Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy

The aim of the present study was to investigate the role of several psychosocial risk factors in predicting depressive symptomatology during pregnancy in mothers and fathers, respectively. A total of 146 primiparous mothers and 105 primiparous fathers reporting a psychosocial risk condition were recruited independently from maternity and child health services, during the second trimester of pregnancy. All parents were evaluated for depressive symptomatology, anxiety, and perceived social support. Two hierarchical multiple regression analyses were performed to determine the role of psychosocial factors in predicting depressive symptomatology during pregnancy, in mothers and fathers. Marital dissatisfaction, personal history of depression, and personal trait anxiety were identified as significant predictors of depressive symptomatology during pregnancy, both in mothers and in fathers. Family history of substance abuse, conflictual relationship with the parents in the past year, and bereavement in the past year were identified as significant factors contributing to elevated depressive symptoms during pregnancy in mothers, but not fathers. In this study, several psychosocial risk factors were consistently related to an increase in maternal and paternal depressive symptoms during pregnancy; some of these factors seem to be specifically related to maternal depressive mood.     

The link between belongingness and depressive symptoms: An exploration in the workplace interpersonal context

Interpersonal factors are crucial to a deepened understanding of depression. Belongingness, also referred to as connectedness, has been established as a strong risk/protective factor for depressive symptoms. To elucidate this link it may be beneficial to investigate the relative importance of specific psychosocial contexts as belongingness foci. Here we investigate the construct of workplace belongingness. Employees at a disability services organisation (N = 125) completed measures of depressive symptoms, anxiety symptoms, workplace belongingness and organisational commitment. Psychometric analyses, including Horn's parallel analyses, indicate that workplace belongingness is a unitary, robust and measurable construct. Correlational data indicate a substantial relationship with depressive symptoms (r = ?.54) and anxiety symptoms (r = ?.39). The difference between these correlations was statistically significant, supporting the particular importance of belongingness cognitions to the etiology of depression. Multiple regression analyses support the hypothesis that workplace belongingness mediates the relationship between affective organisational commitment and depressive symptoms. It is likely that workplaces have the potential to foster environments that are intrinsically less depressogenic by facilitating workplace belongingness. From a clinical perspective, cognitions regarding the workplace psychosocial context appear to be highly salient to individual psychological health, and hence warrant substantial attention.     

Interaction Effects between Maternal Lifetime Depressive/Anxiety Disorders and Correlates of Children��s Externalizing Symptoms

We investigated the interaction effects between mother??s lifetime depressive/anxiety disorders and psychosocial correlates of 6 to 11 year-old children??s self-reported externalizing symptoms in the Quebec Child Mental Health Survey. A representative subsample of 1,490 Quebec children aged 6 to 11 years was selected from the original sample. We conducted multiple linear regression analyses using externalizing symptoms as reported by children through the Dominic questionnaire and multiple child, family and socioeconomic characteristics. Two variables interacted significantly with mother??s lifetime depressive/anxiety disorders to predict 6 to 11 year-old children??s self-reported externalizing symptoms: physical/sexual abuse and mother??s caring behaviours. Results underline the main contribution of mother-child relationship and stressful events in the association between mother??s lifetime depressive/anxiety disorders and children??s externalizing symptoms. It is suggested to develop preventive intervention programs oriented towards children of lifetime depressed/anxious parents who also report parent-child relational difficulties.     

Low-end specificity of childhood measures of emotional distress: consistent effects for anxiety and depressive symptoms in a nonclinical population

Previous research regarding the low-end specificity of self-report measures of affective distress in children suggests that defensiveness acts differentially to lower scores on self-report measures of depressive symptoms, but not on self-report measures of anxiety. This investigation examined this issue in a nonclinical sample of 442 children, ages 7 to 16. Participants completed measures of depressive symptoms (Children's Depression Inventory), anxiety symptoms (State-Trait Anxiety Inventory for Children) and defensiveness (Children's Social Desirability Scale). In contrast to previous research, the results in this study indicated similar effects of defensiveness on measures of depressive symptoms and anxiety. Low-end depression participants obtained significantly higher defensiveness scores, as did low-end anxious participants. In an attempt to circumvent the effects of defensiveness, we measured anhedonia (Pleasure Scale for Children, or PSC) as a proxy of depressive symptoms. We also found the PSC to be subject to the effects of defensiveness at approximately the same magnitude as the measures of anxiety and depressive symptoms.     

