Physical health problems, depressive mood, and cortisol secretion in old age: Buffer effects of health engagement control strategies.

Objective: This study examined the protective role played by control behaviors aimed at overcoming physical health problems (health engagement control strategies; HECS) in the associations between older adults' physical health problems, depressive mood, and diurnal cortisol secretion. It was expected that adaptive levels of HECS would buffer the adverse effects of physical health problems on depressive mood and diurnal cortisol secretion. Design and Measures: Physical health problems and HECS were measured in a cross-sectional sample of 215 community-dwelling older adults. In addition, participants' depressive mood and patterns of diurnal cortisol secretion were assessed across 3 days. Results: The findings demonstrate that physical health problems predicted high levels of depressive mood and diurnal cortisol secretion, but only among older adults who reported low levels of HECS (and not among older adults who reported high levels of HECS). Moreover, depressive mood completely mediated the buffering effect of HECS on the association between physical health problems and cortisol secretion. Conclusion: The results suggest that adaptive levels of HECS represent a psychological mechanism that can protect older adults from experiencing the adverse emotional and biological consequences of physical health problems. (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)     

Effects of Pain on Functioning and Well-Being in Older Adults With Osteoarthritis of the Knee.

The effects of pain on functioning and well-being were examined in 367 older adults with osteoarthritis (OA) of the knee. The relationship of OA-related pain to depressive symptoms and perceived health was hypothesized to be direct as well as mediated by physical and social functioning. Results showed that OA-related pain was related to poorer physical and social functioning, had a direct effect on depressive symptoms, and direct and indirect effects on perceived health. Lower social functioning was related to more depressive symptoms, and both lower social and physical functioning predicted worse perceived health. Thus, distinguishing between physical and social functioning when examining the costs of OA-related pain is useful. Moreover, existing pain-psychological well-being models can be generalized to perceived health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of depressive symptoms on health behavior practices among older adults with vision loss.

Objective: The authors examined the interface between visual impairment and depressive symptoms on health behaviors, self-care, and social participation among adults ages 65 and older. Method: The authors analyzed data from the 1997–2004 National Health Interview Survey on visual impairment and depressive symptoms for 49,278 adults ages 65 and older, comparing visually impaired adults (n = 8,787) with and without depressive symptoms with a reference group of adults with neither condition (n = 3,136) for outcome measures: physical health, health behaviors, and difficulties with self-care and social participation. Results: Adults with visual impairment and severe depressive symptoms were more likely than adults with neither condition to smoke (14.9%, adjusted odds ratio [AOR] = 1.6), be obese (28.2%, AOR = 1.9), be physically inactive (80.5%, AOR = 3.0), have fair–poor health (76.0%, AOR = 26.5), and have difficulties with self-care (27.9%, AOR = 11.8) and social participation (52.1%, AOR = 10.9). Discussion and Conclusions: Older visually impaired adults with depressive symptoms are vulnerable to health decline and further disablement without timely interventions that target smoking cessation, healthy eating, and increased physical activity. (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)     

Neuroticism and depressive symptoms among spouse caregivers: Do health behaviors mediate this relationship?

This study examined the mediating role of health behaviors in the relationship between neuroticism and depressive symptoms among spouse caregivers. Path analysis was used to test a model of the caregiver stress process among 233 caregivers of people with dementia. Results indicate that neuroticism has a significant direct effect on depressive symptoms and also indirectly influences depressive symptoms through health behaviors and perceived stress. When individual health behaviors were examined in the path model, only physical activity served a significant mediating role. These findings suggest that neuroticism may lead to depressive symptoms among caregivers partly through declines in physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters.

Objective: This study investigated the association between mindfulness, other resilience resources, and several measures of health in 124 urban firefighters. Method: Participants completed health measures of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, physical symptoms, and alcohol problems and measures of resilience resources including mindfulness, optimism, personal mastery, and social support. The Mindful Awareness and Attention Scale (MAAS; Brown & Ryan, 2003) was used to assess mindfulness. Participants also completed measures of firefighter stress, number of calls, and years as a firefighter as control variables. Hierarchical multiple regressions were conducted with the health measures as the dependent variables with 3 levels of independent variables: (a) demographic characteristics, (b) firefighter variables, and (c) resilience resources. Results: The results showed that mindfulness was associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems when controlling for the other study variables. Personal mastery and social support were also related to fewer depressive symptoms, firefighter stress was related to more PTSD symptoms and alcohol problems, and years as a firefighter were related to fewer alcohol problems. Conclusions: Mindfulness may be important to consider and include in models of stress, coping, and resilience in firefighters. Future studies should examine the prospective relationship between mindfulness and health in firefighters and others in high-stress occupations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The reciprocal relationship between physical activity and depression in older European adults: A prospective cross-lagged panel design using SHARE data.

