A qualitative exploration of depression in emerging adulthood: disorder, development, and social context

Gender, society and mental health: The moderated mediating role of depression and gender on national resilience and life satisfaction among emerging adults

Recent threats to human security (i.e., COVID-19 pandemic, conflicts, climate change events) call for nurses to have an increased understanding of how sociopolitical environments induce mental health problems and impact the well-being of citizens. This study examines the relationship between national resilience and life satisfaction among Filipino emerging adults, how depression mediates this relationship, and how these correlations are moderated by gender. Drawing from an online survey sample of 1020 Filipino emerging adults (18-29 years old), this cross-sectional study utilised a moderated mediation analysis. Key constructs were measured using the short version of the National Resilience Scale (NR-13), the depression component of the Kessler Psychological Distress (K10) scale and the Satisfaction with Life Scale (SWLS). Gender was measured as sex assigned at birth. Descriptive results show that more than half of the respondents are female (64.2%) and demonstrate below-average levels of national resilience and depression, and high levels of life satisfaction. Also, findings indicate that depression has significant negative relationships with, and partially mediates the positive relationship between national resilience and life satisfaction. Moreover, moderation analysis results suggest that being female synergizes the negative relationship between depression and life satisfaction, and being male strengthens the positive relationship between national resilience and life satisfaction (p < 0.01). The results highlight how the national resilience of emerging adults neutralises their risk for depression and, ultimately, improves life satisfaction. Moreover, the findings emphasise the importance of nursing advocacy actions to ensure that social policies for improving public mental health are gender-sensitive, given that macro-social and psychological factors have varied effects on individuals' lives based on gender.

The impact of intimate partner violence on depressive symptoms among college students: A moderated mediation model of the big five personality traits and perceived social support

BACKGROUND

Previous study has identified a connection between intimate partner violence (IPV) and depressive symptoms. However, the underlying mechanisms of this connection have not yet been well understood. The aim of this study was to investigate the roles of big five personality traits and perceived social support on the association between IPV and depressive symptoms among Chinese college students.

METHODS

A cross-sectional questionnaire survey was conducted among college students in 23 provinces, 5 autonomous regions, and 4 municipalities in China from June to August 2022. Intimate Partner Violence Questionnaire was used to measure the frequency of exposure to IPV. The big five personality traits were measured by 10-item Big Five Inventory, Perceptive Social Support Scale-3 items was used to estimate the degree of perceived social support and the data on depressive symptoms were collected by Patient Health Questionnaire-9 items. We used data from the "Psychology and Behavior Investigation of Chinese Residents in 2022", which includes 6686 valid questionnaires of college students. The PROCESS macro developed by Hayes was utilized to perform moderated mediation analysis.

RESULTS

Among college students, IPV had a significant direct impact on depressive symptoms. Extroversion, agreeableness, conscientiousness and neuroticism mediated the association between IPV and depressive symptoms (β = -0.08, P < 0.001; β = -0.08, P < 0.001; β = -0.14, P < 0.001; β = 0.20, P < 0.001). Perceived social support significantly moderated the mediating role of the big five personality traits between IPV and depressive symptoms. Furthermore, perceived social support moderated the direct relationship between IPV and depressive symptoms (β = 0.34, P < 0.001), as well as the indirect path of extroversion, agreeableness, neuroticism and the first half of the mediating role of conscientiousness. Moreover, perceived social support was one of the preventive factors that could effectively mitigate the harmful effects of IPV, neuroticism and depressive symptoms.

LIMITATIONS

As this was a cross-sectional study, we were unable to investigate causal relationships between variables. The prevalence of IPV and depressive symptoms were self-reported by the college students, and there may be reporting bias. Additionally, this study only explored the influence and mechanism from the integrated dimension of IPV and PSSS, due to spatial constraints.

CONCLUSIONS

The findings contribute to the existing understanding by clarifying the fundamental mechanisms linking IPV and depressive symptoms. These results may serve as a valuable reference for the Chinese government to improve mental health among college students.

Procrastination Mediates the Relationship between Problematic TikTok Use and Depression among Young Adults

Background: Although the prevalence of depression has increased significantly in recent years, especially in the young adult population, little is known about its causes and risk factors. The study aims to examine the mediating role of TikTok use in the relationships between procrastination and depression in young adults. Methods: A sample of 448 adults, ranging in age from 18 to 35 years (M = 24.45, SD = 3.76), including 214 men (48%), participated in the study. The cross-sectional survey consists of a modified Bergen Facebook Addiction Scale (BFAS) to assess problematic TikTok use (PTTU), the Pure Procrastination Scale (PPS) for procrastination measurement, and the nine-item Patient Health Questionnaire (PHQ-9) for screening depression symptoms. Results: The independent samples t-test indicates that emerging adults (ages ranging between 18 and 25 years) have more severe depression symptoms than young adults (26-35 years old). Gender differences were not found for procrastination, PTTU, and depression symptoms. Positive correlations were found between procrastination, PTTU, and depression symptoms. PTTU plays a mediating role in the associations between procrastination and depression. Conclusions: Both procrastination and PTTU treatment should be prioritized in the prevention and intervention programs for improving mental health among young adults. Some effective therapeutic methods are recommended.

Systematic Review and Meta-Synthesis: How Is Depression Experienced by Adolescents? A Synthesis of the Qualitative Literature

OBJECTIVE

To systematically investigate how youth with lived experience report their experience of depression in terms of features of depression and in relation to themselves and their environment.

METHOD

We conducted a systematic review of qualitative research around the world that explored the subjective experience of depression among youth (age range, 10-24 years) who had self-reported, screened positive for, or received a formal diagnosis of the disorder. We used multiple databases to search for relevant studies published in any language up until March 2023. Studies were coded regarding features of depression reported by adolescents. We also used thematic synthesis to extract and synthesize descriptions of the lived experience of depression, and to develop analytic themes. The study was registered with PROSPERO, CRD42021218300.

RESULTS

We identified a total of 23,424 unique records, and included 39 studies in the final review, representing the views of 884 adolescents with lived experience of depression. Most of the studies were conducted in high-income countries (72.8%), and the majority of participants were female (65%). The most frequently reported features of depression were sadness (present in 92.3% of the studies), social withdrawal (76.9%), and loneliness (69.2%). In addition, we constructed 3 themes that aimed to synthesize youths' accounts of their perceptions and experiences of depression: (1) making sense; (2) factoring in culture and contextual influences; and (3) accessing support and care.

