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1.
Economic disparities in children’s behavioral functioning have been observed in prior research. Yet, studies have ignored important perspectives from developmental psychopathology and have not delineated how aspects of income dynamics (i.e., cumulative family income versus income volatility) differentially relate to behavior problems. To address these limitations, the current study examined how both cumulative income and income volatility predict trajectories of children’s internalizing and externalizing problems from kindergarten through fifth grade in a nationally representative sample of 10,900 children (51.4 % male). Results showed four distinct trajectories of internalizing problems and five distinct externalizing trajectories. Family income dynamics were related to trajectory group membership. Specifically, increased cumulative income decreased risk of membership in mid-increasing and mid-stable internalizing groups, and children whose families experienced multiple waves of income loss were 2.4 times as likely to be in the mid-increasing group instead of the low-stable group. With respect to externalizing, higher cumulative income increased the likelihood of belonging in the group exhibiting stably low externalizing problems. Experiencing income loss increased the risk of belonging in the trajectory group exhibiting chronically high externalizing behaviors. These results enhance our knowledge of the role of family income in the development of behavior problems.  相似文献   

2.
Background/Objective: Suicide ideation is common in depressed patients. However, no studies to date have examined whether pretreatment suicide ideation is associated with poorer outcomes after cognitive-behavioral therapy for adult depression. Method: 475 depressed outpatients (age: M = 39.9 years, SD = 11.71; 60.2% female) took part in a pre-treatment and a post-treatment assessment. Pre-treatment suicide ideation measured with the BDI suicide item was considered as a predictor of treatment outcomes – controlling for age, gender, number of attended therapy sessions, as well as pre-treatment depression severity. Results: Hierarchical regression revealed that age, gender, number of completed therapy sessions and depression severity at baseline could explain 25% of the variance in post-treatment BDI-scores. Adding suicide ideation significantly improved the amount of variance explained to 27%. Treatment outcomes were worse for patients with more severe depression, suicidal patients, patients receiving more therapy-sessions and older patients. Conclusions: Suicide ideation added only little incremental variance to the prospective prediction of post-treatment depression severity. Depressed patients with suicide ideation can attain almost as good treatment outcomes as patients without suicide ideation, which is a clinically encouraging result.  相似文献   

3.
We examined whether long QT syndrome (LQTS) mutation carrier status or symptomatic LQTS are associated with depression, and whether there are sex differences in these potential relationships. The sample comprised 782 participants (252 men). Of the 369 genetically defined LQTS mutation carriers, 169 were symptomatic and 200 were asymptomatic. The control group consisted of 413 unaffected relatives. Depression was assessed using the Beck Depression Inventory-II (BDI-II). No association was found for LQTS mutation carrier status with depression. The multinomial logistic regression showed that LQTS mutation carrier men with arrhythmic events scored higher on depression compared with the control group, even when adjusting for age, β-blockers, antidepressants, and social support (OR = 1.09, 95 % CI [1.02, 1.15], p = .007). The binary logistic regression comparing symptomatic and asymptomatic LQTS mutation carriers showed that symptomatic LQTS was associated with depression in men (OR = 1.10, 95 % CI [1.03, 1.19], p = .009). The results were unchanged when additionally adjusted for education. These findings suggest that symptomatic LQTS is associated with depression in men but not in women. Overall, however, depression is more frequent in women than men. Thus, regular screening for depression in LQTS mutation carriers and their unaffected family members can be important.  相似文献   

4.
Though subjective wellbeing (SWB) is generally stable and consistent over time, it can fall below its set-point in response to adverse life events. However, deviations from set-point levels are usually only temporary, as homeostatic processes operate to return SWB to its normal state. Given that income and close interpersonal relationships have been proposed as powerful external resources that are coincident with higher SWB, access to these resources may be an important predictor of whether or not a person is likely to recover their SWB following a departure from their set-point. Under the guiding framework of SWB Homeostasis Theory, this study considers whether access to a higher income and a committed partner can predict whether people who score lower than normal for SWB at baseline will return to normal set-point levels of SWB (rebound) or remain below the normal range (resigned) at follow-up. Participants were 733 people (53.3 % female) from the Australian Unity Longitudinal Wellbeing Study who ranged in age from 20 to 92 years (M = 59.65 years; SD = 13.15). Logistic regression analyses revealed that participants’ demographic characteristics were poor predictors of whether they rebounded or resigned. Consistent with homeostasis theory, the extent of departure from the proposed normal SWB set-point at baseline was significantly associated with rebound or resignation at time 2. These findings have implications for the way that SWB measures can be used in professional practice to identify people who are particularly vulnerable to depression and to guide the provision of appropriate and effective therapeutic interventions.  相似文献   

