The physical postures of yoga practices may protect against depressive symptoms,even as life stressors increase: a moderation analysis

Yoga contains sub-components related to its physical postures (asana), breathing methods (pranayama), and meditation (dhyana). To test the hypothesis that specific yoga practices are associated with reduced psychological distress, 186 adults completed questionnaires assessing life stressors, symptom severity, and experience with each of these aspects of yoga. Each yoga sub-component was found to be negatively correlated with psychological distress indices. However, differing patterns of relationship to psychological distress symptoms were found for each yoga sub-component. Experience with asana was negatively correlated with global psychological distress (r = ?.21, p < .01), and symptoms of anxiety (r = ?.18, p = .01) and depression (r = ?.17, p = .02). These relationships remained statistically significant after accounting for variance attributable to Social Readjustment Rating Scale scores (GSI: r = ?.19, p = .01; BSI Anxiety: r = ?.16, p = .04; BSI Depression: r = ?.14, p = .05). By contrast, the correlations between other yoga sub-components and symptom subscales became non-significant after accounting for exposure to life stressors. Moreover, stressful life events moderated the predictive relationship between amount of asana experience and depressive symptoms. Asana was not related to depressive symptoms at low levels of life stressors, but became associated at mean (t[182] = ?2.73, p < .01) and high levels (t[182] = ?3.56, p < .001). Findings suggest asana may possess depressive symptom reduction benefits, particularly as life stressors increase. Additional research is needed to differentiate whether asana has an effect on psychological distress, and to better understand potential psychophysiological mechanisms of action.     

Menopausal Symptoms: Is Spirituality Associated with the Severity of Symptoms?

The aim of this study was to explore whether spirituality was associated with menopausal symptoms. Menopausal symptoms, spirituality, health and menopausal status, and socio-demographic variables were assessed in a community sample of 710 peri- and postmenopausal women. A structural model was explored using structural equation modeling. The results evidence spirituality as a significant contributor regarding the severity of most menopausal symptoms. Among others, spirituality had a significant weight in depressive mood (β = ?.414; p < .001), anxiety (β = ?.308; p < .001), cognitive impairment (β = ?.287; p < .001), aches/pain (β = ?.148; p < .001), vasomotor (β = ?.125; p = .005) and sexual symptoms (β = ?.211; p < .001). Some socio-demographic variables, as well as perceived health, also predicted the menopausal symptoms’ severity. Therefore, spirituality can have a positive impact on the menopausal symptoms’ reporting.     

Positive affectivity predicts successful and unsuccessful adaptation to stress

This study examined adaptation to work stress among public school teachers (n = 267). Regression analyses tested whether positive affect predicted successful and unsuccessful adaptation to stress (viz., resilience and burnout, respectively) after controlling for demographic characteristics and work stress. Positive affect was largely correlated with resilience (r = .65, p < .001) and burnout (r = ?.57, p < .001). The regression of resilience showed that positive affect had a direct effect (β = .66, p < .001) and the total model explained 44 % of the variance (R ² Change = 37 %). In the regression of burnout, positive affect also had a direct effect (β = ?.41, p < .001) and the total model explained 52 % of the variance (R ² Change = 14 %). Further analyses found no significant interaction between work stress and positive affect, but revealed that positive affect completely mediated the effect of work stress on resilience. Results provide support for the broaden-and-build theory of positive emotions, particularly the theory’s building and undoing effects.     

Association of Stress Management Skills and Perceived Stress with Physical and Emotional Well-Being Among Advanced Prostrate Cancer Survivors Following Androgen Deprivation Treatment

