Social rank theory of depression: A systematic review of self-perceptions of social rank and their relationship with depressive symptoms and suicide risk

Mutual eye gaze and vocal pitch in relation to social anxiety and depression: A virtual interaction task

BACKGROUND

Individuals with high social interaction anxiety (SIA) and depression often behave submissively in social settings. Few studies have simultaneously examined the associations between objectively assessed submissive behaviors and SIA or depression, despite their high comorbidity and unknown mechanisms regarding submissiveness.

METHODS

A sample of 45 young adults self-reported trait SIA and depression, state positive/negative affect (PA/NA) before and after a virtual social interaction. Participants engaged in a four-minute conversation with a confederate who was trained to behave neutrally. Mutual eye gaze, via eye-tracking, and vocal pitch were assessed throughout the interaction.

RESULTS

Depression and SIA were positively correlated with NA, poorer self-rated performance, and vocal pitch. Highly socially anxious women engaged in less mutual eye gaze than highly socially anxious men. Also, vocal pitch was inversely associated with mutual eye gaze and positively related to NA and (nonsignificantly) to self-ratings of poor performance. Finally, our data partially replicated past research on the use of vocal pitch during social stress to detect social anxiety disorder.

LIMITATIONS

The current sample is relatively homogenous in educational attainment, age, and race. All research confederates were women. Future research should examine whether these archival data replicate with the latest telecommunication technologies.

CONCLUSION

Our findings highlight nuanced relationships among SIA, depression, emotions, self-perceptions, and biobehavioral indicators of submissive behavior-in response to an ambiguously negative/positive social interaction. Sex/gender may interact with these effects, emphasizing considerations for research method designs.

An initial investigation into the mental health difficulties in athletes who experience choking under pressure

This study aims to determine the frequency of choking under pressure (i.e., choking) and quantify the prevalence of psychological and behavioural consequences of choking. 165 current and retired athletes (over 18 years old) from various sporting levels completed an online survey that asked about demographics, the frequency of choking, and the psychological (e.g., negative feelings toward sport, passion/enjoyment of sport negatively affected, and suicidal ideation) and behavioural (e.g., missing/skipping sport temporarily, dropping out/quitting sport, and maladaptive, risky behaviour) effects of choking. Descriptive statistics on choking frequency indicated 127 (77%) athletes in this sample experienced choking in the last year of playing their sport, and, on average, "choked" 18.25 times during that year. Of the 65 athletes currently playing sport, 36 (55.4%) experienced choking in the past month. Furthermore, 39.4% and 7.1% of athletes in this sample did not achieve higher levels of competition and had suicidal thoughts due to choking, respectively. High-performance athletes in the current sample were more likely to engage in maladaptive behaviours after choking compared to low-performance athletes. Choking more negatively affected the passion/enjoyment for sport of currently playing (i.e., excluding all retired) high-performance than currently playing low-performance athletes. This seminal study crudely quantifies the frequency of choking in athletes, but more importantly provides crucial evidence of the psychological and behavioural consequences of choking and advocates for further research into choking and athlete mental health.

Threat, safety, safeness and social safeness 30 years on: Fundamental dimensions and distinctions for mental health and well-being

In 1993, the British Journal of Clinical Psychology published my paper titled 'Defence and safety: Their function in social behaviour and psychopathology'. The paper highlights that to understand people's sensitivity to threat, we also need to understand their ability to identify what is safe. This paper offers an update on these concepts, highlighting distinctions that were implicit but not clearly defined at the time. Hence, the paper seeks to clarify distinctions between: (i) threat detection and response, (ii) safety and safety seeking, (iii) safeness and (iv) their social and non-social functions and forms. Threat detection and response are to prevent or minimize harm (e.g., run from a predator or fire). Safety checking relates to monitoring for the absence and avoidance of threat, while safety seeking links to the destination of the defensive behaviour (e.g., running home). Safety seeking also relates to maintaining vigilance to the appearance of potential harms and doing things believed to avoid harm. Threat-defending and safety checking and seeking are regulated primarily through evolved threat processing systems that monitor the nature, presence, controllability and/or absence of threat (e.g., amygdala and sympathetic nervous system). Safeness uses different monitoring systems via different psychophysiological systems (e.g., prefrontal cortex, parasympathetic system) for the presence of internal and external resources that support threat-coping, risk-taking, resource exploration. Creating brain states that recruit safeness processing can impact how standard evidence-based therapies (e.g., exposure, distress tolerance and reappraisal) are experienced and produce long-term change.

