Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals

Rumination and worrying are considered possible mediating variables that may explain the relation between neuroticism and symptoms of depression and anxiety. The current study sought to examine the mediational effects of rumination and worry in the relationships between neuroticism and symptoms of depression and anxiety in a sample of clinically depressed individuals (N = 198). All patients completed a battery of questionnaires including measures of neuroticism, rumination, worrying, depression, and anxiety. Results showed that in subsequent analyses, rumination and worrying both mediated the relation between neuroticism and depression and anxiety. When rumination and worrying were simultaneously entered in the mediation analysis, only rumination was found to mediate the relation between neuroticism and symptoms of anxiety and depression. Two components of rumination (i.e., brooding and reflection) were also analyzed in the mediational analysis. Both reflection and brooding were significant mediators with respect to depressive symptoms, whereas brooding was the only significant mediator in relation to anxiety symptoms. The results are discussed in the light of current theories, previous research, and recent treatment developments. Clinical implications and suggestions for future research are provided.     

Psychological vulnerabilities in patients with major depression vs panic disorder

The tripartite model (Clark & Watson, 1991: Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336) posits that anxiety and depression share nonspecific features of neuroticism but that somatic arousal appears unique to anxiety, and low positive affect appears unique to depression. The present study controlled for these higher-order effects and evaluated the relative contributions of four, specific lower-order vulnerabilities (anxiety sensitivity, rumination, self-criticism, self-oriented perfectionism). Participants were 38 depressed patients and 38 patients with panic disorder matched as closely as possible for age and gender, and all were diagnosed using the same structured interview by an experienced clinician. Results from hierarchical logistic regression analysis were consistent with predictions from the tripartite model in that only the unique features of arousal and positive affectivity differentiated the two diagnostic groups. At a lower-order level, only anxiety sensitivity (and its facet of fear of physical symptoms) and a ruminative response style demonstrated incremental predictive ability. The discussion focuses on the relationships among these higher-order and lower-order variables, and their potential importance for understanding specific manifestations of psychopathology.     

What role does neuroticism play in the association between negative job characteristics and anxiety and depression?

Many studies have established an association between job characteristics and anxiety and depression and noted that personality characteristics such as neuroticism likely play a role in creating or modifying these associations. Few studies, however, have explicitly tested or compared these possible alternative roles. In this study, we tested several specific hypotheses about neuroticism and its effects on job characteristics, anxiety and depression and their association in a series of structural equation models. Participants (N = 372) completed the Big Five Inventory, Job Contents Questionnaire and General Health Questionnaire. We tested (a) whether neuroticism is likely to be an important confounder of the association between job characteristics and anxiety and depression and (b) whether neuroticism moderates the association between job characteristics and anxiety and depression. Results indicated large attenuations by neuroticism of the association between job characteristics and anxiety and depression but there remained significant effects of psychological demands on anxiety, and social support on depression independent of neuroticism. Evidence was also found for interaction effects between neuroticism and decision latitude, with those lower in neuroticism being at higher risk for depression under conditions of low control.     

Personality dimensions and emotional problems: The mediating role of irrational beliefs in Pakistani adult non‐clinical sample

This study presents the first examination of the relation between the Big Five personality traits, irrational beliefs and emotional problems in Pakistan, which is an understudied country in the psychological distress literature. A total of 195 participants (aged 25–60 years), employees at COMSATS University, completed a demographic information sheet, the Big Five Personality Questionnaire, the Irrational Belief Inventory and two subscales of the Brief Symptom Inventory including depression and anxiety. Direct effects of neuroticism, openness and conscientiousness were also observed for depression and anxiety. Structural Equation Modelling demonstrated that irrational beliefs played a significant mediating role in the relationship between neuroticism and anxiety and neuroticism and depression. The results highlight the importance of cognitive beliefs in functionally linking personality traits and emotional problems.     

