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)     

Are life stressors associated with marital violence?

The current study examined the link between different conceptualisations of life stressors and physical violence against spouses. Life stressors were measured in several different ways to test whether stressor frequencies and perceived impacts, life domains of stressors (i.e., loss, threat), and the nature of stressors (i.e., occupational, interpersonal) are correlates of men's and women's moderate and severe violence. Also explored were potential mediators and moderators of the stress-violence relationship. Community and clinic couples participated in this study. Results indicated that occupational and loss stressors were associated with men's violence whereas a wider array of stressors were associated with women's violence. In addition, stressors only discriminated between violent and nonviolent men whereas some stressors also discriminated between moderately and severely violent women. Depressive symptoms moderated the association between stressor impact and violence such that impact and women's violence were significantly correlated for women with elevated depressive symptoms. Results are discussed in light of theoretical and clinical implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal thoughts of women with HIV infection: Effect of stressors and moderating effects of family cohesion.

Associations of suicidality with sociodemographic characteristics, number of HIV-related symptoms, perceived stigma, depressive mood, emotional distress, and family cohesion were investigated in a sample of women with HIV infection. Of 214 women, 56% reported neither suicidal thoughts nor attempts since learning they were HIV infected, 31% reported thoughts but no attempts, and 14% reported both thoughts and attempts. Women who reported suicidal thoughts reported more HIV-related symptoms, more perceived stigma, greater depressive mood, more emotional distress, and less family cohesion than did women who reported no suicidal thoughts; women who reported both thoughts and attempts did not differ from women who reported only thoughts on these variables. Family cohesion moderated the effect of symptoms on thoughts. Those who reported suicidal thoughts reported more HIV-related symptoms only when family cohesion was relatively low. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: Results from a prospective study of bereaved gay men.

Objective: Minority stress is the most frequently hypothesized risk factor for the increased rates of adverse behavioral and mental health outcomes among sexual minorities. However, there is a paucity of longitudinal research addressing this hypothesis. Design: Prospective, community-based cohort of 74 bereaved gay men. Participants were assessed before the partner or close friend died of AIDS and then at 1, 6, 13, and 18 months postloss. Main Outcome Measures: HIV risk behavior (unprotected anal intercourse), substance use and abuse symptoms, and depressive symptoms. Results: Hierarchical Linear Modeling analyses revealed that changes in internalized homophobia, discrimination experiences, and expectations of rejection were differentially associated with HIV risk behavior, substance use, and depressive symptoms, respectively. In contrast to the significant effects of minority stress, bereavement-related stressors (e.g., length of partner illness, quality of relationship with deceased) were largely unrelated to these outcomes. Conclusion: The results provide evidence for the predictive validity of minority stress, even in the context of a major life stressor, and suggest the importance of targeting minority stress experiences in HIV and mental health interventions with gay men. Future studies are needed to assess the mechanisms through which minority stress is associated with adverse health outcomes. (PsycINFO Database Record (c) 2010 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)     

Serotonin transporter genotype and depressive symptoms moderate effects of nicotine on spatial working memory.

Smokers may use nicotine to self-medicate for situation-specific or person-specific cognitive or affective deficits. Although evidence suggests that nicotine replacement therapy (NRT), relative to placebo, enhances spatial working memory (SWM) in smoking-abstinent smokers with schizophrenia, the extent to which NRT may be helpful in attenuating abstinence-related SWM in other groups with deficits in SWM is unknown. Depressive symptoms are associated with both tobacco smoking and deficits in SWM. Previous studies have found that smoking abstinence increases depressive affect and depression-related hemispheric asymmetries in brain activation. Although the serotonin neurotransmitter system is closely associated with depression and the effects of nicotine, the authors are not aware of any studies that have evaluated the possible role of individual differences in serotonin transporter (5-HTT) genotype and depressive symptoms as moderators of the effects of NRT on SWM. Thus, the current study assessed the effects of NRT (nicotine patch) on SWM in relation to: (1) depressive traits and (2) 5-HTT genotype. Smoking-deprived habitual smokers (N = 64) completed the dot recall test of SWM during counterbalanced and double-blind nicotine and placebo testing sessions. There was a marginal overall effect of NRT on SWM. More importantly, NRT enhanced SWM in 5-HTT short allele carriers, relative to those with two long alleles, and this enhancement in short-allele carriers was greater for individuals with higher levels of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional Distress in Nonmetropolitan Persons Living With HIV Disease Enrolled in a Telephone-Delivered, Coping Improvement Group Intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association between depressive symptoms and mortality in older women. Study of Osteoporotic Fractures Research Group

