Mean Beck Depression Inventory-II scores of outpatients with dysthymic or recurrent-episode major depressive disorders

The Beck Depression Inventory-II, published in 1996, was administered to 100 adult outpatients (Age M=43.1 yr., SD=15.6) who were diagnosed with a recurrent-episode Major Depressive Disorder and 100 outpatients (Age M=42.8 yr., SD=15.7) who were diagnosed with a Dysthymic Disorder. Each diagnostic group was composed of 50 men and 50 women who did not have a comorbid depressive disorder. The mean Beck Depression Inventory-II total score and the mean number of symptoms endorsed by the outpatients with a Major Depressive Disorder were significantly (ps<.001) higher than those for outpatients with a Dysthymic Disorder. The usefulness of the Beck Depression Inventory-II was discussed in helping clinicians discriminate between these two unipolar disorders.     

The PHQ-9 as a brief assessment of lifetime major depression

The Patient Health Questionnaire-9 (PHQ-9; R. L. Spitzer, K. Kroenke, J. B. W. Williams, & The Patient Health Questionnaire Primary Care Study Group, 1999), modified to ask about the worst period of depression lifetime, was validated against lifetime mood disorder diagnoses established by the Structured Clinical Interview for DSM-IV (SCID; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W. Williams, 2001) in 526 participants. PHQ-9 dichotomous scores corresponded highly with major depressive episode (MDE) Criterion A, MDE, and major depressive disorder (MDD), odds ratios >or= 9.5, and area under the receiver operating characteristic curve (AUC) >or= 0.84. The continuous scale score was higher in participants who did (M=17.14, SD=7.36) than in those who did not (M=6.05, SD=6.29) meet MDE Criterion A, t(524)=18.09, p<.001; was correlated with number of MDE Criterion A symptoms, r(525)=.67, p<.001; and detected MDE Criterion A (AUC=0.88). The PHQ-9 as a lifetime measure may be used to complement or replace more costly interview assessments.     

Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients.

This study evaluated the psychometric characteristics of the Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in a primary care medical setting. A principal-components analysis with Promax rotation indicated the presence of 2 correlated factors, Somatic-Affective and Cognitive, which explained 53.5% of the variance. A hierarchical, second-order analysis indicated that all items tap into a second-order construct of depression. Evidence for convergent validity was provided by predicted relationships with subscales from the Short-Form General Health Survey (SF-20; A. L. Stewart, R. D. Hayes, & J. E. Ware, 1988). A receiver operating characteristic analysis demonstrated criterion-related validity: BDI-II scores predicted a diagnosis of major depressive disorder (MDD), as determined by the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire (PHQ). This study demonstrated that the BDI-II yields reliable, internally consistent, and valid scores in a primary care medical setting, suggesting that use of the BDI-II in this setting may improve detection and treatment of depression in these medical patients.     

Genetic Testing of Children for Predisposition to Mood Disorders: Anticipating the Clinical Issues

Large-scale sequencing information may provide a basis for genetic tests for predisposition to common disorders. In this study, participants in the Coriell Personalized Medicine Collaborative (N?=?53) with a personal and/or family history of Major Depressive Disorder or Bipolar Disorder were interviewed based on the Health Belief Model around hypothetical intention to test one’s children for probability of developing a mood disorder. Most participants (87 %) were interested in a hypothetical test for children that had high (“90 %”) positive predictive value, while 51 % of participants remained interested in a modestly predictive test (“20 %”). Interest was driven by beliefs about effects of test results on parenting behaviors and on discrimination. Most participants favored testing before adolescence (64 %), and were reluctant to share results with asymptomatic children before adulthood. Participants anticipated both positive and negative effects of testing on parental treatment and on children’s self-esteem. Further investigation will determine whether these findings will generalize to other complex disorders for which early intervention is possible but not clearly demonstrated to improve outcomes. More information is also needed about the effects of childhood genetic testing and sharing of results on parent–child relationships, and about the role of the child in the decision-making process.     

