Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators

Longitudinal trajectories and associated risk factors of paternal mental illness in the nine years surrounding the transition to fatherhood

BACKGROUND

The arrival of one's first child is a known risk factor for mental illness, yet investigations on fathers' mental health are limited. We conducted a longitudinal investigation on paternal depression and anxiety in the nine years surrounding the transition to fatherhood.

METHODS

Using a national cohort of French men (CONSTANCES, n = 6299), we investigated the prevalence and associated risk factors of mental illness amongst first-time fathers. Responses to the Center for Epidemiological Studies Depression (CES-D) and 12-item General Health Questionnaire (GHQ-12) scales were used to identify clinically significant symptom scores. Self-declared mental illness was also reported by participants. Group-based modelling was used to identify latent trajectory groups for both measures.

RESULTS

Levels of self-declared anxiety (averaging 4.9 % pre-fatherhood, 7.8 % post) exceeded that of depression (1.9 % pre- fatherhood, 3.3 % post) or other disorders. However, rates of clinically significant symptom scores (17-27 %) were consistently higher. Participants' mental health appeared to worsen from two-years prior to their child's arrival and improve from two-years after. We identified three trajectory groups for fathers' self-declared mental illness: Low stable (90.3 %); Low risk with high temporary increase (5.6 %); and Consistent high risk (4.1 %). Risk factors associated with worsening mental health trajectories were unemployment, not living with one's partner, having had adverse childhood experiences and foregoing healthcare due to financial reasons.

LIMITATIONS

All measures of mental illness relied on participant self-reports and are thus subject to bias.

CONCLUSIONS

This study reveals an important period of heightened psychological vulnerability amongst first-time fathers, emphasising the need for increased and better adapted paternal mental health screening.

Mapping resilience: a scoping review on mediators and moderators of childhood adversity with a focus on gender patterns

BACKGROUND

Childhood adversity is associated with a host of negative health and socioeconomic outcomes far into adulthood. The process of avoiding such outcomes is often referred to as resilience. Mapping resilience comprehensively and across contexts is highly relevant to public health, as it is a step towards understanding environments and interventions that contribute to preventing or reversing negative outcomes after early adverse experiences.

OBJECTIVES

This review scoped out the literature on resilience factors in relation to adulthood outcomes as diverse as mental health and educational attainment. Our aim was to understand where there is untapped research potential, by examining the current evidence base on resilience factors in terms of (a) resources that can buffer the impact of childhood adversity and (b) the pathways linking adversity to long-term outcomes. Furthermore, we aimed to identify gender patterns in these resources and pathways, which has not been a primary interest of reviews on resilience to date, and which can add to our understanding of the different ways in which resilience may unfold.

ELIGIBILITY CRITERIA

Studies had to include an adversity experienced in childhood, an outcome considered indicative of resilience in adulthood, and at least one putative resilience factor, which had to be approached via mediation or moderation analysis. We considered cohort, case-control and cross-sectional studies.

SOURCES OF EVIDENCE

We searched PubMed, Scopus and PsycINFO and included original, peer-reviewed articles published before 20 July 2023 in English, German, French, Spanish, Dutch and Swedish.

CHARTING METHODS

All three authors collaborated on the extraction of information relevant to answering the research questions. The results were visually and narratively summarised.

RESULTS

We included 102 studies. Traditionally anchored in the field of psychology, the resilience literature focuses heavily on individual-level resilience factors. Gender was considered in approximately 22% of included studies and was always limited to comparisons between men and women. There is no evidence that childhood adversity impacts men and women differently in the long term, but there is some evidence for gender differences in resilience factors.

CONCLUSIONS

There is untapped potential in resilience research. By considering structural-level factors simultaneously with individual-level factors, and including gender as one of the elements that shape resilience, we can map resilience as a heterogeneous, multilevel process from a public health perspective. This would complement the extensive existing literature on individual-level factors and help reframe resilience as a concept that can be intervened on at a structural level, and that is subject to societal norms and forces, such as gender. There is a lack of quantitative studies including transgender and gender-non-conforming persons.

The impact of internet device diversity on depressive symptoms among middle-aged and older adults in China: A cross-lagged model of social participation as the mediating role

BACKGROUND

Depressive symptoms is more prevalent in middle-aged and older populations, and the development of Internet technology has brought new challenges and opportunities for the mental health of this group. This study aims to explore the bidirectional relationship between Internet device diversity and levels of depressive symptoms through longitudinal data analysis, as well as investigate the mediating role of social participation.

METHODS

Data for the analysis was retrieved from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, 2018, and 2020, which included 9259 middle-aged and older adults. The sum of the number of devices mentioned by each participant was calculated to assess the diversity of internet device use, a weighted total score of how frequently and to what extent individuals had participated in various social activities in the past month was calculated to measure the social engagement, and the Center for Epidemiological Studies Depression Scale was used to calculate depressive symptoms. A cross-lagged mediation model and bivariate correlation analysis were employed to examine the longitudinal relationships among depressive symptoms, internet device diversity, and social participation. Age, gender, highest education level, marital status, drinking status, smoking history, self-rated health, sleep duration, and chronic health conditions were adjusted as covariates.

RESULTS

The results from the three waves of longitudinal data revealed mutual predictive relationships among internet device diversity, social participation, and depressive symptoms. The mediating effect was significant (β = -0.612, 95 % CI -0.796 to -0.429), with significant gender differences observed. Furthermore, our findings indicated that social participation functioned as a protective factor against depressive symptoms, and the association between social participation and depressive symptoms was not a straightforward linear relationship. This suggests that participation in social activities (either high or low) is associated with a lower risk of depressive symptoms compared to no social participation, with no gender differences.

CONCLUSIONS

This study suggests that there is a relationship between internet device diversity and lower levels of depressive symptoms among middle-aged and older adults in China. Social participation mediates the relationship between internet device diversity and depressive symptoms, and different levels of social engagement have different effects on depressive symptoms. It is recommended to increase support for social participation among middle-aged and older adults, strengthen structural social capital, and better leverage the use of the internet to reduce depressive symptoms levels and promote the physical and mental well-being of this population.

Comparing network structures of depressive and anxiety symptoms between demographically-matched heart disease and heart disease free samples using propensity score matching: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

BACKGROUND

Older adults with heart disease often experience higher rates of comorbid anxiety and depression. This study examined depression and anxiety network structures among older adults with heart disease and their heart disease free peers.

METHODS

Network analyses of secondary cross-sectional data from the 2017 to 2018 wave of CLHLS were used to construct groups of older adults with and without heart disease using propensity score matching. Depression and anxiety symptoms were assessed using Center for Epidemiological Studies Depression Scale and Generalized Anxiety Disorder Scale, respectively. Central symptoms and bridge symptoms were identified using expected influence.

RESULTS

1689 older adults with heart disease and matched control sample of 1689 older adults without heart disease were included. The prevalence and severity of depression and anxiety were significantly higher in older adults with heart disease compared to the control group. There was no significant difference in overall structures of depression and anxiety network models between two the groups. Key central symptoms and bridge symptoms within these groups were highly similar; GAD 2 "Uncontrollable worrying" and GAD 4 "Trouble relaxing" were identified as the most central symptoms, while GAD 1 "Nervousness" and CESD 1 "Feeling bothered" were identified as key bridge symptoms across both network models.

CONCLUSION

Depression and anxiety are more prevalent in older adults with heart disease than demographically-matched heart disease free controls. However, network structures of these symptoms do not differ between two groups. Accordingly, depression and anxiety psychosocial interventions developed for older adults without heart disease may also benefit older adults with heart disease.

Effect of music on hemodynamic fluctuations in women during induction of general anesthesia: A prospective randomized controlled multicenter trial

BACKGROUND

The authors aim to investigate the effect of music on hemodynamic fluctuations during induction of general anesthesia and reducing preoperative anxiety for women who underwent elective non-cardiac surgery.

METHODS

It is a multicenter, double-blind, randomized, parallel-group clinical trial. Patients were randomized 1:1 to either a Music Intervention group (MI) or a Control group (Control). The MI participants listened to their preferred music for more than 30 minutes in the waiting area. The State-Trait Anxiety Inventory (STAI) was used to measure anxiety levels in the groups, and hemodynamic parameters (Heart Rate [HR], Mean Arterial Pressure [MAP]) were continuously recorded before induction (T0), at loss of consciousness (T1), immediately before intubation (T2), and after intubation (T3). Intubation-related adverse events were also recorded. The primary outcome was the incidence of MAP changes more than 20 % above baseline during T0-T2.

RESULTS

A total of 164 patients were included in the final analyses. The incidence of MAP instability during T0-T2 was lower in the MI, and the 95 % Confidence Interval for the rate difference demonstrated the superiority of MI. HR instability was less frequent in MI participants both in T0-T2 and T2-T3. The overall incidence of preoperative anxiety was 53.7 % (88/164). After the music intervention, the mean score of STAI was significantly lower in the MI than in the Control, with a between-group difference of 8.01.

CONCLUSIONS

Preoperative music intervention effectively prevented hemodynamic instability during anesthesia induction and significantly reduced preoperative anxiety in women undergoing elective non-cardiac surgery.

