Suicidal Ideation in Adolescent Psychiatric Inpatients as Associated With Depression and Attachment Relationships

Examined suicidal ideation in adolescent psychiatric inpatients as associated with depressive symptoms and attachment to mother, father, and peers. Fifty-nine adolescent psychiatric inpatients (25 male, 34 female) completed self-report measures of suicidal ideation, depressive symptoms, and attachment. Attachment to mother accounted for significant variation in levels of depressive symptoms and suicidal ideation. In addition, attachment to peers accounted for significant variation in suicidal ideation and girls' (but not boys') depressive symptoms. However, after adjusting for depressive symptoms, attachment variables failed to contribute additional variance in suicidal ideation. Self-reported depressive symptomatology remained the strongest predictor of suicidal ideation, regardless of its order in the regression analyses. Prevention and treatment efforts may focus on mother-adolescent attachment and peer attachment (particularly in girls) to reduce risk for depression and suicidal ideation.     

Links Among Attachment-Related Cognitions and Adolescent Depressive Symptoms

We assessed the role of self-evaluative and support-seeking processes as mediators of the relation between maternal representations and depressive symptoms in a sample of 168 young adolescents. Representations of mother as unavailable, unresponsive, and unsupportive were associated with depressive symptoms measured by semistructured interview and self-report. Moderation tests revealed that the association between maternal representations and depressive symptoms varied as a function of stress level for self-reported symptoms only. Subsequent mediation analyses for higher and lower stress groups showed that support seeking functioned as a mediator in the higher, but not lower, stress group. When depressive symptoms were assessed via interview, results with the full sample indicated that self-worth contingencies mediated the association between maternal representations and symptoms. Findings are discussed in terms of the identification of proximal targets for intervention.     

高中生负性认知方式、反复思考与抑郁的关系研究

目的探讨负性认知方式、反复思考与抑郁情绪之间的关系。方法运用问卷法,对494名高中生进行负性认知方式、反复思考和抑郁情绪的施测。结果 1相关分析结果显示:负性认知方式(稳定性、普遍性、结果、自我、归因)与抑郁存在显著正相关(r=0.267,0.277,0.274,0.217,0.189;P0.01),反复思考与抑郁存在显著正相关(r=0.554;P0.01),负性认知方式(稳定性、普遍性、结果、自我、归因)与反复思考之间存在显著的正相关(r=0.185,0.269,0.287,0.206,0.138;P0.01);2使用结构方程对负性认知方式、反复思考和抑郁情绪三者进行路径分析并且最终模型拟合良好(χ2=5.397,df=4,P=0.249);3经中介效应检验程序检验,确定反复思考在负性认知方式与抑郁之间的中介效应为0.15,中介效应占总效应的比例为49.3%。结论拥有负性的认知方式的个体抑郁和反复思考的水平较高。反复思考对抑郁具有直接的影响作用,并且在负性认知方式与抑郁之间起部分中介作用。     

Body Dissatisfaction Prospectively Predicts Depressive Mood and Low Self-Esteem in Adolescent Girls and Boys

This research examined whether body dissatisfaction prospectively predicted depressive mood and low self-esteem in adolescent girls and boys 5 years later. Participants were early-adolescent girls (n = 440, Time 1 M age = 12.7 years) and boys (n = 366, Time 1 M age = 12.8 years) and midadolescent girls (n = 946, Time 1 M age = 15.8 years) and boys (n = 764, Time 1 M age = 15.9 years). After controlling for Time 1 of the relevant dependent variable, ethnicity, socioeconomic status, and body mass index, Time 1 body dissatisfaction was a unique predictor of Time 2 depressive mood and low self-esteem in early-adolescent girls (depressive mood: F = 4.80, p < .05; self-esteem: F = 9.64, p < .01) and midadolescent boys (depressive mood: F = 12.27, p < .001; self-esteem: F = 9.38, p < .01) but not in early-adolescent boys or midadolescent girls. These findings are consistent with the hypothesis that body dissatisfaction is a risk factor for depressive mood and low self-esteem in both girls and boys but in different phases of adolescence.     

Preliminary Examination of Sex Differences in Depressive Symptoms Among Adolescent Psychiatric Inpatients: The Role of Anxious Symptoms and Generalized Negative Affect

Assessed the emerging view that generalized negative affect and anxious symptoms are important in understanding sex differences in depressive symptoms. Sixty-three adolescent psychiatric inpatients (32 boys, 31 girls), ages 12 to 16 (M = 13.87, SD = 1.36), completed measures of positive and negative affect and anxious and depressive symptoms. Results demonstrated, as predicted, that depressive and anxious symptoms were more highly associated in adolescent girls than boys. Furthermore, girls with depressive symptoms were more likely to have comorbid anxious symptoms than boys with depressive symptoms. Sex differences were not found for adolescents with specific depressive symptoms and specific anxious symptoms (i.e., the absence of comorbidity). Our findings supported the possibility that sex differences in pure forms of depression are overestimated and that comorbid internalizing conditions may be more prevalent in adolescent girls than boys.     

