Perinatal depression influences on infant negative affectivity: Timing,severity, and co-morbid anxiety

Accumulating evidence suggests that antenatal depression predicts infants’ negative affectivity, albeit with variable effect sizes. With a prospective longitudinal design, we sought to explain that variability by addressing questions about timing of the depression across pregnancy and the early postpartum, the role of high symptom levels relative to diagnosed depression, comorbidity with anxiety, and the potential mediating role of neuroendocrine functioning. Primiparous women (n = 77) with histories of depression prior to pregnancy were assessed for cortisol levels monthly beginning by mid-pregnancy. Depression symptom levels and diagnostic status were similarly assessed monthly in pregnancy and also until infants reached three months of age, when mothers completed the Infant Behavior Questionnaire-Revised to measure infant negative affectivity. Antenatal depression symptoms and infant negative affectivity were positively associated (r = .39). Controlling for depression symptom levels in other trimesters, only second trimester depression symptoms predicted higher infant negative affectivity (β = .44). With postpartum depression symptom levels in the model, only antenatal depression symptoms predicted infant negative affectivity (β = .45). In the context of depression, neither antenatal anxiety symptoms nor anxiety disorder diagnosis were associated with infant NA scores. The hypothesized role of elevated maternal cortisol as a mechanism for the association between antenatal depression and infant NA was not supported. Our findings contribute to efforts to more precisely identify infants of perinatally depressed mothers who are at greater risk for elevated negative affectivity, suggesting a window of vulnerability in mid pregnancy and the need for further study of potential mechanisms.     

The mediating role of self-esteem in the relationship between big five personality traits and depressive symptoms among Chinese undergraduate medical students

The objectives of this study were to examine the correlations between big five personality traits and depressive symptoms among Chinese undergraduate medical students, and to explore the mediating role of self-esteem on the correlations. Self-reported questionnaires, including Big Five Inventory, the Center for Epidemiologic Studies Depression Scale, Rosenberg’s Self-Esteem scale, and socio-demographic section were distributed to 2000 undergraduate medical students at four medical colleges and universities in Liaoning province, China, in June 2014. 1738 students became the final subjects. After adjustment for age and gender, agreeableness (β = −0.329) and openness (β = −0.096) were negatively related to depressive symptoms, while neuroticism (β = 0.245) was positively related to the symptoms. Self-esteem functioned as a mediator in the relationship between agreeableness (a * b = −0.154, 95% CI: −0.182, −0.127)/openness (a * b = −0.097, 95% CI: −0.124, −0.069)/neuroticism (a * b = 0.031, 95% CI: 0.007, 0.058) and depressive symptoms. Therefore, identifying at-risk students and undertaking appropriate intervention strategies that focus on both personality traits and self-esteem may be effective in preventing and reducing depressive symptoms among Chinese medical students.     

Effects of a self-regulation intervention on exercise are moderated by depressive symptoms: A quasi-experimental study

This study investigated whether a computer-based self-regulation intervention increases physical exercise in individuals with or without depressive symptoms. A total of 361 individuals in orthopedic rehabilitation, 36 of them with depressive symptoms, were recruited in Germany. In a quasi-experimental study, individuals were allocated to either a computer-based self-regulation intervention or an online questionnaire. Exercise was measured at the beginning of rehabilitation and six weeks after rehabilitation. Depressive symptoms were assessed at the end of rehabilitation. An analysis of covariance was conducted, controlling for exercise baseline, sex, and phase of assessment. A main effect for depressive symptoms (p = .005) and intervention group (p = .011), as well as a marginal interaction of intervention x depressive symptoms were found (p = .076). Results indicate that the self-regulation exercise intervention in an orthopedic rehabilitation setting seem to be only effective in non-depressed individuals. Future research should examine how health behavior change programs can be designed more effectively for individuals with depressive symptoms.     