The Relationship Between Childhood Trauma and Non-Suicidal Self-Injury Behavior in Adolescents with Depression: The Mediating Role of Rumination

Objective

Non-suicidal self-injury (NSSI) behavior is very common in adolescents with depression, and childhood trauma is considered one of the distal risk factors for its exacerbation. Rumination caused by adverse traumatic experiences, which can be transferred through NSSI behavior, can alleviate symptoms of depression in adolescents. The current research focuses on the relationship between the three, further exploring whether rumination is a mediator in the relationship between childhood trauma and NSSI behavior on the basis of previous studies, and provides some suggestions for future early intervention for adolescents with depression.

Methods

A total of 833 adolescent patients with depression who met the DSM-5 criteria for depressive episode were recruited from 12 hospitals in China. The Chinese version of the Function Assessment of Self-mutilation, Childhood Trauma Questionnaire, and Rumination Inventory were used as research tools.

Results

The scores of childhood trauma and rumination in adolescents with depression in the NSSI group were higher than those in the non-NSSI group. A Pearson's correlation analysis showed that childhood trauma was positively correlated with rumination (r=0.165, P<0.01), different types of childhood trauma were significantly positively correlated with rumination and its three factors, and these results were statistically significant. Rumination partially mediated the relationship between childhood trauma and NSSI behavior in depressed adolescent patients (effect size=0.002), and the effect in female participants (effect size=0.003), was greater than that in male participants (effect size=0.002).

Conclusion

Childhood trauma and rumination were key factors for NSSI behavior in adolescents with depression. Childhood trauma not only has a direct effect on NSSI behavior in adolescent depression, but also plays an indirect effect on NSSI behavior through rumination.

Stability and Change in Mental Health Profiles from Middle Adulthood to Very Old Age

OBJECTIVES

This study investigates mental health (MH) through the dual-factor model, emphasizing both well-being and ill-being. Our objectives were to (1) identify MH profiles based on this model; (2) track these profiles over time; and (3) explore socio-demographic and physical health factors associated with these profiles.

METHODS

We employed Latent Transition Analysis on data from 5,561 individuals aged 39-92, using two waves from the Survey of Health, Ageing, and Retirement in Europe. Well-being was assessed via life satisfaction and quality of life, while ill-being was measured through depression and loneliness. The predictors were socio-demographic and physical health variables.

RESULTS

Four distinct MH profiles emerged, each with unique levels of well-being and ill-being. Stability was more common in adaptive profiles. Physical health was key in predicting transition.

CONCLUSIONS

Identifying MH profiles in old age enhances our understanding of how MH adapts with aging. This approach reveals the complexity of MH beyond traditional ill-being, underscoring the importance of well-being.

CLINICAL IMPLICATIONS

• The majority of older adults maintain good MH, suggesting a need for a paradigm shift toward enhancing well-being rather than solely treating ill-being.• Effective MH interventions should integrate both well-being and ill-being assessments to offer understanding and support.

A study on the influencing factors of mental health of Chinese garden workers: a cross-sectional study

BACKGROUND

Occupational hazards occur in all walks of life. China's horticulture industry is undergoing rapid development. However, the mental health of garden workers has not received much attention. This study investigates the mental health status and influencing factors of Chinese garden workers and provides a basis for promoting their mental health and ensuring the healthy development of Chinese horticulture.

METHODS

A cross-sectional survey of garden workers in Beijing was conducted from 10 July 2021 to 10 October 2021. A total of 3349 valid questionnaires were recovered, with an effective response rate of 95.69%. Descriptive statistical analysis was carried out on the demographic characteristics, job satisfaction, stress, anxiety, and depression of garden workers, and the influencing factors affecting the mental health of Chinese garden workers were found through a t-test, variance analysis, and ordinal multi-class logistic regression analysis.

RESULTS

Survey respondents were mostly male (54.4%) and under the age of 40 (64.1%). The anxiety and depression symptoms of the garden workers were moderate. Among staff members, 40.2% were in a normal state of stress. Gender, three meals on time, monthly income, and job satisfaction were the factors influencing stress, anxiety, and depression symptoms among garden workers.

CONCLUSION

Compared to medical staff and other groups, the stress, anxiety, and depression symptoms of Chinese garden workers are severe. Gender, monthly income, and job satisfaction are important factors affecting their mental health. Managers should continuously improve the working environment of garden workers, provide salaries that match their positions, and improve their job recognition and satisfaction to reduce the impact of negative emotions on personal health.

The Pressing Need to Integrate Mental Health into Obstetric Care

Mental health and substance use conditions are prevalent among perinatal individuals. These conditions have a negative impact on the health of perinatal individuals, their infants, and families, yet are underdiagnosed and undertreated. Populations that have been marginalized disproportionately face barriers to accessing care. Integrating mental health into obstetric care could address the perinatal mental health crisis. We review perinatal mental health conditions and substance use, outline the impact associated with these conditions, and describe the promise and potential of integrating mental health into obstetric settings to improve outcomes for patients receiving obstetric and gynecologic care.

Anxiety Disorders in Athletes

Athletes and non-athletes experience many anxiety-related symptoms and disorders at comparable rates. Contributory factors may include pressure to perform, public scrutiny, sporting career dissatisfaction, injury, and harassment and abuse in sport. Anxiety may negatively impact sport performance. Specific types of anxiety may have unique presentations in athletes. It is important to rule out general medical and substance-related causes of anxiety symptoms. Psychotherapy and pharmacology treatment options should be considered, bearing in mind athletes' environmental circumstances and physiologies.

Gender Differences in Body Satisfaction Perception: The Role of Nutritional Habits, Psychological Traits, and Physical Activity in a Strength-Training Population

The objective of this study is to examine gender disparities in body satisfaction perception, emphasizing the influence of nutritional habits, psychometric assessments, levels of physical activity, and health-related metrics. Employing a sample of 605 strength-trained participants (385 males and 224 females), aged between 20 and 35 years, and regularly engaged in strength training, we conducted a thorough analysis using Google Forms. We evaluated variables including age, anthropometric data, resistance training frequency, food consumption patterns, and psychological profiles. Our findings indicate significant gender-based differences in body satisfaction perception. Females tend to overestimate their muscular size and express heightened concern regarding gluteal shape, while males exhibit a more realistic self-perception, primarily focused on hip width. Dietary patterns also display gender-specific tendencies; females prefer healthier options like vegetables, whereas males consume more milk, fermented products, and carbohydrates. Hydration practices diverge as well, with females showing higher water intake in contrast to males' preference for alcoholic and carbonated beverages. Psychologically, males demonstrate greater extroversion, while females exhibit higher conscientiousness, openness, and a tendency toward negative thoughts and anxiety. Regarding physical activity, females engage in training sessions with greater volume compared to males. This study highlights the intricate interplay of social, cultural, and personal factors shaping gender-specific perceptions of body satisfaction and their subsequent impact on health and lifestyle choices. These insights pave the way for future specialized interventions and research, underscoring the importance of understanding gender-specific nuances to promote healthy body satisfaction and self-perception.

Gender differences in social networks and physical and mental health: are social relationships more health protective in women than in men?

Background

Individuals' relationships are characterized by multidimensional aspects and the unique make-up of different features is more or less supportive of physical and mental health. The current study derived social network types based on an extended set of indicators reflecting the structure, function, and quality of relationships, then examined their associations with diverse physical and mental health outcomes separately for men and women.

Methods

Using samples of 620 South Korean adults (Mage = 53.52), Latent Profile Analysis (LPA) was used to uncover distinct social network types, and multiple regression analyses were conducted to examine the link between network types and health outcomes.

Results

LPA analysis derived four network types: diversified, family-(un)supported, friend- based, and restricted. The prevalence and configuration of network types differed between men and women: the family-unsupported type was more prevalent in women than in men whereas the restricted type was more prevalent in men than in women. An individual's network type membership was significantly associated with one's physical and mental health and the positive effects of an optimal network type and the negative effects of a non-optimal network type on mental health were much greater for women than they were for men.

Discussion

The findings suggest that women benefit more from supportive networks but that they are also more vulnerable to a lack of supportive (or the presence of conflict-filled) relationships, and highlight that having diversified and greater quality relationships, and avoiding conflicts are critical for women to have enhanced health.

Association Between Social Support, and Depressive Symptoms Among Firefighters: The Mediating Role of Negative Coping

Background

Depressive symptoms (DS) can erode physical and mental health; social support (SS) is considered a buffer for DS and a promoter for improving coping and recovery abilities. However, there is almost no research on the mediating role of negative coping (NC) in SS and DS, especially among firefighters.

Methods

A cross-sectional survey was conducted among firefighters in Chongqing, China, and the valid data of 407 firefighters were collected through questionnaires distributed on the WeChat platform in 2020. Statistical Product and Service Solutions (SPSS) 26.0 is used for descriptive statistics and correlation analysis. Structural equation modeling was adopted to analyze the association among SS, NC, and DS. The mediation effect is also evaluated.

