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.     

Post-stroke depression as a predictor of caregivers burden of acute ischemic stroke patients in China

Our aim was to explore the independent attribution of Post-stroke depression (PSD) to caregiver burden of acute ischemic stroke patients. A cross-sectional survey was performed with 271 acute ischemic stroke patients in the Huai-He Hospital and First People’s Hospital of Kaifeng City in China. PSD was assessed by Self-rating Depressive Scale, and caregiver burden was assessed by Zarit Caregiver Burden Interview. Clustered logistic regression was applied to identify the impact of PSD on caregiver burden. As results, female patients, normal muscle strength and PSD were associated with caregiver burden. PSD correlated with an independent influence of 17.2% on the risk of caregiver burden, The independent influence of PSD on caregiver burden was smaller than that of social-demographics of caregivers and clinical factors of stroke patients This study suggests that PSD may have a modest influence on caregiver burden.     

流动人口的饮酒行为及其影响因素分析

选择从农村流入到北京打工的18-30岁的年轻流动人口共2201人参加问卷调查,要求被试自我报告他们的饮酒行为、流动时间、流动城市数量以及抑郁和满意度状况,并根据他们所从事的13种职业的性质将之归类为“低危”和“高危”两类,以考察环境和个体因素与流动人口饮酒行为的关系。结果表明:(1)在过去1个月中,27%的流动人口曾醉过酒,男性流动人口的醉酒率是女性的2倍(35%vs.16%)。但流动人口的饮酒行为不存在显著的年龄、教育水平和婚姻状况的差异;(2)相关分析表明,高危职业流动人口的饮酒行为显著地高于低危职业的流动人口。同时,与没有醉过酒的流动人口相比,曾醉酒者的抑郁情绪更多,生活和工作满意度更低;(3)Amos结果表明,环境和个体因素相互作用影响流动人口的饮酒行为。流动性通过满意度以及抑郁情绪间接地影响流动人口的饮酒行为,职业性质对饮酒行为产生直接的影响,同时,职业性质又通过生活满意度和抑郁情绪间接地作用于流动人口的饮酒行为。     

The association of paternal mood and infant temperament: A pilot study

Maternal depression is associated with adverse child development, but little is known about the effects of paternal depression. This pilot study estimated the prevalence of paternal depression and mood state, and assessed the relationship between paternal mood and infant temperament. The participants in the study were 98 fathers of newborn babies. Fathers were initially screened for depressed mood (Hospital anxiety and depression scale, and Edinburgh postnatal depression scale), and at 6 months parental mood, infant temperament, couple relationship quality, alcohol use, adverse life events, parenting, and demographics were recorded. Infant fussiness was analysed in relation to paternal mood and other contextual factors using multiple regression. Of the 98 fathers, 48 (49%) completed depression-screening measures. Of these 48 fathers, 4 (8%) reported depressive symptoms above the cut-off for case definition. A total of 48% (N=19) completed measures at follow-up. In the adjusted model, higher paternal depression scores, more traditional attitudes towards fathering, and increased recent life events were related to higher infant fussiness scores; and better couple relationship quality was related to lower fussiness scores. This study showed that 1 in 12 fathers had depressed mood, and lower mood was associated with negative infant temperament. Since the findings of this feasibility study were based on a small sample size the association of paternal mood and child development merits further study using a larger sample of fathers.     

Negative cognitions and avoidance in emotional problems after bereavement: a prospective study

Cognitive behavioural conceptualisations of grief propose that negative cognitions and avoidance strategies play a key role in emotional problems after bereavement. In the current study, this assumption was examined. Ninety-seven individuals who had lost a relative less than 5 months ago completed questionnaires tapping background and loss-related variables, negative cognitions (about the self, life, the future, and one's own grief reactions), avoidance, and symptoms of complicated grief (CG) and depression. Of these mourners, 70 people (72%) completed symptom measures again 6 months later at T2 (7-10 months after the loss), and 60 (62%) completed symptoms measures still 9 months later at T3 (16-19 months after the loss). Among other things, results showed that all four cognitive variables and the avoidance variable were strongly associated with concurrent and prospective symptom levels, even when the influence of relevant background/loss-related variables was controlled. In addition, independent of initial symptom levels, most of the cognitive variables predicted later CG and depression. The avoidance variable only predicted additional variance in depression at T3 beyond T1 symptom levels. Findings indicate that negative cognitions are important in emotional problems after bereavement and that the role of avoidance in the development of these problems needs further scrutiny.     

