Comorbidity of anxiety-depression among Australian university students: implications for student counsellors

ABSTRACT

The incidence, factor structure and scale item differences in anxiety-depression comorbidity were investigated in a sample of Australian university students defined according to the presence of anxiety and/or depression. The incidence of anxiety-depression comorbidity was over 32%, about four times that for anxiety or depression alone. Participants with comorbidity had significantly higher Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) total and factor scores than those with anxiety or depression alone. The major differences between the comorbid and unitary disordered subgroups were for self-disintegration and autonomic arousal. Comorbidity of anxiety and depression is a more serious disorder than either anxiety or depression alone, and appears to exist in large proportions among university students. Assessment and treatment plans might benefit from inclusion of this comorbidity.     

A Brief Group Cognitive-Behavioral Program for the Prevention of Depressive Symptoms in Chinese College Students

Depression is a problem among college students in China. Yet the use of preventative group cognitive-behavioral (CB) intervention is rare. One hundred and eighty Chinese college students who were identified as being at risk for depression were randomly assigned to three groups: 1) a brief group cognitive–behavioral (CB) intervention, 2) a supportive group (SG) intervention, and 3) a wait-list control condition. The Zung Self-Rating Depression Scale (SDS), the Zung Self-Rating Anxiety Scale (SAS), and the Chinese College Student Adjustment Scale (CCSAS) were administered at pre-test, post-test, and six-month follow-up. Analysis of variance (ANOVA) conducted among the three groups revealed that the CB group demonstrated significantly less increase in measures of primary symptoms of anxiety and depression than the wait-list controls at post-test and six-month follow-up. The prevention effect of the SG group was significant only at the six-month follow-up. CB participants also showed significantly greater improvements in social adjustment than did SG participants and controls at the post-test and six-month follow-up.     

Psychometric Properties of the Family Support Scale with Head Start Families

Social support systems can have either a beneficial or adverse effect when a family faces stress. Hence, support perceived by family members is an important construct. We studied the psychometric properties of the Family Support Scale (FSS) with a sample of 244 low-income families of children in a Head Start program, and we conducted an exploratory factor analysis with the scale. We obtained a 5-factor solution for the FSS when assessing the family support of low-income families. The internal consistency and test-retest reliability were moderately high for the 5 proposed subscales. The factor structure obtained may prove more valid for Head Start families than structures from previous studies, although there is still a need for further psychometric study of the FSS.     

Psychometric evaluation of the Geriatric Depression Scale and the Zung Self-Rating Depression Scale using an elderly community sample

In this study the psychometric properties of the Geriatric Depression Scale (GDS) and the Zung Self-Rating Depression Scale (SDS) were evaluated and compared, using a relatively large elderly community sample. The GDS generally performed well, replicating earlier findings from a different population. Also, as hypothesized, the SDS, which has a multiple-choice format, had a higher non-completion rate than the GDS, which has a true-false format. Finally, no significant differences between the responses of young-old and old-old subjects were observed.     

Psychometric Properties and Factorial Structure of the State Trait Anxiety Inventory-Trait Version (STAI-T) in Caribbean University Students

The study investigated the psychometric properties of the State Trait Anxiety Inventory—Trait Scale (STAI-T: Spielberger, 1983) in a Caribbean university student sample. Participants were 415 undergraduate students (75% female) who completed the State-Trait Anxiety Inventory-Trait Version (STAI-T; Spielberger, 1983), Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996), the Zung Self-Rating Depression Scale (SDS; Zung, 1965), the Ego Resiliecy-89 (ER-89; Block, 1989), and the Perceived Stress Scale-Ten Item Version (PSS-10; Cohen et al., 1983). Confirmatory factor analysis (CFA) was conducted to examine the construct validity of the trait anxiety scale in terms of factor structure, convergent, discriminant, and nomological validities. CFA results revealed that a two-factor solution (trait anxiety absent and trait anxiety present) provided significantly better fit than the one-factor model of trait anxiety. There was clear evidence of convergent validity, discriminant validity, and nomological validity of the scale. Results support the psychometric adequacy of the STAI-T for use with Caribbean university students.     

Measurement of depression: Comparison between self-reports and clinical assessments of depressed outpatients

Agreement among several depression scales was investigated as regard the relative influences of administration mode (self-rating or clinical rating) and scale content. The Beck Depression Inventory (BDI), the Self-Rating Depression Scale (SDS), the Hamilton Rating Scale for Depression (HRSD), and three corresponding scales with identical structure and content but the alternative administration mode were administered to 47 outpatients with diagnoses of DSM-III major depression disorders. Correlations between the total scores and the degrees of association between corresponding items of different scales were calculated. The results suggest that differences in content contribute more to inter-scale discrepancy than differences in administration mode. The implications for the evaluation of outpatients with major depression are discussed.     

