Impact of comorbid depressive symptoms on neuropsychological performance in obsessive-compulsive disorder.

There is indirect evidence from previous research that several executive disturbances in obsessive-compulsive disorder (OCD) are mediated by comorbid depressive symptoms. For the present study, the authors investigated whether OCD patients with elevated Hamilton Rating Scale for Depression (HRSD; M. Hamilton, 1967) scores would exhibit deficits in tasks sensitive to the medial and dorsolateral frontal cortex as well as other executive tasks. The 36 OCD patients were split along the median according to their HRSD scores and compared with matched control subjects. Patients with high HRSD scores performed significantly worse than control subjects and patients with low HRSD scores on the Wisconsin Card Sorting Test (J. Loong, 1990), the Trail-Making Test (TMT, Part B; R. M. Reitan, 1992), and the TMT difference score. Moreover, patients with high HRSD scores exhibited deficits on a (creative) verbal fluency task. It is suggested that comorbid depressive symptoms may have artificially inflated some executive deficit scores in previous studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental trajectories of adolescents' depressive symptoms: Predictors of change.

in a sample of 240 adolescents assessed annually in Grades 6 through 11, the developmental trajectories of their depressive symptoms were examined using latent factor growth modeling. Growth in mother-reported adolest.ent depressive symptoms was quadratic; growth in adolescent-reported symptoms was linear. In the model with gender and maternal depression, girls reported a greater increase in depressive symptoms over time than boys, and adolescents of mothers with histories of mood disorders had higher initial levels of depressive symptoms than offspring of never-depressed mothers. After gender and maternal depression were controlled, initial levels of negative attributions and stressors significantly predicted initial levels of adolescent- and mother-reported depressive symptoms. Attributional styles that were increasingly negative across time were associated with significantly higher initial levels (mother reported) and increasing growth (adolescent reported) of depressive symptoms. Reciprocal models in which development of depressive symptoms predicted the development of attributions and stress also were examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributional style as a risk marker of genetic effects for adolescent depressive symptoms.

Genetic effects on adolescent depression have been consistently reported, but little is known about mediating pathways from the distal genotype to resultant behavioral symptoms. Identifying intermediate risk markers may provide clues on these pathways. In the present study, longitudinal twin and sibling data were used to address 3 issues pertaining to attributional style as a putative marker of genetic risk for adolescent depression: state independence by assessing predictive effects between attributional style and depressive symptoms, heritability of attributional style at different time points, and genetic links between attributional style and depressive symptoms characterizing concurrent and longitudinal associations. The authors further examined whether these predictive and genetic links varied across levels of stress, age, and gender. Negative attributions preceded, co-occurred with, and followed symptoms. The predictive association between earlier negative attributions and later depressive symptoms did not differ by stress, age, or gender. Attributional style was moderately heritable at both time points. Genetic links with concurrent and prospective depressive symptoms were larger in individuals reporting higher levels of stress, who were older and female. Implications for attributional style as a marker reflecting genetic risks are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prevention of depressive symptoms in children and adolescents: A meta-analytic review.

Research on the prevention of depressive symptoms in children and adolescents was reviewed and synthesized with meta-analysis. When all 30 studies were included, selective prevention programs were found to be more effective than universal programs immediately following intervention. Both selective and indicated prevention programs were more effective than universal programs at follow-up, even when the 2 studies with college students were excluded. Effect sizes for selective and indicated prevention programs tended to be small to moderate, both immediately postintervention and at an average follow-up of 6 months. Most effective interventions are more accurately described as treatment rather than prevention. Suggestions for future research include testing potential moderators (e.g., age, gender, anxiety, parental depression) and mechanisms, designing programs that are developmentally appropriate and gender and culturally sensitive, including longer follow-ups, and using multiple measures and methods to assess both symptoms and diagnoses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spousal similarity in coping and depressive symptoms over 10 years.

Following a baseline sample of 184 married couples over 10 years, the present study develops a broadened conceptualization of linkages in spouses' functioning by examining similarity in coping as well as in depressive symptoms. Consistent with hypotheses, results demonstrated (a) similarity in depressive symptoms within couples across 10 years, (b) similarity in coping within couples over 10 years, and (c) the role of coping similarity in strengthening depressive similarity between spouses. Spousal similarity in coping was evident for a composite measure of percent approach coping as well as for component measures of approach and avoidance coping. The role of coping similarity in strengthening depressive symptom similarity was observed for percent approach coping and for avoidance coping. These findings support social contextual models of psychological adjustment that emphasize the importance of dynamic interdependencies between individuals in close relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of the first onset of a major depressive episode and changes in depressive symptoms across adolescence: Stress and negative cognitions.