Depression mediates the relationship between social performance impairment and hostility

The goal of this study was to test depressive symptoms as a mediator between social difficulties and hostility in young adults. Hostility is often a reaction to both intrinsic and extrinsic factors; therefore a greater understanding of contributing factors is needed, especially among emerging adults. College students (n = 608; 408 females, 200 males) self-reported on social difficulties, depression, and hostility. Via exploratory factor analyses, two latent constructs related to social difficulty were identified: social performance and social motivation. Using structural equation modeling, the direct effects found that poor social performance was significantly positively associated with BPAQ Total (β = .44, p < .01). Social motivation was not associated with BPAQ Total (β = −.07, p = .21). Further, depression scores were found to partially mediate the relationship between social performance deficits (β = .34, p < .01; 95% CI = .05–.16), but not social motivation (β = −.06, p > .05; 95% CI = −.04 to .04), and overall aggression. Results are discussed in terms of the influence of negative affect and impaired emotion regulatory processes on hostility as a consequence of social performance deficits.     

Maternal self-confidence during the first four months postpartum and its association with anxiety and early infant regulatory problems

Maternal self-confidence has become an essential concept in understanding early disturbances in the mother-child relationship. Recent research suggests that maternal self-confidence may be associated with maternal mental health and infant development. The current study investigated the dynamics of maternal self-confidence during the first four months postpartum and the predictive ability of maternal symptoms of depression, anxiety, and early regulatory problems in infants. Questionnaires assessing symptoms of depression (Edinburgh Postnatal Depression Scale), anxiety (State-Trait Anxiety Inventory), and early regulatory problems (Questionnaire for crying, sleeping and feeding) were completed in a sample of 130 women at three different time points (third trimester (T1), first week postpartum (T2), and 4 months postpartum (T3). Maternal self-confidence increased significantly over time. High maternal trait anxiety and early infant regulatory problems negatively contributed to the prediction of maternal self-confidence, explaining 31.8% of the variance (R = .583, F_3,96 = 15.950, p < .001).Our results emphasize the transactional association between maternal self-confidence, regulatory problems in infants, and maternal mental distress. There is an urgent need for appropriate programs to reduce maternal anxiety and to promote maternal self-confidence in order to prevent early regulatory problems in infants.     

Precursors of social emotional functioning among full-term and preterm infants at 12 months: Early infant withdrawal behavior and symptoms of maternal depression

This study forms part of a longitudinal investigation of early infant social withdrawal, maternal symptoms of depression and later child social emotional functioning. The sample consisted of a group of full-term infants (N = 238) and their mothers, and a group of moderately premature infants (N = 64) and their mothers. At 3 months, the infants were observed with the Alarm Distress Baby Scale (ADBB) and the mothers completed the Edinburgh Postnatal Depression Scale (EPDS). At 12 months, the mothers filled out questionnaires about the infants’ social emotional functioning (Infant Toddler Social Emotional Assessment and the Ages and Stages Questionnaire-Social Emotional). At 3 months, as we have previously shown, the premature infants had exhibited more withdrawal behavior and their mothers reported elevated maternal depressive symptoms as compared with the full-born group. At 12 months the mothers of the premature infants reported more child internalizing behavior. These data suggest that infant withdrawal behavior as well as maternal depressive mood may serve as sensitive indices of early risk status. Further, the results suggest that early maternal depressive symptoms are a salient predictor of later child social emotional functioning. However, neither early infant withdrawal behavior, nor gestational age, did significantly predict social emotional outcome at 12 months. It should be noted that the differences in strength of the relations between ADBB and EPDS, respectively, to the outcome at 12 months was modest. An implication of the study is that clinicians should be aware of the complex interplay between early infant withdrawal and signs of maternal postpartum depression in planning ports of entry for early intervention.     

Predictors of aerobic physical activity and resistance training among Canadian adults with type 2 diabetes: An application of the Protection Motivation Theory

