Asthma-Specific Quality of Life in Older Adolescents and Young Adults with Long-Standing Asthma: The Role of Anxiety and Depression

The present study examined the influence of psychological comorbidity (i.e., anxiety and depression) on asthma-specific quality of life (QOL). Sixty-four older adolescents and young adults with childhood onset asthma completed measures of anxiety, depression, and asthma-specific QOL. Objective assessments of illness severity were obtained via a semistructured interview and pulmonary function test. Results revealed that the combination of anxiety and depression severity contributed significant variance to asthma QOL after statistically controlling demographic and disease covariates. Moreover, anxiety demonstrated a significant main effect on asthma QOL. Findings suggest that assessment of anxiety may help identify individuals who are at risk for poorer asthma-specific quality of life. Such early interventions can be effectively incorporated into comprehensive biopsychosocial treatment and behavioral self-management programs for individuals with asthma.     

Screening HIV-Infected Patients with Chronic Pain for Anxiety and Mood Disorders with the Beck Anxiety and Depression Inventory-Fast Screens for Medical Settings

The Beck Anxiety (BAI-FS) and Depression (BDI-FS) Inventory-Fast Screens for Medical Settings were administered to 63 HIV-infected outpatients seeking treatment at a chronic pain clinic to evaluate how effectively these 7-item instruments would, respectively, differentiate those who were and were not diagnosed with DSM-IV anxiety, mood, or both disorders. The Anxiety and Mood Modules from the Primary Care Evaluation of Mental Disorders (PRIME-MD) were employed to establish the diagnoses. The coefficient 's for the BAI- and BDI-FS were, respectively, .80 and .84. A BAI-FS cut-off score of 4 and above yielded 82% sensitivity and 59% specificity rates for identifying patients with and without anxiety disorders, whereas a BDI-FS cut-off score of 4 and above had 90% sensitivity and 74% specificity rates for detecting patients with and without mood disorders. It was concluded that the BDI-FS was a useful instrument for screening HIV-infected patients with chronic pain for mood disorders.     

The Relationship Between Parental Alcoholism and Adolescent Psychopathology: A Systematic Examination of Parental Comorbid Psychopathology

The relationship between parental alcohol dependence (with and without comorbid psychopathology) and adolescent psychopathology was examined in a sample of 665 13-17 year-old adolescents and their parents. Results indicated that adolescents who had parents diagnosed with alcohol dependence only did not significantly differ from adolescents who had parents with no psychopathology in regard to any of the measures of psychological symptomatology (substance use, conduct disorder, and depression) or clinical diagnoses (alcohol dependence, marijuana dependence, conduct disorder, or depression) assessed. In contrast, adolescents who had parents diagnosed with alcohol dependence and either comorbid drug dependence or depression were more likely to exhibit higher levels of psychological symptomatology. In addition, adolescents who had parents diagnosed with alcohol dependence, depression, and drug dependence were most likely to exhibit psychological problems. These findings underscore the importance of considering parental comorbid psychopathology when examining the relationship between parental alcoholism and offspring adjustment.     

Psychosocial Interventions for Children with Early-Onset Bipolar Spectrum Disorder

Once considered virtually nonexistent, bipolar disorder in children has recently received a great deal of attention from mental health professionals and the general public. This paper provides a current review of literature pertaining to the psychosocial treatment of children with early-onset bipolar spectrum disorder (EOBPSD). Commencing with evidence of the emerging interest in this topic, we then focus on terminology, the rationale for studying EOBPSD in children, current research and clinical progress, possible explanations for the recent increase in recognition, and essential issues that form the foundation of effective psychosocial treatment. Next we explore areas of research with direct implications for psychosocial treatment. These include biological and psychosocial risk factors associated with bipolar disorder; and the psychosocial treatment of adult-onset bipolar disorder, childhood-onset unipolar disorder, and anger management in children. Following this, we discuss treatments being developed and tested for children with EOBPSD. Finally, we conclude with recommendations for future studies needed to move the field forward.     

Depression in the Context of Disability and the “Right to Die”

Arguments in favor of legalized assisted suicide often center on issues of personal privacy and freedom of choice over one's body. Many disability advocates assert, however, that autonomy arguments neglect the complex sociopolitical determinants of despair for people with disabilities. Specifically, they argue that social approval of suicide for individuals with irreversible conditions is discriminatory and that relaxing restrictions on assisted suicide would jeopardize, not advance, the freedom of persons with disabilities to direct the lives they choose. This paper examines the idea promoted by some proponents of assisted suicide that it is reasonable to be depressed about one's diminished quality of life in cases of irreversible illness or disability and, therefore, such depression should not call into question the individual's competence to request assistance in dying. The concept of rational depression is defined and examined in the context of: four real-life cases involving individuals with disabilities who requested assistance in dying; a set of criteria commonly applied to decision-making to determine rationality; and research bearing on the emotional status of people with disabilities. It is concluded that although disability is associated with particular socially mediated stressors, there is no theoretical or empirical evidence to indicate that depression and its role in the right to die is dynamically different, more natural, or more reasonable for disabled people than for non-disabled people.     

