Depression, Psychological Resources, and Health-Related Quality of Life in Older Adults 75 and Above

The purposes of this study were (1) to compare psychological resources and health-related quality of life between two groups of community-dwelling elders, 75 years of age and older, with similar chronic illnesses, but with varying levels of depression, and (2) to examine the relationships among depression, psychological resources, and health-related quality of life. Fifty-two elders (14 men and 38 women) were divided into mildly (n = 18) and severely (n = 34) depressed groups based on their depression scores. There were no significant differences between the two groups for demographic and illness characteristics. There were significant differences for number of medications, mastery, health perceptions, mental health functioning, and well-being. Severely depressed elders had poorer health perceptions, and decreased mastery, functioning, and well-being as compared with mildly depressed elders. An explanatory model was developed using factor analysis that fit the data well. Health perceptions and mastery had direct influences on depression, and depression directly impacted well-being.     

Longitudinal Associations Between Parental SES and Adolescent Health-Related Quality of Life Using Growth Curve Modeling

We evaluate how two aspects of socioeconomic status, parental objective and subjective social status, are associated with health-related quality of life in three racial/ethnic groups during pre- to mid-adolescent development, using growth curve modeling. In a longitudinal cohort study, 4,048 Black, Latinx, or White adolescents were assessed in 5th, 7th and 10th grade. Objective social status (OSS) was based on parent-reported highest household educational attainment and total household income, and subjective social status (SSS) was measured with the MacArthur Scale, through which parents indicated their social standing in reference to community and national norms. Adolescents completed the Pediatric Quality of Life Inventory to measure their physical and psychosocial health-related quality of life. Based on growth curve modeling of the intercept, adolescents whose parents have higher OSS levels reported better health-related quality of life, whereas parental SSS was not associated with adolescent health-related quality of life in 5^th grade. These findings were largely consistent across racial/ethnic groups. Based on growth curve modeling of the developmental slopes (or growth curves), higher objective social status was associated with a slower positive growth of health-related quality of life from 5^th to 10^th grade, which was largely consistent across racial/ethnic groups. The opposite appeared for parental SSS and physical health-related quality of life, and only for Latinx, where higher parental perceived social status was associated with an acceleration of positive change. Family income and education may influence health-related quality of life at the start of adolescence, but its effect appears to diminish as youth mature. However, in Latinx youth, parents’ perceived social status may continue to influence improvement in their physical health-related quality of life as they mature.

     

Social confirmation of dysphoria: shared and private reactions to depression

Social responses to dysphoria were investigated. Subjects conversed for 15 minutes with persons selected on the basis of the presence or absence of depressed mood. Following the conversations, mood measures were administered along with social perception questionnaires that were described as either being confidential or to be shared with the other person. Subjects who interacted with depressed persons were anxious, depressed, and hostile, and the subjects rejected them. Contrary to predictions, subjects were willing to share their negative responses with the depressed persons. The depressed persons correctly anticipated rejection and reciprocated. The authors argue that cognitive models of depression need to be integrated with a conception of the social environment as being active and responsive. Judgments of cognitive distortion cannot be made without an understanding of the feedback typically available from the social environment.     

Impact of a Father Figure’s Presence in the Household on Children’s Psychiatric Diagnoses and Functioning in Families at High Risk for Depression

The consequences of living in single-parent households on children’s wellbeing are well documented, but less is known about the impact of living in single-mother households among children with high familial risk for depression. Utilizing data from an ongoing three-generation study of high-risk families, this preliminary study examined a sample of 161 grandchildren of probands diagnosed with major depressive disorder, comparing those in single-parent households to those in dual-parent households with household status defined as the full-time presence of a resident male in the home. High-risk children were compared across households in terms of psychiatric diagnoses (measured by Schedule for Affective Disorders and Schizophrenia for School-Age Children; K-SADS-PL) and global functioning (assessed by Global Assessment Scale, child version; C-GAS). Results indicated that high-risk children in single-parent households had 4.7 times greater odds for developing a mood disorder and had significantly lower mean C-GAS scores (p = 0.01) compared to those in dual-parent households. Differences remained significant when controlling for household income, child’s age, and either parent’s depression status. There were no significant differences between high-risk children across households when household status was instead defined as legal marital status. This study has several limitations: sample size was small, probands were recruited from a clinical population, and participants had not passed completely through the period of risk for adult psychiatric disorders. These findings point towards the importance of identifying and closely monitoring children at risk for depression, particularly if they reside in households without a resident father figure.     