CONCLUSION

Some of the more commonly reported features of depression among youth are not explicitly included in the DSM/ICD diagnostic criteria but are highly relevant and closely connected to the experiences of adolescents. Moreover, contextual interpretations of depression may be more sensitive to capture representations and narratives of depression among youth. Thus, incorporating features of depression reported by adolescents could potentially increase accuracy of detection, promote collaborative work, and enhance therapeutic and care outcomes.

STUDY PREREGISTRATION INFORMATION

The lived experience of depression in adolescence: a systematic review of the qualitative literature; https://www.crd.york.ac.uk/prospero/; CRD42021218300.

Well-being, character strengths, and depression in emerging adults

Introduction

Emerging adulthood is a period of transition between adolescence and adulthood, during which individuals explore different roles and possibilities. This period is often characterized by high levels of stress and uncertainty, which can increase the risk of depression. The aim of this study was to investigate the associations between emerging adulthood dimensions, well-being, character strengths and depression, as well as to verify the differences in the levels of these elements among different groups of depressive symptomatology.

Methods

Participants were 1,060 individuals (741 females, 305 males) between the ages of 18 and 30 years (M = 22.3, SD = 3.72). Spearman's correlation, linear regression, and Kruskal- Wallis with pairwise post-hoc analyses were used to analyze the data.

Results

There were significant positive correlations between emerging adulthood dimensions, well-being, and character strengths, and negative correlations between these variables and depression. There were also significant differences in the means of the evaluated constructs among the symptomm groups.

Discussion

The findings suggest that emerging adulthood dimensions, well-being, and character strengths are all associated with depression in emerging adults and have important implications for the provision of interventions in health and education for emerging adults. The study provides a deeper understanding of the factors influencing depression during emerging adulthood and emphasize the importance of promoting positive psychology elements and developing personalized interventions for emerging adults. This also suggest that public policies related to mental health and education should take into account the unique needs of emerging adults.

The impact of social support and emotion dysregulation on COVID-19 depressive symptoms

Introduction

Stress resulting from the global COVID-19 pandemic has been linked to psychological consequences, such as depressive symptoms, for individuals worldwide. Outbreaks and pandemics are known to accentuate stressors or generate new ones owing to health-related worries, reduced mobility, and social activity due to quarantine, and sudden life changes. Although post-lockdown U.S. research findings suggest a greater risk of depression among 18- to 25-year-olds, familiarity with technology and virtual socializing may offer college students some protective effect, warranting research with such groups.

Methods

The current study thus explored emotion dysregulation (ED) and perceived social support (PSS) as potential mechanisms for the relationship between COVID-19 stress and depressive symptoms among students at a southern university in the United States. Participants (N = 489) completed a cross-sectional survey assessing their current levels of COVID-19 stress, ED, PSS, and depressive symptoms.

Results

Path analysis showed that PSS buffered the effect of ED on depressive symptoms. The results support the explanatory role of ED in the relationship between COVID-19 stress and depressive symptoms.

Discussion

The perceived social connection may be an essential factor for psychological outcomes during periods of stress and isolation, particularly for those reporting high ED.

Disentangling the Effects of Mindfulness, Savoring, and Depressive Symptoms among Emerging Adults

The links between mindfulness, savoring positive experiences, and depressive symptoms have been well established in the literature. Nevertheless, little has been done to disentangle the prospective relations among these constructs. Clarifying the longitudinal relations is crucial, as it enables researchers and practitioners to discern potential trajectories of mental health interventions. In this study, 180 emerging adults between 18 and 27 years old were recruited twice at 3 months apart to complete self-reported measures including mindfulness, savoring positive experiences, and depressive symptoms. Cross-lagged path analysis indicated that savoring the moment was predictive of mindfulness three months later, whereas depressive symptoms were predictive of both mindfulness and savoring the moment three months later, above and beyond the effects of age, gender, and family income. Additionally, mindfulness, savoring positive experiences, and depressive symptoms were significantly correlated at baseline. The present study evidenced short-term inverse effects of depressive symptoms on mindfulness and savoring the moment, as well as a positive effect of savoring the moment on mindfulness. Hence, interventions geared towards reducing symptoms of depression are likely to carry concurrent and prospective benefits for psychological functioning, namely the ability to be present in the moment and to savor.

Family dynamics and adjustment across Latino/a students' transition to college: Disentangling within- and between-person reciprocal associations

Latino/a adolescents are increasingly represented in higher education. Whereas previous work suggests that positive aspects of the family can promote adjustment during the college transition, less is known regarding the longitudinal, reciprocal nature of these associations. The current study examined changes in parenting, family dynamics, and adjustment across the transition from high school to college among 207 Latino/a young adults (Mage = 18.10; 65.0% female identifying) in the Southwestern United States and investigated within- and between-person reciprocal relations using standard and random-intercept cross-lagged panel models. Participants self-reported on parental support, parental monitoring, family communication, depressive symptoms, and alcohol use during their senior year of high school (Time 1; spring/summer 2017), first semester of college (Time 2; fall 2017), and second semester of college (Time 3; spring/summer 2018). Parental support, family communication, depressive symptoms, and alcohol use increased across the initial transition from high school to college, whereas parental monitoring decreased across time. Reciprocal effects were largely between-person driven. Family communication in high school was concurrently and prospectively related to fewer depressive symptoms. Higher parental monitoring during the first semester of college was related to less alcohol use within and across semesters. In addition, students who experienced within-person increases in depressive symptoms during the first semester of college perceived less parental support than usual the next semester. Study findings point to the importance of developmental timing and further highlight the role that family plays during Latino/a students' transition to college. Implications for family-based prevention efforts are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Transition to Adulthood in Children of Depressed Parents: Long-Term Follow-Up Data from the Family Talk Preventive Intervention Project

Little is known about the effects of parental depression on offspring as they transition to adulthood-a challenging time developmentally, when late adolescents must separate from home, achieve intimate relationships, and develop a sense of identity. We present long-term quantitative and qualitative data from early adolescents with a depressed parent who were randomized to one of two family-based preventive interventions and followed over time, across the transition to young adulthood. Specifically, we present clinical measures of psychopathology and Likert-scale questionnaire data from young adults and their parents regarding the transition to adulthood and perceptions of the interventions. We also report in-depth qualitative interview data from young adults about the effects of parental depression on their transition to adulthood. Findings suggest that leaving home, establishing relationships, and coping with stressors may be challenging for emerging adults. Furthermore, the interviews highlight the importance of siblings, the burden of parental depression, and the development of self-understanding and empathy in young adults who grew up with a depressed parent. Data suggest that clinicians, policy makers, educators, and employers must address the preventive and clinical needs of young people and their families as they transition to young adulthood after growing up with depressed parents.