Astrocyte-derived dominance winning reverses chronic stress-induced depressive behaviors

Individuals with low social status are at heightened risk of major depressive disorder (MDD), and MDD also influences social status. While the interrelationship between MDD and social status is well-defined, the behavioral causality between these two phenotypes remains unexplored. Here, we investigated the behavioral relationships between depressive and dominance behaviors in male mice exposed to chronic restraint stress and the role of medial prefrontal cortex (mPFC) astrocytes in these behaviors. Chronic restraint stress induced both depressive and submissive behaviors. Chemogenetic mPFC astrocyte activation significantly enhanced dominance in chronic stress-induced submissive mice by increasing the persistence of defensive behavior, although it did not affect depressive behaviors. Notably, repetitive winning experiences following mPFC astrocyte stimulation exerted anti-depressive effects in chronic restraint stress-induced depressive mice. These data indicate that mPFC astrocyte-derived winning experience renders anti-depressive effects, and may offer a new strategy for treating depression caused by low status in social hierarchies by targeting mPFC astrocytes.

Income rank and depressive symptoms among employees in Germany - A 5-year cross-lagged panel analysis

Background/Objective

Socioeconomic disparities in mental health are well-established. Previous research suggests that relative income rank is associated with depressive symptoms above and beyond absolute income. This study aimed to investigate the predictive value of income rank for future depressive symptoms while accounting for absolute income. Exploring potential reverse pathways from depressive symptoms to income rank was a secondary objective.

Method

A two-wave cross-lagged panel design with a 5-year follow-up was used to analyze data for income rank, absolute income, and two dimensions of depressive symptoms (i.e., cognitive-affective and somatic symptoms) from initially 4,201 employees. Income rank was calculated for reference groups, based on the same gender, the same 5-year age band, and the same occupational skill level.

Results

Lower income rank at baseline predicted a higher severity of cognitive-affective depressive symptoms at five-year follow-up, even after adjusting for absolute income. In contrast, income rank did not demonstrate a significant unique longitudinal association with somatic depressive symptoms when simultaneously taking absolute income into account. There was no evidence for the assumption that depressive symptoms are predictive for future income rank (i.e., reverse pathway).

Conclusions

Cognitive-affective symptoms of depression might be particularly responsive to social comparisons and a relatively low social rank.

Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents

BACKGROUND

This study examined how health behavior patterns are associated with anxiety and suicidal behaviors among Korean adolescents.

METHODS

Data were collected from a national cross-sectional sample of adolescents (n = 54,948, 51.5 % boys) in the 2020 Korea Youth Risk Behavior Web-based Survey. Latent class analysis was conducted based on 12 health behaviors (e.g., eating habits, physical activity, and substance use) using the R-based Jamovi 2.3.21 program.

RESULTS

Four classes of health behaviors were identified: Class 1 (boys: 45.4 %, girls: 34.4 %) engaged in healthy behaviors; Class 2 (boys: 31.7 %; girls: 22.3 %) had unhealthy eating habits; Class 3 (boys: 18.0 %; girls: 39.9 %) had the lowest physical activity; and Class 4 (boys: 5.0 %, girls: 3.4 %) engaged in substance use, including smoking, drinking, and problematic smartphone use. Overall, girls had a higher odds ratio (OR) for anxiety and suicidal behaviors than boys did. Among girls, Class 4 had a higher OR for anxiety (OR = 2.78, 95 % confidence interval [CI] = 2.40-3.21), suicidal ideation (OR = 3.99, 95 % CI = 3.46-4.62), suicide plan (OR = 3.32, 95 % CI = 2.66-4.16), and suicide attempts (OR = 5.62, 95 % CI = 4.43-7.12) than Class 1.