The influence of aging on poststroke depression using a rat model via middle cerebral artery occlusion

Poststroke depression (PSD) is the most frequent psychological sequela following stroke. While previous studies describe the impact of age on brain infarct volume, brain edema, and blood–brain barrier (BBB) breakdown following ischemia, the role of age on PSD has yet to be described. Here, we examine the influence of age on PSD progression in a rat model of PSD by middle cerebral artery occlusion (MCAO). One hundred forty-three rats were divided into three groups. 48 rats 20 weeks of age underwent a sham procedure, 51 rats 20 weeks of age had MCAO, and 44 rats 22–26 months of age had MCAO. Groups were further divided into two subgroups. The first subgroup was used to measure infarct lesion volume, brain edema, and BBB breakdown at 24 h. In the second subgroup at 3 weeks after MCAO, rats were subjected to a sucrose preference test, two-way shuttle avoidance task, forced swimming test, and a brain-derived neurotrophic factor (BDNF) protein level measurement. Total and striatal infarct volume, brain edema, and BBB breakdown in the striatum were increased in older rats, as compared with younger rats. While both old and young rats exhibited depressive-like behaviors on each of the behavioral tests and lower BDNF levels post-MCAO, as compared with control rats, there were no differences between old and young rats. Although older rats suffered from larger infarct volumes, increased brain edema and more BBB disruption following MCAO, the lack of behavioral differences between young and old rats suggests that there was no effect of rat age on the incidence of PSD.     

Brooding as moderator of depressive symptoms after a work accident: A longitudinal study

This study analyzes the relationship between having experienced a work accident and developing depressive symptoms six months later, considering the subjective severity of accidents, the use of both positive and negative religious coping strategies, and brooding as predictors variables. Fifty seven women and 187 men were evaluated during the month following their accident (T1) and six months later (T2). The results show that after controlling for initial depressive symptoms, all predictors showed a statistically significant relationship with depression at six months, including the interaction between brooding and subjective severity of accident. Forty nine percent of resilient participants exhibited low symptoms at T1 and T2, 22% of recovered individuals showed high symptoms at T1 and low symptoms afterwards, 20% of depressive individuals had high symptoms at T1 and T2, and 8% exhibited high symptoms only at T2. High severity, brooding and religious coping at T1 differentiated those who exhibited stable symptoms from those who were resilient. Resilience was specifically predicted with a negative coefficient by the interaction of brooding with subjective severity of accident. We conclude that brooding is a variable that moderates the relationship between subjective severity of accident and the development and maintenance of depressive symptoms. Subjective severity of accident, brooding and negative religious coping are risk factors, while positive religious coping is not a sufficient protection factor.     

Suicide ideation and depression in university students in Botswana

The study aimed at exploring suicide ideation and its relationship to depression in university students in Botswana. Data were collected from 122 undergraduate students (68.9% females, 31.1% males) with a mean age of 20.02 years. Depressive symptoms were measured with an adapted version of Beck's Depression Inventory-II. In total, 47.5% of the respondents reported suicide ideation, 28.7% reported previous suicide attempts, and the mean depression score was 19.14. Suicide ideation correlated strongly with total depression scores. The level of depression severity was linearly related to suicide ideation but 14.3% of respondents who scored at the level of minimal depression and 53.8% of those who scored at the level of mild depression had also contemplated suicide. The level of education of respondents’ mothers had an inverse relationship with suicide ideation and with depression in that those whose mothers had a tertiary level education were less likely to engage in suicide ideation and had significantly lower depression scores. The results are discussed from within the specific social ecological context of Botswana.     

Anxiety sensitivity and major depression: examination of affective state dependence.

An emerging body of research suggests that anxiety sensitivity (AS), and particularly a facet of AS labelled fear of cognitive dyscontrol, is elevated in depressed individuals and is associated with severity of depressed mood. The current prospective study extended previous work by investigating the extent of affective state dependency in the AS-depression relationship in 51 patients who had major depressive episode (MDE) at baseline assessment (Time 1) and did not have MDE 1 year later at follow-up (Time 2). Despite considerable reduction in severity of depressed mood, scores on the Anxiety Sensitivity Index (M=27) remained elevated. Hierarchical regression analysis indicated that, after controlling for both Time 1 and Time 2 depression severity, Time 1 AS continued to predict residual Time 2 AS and increased prediction of variance from approximately 25% to 50%. Time 1 fear of cognitive dyscontrol AS continued to significantly predict Time 2 fear of cognitive dyscontrol AS when Time 2 fear of physical symptoms AS was statistically controlled. A subsample of recovered patients who displayed only minimal depression symptoms was compared to a matched sample of community controls. While the two groups did not significantly differ on level of depressed mood, the formerly depressed patients had significantly higher levels of AS. Implications for a proposed "depression sensitivity" are discussed.     

