A 2-year longitudinal study of depression among Alzheimer's caregivers.

Results from a 2-year (4 waves) longitudinal study show strong evidence for patient decline and high levels of depressive symptomatology among caregivers. Female caregivers reported high, stable rates of depressive symptomatology throughout the study, whereas male caregivers exhibited significant increases in depression over time. Cross-sectional multivariate analyses revealed significant positive relationships between depression and number of patient problem behaviors, negative social support, and concern about financial resources; negative relationships were found between depression and social support, quality of prior relationship, and satisfaction with social contacts. Three significant independent predictors of change in depression were found: Lower depression scores at Time 1 were related to increases in depression over time; men were more likely than women to experience increases; and a decline in social support resulted in increased depression.     

Exploring the factors contributing to empowerment of Turkish migrant women in the UK

This study examined the role of demographic factors (length of stay, education and language level), perceived discrimination, social support, four acculturation attitudes, and psychological distress in predicting empowerment among Turkish migrant women in the UK. The study sample comprised 248 Turkish migrant women (mean age: 34.38; SD: 7.6) living in London. Self-report questionnaires were used to assess empowerment, social support, acculturation attitude and psychological distress. The study hypothesized that perceived discrimination; acculturation attitudes of separation, assimilation and marginalization; and psychological distress would be negative predictors of empowerment and that social support and an integration acculturation attitude would be positive predictors of empowerment. To some extent, the study findings supported this hypothesis. Hierarchical regression analysis indicated psychological distress to be the most significant predictor of empowerment, with other significant predictors including level of education and social support. More specifically, lower levels of psychological distress and higher levels of education and social support appeared to predict greater empowerment. Based on these findings, it can be concluded that level of education and social support may function as protective factors and that psychological distress may function as a risk factor for empowerment in the migration context. The paper discusses the findings of this study in relation to the previous literature and notes their implications for future research and practice.     

Cognitive,affective and social mechanisms in depression risk: Cognition,hostility, and coping style

Although some research has assessed cognitive variables in individuals at risk for depression, few studies have specifically assessed the role of automatic thinking, and virtually no studies have assessed anger and coping in this group. The current study compared measures of these variables in a high-risk group that was defined on the basis of a previous episode of depression, and a control group comprised of low-risk/never depressed individuals. Even though neither group evidenced depressive symptoms at the time of assessment, group comparisons and regression analyses indicated that high-risk individuals reported more negative automatic thoughts than did low-risk participants and that social support seeking, self-blame, and avoidance emerged as coping predictors of risk as did higher levels of anger and hostility. These data thus suggest patterns of interpersonal, behavioural, and cognitive variables that may characterise depression risk.     

Correlates of adolescent parenting

A self-selected sample of 177 teenage parents participated in a study of the correlates of teenage parenting. An ecological model of the predictors of parenting behavior was used to define factors which potentially influence teenage parents' parenting skills as measured by the Home Observation for Measurement of the Environment (HOME). The factors tested include level of punitiveness toward child rearing, knowledge of developmental milestones, level of depression, perceived social support, parental age, and parental race. The results of a stepwise hierarchical regression analysis found that parental race, punitive attitudes toward child rearing, and parental age were statistically significant predictors of total HOME scores. The older, white adolescent mother with less punitive attitudes toward child rearing and child discipline scored the highest on parenting skills. The relevance of these findings to program planners and service providers involved in teenage parent support and education programs is discussed.     

Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women.

The authors examined the prospective influence of stress, self-esteem, and social support on the postpartum depressive symptoms of 191 inner-city women (139 European Americans and 52 African Americans) over 3 waves of data collection. Depressive symptomatology was measured by multiple indicators, including self-report and clinical scales. Women became less depressed as they move from prenatal to postpartum stages and adjusted to their pregnancy and its consequences. LISREL and regression analyses indicated that stress was related to increased depression, whereas greater income and social support were related to decreased depression. Self-esteem was related to lower depression at the prenatal and postpartum periods but not to change in depression from the prenatal to the postpartum period. The results also indicated that self-esteem and social support did not have additional stress-buffering effects over and above their direct effects on depression. Finally, African American women did not differ from European American women terms of depression or in terms of how they were impacted by stress or psychosocial resources.     

