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)     

BDNF genotype moderates the relation between physical activity and depressive symptoms.

Objective: To test whether the BDNF gene interacts with exercise to predict depressive symptoms. Physical activity is associated with a range of positive health outcomes, including fewer depressive symptoms. One plausible mechanism underlying these findings involves Brain-Derived Neurotrophic Factor (BDNF), a protein hypothesized to limit or repair the damage caused by stress. Physical activity increases expression of BDNF, which may enhance brain health. BDNF expression is controlled by the BDNF gene. Compared with individuals without a BDNF met allele, met-allele carriers have a lower expression of BDNF, which has been associated with Major Depressive Disorder. Design: Eighty-two healthy adolescent girls were genotyped for the BDNF val66met polymorphism, and their depressive symptoms and physical activity were assessed using questionnaires. Main Outcome Measures: BDNF genotype, Children’s Depression Inventory, and the Physical Activity Questionnaire for Older Children and Adolescents. Results: The BDNF polymorphism was found to moderate the relation between exercise and depressive symptoms: being physically active was protective for girls with a BDNF met allele (fewer depressive symptoms) but not for girls with the val/val polymorphism. Conclusion: By integrating psychological and biological factors, the present study enhances our understanding of how physical activity contributes to resilience to psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association between adolescents’ depressive symptoms, maternal negative affect, and family relationships in Hong Kong: Cross-sectional and longitudinal findings.

This study investigated the bidirectional relationships of adolescents’ and maternal mood, and the moderating effect by gender and perceived family relationships on these relationships. Data were obtained from 626 adolescent-mother dyads and follow-up data were collected one year later from a subset. Adolescents reported their depressive symptoms, and their mothers reported their negative affect. Adolescents described their perception of family relationships. Maternal negative affect and adolescents’ depressive symptoms were significantly correlated at baseline. This association was moderated by gender and family relationships. The association was stronger in mother-daughter compared to mother-son dyads. In families where relationships were reported to be poor, adolescent depressive symptoms were uniformly high, regardless of maternal negative affect. However, in families where relationships were good, maternal negative affect was associated with higher adolescents’ depressive symptoms. In longitudinal analyses, adolescents’ mood at baseline was found to relate to maternal negative affect at follow-up. Family relationships at baseline were also associated with adolescents’ depressive symptoms at follow-up. However, there was no prediction from maternal negative affect at baseline to adolescents’ depressive symptoms at follow-up. Gender and quality of family relationships did not moderate the longitudinal relationships between adolescents’ depressive symptoms and maternal negative affect in either direction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The fit between stress appraisal and dyadic coping in understanding perceived coping effectiveness for adolescents with type 1 diabetes.

This study examined whether perceived coping effectiveness (PCE) was associated with better diabetes management and was higher when adolescents’ dyadic coping was matched to shared stress appraisals. There were 252 adolescents with Type 1 diabetes who completed stress and coping interviews where they appraised mothers’ and fathers’ involvement in stress ownership (mine, indirectly shared, directly shared with parent), in coping (uninvolved, supportive, collaborative, or controlling), and rated their effectiveness in coping. Adolescents completed assessments of depressive symptoms (Children’s Depression Inventory), self-care behaviors (Self-Care Inventory), and efficacy of disease management (Diabetes Self-Efficacy). Glycosylated hemoglobin levels were obtained from medical records. Higher PCE was associated with fewer depressive symptoms, self-care behaviors, and efficacy across age and, more strongly for older adolescents’ metabolic control. Appraisals of support or collaboration from parents were more frequent when stressors were appraised as shared. PCE was enhanced when dyadic coping with mothers (but not fathers) was consistent with stress appraisals (e.g., shared stressors together with collaborative coping). Stress and coping is embedded within a relational context and this context is useful in understanding the coping effectiveness of adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The co-occurrence of depression and substance abuse in late adolescence

This article examines the role of adolescent social relationships in fostering the occurrence and co-occurrence of depression and substance abuse, using two waves of data from a community sample of adolescents (N = 900). Multinomial logistic response models were estimated to identify the extent to which risk and protective features of youths' family and peer relations were differentially linked with depressive symptoms, substance abuse, and their co-occurrence. Taking a within-person, configurational approach to adolescent adaptation, contrasts involved four subgroups of adolescents: those high on both depressed mood and substance abuse, those who experience neither problem, those evidencing high levels of depressive symptoms only, and those high on substance abuse only. Risk for depressive symptoms was differentiated by its association with conflict and lack of support in the friendship domain. Substance abuse was associated with negative peer pressure, but these youth were otherwise little different from youths with no problems. Whereas co-occurrence of depression and substance use was associated with more difficulties in both the family and peer environments, the most distinctive risk was that of low family support. Discussion centers on the developmental antecedents of co-occurring problems and family relations during adolescence.     

