Eating Attitudes,Coping Styles,and Peer Victimization Among Adolescents with Seasonal and Nonseasonal Depression Symptoms

Seasonal and nonseasonal depression symptoms often emerge during adolescence, although it is unclear if these two issues differ on key adolescent cognitive vulnerability and peer relation variables. This study compared eating attitudes, cognitive coping styles, and peer victimization among adolescents with symptoms of seasonal and nonseasonal depression. A sample of 311 adolescents (mean age = 15.37 years, 57% female) was categorized as experiencing symptoms of seasonal depression (n = 64) and nonseasonal depression (n = 87), as well as controls (n = 160). Self-report measures of seasonality, depression symptoms, eating attitudes, coping styles, and peer victimization were completed. Results suggested that a belief in rigid weight regulation was associated with seasonal depression symptoms. Catastrophizing and rumination were associated with seasonal and nonseasonal depression symptoms, while a lack of planning was associated with nonseasonal depression symptoms. Peer victimization was associated with both seasonal and nonseasonal depression symptoms. Study implications are provided.     

Enhanced Anger Reactivity and Reduced Distress Tolerance in Major Depressive Disorder

Difficulty with effective emotion regulation is a central feature of major depressive disorder (MDD). Correlational evidence suggests that people with MDD experience elevated levels of irritability and anger, although few studies have experimentally tested this idea. The current study examined emotional reactivity across self-report (anger ratings), behavioral (task persistence), and physiological (heart rate, skin conductance) domains in response to a standardized, frustrating task in young adults with MDD (n = 74) and without MDD (n = 107). A secondary goal was to determine whether regulating emotional response with reappraisal, acceptance, or no instruction mitigated emotional reactivity across these domains. People with MDD responded with greater self-reported anger, lower galvanic skin conductance, and less task persistence (i.e., lower distress tolerance) than non-MDD individuals. Emotion regulation strategy did not differentially attenuate emotional responses between MDD groups. Instructions to accept emotions increased anger for all participants compared to reappraisal and no strategy instructions. Results confirm that enhanced anger reactivity and poor distress tolerance are present in MDD compared to healthy controls. However, additional work is needed to further develop and implement strategies that help people with MDD manage their emotional reactivity and enhance distress tolerance.     

Ruminative Response Style and the Severity of Seasonal Affective Disorder

Research generally has supported the hypothesis of the Response Style Theory that a ruminative response style is associated with a greater severity of depression episodes. However, no published research has applied this theory to seasonal affective disorder (SAD). We examined the relationship between response style and severity of winter symptoms in a longitudinal study of individuals previously diagnosed with SAD. Eighteen participants kept accounts of their mood and their responses to mood for 14 consecutive days in the fall. Statistical modeling of these data yielded measures of response style for each participant. Ruminative response style, but not distracting response style, predicted symptom severity in winter, controlling for severity in the fall. As suggested by the Dual Vulnerability Hypothesis of SAD, ruminative response style interacted with fall vegetative symptom severity to predict winter nonvegetative symptom severity. Results also suggest that distracting response style may consist of two different types of response.     

Cognitive Vulnerability to Depression in Seasonal Affective Disorder: Predicting Mood and Cognitive Symptoms in Individuals with Seasonal Vegetative Changes

Research indicates that seasonal fluctuations in vegetative functions (e.g., sleep, appetite, and energy) occur to varying degrees in the general population and a large fluctuation in vegetative functioning is often considered the core of seasonal affective disorder (SAD). The purpose of the present study was to determine if, among those with seasonal changes in vegetative functioning, a cognitive vulnerability to depression is associated with an increased risk for developing the cognitive and affective symptoms of SAD. Results indicate that participants with more dysfunctional attitudes, a more ruminative response style, and a more internal attributional style for negative events report experiencing more severe mood and cognitive symptoms of depression during the winter, controlling for the severity of vegetative symptoms. This was the case both for retrospective reports of typical symptoms and prospective reports of actual symptoms. These results provide support for Young’s dual vulnerability model, in which cognitive factors interact with environmentally mediated biological factors in the pathogenesis of full-symptom SAD, and suggest that cognitively-oriented interventions may be useful as adjunctive or alternative treatments for SAD.