Health-related quality of life among people living with hiv disease in small communities and rural areas

Abstract

While many studies have examined the life quality of HIV-infected persons in large metropolitan areas, few studies have investigated quality of life issues among persons living with HIV disease in America's small and rural communities. In the present study, 78 people living with HIV/AIDS in small and rural communities (i.e., populations <25,000) reported on their health-related quality of life. Many respondents reported decreased social, emotional, functional, and physical well-being. Results revealed that participants' emotional well-being and the quality of their relationship with their doctor were related to their overall quality of life. The majority of participants (73%) expressed interest in participating in a telephone-linked support group involving other people living with HIV designed to improve quality of life.     

Work strain and the post-discharge adjustment of patients following a heart attack

Abstract

The role of work characteristics in determining return to work after an acute coronary event was examined. One hundred and forty nine patients were enrolled. One year post-discharge, 74 had returned to work. Work characteristics (decision latitude, and opportunity for social interaction at work), together with age, depression, and medical prognosis, correctly classified work status in 78% of cases. At 12 months post-discharge, patients who had not returned to work recorded significantly poorer levels of adjustment compared to those who had returned to work. A better quality of life is associated with a lower level of depression pre-hospitalization, ownership of a larger home, being male, and having a more positive work environment. The findings suggest that the pre-illness work environment of the patient is a factor influencing return to work, which needs to be considered in rehabilitation programmes.     

The Impact of Social and Political Changes on Survivors of Political Persecutions in Rural Russia and Ukraine

Differences in depressive symptoms and attitudes about political and social changes were examined for individuals with and without family histories of Stalinist persecution in several small villages in Russia and Ukraine. In a sample of 422 villagers, there were 37 family members of survivors of Stalinist purges. In comparison to villagers with no family history of persecution, those who had such history perceived their social life with other villagers and their life in general to be much improved in the late 1990s. They also reported much lower levels of depression than those without a history of persecution. Differences that were discovered could not be accounted for by demographic characteristics of the respondents. The results suggest that individuals with a history of family trauma related to political persecution may perceive their environment as more positive as a result of political changes and may cope with political transitions differently than persons who have no history of family persecution.     

Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed mothers enrolled in the first year of a home visitation program on parenting stress, quality of home environment, social network, and psychiatric symptoms. Mothers were young, low income, and predominantly unmarried. Results indicated that depressed mothers displayed impairments in parenting, smaller and less robust social networks, and increased psychiatric symptoms relative to their non-depressed counterparts. Path analyses for the full sample revealed a path linking childhood trauma, depression, and parenting stress. Path analyses by group revealed several differential relationships between dimensions of social network and parenting. Number of embedded networks, namely the number of different domains in which the mother is actively interacting with others, was associated with lowered parenting stress among non-depressed mothers and increased parenting stress in their depressed counterparts with childhood trauma histories. In depressed mothers, social network size was associated with lower levels of parenting stress but decreased quality of the home environment, whereas number of embedded networks was positively related to quality of the home environment. Implications of findings for home visitation programs are discussed.     

Predictors of time to remission from depression in primary care patients: do some people benefit more from positive life change than others?

The authors examined the role of personality, social support, and coping strategies and their interaction with positive life change (PLC) in influencing time to remission from depression in 86 depressed primary care patients (69% women, mean age = 36.6 years), who were followed for 3.5 years. Diagnostic information was obtained by the Present State Examination (J. K. Wing, J. Cooper, & N. Sartorius, 1974), and life change by the Life Events and Difficulties Schedule (G. W. Brown & T. O. Harris, 1978). The association of PLC and other predictors with the time to remission was studied by means of Cox regression. PLC reduced time to remission in women, but not in men. Other predictors that expedited remission were low severity of premorbid difficulties, high self-esteem, and a tension-reducing coping style. Neuroticism modified the effect of PLC in that the remission forward bringing effect of PLC was stronger for highly neurotic people. The results suggests that women and psychologically vulnerable persons benefit most from PLC.     