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)     

Depression socialization within friendship groups at the transition to adolescence: The roles of gender and group centrality as moderators of peer influence.

Tests of interpersonal theories of depression have established that elevated depression levels among peers portend increases in individuals' own depressive symptoms, a phenomenon known as depression socialization. Susceptibility to this socialization effect may be enhanced during the transition to adolescence as the strength of peer influence rises dramatically. Socialization of depressive symptoms among members of child and adolescent friendship groups was examined over a 1-year period among 648 youth in grades six through eight. Sociometric methods were utilized to identify friendship groups and ascertain the prospective effect of group-level depressive symptoms on youths' own depressive symptoms. Hierarchical linear modeling results revealed a significant socialization effect and indicated that this effect was most potent for (a) girls and (b) individuals on the periphery of friendship groups. Future studies would benefit from incorporating child and adolescent peer groups as a developmentally salient context for interpersonal models of depression. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The impact of family, peer, and school contexts on depressive symptoms in adolescents with spina bifida.

Objective: Based on social ecological theory, this study examined the joint relations among adolescents' family, peer, and school contexts and depressive symptoms in youth with spina bifida using cumulative, protective, and specific effects models. Method: Sixty families of adolescents with spina bifida and 65 comparison families reported on adolescents' positive experiences within these contexts and on depressive symptoms when youth were 14–15 and 16–17 years old. Results: Adolescents with spina bifida had fewer total positive contexts and less positive experience within peer and school contexts, as compared to typically developing adolescents. Greater total number of positive contexts and higher levels of positive experiences within family and school contexts were associated with fewer depressive symptoms for both groups; peer positive experiences were related to lower depressive symptoms for typically developing adolescents only. Conclusion: Adolescents with spina bifida have fewer positive contexts, which may place them at risk for higher levels of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control.

For adolescents with Type 1 diabetes, lower family income may be associated with poorer diabetes management through depleted parental psychological resources (i.e., higher parental depressive symptoms, lower parental acceptance). Adolescents (N = 252; 46% male) aged 10–14 years with Type 1 diabetes assessed the acceptance of their mother and father (e.g., “gives me the feeling that she likes me as I am”; “she doesn't feel she has to make me over into someone else”). Mothers provided information on family income and demographics. Both mothers and fathers reported their depressive symptoms. HbA1c scores were indexed via medical records. Lower family income was associated with higher (i.e., worse) HbA1c, more mother and father depressive symptoms, and less acceptance from both parents. Mediation analyses revealed that the relationship of lower family income with metabolic control occurred indirectly through lower maternal and paternal acceptance and lower adherence. Lower family income may impair the quality of parent—adolescent relationships that are beneficial for good diabetes management. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Daily negative mood affects fasting glucose in Type 2 diabetes.

Objective: To examine the relationship between mood and blood glucose in a 21-day daily diary study. Design: During a home visit, information was gathered from 206 persons with Type 2 diabetes regarding demographics, disease characteristics and treatment, and depressive symptoms. They had blood drawn at a laboratory, yielding HbA1C. The participants were then telephoned each evening for 21 days and were asked about their positive and negative mood during the past 24 hours. They also tested their blood glucose upon rising in the morning. Main Outcome Measures: The main outcomes measures were positive and negative affect and fasting glucose. Results: Multilevel analyses revealed a relationship between negative affect on one day and morning glucose on the next day. There was no such relationship between positive affect and glucose, nor was there a comparable effect of glucose on one day and either positive or negative affect on the next day. Conclusion: The observed relationship between mood and blood glucose appears to be because of negative affect, not positive, with no evidence of a lagged effect of glucose on mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms and self-concept in young people with spina bifida

Examined self-reported depressive symptoms in 72 young people with spina bifida, ages 9 to 18:11, and matched able-bodied comparison subjects, using the Dimensions of Depression Profile for Children and Adolescents (Harter & Nowakowski, 1987). Independent variables included gender, self-perceptions (including physical appearance), and perceived social support. Young people with spina bifida were at greater risk of depressive mood, low self-worth, and suicidal ideation. Girls, independent of disability, were at greater risk of depressive mood, low self-worth, and self-blame. Multiple regression analyses suggest that global self-worth serves as a mediating variable for the effect of physical appearance self-concept on depressed mood (particularly in young people with spina bifida), and that perceived parental social support has a direct effect on depressed mood (particularly in girls).     

The mediating role of extreme peer orientation in the relationships between adolescent–parent relationship and diabetes management.

