Synergistic effects of pain and alcohol use in relation to depressive and anxiety symptoms among Latinos in primary care

Although past work has shown that alcohol use co-occurs with anxiety/depression among Latinos, little work has examined the variables that qualify such associations. The present investigation sought to address whether pain severity (i.e. pain intensity and/or pain-related disability, respectively) moderated relations between hazardous drinking and depressive/anxious arousal symptoms among an economically disadvantaged Latino sample recruited from a primary care medical setting. Participants included 253 adult Latinos (M_age = 38.5 years, SD = 10.8; 86.6% female) who attended a community-based primary care clinic. There was a significant interaction of hazardous drinking with pain intensity in relation to depressive symptoms and significant interactions of hazardous drinking and pain-related disability in relation to depressive and anxious arousal symptoms. Hazardous drinking was associated with more severe depressive/anxious arousal symptoms only when pain intensity/disability was high. This is the first study to demonstrate the moderating role of pain intensity and disability in associations between hazardous drinking and anxiety/depression among Latinos in a primary care medical setting.     

Suicidal ideation among rural immigrant daughters-in-law with multi-roles as females,farmers and immigrants in China

Suicide is a major public health issue in China, and suicidal ideation is an important step in the suicidal process. The purpose of this study was to understand the prevalence and correlates of suicidal ideation among rural immigrant daughters-in-law with multi-role of female, farmer and immigrant in China. A total of 939 participants including 474 local daughters-in-law and 465 immigrant daughters-in-law were surveyed using the self-rating questionnaire. Demographic characteristics, depression, anxiety, impulsivity and suicidal ideation were assessed. Results indicated that the lifetime prevalence of suicidal ideation among rural immigrant daughters-in-law was 9.68%. Physical disability, domestic violence and negative events demonstrated statistical significance by suicidal ideation (p < .05), and participants with suicidal ideation had higher scores of depression, anxiety and impulsiveness in the univariate analysis. Multivariate logistic regression showed that physical disability (OR = 7.43, 95%CI: 2.84–19.46), domestic violence (OR = 2.65, 95%CI: 1.02–6.88), depression (OR = 1.07, 95%CI: 1.01–1.12), impulsiveness (OR = 1.04, 95%CI: 1.01–1.08) and motor impulsiveness (OR = 1.07, 95%CI: 1.01–1.14) were significantly associated with suicidal ideation. Suicidal ideation is an issue that can’t be ignored among rural immigrant daughters-in-law. And the findings should be considered for the intervention of the suicide among the rural immigrant daughters-in-law.     

Acculturative stress and experiential avoidance: relations to depression,suicide, and anxiety symptoms among minority college students

Although college campuses represent strategic locations to address mental health disparity among minorities in the US, there has been strikingly little empirical work on risk processes for anxiety/depression among this population. The present investigation examined the interactive effects of acculturative stress and experiential avoidance in relation to anxiety and depressive symptoms among minority college students (n = 1,095; 78.1% female; M_age = 21.92, SD = 4.23; 15.1% African-American (non-Hispanic), 45.3% Hispanic, 32.5% Asian, and 7.1% other races/ethnicities. Results provided empirical evidence of an interaction between acculturative stress and experiential avoidance for suicidal, social anxiety, and anxious arousal symptoms among the studied sample. Inspection of the significant interactions revealed that acculturative stress was related to greater levels of suicidal symptoms, social anxiety, and anxious arousal among minority college students with higher, but not lower, levels of experiential avoidance. However, in contrast to prediction, there was no significant interaction for depressive symptoms. Together, these data provide novel empirical evidence for the clinically-relevant interplay between acculturative stress and experiential avoidance in regard to a relatively wide array of negative emotional states among minority college students.     

Anxiety and Depression Symptoms in Children with Asperger Syndrome Compared with Attention-Deficit/Hyperactivity Disorder and Depressive Disorder

The objective of this study was to examine (a) anxiety and depression symptoms in children with Asperger syndrome (AS) compared to children with attention-deficit/hyperactivity disorder (ADHD) and children with depressive disorder; (b) parental anxiety and depressive symptoms in the three groups; and (c) the association between the anxiety and depression symptoms of children and their parents. The emotional and behavioral problems of 56 children with AS (48 boys, 8 girls, mean age, 9.39 ± 2.01 years) were compared with 56 ADHD children and 56 depressive disorder children, matched for age and sex. Their parents’ anxiety and depression symptoms were also compared. Trait-anxiety and internalizing problems in AS children were higher than those in ADHD children and as high as those in depressive disorder children (F = 8.83, p < 0.001 and F = 8.21, p < 0.001). Parents’ anxiety and depression symptoms did not differ among the three groups, but correlations between maternal anxiety and depression and children’s emotional and behavioral problems were most prominent in the AS group. We suggest that the assessment and treatment of children with AS should involve detailed assessment, possible concomitant treatment for comorbid anxiety and depression, and parental education about the effect of parental emotional states on children.     