LIMITATIONS

This study has a few limitations including the participants' response bias, the use of a self-report survey, and the lack of diagnosis by clinicians.

CONCLUSION

Adolescents engaging in substance abuse (Class 4) were more prone to anxiety symptoms and suicidal behaviors (ideation, plan, and attempts) than those engaged in healthy behaviors (Class 1). We suggest that more attention is needed to develop suicide prevention strategies that consider adolescent substance use patterns such as current smoking, drinking, and problematic smartphone use.

The "bubbles"-study: Validation of ultra-short scales for the assessment of depression, anxiety and stress symptoms

Depression, anxiety and stress symptoms cause substantial psychological and economic burdens around the globe. To mitigate the negative consequences, the negative symptoms should be identified at an early stage. Therefore, the implementation of very brief valid screening tools in mental health prevention programs and in therapeutic settings is advantageous. In two studies on representative German population samples, we developed and validated three ultra-short scales-the "bubbles"-that consist of only one item based on the Depression Anxiety Stress 21 subscales (DASS-21) for the assessment of depression, anxiety and stress symptoms. The results of Study 1 (N = 1,001) and Study 2 (N = 894) revealed that the bubbles are valid instruments that fit the DASS-21 subscales on the factor level. Moreover, the bubbles replicated the association pattern of the DASS-21 subscales with demographic variables, and with variables that belong to the negative and the positive dimension of mental health. Thus, due to their time- and cost-efficiency, the bubbles can be used as brief screening tools in research (e.g., large-scale studies, longitudinal studies, experience sampling paradigms) and in praxis. Their shortness can prevent fatigue, motivation decrease, and participants' drop-out.

Decomposition analysis of the difference in depressive symptoms between urban and rural employed people in China: Unpaid work plays an important role

OBJECTIVE

Focusing on the relationship between unpaid labor and the occurrence of depressive symptoms, this study aimed to explore the factors influencing the inequality of depressive symptoms and their contribution among Chinese urban and rural employed people.

METHODS

This study utilized the 2020 China Family Panel Studies' national resampling data. Multivariate logistic regression was used to explore the factors influencing the occurrence of depressive symptoms among employed persons in urban and rural areas in China, respectively. Fairlie decomposition was used to explore the contribution of influencing factors such as unpaid labor to the difference in the occurrence of depressive symptoms between urban and rural areas.

RESULTS

About 2,136 (21.70%) participants had depressive symptoms, of which 1,197 (24.75%) rural employed people had depressive symptoms and 939 (18.75%) urban employed people had depressive symptoms. The results of Fairlie decomposition analysis showed that 70.51% of the differences in depressive symptoms between urban and rural Chinese employed people could be explained by the covariates included in this study, including education level (52.44%), age (-11.91%), housework time (10.42%), self-rated health status (10.22%), self-rated income status (2.53%), exercise (2.36%), job satisfaction status (1.99%), chronic disease status (1.90%), and marital status (1.79%).

CONCLUSION

This study found that the proportion of depressive symptoms was lower among urban employed residents than among rural employed residents. This difference was mainly caused by unpaid labor time, socioeconomic status, personal lifestyle, and health status. Housework, which is one of the unpaid labor, contributed to this depressive symptom difference in the third place.

How, when, and why is social class linked to mental health and wellbeing? A systematic meta-review

RATIONALE

Meta-reviews synthesising research on social class and mental health and wellbeing are currently limited and focused on specific facets of social class (e.g., social capital) or mental health and wellbeing (e.g., mental health disorders), and none sought to identify mechanisms in this relationship.

OBJECTIVES

The present meta-review sought to (1) assess the overall relationship between social class and mental health and wellbeing, (2) determine the mechanisms that act in this relationship, and (3) evaluate the strength of evidence available.