Cognition,daily living,and health-related quality of life in 85-year-olds in Sweden

ABSTRACT

This study investigates how cognition influences activities of daily living and health-related quality of life in 85-year-olds in Sweden (n?=?373). Data collection included a postal questionnaire comprising demographics and health-related quality of life measured by the EQ-5D. The ability to perform personal activities of daily living (PADL) was assessed during a home visit that included administering the Mini Mental State Examination (MMSE). Cognitive impairment was shown in 108 individuals (29%). The majority were independent with respect to PADL. A larger number of participants with cognitive impairment reported that they needed assistance in instrumental activities of daily living (IADL) compared to the group without cognitive impairment. Impaired cognition was significantly related to problems with IADL. Significant but low correlations were found between cognition and health-related quality of life – higher ratings on perceived quality of life correlated with higher results on the MMSE.     

Spiritual well-being and spiritual practices in elderly depressed psychiatric inpatients

This study's aims were to describe the spirituality of depressed elderly psychiatric inpatients and to examine associations among spirituality, depression, and quality of life (QOL). Forty-five persons participated. Most reported frequent, stable spiritual practices and experiencing spiritual comfort and guidance. Some reported spiritual distress and changes in spirituality. During hospitalization, participants demonstrated increased spiritual well-being (SWB) and peacefulness, and reduced hopelessness, worthlessness, and guilt. Positive associations were found between SWB and QOL and negative associations between SWB and depression.     

Behavior of depressed subjects in problem solving groups

This study investigated leadership selection in groups in relation to level of depression of group members. On the basis of MMPI-D and DACL scores 66 subjects were organized into groups of six to eight people consisting of all depressed, all nondepressed, or half depressed and half nondepressed subjects. Subjects performed a problem solving task alone and in groups and completed a questionnaire on leadership choice and group performance. Results indicate that nondepressed group members talked more frequently, were rated as more important contributors, and were selected as leaders more frequently than depressed members. In addition, mixed groups were perceived as more efficient and enjoyable by group members than the unmixed groups. There were no significant differences between depressed and nondepressed subjects on performance of the problem solving task whether working alone or in groups. Results were discussed in relation to other literature on the interpersonal behavior of depressed persons.     

Gender differences in stress reactions: Women filling the gaps

Abstract

Competing hypotheses explaining gender differences in depression were compared in a one-year longitudinal study of parents of ill children in Israel. Women were found to have more depressed mood than men when their children were ill or well, but both men and women responded with increased depression when their child was ill. Women were more likely than men to be with an ill child at the hospital, even if employed, suggesting role overload. Women did not report fewer personal or social resources than men, indicating that poverty of resources could not explain sex differences on depression. Nor did women use their resources less effectively than did men. Women were less depressed the greater their intimacy with their spouse and friends, but at all levels of intimacy were more depressed than men. Men, in contrast, isolated themselves from social support at the time of their child's illness and it was argued that men might be avoiding stress contagion. The importance of examining differential responding of men and women to stressors that have common meaning for both sexes was discussed.     

Das Ausmaß von Müdigkeit und Erschöpfbarkeit in der über 60-jährigen Normalbevölkerung in Deutschland

In a community-based random sample of 622 elderly persons over 60 years of age, fatigue was assessed by means of the multidimensional fatigue inventory (MFI; a self-assessment measure). Higher fatigue values were found with increasing age, particularly physical feelings of fatigue, reduced activity and reduced motivation. Fatigue was associated with depression, with a low health-related quality of life and with subjective physical complaints. Distinct fatigue symptoms in the elderly should therefore be regarded as possible indicators for somatic and/or psychological burdens and should receive diagnostic and therapeutic attention. In the present paper, mean values and percentiles for different age groups over 60 years are given as norm values for the normal population over 60 years of age.     