Psychological adaptation to ICDs and the influence of anxiety sensitivity

Forty-nine patients scheduled for implantable cardioverter defibrillator (ICD) implantation completed self-report psychological questionnaires prior to surgery and at 2, 4 and 6 months after surgery. The most common psychological problem identified was anxiety, with clinically significant cases based on the Depression Anxiety and Stress Scale (DASS) ranging between 26% and 34%. Clinically significant depression ranged between 8% and 20%. Anxiety sensitivity was associated with high levels of anxiety, depression and stress at baseline, but not at follow-up assessments. It is possible that within this population anxiety sensitivity is associated with distress during high-threat situations, but the relationship diminishes once the threat has passed. In addition, the reassurance provided by the ICD may reduce negative perceptions of symptoms, promoting psychological adaptation.     

Cognitive Vulnerability to Emotional Symptoms: Reconsidering the Role of Worry and Rumination

The present study explored the pathways whereby cognitive variables (worry, rumination) may explain the relation between neuroticism and emotional symptoms in a community sample of adults (N?=?499). All participants completed a battery of questionnaires including measures of neuroticism, worry, rumination, anxiety and depression. Multiple mediation and moderated mediation analyses were used. Worry was a common pathway explaining the effect of neuroticism on both anxiety and depressive symptoms. The brooding subtype of rumination significantly mediated the relation between neuroticism and anxiety symptoms, but the reflection subtype did not have a mediating effect. Although worry by itself mediated the association between neuroticism and anxiety symptoms, it required a certain level of brooding to exert its mediating effect on the relation between neuroticism and depressive symptoms. The results are discussed in light of previous research and recent developments in treatment. Clinical implications and suggestions for future research are also discussed.     

The Moderating Relationship of Spirituality on Negative Life Events and Psychological Adjustment

The authors used a path model to examine how spirituality moderates relationships between negative life experiences and psychological adjustment, operationalized for this study as levels of depression and anxiety. Results suggest that spirituality provides a significant moderating effect for both depression and anxiety. The moderating effect was stronger for depression than for anxiety.     

Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: a quantitative review of 30 years of investigations

This meta-analysis included 729 studies from 161 articles investigating how acute stress responsivity (including stress reactivity and recovery of hypothalamic-pituitary-adrenal [HPA] axis, autonomic, and cardiovascular systems) changes with various chronic psychosocial exposures (job stress; general life stress; depression or hopelessness; anxiety, neuroticism, or negative affect; hostility, aggression, or Type-A behavior; fatigue, burnout, or exhaustion; positive psychological states or traits) in healthy populations. In either the overall meta-analysis or the methodologically strong subanalysis, positive psychological states or traits were associated with reduced HPA reactivity. Hostility, aggression, or Type-A behavior was associated with increased cardiovascular (heart rate or blood pressure) reactivity, whereas anxiety, neuroticism, or negative affect was associated with decreased cardiovascular reactivity. General life stress and anxiety, neuroticism, or negative affect were associated with poorer cardiovascular recovery. However, regarding the sympathetic nervous system and parasympathetic nervous system, there were no associations between the chronic psychosocial factors and stress reactivity or recovery. The results largely reflect an integrated stress response pattern of hypo- or hyperactivity depending on the specific nature of the psychosocial background.     

Self-Compassion and Psychological Well-Being in Older Adults

Self-compassion refers to a kind and nurturing attitude toward oneself during situations that threaten one’s adequacy, while recognizing that being imperfect is part of being human. Although growing evidence indicates that self-compassion is related to a wide range of desirable psychological outcomes, little research has explored self-compassion in older adults. The present study investigated the relationships between self-compassion and theoretically based indicators of psychological adjustment, as well as the moderating effect of self-compassion on self-rated health. A sample of 121 older adults recruited from a community library and a senior day center completed self-report measures of self-compassion, self-esteem, psychological well-being, anxiety, and depression. Results indicated that self-compassion is positively correlated with age, self-compassion is positively and uniquely related to psychological well-being, and self-compassion moderates the association between self-rated health and depression. These results suggest that interventions designed to increase self-compassion in older adults may be a fruitful direction for future applied research.     