5.
This study examines whether patients self-reported attachment representations and levels of depression and anxiety influenced psychologists’ evaluations of morbidly obese patients applying for bariatric surgery. A sample of 250 patients (mean age 44, 84 % female) who were referred for bariatric surgery completed questionnaires to measure adult attachment and levels of depression and anxiety. Psychologists rated patients’ suitability for bariatric surgery using the Cleveland Clinic Behavioural Rating System (CCBRS), unaware of the results of the completed questionnaires. Attachment anxiety (OR = 2.50, p = .01) and attachment avoidance (OR = 3.13, p = .001) were found to be associated with less positive evaluations on the CCBRS by the psychologists, and symptoms of depression and anxiety mediated this association. This study strongly supports the notion that patients’ attachment representations influence a psychologist’s evaluation in an indirect way by influencing the symptoms of depression and anxiety patients report during an assessment interview. The clinical implications of these findings are discussed.  相似文献   

6.
Rumination is an important cognitive vulnerability for adolescent and adult depression. However, little is known about the aetiological origins of rumination, as well as its association with depression. Adolescent rumination (self-report) and depressive symptoms (self- and parent-report) were assessed in 674 pairs of same-gender Chinese adolescent twins (11–17 years of age). Females accounted for 53.7 % of the sample. There were significant correlations between self-reported rumination and self-reported depression (r?=?0.41), as well as parent-reported adolescent depression (r?=?0.22). Genetic influences were significant and modest on all three measures, ranging from 24 % to 42 %. The three measures were also significantly influenced by shared environment, ranging from 20 % to 28 %, and non-shared environmental factors, ranging from 30 % to 56 %. Moreover, the genetic correlations between rumination and depression were significant (within-rater: r g?=?0.99; cross-rater: r g?=?0.59) and largely accounted for the phenotypic correlations (within-rater: 68 %; cross-rater: 77 %), while non-shared environmental correlations were also significant (within-rater: r e?=?0.26; cross-rater: r e?=?0.12) and accounted for the remainder of the phenotypic correlations (within-rater: 32 %; cross-rater: 23 %). The shared environmental correlations were non-significant. No significant gender and age differences were found in aetiological models. These findings suggest that rumination may be an endophenotype reflecting genetic risk for depression.  相似文献   

7.
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.  相似文献   

8.
Multiple variables are related to missed clinic appointments. However, the prevalence of missed appointments is still high suggesting other factors may play a role. The purpose of this study was to investigate the relationship between missed appointments and multiple variables simultaneously across a health care system, including patient demographics, psychiatric symptoms, cognitive functioning and literacy status. Chart reviews were conducted on 147 consecutive patients who were seen by a primary care psychologist over a six month period and completed measures to determine levels of depression, anxiety, sleep, cognitive functioning and health literacy. Demographic information and rates of missed appointments were also collected from charts. The average rate of missed appointments was 15.38%. In univariate analyses, factors related to higher rates of missed appointments included younger age (p = .03), lower income (p = .05), probable depression (p = .05), sleep difficulty (p = .05) and limited reading ability (p = .003). There were trends for a higher rate of missed appointments for patients identifying as black (p = .06), government insurance (p = .06) and limited math ability (p = .06). In a multivariate model, probable depression (p = .02) and limited reading ability (p = .003) were the only independent predictors. Depression and literacy status may be the most important factors associated with missed appointments. Implications are discussed including regular screening for depression and literacy status as well as interventions that can be utilized to help improve the rate of missed appointments.  相似文献   

9.
Positive thoughts play a significant role in the experience and recovery from depression. The Coping Attitudes Scale (CAS) is a rationally derived measure of positive cognitions. The CAS contains statements reflective of coping attitudes along five domains: life perspective, personal accomplishment, positive future, self-worth, and coping with problems. The current study examined the CAS in psychiatric outpatients and college students. Measures of depression, hopelessness, suicidal ideation and positive attitudes were administered to 82 adult psychiatric outpatients and 156 college students. Depression and hopelessness were strongly, negatively, partially correlated with each of the CAS factors, after controlling for age. Relationships among individual CAS factors and suicidal ideation demonstrated weak to moderate partial associations, after controlling for age. Depression was significantly associated with the coping with problems subscale (R 2 = .530). Hopelessness was significantly related to the positive future subscale (R 2 = .696). Further, the CAS demonstrated a significant relationship with depression and hopelessness, even after accounting for the Automatic Thoughts Questionnaire-Revised, Positive subscale. The CAS may be an improved measure of positive attitudes that could be useful in establishing a patient’s baseline of positive thinking, determining targets for therapy, and in monitoring progress in treatment.  相似文献   

