Patient and partner correlates of couple relationship functioning in bipolar disorder

Extensive research in unipolar depressed and population-based samples has shown cross-partner associations between depressive symptoms and relationship adjustment. Yet despite evidence that bipolar disorder (BPD) is a more chronic and severe illness than unipolar depression, that individuals with BPD are at risk for interpersonal dysfunction, and that critical, unsupportive relationships are predictive of the course of depressive symptoms in BPD, there have been limited efforts to understand the correlates of relationship functioning within BPD. The current study addresses this gap in the literature by examining the associations between the depressive and manic symptoms of individuals with BPD, their partner's depressive symptoms, and relationship functioning, using a multimethod, multi-informant approach. Results revealed that the depressive symptoms of the individual with BPD were associated with poorer relationship functioning, particularly when the partner without BPD also had elevated depressive symptoms. In addition, an interaction between the individual with BPD's depressive and manic symptoms was observed, such that manic symptoms were associated with increased observed hostility and poorer partner relationship adjustment, but only when depressive symptoms were also elevated. These effects persisted even after overall mental health of both partners was controlled.     

Forecasting life and career satisfaction in midlife from young adult depressive symptoms

This 14-year, six-wave longitudinal study of 583 university graduates examined whether trajectories of depressive symptoms from age 23 to 30 predicted life and career satisfaction outcomes at age 37, after controlling for (a) time-varying associations of marriage and unemployment with depressive symptoms, (b) sociodemographic characteristics (age, sex, parents' education), and (c) family and labor market experiences assessed at age 37 (marriage and divorce, raising children, income, spells of unemployment, occupational status). Net of the effects of all covariates, lower depressive symptoms at age 23 predicted higher life and career satisfaction at age 37, and steeper declines in depressive symptoms predicted higher life satisfaction. From age 23 to 30, being married was associated with fewer depressive symptoms, and more unemployment (in months) was associated with more depressive symptoms. The course of depressive symptoms through young adulthood carries over into midlife, showing continuity even after accounting for family and labor market experiences.     

隔代照料与中老年人心理健康：家庭亲密度的中介作用

研究旨在考察隔代照料与中老年人心理健康的关系以及家庭亲密度的中介作用。采用流行病调查中心抑郁量表（CES-D）、生活满意度量表（SWLS）和家庭环境量表（FES-CV）亲密度分量表测量中老年人抑郁症状、生活满意度和家庭亲密度。自编隔代照料问卷测量中老年人的隔代照料频率。共计325位45岁及以上有照顾孙辈经验的社区中老年人参加了问卷调查。结果发现：第一，隔代照料强度与中老年人的抑郁症状、生活满意度存在显著负相关；第二，家庭亲密度部分中介了隔代照料与抑郁症状、生活满意度的负向关系。结果表明，隔代照料对中老年人心理健康既有积极作用，也有消极作用，家庭亲密度在一定程度上部分中介了上述关系。     

The relation between depressive symptoms and borderline personality disorder features over time in dysthymic disorder

Dysthymic Disorder (DD) and Borderline Personality Disorder (BPD) frequently co-occur. To understand this association better, we tested four competing models of the relationship between depressive and BPD symptoms over time in DD: (a) no association between depression and BPD over time; (b) contemporaneous direct effects in which BPD features and depressive symptoms influence one another over a relatively short time period; (c) lagged direct effects in which one condition influences the other condition over a longer period; and (d) a fixed common factor underlies both depression and BPD, along with influences that are unique to each condition. We assessed 84 outpatients with DD three times over 5 years using semistructured interviews. Data were analyzed using structural equation modeling techniques. The fixed common factor model was the best fitting of the models, providing an excellent fit to the data. These results suggest that depressive symptoms and BPD features in DD arise from partially overlapping processes.     

The Roles of Social Support and Self-Efficacy in Physical Health’s Impact on Depressive and Anxiety Symptoms in Older Adults

Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.     

Age differences and similarities in the correlates of depressive symptoms

The authors investigated whether several life events or concerns were differentially related to depressive symptoms across 3 adult age groups (young adults, middle-aged adults, and older adults). They examined the relationships of 2 measures of depressive symptoms to work status and satisfaction, relationship status and satisfaction, loneliness, recent losses, parenting strain, and caregiving. Some differences between age groups in these relationships were found. Yet, most results suggested that, although the frequency with which people experience specific life events or concerns varies across the adult life span, the relationships between these events or concerns and depressive symptoms are similar across age groups.     