This 6-year longitudinal study examined stressors (e.g., interpersonal, achievement), negative cognitions (self-worth, attributions), and their interactions in the prediction of (a) the first onset of a major depressive episode (MDE), and (b) changes in depressive symptoms in adolescents who varied in risk for depression. The sample included 240 adolescents who were first evaluated in Grade 6 (M = 11.86 years old; SD = 0.57; 54.2% female) and then again annually through Grade 12. Stressful life events and depressive diagnoses were assessed with interviews; negative cognitions and depressive symptoms were assessed with self-report questionnaires. Discrete time hazard modeling revealed a significant interaction between interpersonal stressors and negative cognitions, indicating that first onset of an MDE was predicted by high negative cognitions in the context of low interpersonal stress, and by high levels of interpersonal stressors at both high and low levels of negative cognitions. Analyses of achievement stressors indicated significant main effects of stress, negative cognitions, and risk in the prediction of an MDE, but no interactions. With regard to the prediction of depressive symptoms, multilevel modeling revealed a significant interaction between interpersonal stressors and negative cognitions such that among adolescents with more negative cognitions, higher levels of interpersonal stress predicted higher levels of depressive symptoms, whereas at low levels of negative cognitions, the relation between interpersonal stressors and depression was not significant. Risk (i.e., maternal depression history) and sex did not further moderate these interactions. Implications for intervention are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Childhood depressive symptoms and adolescent cigarette use: A six-year longitudinal study controlling for peer relations correlates.

Objective: To examine potential pathways between childhood depressive symptoms and adolescent cigarette use, controlling for potential “third variable” causes. Design: Participants included 250 youth (60% girls) who were in Grades 4 to 6 at study outset and in Grades 10 to 12 (M age = 16.78) at a 6-year follow-up. At Time 1, children completed measures of depressive symptoms, as well as peer nominations of peer acceptance, rejection, and aggressive behavior. Main Outcome Measures: Time 2 measures included adolescents’ own and close friends’ cigarette use, depressive symptoms, and externalizing behaviors; parents also reported on adolescent behaviors. Results: Higher levels of childhood depressive symptoms and aggressive behavior were associated longitudinally with cigarette use in adolescence. After controlling for other associations, higher levels of childhood depressive symptoms also were associated with higher levels of friends’ cigarette use in adolescence and higher levels of adolescent depressive symptoms; each of these adolescent outcomes was concurrently associated with cigarette use. Conclusion: Depressive symptoms in childhood may lead to altered developmental trajectories that either directly or indirectly contribute to adolescent outcomes, including cigarette use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emergence of attributional style and its relation to depressive symptoms.

The development of depressive attributional style (AS) and its role as a cognitive diathesis for depression were examined in children and adolescents (Grades 2-9). In a 4-wave longitudinal study of 3 overlapping age cohorts, AS, negative life events, and depressive symptoms were evaluated every 12 months. Consistency of children's attributions across situations was moderately high at all ages. The cross-sectional structure of AS changed with age, as stability became a more salient aspect of AS than internality and globality. The structure of AS also changed, becoming more traitlike as children grew older. In longitudinal analyses, evidence of a Cognitive Diathesis × Stress interaction did not emerge until Grades 8 and 9, suggesting that AS may not serve as a diathesis for depression at younger ages. Results suggest that attributional models of depression may require modification before they are applied across developmental levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health-related quality of life in head and neck cancer survivors: Impact of pretreatment depressive symptoms.

Objective: Symptoms of depression are common in those with cancer. The authors investigated whether depressive symptoms assessed before the initiation of cancer treatment predicted diminished health-related quality of life (HRQOL) at follow-up. Design: As part of a large, prospective study of oncologic outcomes, 306 patients with head and neck cancer (HNC) were assessed on several clinical and psychosocial characteristics during a pretreatment clinic visit and then at 3- and 12-month follow-up appointments. Main Outcome Measures: Depressive symptomatology was assessed with the Beck Depression Inventory and HNC-specific HRQOL (main outcome measure) was assessed with the Head and Neck Cancer Inventory. Results: Controlling for age, gender, marital status, cancer site, stage of disease, alcohol and tobacco use, comorbidity status, and pretreatment HRQOL, simultaneous multiple regression analyses revealed that depressive symptoms present at study enrollment, before the initiation of cancer treatment, significantly predicted lower HRQOL at 3- and 12-month follow-up assessments across the 4 HNC-specific domains of speech, eating, aesthetics, and social disruption (all ps ≤ .01). Conclusion: Results suggest that depressive symptomatology present near the time of diagnosis can have a significant, deleterious impact on HRQOL over time in HNC survivors. Thus, it may be useful to assess depression at diagnosis to identify individuals at greater risk for poor HRQOL outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Control-related beliefs and depressive symptoms in clinic-referred children and adolscents: Developmental differences and model specificity.