Relation of perceived emotional intelligence and health-related quality of life of middle-aged women

This study examined the relationship between perceived emotional intelligence and health-related quality of life in middle-aged women. 99 middle-aged Spanish women, who studied in two adult schools, volunteered to participate. 49 were premenopausal and 45 were postmenopausal. These women completed the Trait Meta-Mood Scale and Health Survey SF-36. Scores were analyzed according to social, physical, and mental health, menopausal status, and scores on perceived emotional intelligence. Then, the data regarding the mental and physical health of the premenopausal and postmenopausal women were compared after controlling for age. No associations between menopausal status and health-related quality of life were found. Perceived skill at mood repair was significantly associated with scores on health-related quality of life in these middle-aged women. These findings provide empirical evidence that aspects of perceived emotional intelligence may account for the health-related quality of life in midlife including social, physical, and psychological symptoms.     

Self-schemas and risk for depression: a prospective study

The role of depressive self-schemas in vulnerability to depression was explored in a longitudinal design. Five groups of subjects hypothesized to be at differential risk for depression according to a schema model were identified: depressed schematic, depressed nonschematic, nondepressed schematic, nondepressed nonschematic, and a psychopathology control. They were followed regularly for 4 months with self-report and clinical interview measures of depression. There was no evidence of risk for depression associated with schema status apart from initial mood and no interaction of life stress events and schemas. In a second experiment with the same subjects, it was shown that depressive self-schemas do not exert an ongoing, active influence on everyday information processing; instead current mood affected information processing. Remitted depressed persons resembled nondepressed rather than depressed ones. The results support Kuiper and colleagues' distinction between concomitant and vulnerability schemas, and help to clarify differences between cognitions that are symptoms or correlates of depression and those that may play a causal role under certain conditions.     

Examining the world of the depressed: do depressed people prefer others who are depressed?

Two studies were conducted to examine the interpersonal world of the depressed person. In Study 1, depression levels and perceptions of depressed and nondepressed people and their best friend were assessed to test the hypothesis that depressed Ss have best friends who are themselves more depressed than the best friends of nondepressed Ss. The hypothesis was confirmed, suggesting that depressed persons may prefer others who also tend toward depression. To examine this possibility, in Study 2 depressed and nondepressed college students spoke with one another in either depressed-depressed, nondepressed-depressed, or nondepressed-nondepressed pairs. It was found that depressed Ss felt worse than nondepressed Ss after speaking with nondepressed targets, but not after speaking with depressed targets. There were no differences in liking or in perceived similarity between the groups. Implications for the social world of the depressed person are discussed.     

Religiosity and Social Support: Implications for the Health-Related Quality of Life of African American Hemodialysis Patients

The purpose of this study was to determine whether sociocultural differences have any effect on the health-related quality of life among African American hemodialysis patients. This study examined relationships between religiosity, social support, and the health-related quality of life of African American hemodialysis patients. Four hemodialysis units were selected for the study. The study population consisted of 176 African American hemodialysis patients who had been receiving hemodialysis treatments for at least 1 month. The religiosity variable was measured by the Measure of Religious Involvement. Social Support was measured by the Medical Outcomes Study Social Support Survey, and health-related quality of life was measured by the Medical Outcomes Study 36 Short Form Health Survey (SF-36v2). The investigators found that social support contributed to the emotional and physical health of African American hemodialysis patients in the sample, whereas religiosity was inversely related to the physical health of these patients.     

Effect of depression level and length of acquaintance on reactions of others to a request for help

This experiment examined an interpersonal-process view of depression by assessing subjects' reactions to a request for help from a hypothetical depressed or nondepressed person with whom they had been acquainted for a relatively short (2 weeks) or long (1 year) period of time. Subjects responded to each of the four hypothetical persons by indicating their probable affective reactions to the request, the number of minutes they would be willing to help, their desire for future social contact with the hypothetical person, and their expectations of future requests for help. Requests from depressed persons elicited significantly more anger and social rejection but equal amounts of concern and willingness to help. This mixed response pattern was interpreted as providing partial support for an interpersonal-process view of depression. In addition a path analysis provided limited support for Coyne's (1976b) hypothesis that rejection of depressed persons results from the negative mood they induce in others.