Predictors of Depressive Symptomatology Among Parents of Newly Diagnosed Children with Cancer

Examined predictors of depressive symptoms among 59 parentsproviding primary care to children newly diagnosed with cancer.Parents were studied for a 3-month period. The parent providingprimary care to the child during medical treatment completedmeasures of depressive symptoms, endorsement of family routines,family functioning, amount of assistance from the spouse inproviding care to the child, child behavior problems, as wellas measures of the severity of the child's treatment regimen.A strong relationship was found between child behavior problemsand parent depressive symptomatology. Although disease-relatedfactors such as the child's functional impairment played a rolein the parent's depressive symptoms, results revealed that thechild's behavior problems were most strongly associated withparent depressive symptoms and that family cohesiveness alsohad a contributory role in the maintenance of parent depressivesymptoms.     

自我效能感与高中生应对方式及抑郁情绪

目的 探讨高中生自我效能感、应对方式和抑郁情绪之间的关系.方法 采用自我效能感量表(GSES)、应付方式问卷和抑郁自评量表(SDS)对386名高中生进行问卷调查.结果 ①高中男生的GSES得分显著高于高中女生(t=2.550,P＜0.05);高三学生应对因子解决问题的得分显著高于高一和高二学生(F=3.173,P＜0.05);②高中生GSES得分与应对因子解决问题、求助有显著正相关(r1=0.393,P1＜0.01;r2=0.149,P2＜0.01),与自责有显著负相关(r=-0.149,P＜0.01),与SDS得分有显著负相关(r=-0.338,P＜0.001);③GSES得分高与GSES得分低的高中生在应对因子解决问题、自责、退避和SDS的得分上有差异显著(t1 =-7.695,t2=3.472,t3=-3.258,t4=6.800).结论 高中男生的自我效能感显著高于高中女生;高中女生更多使用求助应对方式;自我效能感高、更多使用积极应对方式的高中生,抑郁水平较低.     

Validity of the Devereux Scales of Mental Disorders With Adolescent Psychiatric Inpatients

Tested the validity of the Devereux Scales of Mental Disorders (DSMD; Naglieri, LeBuffe, & Pfeiffer, 1994) in a sample of 108 adolescent psychiatric inpatients. DSMD scales were compared to parent-report, interview-based, self-report and diagnostic measures. DSMD measures of conduct problems and delinquency were significantly associated with the predicted parent-report, interview-based, and diagnostic measures of conduct disorder and substance abuse and not with any measures of anxiety or depression. DSMD measures of anxiety and depression were related to other parent-report ratings of internalizing symptoms but had more limited convergent and discriminant validity. The DSMD was compared to the Child Behavior Checklist (CBCL; Achenbach, 1991) for diagnostic classification accuracy. The two measures were comparable in classifying oppositional or conduct disorder. The CBCL was superior for classification of major depression. The DSMD was superior for classification of substance abuse.     

Effects of Pain Controllability and Discrepancy in Social Support on Depressed Mood Among Patients with Chronic Pain

Background

Preference of types of social support may vary across recipients, and social support that is less than the amount preferred may be associated with depressed mood.

Purpose

This study aimed to investigate the interaction effects between pain controllability and discrepancy in social support and the additive utility of discrepancy in social support over perceived social support in predicting depressed mood among patients with chronic pain.

Method

A total of 173 patients seeking treatment at two outpatient pain management clinics in Hawaii participated.

Results

The results indicated that (1) patients with low pain controllability preferred significantly more social support than those with high pain controllability, for all types of social support; (2) patients preferred significantly more informational and emotional support than instrumental support for both pain controllability levels; (3) discrepancy in informational or instrumental support was not associated with depressed mood, whereas discrepancy in emotional support was significantly associated with more depressed mood for low pain controllability, but not for high pain controllability; and (4) discrepancy in emotional support added a significant increment of variance in predicting depressed mood over and above perceived emotional support, whereas discrepancy in informational or instrumental support did not.

Conclusion

Findings suggest the relative importance of discrepancy in emotional support from a significant other, especially for patients with low pain controllability.     

抑郁障碍青少年及其父母的求助行为

目的：了解抑郁障碍青少年与父母的求助行为（病因解释，求助途径，延误就诊时间与来诊期望）。方法：对61例门诊抑郁障碍青少年家庭采用求助半定式问卷，SDS，C—GAS调查。结果：患者求助延误平均17个月，与父母无明显差异（P〉0．05），母亲是就诊决策的主要因素（77．5％），患者发病年龄越大、功能越好，就诊延迟时间越长；患者将病因归为外界压力与个性缺陷。父母更倾向于家庭养育问题、婚姻不合和个性缺陷；对专业机构有心理治疗需求。结论：考虑家庭求助特征有利于制定抑郁障碍青少年的干预方案。     

Family Profiles of Expressed Emotion in Adolescent Patients With Anorexia Nervosa and Their Parents

