The existential model of perfectionism and depressive symptoms: Tests of incremental validity,gender differences,and moderated mediation

Socially prescribed perfectionism (i.e., perceiving others are demanding perfection of oneself) is a putative vulnerability factor for depressive symptoms. However, there is still much to learn about when and why socially prescribed perfectionists get depressed. Drawing on the existential model of perfectionism and depressive symptoms (EMPDS), we proposed difficulty in accepting the past (i.e., viewing life experiences as coherent, acceptable, satisfying, and meaningful) clarifies when and why socially prescribed perfectionism is linked to depressive symptoms. In the present study of 269 undergraduates (141 men and 128 women), we tested if accepting the past predicts depressive symptoms beyond competing explanations (e.g., self-esteem). And we extended existing research by testing a novel moderated mediation model wherein the strength of the mediated effect of socially prescribed perfectionism on depressive symptoms through accepting the past is stronger at higher levels of socially prescribed perfectionism than at lower levels of socially prescribed perfectionism. We also tested if our results generalized across women and men. Hypotheses were largely supported. Consistent with the EMPDS, our results suggested people high in socially prescribed perfectionism get depressed because they struggle to consolidate their life experiences into a personally meaningful story.     

A goal-striving life event and the onset of hypomanic and depressive episodes and symptoms: perspective from the behavioral approach system (BAS) dysregulation theory

On the basis of the behavioral approach system (BAS) dysregulation theory of bipolar disorder, this study examined the relation between occurrence of a BAS activation-relevant life event--goal striving--and onset of hypomanic and depressive episodes and symptoms. In particular, the authors examined the relation between preparing for and completing final exams (a goal-striving event) and onset of bipolar spectrum episodes and symptoms in college students with bipolar II disorder or cyclothymia (i.e., "soft" bipolar spectrum conditions). One hundred fifty-nine individuals with either a bipolar spectrum disorder (n=68) or no major affective psychopathology (controls; n=91) were further classified on the basis of whether they were college students (i.e., completed final exams). Consistent with the BAS dysregulation theory, preparing for and completing final exams was associated with an increase in hypomanic but not depressive episodes and symptoms in individuals with a soft bipolar spectrum diagnosis. Furthermore, self-reported BAS sensitivity moderated the presence of certain hypomanic symptoms during final exams.     

Incremental validity of spouse ratings versus self-reports of personality as predictors of marital quality and behavior during marital conflict

The personality traits of neuroticism and agreeableness are consistently related to marital quality, influencing the individual's own (i.e., actor effect) and the spouse's marital quality (i.e., partner effect). However, this research has almost exclusively relied on self-reports of personality, despite the fact that spouse ratings have been found to have incremental validity over self-reports for a variety of other important outcomes. In a study of 300 middle-aged and older married couples, we examined the incremental validity of spouse ratings of neuroticism and agreeableness in predicting concurrent levels of self-reported marital quality, observations of behavior during a marital disagreement task, and depressive symptoms. Neuroticism and agreeableness had expected actor and partner effects on each of these outcomes. Spouse ratings of these traits demonstrated incremental validity in estimates of actor and partner effects on marital quality, marital behavior, and depressive symptoms. Results suggest that spouse ratings of personality may be important additions to the typical reliance on self-reports for research and clinical assessment in marriage.     

Something's missing: need fulfillment and self-expansion as predictors of susceptibility to infidelity

The present authors investigated whether an individual's motivations that are related to need fulfillment and self-expansion within a romantic relationship can predict self-reported susceptibility to infidelity. A sample of 109 college students (50 men, 59 women) who were in dating relationships completed questionnaires that assessed 5 types of variables of need fulfillment (i.e., intimacy, companionship, sex, security, and emotional involvement), 3 types of self-expansion variables (i.e., self-expansion, inclusion of the other in the self, and potential for self-expansion), and susceptibility to infidelity. As the present authors predicted, both sets of predictors (need fulfillment and self-expansion) significantly contributed to the variance in susceptibility to infidelity. The present findings indicated the possibility that, when a relationship is not able to fulfill needs or provide ample self-expansion for an individual, his or her susceptibility to infidelity increases.     

