Lifetime Abuse and Mental Health Among Older Persons: A European Study

This study aimed to investigate the association of lifetime abuse and mental health among older persons, considering associated factors (e.g., demographics) through a cross-sectional design. We recruited 4,467 women and men ages 60–84 years from 7 European cities. Mental health was measured with the Hospital Anxiety and Depression Scale, and abuse (psychological, physical, sexual, financial, and physical injuries) based on the Revised Conflict Tactics Scale and the UK survey of abuse/neglect of older people. Multiple logistic regression analyses showed that country of residence, low educational level, and experienced financial strain increased the odds of probable cases of anxiety and depression. Female sex, white-collar profession, and financial support by social/other benefits/or partner income were associated with higher odds of anxiety, while older age and experience of lifetime injury were associated with increased odds of depressive symptoms. The findings of this study indicate that socioeconomic factors, as well as experienced lifetime severe physical abuse leading to injuries, are significant in perceived mental health of adults in later life.     

Perceived Social Support and Mental Health among First-Year College Students with Histories of Bullying Victimization

Although childhood bullying victimization is associated with adult depression and anxiety, the majority of previously bullied youth do not develop psychopathology. Identifying protective factors has implications for designing interventions that can support a successful adjustment to emerging adulthood. In this study, we investigate whether perceived social support protects against depression and anxiety among first-year college students who had previously experienced bullying. We collected data from 1474 first-year college students attending four large universities across the United States. Students completed a web-based survey in fall 2012 (Wave 1) and 436 (29.5 %) participated in a follow-up survey in spring 2013 (Wave 2). Participants reported on childhood bullying victimization, current depression and anxiety, and current social support (overall and from family, friends, and significant others). Results indicated that a history of childhood bullying victimization was positively associated with depression and anxiety in both fall and spring. Further, overall social support reported in fall moderated the association between childhood bullying victimization and fall and spring anxiety. Also, higher levels of perceived family support, in particular, buffered previously bullied students’ risk for spring anxiety. Results suggest that perceptions of familial social support during the initial adjustment to college may protect previously bullied first-year students from anxiety during their adjustment to college. Research and clinical implications, study limitations, and future directions are discussed.     

Assertiveness, social support, and psychological adjustment following spinal cord injury.

Tested predictions that assertiveness and social support would be significantly predictive of psychological adjustment. Furthermore, it was anticipated that assertiveness and certain types of social relationships would differentially interact to predict adjustment, since positive and negative effects of both variables have been noted in prior research. Trained raters interviewed 156 persons receiving either in-patient or out-patient care for cord injuries and administered measures of assertiveness, social support, depression and psychosocial impairment. Persons who reported a keen sense of responsibility for the welfare of another reported more depression and impairment. Persons reporting higher levels of support facilitating social integration and reassuring personal worth were less depressed. Several significant interactions between assertiveness and different social support relationships revealed beneficial and deleterious effects on depressive behavior and impairment secondary to the disability. Results are discussed as they advance theoretical understanding of the effects of assertiveness and social support. Implications for discriminate cue learning in assertion training for persons with physical disability are proposed.     

Gut interpretations: how difficulties in emotion regulation may help explain the relation of visceral sensitivity with depression and anxiety among young adults with gastrointestinal symptoms

It is widely recognized that abdominal pain and discomfort are common problems in the United States and are often associated with negative quality of life. The prevalence of anxiety/depression elevations and disorders among persons with gastrointestinal disturbances (GI) is estimated to be at least two to three times the rate in the general population. Visceral sensitivity reflects anxiety about GI sensations and its accompanying contexts and often leads to worsening of sensations (e.g. bloating, upset stomach, diarrhea). Among individuals with GI symptoms, visceral sensitivity may be associated with interpreting common sensations as catastrophic which may be related to greater difficulties with emotion dysregulation (e.g. severe anxiety and depression). The current study evaluated the indirect association of visceral sensitivity via emotion dysregulation in relation to depression, anxious arousal, and social anxiety symptoms among 344 young adults with a current history of GI symptoms and problems. Results indicated an indirect effect of visceral sensitivity via emotion dysregulation. These findings provide novel empirical support for the association of visceral sensitivity with emotional distress symptoms among young adults with GI symptoms. Based on the results, targeting emotion dysregulation may be a promising health promotion tactic among young adults with GI symptoms and disorders.     