Results

Firefighters' detection rate of DS is 23.3%, and when they receive more SS were less likely to develop DS. NC was positively correlated with DS (β = 0.54, p < 0.001) after controlling for SS. Besides, the results of structural equation modeling showed that NC partially mediates the relationship between SS and DS (standard error = 0.039, indirect effects = 0.109, 95% confidence interval: 0.047-0.200 p < 0.001).

Conclusion

NC has a partial indirect effect between SS and DS among firefighters. SS could not only affect DS directly but also indirect work on it by affecting NC. This discovery will be a novel and meaningful part of the research on the firefighter population.

Sex differences in the rapid detection of neutral faces associated with emotional value

BACKGROUND

Rapid detection of faces with emotional meaning is essential for understanding the emotions of others, possibly promoting successful interpersonal relationships. Although few studies have examined sex differences in the ability to detect emotional faces, it remains unclear whether faces with emotional meaning capture the attention of females and males differently, because emotional faces have visual saliency that modulates visual attention. To overcome this issue, we tested the rapid detection of the neutral faces associated with and without learned emotional value, which are all regarded as free from visual saliency. We examined sex differences in the rapid detection of the neutral female and male faces associated with emotional value.

METHODS

First, young adult female and male participants completed an associative learning task in which neutral faces were associated with either monetary rewards, monetary punishments, or no monetary outcomes, such that the neutral faces acquired positive, negative, and no emotional value, respectively. Then, they engaged in a visual search task in which previously learned neutral faces were presented as discrepant faces among newly presented neutral distractor faces. During the visual search task, the participants were required to rapidly identify discrepant faces.

RESULTS

Female and male participants exhibited comparable learning abilities. The visual search results demonstrated that female participants achieved rapid detection of neutral faces associated with emotional value irrespective of the sex of the faces presented, whereas male participants showed this ability only for male faces.

CONCLUSIONS

Our results demonstrated that sex differences in the ability to rapidly detect neutral faces with emotional value were modulated by the sex of those faces. The results suggest greater sensitivity to faces with emotional significance in females, which might enrich interpersonal communication, regardless of sex.

Thinking twice: examining gender differences in repetitive negative thinking across the adult lifespan

Background

A wealth of literature shows that women report greater levels of repetitive negative thinking, particularly rumination, than men in adolescence and adulthood. However, little research has examined how these gender differences develop or change across the entire adult lifespan.

Methods

The present study addresses these oversights using a nationwide longitudinal probability sample of adults over 12 annual assessment points (N = 64,901; Mage = 42.50, range 18-81; 62.9% women) and a single-item measure of global repetitive negative thinking. Critically, we use multigroup cohort-sequential latent growth modeling to determine whether changes in this construct over time are due to (a) normative aging, (b) generational differences associated with the historical period one was born and raised in, or (c) a combination of these processes.

Results

Our results reveal that rumination peaks in young adulthood for both women and men but declines steadily thereafter, reaching its lowest levels at the end of the adult lifespan. That said, some gender and cohort differences emerged, with young women-particularly young cohorts-reporting higher levels of rumination than their male counterparts and older birth cohorts.

Discussion

Our study suggests that gender differences in rumination may be most prevalent among young birth cohorts, though future research is needed to elucidate the mechanisms underlying these processes.

Gender differences in depressive symptoms among Chinese older adults based on fairlie decomposition analysis

This study aimed to investigate the factors influencing depressive symptoms among Chinese older adults based on gender differences. Data from the eighth wave of Chinese Longitudinal Health Longevity Survey were used. We analyzed the influencing factors of depressive symptoms reported by older adults using the chi-squared test and logistic model. Fairlie decomposition analysis was performed to quantify the contribution level of each influencing factor. We found that 11.71 % of older adults met the CES-D-10 criteria for depressive symptoms. Females (13.89 %) reported a significantly higher level of depressive symptoms than males (9.24 %). Age, residence, sleeping time, exercise, activities of daily living functional disability, instrumental activity of daily living functional disability, and living status influenced depressive symptoms in older adults. Higher education and lower body mass index were only significant in male, whereas middle annual income and exercising were significant only in female. The Fairlie decomposition model explained the reasons for 75.64 % of the gender differences in depressive symptoms, with instrumental activity of daily living functional disability (33.60 %), age (-17.79 %), and education level (17.41 %) being major factors affecting gender differences in depressive symptoms. This is the first nationwide study to examine gender differences in depressive symptoms among older adults. These results provide a basis for relevant Chinese government departments to formulate policies to prevent and control depressive symptoms.

Depression by gender and associated factors among older adults in India: implications for age-friendly policies

Inspite of implementing policies to control mental health problems, depression remains a severe health concern among older adults in India. We examined self-reported differences in the depression among older men and women in India and examined associated factors for gender differences in depression at the population level. We utilized nationally representative data from the Longitudinal Aging Study in India (LASI) wave I, for years 2017-2019. Our analytical sample comprised of 30,637 older adults ages 60 years and above (14,682 men and 15,655 women). We conducted descriptive statistics and Chi-Square tests followed by binary logistic regression and multivariate decomposition analyses to examine our study objectives. Depression was reported in - 7.4% (95% CI 7.0, 7.8) of older men and 9.5% (CI 9.1, 10.0) of older women. Poor self-rated health, multimorbidity status, physical activity, difficulty in activities of daily living (ADL) and instrumental ADL (IADL) were the significant health-related factors associated with depression among older men and women. Not being satisfied with one's life, not being satisfied with their present living arrangement, receiving any type of ill-treatment, and being widowed were the significant factors associated with depression among older men and women. We found gender disparity in self-reported depression. Marital status contributed-to 36.7% of the gender gap in depression among older adults. Additionally, ADL and IADL difficulties among men and women contributed to 17.6% and 34.0%, gender gap, self-rated health contributed to 18.8% gap, whereas not having equal social participation (4.4%) and not satisfied in present living arrangements (8.1%) were other factors that contributed to gender gap for depression in India. Depression is a critical and persistent public health problem among-older females in India. Our findings provide a broader framework for policymakers and health practitioners to focus on gender-specific strategies to mitigate this highly emergent problem.

Sex Differences in Recovery Capital Gains Post-Incarceration

BACKGROUND

People with substance use disorders are highly prevalent in the carceral system. Recovery capital (RC) is the resources available to an individual to initiate or maintain substance use cessation. Sex differences have been identified in RC during both active substance use and recovery in the general population, however, less is known about these sex differences in the post-incarceration population.

METHODS

Participants (n = 136) were those with an opioid or stimulant use disorder with past year involvement with the Iowa criminal justice system (USA), who completed the Assessment of Recovery Capital (ARC) twice over a six-month cohort study. Participants were involved in an addiction clinic that utilized active case management. Analysis of covariance evaluated changes in ARC during the study. Separate models compared total ARC and individual ARC domains, with sex as the independent variable of interest. Model means were generated for interpretation based on sex, comparing baseline and study endpoint ARC scores.

RESULTS

There were no baseline sex differences in total ARC. ARC increased significantly for the group, however, males showed disproportionate growth. Females ended the study with a mean ARC of 37.8 (SD= 9.3) and males finished at 41.6 (SD= 9.3), which was a significant difference (p = 0.044); this significant difference was driven by ARC subdomains of 'Psychological Health' and 'Physical Health.'

CONCLUSIONS

People post-incarceration are at high risk for return to substance use. Treatment that is informed by sex-based differences may have the potential to decrease the differing rates of growth in RC between sexes.

Pandemic-induced increase in adjustment disorders among postpartum women in Germany

BACKGROUND

The current paper analyzed the effect of the pandemic-induced lockdown on maternal mental health during the first 12 postpartum weeks in Germany.

METHODS

In this cohort study, we compared the participants' anamnestic backgrounds and the results of psychological tests, measuring stress levels, depressive symptoms and attachment. The 327 participants were divided into two groups with one representing the "pre-COVID" sample and the other the "lockdown" sample. We performed multiple comparisons, investigating the distribution of diagnoses and the correlating risk profiles between the two cohorts.

RESULTS

Our analysis showed a significant difference between the two cohorts, with a 13.2% increase in the prevalence of adjustment disorders (AD), but not postpartum depression (PPD), in the first 12 weeks postpartum. However, during the pandemic, women with AD had fewer risk factors compared to their pre-pandemic counterparts. In the "lockdown" cohort, a tendency toward higher stress and lower mother-child attachment was observed in AD.

CONCLUSIONS

In sum, we observed some negative impact of the pandemic on maternal mental health. The lockdown might have contributed to an increase in the number of cases involving AD in the postpartum period. The prevalence of PPD (ca. 6-10%), on the other hand, was not affected by the lockdown. Thus, the effect of COVID-19 on maternal mental health might not, after all, have been as severe as assumed at the beginning of the pandemic.

Translation and validation of the Turkish forms of the International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ)

BACKGROUND

The 11th version of the International Classification of Diseases (ICD-11) included revised formulations of single episode depressive disorder (DD) and generalized anxiety disorder (GAD). Consequently, the International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ) have been developed as self-report measures which directly align with the ICD-11 description of DD and GAD, respectively.

