Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study

With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.     

Self-Competence and Depressive Symptom Trajectories during Adolescence

The purpose of this study was to examine the relationship between self-competence and subsequent depressive symptom trajectories, by gender, in a community sample of adolescents (N = 753; 53% female; 65% non-Hispanic White). Data were collected annually for three years beginning when adolescents were in the 10th and 11th grades (Age: M = 16.09, SD = 0.72 years). Adolescents provided self-reports of self-competence at baseline and depressive symptoms every year. In latent growth curve models examining the overall trajectory of depressive symptoms, higher global self-worth and self-competence in close friendships were significantly associated with greater decreases in depressive symptoms (ps < 0.05). In contrast, higher academic self-competence was associated with more attenuated decreases in depressive symptoms (p = 0.001). When examining subgroups of latent depressive symptom trajectories within the context of growth mixture modeling, higher self-competence in physical appearance was associated with a decreased likelihood of membership in trajectory classes characterized by high initial, then decreasing depressive symptoms or and low initial, then increasing depressive symptoms (ps < 0.01). Among girls, higher global self-worth and self-competence in close friendship and academic domains were associated with membership in a trajectory class distinguished by high stable depressive symptoms (ps < 0.01); these associations were not observed among boys (ps > 0.05). Findings suggest that the competence-based model of depression is valid and applicable during middle-to-late adolescence, and emphasize the importance of considering gender and individual differences in the developmental course of depressive symptoms to gain a more nuanced understanding of the role of self-competence in depressive symptom trajectories.     

Biased attention and dysphoria: Manipulating selective attention reduces subsequent depressive symptoms

Selective attention for dysphoric stimuli has been observed in individuals with depression and those at risk for depression. To date, no studies have investigated the effects of directly manipulating selective attention for dysphoric stimuli on depressive symptoms. Mild to moderately depressed college students (N=34) were randomly assigned to complete 4 sessions of either attention training (AT) or no training (NT) during a two-week period. Participants completed self-reported assessments of depressive symptoms at baseline, post-training, and follow-up. Participants in the AT condition had a significantly greater decrease in depressive symptoms from baseline to follow-up than participants in the NT condition. This group difference was mediated by change in attention bias. Our findings suggest that biased attention may have a causal role in the maintenance of depressive symptoms.     

Happiness vs. mindfulness exercises for individuals vulnerable to depression

An online ‘positivity’ exercise involving the practice of discrete positive emotions was pitted against a mindfulness meditation exercise and an active placebo control. The effects of positivity and meditation were examined in relationship to personality variables known to entail vulnerability to depression. Participants (N = 741) were randomly assigned to the positivity, mindfulness, or control condition. They completed their exercise for three weeks and were assessed on measures of subjective well-being at baseline, post-test, and one, and two months later. Results indicated that all groups showed significant decreases in depressive symptoms from baseline to two months. The positivity exercise uniquely predicted increases in meaning, pleasure, engagement, and satisfaction in life across follow-ups. Dependent individuals responded favorably to the positivity intervention in the short run, but worsened in the long run for pleasure-related happiness. Self-criticism was associated with significantly greater gains in life satisfaction following exercise completion.     

Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis

This meta-analysis summarizes the findings of outcome research on the degree to which telehealth treatments reduce posttraumatic stress disorder (PTSD)-related symptoms. In a search of the literature, 13 studies were identified for inclusion in the meta-analysis and were coded for relevant variables. A total of 725 participants were included. Results indicate that telehealth treatments are associated with significant pre- to postreduction in PTSD symptoms (d = 0.99, 95% confidence interval [CI]: 0.87–1.11, p < .001), and result in superior treatment effects relative to a wait-list comparison condition (d = 1.01, 95% CI: 0.76–1.26, p < .001). However, no significant findings were obtained for telehealth intervention relative to a supportive counseling telehealth comparison condition (d = 0.11, 95% CI: ? 0.38 to 0.60, p = .67), and telehealth intervention produced an inferior outcome relative to a face-to-face intervention (d = ? 0.68, 95% CI: ? 0.39 to ? 0.98, p < .001). Findings for depression symptom severity outcome were generally consistent with those for PTSD outcome. Telehealth interventions produced a significant within-group effect size (d = 0.98, 95% CI: 0.86 to 1.10, p < .001) and superior effect relative to wait-list comparison condition (d = 0.80, 95% CI: 0.56–1.05, p < .001). Relative to face-to-face interventions, telehealth treatments produced comparable depression outcome effects (d = 0.13, 95% CI: ? 0.55 to 0.28, p = .53). Taken together, these findings support the use of telehealth treatments for individuals with PTSD-related symptoms.     

The Effect of Holy Qur’an Recitation on Depressive Symptoms in Hemodialysis Patients: A Randomized Clinical Trial

Patients with advanced renal failure often face considerable sociopsychological stress as a result of lifestyle changes due to the disease and its treatment. The aim of the present study is to examine the effect of the Holy Qur’an recitation on depressive symptoms in hemodialysis patients. In this clinical trial, 54 hemodialysis patients were randomized to either an experimental (n = 27) or a control (n = 27) group. Patients completed the Beck Depression Inventory-II (BDI-II) at baseline and at 1 month after the intervention. Participants in the experimental group listened to recitation of the Holy Qur’an, while those in the control group received no intervention. The mean BDI-II score at baseline was 33.6 (±6.7) for the experimental group and 29.3 (±9.0) for the control group; at the end of treatment, BDI-II scores in the experimental and control groups were 14.5 (±4.8) and 31.6 (±9.2), respectively. Results from the repeated-measures general linear model controlling for baseline differences indicated a significant treatment effect (F = 9.30, p = 0.004, Cohen’s d = 0.85). Holy Qur’an recitation has a significant effect on lowering depressive symptoms in hemodialysis patients. Holy Qur’an recitation is an easy-to-implement and cost-effective strategy that may be used to supplement the treatment of depression in this setting in Iran.

     

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.     

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.     

SHS-Related Pediatric Sick Visits are Linked to Maternal Depressive Symptoms Among Low-Income African American Smokers: Opportunity for Intervention in Pediatrics

Maternal smoking and depressive symptoms are independently linked to poor child health outcomes. However, little is known about factors that may predict maternal depressive symptoms among low-income, African American maternal smokers—an understudied population with children known to have increased morbidity and mortality risks. The objective of this study was to test the hypothesis that secondhand smoke exposure (SHSe)-related pediatric sick visits are associated with significant maternal depressive symptoms among low-income, African American maternal smokers in the context of other depression-related factors. Prior to randomization in a behavioral counseling trial to reduce child SHSe, 307 maternal smokers in Philadelphia completed the Center for Epidemiologic Studies Depression (CES-D) and questionnaires measuring stressful events, nicotine dependence, social support, child health and demographics. CES-D was dichotomized at the clinical cutoff to differentiate mothers with significant versus low depressive symptoms. Results from direct entry logistic regression demonstrated that maternal smokers reporting more than one SHSe-related sick visit (OR 1.38, p < .001), greater perceived life stress (OR 1.05, p < .001) and less social support (OR 0.82, p < .001) within the last 3 months were more likely to report significant depressive symptoms than mothers with fewer clinic visits, less stress, and greater social support. These results suggest opportunities for future hypothesis-driven evaluation, and exploration of intervention strategies in pediatric primary care. Maternal depression, smoking and child illness may present as a reciprocally-determined phenomenon that points to the potential utility of treating one chronic maternal condition to facilitate change in the other chronic condition, regardless of which primary presenting problem is addressed. Future longitudinal research could attempt to confirm this hypothesis.     

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.     

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.     