The amygdala response to emotional stimuli: a comparison of faces and scenes

As a central fear processor of the brain, the amygdala initiates a cascade of critical physiological and behavioral responses. Neuroimaging studies have shown that the human amygdala responds not only to fearful and angry facial expressions but also to fearful and threatening scenes such as attacks, explosions, and mutilations. Given the relative importance of facial expressions in adaptive social behavior, we hypothesized that the human amygdala would exhibit a stronger response to angry and fearful facial expressions in comparison to other fearful and threatening stimuli. Twelve subjects completed two tasks while undergoing fMRI: matching angry or fearful facial expressions, and matching scenes depicting fearful or threatening situations derived from the International Affective Picture System (IAPS). While there was an amygdala response to both facial expressions and IAPS stimuli, direct comparison revealed that the amygdala response to facial expressions was significantly greater than that to IAPS stimuli. Autonomic reactivity, measured by skin conductance responses, was also greater to facial expressions. These results suggest that the human amygdala shows a stronger response to affective facial expressions than to scenes, a bias that should be considered in the design of experimental paradigms interested in probing amygdala function.     

Stress-evoked opioid release inhibits pain in major depressive disorder

To determine whether stress-evoked release of endogenous opioids might account for hypoalgesia in major depressive disorder (MDD), the mu-opioid antagonist naltrexone (50mg) or placebo was administered double-blind to 24 participants with MDD and to 31 non-depressed controls. Eighty minutes later participants completed a painful foot cold pressor test and, after a 5-min interval, began a 25-min arithmetic task interspersed with painful electric shocks. Ten minutes later participants completed a second cold pressor test. Negative affect was greater in participants with MDD than in non-depressed controls throughout the experiment, and increased significantly in both groups during mental arithmetic. Before the math task, naltrexone unmasked direct linear relationships between severity of depression, negative affect while resting quietly, and cold-induced pain in participants with MDD. In contrast, facilitatory effects of naltrexone on cold- and shock-induced pain were greatest in controls with the lowest depression scores. Naltrexone strengthened the relationship between negative affect and shock-induced pain during the math task, particularly in the depressed group, and heightened anxiety in both groups toward the end of the task. Thus, mu-opioid activity apparently masked a positive association between negative affect and pain in the most distressed participants. These findings suggest that psychological distress inhibits pain via stress-evoked release of opioid peptides in severe cases of MDD. In addition, tonic endogenous opioid neurotransmission could inhibit depressive symptoms and pain in people with low depression scores.     

Rumination and Vegetative Symptoms: A Test of the Dual Vulnerability Model of Seasonal Depression

The Dual Vulnerability Model of seasonal affective disorder proposes that the cognitive-affective symptoms of seasonal depression are the result of an interaction of a diathesis of cognitive vulnerability to depression and the stressor of seasonal vegetative change. Two studies examined this hypothesis employing a within-subject design with daily data on vegetative and cognitive-affective depressive symptoms. Study 1 included a subclinical sample and a trait measure of ruminative response style. Study 2 included a clinical sample and reports of actual ruminative thoughts and behaviors in response to fatigue. Results of mixed linear model analyses in both studies supported the hypothesis that rumination moderates the relationship between the vegetative symptoms and the cognitive-affective symptoms of seasonal depression. The extension of the model to other subtypes of depression is considered.