OBJECTIVE

The current study sought to (1) test the factorial validity of the Turkish translations of the IDQ and IAQ, (2) evaluate their internal reliability, (3) determine how meeting diagnostic requirements for ICD-11 DD and ICD-11 GAD vary across different demographic variables, and (4) determine the convergent validity of the Turkish translations of the IDQ and IAQ.

METHODS

Participants were a community sample of 1455 Turkish adults and largely comprised of university students. This study used confirmatory factor analysis (CFA) to test the latent structure of both scales. Prevalence rates of ICD-11 GAD and DD were also estimated, and differences in prevalence rates according to gender and relationship status were examined.

RESULTS

The CFA results indicated that both scales were unidimensional. Both scales demonstrated high levels of internal consistency. The prevalence of ICD-11 DD and GAD was 26.6 % and 28.5 %, respectively. Rates of probable ICD-11 DD and GAD were highest for females and single participants. Convergent validity was indicated by strong associations with external measures of depression and anxiety.

CONCLUSION

Findings from this study provide support for the validity and reliability of the Turkish versions of the IDQ and IAQ in a large community sample.

What explains the link between romantic conflict with gambling problems? Testing a serial mediational model

Introduction

While individuals have many motives to gamble, one particularly risky motive for gambling is to cope with negative affect. Conflict with one's romantic partner is a strong predictor of negative affect, which may elicit coping motives for gambling and, in turn, gambling-related problems. Support for this mediational model was demonstrated in relation to drinking-related problems. We extended this model to gambling.

Method

Using a cross-sectional design, we examined links between romantic conflict (Partner-Specific Rejecting Behaviors Scale), negative affect (Depression, Anxiety, and Stress Scales-21), coping gambling motives (Gambling Motives Questionnaire, coping subscale), and gambling-related problems [Problem Gambling Severity Index (PGSI)] in 206 regular gamblers (64% men; mean age = 44.7 years; mean PGSI = 8.7) who were in a romantic relationship and recruited through Qualtrics Panels in July 2021.

Results

Results supported our hypothesis that the association between romantic conflict and gambling-related problems would be sequentially mediated through negative affect and coping gambling motives, β = 0.38, 95% CI [0.27, 0.39], and also showed a strong single mediation pathway through negative affect alone, β = 0.27, 95% CI [0.17, 0.38].

Discussion

Negative affect and coping gambling motives partially explain the link between romantic conflict and gambling-related problems. Interventions should target both negative affect and coping gambling motives in response to romantic conflict to reduce gambling-related problems in partnered gamblers.

Generalised anxiety disorder, depressive symptoms and their subjective change after the first wave of COVID-19 among gamers in Poland

Previous studies have indicated that levels of emotional distress were considerably elevated during the COVID-19 pandemic; however, some longitudinal studies did not confirm these findings. There is a very limited number of studies on specific subpopulations, such as video gamers in this particular period. Playing video games may have either a beneficial influence on mental health by diminishing stress or a detrimental impact in terms of increasing depression and anxiety. It is, therefore, important to establish whether regular gamers differ from the general population in terms of symptoms of depression and anxiety during COVID-19. A total of 1023 participants (aged 18-50) participated in the study. The sample was composed of gamers and was representative of the Polish population. Participants completed a modified version of GAD-7, PHQ-9 online, addressing subjective change in anxiety and depressive symptoms. 25% of the sample reported clinically significant anxiety levels, and 35% mentioned depression. There were no differences in anxiety and depression levels between the investigated sample of gamers and the general population. However, up to 30% of individuals reported an increase in subjective change in anxiety or depressive symptoms during COVID-19. A further 30% reported a downward subjective change in anxiety or depressive symptoms during COVID-19. The remaining 40% declared a lack of change in the subjective change in anxiety or depressive symptoms during COVID-19. Those who reported an increase scored substantially higher in anxiety and depression than other groups. This indicates that the COVID-19 pandemic may have impacted people's mental health along a syndemic-syndaimonic continuum. COVID-19 might have been harmful to those with already poorer mental health and beneficial to those with good mental health. It is also important to plan interventions targeting vulnerable individuals who report clinically significant levels of anxiety and depression - women and younger adults and those who subjectively perceive their emotional condition to deteriorate during the COVID-19 lockdown.

Impacts of Anxiety and Depression on Clinical Hypertension in Low-Income US Adults

INTRODUCTION

Depression and anxiety are common leading causes of disability and are associated with systemic effects including cardiovascular comorbidities. Low-income populations may experience higher frequencies of depressive or anxiety-related symptoms, and be at greater risk for developing hypertension.

AIM

We performed a cross-sectional study of low-income participants who completed hypertension and disability questionnaires as part of the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES) to identify associations between depressive/anxiety-related symptoms and hypertension status.

METHODS

Multivariable logistic regressions were performed to identify whether (1) frequency of depressive symptoms, (2) frequency of anxiety-related symptoms, (3) self-reported depression medication use, or (4) self-reported anxiety medication use predicted previous hypertension diagnosis.

RESULTS

A total of 74,285,160 individuals were represented in our cohort. Participants that reported taking depression (OR 2.72; 95% CI 1.41-5.24; P = 0.009) and anxiety (OR 2.50; 95% CI 1.42-4.41; P = 0.006) medications had greater odds of hypertension. Individuals with depressive feelings daily, monthly, and few times per year were more likely to have hypertension. Respondents with daily (OR 2.28; 95% CI 1.22-4.24; P = 0.021) and weekly (OR 1.88; 95% CI 1.05-3.38; P = 0.040) anxiety symptoms were more likely to have hypertension.

CONCLUSIONS

Low-income adults in the United States with symptoms of anxiety or depression have higher likelihood of hypertension than those with no symptoms. Respondents who indicated taking medication for anxiety disorders or depression were more likely to have been diagnosed with hypertension.

Prevalence of Psychiatric Disorders by Demographics in Jail Populations

Many individuals incarcerated in jails suffer from psychiatric disorders and require mental health treatment. However, there has yet to be a study which comprehensively described the prevalence of mental illness diagnoses by demographic variables or compared results to the general population. Data for this study were the Survey of Inmates in Local Jails, 2002. Binary logistic regression was run to compare the prevalence of diagnoses to demographic variables of the jail population. Results were compared to studies in the general population. Males were less likely than females to report five of the seven disorder categories, and employed individuals were less likely to report all seven disorders. The results were consistent with research on the general population. It is important to understand the population of individuals with mental illness in jail so we can better serve them and catch psychiatric disorders early while they are more easily treatable.

The COVID-19 pandemic: asthma control, tobacco use, and mental health among African American and Latinx college students

OBJECTIVE

This study investigated the impact of COVID-19 on tobacco use and mental health in US African American and Latinx college students with asthma. Associations among asthma control, tobacco use, and mental health were also examined.

METHODS

105 African American and Latinx college students with asthma (18-23 years) completed two online questionnaires (June 2019-March 2020 for Time 1; August 2020-October 2020 for Time 2). Participants completed the Epidemic-Pandemic Impacts Inventory (measure of COVID-19 impact), Asthma Control Test, Generalized Anxiety Disorder scale, Patient Health Questionnaire (measure of depression), Perceived Stress Scale, and items related to tobacco use.

RESULTS

Asthma control improved (t = -3.326, p = 0.001) from Time 1 to 2, and e-vapor product use decreased (χ²₁₀₄ = 6.572, p = 0.010). COVID-19 impact was positively associated with students' symptoms of anxiety, depression, and perceived stress (B = 0.201, p < 0.001; B = 0.179, p < 0.001; and B = 0.199, p = 0.001, respectively) at Time 2. These results remained significant with the Benjamini-Hochberg correction. Asthma control at Time 1 was negatively associated with anxiety symptoms at Time 2 (B = -0.418, p = 0.023); however, associations with perceived stress (B = -0.514, p = 0.019) and all other tobacco product use (B = -0.233, p = 0.030) did not remain significant with the Benjamini-Hochberg correction.

CONCLUSIONS

As hypothesized, a higher COVID-19 impact score was associated with students endorsing more mental health symptoms. Better control of asthma symptoms before the pandemic predicted fewer anxiety symptoms during the pandemic.

Changes in mental health and help-seeking among young Australian adults during the COVID-19 pandemic: a prospective cohort study

BACKGROUND

Young people may have elevated risk for poorer mental health during the coronavirus disease 2019 (COVID-19) pandemic, yet longitudinal studies documenting this impact are lacking. This study assessed changes in mental health and help-seeking since COVID-19 restrictions in young Australians, including gender differences.

METHODS

Data were drawn from a recent subsample (n = 443; 60% female; Mage = 22.0) of a prospective cohort originally recruited in secondary school to complete annual surveys. The subsample completed an additional COVID-19 survey during COVID-19 restrictions (May-June 2020), which was compared to responses from their latest annual survey (August 2019-March 2020). Mixed effect models with time and gender as the primary predictors were conducted for: (i) scores on the Patient Health Questionnaire Depression 9-item (PHQ-9) and Generalised Anxiety Disorder 7-item (GAD-7) modules assessed before and during COVID-19 restrictions, and (ii) self-reported help-seeking from a health professional in February 2020, and the month preceding May-June 2020.