BACKGROUND: Major depression is associated with increased mortality, but it is not known whether patients who report depressive symptoms have greater mortality. SUBJECTS AND METHODS: We performed a prospective cohort study of 7518 white women 67 years of age or older who were recruited from population-based listings in Baltimore, Md, Minneapolis, Minn, Portland, Ore, and the Monongahela Valley, Pa. Participants completed the Geriatric Depression Scale (short form) and were considered depressed if they reported 6 or more of 15 possible symptoms of depression. Women were followed up for an average of 6 years. If a participant died, we obtained a copy of the official death certificate and hospital records, if available, and used International Classification of Diseases, Ninth Revision, codes to classify death attributable to cardiovascular, cancer, or noncancer, noncardiovascular cause. RESULTS: Mortality during 7-year follow-up varied from 7% in women with no depressive symptoms to 17% in those with 3 to 5 symptoms to 24% in those with 6 or more symptoms of depression (P<.001). Of 473 women (6.3%) with 6 or more depressive symptoms at baseline, 24% died (111 deaths in 2610 woman-years of follow-up) compared with 11% of women who reported 5 or fewer symptoms of depression (760 deaths in 41 460 woman-years of follow-up) (P<.001). Women with 6 or more depressive symptoms had a 2-fold increased risk of death (age-adjusted hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.75-2.61; P<.001) compared with those who had 5 or fewer depressive symptoms. This association remained strong after adjusting for potential confounding variables, including history of myocardial infarction, stroke, diabetes mellitus, hypertension, chronic obstructive pulmonary disease, smoking, perceived health, and cognitive function (HR, 1.47; 95% CI, 1.14-1.88; P=.003). Depressive symptoms were associated with an increased adjusted risk of death from cardiovascular diseases (HR, 1.8; 95% CI, 1.2-2.5; P= .003), and non-cancer, noncardiovascular diseases (HR, 1.8; 95% CI, 1.2-2.7; P = .01), but were not associated with deaths from cancer (HR, 1.0; 95% CI, 0.6-1.7; P=.93). CONCLUSIONS: Depressive symptoms are a significant risk factor for cardiovascular and noncancer, noncardiovascular mortality but not cancer mortality in older women. Whether depressive symptoms are a marker for, or a cause of, life-threatening conditions remains to be determined.     

Adaptive demands along the HIV disease continuum

Our knowledge of the problems or adaptive demands associated with HIV infection has largely been derived from clinical history taking and qualitative research of persons with AIDS. This study uses a behaviour-analytic approach to systematically describe and quantify the specific adaptive demands encountered by persons with HIV across the disease continuum. Ninety six HIV-infected gay men and 33 seronegative comparison group participants were interviewed in depth. Participants were divided into three groups representing the disease continuum: seronegative, HIV asymptomatic and HIV symptomatic groups. Responses to a Problem Checklist were statistically and content analysed. Distressing emotions, relationship difficulties and HIV-related symptoms were the three most frequently endorsed problems and were also the three most frequently reported problems of most concern. Overall there was a trend for instrumental difficulties to increase with disease progression, whereas emotional and existential problems did not vary as a function of HIV stage. The behaviour-analytic approach to the specification of problems related to HIV infection has implications for both clinical and research endeavours. The specification of problems provided a means for accurately identifying common problems to target and could, therefore, provide the basis for developing suitably matched interventions for use with HIV-infected persons.     