Well-Being and Generalized Anxiety in Japanese Undergraduates: A Prospective Cohort Study

Psychological well-being is thought to protect against common mental health problems. This study investigated the buffering effects of psychological well-being on the relationships between cognitive vulnerabilities (fear of anxiety and negative beliefs about worry) and GAD symptoms among 297 Japanese undergraduates (female = 62%, age = 18.91 ± 1.61) in a two-wave prospective cohort study. Participants completed the Generalized Anxiety Disorder Questionnaire for DSM-IV, Center for Epidemiologic Studies Depression Scale, anxiety control subscale of Affective Control Scale, negative belief about worry subscale of Meta-Cognitions Questionnaire, and Nishida’s psychological well-being scale. A moderated regression analysis tested the buffering effect of psychological well-being sub-dimensions on the relationship between cognitive vulnerabilities and generalized anxiety symptoms. Fear of anxiety (β = 0.16, p < 0.01) and negative beliefs about worry (β = 0.16, p < 0.01) at baseline predicted generalized anxiety at follow-up, after controlling for baseline symptoms, and three interaction terms significantly predicted generalized anxiety symptoms. Purpose in life and autonomy buffered the negative relationship between cognitive vulnerabilities and generalized anxiety symptoms. Contrary to the hypothesized relationship, positive relationships with others at baseline facilitated a positive relationship between fear of anxiety and generalized anxiety symptoms. Those results suggested that enhanced Purpose in life and Autonomy dimension of Psychological well-being may be useful in preventing GAD, while the enhanced positive relationship with others dimension of Psychological well-being may facilitate generalized anxiety, as a function of fear of anxiety. In a primary prevention setting, it may be useful to consider the dimensions of Psychological well-being.     

Efficacy of an adaptation of the Best Possible Self intervention implemented through positive technology: a randomized control trial

Best possible Self (BPS) is a positive psychological intervention based on positive future thinking. It has been shown to be effective in improving well-being and depressive symptoms over short periods of time. Positive technology is a scientific approach designed to increase well-being through Information and Communication Technologies. To assess the efficacy of the BPS implemented through a positive technology application in improving optimistic thinking, affect and depressive symptoms, during a one-month period, with two follow-ups one and three months later. Randomized, single-blind control trial. Central randomization was performed by an independent researcher using computer software to generate lists allocating participants to treatments. Recruitment was carried out through advertisements at two universities. Randomized participants were 78 young adults who were assigned to the e-BPS condition (n = 38) or to a control group (n = 40). Participants were asked to visualize their BPS each day using a Positive Technology Application. The Control condition consisted of thinking and writing about daily activities, also through technologies. Affect, future expectations, and depressive symptoms were measured in different time frames. 78 participants were analyzed using intention-to-treat analyses. Results showed that BPS was effective in improving future expectations measures and reducing depressive symptoms until the post-training. However, these effects were not maintained in the three-month follow-up period. This study indicates that BPS can be effectively adapted for implementation through positive technologies. Factors such as the variety of exercises and the instructions can play a role in maintaining the changes in the long term. Trial registration clinicaltrails.gov Identifier: NCT02321605.     

Predictors of psychological outcomes in a longitudinal study of Latina breast cancer survivors

Objective: This study sought to investigate the unique contributions of socio-ecological, cultural and cancer treatment-related factors in predicting depressive symptoms and cancer-specific distress among Latinas. Design: Participants were 140 English or Spanish-speaking Latinas (M_age = 50.6) with non-metastatic breast cancer who were assessed within two years of diagnosis (Time 1) and three months later (Time 2).

Main Measures: Hierarchical regression analyses identified predictors of depressive symptoms and cancer-specific distress at Time 1 and 2.