RESULTS

Mean symptom scores increased from before to during COVID-19 restrictions on the PHQ-9 (coefficient: 1.29; 95% CI 0.72-1.86) and GAD-7 (0.78; 95% CI 0.26-1.31), but there was no increase in help-seeking over time (odds ratio 0.50; 95% CI 0.19-1.32). There was no evidence of differential changes by gender.

CONCLUSIONS

This study found increases in depression and anxiety symptoms but not greater help-seeking among young Australian adults during the first wave of the pandemic. Increasing availability and awareness of accessible treatment options and psychoeducation is critical, as well as further research into risk and protective factors to help target treatment to this vulnerable age group.

The Mediating Role of Depression and of State Anxiety οn the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis

The coronavirus pandemic (COVID-19) is a global health crisis with a particular emotional and physical impact on health professionals, especially nurses. The aim of this study was to investigate the prevalence of anxiety, depression and fatigue and their possible relationships among nurses during the pandemic. The study population consisted of nurses from five tertiary-level public hospitals in Athens who completed the Fatigue Assessment Scale (FAS), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) questionnaires. Gender, age and years of work experience were recorded. The study was conducted from mid-November to mid-December 2021. The sample included 404 nurses (69 males and 335 females) with a mean age of 42.88 years (SD = 10.90) and 17.96 (SD = 12.00) years of work experience. Symptoms of fatigue were noted in 60.4% of participants, while 39.7% had symptoms of depression, 60.1% had abnormal scores on state anxiety and 46.8% on trait anxiety, with females showing higher scores on all scales (p < 0.05). High positive correlations (p < 0.01) were found between the FAS, BDI, State Anxiety and Trait Anxiety scales. Regression analysis showed that 51.7% of the variance in FAS scores can be explained by trait anxiety, an additional 6.2% by the BDI and 1.2% by state anxiety. Mediation analysis showed that state anxiety and BDI mediate the relationship between trait anxiety and FAS. Finally, BDI was found to exert a moderating role in the relationship between trait anxiety and fatigue. In conclusion, our study showed that nurses continue to experience high rates of anxiety, depression and fatigue. The variation in fatigue appears to be significantly dependent on trait anxiety. Depressive symptomatology and state anxiety exert a parallel positive mediation on the relationship between trait anxiety and fatigue, with depression exhibiting a moderating role in this relationship.

Prefrontal modulation of anxiety through a lens of noradrenergic signaling

Anxiety disorders are the most common class of mental illness in the U.S., affecting 40 million individuals annually. Anxiety is an adaptive response to a stressful or unpredictable life event. Though evolutionarily thought to aid in survival, excess intensity or duration of anxiogenic response can lead to a plethora of adverse symptoms and cognitive dysfunction. A wealth of data has implicated the medial prefrontal cortex (mPFC) in the regulation of anxiety. Norepinephrine (NE) is a crucial neuromodulator of arousal and vigilance believed to be responsible for many of the symptoms of anxiety disorders. NE is synthesized in the locus coeruleus (LC), which sends major noradrenergic inputs to the mPFC. Given the unique properties of LC-mPFC connections and the heterogeneous subpopulation of prefrontal neurons known to be involved in regulating anxiety-like behaviors, NE likely modulates PFC function in a cell-type and circuit-specific manner. In working memory and stress response, NE follows an inverted-U model, where an overly high or low release of NE is associated with sub-optimal neural functioning. In contrast, based on current literature review of the individual contributions of NE and the PFC in anxiety disorders, we propose a model of NE level- and adrenergic receptor-dependent, circuit-specific NE-PFC modulation of anxiety disorders. Further, the advent of new techniques to measure NE in the PFC with unprecedented spatial and temporal resolution will significantly help us understand how NE modulates PFC function in anxiety disorders.

Disparities in healthcare utilization and depression among young mothers: The role of family functioning

BACKGROUND

Extant research suggests that disparities in healthcare utilization and experiences of mental health disorders such as depression exist across sociodemographic groups. One understudied pathway that may have significant implications for these disparities is the role of family functioning. How families interact, communicate, and adapt may vary, but these relationships remain integral for vulnerable subsets of the population due to their seemingly protective properties. Yet, few studies have examined the relationship between family functioning and health.

OBJECTIVE

The aim of this study was to explore family functioning as a predictor for healthcare utilization and depression among young mothers and as a moderator of disparities for each of these outcomes.

DESIGN/METHODS

This analysis uses data from a prospective cohort study which was conducted with 296 pregnant young women recruited from obstetrics clinics in Connecticut between July 2007 and February 2011 and followed 1-year postpartum. Logistic regression models were used to assess family functioning, race/ethnicity, and immigrant status as predictors of healthcare utilization and depression. Family functioning was evaluated as a moderator for both outcomes.

RESULTS

Black and Latina mothers had decreased odds of using physical healthcare services (odds ratioBlack = 0.13, p < 0.001; odds ratioLatina = 0.31, p = 0.02). Family functioning was associated with decreased odds of using mental healthcare services (odds ratio = 0.97, p = 0.04) and had a protective effect against depression (odds ratio = 0.96, p = 0.003). Family functioning significantly moderated the relationship between immigrant status and physical healthcare utilization, Black race/ethnicity and physical healthcare utilization, and Other race/ethnicity and depression.

CONCLUSION

Family functioning is a significant factor associated with both healthcare utilization and depression among young mothers. It should be a strongly considered component within healthcare settings to mitigate risks among vulnerable populations.

Previous School Bullying-Associated Depression in Chinese College Students: The Mediation of Personality

Previous school bullying was associated with increased risk of depression in students. However, little was known about the role of the Big Five personality traits in this association. The purpose of this study was to investigate the possible mediation by the Big Five personality traits in this association in a large group of Chinese college students, and to provide help for educators to prevent students from serious psychological and mental diseases caused by school bullying. Random stratified cluster sampling was used to survey 2152 college students ranging from freshmen to seniors at three universities in Qiqihar city, Heilongjiang Province, China. The risk factors for previous school bullying included gender, living expenses per month, caregivers, parents often quarreling, and divorced parents. Males were more likely to be bullied at school than females. The influencing factors of depression include gender, caregivers, living expenses per month, frequent parents quarreling, and parental divorce. Females were more prone to depression than males. Depression was significantly correlated with all dimensions of school bullying and the Big Five personality traits (p < 0.05). The Big Five personality traits were found to play a significant mediating role between depression and school bullying in up to 45% of cases involving depression. Our major findings highlighted the promising role of personality-based intervention measures in reducing the risk of depression associated with school bullying in Chinese students.

Sex-specific roles of hippocampal microRNAs in stress vulnerability and resilience

Contrary to intuition, most individuals are resilient to psychological trauma and only a minority is vulnerable. Men and women are known to respond differently to trauma exposure, however, mechanisms underlying the relationship between sex differences and trauma resilience and vulnerability are not yet fully understood. Taking advantage of the Behavioral Profiling approach, which enables differentiating between 'affected' and 'unaffected' individuals, we examined sex-associated differences in stress exposure effects on hippocampal expression of selected stress-related GABA-A receptor targeting miRNAs. Levels of the miRNA-144 and miRNA-33 were measured in male and female affected (vulnerable, e.g., higher freezing time) and unaffected (resilient) rats. In male rats, increased levels of miRNA-144 and miRNA-33 were observed in the dorsal dentate gyrus (dDG) and ventral dentate gyrus (vDG) respectively, of stress-exposed but unaffected animals. In females, we observed an increased expression of miRNA-144 and miRNA-33 in the ventral cornu ammonis 1 (vCA1) of affected animals. Accordingly, we inhibited miRNAs expression selectively in hippocampal subregions using oligonucleotides containing locked nucleic acid bases, to examine the miRNAs' causal contribution to either vulnerability or resilience to stress in each sex. Inhibition of miRNA-144 in dDG and miRNA-33 in vDG in males resulted in an increased prevalence of vulnerable animals, while inhibition of miRNA-144 and miRNA-33 in vCA1 in females increased the proportion of resilient animals. The current findings reveal a critical sex-associated difference in the role of miRNAs in stress vulnerability and resilience. This novel understanding of sex-associated epigenetic involvement in the mechanism of stress-related psychopathologies may help improve gender-specific diagnosis and effective treatment.

Neutrophilic granulocyte percentage is associated with anxiety in Chinese hospitalized heart failure patients

BACKGROUND

In patients with heart failure, anxiety disorder is common and associated with adverse prognosis. This study intended to find more confounding factors of Chinese heart failure patients.

METHODS

We enrolled 284 hospitalized heart failure patients, whose New York Heart Association (NYHA) classed as II-IV and left ventricular ejection fraction (LVEF) ≤ 45%. All the patients were scaled in Hamilton Rating Scale for Anxiety (14-items) (HAM-A14). Ordinal logistic regression analysis was performed to examine the association of correlated factors with anxiety disorder.

