Responses to Positive Affect in Daily Life: Positive Rumination and Dampening Moderate the Association Between Daily Events and Depressive Symptoms

Depressive rumination has been strongly linked to the development and maintenance of depression; however, less attention has been paid to ruminative processes in response to positive affect, and fewer have examined these processes in daily life. The current study sought to address these gaps by exploring depressive rumination and two forms of responses to positive affect, dampening and positive rumination, under ecologically valid conditions using daily diary methodology. One hundred fifty-seven young adults completed 14-day end-of-day diaries assessing positive affect and depressive symptoms in relation to depressive rumination, responses to positive affect, and daily positive and negative events. Daily depressive rumination predicted stronger associations between negative events and daily depressive symptoms. Higher daily dampening was associated with higher daily depressive symptoms and decreased positive affect and predicted lower associations between daily positive events and improvements in mood (including reduced daily positive affect and increased daily depressive symptoms). Higher daily positive rumination was negatively associated with daily depressive symptoms and interacted with daily positive events such that positive rumination had a greater impact on depressed mood on days when positive experiences were low. Results indicate that both depressive rumination and responses to positive affect play a role in influencing daily mood and depressive symptoms.     

How do Relationship Stability and Quality Affect Wellbeing?: Romantic Relationship Trajectories,Depressive Symptoms,and Life Satisfaction across 30 Years

Lifecourse theory scholars focus on how individuals traverse social roles, such as marriage, parenthood, and employment, in similar and different ways across their lives. This study examined one specific role trajectory: romantic relationships. This study examined men’s and women’s (N?=?3617) relationship status and quality across approximately 30 years. Using second-order latent class analysis, results showed four predominant relationship role trajectories: (a) Multiple Transitions, (b) Stable Marriage with High Conflict, (c) Stable Marriage with High Satisfaction, and (d) Marriage to Divorce/cohabitation. These relationship role trajectories differed on two aspects of quality of life: life satisfaction and depressive symptoms. Individuals in the Multiple Transitions trajectory consistently reported poorest quality of life; however, those in the Multiple Transitions and Stable Marriage with High Conflict trajectories were the only that reported decreases in depressive symptoms over 30 years. Relationship satisfaction poorly differentiated the trajectories compared to relationship conflict and stability.     

Do Children’s Attributions Mediate the Link Between Parental Conditional Regard and Child Depression and Emotion?

Both parental conditional regard for academics and depressogenic attributions are related to detrimental psychological outcomes for children. Here we examine associations among parental conditional negative regard, child depressogenic attributions, child depressive symptoms, and emotion reactivity in children between the ages of 8 and 12, as well as whether children’s self-reported and behavioral attributions for negative events mediate associations between parental conditional negative regard for academics with children’s depressive symptoms and emotion reactivity. In Study 1 (N?=?108, M _age ?=?9.73, 50 male), children’s self-reported attributions for hypothetical events mediated the link between parental conditional negative regard and child depressive symptoms. In Study 2 (N?=?104, M _age ?=?10.28, 54 male), children attempted an impossible puzzle task while their skin conductance level was monitored, after which they completed an interview that was coded for spontaneous attributions for failure. Children’s spontaneous attributions mediated the link between parental conditional negative regard and child emotion reactivity, but not depressive symptoms. Findings suggest that children’s attributions may be a mechanism through which parental conditional negative regard is related to children’s depressive symptoms and emotion reactivity during a performance challenge. These results have implications for developmental models of depression risk and potential areas for clinical interventions with both children and their parents.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

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.     

Self-Competence and Depressive Symptom Trajectories during Adolescence

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

Associations Between Dopamine D2 Receptor (<Emphasis Type="Italic">DRD2</Emphasis>) Gene,Maternal Positive Parenting and Trajectories of Depressive Symptoms from Early to Mid-Adolescence

