Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.     

Subclmical depression and role fulfillment in domestic settings: Spurious relationships,imagined problems,or real effects?

Considerable evidence has accumulated in support of the hypothesis that subclinical depression may inhibit role performance in important ways. However, interpersonal stress and marital discord often precede the development of depressive symptomatology and may independently predict deficits in family role functioning. In addition, cognitive theories suggest that persons with subclinical depression may report poor role functioning even in the absence of any real performance deficits. The current research examines the possibility (1) that the effect of depression on the fulfillment of important family roles is attributable to previously unmeasured contextual variables of ongoing interpersonal stress and/or relationship dissatisfaction or, alternatively, (2) that this relationship is the result of depressive distortion associated with self-report of symptoms and performance. Multiple regression analyses of interview data collected from 495 community-dwelling adults found, however, that depression is related to role functioning beyond any spurious effects attributable to interpersonal stress, spousal stress, or marital satisfaction. In addition, the effect of depression persists when collateral reports of role functioning utilized. Accordingly, it appears that subclinical depression is related to decrements in role performance, and this effect is not entirely due to contextual elements or shared method variance between self-report measures.The authors acknowledge research support from Research Grants R01-AA-07250 and R01-AA-07218 from the National Institute on Alcohol Abuse and Alcoholism, Research Grant R01-DA-07417 from the National Institute on Drug Abuse, and National Institutes of Mental Health Grant A-41487-07.     

Positive and negative self-related goals and subjective well-being: A prospective study

To examine whether having self-related personal goals, or rather whether positive or negative appraisal of them, is associated with subjective well-being, 311 students were asked to complete the Personal Project Analysis (PPA) and revised Beck Depression Inventory, first at the beginning of their studies, and then 2 years later. After 3 years they were asked about the use of mental health services. Two groups of students were identified: (1) those with positive self-projects and (2) those with negative self-projects. The results showed that both positive and negative self-related projects showed stability across a 2-year period, but only negative ones were prospectively predicted by earlier depressive symptomatology. Although neither positive nor negative projects predicted depressive symptomatology, both predicted the use of mental health services.     

Diagnosis and Assessment of Depression and Suicidality Using the NIMH Diagnostic Interview Schedule for Children (DISC-2.3)

The Diagnostic Interview Schedule for Children (DISC-2.3) was studied in a sample of 265 adolescent inpatients to determine type and concurrent validity of depressive symptoms and depressive disorder diagnoses for different DISC-2.3 informants (parent, adolescent, both). The Children's Depression Rating Scale — Revised, Reynolds Adolescent Depression Scale (RADS), Suicide Ideation Questionnaire — Junior, Spectrum of Suicide Behavior Scale, and clinical consensus diagnoses were used to assess concurrent validity. Results indicated that (1) parents, compared to adolescents, reported a higher prevalence of all depressive symptoms with the exception of weight change; (2) DISC-2.3 depressive and suicidality symptoms were related positively to independent validating criteria for all informant conditions, suggesting good concurrent validity; (3) the DISC-2.3 both informant condition correctly identified the most depressive disorders; and (4) the parent, but not the adolescent, DISC-2.3 Informant condition contributed to the prediction of clinical consensus diagnoses of depression after taking into account RADS scores.     

The Moderating Effects of Children's Fear and Activity Level on Relations Between Parenting Practices and Childhood Symptomatology

Parenting practices have been previously linked to childhood symptomatology. However, little consideration has been given to the potential effect of individual differences within the child on this relation. The current study assessed the moderating effects of children's activity level and fear on relations between parenting practices and childhood aggression and depressive symptoms using a sample of 64 fourth-, and fifth-grade boys. The findings showed that poorly monitored active boys and fearful boys who were exposed to harsh discipline exhibited high levels of aggression. Boys characterized by high fear who were exposed to harsh discipline or whose parents were extremely overinvolved showed elevated levels of depressive symptoms. These findings suggest that integrating children's individual differences with parenting models enhances our understanding of the etiology of childhood symptomatology. The intervention implications of such an integration are discussed.     

