Relationships between health behaviors,posttraumatic stress disorder,and comorbid general anxiety and depression

Poor health outcomes associated with posttraumatic stress disorder (PTSD) may reflect engagement in unhealthy behaviors that increase morbidity risk and disengagement in healthy behaviors that decrease morbidity risk. Although research supports this pattern, findings are not definitive, particularly for healthy behaviors. Many studies have not controlled for effects of concurrent generalized anxiety and depression, which might explain conflicting findings. To address this limitation, we used an online cross-sectional research design and multivariate multilevel modelling to evaluate associations between a multitude of health behaviors (i.e. sedentary behavior, sleep quality, physical activity, eating habits, alcohol use and substance use) and PTSD, while adjusting for comorbid generalized anxiety and depression, in a sample of trauma-exposed individuals (N = 246). Our results indicate that PTSD and comorbid generalized anxiety and depression symptoms were differentially associated with specific health constructs. Specifically, sedentary behavior and poor sleep quality were associated with PTSD, whereas low physical activity, poor sleep quality, and unhealthy eating habits were associated with depression. Both increased alcohol and substance use were associated with generalized anxiety. Results from our study highlight the need to conceptualize associations between health behaviors and specific psychological symptoms in a comprehensive manner as part of clinical presentations of PTSD.     

Deployment of attention in clinical depression during symptom remission

The purpose of the current study was to investigate deployment of attention in clinically depressed patients during the process of symptom remission. Previous research indicates a non-depressed protective bias in attention whereas depressed individuals evidence no bias. A deployment-of-attention task based on negative, positive, and neutral adjectives was administered twice to 15 inpatients with major depression and 15 normal controls, at about 6 weeks apart. From test 1 to test 2, severity of patients' depressive symptoms improved significantly. Acutely depressed patients tended to show an attentional bias towards negative information whereas partially remitted patients manifested no attentional bias. Non-depressed individuals attended less to negative information than (acutely and partially remitted) depressed patients. Non-depressed participants but not depressed patients avoid negative information demonstrating a protective processing bias. Depressed patients are not characterized by a shift towards a pronounced protective pattern during symptom remission.     

Social capital,migration stress,depression and sexual risk behaviors among rural-to-urban migrants in China: a moderated mediation modeling analysis

Background: Few studies have examined the complex relationship of migration stress and depression with sexual risk behaviors among migrants. The relationship between migration stress and sexual risk behaviors may be mediated by depression, and the mediation process may be modified by social capital. The study aims to investigate this moderated mediation mechanism among rural-to-urban migrants.

Methods: Data were collected from rural-to-urban migrants in China. Migration stress, depression, and social capital were measured with validated scales and used as predictor, mediator and moderator, respectively, to predict the likelihood of having sex with risk partners. Mediation and moderated mediation models were used to analyze the data.

Results: Depression significantly mediated the migration stress–sex with risk partner relationship for males (the indirect effect [95%CI]?=?0.36 [0.08, 0.66]); the mediation effect was not significant for females (0.31 [?0.82, 0.16]). Among males, social capital significantly moderated the depression-sex with risk partner relation with moderation effect ?0.12 [?0.21, ?0.04], ?0.21 [?0.41, ?0.01] and ?0.17 [?0.30, ?0.05] for total, bonding and bridging capital respectively.

Conclusion: Social capital may weaken the association between migration stress and sexual risk behavior by buffering the depression-sexual risk behaviors association for males. Additional research is needed to examine this issue among females.     

Age trends in early behavioral predictors of serious antisocial behaviors

A risk group of disruptive boys (N=65) identified in kindergarten was assessed using the same procedures at ages 6–7, 8–9, and 10–11. Criteria used to define the predictors and criterion variable were the same at all assessment times. Severity was addressed by comparing different forms of behaviors, considering the extent of harmful consequences to others (aggressiveness was considered as most harmful, whereas inattention was considered as least harmful), manifestation in multiple settings, and extreme scores (manipulation of cutoff scores). Different assessment strategies (direct observations, ratings) and different informants (trained observers, mothers and teachers) were used. Aggressiveness as rated by mothers was highly stable from age 6 to age 11. Inattention as rated by teachers was stable only from age 6 to age 9, whereas no stability was found for observations of task inappropriate behaviors. Taskinappropriate behaviors observed in mother-child interactions and in multiple settings at age 6–7 were significant predictors of self-reported antisocial behaviors at age 12, but this prediction was not repeated at ages 8–9 and 10–11. Teacher ratings of inattention at ages 6–7 and 8–9 were also significant predictors of self-reported antisocial behaviors at age 12. The predictive power was much lower when mothers' ratings of aggressiveness were used. Findings from the present study support the hypothesis that some antisocial behavior precursors are age dependent, in that they are more characteristic of certain age groups than of others. Implications for the selection of assessment screening procedures are discussed.     

