Effect of Daily Life Reward Loop Functioning on the Course of Depression

Engagement in activities increases positive affect (Reward Path 1), which subsequently reinforces motivation (Reward Path 2), and hence future engagement in activities (Reward Path 3). Strong connections between these three reward loop components are considered adaptive, and might be disturbed in depression. Although some ecological nomentary assessment (EMA) studies have investigated the cross-sectional association between separate reward paths and individuals’ level of depression, no EMA study has looked into the association between individuals’ reward loop strength and depressive symptom course. The present EMA study assessed reward loop functioning (5x/day, 28 days) of 46 outpatients starting depression treatment at secondary mental health services and monitored with the Inventory of Depressive Symptomatology—Self-Report (IDS-SR) during a 7-month period. Results of multilevel regression analyses showed significant within-person associations for Reward Path 1 (b = 0.21, p < .001), Reward Path 2 (b = 0.43, p < .001), and Reward Path 3 (b = 0.20, p < .001). Stronger average reward loops (i.e., within-person mean of all reward paths) did not relate to participants’ improvement in depressive symptoms over time. Path-specific results revealed that Reward Paths 1 and 2 may have partly opposite effects on depressive symptom course. Together, our findings suggest that reward processes in daily life might be best studied separately and that further investigation is warranted to explore under what circumstances strong paths are adaptive or not.     

Treating Young Adult Depression With Text-Delivered Cognitive Behavioral Therapy: A Pilot Randomized Clinical Trial

Young adults (ages 18 to 25) in the U.S. suffer from the highest rates of past-year major depressive episode and are the least likely to receive treatment compared to other age groups. As such, we examined the feasibility, acceptability, and efficacy of a text-message delivered cognitive behavioral therapy: CBT-txt with young adults. The study was a 2-month pilot RCT to test a 4-week intervention for depression that contained 197 text messages (average 12 texts every other day). The sample, recruited via Facebook and Instagram, was 102 U.S. young adults who presented with at least moderate depressive symptomatology. Assessments occurred at baseline prior to randomization and at 1 and 2 months post enrollment. The primary outcome, severity of depressive symptoms, was assessed using the Beck Depression Inventory II. Feasibility benchmarks were met and participants reported high levels of engagement with and acceptability of the intervention. Logistic regression indicated that treatment participants were three times as likely to have minimal or mild depression symptoms at 2 months compared to waitlist control participants. Latent change score modeling found that the strongest significant treatment effect appeared at the 1-month follow-up period, particularly for participants who began with severe depressive symptoms. Mediation analysis revealed significant indirect treatment effects of increases in behavioral activation on reducing depressive symptoms, suggesting a mechanism of change. Limitations were that the sample was relatively small and consisted of primarily women. These results provide initial evidence for the feasibility, acceptability, and efficacy of a text-delivered treatment for young adult depression.     

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.     

The many null distributions of person fit indices

This paper deals with the situation of an investigator who has collected the scores ofn persons to a set ofk dichotomous items, and wants to investigate whether the answers of all respondents are compatible with the one parameter logistic test model of Rasch. Contrary to the standard analysis of the Rasch model, where all persons are kept in the analysis and badly fittingitems may be removed, this paper studies the alternative model in which a small minority ofpersons has an answer strategy not described by the Rasch model. Such persons are called anomalous or aberrant. From the response vectors consisting ofk symbols each equal to 0 or 1, it is desired to classify each respondent as either anomalous or as conforming to the model. As this model is probabilistic, such a classification will possibly involve false positives and false negatives. Both for the Rasch model and for other item response models, the literature contains several proposals for a person fit index, which expresses for each individual the plausibility that his/her behavior follows the model. The present paper argues that such indices can only provide a satisfactory solution to the classification problem if their statistical distribution is known under the null hypothesis that all persons answer according to the model. This distribution, however, turns out to be rather different for different values of the person's latent trait value. This value will be called ability parameter, although our results are equally valid for Rasch scales measuring other attributes.As the true ability parameter is unknown, one can only use its estimate in order to obtain an estimated person fit value and an estimated null hypothesis distribution. The paper describes three specifications for the latter: assuming that the true ability equals its estimate, integrating across the ability distribution assumed for the population, and conditioning on the total score, which is in the Rasch model the sufficient statistic for the ability parameter.Classification rules for aberrance will be worked out for each of the three specifications. Depending on test length, item parameters and desired accuracy, they are based on the exact distribution, its Monte Carlo estimate and a new and promising approximation based on the moments of the person fit statistic. Results for the likelihood person fit statistic are given in detail, the methods could also be applied to other fit statistics. A comparison of the three specifications results in the recommendation to condition on the total score, as this avoids some problems of interpretation that affect the other two specifications.The authors express their gratitude to the reviewers and to many colleagues for comments on an earlier version.     