The current study examined expressed emotion (EE) among families of adolescents with anorexia nervosa (AN) participating in a treatment study. EE ratings were made from 110 adolescents toward their parents and from parents toward their children using videotaped family interviews. Participants were 92% female and 75% Caucasian with a mean age of 14.41 years. Four family profiles were created (low patient EE/low parent EE, high patient EE/high parent EE, low patient EE/high parent EE, high patient EE/low parent EE). Family EE profile was not related to full remission at end of treatment. Groups were then combined according to EE level of parent. The low parent group (defined as low on criticism, hostility, and emotional overinvolvement) had significantly lower scores on a measure of eating disorder psychopathology than the high parent group at the end of treatment. Patients with AN in low EE families do better in treatment than those patients belonging to high EE families. These findings are true regardless of the EE status of the patient.     

Physiological Stress Responsivity and Perceived Stress Among Subjects With Irritable Bowel Syndrome1

This study sought to evaluate perceived and physiological stress responsivity among subjects with Irritable Bowel Syndrome (IBS). Nineteen females with IBS symptoms and 19 nonsymptomatic female comparison participants participated in the experiment. Participants completed a series of personality and mood questionnaires, as well as a laboratory procedure measuring cardiovascular responses and perceived stress while performing laboratory tasks (i.e., the Stroop Color Naming Test and a Serial 7s subtraction task). Although participants did not significantly differ in blood pressure during the laboratory procedures, IBS participants had significantly lower pulse rates during the procedure. IBS participants perceived the laboratory tasks as being more stressful than comparison participants, which was measured by self-report. Results suggest that IBS sufferers may be more sensitive to perceived stress than others.     

Internet-Based Motivation Program for Women With Eating Disorders: Eating Disorder Pathology and Depressive Mood Predict Dropout

Background

One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology.

Objective

The aim of the present study was to identify predictors of dropout from this Web program.

Methods

A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants’ age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method.

Results

The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout.

Conclusions

Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.     

Religiousness and Depressive Symptoms Among Adolescents

Examined the relations between depressive symptoms and (a) 3 standard indicators of religiousness and (b) a potentially more age-specific indicator in a sample of 744 adolescents (M age = 13.06 years, SD = 0.45). Adolescents completed the Children's Depression Inventory (CDI) and the Brief Multidimensional Measure of Religiousness/Spirituality. Results indicate that several dimensions of religiousness are associated with lower levels of depressive symptoms (i.e., attendance, self-ranking, and positive interpersonal religious experience), whereas negative interpersonal religious experience was associated with higher levels. These relations were not moderated by sex or ethnicity. Interpersonal religious experience had a stronger relation with depressive symptoms than did the standard dimensions of religiousness. The importance of social support during adolescence and future directions for this relatively new area of research are discussed.     

Confounding Variables Affecting the Relationship Between Emotional Family Atmosphere and Perceived Parental Rearing Behaviour in Adult Depressive Inpatients: A Cross-Validation Study

In a series of 151 psychiatric inpatients of various diagnoses, the relationships between severity of depression, emotional family atmosphere and perceived parental rearing were investigated at admission and discharge for each of the sexes. Significant correlations between perceived parental rearing characteristics and the present family atmosphere were yielded. Particularly in males were the EMBU factors of parental rejection and emotional warmth closely related to the present family atmosphere factors of acceptance, emotional closeness, and relaxed relations. Only in the female subsample were the correlations between parental rejection and both emotional family atmosphere factors (strained versus relaxed relations and rejection versus acceptance/emotional closeness) consistently significant. Possible explanations for the gender differences are discussed. The results verify the findings from a previous study.     

Relationship Between Perceived Family Climate and Adolescent Adjustment

Determined, for each subscale of the Family Environment Scale (FES), whether cutoff scores exist that are related to adolescent distress. TWO epidemiological measures, the Langner Symptom Survey and the General Health Questionnaire, assessed adjustment. We employed a conservative definition of adolescent distress. Analyses revealed that three FES subscales (Cohesion, Conflict, and Active-Recreational Orientation) were related to adolescent distress, regardless of age and sex, and that one FES subscale (Expressiveness) was related to distress in male adolescents but not in female adolescents. We established cutoff scores for each FES subscale found to be related to adolescent distress.     

老年住院患者抑郁状况的调查及影响因素分析

目的对老年住院患者抑郁状况的调查及影响因素进行分析。方法以老年抑郁量表（GDS）、社会支持评定量表（SSRS）、应对方式问卷（CSQ）为调查工具,对426名老年住院患者进行调查。采用χ^2检验及多因素非条件logistic回归分析进行统计分析。结果24.4%的老年住院患者存在轻重不等的抑郁症状;患者的性别、负性生活事件是影响其抑郁症状发生的主要因素;社会支持问卷中主观支持、对支持的利用度也影响抑郁症状的发生;应对方式问卷中解决问题、自责、求助及幻想等因子也影响抑郁症状的发生。结论性别、负性生活事件、社会支持及应对方式是影响老年住院患者抑郁的重要因素。