Depression and risk of coronary heart disease in elderly men and women: New Haven EPESE, 1982-1991. Established Populations for the Epidemiologic Studies of the Elderly

BACKGROUND: Results of several recent studies suggest that depression is predictive of incident coronary disease. However, few studies have examined this relationship in the elderly, the age at which most coronary heart disease (CHD) becomes clinically manifest. METHODS AND RESULTS: Data are from the New Haven, Conn, cohort (N = 2812) of the Established Populations for the Epidemiologic Studies of the Elderly project. Baseline information on depressive symptoms and CHD risk factors was collected during an in-person interview in 1982. Nonfatal myocardial infarctions were identified through monitoring of admissions to local hospitals and were validated by medical chart review. Cause of death was obtained from death certificates for all deceased participants. Outcomes were defined as CHD deaths (n = 255) and total incident CHD events (n = 391) between January 1, 1982, and December 31, 1991. There was no association between depressive symptoms and CHD outcomes in men. Among women, depressive symptoms were associated with an age-adjusted relative risk of 1.03 (per unit increase on the symptom scale) for CHD mortality (P=.001) and total CHD incidence (P=.002). These associations were largely unaffected by adjustment for established CHD risk factors but were reduced to nonsignificant levels after additional adjustment for impaired physical function. Additional analysis showed a significant association for depressive symptoms among women who had no physical function impairments or who survived at least 3 years without an event. CONCLUSION: Depressive symptoms may not be independent risk factors for CHD outcomes in elderly populations in general but may increase risk among relatively healthy older women.     

Exercise of young thoroughbred horses increases impact strength of the third metacarpal bone

OBJECTIVE: The aim of this study was to assess the frequency and severity of depressive symptoms, to determine the rate of depressive disorder, to explore possible reasons for the development of depressive symptoms and to examine the effects of depression in a group of human immunodeficiency virus (HIV)-positive patients. METHOD: HIV-positive patients attending an outpatient treatment facility were assessed by the research psychologist and completed a number of questionnaires: the Beck Depression Inventory (BDI); the Life Event Inventory (LEI); the Core Bereavement Item (CBI-17) questionnaire; and the Psychosocial Adjustment to illness Scale (PAIS). Patients scoring > or = 14 on the BDI were seen by the psychiatrist for further assessment, and where appropriate, diagnoses were made according to DSM-III-R criteria. RESULTS: One hundred and ninety-two patients participated in the study; 95 scored > or = 14 on the BDI and one-third of these were found to have a depressive disorder. Factors significantly predictive of a BDI score > or = 14 were: an LEI score > 77; a diagnosis of acquired immunodeficiency syndrome (AIDS); being on sickness benefits or a pension; no current relationship; and a past history of depression. Few differences were demonstrated between those with a depressive disorder and those with a BDI score > or = 14 but no diagnosis of depressive disorder. Both groups had high mean PAIS scores indicating significant illness effects in multiple areas of function. CONCLUSIONS: Depressive symptoms are common among patients with HIV infection. Few factors differentiate between patients with a depressive disorder and those whose depressive symptoms do not meet diagnostic criteria. Substantial disability is present in both groups.     

Interpersonal predictors of depression trajectories in women with HIV.

This article tests an interpersonal model of depression symptom trajectories tailored to the experiences of women with HIV. Specifically, the authors examined how bereavement, maternal role difficulty, HIV-related social isolation, and partner conflict predicted change in depressive symptoms over 5 years in 761 women with HIV, controlling for sociodemographic and clinical health factors. Of these interpersonal characteristics, partner conflict emerged as a robust predictor of change in depressive symptoms in growth curve and cross-lag models. Results highlight the need for interventions focusing on interpersonal issues, particularly intimate relationships, in women with HIV. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Incidence and consequences of pregnancy in women with known duration of HIV infection. Italian Seroconversion Study Group

