Temporal patterns of anxious and depressed mood in generalized anxiety disorder: a daily diary study

Research suggests that anxiety disorders tend to temporally precede depressive disorders, a finding potentially relevant to understanding comorbidity. The current study used diary methods to determine whether daily anxious mood also temporally precedes daily depressed mood. 55 participants with generalized anxiety disorder (GAD) and history of depressive symptoms completed a 21-day daily diary tracking anxious and depressed mood. Daily anxious and depressed moods were concurrently associated. Daily anxious mood predicted later depressed mood at a variety of time lags, with significance peaking at a two-day lag. Depressed mood generally did not predict later anxious mood. Results suggest that the temporal antecedence of anxiety over depression extends to daily symptoms in GAD. Implications for the refinement of comorbidity models, including causal theories, are discussed.     

Depression history, depression vulnerability and the experience of everyday negative events

This study examined whether deficits in dealing with daily problems emerge before a depressive episode (i.e., pre-existing vulnerability) or after a depressive episode (i.e., psychosocial scar). Participants completed a 30-day daily diary in which they reported their most negative event of the day, their appraisals of that event, and their mood. Three years later, they completed a structured depression interview. The sample consisted of 350 college students, 24 of whom had a past history of depression and 54 of whom experienced a depressive episode subsequent to dairy completion. Multilevel modeling revealed that students with past depression blamed others more than the never-depressed and those with subsequent depression, which supported the scar hypothesis. In support of the vulnerability hypothesis, as compared to the never-depressed group, participants with past depression demonstrated steeper declines in positive mood on more stressful days but did not significantly differ from the subsequent depression group. Overall, our findings do not provide clear support for either hypothesis; however, this study is the first to use a daily diary design to directly compare individuals with past depression to individuals who would subsequently experience depression.     

Mood variability and the intensity of depressive states

Little is known about the relationship between the variability of moods and the tendency to experience depressed mood. The moods of twenty-five student subjects were measured over a period of some 30 days using scales assessing positive affect and negative affect. An index of mood variability was computed. This was correlated with two measures of average level of depression. The results showed a strong correlation between variability of moods and level of depression. High levels of mood variability accompanied high levels of depressive state in this nonclinical sample.     

Toward Mapping Daily Challenges of Living with ADHD: Maternal and Child Perspectives Using Electronic Diaries

Attention-deficit/hyperactivity disorder (ADHD) has an impact on the family as well as the affected child. This study developed and tested an electronic diary for mapping the challenges of everyday family life in a sample of children with ADHD being treated with pharmacotherapy. Across 7 days, mothers and children (27 ADHD; 25 non-ADHD) independently reported their moods, behaviors, and social contexts every 30 min during nonschool hours. Symptomatic behaviors and negative moods were elevated in the ADHD group, combined with maternal perceptions of lower parenting effectiveness and quality of life. Differences in the contexts of maternal anger were salient, with mothers in the ADHD group more often angry when with their children and comparison mothers more often angry when not. Although mothers' diaries were more informative, children's diaries also distinguished the two groups, especially during mornings and weekends. The need for family-wide interventions, the utility of child self-reports, and the promise of electronic diaries are discussed.     

Depression and empathic accuracy in couples: an interpersonal model of gender differences in depression

We examine the link between depression and empathic accuracy, the ability to infer other people's thoughts and feelings, as a possible mechanism underlying gender differences in the association between depression and interpersonal difficulties within intimate relationships. Fifty-one heterosexual couples completed questionnaires assessing depressive symptoms and participated in both a lab and a daily diary procedure assessing empathic accuracy. In the lab measures, women's (but not men's) higher levels of depressive symptoms were associated with lower empathic accuracy regarding partners' thoughts and feelings. In the daily diary data, women's depressive symptoms were specifically associated with lower levels of empathic accuracy for negative feelings but not for positive feelings, and with lower levels of their partners' empathic accuracy for the women's negative feelings. Men's depressive symptoms were again unrelated to levels of empathic accuracy. Our findings suggest that depressive symptoms may have a stronger impact on interpersonal perception in intimate relationships among women than among men.     

