A motivation-enhancing treatment to sustain goal engagement during life course transitions

Although theory-driven control striving treatments may sustain motivation for individuals navigating life course transitions, their efficacy during these challenging junctures remains unexamined. In a pre-post randomized field study (n = 316), a novel control striving treatment based on Heckhausen et al.’s (Psychol Rev 117:32–60, 2010) motivational theory of life-span development was administered to young adults making the landmark transition to university. For students who faced obstacles to goal attainment, the motivation-enhancing selective secondary control (SSC) striving treatment (vs. no-treatment) increased performance by 8 % in a two-semester course (74.85 % vs. 66.68 %). Consistent with theory, the SSC treatment-performance linkage was mediated by selective secondary and selective primary control in a hypothesized causal sequence. Findings advance the literature by showing control striving treatments can improve performance for some young adults in transition by promoting adaptive changes in theoretically-derived psychological process variables.     

Evidence that anticipated stigma predicts poorer depressive symptom trajectories among emerging adults living with concealable stigmatized identities

People living with concealable stigmatized identities are vulnerable to experiencing greater depressive symptoms as a result of occupying a lower social status. In the present research, we examine the effect of changes in enacted stigma and changes in anticipated stigma on trajectories of depressive symptoms over time. A sample of 192 college-aged emerging adults (81.0% female, 81.9% Caucasian, M_age = 18.82 years) living with a concealable stigmatized identity (e.g., mental illness and sexual minority status) completed measures of enacted stigma, anticipated stigma, and depressive symptoms at two time points across eight weeks. Hierarchical linear modeling analyses indicate that increases in anticipated stigma, but not enacted stigma, predicted poorer trajectories of depressive symptoms, controlling for the effect of baseline rumination and other identity-related variables. These data are among the first to demonstrate that worries about future devaluation predict poorer depressive symptom trajectories over time among college-aged emerging adults.     

Attributional Retraining: A Motivation Treatment With Differential Psychosocial and Performance Benefits for Failure Prone Individuals in Competitive Achievement Settings

Our quasi-experimental, longitudinal treatment study examined whether Attributional Retraining (AR) facilitated adjustment among young adults (n = 324) making the challenging school-to-university transition. An AR by performance orientation group 2 × 4 design showed AR primarily benefited high-risk students: Failure-ruminators (high failure preoccupation, low perceived control) receiving AR reported higher intrinsic motivation and more adaptive attribution-related emotions than their no-AR peers. Failure-acceptors (low failure preoccupation, low perceived control) receiving AR had higher intrinsic motivation, higher grade point averages, and fewer course withdrawals than their no-AR counterparts. Thus, AR had differential benefits (emotions, achievement) for vulnerable students who were psychologically distinct.     

The positive role of hope on the relationship between loneliness and unhappy conditions in Hungarian young adults: How pathways thinking matters!

ABSTRACT

In this study, we examined loneliness and hope components as predictors of unhappy conditions (viz., anxious symptoms, depressive symptoms, & suicidal ideation) in young adults. The sample was comprised of 489 Hungarian college students. Results of conducting hierarchical regression analyses indicated that loneliness and hope pathways (but not hope agency) were important unique predictors of anxious symptoms, depressive symptoms, and suicidal ideation. Moreover, in part, consistent with the notion that hope might buffer the negative effects of loneliness on unhappy conditions, evidence for a significant Loneliness × Hope Pathways interaction effect in predicting each of the three indices of unhappy conditions was found. In contrast, the Loneliness × Hope Agency interaction effect was not found to be significant. Some implications of the present findings for the study and treatment of unhappy conditions in adults are discussed.     

The Relational Context of Social Support in Young Adults: Links with Stress and Well-Being

This study examined the roles of relationship-specific social support and gender in the associations between perceived stress and well-being. Three sources of support (family, friends, and romantic partners) and three well-being indicators (loneliness, depressive symptoms, and physical health) were assessed in 628 young adults attending college (M _age = 19.72; range of 18–24). Stress directly predicted all well-being indicators, and indirectly predicted well-being through social support in relationship-specific ways. Family support mediated the relationship between stress and physical health, friend support mediated the association between stress and loneliness, and romantic partner support mediated the relationships of stress with both loneliness and depressive symptoms. With regard to loneliness and physical health, women were more strongly impacted when they had less support from friends.     

