Adolescent Humor and its Relationship to Coping,Defense Strategies,Psychological Distress,and Well-Being

Objective This study investigated the psychometric properties of the Humor Styles Questionnaire (HSQ) in measuring adolescent humor, including the relationship between humor and coping style, defense style, depressive symptoms, and adjustment in a non-clinical sample of adolescents. Method Humor, coping, defense strategies, depressive symptoms, and adjustment were investigated in 94 adolescents aged 12–15. Results The HSQ demonstrated adequate internal consistency. Inter-scale correlational patterns and scale means were similar for adolescents and adults. Convergent validity for the HSQ was supported by its relationship to: an adolescent-standardized humor defense scale; coping and defense strategies; and depressive symptoms and adjustment. Clinical utility of the HSQ was demonstrated by its unique contribution in predicting both depressive symptoms and adjustment above and beyond contributions from coping and defense composites. Discussion The HSQ appears to be a psychometrically sound and clinically useful measure to assess humor dimensions in adolescents.     

Do individuals with autism lack a sense of humor? A study of humor comprehension,appreciation, and styles among high school students with autism

Humor helps to build interpersonal bonds and allows individuals to feel closer. Previous research has generally claimed that individuals with autism have difficulty with interpersonal communication and social contacts, but there has been no such consensus regarding the sense of humor among individuals with autism. To address this issue, the present study aimed to compare the comprehension of, appreciation for, and preferred styles of humor between students with and without autism. The samples consisted of 177 high school students with autism and 177 control high school students. Every participant was within the normal range of intelligence. The gender ratio and age ratio of the two groups were maintained through pairwise sampling. The research tools were a questionnaire regarding the comprehension of and appreciation for nonsense and incongruity-resolution jokes, and the Humor Styles Questionnaire. The results show that the students with autism did not comprehend the nonsense jokes and incongruity-resolution jokes as well as the control students did, but they felt greater enjoyment when reading nonsense jokes. The students with autism preferred the nonsense jokes which is featured of less logical reasoning and using homophones for double-meaning. The tendencies toward affiliative humor, self-enhancing humor, and self-defeating humor among the students with autism were not as strong as those among the control students. Only the tendency toward aggressive humor was equal between two groups, showing that the students with autism still have sense of humor but tend to use hostile humor style. It is suggested to investigate the tendency of hostile humor in people with autism, and to provide them with affiliative humor to break the interpersonal stalemate experienced by individuals with autism.     

Depressive symptoms are independently correlated with lipid peroxidation in a female population: comparison with vitamins and carotenoids

OBJECTIVE: Lipid peroxidation (LPO) is involved in oxidative tissue injuries. The present investigation examined the association between LPO and psychological depressive symptoms. METHODS: A cross-sectional study was conducted on 66 female volunteers aged 38-70. Lipid peroxides (LOOH) in serum were evaluated by hemoglobin-methylene blue (Hb-MB) method; additionally, serum antioxidants were also detected. To assess depressive symptoms, the Center for Epidemiologic Studies Depression (CES-D) Scale and a subscale in the 28-item General Health Questionnaire (GHQ) were applied. RESULTS: LOOH concentration displayed a significant positive correlation with CES-D and GHQ depression scores. Multiple regression analysis was performed in which LOOH concentration served as a dependent variable and CES-D scores and antioxidants as independent variables. Consequently, CES-D scores demonstrated significant positive correlation with LOOH. CONCLUSIONS: The positive relationship between depressive symptoms and LPO in a female population may support the hypothesis that LPO may affect depressive symptoms.     