Emotional modulation of pain and spinal nociception in persons with major depressive disorder (MDD)

Major depressive disorder (MDD) is associated with risk for chronic pain, but the mechanisms contributing to the MDD and pain relationship are unclear. To examine whether disrupted emotional modulation of pain might contribute, this study assessed emotional processing and emotional modulation of pain in healthy controls and unmedicated persons with MDD (14 MDD, 14 controls). Emotionally charged pictures (erotica, neutral, mutilation) were presented in 4 blocks. Two blocks assessed physiological-emotional reactions (pleasure/arousal ratings, corrugator electromyography (EMG), startle modulation, skin conductance) in the absence of pain and 2 blocks assessed emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations. Results indicated pictures generally evoked the intended emotional responses; erotic pictures elicited pleasure, subjective arousal, and smaller startle magnitudes, whereas mutilation pictures elicited displeasure, corrugator EMG activation, and subjective/physiological arousal. However, emotional processing was partially disrupted in MDD, as evidenced by a blunted pleasure response to erotica and a failure to modulate startle according to a valence linear trend. Furthermore, emotional modulation of pain was observed in controls but not MDD, even though there were no group differences in NFR threshold or emotional modulation of NFR. Together, these results suggest supraspinal processes associated with emotion processing and emotional modulation of pain may be disrupted in MDD, but brain to spinal cord processes that modulate spinal nociception are intact. Thus, emotional modulation of pain deficits may be a phenotypic marker for future pain risk in MDD.     

Seasonal affective disorder: its recognition and treatment

This article provides an introduction to seasonal affective disorder (SAD) and outlines various therapies, including phototherapy (light therapy), used in its treatment. SAD, colloquially termed 'winter blues', is a common condition that is thought to be caused by reduced levels of daylight in winter. During this period sufferers generally feel low and may experience clinical depression. The Department of Psychiatry at the University of Southampton has an established SAD service as part of its mood disorders clinic, which was developed from a research-based clinical investigation unit set up in the early 1990s. SAD is described as a mood disorder with a seasonal pattern and has a greater prevalence in countries with greater northern latitude. The aetiology of SAD is unclear, although the most promising theory suggests the role of the neurotransmitter serotonin. SAD is difficult to treat with conventional antidepressants although there is evidence that serotonin selective reuptake inhibitors may be useful for some patients. Phototherapy (light therapy) has been used successfully by many patients although it remains controversial and difficult to obtain on the NHS.     

Neuronal correlates of altered empathy and social cognition in borderline personality disorder

Borderline personality disorder (BPD) is a severe psychiatric condition of undetermined brain underpinnings, which involves profound emotion regulation deficits and interpersonal impairment. To elucidate biopsychological markers of the disorder, we performed two studies: i.) assessing empathy and social cognition and ii.) measuring the psychophysical properties and functional brain correlates of empathic functioning in a total of fifty-one affected patients and 50 age- and gender-matched controls. In the behavioral study we applied the Multifaceted Empathy Test (MET), a new, ecologically valid measure to assess cognitive (i.e., social cognition) and emotional (i.e., empathic concern) empathy to a subset of participants. In the second study, functional Magnetic Resonance Imaging and skin conductance measurements were performed while participants took a scanner-adapted version of the MET. Patients with BPD showed impairments in cognitive and emotional empathy. Brain responses during cognitive empathy were significantly reduced in patients compared to controls in the left superior temporal sulcus and gyrus (STS/STG), where this reduction was associated with levels of intrusive symptomatology in the BPD group. During emotional empathy, patients with BPD exhibited greater brain activity than controls in the right middle insular cortex, a response that was associated with skin conductance responses in the patients. Results indicate that altered functioning of the STS/STG and insula represents pathophysiological mediators for reduced empathy in BPD, with an important role for intrusive symptomatology and levels of arousal. The findings thus support a conceptualization of BPD as involving deficits in both inferring others' mental states and being emotionally attuned to another person.     

急性冠脉综合征患者发病率季节变异分析

目的：就急性冠脉综合征患者6年发病率的四季构成差异进行了探讨.方法：回顾了成都地区两所医院6年间共1452例急性冠脉综合征患者发病率的四季平均构成比,并进行了汇总分析.结果：急性冠脉综合征患者发病率确实存在季节差异,均表现为冬达峰期夏抵低谷.结论：急性冠脉综合征发病率皆存在冬高夏低的季节变异.     