Observed maternal responses to adolescent behaviour predict the onset of major depression

Two mechanisms have been proposed regarding relations between parental responses to adolescent affective behaviours and the development of depression: the elicitation of parental negativity and the suppression of parental aggression. This study aimed to investigate the boundary conditions under which these two mechanisms operate in relation to the prospective prediction of Major Depressive Disorder (MDD) onset in adolescence. A community sample of 159 adolescents (aged 11–13 years) with no history of MDD completed a family interaction assessment with their mothers, and were followed-up with a diagnostic interview 2–3 years later. Results showed that onset of MDD was prospectively predicted by the elicitation of maternal aggression in response to adolescent aggression (in girls only) and maternal dysphoria in response to adolescent aggression, as well as the suppression of maternal aggression and dysphoria in response to adolescent dysphoria. Thus, support was obtained for both the elicitation of negativity mechanism in relation to maternal responses to adolescents’ aggressive behaviours, and the suppression of aggression mechanisms in relation to maternal responses to adolescents’ dysphoric behaviours. Mothers’ responses to adolescents’ aggressive and dysphoric behaviours may differentially influence the risk of MDD onset for adolescents over time.     

Depressive realism and clinical depression

Depressive realism suggests that depressed individuals make more accurate judgments of control than their nondepressed counterparts. However, most studies demonstrating this phenomenon were conducted in nonclinical samples. In this study, psychiatric patients who met criteria for major depressive disorder underestimated control in a contingent situation and were consistently more negative in their judgments than were nondepressed controls. Depressed patients were less likely than their nondepressed counterparts to overestimate control in a noncontingent situation, but largely because they perceived receiving less reinforcement. Depressed patients were no more likely to use the appropriate logical heuristic to generate their judgments of control than their nondepressed counterparts and each appeared to rely on different primitive heuristics. Depressed patients were consistently more negative than their nondepressed counterparts and when they did appear to be more “accurate” in their judgments of control (as in the noncontingent situation) it was largely because they applied the wrong heuristic to less accurate information. These findings do not support the notion of depressive realism and suggest that depressed patients distort their judgments in a characteristically negative fashion.     

Responding to symptoms of depression and anxiety: emotion regulation, neuroticism, and engagement in risky behaviors

The current study examined whether neuroticism, emotional regulation deficits, and/or their interaction predict increased engagement in risky behaviors following increases in symptoms of depression or anxiety over the course of 6 weeks. Results of hierarchical linear modeling analyses indicated that individuals who exhibited high levels of both neuroticism and emotional regulation deficits were more likely than other individuals to report increased engagement in risky behaviors following increases in symptoms of either depression or anxiety. Unexpectedly, individuals who exhibited high levels of neuroticism and adaptive emotion regulation strategies exhibited decreased engagement in risky behaviors following increases in depressive or anxious symptoms.     

Self-referential schemas and attentional bias predict severity and naturalistic course of depression symptoms

Attentional bias and self-referential schemas have been observed in numerous cross-sectional studies of depressed adults and are theorised to maintain negative mood. However, few longitudinal studies have examined whether maladaptive cognition predicts the course of depressive symptoms. Fifty-seven adults with elevated depression symptoms were assessed for negative attentional bias using a dot-probe task with eye-tracking and self-referential schemas using a self-referent encoding task. Participants subsequently completed five weekly depression symptom assessments. Participants with more negative self-referential schemas had higher baseline depression symptoms (r?=?.55). However, participants who spent more time attending to negative words showed greater symptom worsening over time (r?=?.42). The findings for negative self-referential schemas replicate past research, while the findings for negative attention bias represent the first evidence showing that attentional biases predict naturalistic symptom course. This work suggests that negative attention biases maintain depression symptoms and represent an important treatment target for neurocognitive therapeutics.     