RESULTS

There were 184 patients had anxiety accounting for 64.8% of all 284 hospitalized heart failure patients. The neutrophilic granulocyte percentage, urea nitrogen, total bilirubin and brain natriuretic peptide were positively associated with HAM-A14 score, meanwhile, the hemoglobin, red blood cells counts, albumin and LVEF were negatively associated with HAM-A14 score (All P < 0.05). After the adjustments of sex, hemoglobin, urea nitrogen, total bilirubin, albumin and brain natriuretic peptide, the neutrophilic granulocyte percentage was significantly associated with anxiety (OR = 43.265, P = 0.012). The neutrophilic granulocyte percentage was 0.616 ± 0.111, 0.640 ± 0.102, 0.681 ± 0.106 and 0.683 ± 0.113 in heart failure patients with no anxiety, possible anxiety, confirmed anxiety and obvious anxiety, respectively.

CONCLUSIONS

Neutrophilic granulocyte percentage as well as the traditional risk factors such as sex, urea nitrogen and brain natriuretic peptide is associated with anxiety in hospitalized heart failure patients.

The Big Five personality traits and the fear of COVID-19 in predicting depression and anxiety among Japanese nurses caring for COVID-19 patients: A cross-sectional study in Wakayama prefecture

Recent studies have found a relationship between fear of COVID-19 and mental health problems. Medical workers caring for COVID-19 patients tend to suffer from mental health problems; however, the impact of their personality traits, in the form of mental problems like depression and anxiety in Japan is unclear. In this study, we investigated the risk of nurses' depression and anxiety, predicted by the fear of COVID-19 and the Big Five personality traits. A total of 417 nurses working in hospitals providing care to COVID-19 patients in Wakayama prefecture of the Kansai region participated in this study. The questionnaires comprised items on nurses' basic characteristics and three scales: the Fear of COVID-19 Scale 2020, the Big-Five Scale, and the Japanese version of the Hospital Anxiety and Depression Scale (HADS). Depression and anxiety in the HADS were set as dependent variables, and basic attributes, fear, and personality traits as independent variables; multivariate logistic regression analyses were conducted. The questionnaire, with no missing items was distributed from February to March 2021. Neuroticism (OR = 1.06, 95%CI = 1.03-1.09) was the only significant factor associated with the depression symptom, and both FCV-19S scores (OR = 1.16, 95%CI = 1.09-1.23) and neuroticism (OR = 1.09, 95%CI = 1.06-1.13) were the significant factors associated with anxiety. The Nagelkerke's R squared was 0.171 in the depression model and 0.366 in the anxiety model. Thus, it was found that it is necessary to support nurses' mental health by developing methods suitable to their personalities.

Fluctuation of depressive symptoms in cognitively unimpaired participants and the risk of mild cognitive impairment 5 years later: Results of the Heinz Nixdorf Recall study

BACKGROUND

Depression might be an independent risk factor for cognitive decline, a prodromal dementia symptom or a reaction to cognitive/functional impairment.

OBJECTIVE

To investigate the association between (1) depressive symptoms and (2) depressive symptom patterns over 13 years with incident mild cognitive impairment (MCI) 5 years later.

MATERIALS AND METHODS

We included 724/823 cognitively unimpaired men/women who participated in the population-based Heinz Nixdorf Recall study (t1: 2005-2008, ø62.9 years; t2: 2010-2015, ø68.1 years). Depressive symptoms were assessed in the study center and during six postal follow-ups using the short form of the Center for Epidemiologic Studies Depression Scale (CES-D). Relative risks (RR; 95% confidence intervals) for MCI at t2 (men/women: 71/76) were estimated for CES-D at t1 (linear and dichotomized at ≥17, cut-off for clinically relevant depressive symptoms) and CES-D fluctuations over 13 years (stable low, large fluctuations, stable high/stable around cut-off) using log-linear regression models with Poisson working likelihood adjusted for age, sex, education, diabetes mellitus, coronary heart disease, and stroke.

RESULTS

Fully adjusted risk for MCI at t2 (per CES-D point increase at t1) was elevated for the total cohort (1.053, 1.031-1.076), men (1.046, 1.012-1.081), and women (1.059, 1.029-1.090). Applying the dichotomized CES-D, risk for MCI was substantially increased for the total cohort [2.22 (1.38-3.58)] and in women [2.59 (1.46-4.58)]. Large CES-D fluctuations and stable high/stable around cut-off were associated with increased RR for MCI in the total cohort and in women compared to stable low symptoms.

CONCLUSION

Depressive symptoms predicted MCI in cognitively unimpaired participants of our population-based study. Adequate treatment of depression may therefore contribute to the maintenance of normal cognition and delay dementia onset.

Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review

Background: The prevalence and comorbidity of anxiety disorders are significantly different between women and men, with research showing a greater impact on women. The aim of this review was to identify the psychosocial and biological factors that have been considered to explain this gender and sex difference in prevalence and determine whether these factors are related to any anxiety comorbidity differences between men and women. Methods: Following the PRISMA guidelines, we carried out a systematic review of studies published between 2008 and 2021 in PsycINFO and PubMed databases. Empirical and review studies evaluating psychosocial and biological factors that could influence the difference in prevalence and comorbidity between men and women were included. A qualitative narrative synthesis was performed to describe the results. Results: From 1012 studies, 44 studies were included. Retrieved articles were categorized depending on their object of study: psychosocial factors (n = 21), biological factors (n = 16), or comorbidity (n = 7). Results showed that differences in anxiety between women and men have been analyzed by psychosocial and biological factors but rarely together. Among the psychosocial factors analyzed, masculinity may be a protective factor for anxiety development, while femininity can be a risk factor. In the studies that took biological factors into account, the potential influence of brain structures, genetic factors, and fluctuations in sexual hormones are pointed out as causes of greater anxiety in women. Concerning comorbidity, the results noted that women tend to develop other internalizing disorders (e.g. depression), while men tend to develop externalizing disorders (e.g. substance abuse). Conclusions: For an accurate understanding of differences between women and men in anxiety, both biological and psychosocial factors should be considered. This review highlights the need to apply the biopsychosocial model of health and the gender perspective to address differences in anxiety between sexes.

The Association of Socioeconomic Status, the Concern for Catching Covid-19, and Anxiety Between Individuals with and without a Cancer History from a Cross-sectional Study

Background

COVID-19 has negative impacts on mental health in all populations. Individuals with a history of cancer have an increased risk of catching and having more severe symptoms of COVID-19 than the general public. The objective of this study was to examine how cancer history and concern for catching COVID-19 relate to anxiety.

Methods

This cross-sectional study is part of the "Impact of COVID-19 on Behaviors across the Cancer Control Continuum in Ohio" project conducted from June to November 2020. The sample consisted of 7012 participants who completed survey online, by phone, or by mail. Self-reported concern for catching COVID-19 and anxiety over the last 7 days were used. Linear and logistic regression models were performed to determine the association between demographics, cancer history, concern for catching COVID-19, and anxiety.

Results

In our study sample, most participants rated their concern for catching COVID-19 as moderately high or high (56%) and reported anxiety for one day or more (63%). Individuals with a cancer history were more likely to report moderate-high or high concern for catching COVID-19 (59% vs.54%, P<0.001) but less likely to report anxiety (58% vs. 67%, P<0.001) compared to those without a cancer history. Individuals with higher SES were less likely to report anxiety (middle vs. low SES: OR=0.68, 95%CI=0.59-0.79; high vs. low SES: OR=0.70, 95%CI=0.61-0.82). Additionally, increased concern for catching COVID-19 was associated with higher likelihood of reporting anxiety (moderate-low vs. low: OR=1.65, 95%CI=1.42-1.92; moderate-high vs. low: OR=2.98, 95%CI=2.53-3.50; high vs. low: OR=4.35, 95%CI=3.74-5.07).

Conclusions

Our findings suggest individuals with a cancer history reported higher concern for catching COVID-19. Higher concern for catching COVID was associated with anxiety. These findings indicate that healthcare providers should pay special attention to the different populations to reduce concerns for catching COVID-19 and provide strategies to improve mental health during a pandemic outbreak.

Funding

This study was supported by a supplement to The Ohio State University Comprehensive Cancer Center (OSUCCC) core support grant ( P30 CA016058), and the OSUCCC The Recruitment, Intervention and Survey Shared Resource (RISSR)(P30 CA016058).The Ohio State University Center for Clinical and Translational Science grant support (National Center for Advancing Translational Sciences, Grant UL1TR001070) in publications relating to this project. This work was supported by the National Cancer Institute (F99CA253745 to X.Z.).

Substance use confounds associations between peer victimization and aggression in adolescence with mental disorders in adulthood: A prospective birth cohort study

INTRODUCTION

Peer victimization and aggression in adolescence are associated with later mental health morbidity. However, studies examining this association have not controlled for adolescent substance use. We aimed to study the associations between peer victimization, peer aggression, and mental disorders in adulthood, adjusting for substance use in adolescence.

