Lower Levels Of Positive Affect Research Articles

Relationships between sociocultural factors (gender, immigrant and socioeconomic background), peer relatedness and positive affect in adolescents

IntroductionDuring adolescence, experiencing positive emotions at school is important for motivation as well as for academic success and psychological well-being. In the present study, on the basis of Self-Determination Theory (SDT), we investigated the relationships between sociocultural factors (gender, immigrant and socioeconomic background), peer relatedness (acceptance and friendship) and positive affect at school. MethodsData was based on a random sample of 36,712 tenth grade Italian adolescents. Their average age was 15.6 years (SD = 0.77), 50.6% were males, while 6.1% were first-generation immigrants and 3.8% were second-generation immigrants. Firstly, comparing latent means, we established peer relatedness and positive affect profiles of adolescents with different sociocultural backgrounds. Subsequently, we tested a structural equation model, based on SDT, according to which the effects of sociocultural factors on experiencing positive affect at school are mediated by peer relatedness dimensions. ResultsLatent mean comparisons showed that immigrant adolescents, students with a lower-SES and girls had fewer friendships with their classmates, lower levels of positive affect at school and were less accepted by their peers. A well-fitting structural equation model corroborated the mediating role of acceptance and friendship, which accounted for 16% of variance in positive affect. ConclusionsDue to sociocultural factors, some groups of adolescents proved to be more at risk of being socially excluded and of experiencing less positive affect at school. Moreover, our findings support the claim of SDT that the satisfaction of basic psychological needs, such as relatedness, is more important than sociocultural factors in determining adolescents’ psychological well-being.

Protocol for a randomized controlled dismantling study of an internet-based intervention for depressive symptoms: exploring the contribution of behavioral activation and positive psychotherapy strategies

BackgroundThere are evidence-based interventions for depression that include different components. However, the efficacy of their therapeutic components is unknown. Another important issue related to depression interventions is that, up to now, their therapeutic components have only focused on reducing negative symptoms rather than on improving positive affect and well-being. Because the low levels of positive affect are more strongly linked to depression than to other emotional disorders, it is important to include this variable as an important treatment target. Positive psychotherapeutic strategies (PPs) could help in this issue. The results obtained so far are consistent and promising, showing that Internet-based interventions are effective in treating depression. However, most of them are also multi-component, and it is important to make progress in investigating what each component contributes to the intervention.MethodsThe current study will be a three-armed, simple-blinded, randomized controlled clinical trial with a dismantling design. 192 participants will be randomly assigned to: a) an Internet-based Global Protocol condition, which includes traditional therapeutic components of evidence-based treatments for depression (Motivation for change, Psychoeducation, Cognitive Therapy, Behavioral Activation (BA), Relapse Prevention) and PPs component, offering strategies to enhance positive mood and promote psychological strengths; b) an Internet-based BA Protocol condition (without the PPs component), and c) an Internet-based PPs Protocol condition (without the BA component). Primary outcome measures will be the BDI-II and PANAS. Secondary outcomes will include other variables such as depression, anxiety and stress, quality of life, resilience, and wellbeing related measures. Treatment acceptance and usability will also be measured. Participants will be assessed at pre-, post-treatment, 3-, 6- and 12- month follow- ups. The data will be analyzed based on the Intention-to-treat principle. Per protocol analyses will also be performed.DiscussionTo the best of our knowledge, this is the first randomized dismantling intervention study for depression with the aim of exploring the contribution of a PPs component and the BA component in an Internet-based intervention. The three protocols are online interventions, helping to reach many people who need psychological treatments and otherwise would not have access to them.Trial registrationClinicalstrials.gov as NCT03159715. Registered 19 May 2017.