Organizational factors and mental health in community volunteers. The role of exposure,preparation, training,tasks assigned,and support

During disasters, aid organizations often respond using the resources of local volunteer members from the affected population who are not only inexperienced, but who additionally take on some of the more psychologically and physically difficult tasks in order to provide support for their community. Although not much empirical evidence exists to justify the claim, it is thought that preparation, training, and organizational support limit (or reduce) a volunteer's risk of developing later psychopathology. In this study, we examined the effects of preparation, training, and organizational support and assigned tasks on the mental health of 506 Indonesian Red Cross volunteers who participated in the response to a massive earthquake in Yogyakarta, Indonesia, in 2006. Controlling for exposure level, the volunteers were assessed for post-traumatic stress disorder (PTSD), anxiety, depression, and subjective health complaints (SHCs) 6, 12, and 18 months post-disaster. Results showed high levels of PTSD and SHCs up to 18 months post-disaster, while anxiety and depression levels remained in the normal range. Higher levels of exposure as well as certain tasks (e.g., provision of psychosocial support to beneficiaries, handling administration, or handing out food aid) made the volunteers more vulnerable. Sense of safety, expressed general need for support at 6 months, and a lack of perceived support from team leaders and the organization were also related to greater psychopathology at 18 months. The results highlight the importance of studying organizational factors. By incorporating these results into future volunteer management programs the negative effects of disaster work on volunteers can be ameliorated.     

Nonlinear Predictive Models for Multiple Mediation Analysis: With an Application to Explore Ethnic Disparities in Anxiety and Depression Among Cancer Survivors

Mediation analysis allows the examination of effects of a third variable (mediator/confounder) in the causal pathway between an exposure and an outcome. The general multiple mediation analysis method (MMA), proposed by Yu et al., improves traditional methods (e.g., estimation of natural and controlled direct effects) to enable consideration of multiple mediators/confounders simultaneously and the use of linear and nonlinear predictive models for estimating mediation/confounding effects. Previous studies find that compared with non-Hispanic cancer survivors, Hispanic survivors are more likely to endure anxiety and depression after cancer diagnoses. In this paper, we applied MMA on MY-Health study to identify mediators/confounders and quantify the indirect effect of each identified mediator/confounder in explaining ethnic disparities in anxiety and depression among cancer survivors who enrolled in the study. We considered a number of socio-demographic variables, tumor characteristics, and treatment factors as potential mediators/confounders and found that most of the ethnic differences in anxiety or depression between Hispanic and non-Hispanic white cancer survivors were explained by younger diagnosis age, lower education level, lower proportions of employment, less likely of being born in the USA, less insurance, and less social support among Hispanic patients.     

To Flourish or Languish,that is the question: Exploring the mental health profiles of Danish elite athletes

ObjectivesThe purpose of this study was (a) to investigate mental well-being and the prevalence of anxiety and depressive symptoms in Danish male and female elite athletes, (b) to identify latent profiles in athletes based on their mental health and ill health, and (c) to examine whether the different profiles vary in selected protective and risk factors concerning mental health.MethodsA total of 612 Danish athletes (M = 18.99, SD = 4.29) from 18 different sports completed an online version of the Holistic Athlete Mental Health Survey that assessed well-being, depression, and anxiety together with potential risk and protective factors (e.g., injuries, stress, sleep, social support, sport environment).ResultsOverall, 13.9% of athletes reported moderate or severe anxiety symptoms while 21.1% reported moderate or severe depressive symptoms. Female athletes had a significantly higher prevalence of anxiety and depressive symptoms and lower mental well-being scores than male athletes. Through a latent profile analysis, three distinctive mental health profiles (flourishing, moderate mental health, languishing) were discovered. MANOVA following Kruskal-Wallis tests revealed substantial differences between these profiles regarding their perception of social support, sport environment, and stressors from different life domains.Conclusions: Danish elite athletes display similar levels of anxiety and depressive symptoms as the Danish general population. Flourishing athletes report lower stress levels, receive higher support from the private and sport domain, and perceive their sport environment as more supportive than athletes who are languishing. A tailored approach is proposed to support athletes' mental health.     