Psychological well-being of patients with insomnia and its relationship with anxiety and depression

The aims of the present study are to evaluate the impact of insomnia on psychological well-being and to examine the associations of insomnia and psychological well-being with anxiety and depression. Forty-one patients attending our hospital-based Centre for sleep medicine were administered scales for the evaluation of insomnia (ISI), anxiety (STAI-Y), depression (BDI-II) and psychological well-being (PWB). The scores were compared to those of a control group of 68 subjects attending the hospital for routine examinations or as accompanying persons. Significant differences between patients and controls were detected for anxiety and depression, as well as for psychological well-being. Even if subclinical on average, anxiety and depression symptoms were significantly related to poor psychological well-being, whereas insomnia per se was not. These findings suggest that patients with insomnia report a relevant impact on their psychological well-being, and that such an impact seems to be strongly associated with concomitant subthreshold symptoms of anxiety and depression. The implications for diagnosis and treatment are discussed.     

Breathing Characteristics and Symptoms of Psychological Distress: An Exploratory Study

In this exploratory study of the relationship between characteristics of breathing and 3 common psychological issues (i.e., symptoms of anxiety, alexithymia, and depression), 79 college‐age adults were examined using self‐report, rater observation, and physiological measures. Results indicated significant positive relationships between dysfunctional breath characteristics and symptoms of both anxiety and alexithymia. A significant positive correlation was found between self‐reported symptoms of dysfunctional breathing and symptoms of depression, but no significant relationships existed between symptoms of depression and either rater‐observed breath characteristics or physiological measures.     

The Psychological Impact of Domestic Violence on Spanish Women1

This study examined the psychological impact of partner violence on 240 Spanish women who were identified as abused, comparing them to a control group of 240 non‐abused women. The abused women suffered more long‐lasting anxiety and insomnia, severe depression, and somatic symptomatology, and also had lower self‐esteem than did the non‐abused women. The severity of the psychological abuse was correlated positively with the severity of the physical abuse, while the number of years of abuse endured correlated with the women's age and number of children. The most relevant variable for predicting severe depression, social dysfunction, anxiety and insomnia, and somatic symptoms was low self‐esteem.     

Psychological adjustment to cancer in a collective culture

We examined the associations between social support, health locus of control, neuroticism, and psychological adjustment (PA) in 152 Hong Kong Chinese patients. Our objective was to assess hypotheses relevant to the cohesive family structure, and the belief in external sources of control that pervade this culture. Use of social support by individuals who reported reliable support, and internal locus of control (ILOC) associated positively, and neuroticism associated negatively with PA. The independent variables accounted for up to 39% of the variance in PA measures. Our findings provide rare information about coping with serious illness in a non‐Western culture. They illustrate the centrality of family relationships in Chinese culture. They suggest that even in a culture where supernatural beliefs are widespread, ILOC relates positively and “chance” beliefs relate negatively to adjustment. Finally they support the importance of controlling for neuroticism in examining stress.     

Anxiety and Depression in Patients with Amyotrophic Lateral Sclerosis and Their Caregivers

A large number of studies have investigated a variety of psychological aspects in people with Amyotrophic Lateral Sclerosis, but there is still considerable uncertainty concerning the actual morbidity, in particular for anxiety. We aim to evaluate depression levels and anxiety disposition in ALS patients and their caregivers, in comparison to healthy controls. We conducted a cross-sectional comparison between people with ALS, their caregivers and a non-clinical control group in order to evaluate anxiety and depression levels. 40 ALS patients, their caregivers and 40 healthy adult subjects completed the Beck Depression Inventory II (BDI-II) and the State-Trait Anxiety Inventory—Y2 scale (STAI). We compared overall and single item scores in order to find differences between the three groups. BDI-II scores were significantly different between groups. Depression scores were higher for patients than for healthy controls, in both somatic and psychological sub-scales. Caregivers presented higher levels of psychological depression in comparison with healthy controls, and lower scores of somatic depression in comparison to patients. No differences were found in trait anxiety levels comparing the three groups. ALS patients and their caregivers developed more depression related symptomatology than the non-clinical sample. However, susceptibility to anxiety for both patients and caregivers seemed to be at a normal level.     