BACKGROUND: The increasing incidence of human immunodeficiency virus (HIV) infection in women of childbearing age led us to evaluate whether pregnancy affects the natural history of this disease. OBJECTIVES: To conduct a prospective study of women with known dates of HIV seroconversion to describe the incidence and outcome of pregnancy and to assess differences according to age and exposure group. To compare the rate of disease progression between pregnant and nonpregnant women. PATIENTS: All participants, recruited from 14 clinical centers in Italy, had documented HIV-seronegative test results followed by confirmed positive test results within 2 years. RESULTS: A total of 331 women, who had seroconversion between 1981 and 1994, were followed up for a median of 5.5 years from seroconversion; 94 developed HIV-related diseases, 47 developed acquired immunodeficiency syndrome, and 53 had at least 1 CD4 cell count lower than 0.10 x 10(9)/L (< 100 cells/mm3). Thirty-eight women (11.5%) were pregnant at the time of HIV seroconversion and 31 (9.4%) became pregnant after HIV seroconversion (cumulative incidence of pregnancy within 8 years of seroconversion, 28.9%; 95% confidence interval, 21.6%-36.2%). Forty-five (65.2%) of the 69 pregnancies were carried to term. There were no discernible differences in these findings by age or exposure group. Pregnant women did not experience a more rapid rate of progression of disease, even when adjusting for age, exposure group, CD4 cell count, or use of treatment (adjusted relative hazards: HIV-related diseases, 0.72; acquired immunodeficiency syndrome, 0.69; CD4 cell count <0.10 x 10(9)/L, 1.24). CONCLUSION: Women infected with HIV continue to become pregnant after seroconversion, yet pregnancy does not appear to influence the rate of progression of HIV disease.     

The relationship among genital herpes simplex virus, stress, and social support.

Examined the role of stress in activation of genital herpes simplex virus (HSV) lesions, as mediated by social support, in 59 adults who had self-reported culture-positive genital HSV for at least 10 mo. Retrospective reports of HSV symptoms revealed that duration of disease and herpes-specific social support were significant moderators of the relation between stress and number of HSV recurrences (HSV-R) in the preceding 12 mo. When duration of disease was short (     

Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms.

This study examined the role of both pubertal and social transitions in the emergence of gender differences in depressive symptoms during adolescence. This study generated the following findings: (a) Gender differences in depressive symptoms emerged during 8th grade and remained significant through 12th grade. (b) Pubertal status in 7th grade was related to adolescent depressive symptoms over time. (c) Early-maturing girls represented the group with the highest rate of depressive symptoms. (d) Depressive symptoms measured in 7th grade predicted subsequent symptom levels throughout the secondary school years. (e) Recent stressful life events were associated with increased depressive symptoms. (f) Early-maturing girls with higher levels of initial symptoms and more recent stressful life events were most likely to be depressed subsequently. The findings demonstrate the importance of the interaction between the pubertal transition and psychosocial factors in increasing adolescent vulnerability to depressive experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical outcome after infection with Helicobacter pylori does not appear to be reliably predicted by the presence of any of the genes of the cag pathogenicity island

OBJECTIVE: This study proposes to assess the differences of two psychosocial risk indicators for coronary artery disease (CAD), ie, depressive symptoms and vital exhaustion. METHOD: In a representative, stratified, nation-wide sample of the population of Hungary over the age of 16 years (N = 12,640), analyses were made of whether those risk indicators were differentially related to several illness behaviors (including history of cardiovascular treatment and cardiovascular sick days), cognitions, mood states, and socioeconomic characteristics that may generally be associated with increased CAD risk. The sample was stratified by age, sex, and composition of the population of all counties in Hungary. RESULTS: Although depressive symptoms and vital exhaustion correlated strongly, there were clear and significant differences in strength of association between depressive symptoms, vital exhaustion and several variables under study. Dysfunctional cognitions, hostility, lack of purpose in life, low perceived self-efficacy, illegal drug use, alcohol and drug abuse, several forms of subjective disability complaints and history of treatment because of congenital disorders, and chronic skin and hematological disorders were more often associated with depressive symptoms, whereas loss of energy, use of stimulants, chest-pain-related disabilities, history of treatment because of cardiovascular disorders, and self-reported cardiovascular sick days were significantly more often associated with vital exhaustion. CONCLUSIONS: Vital exhaustion and depressive symptomatology are differentially associated with relevant external criteria. Vital exhaustion is associated with perceived cardiovascular complaints and history of cardiovascular treatment, whereas depressive symptomatology seems to be more closely connected to disabilities and complaints related to alcohol, drug, and congenital-disorder, and to dysfunctional cognitions and hostility.     