Longitudinal Relations Between Depressive Symptoms and Life Satisfaction Over 15 Years

The longitudinal relationships between depressive symptoms and life satisfaction were examined using the random intercept cross-lagged panel model. This model allows the study of the relationship between the two variables both at the within-person and between-person levels. Data were obtained from the German Ageing Survey (DEAS). Analyses were conducted at lags of 3 (N = 8,492) and 6 years (N = 4,878), with data collected over a period of approximately 15 years. At the within-person level, the bidirectional associations between the two variables were significant in the 3-year lag analysis, whereas in the 6-year lag analysis, only life satisfaction predicted future depressive symptoms. An implication is that dissatisfaction with life may signal the possibility of developing depressive symptoms in the future. Increasing life satisfaction may act as a preventive measure against future depressive symptoms. Depressive symptoms may also be an indicator of future deterioration in subjective well-being.

     

Longitudinal relationships between depressive symptoms and health in normal older and middle-aged adults

Comorbidity between health and depression is salient in late life, when risk for physical illness rises. Other community studies have not distinguished between the effects of brief and long-standing depressive symptoms on excess morbidity and mortality. S. Cohen and M. S. Rodriguez's (1995) differential hypothesis of pathways between depression and health was used to examine the relationships between health and depression in a prospective probability sample of 1,479 community-resident middle-aged and older adults. Findings suggest that different durations of depressive symptoms have different relationships to health. Health had an impact on short-term increases in depressive symptoms but depressive symptoms had a weaker impact on health. The reciprocal impact was indistinguishable from the health influence on depression. In contrast, longer term depressive symptoms had a clear impact on health. The results imply that physical illness can affect depressive states; depressive traits but not states can affect illness.     

The role of emotion reactivity and gender in the relationship between psychopathology and self-injurious behavior

The goal of the present study was to examine emotion reactivity, a broad construct that consists of an individual’s sensitivity, intensity, and persistence of emotional reactions, as a mediator of the relationship between two types of psychopathology (depression symptoms and borderline personality disorder (BPD) symptoms) and history of self-injurious behavior (non-suicidal self-injury (NSSI) and suicide attempts (SA)). We also examined gender as a potential moderator of this relationship. Participants (N = 1914) completed measures of emotion reactivity, psychopathology, and self-injurious behavior. Results using a series of mediated path analyses indicated that emotion reactivity mediated the relationship between (1) depressive symptoms and NSSI in females only, (2) depressive symptoms and SA in females only, and (3) probable BPD diagnosis and NSSI in both genders. Emotion reactivity did not mediate the relationship between probable BPD diagnosis and SA in either gender. Our findings suggest that emotion reactivity is a possible pathway through which depression and self-injurious behavior relate, especially in women. We temper these findings, however, within the context of relatively modest observed effects.     

Maternal borderline personality disorder symptoms and adolescent psychosocial functioning

Borderline personality disorder (BPD) is characterized by severe disruption of interpersonal relationships, yet very little research has examined the relationship between maternal BPD and offspring psychosocial functioning. The present study examined 815 mothers and their 15-year-old children from a community-based sample to determine (1) if there is an association between mothers' BPD symptoms and the interpersonal functioning, attachment cognitions, and depressive symptoms of their offspring, and (2) if the association of maternal BPD and youth outcomes is independent of maternal and youth depression. Measures of youth psychosocial functioning included self, mother, interviewer rated, and teacher reports. Results indicated that there was a significant association between maternal BPD symptoms and youth outcomes, and that this association remained even after controlling for maternal lifetime history of major depression, maternal history of dysthymic disorder, and youth depressive symptoms. This study provides some of the first empirical evidence for a link between mother's BPD symptoms and youth psychosocial outcomes.     

Self-mutilation and symptoms of depression, anxiety, and borderline personality disorder

The goal of this study was to examine the relationship between self-mutilation and symptoms of depression and anxiety in a nonclinical population. Self-mutilators reported significantly more symptoms of depression and anxiety than did the control group. When the group of self-mutilators was divided into individuals who cut themselves and individuals who harm themselves in other ways, we found that the between-group differences were primarily due to individuals with a history of cutting. Yet when symptoms of borderline personality disorder (BPD) were statistically controlled, all significant between-group differences in depressive and anxious symptoms were reduced to nonsignificant. These findings highlight the importance of assessing symptoms of BPD in self-mutilators, regardless of diagnosis.     