Results: Most women scored above the clinical cut-offs for depressive symptoms and cancer-specific distress. After adjusting for socio-ecological factors, greater Latino enculturation, measured by Latino ethnic identity, was significantly associated with greater cancer-specific distress at Time 1 (β = .20, p < .05). A significant interaction (p < .01) revealed that among women high on Latino identity, lower English language use was associated with more cancer-specific distress than higher English language use. After adjusting for socio-ecological factors, greater satisfaction with surgical treatment predicted improved depressive symptoms and cancer-specific distress across time (β_s range from ?.31 to ?.18, p_s < .01).

Conclusions: Findings elucidate the complex relationship between culture and psychological outcomes in the breast cancer context and suggest that treatment satisfaction might be an important intervention target for Latinas.     

Randomized single-blind multicenter trial comparing the effects of standard and augmented acupuncture protocols on sleep quality and depressive symptoms in patients with depression

The study was aimed to compare the effects of standard and augmented acupuncture on depressive symptoms and sleep disturbances in patients with depression. This is a randomized, single-blind, multicenter trial. 140 subjects with clinical insomnia (score of ≥ 7 on the Pittsburgh Sleep Quality Index (PSQI)) were randomized to the standard (LI4, LIV3, EX-HN3, and GV20) or augmented (LI4, LIV3, EX-HN3, GV20, LU7, and KID6, including intradermal needles for sustained treatment) acupuncture groups. Participants received two sessions weekly for six weeks. In trial, The primary outcomes were improvements in PSQI and the Hamilton Rating Scale (HAMD). Secondary outcomes were treatment credibility and adverse events. Outcomes were assessed at baseline, week 3, end of treatment, and 4-week follow-up. From the 105 randomized patients, 89 completed the trial and were included in the final analyses. Better efficacy was observed in the augmented group compared with the standard acupuncture to improve the PSQI and HAMD at week 3, end of treatment, and 4-week follow-up (all p < .05). The HAMD scores improved with time, except between end of treatment and 4-week follow-up, while in the standard group, HAMD scored improved from baseline to week 3, and stopped improving thereafter. The PSQI scores improved with time in the two groups, except between end of treatment and 4-week follow-up. Compared with the standard protocol, the augmented acupuncture protocol had a better efficacy to treat depression and to improve sleep quality of patients with depression.     

Standardized Web-Based Cognitive Behavioural Therapy of Mild to Moderate Depression: A Randomized Controlled Trial with a Long-Term Follow-Up

Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment (web-CBT) of mild to moderate depression. Fifty-four individuals with chronic, moderate depression participated in a randomized wait-list controlled trial, with an 18-month follow-up (immediate treatment: n = 36, wait-list control: n = 18). Primary outcome measures were the Beck Depression Inventory (BDI-IA) and the Depression scale of the Symptom Checklist-90-Revised (SCL-90-R. DEP). Secondary outcome measures were the Depression Anxiety Stress Scales and the Well-Being Questionnaire. Five participants (9%) dropped out. Intention-to-treat analyses of covariance revealed that participants in the treatment condition improved significantly more than those in the wait-list control condition (.011 < p < .015). With regard to the primary measures, between-group effects (d) were 0.7 for the BDI-IA and 1.1 for the SCL-90-R DEP. Posttest SCL-90- R DEP scores indicated recovery of 49% of the participants in the treatment group compared with 6% in the control group (odds ratio = 14.5; p < .004). On average, the effects were stable up to 18 months (n = 39), although medication was a strong predictor of relapse. The results demonstrate the efficacy of web-CBT for mild to moderate depression and the importance of therapist guidance in psychological interventions.     