青少年抑郁情绪影响因素的双生子研究

目的探讨遗传及环境因素对青少年抑郁情绪的影响。方法采用贝克抑郁量表(Beck depression inventory,BDI)对重庆市107对11~18岁双生子的抑郁情绪进行评定,采用一般情况问卷、父母的养育方式和维度问卷(parenting styles and dimensions questionaire,PSDQ)、家庭压力问卷(family stresses questionnaire,FSQ)、家庭亲密度与适应性量表(family adaptability and cohesion evaluation scale 2nd edition Chinese version,FACES II-CV)、应激生活事件(stressful life event,SLE)等量表调查环境因素,采集双生子静脉血标本提取DNA以进行卵型鉴定。构建单因素结构方程模型,分析加性遗传因素(A)、共享环境因素(C)、特殊环境因素(E)对双生子抑郁情绪的影响。结果双生子的抑郁情绪与父亲受教育程度(r=-0.15,P=0.03)、母亲受教育程度(r=-0.17,P=0.01)、权威型养育方式(r=-0.18,P0.01)、家庭适应性(r=-0.27,P0.01)及亲密度(r=-0.20,P0.01)呈负相关,与家庭压力呈正相关(r=0.12,P=0.04),与应激生活事件无统计学相关性(P0.05)。结构方程示,在抑郁情绪总变异方差中加性遗传效应占0.37(95%CI:0.14~0.57),个体特殊环境因素占0.63(95%CI:0.43~0.86)。结论抑郁情绪与父母权威型养育方式、家庭适应性负性相关,与家庭压力正性相关;青少年抑郁情绪受加性遗传和特殊环境因素的共同影响,但受特殊环境的影响更大。     

Association of depressive symptoms and disease activity in children with asthma: methodological and clinical implications

OBJECTIVE: This study was designed to assess the prevalence of depressive symptoms in children with asthma and the association between depression and asthma activity. METHOD: Children ages 7 to 17 (n = 129) were recruited from a hospital emergency department after presenting for asthma symptoms. The majority of subjects were from disadvantaged, inner city families. Subjects' asthma disease activity was assessed using the revised National Heart, Lung, and Blood Institute guidelines, and subjects' emotional status was assessed by a combination of self-, parent-, and clinician-reported measures. Parental emotional status was assessed by self-report. RESULTS: Depressive symptoms within the clinical range were reported in 26% of subjects and 43% of mothers, although symptom severity varied across scales. Self-reported depressive symptoms were more strongly correlated with asthma activity (r = 0.25) than clinician-reported (r = 0.14) or parent-reported symptoms (r = 0.12/0.18). Depressive symptoms in parents were correlated with child's depression scores but not with their asthma activity. CONCLUSIONS: Depressive symptoms were common and associated with asthma activity in this inner city population of asthmatic children. Self-reported depressive symptoms were more strongly associated with child's asthma activity than either parental depression or parental/clinician ratings of the child's depression.     

Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health

OBJECTIVE: To describe the range of depressive symptoms reported by adolescents in a nationally representative U.S. sample and to examine factors associated with persistent depressive symptoms. METHOD: Secondary analysis was done on National Longitudinal Study of Adolescent Health (AddHealth) data from 13,568 adolescents who completed the initial survey in 1995 and follow-up 1 year later. Main outcomes of Center for Epidemiologic Studies-Depression Scale (CES-D) scores were analyzed by chi2 comparisons and sample-weighted logistic regression. RESULTS: Over 9% of adolescents reported moderate/severe depressive symptoms at baseline (CES-D > or = 24). Females, older adolescents, and ethnic minority youths were more likely to report depressive symptoms at baseline. Only 3% of adolescents with low initial CES-D scores (CES-D < 16) developed moderate/severe depressive symptoms at follow-up. Factors associated with persistent depressive symptoms at 1-year follow-up included: female gender, fair/poor general health, school suspension, weaker family relationships, and health care utilization. Other factors, including race and socioeconomics, did not predict persistent depressive symptoms. CONCLUSIONS: Depressive symptoms are common in adolescents and have a course that is difficult to predict. Most adolescents with minimal symptoms of depression maintain their status and appear to be at low risk for depression; however, adolescents with moderate/severe depressive symptoms warrant long-term follow-up and reevaluation.     