Advanced prostate cancer (APC) is associated with disruptions that compromise health related quality of life (HRQOL). Treatment often includes androgendeprivation therapy (ADT), which results in a range of side effects (e.g., fatigue, urinary dysfunction) that further impact HRQOL. Despite these challenges, there are limited evaluations of the impact of stress and stress management skills on HRQOL among APC survivors on ADT. This study evaluated relationships among stress, stress management skills, and HRQOL, and it was hypothesized that better stress management skills would relate to greater physical and emotional well-being by mitigating perceived stress levels. Participants (N = 77) were 69.7 years old (SD = 9.8), 18.6 months post-treatment (SD = 17.5), and ethnically diverse (65 % Non-Hispanic White, 13 % Hispanic, 21 % African-American). Measures included the Measure of Current Status for stress management skills, the Perceived Stress Scale for perceived stress, and the Medical Outcomes Study—Short Form (MOS SF-36; physical functioning and emotional well-being subscales) for HRQOL. Direct effects and mediation models were evaluated to determine the relationships between perceived stress, stress management skills, and HRQOL domains, controlling for relevant covariates. Stress management skills and perceived stress were significantly associated with physical functioning (β = .24, p < .05 and β = ?.43, p < .01, respectively) and emotional well-being (β = .35, p < .01 and β = ?.64, p < .01, respectively). Regression analyses supported the hypothesis that reduced perceived stress mediated the relationship between stress management skills and both physical functioning and emotional well-being. These results demonstrate that one way stress management skills may impact HRQOL is by lessening ongoing perceptions of stress.     

A Randomized Trial of Mindfulness-Based Cognitive Therapy for Children: Promoting Mindful Attention to Enhance Social-Emotional Resiliency in Children

Mindfulness-based cognitive therapy for children (MBCT-C) is a manualized group psychotherapy for children ages 9–13 years old, which was developed specifically to increase social-emotional resiliency through the enhancement of mindful attention. Program development is described along with results of the initial randomized controlled trial. We tested the hypotheses that children randomized to participate in MBCT-C would show greater reductions in (a) attention problems, (b) anxiety symptoms, and (c) behavior problems than wait-listed age and gender-matched controls. Participants were boys and girls aged 9–13 (N = 25), mostly from low-income, inner-city households. Twenty-one of 25 children were ethnic minorities. A randomized cross-lagged design provided a wait-listed control group, a second trial of MBCT-C, and a 3-month follow-up of children who completed the first trial. Measures included the Child Behavior Checklist, State-Trait Anxiety Inventory for Children, and Multidimensional Anxiety Scale for Children. Participants who completed the program showed fewer attention problems than wait-listed controls and those improvements were maintained at three months following the intervention [F (1, 1, 18) = 5.965, p = .025, Cohen’s d = .42]. A strong relationship was found between attention problems and behavior problems (r = .678, p < .01). Reductions in attention problems accounted for 46% of the variance of changes in behavior problems, although attention changes proved to be a non-significant mediator of behavior problems (p = .053). Significant reductions in anxiety symptoms and behavior problems were found for those children who reported clinically elevated levels of anxiety at pretest (n = 6). Results show that MBCT-C is a promising intervention for attention and behavior problems, and may reduce childhood anxiety symptoms.     

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.     

Is the Association of ADHD with Socio-Economic Disadvantage Explained by Child Comorbid Externalizing Problems or Parent ADHD?

It has been unclear whether an associations of child ADHD with socio-economic disadvantage (SES) could be accounted for by (a) parental ADHD explaining both low SES and child ADHD, and/or (b) the joint overlap of ODD or CD with low SES and ADHD. Study 1 used a community-recruited case-control sample with detailed evaluation of SES indicators, child ADHD, child externalizing, and parent ADHD symptoms (n = 931 children, 521 ADHD, 577 boys, 354 girls) in a path modeling analysis with latent variables. Study 2 evaluated ADHD and externalizing behavior in a regression model using a poverty index for SES, in 70,927 children (48.2% female) aged 5–17 years from the US 2011–2012 National Survey of Children’s Health (NSCH). In Study 1, lower SES was related to the ADHD latent variable, β = ?.18, p < .001; 95%CI [?.25,-.12]. This effect held when parent ADHD and child ODD and CD were in the model, β = ?.11, p < .01, 95% CI [?.09,-.03], equivalent to OR = 1.50, 95% CI[1.12–2.04]). In Study 2, these results replicated. Adjusting only for age and sex, children from families who were below 200% of the federal poverty line were more likely to have moderate or severe ADHD than no ADHD, versus children above that line, OR = 2.13, 95% CI[1.79,2.54], p < .001. The effect held after adjusting for disruptive/externalizing problems, OR = 1.61, p < .01, 95%CI [1.32,1.96]. The effect size for comparable models was similar across both studies, lending higher confidence to the results. It is concluded that the SES association with child ADHD is not explained by artifact and requires a mechanistic explanation.     

