Turning the pink cloud grey: Dampening of positive affect predicts postpartum depressive symptoms

Objective

Maladaptive response styles to negative affect have been shown to be associated with prospective (postpartum) depression. Whether maladaptive styles to positive affect are also critically involved is understudied, even though anhedonia (a correlate of low positive affectivity) is a cardinal symptom of depression. The present study is the first to investigate the predictive value of cognitive response styles to both negative (depressive rumination) and positive affect (dampening) for postpartum depressive symptoms.

Methods

During the third trimester of pregnancy, 210 women completed self-report instruments assessing depression (symptom severity and current and/or past episodes) and scales gauging the presence of depressive rumination and dampening. Of these women, 187 were retained for postpartum follow-up, with depressive symptoms being reassessed at 12 (n = 171) and 24 (n = 176) weeks after delivery.

Results

Regression analyses showed that higher levels of dampening of positive affect during pregnancy predicted higher levels of depressive symptoms at 12 and 24 weeks postpartum, irrespective of initial symptom severity, past history of depression and levels of rumination to negative affect. Prepartum trait levels of rumination, however, did not predict postpartum symptomatology when controlled for baseline symptoms and history of major depressive episode(s).

Conclusions

The results of this investigation suggest that the way women cognitively respond to positive affect contributes perhaps even more to the development of postpartum depression than maladaptive response styles to negative affect.     

The cyclical nature of depressed mood and future risk: Depression,rumination, and deficits in emotional clarity in adolescent girls

Deficits in emotional clarity, the understanding and awareness of one's own emotions and the ability to label them appropriately, are associated with increased depressive symptoms. Surprisingly, few studies have examined factors associated with reduction in emotional clarity for adolescents, such as depressed mood and ruminative response styles. The present study examined rumination as a potential mediator of the relationship between depressive symptoms and changes in emotional clarity, focusing on sex differences. Participants included 223 adolescents (51.60% female, Mean age = 12.39). Controlling for baseline levels of emotional clarity, initial depressive symptoms predicted decreases in emotional clarity. Further, rumination prospectively mediated the relationship between baseline depressive symptoms and follow-up emotional clarity for girls, but not boys. Findings suggest that depressive symptoms may increase girls' tendencies to engage in repetitive, negative thinking, which may reduce the ability to understand and label emotions, a potentially cyclical process that confers vulnerability to future depression.     

Gender Differences in Internet Addiction Associated with Psychological Health Indicators Among Adolescents Using a National Web-based Survey

Internet addiction, especially its prevalence among adolescents and its predictors, has been the focus of much research. Few studies have investigated gender differences in the relationship between Internet addiction and psychological health among adolescents. The present study investigated gender differences in Internet addiction associated with self-rated health, subjective happiness, and depressive symptoms among Korean adolescents aged 12 to 18 years using a nationally representative dataset. Data from 56,086 students (28,712 boys and 27,374 girls) from 400 middle schools and 400 high schools were analyzed. We found that 2.8 % of the students (3.6 % boys and 1.9 % girls) were addicted users, and the prevalence of Internet addiction was higher in boys than in girls. In multiple logistic regression analysis, three psychological health indicators including poor self-rated health, subjective unhappiness, and depressive symptoms were significantly related with Internet addiction in boys and girls. Girls with emotional difficulties such as subjective unhappiness or depressive symptoms had much higher risks of Internet addiction than did boys with similar problems. Further attention should be given to developing Internet addiction prevention and intervention programs that are tailored to fit boys’ and girls’ different needs.     

Daily life with depressive symptoms: Gender differences in adolescents' everyday emotional experiences

Depression is a prevalent and debilitating illness facing many adolescents, especially adolescent girls, whose risk for this disorder is approximately twice that of boys. Many studies have identified mechanisms that place girls at higher risk for depression during adolescence. Few, however, have examined differences in the everyday emotional experiences of boys and girls with varying levels of depressive symptoms. Using the Experience Sampling Method, this study investigated the roles of gender and depressive symptomatology in the emotional experiences of a community sample of youth (11–18 year-olds) from the Sloan 500 Family Study. Females with higher levels of depressive symptoms were more likely than females with fewer depressive symptoms and all males to experience strong negative emotions and to attribute the cause of these emotions to other people. These results suggest that emotional reactivity in interpersonal contexts is especially important to understand gender differences in the daily experience of depressive symptoms.     