BackgroundIt is well established that both aerobic physical activity (PA) and resistance training are essential in the treatment and management of type 2 diabetes (T2D), but few studies have examined the determinants of both modes of PA in the same sample.PurposeThe main objective was to investigate the utility of the Protection Motivation Theory (PMT) in predicting aerobic PA and resistance training in a population sample of T2D adults.MethodsA total of 244 individuals completed self-report PMT constructs of vulnerability, severity, fear, response efficacy, self-efficacy and intention, and a 3-month follow-up that assessed aerobic PA and resistance training.ResultsPMT explained 19% (p < .001) and 20% (p < .001) of the variance respectively for aerobic PA and resistance training behaviour. Significant associations were found between self-efficacy (β = 0.45, p < .001) and gender (β = 0.15, p < .05) for aerobic PA, and self-efficacy (β = 0.48, p < .001) and age (β = 0.17, p < .05) for resistance training. PMT accounted for 43% (p < .001) and 56% (p < .001) of the variance respectively for aerobic PA and resistance training intentions. For aerobic PA, response efficacy (β = 0.14, p < .05) and self-efficacy (β = 0.59, p < .001) were significantly associated with intention, while response efficacy (β = 0.23, p < .001), self-efficacy (β = 0.64, p < .001) and age (β = 0.10, p < .05) were significantly related with resistance training intention.ConclusionsNone of the unique constructs of the PMT (i.e., perceived vulnerability, severity and fear) were significant with either aerobic and resistance training intention. These results may guide the development of effective PA interventions in people with T2D.     

Adolescents with and without a facial difference: The role of friendships and social acceptance in perceptions of appearance and emotional resilience

This study investigated the role of friendships and social acceptance in self-perceptions of appearance and depressive symptoms, comparing adolescents with and without a facial difference. Adolescents with a visible cleft (n = 196) were compared with adolescents with a non-visible cleft (n = 93), and with a comparison group (n = 1832). Boys with a visible difference reported significantly more positive perceptions of friendships and less depressive symptoms than the comparison group. These results were interpreted in the context of indicators of emotional resilience. The objective measure of facial difference did not explain levels of depressive symptoms, while subjective measures did. Subjective ratings of appearance mediated the association between social acceptance and depressive symptoms in all samples. Gender did not contribute in explaining the paths between friendships, appearance, and depressive symptoms. The associations between perceptions of social acceptance, appearance, and emotional distress, support the possible utility of strengthening social experiences in preventing and treating appearance-concerns.     

Mindfulness-based interventions with youth: A comprehensive meta-analysis of group-design studies

The treatment effects of Mindfulness-Based Interventions (MBIs) with youth were synthesized from 76 studies involving 6121 participants. A total of 885 effect sizes were aggregated using meta-regression with robust variance estimation. Overall, MBIs were associated with small treatment effects in studies using pre-post (g = 0.305, SE = 0.039) and controlled designs (g = 0.322, SE = 0.040). Treatment effects were measured after a follow-up period in 24 studies (n = 1963). Results demonstrated that treatment effects were larger at follow-up than post-treatment in pre-post (g = 0.462, SE = 0.118) and controlled designs (g = 0.402, SE = 0.081). Moderator analyses indicated that intervention setting and intervention dosage were not meaningfully related to outcomes after controlling for study design quality. With that said, the between-study heterogeneity in the intercept-only models was consistently small, thus limiting the amount of variance for the moderators to explain. A series of exploratory analyses were used to investigate the differential effectiveness of MBIs across four therapeutic process domains and seven therapeutic outcome domains. Small, positive results were generally observed across the process and outcome domains. Notably, MBIs were associated with moderate effects on the process variable of mindfulness in controlled studies (n = 1108, g = 0.510). Limitations and directions for future research and practice are discussed.     

Validation of the Brief Shame and Guilt Questionnaire for Children

While both shame and guilt are described as self-conscious emotions, they differ in many ways, including their contextual antecedents and their associations with mental health. A measure that distinguishes proneness to experience shame and guilt is crucial.In the present study we present a brief questionnaire to measure shame- and guilt-proneness in children using short concrete items. Specifically, we presented our 12-item Brief Shame and Guilt Questionnaire to Dutch (n = 219) 9–14 year-olds along with measures of internalizing problems (social anxiety, worry) and externalizing problems (aggression and conduct behavior). In addition to self-reports, teacher-reports on the externalizing problems were also collected. Results confirmed the two-factor structure, showed good psychometric properties of the two scales and a good concurrent validity. Specifically, shame-proneness contributed to the prediction of more internalizing problems and guilt-proneness contributed to the prediction of fewer externalizing problems. As such, the Brief Shame and Guilt Questionnaire for Children is a reliable and accessible instrument to administer in children.     

