Depression and somatic symptoms in Japanese and American college students: Negative mood regulation expectancies as a personality correlate

How personality factors, coping with identity-stress, and parental rearing styles contribute to the expression of somatic complaints in emerging adults in seven countries

Objective

Somatic complaints are frequently named by emerging adults in many countries, but psychological factors contributing to the high level of these often medically unexplained symptoms have received little attention. This study examines the influence of shared risk factors on somatic complaints in a culturally diverse sample.

Methods and measures

In a cross-cultural survey study of 2,113 emerging adults (mean age = 22.0 yrs.; SD = 2.04) from seven countries (France, Germany, Turkey, Greece, Peru, Pakistan, and Poland) personality variables, parental rearing styles, coping abilities as well as identity-related stress were assessed. In a second step we successively entered these variables in hierarchical linear mixed models, controlling for country and gender effects and their respective interaction, in order to determine their impact on the level of somatic complaints across countries.

Results

All these dimensions varied extensively between all countries, with females reporting higher levels of somatic complaints than men in several countries. Despite this variation, our findings demonstrate a general and stable influence of neuroticism, openness, parental rearing styles, coping abilities and identity-related stress on somatic complaints across countries.

Conclusion

Findings support the use of a general intervention model that includes appropriate coping strategies for emotion regulation, but also encourages support seeking for age-specific problems in dealing with identity stress during the transition to adulthood. In addition, this intervention model should be adjusted for a specific culture and gender.

The mediating role of depression in the association between perceived financial wellbeing and somatization: a study in the context of Lebanon's financial crisis

The objectives of this study were to examine the association between financial wellbeing and somatization, in addition to the mediating effect of anxiety, depression and stress. To test such hypotheses, a cross-sectional study was carried out between September and October 2021; 403 participants (264 females; age = 32.76 ± 13.24 years) were recruited. Depression mediated the association between financial wellbeing and somatization. A worse financial wellbeing was significantly associated with more depression, which was associated with more somatization. Moreover, a worse financial wellbeing was significantly and directly associated with more somatization. Our study adds to the narrow body of research revolving around the relationship between financial wellbeing and somatization in Lebanese adults. Understanding that the effects of, depression are aggravated in a country such as Lebanon would help establish more preventative guidelines and mental health awareness campaigns. Identifying the correlates of somatization can also be translated into improved interventions.

Association between Negative Life Events and Somatic Symptoms: A Mediation Model through Self-Esteem and Depression

The purpose of this study was to investigate the serial multiple mediation of self-esteem and depression in the relationship between negative life events and somatic symptoms in Chinese medical students. We recruited a total of 3383 medical students for this study, and used the Patient Health Questionnaire-15 to assess the somatic symptoms of subjects; the Adolescent Self-Rating Life Events Check List to assess negative life events; the Rosenberg Self-Esteem Scale to assess self-esteem; and the Patient Health Questionnaire for depression. Descriptive analysis and statistical tests were then performed on the collected data. We showed that 39.17% of the medical students had mild somatic symptoms, 24.14% had moderate somatic symptoms, and 5.66% had severe somatic symptoms; we observed significant differences in somatic symptoms among genders, living expenses, and one-child. For negative life events, interpersonal stress was the most important predictor of somatization during the regression analysis. In addition, we observed significance for both the direct and part of the indirect paths from negative life events to somatic symptoms using mediation model analysis. However, we noted that there was no significance for the path through negative life events and self-esteem to somatic symptoms. This study revealed a high prevalence of somatic symptoms among Chinese medical students, and the findings suggested that interventions aimed at reducing somatization in this population should consider the impact of negative life events, particularly those related to interpersonal stress. One potential approach to mitigating the effects of negative life events on somatization is to enhance self-esteem and decrease the level of depression among medical students.

Systematic review on somatization in a transcultural context among teenagers and young adults: Focus on the nosography blur

Aims

Somatic complaints are a frequent cause for consultation in primary care. In a transcultural context, somatic complaints are typically associated with psychological distress. A recent review about somatic symptom disorders in adolescence showed some nosographic heterogeneity and outlined various etiological hypotheses (traumatic, environmental, or neurologic), separate from the cross-cultural considerations. Migrants' children encounter specific problems involving cultural mixing-issues of filiation (familial transmission) and affiliation (belonging to a group). This paper aims to provide a systematic review of somatization in transcultural contexts among teenagers and young adults, aged 13 to 24, over the past decade.

Methods

This review adheres to the quality criteria set forth by the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two authors queried three English databases (Medline, PsycInfo, WebOfScience) about somatization in transcultural contexts (migrant or non-Western population) among teenagers (13-18), young adults (19-24), or both. The methodological process comprised articles selection, data extraction, and then the analysis of emerging themes. Setting selection criteria to limit the transcultural field was difficult.