An investigation of organic factors in the neuropsychological functioning of patients with borderline personality disorder

The hypothesis to be tested in this study was that the cognitive deficits that have been documented in patients with Borderline Personality Disorder (BPD) are largely the consequence of organic insult, either developmental or acquired. Using a cross-sectional design, 80 subjects (males and females) who met the criteria for BPD participated in the study. They completed a battery of neuropsychological tests and a comprehensive interview assessing organic status as well as measures of the potentially confounding factors of current levels of depression and anxiety. It was expected that BPD-patients with a probable history of organic insult would perform significantly worse than would BPD patients without such a history. Analyses of the results provided partial support for the hypothesis. Subjects with both BPD and a history of organic insult were significantly more impaired on several measures including measures of attention than were BPD only subjects. The results suggested that the impaired cognitive performance of persons diagnosed with BPD may, in part, be attributed to organic factors.     

Emotional health predictors of substance use initiation during middle school

This study aimed to evaluate whether emotional health factors, including anxiety and depression, stress, and social support, are associated with earlier youth initiation of alcohol and illicit substances during middle school (from the sixth to the eighth grade). Data for this study were from the Developmental Pathways Project, a longitudinal study of 521 youth sampled from the Seattle Public Schools. Discrete time survival analyses were used to assess the effects of depression, anxiety, stress, and support on initiation of substance use, measured every 6 months at five time points between sixth and eighth grade. Youth who had initiated prior to sixth grade had significantly higher levels of depressive symptoms. In multivariate survival analyses controlling for child race/ethnicity, gender, and socioeconomic status, and accounting for conduct problems, youth who reported higher levels of separation anxiety/panic symptoms were at decreased risk for early alcohol initiation. Children with higher levels of perceived teacher support had a significantly lower risk of alcohol initiation during early follow-up periods. Recent stressful life events in Grade 6 were associated with significantly greater risk of initiating an illicit substance by Grade 8. The current findings highlight the role of stress in the initiation of illicit substance use and suggest that teacher support is associated with lower risk for very early alcohol use. Future research examining anxiety as a predictor of substance use should distinguish between subtypes of anxiety.     

Sex role and dysphoric mood

This study was designed to examine the relation of sex-role type to dysphoric mood and to the manipulation of dysphoric affect. Initially, subjects completed a variety of measures yielding indices of dysphoria, anxiety, and hostility. Androgynous persons reported the least dysphoria, anxiety, and hostility. Subjects from the original sample who volunteered for the second part of the study were randomly assigned to the neutral or depression conditions of the Velten Mood Induction Procedure. Androgynous types again reported the least anxiety and dysphoria in the neutral type situation; however, when exposed to depressive stimuli, they showed the greatest increase in dysphoria. Masculine-typed persons showed virtually no change in mood. These results lend strong support to the association of sex-typing with depression in that the sex types were differentially susceptible to dysphoric mood. However, the results are contrary to the only other reported study of sex role and depression which successfully manipulated affect. Differences in methodology (learned helplessness versus mood induction) and the fact that the previous study forced subjects to lose control and fail may account for the differing results.     

The tripartite model and dimensions of anxiety and depression: an examination of structure in a large school sample

This study was designed to build on recent findings that (a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested (T. A. Brown, B. F. Chorpita, & D. H. Barlow, 1998; S. Mineka, D. W. Watson, & L. A. Clark, 1998), and (b) the tripartite model of emotion appears to have increasing support and utility in child samples (e.g., C. J. Lonigan, E. S. Hooe, C. F. David, & J. A. Kistner, 1999). The structural relations were evaluated among tripartite factors and dimensions representing selected anxiety disorders and depression in a large multiethnic school sample of children and adolescents. General aspects of the tripartite model were supported. For example, Negative Affect was positively related with all anxiety and depression scales, and Positive Affect was negatively correlated with the depression scale. Consistent with previous observations in adult samples, Physiological Hyperarousal was positively related with Panic only, and was not significantly positively correlated with other anxiety syndromes. The structure of the best fitting model appeared robust across different grade levels and gender. In follow-up analyses, several interactions of grade level with structural parameters emerged, such that the relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.     