Physical illness and symptoms of depression among elderly outpatients.

Elderly outpatients were assessed to clarify relations between symptoms of depression and physical illness, disability, pain, and selected psychosocial variables. Three types of assessments were made: (a) medical evaluations by physicians, (b) self-reported symptoms of depression and physical health, and (c) demographic and psychosocial data relating to participants' life circumstances. Both objective (physician-rated illness symptoms) and subjective (self-reported health, activity restriction, and use of pain medications) indicators of health accounted for independent variance in symptoms of depression. After controlling for these factors, additional variance was explained by health-related concerns (e.g., health care expenses, service needs), social support, and "other worries" (e.g., feeling useless, becoming a burden to others).     

Social factors and the psychobiology of depression: relations between life stress and rapid eye movement sleep latency.

We examined psychosocial factors (i.e., life stress) and biological factors (i.e., REM sleep latency) that are hypothesized to be of complementary importance for defining depressive subtypes in a sample of 61 nonpsychotic, endogenous major depressives. Subjects were evaluated on several diagnostic scales for life stress, on electroencephalographic sleep data, and on 2 symptom measures for depression. As predicted, persons with severe stress that occurred shortly before depression onset had essentially normal REM latency values; patients without such stress had reduced REM latency values. Both stress and REM latency were also associated with greater severity of self-reported depressive symptoms. Alternative explanations of these findings are discussed, with particular emphasis on different roles of pre-onset and post-onset stressors.     

Positive Events and Social Supports as Buffers of Life Change Stress1

A perceived availability of social support measure (the ISEL) was designed with independent subscales measuring four separate support functions. In a sample of college students, both perceived availability of social support and number of positive events moderated the relationship between negative life stress and depressive and physical symptomatology. In the case of depressive symptoms, the data fit a “buffering” hypothesis pattern, i.e., they suggest that both social support and positive events protect one from the pathogenic effects of high levels of life stress but are relatively unimportant for those with low levels of stress. In the case of physical symptoms, the data only partially support the buffering hypothesis. Particularly, the data suggest that both social support and positive events protect one from the pathogenic effects of high levels of stress but harm those (i.e., are associated with increased symptomatology) with low levels of stress. Further analyses suggest that self-esteem and appraisal support were primarily responsible for the reported interactions between negative life stress and social support. In contrast, frequency of past social support was not an effective life stress buffer in either the case of depressive or physical symptomatology. Moreover, past support frequency was positively related to physical symptoms and unrelated to depressive symptoms, while perceived availability of support was negatively related to depressive symptoms and unrelated to physical symptoms.     

Patterns of psychosocial risk and long-term outcomes in rheumatoid arthritis

This study examined the extent to which patterns of psychosocial risk were uniquely associated with long-term outcomes of rheumatoid arthritis (RA), after demographic factors and self-reported symptom severity over time were accounted for. Data were collected over an 8-year period from 561 individuals with RA who were participants in the ongoing UCSF RA Panel Study in 1995. Panel members were interviewed annually, using a comprehensive structured telephone interview. Psychosocial factors assessed included mastery, perceptions about adequacy of social support, the impact of RA and self-assessed ability to cope with RA and satisfaction with health and function. Cluster analysis of psychosocial factors identified three distinctive patterns/levels of psychosocial risk (high, medium and low risk). The unique effects of psychosocial risk status on changes in depressive symptoms, basic functional limitations, global pain ratings and average annual doctor visits over an 8-year period were estimated, using growth curve analyses. Analyses controlled for demographic factors (gender, marital/partner status, education, age and ethnicity), disease duration and year in the panel and time-varying self-reported symptom severity (morning stiffness, swollen joint counts, co-morbid medical conditions, extra-articular RA symptoms and changes in joint appearance), as well as self-reported medications taken over time (disease-modifying antirheumatic drugs [DMARDS], and prednisone). Overall, 32.4% of total variance in depressive symptoms was accounted for by the fully-estimated model, with 12.9% uniquely associated with psychosocial risk status. Half of the total variance (50.0%) in basic functional limitations was explained, with 12.1% of variance uniquely predicted by psychosocial risk status. Psychosocial risk status accounted for comparatively little total explained variance in global pain ratings (total = 38.6%, incremental = 3.2%), and average annual total doctor visits (total = 10.9%, incremental = 1.5%). Thus, psychosocial risk factors are more closely linked to depressive symptoms and function over time. Global pain and utilization appear to be more closely related to disease factors.     