Results

The study analyzed 68 articles. We present a descriptive analysis of the results, centered on three main themes. First, the literature highlights a nosographic muddle reflected in the combination of anxious and depressive symptoms together with the highly variable symptomatology. Second, discrimination issues were prevalent among the migrant population. Lastly, the literature review points out possibilities for improving a care pathway and reducing the diagnostic delay induced by migrants' hesitancy about Western care and the recurrent use of inappropriate diagnostic criteria.

Conclusion

This review discusses the links between the nosographic muddle described here and the diagnostic delays these patients experience and raises concerns about rigid diagnostic compartmentalization. The work of the psychiatrist Frantz Fanon is here useful to understand externalized symptoms resulting from physical and psychological confinement. Discrimination issues raise questions about the cultural counter-transference health professionals experience in dealing with young migrants. Defining healthcare professionals' representations about somatic complaints in a transcultural context might be a fruitful path to explore in future research.

Protocol PROSPERO registration number

CRD42021294132. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021294132.

Psychological Distress in Quarantine Designated Facility During COVID-19 Pandemic in Saudi Arabia

BACKGROUND

Quarantine is a useful measure for preventing and controlling pandemics; however, it might be stressful for quarantined individuals. Fear and anxiety about a disease can be overwhelming. These emotions were reported for individuals in involuntary quarantine facilities dedicated to quarantine purposes.

METHODS

This cross-sectional study surveyed the individuals in involuntary quarantine institutions (for a planned period of 14 days of quarantine) in two regions of Saudi Arabia. The mental health status of individuals was assessed using the Revised Impact of Event Scale (IES-R) and Depression, Anxiety, and Stress Scale (DASS-21).

RESULTS

The study surveyed 214 quarantined/isolated individuals. The stress, anxiety, and depression rates were 25.7%, 21.5%, and 32.7%, respectively. On the IES-R, 28.0% of the participants met the criteria for psychological distress. Female gender, self-reported history of psychiatric disorder, and average health status were significantly associated with negative psychological impact and depression, anxiety, and stress symptoms (p<0.05). Watching television was found to be a factor in reducing rates on the IES-R and DASS-21 scale while working out lowered rates on the IES-R alone (p<0.05).

CONCLUSION

During an institutional involuntary quarantine, additional attention should be paid to vulnerable groups like females and individuals with a history of psychiatric illness. More than one-fourth of our sample experienced a negative psychological impact; therefore, coping practices like working out should be encouraged. This study contributes to the ongoing discussion about the psychological aspects of being quarantined. Much work remains to be done to identify strategies that prevent and mitigate psychological distress throughout the quarantine experience and to determine whether these impacts will last for an extended period of time.

Interpersonal Emotion Regulation and Psychological Distress: What Is the function of Negative Mood Regulation Expectancies in This Relationship?

Individuals' tendency to use their interactions with others in the management of their own emotions is called Interpersonal Emotion Regulation (IER). Limited studies have explored the association between IER and psychological distress with none focusing on the role of mediating variables in this relationship. The current study aims to explore the role of negative mood regulation expectancies (NMRE), which is defined as one's confidence in the effectiveness of their coping skills while dealing with difficult emotions, as a possible mechanism underlying the association between IER and psychological distress. The data were collected from 204 (164 women) Turkish speaking individuals whose age ranges between 18 and 32 (M = 22.78, SD = 3.21). The participants completed measures of IER, NMRE and psychological distress. The results have indicated that NMRE has a significant mediating role in the relationship of Soothing dimension of IER with psychological distress. The present findings highlighted the maladaptive function of Soothing as an IER strategy in addition to shedding light on the important role of NMRE in this relationship.

Negative Mood Is Associated with Diet and Dietary Antioxidants in University Students During the Menstrual Cycle: A Cross-Sectional Study from Guangzhou, China

Postpubescent females may have negative mood or premenstrual syndrome during the menstrual cycle; with the emotional and physical symptoms interfering with their quality of life. Little is known about the relationship of dietary behaviors and dietary antioxidant intake with negative mood or premenstrual syndrome in university students in China; so we explored the relationship between negative mood and dietary behavior in female university students during the three menstrual cycle phases. Random sampling was used to enroll 88 individuals from a university in Guangzhou; China in the study. Data were collected using self-administered questionnaires. Descriptive statistics and multiple logistic regression analyses were performed. During the menstrual phase, tea, black coffee and carbonated beverage intake was higher in the group with a high negative affect scale score than in the low score group (p < 0.05). Likewise; during the premenstrual phase, fresh fruit (banana and red Chinese dates) intake was higher in the group with a high negative affect scale score than in the low-score group (p < 0.05). The logistic regression analysis results showed that negative mood was positively associated with tea, coffee, and carbonated beverage intake during the menstrual phase (β = 0.21, p = 0.0453, odds ratio = 1.23), and negative mood was positively associated with banana and red Chinese dates intake during the premenstrual phase (β = 0.59, p = 0.0172, odds ratio = 1.81). Our results suggest that negative mood may be associated with diet and specific food in university postpubescent females.