Psychometric properties and factor structure of the appearance-related social media consciousness scale among emerging adults

Appearance-related social media consciousness (ASMC) is the persistent awareness of one's attractiveness on social media. The ASMC Scale, recently developed for use with adolescents (Choukas-Bradley et al., 2020), provides a promising tool for systematically examining ASMC and associations with mental health. The current study examined the psychometric properties of the ASMC Scale among emerging adult men and women. Participants for Study 1 were 428 emerging adults (M age = 21.9) from five Anglophone, industrialized countries (U.S., U.K., Canada, Australia, New Zealand). Results from Study 1 provide evidence that the 13-item ASMC Scale has a unidimensional structure, strong internal consistency, measurement invariance across gender, and convergent validity (i.e., associations with related offline appearance concerns and cognitions) and incremental validity (i.e., associations with depressive symptoms and disordered eating, above and beyond time spent on social media). Participants from Study 2 were 296 U.S. college students (M age = 18.6). Results from Study 2 confirmed the factor structure and further demonstrated the convergent and incremental validity (above and beyond both time spent on social media and offline appearance concerns) of the ASMC Scale. Findings suggest that the ASMC Scale can be used among emerging adults, aiding future research investigating social media experiences and mental health.

A Developmental System Perspective to Interpret the Link between Parental Fixed Mindset and Youth Mental Health: A Moderated Mediation Model

From a developmental system perspective, the present study constructed a moderated mediation model to examine whether youth core self-evaluation (individual factor) served as a mediator and peer support (peer system) served as a moderator in the effect of parental fixed mindset (family system) on youth mental health symptoms. In total, 658 pairs of emerging adults and their parents participated in this study. Youth completed measurements on core self-evaluation, peer support, and mental health symptoms, while their parents filled in the questionnaire on fixed mindset. Mediation analysis indicated that parental fixed mindset was related to increased youth mental health symptoms, and youth core self-evaluation partially mediated this relationship. Moderated mediation analysis suggested that peer support mitigated the mediating process with the direct pathway from parental fixed mindset to youth mental health symptoms and the indirect pathway from parental fixed mindset to youth core self-evaluation being weaker at a high level of peer support. This study highlights how and when a family system, peer system, and individual factors combine to influence youth mental health. The findings suggest it is the interaction of these factors that has to be addressed in efforts to reduce the prevalence of youth mental health symptoms.

Emotion Regulation Mediates the Relationship Between Therapeutic Alliance and Anxiety in Emerging Adults During Inpatient Psychiatric Treatment

Emerging adulthood is a critical developmental period characterized by emotional growth and unstructured living. To date, there is little research on emerging adults-defined as those 18 to 25 years old-with serious mental illnesses and even less on emerging adults in psychiatric hospitals. This study analyzed therapeutic alliance with the clinical team and change in anxiety symptoms in emerging adult psychiatric inpatients with the goal of establishing whether emotion regulation could serve as a mediator between these 2 constructs. Participants were 913 emerging adults (46.7% female; 18 to 25 y of age) who were voluntarily admitted to an intermediate length-of-stay (6 to 8 wk) inpatient psychiatric hospital. Each patient completed measures assessing anxiety symptoms, emotion regulation strategies, and working alliance as an assessment of therapeutic alliance. The results indicated that working alliance had significant indirect effects on change in anxiety symptoms through emotion dysregulation and lack of awareness, limited access to emotion regulation strategies, and lack of emotional clarity. This study emphasizes the need to understand emerging adults and the difficulties characteristic of this developmental period, and that clinicians should be aware that cognitive factors involved in emotion regulation may impact anxiety symptoms in emerging adult populations.

From Self-Doubt to Pride: Understanding the Empowering Effects of Delivering School-Based Wellness Programmes for Emerging Adult Facilitators-A Qualitative Study

Ample literature exists on the impact of prevention programmes on their target audience, while much less is known about how delivering such programmes influences their facilitators. Even less literature exists on the emotional and social processes that form this potential impact on facilitators. The current study analysed qualitative in-depth, non-structured interviews, as well as written essays provided by 33 student-facilitators who delivered the "Favoring Myself" programme in Israel during 2019-2021. This school-based wellness programme comprised 10 weekly, 90 min sessions on self-care behaviours, media literacy, self-esteem, and positive body image, which are well-known protective factors against risky behaviours. A thematic analysis was applied to explore the main themes in the collected data. An interesting affective transformation from self-doubt to pride in themselves emerged as a shared experience of these young facilitators. Facilitators related their ability to facilitate the programme, as well as to undergo an individual maturation and empowerment experience, to certain components of the programme itself, such as the preparatory course, individual supervision, and the peer-group experience. This shift from doubt to pride is discussed using two frameworks-a theoretical discourse of emerging adulthood as a developmental stage, and the self-determination theory.

Supporting the Transition to Postsecondary Institutions for Students with Mental Health Conditions: A Scoping Review

OBJECTIVE

To conduct a scoping review to identify programs and interventions to support youth with mental health conditions (MHCs) with their transition to postsecondary institution (PSI).

METHOD

A database search of MEDLINE, PsycINFO, Embase, SocINDEX, ERIC, CINHAL, and Education Research Complete was undertaken. In this review, MHC was defined as a mental, behavioural, or emotional condition, or problematic substance use, and excluded neurodevelopmental or physical disorders. Two reviewers independently screened studies and extracted the data. Included studies are described and a risk-of-bias assessment was conducted on included studies.