Does Worrying Mean Caring Too Much? Interpersonal Prototypicality of Dimensional Worry Controlling for Social Anxiety and Depressive Symptoms

Worry, social anxiety, and depressive symptoms are dimensions that have each been linked to heterogeneous problems in interpersonal functioning. However, the relationships between these symptoms and interpersonal difficulties remain unclear given that most studies have examined diagnostic categories, not accounted for symptoms’ shared variability due to general distress, and investigated only interpersonal problems (neglecting interpersonal traits, interpersonal goals, social behavior in daily life, and reports of significant others). To address these issues, students (Study 1; N = 282) endorsed symptoms and interpersonal circumplex measures of traits and problems, as well as event-contingent social behaviors during one week of naturalistic daily interactions (N = 184; 7,036 records). Additionally, depressed and anxious patients (N = 47) reported symptoms and interpersonal goals in a dyadic relationship, and significant others rated patients’ interpersonal goals and impact (Study 2). We derived hypotheses about prototypical interpersonal features from theories about the functions of particular symptoms and social behaviors. As expected, worry was uniquely associated with prototypically affiliative tendencies across all self-report measures in both samples, but predicted impacting significant others in unaffiliative ways. As also hypothesized, social anxiety was uniquely and prototypically associated with low dominance across measures, and general distress was associated with cold-submissive tendencies. Findings for depressive symptoms provided less consistent evidence for unique prototypical interpersonal features. Overall, results suggest the importance of multimethod assessment and accounting for general distress in interpersonal models of worry, social anxiety, and depressive symptoms.     

Experiential avoidance in body dysmorphic disorder

Experiential avoidance (i.e., the attempt to avoid certain internal experiences including bodily sensations, thoughts, emotions, memories, and urges) has been studied in various psychological disorders. However, research examining experiential avoidance in individuals with body dysmorphic disorder (BDD) is limited and inconsistent. The present study compared experiential avoidance in individuals with primary BDD (n = 23) to healthy controls (n = 22). Standardized measures were used to assess baseline clinical characteristics as well as experiential avoidance. Compared to healthy controls, individuals with BDD presented with significantly greater experiential avoidance (p < .001, d = −2.51). In BDD, experiential avoidance was positively correlated with depressive symptoms (p < .01) and avoidant coping strategies (p < .01). Clinician sensitivity to experiential avoidance may serve to improve the course of treatment for BDD.     

Personality styles in a non-clinical sample: The role of emotion dysregulation and impulsivity

Theories of personality and personality disorders are increasingly considering the centrality of emotion regulation and its dimensions. Impulsivity as well is recognized as a personality trait underlying diverse symptom presentations. Although research in this field has mainly regarded borderline personality disorder, recent studies supported the association of both emotion dysregulation and impulsivity with personality styles across all clusters. In the present study, we sought to extend extant research by investigating the joint contribution of selected difficulties in emotion regulation and impulsivity to traits of four personality styles in a community sample (N = 399, mean age = 37.91, 56.6% males). In particular, we focused on depressive, masochistic, passive-aggressive and sadistic personality styles. Multiple regression analyses showed the unique association of several domains of emotion dysregulation with all personality styles examined. Nonacceptance of emotional response was significantly and positively related with scores of all personality styles. Lack of emotional awareness was also characteristic of different styles. Beyond these similarities, distinct patterns were able to distinguish between externalizing (sadistic and passive-aggressive), and internalizing (depressive and masochistic) traits. Beyond the role of emotion dysregulation, trait impulsivity was also related to masochistic, passive-aggressive, and sadistic traits, independently explaining a significant amount of additional variance.     