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)     

Antecedents of stressful experiences: Depressive symptoms, self-esteem, gender, and coping.

Numerous studies have identified depressive symptoms as antecedent to stressful experiences. However, the interrelations of depressive symptoms, personal resources, and coping as antecedents of stressful experiences are largely unknown. For this investigation, a prospective design was used to test a model estimating two categories of daily hassles at Time 2 in relation to depressive symptoms, self-esteem, gender, coping, and daily hassles at Time 1. Utilizing simultaneous equations, direct effects were observed for depressive symptoms, Time 1 hassles, gender, and avoidance coping in relation to category of hassles at Time 2. Depressive symptoms and avoidance coping were observed to be mediators for gender and self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lipid trajectories as predictors of depressive symptoms: The Young Finns Study.

Objective: The aim of this study was to identify common trajectories of lipid levels across childhood and early adulthood life span. Design: The sample was a subpopulation of 824 young adults (3 to 9 years of age at baseline in 1980) of the ongoing population-based prospective Cardiovascular Risk in Young Finns Study. Lipid levels were determined in 1980, 1983, 1986, and 2001. Main Outcome Measures: Depressive symptoms were assessed using a modified version of Beck's Depression Inventory (Beck, 1967) in 1992 and 2001. Results: The 2 triglycerides trajectories (steeply vs. moderately increasing) were differently related to depressive symptoms in adulthood. The trajectory showing steep increase over time was associated with higher level of depressive symptoms (M 2.18, 95% CI [2.08, 2.28] vs. 1.99, [1.95, 2.04]). This relationship persisted after adjustments for various risk factors. These triglycerides trajectories accounted for part of the association between high body mass index and depressive symptoms. Conclusion: A pattern of steeply increasing triglyceride levels throughout childhood and adulthood may be associated with increased the risk of depressive symptoms in adulthood. This pattern may also be one link between obesity and depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and hostility as predictors of depressive symptoms in cardiac patients one month after hospitalization: a prospective study

OBJECTIVE: Hospitalization for cardiac disease is associated with an increased risk for depression, which itself confers a poorer prognosis. Few prospective studies have examined the determinants of depression after hospitalization in cardiac patients, and even fewer have examined depression within the weeks after hospital discharge. The present study assessed the prospective relations among perceptions of social support and trait hostility in predicting symptoms of depressive symptoms at 1 month after hospitalization for a diagnostic angiography in 506 coronary artery disease (CAD) patients. METHOD: A series of structural equation models 1) estimated the predictive relations of social support, hostility, and depressive symptoms while in the hospital to symptoms of depression 1 month after hospitalization, and 2) compared these relations across gender, predicted risk classification, and age. RESULTS: Social support assessed during hospitalization was independently negatively associated with depressive symptoms 1 month after hospitalization, after controlling for baseline symptoms of depression, gender, disease severity, and age. Hostility was an indirect predictor of postdischarge depressive symptomology by way of its negative relation with social support. This pattern of relations did not differ across gender, predicted risk classification, and age. CONCLUSIONS: Our findings suggest that a patient's perceived social support during hospitalization is a determinant of depressive symptoms 1 month later. The relation of social support and hostility to subsequent depressive symptoms was similar across a variety of populations.