A Randomized Controlled Trial of the Impact of a Family-Based Adolescent Depression Intervention on both Youth and Parent Mental Health Outcomes

This paper presents findings from a multi-centre, double-blind, randomized controlled trial that tested the hypothesis that parent and youth mental health improvements would be superior in a family-based intervention for adolescent depression (BEST MOOD) compared to a treatment-as-usual supportive parenting program (PAST). Eligible participants were families with a young person aged between 12 and 18 years who met diagnostic criteria for a depressive disorder (major, minor or dysthymic). Participating families (N = 64; 73.4% of youth were female) were recruited in Victoria, Australia and allocated to treatment condition using a block randomization procedure (parallel design) with two levels of blinding. This paper reports on the trial’s secondary outcomes on youth and parent mental health. General linear mixed models were used to examine the longitudinal effect of treatment group on outcome. Data were analyzed according to intention-to-treat; 31 families were analyzed in BEST MOOD, and 33 families in PAST. Parents in the BEST MOOD group experienced significantly greater reductions in stress and depressive symptoms than parents in the PAST group at 3-month follow-up. A greater reduction in parental anxiety was observed in the BEST MOOD group (d = 0.35) compared with PAST (d = 0.02), although the between-group difference was not significant. Both groups of youth showed similar levels of improvement in depressive symptoms at post-treatment (d = 0.83 and 0.80 respectively), which were largely sustained at a 3-month follow-up. The family-based BEST MOOD intervention appeared superior to treatment-as-usual (PAST) in demonstrating greater reductions in parental stress and depression. Both interventions produced large reductions in youth depressive symptoms.     

Randomized Controlled Trial Testing the Effectiveness of a Depression Prevention Program (‘Op Volle Kracht’) Among Adolescent Girls with Elevated Depressive Symptoms

Depression rates rise dramatically from the early to late adolescence. Especially young adolescent girls with elevated depressive symptoms are at high risk for developing a depression during adolescence or adulthood. Therefore, the prevention of depression is important especially in this high-risk group. The aim of the present study was to examine the effectiveness of the Cognitive Behavioral Therapy (CBT) component of the depression prevention program ‘Op Volle Kracht’ (OVK) among Dutch adolescent girls with elevated depressive symptoms. In total, 102 adolescent girls (11–15 years) in the first and second year of secondary school participated in this study. The girls in the experimental group (n?=?50) followed the eight CBT-lessons of OVK and reported depressive symptoms 1 week prior to the start of the lessons, after every lesson, at one-month and 6-months follow-up. The girls in the control group (n?=?52) exclusively reported depressive symptoms at the same time points. Latent Growth Curve Modeling showed that the decrease in depressive symptoms was significantly larger for girls in the experimental group compared to the girls in the control group. Furthermore, it was found that at 6-months follow-up, the girls in the experimental group had significantly lower levels of depressive symptoms compared to the girls in the control group. These findings indicate that the CBT-component of OVK effectively reduces depressive symptoms in short term and possibly prevents the development of a clinical depression.     

Effectiveness of Cognitive Behavior Therapy for Severe Mood Disorders in an Acute Psychiatric Naturalistic Setting: A Benchmarking Study

The current study examined the effectiveness of brief cognitive behavior therapy (CBT) for severe mood disorders in an acute naturalistic setting. The sample included 951 individuals with either major depressive disorder (n = 857) or bipolar disorder with depressed mood (n = 94). Participants completed a battery of self-report measures assessing depression, overall well-being, and a range of secondary outcomes both before and after treatment. We found significant reductions in depressive symptoms, worry, self-harm, emotional lability, and substance abuse, as well as significant improvements in well-being and interpersonal relationships, post-treatment. Comparable to outpatient studies, 30% of the sample evidenced recovery from depression. Comparison of findings to benchmark studies indicated that, although the current sample started treatment with severe depressive symptoms and were in treatment for average of only 10 days, the overall magnitude of symptom improvement was similar to that of randomized controlled trials. Limitations of the study include a lack of control group, a limitation of most naturalistic studies. These findings indicate that interventions developed in controlled research settings on the efficacy of CBT can be transported to naturalistic, “real world” settings, and that brief CBT delivered in a partial hospital program is effective for many patients with severe depressive symptoms.     

