Associations of Lifetime Depression with Trauma Exposure,Other Environmental Adversities,and Impairment in Adolescents with ADHD

Depression is a common, potentially devastating comorbidity in youth with attention-deficit/hyperactivity disorders (ADHD). Various environmental adversities are well-described as correlates of depression in general pediatric populations, but not in youth with ADHD. In 104 adolescents with ADHD, we examined potential environmental correlates of lifetime depression, including trauma exposure, recent negative life events and current parent-child conflict, along with current and past ADHD severity and current impairment. Controlling for demographic variables, comorbid disorders, and ADHD severity, we noted significant associations between lifetime depression and environmental adversities, including victimization trauma, parent-child conflict, and behaviorally-independent negative life events. Current impairment but not ADHD severity was also highly associated with lifetime depression, controlling for the same covariates. Findings from this preliminary, cross-sectional study suggest that environmental adversities and impairment in youth with ADHD should also be targeted along with the ADHD when contemplating strategies to treat or prevent comorbid depression.     

Recognition of affective prosody in brain-damaged patients and healthy controls: A neurophysiological study using EEG and whole-head MEG

A passive oddball experiment was used in which stimuli were emotional exclamations differing in their affective tone. In both electroencephalography (EEG) and magnetoencephalography (MEG), deviants elicited an N300 component, sometimes accompanied by a slow wave. Both components had a symmetrical distribution, but the former was more posterior than the latter. The same responses to prosodic stimuli were significant in 6 of 27 patients with severe disorders of consciousness (persistent vegetative state and minimally conscious state) and in all 3 of the examined locked-in patients, indicating that the procedure can be applied for testing neurological patients. The occurrence of significant responses depended on the presence or absence of a lesion to the right temporal lobe. Obviously, the N300 depends on the activity of the right temporal cortex but does not originate there. We suggest that the component is related not to the recognition of affective prosody as such, but to the following detection of affective mismatch due to violations of emotional context of stimulation.     

Using selection,optimization, and compensation to reduce job/family stressors: effective when it matters

Previous research has demonstrated that the use of general behaviors specified by a life-management strategy entitled Selection, Optimization, and Compensation (SOC) reduces, if only to a small extent, the perceived amounts of the main antecedents (i.e., job/family stressors) of work-family conflict. The results of the current study demonstrate that several variables that impact the amount of resources demanded of, or resources available to, an individual (e.g., supervisor support) moderate the relationship between SOC behaviors and job/family stressors. Specifically, SOC strategies are more effective than previously thought at reducing job/family stressors for precisely those individuals in the most demanding situations.     

Comparing gain- and loss-framed messages for smoking cessation with sustained-release bupropion: a randomized controlled trial.

Prospect theory suggests that because smoking cessation is a prevention behavior with a fairly certain outcome, gain-framed messages will be more persuasive than loss-framed messages when attempting to encourage smoking cessation. To test this hypothesis, the authors randomly assigned participants (N=258) in a clinical trial to either a gain- or loss-framed condition, in which they received factually equivalent video and printed messages encouraging smoking cessation that emphasized either the benefits of quitting (gains) or the costs of continuing to smoke (losses), respectively. All participants received open label sustained-release bupropion (300 mg/day) for 7 weeks. In the intent-to-treat analysis, the difference between the experimental groups by either point prevalence or continuous abstinence was not statistically significant. Among 170 treatment completers, however, a significantly higher proportion of participants were continuously abstinent in the gain-framed condition as compared with the loss-framed condition. These data suggest that gain-framed messages may be more persuasive than loss-framed messages in promoting early success in smoking cessation for participants who are engaged in treatment.     

Psychiatrische Beiträge

JOURNAL CLUB

Psychiatrische Beitr?ge     

Comparing the CASI-4R and the PGBI-10 M for Differentiating Bipolar Spectrum Disorders from Other Outpatient Diagnoses in Youth