Attachment and psychological distress: The mediator role of Negative Mood Regulation Expectancies

OBJECTIVE

The current study aims to examine the relation between different dimensions of attachment with psychological distress, by specifically focusing on the mediator role of Negative Mood Regulation Expectancies (NMRE), which are considered as a form of coping self-efficacy. There is ample evidence showing the role of emotion regulation strategies predicting the relationship between attachment and psychological disorders. However, little is known about how NMRE might mediate the relationship between attachment dimensions and psychological distress.

METHOD

Four hundred and two (318 women) individuals between ages 18 and 62 (mean = 29.65; standard deviation [SD] = 8.96) completed measures of NMRE, attachment dimensions, and psychological distress.

RESULTS

NMRE mediated the relationship between anxious attachment dimension and all dimensions of psychological distress (e.g., anxiety, depression, stress). However, NMRE mediated the relationship of avoidant attachment only with stress.

CONCLUSION

Distinct mechanisms explain the relationship between two dimensions of attachment with NMRE and different forms of psychological distress.

The effects of sensory-processing sensitivity and sense of coherence on depressive symptoms in university students

Sensory-processing sensitivity differentiates individuals according to responsivity to internal and external stimuli. It has been positively correlated with depressive symptoms. Meanwhile, sense of coherence, an individual’s perception that stressors are comprehensible, manageable, and meaningful for their life, could improve depression. This cross-sectional study investigated the moderation effect of sense of coherence on the relationship between sensory-processing sensitivity and depressive symptoms in university students. Japanese students (N = 430) participated in a questionnaire survey that assessed levels of sensory-processing sensitivity, sense of coherence, and depressive symptoms. The results showed that a strong sense of coherence moderated the relationship between sensory-processing sensitivity and depressive symptoms in university students.

Standalone Effects of a Cognitive Behavioral Intervention Using a Mobile Phone App on Psychological Distress and Alcohol Consumption Among Japanese Workers: Pilot Nonrandomized Controlled Trial

BACKGROUND

Research that investigates standalone effects of a mobile phone-based cognitive behavioral therapy without any human contact for reducing both psychological distress and risky drinking has been advancing; however, the number of studies is still limited. A mobile phone app called Self Record that facilitates cognitive restructuring through self-monitoring of daily thoughts and activities was developed in Japan.

OBJECTIVE

This study conducted a nonrandomized controlled pilot trial of the Self Record app to investigate standalone effects of the intervention on psychological distress and alcohol consumption among Japanese workers. Additionally, we examined moderating effects of negative mood regulation expectancies, which are beliefs about one's ability to control one's negative mood.

METHODS

A quasi-experimental design with a 1-month follow-up was conducted online in Japan from February 2016 to March 2016. A research marketing company recruited participants. The selection criteria were being a Japanese full-time worker (age 20-59 years), experiencing mild to moderate psychological distress, and having some interest in self-record apps. Assignment to group was based on participants' willingness to use the app in the study. All participants completed outcome measures of negative mood regulation expectancies, positive well-being, general distress, depression, anxiety, and typical/most weekly alcohol consumption.

RESULTS

From the recruitment, 15.65% (1083/6921) of participants met the inclusion criteria. Of these, 51.43% (557/1083) enrolled in the study: 54.9% (306/557) in the intervention group and 45.1% (251/557) in the control group. At the 1-month follow-up, 15.3% (85/557) of participants had dropped out. Intention-to-treat analyses revealed that participants in the intervention group reported increased typical drinking (η2=.009) and heavy drinking (η2=.001). Adherence to using the app was low; 64.8% (199/306) of participants in the intervention group discontinued using the app on the first day. Additionally, 65.7% (366/557) of the total sample did not correctly answer the validity checks in the outcome measures (eg, "Please select 'mildly agree' for this item"). Therefore, per-protocol analyses were conducted after removing these participants. Results showed that continuing app users (42/127) in the intervention group reported increases in anxiety (η2=.006), typical drinking (η2=.005), and heavy drinking (η2=.007) compared to those in the control group (85/127). Negative mood regulation expectancies moderated the effects of the intervention for general distress (beta=.39).

CONCLUSIONS

Results were contrary to our hypotheses. Self-recording methods of standalone mobile phone interventions may heighten individuals' awareness of their pathological thought and drinking behavior, but may be insufficient to decrease them unless combined with a more intense or face-to-face intervention. Limitations include high attrition in this study; measures to improve the response rate are discussed.