The contingency–competence–control (CCC) model links contingency and competence beliefs to perceived control and, in turn, to depression. However, a developmental perspective suggests that noncontingency may be too abstract a concept to be directly tied to depression before adolescence. We tested the CCC model and this developmental notion, using structural equation modeling, with 360 clinic-referred 8- to 17-year-olds. The CCC model fit the data well for the full sample accounting for 46% of the variance in depression. Separate analyses by age group placed perceived contingency in the best-fit model for adolescents (ages 12–17 years) but not for children (8–11 years). This suggests that abstract cause–effect concepts may have more direct affective impact after the cognitive changes of adolescence (e.g., formal operations) than before. Finally, the CCC model accounted for much more variance in depression than conduct problems, suggesting diagnostic specificity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maladaptive perfectionism as an intervening variable between psychological control and adolescent depressive symptoms: A three-wave longitudinal study.

Maladaptive perfectionism has been postulated as an intervening variable between psychologically controlling parenting and adolescent internalizing problems. Although this hypothesis has been confirmed in a number of cross-sectional studies, it has not yet been examined from a longitudinal perspective. Findings from this 3-wave longitudinal study show that parental psychological control (as indexed by parent and adolescent reports) at age 15 years predicted increased levels of maladaptive perfectionism 1 year later. Maladaptive perfectionism, in turn, predicted increased levels of adolescent depressive symptoms again 1 year later and acted as a significant intervening variable between parental psychological control at Time 1 and depressive symptoms at Time 3. Multigroup analyses show that the model tested was consistent across gender for paternal psychological control but not for maternal psychological control. Suggestions for future research are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult attachment, the transition to parenthood, and depressive symptoms.

Testing a model suggested by J. Bowlby (1988), this study investigated how a personal vulnerability (attachment ambivalence) interacts with perceptions of deficient spousal support before and during a major life stressor (the transition to parenthood) to predict pre-to-postnatal increases in depressive symptoms. Highly ambivalent women who entered parenthood perceiving either less support or greater anger from their husbands experienced pre-to-postnatal increases in depressive symptoms at 6 months postpartum. The associations between these 2 prenatal interaction terms and pre-to-postnatal increases in depressive symptoms were mediated by perceptions of declining spousal support across the transition period. Moreover, for highly ambivalent women, the association between prenatal and postnatal depression scores was mediated by perceptions of the amount of support available from their husbands. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: A growth curve analysis.

Using data from a longitudinal community study (N?=?231), the authors tested whether body-image and eating disturbances might partially explain the increase in depression observed in adolescent girls. Initial pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, but not body mass, predicted subsequent increases in depressive symptoms, as did increases in these risk factors over the study. There was also prospective support for each of the hypothesized mediational relations linking these risk factors to increases in depressive symptoms. Effects remained significant when other established gender-nonspecific risk factors for depression (social support and emotionality) were statistically controlled. Results provide support for the assertion that body-image and eating disturbances, operating above and beyond gender-nonspecific risk factors, contribute to the elevated depression in adolescent girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevention of depressive symptoms in adolescents: A randomized trial of cognitive-behavioral and interpersonal prevention programs.

This study evaluated the efficacy of 2 programs for preventing depressive symptoms in adolescents. Participants were 380 high school students randomly assigned to a cognitive-behavioral program (CB), an interpersonal psychotherapy-adolescent skills training program (IPT-AST), or a no-intervention control. The interventions involved eight 90-min weekly sessions run in small groups during wellness classes. At postintervention, students in both the CB and IPT-AST groups reported significantly lower levels of depressive symptoms than did those in the no-intervention group, controlling for baseline depression scores; the 2 intervention groups did not differ significantly from each other. The effect sizes, using Cohen's d, for the CB intervention and the IPT-AST intervention were 0.37 and 0.26, respectively. Differences between control and intervention groups were largest for adolescents with high levels of depressive symptoms at baseline. For a high-risk subgroup, defined as having scored in the top 25th percentile on the baseline depression measure, the effect sizes for the CB and the IPT-AST interventions were 0.89 and 0.84, respectively. For the whole sample, sociotropy and achievement orientation moderated the effect of the interventions. Intervention effects were short term and were not maintained at 6-month follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School-based prevention of depressive symptoms: A randomized controlled study of the effectiveness and specificity of the penn resiliency program.