RESULTS

Nine studies were included in this review, describing eight unique interventions. Sixty-two percent of interventions were nonspecific in the MHCs that they were addressing in postsecondary students. These interventions were designed to support students upon arrival to their PSIs. Peer mentorship, student engagement, goal setting, and interagency collaboration were some of the strategies employed. However, the overall quality and level of evidence in these studies was low and the effectiveness of these programs was not established.

CONCLUSION

The volume of research identified was limited, no reliable nor policy informing conclusions can yet be made about the impact of these interventions as the evaluation methods, quality of the research methodologies, and the levels of evidence available were of low-quality. Future randomized control trials are required that are designed to target and improve transitions from secondary education to PSIs for those with MHCs.

Experiences of adolescents and parents on the mental health management of depression in adolescents, North West province, South Africa

Background

Living with or managing an adolescent suffering from depression predisposes the adolescent and parents to various experiences, considering the multifactorial nature of depression and associated symptoms.

Objective

This study explored and described the experiences of adolescents and their parents on the mental health management of depression in the North West province (NWP), South Africa.

Method

A qualitative, exploratory, descriptive, contextual research design was adopted. Data was collect from two mental health care institutions and two mental health care units attached to two general hospitals in the NWP, SA. Thirty-two participants (18 adolescents and 14 parents) were purposefully selected for the study. Data were collected through individual interviews and analysed using Tesch’s open-coding method to generate themes and categories which were presented with the concurrent support of participants direct quotations.

Results

The study revealed that the experiences of adolescents with depression and their parents taking care of them at homes include the following: emotional distress, poor coping mechanisms, financial burden, repeated suicidal attempts, negative attitudes from support systems and withdrawal behaviours. Appropriate therapeutic environments, ongoing monitoring by mental healthcare practitioners and adequate support systems were suggested by participants as management approaches that could enhance the recovery of adolescents from depression.

Conclusion

The findings revealed the devastating experiences of adolescents with depression and their parents taking care of them in their various homes which confirms the dire need for attention on the plights of these groups in order to facilitate adolescents’ recovery and strengthen the adolescents’ and parents’ coping mechanisms for a healthier family.

The Longitudinal Interplay Between Social Network and Psychopathology in Multi-Problem Young Adult Men; Separating Within-and Between-Person Effects

Young adulthood is characterized by many life changes. Especially for young men with problems across different life domains (i.e., multi-problem), these changes may entail obstacles. Incidences of psychopathology increase during young adulthood and at the same time important shifts in social networks - such as changing relations with peers and parents, isolation, or deviant peer affiliation - take place. The present study examined the longitudinal interplay between psychopathology and social network characteristics over the course of 1 year in multi-problem young adults, at both between-person and within-person level. A sample of 696 multi-problem young adult men (age 18-27) participated in this three wave study. We used traditional cross-lagged panel models (CLPM) to examine how social network characteristics and psychopathology are related at the between-person level, and random intercept cross-lagged panel models (RI-CLPM) to examine within-person links. Between-person associations between internalizing problems and social networks were bidirectional, and externalizing problems were related to problematic social network characteristics, but not vice versa. At the within-person level, no such cross-lagged paths were found. Overall, results indicated that in multi-problem young adults, social network characteristics and psychopathology are related. However, looking at within-person processes this relation is not reciprocal.

Prevalence of Depression Symptoms Before and During the COVID-19 Pandemic Among Two Asian American Ethnic Groups

Asian Americans have experienced compounding stressors during the pandemic as a result of racial discrimination. We aim of to investigate the prevalence of depression symptoms among Asian Americans before and during the COVID-19 pandemic and examine differences based on socio-demographic factors. Data are from a cross-sectional study (N = 636) among Chinese and South Asian adults in Chicago collected between February and May 2020. One cohort of participants were surveyed from each ethnic group before the pandemic and a second cohort of participants were surveyed during the pandemic. Depression symptoms increased more than two-fold, from 9% pre-pandemic to 21% during the COVID-19 pandemic. We found an increase in depression symptoms during the pandemic for South Asians, men and adults older than 30 years. These findings call for public health education that effectively addresses anti-Asian harassment and violence and ensure that culturally competent mental health services are provided to Asian Americans from diverse ethnic backgrounds.

Beliefs About Transitional Events: The Effect of Experience and Life-Script Consistency

The present study examined the beliefs about two types of important life transitions: transitions that are consistent with the cultural life script (e.g., getting married) and transitions that diverge from it (e.g., relocating). Data were collected from two conditions: individuals in the experienced condition only responded to transitions they had experienced; individuals in the hypothetical condition provided ratings only for transitions they had not experienced. Participants rated the likelihood and typical age of occurrence, importance, transitional impact, and valence for an individualized set of condition-appropriate events. We found that script-consistent events were considered more normative and positive than script-divergent events. The two types of events, however, differed little in terms of importance or transitional impact. We conclude by arguing that although script-consistent and script-divergent transitions have much in common from a mnemonic perspective, the distinction is still warranted in the context of lifetime planning and evaluation.

Family Interaction and Depressive Symptoms in Chinese Emerging Adults: A Mediation Model of Gratitude

In this study, we investigated the relations between family interaction, gratitude, and depressive symptoms among Chinese emerging adults. It also investigated gratitude as a mediator in the relation between family interaction and depression. Data were obtained from 321 college students who completed the online questionnaire about the Family Assessment Instrument, Gratitude Questionnaire, Patient Health Questionnaire, and demographic information. Structural equation modeling (SEM) was used to test hypotheses and bootstrapping with 5,000 resamplings (95% confidence interval) was used to confirm the mediation model. Results showed that gratitude partially mediated the relation between family interaction and depression. In other words, students with healthy family interaction, as indicated by perceived better family communication, mutuality, and harmony with family members, tended to report higher general gratitude, and subsequently diminished depressive symptoms. The practical implications were discussed.

The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature

BACKGROUND

Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex inter-relationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies.

METHODS

We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity.

RESULTS

Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression.

CONCLUSIONS

Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.