Prevalence and severity of anxiety, depression and Type A behaviors in angina pectoris

The role of psychological factors in coronary heart disease was examined by administering the Bech Rating Scale (BRS) of mood disorders and the Jenkins Activity Survey (JAS) for Type A behavior patterns (TABP) to a consecutive sample of angina patients ( N = 94), to a consecutive sample of noncardiac patients ( N = 47), and to a random sample of adults from the general population ( N = 217). Anxiety and depression were both more frequent and more severe in angina patients than in noncardiac patients or in the general population. There was a tendency for certain components of TABP (i. e. speed, impatience, hard-driving and competitive disposition) to be elevated in angina patients, but a similar trend was noted in noncardiac patients. Although no consistent relations were observed between negative emotions and TABP scores in angina patients, their anxiety and depression scores were reliably related to their use of nitroglycerin. The findings concur with previous studies concerning the presence of anxiety and depression in patients with angina pectoris and indicate that such negative emotions are not closely related to Type A personality traits.     

The nature of clinical depression: symptoms, syndromes, and behavior analysis

In this article we discuss the traditional behavioral models of depression and some of the challenges analyzing a phenomenon with such complex and varied features. We present the traditional model and suggest that it does not capture the complexity of the phenomenon, nor do syndromal models of depression that dominate the mainstream conceptualization of depression. Instead, we emphasize ideographic analysis and present depression as a maladaptive dysregulation of an ultimately adaptive elicited emotional response. We emphasize environmental factors, specifically aversive control and private verbal events, in terms of relational frame theory, that may transform an adaptive response into a maladaptive disorder. We consider the role of negative thought processes and rumination, common and debilitating aspects of depression that have traditionally been neglected by behavior analysts.     

Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression

Pharmacotherapy and psychotherapy are generally effective treatments for major depressive disorder (MDD); however, research suggests that patient preferences may influence outcomes. We examined the effects of treatment preference on attrition, therapeutic alliance, and change in depressive severity in a longitudinal randomized clinical trial comparing pharmacotherapy and psychotherapy. Prior to randomization, 106 individuals with MDD reported whether they preferred psychotherapy, antidepressant medication, or had no preference. A mismatch between preferred and actual treatment was associated with greater likelihood of attrition, fewer expected visits attended, and a less positive working alliance at session 2. There was a significant indirect effect of preference match on depression outcomes, primarily via effects of attendance. These findings highlight the importance of addressing patient preferences, particularly in regard to patient engagement, in the treatment of MDD.     

Parenting practices and their relevance to child behaviors in Canada and China

Liu, M. & Guo, F. (2010). Parenting practices and their relevance to child behaviors in Canada and China. Scandinavian Journal of Psychology, 51, 109–114. Recent studies have revealed that parents in different cultures endorse different child‐rearing practices. Studies in the West suggest that there is a cluster of behavioral characteristics in children that are linked with each type of parenting styles. Mixed results, however, were found in non‐Western countries. This study examined (1) parenting practices in Canadian and Chinese mothers, and (2) the relevance between parenting practices and child behaviors in Canada and China. Forty Canadian children (average age = 5.40) and 39 Chinese children (average age = 4.84) and their mothers participated in the study. Information on maternal authoritative and authoritarian behaviors and children’s behaviors, including coercive request, polite request, and assertiveness, was obtained from observations of mother‐child interactions in a laboratory situation. The results indicated that Chinese mothers were less authoritative and more authoritarian than Canadian mothers. Both cross‐cultural differences and similarities were found on the associations between maternal parenting practices and child behaviors.     

Cognitive and marital factors in depression

The current investigation examines three groups of wives: (1) a group of nondepressed, nondiscordant community wives; (2) a group of nondepressed, discordant clinic wives; and (3) a group of depressed, discordant clinic wives. Groups were formed on the basis of structured interview responses and responses to a self-report inventory of depressive symptomatology. To be classified as depressed, wives were required to meet DSM III criteria for depression according to interview data and to exceed a Beck Depression Inventory score of 14. Both clinic groups showed equal levels of marital discord. Both nondepressed groups showed equally few cognitive errors. Accordingly, comparisons of these three groups allow us to test current interpersonal and cognitive theories of depression. The level of closeness in the marriage differentiated the depressed, discordant from the nondepressed, discordant wives despite their equal levels of overall marital discord. The level of depressive symptomatology was greater for the nondepressed clinic wives than it was for the community wives despite their equal levels of cognitive errors. Both closeness in the marriage and cognitive errors accounted for the unique variance in level of depression. Implications for current interpersonal and cognitive accounts of depression are discussed.Support for this research came in part from NIMH Grant 38390-02. Portions of this paper were presented at the 25th Annual Convention of the American Association for the Advancement of Behavior Therapy.     