The Zung Self-Rating Depression Scale: convergent validity and diagnostic discrimination

This study examined the concurrent validity of the Zung Self-Rating Depression Scale (SDS) in relation to the Depression (D) scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and addressed a gap in the literature with respect to diagnostic discrimination. The participants were persons on probation or parole. Although women were more depressed than men on the SDS, gender did not interact with SDS as a predictor in a logistic regression analysis. The SDS was found to be the primary discriminating variable in distinguishing depressed from nondepressed participants. In addition, the SDS contributed significant incremental validity over the D scale and showed greater accuracy in identifying nondepressed individuals.     

The relationship between state anxiety and depressed mood: A validity study

The validity of the A-State Scale of the State-Trait Anxiety Inventory and the Zung Self-Rating Depression Scale was assessed using data from a general health survey. Depression and anxiety states were found to coexist, however, evidence from a factor analysis, showing items from the two tests loaded on separate factors, demonstrated that these states can be measured independently. Both the A-State and the Zung Scales were found to comprise two factors, and for each scale, one factor consisted of positively phrased items, and the other of negative items. The implications of these findings for the construct validity of the two scales are discussed.     

Examining the Factor Structure of the Self-Compassion Scale in Four Distinct Populations: Is the Use of a Total Scale Score Justified?

This study examined the factor structure of the Self-Compassion Scale (SCS) using a bifactor model, a higher order model, a 6-factor correlated model, a 2-factor correlated model, and a 1-factor model in 4 distinct populations: college undergraduates (N = 222), community adults (N = 1,394), individuals practicing Buddhist meditation (N = 215), and a clinical sample of individuals with a history of recurrent depression (N = 390). The 6-factor correlated model demonstrated the best fit across samples, whereas the 1- and 2-factor models had poor fit. The higher order model also showed relatively poor fit across samples, suggesting it is not representative of the relationship between subscale factors and a general self-compassion factor. The bifactor model, however, had acceptable fit in the student, community, and meditator samples. Although fit was suboptimal in the clinical sample, results suggested an overall self-compassion factor could still be interpreted with some confidence. Moreover, estimates suggested a general self-compassion factor accounted for at least 90% of the reliable variance in SCS scores across samples, and item factor loadings and intercepts were equivalent across samples. Results suggest that a total SCS score can be used as an overall mesure of self-compassion.     

The effects of anxiety and depression on in vitro fertilisation outcomes of infertile Chinese women

The object was to assess anxiety and depression during in vitro fertilisation (IVF) treatment and determine IVF-related psychological factors in infertile Chinese women. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate anxiety and depression among 842 patients, respectively. A univariate analysis was used to compare variables among three SAS groups and three SDS groups. Anxiety and depression were both represented in 21.3% of the cases. Patients <35 years tended to be more anxious. In women <35 years, the SDS scores were higher with lower educational backgrounds and female or couple’s infertility, while the SAS scores were higher in female or couple’s infertility. In older ones, the SDS scores were higher in those with lower educational backgrounds and longer time for infertility, while the SAS scores were higher in those with lower educational backgrounds. In SAS groups 1–3, the embryo availability was 5.0 (3.0–8.0), 5.0 (3.0–8.0), and 3.0 (2.0–4.5) (p = .013); and the fertilisation rate was 91.9, 90.4, and 81.8% (p < .001), respectively. We concluded that infertile women experience anxiety and depression during IVF treatment, especially in women <35 years. Younger women with female infertility would be more anxious and depressive while higher education can protect them from depression. In older ones, they would experience more depressive with longer time for infertility and be less anxious and depressive with higher education. Anxiety affects the fertilisation rate and embryo availability.     