儿童心理虐待与抑郁：自动思维的中介作用

目的：运用结构方程模型验证儿童心理虐待、自动思维与抑郁的关系。方法：采用儿童心理虐待量表、自动思维问卷（ATQ）及自评抑郁量表（SDS）,对黑龙江省838名初中生进行调查。结果：儿童心理虐待对自动思维及抑郁有直接影响（β=0.245,β=0.674,均P＜0.001）;自动思维在儿童心理虐待对抑郁的影响中起部分中介作用(Z=51.2,P＜0.01)。结论：自动思维在儿童心理虐待和抑郁之间起中介作用,表明可以从认知方面改善心理虐待初中生的抑郁状态。     

Correlates of suicide in the older adult population in Quebec

This study was undertaken to describe the characteristics of adults aged 60 years and over who committed suicide in Quebec in 1998-1999. In this study, 42.6% of the suicide cases presented mental disorders at the time of their death, mainly depression. Sixty-five (65.3%) percent of the suicide cases would have been considered as having a mental health disorder if sub-threshold depression cases were included. Only 27.7% of the cases did not express any idea of death during the 6-month period preceding their suicide. One interesting finding was that 53.5% of the suicide cases consulted a general practitioner or specialist during the 2-week period preceding their death. Our results showed that only 8.1% had a severe level of functional limitations at the time of their death. This result leads us to interpret with caution the conclusion of some studies suggesting that physical frailty is a major causal factor associated with suicide among the elderly.     

Attachment and Affect between Mothers with Depression and their Children: Longitudinal Outcomes of Child Parent Psychotherapy

The present investigation examined the longitudinal effects of Child-Parent Psychotherapy (CPP) for toddlers and their mothers with depression on: a) maternal affective expression, b) child affective expression, and c) mother-child cohesion. Mothers with depression (M_age?=?31.7 years; 92.8% White, 3.5% Black, 2.1% Hispanic, 2.3% other) and their toddlers were randomized to receive CPP (DI; n?=?66) or to a control group (DC; n?=?64). Mothers without depression and their toddlers (NC; n?=?68) were recruited as an additional comparison group. Dyads were assessed at baseline (T1; 20 months old), post-intervention (T2; 36 months old), and follow-up (T3; 9 years old). Data from a mother-child conflict task was coded as a measure of observed outcome variables. Change in post-intervention attachment security assessed via the Strange Situation was evaluated as a mediator between intervention condition and maternal and child affective expression and dyadic cohesion at T3. Change to secure attachment post-intervention significantly mediated the association between intervention condition and T3 maternal warmth and child anger/problem behavior. Toddlers of mothers with depression who received CPP showed higher rates of change to secure attachment compared to those in both the DC and NC groups. Dyads who changed to secure attachment at T2 displayed higher levels of maternal warmth at T3 and lower levels of child anger and problem behavior at T3. Implications for the use of CPP as a preventive intervention and the importance of attachment as a mediator of long-term outcomes are discussed.

     

Experiential differences between voluntary and involuntary job redundancy on depression,job‐search activity,affective employee outcomes and re‐employment quality

The current study used learned helplessness theory and legacy theory to examine experiential differences in voluntary vs. involuntary job redundancy in a baseline study (Study 1) and a 3‐month retest (Study 2). The sample for Study 1 comprised 102 job seekers who had voluntarily taken a job redundancy and 114 job seekers who had been made involuntarily redundant from their last job. Results at Study 1 showed that voluntarily redundant participants experienced lower levels of depression and engaged in more job‐search activity than those who experienced involuntary redundancy. Employees who became re‐employed 3 months later (voluntarily redundant N = 28, involuntarily redundant N = 26) were compared on depression, organizational commitment, perceived job insecurity and perceived re‐employment quality. The involuntarily redundant employees reported higher depression, lower organizational commitment, higher perceived job insecurity and lower perceived re‐employment quality. The voluntarily redundant employees also experienced a significant drop in depression upon re‐employment while the involuntarily redundant employees reported no significant changes to depression scores from baseline. Implications for practice and future research are discussed together with the limitations of the two studies.     

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.     