The Children’s Attention-Deficit Hyperactivity Disorder Telemental Health Treatment Study: Caregiver Outcomes

The Children’s Attention-deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) tested the hypotheses that children and caregivers who received guideline-based treatment delivered through a hybrid telehealth service delivery model would experience greater improvements in outcomes than children and caregivers receiving treatment via a comparison delivery model. Here, we present caregiver outcomes. 88 primary care providers (PCPs) in seven geographically underserved communities referred 223 children (ages 5.5 ? 12.9 years) to the randomized controlled trial. Over 22 weeks, children randomized to the CATTS service delivery model received six sessions of telepsychiatry and six sessions of caregiver behavior management training provided in person by community therapists who were trained and supervised remotely. Children randomized to the comparison Augmented Primary Care (APC) service model received management in primary care augmented by a single telepsychiatry consultation. Caregiver outcomes included changes in distress, as measured by the Patient Health Questionnaire (PHQ-9), Parenting Stress Index (PSI), Caregiver Strain Questionnaire (CSQ) and Family Empowerment Scale (FES). Caregivers completed five assessments. Multilevel mixed effects regression modeling tested for differences between the two service delivery models in caregiver outcomes from baseline to 25 weeks. Compared to caregivers of children in the APC model, caregivers of children in the CATTS service model showed statistically significantly greater improvements on the PHQ-9 (β?=?-1.41, 95 % CI?=?[?2.74, ?0.08], p?<?.05), PSI (β?=??4.59, 95 % CI?=?[?7.87, ? 1.31], p?<?.001), CSQ (β?=??5.41, 95 % CI?=?[? 8.58, ?2.24], p?<?.001) and FES (β?=?6.69, 95 % CI?=?[2.32, 11.06], p?<?.01). Improvement in child ADHD symptoms mediated improved caregiver scores on the PSI and CSQ. Improvement in child ODD behaviors mediated caregiver CSQ scores. The CATTS trial supports the effectiveness of a hybrid telehealth service delivery model for reducing distress in caregivers of children with ADHD and suggests a mechanism through which the service model affected caregiver distress.     

Using online social media,Facebook, in screening for major depressive disorder among college students

This study explored the feasibility of using Internet social networking media in an online program for Major Depressive Disorder (MDD) screening and psychoeducation targeting college students. A Facebook advertisement targeted students at five colleges in the United States to complete a mental health research survey that screened for MDD using the Patient Health Questionnaire-9 (PHQ-9). Students who screened positive for MDD were offered an eightweek follow-up survey. Of the 259 students who consented to participate in the study, 26.7% screened positive for MDD, while only 14.2% were receiving treatment. The use of Facebook to advertise for online screening for MDD required very little start-up time, and the average cost was $11.45 per subject recruited. It is feasible to use online, commercially available social networking media such as Facebook for online screening for MDD among college students. However, conducting online screening and offering treatment resources alone did not increase treatment rate in this population.     

Effectiveness of Web- and Mobile-Based Treatment of Subthreshold Depression With Adherence-Focused Guidance: A Single-Blind Randomized Controlled Trial

Evidence for the impact of psychological Interventions for subthreshold depression (sD) is conflicting. Moreover, human resources to deliver such treatments are limited. This study aimed to evaluate the effectiveness of a web-based intervention with adherence-focused guidance in the treatment of sD. Participants with sD (CES-D ≥ 16, no Major Depressive Disorder according to DSM-IV criteria, N = 204) recruited via a large health insurance were randomly allocated to a web-based mobile-supported cognitive-behavioral intervention or to a waitlist control condition with unrestricted access to usual care. The primary outcome was the reduction in depressive symptom severity as measured by blind diagnostic raters using the Quick Inventory of Depressive Symptomatology (QIDS) at posttreatment. There was a statistically significant between-group difference in QIDS scores at posttreatment in favor of the intervention group, F(1, 201) = 11.31, p = .001, corresponding to a medium effect size of d = 0.37 (95% CI 0.09–0.64) and a NNT of 7 (95%–CI 3.7–41.2). Significant effects in favour of the intervention group were also found for secondary outcomes such as quality of life, anxiety, and insomnia severity. Web-based self-help interventions with adherence-focused guidance could be an acceptable and effective approach to reduce a range of negative consequences associated with subclinical depression.     

