Prevention of depression among Icelandic adolescents: a 12-month follow-up

This paper reports the 12-month follow-up results regarding a program designed to prevent the initial episode of depression and/or dysthymia among Icelandic adolescents. This indicated prevention program was implemented in school settings for 14–15 year-old students judged to be “at risk” for depression because of the presence of some depressive symptoms and/or a negative attributional style. We previously reported (Arnarson & Craighead, 2009) that this program, when compared to treatment-as-usual, was effective in preventing the first episode of depression and/or dysthymia at 6-months following completion of the program. Survival analyses of the 12-month follow-up data indicated that the preventive effects were sustained at the end of 1 year following the completion of the prevention program with only 2 of the prevention program participants reporting an initial episode of MDD/DYS versus 13 of the TAU participants (χ² = 5.02, p = .025). Using logistic regression, we also found that initial level of depressive symptoms significantly (p = .0330) predicted the first episode of depression and/or dysthymia among TAU subjects. The limitations of the study were noted, and future directions of research regarding prevention of depression were discussed.     

Cluster C personality disorder and recovery from major depression: 24-month prospective follow-up

We investigated whether Cluster C personality disorder (CPD) is associated with recovery from depression. Changes in symptom scales in 30 patients with MD and CPD were compared with changes in 60 patients with MD alone over a 24-month follow-up period. Recovery of patients with MD and comorbid CPD was inferior to recovery of those with MD alone based on the Hamilton and Beck Depression Inventory (BDI) scales, and the SCL-90 total score. Only 18% of those with MD alone but 47% of those with CPD and MD met the criteria for major depression at the end of the 24-month follow-up. Multiple logistic regression analyses revealed an independent association between the lack of recovery (BDI score > 9 at 24 months) and the presence of CPD (OR 4.9, 95% CI 1.5-16.0). Moreover, the presence of CPD associated with the presence of major depression at 24 months (OR 4.2, 95% CI 1.4-12.2). The presence of CPD hinders the alleviation of depressive symptoms in major depression.     

Dementia caregiving: recent research on negative health effects and the efficacy of caregiver interventions

Provision of care to an older adult with dementia is an important societal resource. This resource may also come at a high cost to informal caregivers, most of whom are family members. In this paper we provide an overview of recent research on dementia caregiving and caregiver interventions. First, we provide background information on the prevalence and costs of Alzheimer's disease and related disorders. Second, we describe the specific stressors and broader mental and physical health outcomes of dementia caregiving. Third, recent evidence of the efficacy of caregiver interventions for both caregiver and patient outcomes is reviewed. Throughout the paper, we describe promising new directions for future research in this area, including assessment and intervention with family caregivers of older patients with comorbid dementia and depression, and the focus on sleep disturbance as a critical health consequence of dementia caregiving.     

The effects of flooding on reducing snake fear in rhesus monkeys: 6-month follow-up and further flooding

Seven wild-reared rhesus monkeys were given two different 6-month follow-up tests to assess for spontaneous recovery of snake fear that had been somewhat reduced following 7 flooding sesions 6 months earlier. Both tests revealed essentially complete spontaneous recovery of fear. In addition, all 7 monkeys received 4 further mixed flooding sessions that involved exposure to real, toy and model snakes, and the 4 most fearful monkeys also received 3 more hours of exposure to the real snake alone. A final behavioral test following these additional flooding sessions revealed a pattern of changes very similar to that observed after the original 7 sessions 6 months earlier. In particular, there were some significant changes in the behavioral avoidance component of the fear but no changes in the behavioral disturbance component of the fear. The results are discussed in the context of earlier studies that purported to demonstrate that snake fear is easy to abolish. It is concluded that these earlier studies erred by not having tests for spontaneous recovery and by only testing for changes in the behavioral avoidance component of fear. Possible reasons for the failure to produce significant changes in the behavioral disturbance component of fear are discussed.     

Influence of caregiver burden on the association between daily fluctuations in pleasant activities and mood: A daily diary analysis

Much research has focused on behavioral activation and its effect on depression, but less is known about the effects of leisure activities on the two distinct affective domains of depression: positive affect (PA) and negative affect (NA). Furthermore, individual factors (i.e., stress level) may moderate the impact of behavioral activation on affect. The present study utilized a daily diary approach to examine the moderating effect of stress on the relationship between leisure satisfaction and both PA and NA. Twenty-five dementia caregivers completed activity and affect measures four times daily for 14 days. Results were analyzed using multilevel modeling, an approach that considers intra-individual differences in activity and affect over time. Results supported the hypothesis that caregivers with higher burden display a stronger association between leisure satisfaction and affect than caregivers with lower burden. Specifically, caregivers with higher burden had a stronger positive relationship between leisure satisfaction and PA and a stronger negative relationship between leisure satisfaction and NA. These findings suggest that screening caregivers for level of burden may help identify those most likely to benefit from behavioral interventions.     

