnaire that included sociodemographic data and scales to measure anxiety (Patient-Reported Outcomes Measurement Information System Adult (PROMIS®) Short Form v1.0-Anxiety 4a), depression (PROMIS® Short Form v1.0-depression 4a), resilient coping (4-item Brief Resilient Coping Scale), and hope (12-item Herth Hope Index). The results showed that being young, female, having suicidal thoughts, and adhering to quarantine policies were associated with higher levels of anxiety. Higher scores in resilient coping (-0.24) and hope (-0.06) correlated with lower anxiety. The data also revealed that being young, female, having suicidal thoughts, and living with elderly individuals increased depression scores. Conversely, higher scores in resilient coping (-0.35) and hope (-0.14) were related to lower levels of depression. These findings indicate that the pandemic significantly affected mental health in São Paulo. Resilient coping strategies and hope demonstrated potential to alleviate psychological distress, highlighting the importance of effective public mental health policies to address future crises. Therefore, investing in programs that promote resilience and hope may be crucial for mitigating adverse psychological impacts in emergency health situations.

Mental Health and Meditation in a Post-Pandemic Perú: A Normative Study of Upper Primary School Children

In a post-pandemic Perú, problems associated with the mental health of children have been highlighted and effective methods of intervention have been discussed. This study sought to examine: 1) current levels of depression, anxiety, and stress in Perúvian school children; 2) how these levels compare to other children in Latin America and elsewhere; 3) whether these levels are different when covaried for school, age, gender, and grade level; and 4) whether there are any indications that depression, anxiety, or stress are lower when Perúvian school children practice Transcendental Meditation. For a group of 809 children from two schools using the DASS-21, findings indicate depression M = 6.79, anxiety M = 6.31, and stress M = 7.37. These data indicate somewhat elevated levels when compared to other pre-pandemic adolescents in Australia, Chile, China, and Malaysia, but were lower when compared to a group of similar-aged children at another school in China. Preliminary results also suggest lower levels of depression, anxiety, and stress can be observed in children who practice Transcendental Meditation as part of the school curriculum. School, age, gender, and grade level did not predict these differences, although girls had higher levels than boys, a finding consistent with other research.

The triangular relationship of physical activity, depression, and inflammatory markers: A large cross-sectional analysis with NHANES data

Depression is a major public health problem worldwide and is closely related with systemic inflammatory responses. Additionly, physical activity (PA) is thought to be associated with lower levels of depression and inflammatory markers. This study aimed to elucidate the complex interactions between PA, depression, and inflammatory markers. Based on the National Health and Nutrition Examination Survey (NHANES), various logistic regression were applied to analyze the pairwise correlations among the three. Restrictive cubic splines were constructed to explore the nonlinear relationship between PA and depression. Mediation models were used to identify the mediating role of inflammatory markers. The findings revealed a positive link between depression and inflammatory marker, whereas PA was inversely correlated with both inflammatory marker and depression. Particularly, we noticed the greatest reduction in the risk of depression when the level of PA was between 1200 and 1722 MET-min/week. Besides, we demonstrated that inflammatory markers mediate the potential effects of physical inactivity on depression, ranging from 1.72 % to 6.25 %. In conclusion, PA appear to protect against depression, in which inflammatory markers may play a mediating role. Moreover, we determined the optimal dosage of PA to minimize the likelihood of depression, thereby offering valuable guidance for managing depression.

Approach and withdrawal from cognitively effortful activities: Development, validation, and transdiagnostic clinical utility of a cognitive motivation scale

BackgroundDeficits in cognition and motivation predict functioning in depressive and psychotic disorders. However, experimental tasks of cognitive motivation are inconsistently correlated with functioning, time-intensive, and not intuitive in clinical practice. We aimed to develop and validate a self-report instrument to assess motivation processes pertinent to engagement with cognitive activities in daily life. MethodFollowing item generation, scale dimensionality, reliability, and validity were evaluated iteratively over Studies 1–3 with online general adult participants (n1 = 205; n2 = 235; n3 = 181). The 20-item Cognitive Motivation scale was also validated in a Study 3 sub-sample reporting high levels of depressive symptoms (n = 74) and Study 4 early psychosis outpatients (n = 25). ResultsTwo-factor model of cognitive approach and cognitive withdrawal, each with good internal consistency, convergent validity, discriminant validity was supported. Cognitive withdrawal showed stronger associations with cognitive difficulties, depressive symptoms, and functional impairments than traditional motivation scale. Participants reporting high depression levels showed more severe difficulties with cognitive motivation than participants reporting low depression levels. In early psychosis outpatients, correlations with functioning and cognitive effort expenditure provided support for scale validity. LimitationsCross-sectional data collection restricted evaluation of repeated administration psychometric properties. Scale validation was mostly established in online community samples and a small patient sample during the COVID-19 pandemic, thereby limiting generalizability of clinical applications. ConclusionsCognitive Motivation scale is a promising tool for future intervention trials seeking to target motivational processes associated with functioning in the general population and potentially across patient groups with amotivation symptoms.

Beyond medications: a multifaceted approach to alleviating comorbid anxiety and depression in clinical settings.

Comorbid anxiety and depression are common and can make the problems more complex and sometimes resistant to pharmacological treatment. In existing research, the diagnoses are often studied separately, and physical activity, healthy nutrition, psychoeducation, and social support have shown good effects. The aim of the present study was to explore the longitudinal effects of a comprehensive treatment on patients with comorbid anxiety and depression in a clinical context. Eighty inpatients (15 men and 65 women) in age range 23-65 years receiving psychiatric treatment in Norwegian clinic participated in the longitudinal study. Treatment was person-centered and was most frequently given for anxiety and depression, e.g., pharmacological treatment and psychotherapy, individually and in groups. In combination with this, physical activity, healthy nutrition, psychoeducation and social support in contacts with authorities and relatives were also a part of treatment. Depression and anxiety were assessed using the Beck Anxiety Inventory and Beck Depression Inventory at three points in time: baseline, at the end of treatment, and 3 months after treatment. The answers were categorized and combined into four groups according to severity of anxiety and depression to measure effects on comorbidity. Mann Whitney U test, Chi-square, Friedmans test, and McNemar test were used to analyze the data. The results showed a significant increase of frequencies in the group with mild anxiety and depression 3 months past treatment compared to baseline. Through the comprehensive, person-centered treatment more patients had low levels of both anxiety and depression 3 months after treatment. We suggest that clinics working with comorbid depression and anxiety patients should add physical activity, nutrition advice, social support, and psychoeducation to the traditional treatment regimes. More research concerning comorbid anxiety and depression are urgent to further expand the treatment possibilities.