METHODS

The protocol was prospectively registered on PROSPERO (CRD42021214731). We systematically searched twelve databases in September 2022 and identified 149 eligible reviews from 38,257 records screened. Quality of evidence was assessed with the JBI levels of evidence and risk of bias with the ROBIS tool.

RESULTS

A large but low-quality evidence base points to class-based inequalities in mental health and wellbeing, with the strongest available evidence linking lower social positions to an increased risk of depression. In terms of different facets of stratification, the best available evidence suggests that deprivation (e.g., poverty), socioeconomic status, income, and subjective social status are consequential for individuals' mental health and wellbeing. However, high-quality evidence for the roles of education, occupation, other economic resources (e.g., wealth), and social capital is currently limited. Most reviews employed individual-level measures (e.g., income), as opposed to interpersonal- (e.g., social capital) or community-level (e.g., neighbourhood deprivation) measures. Considering mechanisms, we found some evidence for mediation via subjective social status, sense of control, and experiences of stress and trauma. There was also some evidence that higher socioeconomic status can provide a buffer for neighbourhood deprivation, lower social capital, and lower subjective social status.

CONCLUSIONS

Future research employing experimental or quasi-experimental methods, and systematic reviews with a low risk of bias, are necessary to advance this area of research.

Epidemiological profile, temporal analysis, and future projections of suicide cases in rural cities in the extreme south of Brazil

The present study aimed to verify the time series (2000-2017) of death rates by suicide and its associated factors in 4 municipalities in the extreme south of Brazil. Data were obtained through the analysis of medical reports and police report bulletins at the Instituto Médico Legal, in the city of Rio Grande. The suicide rate in the Rio Grande region varied from 4 to 11 suicides per 100,000 inhabitants and it is estimated that by 2030 this rate could reach 16.5 suicides per 100,000 inhabitants. The rural cities of Santa Vitória do Palmar and Chuí present even higher suicide averages when compared to Rio Grande, the most populous city of the four. The death rate from suicide increased gradually in the period analyzed, with the prevalence rising among the youngest and the elderly population. A more comprehensive understanding of the influences of environmental issues on suicidal decisions constitutes an important action that needs to be taken, both because of regional vulnerabilities and the target population identified. Evidence indicates that knowledge of factors affecting individuals residing in this Brazilian region where increased suicide rates are recorded needs to be recognized as a priority.

The role of insight, social rank, mindfulness and self-compassion in depression following first episode psychosis

Gaining awareness of psychosis (i.e., insight) is linked to depression, particularly in the post-acute phase of psychosis. Informed by social rank theory, we examined whether the insight-depression relationship is explained by reduced social rank related to psychosis and whether self-compassion (including uncompassionate self-responding [UCS] and compassionate self-responding [CSR]) and mindfulness buffered the relationship between social rank and depression in individuals with first episode psychosis during the post-acute phase. Participants were 145 young people (Mage  = 20.81; female = 66) with first episode psychosis approaching discharge from an early psychosis intervention centre. Questionnaires and interviews assessed insight, depressive symptoms, perceived social rank, self-compassion, mindfulness and illness severity. Results showed that insight was not significantly associated to depression and thus no mediation analysis was conducted. However, lower perceived social rank was related to higher depression, and this relationship was moderated by self-compassion and, more specifically, UCS. Mindfulness was related to depression but had no moderating effect on social rank and depression. Results supported previous findings that depressive symptoms are common during the post-acute phase. The role of insight in depression for this sample is unclear and may be less important during the post-acute phase than previously considered. Supporting social rank theory, the results suggest that low perceived social rank contributes to depression, and reducing UCS may ameliorate this effect. UCS, social rank and possibly mindfulness may be valuable intervention targets for depression intervention and prevention efforts in the recovery of psychosis.