A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology

To date, most early intervention programs have been based on emotion regulation strategies that address dysfunctional cognitive appraisals, problem-solving skills, and rumination. Another emotion regulation strategy, ‘acceptance’ training, has largely been overlooked. To examine the efficacy of this strategy, a school-based mental health program combining positive psychology with acceptance and commitment therapy (Strong Minds) was evaluated in a randomized controlled trial with a sample of 267 Year 10 and 11 high-school students in Sydney, Australia. Mixed models for repeated measures examined whether the program led to reductions in symptoms amongst students who commenced the program with high depression, anxiety, and stress scores, and increased wellbeing scores amongst all students. Results demonstrated that compared to controls, participants in the Strong Minds condition with elevated symptom scores (n = 63) reported significant reductions in depression (p = .047), stress (p = .01), and composite depression/anxiety symptoms (p = .02) with medium to strong effect sizes (Cohen's d = 0.53, 0.74, and 0.57, respectively). Increased wellbeing (p = .03) in the total sample and decreased anxiety scores (p = .048) for students with elevated symptoms were significant for Year 10 students with medium effect sizes (Cohen's d = 0.43 and 0.54, respectively). This study tentatively suggests that including the emotion regulation strategy of acceptance in early intervention programs may be effective in reducing symptoms and improving wellbeing in high school students. Further research to investigate the generalizability of these findings is warranted.     

The link between stress,well-being,and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention

Background/Objective: Prolonged stress can overwhelm coping resources, leading people to seek mental health care. Acceptance and commitment therapy (ACT) is an intervention that enhances well-being and reduces distress, assumedly by means of increasing psychological flexibility (PF). We examined the association between a total increase in PF during an intervention and decreases in stress and increases in well-being during and after the intervention. Method: The intervention was a randomized controlled trial of an ACT-based self-help intervention. Participants were 91 individuals reporting elevated levels of work-related stress. Measurements were completed at preintervention, postintervention, and 3-month follow-up. Results: Structural equation models revealed that the total increase in PF during the intervention was negatively associated with a decrease in stress (b = -0.63, SE = 0.14, p < .001) and positively associated with an increase in well-being during the intervention (b = 0.48, SE = 0.11, p < .001), but not with a decrease in stress (b = 0.03, SE = 0.27, p > .05) and well-being (b = -0.04, SE = 0.39, p > .05) following the intervention. Conclusions: Our study provides empirical support for decreasing stress and promoting well-being through ACT and emphasizes the potential of PF in promoting well-being.     

Rumination and depression in Chinese university students: The mediating role of overgeneral autobiographical memory

ObjectiveIn this study, we examined the mediator effects of overgeneral autobiographical memory (OGM) on the relationship between rumination and depression in 323 Chinese university students.Method323 undergraduates completed the questionnaires measuring OGM (Autobiographical Memory Test), rumination (Ruminative Response Scale) and depression (Center for Epidemiologic Studies Depression Scale).ResultsResults using structural equation modeling showed that OGM partially-mediated the relationship between rumination and depression (χ² = 88.61, p < .01; RMSEA = .051; SRMR = .040; and CFI = .91). Bootstrap methods were used to assess the magnitude of the indirect effects. The results of the bootstrap estimation procedure and subsequent analyses indicated that the indirect effects of OGM on the relationship between rumination and depressive symptoms were significant.ConclusionThe results indicated that rumination and depression were partially mediated by OGM.     

Is sensory processing an issue for infants with colic?

ObjectivesTo determine the association between sensory functioning, sleep, cry/fuss, and feeding behaviors of infants with colic younger than 4 months of age.MethodsDunn’s Infant/Toddler Sensory Profile™ and a modified Barr Baby Day Diary^© were used to assess 44 breastfed infants with colic under four months of age. Colic was defined according to Wessel’s criteria.ResultsThirty-four of the 44 infants with colic (77%) scored as atypical for sensory processing. Of these, 56% scored atypical for sensory processing on quadrant one (Q1) (Low Registration), with 24%, 65%, and 18% scoring as atypical for sensory processing on Q2 (Sensory seeking), Q3 (Sensory sensitivity), and Q4 (Sensation avoiding), respectively. All infants demonstrating sensation avoiding also scored as Low Threshold. A moderate statistically significant correlation was found between sensation seeking and time spent sleeping (r = 0.31; p = 0.04). No other statistically significant associations between infant behaviors and their sensory functioning were demonstrated. Overall, infants demonstrating atypical sensory responses (in any quadrant) slept significantly more than infants demonstrating typical sensory responses (mean difference = −67.8 min/day; 95% CI = −133.6 to −2.1; p = 0.04).ConclusionVery limited associations between infant behaviors and sensory functioning were demonstrated, suggesting that sensory functioning may not be a significant factor in the multifactorial nature of infant colic. Further well-designed studies using validated tools for infants with colic are required to determine whether associations between infant behaviors and sensory functioning exist.     