Investigating the influence of an effort–reward interaction on cognitive fatigue in individuals with multiple sclerosis

This study examined whether an alteration in the effort–reward relationship, a theoretical framework based on cognitive neuroscience, could explain cognitive fatigue. Forty persons with MS and 40 healthy age- and education-matched cognitively healthy controls (HC) participated in a computerized switching task with orthogonal high- and low-demand (effort) and reward manipulations. We used the Visual Analog Scale of Fatigue (VAS-F) to assess subjective state fatigue before and after each condition during the task. We used mixed-effects models to estimate the association and interaction between effort and reward and their relationship to subjective fatigue and task performance. We found the high-demand condition was associated with increased VAS-F scores (p < .001), longer response times (RT) (p < .001) and lower accuracy (p < .001). The high-reward condition was associated with faster RT (p = .006) and higher accuracy (p = .03). There was no interaction effect between effort and reward on VAS-F scores or performance. Participants with MS reported higher VAS-F scores (p = .02). Across all conditions, participants with MS were slower (p < .001) and slower as a function of condition demand compared with HC (p < .001). This behavioural study did not find evidence that an effort–reward interaction is associated with cognitive fatigue. However, our findings support the role of effort in subjective cognitive fatigue and both effort and reward on task performance. In future studies, more salient reward manipulations could be necessary to identify effort–reward interactions on subjective cognitive fatigue.     

Androgyny,depression, and self-esteem in irish homosexual and heterosexual males and females

An examination was made of the following research questions: (a) Do Irish homosexuals and heterosexuals differ in the frequency of their classification in sex-role categories? (b) Is sexual orientation related to psychological adjustment? (c) Is androgyny related to psychological adjustment? Subjects were 112 Irish men and women who were administered Bem's Sex-Role Inventory, Rosenberg's Self-Esteem Scale, Zung's Self-Rating Depression Scale, and a questionnaire. Results indicated that Irish homosexuals were classified more frequently than Irish heterosexuals as androgynous. Homosexuals did not differ from heterosexuals in self-esteem or depression scores. Among these Irish subjects, psychological sex-role category is a more powerful influence on psychological health than actual sexual orientation. It is not whether you are homosexual or heterosexual that affects your psychological health, but how you perceive your own psychological masculinity and femininity.     

Study of Sexual Concordance in Men and Women with Different Typologies of Adherence to the Sexual Double Standard

Background/ObjectiveSexual concordance (i.e., relationship between genital response and subjective sexual arousal) is higher in men than in women. Among the factors that could explain this difference would be the sexual double standard (SDS). Sexual concordance is examined by SDS typologies of adherence (egalitarian, man-favorable, and woman-favorable).MethodDuring exposure to a film with sexual content, genital response (penile circumference/vaginal pulse amplitude) and self-reported sexual arousal were recorded in 104 young adults (42 men and 62 women), distributed into SDS typologies of adherence on the basis of their scores on the Sexual Double Standard Scale.ResultsSexual concordance was obtained in men and women with egalitarian and man-favorable typology. Subjective sexual arousal explained a significant percentage of the variance in genital response in the egalitarian typology (men: R² = .32, p < .01; women: R² = .19, p < .05) and man-favorable typology (men: R² = .21, p < .05; women: R² = .23, p < .05).ConclusionsAgreement between genital responsiveness and subjective sexual arousal depends on DES adherence typology.     

Individual Differences in Coping with Stressful Mass Media An Activation-Arousal View

In this article, we summarize recent advances in the study of behavioral dispositions by detailing the activation-arousal framework. This approach locates the origin of behavioral traits in the activation and arousal systems and, consequently, it offers a more fundamental explanation of personality traits than is typically seen in the mass communication literature. In the interest of applying this view, we propose the Miller Behavioral Style Scale (MBSS) as a measure of an individual's tendency toward activation or arousal. Study I was conducted to test the prediction that scores on the MBSS would be related to the intensity of negative affect during a film segment from Nightmare on Elm Street. The results were encouraging in that the predicted relationship emerged between the MBSS and skin conductance responses. Study U was conducted to test the prediction that scores on the MBSS would be related to information-seeking of highly negative emotional information transmitted by the media when the space shuttle, Challenger, exploded. The results indicated support for this prediction. Implications for future research in mass communication are discussed.     

A factor analysis of six commonly used instruments associated with suicide using college students

Determined whether six commonly used inventories which are associated with suicide (Hopelessness Scale, Zung Self-Rating Depression Scale, Scale for Suicide Ideation, Reasons for Living Inventory, Suicide Probability Scale, and the Suicide Ideation Questionnaire) overlap; all six were given to 308 undergraduates. A principal components factor analysis yielded four factors with Eigenvalues greater than 1.00. These four factors were labeled Suicidal/Negative Ideas, Reasons for Living, Self-Doubt, and Suicide Desire. Each scale or subscale had a factor loading of .4 or greater on one factor. Only the Survival and Coping Beliefs subscale of the Reasons for Living Inventory and the Suicide Ideation Questionnaire loaded on two factors. Thus, each of these six instruments accounts for unique variance in suicidality. A suicide screening battery that includes all six inventories would take approximately 20 min for college students to complete, and would be valuable in identifying different aspects of suicidality.     