Examining the Role of Anxiety and Depression in Dietary Choices among College Students

This study examines the role of anxiety and depression symptoms in predicting dietary choices in emerging adults while accounting for sex differences in these relationships. Participants were 225 English speaking undergraduates enrolled in a university in southeastern United States. Participants were recruited through an online research recruitment application utilized by the university. Participants volunteered for a two-phased anonymous survey monitoring the effects of eating habits and gastrointestinal health in young adults. As part of this effort, participants completed self-reporting measures related to anxiety and depression, as well as an automated, self-administered 24-h diet recall. Multigroup path analysis was used to test primary hypotheses. Overall, a decrease in total caloric intake and an increase in sugar consumption were found as self-reported symptoms of anxiety and depression increased. In addition, there were sex differences in the relationship between depression and food choices. Men consumed more saturated fat as well as less fruits and vegetables as self-reported symptoms of depression increased. Results suggest symptoms of depression are a greater risk factor for poor nutrition in male college students than females. The findings provide another justification to screen for psychological distress in student health services given the implications on behavioral lifestyle and health.

Stumbling Into Adulthood: Learning From Depression While Growing Up

Depression manifests in distinct ways across the life course. Recent research emphasizes how depression impedes development during emerging adulthood. However, our study-based on 40 interviews with emerging adults from multiple regions in the United States, analyzed following grounded theory-suggests a more complex narrative. Increasing experience with cycles of depression can also catalyze (a) mature perspectives and coping mechanisms that protect against depression's lowest lows; (b) deeper self-knowledge and direction, which in turn promoted a coherent personal identity; and (c) emergence of a life purpose, which fostered attainment of adult roles, skill development, greater life satisfaction, and enriched identity. Our synthesis reveals how depression during emerging adulthood can function at once as toxin, potential antidote, and nutritional supplement fostering healthy development. Our central finding that young adults adapt to rather than recover from depression can also enrich resilience theory, and inform both social discourse and clinical practice.

Contextualized School-Based Cognitive Behavioral Therapy (CBT) Intervention for Malaysian Secondary School Students

This study investigates the effectiveness of the school-based Shine Through Any Roadblocks (STAR) CBT intervention, by a screening conducted on 634 students from eight secondary schools in Malaysia. Participants (n = 85) who fulfilled the eligibility criteria were assigned randomly to either the intervention group (n = 42) or the assessment-only waitlist control group (n = 43). The intervention consisted of eight group-based sessions over a period of 2 months. Sessions were 60-min each and conducted according to the STAR module. Outcome measures (depressive symptoms and automatic negative thoughts) were administered at five intervals: baseline/pre-intervention, mid-intervention, post-intervention, 1-month after intervention, and 3-months after intervention. Results showed significant and lasting lower levels of depressive symptoms and automatic negative thoughts in the intervention group, indicating that the STAR intervention could be an effective means of reducing depressive symptomatology among adolescents. Clinical implications for the Malaysian secondary school context are further discussed.

Association between Physical Activity, Food Consumption and Depressive Symptoms Among Young Adults in Spain: Findings of a National Survey

Young adults have a significant prevalence of mental disorders, which could lead to dysfunctional quality of life. Records of 1,645 Spanish adolescents were examined and multiple logistic regressions were performed. Being a woman, being older and having a sedentary life were all associated with a higher psychological vulnerability, whereas a low frequency of fresh fruit and bread/cereals consumption, as well as regular intense physical activity, were considered protective against such susceptibility. Regular physical activity and a diet with a high consumption of fruit and cereals may help reduce depressive symptoms, but sociodemographic features are as much as important as lifestyle habits.

Agency of depressed adolescents: embodiment and social representations

Purpose: Major depression is becoming more common among adolescents. Most research into major depression disorder focuses on intrapersonal and interpersonal processes, but the importance of sociocultural factors is less investigated. This study explores the role of social representations in the construction of adolescents diagnosed with major depression. The researched was informed by the concept of human agency and Social Relational Theory.

Method: Interviews were conducted with fifteen hospitalized adolescents diagnosed with a major depression disorder using a semi-structured interview schedule. The research question was: What are the social representations about being a normal person that influence depressed adolescents and their lived experiences of having major depression? Transcripts were subjected to Interpretative Phenomenological Analysis.

Results: Five superordinate themes emerged out of the data: (a) Depression means personal failure; (b) Feeling bad is not allowed and is not normal: in fact, depression doesn’t really exist; (c) You are obliged to have an intimate relationship, otherwise you are not normal; (d) It is important to have future projects for personal and social well-being; (e) Being socially well integrated is normality.

Conclusions: Clinical and therapeutic implications are discussed.

The Young Adult Love Lives of Happy Teenagers: The Role of Adolescent Affect in Adult Romantic Relationship Functioning

This study assessed early adolescent positive and negative affect as long-term predictors of romantic conflict, anxious and avoidant attachment, romantic and social competence, and relationship satisfaction in adulthood utilizing a longitudinal, multi-informant study of 166 participants assessed annually at ages 14-17, and again at ages 23-25. Positive affect in adolescence predicted greater self-rated social competence during late adolescence and greater self-rated romantic competence and less partner-reported hostile conflict almost a decade later. Negative affect predicted lower social and romantic competence. Results generally remained significant after controlling for personality traits, providing greater support for the hypothesis that affect has a robust, direct relation to romantic development over time.

Association of Antipsychotic Treatment With Risk of Unexpected Death Among Children and Youths

IMPORTANCE

Children and youths who are prescribed antipsychotic medications have multiple, potentially fatal, dose-related cardiovascular, metabolic, and other adverse events, but whether or not these medications are associated with an increased risk of death is unknown.

OBJECTIVE

To compare the risk of unexpected death among children and youths who are beginning treatment with antipsychotic or control medications.

DESIGN, SETTING, AND PARTICIPANTS

This retrospective cohort study was conducted from 1999 through 2014 and included Medicaid enrollees aged 5 to 24 years in Tennessee who had no diagnosis of severe somatic illness, schizophrenia or related psychoses, or Tourette syndrome or chronic tic disorder. Data analysis was performed from January 1, 2017, to August 15, 2018.

EXPOSURES

Current, new antipsychotic medication use at doses higher than 50 mg (higher-dose group) or 50 mg or lower chlorpromazine equivalents (lower-dose group) as well as control medications (ie, attention-deficit/hyperactivity disorder medications, antidepressants, or mood stabilizers) (control group).

