Perfectionism, Anxiety, and Depression: Are the Relationships Independent?

The present study examined the relationship between perfectionism and various features of anxiety to determine whether these features of anxiety were related to perfectionism independent of depression. A factor analysis of various measures of anxiety symptoms reduced the measures to three factors: obsessive-compulsive disorder, social anxiety/trait anxiety/worry, and posttraumatic stress disorder (PTSD) symptoms. All three factors were significantly related to maladaptive perfectionism, but the social/trait/worry factor was the only factor found to be related to maladaptive perfectionism independent of depression. The PTSD factor was the only factor related to the adaptive component of perfectionism, and this relationship remained significant even after controlling for depression. Perfectionism was related to depression after controlling for the three anxiety factors; maladaptive perfectionism was positively related to depression and adaptive perfectionism was negatively related to depression. These findings indicate that there appears to be an aspect of perfectionism that is related to anxiety independent of depression and a separate aspect of perfectionism that is related to depression independent of anxiety.     

Differentiating Symptoms of Anxiety and Depression in Older Adults: Distinct Cognitive and Affective Profiles?

Cognitive and affective dimensions of symptomsof anxiety and depression were examined in a sample of283 community-dwelling older adults (ranging in age from65 to 93 years). A principal-axis factor analysis with varimax rotation conducted on theCognition Checklist (CCL) revealed a factor structuredifferent than that found in younger adults. Threefactors emerged (Anxious, Social Loss, and NegativeSelf-Evaluation/Worthlessness Cognitions) and, in general, these cognitionswere not specifically related to anxious and depressivesymptoms. Instead, worthlessness cognitions wererobustly associated with both anxious and depressive symptoms, including variance that was unique toeach. In terms of affective dimensions, factor analysesrevealed that only anxiety-related items loaded on thenegative affectivity subscale. Consequently, negative affectivity was strongly related tovariance that was unique to anxious symptoms, but wasonly weakly related to variance that was unique todepressive symptoms. On the other hand, positiveaffectivity was only weakly associated with both forms ofsymptomatology. Findings are discussed in terms of thecognitive and affective distinctions between older andyounger adulthood.     

Cognitive Biases in Childhood Anxiety, Depression, and Aggression: Are They Pervasive or Specific?

This study investigated the extent to which children’s negative information processing biases are pervasive across the cognitive modalities of attention, judgment, and memory and, further, whether such biases are specifically associated with anxiety, depression, and/or aggression. 133 children between the ages of 8 and 14 years were assessed on an attention allocation task, a vignette interpretation measure, and a memory recall task. Children also completed anxiety and depression inventories, and were rated by teachers on a measure of aggression. Overall the results suggested a predominantly pervasive negative bias associated with childhood psychopathology, with some evidence of specificity. The canonical correlation analyses indicated that high levels of anxiety, depression, and aggression were associated with biases: attention to negative information, interpretation of ambiguous situations as negative, and preferential recall of negative words. Above this general bias, anxiety displayed a specific association with attention to negative information in the univariate analyses.

The Relationship Between Parenting Style,Cognitive Style,and Anxiety and Depression: Does Increased Early Adversity Influence Symptom Severity Through the Mediating Role of Cognitive Style?

Despite the central role accorded to cognitive style in mediating the relationship between negative parenting and the development of anxiety and depression, few studies have empirically examined this relationship. Using a clinical sample, this study examined the relationship between early experiences with low care, increased control, abuse and neglect, and symptoms of anxiety and depression, via the mediating effects of cognitive style. It was found that individuals who rate their parents as being more abusive and neglectful reported a greater degree of depression and that this relationship was mediated by dysfunctional cognitive style. These findings contribute to the growing literature by providing support for the role of cognitions in mediating the link between negative parenting and psychopathology.     

Responding to Anxiety with Rumination and Hopelessness: Mechanism of Anxiety-Depression Symptom Co-Occurrence?

The current research proposes that certain anxiety response styles (specifically, responding to anxiety symptoms with rumination or hopeless cognitions) may increase risk of depressive symptoms, contributing to anxiety-depression comorbidity. We delineate preliminary evidence for this model in three studies. In Study 1, controlling for anxiety response styles significantly reduced the association between anxiety and depressive symptoms in an undergraduate sample. In Study 2, these findings were replicated controlling for conceptually related variables, and anxiety interacted with anxiety response styles to predict greater depressive symptoms. In Study 3, anxiety response styles moderated the prospective association between anxiety and later depression in a generalized anxiety disorder sample. Results support a role for anxiety response styles in anxiety-depression co-occurrence, and show that hopeless/ruminative anxiety response styles can be measured with high reliability and convergent and divergent validity.     

Are Sleep Difficulties Associated With Migraine Attributable to Anxiety and Depression?