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

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

Perceived loneliness and general cognitive status in community-dwelling older adults: the moderating influence of depression

The relationship between depression, loneliness, and cognitive functioning among the elderly is not well understood in the literature. In the present study, we tested the moderating influence of depressive symptoms on loneliness and cognitive functioning. We recruited 100 community-dwelling older adults in Hong Kong. Demographic information, perceived loneliness, depressed mood, and general cognitive status were assessed. Results indicated that married participants reported lower levels of perceived loneliness (t (96) = 2.26, p = .03). We found a significant moderating effect of depressive symptoms on the relationship between perceived loneliness and general cognitive status (B = ?.05, p = .002). Perceived loneliness correlated negatively with general cognitive status only in participants with higher levels of depressed mood (B = ?.16, p = .01). Together, these findings suggest that perceived loneliness combined with depressed mood is related to poorer general cognitive status in older adults. The implications of these findings are discussed.     

A randomized crossover trial to test the effects of positive psychology intervention delivered by text messaging

Positive psychology (PP) interventions delivered through technology have shown encouraging results. In a crossover design, we randomized 60 participants recruited from the community to two weeks of either text messaging-based PP exercises or control exercises, before being crossed over to receive the other condition. Participants were compensated for maintaining high response rates to the texts. Participants reported greater satisfaction and had higher engagement in the program when PP exercises were received first. Overall, PP exercises did not improve moods significantly more than control exercises. However, baseline depressive symptoms significantly moderated the effect of condition on change in depressive symptoms (p < 0.032) and negative affect (p < 0.006), such that regular completion of exercises resulted in better mood outcomes compared to control exercises for those with high depressive symptoms at baseline. Results suggest that completing PP exercises through text messaging can improve moods in those who have elevated depressive symptoms.     

The relationship between family support; pain and depression in elderly with arthritis

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0%) and 1567 females (65.0%) with arthritic conditions (n = 2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p < .05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.     

Autobiographical Memory and Depression: Identity‐continuity and Problem‐solving Functions Indirectly Predict Symptoms over Time through Psychological Well‐being

The aim of this study was to assess the longitudinal associations between adaptive autobiographical memory functions and depressive symptoms. Consistent with the proposed mechanisms of change underpinning cognitive‐reminiscence therapy (CRT), it was hypothesised that more frequent adaptive reminiscence would lead to increases in psychological resources over time and indirectly affect depressive symptoms through this pathway. A sample of 171 young adults (mean age = 25.9 years, SD = 3.5) completed measures of how frequently they utilised autobiographical memory for identity‐continuity and problem‐solving purposes, depressive symptoms and personal resources (self‐esteem, self‐efficacy, meaning in life and optimism) at two time‐points. The results of structural equation modelling supported the model of indirect influence between reminiscence functions and depression through these psychological resources. These findings clarify the effects of adaptive autobiographical memory on depressive symptoms in young adults and indicate potential benefits of interventions such as CRT. Copyright © 2015 John Wiley & Sons, Ltd.     

Does cognitive flexibility training enhance subjective mental functioning in healthy older adults?

Declining cognitive abilities in older adults can contribute to significant changes in socioemotional health and substantially reduce their perception of well-being. Whereas much attention has been dedicated to creating cognitive training programs to improve cognitive health in old age, there is little emphasis on the consequences of such interventions for subjective mental functioning. We created a randomized controlled trial in which we evaluated the effects of an adaptive computerized cognitive flexibility training. Healthy older adults (60–80 years old) were assigned to one of three conditions (frequent or infrequent switching or active control group) and performed 58 half-hour sessions within a period of 12 weeks. We measured effects on subjective cognitive failures and executive dysfunctioning, everyday functioning, depressive symptoms, anxiety, and quality of life, before, and after training. Additionally, participants’ proxies rated their cognitive failures and executive dysfunctioning. Subjective cognitive failures and executive dysfunctioning improved 4 weeks posttraining in all groups, although effect sizes were low (?_p² = .058 and .079, respectively) and there were no differences between groups (all p’s > .38). No significant changes in subjective reports were seen directly after training, which was the case in all groups. Proxies did not report any functional changes over time, yet their evaluations were significantly more favorable than those of the participants, both pretraining (p < .0005) and posttraining (p = .004). Although we found no evidence of improvement on subjective mental functioning, we adduce several factors that encourage further research into the effects of computerized cognitive training on subjective performance.     

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.     

Parent–Child Cultural Value Gaps and Depressive Symptoms Among Mexican American Youth

Cultural value gaps between Mexican American parents and their children are hypothesized to place youth at risk for poor mental health outcomes. While most studies examine these gaps on broad measures of acculturation, the present study examined value gaps in affiliative obedience, a cultural value that has at its core the belief that respect and deference must be shown to parents and adults. The present study hypothesized that adolescents would exhibit greater depressive symptoms when youth demonstrated lower levels of affiliative obedience than their mothers. Moreover, we examined whether gender, nativity status, and age predicted cultural value gaps and moderated the relationship between gaps and depressive symptoms. These questions were evaluated in a school-based sample of 159 Mexican American families whose children were either US born (n = 82) or foreign-born (n = 77). Twenty-five percent of the sample demonstrated a cultural value gap where youth endorsed lower levels of affiliative obedience than their parents, and this group reported the greatest depressive symptoms. Age moderated this relationship, and the greatest association between cultural value gaps and depression was found among the older group of early adolescents.     