Depressive and anxiety symptoms in patients with schizophrenia and schizophreniform disorder

BACKGROUND: Symptoms of depression and anxiety are frequently encountered in the course of schizophrenia and are of considerable clinical importance. They may compromise social and vocational functioning, and they are associated with an increased risk of relapse and suicide. Various treatment approaches have been reported to be successful. METHOD: The sample comprised 177 patients with DSM-III-R or DSM-IV schizophrenia or schizophreniform disorder who were participants in multinational clinical drug trials at our academic psychiatric unit over a 7-year period and who were assessed by means of the Positive and Negative Syndrome Scale (PANSS). Analysis was performed on baseline PANSS scores. The depression/anxiety score was compared in the men and women, first-episode and multiple-episode patients, and those with predominantly positive and negative syndromes. Correlations were sought between depression/anxiety scores and age, total PANSS score, positive score, negative score, general psychopathology score, and treatment outcome. Multivariate analysis was applied to determine contributions of individual variables toward depression/anxiety and outcome scores. RESULTS: Depression and anxiety symptoms were more severe in women (p = .007), first-episode patients (p = .02), and those with predominantly positive symptoms (p < .0001). Depression/anxiety scores were significantly correlated to age (r = -0.31, p < .0001), PANSS positive scores (r = 0.39, p < .0001), and treatment outcome (r = 0.25, p = .006). Multivariate analysis bore out these results, with the exception that first episode was not a significant predictor of depression and anxiety scores. CONCLUSION: PANSS depressive/anxiety scores were generally low in our sample, perhaps because patients with schizoaffective disorder were excluded. The finding that these symptoms were more prominent in women and first-episode patients is in keeping with previous literature. The higher scores in first-episode patients are likely due to the higher positive symptom scores in these patients. The association between depressive/anxiety scores and positive symptoms but not with negative symptoms points to a specific relationship between affective symptoms and the positive symptom domain of schizophrenia. The presence of depressive and anxiety symptoms may predict a more favorable outcome to treatment, although this may only apply to the acute exacerbations of the illness.     

Self-image and depressive symptoms among adolescents in a non-clinical sample

The connection between self-image and depressive symptoms in non-clinical adolescent populations has not been well documented in large samples of teenagers. Our purpose was to investigate the correlation between self-image and depressive symptoms. To assess the adolescent's self-concept, we used the Offer Self-Image Questionnaire (OSIQ), and to study their depressive symptoms, we chose the Children's Depression Inventory (CDI). The sample consisted of 1054 eighth-grade students (465 boys, 589 girls) from normal comprehensive schools in one town with 200 000 inhabitants. The mean age of both gender groups was 14.5 years and they came from all social classes. The results showed a highly significant correlation between OSIQ scale scores and CDI scores. The more problems the adolescents had with their self-image, the greater the number of depressive symptoms. The correlation between the CDI total score and OSIQ scales scores was higher for girls than for boys except for the Superior Adjustment scale. The difference between sexes in the strengths of the correlations was highly significant (P<0.0001) except in the Sexuality scale. Since both the tests have shown to have predictive value for later psychiatric symptoms, further investigation of high-scoring CDI adolescents', and especially girls', self-image problems is important.     

Subsyndromal depression is associated with functional impairment in patients with bipolar disorder

BACKGROUND: The purpose of this study was to assess whether a relationship exists between mild depressive symptoms and overall functioning in subjects with bipolar disorder. METHOD: Twenty-five male subjects with bipolar I disorder (DSM-III-R criteria), who had not experienced a DSM-III-R episode of mania, hypomania, or major depression for 3 months as determined using the Structured Clinical Interview for DSM-III-R, were evaluated for degree of depressive symptoms using the Hamilton Rating Scale for Depression (HAM-D) and for overall functional status using the Global Assessment of Functioning (GAF, DSM-IV Axis V). RESULTS: GAF scores were significantly negatively correlated with HAM-D scores (r = -0.61, df = 23, p = .001), despite the fact that no patient had a HAM-D score high enough to be considered clinically depressed. CONCLUSION: The results of this study support a relationship between subsyndromal depressive symptoms and functional impairment in bipolar subjects, despite their not meeting threshold criteria for a major depressive episode. These findings raise the possibility that in some patients with bipolar disorder subsyndromal depressive symptoms might contribute to ongoing functional impairment.     

Everyday competence and depressive symptoms: Social support and sense of control as mediators or moderators?