Internalizing symptoms and chronotype in youth: A longitudinal assessment of anxiety, depression and tripartite model

Biological rhythm theories highlight the reciprocal relations between dysregulated circadian patterns and internalizing psychopathology. Chronotype characterizes individuals’ diurnal preference, as some exhibit more morningness or eveningness. Previous research suggests that eveningness prospectively predicts depression in adolescence. Anxiety often co-occurs with depression, but little is known about longitudinal, reciprocal associations between chronotype and anxiety, and whether this relationship remains after controlling for depression. We assessed different forms of anxiety (social, panic, separation), positive/negative affect, anxious arousal (from tripartite theory), and depression, in relation to chronotype to better understand the specificity and directionality of associations between chronotype and internalizing problems in adolescence. Community youth participated in three assessment time points: T1, T2 (18-months post-T1), and T3 (30-months post-T1) as part of a larger longitudinal study. Youth completed self-report measures of anxiety, depression, positive and negative affect, and chronotype. Regression analyses showed that eveningness: (1) concurrently associated with decreased separation anxiety, elevated symptoms of depression and low levels of positive affect, (2) was prospectively predicted by elevated depression, (3) did not predict later symptoms of anxiety. The reciprocal, prospective relationship between chronotype and internalizing psychopathology is specific to depression during adolescence.

The Moderating Role of Trait Affect in the Relationship Between Negative Life Events and Life Satisfaction

This study investigated the moderating roles of trait positive affect (PA) and trait negative affect (NA), both separately and conjointly, in the relationship between negative life events and life satisfaction. The final sample consisted of 654 students (83.3% females; mean age = 19.58 years) who completed measures of dispositional PA and NA at Time 1, and measures of negative life events and life satisfaction at Time 2 (after 1 year). The results showed that neither PA nor NA alone moderated the negative life events–life satisfaction relationship. However, it has been found that an increase in the number of negative life events is associated with a substantial decrease in life satisfaction for individuals experiencing generally low levels of both PA and NA. Our findings indicate that high trait PA acts as a protective factor independently of the levels of trait NA, whereas low trait PA represents a vulnerability factor only in a combination with a low trait NA.

Racial/ethnic disparities in cortisol diurnal patterns and affect in adolescence.

Racial/ethnic minorities are more vulnerable to mental and physical health problems, but we know little about the psychobiological underpinnings of these disparities. In this study, we examined racial/ethnic differences in cortisol diurnal patterns and affect as initial steps toward elucidating long-term health disparities. A racially/ethnically diverse (39.5% White, 60.5% minority) sample of 370 adolescents (57.3% female) between the ages of 11.9 and 18 years (M = 14.65 years, SD = 1.39) participated in this study. These adolescents provided 16 cortisol samples (4 samples per day across 4 days), allowing the computation of diurnal cortisol slopes, the cortisol awakening response, and diurnal cortisol output (area under the curve), as well as daily diary ratings of high-arousal and low-arousal positive and negative affect. Consistent with prior research, we found that racial/ethnic minorities (particularly African American and Latino youth) exhibited flatter diurnal cortisol slopes compared to White youth, F (1, 344.7) = 5.26, p = .02, effect size g = 0.25. Furthermore, African American and Asian American youth reported lower levels of positive affect (both high arousal and low arousal) compared to White youth. Racial/ethnic differences in affect did not explain differences in cortisol patterns, suggesting a need to refine our models of relations between affect and hypothalamic-pituitary-adrenocortical activity. We conclude by proposing that a deeper understanding of cultural development may help elucidate the complex associations between affect and hypothalamic-pituitary-adrenocortical functioning and how they explain racial/ethnic differences in both affect and stress biology.

Emotion regulation and positive affect in the context of salivary alpha-amylase response to pain in children with cancer.