METHODS

Participants were from the prospective Northern Finland Birth Cohort 1986. Data were available for 6682 individuals (70.8% of the original sample). Peer victimization and peer aggression were assessed with items from the Achenbach Youth Self Report at ages 15-16 years. Outcomes were nonorganic psychosis, anxiety disorder, mood disorder, substance use disorder, and any mental disorder (a none-vs-any indicator) at age 33 years collected from nationwide health care, insurance, and pension registers. Family structure, alcohol intoxication frequency, daily smoking, illicit drug use, and baseline psychopathology using Youth Self-Report total score, and parental mental disorders were considered as confounding factors.

RESULTS

In multivariable analyses, the association between peer victimization and psychosis (Hazard ratio [HR]: 2.9, 95% confidence interval [CI]: 1.2-6.9, p = .020) and mood disorder (HR: 1.7, 95% CI: 1.2-2.4, p = .012) in females remained significant after adjusting for confounders. Other associations between female and male peer victimization or aggression and the studied outcomes attenuated after adjustments.

CONCLUSIONS

Some associations between peer victimization and aggression and later mental health morbidity are explained by adolescent substance use. For females, substance use does not account for the increased risk of psychosis and mood disorder in those who experience peer victimization.

Gender Differences in Coping, Depression, and Anxiety in Patients with Non-Metastatic Lung Cancer

Background

Depression and anxiety are prevalent issues amongst individuals suffering from thoracic cancer. Gender differences in coping with thoracic cancer have a serious impact upon the management of emotional distress. The purpose of our study has been to assess sex variations in handling anxiety and depression, including the use of coping mechanisms and their relationship with respect to anxiety and depression.

Methods

This cross-sectional study registered 18 women and 22 men with non-metastatic lung cancer and operated upon. Pre-operatively and at one month post-operatively, the patients were assessed by means of scales (COPE, GAD-7 and PHQ-9).

Results

Post-operatively, the intensity of depression and anxiety was substantially greater in males than in females (p = 0.049, p = 0.042). Male individuals tended to use coping mechanisms of humour (p = 0.009) and restraint (p = 0.029) significantly more frequently than women. Moreover, in women, depression correlated significantly with denial and behavioural deactivation (rho = 0.465, p = 0.029, respectively, rho = 0.562, p = 0.006); whilst anxiety, similarly, correlated with positive interpretation, behavioural deactivation, and use of social-emotional support (rho = 0.484, p = 0.022, respectively, rho = 0.590, p = 0.004 and rho = 0.502, p = 0.017). Furthermore, in males, depression correlated significantly with mental deactivation, use of social-instrumental and social-emotional support (rho = 0.702, p = 0.001, respectively, rho = 0.505, p=0.033, and rho = 0.773 with p < 0.001), whilst anxiety correlated significantly with mental deactivation, denial, and use of social-emotional support (rho = 0.597, p = 0.009, respectively, rho = 0.553 with p = 0.017 and rho = 0.755, p < 0.001).

Conclusion

There were gender divergences in the use of coping mechanisms and the level of post-surgical anxiety and depression. We found significant positive relationships between some coping mechanisms and depression/anxiety. The patient’s gender governs the coping style, which in turn has bearing upon the post-operative evolution.

The Mental Health Impact of the COVID-19 Pandemic Second Wave on Shielders and Their Family Members

In March 2020, individuals shielding from coronavirus reported high rates of distress. This study investigated whether fear of contamination (FoC) and use of government-recommended behaviours (GRB; e.g., handwashing and wearing masks) were associated with psychological distress during February 2021. An online cross-sectional questionnaire assessed psychological distress in three groups (shielding self, shielding other/s, and control), and those shielding others also completed an adapted measure of health anxiety (α = 0.94). The sample (N = 723) was predominantly female (84%) with a mean age of 41.72 (SD = 15.15). Those shielding (self) demonstrated significantly higher rates of health anxiety and FoC in comparison to other groups (p < 0.001). The use of GRB was significantly lower in controls (p < 0.001), with no significant difference between the two shielding groups (p = 0.753). Rates of anxiety were higher when compared to March 2020 findings, except for controls. Hierarchical regressions indicated FoC and GRB accounted for 24% of variance in generalised anxiety (p < 0.001) and 28% in health anxiety, however, the latter was a non-significant predictor in final models. Those shielding themselves and others during the pandemic have experienced sustained levels of distress; special consideration must be given to those indirectly affected. Psychological interventions should account for realistic FoC and the impact of government-recommended health behaviours, as these factors are associated with distress in vulnerable groups and may extend beyond the pandemic. Future research should focus on longitudinal designs to monitor and better understand the clinical needs of those shielding, and those shielding others post-pandemic.

Repetitive Negative Thinking and Sexual Functioning in Portuguese Men and Women: A Cross-Sectional Study

Objective: Repetitive negative thinking (RNT) is a transdiagnostic process involved in the development and maintenance of emotional disorders that negatively affect sexual functioning. However, empirical evidence for the role of RNT on sexual functioning is still lacking. The current study aimed to investigate the role of RNT on sexual functioning in men and women by examining differences in RNT between men and women and between individuals with and without subclinical sexual difficulties. It also aimed to investigate the predictive role of RNT on sexual function indices in men and women. Methods: A total of 424 participants (270 women) completed online a sociodemographic questionnaire and Portuguese versions of the Persistent and Intrusive Negative Thoughts Scale, the Female Sexual Functioning Index, and the International Index of Erectile Function. Results: The main findings showed that women scored significantly higher than men on the RNT. Similarly, individuals with subclinical sexual difficulties scored significantly higher on the RNT compared with individuals without sexual difficulties. RNT was a statistically significant and negative predictor of sexual functioning in women and men. The role of RNT on sexual functioning in women and men was found, with men and women with subclinical sexual difficulties more likely to express persistent and intrusive negative thoughts compared with men and women without sexual difficulties. Conclusions: In summary, RNT appears to be a negative predictor of sexual functioning in both women and men, suggesting that individuals with more intrusive and negative persistent thoughts also have more difficulty in their sexual response.

Incidence and risk factors of mental disorders in the elderly: The European MentDis_ICF65+ study

OBJECTIVE

While incidence rates of depression and anxiety disorders in the elderly have been comprehensively investigated, the incidence rates of other mental disorders have rarely been researched. The incidence rate and predictors of various mental disorders in the elderly were evaluated in different European and associated countries.

METHODS

A cross-sectional and longitudinal multi-centre survey of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnoses was conducted in different European and associated countries (Germany, Italy, Spain, Switzerland, the United Kingdom and Israel) to collect data on the prevalence and incidence of mental disorders in the elderly. The sample size of the longitudinal wave was N = 2592 elderly.

RESULTS

The overall 1-year incidence rate for any mental disorder in the elderly is 8.65%. At 5.18%, any anxiety disorder had the highest incidence rate across all diagnostic groups. The incidence rate for any affective disorder was 2.97%. The lowest incidence rates were found for agoraphobia (1.37%) and panic disorder (1.30%). Risk factors for the development of any mental disorder were never having been married, no religious affiliation, a higher number of physical illnesses and a lower quality of life.

CONCLUSION

In comparison to other studies, lower incidence rates for any affective disorder and middle-range incidence for any anxiety disorder were found. To the authors' knowledge, no prior studies have reported 1-year incidence rates for somatoform disorder, bipolar disorder and substance misuse in community-dwelling elderly. These findings indicate the need to raise awareness of psychosocial problems in the elderly and to ensure adequate availability of mental health services.

Gender differences in the association of depression trajectories with executive and memory functions: Evidence from the longitudinal study of the Survey of Health, Ageing and Retirement in Europe (2004-2017)

Gender differences in depression trajectories and their effects on cognitive function are poorly understood. This article aims to identify depression trajectories in both genders and further explore the association of depression trajectories with executive and memory functions by gender. A total 3990 participants aged 50 years or older with repeated measurements from waves 1 to 7 (wave 3 excluded) of the Study of the Survey of Health, Ageing and Retirement in Europe (SHARE) were included. Group-based trajectory modeling (GBTM) was conducted to identify the optimal number of depression trajectories. Generalized estimating equation (GEE) models were used to examine the relation of depression trajectories to cognitive function after stratification by gender. Three distinct depression trajectories were identified in both genders, but the patterns of trajectories among genders were nonidentical. The trajectories of depression in males were characterized by non-low, moderate, persistent-depressive symptoms but with an unstable trend, while in females, they were characterized by non-low, moderate, persistent-depressive symptoms and with a worsening trend. The prevalence of persistent high depression in women (20.08%) was higher than that in men (3.13%). Moderate and persistent high depression trajectories were negatively associated with episodic memory (β = -0.53 and -0.72, respectively, p < 0.001) and verbal fluency in females (β = -0.96 and -1.47, p=0.01 and < 0.001, respectively). Older women had a greater frequency of developing depression than older men. Gender differences in depression trajectories existed. Moderate and persistent high depression trajectories exerted a negative effect on some domains of cognitive impairment only in females.

Factors associated with quality of life and its prediction in kidney patients on haemodialysis

BACKGROUND AND OBJECTIVE

The present study aims to analyze the levels of health-related quality of life (HRQoL) in patients with end-stage kidney disease (ESKD) in haemodialysis, and to explore what demographic, medical and psychological variables are associated with HRQL and contribute to its prediction.