MAIN OUTCOMES AND MEASURES

Deaths during study follow-up while out of hospital or within 7 days after hospital admission, classified as either deaths due to injury or suicide or unexpected deaths. Secondary outcomes were unexpected deaths not due to overdose and death due to cardiovascular or metabolic causes.

RESULTS

This study included 189 361 children and youths in the control group (mean [SD] age, 12.0 [5.1] years; 43.4% female), 28 377 in the lower-dose group (mean [SD] age, 11.7 [4.4] years; 32.3% female), and 30 120 in the higher-dose group (mean [SD] age, 14.5 [4.8] years; 39.2% female). The unadjusted incidence of death in the higher-dose group was 146.2 per 100 000 person-years (40 deaths per 27 354 person-years), which was significantly greater than that in the control group (54.5 per 100 000 population; 67 deaths per 123 005 person-years) (P < .001). The difference was primarily attributable to the increased incidence of unexpected deaths in the higher-dose group (21 deaths; 76.8 per 100 000 population) compared with the control group (22 deaths; 17.9 per 100 000 population). The propensity score-adjusted hazard ratios were as follows: all deaths (1.80; 95% CI, 1.06-3.07), deaths due to unintentional injury or suicide (1.03; 95% CI, 0.53-2.01), and unexpected deaths (3.51; 95% CI, 1.54-7.96). The hazard ratio was 3.50 (95% CI, 1.35-9.11) for unexpected deaths not due to overdose and 4.29 (95% CI, 1.33-13.89) for deaths due to cardiovascular or metabolic causes. Neither the unadjusted nor adjusted incidence of death in the lower-dose group differed significantly from that in the control group.

CONCLUSIONS AND RELEVANCE

The findings suggest that antipsychotic use is associated with increased risk of unexpected death and appear to reinforce recommendations for careful prescribing and monitoring of antipsychotic treatment for children and youths and to underscore the need for larger antipsychotic treatment safety studies in this population.

Higher Benefit for Greater Need: Understanding Changes in Mental Well-being of Young Adults Following the ACA Dependent Coverage Mandate

BACKGROUND

Beginning in late 2010, private health insurance plans were required to allow dependents up to age 26 to remain on a parent's plan. Known as the dependent coverage or young adult mandate, this provision increased coverage substantially within the group of 19-25 year-olds affected by the policy change. Subsequent work evaluating whether increased coverage had a positive effect on mental health found mild improvements in self-reported mental health. This work focused exclusively on average effects among young adults in the years after the policy change, leaving open the question of how young adults fared depending on where they reside in terms of the distribution of risk for mental health issues.

AIMS OF THE STUDY

We assess the effects of the dependent coverage mandate on young adult mental well-being focusing on the distribution of mental health issues. We seek to understand how potential improvements (or degradations) differ across the entire risk profile. Gains among individuals who are at low risk for severe mental health issues may send a far different signal than gains among those with higher risks.

METHODS

Using MEPS data from 2006 through 2013, we use quantile regression within a difference-in-differences design to compare pre/post outcomes across the distribution of risk for young adults ages 23-25 affected by the mandate to 27-29 year-olds not affected by the mandate. Further, we evaluate differences in the effect of the mandate by sex, given well-known disparities in incidence and prevalence of mental illness between men and women. To gauge the effects of the mandate on mental health, we use the Mental Component Score measure within the MEPS, ideal for our quantile regression given the broad range of scores. The key premise in our evaluation is that individuals with higher risks for mental health problems due to biological or socioeconomics factors are more likely to rank at locations of the mental health score distribution indicating worse outcomes.

RESULTS

We find significant improvements in self-reported mental health in the 23-25 year-old group following the mandate. However, the gains were not equal across the risk distribution. For individuals at the 0.1 quantile (worse self-reported mental health), the improvement in MCS scores was significant, a 6.1% increase compared to the pre-mandate baseline at that quantile. Effects were smaller but still significant at the median but there was no apparent effect for those that were at higher levels of self-reported mental health. Our results also suggest improvements for women (+9% relative to baseline at the 0.1 quantile, e.g.) but limited evidence of an effect for men.

IMPLICATIONS FOR FUTURE RESEARCH

The finding that increased insurance coverage led to improved self-reported mental health foremost for young adults with the highest risk of mental health problems is encouraging. However, the mechanism for this effect is unclear and in need of further study. Whether improvements in the mental health status of the population depend more on increased access to services or derive primarily from improved financial security is an important research area.

Family and Personality Predictors of Clinical Depression and Anxiety in Emerging Adults: Common, Distinctive, or a Vulnerability Continuum?

There is an ongoing debate on the relationship between depression and anxiety, but data on similarities and differences in their predictor profiles are scarce. The aim of our study was to compare family and personality predictors of these disorders among 220 "emerging adults." As such, two clinical groups with noncomorbid depressive and anxiety disorders, and one healthy control group were assessed by sociodemographic questionnaires, Structured Clinical Interview for DSM-IV Disorders and NEO Personality Inventory, Revised. We found significant overlap in family and personality risk profiles, with increasing effect size for predictors common to anxiety and depression when the categories "no disorder-anxiety disorder-depressive disorder" were considered as existing along a continuum. Among the contributing factors we assessed, family psychiatric history, family structure and conflicts with parents were more significant than personality traits. Our study indicates that emerging adults may be more vulnerable to depression than anxiety in the presence of family and personality risk factors.

Food and Mood: Diet Quality is Inversely Associated with Depressive Symptoms in Female University Students

Researchers have found support for an inverse association between diet quality and depressive symptoms in middle-aged adults. This association has not been well examined among university students, a population at risk of developing both depression and unhealthy lifestyle habits. We sought to examine the cross-sectional association between depressive symptoms and diet quality in female university students. One hundred and forty-one females (19.1 ± 1.5 years, 22.3 ± 3.4 kg/m²) were recruited from a Canadian university in 2012 and 2013. Dietary intake data were collected using 3-day food records and analysed using the Canadian Healthy Eating Index. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results of a linear regression demonstrated an inverse association between depressive symptoms and diet quality score (β = -0.016, 95% CI = -0.029 to -0.003, P = 0.017). Elevated depressive symptoms were associated with consumption of diets of poor nutritional quality in our female university student sample. Thus, healthy eating may correspond with lower levels of depression in young adult females.