Maternal Depressive Symptoms When Caring for a Child with Mental Health Problems

As primary caregivers of children with mental health problems, mothers face challenges that put them at risk for depression, which is rarely identified or addressed. The aims of this paper were to (a) identify mean differences among demographic, stressor, threat, and resource variables specified in a theoretical model and thought to be associated with maternal depressive symptoms and (b) determine how much variability in depressive symptoms is explained by these variables. High levels and prevalence of depressive symptoms were found within a quality of life study that these data were drawn from. Of 139 mothers participating in this study, 58% had a score of 16 or greater on the CES-D indicating moderate to high levels of depressive symptoms. Significant differences were found between mothers with higher versus lower levels of depressive symptoms for 11 of the 18 variables. Hierarchical regression was used to examine the variance explained in depressive symptoms based upon the conceptual model with 4 composite variables. Income (step 1), behavioral problems (step 2), threat appraisal (step 3), and resource appraisal (step 4) combined explained 42% of the variance.     

Changes in Risk Factors During the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents

This study aimed to assess whether changes in potentially modifiable risk factors associated with the construct of neuroticism and common to emotional disorders (i.e., poor distress tolerance and heightened avoidance) occur in concordance with the administration of different treatment components of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) and with reductions in emotional disorder symptoms (i.e., anxiety and depressive symptoms) overall. Using single-case analytic strategies, including multiple-baseline design and modeling techniques, the authors treated 8 adolescents with emotional disorder diagnoses and evaluated trajectories of change in distress tolerance and experiential avoidance as well as in the sequencing of such change in regard to change in anxiety and depressive symptoms. Clinical outcomes were favorable based on parent, adolescent, and clinician-rated measures. Treatment-based change was demonstrated, at both group and individual levels, and at expected points in treatment, in regard to facets of neuroticism. Overall, self-reported change in experiential avoidance and distress tolerance tended to occur simultaneously to reductions in emotional disorder symptoms. This study helps to clarify the course of expected change in variables believed to be common among a range of emotional disorders during a transdiagnostic treatment and provides initial information regarding tailoring the UP-A for individuals with different clinical profiles.     

The weight of being: Psychological perspectives on the existential moment

As the prefrontal cortex expanded in human evolution, so too did the capacity for nesting basic biological goals within more complex systems of behavioral organization. This increased ability for abstraction brought with it the challenge of deciding how to interpret the personal significance of any given experience. The human brain appears to manage this increased complexity by defining meaning in relation to one's currently adopted goals. When encountering goal-related information, arousal and exploratory systems become engaged, such that information is processed more thoroughly. As a consequence of this enhanced attention and arousal, neural plasticity is facilitated, allowing motivationally relevant experiences to have a stronger influence on an individual's neural organization. To borrow a gravitational metaphor, the existential weight, or significance, of a particular moment will determine the strength of that moment's influence on an individual's life. Human experience thus appears to be curved around fluctuations in the existential weight of being.     

Presence of meaning,search for meaning,religiousness, satisfaction with life and depressive symptoms among a diverse Israeli sample

The present study explored the structure and correlates of meaning in life (MIL) among an Israeli sample. The sample consisted of 559 adults. The average age of participants was 48.24 and 61.3% of them were females. Participants provided demographic information and completed measures of MIL, satisfaction with life, and depressive symptoms. The MIL Questionnaire showed a very good fit for the proposed 2-factor model (i.e. presence of meaning, search for meaning) to the data collected from the current sample. Presence of meaning correlated positively with both search for meaning and satisfaction with life, and negatively with depressive symptoms. Search for meaning was positively and weakly tied to satisfaction with life, but was unrelated to depressive symptoms. Religiousness appeared as a significant moderator between the two meaning factors, and between them and life satisfaction. Specifically, as religiousness became stronger: (a) the link between presence of meaning and search for meaning became weaker; (b) the link between presence of meaning and life satisfaction became stronger and (c) the link between search for meaning and life satisfaction became weaker. The findings suggest that there are differential implications of presence search for meaning on the health and well-being, and the important role religiousness plays in this regard.     