The study examined whether the quality of the adolescent–parent relationship was associated with better diabetes management in adolescents with Type 1 diabetes by decreasing adolescents' extreme peer orientation. Adolescents (n = 252; 46% male and 54% female) aged 10 to 14 years with Type 1 diabetes completed assessments of extreme peer orientation (i.e., tendency to ignore parental advice and diabetes care to fit in with friends), adolescent–parental relationship, and adherence; HbA1c scores indexed metabolic control. Adolescents with higher quality relationships with parents reported less peer orientation and better diabetes care. The mediational model revealed that adolescents' high quality relationships with their parents (mother and father) were associated with better treatment adherence and metabolic control through less peer orientation. It is likely that high quality adolescent–parent relationships may be beneficial to adolescent diabetes management through a healthy balance between peer and parental influence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of stressful life events to metabolic control among adolescents with diabetes: 5-year longitudinal study.

Objective: To determine the relation of stressful life events to metabolic control. Design: We interviewed adolescents with Type 1 diabetes (n = 132; average age at enrollment = 12 years) annually for 5 years. Measures: Each year we administered measures of stressful life events, psychological distress, and self-care behavior. We downloaded data from blood glucose meters, and obtained measures of metabolic control (hemoglobin A1c) from medical records. Results: Using longitudinal growth curve modeling, stressful life events predicted greater psychological distress, poorer self-care behavior, and worse metabolic control in both cross-sectional and longitudinal (lagged) analyses. Cross-sectionally, many of these relations were stronger among older than younger adolescents. Self-care behavior partly mediated this association. Conclusion: Stressful life events are related to poor metabolic control—especially for older adolescents. A primary mechanism appears to be a lack of good self care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gap junction expression following UVC-induced neoplastic transformation in human hybrid cell lines

OBJECTIVE: A randomized trial with 1-year follow-up was conducted in 23 general practices to study the relationship between target values for glycemic control and well-being in type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 176 patients with type 2 diabetes, aged 40-75 years, were included. General practitioners were encouraged to make decisions according to a standardized step-up regimen until the target level of glycemic control was reached. The random allocation to a strict or a less strict target level of glycemic control (fasting capillary glucose < 6.5 or < 8.5 mmol/l), change in HbA1c and fasting glucose, and initiating insulin or treatment with oral hypoglycemic agents were studied as putative determinants of scores on a type 2 diabetes symptom checklist, a profile of mood states, an affect balance scale, and general well-being. Adjustments were made for baseline scores on the outcome at issue. RESULTS: Positive affect (an odds ratio [OR] [95% CI] of 0.39 [0.19-0.83]) and perceived treatment burden (OR 0.48 [0.23-0.98]) were unfavorably altered in the group randomly allocated to stricter target levels (fasting capillary glucose < 6.5 mmol/l). Patients who had a decrease in HbA1c of 1% or more tended to have comparatively favorable mood (OR displeasure score 0.35 [0.13-0.94]) and general well-being scores at 1 year (ORs of having unfavorable scores ranged from 0.4 to 0.5, NS). CONCLUSIONS: Perceived treatment burden and positive effect are unfavorably affected by random allocation to a strict target level for glycemic control. Improved glycemic control is associated with favorable mood and possibly general well-being in type 2 diabetes.     

"Learning to Live With What You Can't Rise Above": Control Beliefs, Symptom Control, and Adjustment to Tinnitus.

The relations between 3 types of perceived control, symptom severity, and 2 adaptational outcomes, depressive symptoms and psychological well-being, were examined in a sample of 319 people with tinnitus. Consistent with previous studies of control and adjustment to chronic health conditions, general health and symptom control were associated with better psychological adjustment, and retrospective control was associated with worse psychological adjustment. Only symptom control emerged as a significant moderator in the symptom severity--adjustment relationship, such that stronger beliefs in one's ability to control symptoms were most strongly associated with better adjustment among those with more severe tinnitus symptoms. These findings were consistent with coping perspectives and cognitive adaptation theory and suggest that symptom-related perceptions of control may be an effective coping resource to nurture in chronic health contexts with severe symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Don't hide your happiness! Positive emotion dissociation, social connectedness, and psychological functioning.