Smartphone Applications for Mental Health

Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based.

Understanding Help-Seeking Behavior in Depression: A Qualitative Synthesis of Patients' Experiences

Despite decades of evidence-based interventions, depression remains a great challenge for public health due to enormous treatment gap and lag which, at least partially, result from low professional help-seeking by people suffering from depressive symptoms. In this article, we aim to gain a better understanding of help-seeking behavior in depression, and how to intervene effectively decreasing treatment gap and delay by using a meta-ethnography approach-an interpretive technique to systematically synthesize qualitative data. It integrates views and experiences of 474 individuals with depression across 20 papers. Findings suggest several interrelated major concepts-help-seeking as a threat to identity, social networks as a conflict or support, and alternative coping strategies as the main factor for treatment delay-as well as multiple relational, structural, attitudinal, cognitive, culture-specific, or gender-specific barriers. A model of help-seeking as a threat to identity is developed and discussed in the context of existing research.

The Family System and Depressive Symptoms during the College Years: Triangulation, Parental Differential Treatment, and Sibling Warmth as Predictors

Guided by Bowen theory, we investigated the relationships between parent-child triangulation, parental differential treatment (PDT), sibling warmth, and individual depressive symptoms in a sample of 77 sibling dyads, aged 18-25 years, recruited through undergraduate classes at a U.S. public University. Results of the actor-partner interdependence models suggested that being triangulated into parental conflict was positively related to both siblings' perception of PDT; however, as one sibling felt triangulated, the other perceived reduced levels of PDT. For both siblings, the perception of higher levels of PDT was related to decreased sibling warmth and higher sibling warmth was associated with fewer depressive symptoms. The implications of these findings for research and the treatment of depression in the college-aged population are discussed.

Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives

OBJECTIVE

To understand how primary care providers (PCPs) perceive barriers to adolescent depression care to inform strategies to increase treatment engagement.

STUDY DESIGN

We conducted semistructured interviews with 15 PCPs recruited from community pediatric offices with access to integrated behavioral health services (ie, low system-level barriers to care) who participated in a larger study on treating adolescent depression. Interviews addressed PCP perceptions of barriers to adolescents' uptake of care for depression. Interviews were audiorecorded, transcribed, and coded for key themes.

RESULTS

Although PCPs mentioned several adolescent barriers to care, they thought parents played a critical role in assisting adolescents in accessing mental health services. Important aspects of the parental role in accessing treatment included transportation, financial support, and social support. PCPs perceived that parental unwillingness to accept the depression diagnosis, family dysfunction, and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a "life coach" at home to help monitor for side effects and watch for increased suicidality when starting antidepressants.

CONCLUSIONS

In this PCP population, which had enhanced access to mental health specialists, PCPs primarily reported attitudinal barriers to adolescent depression treatment, focusing mainly on perceived parent barriers. The results of these qualitative interviews provide a framework for understanding PCP perceptions of parental barriers to care, identifying that addressing complex parental barriers to care may be important for future interventions.

Career Adaptability and Subjective Well-Being in Unemployed Emerging Adults

Unemployment is associated with increased levels of anxiety, depression, and disconnection among emerging adults. Given the greater risk of unemployment for emerging adults (13.2% in the United States), career adaptability is relevant to understanding how emerging adults survive and thrive in today’s challenging work environment. This study examined the effect of career adaptability on subjective well-being in 184 unemployed diverse emerging adults of age 21–29. Results revealed that emerging adults with higher levels of control and confidence had higher life satisfaction. Control was positively related to positive affect while at the same time negatively related to negative affect. Control was the most consistent informant of subjective well-being (significant on all three subscale measures). The implications of the significant findings, and the caution warranted in relation to these findings, are discussed.

Preparing individuals to communicate genetic test results to their relatives: report of a randomized control trial

This study reports a randomized clinical trial evaluating the efficacy of an intervention to prepare individuals to communicate BRCA1/BRCA2 results to family members. Women aged 18 years and older, who had genetic testing, and who had adult first-degree relatives, were randomly assigned to a communication skills-building intervention or a wellness control session. Primary outcomes were the percentage of probands sharing test results, and the level of distress associated with sharing. The ability of the theory of planned behavior variables to predict the outcomes was explored. Four hundred twenty-two women were enrolled in the study, 219 (intervention) and 203 (control). Data from 137 in the intervention group and 112 in the control group were analyzed. Two hundred forty-nine probands shared test results with 838 relatives (80.1 %). There were no significant differences between study groups in the primary outcomes. Combining data from both arms revealed that perceived control and specific social influence were associated with sharing. Probands were more likely to share genetic test results with their children, female relatives and relatives who they perceived had a favorable opinion about learning the results. The communication skills intervention did not impact sharing of test results. The proband's perception of her relative's opinion of genetic testing and her sense of control in relaying this information influenced sharing. Communication of test results is selective, with male relatives and parents less likely to be informed. Prevalent psychosocial factors play a role in the communication of genetic test results within families.

Narratives reflecting the lived experiences of people with brain disorders: common psychosocial difficulties and determinants

BACKGROUND

People with brain disorders - defined as both, mental disorders and neurological disorders experience a wide range of psychosocial difficulties (PSDs) (e.g., concentrating, maintaining energy levels, and maintaining relationships). Research evidence is required to show that these PSDs are common across brain disorders.

OBJECTIVES

To explore and gain deeper understanding of the experiences of people with seven brain disorders (alcohol dependency, depression, epilepsy, multiple sclerosis, Parkinson's disease, schizophrenia, stroke). It examines the common PSDs and their influencing factors.

METHODS

Seventy seven qualitative studies identified in a systematic literature review and qualitative data derived from six focus groups are used to generate first-person narratives representing seven brain disorders. A theory-driven thematic analysis of these narratives identifies the PSDs and their influencing factors for comparison between the seven disorders.

RESULTS

First-person narratives illustrate realities for people with brain disorders facilitating a deeper understanding of their every-day life experiences. Thematic analysis serves to highlight the commonalities, both of PSDs, such as loneliness, anger, uncertainty about the future and problems with work activities, and their determinants, such as work opportunities, trusting relationships and access to self-help groups.