Personality assessment screener in a primary care sample of low-income urban women

The diagnostic efficiency of the Personality Assessment Screener (PAS; Morey, 1997) total score was evaluated using selected scales from the Patient Health Questionnaire (Spitzer, Kroenke, & Williams, 1999), the fourth edition of the Personality Diagnostic Questionnaire (Hyler, 1994), and the Alcohol Use Disorders Identification Test (Saunders, Aasland, Babor, DeLaFuente, & Grant, 1993) as reference standards. Complete data were collected from 110 women seeking treatment at an urban family medicine training clinic. Total PAS scores were effective in identifying patients with mood disorders, cluster B personality disorders, and alcohol use disorders, but the optimum cut scores were higher than the cut score of 19 recommended by Morey (1997). The 10 PAS element scores showed good convergent and discriminant correlations with the reference measures. These findings support the utility of the PAS to screen for major forms of psychopathology in an urban primary care setting.     

Evidence for the construct validities of the Beck Youth Inventories with child psychiatric outpatients

To provide further information about the construct validities of the Beck Youth Inventories of Emotional and Social Impairment, these inventories were administered to 35 female and 65 male outpatients whose ages ranged from 7 to 12 years and who were diagnosed with various psychiatric disorders. The Children's Depression Inventory was also administered, and the children were rated by a parent with the Conners' Parent Rating Scale-Revised: Short Form. The scores on the former inventory were more positively correlated with the scores on the Beck Youth Depression Inventory (r =.81, p<.001) than with scores on the four other Beck Youth Inventories, and those on the Conners Oppositional scale were comparably correlated with the scores on the Beck Youth Disruptive Behavior (r=.49, p<.001) and Anger (r=.41, p<.001) Inventories. These latter correlations were higher than those for scores on the Oppositional scale with the scores on the three other Beck scales.     

Executive Functioning in Children and Adolescents with Major Depressive Disorder

The present investigation examined neurocognitive functioning, focusing on executive functioning (EF), in 39 children and adolescents with Major Depressive Disorder (MDD) and 24 healthy control subjects all ages 8 to 17 years. The Wechsler Intelligence Scale for Children-Third Edition along with several measures of executive functioning including the Wisconsin Card Sorting Task, Trail Making Test, Controlled Oral Word Association Test, and the Stroop Color Word Test were administered. The neurocognitive profiles for the group of depressed children and adolescents were grossly intact as most scores on intellectual and EF measures fell within the average range and did not differ from the comparison group. Mental processing speed was decreased in the MDD versus normal control group and 27% of the depressed group performed below average on the Trail Making Test. This investigation provided a good base from which to compare future literature on EF in outpatients with early-onset MDD.     

Concurrent validity of the DSM-IV scales Affective Problems and Anxiety Problems of the Youth Self-Report

This study investigated the concurrent validity of the DSM-IV scales Anxiety Problems and Affective Problems of the Youth Self-Report (YSR) in a community sample of Dutch young adolescents aged 10-12 years. We first examined the extent to which the YSR/DSM-IV scales reflect symptoms of DSM-IV anxiety disorders and DSM-IV Major Depressive Disorder, assessed with the Revised Child Anxiety and Depression Scale (RCADS). Second, we examined whether the association between the YSR/DSM-IV scales and the RCADS scales was stronger than the association between the empirically derived YSR narrow-band scales Anxious/Depressed and Withdrawn and the same RCADS scales. Results showed that the YSR/DSM-IV scale Affective Problems had a stronger association with symptoms of DSM-IV Major Depressive Disorder than the YSR narrow-band scales Withdrawn and Anxious/Depressed. However, the YSR/DSM-IV scale Anxiety Problems had a weaker association with symptoms of DSM-IV anxiety disorders, compared to the YSR narrow-band scale Anxious/Depressed. It was concluded that the construction of the DSM-IV scales improved the correspondence with DSM-IV Major Depressive Disorder, but not with DSM-IV anxiety disorders.     