Sleep Problems and Separation Anxiety in Preschool-Aged Children: A Path Analysis

Sleep problems occur frequently in young children, possibly causing detrimental effects on their development. Parental marital difficulties are known to put a burden on children’s sleep and adjustment. However, research concerning the relation between the parental relationship quality and children’s sleep difficulties is rare for preschool-aged children. This study aims to fill in the gap. Initially, caregivers of 94 preschoolers (41 girls and 53 boys, aged 2–6 years) filled in questionnaires providing information on their children’s sleep and anxiety as well as on their own sleep and relationship quality. A path model approach was used to examine two competing theoretical models linking these factors. The conducted path analysis indicated that children’s separation anxiety, β = ?.134, p = .017, as well as their anxiety in general, β = ?.177, p = .024, partially mediated the relation between the parental relationship quality and children’s sleep problems. Parental sleep problems correlated with the relationship quality, r = ?.371, p = .030, but had no significant influence on children’s sleep. The results of our study suggest that children growing up with parents who state a low relationship quality might thus be concerned about the stability of their family system. As a result children’s sleep quality might be compromised due to irritation and feelings of insecurity. The study highlights the importance of the parental relationship as an influence factor in children’s sleep quality.     

Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: a cross-sectional study

Hematological cancer patients experience high levels of psychological distress during diagnoses and intensive treatments. The aim of the present study is to explore the effects of positive psychological resources on depressive and anxiety symptoms in hematological cancer patients. This survey was conducted in a hospital during the period from July 2013 to April 2014. A total of 300 inpatients were recruited and finally 227 of them completed the questionnaires. Questionnaires included demographic and clinical variables, the Center for Epidemiologic Studies Depression Scale, the Self-Rating Anxiety Scale, the Life Orientation Scale-Revised, the General Perceived Self-Efficacy Scale, and the Resilience Scale-14. Results showed that the prevalence of depressive and anxiety symptoms was 66.1 and 45.8%, respectively. Both optimism (β = ?.479, p < .001) and resilience (β = ?.174, p < .05) were negatively associated with depressive symptoms, and optimism (β = ?.393, p < .001) was negatively associated with anxiety symptoms. However, resilience (β = ?.133, p > .05) was not significantly associated with anxiety symptoms, and self-efficacy was not significantly associated with depressive (β = ?.032, p > .05) or anxiety symptoms (β = ?.055, p > .05). The results suggest that hematological cancer patients who possess high levels of positive psychological resources may have fewer symptoms of psychological distress. The findings indicate that enhancing positive psychological resources can be considered in developing intervention strategies for decreasing depressive and anxiety symptoms.     

Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design

Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient?Cprovider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = ?.636, p < .01) and physician depersonalization (r = ?.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients?? satisfaction occurred at the physician level, after adjustment for patients?? characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.     

Monitoring stress among internal medicine residents: an experience-driven,practical and short measure

Residents experience severely high levels of stress, depression and burnout, leading to perceived medical errors, as well as to symptoms of impairment, such as chronic anger, cognitive impairment, suicidal behavior and substance abuse. Because research has not yet provided a psychometrically robust population-specific tool to measure the level of stress of medicine residents, we aimed at building and validating such a measure. Using an inductive scale development approach, a short, pragmatic measure was built, based on the interviews of 17 medicine residents. The Internal Medicine Residency Stress Scale (IMRSS) was then administered in a sample of 259 internal medicine residents (199 females, 60 males, M_Age = 25.6) along with the Hospital Anxiety and Depression Scale, Maslach Burnout Inventory, Satisfaction With Life Scale and Ways of Coping Checklist. The IMRSS showed satisfactory internal reliability (Cronbach’s α = .86), adequate structural validity – studied through Confirmatory Factor Analysis (χ²/df = 2.51, CFI = .94; SRMR = .037, RMSEA = .076) – and good criterion validity – the IMRSS was notably strongly correlated with emotional exhaustion (r = .64; p < .001) and anxiety (r = .57; p < .001). Because of its short length and robust psychometric qualities, the use of the IMRSS is recommended to quickly and frequently assess and monitor stress among internal medicine residents.     