Mood regulation expectancies, affect intensity, dispositional coping, and depressive symptoms: A conceptual analysis and empirical reanalysis

In a recent article, Flett, Blankstein and Obertinsky (1996, Personality and Individual Differences, 20, 221–228) examined cross-sectional relations between affect intensity, generalized expectancies for negative mood regulation (NMR expectancies), coping dispositions, and depression in a sample of 153 women. However, they did not report partial correlations of affect intensity and NMR expectancies, independent of each other, with coping and depression. Such information is needed for development of models of the coping process which integrate the roles of temperament variables, such as affect intensity, and cognitive-social learning person variables, such as NMR expectancies. Reanalysis of Flett etal.'s correlation matrix revealed that affect intensity and NMR expectancies were each independently associated with distinct coping dispositions, but that only NMR expectancies were independently associated with depressive symptoms.     

再认记忆测验中抑郁个体的心境一致性记忆研究

采用Ｊａｃｏｂｙ的加工分离程序,对再从记忆测验中外显记忆成分与内隐记忆成分的贡献进行分离,考察了抑郁个体的内隐记忆和外显记忆是否具有心境一致性记忆倾向。结果表明：抑郁个体的外显记忆具有心境一致性倾向,而内隐记忆不存在心境一致性倾向,表明心境一致性记忆需要精细加工机制的参与。另外发现,抑郁个体存在外显记忆缺损而没有出现内隐记忆缺损。最后就一些有待进一步研究的方面进行了讨论。     

Marital attributions in spouses of depressed patients

Causal attributions (i.e., locus, stability, globality) and responsibility attributions (i.e., bad intent, selfish motivation, blame) were assessed in the spouses of 27 depressed psychiatric inpatients and 30 nondepressed dyads to test predictions derived from Hooley's (1987) symptom-controllability model of marital distress. Results indicated that (1) depressed patients and their spouses were less dyadically adjusted than nondepressed spouses, (2) causal and responsibility attributions about depressive behaviors predicted lower dyadic adjustment, and (3) attributions of causality mediated the relationship between group status (depressed or nondepressed) and dyadic adjustment among spouses who had higher expectations for their partner to change. Results suggest that among spouses with a high expectancy for change, depression may be a risk factor for marital distress.     

An investigation of the effects of comorbid Axis II pathology on outcome of inpatient treatment for unipolar depression

DSM-based research on comorbidity has suggested thatdepression andpersonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depression. The present study was designed to explore the effect of comorbid Axis II pathology for a sample of 45 inpatients who received treatment for major depression. Both categorical and dimensional ratings of personality disorder were used in the statistical analysis. Positive categorical diagnosis of Cluster C (anxious-avoidant) disorder, as well as higher dimensional rating of Cluster A (odd-eccentric) pathology, was predictive of a poor response to treatment (p<.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depression Rating Scale. These results were construed as indicative of a significant Axis II comorbidity effect in the context of an inpatient, multimodal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.     

The stability of depressive symptoms in college students: An empirical demonstration of regression to the mean

In a recent paper, Vredenburg, Flett, and Krames (1993) hypothesized that the apparent instability of depressive symptom scores in college students may be due, in part, to the phenomenon known as statistical regression to the mean. This statistical principle was demonstrated in the current study. A sample of 183 university students completed the Beck Depression Inventory (BDI) at two timepoints separated by a 3-month interval. Consistent with past results, analyses revealed substantial changes in symptom scores over time with decrements being evident among many subjects with elevated symptom scores at Time 1. Examination of the amount of change over time in BDI scores indicated a pattern of findings that approximated the regression to the mean phenomenon. Statistical tests confirmed that regression to the mean accounted for a significant amount of the change in symptom scores over time. The implications of these findings are discussed in terms of the nature of depressive symptoms in students and the inappropriateness of assigning subjects to depressed or nondepressed groups on the basis of elevated scores on a self-report measure.