Eudaimonic conceptions of well-being, meaning in life, and self-reported well-being: Initial test of a mediational model

The current study examined relationships between eudaimonic dimensions of individual conceptions of well-being (e.g., self-development, contribution), meaning in life, and self-reported well-being, and whether meaning in life mediates associations between eudaimonic conception dimensions and well-being. A sample of 275 adult volunteers completed several instruments assessing the above constructs. Results from structural equation modeling (SEM) indicated that eudaimonic conception dimensions were positively associated with both meaning in life and well-being. Further, the relationship between eudaimonic conception dimensions and self-reported well-being was found to be partially mediated by meaning in life. The findings of the current study thus suggest that the experience of meaning in life is one route through which eudaimonic conception of well-being dimensions are associated with self-reported well-being.     

Specificity of cognitive and behavioral variables to Positive and Negative Affect

The Tripartite Model proposes that a combination of greater Negative Affect (NA) and reduced Positive Affect (PA) contributes to depressive symptoms. The purpose of this study was to test a model of affective experience in which cognitive variables (i.e., negative cognitions and appraisals) are uniquely related to NA but not PA, and in which behavioral variables (i.e., activity participation) are uniquely associated with PA but not NA. Participants included 88 spousal Alzheimer caregivers (mean age = 74 years). Multiple regression models, in which negative cognitions (i.e., helplessness, blames self, and negative appraisals) and activity participation (i.e., frequency of engaging in social and recreational activities) were used to predict depressive symptoms, PA and NA. Results indicated that while helplessness, blaming oneself, negative appraisals, and activity participation all significantly predicted depressive symptoms, only negative cognitive variables significantly predicted NA, and only activity participation significantly predicted PA. These data confirm that depressive experience consists of two relatively independent components - increased Negative Affect and reduced Positive Affect - which have unique correlates in negative cognitions and activity participation. If confirmed, the findings suggest the utility of focusing interventions on each of these components in the management of depressive symptoms.     

Goal adjustment capacities, coping, and subjective well-being: the sample case of caregiving for a family member with mental illness

This study examined the associations between goal adjustment capacities, coping, and indicators of subjective well-being in 2 waves of data from individuals who provide care for a family member with mental illness. We hypothesized that goal adjustment capacities would predict higher levels of subjective well-being by facilitating coping with caregiving stress. Results showed that goal disengagement was associated with effective care-specific coping (e.g., less self-blame and substance use). Goal reengagement was also associated with effective care-specific coping (e.g., positive reframing), but at the same time it predicted the use of less effective strategies (e.g., venting and self-distraction). Moreover, goal disengagement predicted lower levels of caregiver burden and depressive symptoms and buffered the longitudinal effect of caregiver burden on increases in depressive symptoms. Goal reengagement, by contrast, predicted higher levels of caregiver burden and purpose in life and buffered the cross-sectional association between caregiver burden and depressive symptoms. Finally, effective (and less useful) care-specific coping statistically explained the adaptive (and maladaptive) effects of goal adjustment capacities on participants' well-being.     

Further Exploring the Link Between Religion and Existential Health: The Effects of Religiosity and Trait Differences in Mentalizing on Indicators of Meaning in Life

Religiosity contributes to perceptions of meaning. One of the cognitive foundations for religious belief is the capacity to mentalize the thoughts, emotions, and intentions of others (Theory of Mind). We examined how religiosity and trait differences in mentalizing interact to influence meaning. We hypothesized that people who are most cognitively inclined toward religion (high mentalizers) receive the greatest existential benefits (i.e., high and secure meaning) from religiosity. We assessed individual differences in mentalizing and religiosity, and measured indicators of meaning. Results confirmed that the combination of high mentalizing and high religiosity corresponded to the highest levels of existential health.     