The Tripartite Model of Neuroticism and the suppression of depression and anxiety within an escalation of commitment dilemma

We found evidence of a mutual suppression effect between anxiety and depression on an individual's level of commitment within escalation dilemmas. On the one hand, our results demonstrate a positive relationship between anxiety and level of commitment; on the other, our results demonstrate a negative relationship between depression and level of commitment. Based on the opposing relationships between anxiety and depression and commitment, the broad factor of neuroticism does not demonstrate any relationship with level of commitment, and the significant effects of anxiety and depression on commitment is contingent upon partialling the effect of the other facet of neuroticism. Thus, we contend that applied psychologists, who have focused on neuroticism as a broad construct, should consider the large body of work among clinical psychologists, who argue that anxiety and depression have unique variance associated with them. We conclude by addressing organizational implications of measuring the broad trait of neuroticism more narrowly.     

Psychological correlates of early onset of ischemic heart disease in a sample drawn from a Pakistani population

Even in the presence of substantial empirical evidence which proves that psychological risk factors play a significant role in onset of ischemic heart disease (IHD), in Pakistan researchers have not paid much attention to exploring these factors. This research was mainly undertaken to investigate whether psychological factors such as stress, anxiety, depression, anger, and hostility in their intense states are prevalent within the indigenous patients with IHD. It was hypothesized that: High levels of perceived stress will significantly increase risk for IHD versus lower levels of perceived stress; high levels of anxiety will significantly increase the risk for IHD versus lower levels of anxiety; high levels of depression will increase the chances of IHD versus lower levels. Likewise, it was proposed that elevated trait anger will significantly increase risk for IHD versus lower levels of trait anger and that higher levels of hostility significantly increase risk for IHD versus lower levels. A case–control research design was employed to conduct this study. To investigate the association of the abovementioned factors with IHD and to find whether these factors differ between cases and controls, we solicited a sample of 190 patients with confirmed diagnosis of IHD and 380 age‐ and gender‐matched community controls, who were free of IHD, aged 35 to 55 years. Standardized tools to measure psychological factors were translated and semistandardized into the national language and their psychometric properties were predetermined before use in this study. To infer the proposed hypotheses, multivariate binary logistic regression analysis was carried out. Results highlight significant association between stress, depression, anxiety, anger, and IHD. Implications for the implementation of routine screening for psychological factors, particularly stress, depression and anger, are proposed.     

Personality, emotions and coping styles: predictive value for the evolution of cancer patients

This study had a twofold goal: to define differences in psychological aspects between cancer patients and a control group and to explore the predictive value of such aspects for the evolution of the disease two years later. Firstly, personality, anxiety, anger and depression were assessed in both groups. Results of t-analyses revealed significant group differences. In personality, cancer patients had higher levels of neuroticism and lower levels of extraversion, agreeableness and conscientiousness than the control group. In emotional variables, cancer patients had higher levels of anxiety and some aspects of anger, but there were no group differences in depression levels. Secondly, applying a quasi-prospective design, the predictive value of personality, emotions and coping styles for the evolution of cancer (favourable or unfavourable) was explored using generalized linear models and logistic regression. A four-predictor logistic model was fitted: Anger Expression-In, Resignation, Self-blame and Conscientiousness, indicating that the higher Anger Expression-in, Resignation, and Self-blame scores together with a lower Conscientiousness score, the more likely it is for patients' cancer to evolve unfavourably. These results indicate the crucial role of psychological aspects for the evolution of the disease and the need to include such aspects in the design of clinical interventions.     