Children with cancer routinely undergo painful medical procedures invoking strong physiological stress responses. Resilience to this pain may be conferred through resources such as emotion regulation strategies and positive affect. This study measured dispositional positive affect in children with cancer (N=73) and randomly assigned participants to one of three emotion regulation strategy conditions (distraction, reappraisal, or reassurance). Children applied their assigned strategy during an experimental pain procedure (the cold pressor task [CPT]) and provided saliva samples before, immediately after, and 15 min after the CPT. Saliva samples were later assayed for salivary alpha amylase (sAA)-a surrogate marker for autonomic/sympathetic nervous system activity and regulation. Children in the reassurance group had sAA levels that continued to rise after completion of the CPT compared to children in the distraction (b=-1.68, P=0.021) and reappraisal conditions (b=-1.24, P=0.084). Furthermore, dispositional positive affect moderated the effect of condition such that children in the reassurance group with lower levels of positive affect had sAA levels that continued to rise after completion of the CPT (dy/dx=1.56, P=0.027), whereas children in the reassurance condition with higher levels of positive affect did not exhibit this rise (P>0.05). Specific emotion regulation strategies, such as distraction and reappraisal, may attenuate the stress response to pain in pediatric patients with cancer, and positive affect may confer resilience in response to pain even with use of less effective coping strategies such as reassurance.

Beyond Disease: Happiness, Goals, and Meanings among Persons with Multiple Sclerosis and Their Caregivers.

The experience of persons with multiple sclerosis (MS) and their caregivers is usually investigated in terms of emotional distress and health-related quality of life, while well-being indicators remain largely underexplored. In addition, findings are often interpreted from the clinical perspective, neglecting socio-cultural aspects that may crucially contribute to individuals' functioning. At the methodological level, most studies rely on scaled instruments, not allowing participants to freely express their needs and resources. Based on the bio-psycho-social perspective endorsed by the International Classification of Functioning, well-being indicators were investigated among 62 persons with MS (PwMS), their 62 caregivers and two control groups, matched by age and gender. Participants completed the Positive Affect Negative Affect Schedule (PANAS), the Satisfaction with Life Scale (SWLS), and the Eudaimonic and Hedonic Happiness Investigation instrument (EHHI). EHHI provides information on participants' happiness, goals and meanings through scaled and open-ended questions, contextualized within major life domains. No relevant differences emerged among PwMS and caregivers, compared with the respective control groups, as concerns life domains associated with happiness, goals and meaning. Participants across groups prominently mentioned family, highlighting its intrinsic value and its relevance as a sharing context; health did not represent a major theme for PwMS; community, society and religion/spirituality issues were substantially neglected by all participants. PwMS and caregivers reported lower levels of positive affect than their control groups, while no substantial differences emerged for negative affect, happiness and meaningfulness levels in life and across most domains. Results suggest that the experience of MS is associated with well-being in relevant life domains, such as family and close relationships. Although PwMS and caregivers identified a lower number of goals and meaning-related opportunities compared to control groups, they showed a positive adjustment to disease through the development of personal and family resources. These assets are often undervalued by health professionals and social institutions, while they could be fruitfully exploited through the active involvement of PwMS and their families as expert and exemplary informants in initiatives aimed at promoting the well-being of individuals and communities

University students' need satisfaction trajectories: A growth mixture analysis

This study examines trajectory profiles of University students over the course of a University semester defined based on global levels of psychological need satisfaction, as proposed by self-determination theory (SDT). This study also documents the implications of these trajectories for a variety of educational outcomes. A sample of 461 first-year undergraduates completed all measures three times over the course of a University semester. Longitudinal growth mixture analyses (GMA) revealed three distinct need satisfaction trajectories (Low-Decreasing, Moderate-Decreasing, and Moderate-Increasing). The Moderate-Increasing profile was associated with the highest levels of positive affect and effort. In contrast, the Low-Decreasing profile was associated with lower levels of positive affect, effort, and achievement, and higher levels of negative affect than the Moderate-Increasing profile.