Motivational characteristics of obese adolescents toward physical activity: Contribution of self-determination theory

IntroductionRegular physical activity (PA) practice represents a key component of obesity treatment.ObjectiveBased on self-determination theory (SDT), this cross-sectional study aimed to explore the motivational characteristics associated with PA practice among obese adolescents.MethodOne hundred and five overweight or obese adolescents (mean age = 15 years old, SD = 2.69) were questioned about their level of PA, motivational regulations toward PA and level of satisfaction of basic psychological needs.ResultsData revealed that satisfaction of autonomy and relatedness needs is positively associated with autonomous forms of motivation (e.g., for integrated regulation β = .44; and 0.35, respectively, p < .01). Otherwise, non-satisfaction of the needs of autonomy and competence is associated with the most controlled forms of motivation (e.g., for external regulation β = −.27, p < .01; and −.18, p < .05, respectively). In turn, a high level of identified regulation, a low level of external regulation and a high level of satisfaction of the need for competence are associated with weekly PA (β = .28; −.19 and .24, respectively, p < .05).ConclusionSDT appears as an interesting theoretical framework to explore motivational antecedents of PA among obese adolescents.     

Transdiagnostic and Transcultural: Pilot Study of Unified Protocol for Depressive and Anxiety Disorders in Japan

Unified protocol (UP) is a transdiagnostic cognitive behavior therapy for emotional disorders. It remains unknown whether UP is applicable for use in non-Western countries and for depressive disorders. We therefore examined its feasibility for a Japanese clinical population using this clinical trial design, which is multicentered, open-labeled, and single-armed (Clinical registry: UMIN000008322). The primary outcome was severity of anxiety symptoms, as assessed using Structured Interview Guide for the Hamilton Anxiety Rating Scale. Secondary outcomes were depressive symptoms, clinical global impression, functioning, quality of life, affectivity, emotion regulation, and adverse events. Of the 28 prospective participants, 17 were eligible and enrolled (depressive disorders = 9, anxiety disorders = 8). Severity of anxiety symptoms, which decreased significantly after the intervention, remained low for 3 months (Hedges’ g = 1.29, 95% CI = 0.56–2.06). Similar tendencies were observed for secondary outcome measures. No severe adverse event occurred. Two participants dropped out of the intervention. High treatment adherence and interrater reliability were confirmed. Results suggest the feasibility of UP in the Japanese context sufficient to warrant a larger clinical trial.     

Randomized Controlled Trial of a Family Intervention for Children Bullied by Peers

This study examined the effects of a family intervention on victimization and emotional distress of children bullied by peers. The intervention, Resilience Triple P, combined facilitative parenting and teaching children social and emotional skills relevant to developing strong peer relationships and addressing problems with peers. Facilitative parenting is parenting that supports the development of children’s peer relationship skills. A randomized controlled trial was conducted with 111 families who reported chronic bullying of children aged 6 to 12 years. Families were randomly allocated to either an immediate start to Resilience Triple P (RTP) or an assessment control (AC) condition. Assessments involving children, parents, teachers, and observational measures were conducted at 0 (pre), 3 (post) and 9 months follow-up. RTP families had significantly greater improvements than AC families on measures of victimization, child distress, child peer and family relationships, including teacher reports of overt victimization (d = 0.56), child internalizing feelings (d = 0.59), depressive symptoms (d = 0.56), child overt aggression towards peers (d = 0.51), acceptance by same sex and opposite sex peers (d = 0.46/ 0.60), and child liking school (d = 0.65). Families in both conditions showed significant improvements on most variables over time including child reports of bullying in the last week reducing to a near zero and indistinguishable from the normative sample. The intervention combining facilitative parenting and social and emotional skills training for children produced better results than the comparison assessment control condition. This study demonstrated that family interventions can reduce victimization and distress and strengthen school efforts to address bullying.