Objective: The aim of this prospective study was to investigate the reciprocal nature of the physical activity-depressive symptoms relationship in 17,593 older adults from 11 European countries older adults (M age = 64.07, SD = 9.58) across two-year follow-up. Also, gender and age were examined as potential moderators of this relation. Method: A two-wave cross-lagged panel design and latent change score models with structural equation modeling was used to analyze data. Depressive symptoms were measured at baseline (T1) and follow-up (T2) using the EURO-D scale, capturing the two factors of affective suffering and motivation. Physical activity was measured at T1 and T2 as frequency of moderate physical activity and vigorous physical activity. Results: Cross-sectional latent variable analyses revealed that higher levels of physical activity at T1 and T2 were associated with lower levels of affective suffering and motivation at T1 and T2. Physical activity at T1 was significantly associated with affective suffering and motivation at T2. The relations of depressive symptoms at T1 with physical activity at T2 were not significant. However, a cross-lagged model showed best model fit, supporting a reciprocal prospective relationship between physical activity and depressive symptoms in older adults. Latent change in depressive symptoms factors was related to latent change in physical activity indicating complex and dynamic associations across time. Conclusions: Regular physical activity may be a valuable tool in the prevention of future depressive symptoms in older adults, and depressive symptoms may also prevent older adults from engaging in regular physical activity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A Cross-Cultural Investigation of Cognitions and Depressive Symptoms in Adolescents.

Adolescents (N=2,272) from Hong Kong and the United States provided information regarding their depressive symptoms, cognitions (self-efficacy, negative cognitive errors, and hopelessness), and stressful events between 2 surveys 6 months apart. Depressive symptoms and hopelessness were higher, and self-efficacy and negative cognitive errors were lower in Hong Kong than in the United Stales. Cognitions were associated with concurrent depressive symptoms and predicted depressive symptoms 6 months later in both cultures. The "reverse" model was also supported with more variance predicted by depressive symptoms to later cognitions than from cognitions to depressive symptoms. There was some support for the hypothesis that self-efficacy is less salient in collective compared with individualistic cultures. These findings extend cognitive theories of depression to a non-Western culture. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived discrimination, sense of control, and depressive symptoms among Korean American older adults.

This study explored a potential pathway by which perceived discrimination may affect levels of depressive symptoms in a sample of 472 Korean American older adults (Mage = 69.9, SD = 7.04). Building upon previous studies demonstrating that perceived discrimination has negative impacts on mental health, we hypothesized that sense of control would mediate the associations between perceived discrimination and depressive symptoms. Our analyses showed that the effects of perceived discrimination on depressive symptoms were not only direct but also mediated through a lowered sense of control. Finding that sense of control serves as an intervening step between perceived discrimination and mental health may help explicate the psychological mechanisms involved in responses to discriminatory experience and has implications for intervention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships over time between mental health symptoms and transmission risk among persons living with HIV.

Relationships between mental health symptoms (anxiety and depression) or a positive state of mind and behavior associated with HIV transmission (substance use and risky sexual behavior) were explored in a longitudinal study of persons living with HIV (PLH; N = 936) who were participants in a transmission-prevention trial. Bivariate longitudinal regressions were used to estimate the correlations between mental health symptoms and HIV-related transmission acts for 3 time frames: at the baseline interview, over 25 months, and from assessment to assessment. At baseline, mental health symptoms were associated with transmission acts. Elevated levels of mental health symptoms at baseline were associated with decreasing alcohol or marijuana use over 25 months. Over 25 months, an increasingly positive state of mind was associated with decreasing alcohol or marijuana use; an increasingly positive state of mind in the immediate intervention condition and increasing depressive symptoms in the lagged condition were related to increasing risky sexual behavior. Our findings suggest that mental health symptoms precede a decrease in substance use and challenge self-medication theories. Changes in mental health symptoms and sexual behavior occur more in tandem. (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)     

A longitudinal study of children's depressive symptoms, self-perceptions, and cognitive distortions about the self.

This longitudinal study examined how depressive symptoms relate to children's self-perceptions and to estimates of children's cognitive distortions about the self in a nonclinical sample of children who were followed from 4th grade (n=248) through 6th grade (n=227). Report card grades measured children's academic competence, and teachers' ratings of children's level of peer acceptance at school indicated social acceptance. Self-reported depressive symptoms predicted a change in children's negative views of the self. Moreover, the self-perceptions of children who exhibited more symptoms of depression appeared to reflect an underestimation of their actual competence. Children's negative self-perceptions and underestimations about the self were not associated with a subsequent change in depressive symptoms. The implications of the findings for cognitive theories of depression and future research with this population are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dynamic processes in health outcomes among caregivers of patients with spinal cord injuries.