AFECTO POSITIVO COMO INDICADOR DE LAS ATRIBUCIONES ACADÉMICAS EN MATEMÁTICAS

Abstract.POSITIVE AFFECT AS AN INDICATOR OF THE ACADEMIC ATTRIBUTIONS IN MATHEMATICS The aim of the current study was to analyse the differences in the scores of academic attributions in Mathematics (success and failure attributed to capacity, effort and external causes) of Spanish students of primary education according to high and low scores in positive affect. To fulfil this target, a sample of 862 students of primary education (8-11 years old) was recruited. To obtain the scores of the analysed variables, the positive affect subscale of the Positive and Negative Affect Schedule for Children (PANAS) and the Mathematics subscale of the Sydney Attribution Scale (SAS) were used. After performing the Levene’s test, the Student’s t-test was used to analyse the existence of statistically significant differences in the scores of academic attributions between students with high scores in positive affect and students with low scores. In this sense, it was proved that students with high marks in positive affect attributed more their failures and successes in Mathematics to external causes. On the contrary, students with low levels of positive affect attributed more their failures to the lack of capacity or effort. The presented results broad the knowledge of affect during childhood and possibility the future work in improving these aspects. Keywords: positive affect; academic attributions; Mathematics; PANAS; primary education.Resumen. El objetivo del presente estudio fue el de analizar las diferencias de las puntuaciones en las atribuciones académicas en Matemáticas (éxito y fracaso atribuido a la capacidad, esfuerzo y causas externas) de estudiantes españoles de Educación Primaria en función de altas y bajas puntuaciones de afecto positivo. Para conseguir este objetivo, se recurrió a una muestra 962 de estudiantes de Educación Primaria (8-11 años de edad). Para obtener la medición de las variables analizadas, se utilizó la subescala de afecto positivo del Positive and Negative Affect Schedule for Children (PANAS) y la subescala de Matemáticas de la Sydney Attribution Scale (SAS). Tras llevar a cabo la prueba de Levene, se empleó la prueba t de Student para analizar la existencia de diferencias estadísticamente significativas en las puntuaciones de atribuciones académicas entre los grupos de altos y bajos niveles de afecto positivo. En este sentido, se descubrió que los alumnos con altas puntuaciones de afecto positivo atribuyeron más sus éxitos y fracasos en Matemáticas a causas externas. Por el contrario, los estudiantes con bajos niveles de afecto positivo atribuyeron sus fracasos a la falta de capacidad y esfuerzo. Los resultados del presente trabajo amplían el conocimiento del afecto en la infancia y posibilitan el trabajo futuro de mejora en estos aspectos.Palabras clave: afecto positivo; atribuciones académicas; Matemáticas; PANAS; Educación Primaria.

Material values: A study of some antecedents and consequences

Two studies were conducted to analyze some antecedents and consequences of holding material values among college students from Mexico. Participants completed a battery of questionnaires measuring social comparison orientation, autonomy support, materialism, life satisfaction, positive and negative affect, and job preferences. Results showed that social comparison was a robust predictor of materialism in both studies. Materialism was related to lower levels of positive affect and life satisfaction and to higher levels of negative affect. Materialism was also related to a preference for jobs that pay more money at the expense of working longer hours or doing more routine tasks. The implications of the results were discussed.

Age Differences in Stress and Coping: Problem-Focused Strategies Mediate the Relationship Between Age and Positive Affect.

The present study examined the different types of stressors experienced by adults of different ages, their coping strategies, and positive/negative affect. A mediation hypothesis of coping strategies was tested on the relationships between age and positive/negative affect. One-hundred and ninety-six community-dwelling adults (age range 18-89 years) reported the most stressful situation they experienced in the past month and coping strategies. Levels of positive and negative affect in the past month were also measured. Content analysis revealed age differences in different types of stressors adults reported. Three types of coping strategies were found: problem-focused, positive emotion-focused, and negative emotion-focused coping. Older adults were less likely than younger adults to use problem-focused coping and reported lower levels of positive affect. Path analysis supported the mediation hypothesis, showing that problem-focused coping mediated the relationship between age and positive affect. Implications are discussed on the importance of promoting problem-focused coping among older adults.

A child’s psychological adjustment impacts teachers’ instructional support and affective response

This cross-lagged longitudinal study examines the evocative impact of a child’s psychological adjustment on teachers’ affective response and instructional support for a child, and the influence this support and response has on the child’s subsequent adjustment. A hundred and seventeen Finnish teachers self-rated the instructional support they gave, and the affect they experienced while teaching 307 children from school grades 1, 2 and 3. Teachers also rated the level of prosocial and externalizing problem behaviour among children. Results showed that the more children exhibited externalizing problem behaviour in grades 1 and 2, teachers not only did provide more instructional support for them a year later but, at the same time, they reported feeling less positive affect. Low levels of positive affect were also reported by teachers a year later with regard to children who had received more instructional support from them in grades 1 and 2.