Inferential procedures for multifaceted coefficients of generalizability

A two-facet measurement model with broad application in the behavioral sciences is identified, and its coefficient of generalizability (CG) is examined. A normalizing transformation is proposed, and an asymptotic variance expression is derived. Three other multifaceted measurement models and CGs are identified, and variance expressions are presented. Next, an empirical investigation of the procedures follows, and it is shown that, in most cases, Type I error control in inferential applications is precise, and that the estimates are relatively efficient compared with the correlation coefficient. Implications for further research and for practice are noted. In an Appendix, four additional models, CGs, and variance expressions are presented.The research reported herein formed part of a doctoral dissertation conducted by Marsha Schroeder (Schroeder, 1986), under the direction of Ralph Hakstian, at the University of British Columbia. We acknowledge with thanks the contributions to this research of Todd Rogers and James Steiger. We are also very indebted to an mous reviewer who provided some important clarifications in connection with two of the models considered. Some support for this research was provided by a grant to Ralph Hakstian from the Natural Sciences and Engineering Research Council of Canada.     

Linear Analogue Self-Assessment and Procrustean Measurement: A Critical Review of Visual Analogue Scaling in Pain Assessment

Visual analogue scales (VASs) are one of the most widely used self-report measures of clinical pain. This article reviews the empirical literature on linear analogue self-assessment (LASA) and critically examines the features that appear to have made it such an attractive measurement option in pain assessment. It is concluded that analogue scaling does not withstand critical scrutiny as a primary measure of either pain intensity or pain affect and that, in most circumstances, the overall clinical utility of VASs is inferior to that of more structured pain indices.     

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.     

Shrinkage estimation of linear combinations of true scores

This paper is concerned with combining observed scores from sections of tests. It is demonstrated that in the presence of population information a linear combination of true scores can be estimated more efficiently than by the same linear combination of the observed scores. Three criteria for optimality are discussed, but they yield the same solution which can be described and motivated as a multivariate shrinkage estimator.Input from Eric Bradlow, Charles Lewis, and Linda Zeger is acknowledged. Research for this paper was funded by the Program Research Council (ETS). Suggestions of the Editor and of anonymous referees were instrumental in several improvements of the paper.     

A measure of parental stress in mothers with small children: dimensionality, stability and validity

Self-reported parental stress was investigated in three samples of mothers with small children, using a Swedish version of the Parenting Stress Index (PSI). Dimensionality in experienced stress using items from six PSI Parent Domain subscales and eight new items was examined in factor analyses of data from a nationwide representative sample. Cross-validation proved the chosen factor pattern to be stable. Based on an oblique 5-factor solution new subscales were constructed. A second order factor analysis indicated influence from a higher order factor, seen as a general parental stress construct. High alpha coefficients revealed that homogeneous subscales had been formed. Test-retest correlations indicated good stability over a mean time period of 30 days. Influences from maternal background variables were found, but no relation to child age or gender. Global estimates of parental stress, reported child problems, mothers' scoring on the Edinburgh Postnatal Depression Scale and two measures of social support all correlated significantly with overall parental stress, and with some subscales. The justification of the subscale approach to parental stress was discussed. It was concluded that the PSI in its present form could be used as a reliable and valid instrument for measuring experienced parental stress in mothers of young children.