Is there a role of depressive symptoms in the fear-avoidance model? A structural equation approach

The fear-avoidance (FA) model has gained widespread acceptance as a conceptual framework for investigating psychological factors such as FA beliefs and avoidance behavior, which contribute to chronic back pain and reduced functioning. Depressive symptoms are supposed to be related to FA beliefs and to foster avoidance behavior. This study aims to investigate the multivariate assumptions of the FA model with a focus on the role of depressive symptoms. A total of N = 360 patients with chronic nonspecific low back pain at admission of inpatient orthopedic rehabilitation participated in the survey. Measures included a numeric pain rating scale, Fear-Avoidance Beliefs Questionnaire, Pain Anxiety Symptoms Scale, Hannover Functional Ability Questionnaire and Patient Health Questionnaire. Using structural equation modeling (SEM), we construed a basic FA model and subsequently extended it by adding symptoms of depression as a covariate. The results of SEM indicated a good model fit for a basic FA model (χ²(263) = 431.069, p < .001, RMSEA = .042, CFI = .964, WRMR = .986). They confirmed the hypothesized relations and supported single mediations of the relationship between pain and functioning by FA beliefs and avoidance behavior. A second model including symptoms of depression as additional covariate (χ²(511) = 722.761, p < .001, RMSEA = .034, CFI = .956, WRMR = .949) showed a high impact of depressive symptoms on all FA model variables leading to a decrease of the FA mediations. The findings provide empirical support for the multivariate FA model and underline the importance of considering depressive symptoms in a multiple-target approach to understand the mechanisms of chronic pain.     

Relationships between mood state, time estimation, and selected movement speed

We investigated whether different aspects of mood state influence sense of time estimation and movement speed. Mood states were measured on the Multiple Mood Scale for 142 female undergraduate students, who were then asked to estimate the interval of time elapsed between the words "start" and "stop" spoken by a tester. Next, the same subjects were told to draw circles inside 1-cm squares printed on an A4 size sheet of paper in succession at their freely elected comfortable speed. Scores on Concentration (r=-.22, p<.01) and Being Startled (r=-.26, p<.01) each correlated significantly and negatively with time estimation, while scores on Boredom (r =.17, p <.05) had a significant positive correlation with movement speed. These results suggest that different aspects of mood state have some association with time estimation and selected movement speed. Values account for small common variance.     

A profile of adolescent alcohol offenders in two rural Midwestern counties

Screening tools specifically developed for use with adolescents may be more sensitive predictors of relapse or recidivism than self-report inventories typically used to screen adults. 70 adolescents in a program for drunk drivers in two counties in southeastern Nebraska were given both the CRAFFT and the Alcohol Use Disorder Identification Test questionnaires during routine alcohol-dependency evaluations. The Michigan Alcoholism Screening Test was also given to 28 subjects selected at random. 11 boys and 6 girls did not successfully complete the program. Significant correlations obtained for AUDIT scores for both the CRAFFT (r69=.65, p<.01) and failure to complete diversion (r69=.23, p<.05). Subjects were grouped by age (18 and younger and over 18 years) and by sex. A 2 x 2 analysis of variance for scores on the AUDIT indicated significant main effects for both age (F1,66=4.86, p<.05) and sex (F1.66=5.96, p<.01). MAST and CRAFFT scores showed no age or sex differences. The AUDIT might be included in drug and alcohol assessments with similar samples of adolescents.     

Impact of psychiatric illness upon asthma patients’ health care utilization and illness control. Are all psychiatric comorbidities created equal?