The effects of anxiety and depression on in vitro fertilisation outcomes of infertile Chinese women

The object was to assess anxiety and depression during in vitro fertilisation (IVF) treatment and determine IVF-related psychological factors in infertile Chinese women. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate anxiety and depression among 842 patients, respectively. A univariate analysis was used to compare variables among three SAS groups and three SDS groups. Anxiety and depression were both represented in 21.3% of the cases. Patients <35 years tended to be more anxious. In women <35 years, the SDS scores were higher with lower educational backgrounds and female or couple’s infertility, while the SAS scores were higher in female or couple’s infertility. In older ones, the SDS scores were higher in those with lower educational backgrounds and longer time for infertility, while the SAS scores were higher in those with lower educational backgrounds. In SAS groups 1–3, the embryo availability was 5.0 (3.0–8.0), 5.0 (3.0–8.0), and 3.0 (2.0–4.5) (p = .013); and the fertilisation rate was 91.9, 90.4, and 81.8% (p < .001), respectively. We concluded that infertile women experience anxiety and depression during IVF treatment, especially in women <35 years. Younger women with female infertility would be more anxious and depressive while higher education can protect them from depression. In older ones, they would experience more depressive with longer time for infertility and be less anxious and depressive with higher education. Anxiety affects the fertilisation rate and embryo availability.     

Acute Stress,Depression, and Anxiety Symptoms Among English and Spanish Speaking Children with Recent Trauma Exposure

A growing literature suggests the clinical importance of acute stress disorder symptoms in youth following potentially traumatic events. A multisite sample of English and Spanish speaking children and adolescents (N = 479) between the ages of 8–17, along with their caregivers completed interviews and self-report questionnaires between 2 days and 1 month following the event. The results indicate that children with greater total acute stress symptoms reported greater depressive (r = .41, p < .01) and anxiety symptoms (r = .53, p < .01). Examining specific acute stress subscales, reexperiencing was correlated with anxiety (r = .47, p < .01) and arousal was correlated with depression (r = .50, p < .01) and anxiety (r = .55, p < .01). Age was inversely associated with total acute stress symptoms (r = ?.24, p < .01), reexperiencing (r = ?.17, p < .01), avoidance (r = ?.27, p < .01), and arousal (r = ?.19, p < .01) and gender was related to total anxiety symptoms (Spearman’s ρ = .17, p < .01). The current study supports the importance of screening acute stress symptoms and other mental health outcomes following a potentially traumatic event in children and adolescents. Early screening may enable clinicians to identify and acutely intervene to support children’s psychological and physical recovery.     

Parental Depressive Symptoms as a Predictor of Outcome in the Treatment of Child Depression

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.     

Wealth differentials in the impact of conditional and unconditional cash transfers on education: findings from a community-randomised controlled trial in Zimbabwe

We investigated (1) how household wealth affected the relationship between conditional cash transfers (CCT) and unconditional cash transfers (UCT) and school attendance, (2) whether CCT and UCT affected educational outcomes (repeating a year of school), (3) if baseline school attendance and transfer conditions affected how much of the transfers participants spent on education and (4) if CCT or UCT reduced child labour in recipient households. Data were analysed from a cluster-randomized controlled trial of CCT and UCT in 4043 households from 2009 to 2010. Recipient households received $18 dollars per month plus $4 per child. CCT were conditioned on above 80% school attendance, a full vaccination record and a birth certificate. In the poorest quintile, the odds ratio of above 80% school attendance at follow-up for those with below 80% school attendance at baseline was 1.06 (p = .67) for UCT vs. CCT. UCT recipients reported spending slightly more (46.1% (45.4–46.7)) of the transfer on school expenses than did CCT recipients (44.8% (44.1–45.5)). Amongst those with baseline school attendance of below 80%, there was no statistically significant difference between CCT and UCT participants in the proportion of the transfer spent on school expenses (p = .63). Amongst those with above 80% baseline school attendance, CCT participants spent 3.5% less (p = .001) on school expenses than UCT participants. UCT participants were no less likely than those in the control group to repeat a grade of school. CCT participants had .69 (.60–.79) lower odds vs. control of repeating the previous school grade. Children in CCT recipient households spent an average of .31 fewer hours in paid work than those in the control group (p < .001) and children in the UCT arm spent an average of .15 fewer hours in paid work each week than those in the control arm (p = .06).