Negative mood,depressive symptoms,and major depression after smoking cessation treatment in smokers with a history of major depressive disorder

Negative mood, depressive symptoms, and major depressive episodes (MDEs) were examined in 179 smokers with a history of major depression in a trial comparing standard smoking cessation treatment to treatment incorporating cognitive-behavioral therapy for depression (CBT-D). Early lapses were associated with relatively large increases in negative mood on quit date. Mood improved in the 2 weeks after quit date among those returning to regular smoking but not among those smoking moderately. Continuous abstinence was associated with short- and long-term reductions in depressive symptoms. MDE incidence during follow-up was 15.3% and was not associated with abstinence. Unexpected was that CBT-D was associated with greater negative mood and depressive symptoms and increased MDE risk. Results suggest complex bidirectional associations between affect and smoking outcomes.     

A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake

Measures of emotional health and styles of responding to negative moods were obtained for 137 students 14 days before the Loma Prieta earthquake. A follow-up was done 10 days again 7 weeks after the earthquake to test predictions about which of the students would show the most enduring symptoms of depression and posttraumatic stress. Regression analysis showed that students who, before the earthquake, already had elevated levels of depression and stress symptoms and a ruminative style of responding to their symptoms had more depression and stress symptoms for both follow-ups. Students who were exposed to more dangerous or difficult circumstances because of the earthquake also had elevated symptom levels 10 days after the earthquake. Similarly, students who, during the 10 days after the earthquake, had more ruminations about the earthquake were still more likely to have high levels of depressive and stress symptoms 7 weeks after the earthquake.     

Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool

Methods for detecting depression in fathers after the birth of their child are scarce. The Edinburgh Postnatal Depression Scale (EPDS), used to screen mothers for postpartum depression (PPD), lacks somatization and externalizing items. This potentially decreases its sensitivity in detecting depression in fathers, as many men actually express depression with somatization or externalizing symptoms. The present study assessed depressive symptoms in fathers of children 0–18 months old, and evaluated whether addressing both typical depression and externalizing, so‐called “depressive equivalent” symptoms, might be more suitable for such assessment. The Beck Depression Inventory‐II (BDI‐II), EPDS, and Gotland Male Depression Scale (GMDS) were responded to by 447 Swedish fathers online. Among participants, 27% reported depressive symptoms above the BDI‐II cut‐off suggestive of depression. Most fathers reported both traditional and depressive equivalent symptoms and a subgroup expressed exclusively depressive equivalent symptoms. Consistently, a scale combining items from the EPDS and GMDS showed higher sensitivity than the EPDS alone in identifying fathers with elevated depressive symptoms, at equal levels of specificity. Our findings suggest that a combination of EPDS and depressive equivalent symptom items results in a more suitable instrument for screening for depression in fathers during the postnatal period.     

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.     

Facial affect processing and depression susceptibility: cognitive biases and cognitive neuroscience

Facial affect processing is essential to social development and functioning and is particularly relevant to models of depression. Although cognitive and interpersonal theories have long described different pathways to depression, cognitive-interpersonal and evolutionary social risk models of depression focus on the interrelation of interpersonal experience, cognition, and social behavior. We therefore review the burgeoning depressive facial affect processing literature and examine its potential for integrating disciplines, theories, and research. In particular, we evaluate studies in which information processing or cognitive neuroscience paradigms were used to assess facial affect processing in depressed and depression-susceptible populations. Most studies have assessed and supported cognitive models. This research suggests that depressed and depression-vulnerable groups show abnormal facial affect interpretation, attention, and memory, although findings vary based on depression severity, comorbid anxiety, or length of time faces are viewed. Facial affect processing biases appear to correspond with distinct neural activity patterns and increased depressive emotion and thought. Biases typically emerge in depressed moods but are occasionally found in the absence of such moods. Indirect evidence suggests that childhood neglect might cultivate abnormal facial affect processing, which can impede social functioning in ways consistent with cognitive-interpersonal and interpersonal models. However, reviewed studies provide mixed support for the social risk model prediction that depressive states prompt cognitive hypervigilance to social threat information. We recommend prospective interdisciplinary research examining whether facial affect processing abnormalities promote-or are promoted by-depressogenic attachment experiences, negative thinking, and social dysfunction.     