Development of a Behavioral Activation–Based Intervention for Cigarette-Smoking Young Adults

Quitting smoking during young adulthood can substantially reduce tobacco-related morbidity and mortality later in life. Depressive symptomatology is prevalent among smokers and increases risk for poor smoking cessation outcomes. However, few integrated behavioral interventions simultaneously target smoking and depressive symptoms and rarely have young smokers been included in the development of these interventions. In this paper we describe an 8-session behavioral activation–based treatment for smoking (BATS; MacPherson et al., 2010) adapted for youth. We conducted a series of focus groups with young adult smokers with depressive symptoms in order to modify treatment manuals to be developmentally appropriate. Subsequently, we completed a small pilot group (n = 5) of the intervention to provide preliminary data on feasibility, acceptability, and outcomes. We provide a case series of the participants in order to provide clinical illustrations of how the modified BATS treatment was implemented among young adults. Most pilot study participants exhibited smoking abstinence and smoking reductions at the end of treatment, as well as improvement in depressive symptoms and maintenance of levels of activation and environmental reward. Participants provided positive qualitative constructive feedback regarding the intervention.     

Internet-based acceptance and commitment therapy for psychological distress experienced by people with hearing problems: a pilot randomized controlled trial

Psychological distress is common among people with hearing problems, but treatments that specifically target this aspect have been almost non-existent. In this pilot randomized controlled trial, an eight-week long Internet-based treatment, informed by Acceptance and Commitment Therapy, was administered to explore the feasibility and efficacy of such a treatment. Included participants were randomized to either treatment (n = 31) or wait-list control (n = 30) condition. All participants were measured prior to randomization and immediately after treatment ended using standardized self-report instruments measuring hearing-related emotional and social adjustment (Hearing Handicap Inventory for the Elderly – S, HHIE-S), quality of life (Quality of Life Inventory, QOLI), and symptoms of depression and anxiety (Patient health Questionnaire, PHQ-9 and Generalized Anxiety Disorder scale, GAD-7). Linear mixed effects regression analysis using the full intention-to-treat sample demonstrated that the treatment had superior outcomes on the main outcome measure as compared with the control group, Cohen’s d = 0.93, 95% CI [0.24, 1.63]. The benefits of treatment over control were also evident in scores of depression, Cohen’s d = 0.61, 95% CI [0.04, 1.19], and quality of life, Cohen’s d = 0.88, 95% CI [0.14, 1.61]. The results provide preliminary support for Internet-delivered acceptance and commitment therapy as a potentially effective treatment of psychological symptoms associated with hearing problems.     

Efficacy of guided self-help behavioural activation and physical activity for depression: a randomized controlled trial

Behavioural activation and physical activity have received empirical support that highlight their efficacy in reducing depression. Even though both behavioural activation and physical activity share the common goal of reactivating the individual, limited research has directly compared these interventions, and more research is required to evaluate their efficacy when offered in low-intensity formats. The present study involves a randomized controlled clinical trial comparing the efficacy of two guided self-help interventions for the treatment of depression: behavioural activation and physical activity. Fifty-nine participants presenting mild-to-moderate symptoms of depression were randomized either to a behavioural activation intervention (n = 20), a physical activity intervention (n = 19) or a wait-list control group (n = 20). All participants completed symptom measure pre-, mid- and post-intervention, as well as at a two-month follow-up. Mixed-model analyses of variance revealed that both interventions were significantly more efficacious in reducing depressive symptoms in comparison with the control group. Physical activity involved significantly less time-investment compared to the behavioural activation condition (less than half the amount of time). These results indicate that physical activity and behavioural activation both effectively reduce depressive symptoms and are favourably applicable in low-intensity formats. Implications of these results and avenues for future research are discussed.     

Negative Life Events and Substance Use Moderate Cognitive Behavioral Adolescent Depression Prevention Intervention

Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n = 173) in which adolescents (M age = 15.5, SD = 1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Results imply that high-risk adolescents with either high rates of major life stress or initial substance use may require specialized depression prevention efforts.