Mapping Mindfulness Facets Onto Dimensions of Anxiety and Depression

Mindfulness has been associated with anxiety and depression, but the ways in which specific facets of mindfulness relate to symptoms of anxiety and depression remains unclear. The purpose of the current study was to investigate associations between specific facets of mindfulness (e.g., observing, describing, nonjudging, acting with awareness, and nonreactivity) and dimensions of anxiety and depression symptoms (e.g., anxious arousal, general distress-anxiety, general distress-depression, and anhedonic depression) while controlling for shared variance among variables. Participants were 187 treatment-seeking adults. Mindfulness was measured using the Five Facet Mindfulness Questionnaire and symptoms of depression and anxiety were measured using the Mood and Anxiety Symptom Questionnaire. Bivariate correlations showed that all facets of mindfulness were significantly related to all dimensions of anxiety and depression, with two exceptions: describing was unrelated to general distress-anxiety, and observing was unrelated to all symptom clusters. Path analysis was used to simultaneously examine associations between mindfulness facets and depression and anxiety symptoms. Significant and marginally significant pathways were retained to construct a more parsimonious model and model fit indices were examined. The parsimonious model indicated that nonreactivity was significantly inversely associated with general distress anxiety symptoms. Describing was significantly inversely associated with anxious arousal, while observing was significantly positively associated with it. Nonjudging and nonreactivity were significantly inversely related to general distress-depression and anhedonic depression symptomatology. Acting with awareness was not significantly associated with any dimensions of anxiety or depression. Findings support associations between specific facets of mindfulness and dimensions of anxiety and depression and highlight the potential utility of targeting these specific aspects of mindfulness in interventions for anxiety and mood disorders.     

Self-Report Differentiation of Anxiety and Depression in a Mood Disorders Sample

Several lines of research suggest there is considerable overlap between anxiety and depression and that it is difficult to distinguish between these two constructs. However, a few studies utilizing factor analytic procedures have provided evidence that anxiety and depression can be differentiated when measures of these constructs are considered at the item level. In addition, there is some evidence that differentiation can be accomplished in samples experiencing high levels of anxiety (i.e., a clinically anxious sample; B. J. Cox, R. P. Swinson, L. Kuch, & J. Reichman, 1993). In the present study, this research strategy was extended to a sample of patients with high levels of depressed mood (i.e., a mood disorders sample; N = 378). Their responses to widely used measures of depression (i.e., Beck Depression Inventory; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) and anxiety (i.e., Spielberger State-Trait Anxiety Inventory—State subscale; C. D. Spielberger, R. L. Gorsuch, & R. E. Lushene, 1970) were entered into a principal-components analysis with oblique rotation. A 4-factor solution was retained. This solution was comprised of factors representing anxiety, anxiety absent (a reverse scored factor), cognitive symptoms of depression, and somatic/vegetative symptoms of depression. These findings indicated that anxiety and depression, as emotional states, can be differentiated within a mood disorders sample, using existing popular self-report measures. The clinical and research implications of these findings are briefly discussed.     

Replication and Extension of a Hierarchical Model of Social Anxiety and Depression: Fear of Positive Evaluation as a Key Unique Factor in Social Anxiety

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215–224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.     

Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer

Although the presence of psychological distress has been documented in women with breast cancer, previous studies have not established rates of DSM-IV diagnoses in this population, nor have prior investigations compared the utility of diagnostic interviewing vs. symptom checklists to assess distress. DSM-IV diagnoses of anxiety disorders and major depression, symptoms of anxiety and depression, and quality of life were examined in 207 women with newly diagnosed breast cancer. Eighteen percent of breast cancer patients met criteria for a current DSM-IV anxiety or depressive disorder and 54% met criteria for a disorder at some point in their lifetime. These rates are comparable to those found in recent community epidemiological studies (e.g., R. C. Kessler, K. A. McGonagle, S. Zhao, C. B. Nelson, M. Hughes, S. Esheman, et al., 1994). Sensitivity, specificity, and positive predictive value for anxiety and depression symptoms as predictors of DSM disorders were relatively poor. However, after accounting for demographic, treatment, and cancer variables, self-reported anxiety symptoms were significantly related to the presence of an anxiety disorder and self-reported depressive symptoms were significantly related to a diagnosis of a depressive disorder. Symptoms of anxiety and depression contributed significantly and uniquely to physical, medical, and sexual quality of life; DSM-IV diagnoses were not significantly related to quality of life after controlling for symptoms of depression and anxiety. The importance of measuring both symptoms of distress and psychiatric diagnoses in cancer patients and the clinical practice implications of the results are discussed.     