SLE患者焦虑抑郁影响因素调查分析

为了探讨SLE（systemic lupus erythematosus）即系统性红斑狼疮患者焦虑抑郁心理影响因素,应用Zung焦虑自评量袁（Self—rating anxiety scale,SAS）和抑郁自评量表（self—rating depression scale,SDS）,对36例系统性红斑狼疮患者进行检测,辅以自行设计因素调查表进行相关因素调查。结果显示,SDS和SAS均分为49．70±11．3和42．13±8．9,与国内常模比较,差异有统计学意义,P〈0．01。单因素分析显示：对疾病的恐惧感、对病情了解程度、治疗效果、药物副作用、家庭经济状况、家庭支持、婚姻关系、睡眠质量、担心事业受影响、躯体症状的反复出现、社交娱乐活动受限、担心医护不精心12项因素与SLE患者抑郁焦虑状态的发生显著相关,P〈0．01。证明SLE患者抑郁焦虑心理与对疾病的恐惧感、治疗效果、家庭经济状况、睡眠质量等因素相关,这为心理干预提供了依据。     

Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.     

Within-subject covariation between depression- and anxiety-related affect

Studies find a strong positive relationship between the affective components of anxiety and depression. However, most research thus far has examined the between-person correlations among these constructs, while ignoring how changes in these two types of affect covary over time within a person. Within-person correlations could differ meaningfully from how anxiety- and depression-related affect relate across individuals. Further, individuals may differ in terms of how highly these constructs covary over time. The current study aimed to (1) compare between- and within-person correlations between anxious and depressive affect, (2) examine lagged effects between anxious and depressive affect over time, (3) test whether individuals differ in their within-person correlations between these two types of affect, and (4) examine whether the mean level of affective intensity moderated these individual differences. These questions were explored using college undergraduates (N?=?50) who rated their depression- and anxiety- related affect six times a day for two weeks. A higher average correlation was observed between anxious and depressive affect in between-person compared to within-person analyses. Significant bidirectional lagged effects were observed between these constructs. Individuals with higher average levels of anxious affect experienced stronger within-person correlations between anxious and depressive affect.     

Locus of control,anxiety, and depression in infertile patients

This study aimed to examine the relationship of locus of control (LoC) with anxiety and depression disorders, applying multivariate statistical techniques to control for the effects of demographic/fertility variables. This cross-sectional study included 312 infertile patients in a referral fertility center in Tehran, Iran via convenience sampling. The Hospital Anxiety and Depression Scale and the Levenson’s Locus of Control Scale were administered to all participants. Hierarchical multiple linear regressions were used to identify factors associated with anxiety and depression. After controlling for demographic/fertility variables, hierarchical regression analyses showed that internal LoC was negatively associated with anxiety (β = –.213, p < .001) and depression (β = –.269, p < .001). Powerful others subscale was positively associated with anxiety (β = .176, p < .001), but there was no significant relationship between this subscale and depression (β = .047, p = .467). The findings of this study merit the understanding of the role of demographic/fertility characteristics and LoC orientations in anxiety and depression of infertile patients to identify beforehand those patients who might be at risk of experiencing high anxiety and depression and in need of support.     

Time to get happy: associations of time perspective with indicators of well-being

The present study examined associations of time perspective (TP) with indicators of well-being including satisfaction with life, anxiety and depression, after controlling for sociodemographic factors. Adult participants (N = 413) completed a web-based questionnaire that included a short version of the Zimbardo Time Perspective Inventory, the State-Trait Anxiety Inventory, and the Center for Epidemiologic Studies-Depression Scale. Life satisfaction was more strongly associated with the present hedonistic dimension, suggesting that the tendency to take risks and to fulfil one’s desires may lead to experiencing pleasure in a ‘seize the day’ approach to life. The existence of depressive symptoms and elevated anxiety levels were associated with higher scores on the past present and the present fatalistic dimensions, suggesting that feeling hopeless, or dwelling on bad moments from the past may be largely related to feeling depressed and anxious. Considering the recently reported implications of TP in clinical and counseling settings, the present study contributes to the growing body of research that associates TP with mental health and psychological well-being.     