Chronic Medical problems,coping resources,and depression: A longitudinal study of rural Tennesseans

This analysis examined chronic medical problems as a risk factor for depressive symptomatology using longitudinal survey data from a sample of rural Tennesseans. Two waves of data (1977 and 1983) were collected on 532 rural Middle-Tennessee residents. An initial investigation found chronic medical problems a powerful predictor of depression. Furthermore, internal and external resources (personal resources and social support) operated as moderating factors between the stress of medical problems and psychiatric impairment. Panel regression analyses indicated that Time 1 depression level as well as medical problems at Time 2 (t2) were significant predictors of depression at t2 in rural areas of the mid-South. Finally, the buffering effects of both social support and personal resources were explored.     

Depression for college students in a traditional Christian culture context: the role of attachment,spirituality and social support

The role of attachment, perceived social support, and perceived discrepancy from spiritual ideal were assessed in their association with depression in college students in a Christian culture environment. Participants (N?=?155) at a small Christian university completed the Center for Epidemiological Studies Depression Scale, the Experiences in Close Relationships questionnaire, and questions about satisfaction with social support and discrepancy of their spiritual well-being to an ideal spiritual well-being. Results showed that social support, insecure attachment and discrepancy from spiritual ideal were all significant predictors of depression. Attachment was found to moderate the association between perceived spiritual well-being and depression, with insecurely attached individuals more at risk for depression if they evaluate their spiritual development as lacking. Implications are discussed.     

To be or not to be at risk: Spontaneous reactions to risk information

Rheumatoid arthritis (RA) is a chronic disease, which can lead to considerable psychological distress. The present study evaluated anxiety and depression symptoms for this chronic and painful illness within the framework of the conservation of resources (COR) theory. Coping strategies, coping self-efficacy, religiousness and social support are very important personal resources, which have been found to protect individuals from psychological distress. The aim of the present study was to examine the predictive values of socio-demographic and illness-related variables, perceived social support, ways of coping, religiousness, arthritis self-efficacy and resource loss for psychological distress in a sample of 117 RA patients from Turkey, a secular, Islamic, non-western developing country. The results revealed that RA patients experience considerable anxiety and depressive symptoms. The results of the regression analysis showed that gender, helplessness coping and resource loss are significant predictors of anxiety, whereas arthritis self-efficacy and resource loss are significant predictors of depression. Resource loss appeared as an important predictor for both anxiety and depression. This finding was consistent with the COR theory. The clinical implications of these findings are discussed.     

Ratings of social support by adolescents and adult informants: degree of correspondence and prediction of depressive symptoms

It has been suggested that the personality of the individual influences appraisal processes that determine ratings of both social support and mental health, thus leading to an association between these variables that reflects only their shared self-report bias. To test whether ratings of social support made by someone other than the target individual would significantly predict outcomes, 115 pregnant adolescent girls and 115 adults who knew the adolescents well both completed ratings of the adolescent's social support. Results showed a moderate level of agreement between adolescent and informant support ratings. Both self-report and informant total social support ratings predicted pregnancy depression scores. Only informant social support ratings were significant predictors of postpartum depression scores. The ability of informants' ratings of social support to predict the adjustment of the adolescents to a major life stress was viewed as evidence that the commonly found link between social support and mental health reflects more than self-report biases.     

Gender-Role Differences in Susceptibility to the Influence of Support Availability on Depression

Previous gender-role research on depression has revealed a consistent inverse relationship between masculinity and depression, but a non-significant relationship between femininity and depression. In light of the stronger affiliative needs for feminine individuals, received social support was speculated to moderate the relationship between femininity and depression in the present research. In a longitudinal study of a sample of Hong Kong college students, the relationships among gender-role orientation, received social support, and depression were examined. Consistent with previous findings, masculinity and androgyny were inversely related to depression. Moreover, the present study supplemented previous research by revealing that femininity was related to depression through its interaction with received social support. When the amount of received social support was increased, femininity was associated with a reduction in depression level over time. In contrast, when the amount of received social support was decreased, depression tended to increase with femininity over time. The findings are discussed in terms of their implications for the gender-role literature.     

Career adaptability development in adolescence: Multiple predictors and effect on sense of power and life satisfaction

This longitudinal panel study investigated predictors of career adaptability development and its effect on development of sense of power and experience of life satisfaction among 330 Swiss eighth graders. A multivariate measure of career adaptability consisting of career choice readiness, planning, exploration, and confidence was applied. Based on Motivational Systems Theory four groups of predictors were assessed: positive emotional disposition, goal decidedness, capability beliefs and social context beliefs. Influence of gender, age, immigration background, parental educational level, and college-bound or vocational education plans were also assessed. Perceived social support and positive emotional disposition, non-immigration background, and continuing to vocational education were single significant predictors of more career adaptability development over the school year. Supporting the connection of career adaptability and positive youth development, increase in career adaptability over time predicted increase in sense of power and experience of life satisfaction.     

