Prevention of depression with primary care patients: A randomized controlled trial

The prevention of major depression is an important research goal which deserves increased attention. Depressive symptoms and disorders are particularly common in primary care patients and have a negative impact on functioning and well-being comparable with other major chronic medical conditions. The San Francisco Depression Prevention Research project conducted a randomized, controlled, prevention trial to demonstrate the feasibility of implementing such research in a public sector setting serving low-income, predominantly minority individuals: 150 primary care patients free from depression or other major mental disorders were randomized to an experimental cognitive-behavioral intervention or to a control condition. The experimental intervention group reported a significantly greater reduction in depressive levels. Decline in depressive levels was significantly mediated by decline in the frequency of negative conditions. Group differences in the number of new episodes (incidence) of major depression did not reach significance during the 1-year trial. We conclude that depression prevention trials in public sector primary care settings are feasbile, and that depressive symptoms can be reduced even in low-income, minority populations. To conduct randomized prevention trials that can test effects on incidence with sufficient statistical power, subgroups at greater imminent risk have to be identified.     

The relationship of young adolescent Children's Depression Inventory (CDI) scores to their social and cognitive functioning

The relationship of young adolescents' scores on the Children's Depression Inventory (CDI) to subjective and objective indices of their social and cognitive functioning was examined. Subjects were 89 young adolescents (11–15 years old), their parents, and their social studies teachers. The correlations of adolescents' CDI scores with recent school grades, objective ratings of overt social behavior, and measures of adolescent social and cognitive competence as perceived by the adolescent, both parents, and the teacher were examined. CDI scores were significantly and negatively correlated with school grades, behavioral ratings of positive social communication, and adolescent, mother, father, and teacher perceptions of the adolescents' social and cognitive competence. The relationship of these findings to those of other CDI validity studies is discussed.This research was supported, in part, by the William T. Grant Foundation and the University of Georgia's Institute for Behavioral Research.     

Alexithymia and hypersensitivity to touch and palpation

Alexithymia appears to be directly related to the process of somatization of psychological distress that has not found verbal expression. The lack of a meaningful dialogue between mother and child in early infancy may predispose the development of an alexithymic strategy in expressing psychic and psychosocial stress. This can occur in the form of unpleasant bodily sensations or pain. The human skin is, in addition to the oral and gastrointestinal organs, the earliest contact sphere between the young infant and the environment. In a group of 312 randomly chosen patients at an outpatient primary health care clinic a significant relationship was found between palpational hypersensitivity to touch on the one hand and somatization proneness and the degree of alexithymia on the other hand.     

Etiological hypotheses in a time-series case study of multiple behavior problems

A 15-year-old male was treated over a 20-month period for multiple behavior problems, including social isolation, family conflict, classroom behavior problems, scholastic underachievement, and impulsivity. Initial assessment data suggested that the problems were the result of a complex, interacting set of environmental, cognitive, and psychophysiological factors. Treatment was delivered and validated using a time-series design to test hypotheses generated by etiological theory. Discussion addresses the need for better use of psychopathological principles and etiological theory in clinical practice. The success of the case study suggests that this can be done by combining behavioral and psychometric clinical assessment, idiographic application of theory, an hypotheticodeductive approach to intervention, and time-series methodology.This study was supported in part by the University of Nebraska — Lincoln College of Arts and Sciences, by the UN-L Research Council, and by a George C. Holmes Fellowship granted to the senior author.The authors wish to acknowledge the assistance of Ms. Dorie Reed.     

Personalized versus standard role plays in the assessment of depressed patients' social skill

Chronically depressed outpatients participated in a study of the role-play assessment of social skill. Patients role-played a series of standard situations typical of those employed in social-skills research and additional scenes drawn from critical situations in their personal lives. These “personalized” role-play situations were perceived as more relevant by patients and resulted in more discomfort and less skillful interpersonal behavior than standard scenes. Behavioral measures derived from personalized role plays were also found to be more strongly related to measures of depression than the same measures derived from the standard role-play scenes. Implications of these findings for the role-play assessment of social skill are discussed.     

创伤暴露对青少年暴力行为和自杀意念的影响:创伤后应激障碍和抑郁的中介作用

采用创伤暴露问卷、基于DSM-5的创伤后应激障碍症状核查表、流调中心用抑郁量表和青少年行为问题调查表,在雅安地震3.5年后对地震极重灾区的703名中学生进行调查,考察创伤暴露对暴力行为和自杀意念的影响,并检验创伤后应激障碍和抑郁在其中的中介作用。结果发现：创伤暴露可以直接正向预测暴力行为和自杀意念,PTSD在创伤暴露对暴力行为和自杀意念的影响间起中介作用,抑郁仅在创伤暴露对自杀意念的影响间起中介作用,而在创伤暴露对暴力行为影响间的中介效应不显著。     

青少年心理健康素质的概念和结构初探

青少年心理健康素质是健康心理学中具有开创性和探索性的研究领域,因此涉及若干理论问题需要探讨。其中青少年心理健康素质的基本概念和基本结构是该研究领域首先应探讨的基本理论问题。