10.
Patients with psoriasis may have increased risk of psychological comorbidities. This cross-sectional study aimed at determining associations between sociocultural and socioeconomic factors with the Depression Anxiety Stress Scale (DASS) scores and the Dermatology Life Quality Index (DLQI) scores. Adult patients with psoriasis were recruited from a Dermatology outpatient clinic via convenience sampling. Interviews were conducted regarding socio-demographic factors and willing subjects were requested to complete the DASS and DLQI questionnaires. The Pearson χ2 test, Fisher’s exact test and multivariate logistic regression were used for statistical analysis to determine independent predictors of depression, anxiety, stress and severe impairment of quality of life. Unadjusted analysis revealed that depression was associated with Indian ethnicity (p = .041) and severe impairment of quality of life was associated with Indian ethnicity (p = .032), higher education (p = .013), higher income (p = .042), and employment status (p = .014). Multivariate analysis revealed that Indian ethnicity was a predictor of depression (p = .024). For stress, tertiary level of education (p = .020) was an independent risk factor while a higher monthly income was a protective factor (p = .042). The ethnic Indians and Malays were significantly more likely than the ethnic Chinese to suffer reduced quality of life (p = .001 and p = .006 respectively) and subjects with tertiary education were more likely to have severe impairment of quality of life (p = .002). Our study was unique in determining sociocultural influences on psychological complications of psoriasis in a South East Asian population. This has provided invaluable insight into factors predictive of adverse effects of psoriasis on psychological distress and quality of life in our patient population. Future studies should devise interventions to specifically target at risk groups in the development of strategies to reduce morbidity associated with psoriasis.  相似文献   

11.
The aim of the present study is to describe how religiosity and spirituality affect the psychiatric morbidity of Muslim intensive care unit (ICU) patients. We conducted a prospective nationwide cross-sectional study of ICU patients discharged from 45 medical centers spanning 31 proivinces in Iran. Adults (age ≥ 18 years) admitted to the ICU and treated with invasive mechanical ventilation were eligible. Nine validated survey tools were administered to detect direct and indirect associations between spiritual health (SH) and depression, anxiety, and post-traumatic disorder. The Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale—Revised (IES-R), Post-Traumatic Stress Syndrome 14 question (PTSS-14) quality-of-life (QoL), and quality of patient to physician or nurse communication (PP-QoC and PN-QoC) scales were modeled through two mediators by structural equation modeling (SEM). Sex, ICU type, LOS, and APACHE II score were added in the independent variable list. 338 eligible patients were discharged from the ICUs during the study period. 56 were excluded (clinical status), and 282 were administered the survey. 278 returned it, with 272 complete and 6 partial responses. SH displayed no direct or indirect association to QoL. SH was indirectly associated with decreased depression and anxiety (B = ? 0.081, p < 0.05) via PP-QoC mediator. Both direct and indirect positive associations were observed between SH and IES-R (B = 0.293, p < 0.05; via PP-QoC) and PTSS-14 scores (B = 0.267, p < 0.001; via PP-QoC). Medical ICU location was associated with decreased PTSS-14 scores via the same mediator. In this survey of Muslim ICU patients treated with invasive mechanical ventilation, SH correlated with decreased depression and anxiety, but paradoxically increased post-traumatic stress. The most influential mediator was patient–physician quality-of-communication.  相似文献   