Preventing depression: A review of cognitive-behavioral and family interventions

Depression is one of the most common psychological disorders. It is associated with tremendous costs in terms of suffering, decrease in productivity, and loss of life. For many individuals, depression is a disorder that will recur throughout life. Recent findings suggest that the prevalence of depression is on the rise, particularly in young people. Clearly, depression prevention is an important goal. Can depression be prevented? In this article we review research on interventions designed to prevent episodes and symptoms of unipolar depression in adults and children. Our review focuses specifically on cognitive-behavioral and family interventions. We discuss what researchers have learned about the prevention of depression and conclude with recommendations for future investigations.     

Alexithymia in patients with major depressive disorder and comorbid cluster C personality disorders: a 6-month follow-up study.

The authors examined the association between alexithymia, cluster C personality disorders (CPD), and severity of depression among 121 outpatients with major depressive disorder (MDD) in a 6-month, follow-up study. Diagnosis of depression and CPD was confirmed by means of the Structured Clinical Interviews for DSM-III-R (SCID I and SCID II). Alexithymia was screened using the 20-item version of the Toronto Alexithymia Scale and severity of depression was assessed using the 21-item Beck Depression Inventory. Results indicated that alexithymic features are common in patients with MDD but often alleviated during recovery from depression. Moreover, comorbid CPD and severity of depression seemed to be associated with poorer recovery from alexithymia. The implications of these findings are discussed.     

Maternal communication: predictors of outcome at follow-up in a sample of children at high and low risk for depression

Separate lines of investigation have shown the increased risk of dysfunction for children of depressed women and impaired interaction between depressed mothers and their children. The link between the two was examined in 57 children at high and low risk for depression. Children of unipolar depressed, bipolar depressed, chronically medically ill, and normal mothers were evaluated at a 6-month follow-up. Hierarchical regression analyses suggested a relation between maternal interaction behavior on two dimensions, task focus and affective quality, and children's subsequent depression and school behavior; academic performance was related only to affective quality of interaction. Chronic stress was predictive of more negative, critical maternal behavior, whereas depressed mood was associated with less task involvement. Maternal interactions are viewed as a marker of a complex, mutual process involving interpersonal relationships in an adverse environmental context.     

Creativity and innovation at work: the role of work characteristics and personal initiative

In this longitudinal study, we examined the role of work characteristics (creative requirement, job control, coworker and supervisor support) and personal initiative for teachers' idea generation, idea promotion, and idea implementation. Eighty-nine teachers responded to two surveys with an interval of two weeks. Hierarchical regression analyses showed that creative requirement and job control predicted idea generation, whereas support from coworkers and the supervisor predicted idea promotion. Coworker and supervisor support, as well as teachers' personal initiative, predicted idea implementation.     

Relationship of social support and social burden to repeated breast cancer screening in the women's health initiative.

Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps<.01). Repeated mammography decreased with frequent caregiving (p<.01). Less social strain reduced the frequency of repeated breast self-examinations (BSEs; ps<.01), but frequent caregiving and more negative life events increased repeated use of BSE (ps<.01). Interactive effects suggested that emotional/informational but not tangible support is associated with repeated mammography and clinical breast examinations (ps<.01) and may be particularly important among low-income older women, especially those burdened by caregiving.     

Social phobia: individual response patterns and the long-term effects of behavioral and cognitive interventions. A follow-up study

In this study the long-term effectiveness of Social Skills Training (SST) and Rational Emotive Therapy (RET), on social phobia was studied, as well as the differential influence of patient characteristics on treatment effectiveness. Fifty-seven patients were assessed 14 months after the post-test. Results showed that long-term effectiveness was independent of the response-pattern of the patients. Comparisons between methods, irrespective of the response-pattern of the patients, showed no differences in effectiveness in favor of either SST or RET. Explorative analysis indicated the potential predictive power for treatment-outcome of confederate ratings of overt behavior on the SSIT. Patients who needed additional treatment appeared to perform significantly worse on this measure at the pretest. No factors could be traced that predict relapse after a relatively successful treatment.     

Medical burden, cerebrovascular disease, and cognitive impairment in geriatric depression: modeling the relationships with the CART analysis

Herein, the background information reflecting roles of medical burden, cerebrovascular disease and risk factors, and cognitive impairment in geriatric depression are reviewed. The authors then propose a nonparametric statistical approach to the data analysis of multiple putative causal variables for late-life depression, the Classification and Regression Tree Analysis. This analysis presents a useful approach to modeling nonlinear relationships and interactions among variables measuring physical and mental health, as well as magnetic resonance imaging and cognitive measures in depressed elderly. This method uncovers the existing interactions among multiple predictor variables, and provide thresholds for each variable, at which its predictive power becomes statistically significant. It presents a "hierarchy" of the predictors in a form of a decision tree by finding the best combination of predictors of an outcome. The authors present two models based on demographic variables, measures of vascular and nonvascular medical burden, neuroimaging indices, the Mini-Mental State Examination score, and neuropsychological test scores of 81 elderly depressed subjects. Cognitive tests of verbal fluency and executive function are identified as the best predictors of depression, followed by the frontal lobe volume and Mini-Mental State Examination. The authors observed that an interaction between frontal lobe volume, total lesion volume, and medical burden was predictive of depression.     