Positive and Negative Affect as Links Between Social Anxiety and Depression: Predicting Concurrent and Prospective Mood Symptoms in Unipolar and Bipolar Mood Disorders

The co-occurrence of social anxiety and depression is associated with increased functional impairment and a more severe course of illness. Social anxiety disorder is unique among the anxiety disorders in sharing an affective profile with depression, characterized by low levels of positive affect (PA) and high levels of negative affect (NA). Yet it remains unclear how this shared affective profile contributes to the covariation of social anxiety and depressive symptoms. We examined whether self-reported PA and NA accounted for unique variance in the association between social anxiety and depressive symptoms across three groups (individuals with remitted bipolar disorder, type I [BD; n = 32], individuals with remitted major depressive disorder [MDD; n = 31], and nonpsychiatric controls [n = 30]) at baseline and follow-ups of 6 and 12 months. Low levels of PA, but not NA, accounted for unique variance in both concurrent and prospective associations between social anxiety and depression in the BD group; in contrast, high levels of NA, but not PA, accounted for unique variance in concurrent and prospective associations between social anxiety and depression in the MDD group. Limitations include that social anxiety and PA/NA were assessed concurrently and all measurement was self-report. Few individuals with MDD/BD met current diagnostic criteria for social anxiety disorder. There was some attrition at follow-up assessments. Results suggest that affective mechanisms may contribute to the high rates of co-occurrence of social anxiety and depression in both MDD and BD. Implications of the differential role of PA and NA in the relationship between social anxiety and depression in MDD and BD and considerations for treatment are discussed.

Feeling happy when feeling down: The effectiveness of positive mental imagery in dysphoria

Background and objectivesMental imagery can evoke strong emotional responses, but imagery perspective can influence the response, with observer perspective reducing emotionality. This is important provided that positive imagery can be an effective mood repair strategy in healthy individuals. However, (sub-clinical) depressed individuals tend to spontaneously adopt an observer perspective. We investigated whether positive imagery would result in a similar emotional response in dysphoric and non-dysphoric individuals when instructed and trained to use field perspective imagery. Additionally, we compared the emotional response in dysphoric individuals who received instructions to dysphoric individuals who received no instructions on processing mode during positive memory recall. MethodsDysphoric and non-dysphoric individuals completed a mood induction procedure imagining positive or neutral memories. They received instructions and practice in the use of field perspective imagery. An additional control group of dysphoric individuals recalled positive memories without receiving instructions on processing mode. ResultsDysphoric and non-dysphoric individuals who received instructions on field perspective imagery reported similar use of field and observer perspective imagery, and a similar positive emotional response. Dysphoric individuals who did not receive specific instructions, as compared to those who did, reported greater use of observer perspective and lower levels of positive affect afterwards. LimitationsA dysphoric sample limits generalization to clinically depressed individuals, although these individuals are at risk for developing depression. However, mental imagery used in relapse prevention is likely targeting sub-clinical populations. ConclusionsProviding practice in field perspective imagery could potentially improve the effectiveness of positive memory recall as a mood repair strategy in (sub-clinically) depressed individuals, and may therefore have important therapeutic benefits.