The developmental trajectories of health outcomes in caregivers of patients with spinal cord injuries (SCIs) were studied as a function of caregiver and patient characteristics. Hierarchical linear modeling analysis examined (a) intraindividual developmental patterns of depressive behavior, anxiety, and physical symptoms over the 1st year of the caregiving career and (b) correlates of heterogeneity in the developmental patterns among 62 caregivers of persons with SCIs. Physical symptoms and anxiety were highly interdependent. Anxiety was a salient predictor of initial levels of and the rate of change in physical symptoms of caregivers. Physical symptoms and younger patient age were significantly predictive of initial levels of anxiety. Physical symptoms and positive affect predicted initial levels of depressive behavior among caregivers. Expressive support predicted the rate of change in anxiety and depressive behavior over time. These findings illustrate the value of studying caregiving as a developmental process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of life satisfaction and depressive symptoms in all-cause mortality.

The objective of this study was to investigate whether life satisfaction and depressive symptoms are independent predictors of mortality in a non-Western sample of adults. The sample included 5,131 adults (ages 50–95 at baseline) in Taiwan who participated in the Survey of Health and Living Status of the Near Elderly and Elderly. There were 1,815 deaths recorded over a 10-year period. Higher life satisfaction significantly predicted lower risk of mortality after controlling for age, sex, education, marital status, and health status. Depressive symptoms significantly predicted higher risk of mortality. A significant interaction with age revealed that the protective effect of life satisfaction weakened with age. The results suggest that life satisfaction and depressive symptoms independently predict mortality risk in adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of paternal and maternal depressive symptoms on child internalizing symptoms and asthma disease activity: Mediation by interparental negativity and parenting.

This study tested a hypothesized model of the relationships among parental depressive symptoms, family process (interparental negativity and negative parenting behavior), child internalizing symptoms, and asthma disease activity. A total of 106 children with asthma, aged 7 to 17, participated with their fathers and mothers. Parental depressive symptoms were assessed by self-report. Interparental and parenting behaviors were observed and rated during family discussion tasks. Child internalizing symptoms were assessed by self-report and by clinician interview and rating. Asthma disease activity was assessed according to National Heart, Lung and Blood Institute guidelines. Results of structural equation modeling generally supported interparental negativity and negative parenting behavior as mediators linking parental depressive symptoms and child emotional and physical dysfunction. However, paternal and maternal depressive symptoms play their role through different pathways of negative family process. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Adolescent Girls' Interpersonal Vulnerability to Depressive Symptoms: A Longitudinal Examination of Reassurance-Seeking and Peer Relationships.

A transactional, interpersonal framework involving adolescents' reassurance-seeking and peer experiences may be useful for understanding the emergence of gender differences in depression prevalence during the adolescent transition. Sociometric nominations of peer acceptance/rejection and ratings of friendship quality provided by adolescents and their friends were used to measure peer experiences among 6th-8th-grade adolescents (N = 520) over 3 annual time points. After controlling for age and pubertal development, significant but small prospective effects offered mixed support for hypotheses: (a) depressive symptoms and negative peer relations predicted increasing levels of girls' reassurance-seeking; (b) initial levels of reassurance-seeking and depressive symptoms predicted deteriorating friendship quality among girls and low friendship stability, respectively; and (c) reassurance-seeking combined with poor peer experiences predicted increases in girls' depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative attributional style as a moderator of the link between perfectionism and depressive symptoms: Preliminary evidence for an integrative model.

An integrative model involving perfectionism and negative attributional style as predictors of depressive symptoms was proposed and tested in 222 college students. Beyond the expected additive influences of the 2 predictors in the prediction of dysphoria, negative attributional style was also hypothesized to moderate the link between perfectionism and depressive symptoms. As theorized, results indicated that dimensions of perfectionism (P. Hewitt & G. Flett, 1991b) predicted depressive symptoms (2 months later) and that a negative attributional style added incremental validity to these predictions. Moreover, consistent with the proposed model, the Perfectionism?×?Negative Attributional Style interaction was found to further augment the prediction of depressive symptoms. These findings are taken to offer preliminary support for the proposed model. Some implications for future studies are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms can be useful: Self-regulatory and emotional benefits of dysphoric mood in adolescence.

Propositions derived from evolutionary biology and personality psychology suggest that depressive symptoms may serve adaptive functions by enabling people to adjust to unattainable goals, which in turn promotes quality of life. The authors tested this hypothesis in a longitudinal study of adolescent girls involving 4 waves of data collected over approximately 19 months. The authors expected that high baseline levels of depressive symptoms would facilitate the development of adolescents’ goal adjustment capacities (i.e., goal disengagement capacities and goal reengagement capacities). In addition, the authors expected that improvements in goal adjustment capacities over time would presage lower levels of subsequent depressive symptoms. Data from the first 3 waves produced results demonstrating that baseline levels of depressive symptoms predicted an increase in goal disengagement capacities over time but not in goal reengagement capacities. Moreover, increases in goal disengagement capacities predicted a reduction in subsequent depressive symptoms. The findings suggest that depressive symptomatology may serve adaptive functions by facilitating the development of goal disengagement capacities in adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)