高中生沉思与应激性生活事件对抑郁症状的影响:1年追踪研究

探讨沉思及沉思亚型与应激性生活事件的交互作用对抑郁症状的影响。采用流调中心用抑郁量表、青少年生活事件问卷和沉思反应量表等自评量表对527名高中生的抑郁症状、应激性生活事件和沉思进行评估,随后每3个月测评一次抑郁症状和应激性生活事件的发生情况,追踪调查1年,用多层线性模型分析数据。结果表明:沉思和强迫性冥思对抑郁症状的主效应显著,而反思不显著;沉思、强迫性冥思和反思与生活事件对抑郁症状的交互作用均不显著。结论:应激性生活事件和强迫性冥思会加重抑郁症状,而反思没有加重抑郁症状;沉思及亚型均不会改变应激性生活事件对抑郁症状的影响程度。     

Presence of meaning,search for meaning,religiousness, satisfaction with life and depressive symptoms among a diverse Israeli sample

The present study explored the structure and correlates of meaning in life (MIL) among an Israeli sample. The sample consisted of 559 adults. The average age of participants was 48.24 and 61.3% of them were females. Participants provided demographic information and completed measures of MIL, satisfaction with life, and depressive symptoms. The MIL Questionnaire showed a very good fit for the proposed 2-factor model (i.e. presence of meaning, search for meaning) to the data collected from the current sample. Presence of meaning correlated positively with both search for meaning and satisfaction with life, and negatively with depressive symptoms. Search for meaning was positively and weakly tied to satisfaction with life, but was unrelated to depressive symptoms. Religiousness appeared as a significant moderator between the two meaning factors, and between them and life satisfaction. Specifically, as religiousness became stronger: (a) the link between presence of meaning and search for meaning became weaker; (b) the link between presence of meaning and life satisfaction became stronger and (c) the link between search for meaning and life satisfaction became weaker. The findings suggest that there are differential implications of presence search for meaning on the health and well-being, and the important role religiousness plays in this regard.     

Relationship satisfaction and depressive symptoms in emerging adults: cross-sectional associations and moderating effects of relationship characteristics

Extending research that was based on married adults, we explored associations between romantic relationship satisfaction and depressive symptoms in a sample of 484 emerging adults (ages 18-25) in nonmarital dating relationships. In addition, we investigated whether the relationship characteristics of relationship length, interdependence (i.e., investment size and quality of alternatives) and commitment moderated these associations. Overall, there was a negative association between relationship quality and depressive symptoms that was stronger for emerging adult women than men, echoing findings from married adults. The extent to which relationship characteristics moderated this association generally differed by gender. For men, the negative association between satisfaction and depressive symptoms was moderate to strong in relationships of above-average interdependence, commitment, and length, but it was weak in shorter and less interdependent relationships and nonexistent in relatively uncommitted relationships. In contrast, for women, the association between relationship satisfaction and symptoms was moderate to strong at all levels of interdependence and commitment, although amplified at higher commitment levels. Interestingly, shorter relationship length was associated with a stronger association between satisfaction and depressive symptoms for women. In general, findings suggest the importance of romantic relationship quality to the emotional well being of emerging adults, particularly young women, and highlight gender differences in relationship processes during this life period.     

The Role of Hope in the Psychological Adjustment of Gastropareutic Patients Receiving the Gastric Pacemaker: A Longitudinal Study

Hope, depressive symptoms, anxiety, and physical quality of life (QOL) were assessed in three subgroups of patients receiving the gastric pacemaker. Patients (n = 22) completed questionnaires prior to pacemaker implantation and at 3 and 6 months post-surgery. The idiopathic subgroup reported a significantly greater degree of hope and less anxiety at 6-month follow-up, compared to the diabetes patients. The idiopathic patients also reported significantly less anxiety at 6 months than the postsurgical patients. Across all subgroups, there was an increase in hope and physical QOL, and decrease in depressive symptoms and anxiety, from baseline levels. There was a significant negative relationship between hope and both depressive symptoms and anxiety at baseline and 3- and 6-month follow-up. Presurgical hope level did not significantly predict depressive symptoms or anxiety after implantation. This study provides evidence that the pacemaker improves the physical and psychological health of gastropareutic patients; hope appears to play a role in the psychological adjustment of these patients.     