Associations of depression status and hopelessness with blood pressure: a 24-year follow-up study

Hypertension is estimated to cause 12.8% of all deaths worldwide. Both literature and well-supported cognitive models indicate that hopelessness predicts depressive symptoms. This study aimed to test whether high levels of hopelessness are associated with increased blood pressure, as well as whether depression acts as a mediator between hopelessness and blood pressure. Data from the original 24-year longitudinal Baltimore Epidemiologic Catchment Area Study (ECA) were analyzed via linear regression (N = 917; 60.3% female; 62.9% European American; mean age = 42.96 years, SD = 16.94). Hopelessness was found to have a significant direct relationship with systolic blood pressure (SBP, p < .05), but not with diastolic blood pressure (DBP, p > .05); while depression had no significant direct relationship with SBP or with DBP. Overall, findings indicated that hopelessness has a significant relationship with SBP. Limitations and implications are discussed.     

Two forms of group therapy and individual treatment of work-related depression: a one-year follow-up study

Patients on long-term sick-leave (> 90 days) from white collar work, with a diagnosis of work-related depression, dysthymia, or maladaptive stress reaction were randomized either to cognitive group therapy (CGT), focused psychodynamic group therapy (FGT), or to a comparison group. All patients were interviewed and responded to self-report questionnaires before the start of treatment and at 6 and 12 months. At the 12-month follow-up, 70% of the patients met the criteria for reliable change of the target symptom (depression), and the sample as a whole improved significantly on all measures used. However, there were no differences in outcome between the three treatment groups.     

Prospective study of postpartum depression: 4 1/2-year follow-up of women and children

The consequences of maternal postpartum depression for mothers and children were investigated in a 4 1/2-year follow-up study, which included 70 of 99 women who had participated in an earlier study of postpartum depression. Information about maternal adjustment and depression during the follow-up period and child adjustment at age 4 1/2 years was obtained. Women who had experienced a postpartum depression were predicted to be at increased risk for subsequent depression and poor adjustment of their child. Postpartum depression was directly related to subsequent depression but not child problems. Later depression was related to child problems at 4 1/2 years. We concluded that postpartum depression may increase risk for later maternal depression and in turn increases risk for child behavior problems. Intervening with women who have experienced a postpartum depression may reduce likelihood of future depressions and child behavior problems.     

Development of infant prehension handedness: A longitudinal analysis during the 6- to 14-month age period

Handedness is a developmental phenomenon that becomes distinctively identifiable during infancy. Although infant hand-use preferences sometimes have been reported as unstable, other evidence demonstrates that infant hand-use preference for apprehending objects can be reliably assessed during the second half of the infant's first year of life. The current study provides further insight into the stability of prehension preferences. We modeled individual and group level patterns of prehension handedness during the period from 6 to 14 months of age. We examined the developmental trajectories for prehension handedness in relation to the sampling rate at which preferences are assessed. The results revealed interesting developmental changes in prehension handedness that can only be identified when using monthly sampling intervals. We conclude that using non-linear multilevel models of infant handedness with monthly sampling intervals permit us to accurately capture the developmental changes in manual skills that occur during this period of infancy.     

Effect of depression on quantity and quality of social inferences

Two studies explored depressives' sensitivity to social information as an impediment to their gaining a sense of confidence and control. In Study 1, Ss viewed a videotape of an actor performing an achievement task and were asked to list their impressions of the actor. As compared with nondepressed Ss, depressed Ss generated more inferences overall, generated more abstract inferences, and exhibited less overall confidence in their impression of the actor. In Study 2, Ss reported their beliefs of the utility of information about a person's past behaviors and personality for understanding, predicting future behavior, and describing that person. Depressed Ss expressed more interest than did nondepressed Ss in both types of information but were less confident of the utility of the information for prediction.     

Comparison of DSM-III-R chronic major depression and major depression superimposed on dysthymia (double depression): validity of the distinction

The nosology of chronic depression has become increasingly complex since the publication of the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987), but there are few data available to evaluate the validity of the distinctions between the subtypes of chronic depression. The validity of the distinction between DSM-III-R chronic major depression (CMD) and major depression superimposed on dysthymia (double depression, DD) was examined. Participants were 635 patients with chronic depression in a 12-week trial of antidepressant medications. Patients with CMD, DD, and a 3rd group with a chronic major depressive episode superimposed on dysthymia (DD/CMD) were compared on demographic and clinical characteristics, family history, and response to treatment. Few differences were evident, although the depression of patients with DD/CMD tended to be more severe.