Intraindividual relations between the intensity and disclosure of daily emotional events: The moderating role of depressive symptoms

Individuals with high levels of depressive symptoms tend to engage in lower levels of emotional disclosure than individuals who are lower in depressive symptoms. However, little is known about how depressive symptoms relate to the intraindividual relation between daily disclosure and the intensity of the daily events. The authors addressed these relations using a daily diary methodology. College students (N = 239) completed a measure of depression symptoms. They then completed measures of the intensity of the day's most unpleasant event and their disclosure of that event each day for 7 days. Results indicated that depression moderated the intensity-disclosure relation such that depression symptoms were associated with diminished emotional disclosure for high-intensity events but not for low-intensity events. Individuals with relatively higher levels of depressive symptoms also experienced unpleasant daily events at a higher intensity level than did individuals with relatively fewer symptoms. Sex differences emerged such that men were less likely than women to disclose high-intensity negative events. These findings extend the use of the diary methodology to the study of emotional disclosure and also suggest possible interventions for counseling psychology practitioners.     

Daily depression and cognitions about stress: evidence for a traitlike depressogenic cognitive style and the prediction of depressive symptoms in a prospective daily diary study

The authors examined the stability and dynamic structure of negative cognitions made to naturalistic stressors and the prediction of depressive symptoms in a daily diary study. Young adults reported on dispositional depression vulnerabilities at baseline, including a depressogenic cognitive style, dysfunctional attitudes, rumination, neuroticism, and initial depression, and then completed short diaries recording the inferences they made to the most negative event of the day along with their experience of depressive symptoms every day for 35 consecutive days. Daily cognitions about stressors exhibited moderate stability across time. A traitlike model, rather than a contextual one, explained this pattern of stability best. Hierarchical linear modeling analyses showed that individuals' dispositional depressogenic cognitive style, neuroticism, and their daily negative cognitions about stressors predicted fluctuations in daily depressive symptoms. Dispositional neuroticism and negative cognitive style interacted with daily negative cognitions in different ways to predict daily depressive symptoms.     

The effect of acculturation on depressive moods: immigrant boys and girls during their transition from late adolescence to early adulthood

Using data (N = 773) from a longitudinal study of former Soviet Union immigrants to Israel, this study aimed to identify the psychosocial correlates of depressive mood among immigrant adolescents and differences by age and gender. OLS regression results suggest acculturative and social factors as useful variables in predicting depression. Adolescents with a high probability of assimilating (simultaneous strengthening of Israeli identity and weakening of Russian identity) proved more likely to report low levels of depression. Consistent with the literature, girls were more depressed than boys and age was positively related to depressive moods. As expected, different factors explain the psychological well-being of adolescents of different age groups and sex: in boys, depression was found mainly related to acculturation difficulties; in girls it was related more to their social support. As for age, more independent variables were statistically significant in accounting for depression in the older than in the younger group, which suggests that depression is age-related. The study results should be understood in connection with socialization processes to sex roles and the impact immigration has on this process.     

An attributional approach to moods and the menstrual cycle.

Acceptance of an attribution pattern linking negative moods (depression, irritability) to the approach of menstruation and the likelihood of internal and external attributions were examined in a questionnaire study in which cycle phase (pre- versus postmenstrual), mood (positive versus negative), and environment (pleasant versus unpleasant) were varied. Subjects' rating indicated that (a) biology was judged important for explaining negative moods occurring premenstrually: (b) inconsistency between mood and environment produced more internal (personality) attributions, while consistency enhanced external attributions; and (c) emotionally expressive behavior was thought to reflect underlying personality dispositions despite extenuating situational factors (assumed personal causation). The theoretical relevance of the findings to a new conceptualization of premenstrual emotionality and to an attributional chain relating female self-concept and premenstrual tension is discussed.     

Interparental Interactions and Adolescent Mood: A Daily Diary Approach

The literature assessing relations between interparental functioning and youth adjustment is extensive. Most of this literature used a between subjects approach and examines youth responses to conflict reported by parents. The current study used a daily diary approach to complement the existing literature by assessing relations between aspects of marital interactions and adolescent reported daily mood using a within-family approach. We hypothesized that parents’ emotionality during interactions, the severity of their marital conflicts, and the degree to which their conflicts were resolved would be associated with their adolescents’ daily moods. To test these hypotheses a diverse sample (N?=?86; 27% Black, 33% White, 26% Hispanic, and 14% another race or families members differed in race) of mothers, fathers, and adolescents drawn from the Supporting Healthy Marriage project completed 15 days of daily diaries. Multilevel modeling results suggested differential associations between mother and father reports of their own emotions during interactions, conflict severity, and conflict resolution and adolescents’ daily moods. Overall, there were more significant results indicating fathers’ compared to mothers’ associations with adolescents’ daily moods, providing support for the need to continue efforts to engage fathers in family strengthening programs.     