Using data from the Longitudinal Study of Chinese Children and Adolescents (LSCCA), this study is the first to examine the roles of the dopamine D2 receptor (DRD2) gene polymorphisms (i.e., TaqIA and A241G) and maternal positive parenting at ages 10 and 11 years in the trajectories of depressive symptoms from early to mid-adolescence (ages 11 to 16 years). In a sample of 1090 Chinese adolescents (50% girls), three trajectories of depressive symptoms were identified: (i) low-stable (36.1%), (ii) moderate-increasing (44.5%), and (iii) high-increasing (19.4%). A241G AA homozygotes and youth exposed to lower levels of maternal positive parenting were both at increased odds to follow the high-increasing vs. low-stable trajectory. Moreover, the A241G polymorphism interacted with maternal positive parenting to distinguish the moderate-increasing trajectory from the high-increasing and the low-stable trajectories. For A241G G-allele carriers, but not AA homozygotes, exposure to high quality of maternal parenting decreased the odds to follow the high-increasing vs. moderate-increasing trajectory of depressive symptoms. For AA homozygotes, but not G-allele carriers, high quality of maternal parenting increased the odds to follow the low-stable vs. moderate-increasing trajectory. The DRD2 TaqIA polymorphism had neither a direct nor an interactive effect with maternal positive parenting on trajectory membership. The current findings highlight the importance of investigating gene-by-environment interactions (G × E) in trajectories of depressive symptoms over adolescence, and support a developmental versus static nature of G × E effects.     

Transitions of Developmental Trajectories of Depressive Symptoms Between Junior and Senior High School Among Youths in Taiwan: Linkages to Symptoms in Young Adulthood

We investigated the heterogeneous developmental trajectories of depressive symptoms in junior and senior high school, the transitions to different trajectories after entering senior high school, and the linkages to the development of depressive symptoms in early adulthood among Taiwanese adolescents. An eight-wave longitudinal data set was analyzed, including 2687 Taiwanese adolescents (51.2% boys, M age?=?14.3 at first wave). Using a manual three-step latent transition growth mixture model, we found that a three-class solution fit the data for both junior high school (termed high-improving, cumulative, and JS-low-stable) and senior high school period (termed heightening, moderate-stable, and HS-low-stable). The depressive symptoms of most individuals maintained at a low level (i.e., low-stable) from adolescence to early adulthood; however, nearly a quarter of the adolescents reported depressive symptoms that were moderately or highly severe in senior high school and beyond. More than 30% of the participants experienced transitioning into a different developmental trajectory between junior and senior high school. When perceiving a higher level of paternal behavioral control, adolescents categorized in the high-improving class in junior high school would have a higher chance to transition to the moderate-stable class than to HS-low-stable class in senior high school. Adolescent boys and girls did not differ in the probability of transitioning between trajectories across junior and senior high school. However, a clear and consistent pattern of symptoms between late adolescence and early adulthood was not observed. These results help elucidate the heterogeneity and fluidity associated with the development of depressive symptoms between early adolescence and early adulthood in light of school transition among youths in Taiwan.     

Mediational Pathways Through Which Positive and Negative Emotionality Contribute to Anhedonic Symptoms of Depression: A Prospective Study of Adolescents

This study takes a developmental psychopathological approach to examine mechanisms through which baseline levels of positive emotionality (PE) and negative emotionality (NE) prospectively predict increases in anhedonic depressive symptoms in a community sample of 350 adolescents (6th–10th graders). Dependent stressors mediated the relationship between baseline levels of NE and anhedonic depressive symptoms after controlling for initial symptoms. Supportive relationships mediated the relationship between baseline levels of PE and anhedonic depressive symptoms, after controlling for baseline symptoms. In addition, NE X PE interacted to predict later anhedonic depressive symptoms, such that adolescents with low levels of PE and high levels of NE experienced the greatest increase in anhedonic depressive symptoms. Last, supportive relationships interacted with baseline PE to predict prospective changes in anhedonic depressive symptoms, such that adolescents with low PE and low supportive relationships experienced the greatest increase in anhedonic depressive symptoms. Results are discussed in terms of current theoretical models of the link between temperament and depression. This work was supported, in part, by NIMH grants R03-MH 066845 and 1R01HD054736-01A1 to Benjamin L. Hankin.     