Depression is common among the elderly members of Hong Kong Chinese society. The objectives of the present study are to assess the relationship between everyday competence and depressive symptoms and to test whether sense of control and social support mediate and moderate the impact of deterioration in everyday competence on depressive symptoms. The respondents were 393 people aged 60 years and older from a cross-sectional study of a representative community sample of the elderly population in Hong Kong and they were interviewed using a structured questionnaire. In multiple regression analyses, we found that everyday competence was significantly and negatively related to depressive symptoms (beta = -0.26, p < 0.01) after we had adjusted age, gender, marital status, years of education, self-rated health status, and number of chronic illnesses. Moreover, both sense of control and social support were mediators in the linkage between everyday competence and depression. However, neither sense of control nor social support moderated the effect of everyday competence on depression. Findings suggest that both sense of control and social support play important roles in the relationship between everyday competence and depression.     

Depressive symptoms at baseline predict fewer negative symptoms at follow-up in patients with first-episode schizophrenia

There is uncertainty regarding the prognostic value of depressive symptoms in schizophrenia, having previously been associated with both favourable and poor outcome. This study investigated the relationship between baseline depressive symptoms and treatment outcome at 6, 12 and 24 weeks in 80 subjects with first-episode schizophrenia or schizophreniform disorder in terms of PANSS total and subscale score changes. No significant association was found between baseline PANSS depression factor scores and PANSS total and subscore changes. However, a significant inverse correlation between baseline depression scores and negative scores at 6, 12 and 24 weeks was found (p=0.044, 0.023 and 0.012, respectively). Multiple regression analysis indicated that this finding could not be explained on the basis of age, gender or duration of untreated psychosis. These findings support previous work suggesting that high baseline depressive scores predict favourable outcome.     

Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population

OBJECTIVE: The aim of this study was to assess the validity of the Patient Health Questionnaire depression module (PHQ-9). It has been subject to studies in medical settings, but its validity as a screening for depression in the general population is unknown. METHOD: A representative population sample (2,066 subjects, 14-93 years) filled in the PHQ-9 for diagnosis [major depressive disorder, other depressive disorder, depression screen-positive (DS+) and depression screen-negative (DS-)] and other measures for distress (GHQ-12), depression (Brief-BDI) and subjective health perception (EuroQOL; SF-36). RESULTS: A prevalence rate of 9.2% of a current PHQ depressive disorder (major depression 3.8%, subthreshold other depressive disorder 5.4%) was identified. The two depression groups had higher Brief-BDI and GHQ-12 scores, and reported lower health status (EuroQOL) and health-related quality of life (SF-36) than did the DS- group (P's < .001). Strong associations between PHQ-9 depression severity and convergent variables were found (with BDI r = .73, with GHQ-12 r = .59). CONCLUSION: The results support the construct validity of the PHQ depression scale, which seems to be a useful tool to recognize not only major depression but also subthreshold depressive disorder in the general population.     

Measurement matters in the association between early adolescent depressive symptoms and body mass index

OBJECTIVE: The objectives of this study were to examine associations between depressive symptoms and body mass over 1 year during early adolescence and to assess how the associations might differ depending upon whether self-reported or directly measured height and weight were used. METHOD: Participants were 446 sixth-grade Seattle students. Depressive symptoms were assessed using the Mood and Feelings Questionnaire. Regression models were used to examine whether baseline depression status was associated with 12-month body mass index (BMI; using self-reported height and weight) and whether baseline overweight status was associated with 12-month depressive symptom score. Analyses were rerun among a subsample (n=165) who had height and weight directly measured. RESULTS: Using BMI derived from self-reported values, depressed males had a significantly lower BMI than nondepressed males, while depressed females had a significantly higher BMI than nondepressed females, after adjusting for covariates. Among a subsample using measured height and weight values, however, depression was no longer associated with BMI in either gender. Baseline overweight status did not predict 12-month depression score. CONCLUSIONS: Observed associations between depression and subsequent BMI were explained by differential misclassification of self-reported height and weight by depression status and gender. Direct measurement of height and weight may be necessary to ensure validity in studies of adolescent depression and weight-related outcomes.     