Toward understanding the role of body dissatisfaction in the gender differences in depressive symptoms and disordered eating: A longitudinal study during adolescence

This study was aimed at examining whether body dissatisfaction in early adolescence contributes to the development of gender differences in depressive symptoms and disordered eating across early to mid-adolescence, testing both a mediation hypothesis (higher levels of body dissatisfaction in girls, provided body dissatisfaction is a predictor of psychopathology beyond the effect of gender) and a moderation hypothesis (more detrimental effect of body dissatisfaction in girls). A community-based sample initially comprising 882 (49.55% female) adolescents (M_age = 12.85) was followed-up after 2 and 4 years. Multilevel models were used to analyze the data. Results supported the mediation hypothesis for depressive symptoms and disordered eating, and the moderation hypothesis for disordered eating. Whereas gender differences in depressive symptoms may be simply linked to dissimilar levels of body dissatisfaction in girls and boys, gender differences in disordered eating may arise from both dissimilar levels and effects of body dissatisfaction for each gender.     

The prevalence of transitional object use in adolescence: is there a connection between the existence of a transitional object and depressive symptoms?

Objective  The purpose of the study was to investigate the prevalence of the use of a transitional object (TO) in adolescence and its connection with depressive symptoms and mental distress in youth by gender. Method  The study group consisted of 1,054 adolescents (465 boys, 589 girls) from normal comprehensive schools in Turku, a Finnish town with approximately 175,000 inhabitants. The mean age of both gender groups was 14.5 years (SD 0.5); respondents came from all social classes. Background and TO information was collected with questionnaires. Depressive symptoms and mental distress were explored by the children’s depression inventory (CDI) and its subscales: low self-confidence, anhedonia and sadness. Results  Of all respondents, 29% (n = 285) had a TO: 37% of girls and 18% of boys. The difference between genders was statistically significant. There was also a statistically significant gender difference in the character of the TO reported: 72 % of girls with a TO had a soft toy, whereas 49% of boys with a TO used hard objects, such as pens, hard toys or books. TO-users showed more depressive symptoms than non-users, but the difference was not statistically significant (P = 0.053). Significant differences were found in the CDI subscales: TO-users had more sadness than non-users and girls using a TO showed more sadness than non-using girls. TO-using boys did not differ from non-using boys with regard to sadness or the other CDI-subscales. Conclusions  The use of a TO seems to be common in adolescence. Adolescents with more depressive symptoms more often used a TO. The sadness of girls using TOs requires attention.     

Symptomatic expression of depression among Jewish adolescents: effects of gender and age

BACKGROUND: Depression symptomatology was assessed with the Beck Depression Inventory (BDI) in a sample of Jewish adolescents, in order to compare the frequency and severity of depression with non-Jewish adolescents as well as examine gender difference of the expression of depressive symptomatology. METHOD: Subjects comprised 475 students from Jewish private schools, aged 13-17 years, who were compared with an age-matched non-Jewish sample (n=899). Kendall's definition was adopted to classify these adolescents according to level of depressive symptoms. The frequency of depression was calculated for ethnicity, gender and age strata. Discriminant analysis and principal component analysis were performed to assess the importance of depression-specific and non-specific items, along with the factor structure of the BDI, respectively. RESULTS: The overall mean score on the BDI in the Jewish and the non-Jewish sample was 9.0 (SD=6.4) and 8.6 (SD=7.2), respectively. Jewish girls and boys had comparable mean BDI scores, contrasting with non-Jewish sample, where girls complained more of depressive symptoms than boys (p<0.001). The frequency of depression, adopting a BDI cutoff of 20, was 5.1% for the Jewish sample and 6.3% for the non-Jewish sample. The frequency of depression for Jewish girls and boys was 5.5% (SE=1.4) and 4.6% (SE=1.5), respectively. On the other hand, the frequency of depression for non-Jewish girls and boys was 8.4% (SE=1.2) and 4.0% (SE=1.0), respectively. The female/male ratio of frequency of BDI-depression was 1.2 in the Jewish sample, but non-Jewish girls were twice (2.1) as likely to report depression as boys. Discriminant analysis showed that the BDI highly discriminates depressive symptomatology among Jewish adolescents, and measured specific aspects of depression. Factor analysis revealed two meaningful factors for the total sample and each gender (cognitive-affective dimension and somatic dimension), evidencing a difference between Jewish boys and Jewish girls in the symptomatic expression of depression akin to non-Jewish counterparts. CONCLUSIONS: Ethnic-cultural factor might play a role in the frequency, severity and symptomatic expression of depressive symptoms in Jewish adolescents. The lack of gender effect on depression, which might persist from adolescence to adulthood among Jewish people, should be investigated in prospective studies.     