General Belongingness,Workplace Belongingness,and Depressive Symptoms

Research has shown that a strong relationship exists between belongingness and depressive symptoms; however, the contribution of specific types of belongingness remains unknown. Participants (N=369) completed the sense of belonging instrument, psychological sense of organizational membership, and the depression scale of the depression anxiety stress scales. Factor analysis demonstrated that workplace and general belongingness are distinct constructs. When regressed onto depressive symptoms, these belongingness types made independent contributions, together accounting for 45% of variance, with no moderation effects evident. Hence, general belongingness and specific workplace belongingness appear to have strong additive links to depressive symptoms. These results add support to the belongingness hypothesis and sociometer theory and have significant implication for depression prevention and treatment. Copyright © 2012 John Wiley & Sons, Ltd.     

The role of coping, anxiety, and stress in depression post-acute coronary syndrome

Depressive symptoms are common and can affect prognosis following acute coronary syndromes (ACS). This study examined the psychological factors, coping, anxiety, and perceived stress associated with depression following ACS. Psychological variables were assessed in 15 females and 66 males (M = 57 years, SD = 12). Repeated measures at 2, 12, and 24 weeks post-ACS compared depression, anxiety, perceived stress, and coping resources as determined by the Cardiac Depression Scale, Beck Depression Inventory-II, State Trait Anxiety Inventory, Perceived Stress Scale, and Coping Resources Inventory. Depression, anxiety, and perceived stress remained high in the depressed group across time. Coping scores at 2 weeks post-ACS predicted depression scores at 24 weeks post-ACS. It appears that trait anxiety and coping resources are related to depressive symptoms post-ACS.     

Perfectionism Dimensions and Dependency in Relation to Personality Vulnerability and Psychosocial Adjustment in Patients with Coronary Artery Disease

The present study sought to illuminate self-criticism and personal standards dimensions of perfectionism and dependency as specific cognitive-personality vulnerability factors that might contribute to a better understanding of numerous psychosocial problem areas that are relevant to coronary artery disease (CAD). One hundred and twenty-three patients diagnosed with clinically significant CAD completed self-report questionnaires. Zero-order correlations and factor analysis results revealed that self-criticism was primarily related to personality vulnerability (aggression/anger/hostility, Type D negative affectivity) and psychosocial maladjustment (depressive symptoms, worry, avoidant coping, support dissatisfaction), whereas personal standards was primarily related to adaptive coping (problem-focused coping, positive reinterpretation) and dependency was primarily related to worry. Hierarchical regression results demonstrated the incremental utility of self-criticism, personal standards, and dependency in relation to (mal)adjustment over and above aggression/anger/hostility, negative affectivity, and social inhibition. Continued efforts to understand the role of perfectionism dimensions and dependency in CAD appear warranted.     

冠心病患者的抑郁和焦虑

许多临床研究表明,冠心病患者常发生抑郁及焦虑。而在严重精神症状（如抑郁或/和焦虑）者中有较高的冠心病发生率。抑郁增加冠心病患者的不良心血管事件发生率,影响预后。其机制有如下几个方面：对医疗措施及生活方式改变的依从性差、血小板功能异常、血管内皮功能紊乱以及心率变异性降低。选择性5-羟色胺再摄取抑制剂由于其较好的耐受性且无明显的心血管副作用而应用于冠心病合并抑郁及焦虑的药物治疗并改善患者的生活质量。但仍需要更大规模的临床研究以确定抑郁及焦虑对冠心病预后的影响。临床上应更加关注焦虑对冠心病的影响,进一步探讨焦虑能否作为冠心病的危险因素。     

Maternal postpartum depressive symptoms predict delay in non-verbal communication in 14-month-old infants

We investigated the potential relationship between maternal depressive symptoms during the postpartum period and non-verbal communication skills of infants at 14 months of age in a birth cohort study of 951 infants and assessed what factors may influence this association. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, and non-verbal communication skills were measured using the MacArthur-Bates Communicative Development Inventories, which include Early Gestures and Later Gestures domains. Infants whose mothers had a high level of depressive symptoms (13+ points) during both the first month postpartum and at 10 weeks were approximately 0.5 standard deviations below normal in Early Gestures scores and 0.5–0.7 standard deviations below normal in Later Gestures scores. These associations were independent of potential explanations, such as maternal depression/anxiety prior to birth, breastfeeding practices, and recent depressive symptoms among mothers. These findings indicate that infants whose mothers have postpartum depressive symptoms may be at increased risk of experiencing delay in non-verbal development.     

Depressive Tendencies and Susceptibility to Anxiety: Differential Personality Correlates

Although the constructs of depression and anxiety are conceptually and clinically separable, they have been difficult to separate psychometrically. The present study is an attempt to statistically disentangle the two constructs and to evaluate their differential correlates. A common factor analysis of the items in a depression and an anxiety inventory was conducted using data collected from two samples—208 college students and eighty-seven 18-year-olds participating in the Block Longitudinal Study. In both samples two factors, interpreted as depressive tendencies and susceptibility to anxiety, were found; the factor loadings on each factor were highly correlated across the two samples. No sex differences were found in these factor structures. Factor-based scores comprised of well-differentiating items were computed for participants in the Block sample. Using partial correlation analyses, observer-measured as well as self-report-based personality correlates of the specific variance associated with depressive tendencies and with susceptibility to anxiety, respectively, were contrasted. The results indicated that a strong interpersonal component discernible in depression was less noticeable in anxiety.     