12.
The transition to secondary school is accompanied by the fragmentation of peer groups, while adolescents are also confronted with heightened incidents of bullying and increased levels of internalizing problems. Victimization, peer rejection, and internalizing problems are known to be interrelated, but how they influence each other over time remains unclear. We tested the direction of these associations by applying a cross-lagged path model among a large sample of Finnish adolescents (N = 5645; 49.1 % boys; M age at T1 = 14.0 years) after they transitioned to secondary school (grades 7–9). Self-reported depression, anxiety, and victimization and peer-reported rejection were measured 3 times over the course of 1 year. Results showed that depression was predictive of subsequent victimization for both boys and girls, in line with a symptoms-driven model; for girls, anxiety was reciprocally related to victimization, in line with a transactional model; for boys, victimization was related to subsequent anxiety, in line with an interpersonal risk model. Peer rejection was not directly related to depression or anxiety, but among girls peer rejection was bi-directionally related to victimization. Overall, our results suggest that associations between internalizing problems and peer relations differ between depression and anxiety and between genders. Implications for practice and directions for future research are discussed.  相似文献   

13.
Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.  相似文献   

14.
The present study aimed to characterize the association of psychopathology with the clinical correlates of epilepsy, asthma, and allergy within and between neurobehavioral syndromes. Participants were consecutively evaluated youth (6–18 years, 75 % male) with autism spectrum disorder (ASD; n = 589) and non-ASD outpatient psychiatry referrals (n = 653). Informants completed a background questionnaire (parents) and a psychiatric symptom severity rating scale (parents, teachers). Youth with ASD had higher rates of epilepsy and allergy but not asthma than psychiatry referrals, even when analyses were limited to youth with IQ ≥ 70. Somatic conditions evidenced variable associations with medical services utilization, educational interventions, family income, and maternal education. Youth with ASD with versus without epilepsy had more severe ASD social deficits (parents’ ratings) and less severe ASD repetitive behaviors (teachers’ ratings). Epilepsy was associated with more severe depression, mania, and schizophrenia symptoms in youth with ASD. Youth with allergy (psychiatry referrals only) had more severe anxiety and depression symptoms (parents’ ratings) but less severe aggression (teachers’ ratings) thus providing evidence of both context- and diagnostic-specificity. Youth with ASD versus non-ASD psychiatry referrals evidence a variable pattern of relations between somatic conditions and a range of clinical correlates, which suggests that the biologic substrates and psychosocial concomitants of neurodevelopmental disorders and their co-occurring somatic conditions may interact to produce unique clinical phenotypes.  相似文献   

15.
The consequences of living in single-parent households on children’s wellbeing are well documented, but less is known about the impact of living in single-mother households among children with high familial risk for depression. Utilizing data from an ongoing three-generation study of high-risk families, this preliminary study examined a sample of 161 grandchildren of probands diagnosed with major depressive disorder, comparing those in single-parent households to those in dual-parent households with household status defined as the full-time presence of a resident male in the home. High-risk children were compared across households in terms of psychiatric diagnoses (measured by Schedule for Affective Disorders and Schizophrenia for School-Age Children; K-SADS-PL) and global functioning (assessed by Global Assessment Scale, child version; C-GAS). Results indicated that high-risk children in single-parent households had 4.7 times greater odds for developing a mood disorder and had significantly lower mean C-GAS scores (p = 0.01) compared to those in dual-parent households. Differences remained significant when controlling for household income, child’s age, and either parent’s depression status. There were no significant differences between high-risk children across households when household status was instead defined as legal marital status. This study has several limitations: sample size was small, probands were recruited from a clinical population, and participants had not passed completely through the period of risk for adult psychiatric disorders. These findings point towards the importance of identifying and closely monitoring children at risk for depression, particularly if they reside in households without a resident father figure.  相似文献   

16.
Health-related quality of life (HRQoL) is a well-established measure of health and general well-being. Socioeconomic status (SES) can affect HRQoL. We sought to determine whether there were differences in HRQoL between low versus higher area-SES flat communities in Singapore. Residents in two integrated public housing precincts comprising of rental-flat blocks (low area-SES neighborhood) and neighboring owner-occupied blocks (higher area-SES neighborhood) were asked to rate their self-perceived HRQoL using the EuroQol Group five dimensions (EQ-5D) instrument. The EQ-5D assesses HRQoL in five domains (mobility, self-care, usual activities, anxiety/mood and pain) and with a global visual analogue scale (EQ-VAS). We evaluated differences in HRQoL between the rental and owner-occupied neighborhoods, and factors associated with anxiety/depression in the rental-flat neighborhood using multivariate logistic regression. The participation rate was 89.1% (634/711). In the owner-occupied neighborhood, 56.7% (216/381) were in full health, compared with 54.2% (137/253) in the rental-flat population (OR = 0.90, 95%CI = 0.66–1.24, p = 0.568). Across the five domains, staying in a rental-flat neighborhood was independently associated with anxiety/depression (adjusted odds ratio [aOR] = 1.79, 95%CI = 1.10–2.92, p = 0.019). In the rental-flat population, having anxiety/depression was independently associated with minority ethnicity, problems with self –care, pain/discomfort, difficulty with healthcare costs, and not being on subsidized primary care (p < 0.05). There was no significant difference on the EQ-VAS between the two neighborhoods (p = 0.627). Staying in a low area-SES neighborhood was associated with more mental health problems. In the rental-flat population, self-reported anxiety/depression was associated with minority ethnicity, physical health problems, and financial disadvantage in healthcare.  相似文献   