Interpersonal Style, Stress, and Depression: An Examination of Transactional and Diathesis-Stress Models

The present study examines a transactional, interpersonal model of depression in which stress generation (Hammen, 1991) in romantic relationships mediates the association between aspects of interpersonal style (i.e., attachment, dependency, and reassurance seeking) and depressive symptoms. It also examines an alternative, diathesis-stress model in which interpersonal style interacts with romantic stressors in predicting depressive symptoms. These models were tested in a sample of college women, both prospectively over a four-week period, as well as on a day-today basis using a daily diary methodology. Overall, there was strong evidence for a transactional, mediation model in which interpersonal style predicted romantic conflict stress, and in turn depressive symptoms. The alternative diathesis-stress model of depression was not supported. These results are interpreted in relation to previous research, and key limitations that should be addressed by future research are discussed.     

Adolescents React to the Events of September 11, 2001: Focused Versus Ambient Impact

This study examined the perceived impact of the events of September 11, 2001, on adolescents distant from the disaster sites and compared these perceptions with changes in everyday moods. A survey of reactions to September 11 was completed 2-5 months after the events by 171 adolescents participating in a longitudinal study of stress and health. Electronic diary ratings of contemporaneous moods before and after the attacks were also compared. Many adolescents distant from the disaster sites reported changes in everyday activities and signs of distress along with some positive outcomes. Elevated levels of negative affect emerged when adolescents were asked directly about the event (focused impact), but no changes were detected in their ongoing, momentary mood reports before and after September 11 (ambient impact). Trait and electronic diary measures of anxiety independently predicted posttraumatic distress. Refined assessments are needed to evaluate the degree to which self-reported traumatic symptoms reflect significant clinical distress versus an attentional focus generated by the question-asking process.     

Elevated Appraisals of the Negative Impact of Naturally Occurring Life Events: A Risk Factor for Depressive and Anxiety Disorders

The tendency to appraise naturally occurring life events (LEs) as having high negative impact may be a predisposing factor for the development of depression and anxiety disorders. In the current study, appraisals of the negative impact of recent LEs were examined in relationship to depressive and anxiety disorders in a sample of 653 adolescents who were administered diagnostic and life stress interviews at ages 15 and 20. Participants’ appraisals of the negative impact of LEs reported at age 15 were statistically adjusted using investigator-based ratings to control for objective differences across LEs. Higher appraisals of the negative impact of LEs were associated with both past and current depressive and anxiety disorders at age 15 and predicted subsequent first onsets of depressive and anxiety disorders occurring between ages 15 and 20. In addition, appraisals of the negative impact of LEs were particularly elevated among those experiencing both a depressive and anxiety disorder over the course of the study. The findings suggest that systematically elevated appraisals of the negative impact of LEs are a predisposing factor for depression and anxiety disorders and may represent a specific risk factor for co-morbid depression and anxiety in mid-adolescence and early adulthood.     

The Role of Relationships in Understanding the Alexithymia–Depression Link

Alexithymia is associated with increased depressive symptoms in both clinical and community samples. One way that alexithymia may lead to depression is through its impact on interpersonal relationships. Individuals with alexithymia report lower perceived social support, intimacy, and relationship satisfaction. Furthermore, poor relationship functioning is a clear risk factor for depressive symptoms. Given the established alexithymia–depression link and marital dysfunction–depression link, a logical next step is to examine whether relationship dysfunction (low social support, intimacy, negative relationship behaviours, and relationship dissatisfaction) mediates the association between alexithymia and depressive symptoms. The hypothesized mediation model was assessed in a sample of 104 community couples with two analytical approaches—first with cross‐sectional measures using path analysis and second with daily diary measures collected over a seven‐day period using a multilevel modelling approach. Poor relationship functioning mediated the association between alexithymia and depressed mood in the daily diary data and partially mediated that association with the cross‐sectional measures. These results identify alexithymia as an important variable in understanding the marital functioning–depression association, and this finding has implications for treatment. Copyright © 2012 European Association of Personality Psychology