Relationships among pain intensity,pain-related distress,and psychological distress in pre-surgical total knee arthroplasty patients: a secondary analysis

The current study aimed to examine the relationships between movement and resting pain intensity, pain-related distress, and psychological distress in participants scheduled for total knee arthroplasty (TKA). This study examined the impact of anxiety, depression, and pain catastrophizing on the relationship between pain intensity and pain-related distress. Data analyzed for the current study (N = 346) were collected at baseline as part of a larger Randomized Controlled Trial investigating the efficacy of TENS for TKA (TANK Study). Participants provided demographic information, pain intensity and pain-related distress, and completed validated measures of depression, anxiety, and pain catastrophizing. Only 58% of the sample reported resting pain >0 while 92% of the sample reported movement pain >0. Both movement and resting pain intensity correlated significantly with distress (r_s = .86, p < .01 and .79, p < .01, respectively). About three quarters to two thirds of the sample (78% for resting pain and 65% for movement pain) reported different pain intensity and pain-related distress. Both pain intensity and pain-related distress demonstrated significant relationships with anxiety, depression, and catastrophizing. Of participants reporting pain, those reporting higher anxiety reported higher levels of distress compared to pain intensity. These findings suggest that anxious patients may be particularly distressed by movement pain preceding TKA. Future research is needed to investigate the utility of brief psychological interventions for pre-surgical TKA patients.     

The dermatology life quality index (DLQI) and the hospital anxiety and depression (HADS) in Chinese rosacea patients

The study aims to investigate the quality of life (QOL) and the psychological situation in Chinese patients with rosacea. A total of 196 healthy controls and 201 rosacea patients were involved in the final analysis. The general information, the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS) were collected. Significantly higher DLQI, anxiety and depression score were observed in the rosacea group compared to the control group (p < .01). Total DLQI score of patients was positively related with anxiety (r = .526, p < .001) and depression scores (r = .399, p < .001) in HADS. Rosacea had significant psychological impact on Chinese patients and had substantial influence on their QOL. Physicians should address the psychosocial needs of rosacea patients as much as its physical symptoms.     

The contribution of anxiety and depression to fatigue among a sample of Australian university students: suggestions for university counsellors

Responses to the Zung Self-Rating Anxiety Scale (SAS: Zung, W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12, 371–379), the Self-Rating Depression Scale (SDS: Zung, W. (1973). From art to science: The diagnosis and treatment of depression. Archives of General Psychiatry, 29, 328–337) and the Fatigue Severity Scale (FSS) developed by Krupp and colleagues (Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 1121–1123) were collected from 200 Australian university students to explore the links between these three disorders. Reliability data were satisfactory for all three scales and there were no significant gender or age-related differences between total scale scores. Factor analyses revealed a 5-factor solution for the SAS, a 6-factor solution for the SDS and a single factor for the FSS. There were 8 major and meaningful correlations found and these were entered into a regression of the SAS and SDS factor scores upon the single factor of the FSS. Fatigue factor scores were most powerfully predicted by psychomotor agitation, pain and resultant fatigue and cognitive and emotional arousal factor scores from the SAS and SDS. These data argue for an arousal/anxiety-fatigue-depression progression in disease that may be developmental or accumulative, with extreme levels of psychomotor arousal, resultant muscle fatigue and pain, plus concurrent elevated emotional state and cognitive arousal contributing to an eventual depletion of physical resources, leaving the individual in extreme fatigue. Implications for diagnosis and treatment by counsellors are discussed.     

The Differential Role of Anxiety Sensitivity and its Components in the Relation between Emotional Nonacceptance and Anxiety and Depressive Symptoms and Disorders among Latinos in Primary Care

The present investigation examined anxiety sensitivity (AS) in the relation between emotional nonacceptance (unwillingness to experience unwanted emotions) and mood and anxiety symptoms among Latinos seeking health services at a primary healthcare facility. Participants included 267 adult Latinos (85.4% female; Mage = 38.8 years, SD = 10.7, and 95.9% used Spanish as their first language). Results indicated that emotional nonacceptance was indirectly related to number of mood and anxiety disorders, anxious arousal, social anxiety, and depressive symptoms through AS. The observed effects were evident above and beyond the variance accounted for by gender, age, marital status, educational status, employment status, years living in the United States, and negative affectivity. Using a multiple mediation model revealed that the AS cognitive, physical, and social concerns demonstrated unique incremental explanatory effects (above and beyond the other two AS sub-scales) for depressive, anxious arousal, and social anxiety symptoms, respectively. Thus, specific sub-scales of AS were uniquely related with the expression of particular affective symptom domains. Overall, the present findings suggest that there is merit in focusing further scientific attention on the interplay between nonacceptance and AS in regard to better understanding and intervening to reduce anxiety/depressive vulnerability among Latinos in primary care.     

Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials

Anxiety and depressive disorders are often comorbid. Transdiagnostic and tailored treatments seem to be promising approaches in dealing with comorbidity. Although several primary studies have examined the effects of Internet-delivered cognitive behavior therapy (iCBT) for anxiety and depression, no meta-analysis including different types of iCBT that address comorbidity has been conducted so far. We conducted systematic searches in databases up to 1 July 2016. Only randomized trials comparing transdiagnostic/tailored iCBT for adult anxiety and/or depression with control groups were included. Nineteen randomized trials with a total of 2952 participants that met inclusion criteria were analyzed. The quality of the studies was high, however the blinding criteria were not fulfilled. The uncontrolled effect size (Hedges’ g) of transdiagnostic/tailored iCBT on anxiety and depression outcomes was large and medium for quality of life. The controlled effect size for iCBT on anxiety and depression outcomes was medium to large (anxiety: g = .82, 95% CI: .58–1.05, depression: g = .79, 95% CI: .59–1.00) and medium on quality of life (g = .56, 95% CI: .37–.73). Heterogeneity was small (quality of life) to moderate (anxiety, depression). There was a large effect on generic outcome measures and a moderate effect on comorbidities. When compared to disorder-specific treatments there were no differences on anxiety and quality of life outcomes, however there were differences in depression outcomes. Transdiagnostic and tailored iCBT are effective interventions for anxiety disorders and depression. Future studies should investigate mechanisms of change and develop outcome measures for these interventions.     

Social Anxiety Symptoms and Suicidal Ideation in a Clinical Sample of Early Adolescents: Examining Loneliness and Social Support as Longitudinal Mediators

Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12–15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents.     

Associations of depression,anxiety and PTSD with neurological disability and cognitive impairment in survivors of moyamoya disease

Depression, anxiety and posttraumatic stress disorder (PTSD) are common complications of cerebrovascular diseases. However, they were seldom explored in Moyamoya Disease (MMD) survivors. In this study, we measured the prevalence of depression, anxiety and PTSD in MMD survivors. We evaluated the association of mental disorders with neurological disability and cognitive impairment, and further find out the independent protective and risk factors of neurological disability and cognitive impairment. In MMD survivors, the prevalence of these three mental disorders is high, 46.7% for depression, 50% for anxiety and 47.5% for PTSD. Anxiety and PTSD were significantly associated with more severe neurological disability (p = 0.039 and < 0.001); depression and anxiety were significantly associated with greater cognitive deficiency (p = 0.004 and 0.002). We further found PTSD was the only risk factor associated with neurological disability, and the corresponding odds ratio (OR) and 95% confidence interval (CI) was 81.74 (9.91–674.17); depression and anxiety were risk factors associated with cognitive impairment, and the corresponding OR and 95%CI were 2.73 (1.10–6.81) and 3.37 (1.29–8.78). Therefore, these three mental disorders were associated with more severe neurological disability and greater cognitive deficiency in MMD survivors.     

2型糖尿病患者焦虑抑郁状况及影响因素研究

为探讨2型糖尿病患者焦虑、抑郁状况及影响因素,对243例患者使用SAS、SDS、DSQL量表进行横断面调查。结果显示SAS、SDS评分均高于国内常模;多元回归分析显示有并发症、文化程度低的患者更易出现焦虑情绪,并发症出现时更易出现抑郁情绪。提示糖尿病患者普遍存在焦虑、抑郁等负性情绪,因此对医护人员要进行规范系统的心理干预培训,特别对病程10年、有并发症、文化程度较低的患者更要进行一对一的心理健康教育指导。     

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

ABSTRACT

Anxiety 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.     

A dysphoric's TALE: The relationship between the self-reported functions of autobiographical memory and symptoms of depression

Autobiographical memory (AM) is believed to serve self, social and directive functions; however, little is known regarding how this triad of functions operates in depression. Using the Thinking About Life Experiences questionnaire [Bluck, S., & Alea, N. (2011). Crafting the TALE: Construction of a measure to assess the functions of autobiographical remembering. Memory, 19, 470–486.; Bluck, S., Alea, N., Habermas, T., & Rubin, D. C. (2005). A TALE of three functions: The self–reported uses of autobiographical memory. Social Cognition, 23, 91–117.], two studies explored the relationship between depressive symptomology and the self-reported frequency and usefulness of AMs for self, social and directive purposes. Study 1 revealed that thinking more frequently but talking less frequently about past life events was significantly associated with higher depression scores. Recalling past events more frequently to maintain self-continuity was also significantly associated with higher depressive symptomology. However, results from Study 2 indicated that higher levels of depression were also significantly associated with less-frequent useful recollections of past life events for self-continuity purposes. Taken together, the findings suggest atypical utilisations of AM to serve self-continuity functions in depression and can be interpreted within the wider context of ruminative thought processes.     

Role of Comorbid Depression and Co-occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7–14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia). Hierarchical linear modeling examined treatment outcome and maintenance in terms of severity of the principal anxiety disorder. Results indicated that higher levels of child-reported depressive symptoms predicted less favorable treatment outcome. Higher levels of mother-reported depressive symptoms predicted less favorable treatment maintenance at a 1-year follow-up. Results suggest that co-occurring depressive symptoms play a role in effective treatment for anxiety-disordered youth and support the merits of treatment adaptations for these youth.