Understanding Facial Expressions of Pain in Patients With Depression

Although depression is associated with more clinical pain complaints, psychophysical data sometimes point to hypoalgesic alterations. Studying the more reflex-like facial expression of pain in patients with depression may offer a new perspective. Facial and psychophysical responses to nonpainful and painful heat stimuli were studied in 23 patients with major depressive disorder (MDD) and 23 matched control participants. As psychophysical data, pain thresholds, tolerance thresholds, and self-report were assessed. Facial responses were videotaped and subjected offline to Facial Action Coding System analysis. One of the key facial responses of pain, which is a known facial signal of negative affect (contraction of the eyebrows), was significantly increased in MDD patients. Moreover, facial expressions and pain ratings were strongly correlated in MDD patients, whereas these 2 response systems were—in line with established findings—only weakly related in healthy participants. Pain psychophysics was unaltered in MDD patients compared with healthy control participants. In conclusion, the facial expression of pain in MDD patients indicates rather hyper- than hypoalgesia, with enhanced affective pain processing. Moreover, the linkage between subjective and facial responses was much stronger in MDD patients, which may be due to a reduced influence of social display rules, which normally complicate this relationship.

Seasonal affective disorder

Patients with seasonal affective disorder have episodes of major depression that tend to recur during specific times of the year, usually in winter. Like major depression, seasonal affective disorder probably is underdiagnosed in primary care settings. Although several screening instruments are available, such screening is unlikely to lead to improved outcomes without personalized and detailed attention to individual symptoms. Physicians should be aware of comorbid factors that could signal a need for further assessment. Specifically, some emerging evidence suggests that seasonal affective disorder may be associated with alcoholism and attention-deficit/hyperactivity disorder. Seasonal affective disorder often can be treated with light therapy, which appears to have a low risk of adverse effects. Light therapy is more effective if administered in the morning. It remains unclear whether light is equivalent to drug therapy, whether drug therapy can augment the effects of light therapy, or whether cognitive behavior therapy is a better treatment choice.     

Remoteness and Valence of Autobiographical Memory in Depression

We examined whether major depressive disorder (MDD) is associated with a tendency to recall more remote, specific autobiographical memories, particularly in the context of positive memories. To this end, individuals with MDD (n?=?26) and healthy controls (n?=?54) completed the Autobiographical Memory Test. Consistent with the hypothesis, remoteness of specific memories in the MDD group, but not the control group, depended on valence. Compared to the control group, the MDD group recalled more remote positive events. Additionally, the MDD group’s positive specific memories were significantly more remote than their negative specific memories. Retrieving remote positive memories might impair mood regulation and maintain an individual’s negative mood and perpetuate depression.     

Myoadenylate deaminase deficiency. Functional and metabolic abnormalities associated with disruption of the purine nucleotide cycle.