Objective.— To examine whether sleep complaints reported by migraineurs can be attributed to comorbid anxiety and/or depression. Background.— A consistent association between migraine and sleep complaints has been reported in community and clinical studies. However, anxiety and depression are often comorbid with migraine. Thus, it may be possible that the increased prevalence of sleep problems in migraineurs is attributable to comorbid anxiety and depression. To our knowledge, no previous studies have demonstrated that the associations are not solely attributed to comorbid anxiety and depression. Design and Methods.— Controlled family study of anxiety disorders and substance use disorders in a community in New Haven County, CT. The sample included 221 probands (41 migraineurs) and their 261 directly interviewed first‐degree relatives (39 migrainuers), including parents, siblings, and offspring over age 18. A lifetime history of migraine was obtained using the Diagnostic Interview for Headache Syndromes. A lifetime history of psychiatric disorders was obtained using the semi‐structured Schedule for Affective Disorders and Schizophrenia which was modified to incorporate Diagnostic and Statistical Manual diagnostic criteria. Several sleep items on current and lifetime sleep complaints were included as a subset of the interview. Results.— There was a significant association between migraine and the number of sleep problems as well as several specific sleep symptoms among probands and their adult relatives. Adults with migraine reported having significantly more lifetime sleep problems (OR [CI] = 2.3 [1.1‐4.6]), and more current sleep difficulties, specifically, inadequate sleep (2.5 [1.2‐5.0]), difficulty falling asleep (3.0 [1.5‐6.3]), and persistent nightmares of childhood onset (4.3 [1.8‐9.9]) than those without migraine. The associations between sleep problems and migraine persisted after controlling for both lifetime and current anxiety and mood disorders. Conclusions.— The association between sleep problems and migraine that is not solely explained by comorbid anxiety disorders or depression suggests that sleep problems should be evaluated among people with migraine.     

Rumination in Clinical Depression: A Type of Emotional Suppression?

This study examined the relationship between rumination and the use of other emotion-regulation strategies in a depressed sample. Sixty outpatients diagnosed with unipolar depression completed questionnaires and participated in a sad mood induction. The mood induction was used to investigate the relationship between the use of rumination and each of two theoretically relevant emotion-regulation strategies—suppression and acceptance. Findings demonstrated that rumination was positively associated with other types of suppression and negatively related to acceptance. Results offer tentative support for the conceptualization of rumination as a maladaptive, cognitive emotion-regulation strategy utilized by depressed individuals in an attempt to suppress their experience of negative emotion. Findings also suggest a potential mechanism of action for efficacious mindfulness and acceptance-based treatments for depression.     

Do Symptoms of Generalized Anxiety and Obsessive-Compulsive Disorder Share Cognitive Processes?

There is tremendous interest in understanding the role of cognitive processes within generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD). Regarding one process, intolerance of uncertainty (IU), extant data provide equivocal conclusions as to whether it shares a specific relation with either disorder. This study tested the specificity of IU and other cognitive processes, including negative problem orientation, responsibility and threat estimation, perfectionism and certainty, and importance and control of thoughts, in relation to symptoms of GAD and OCD in a large nonclinical sample. All cognitive processes except importance and control of thoughts (ICT) shared comparable relations with symptoms of both disorders and IU was the only cognitive process to predict unique variance—that above and beyond the other cognitive processes—in both GAD and OCD symptoms. We discuss the implications of these findings for conceptualizing points of convergence and divergence between the symptoms of two disorders that historically have shown meaningful overlap.     

Can the Hospital Anxiety and Depression Scale be used in patients with schizophrenia?

Rationale, aims, objectives The Hospital Anxiety and Depression Scale (HADS) was developed explicitly for use in non‐psychotic populations, yet is routinely used for screening patients with psychotic illness. The utility of the HADS as a screening instrument for use in patients with schizophrenia was investigated. Method Exploratory factor analysis and confirmatory factor analysis were conducted on the HADS to determine its psychometric properties in 100 patients with a primary ICD‐10 diagnosis of schizophrenia. Results Three distinct factors were identified within the HADS. Support was found for the clinical use of the HADS anxiety subscale to assess anxiety in patients with schizophrenia; however, evidence was also found that the HADS depression subscale may not be a unidimensional measure of depression in this clinical group. Conclusions Caution should be used when using the HADS depression subscale in this clinical group. The direction of future research in this area is indicated, in particular comparison of HADS anxiety and depression measures to determine further the validity or otherwise of these subscale domains.     