Positive affective functioning in anhedonic individuals’ daily life: Anything but flat and blunted

BackgroundAnhedonia, the decreased interest and pleasure, is often described as ‘flat’ or ‘blunted’ positive affect (PA). Yet, little is known about PA functioning in anhedonic individuals’ daily lives. The current study investigates PA reactivity to pleasurable experiences in anhedonia together with its relevant temporal dynamics (i.e., variability, instability, and inertia), and expands current knowledge by exploring the role of arousal therein. MethodsUsing the Experience Sampling Method (ESM), we collected 90 assessments of real-life PA experiences across 30 days in 18–24 year old individuals with anhedonia (N=69) and without anhedonia (N=69). ResultsMultilevel analyses showed that anhedonia was associated with less intense pleasure experience, and lower levels of PA. Contrary to predictions from laboratory research and depression theory, individuals with anhedonia showed more variability and less stability in PA, and no signs of blunted PA reactivity. In fact, when exploring high and low arousal PA, individuals with anhedonia showed a slightly stronger reactivity to pleasurable experiences in high-arousal PA but not low-arousal PA. LimitationsWe did not control for previous pleasure experiences and, instead of the last positive event, accumulation of positive events may have determined the change in high-arousal PA. ConclusionsIndividuals with anhedonia are likely less ‘flat’ or ‘blunted’ than generally thought. Although replication is warranted, impairments in high-arousal positive emotions may be of particular interest in the clinical treatment of anhedonia.

Caregiving and Perceived Generativity: A Positive and Protective Aspect of Providing Care?

ABSTRACTObjectives: Although a sizable body of research supports negative psychological consequences of caregiving, less is known about potential psychological benefits. This study aimed to examine whether caregiving was associated with enhanced generativity, or feeling like one makes important contributions to others. An additional aim was to examine the buffering potential of perceived generativity on adverse health outcomes associated with caregiving.Methods: Analyses utilized a subsample of participants (n = 3,815, ages 30–84 years) from the second wave of the National Survey of Midlife Development in the United States (MIDUS).Results: Regression analyses adjusting for sociodemographic factors indicated greater negative affect and depression (p < .001) and lower levels of positive affect (p < .01), but higher self-perceptions of generativity (p < .001), in caregivers compared with non-caregivers. This association remained after adjusting for varying caregiving intensities and negative psychological outcomes. Additionally, generativity interacted with depression and negative affect (p values < .05) to lessen the likelihood of health-related cutbacks in work/household productivity among caregivers.Conclusions: Results suggest that greater feelings of generativity may be a positive aspect of caregiving that might help mitigate some of the adverse health and well-being consequences of care.Clinical Implications: Self-perceptions of generativity may help alleviate caregiver burden and explain why some caregivers fare better than others.

Perfectionism and Therapeutic Alliance: A Review of the Clinical Research.

In this review, we synthesize findings regarding the relationship between perfectionism and therapeutic alliance, most of which come from analyses by Blatt and colleagues. Results suggest what follows. First, patients’ initial level of perfectionism negatively affects patients’ bond with therapists and perception of therapists’ Rogerian attributes (empathy, congruence, and regard) early in treatment and engagement in therapy later in treatment. Second, therapists’ contribution to alliance is not seemingly affected by patients’ initial perfectionism level. Third, individual patients of therapists who are perceived on average by their patients to be higher on Rogerian attributes experience greater decreases in perfectionism and symptoms. Fourth, more positive perceptions of therapists’ Rogerian attributes early in treatment lead to greater symptom decrease for patients with moderate perfectionism. Fifth, greater early patient engagement in therapy is related to greater decrease in perfectionism, but a strong relationship with the therapist may be necessary for an accompanied greater decrease in symptoms. The relationship between pre-treatment perfectionism and alliance is partially explained by higher levels of hostility and lower levels of positive affect. Sixth, the relationship between pre-treatment perfectionism and outcome is almost entirely explained by level of patient contribution to alliance and satisfaction with social network, highlighting the importance of focusing on social functioning for patients with high perfectionism (both in and outside of the session). Limitations include that most of the findings are from analyses of one large data set and a range of measurement issues. Future research should utilize different measures, perspectives, and populations and examine specific session process.

Prevalence of Suicidal Ideation and Its Association with Positive Affect in Working Women: A Day Reconstruction Study.