Disrupted amygdala-prefrontal connectivity during emotion regulation links stress-reactive rumination and adolescent depressive symptoms

Rumination in response to stress (stress-reactive rumination) has been linked to higher levels of depressive symptoms in adolescents. However, no work to date has examined the neural mechanisms connecting stress-reactive rumination and adolescent depressive symptoms. The present work attempted to bridge this gap through an fMRI study of 41 adolescent girls (M_age = 15.42, SD = 0.33) – a population in whom elevated levels of depressive symptoms, rumination, and social stress sensitivity are displayed. During the scan, participants completed two tasks: an emotion regulation task and a social stress task. Using psychophysiological interaction (PPI) analyses, we found that positive functional connectivity between the amygdala and ventrolateral prefrontal cortex (VLPFC) during the emotion regulation task mediated the association between stress-reactive rumination and depressive symptoms. These results suggest that stress-reactive rumination may interfere with the expression and development of neural connectivity patterns associated with effective emotion regulation, which may contribute, in turn, to heightened depressive symptoms.     

Sensitivity to the depressogenic effect of stress and HPA-axis reactivity in adolescence: a review of gender differences

Adolescence is characterized by major biological, psychological, and social challenges, as well as by an increase in depression rates. This review focuses on the association between stressful experiences and depression in adolescence, and the possible role of the hypothalamus-pituitary-adrenal cortex (HPA-)axis in this link. Adolescent girls have a higher probability to develop depressive symptoms than adolescent boys and preadolescents. Increasing evidence indicates that girls’ higher risk of depression is partly brought about by an increased sensitivity for stressful life events, particularly interpersonal stressors, which are highly prevalent in adolescent girls. Genetic risk factors for depression, as well as those for stress sensitivity, are often expressed differently in girls and boys. Also environmental adversity tends to affect girls’ stress responses more than those of boys. These gender-specific association patterns have been reported for both sensitivity to stressful life events and HPA-axis responses to social stress. Together, the findings suggest that girls are more malleable than boys in response to internal and external influences. This postulated greater malleability may be adaptive in many circumstances, but also brings along risk, such as an increased probability of depression.     

The relationship of early risk and current mediators to depressive symptomatology in adolescence

In an ongoing 10-year longitudinal study in a lower-middle-class community, 21% of 378 fifteen-year-olds studied through interviews and questionnaires reported high levels of depressive symptoms on the Children's Depression Inventory. Girls were twice as likely to express depressive symptoms as boys. Early risk factors for high levels of depressive symptomatology included serious preschool illness, anxiety expressed at age 9, and death of a parent for girls but not boys. Mediators of high depressive symptoms at adolescence consisted of family cohesiveness and satisfactory social supports as well as adolescents' positive self-perceptions of popularity, attractiveness, and intellectual competence.     

Gender and the course of major depressive disorder through adolescence in clinically referred youngsters

OBJECTIVES: To determine whether there are gender differences among psychiatrically referred young patients in the presenting features and subsequent course of major depressive disorder (MDD) through adolescence. METHOD: The subjects were 92 participants in a longitudinal follow-up study that included repeated standardized psychiatric evaluations. Gender effects were examined on features of MDD as patients progressed from late childhood (mean age 11 years) to late adolescence (mean age 17 years). RESULTS: Salient features of MDD did not differ for girls versus boys, including age at MDD onset, recovery from the index episode, risk of a new episode, and rates of various comorbid disorders in the index and recurrent episodes. Rates of selected symptoms and severity of the depressive syndrome also were comparable for boys and girls throughout their development. CONCLUSIONS: Gender differences have been documented in epidemiological and community samples with respect to rates and correlates of depressed mood and some features of depressive disorders. However, the study of gender differences among clinically referred depressed youths has only recently gained momentum. The present findings complement existing reports suggesting a lack of compelling gender effects on salient presenting features and adolescent outcomes of MDD in clinically referred youths. Additional work is needed to determine whether gender effects are detectable on other clinical parameters of MDD during adolescence or further along in development.     