Psychosocial factors in heart surgery: presurgical vulnerability and postsurgical recovery

OBJECTIVE: Distress and low perceived social support were examined as indicators of psychosocial vulnerability in patients about to undergo heart surgery. Design: A total of 550 study patients underwent heart surgeries, including bypass grafting and valve procedures. Psychosocial interviews were conducted about five days before surgery, and biomedical data were obtained from hospital records. MAIN OUTCOME MEASURES: Sociodemographic, personality, religious, and biomedical factors were evaluated as predictors of psychosocial vulnerability, and all five sets of variables were evaluated as contributors to hospital length of stay (LOS). RESULTS: Patients scoring higher on one or more indicator of presurgical psychosocial vulnerability were younger, more likely to be female, less likely to be married, less well educated, lower in dispositional optimism, higher in trait anger, and lower in religiousness. Older age, depression, low support, and low trait anger each showed an independent, prospective association with greater LOS, and several other predictors had prospective relationships with LOS that were statistically mediated by depression or perceived support. CONCLUSION: Evidence that multiple psychosocial factors may influence adaptation to heart surgery has implications for understanding and ameliorating presurgical distress and for improving postsurgical recovery.     

Major life events and major chronic difficulties are differentially associated with history of major depressive episodes

Major life events have been found to precede onsets of a 1st lifetime episode of depression more commonly than subsequent recurrences. Despite general empirical support for this finding, few data directly address how the role of major life events may change over successive recurrences. Further, little research has examined major chronic difficulties in relation to a 1st lifetime episode versus a recurrence of depression. The present study tested the associations between major life events and major difficulties in relation to lifetime history of depressive episodes in a sample of 96 individuals diagnosed with major depression. Using investigator-based measures of life stress, the authors found that, whereas major life events were associated with fewer lifetime episodes, major chronic difficulties were related to more prior episodes. These findings are discussed in terms of underlying mechanisms that may account for the changing role of major life stress over successive recurrences of depression.     

Predicting Parenting Stress in Families of Children with ADHD: Parent and Contextual Factors

We examined parental ADHD symptoms and contextual (parental education, social support, marital status) predictors of parent domain parenting stress (parental distress) as a function of child ADHD symptoms in a sample of 95 parents of 8 to 12 year-old children with and without ADHD. Parents’ perceptions of parental distress and social support were inversely-related. Parental ADHD symptomatology was the strongest predictor of parental distress of the variables considered. Models using teacher reports of child ADHD symptomatology and oppositionality differed from ones using parent reports, in that child oppositionality was only predictive of parental distress in the parent-report model. A post-hoc analysis showed that child factors did not predict parental distress over and above parent ADHD symptoms and contextual factors. These results suggest that parental ADHD symptomatology and parenting stress reduction should be considered in development of interventions for families of children with ADHD.     

The effect of low social support on short-term prognosis in patients following a first myocardial infarction

The objectives of the current study were (1) to assess adjustment in patients following a first myocardial infarction (MI) at 9 months compared with 4-6 weeks post-MI, (2) to examine the availability of and satisfaction with social support over time, and (3) to determine separate baseline psychosocial predictors of recurrent cardiac events. A questionnaire assessing post-traumatic stress disorder, anxiety, depression, health complaints, and social support, was distributed to consecutive patients 4-6 weeks and 9 months post-MI. Prior to assessment at follow-up, 8 (7%) of 112 patients had dropped out, and two had died due to cardiac causes. Objective clinical measures were obtained from medical records. There was an improvement in somatic and cognitive symptoms at follow-up, but no change in symptoms of arousal, depression, and anxiety. Half of the patients were afraid of a recurrent MI. There was a significant decrease in social support between baseline and follow-up, and lower social support at baseline was associated with a 10% increased risk of recurrent cardiac events at follow-up (OR: 0.90; 95% CI: 0.84 to 0.97) adjusting for all other variables. Some patients still experienced difficulties with psychosocial adjustment 9 months post-MI despite a reduction in somatic and cognitive symptoms. Social support decreased over time, which may have serious prognostic implications; lower social support at baseline was an independent predictor of recurrent events at 9 months. An important step for future research will be to investigate how social support can be enhanced in patients at risk.     

