Cognitive vulnerabilities and Depression: A Culture-Moderated Meta-Analysis

Comorbidity among depression, anxiety and stress symptoms in naturalistic clinical samples: A cross-cultural network analysis

Comorbidity between depression and anxiety is well-established across various settings and cultures. We approached comorbidity from the network psychopathology perspective and examined the depression, anxiety/autonomic arousal and stress/tension symptoms in naturalistic clinical samples from Serbia, Italy and Croatia. This was a multisite study in which regularized partial correlation networks of the symptoms, obtained via self-reports on the Depression Anxiety and Stress Scales-21 (DASS-21) in three cross-cultural, clinical samples (total N = 874), were compared with respect to centrality, edge weights, community structure and bridge centrality. A moderate degree of similarity in a number of network indices across the three networks was observed. While negative mood emerged to be the most central node, stress/tension nodes were the most likely bridge symptoms between depressive and anxiety/autonomic arousal symptoms. We demonstrated that the network structure and features in mixed clinical samples were similar across three different languages and cultures. The symptoms such as agitation, restlessness and inability to relax functioned as bridges across the three symptom communities explored in this study. Important theoretical and clinical implications were derived.

Beliefs and Practices on Depression Among Selected Filipino Indigenous Peoples: A Focused Ethnography

INTRODUCTION

Depression beliefs and practices among indigenous peoples are essential to creating responsive mental health services. The purpose of the study is to explore the cultural beliefs and practices on depression among the Ilocanos, Kankana-eys, and Maranaos indigenous peoples in the Philippines.

METHOD

The study employed a focused ethnography research design. The study involved 41 (N = 41) traditional healers and tribal leaders across Ilocano, Kankana-ey, and Maranao ethnic groups in the Philippine Islands. Interviews, reviews of records, and participant observation were used as data gathering tools.

RESULTS

Beliefs about depression include magico-spiritual influence, relational problems, economic pressure, and emotional domains. Practices were divided into three domains: preventive, curative, and rehabilitative interventions.

DISCUSSION

The depression beliefs and practices of Ilocano, Kankana-ey, and Maranao indigenous peoples are rooted in their tradition, culture, religion, and medical influences largely rooted in magico-spiritual approaches. These findings suggest the inclusion of culturally-based care to address depression.

Barriers and facilitators of evidence-based psychotherapies for chronic pain in adults: A systematic review

Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) have demonstrated effectiveness for improving outcomes in chronic pain. These evidence-based psychotherapies (EBPs) remain underutilized in clinical practice, however. To identify research gaps and next steps for improving uptake of EBPs, we conducted a systematic review of patient-, provider-, and system-level barriers and facilitators of their use for chronic pain. We searched MEDLINE, Embase, PsycINFO, and CINAHL databases databases from inception through September 2022. Prespecified eligibility criteria included outpatient treatment of adults with chronic pain; examination of barriers and facilitators and/or evaluation of implementation strategies; conducted in the United States (US), United Kingdom (UK), Ireland, Canada or Australia; and publication in English. Two reviewers independently assessed eligibility and rated quality. We conducted a qualitative synthesis of results using a best-fit framework approach building upon domains of the Consolidated Framework for Implementation Research (CFIR). We identified 34 eligible studies (33 moderate or high quality), most (n=28) of which addressed patient-level factors. Shared barriers across EBPs included variable patient buy-in to therapy rationale and competing responsibilities for patients; shared facilitators included positive group or patient-therapist dynamics. Most studies examining ACT and all examining MBSR assessed only group formats. No studies compared barriers, facilitators, or implementation strategies of group CBT to individual CBT, or of telehealth to in-person EBPs. Conceptual mismatches of patient knowledge and beliefs with therapy principles were largely analyzed qualitatively, and studies did not explore how these mismatches were addressed to support engagement. Future research on EBPs for chronic pain in real-world practice settings is needed to explore provider and system-level barriers and facilitators, heterogeneity of effects and uptake, and both effects and uptake of EBPs delivered in various formats, including group vs. individual therapy and telehealth or asynchronous digital approaches. Perspective This systematic review synthesizes evidence on barriers and facilitators to uptake of cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based stress reduction for chronic pain. Findings can guide future implementation work to increase availability and use of evidence-based psychotherapies for treatment of chronic pain. Registration: PROSPERO number CRD42021252038.

The Protective Effect of Culture on Depression During Covid-19 Pandemic: A Romanian National Study

Previous studies indicated that collectivism represents a protective factor against depressive disorders, even among vulnerable populations. The protective effect of collectivism in relation to depressive disorders is often attributed to the social support networks available to individuals in collectivistic societies. The current study aims to investigate the protective effect of collectivism in the relationship between psychological vulnerabilities and depression. Moreover, we examined whether the protective effect of collectivism in relation to depression can be explained through the mechanism of social support. We measured individualism-collectivism for 42 Romanian counties ( n = 2,882) before the onset of the COVID-19 pandemic. Data for irrational cognitions, depression, and social support were collected online during the lockdown in Romania ( n = 5,310). All instruments showed acceptable measurement and scalar invariance across regions. In a multi-level regression model, county-level collectivism was associated with lower levels of depressive symptoms b = −.032, 95% CI [−0.045; −0.019], while irrational cognitions were positively associated with depression b = .474, 95% CI [0.438; 0.510]. The interaction between irrational beliefs and collectivism had a significant and negative effect on depression, b = −.004, 95% CI [−0.008; −0.000]. The indirect effect of collectivism on depression via social support was tested in a two-level SEM model. Explicit and implicit social support were not significant mediators. Collectivism was negatively associated with the perceived availability of explicit social support, b = −.043, 95% CI [−0.074; −0.012]. The results support a general protective effect of collectivism on mental health but cast doubt that the mechanism for this effect is related to social support.