Validation of the Patient Health Questionnaire-2 with Iranian students

ABSTRACT

Depression is a serious public health problem in community settings and primary care. The Patient Health Questionnaire-2 (PHQ-2) is a brief screen for depression. The PHQ-2 has not had its validity examined in academic settings in Iran. A cross-sectional study was conducted to investigate the reliability, validity, and factorial structure of the PHQ-2 in a convenience sample of 157 Iranian volunteer college students selected from the Iran University of Medical Sciences. Participants completed the PHQ-2, and the Loneliness Scale (LS). The mean score of the PHQ-2 was 2.26 (SD?=?1.64). The Cronbach's α coefficient was .74, indicating high internal consistency. The PHQ-2 correlated .68 with the LS, demonstrating good construct validity. The results of the factor analysis of the PHQ-2 identified one factor labeled: General depression (79.87% of the variance). The PHQ-2 has a unidimensional structure, acceptable validity and reliability, and it can be used in the non-clinical settings in Iran.     

Missing

Wartime experience in Britain during World War Two left thousands of empty spaces where once buildings and streets had been. It simultaneously left gaps in families, often with far-reaching consequences. In this paper, I reflect on one such case in my own family. I examine how the devastating loss of a particular family member as a consequence of an unlucky combination of time and place played into a silent history of earlier losses connected to physical migration, experiences which had traumatic impact decades later. The interweaving of physical place, space, and gaps, with their emotional and unconscious counterparts is explored in a narrative which also traces their ripple effect through time. As part of this meditation on my family's history, I draw on research on the impact later in life of early childhood experience of maternal depression, and on studies concerning the emotional impact of migration.     

Autobiographical memory characteristics in depression vulnerability: Formerly depressed individuals recall less vivid positive memories

The differential activation hypothesis (DAH; Teasdale, 1988) proposes that individuals who are vulnerable to depression can be distinguished from non-vulnerable individuals by the degree to which negative thoughts and maladaptive cognitive processes are activated during sad mood. While retrieval of negative autobiographical memories is noted as one such process, the model does not articulate a role for deficits in recalling positive memories. Two studies were conducted to compare the autobiographical memory characteristics of never-depressed and formerly depressed individuals following a sad mood induction. In Study 1, features of negative memories of never-depressed and formerly depressed individuals did not differ, either in neutral or sad mood. For positive memories, groups did not differ in neutral mood, but following a sad mood induction, formerly depressed individuals rated their positive memories as less vivid than their never-depressed counterparts. Study 2 examined positive autobiographical memory features more comprehensively and replicated the finding that in a sad mood formerly depressed individuals recalled less vivid positive memories than never-depressed controls. These findings suggest that the phenomenological features of positive memories could represent an important factor in depressive vulnerability, and, more broadly, that depression may be associated with a deficit in the processing of positive material.     

The validity of personal disturbance scale (DSSI/sAD) in people with diabetes mellitus,using longitudinal data

Despite being used since 1976, Delusions-Symptoms-States-Inventory/states of Anxiety and Depression (DSSI/sAD) has not yet been validated for use among people with diabetes. The aim of this study was to examine the validity of the personal disturbance scale (DSSI/sAD) among women with diabetes using Mater-University of Queensland Study of Pregnancy (MUSP) cohort data. The DSSI subscales were compared against DSM-IV disorders, the Mental Component Score of the Short Form 36 (SF-36 MCS), and Center for Epidemiologic Studies Depression Scale (CES-D). Factor analyses, odds ratios, receiver operating characteristic (ROC) analyses and diagnostic efficiency tests were used to report findings. Exploratory factor analysis and fit indices confirmed the hypothesized two-factor model of DSSI/sAD. We found significant variations in the DSSI/sAD domain scores that could be explained by CES-D (DSSI-Anxiety: 55%, DSSI-Depression: 46%) and SF-36 MCS (DSSI-Anxiety: 66%, DSSI-Depression: 56%). The DSSI subscales predicted DSM-IV diagnosed depression and anxiety disorders. The ROC analyses show that although the DSSI symptoms and DSM-IV disorders were measured concurrently the estimates of concordance remained only moderate. The findings demonstrate that the DSSI/sAD items have similar relationships to one another in both the diabetes and non-diabetes data sets which therefore suggest that they have similar interpretations.     

Predictors of anxiety and depression among newly diagnosed people living with HIV: A longitudinal study

This longitudinal study examined whether past resilience and internalized stigma predicted anxiety and depression among newly diagnosed Spanish-speaking people living with HIV (PLWH). We also analyzed whether coping strategies mediated this relationship. Data were collected at two time points from 119 PLWH. Approximately a third of participants had scores indicative of anxiety symptoms, the same result was found for depressive symptoms. Structural equations modeling revealed that 61% of the variance of anxiety and 48% of the variance of depression 8 months after diagnosis was explained by the proposed model, which yielded a good fit to data. Anxiety and depressive symptoms were significantly and negatively predicted by positive thinking, thinking avoidance, and past resilience, and positively predicted by self-blame. Additionally, anxiety was positively predicted by internalized stigma. Past resilience negatively predicted internalized stigma, self-blame, and thinking avoidance and it positively predicted positive thinking. Internalized stigma positively predicted self-blame. Moreover, internalized stigma had a significant indirect effect on anxiety symptoms through self-blame, and past resilience had significant indirect effects on anxiety symptoms and depressive symptoms through internalized stigma and coping. The results point to the need for clinicians and policy makers to conduct systematic assessments and implement interventions to reduce internalized stigma and train people living with HIV to identify and use certain coping behaviors.     