Beck's Depression Inventory as a screening instrument for adolescent depression in Sweden: gender differences

Beck's Depression Inventory was administered in a study of all students aged 16–17 years in the first year of high school in a Swedish town, and was completed by 93% of them (n=2270). Cronbach's reliability coefficient alpha was 0.89, and there were strong correlations between item scores and total scores. A diagnostic interview focused on depressive diagnosis during the last year was conducted with 88% (n=199) of all students with high scores (≥16), and with the same number of controls with low scores. A depressive diagnosis was confirmed in 73% of high scorers and 13% of low scorers. The questionnaire performed better with girls than with boys. The mean score was significantly higher for girls, and the proposed limit for moderate depression (a score of 16) was reached by 14.2% of girls and 4.8% of boys. All symptoms were significantly more frequent and more severe in girls. It was found that 20% of girls and 6% of boys reported suicidal ideation. In a factor analysis the strongest factor that emerged differed between the sexes. For boys it included sadness, crying and suicidal ideation, and for girls it included failure, guilt, self-dislike and feeling unattractive, combined with suicidal ideation. The gender differences are discussed.     

Developmental trajectory of purpose identification during adolescence: Links to life satisfaction and depressive symptoms

IntroductionWhereas evidence has shown that a sense of purpose is linked to optimal adjustment, longitudinal work investigating the development of purpose identification as well as its effect on psychological functioning among non-Western samples during adolescence is needed.MethodsThree hundred and eighty-seven senior high school students (253 female, 65.37%; mean age = 15.76 years at the first investigation) from Taiwan completed surveys four times beginning in the fall of tenth grade and ending in the spring of eleventh grade with a six-month interval. Using self-ratings, purpose identification was evaluated in all four assessments and psychological functioning was examined through life satisfaction and depressive symptoms in the first and the last survey.ResultsGrowth curve analyses revealed an increased slope in purpose identification over the first two years of high school, and such a trajectory was similar across boys and girls. Additionally, increases in purpose identification predicted enhanced life satisfaction and reduced depressive symptoms among both boys and girls. There was only one gender difference: The negative association between purpose identification trajectory and depressive symptoms was stronger for girls than for boys.ConclusionsThere is an increase in the development of identified purpose during middle adolescence among high school students in Taiwan. Such change not only promotes life satisfaction in adolescents but is also preventive of adolescent depression. As such, the current findings highlight the significance for adolescents to discover and commit to a purpose.     

Associations between depressive symptoms and obesity during puberty

BACKGROUND: Adolescent depression has been shown to be associated with later development of obesity. The purpose of this study was to examine the association between depressive symptoms and obesity with progressive pubertal development. METHODS: We conducted an analysis of the association between depressive symptoms and obesity using data from a cross-sectional study of 3101 youth aged 11-17 years. Logistic regression analyses were used to control for maternal education level, race and age. Analyses were stratified by pubertal status and sex to examine how the relationship between depressive symptoms and obesity varies with pubertal development. RESULTS: Depressive symptoms increased with pubertal development for both boys and girls, but the increase was larger for girls. Obesity prevalence was similar for all categories of pubertal development in boys and girls. After controlling for age, pubertal development, parental education and race, an association was noted between depressive symptoms and obesity among both males and females. Youth above the 90th percentile in the depressive symptom score had two times the odds of being obese [males: odds ratio (OR)=1.95, 95% confidence interval (95% CI)=1.19-3.18; females: OR=2.17, 95% CI=1.25-3.77]. With the exception of males in late puberty (OR=0.91, 95% CI=0.29-2.87), the magnitude of this association between depressive symptoms and obesity was similar for all levels of pubertal development, with no apparent increase in later puberty among girls. CONCLUSION: Depressive symptoms and obesity were associated during adolescence, and this association did not increase with advancing pubertal development.     

Adolescent vulnerability and the distress of rejection: Associations of adjustment problems and gender with control,emotions, and coping

We examined adjustment problems as risks for patterns of emotions, appraisals, and coping with rejection, and explored whether these processes could account for sex (boy/girl) differences in coping. Young adolescents (N = 669, grades 6–8) completed questionnaires, which assessed responses to peer rejection threat with two short scenarios. Using structural equation modeling to test a multivariate process model, adolescents with heightened social anxiety had the most maladaptive responses to rejection threat, including elevated emotional reactions, more self-blame, and coping using more social isolation, rumination and opposition. Adolescents reporting more depressive symptoms felt less control and anticipated using less adaptive coping (less support seeking, distraction, and negotiation), whereas aggressive adolescents responded with more anger and coped via opposition. Moreover, as anticipated, sex differences in coping, symptoms, emotions, and appraisals were found. However, coping differences between boys and girls were mostly nonsignificant after accounting for symptoms, aggression, emotional reactions, and appraisals.     