Self-punishment as a regulation strategy in borderline personality disorder

Studies using the Thought Control Questionnaire (TCQ; Wells & Davies, 1994) suggest that the tendency to use self-punishment (e.g., shouting at oneself) in order to control unpleasant internal experiences (e.g., cognitive and emotional) is associated with psychopathology. To evaluate the role of self-punishment in borderline personality disorder (BPD), we first examined whether TCQ scales, including Self-Punishment, were different among adults with BPD (n = 31) when compared to those with other personality disorders (OPD; n = 24), elevated symptoms of major depressive disorder (MDD; n = 24), and healthy controls (n = 105). Findings indicated that Self-Punishment was elevated in the BPD group relative to other groups. Next, Self-Punishment was examined as a potential mediator in the relationship between negative affectivity and BPD symptom severity in all participants. Results indicated that Self-Punishment did not mediate this relationship, but did account for significant variance in BPD symptoms over and above negative affectivity. Implications and future research directions are discussed.     

Borderline personality disorder symptoms as predictors of 4-year romantic relationship dysfunction in young women: addressing issues of specificity

The relationships between romantic relationship dysfunction and symptoms of borderline personality disorder (BPD), other personality disorders, and depression were examined prospectively in a community sample of 142 late adolescent women. Although BPD symptoms predicted 4-year romantic dysfunction (romantic chronic stress, conflicts, partner satisfaction, abuse, and unwanted pregnancy), the associations were not unique to BPD. Instead, relationship dysfunction was better predicted by a cumulative index of non-BPD Axis II pathology. Depression did not predict outcomes uniquely when Axis II symptoms were included, except in the case of unplanned pregnancy. The results suggest that although BPD is associated with relationship dysfunction, the effect is a more general phenomenon applying rather broadly to Axis II pathology. The results also highlight the importance of subclinical psychopathology in the construction of early intimate relationships.     

The role of community context and psychological well-being for physical health: A dyadic study of military couples

Drawing from the social organizational theory of community action and change (SOAC) within a systemic biopsychosocial perspective, associations between community context (military community connections and satisfaction with military life), psychological well-being (depressive symptoms, anxiety, and self-efficacy), and physical health were examined for a sample of active duty service members and their civilian spouses (N = 236 couples) using an actor partner interdependence framework. Service members with higher levels of military community connections reported better psychological well-being. When civilian spouses were more satisfied with military life, both partners reported better psychological well-being. In turn, both spouses’ psychological well-being was related to their own reports of physical health. Statistically significant indirect effects were found between community contexts and spouses’ physical health. Enhancing community connections may be an important leverage point for supporting health and family readiness.     

家庭累积风险与青少年心理健康的关系——心理资本的补偿效应和调节效应

对1473名初、高中生进行问卷调查，考察家庭累积风险与青少年心理健康的关系以及心理资本的补偿效应和调节效应。结果发现：（1）家庭累积风险负向预测生活满意度，正向预测焦虑/抑郁；（2）心理资本正向预测生活满意度，负向预测焦虑/抑郁；（3）心理资本只能调节家庭累积风险与焦虑/抑郁的关系，表现为心理资本缓冲家庭累积风险对青少年焦虑/抑郁的不利影响。因此，改善家庭环境和培养心理资本是提升青少年心理健康的重要途径，需注意心理资本的培育对焦虑/抑郁和生活满意度作用的差异。     

The impact of parental borderline personality disorder on vulnerability to depression in children of affectively ill parents

Children of parents with major depressive disorder (MDD) are four to six times more likely than other children to develop MDD. Little research has examined whether comorbid parental diagnoses further increase children's risk. This study examines whether children of parents with comorbid MDD and Borderline Personality Disorder (BPD) (1) are at greater risk for experiencing depressive symptoms and/or episodes and (2) whether such increased risk may be due, in part, to their exhibiting higher levels of cognitive/interpersonal vulnerability factors. Children (n = 140; ages 6-14) of parents with MDD completed measures assessing cognitive/interpersonal vulnerability factors. Parents completed semi-structured clinical interviews assessing severity of current depressive symptoms and BPD. Both children and parents completed a semi-structured clinical interview assessing the child's current and past history of MDD. Children of parents with comorbid MDD and BPD exhibited higher levels of current depressive symptoms and higher levels of cognitive/interpersonal vulnerability factors than children of parents with MDD but no BPD, even after controlling for parents' current levels of depressive symptoms. The relationship between parental BPD and chil-dren's current levels of depressive symptoms was partially mediated by children's cognitive/interpersonal vulnerability factors. Last, children of parents with comorbid BPD and MDD were 6.84 times more likely to exhibit a current or past diagnosis of MDD.