A Factor Analysis of Six Commonly Used Instruments Associated With Suicide Using College Students

Determined whether six commonly used inventories which are associated with suicide (Hopelessness Scale, Zung Self-Rating Depression Scale, Scale for Suicide Ideation, Reasons for Living Inventory, Suicide Probability Scale, and the Suicide Ideation Questionnaire) overlap; all six were given to 308 undergraduates. A principal components factor analysis yielded four factors with Eigenvalues greater than 1.00. These four factors were labeled Suicidal/Negative Ideas, Reasons for Living, Self-Doubt, and Suicide Desire. Each scale or subscale had a factor loading of .4 or greater on one factor. Only the Survival and Coping Beliefs subscale of the Reasons for Living Inventory and the Suicide Ideation Questionnaire loaded on two factors. Thus, each of these six instruments accounts for unique variance in suicidality. A suicide screening battery that includes all six inventories would take approximately 20 min for college students to complete, and would be valuable in identifying different aspects of suicidality.     

A Counselor's Guide to the Assessment of Depression

This article discusses various methods and procedures for assessing depression in clients. The following eight clinician rating and client self-report measures of depression are reviewed on the basis of their psychometric properties and applied pragmatic utility: the Hamilton Rating Scale for Depression, the Beck Depression Inventory, the Minnesota Multiphasic Personality Inventory-Scale 2 (Depression), the Depression Adjective Checklists, the Multiple Affect Adjective Checklist, the Zung Self-Rating Depression Scale, the Hopkins Symptom Checklist-90, and the Children's Depression Inventory.     

Assessing the Unidimensionality of Trait Reactance Using a Multifaceted Model Assessment Approach

This study employed a multifaceted model assessment approach to investigate the dimensionality and nomological network of a popular measure of trait reactance, the Hong Psychological Reactance Scale (HPRS; Hong &; Page, 1989 Hong, S.-M., &; Page, S. (1989). A psychological reactance scale: Development, factor structure and reliability. Psychological Reports, 64, 1323–1326.[Crossref], [Web of Science ®] , [Google Scholar]). To address confusion regarding the scoring and modeling of the HPRS as well as its limited external validity evidence, we tested competing factor models, diagnosed model–data misfit, examined relationships between competing factor models and key personality traits, and cross-validated the results. Confirmatory factor analytic results supported modeling the HPRS via a bifactor model and, when this model was applied, trait reactance was negatively related to agreeableness, conscientiousness, and conformity, and positively related to entitlement, as expected. However, we also demonstrated the consequences of championing a 1-factor model by highlighting differences in relationships with external variables. Specifically, although modeling the HPRS scores with the bifactor model resulted in greater model–data fit than the 1-factor model, relationships with external variables based on the 2 models differed negligibly. Moreover, bifactor statistical indexes indicted that scores were essentially unidimensional, providing some support that HPRS scores can be treated as unidimensional in structure. Implications for using and scoring the HPRS are discussed.     

The Role of Attachment Style and Depression in Patients with Hepatitis C

Patients infected with chronic hepatitis C virus (HCV) commonly suffer from the triad of depression, pain and fatigue. This symptom triad in HCV is likely influenced by additional psychological and interpersonal factors, although the relationship is not clearly understood. This retrospective study aimed to characterize the relationship between attachment style and depressive and physical symptoms in the HCV-infected population. Over 18 months, 99 consecutively referred HCV infected patients were assessed with the Hamilton Depression Rating Scale (HDRS), Fatigue Severity Scale, Patient Health Questionnaire-15 for physical symptoms and the Relationship Questionnaire for attachment style. An ANOVA was used to identify differences between attachment styles and Pearson correlations were used to evaluate the association between depression, fatigue and physical symptoms. Approximately 15 % of patients in the sample had a fearful attachment style. Patients with fearful attachment style had significantly higher depressive symptoms compared to a secure attachment style (p = .025). No differences in physical and fatigue symptoms were observed between attachment styles. Further, HDRS scores were significantly associated with fatigue scores (p < .001) and physical symptoms (p < .001), reinforcing the relationship between these symptom domains in HCV-infected patients. Although depressive, physical and fatigue symptoms are inter-related in HCV-infected patients, our study results suggest that only depressive symptoms were influenced by the extremes of attachment style. Screening of relationship styles may identify at-risk HCV-infected individuals for depression who may have difficulty engaging in care and managing physical symptoms.