The suicide rate for females in China is the second highest worldwide, and China is the only country in the world in which the rate of suicides is higher for women than men. Affective instability has been shown to be a strong predictor of suicidal ideation, particularly among women. However, prior research has mainly focused on the impact of women's negative affect on suicidal ideation, ignoring the influence of positive affect on suicidal ideation. Studies have revealed that hopelessness, which is 1.3 times more important than depression for explaining suicidal ideation, is driven more by low levels of positive affect than by high levels of negative affect. Although positive affect has also been found to be related to suicidal ideation, and it demonstrates independent, beneficial effects on mental health, much remains to be learned about the association between positive affective instability and suicidal ideation. Therefore, we investigated the prevalence of suicidal ideation among Chinese working women and explored the differences between working women with and without suicidal ideation in the intensity and daily variability of positive affect. A total of 222 young working women of ages 22–36 years (M = 27.64, SD = 3.73) were recruited from a free weekend psychology lecture. The women subsequently completed a daily diary Day Reconstruction Method (DRM) as well as a suicidal ideation questionnaire. We used hierarchical linear modeling (HLM) to analyze the data, and the results showed that: (1) 10.81% of participates reported suicidal ideation, the intensity of positive affect (happiness, warmth/friendliness, interest and relaxation/calmness) was significantly lower for women with suicidal ideation compared to women without suicidal ideation; (2) differing diurnal patterns of positive emotions were observed between women with and without suicidal ideation; women with suicidal ideation demonstrated a significantly lower trend of growth and a higher volatility in happiness, warmth/friendliness, relaxation/calmness. Given that lower intensity of positive affect and greater affective instability significantly predicted suicidal ideation in Chinese women, researchers should pay more attention to the role of positive affect in female suicide prevention research and intervention efforts in the future.

Anxiety, depression, and the suicidal spectrum: a latent class analysis of overlapping and distinctive features

ABSTRACTAnxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analysis of 97 depression, anxiety, and suicidality-related items among 616 psychiatric outpatients indicated a 3-class solution, specifically: (1) a higher suicide-risk class uniquely differentiated from both other classes by high reported levels of depression and anxious arousal; (2) a lower suicide-risk class that reported levels of anxiety sensitivity and generalised worry comparable to Class 1, but lower levels of depression and anxious arousal; and (3) a low to non-suicidal class that reported relatively low levels across all depression and anxiety measures. Discriminants of the higher suicide-risk class included borderline personality disorder; report of worthlessness, crying, and sadness; higher levels of anxious arousal and negative affect; and lower levels of positive affect. Depression and anxiety diagnoses were not discriminant between higher and lower suicide risk classes. This transdiagnostic and dimensional approach to understanding the suicidal spectrum contrasts with treating it as a depressive symptom, and illustrates the advantages of a tripartite model for conceptualising suicide risk.

Depressive symptoms and positive affect in Chinese and United States breast cancer survivors: a cross-cultural comparison.

Research in the area of cultural response pattern on questionnaires in the oncological setting and direct cross-cultural comparisons are lacking. This study examined response pattern in the reporting of depressive symptoms in Chinese and US women with breast cancer. We hypothesized that Chinese women are less likely to endorse positive affect items compared to their US counterparts. Additionally, we explored cultural differences in the association between positive affect and QOL. Secondary analyses of baseline assessments of two mind-body intervention studies for women with breast cancer undergoing radiotherapy in the USA (N=62) and China (N=97) are presented. All participants completed measures of depressive symptoms (CES-D) and cancer-specific QOL (FACT-B). We examined cultural differences on positive and negative affect items on the CES-D. Controlling for demographic factors, ANCOVA revealed a significant cultural difference in positive (F=7.99, p=0.005) but not negative affect (p=0.82) with Chinese women reporting lower positive affect compared to US women (Chinese = 6.97 vs. US = 8.31). There was also a significant cultural difference (F=3.94, p=0.03) in the association between positive affect and QOL so that lower positive affect was more strongly associated with worse emotional well-being in Chinese (beta=0.57, p<0.0001) than US women (beta=0.35, p<0.01). Chinese women reported lower positive affect compared to US women and lower levels of positive affect were more strongly associated with worse QOL. Special attention is needed when examining mental health in different cultures to ascertain effective delivery of clinical services to those in need.