The Orpheus complex

This paper examines the possible psychological implications of two adaptations of the myth of Orpheus and Eurydice, both of which were completed in 1997. The first is by a man: 'Deconstructing Harry', a film by Woody Allen. The second is by a woman: 'Eurydice in the Underworld', a short story written by Kathy Acker in the last year of her life. The paper argues that there are only four 'necessary events' in the myth of Orpheus and Eurydice. It defines the sequence of these events as a 'mythic pattern' that represents the experience of loss, unconscious yearning, depression, and psychological inflation. The film is examined as an expression of an 'Orpheus complex', the short story as an expression of an 'Eurydice complex'. The paper suggests a possible reason for the persistence of interest in the myth throughout the twentieth century. Although it notes that women appear to find it easier to free themselves from identification with the mythic pattern, it also provides reasons for thinking that men may be about to do the same.     

Mutual Help Groups, Perceived Status Benefits, and Well-Being: A Test with Adult Children of Alcoholics with Personal Substance Abuse Problems

A field experiment was conducted to examine the potential effects of mutual help group participation on perceived status benefits, depression, and substance use among adult children of alcoholics (ACOAs) with personal substance abuse problems. Participants were randomly assigned to attend either ACOA-specific mutual help group meetings or substance abuse education classes during the initial month that they were enrolled in a residential treatment program for low-income substance abusers. Analyses were based on assessments made at baseline, a 1-month posttest, and a 6-month follow-up. Results indicated that participation in the mutual help group promoted perceived status benefits, which in turn led to reductions in depression and substance use. These findings have clear implications for consumers of ACOA groups and can inform research on the social psychological underpinnings of different types of mutual help groups.     

Friends as Reporters of Children's and Adolescents' Depressive Symptoms

Obtaining information from multiple informants is important when assessing youth depression. Past studies have utilized adults' reports of youths' emotional functioning and aggregate reports from classmates but have not considered close friends as reporters of depressive symptoms. This is surprising given the important roles of friends as companions and confidants. This study investigated relations between friend-reported depressive symptoms and youths' self-reports. From a larger sample of fifth-, seventh-, and ninth-grade participants, self-reports and friend reports of depressive symptoms and friend reports of friendship quality were available for a subset of 367 participants. Significant positive relations emerged between friend reports and self-reports of affective depressive symptoms for girls and youth in high-quality friendships. Relations between friend reports and self-reports were stronger for conduct-related than affective depressive symptoms and reached significance for boys as well as for girls and for youth in low-quality friendships as well as for youth in high-quality friendships. Implications for identifying at-risk youth are discussed.     

Automatic and effortful information processing in unipolar major depression

The present study investigated attentional dysfunction in patients with recurrent unipolar major depression in a visual search paradigm. The attentional aspects of automatic and effortful information processing were examined. The general hypothesis was that patients with unipolar major depression would have more problems with tasks that require effortful information processing than with tasks that require only automatic information processing. A task requiring effortful processing attracts attention, is more demanding, and is instruction-driven. A task that is automatically processed does not invoke attention, is less demanding, and is stimulus-driven. The results showed that the patient group needed significantly longer reaction times on the tasks requiring more effortful information processing than the control group, but there were no significant differences between groups on tasks requiring automatic information processing. Thus it seems as if the depressed patients show an impaired profile as a function of the degree of effort a task requires.     

Discriminative validity of the general behavior inventory using youth report

The present study investigated the ability of the General Behavior Inventory (GBI) to discriminate between diagnostic groups using youth self-report. One hundred and ninety-seven youths ages 10–17 years presenting at a midwestern urban outpatient clinic specializing in mood disorders completed the GBI as part of the intake process. Diagnoses were determined by a structured clinical interview (K-SADS) administered by either a child and adolescent psychiatrist or a research assistant trained to a high level of interrater reliability ( > .85). Games–Howell post hoc tests showed that the diagnostic groups significantly differed on the GBI's 2 subscales, Depression and Hypomanic–Biphasic. Logistic regression demonstrated that the scales discriminated between bipolar and disruptive behavior disorders, unipolar and bipolar depression, and mood and disruptive behavior disorders or no diagnosis. Receiver Operating Characteristic (ROC) curves further indicated the good diagnostic efficiency of the scales. Results indicate that the GBI's subscales might aid in making traditionally difficult differential diagnoses, such as between bipolar disorder and Attention Deficit Hyperactivity Disorder (ADHD) and between unipolar and bipolar depression.