The Role of Spiritual Experiences and Activities in the Relationship Between Chronic Illness and Psychological Well-Being

Our research explores the correlates of spiritual experiences over a 2-year period in a sample of older adults (N = 164; mean age 81.9 years) living in a continuing care retirement community. Utilizing responses to the Daily Spiritual Experiences Scale, scores were analyzed for changes over time and for their hypothesized moderating effect in the relationship between chronic illness impact and markers of psychological well-being (as measured by the Geriatric Depression and Life Satisfaction scales). Repeated measures ANOVA indicated a significant decline (P < .01) in the reported spiritual experiences over a 2-year period of time, and t tests showed a significant difference by gender (P < .01) in years 1 and 2, with women reporting higher levels of spiritual experiences than men. Analyses found low spirituality scores associated with low life satisfaction in all years (baseline: r = ?.288, P < .01; year 1: r = ?.209, P < .05; year 2: r = ?.330, P < .001). Only weak associations were detected between low spirituality and the presence of depressive symptoms at baseline (r = .186, P < .05) and year 2 (r = .254, P < .01). Moderation effects of spirituality on the relationship between chronic illness impact and markers of psychological well-being were explored in all years, with a statistically significant effect found only for the presence of depressive symptoms in year 2. Higher impact of chronic illnesses is associated with more depressive symptoms under conditions of low spirituality. Future research may center upon longer-duration evaluation of reliance upon spiritual practices and their impact in care management models.     

Examination of the Association Among Personality Traits,Anxiety Sensitivity,and Cannabis Use Motives in a Community Sample

Personality factors, such as neuroticism, are important for understanding motives for cannabis use; however, few studies have examined the role of neuroticism in the context of other personality factors, or possible mechanisms accounting for an association between neuroticism and motives for use. The present study examined concurrent associations between personality traits (i.e., conscientiousness, extraversion, agreeableness, and neuroticism) and cannabis use motives, and the role of anxiety sensitivity (AS) in the association between neuroticism and coping cannabis use motives. Seventy young adults endorsing past-month cannabis use (58.6 % female, M _age = 20.91) completed self-report measures. Linear regressions were conducted to examine the concurrent associations between personality factors and cannabis use motives. Higher levels of neuroticism, but no other personality traits, were significantly associated with greater coping (β = 45, p < .01) and expansion (β = 0.29, p = <.05) motives. Bootstrap analysis (10,000 re-samples) revealed that a significant portion of the relationship between neuroticism and coping motives was explained by AS (point estimate = 0.029, PB 95 % CI: 0.0089 to 0.0615). Greater neuroticism may result in heightened sensitivity to arousal, which may then increase motivation to use cannabis to alleviate such arousal.     

Does Symptom Type Moderate the Relationship Between Insight and Outcome in Cognitive Behavioral Therapy for Psychosis? A Preliminary Investigation

Insight has emerged as a potential predictor variable in cognitive behavioral therapy for psychosis (CBTp). However, previous research has produced mixed results. The present study aimed to clarify whether symptom type is a moderating variable. A group of psychotic patients (n = 44) were assessed through pre- and post-treatment in a CBTp specialty track in a partial hospital-based program in the USA. The Insight Scale was used to measure insight, and psychotic symptomatology was assessed using the Mini-International Neuropsychiatric Interview and the Behavior and Symptom Identification Scale. Patients showed a significant decrease in psychotic symptom scores over the course of treatment [t(43) = 3.59, p < .001, Cohen's d = .64]. Furthermore, illness awareness was specifically associated with a decrease in psychotic symptoms for patients who endorsed visual hallucinations (r = ? .68, p < .01), auditory hallucinations (r = ? .49, p = .01), and/or ideas of reference (r = ? .66, p < .01). Insight did not confer additional benefit for patients with paranoid delusions, mind reading, or thought insertion symptoms. These results are discussed in relation to treatment implications within the current US health care delivery system.     

Stress-Related Growth in Japanese Adolescents Experiencing High School Entrance Examinations

High school entrance examinations and preparation for them have become a highly stressful experience for many Japanese adolescents. This study examined the relationship between stress-related growth (SRG) and distress resulting from these exams from the perspective of positive meaning-making. Ninth graders (N = 183, 87 females, aged 14–15 years) of a public school in Tokyo participated in the study by responding to a questionnaire survey. Results indicated that meaning-making was positively correlated with SRG (r = .58, p < .001), whereas it was negatively correlated with distress (r = ?.20, p = .006). Moreover, SRG was negatively correlated with distress (r = ?.34, p < .001). Mediation analysis demonstrated that SRG positively mediates the relationship between meaning-making and distress, while distress negatively mediates the relationship between meaning-making and SRG. These results have implications for understanding the causal relationships between SRG and distress, from the perspective of positive meaning-making regarding high school entrance examinations in Japan.     