Maltreated Children in Out-of-Home Care: The Relation between Attachment Quality and Internalizing Symptoms

Maltreated children in out-of-home care are at high risk for poor relationships with caregivers (i.e., biological parents and substitute caregivers) and high levels of internalizing symptoms. It is unclear if these poor relationships are related to, and account for a large portion of the variance in maltreated children’s internalizing symptoms, above and beyond maltreatment type and out-of-home care factors. This study examined the relation between attachment quality with both biological parents and substitute caregivers and children’s internalizing symptoms within a sample of 493 maltreated children (aged 9–11; 51.0?% male) recently placed in out-of-home care. A series of hierarchical regression models indicated that greater child-reported attachment quality with both biological parents and substitute caregivers was associated with fewer child-reported anxiety (β?=??.15, p?<?.01; β?=??.29, p?<?.001, respectively) and depression symptoms (β?=??.14, p?<?.01; β?=??.28, p?<?.001, respectively) as well as fewer child internalizing symptoms (β?=??.12, p?<?.05; β?=??.14, p?<?.01, respectively). Attachment quality with the biological parent and substitute caregiver each explained a significant proportion of the variance in children’s internalizing symptoms, above and beyond child demographics, maltreatment type, and out-of-home care variables. The study also examined whether children’s attachment with substitute caregivers moderated the relationship between children’s attachment with biological parents and children’s internalizing symptoms. No statistically significant moderation effects were found. Future clinical work should focus on enhancing attachment quality between children and both biological parents and substitute caregivers, as these relationships appear to individually relate to the children’s internalizing symptomology.     

Family Allocentrism and Adolescent Depressive Symptoms: The Role of Self-Identity Style

Recent research has found that a strong family allocentrism relates to reduced adolescent depressive symptoms. Besides providing continuous support for this relation, this research extended the scope by exploring whether there was a U-shaped association between family allocentrism and depressive symptoms and testing the mediation effect of identity style among Italian adolescents (N?=?387, 183 boys, 204 girls, M_age?=?16.38 years). Result of hierarchical regression model showed that the association between family allocentrism and depressive symptoms was linear rather than U-shaped. More importantly, this linear relation was mediated by normative and diffuse-avoidant style. In sum, the current findings suggest that adolescents who are allocentric toward family tend to follow family members’ expectations to establish self-identity and deal with identity issues more proactively, and thus they are less likely to experience depressive symptoms. Moreover, there is no significant evidence that too much family allocentrism would lead to elevated depressive symptoms.     

Anxiety and Depression During Childhood and Adolescence: Testing Theoretical Models of Continuity and Discontinuity

The present study sought to clarify the trajectory (i.e., continuous vs. discontinuous) and expression (i.e., homotypic vs. heterotypic) of anxiety and depressive symptoms across childhood and adolescence. We utilized a state-of-the-science analytic approach to simultaneously test theoretical models that describe the development of internalizing symptoms in youth. In a sample of 636 children (53% female; M _age = 7.04; SD _age = 0.35) self-report measures of anxiety and depression were completed annually by youth through their freshman year of high school. For both anxiety and depression, a piecewise growth curve model provided the best fit for the data, with symptoms decreasing until age 12 (the “developmental knot”) and then increasing into early adolescence. The trajectory of anxiety symptoms was best described by a discontinuous homotypic pattern in which childhood anxiety predicted adolescent anxiety. For depression, two distinct pathways were discovered: A discontinuous homotypic pathway in which childhood depression predicted adolescent depression and a discontinuous heterotypic pathway in which childhood anxiety predicted adolescent depression. Analytical, methodological, and clinical implications of these findings are discussed.     

Parenting Style and Children’s Life Satisfaction and Depressive Symptoms: Preliminary Findings from Romania,France, and Russia

This study evaluated how culture relates to parenting and children’s life satisfaction and depressive symptoms, and whether there are cultural differences in how maternal parenting style relates to children’s adjustment among three cultural contexts: Romanian, Russian, and French. The sample included 325 children, aged 9–11 years, from Romania (n = 123), Russia (n = 112), and France (n = 90). Children completed questionnaires regarding their perceptions of maternal parenting style, and their life satisfaction and depressive symptoms. French children reported lower levels of authoritative parenting style and higher levels of authoritarian parenting style compared to their Romanian and Russian peers. Further, French children reported higher levels of depressive symptoms than both their Romanian and Russian peers, while Russian children had higher life satisfaction than their Romanian and French peers. The strengths of the associations between parenting style and both children’s life satisfaction and depressive symptoms, however, did not differ based on children’s cultural context. Our findings suggest the importance of cultural context in relation to parenting styles and children’s life satisfaction and depressive symptoms. Further, our study shows that the relations between parenting and children’s adjustment are similar across the cultural contexts included in this study.     

