The role of depression symptoms in dialysis withdrawal.

Among end-stage renal disease (ESRD) patients on hemodialysis, death from withdrawal from life-sustaining dialysis is increasingly common. The present study's objective was to examine depression as a potential risk factor for hemodialysis withdrawal. Two hundred forty ESRD hemodialysis (133 male and 107 female) patients were followed for an average of 4 years after depression symptom assessment. Of these, 18% withdrew from dialysis. Using multivariate survival analysis and after controlling for the effects of age (p < .001) and clinical variables, the authors found that level of depression symptoms was a unique and significant predictive risk factor for the subsequent decision to withdraw from dialysis (p < .05). The potential impact that depression may have on the decision to withdraw from hemodialysis should be considered by health care providers, patient families, and patients.     

Further validation of the IDAS: evidence of convergent, discriminant, criterion, and incremental validity

The authors explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; D. Watson et al., 2007) in 2 samples (306 college students and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS; the mean convergent correlations were .51 and .62 in the student and patient samples, respectively. With the exception of the Well-Being Scale, the scales also consistently demonstrated significant discriminant validity. Furthermore, the scales displayed substantial criterion validity in relation to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) mood and anxiety disorder diagnoses in the patient sample. The authors identified particularly clear and strong associations between (a) major depression and the IDAS General Depression, Dysphoria and Well-Being scales, (b) panic disorder and IDAS Panic, (c) posttraumatic stress disorder and IDAS Traumatic Intrusions, and (d) social phobia and IDAS Social Anxiety. Finally, in logistic regression analyses, the IDAS scales showed significant incremental validity in predicting several DSM-IV diagnoses when compared against the Beck Depression Inventory-II (A. T. Beck, R. A. Steer, & G. K. Brown, 1996) and the Beck Anxiety Inventory (A. T. Beck & R. A. Steer, 1990).     

Sexualization in U.S. Latina and White Girls’ Preferred Children’s Television Programs

Master narratives, or prevailing cultural storylines, of motherhood provide a framework for new mothers to make sense of their experiences and to develop a coherent maternal identity. The present mixed methods study developed a theory-driven methodology to systematically identify a master narrative and examined whether one is present in 32 U.S. first-time mothers’ accounts of developing feelings for, and connection to, their newborns. In coding these mothers’ 95 episodes, we found that just over half of the mothers exclusively described positive feelings/connection toward their babies that were present in pregnancy or at birth (“At First Sight”; AFS), whereas 31 % exclusively described feelings/connection that took time to develop, or were negative, questioned, and/or tentative (“It Took Time”; ITT). To identify the presence of a master narrative, we compared these groups’ accounts on several theoretical indicators; the episodes of mothers who exclusively described ITT experiences were longer, more often contained talk of expectations, and were more likely to have a mismatch between expectation and experience than those of mothers who exclusively described AFS experiences. This suggests that ITT experience accounts countered a master narrative that mothers should have overwhelming, positive, and immediate feelings for/connection to their babies (AFS). Using discursive analysis, we then examined how the master narrative was actually invoked in the accounts of two mothers, one who positioned her experiences as aligned with, and one who positioned her experiences as counter to, the master narrative. Implications for supporting mothers in making meaning of their experiences, whether by aligning with the master narrative or co-constructing an empowering counter-narrative, are discussed.     

The Effect of Stress on Spontaneous Nest Leaving Behavior in the Mouse: An Improved Model of Stress-Induced Behavioral Pathology

The present experiments were conducted to develop a more sensitive and reliable model of stress-induced behavioral pathology in the mouse. Male mice were housed singly in nest cages connected to either a circular tunnel, a recreational cage or a large box with food foraging apparatus. Spontaneous nocturnal out of nest activity or food foraging behavior in these environments was continuously monitored for a two week period during which time the effects of stress were examined. It was found that both repeated restraint and aggression stress markedly and persistently reduced out of nest nocturnal activity or food foraging behavior in all 3 environments but did not alter activity in a novel open field or plus maze or food or saccharin intake in the nest cage. In a preliminary experiment the reduction in out of nest activity by stress was attenuated by prior chronic treatment with the antidepressant, desmethylimipramine. Plasma corticosterone was elevated immediately after aggression stress but reduced 5 hr after chronic aggression stress. The reduction in activity did not appear the result of increased anxiety as measured by spontaneous risk assessment behavior in the nest. It is concluded that the decrease in out of nest activity after stress in the present studies models a withdrawn behavioral state and may be due to either or both a decrease in appetitive motivation to leave the nest or an increased aversion to the external environment which does not apparently involve anxiety.     

Development and validation of the Inventory of Depression and Anxiety Symptoms (IDAS)

The authors describe a new self-report instrument, the Inventory of Depression and Anxiety Symptoms (IDAS), which was designed to assess specific symptom dimensions of major depression and related anxiety disorders. They created the IDAS by conducting principal factor analyses in 3 large samples (college students, psychiatric patients, community adults); the authors also examined the robustness of its psychometric properties in 5 additional samples (high school students, college students, young adults, postpartum women, psychiatric patients) who were not involved in the scale development process. The IDAS contains 10 specific symptom scales: Suicidality, Lassitude, Insomnia, Appetite Loss, Appetite Gain, Ill Temper, Well-Being, Panic, Social Anxiety, and Traumatic Intrusions. It also includes 2 broader scales: General Depression (which contains items overlapping with several other IDAS scales) and Dysphoria (which does not). The scales (a) are internally consistent, (b) capture the target dimensions well, and (c) define a single underlying factor. They show strong short-term stability and display excellent convergent validity and good discriminant validity in relation to other self-report and interview-based measures of depression and anxiety.