We compared 2 rating scales with different manic symptom items on diagnostic accuracy for detecting pediatric bipolar spectrum disorder (BPSDs) in outpatient mental health clinics. Participants were 681 parents/guardians of eligible children (465 male, mean age = 9.34) who completed the Parent General Behavior Inventory-10-item Mania (PGBI-10 M) and mania subscale of the Child and Adolescent Symptom Inventory-Revised (CASI-4R). Diagnoses were based on KSADS interviews with parent and youth. Receiver operating characteristic (ROC) analyses and diagnostic likelihood ratios (DLRs) determined discriminative validity and provided clinical utility, respectively. Logistic regressions tested for incremental validity in the CASI-4R mania subscale and PGBI-10 M in predicting youth BPSD status above and beyond demographic and common diagnostic comorbidities. Both CASI-4R and PGBI-10 M scales significantly distinguished BPSD (N = 160) from other disorders (CASI-4R: Area under curve (AUC) = .80, p < 0.0005; PGBI-10 M: AUC = 0.79, p < 0.0005) even though scale items differed. Both scales performed equally well in differentiating BPSDs (Venkatraman test p > 0.05). Diagnostic likelihood ratios indicated low scores on either scale (CASI: 0–5; PGBI-10 M: 0–6) cut BPSD odds to 1/5 of those with high scores (CASI DLR- = 0.17; PGBI-10 M DLR- = 0.18). High scores on either scale (CASI: 14+; PGBI-10 M: 20+) increased BPSD odds about fourfold (CASI DLR+ = 4.53; PGBI-10 M DLR+ = 3.97). Logistic regressions indicated the CASI-4R mania subscale and PGBI-10 M each provided incremental validity in predicting youth BPSD status. The CASI-4R is at least as valid as the PGBI-10 M to help identify BPSDs, and can be considered as part of an assessment battery to screen for pediatric BPSDs.     

Generational Differences in Work Ethic: Fact or Fiction?

Even though stereotypes suggest that older generational cohorts (e.g., Baby Boomers) endorse higher levels of work ethic than younger generations (e.g., Millennials), both the academic literature and popular press have found mixed evidence as to whether or not generational differences actually exist. To examine whether generational differences exist in work ethic, a dataset was compiled (k = 105) of all published studies that provided an average sample age and average work ethic score, with each sample becoming an observation, and being assigned a generational cohort based upon the average age of the sample. Three hierarchical multiple regressions found no effect of generational cohort on work ethic endorsement. In two of the three phases, results found a main effect of sample type, such that industry samples had higher work ethic endorsement than student samples. Implications for applied practitioners and future research streams for generational and work ethic research are discussed.     

Typing Speed as a Confounding Variable and the Measurement of Quality in Divergent Thinking

The need to control for writing or typing speed when assessing divergent-thinking performance has been recognized since the early ‘90s. An even longer tradition in divergent-thinking research has the issue of scoring the responses for quality. This research addressed both issues within structural equation modeling. Three dimensions of originality—uncommonness, remoteness, and cleverness—were used to derive an overall quality score. Mixed evidence was found in Study 1 for the direct effect of typing speed on fluency. In addition, indirect effects of typing speed via cognitive complexity on overall quality of ideas were uncovered but marginal in both Study 1 and Study 2. This indirect effect was also found for cleverness in Study 2. Another indirect effects of typing speed via fluency was found for cleverness and uncommonness. These findings indicate that controlling for typing speed is important in online divergent-thinking assessment. The inter-relations of various quality scores pertaining to the dimensions of uncommonness, remoteness, and cleverness were promising in terms of convergent validity. Important problems with respect to these scores were identified and discussed to guide future attempts to measure quality in DT.     

Suicidality and its relationship to treatment outcome in depressed adolescents

This study investigates the impact of suicidality on treatment outcome in 107 depressed adolescents who participated in a clinical trial, and received either cognitive-behavioral (CBT), systemic-behavioral-family (SBFT), or non-directive-supportive therapy (NST). Suicidal depressed adolescents had a higher dropout rate and were more likely to be depressed at the end of treatment, in large part due to the particularly poor response of suicidal patients to NST. The relationship between suicidality and treatment response was mediated by severity of depression and hopelessness at intake. Hopelessness should be specifically targeted early in treatment. Suicidal depressed adolescents should not receive NST but a specific treatment like CBT.     

Effectiveness of cognitive-behavioral therapy for adolescent depression: a benchmarking investigation

In this study, we examined the effectiveness of cognitive-behavioral therapy (CBT) for adolescent depression. Outcomes of 80 youth treated with CBT in an outpatient depression specialty clinic, the Services for Teens at Risk Center (STAR), were compared to a "gold standard" CBT research benchmark. On average, youths treated with CBT in STAR experienced significantly slower symptom improvement than youths in the CBT benchmark. However, outcomes for STAR teens were more similar to the research benchmark when accounting for differences in referral source (clinical versus advertisement) between the datasets. Results support further efforts to test the effectiveness of CBT in clinically representative community practice settings and samples.