17.
Child depression is an impairing condition for which psychotherapies have shown modest effects. Parental depression is a risk factor for development of child depression and might also be negatively associated with child depression treatment outcomes. To explore this possibility, we analyzed data from a study in which children were treated for depression after parental depressive symptoms had been assessed at baseline. Among children treated for depression in a randomized controlled trial, we identified 31 who had child- and parent-report pre- and post-treatment data on child symptoms and parent-report of pre-treatment parental depressive symptoms. Children were aged 8–13, 77% boys, and 52% Caucasian, 13% African-American, 6% Latino, and 29% multi-racial. Analyses focused on differences in trajectories of change (across weekly measurements), and post-treatment symptoms among children whose parents did (n = 12) versus did not (n = 19) have elevated depressive symptoms at baseline. Growth curve analyses showed markedly different trajectories of change for the two groups, by both child-report (p = 0.03) and parent-report (p = 0.03) measures: children of parents with less severe depression showed steep symptom declines, but children of parents with more severe depression showed flat trajectories with little change in symptoms over time. ANCOVAs showed lower post-treatment child symptoms for children of parents with less severe depression versus parents with more severe depression (p = 0.05 by child report, p = 0.01 by parent report). Parental depressive symptoms predict child symptom trajectories and poorer child treatment response, and may need to be addressed in treatment.  相似文献   

18.
We explored associations between natural mentoring relationship profiles and young adults’ life satisfaction and symptoms of depression via participants’ perceived support from important others accounting for participants’ perceived support and mental health prior to the onset of their natural mentoring relationships. Participants included 396 young adults (57 % female; mean age = 30.97, SD = .6), the majority of whom identified as Black or African American (79 % Black, 18 % White, 3 % Biracial). Most participants had completed high school but few participants (13 %) had completed degrees from 4 year institutions. We used a latent profile approach to identify natural mentoring relationship profiles and employed structural equation modeling to test our study hypotheses. Slightly over half of study participants (53 %) reported the presence of a natural mentor in their lives since the age of 14. Results suggest that natural mentoring relationships characterized by high levels of relational closeness and either extended relationship duration or frequent contact may promote improvements in psychological well-being among mentees over time via greater experiences of social support from important others.  相似文献   

19.
The current study is an examination of low income children’s reactive and regulatory temperamental characteristics as predictors of their executive function, with a particular focus on children’s regulatory temperament (i.e., inhibitory control and attentional focusing) as moderators of associations between reactive temperament (i.e., negative emotionality) and executive function. Participants were 291 children (159 boys) ages 37 to 70 months (M = 53.88 months, SD = 6.44 months) enrolled in 17 classrooms within 3 different preschools serving low income children in two Midwestern cities in the United States. Temperament was assessed via parent report during Fall 2014, and executive function were assessed via structured tasks implemented by independent researchers during Spring and Summer 2015. SAS PROC MIXED was used to test hierarchical regression models of children nested within classrooms. After controlling for child age, gender, ethnicity, and parent education, regulatory temperament moderated the association between reactive temperament and executive function. Children’s reactive temperament was inversely associated with their executive function. These findings suggest that understanding children’s regulatory and reactive temperamental characteristics may help to improve their executive functioning in early childhood.  相似文献   

20.
Significant associations of private prayer with mental health have been found, while mechanisms underlying these associations are largely unknown. This cross-sectional online study (N = 325, age 35.74, SD 18.50, 77.5 % females) used path modeling to test if trust-based beliefs (whether, when, and how prayers are answered) mediated the associations of prayer frequency with the Anxiety, Confusion, and Depression Profile of Mood States-Short Form scales. The association of prayer and depression was fully mediated by trust-based beliefs; associations with anxiety and confusion were partially mediated. Further, the interaction of prayer frequency by stress was associated with anxiety.  相似文献   

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