To assess the role of the purine nucleotide cycle in human skeletal muscle function, we evaluated 10 patients with AMP deaminase deficiency (myoadenylate deaminase deficiency; MDD). 4 MDD and 19 non-MDD controls participated in an exercise protocol. The latter group was composed of a patient cohort (n = 8) exhibiting a constellation of symptoms similar to those of the MDD patients, i.e., postexertional aches, cramps, and pains; as well as a cohort of normal, unconditioned volunteers (n = 11). The individuals with MDD fatigued after performing only 28% as much work as their non-MDD counterparts. Muscle biopsies were obtained from the four MDD patients and the eight non-MDD patients at rest and following exercise to the point of fatigue. Creatine phosphate content fell to a comparable extent in the MDD (69%) and non-MDD (52%) patients at the onset of fatigue. Following exercise the 34% decrease in ATP content of muscle from the non-MDD subjects was significantly greater than the 6% decrease in ATP noted in muscle from the MDD patients (P = 0.048). Only one of four MDD patients had a measurable drop in ATP compared with seven of eight non-MDD patients. At end-exercise the muscle content of inosine 5'-monophosphate (IMP), a product of AMP deaminase, was 13-fold greater in the non-MDD patients than that observed in the MDD group (P = 0.008). Adenosine content of muscle from the MDD patients increased 16-fold following exercise, while there was only a twofold increase in adenosine content of muscle from the non-MDD patients (P = 0.028). Those non-MDD patients in whom the decrease in ATP content following exercise was measurable exhibited a stoichiometric increase in IMP, and total purine content of the muscle did not change significantly. The one MDD patient in whom the decrease in ATP was measurable, did not exhibit a stoichiometric increase in IMP. Although the adenosine content increased 13-fold in this patient, only 48% of the ATP catabolized could be accounted for by the combined increases of adenosine, inosine, hypoxanthine, and IMP. Studies performed in vitro with muscle samples from seven MDD and seven non-MDD subjects demonstrated that ATP catabolism was associated with a fivefold greater increase in IMP in non-MDD muscle. There were significant increases in AMP and ADP content of the muscle from MDD patients following ATP catabolism in vitro, while there was no detectable increase in AMP or ADP in non-MDD muscle. Adenosine content of MDD muscle increased following ATP catabolism, but there was no detectable increase in adenosine content of non-MDD muscle following ATP catabolism in vitro. These studies demonstrate that AMP deaminase deficiency leads to reduced entry of adenine nucleotides into the purine nucleotide cycle during exercise. We postulate that the resultant disruption of the purine nucleotide cycle accounts for the muscle dysfunction observed in these patients.     

Physiological reactivity and facial expression to emotion-inducing films in patients with schizophrenia

The present study aimed to investigate the physiological reactivity and recognition to emotional stimuli in outpatients with schizophrenia and in healthy controls. Skin conductance response, skin conductance level, heart rate, respiration, corrugator muscle, and orbicularis muscle were all measured using five emotion-eliciting film clips. The patients reported lower intensity of experienced anger and disgust than controls. The patient and control groups did not differ in accuracy to recognize emotions except anger. Anger, fear, amusement, and sadness had a discriminative effect on physiological responses in the two groups. These findings provide helpful physiological evidence influenced by harmful or favorable emotional stimuli. Future directions may include to clarify how physiological reactivity and subject experience to emotion are related to their functioning.     

Increased Cold-Pain Thresholds in Major Depression

Most previous studies indicated that patients suffering from major depressive disorder (MDD) showed a decreased sensitivity for external or skin surface pain, eg, for heat or electrical stimuli, as compared to healthy controls. Here, we investigated cold-pain thresholds in 20 unmedicated patients suffering from MDD and 20 matched controls. We applied the ascending method of limits which has previously been used for heat-pain assessment in patients with depression. Similar to previous results for heat-pain thresholds we found a decreased sensitivity for cold pain in patients with MDD as indicated by increased cold-pain thresholds. This difference was significant on the right arm, whereas only a trend was obtained on the left arm, thus suggesting a certain degree of lateralization, similar to that seen in heat-pain perception in patients suffering from MDD or adjustment disorder. The study confirms our previous results of a lower sensitivity for externally induced pain in patients with MDD. Moreover, it adds weight to the assumption of a lateralized perception of thermal pain in depression.PerspectiveThis investigation provides further evidence for reduced pain perception of externally applied stimuli in major depression. Thus, central-nervous correlates for this altered pain perception in major depression are worth examining in future studies in order to gain more insight into mechanisms of pain perception on the one hand, and pathology of depression on the other.     

Sensitivity to feared stimuli in obsessive-compulsives: A dichotic listening analysis

The experiment reported here was designed to test whether fear-relevant stimuli are preceived more readily than neutral ones, and whether vigilance for the former is due to fear or to familiarity. Eleven obsessive-compulsives were administered a dichotic listening task before and after treatment by exposure and response prevention. Behavioral (button press) and physiological (skin conductance response) measures revealed that fear-relevant words were detected more than neutral words before but not after treatment. Additionally, the magnitude of the skin conductance response was greater to fearrelevant than to neutral targets before but not after treatment. These findings suggest that sensitivity to fear-relevant stimuli is due to fear and not familiarity.