The impact of psychiatric illnesses upon asthma patients' functioning is not well understood. This study examined the impact of psychiatric comorbidity upon illness management in asthma patients using empirically-derived psychiatric comorbidity groups. Participants were a clinic sample of Greek-speaking asthma patients (N = 212) assessed using the Patient Health Questionnaire (PHQ) Somatoform, Depression, Panic Disorder (PD), Other Anxiety Disorder, Eating Disorder (ED) and Alcohol sub-scales. The associations between sub-scales were examined using multiway frequency analysis. The following groups were derived: Somatoform disorder and/or Any Depressive disorder (n = 63), Somatoform disorder and/or Other Anxiety disorder (n = 51), Somatoform disorder and/or Any ED (n = 60), and Any Anxiety group including PD and/or Other Anxiety disorder (n = 24). Across all groups, psychiatric illness was associated with significantly worse asthma control (p < .01). Participants in Any Anxiety group, OR = 4.61, 95% CI [1.90, 11.15], Somatoform and/or Any Depressive disorder, OR = 2.06, 95% CI [1.04, 4.09] and Somatoform and/or Other Anxiety disorder, OR = 2.75, 95% CI [1.35, 5.60] were at higher risk for asthma-related Emergency Room (ER) visits compared to controls. However only Somatoform and/or Any Depressive disorder, OR = 3.67, 95% CI [1.60, 8.72], Somatoform and/or Other Anxiety disorder, OR = 5.50, 95% CI [2.34, 12.74], and Somatoform and/or Any ED, OR = 4.98, 95% CI [2.14, 11.60] group membership were risk factors for asthma-related hospitalizations. Results suggest that while comorbid psychiatric disorders generally negatively impact asthma illness management, different psychiatric comorbidities appear to have disparate effects upon illness management outcomes.     

Changes in Sexual Functioning and Mood Among Women Treated for Gynecological Cancer Who Receive Group Therapy: A Pilot Study

This study examined changes in sexual functioning and mood disturbance among women who have been treated for gynecological cancer and who participated in a 12-week group intervention for psychosexual problems. The Changes in Sexual Functioning Questionnaire (CSFQ) assessed the sexual functioning, and the Profile of Mood States (POMS) assessed the mood disturbance of 19 women at baseline who completed follow-ups conducted posttreatment and three-month posttreatment. The results showed that the women improved significantly in their CSFQ total scores after being provided with the group therapy intervention at the posttreatment assessment (p < .01), and a statistical trend (p < .10) suggested continued improvement in CSFQ total scores at the three months posttreatment follow-up. Women's POMS total mood disturbance scores improved significantly at the posttreatment assessment (p = .01), but did not show significant improvement at the 3-month posttreatment follow-up. These results suggest that this group intervention achieved its main goal in treating sexual dysfunction as well as mood disturbance, but these improvements dissipated over time and may require further intervention in order to be maintained.     

儿童期心理虐待对青少年网络欺负的影响:领悟社会支持及性别的调节作用

近年来,网络欺负现象逐渐成为网络心理学研究的热点问题。青少年网络欺负的发生率约为60.8%,且每年都在呈增长的趋势,这对青少年正常的学习生活造成了严重的影响。故本研究主要探讨儿童期心理虐待对青少年网络欺负的影响,以及领悟社会支持和性别起到的调节作用。本研究以447名青少年作为被试(男生205人,女生242人,被试年龄范围为11~17岁,平均年龄为14.17±1.35岁),采用儿童期心理虐待量表、网络欺负问卷及领悟社会支持量表进行调查。运用SPSS 22.0及AMOS 21.0统计软件进行数据处理,Harman单因素法表明,本研究不存在严重的共同方法偏差问题。研究结果表明:(1)儿童期心理虐待与领悟社会支持呈显著负相关(r=-.14,p<.01),儿童期心理虐待与青少年网络欺负呈显著正相关(r=.44,p<.01),领悟社会支持与青少年网络欺负呈显著负相关(r=-.15,p<.01);(2)结构方程模型显示,模型各指标均达到了临界值(χ^2/df=2.67,GFI=.90,TLI=.91,CFI=.92,RMSEA=.07);(3)儿童期心理虐待对青少年网络欺负具有显著的正向预测作用(β=.21,p<.01),领悟社会支持对青少年网络欺负具有显著的负向预测作用(β=-.11,p<.05),同时,儿童期心理虐待与领悟社会支持的交互项对青少年网络欺负具有显著的负向预测作用显著(β=-.19,p<.01),简单斜率检验表明,对于低领悟社会支持水平的青少年,儿童期心理虐待对网络欺负有显著的正向预测作用(β=.54,p<.001);对于高低领悟社会支持水平的青少年,儿童期心理虐待对网络欺负的预测作用不显著(β=-.17,p>.05);(4)儿童期心理虐待与性别的交互项对青少年网络欺负具有显著的正向预测作用(β=.28,p<.001),简单斜率检验表明,对于男青少年,儿童期心理虐待对网络欺负有显著的正向预测作用(β=.54,p<.001);对于女青少年,儿童期心理虐待对网络欺负的预测作用不显著(β=.13,p>.05);由此可说明,儿童期心理虐待是青少年网络欺负出现的助推机制,而领悟社会支持和性别是青少年网络欺负出现的抑制机制,它可以弱化儿童期心理虐待对青少年网络欺负造成的创伤。     