It is now clear that positive emotion leads to enhanced psychological functioning. What is less clear, however, is just why this is so. Drawing on a social-functional perspective, we argue that positive emotional behavior that accurately signals to others the individual's internal state will enhance social connectedness. Positive emotional behavior that does not accurately signal a person's experience—such as a smile that is not felt—may impede social connectedness and, in turn, psychological functioning. This perspective suggests that (a) the degree to which experience and behavior are dissociated during positive emotional episodes, over and above level of positive behavior, should predict worse psychological functioning and (b) the effect of dissociation should be mediated by social connectedness. To test these hypotheses, we conducted a short-term prospective longitudinal study, with a baseline assessment of depressive symptoms and well-being at Time 1. Six months later, at Time 2, we used a novel within-individual laboratory paradigm to measure the degree to which positive emotional behavior was dissociated from (vs. coherent with) a participant's positive emotional experience. We also assessed level of positive behavior and experience. Then, another 6 months later, we assessed social connectedness as a mediator and depressive symptoms and well-being as outcomes at Time 3. Even when controlling for baseline functioning and for level of positive emotion behavior and experience, we found that greater positive experience–behavior dissociation at Time 2 predicted higher levels of depressive symptoms and lower levels of well-being at Time 3. As predicted, these associations were mediated by social connectedness. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A prospective study of pediatric loss of control eating and psychological outcomes.

Loss of control (LOC) eating in youth is associated cross-sectionally with eating-related and psychosocial distress and is predictive of excessive weight gain. However, few longitudinal studies have examined the psychological impact and persistence of pediatric LOC eating. We administered the Eating Disorder Examination and self-reported measures of depressive and anxiety symptoms to 195 boys and girls (mean age = 10.4 years, SD = 1.5) at baseline and again 4.7 years (SD = 1.2) later to 118 of these youth. Missing data were imputed. Baseline report of LOC was associated with the development of partial- or full-syndrome binge eating disorder (p = .03), even after accounting for the contribution of sex, race, baseline characteristics (age, disordered eating attitudes, and mood symptoms), body mass index growth between baseline and follow-up, and years in study. Half (52.2%; 95% CI [1.15, 6.22]) of children who endorsed experiencing LOC at baseline reported persistence of LOC at follow-up (p = .02). Compared with children who never reported LOC eating or reported LOC only at baseline, those with persistent LOC experienced significantly greater increases in disordered eating attitudes (ps p = .027) over time. These data suggest that LOC eating in children is a problematic behavior that frequently persists into adolescence and that persistent LOC eating is associated with worsening of emotional distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent recognition of parental affect: Influence of depressive symptoms.

This study examined depressive biases in adolescents' labeling of parental affect. Adolescents (151 girls; 82 boys) and their parents engaged in videotaped problem-solving interactions. Adolescents then participated in a video-mediated recall procedure in which they watched the videotaped interaction and indicated how they thought their parents were feeling. Indices of parents' affect during the problem-solving interactions were also provided by parent self-report and behavioral observations. Adolescent depressive symptoms were associated with overreporting of parental aggressive affect and underreporting of parental happy and neutral affects, relative to both directly observed and self-reported parental affect. Depressive symptoms were not associated with overreporting of parental dysphoric affect. Given the importance of accurately reading affective cues for negotiating interpersonal interactions, these findings likely have implications for understanding processes that contribute to adverse relationships among the families of adolescents with depressive symptoms. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A Longitudinal Analysis of the Course of Depressive Symptomatology in Geriatric Patients With Cancer of the Breast, Colon, Lung, or Prostate.

This study mapped the trajectory of depression and its components (depressive mood, somatic expression of depression, and lack of positive affect) for 1 year after an initial cancer diagnosis, revealing the complex nature of the psychological response to the cancer experience. The analysis was based on 4 waves of panel data from 860 older patients with incident breast, colon, lung, or prostate cancer. Predictors of depressive symptoms included cancer site; stage; comorbidities; sociodemographic characteristics; and indicators of physical functioning, symptom severity, and treatment. Patients' overall depressive symptoms declined, especially depressive mood and somatic indicators. By contrast, the sense of well-being did not recover; in fact, it would have deteriorated without improvements in physical functioning and physical symptoms. The present findings show the importance of psychological assessments and symptom management during cancer treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of psychosocial well-being among overweight adolescents: The role of the family.

An ethnically diverse sample of at-risk-for-overweight and overweight youths (body mass index greater than the 85th percentile for age and gender; n = 667 male participants, and n = 684 female participants) completed a school-based survey measuring family variables (connectedness, mealtime environment, and weight commentary), psychosocial well-being (depressed mood, body satisfaction, and self-esteem), and unhealthy weight-control behaviors; all measures were assessed concurrently. Hierarchical linear regression analyses revealed that measures of general family connectedness, priority of family meals, and positive mealtime environment were significantly positively associated with psychological well-being and inversely associated with depressive symptoms and unhealthy weight-control behaviors. Familial weight commentary (i.e., weight-based teasing and parental encouragement to diet) was associated with many indicators of poor psychological health. The authors conclude that greater psychosocial well-being and fewer unhealthy weight-control behaviors are associated with making family time at meals a priority, creating a positive mealtime atmosphere, and refraining from weight commentary. (PsycINFO Database Record (c) 2010 APA, all rights reserved)