Sense of humor, hassles, and immunoglobulin A: evidence for a stress-moderating effect of humor

This study was designed to investigate whether sense of humor moderates immunosuppressive effects of stress. At two time periods one and one-half months apart, forty subjects completed the Daily Hassles Scale and provided saliva samples for determining secretory immunoglobulin A (S-IgA) levels. Four scales were used to assess different aspects of the sense of humor. A negative correlation was obtained between frequency of hassles at time 1 and S-IgA levels at time 2 (r = -.32, p less than .05), suggesting an immunosuppressive effect of hassles. In support of our hypothesis, hierarchical multiple regression analyses revealed significant moderating effects of three of the four humor measures on this relationship between hassles and S-IgA. Subjects with low scores on the humor scales revealed a stronger negative relationship between hassles and S-IgA than did those with high humor scores. These results are discussed in terms of other research examining psychological influences on immune function.     

Depression and bulbar involvement in amyotrophic lateral sclerosis.

OBJECTIVE: Patients with amyotrophic lateral sclerosis (ALS) often develop depressive symptoms. Little is known of the factors that predict or influence depression in ALS patients. PATIENTS AND METHODS: In 41 ALS patients we compared a self-rating depression scale with the ALS Functional Rating Scale (ALS-FRS), duration of disease, age, sex, education and participation in a self-help group. RESULTS: There was no significant relation between the total ALS-FRS score and the self-rating depression scale. In contrast, we found a significant correlation between the swallowing (r=-0.453; P=0.003) and breathing (r=-0.333; P=0.033) items of the ALS-FRS and the depressive scale. Depressive symptoms were negatively correlated with the duration of the disease (r=-0.377; P=0.016); there was no influence of age or sex. CONCLUSION: We found no evidence for a direct association between the loss of physical ability in general and depression, but for a decrease of depressive symptoms in relation to the length of time since diagnosis. Therefore, depressive symptoms in ALS patients seem to occur mainly as a depressive reaction following the communication of the diagnosis. In addition, patients with bulbar and respiratory symptoms should carefully be screened for depressive symptoms.     

Phenomenology of depression in young girls

OBJECTIVE: To examine the prevalence of depressive symptoms, the overlap between caregiver and child report, the association between depression and anxiety, and the relationship between symptoms of depression and impairment in young girls. METHOD: Participants in the Pittsburgh Girls Study, a community sample of 2,451 girls aged 5-8 years old and their primary caregivers were interviewed in 2000-2001 using the Child Symptom Inventory and the Short Moods and Feelings Questionnaire to measure depression, the Screen for Child Anxiety and Related Emotional Disorders to measure anxiety, and the Children's Global Assessment Scale to measure impairment. RESULTS: Less than 1% of 5- to 8-year-old girls had five or more symptoms of major depression according to the caregiver report. Individual differences in symptom counts and depression scores by caregiver and child report were observed. Agreement between caregivers and girls on depression symptoms was low, with only 2% of the variance in caregiver-reported depression on the Child Symptom Inventory being accounted for by child report on the Short Moods and Feelings Questionnaire. The level of association between depression and anxiety scores suggested that these constructs are associated but relatively independent in young girls. Both caregiver report and child report of depressive symptoms were uniquely associated with impairment ratings. CONCLUSIONS: Although major depression appears to be rare among 5- to 8-year-old girls, continuous measures of depressive symptoms yield significant individual differences that are associated with impairment. Thus, preliminary evidence suggests that depressive symptoms can be validly measured in 5- to 8-year-old girls.     