An investigation of psychopathology in nonreferred suicidal and nonsuicidal adolescents

This investigation examined self-reported psychopathology in a school-based sample of 456 suicidal and nonsuicidal adolescents. The sample consisted of four groups: three at-risk for suicidal behavior based on current suicidal ideation as assessed by the Suicidal Ideation Questionnaire (SIQ; Reynolds, 1988), past suicide attempts, or both; and one nonsuicidal comparison group. Psychopathology was examined using ten scales from the Adolescent Psychopathology Scale (APS; Reynolds, 1998a) including: Major Depression, Conduct Disorder, Substance Abuse, Schizophrenia, Adjustment Disorder, Anorexia Nervosa, Borderline Personality Disorder, Obsessive-Compulsive Personality Disorder, Schizotypal Personality Disorder, and Avoidant Personality Disorder. Analyses were conducted separately for males and females using a MANOVA design that examined psychopathology severity among the four groups. Adolescents who engaged in past or current suicidal behavior had higher psychopathology severity scores compared to their nonsuicidal peers. Males with current suicidal thoughts who had attempted suicide had the highest levels of psychopathology severity compared to males in the other three groups. Females with a past suicide attempt or current suicidal ideation had higher psychopathology severity scores compared to nonsuicidal females. Results show greater psychopathology in school-based adolescents who have engaged in past and/or current suicidal behavior. The need for clinicians and mental health professionals working with at-risk youth to focus on concurrent psychopathology along with suicidal behavior is discussed.     

The Role of Attachment Style and Depression in Patients with Hepatitis C

Patients infected with chronic hepatitis C virus (HCV) commonly suffer from the triad of depression, pain and fatigue. This symptom triad in HCV is likely influenced by additional psychological and interpersonal factors, although the relationship is not clearly understood. This retrospective study aimed to characterize the relationship between attachment style and depressive and physical symptoms in the HCV-infected population. Over 18 months, 99 consecutively referred HCV infected patients were assessed with the Hamilton Depression Rating Scale (HDRS), Fatigue Severity Scale, Patient Health Questionnaire-15 for physical symptoms and the Relationship Questionnaire for attachment style. An ANOVA was used to identify differences between attachment styles and Pearson correlations were used to evaluate the association between depression, fatigue and physical symptoms. Approximately 15 % of patients in the sample had a fearful attachment style. Patients with fearful attachment style had significantly higher depressive symptoms compared to a secure attachment style (p = .025). No differences in physical and fatigue symptoms were observed between attachment styles. Further, HDRS scores were significantly associated with fatigue scores (p < .001) and physical symptoms (p < .001), reinforcing the relationship between these symptom domains in HCV-infected patients. Although depressive, physical and fatigue symptoms are inter-related in HCV-infected patients, our study results suggest that only depressive symptoms were influenced by the extremes of attachment style. Screening of relationship styles may identify at-risk HCV-infected individuals for depression who may have difficulty engaging in care and managing physical symptoms.     

Testing a model of the predictors and consequences of body dissatisfaction

A cross-sectional study, testing a model of predictors and consequences of body dissatisfaction, was undertaken in Taiwan from December 30, 2006 to January 10, 2007. Two hundred and thirty-two female college students enrolled at a major university completed the self-administered questionnaire. Analytical results revealed that body dissatisfaction among respondents increased with BMI (beta=.32, p<.001), perceptions of how others viewed their bodies (beta=.38, p<.001), and upward social comparisons (beta=.17, p<.01). Body dissatisfaction also markedly influenced respondent weight-loss intentions (beta=.51, p<.001). Results imply that medical, psychological and social factors must be considered by school health educators wishing to understand the causes and consequences of body dissatisfaction among female college students.