CONCLUSIONS

The strength of the methodology and the narratives is that they provide the opportunity for the reader to empathise with people with brain disorders and facilitate deeper levels of understanding of the complexity of the relationship of PSDs, determinants and facilitators. The latter reflect positive aspects of the lives of people with brain disorders. The result that many PSDs and their influencing factors are common to people with different brain disorders opens up the door to the possibility of using cross-cutting interventions involving different sectors. This strengthens the message that 'a great deal can be done' to improve the lived experience of persons with brain disorders when medical interventions are exhausted.

Volunteering and Reemployment Status in Unemployed Emerging Adults

Given the alarming unemployment rates among emerging adults in the United States, this study investigates the relationships among volunteering, length of unemployment, likelihood/quality of reemployment, and job search strategies in a sample of emerging adults. Two hundred and sixty-five emerging adults aged between 21 and 29, all of whom were unemployed 6 months prior to taking the survey, completed an online survey. Results affirm positive associations between volunteering and likelihood of reemployment 6 months later. The number of hours spent volunteering was significantly related to reemployment status as was the length of unemployment. The use of an exploratory job search strategy, in contrast to the use of a focused or a haphazard job search strategy, was associated with reemployment. Implications of the findings and suggestions for further research are discussed along with the limitations of the present study.

Psychosocial features of depression: a systematic literature review

BACKGROUND

Despite the great burden of depression on sufferers and society, there is a lack of reliable information regarding the full range of psychosocial difficulties associated with depression and their related variables. This systematic review aimed to demonstrate the utility of the International Classification of Functioning, Disability and Health (ICF) in describing the psychosocial difficulties that shape the lived experience of persons with depression.

METHODS

An electronic search that included publications from 2005 to 2010 in the MEDLINE and PsycHINFO databases was conducted to collect psychosocial outcomes. Quality of studies was also considered.

RESULTS

103 studies were included. 477 outcomes referring psychosocial difficulties were extracted and grouped into 32 ICF related categories. Emotional functions (19% of studies), followed by energy and drive (17% of studies), were the most frequent psychosocial outcomes. The onset, course, determinants, and related variables of the most important psychosocial difficulties, reported in at least 10% of studies, were described. Medication played a dual role as determinant of onset and change in some psychosocial areas, e.g. in pain, sleep, and energy and drive.

LIMITATIONS

The search was limited by year of publication and focused only on minor and major depression diagnoses: other depressive disorders were not included. Some underresearched, but relevant psychosocial areas could have not been analyzed.

CONCLUSIONS

The present systematic review provides information on the psychosocial difficulties that depressive patients face in their daily lives. Future studies on depression should include outcome instruments that cover these relevant areas in order to comprehensively describe psychosocial functioning.

Development and pilot study of a marketing strategy for primary care/internet-based depression prevention intervention for adolescents (the CATCH-IT intervention)

BACKGROUND

Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice.

OBJECTIVE

To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs.

METHOD

A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design.

RESULTS

The marketing plan focused on "resiliency building" rather than "depression intervention" and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1-10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048).

CONCLUSIONS

Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care.

Adolescent and parent experiences with a primary care/Internet-based depression prevention intervention (CATCH-IT)

This article describes a mixed-methods approach to understand the experience of adolescents involved in the Internet-based intervention for depression, Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training (CATCH-IT), as well as the experiences of their parents while they were involved. Qualitative analysis was done with grounded theory-based categorization of interview comments and typed program responses (adolescents only) into themes. Quantitative analysis was done with self-report surveys. The article describes the nine themes reflecting the adolescent experience and the three themes reflecting the parent experience. The article also describes the results of the quantitative surveys of helpfulness and attitudes change, which were favorable of the Internet-based intervention. Separate models explaining the psychological transformation of the adolescents and the experience of the parents are proposed. The positive experience of the adolescents and parents involved in CATCH-IT is discussed in the context of growing interest in how best to utilize Internet-based interventions for mental illness, and suggestions are made for future investigation.

Gluteal adipose-tissue polyunsaturated fatty-acids profiles and depressive symptoms in obese adults with obstructive sleep apnea hypopnea syndrome: a cross-sectional study

Biomarkers of Polyunsaturated Fatty Acids (PUFAs) have been related to depressive symptoms in healthy adults. It is also known that depression is high prevalent in Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) and obesity. The aim of our study was to examine a possible association between PUFAs of the n-6 and n-3 families and depressive symptoms in obese OSAHS patients. Sixty three patients with OSAHS based on overnight attended polysomnography were included. Gluteal adipose tissue biopsies were performed in all participants. Fatty acids were analyzed by gas chromatography. Depressive symptoms were assessed by the Zung Self-rating Depression Scale. The majority of participants had grade II obesity (BMI: 36.2±4.3 kg/m(2)) and moderate to severe OSAHS. Mild depressive symptoms were found to affect 27.8% of the studied patients. No link between symptoms of depression and individual n-6 and/or n-3 PUFAs of gluteal adipose tissue was detected. However, multiple linear regression analysis showed a positive correlation between depressive symptoms and 20:3n-6/18:3n-6 ratio, and a negative association with age and n-6/n-3 ratio. The possible influence of OSAHS and obesity in depression development and the quiescent nature of gluteal adipose tissue may account for the absence of any significant relations between n-6 and/or n-3 PUFAs and depressive symptoms in our sample. The positive relationship between symptoms of depression and the particular fatty acid ratio probably indicates an increase in prostaglandins family although this needs further research.

Adolescents with depressive symptoms and their challenges with learning in school

We examine school performance among 83 adolescents at risk for major depression. Negative mood interfered with subjective measures of school performance, including ability to do well in school, homework completion, concentrate in class, interact with peers, and going to class. No significant relationships were found for mood and objective measures of school performance (school attendance, English, and Math grades). Students with a college-educated parent had stronger performance in objective measures (school attendance and Math grades), whereas males had lower English grades. In qualitative interviews, adolescents reported that negative thinking led to procrastination, which led to poor school performance, which led to more negative thinking. Adolescents with depressive symptoms that do not meet the threshold for referral report struggles in school. Understanding the specific challenges faced by adolescents with even low levels of depressive symptoms can help school nurses, teachers, and parents identify appropriate interventions to help adolescents succeed in school.