Resilience is a good predictor of hopelessness even after accounting for stressful life events, mood and personality (NEO-PI-R)

A better understanding of the relation between protection and vulnerability may advance our understanding of mental health. Therefore the purpose of this study was to examine the incremental validity of the Resilience Scale for Adults (RSA) as a predictor for level of hopelessness. A healthy sample (N = 532) completed the Beck Hopelessness Scale, a list of Stressful Life Events (SLE), the Hopkins Symptom Checklist-25 (HSCL-25), NEO-PI-R (NEO Personality Inventory Revised) and the RSA. The relations between the variables were explored with correlations and multiple hierarchical regression analyses. The results indicated that the RSA measures important protective factors that significantly predict lower levels of hopelessness even when accounting for age, gender, SLE, HSCL-25 and NEO-PI-R. This study supports the notion that the protective resilience factors in the RSA have unique contributions over and above established constructs of stressful life events, depressive and anxiety symptoms and personality in predicting hopelessness, supporting the incremental validity of the RSA.     

Effects of age on symptoms of anxiety and depression in a sample of retired police officers

This study addressed the effects of age on anxiety and depressive symptoms. The analysis was based on the responses of 1,334 retired male Scottish police officers (34-94 years old) to the Hospital Anxiety and Depression Scale. Multiple regression analysis was used to determine the partialed linear and curvilinear effects of symptoms of, separately, anxiety and depression on age and retirement variables. Significant partialed effects of retirement type and present age were found. Early retirement was a vulnerability factor for both disorders. The authors found a consistent linear reduction in anxiety across age and a U-shaped function for depression across age. The differing profiles and independent effects of age on anxiety and depression are consistent with their status as separate entities. Respondents were increasingly susceptible to depression from the mid-50s onward, whereas susceptibility to anxiety was reduced with age.     

Australian factorial confirmation of Vando's Reducer—Augmenter Scale

Vando's (1970) 54-Item Reducer—Augmenter Scale (RAS) was completed by 549 Australian university students. Factor analysis of scores yielded three dimensions analogous to Canadian results: auditory modality, kinesthetic activity, and sensation seeking. Refactoring 18 RAS items produced a test explaining almost twice as much variance as the original scale. Factor scores of both tests at best duplicated the validity of total scores against constructs reflecting stimulus need. Results justify the use of Vando's total RAS in Australia.     

Subtyping borderline personality disorder by suicidal behavior

Course and outcome of Borderline Personality Disorder (BPD) are favorable for the vast majority of patients; however, up to 10% die by suicide. This discrepancy begs the question of whether there is a high lethality subtype in BPD, defined by recurrent suicidal behavior and increasing attempt lethality over time. In a prospective, longitudinal study, we sought predictors of high lethality among repeat attempters, and defined clinical subtypes by applying trajectory analysis to consecutive lethality scores. Criteria-defined subjects with BPD were assessed using standardized instruments and followed longitudinally. Suicidal behavior was assessed on the Columbia Suicide History, Lethality Rating Scale, and Suicide Intent Scale. Variables discriminating single and repeat attempters were entered into logistic regression models to define predictors of high and low lethality attempts. Trajectory analysis using three attempt and five attempt models identified discrete patterns of Lethality Rating Scale scores. A high lethality trajectory was associated with inpatient recruitment, and poor psychosocial function, a low lethality trajectory with greater Negativism, Substance Use Disorders, Histrionic and/or Narcissistic PD co-morbidity. Illness severity, older age, and poor psychosocial function are characteristics of a poor prognosis subtype related to suicidal behavior.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

A depressive symptom scale for the California Psychological Inventory: construct validation of the CPI-D

To facilitate life span research on depressive symptomatology, a depressive symptom scale for the California Psychological Inventory (CPI) is needed. The authors constructed such a scale (the CPI-D) and compared its psychometric properties with 2 widely used self-report depression scales: the Beck Depression Inventory and the Center for Epidemiological Studies Depression Scale. Construct validity of the CPI-D was examined in 3 studies. Study 1 established content validity, classifying CPI-D items into Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition depressive symptoms. Study 2 used 3 large samples to gather evidence for reliability and validity: correlational analyses demonstrated alpha reliability and convergent and discriminant validity; factor analysis provided evidence for discriminant validity with anxiety; and regression analyses demonstrated comparative validity with existing standard PI scales. Study 3 used clinician ratings of depression and anxiety as criteria for external validity.     