Do Youth Development Programs Matter? An Examination of Transitions and Well-Being Among Military Youth

The current correlational study examines the association between internal and external military family contextual factors (e.g., parental rank, having multiple military parents, school changes, living more than 30 min from a military installation, parental deployment, relationship provisions) and military youth well-being outcomes (i.e., depressive symptoms, anxiety, self-efficacy) in a sample of children of active duty military members (i.e., military youth). Data from 749 military youth, ages 11–14, were analyzed using structural equation modeling. The model explained a reasonable amount of the variation in the outcomes of interest (r-square statistics for depressive symptoms, anxiety, and self-efficacy were .151, .018, and .086, respectively). Results indicated that military youth who reported more social provisions experienced fewer depressive symptoms and more self-efficacy. Youth who reported certain military risk factors (i.e., parental rank; living farther from the military installation; multiple school changes) were associated with decreased well-being (i.e., more depressive symptoms and anxiety and less self-efficacy). However, findings suggest that participation in military programs may serve a moderating or buffering factor for these youth.     

Caught in a bad romance: perfectionism, conflict, and depression in romantic relationships

According to the social disconnection model, perfectionistic concerns (i.e., harsh self-scrutiny, extreme concern over mistakes and others' evaluations, and excessive reactions to perceived failures) confer vulnerability to depressive symptoms indirectly through interpersonal problems. This study tested the social disconnection model in 226 heterosexual romantic dyads using a mixed longitudinal and experience sampling design. Perfectionistic concerns were measured using three partner-specific self-report questionnaires. Conflict was measured as a dyadic variable, incorporating reports from both partners. Depressive symptoms were measured using a self-report questionnaire. Perfectionistic concerns and depressive symptoms were measured at Day 1 and Day 28. Aggregated dyadic conflict was measured with daily online questionnaires from Days 2 to 15. Data were analyzed using structural equation modeling. There were four primary findings: (a) Dyadic conflict mediated the link between perfectionistic concerns and depressive symptoms, even when controlling for baseline depressive symptoms; (b) depressive symptoms were both an antecedent and a consequence of dyadic conflict; (c) perfectionistic concerns incrementally predicted dyadic conflict and depressive symptoms beyond neuroticism (i.e., a tendency to experience negative emotions) and other-oriented perfectionism (i.e., rigidly demanding perfection from one's partner); and (d) the relationships among variables did not differ based on gender. As the most rigorous test of the social disconnection model to date, this study provides strong support for this emerging model. Results also clarify the characterological and the interpersonal context within which depressive symptoms are likely to occur.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

Predictors of the first onset of a major depressive episode and changes in depressive symptoms across adolescence: stress and negative cognitions

This 6-year longitudinal study examined stressors (e.g., interpersonal, achievement), negative cognitions (self-worth, attributions), and their interactions in the prediction of (a) the first onset of a major depressive episode (MDE), and (b) changes in depressive symptoms in adolescents who varied in risk for depression. The sample included 240 adolescents who were first evaluated in Grade 6 (M = 11.86 years old; SD = 0.57; 54.2% female) and then again annually through Grade 12. Stressful life events and depressive diagnoses were assessed with interviews; negative cognitions and depressive symptoms were assessed with self-report questionnaires. Discrete time hazard modeling revealed a significant interaction between interpersonal stressors and negative cognitions, indicating that first onset of an MDE was predicted by high negative cognitions in the context of low interpersonal stress, and by high levels of interpersonal stressors at both high and low levels of negative cognitions. Analyses of achievement stressors indicated significant main effects of stress, negative cognitions, and risk in the prediction of an MDE, but no interactions. With regard to the prediction of depressive symptoms, multilevel modeling revealed a significant interaction between interpersonal stressors and negative cognitions such that among adolescents with more negative cognitions, higher levels of interpersonal stress predicted higher levels of depressive symptoms, whereas at low levels of negative cognitions, the relation between interpersonal stressors and depression was not significant. Risk (i.e., maternal depression history) and sex did not further moderate these interactions. Implications for intervention are discussed.