Responses to Positive Affect Predict Mood Symptoms in Children Under Conditions of Stress: A Prospective Study

Rumination to negative affect has been linked to the onset and maintenance of mood disorders in adults as well as children. Responses to positive affect have received far less attention thus far. A few recent studies in adults suggest that responses to positive affect are involved in the development of both depressive and hypomanic symptoms, but thus far no study has investigated their role in childhood mood problems. The purpose of the present study was to validate a child version of the Responses to Positive Affect questionnaire and examine the extent to which responses to positive affect prospectively predict mood symptoms over a 3-month interval. The Responses to Positive Affect questionnaire for Children was found to assess two types of responses to positive affect: Positive Rumination and Dampening. Both subscales showed sufficient internal consistency and moderate stability over a 3-month interval. Low levels of positive rumination and high levels of dampening were concurrently associated with depressive symptoms, over and above responses to negative affect. Importantly, low levels of positive rumination also predicted increases in depressive symptoms over a 3-month interval over and above baseline symptoms in children reporting high levels of stress. Both positive rumination and dampening were positively related to concurrent hypomanic symptoms and high levels of positive rumination predicted increases in hypomanic symptoms over a 3-month interval over and above baseline symptoms in children reporting high levels of stress. The results underscore the added value of assessing responses to positive affect in addition to responses to negative affect.     

Longitudinal Associations between Depression and Aggression in Children and Adolescents

Due to the longstanding and detrimental effects of engaging in aggressive behaviour and of experiencing symptoms of internalizing problems in children and adolescents, there is an increasing interest in identifying the temporal sequence between these 2 problems with previous research yielding inconsistent findings. Therefore, the longitudinal links between relational aggression, physical aggression, and depression were examined across 7 years in a sample of 643 children (54 % girls) aged 10 at Time 1. Three models were compared— (1) the failure model, in which aggression predicted depression, (2) the acting out model, in which depression predicted aggression, and (3) a reciprocal model, in which both aggression and depression shared a reciprocal relation over time. Cross-lagged path analyses using structural equation modeling supported the failure model (i.e., engaging in relational and physical aggression predicts subsequent depressive symptoms). Findings were similar for boys and girls. These findings add to the literature suggesting that externalizing problems precede internalizing problems.     

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

Child depression is an impairing condition for which psychotherapies have shown modest effects. Parental depression is a risk factor for development of child depression and might also be negatively associated with child depression treatment outcomes. To explore this possibility, we analyzed data from a study in which children were treated for depression after parental depressive symptoms had been assessed at baseline. Among children treated for depression in a randomized controlled trial, we identified 31 who had child- and parent-report pre- and post-treatment data on child symptoms and parent-report of pre-treatment parental depressive symptoms. Children were aged 8–13, 77% boys, and 52% Caucasian, 13% African-American, 6% Latino, and 29% multi-racial. Analyses focused on differences in trajectories of change (across weekly measurements), and post-treatment symptoms among children whose parents did (n = 12) versus did not (n = 19) have elevated depressive symptoms at baseline. Growth curve analyses showed markedly different trajectories of change for the two groups, by both child-report (p = 0.03) and parent-report (p = 0.03) measures: children of parents with less severe depression showed steep symptom declines, but children of parents with more severe depression showed flat trajectories with little change in symptoms over time. ANCOVAs showed lower post-treatment child symptoms for children of parents with less severe depression versus parents with more severe depression (p = 0.05 by child report, p = 0.01 by parent report). Parental depressive symptoms predict child symptom trajectories and poorer child treatment response, and may need to be addressed in treatment.     

Attachment Representations and Maternal Confidence: The Mediating Role of Postnatal Depressive Symptoms and Negative Thoughts