Verbal and practical intelligence in general anxiety,obsessive compulsive and major depression disorders

IntroductionPrevious researches have shown that anxiety symptoms are negatively associated with measures of intelligence. However, recent findings indicate possible positive relationships between Generalized Anxiety Disorders (GAD) and intelligence. Also, Obsessive Compulsive Disorder (OCD) is associated with a moderate degree of underperformance on cognitive tests, including deficient processing. There are inconsistent results to present the relationship between Major Depression Disorder (MDD) and IQ. The present study has three main aims. The first aim of this study is to investigate the difference between IQ in individuals with GAD, OCD and major depressive disorder, and normal group. The second purpose is to perform a comparative study between the GAD, OCD and MDD groups on verbal and non-verbal intelligence. The third aim of this study is to examine the relationships between GAD, OCD and MDD as well as their underlying cognitive processes, including worry, rumination, and post-event processing, with verbal and non-verbal intelligence.ObjectiveThe present study is performed on four groups of participants including those with GAD, OCD, MDD and Healthy Volunteer (HV) group consisting of individuals without psychiatric disorders.MethodThe number of 50 healthy volunteers as the control group, 45 patients with GAD, 20 patients with OCD and 25 patients with MDD (n = 140) were selected as the case-referent groups. The present study was a cross-sectional type and the research was performed based on the causal-comparative method. Verbal and non-verbal intelligence was measured with the Wechsler Adult Intelligence Scale-3rd edition (WAIS-III). Rumination and post-event processing were measured by PSWQ, RRS-BR, and PEPQ, respectively.ResultsThe results indicate that Verbal Intelligence and Verbal Comprehension Index in GAD patients have significant differences in comparison to the OCD, MDD and control groups. While, the value of the Working Memory Index (WMI) in the normal group is higher than the value of the same index in the GAD, OCD and MDD groups. Also, the values of the Processing Speed Index (PSI) in normal and GAD groups are higher than the OCD and MDD groups. The worry, rumination, and post-event processing in patients with GAD are positively correlated with general and verbal intelligence. But, verbal and non-verbal intelligence had a negative correlation with worry, rumination and post-event processing in healthy volunteers.ConclusionInvestigation of the possible connections between intelligence and the cognitive processes underlying emotional disorders can provide therapeutic strategies for smart individuals who are at risk for GAD.     

The relationship between personality traits and psychotic like experiences in a large non-clinical adolescent sample

ObjectiveThe relationship between personality and psychosis is well established. It has been suggested that this relationship may be partly accounted for by higher levels of depression in individuals with certain personality traits. We explored whether the link between personality and psychotic symptoms is already apparent in adolescence, and if this association would still hold when depression was controlled for.Method654 secondary school students were surveyed via self-report questionnaires measuring the Five-Factor model of personality (NEO-FFI), depression (CES-D) and psychotic-like experiences (CAPE).ResultsPositive associations were found between Neuroticism and all CAPE-subscales except Magical Thinking, which was in turn associated with all other personality traits when at high levels. Agreeableness was negatively associated with all CAPE-subscales, while Openness to Experience was only positively associated with Persecutory Ideas and Magical Thinking. After controlling for depression, many of the significant associations remained.ConclusionOur findings suggest that the chance of having psychotic like experiences is more likely for adolescents with certain personality traits. These associations are not fully explained by depression, especially when psychotic experiences are at higher levels. Future research is needed to investigate if these personality traits might put a person at risk for the development of full-blown psychosis.     

Depression severity and psychosocial determinants of physical activity behavior in in-patients with major depressive disorders

BackgroundPhysical inactivity is a world-wide health issue. In people with major depressive disorders approximately 68% do not reach the recommended physical activity levels. Psychosocial determinants of and implicit attitudes towards physical activity serve to explain physical activity behavior and may form the basis of interventions to promote physical activity. The aim of this study was to examine, whether psychosocial determinants and implicit attitudes towards physical activity vary according to depression severity.MethodsPhysically inactive, adult in-patients diagnosed with major depressive disorder (according to ICD-10) were recruited from four Swiss psychiatric clinics. Psychosocial determinants of physical activity were assessed with seven questionnaires pertaining to motivational and volitional aspects of physical activity. Implicit attitudes towards physical activity were measured with a computer-based Single Target Implicit Association Test.ResultsIn-patients (N = 215, M_age = 41 ± 13 years, 53% female) with major depressive disorder reporting more severe (n = 52) depression symptomology exhibited less favorable psychosocial determinants for physical activity behavior (self-efficacy, negative outcome expectancies, intention, intrinsic motivation, introjected motivation, external motivation, action planning, perceived barriers, coping planning) compared to those with mild (n = 89) and moderate (n = 74) depression symptomology. Positive outcome expectancies, identified, social support and implicit attitudes towards physical activity did not vary according to depression severity.ConclusionsPsychosocial determinants of physical activity do vary according to depression severity. Attempts to promote physical activity among people with major depressive disorder should take depression severity into account when developing and delivering interventions.Trial registrationISRCTN registry, ISRCTN10469580, registered on 3^rd September 2018, https://www.isrctn.com/ISRCTN10469580.