青少年同伴依恋对抑郁的影响:朋友社会支持和自尊的中介作用

为探讨青少年同伴依恋与抑郁的关系,以及社会支持和自尊在二者关系中的作用机制,采用父母和同伴依恋问卷(IPPA)中的同伴依恋分量表、领悟社会支持量表(PSSS)、自尊量表(SES)和流调中心用抑郁量表(CES-D)对668名中学生进行调查,结果发现:(1)青少年同伴依恋、朋友社会支持和自尊两两之间呈显著正相关,且三者与抑郁均呈显著负相关。(2)青少年同伴依恋不仅能直接负向预测抑郁,而且还能通过自尊的单独中介作用对抑郁产生影响;朋友社会支持的单独中介作用以及社会支持→自尊的链式中介作用在初、高中生群体中存在差异,即在初中生群体中,同伴依恋能够通过社会支持的单独中介作用以及社会支持→自尊的链式中介作用对抑郁产生影响,而在高中生群体中,这两种间接作用均不显著。研究结果揭示了青少年同伴依恋对抑郁产生影响的心理机制,为引导青少年建立良好的同伴依恋,促进自尊及心理健康发展提供了有益建议。     

Depression as a predictor of perceived social support and demand: a componential approach using a prospective sample of older adults

This study examined the relationship of the cognitive, mood, and somatic components of depression on perceptions of social support and social demand among older adults (n = 851) over two years. Factor-analyses confirmed the factor structure of our multicomponential model of depression. Results supported our proposal that interpersonal specificity, as measured by depressive cognition about self and others, is important to predicting changes in perceived support and demand over time. Each component of depression was related to social support and social demand cross-sectionally, whereas only the cognitive component of depression predicted changes in support and demand prospectively. Future research should consider the pathways linking depressive cognition to perceived support and demand.     

Controlled prospective study of postpartum mood disorders: psychological, environmental, and hormonal variables

Demographic, psychiatric, social, cognitive, and life stress variables were used to determine the etiology of depression in childbearing (CB; n = 182) and nonchildbearing (NCB; n = 179) women. Hormonal variables in postpartum depression were also evaluated. In the CB group predictors of depression diagnosis were previous depression, depression during pregnancy, and a Vulnerability (V) x Life Stress (LS) interaction; predictors of depressive symptomatology were previous depression, depressive symptoms during pregnancy, life events, and V x LS. Only estradiol was associated with postpartum depression diagnosis. In the NCB group V X LS was the only predictor of depression diagnosis; depressive symptoms during pregnancy and life events were predictors of depressive symptomatology. Previous findings about depression vulnerability were replicated. The significant V x LS interactions support the vulnerability-stress model of postpartum depression.     

A longitudinal study of the psychosocial impact of stroke on primary support persons

We investigated longitudinally the effects of a stroke on the social support systems and well-being of the patient's primary support person, both acutely and as the condition stabilized. Individuals who had suffered a first stroke and a primary support person participated in two waves of data collection, carried out in 6-month intervals beginning 7 weeks after the stroke. Our data show that the prevalence of depressive symptoms is from 2 1/2 to 3 1/2 times higher than rates found among representative samples of middle-aged and elderly populations. Mean level of depression did not change over time, although level of optimism declined significantly. Multiple regression analyses showed that levels of depression and perceived burden in support persons are highly related to aspects of the stroke such as its severity, and that demographic variables such as age and income play a relatively minor role in attenuating these relations in the acute adjustment phase. However, from 7 to 9 months after the stroke, well-established demographic variables such as health, income, and age were significant predictors of depression. Individuals who were older and who had good health and higher incomes were least depressed.     

Older adults' recovery from surgery for osteoarthritis of the knee: psychosocial resources and constraints as predictors of outcomes.

The authors investigated psychosocial resources (positive support, active coping) and psychosocial constraints (negative support, avoidant coping) as predictors of improvement in the health of 63 older adults undergoing surgery for osteoarthritis of the knee. Following surgery, patients and social partners are motivated both to strive for the appetitive goal of recovery (approach), and to protect themselves from pain and impairment (avoidance). The authors assessed resources and constraints 6 weeks after surgery as predictors of outcomes (improvement in knee pain, knee functioning, and psychological well-being) 6 months after surgery. The constraints patients encountered early in recovery were strong predictors of poor recovery. Although resources were associated with some improvement, these effects were largely accounted for by constraints.