To be sure, to be sure: intolerance of uncertainty mediates symptoms of various anxiety disorders and depression

The Intolerance of Uncertainty Model was initially developed as an explanation for worry within the context of generalized anxiety disorder. However, recent research has identified intolerance of uncertainty (IU) as a possible transdiagnostic maintaining factor across the anxiety disorders and depression. The aim of this study was to determine whether IU mediated the relationship between neuroticism and symptoms related to various anxiety disorders and depression in a treatment-seeking sample (N=328). Consistent with previous research, IU was significantly associated with neuroticism as well as with symptoms of social phobia, panic disorder and agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder, and depression. Moreover, IU explained unique variance in these symptom measures when controlling for neuroticism. Mediational analyses showed that IU was a significant partial mediator between neuroticism and all symptom measures, even when controlling for symptoms of other disorders. More specifically, anxiety in anticipation of future uncertainty (prospective anxiety) partially mediated the relationship between neuroticism and symptoms of generalized anxiety disorder (i.e. worry) and obsessive-compulsive disorder, whereas inaction in the face of uncertainty (inhibitory anxiety) partially mediated the relationship between neuroticism and symptoms of social anxiety, panic disorder and agoraphobia, and depression. Sobel's test demonstrated that all hypothesized meditational pathways were associated with significant indirect effects, although the mediation effect was stronger for worry than other symptoms. Potential implications of these findings for the treatment of anxiety disorders and depression are discussed.     

Demographic,health-related and psychosocial predictors of changes in depressive symptoms and anxiety in late middle-aged and older persons with fall-related injuries

Research on anxiety and depression after fall-related injuries to the extremities and its pre-fall determinants is scarce. The present study sought to examine change between pre-fall and post-fall anxiety and depression and its (pre-fall) predictors. Data were obtained from 181 Dutch persons, aged 57 and older, who sustained fall-related injuries between 1993 and 1997. Demographic (e.g. socio-economic status), health-related (e.g. number of chronic conditions), and psychosocial (e.g. social support, neuroticism) factors were determined in 1993 (prior to the fall). Depressive symptoms and anxiety were determined prior to the fall, and two, five and twelve months after the fall. Taking into account pre-fall anxiety and depression, pre-fall neuroticism was the most consistent, independent predictor of adverse changes in anxiety and depression. Other factors, including severity of the fall and age were not related to changes in anxiety and depression. Our prospective findings may be interpreted as support for the importance of personality for mental health outcomes in persons who have sustained fall-related injuries.     

Empathy in informal dementia caregivers and its relationship with depression,anxiety, and burden

Background/Objective: Recent interventions aim to heighten informal caregivers’ empathy levels assuming that this will lead to better well-being. However, previous studies have explored linear associations between empathy and aspects of well-being and yielded mixed results. We hypothesized that quadratic models may be more fitting to describe these relationships. Method: A cross-sectional study, with two groups (201 informal caregivers, and 187 non-caregivers) was conducted. Participants completed questionnaires on cognitive and affective empathy, and depression, anxiety, and caregiver burden. AN(C)OVA's and multiple hierarchical regression analyses including linear and quadratic terms were used to analyze the data. Results: For caregivers, there was a negative quadratic relationship between depression and cognitive empathy, and a positive linear relationship between anxiety and affective empathy, irrespective of sociodemographic characteristics. For non-caregivers, there were positive quadratic relationships between depression and cognitive and affective empathy, and between anxiety and affective empathy. The empathy levels did not differ between the groups. Conclusions: While caregivers and non-caregivers had the same amount of empathy, the relationships between empathy and depression and anxiety differed between the groups. Interventions for informal caregivers could aim to heighten cognitive empathy and to lower affective empathy to diminish depression and anxiety symptoms.