Attachment security can act as an inner resource to promote women’s adjustment to motherhood. However, the mechanisms explaining the relationship between attachment representations and maternal adaptation outcomes are not well understood. This study aimed to examine the direct and indirect effects of attachment representations on maternal confidence, through postpartum negative automatic thoughts and depressive symptoms. The sample consisted of 387 postpartum women who completed a cross-sectional online survey including measures of attachment representations, depressive symptoms, postpartum negative automatic thoughts and maternal confidence. Our results showed a significant relationship between more insecure attachment representations and higher depressive symptoms (p?<?.001), but also with more frequent postpartum negative automatic thoughts (p?<?.001); depressive symptoms and postpartum negative automatic thoughts were also inversely associated with women’s maternal confidence (p?<?.001). Moreover, indirect effects of attachment representations on maternal confidence were found, but only through postpartum negative thoughts [attachment-related anxiety: 95% CI?=??0.03/?0.01; attachment-related avoidance: 95% CI?=??0.05/?0.01]. The results of the present study emphasize the important role of the cognitive component of depressive symptomatology (postpartum negative automatic thoughts) in the relationship between attachment representations and maternal confidence, allowing to draw specific implications. We highlight the implications for clinical practice during the perinatal period to address both negative thoughts and women’s maternal confidence.     

Child Conduct Problems Across Home and School Contexts: a Person-Centered Approach

To examine patterns of conduct problems across the home and school context, we used latent class analysis to analyze primary caregivers’ and teachers’ ratings on the conduct problems subscale of the Strengths and Difficulties Questionnaire (Goodman Journal of Child Psychology and Psychiatry, 38, 581–586, 1997) in the Family Life Project (N?=?1,292), a prospective study of child development in rural and small town contexts. We found a similar four-class solution at 5 and 7 years of age. In decreasing prevalence, the following classes were identified: (1) low symptoms reported by both informants (low cross-context); (2) high parent-reported symptoms, low teacher-reported symptoms (home context); (3) low parent-reported symptoms, moderate teacher-reported symptoms (school context); and (4) high symptoms reported by both informants (high cross-context). Classes exhibited stability from age five to age seven: children were more likely to remain in the same class than to transition to a different class, and longitudinal stability was especially high for children in the low cross-context class at age 5. A number of child and family characteristics measured in early childhood (executive function, verbal ability, poverty-related risk, sensitive parenting, and parental depressive symptoms) were associated with class membership at age five and age seven, but were generally not associated with longitudinal transitions between classes.     

Exploring the Relationships Between Maternal Mental Health Symptoms and Young Children’s Functioning in a Low-Income,Minority Sample

Poor maternal mental health, including depression and high stress levels, can negatively impact many domains of child development, particularly among low-income, ethnic minority families experiencing multiple stressors. Low-income minority mothers, particularly Hispanic mothers, are also at increased risk of experiencing exposure to community violence and other types of trauma. However, studies exploring the additional impact of maternal trauma symptoms on children’s functioning are rare. This study aims to address this gap by examining the impact of maternal trauma symptoms on young children’s functioning in a low-income, predominantly Hispanic sample through the mechanisms of maternal depressive symptoms, and mother’s experiences of parenting stress and strain. The sample consisted of 158 biological mothers (58% Hispanic, 13% African American, 5.7% White American) who were participating in community-based mental health treatment for their children (M_AGE?=?3.7, SD?=?1.2). Mothers completed questionnaires providing information on their children’s behaviors and their own mental health and stress levels at intake. Path analysis indicated that there was a significant indirect effect of maternal trauma symptoms on children’s behavior problems through maternal depressive symptoms and maternal stress in the parent-child relationship (β?=?0.09, p?<?0.01). In addition, there was a direct effect of maternal trauma symptoms on children’s behavior problems (β?=?0.32, p?<?0.001). The results suggest that maternal trauma symptoms, in addition to maternal depressive symptoms, contribute to poor maternal and child functioning.     

A prospective investigation of rumination and executive control in predicting overgeneral autobiographical memory in adolescence

The CaR-FA-X model (Williams et al., 2007), or capture and rumination (CaR), functional avoidance (FA), and impaired executive control (X), is a model of overgeneral autobiographical memory (OGM). Two mechanisms of the model, rumination and executive control, were examined in isolation and in interaction in order to investigate OGM over time. Across two time points, six months apart, a total of 149 adolescents (13–16 years) completed the minimal-instruction autobiographical memory test, a measure of executive control with both emotional and nonemotional stimuli, and measures of brooding rumination and reflective pondering. The results showed that executive control for emotional information was negatively associated with OGM, but only when reflective pondering levels were high. Therefore, in the context of higher levels of reflective pondering, greater switch costs (i.e., lower executive control) when processing emotional information predicted a decrease in OGM over time.