MATERIALS AND METHODS

Cross-sectional study with 302 patients with ACKD on haemodialysis. They were assessed: (1) HRQoL (Shorter Form Health Survey Questionnaire); (2) Anxiety and depression (Goldberg Anxiety and Depression Scale); (3) Sociodemographic data and (4) Medical data. Correlational analyses, means comparison and a path analyses with latent variables (PALV) were conducted.

RESULTS

The PALV showed that 42% of the variance in the HRQL could be explained by the variables evaluated (χ²/df=2.10; GFI=.938; IFI=.920; CFI=.918; RMSEA=.062; SRMR=.056). Depression was the strongest predictor of HRQL (-.71; p=.002), followed by physical activity (-.19; p=.044). Age (-.122; p=.034) and comorbidity (-.206; p=.001) were weakly associated with physical HRQL. The practice of regular physical activity is related to the physical HRQoL (r=.21; p=.00) and mental (r=.12; p=.028).

CONCLUSIONS

A high percentage of the variance in HRQoL is explained by the levels of depression and physical activity. Interventions to promote HRQoL in patients with ESKD should focus in promoting physical activity and taking care of patient's mental health.

Psychological Distress in Elite Sambo and Recreational Athletes

Background

Previous studies suggest that engagement in any type of physical activity can be protective against mental health issues, whereas elite-level athletes can endure various mental health challenges. The aim of this study was to determine variations in the prevalence of psychological distress among elite sambo athletes and their recreational counterparts.

Methods

A sample consisting of 245 athletes (127 males and 118 females) was chosen. Out of the total sample, 105 were elite-level athletes while 140 were recreational athletes. Participants were accessed via the Depression Anxiety Stress Scales-21 to determine their stress in various domains at a given time.

Results

Data indicated that all tested differences between elite sambo athletes and recreational athletes were statistically significant; recreational athletes had a higher score on the depression scale, anxiety and stress, and a general distress score than sambo athletes. Although there are no gender differences in psychological distress in the total sample of athletes, elite sambo athletes achieve significantly lower scores in all tested variants than recreational ones. Women who engage in recreational activities have stood out as a vulnerable subsample in psychological stress.

Conclusion

Future epidemiological and interventional studies should explore optimal strategies to identify mental health needs based on specific sport activity, especially in terms of gender. There is a need to place special emphasis on psychological distress in the context of combat sports.

Construction and Validation of a Scale to Measure Loneliness and Isolation During Social Distancing and Its Effect on Mental Health

A variety of factors contribute to the degree to which a person feels lonely and socially isolated. These factors may be particularly relevant in contexts requiring social distancing, e.g., during the COVID-19 pandemic or in states of immunodeficiency. We present the Loneliness and Isolation during Social Distancing (LISD) Scale. Extending existing measures, the LISD scale measures both state and trait aspects of loneliness and isolation, including indicators of social connectedness and support. In addition, it reliably predicts individual differences in anxiety and depression. Data were collected online from two independent samples in a social distancing context (the COVID-19 pandemic). Factorial validation was based on exploratory factor analysis (EFA; Sample 1, N = 244) and confirmatory factor analysis (CFA; Sample 2, N = 304). Multiple regression analyses were used to assess how the LISD scale predicts state anxiety and depression. The LISD scale showed satisfactory fit in both samples. Its two state factors indicate being lonely and isolated as well as connected and supported, while its three trait factors reflect general loneliness and isolation, sociability and sense of belonging, and social closeness and support. Our results imply strong predictive power of the LISD scale for state anxiety and depression, explaining 33 and 51% of variance, respectively. Anxiety and depression scores were particularly predicted by low dispositional sociability and sense of belonging and by currently being more lonely and isolated. In turn, being lonely and isolated was related to being less connected and supported (state) as well as having lower social closeness and support in general (trait). We provide a novel scale which distinguishes between acute and general dimensions of loneliness and social isolation while also predicting mental health. The LISD scale could be a valuable and economic addition to the assessment of mental health factors impacted by social distancing.

Associations of Internalized Skin Bias With Age, Adverse Psychopathology, and Health-Related Quality of Life Among Patients With Hidradenitis Suppurativa: A Cross-sectional Analysis

Importance

Hidradenitis suppurativa (HS) is a chronic autoinflammatory disease that is highly associated with affective disorders such as depression and anxiety. Recent studies have shown that patients with HS may also endorse high levels of internalized skin bias (ISB). This redirection of skin disease-related social stigma toward oneself may also play an important role in the associations between adverse psychopathology (eg, depression, anxiety) and health-related quality of life (HRQOL).

Objectives

To evaluate the associations of ISB with other core outcomes in HS and to determine if ISB may mediate the associations between adverse psychopathological outcomes and impaired HRQOL.

Design, Setting, and Participants

A cross-sectional study of adult patients with HS recruited from 1 academic medical center as well as through virtual social and recruitment networks. Eligible participants completed an online survey comprised of 4 survey instruments along with demographic and disease history information from April 1, 2021, to July 15, 2021.

Main Outcomes and Measures

Measures included the Internalized Skin Bias Questionnaire (ISBQ), Burns Anxiety Inventory, the Beck Depression Inventory-II, the Hidradenitis Suppurativa Quality of Life (HiSQOL) instrument, along with demographic and disease history information. The primary outcome was HRQOL as measured by the HiSQOL. Data were analyzed in July through August 2021.

Results

The survey was completed by 230 of 279 patients (82.4%; mean [SD] age, 39.2 [11.2] years; 209 [90.9%] identified as female, 203 [88.7%] as not Hispanic, 178 [77.7%] as White). Depression and anxiety were shown to be a substantial burden in this sample, with 56.5% of participants' scores qualifying for moderate or greater anxiety and 45.7% moderate or greater depression. The mean (SD) HRQOL scores were moderately high at 34.5 (16.7), indicating strong levels of impairment. There was a moderate correlation between ISBQ score and depression (r = 0.67); and fair correlations with HRQOL (r = 0.52) and anxiety (r = 0.56). Therefore, ISB appears to positively mediate the associations between depression and anxiety (estimated proportions of total effect that were mediated, 38.7% and 24.9%, respectively) and HRQOL. After controlling for age, disease severity, and disease duration, both ISB and anxiety were positive predictors of impaired HRQOL.

Conclusions and Relevance

This cross-sectional study found that ISB was associated with adverse psychopathology and impaired HRQOL in patients with HS. Furthermore, ISB appears to mediate the associations of depression and anxiety with HRQOL. Future studies are needed to design interventions targeted at addressing adverse psychopathology associated with ISB and improving HRQOL and well-being for patients with HS.

The role of the dorsolateral and ventromedial prefrontal cortex in emotion regulation in females with major depressive disorder (MDD): A tDCS study

BACKGROUND

Individuals with major depressive disorder (MDD) have deficits in emotion regulation, which plays a putative role in psychopathology. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are assumed to be involved in respective processes. In the present study, we aimed to explore the effect of stimulation over the dlPFC and vmPFC on emotion regulation in female with MDD.

MATERIAL AND METHODS

Twenty women with MDD performed the Emotional Stroop, Emotional Go/No-Go, and Emotional 1-Back tasks during transcranial direct current stimulation (tDCS) in three separate sessions with the following electrode montages: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation.

RESULTS

Independent of the valence of the respective stimuli, accuracy and speed of interference control, accuracy of pre-potent inhibition, and accuracy, but not speed, of working memory performance improved during anodal left dlPFC/cathodal right vmPFC stimulation. Independent of stimulation conditions, interference control was reduced for sad faces, as compared to happy and neutral faces, and working memory performance was faster for happy than for neutral and sad faces. For the impact of stimulation on specific emotional qualities, anodal left dlPFC/cathodal right vmPFC, compared to sham stimulation, led to improved interference control of sad and neutral faces in the emotional Stroop task, as shown by faster reaction times. Furthermore, in that task accuracy with respect to neutral and happy face conditions was higher during both real stimulation conditions, as compared to sham stimulation.

CONCLUSION

The dlPFC is involved in emotion regulation in MDD. Emotional valence is moreover relevant for the effect of stimulation over this area on interference control in MDD.

The Effect of Worktime Control on Overtime Employees' Mental Health and Work-Family Conflict: The Mediating Role of Voluntary Overtime

Overtime has become a widespread phenomenon in the current information age that creates a high speed working pace and fierce competition in the high technology global economy. Based on the time-regulation mechanism and effort-recovery model, we examined the effect of worktime control (WTC) on mental health and work-family conflict (WFC) among overtime employees, and whether voluntary overtime mediated the relationships. We also examined two separate dimensions of WTC (control over time-off and control over daily hours). The results showed that control over time-off was related to decreased depression, anxiety, stress and WFC, while control over daily hours was related to decreased stress and WFC. Generally, control over time-off was beneficial to females and employees with dependents. Furthermore, mediation results showed that voluntary overtime was a complete mediator of relationships between WTC and depression and anxiety as well as a partial mediator of the relationship between WTC and stress. However, this study did not find a mediating effect of voluntary overtime on the WTC-WFC relationship. Limitations and practical implications are discussed.