Interactive Effects of Psychosocial Stress and Early Pubertal Timing on Youth Depression and Anxiety: Contextual Amplification in Family and Peer Environments

While off-time pubertal development has emerged as a potential risk factor for both symptoms of depression and anxiety in youth, the literature is mixed and inconsistent as to (1) how early versus late pubertal timing confers risk for both boys and girls, (2) if the conferred risk is distinct between symptoms of anxiety and depression, and (3) under what social contexts (e.g., family environment, peer relationships) off-time pubertal development may emerge as a potent risk factor for these symptoms. The present study examined the impact of perceived pubertal timing on symptoms of anxiety and depression in two distinct psychosocial contexts: parent’s perceptions of their own harsh parenting and parent’s perceptions of their child’s peer problems. The sample consisted of 412 parents (M = 38.6 years old, SD = 7.8, 60.4 % mothers) of children between the ages of 8 and 17 (M = 12.13, SD = 2.97, 45.4 % girls). All constructs were assessed by parent reports. Linear multiple regression analyses revealed that the interaction between earlier pubertal timing and greater peer problems was significantly related to higher youth depressive and anxiety symptoms. The interaction between earlier pubertal timing and greater harsh discipline was significantly related to higher youth anxiety but not depressive symptoms. Youth gender did not qualify findings. Results suggest that the contextual amplification process of early pubertal timing may occur in both high stress family and peer environments and impact both girls and boys.     

Psychological Factors that Link Socioeconomic Status to Depression/Anxiety in Patients with Systemic Lupus Erythematosus

Our analyses examined whether reserve capacity factors would explain the relationship between socioeconomic status (SES) and symptoms of depression/anxiety in patients with systemic lupus erythematosus (SLE). We assessed disease activity, depression/anxiety symptoms, and intrapersonal and interpersonal reserve capacity measures in 128 patients with SLE. Multiple meditational analyses revealed that intrapersonal and interpersonal psychosocial aspects of reserve capacity fully mediated the relationship between SES and depression/anxiety. Lower SES was indirectly associated with higher symptoms of depression and anxiety through the effects of psychosocial resilience. Interventions aimed at improving modifiable reserve capacity variables, such as self-esteem and optimism, may improve anxious/depressive symptomatology in patients with SLE.     

DS14 is more likely to measure depression rather than a personality disposition in patients with acute coronary syndrome

It has been suggested that Type D Personality is a risk factor for acute coronary syndrome (ACS) and the DS14 has been developed for its assessment. However, some of the items on the DS14 seem to evaluate depressive symptoms rather than personality features. Therefore, the present study aims to verify whether an overlap exists between the constructs of Type D Personality and depression. Three‐hundred‐and‐four consecutive patients who were both presenting their first ACS and had no history of major depression completed the Hospital Anxiety and Depression Scale (HADS) and the DS14 to assess Type D personality at baseline and have been re‐evaluated at 1, 2, 4, 6, 9 and 12‐month follow‐ups. Out of 304 subjects (80.6% males), 40 were diagnosed as depressed. An exploratory factor analysis of HADS and the DS14 in the second month revealed that four out of seven items on the depressive subscale of HADS (HADS‐D) and six out of seven items on the Negative Affectivity (NA) subscale of the DS14 segregated on the same factor. Results were verified by a Partial Confirmatory Factor Analysis performed at the twelfth month when most of the patients achieved complete remission from the depressive episode. Temporal stability was poor for NA and Type D Personality and these construct co‐vary with HADS‐D over time. Our data suggests that NA and depression are overlapping constructs, supporting the idea that the DS14 measures depressed features, rather than a personality disposition.     

Early Maladaptive Schemas as Moderators of the Impact of Stressful Events on Anxiety and Depression in University Students

The aim of this study was to test the effects of early maladaptive schemas (EMS) derived from the Schema Therapy model (Young 1999) according to the diathesis-stress paradigm. We expected that EMS would make students more vulnerable to symptoms of depression and anxiety in the presence of stressful events and that the effects of these schemas would be different for each symptom. In particular, it was hypothesised that abandonment, emotional deprivation, defectiveness, and failure schemas would interact with stressful events to predict depressive symptoms, whereas abandonment, vulnerability to harm, and dependence schemas were expected to moderate anxiety symptoms. Due to gender differences in EMS and depressive and anxiety symptoms, we also expected that sex would act as a moderator of the relationships between EMS and symptoms. A two-wave prospective study showed that the presence of EMS constitutes a vulnerability factor for both, depressive and anxiety symptoms, and this effect was also moderated by sex. Moreover, the EMS’s content specificity revealed which schemas were more relevant to each symptom, providing valuable information for prevention and intervention programmes.