The authors investigated the effectiveness and specificity of the Penn Resiliency Program (PRP; J. E. Gillham, L. H. Jaycox, K. J. Reivich, M. E. P. Seligman, & T. Silver, 1990), a cognitive-behavioral depression prevention program. Children (N = 697) from 3 middle schools were randomly assigned to PRP, Control (CON), or the Penn Enhancement Program (PEP; K. J. Reivich, 1996; A. J. Shatté, 1997), an alternate intervention that controls for nonspecific intervention ingredients. Children's depressive symptoms were assessed through 3 years of follow-up. There was no intervention effect on average levels of depressive symptoms in the full sample. Findings varied by school. In 2 schools, PRP significantly reduced depressive symptoms across the follow-up relative to both CON and PEP. In the 3rd school, PRP did not prevent depressive symptoms. The authors discuss the findings in relation to previous research on PRP and the dissemination of prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolutionary significance of depressive symptoms: Different adverse situations lead to different depressive symptom patterns.

Although much depression may be dysfunctional, the capacity to experience normal depressive symptoms in response to certain adverse situations appears to have been shaped by natural selection. If this is true, then different kinds of situations may evoke different patterns of depressive symptoms that are well suited to solving the adaptive challenges specific to each situation. The authors called this the situation-symptom congruence hypothesis. They tested this hypothesis by asking 445 participants to identify depressive symptoms that followed a recent adverse situation. Guilt, rumination, fatigue, and pessimism were prominent following failed efforts; crying, sadness, and desire for social support were prominent following social losses. These significant differences were replicated in an experiment in which 113 students were randomly assigned to visualize a major failure or the death of a loved one. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shame, guilt, and depressive symptoms: A meta-analytic review.

Recent theoretical and empirical work has facilitated the drawing of sharp conceptual distinctions between shame and guilt. A clear view of these distinctions has permitted development of a research literature aimed at evaluating the differential associations of shame and guilt with depressive symptoms. This study quantitatively summarized the magnitude of associations of shame and guilt with depressive symptoms. Two hundred forty-two effect sizes were obtained from 108 studies employing 22,411 participants. Shame showed significantly stronger associations with depressive symptoms (r = .43) than guilt (r = .28). However, the association of shame and depressive symptoms was statistically indistinguishable from the associations of 2 maladaptive variants of guilt and depressive symptoms (contextual-maladaptive guilt, involving exaggerated responsibility for uncontrollable events, r = .39; generalized guilt, involving “free-floating” guilt divorced from specific contexts, r = .42). Other factors also moderated the effects. External shame, which involves negative views of self as seen through the eyes of others, was associated with larger effect sizes (r = .56) than internal shame (r = .42), which involves negative views of self as seen through one's own eyes. Depressive symptom measures that invoked the term guilt yielded stronger associations between guilt and depressive symptoms (r = .33) than depressive symptom measures that did not (r = .21). Age, sex, and ethnicity (proportion of Whites to Asians) did not moderate the effects. Although these correlational data are ambiguous with respect to their causal interpretation, results suggest that shame should figure more prominently in understandings of the emotional underpinnings of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of successful dietary restriction to change in bulimic symptoms: A prospective study of adolescent girls.

Recent experimental evidence that dietary restriction results in decreased bulimic and depressive symptoms seems inconsistent with findings from prospective studies and etiologic theory. However, because the dieting manipulated in these experiments may be unrepresentative of real-world weight loss dieting, the authors tested whether successful dietary restriction was associated with decreases in these outcomes by using longitudinal data from a school-based study of 496 adolescent girls. Moderately overweight participants who evidenced successful dietary restriction showed significantly greater decreases in bulimic symptoms than weight-matched participants who did not show successful dietary restriction; however, there were no effects for depressive symptoms. In conjunction with past experimental findings, results seem to imply that successful dietary restriction curbs bulimic symptoms, suggesting that current etiologic models may need revision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural considerations in adolescent suicide prevention and psychosocial treatment.

Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community- based interventions are discussed, along with future opportunities for research in intervention development and evaluation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship functioning moderates the association between depressive symptoms and life stressors.

Data from 172 newlywed couples were collected over the first 4 years of marriage to test how behaviors demonstrated during marital interactions moderate associations between depressive symptoms and subsequent life stressors. Depressive symptoms and behaviors coded from problem-solving and social support interactions were analyzed as predictors of nonmarital stressors that were interpersonal and dependent on the participant's actions. Behavioral codes were found to moderate 3 of 16 symptom-to-life event associations for husbands. Husbands' reports of more depressive symptoms predicted greater levels of stress when husbands' positive affect and hard negative affect during problem-solving were relatively infrequent and when wives made frequent displays of positive behaviors during husbands' support topics. These effects remained after controlling for marital satisfaction. For wives, behavioral moderators did not interact with depressive symptoms to predict changes in stress, but marital satisfaction consistently interacted with depressive symptoms to predict future stressors beyond interpersonal behaviors. Specifically, for wives, stress generation was more evident when relationship satisfaction was low than when it was high. Our results, though different for men and women, suggest that relationship functioning can alter associations between depressive symptoms and life stress in the early years of marriage. (PsycINFO Database Record (c) 2011 APA, all rights reserved)