Street Music or the Blues? The Lived Experience and Social Environment of Depression

Life's complexity is a haunting melody of continuously interacting variables .... Professional practice in nursing seeks to promote symphonic interaction between man [sic] and environment. . . (Rogers, 1970, pp. 41, 122). The purpose of this phenomenological study was to explore the lived experience of clinical depression for women in the context of their social relations and environment. Twelve ethnically diverse female friend dyads were interviewed and completed the Beck Depression Inventory (BDI). Seventeen of these women had experienced a major depression in the past or were in treatment for clinical depression at the time of the study. This depression was characterized by dissonance experienced in childhood abuse and incest, uncontrollable moods despite self-medication, abusive or negligent therapy, failed social relationships in adulthood, and a lack of resources in the environment. In contrast, seven healthy women described their social environment as generally resonant and connected. Prevention of childhood abuse and racism, relief from economic hardships, early diagnosis, and safe, effective treatment are essential in helping women to survive clinical depression. Nurses in the community are in a unique position to affect this public health problem.     

Developing Perspectives on the Cognitive–Developmental Origins of Depression: Back Is the Future

Theory and empirical research assessing the developmental precursors of depression is examined. This theory and research tends to emphasize three sets of variables that may guide the eventual development of depression. The first focuses on the role of interpersonal factors, which tend to revolve around parenting. Although parenting is important, research has also suggested that other interpersonal relations, such as interactions with friends, teachers, and romantic partners, may play a role in creating cognitive vulnerability to depression. The second emphasizes the effects of stressful experiences on the development of cognitive vulnerability. The third set of variables highlight the need to examine the precursors of vulnerability at different stages in the development process. Each of these emphases has contributed important pieces to the puzzle of how depression develops, and we are beginning to develop an emerging picture of the origins of depression.     

The Effects of Inhalation Lavender Aromatherapy on Postmenopausal Women’s Depression and Anxiety: A Randomized Clinical Trial

The main aim of this study was to investigate the effects of inhaled lavender aromatherapy on depression and anxiety levels among postmenopausal women. A randomized clinical trial was performed in which 46 postmenopausal women received 2% inhaled lavender essence or distilled water 20 minutes nightly before bedtime for 4 successive weeks. Depression and anxiety mean scores decreased in the lavender group compared with controls, providing evidence that lavender aromatherapy may be an effective noninvasive treatment during the postmenopausal stage.     

Anxiety,Depression, and Pain in Burning Mouth Syndrome: First Chicken or Egg?

Background.— Burning mouth syndrome (BMS) is an idiopathic and chronic pain condition for which patients may experience high levels of pain, anxiety, and depression. So far, it has not yet been well investigated whether specific psychiatric features (anxious traits, personality disorder, or somatization) may play a role in the BMS pathogenesis or whether some BMS symptoms, or BMS itself, may cause secondary psychiatric symptoms. Objective.— The aim of this study was to evaluate the relationship between pain, depression, and anxiety in BMS and healthy patients in order to hypothesize a possible underlying pathogenetic model. Methods.— Fifty‐three patients with BMS and 51 healthy volunteers matched for sex and age were enrolled. All patients underwent a physical examination, laboratory screening tests, and psychiatric assessment with the following instruments: Visual Analog Scale, the Hamilton Rating Scale for Depression, the State‐Trait Anxiety Inventory Form Y 1‐2 (STAI Y1‐Y2), and the Symptom Checklist‐90‐Revised (SCL‐90‐R). Results.— BMS patients and healthy volunteers showed a statistically significant difference in psychiatric features: Regression analysis showed that pain is affected by depression (R = 0.373; R² corrected = 0.123; F = 8.563; P < .005), and depression is affected by anxiety (R = 0.512; R² corrected = 0.248; F = 18.519; P < .001). BMS patients have statistically significant higher scores of anxiety (STAI Y1, P = .026 and STAI Y2, P = .046) and depression (P < .001), and higher SCL‐90‐R scores on somatization (P = .036) and hostility dimensions (P = .028) than the control group. Conclusions.— We may hypothesize that anxiety could determine a secondary demoralization in BMS patients (depression) and depressive symptoms could contribute to pain, accordingly. Therefore, pain could be a somatic feature of depression. Our findings provide an example of a possible pathogenetic model for BMS.     

The Effect of a PNF Technique Program after Mastectomy on Lymphedema Patients’ Depression and Anxiety

[Purpose] This study was conducted to examine the effects of exercises applied with PNF techniques performed for 30 minutes per session, three times per week, after receipt of radiation therapy following mastectomy on depression and anxiety in patients diagnosed with lymphedema and to prepare basic data for creation of self-directed exercise programs for lymphedema patients that will enable them to perform exercises within the range of no pain. [Methods] The subjects of this study were 45 patients selected from among those diagnosed with breast cancer who showed lymphedema after anti-cancer therapy following mastectomy. [Results] The Beck depression score changed significantly during the five assessment periods however, there was no significant difference between the treatment groups. Post hoc analyses revealed that there was significant improvement in the Beck depression score from 4 weeks in all three groups. The interaction between group and time was also statistically significant. [Conclusion] In conclusion, PNF techniques helped to improve the depression and anxiety rates. Four weeks after the start of therapy, PNF techniques Depression and anxiety to create a greater degree of decline was on display.Key words: Lymphedema, Depression, Anxiety