Body-Focused Repetitive Behaviors: The Proximal and Distal Effects of Affective Variables on Behavioral Expression

This paper reports on 2 studies designed to examine the contribution of affective variables on the expression of body-focused repetitive behaviors (BFRBs; e.g., skin picking, nail biting). The first study revealed that persons engaging in a BFRB experienced significantly higher levels of anxiety and depression than those without BFRBs. The second study was conducted to determine if repetitive behaviors were differentially affected across various emotional states and across those persons with and without BFRBs. Participants were randomly exposed to anxiety, depression, boredom, and control conditions. Results showed no differential effects on the occurrence of repetitive behaviors within the no-BFRB group; however, the BFRB group engaged in more repetitive behaviors in the Bored condition than in the Control condition. This study offers the first experimental evidence that emotional variables can have a differential impact on the expression of BFRBs.     

Disruptions of social relationships accentuate the association between emotional distress and menstrual pain in young women.

This study examined the effects of social support on dysmenorrhea and whether social support moderates the relationship between negative emotions and painful symptoms. Women (N = 184) completed questionnaires on menstrual symptoms, depression, anxiety, and social networks. Depression and anxiety were strongly associated with menstrual pain. Women who no longer had access to their prior support providers manifested more symptoms than did women with stable social relations. In addition, this disruption in their social networks moderated the relationship between distress and menstrual pain. Results indicate that loss of social support is a significant contributor to menstrual symptoms and point to the importance of considering specific aspects of social support in studying its effect on health.     

Characteristics Predicting Effective Outcomes After Coping Effectiveness Training for Patients With Spinal Cord Injuries

Coping effectiveness training (CET), based on R. S. Lazarus and S. Folkmans (1984) theory of stress and coping, teaches appraisal and coping skills. It has been adapted for use with people with spinal cord injuries and the effect of this intervention on coping, anxiety and depression and self perception has been investigated. Using data from P. Kennedy, J. Duff, M. Evans, and A. Beedies (2003) study, the psychological characteristics of people who benefited from CET (no increase in depression and anxiety at the end of CET and 6 weeks after) were compared with those who did not benefit. Coping strategies were not predictive factors but differences in some self-perception items were found between the two groups. Age, gender, level, and type of injury were not shown to be predictive but time since injury was, suggesting that the effectiveness of a CET programme could be maximized by reducing the time between onset of injury and the start of CET.     

MMPI-ER two-point codes of industrially injured Hispanic workers by DSM-III--R diagnosis.

The purpose of this study was to describe the MMPI-ER two-point codes of 492 Hispanic adults who had sustained work-related injuries and who had applied for workers' compensation benefits. More specifically, the focus was on whether there are unique MMPI two-point codes for Hispanic workers with three specific types of DSM-III--R diagnoses--adjustment disorder, anxiety disorder, and major depression. Analysis suggests that psychiatric condition or diagnosis may act as a moderator variable in Hispanic persons' MMPI performance, including MMPI two-point codes.     

Changes in affect during treatment for depression and anxiety

We tested the hypothesis that the tripartite model [Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and psychometric implications. Journal of Abnormal Psychology, 100, 316-336] can be extended to account for change during treatment for anxiety and depression. Forty-one patients treated naturalistically in private practice with cognitive behavior therapy completed weekly measures of depression, anxiety, negative affect (NA), positive affect (PA), and anxious arousal (AA). Consistent with the model, NA was associated with anxiety and depression during treatment, PA was more strongly related to depression than to anxiety, and AA was more strongly related to anxiety than to depression. As predicted, symptoms of depression and anxiety and NA all decreased during treatment. As predicted, AA also decreased, particularly for patients with panic disorder. PA increased during treatment, but only for patients who showed a significant decline in depression and only over an extended period of treatment. Nearly two-thirds of the variance in anxiety change was accounted for by changes in depression and NA, and just over three-fourths of the variance in depression change was accounted for by changes in anxiety and NA, indicating that much of the change in anxiety and depression across the course of treatment is shared in common.