Preliminary Validity of the Eyberg Child Behavior Inventory With Filipino Immigrant Parents

Filipinos are an understudied minority affected by significant behavioral health disparities. We evaluate evidence for the reliability, construct validity, and convergent validity of the Eyberg Child Behavior Inventory (ECBI) in 6- to 12-year-old Filipino children (N = 23). ECBI scores demonstrated high internal consistency, supporting a single-factor model (preintervention α = .91; postintervention α = .95). Results document convergent validity with the Child Behavior Checklist Externalizing scale at pretest (r = .54, p < .01) and posttest (r = .71, p < .001). We conclude that the ECBI is a promising tool to measure behavior problems in Filipino children.     

Maternal stress and behavioral adaptation in methadone- or buprenorphine-exposed toddlers

The current study examined the relationship between early interaction, parenting stress, maternal psychological distress symptoms, and behavior problems and health-related quality of life among children born to mothers in opioid maintenance treatment (OMT) in Norway during the period 2005–2007 (N = 36). This group was compared with a normative sample of mothers without substance abuse problems and their children (N = 36). There were significant group differences (p < .01) in perceived child problems in toddlerhood. In a regression model, mothers’ self-reported psychological distress symptoms in terms of depression and anxiety symptoms significantly predicted child behavior problems (p < .01) and health-related quality of life (p < .01) rather than parenting stress. No significant, unique effect of exposure was found after controlling for other factors that could influence developmental outcomes. These findings add to the growing evidence on the importance of maternal psychological well-being for child development, and underscore the need to address opioid-maintained women's personal maladjustment and the constellation of stress experienced by mothers in recovery.     

The relationships of change in work climate with changes in burnout and depression: a 2-year longitudinal study of Chinese mental health care workers

Mental health care workers face heavy emotional demand and are prone to work burnout. Work burnout has been associated with poor mental health and work climate, which refers to individual perceptions about work setting. The purpose of this study was to examine whether intra-individual changes in work climate were associated with intra-individual changes in burnout and depression over two years. The present sample included Chinese mental health care workers (N = 312; mean age = 38.6, SD = 9.9) working in a psychosocial rehabilitation institution. The participants completed questionnaires on work climate, work burnout and depression at seven time points across two years. Parallel process latent growth modeling was used to analyze the associations of change between work climate and burnout and depression. Work climate displayed a logarithmic decreasing trend while burnout and depression displayed logarithmic increasing trends over two years. Baseline levels of work climate were negatively and moderately associated with baseline levels of burnout and depression (r = ?.44 to ?.60, p < .01). Changes in work climate were negatively and moderately associated with change in burnout (r = ?.43, p < .01) and change in depression (r = ?.31, p < .05). Change in burnout was positively and strongly associated (r = .58, p < .01) with change in depression. The current results support temporal relationships among changes in work climate, burnout and depression across time. Practical implications for future preventive work in burnout interventions were discussed within this population.     

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.     

The Relationship Between Parent and Child Dysfunctional Beliefs About Sleep and Child Sleep

Cognitive theories emphasise the role of dysfunctional beliefs about sleep in the development and maintenance of sleep-related problems (SRPs). The present research examines how parents’ dysfunctional beliefs about children’s sleep and child dysfunctional beliefs about sleep are related to each other and to children’s subjective and objective sleep. Participants were 45 children aged 11–12 years and their parents. Self-report measures of dysfunctional beliefs about sleep and child sleep were completed by children, mothers and fathers. Objective measures of child sleep were taken using actigraphy. The results showed that child dysfunctional beliefs about sleep were correlated with father (r = 0.43, p < 0.05) and mother (r = 0.43, p < 0.05) reported child SRPs, and with Sleep Onset Latency (r = 0.34, p < 0.05). Maternal dysfunctional beliefs about child sleep were related to child SRPs as reported by mothers (r = 0.44, p < 0.05), and to child dysfunctional beliefs about sleep (r = 0.37, p < 0.05). Some initial evidence was found for a mediation pathway in which child dyfunctional beliefs mediate the relationship between parent dysfunctional beliefs and child sleep. The results support the cognitive model of SRPs and contribute to the literature by providing the first evidence of familial aggregation of dysfunctional beliefs about sleep.