Sexual abuse and suicidal behavior: a model constructed from a large community sample of adolescents

OBJECTIVE: To investigate relationships between self-reported sexual abuse, depression, hopelessness, and suicidality in a community sample of adolescents. METHOD: In 1995, students (mean age 13 years) from 27 high schools in Australia (n = 2,603) completed a questionnaire including measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale), hopelessness, sexual abuse, and suicidality. Data analysis included logistic regression. RESULTS: Sexual abuse is associated with suicidality, both directly and indirectly through hopelessness and depressive symptoms in the model developed. High suicide risk (behavior exceeding thoughts such as plans and threats, or deliberate self-injury) is strongly correlated with suicide attempts (odds ratio 28.8, 95% CI 16-52, p <.001). Hopelessness is associated with high suicide risk only, whereas depressive symptoms are associated with high suicide risk and attempts. Hopelessness is more strongly associated with sexual abuse in boys than girls. Depressive symptoms are more strongly associated with high suicide risk in girls than boys. Controlling for other variables, sexual abuse is independently associated with suicide attempts in girls but not boys. CONCLUSIONS: Clinical assessment should consider gender differences in relationships between sexual abuse, depressive symptoms, hopelessness, and suicidality. Sexually abused girls may be at increased risk of attempting suicide, independent of other psychopathology.     

Components of interference control predict depressive symptoms and rumination cross-sectionally and at six months follow-up

Recent research has shown that depression is characterized by difficulties inhibiting irrelevant emotional material and that these difficulties are linked to rumination. The present study examined the relation among tasks that assess different aspects of interference control, depressive symptoms, and rumination, cross-sectionally and in a 6-months follow-up. 111 participants completed an emotional flanker task to assess individual differences in resolving interference from simultaneously presented irrelevant stimuli. In addition, participants completed two negative affective priming tasks using word and face stimuli to assess difficulty controlling interference from internal representations of previously rejected material. Six months after the initial session, depressive symptoms and rumination were re-assessed. Depressive symptoms at time 1 were related to individual differences in negative priming for verbal as well as pictorial material, but not to individual differences in interference resolution from simultaneously presented external stimuli in the flanker task. Individual differences in negative priming at time 1 further predicted depressive symptoms and rumination at time 2. These results suggest that depressive symptoms are related to impaired interference control for verbal and pictorial information and provide first evidence that individual differences in interference control predict the maintenance of depressive symptoms and rumination over a period of six months.     

Changes in psychiatric problems and service use among 8-year-old children: a 16-year population-based time-trend study

OBJECTIVE: To study differences in children's psychiatric symptoms and child mental health service use at three time points: 1989, 1999, and 2005. MethoD: Three cross-sectional representative samples of 8-year-old children were compared from southern Finland. The sampling, procedure, and methods were similar at all three time points. Information was gathered from parents and teachers using Rutter questionnaires and other related determinants of service use and from children using the Children's Depression Inventory. The participation rate at the three time points was 96% in 1989, 86% in 1999, and 84% in 2005. RESULTS: Overall, parent and teacher reports of children's problems did not show a significant increase during the 16-year period. Parent reports of boys' conduct symptoms decreased from 1989 to 1999. However, self-reported depressive symptoms among girls increased from 1989 to 2005. Low parental education level, broken family, and negative life events were associated with depressive symptoms among girls. Although 4% of boys and 1% of girls had used child mental health services in 1989, the respective figures in 2005 were 12% and 4%. The majority of children who were screen positive on either parent or teacher ratings of emotional and behavioral problems using Rutter scales had received some educational support from school in 2005. CONCLUSIONS: Reports of depressive symptoms increased among girls, and this finding merits further studies. Use of services has continuously increased. School services play an important role in providing support and early detection of children who need to be referred to child mental health services.     

Perceived Competence and Depressive Symptoms Among Adolescents: The Moderating Role of Attributional Style

This longitudinal study examined the interactive effects of depressive attributional style and multiple domains of perceived competence on depressive symptoms among 431 adolescents. Our structural equation modeling with latent factor interactions indicated that (1) for girls with a higher depressive attributional style, lower perceived competence in physical appearance was predictive of depressive symptoms over a 2.5 year period, and (2) regardless of gender, among adolescents with a higher depressive attributional style, lower athletic competence was predictive of higher depressive symptoms 6 months later, which in turn were related to higher depressive symptoms 2 years later. Significant main effects suggested that lower levels of perceived social acceptance were associated with higher subsequent levels of depressive symptoms but only for boys. These findings have implications for understanding the roles of perceived competence and attributional style in predicting depressive symptoms among adolescent girls and boys.