抑郁症患者的述情障碍特征及情绪调节研究

背景:抑郁症患者表现出明显的述情障碍,而关于其述情障碍的机制尚未明确,也较少有关于抑郁症患者情绪调节能力的研究.目的:探索抑郁症患者的述情障碍特征,以及抑郁症状、述情障碍与个体情绪调节能力的关系.方法:采用汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)、多伦多述情障碍量表(TAS)和计算机情绪调节实验,对36名抑郁症患者和31名健康志愿者进行评定分析.结果:病例组中述情障碍发生率为66.67%,对照组为3.23%,两组比例差异有显著性(χ2=28.661,p<0.001).病例组的TAS得分显著高于对照组(t=7.378,p<0.001).情绪调节实验中,病例组观看中性图片的评分显著高于对照组(t=2.080,p=0.043);而负性-观看、负性-重评和负性-抑制三种实验条件下,两组评分无显著差异.在病例组中,HAMD-24、HAMA与TAS得分之间存在显著相关,而情绪调节实验得分与HAMD-24、HAMA、TAS之间均未发现相关.结论:抑郁症患者中述情障碍的发生率可能高于一般人群,其抑郁症状与述情障碍之间可能存在相互影响.情绪调节能力可能是一种独立的特质,与抑郁状态无关.     

Do humor styles mediate or moderate the relationship between self-criticism and neediness and depressive symptoms?

This study examined whether, in a community sample of Israeli adults (N = 335), benign (i.e., affiliative and self-enhancing) and injurious (i.e., aggressive and self-defeating) humor styles mediated or moderated the relationship between self-criticism and neediness, two traits that confer vulnerability to depression, on the one hand, and levels of depressive symptoms, on the other. There was no evidence of any moderating effect of humor styles on the relationship between self-criticism and neediness and depressive symptoms. However, results indicated that the use of injurious styles of humor mediated the relationship between self-criticism and depressive symptoms as well as the relationship between neediness and depressive symptoms. Moreover, the relationship between neediness and depressive symptoms was also mediated by low levels of benign humor. These findings may have important implications for theories concerning vulnerability to depressive symptoms and intervention strategies.     

Depression and the metabolic syndrome: gender-dependent associations

This study was designed to test the extent to which depressive symptoms are associated with the presence of the metabolic syndrome (MS) and each of its components, and whether these relationships are gender dependent. Participants were apparently healthy employed men (N=2,355) and women (N=1,525) who underwent a routine health check between the years 2003 and 2005. We used logistic regression analysis, predicting the MS by depressive symptoms, as assessed by the Patient Health Questionnaire, and the following control variables: age, education, smoking status, physical exercise, anxiety, and burnout. As hypothesized, we found that depression among women, but not men, was associated with a 1.94-fold risk of having the MS, and with an elevated risk of having two of its five components: elevated waist circumference (odds ratio, OR=2.23) and elevated glucose levels (OR=2.44). In addition, a positive trend was observed toward an association with the other three components: low high-density lipoprotein, hypertension, and elevated triglycerides. Among men depression was associated with elevated waist circumference only (OR=1.77). These findings suggest that especially among women, the association between depression and cardiovascular diseases might be linked to metabolic processes. If replicated in longitudinal studies, these findings may have important health-care policy implications with regard to depression management interventions.     

Characterization of depression in war-related posttraumatic stress disorder

OBJECTIVE: Many patients with posttraumatic stress disorder (PTSD) have symptoms of depression, but operationalized psychological constructs related to depression have not been used extensively in characterizing affective symptoms of PTSD. The authors' objective is to better characterize the affective component of PTSD. METHOD: The subjects were 45 male psychiatric inpatients at a Veterans Administration medical center; 28 met DSM-III-R criteria for PTSD and 17 met Research Diagnostic Criteria (RDC) for major depressive disorder. All of the subjects with PTSD were Vietnam veterans. The 21-item Hamilton Rating Scale for Depression was used to assess state measures of symptom severity, and the Depressive Experiences Questionnaire was used to measure dimensions of dependency, self-criticism, and self-efficacy. RESULTS: The mean total Hamilton scale score of the patients with PTSD was nonsignificantly higher than that of the patients with major depressive disorder; patients with PTSD had higher scores on almost all individual Hamilton symptoms, particularly insomnia, somatic anxiety, and diurnal variation. Patients with PTSD had significantly higher scores on the self-criticism scale but not on the dependency and self-efficacy scales of the Depressive Experiences Questionnaire. The scores of patients with PTSD on the dependency and self-criticism scales were negatively correlated. No significant differences between patients with PTSD with and without concurrent major depressive disorder were observed. CONCLUSIONS: Characterization of such depressive dimensions of PTSD as dependency and self-criticism may have important clinical implications.