Gender differences in the development of depression

The present study attempted to examine possible gender differences in the vulnerability to depression, specifically with regard to eliciting factors, marital status, age of onset, season of hospitalization, and type of treatment. The records of all patients (67 women and 34 men), treated during 1991 for major depression, dysthymia, or depression NOS at a psychiatric hospital in Southeastern Sweden were examined, and placed in empirically derived categories regarding eliciting factors.
The results indicated significant gender differences with regard to eliciting factors, marital status, and age. The eliciting factor in female depression was most commonly "threat to social bonds" whereas in male depression it was "threat to self esteem" or "threat to self respect". Married women were more prone to depression than were married men, as were men living alone compared to women living alone. Women above 60 years of age were significantly more prone to depression than were men of this age group. The results were discussed from two theoretical perspectives: gender role theory and gender-specific developmental theory.     

A diathesis-stress model of engagement in risky behaviors in Chinese adolescents

The current study examined whether the association between the occurrence of negative events and increased engagement in risky behavior is moderated by maladaptive and/or adaptive coping strategies. At time 1, 411 adolescents (ages 14–19) from Yue Yang, Hunan, completed self-report measures assessing coping strategies, engagement in risky behaviors, and the occurrence of negative events. Once a month for the subsequent 6 months, adolescents completed measures assessing engagement in risky behaviors and the occurrence of negative events. In line with our hypotheses, results of hierarchical linear modeling analyses indicated that adolescents possessing high levels of maladaptive coping strategies reported greater engagement in risky behaviors following the occurrence of negative events than adolescents possessing low levels. In contrast to our hypotheses, the association between the occurrence of negative events and increased engagement in risky behavior was not moderated by adaptive coping strategies.     

Safety behaviors and judgmental biases in social anxiety disorder

Two experiments were conducted to examine the link between safety behaviors and social judgments in social anxiety disorder (SAD). Safety behaviors were manipulated in the context of a controlled laboratory-based social interaction, and subsequent effects of the manipulation on the social judgments of socially anxious participants (N = 50, Study 1) and individuals meeting diagnostic criteria for generalized SAD (N = 80, Study 2) were examined. Participants were randomly assigned to either a safety behavior reduction plus exposure condition (SB + EXP) or a graduated exposure (EXP) control condition, and then took part in a conversation with a trained experimental confederate. Results revealed across both studies that participants in the SB + EXP group were less negative and more accurate in judgments of their performance following safety behavior reduction relative to EXP participants. Study 2 also demonstrated that participants in the SB + EXP group displayed lower judgments about the likelihood of negative outcomes in a subsequent social event compared to controls. Moreover, reduction in safety behaviors mediated change in participant self-judgments and future social predictions. The current findings are consistent with cognitive theories of anxiety, and support the causal role of safety behaviors in the persistence of negative social judgments in SAD.     

Personality types and risky health behaviors in Norwegian students

Typological research has received increasing interest in recent years, but is still regarded as substandard by personality psychologists. The current investigation shows how a typological approach can enhance our understanding of the influence of personality on risky health behaviors. We focused on Torgersen's eight personality types that represent unique configurations of high and low Extraversion, Neuroticism, and Constraint (Vollrath & Torgersen, 2000). Participants were 606 Norwegian university students. Measures assessed personality factors, smoking, abuse of drugs and alcohol, drunk driving, and risky sexual behaviors. Results replicated earlier research showing that types combining either high Extraversion and low Constraint (Hedonists, Impulsives) or high Neuroticism and low Constraint (Insecures) engage in more risky health behaviors. The discussion focuses on demonstrating that the study of types is a valuable supplement to the dimensional tradition in personality psychology.     

Undesirable life-events and depression in young adolescents

We compared the relationship between individual undesirable life-events and comprehensive life-event factors, as well as major depression in adolescents. Students in four public suburban middle schools were screened for depressive symptomatology and life-events by a self-administered questionnaire. Seven of 21 individual events (parents' divorce, parental job loss, problems between parents, problems between the adolescent and his/her parents, failing a grade in school, school suspension, death of a close friend) and three of six life-event factors (conflict/disappointment, marital discord, maladjustment) were significantly related to depression in univariate models. A multivariate examination of the individual events was difficult to interpret, but examination of the event factors found maladjustment and conflict/disappointment significant. Analyses using the undesirable life-event factors provided a clearer picture of the relationships investigated by grouping related events into a more manageable number of independent categories. Specific combinations of life-events suggest stronger associations with adolescent depression than others. Clinicians may identify youths at risk for depression when specific combinations of undesirable life-events occur.