幸福者更适应,还是适应者更幸福?——基于大学新生的追踪研究

本研究对122名大学新生进行了半年追踪,采用交叉滞后分析法考察适应性与幸福感之间的关系。入学三个月时初次测试（T1）,初测半年之后后测（T2）。结果发现：（1）幸福感和适应性之间显著正相关,同时预测的效果高于继时预测;（2）交叉滞后相关分析表明,适应性T1对幸福感T2的预测（r=0.50）高于幸福感T1对适应性T2的预测（r=0.32）;（3）学习适应性T1（18%）和人际适应性T1（11%）共同预测主观幸福感T1中29%的变异;（4）控制初测总体适应性T1（31%）,对大学的认可度T2（21%）和个人情绪适应性T2（3%）还可以解释幸福感T2中24%的变异。因此,本研究发现大学生适应者更幸福,而不是幸福者更适应。该结果对于提升大学生的幸福感具有一定的教育启示意义。     

Anxiety and depression in adolescents in urban and rural China

The goal was to assess rates of anxiety and depression in adolescents in two areas of Zhejiang Province, China. A cross-sectional survey was carried-out using a self-report questionnaire developed for this study. Participants were middle school students (age range 13-16 years) in an urban and a rural setting. There were 1576 completed questionnaires. Symptoms of anxiety sufficient to interfere with enjoyment of life, relaxation, and sleep were common (48%, 40%, and 27%, respectively). School-related problems were the predominant sources of worry. One third reported a history of depression, 16% had at times felt life was not worth living, and 9% reported that they had attempted suicide. Girls were more likely to report symptoms of depression. Patterns of help-seeking showed reliance on friends and parents; only 1% had sought professional help. There were no significant differences in anxiety and depression between one-child and multisibling families.     

流动儿童压力应对方式与抑郁感、社交焦虑的关系:一项追踪研究

为了探讨流动儿童压力应对方式与抑郁感、社交焦虑的变化特点及其动态关系,本研究通过整群抽样法从5所北京市公立学校和1所打工子弟学校选取1164名流动儿童,采用问卷调查的形式对其进行为期一年的追踪测查,追踪时回收有效数据680份.对前、后测均参加调查的680名被试的数据进行分析,结果发现:(1)经过一年的城市适应,流动儿童整体的积极应对增多,消极应对减少,抑郁感下降,但社交焦虑水平无明显变化;(2)流动儿童个体在压力应对、抑郁感、社交焦虑的发展上均表现出两极分化的现象,年龄越小、来京时间越短、低年级及女生流动儿童群体的发展趋势更为良好;(3)流动儿童压力应对方式与抑郁感、社交焦虑间存在相互作用的动态关系,前测压力应对方式、抑郁感、社交焦虑均能显著预测后测相应变量的水平,前后测压力应对方式对抑郁感、社交焦虑均有即时预测作用,而前测抑郁感和社交焦虑对后测压力应对方式有不同的延时性影响.     

Maternal Separation Anxiety and Attitudes About Maternal Grandmother Participation in Child Care

A sample of 75 primiparas in Athens, Greece were interviewed 3 days following birth (T1) regarding their attitudes towards maternal grandmother participation in child care. A follow-up questionnaire measuring the same attitudes and maternal separation anxiety (MSA) was answered 3–8 months later (T2). It was found that maternal grandmothers were going to assist in child care in 68% of the cases. Higher scores on the MSA subscale ‘employment-related separation concerns’ were obtained by all mothers who were not assisted in child care by the maternal grandmother and were highest among those mothers intending to work before the child was 1 year old. Mothers who intended to work as well as those who had a higher educational level had significantly lower scores on the MSA subscale ‘maternal separation anxiety’. Overall, mothers expressed favourable attitudes towards maternal grandmother participation at T1 and T2. Positive attitudes were especially observed among mothers who relied on grandmothers for child care.     

中学生创新心理素质与心理健康的相关研究

采用自编的创新心理素质量表和中国中学生心理健康量表对558名中学生进行问卷调查,以探讨中学生创新心理素质和心理健康之间的关系。结果表明：(1)自编创新素质量表包括三个子量表,分别为创新意识、创新能力与竞争心量表,经检验三个子量表均具有较高的信度、效度。(2)中学生的创新心理素质整体处于中等偏上水平。(3)中学生创新心理素质与心理健康水平较为密切,创新意识与学习压力、抑郁、焦虑显著负相关,创新能力与学习压力、抑郁显著负相关,与适应不良显著正相关,竞争心与抑郁、焦虑、学习压力、总均分有着显著的负相关关系;心理健康水平高者其创新意识和竞争心较心理健康水平低者高;学习压力对创新意识和竞争心的预测作用较大,学习压力、适应不良和抑郁对创新能力的预测作用较大。     

Enhancing recovery rates: Lessons from year one of IAPT

BackgroundThe English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines.MethodData from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7).ResultsData completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff.ConclusionsCompliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.