Crying over spilled milk? A network analysis of aversive well-being comparison, brooding rumination and depressive symptoms

BACKGROUND

Comparative thinking about one's well-being is ubiquitous. Comparisons that threaten an individual's self-motives are aversive and interact with rumination and depression. Aversive well-being comparisons include upward social, past temporal, counterfactual, and criteria-based comparisons, as well as downward prospective temporal comparisons. Although the frequency, discrepancy, and affective impact of aversive comparison total scores have been associated with brooding rumination and depression, no study has investigated the interaction of specific comparison standards (e.g., social or counterfactual) with symptom cascades of brooding and depressive symptoms.

METHODS

To examine this interaction, we conducted network analyses on the interplay between aversive well-being comparisons, brooding rumination, and depression. Specifically, we conducted a cross-sectional study in N = 500 dysphoric individuals and a longitudinal study in N = 921 participants at two timepoints, three months apart. Participants completed measures of depression, brooding, and the Comparison Standards Scale for Well-being, which assessed the frequency, perceived discrepancy, and affective impact of aversive well-being comparisons.

RESULTS

Feelings of worthlessness emerged as the most central attribute in the networks of the dysphoric sample. Longitudinally, brooding and depressive symptoms predicted aversive comparisons, but not the other way around, which accounted for social and other-referent counterfactual comparisons to a greater degree than for other comparison types.

LIMITATIONS

We used nonclinical samples.

CONCLUSIONS

The findings highlight the critical role of comparison standards in depression. Further research is warranted to detect potential intervention targets for mitigating negative effects of negative self-evaluation.

Depressive and anxiety symptoms in the course of the COVID-19 pandemic among physicians in hospitals: results of the longitudinal, multicenter VOICE-EgePan survey over two years

BACKGROUND

This longitudinal, multicenter web-based study explored the trajectories of depressive and anxiety symptoms during the COVID-19 pandemic among physicians over two years.

METHODS

At four measurement points between 4/2020 and 5/2022 depressive (Patient Health Questionnaire-2, PHQ-2) and anxiety symptoms (Generalized Anxiety Disorder Scale-2, GAD-2) among physicians in German hospitals were assessed. Time, gender and age effects were analyzed with linear mixed regression models. Comparisons with norm values for the German population during the COVID-19 pandemic were also performed and frequencies of probable depression and anxiety are reported.

RESULTS

The physicians (N = 340) showed a significant increase of depressive symptoms from T1 (M = 1.35, SD = 1.33) to T4 (M = 1.64, SD = 1.34) (p < .001) and of anxiety symptoms from T1 (M = 1.35, SD = 1.42) to T2 (M = 1.59, SD = 1.43) (p = .024). The main effect of gender was only significant for anxiety symptoms (p = .001): women demonstrated higher scores than men. A significant age class difference was observed only for depressive symptoms: the youngest age group (18-40 years) revealed higher values than the oldest group (> 50 years, p = .003). As compared to the general population, the physicians reported significantly elevated PHQ-2 (T1: M = 1.35, SD = 1.33; T2: M = 1.53, SD = 1.37; T3: M = 1.55, SD = 1.40; T4: M = 1.64, SD = 1.34) and GAD-2 scores (T1: M = 1.35, SD = 1.42; T2: M = 1.59, SD = 1.43; T3: M = 1.61, SD = 1.57; T4: M = 1.49, SD = 1.46) for all measurement points (all p < .001). The frequencies of probable depression (PHQ-2 ≥ 3) and anxiety (GAD-2 ≥ 3) were: 14.1% and 17.0% (T1), 16.5% and 21.9% (T2), 17.8% and 22.6% (T3) and 18.5% and 17.3% (T4), respectively.

CONCLUSIONS

Mental distress of physicians in German hospitals has increased in the course of the COVID-19 pandemic with gender and age-related differences. Possible causes should be explored and regular monitoring of mental health and prevention programmes for physicians should be established.

TRIAL REGISTRATION

The study was registered on ClinicalTrials (DRKS-ID: DRKS00021268) on 9.4.2020.

Machine learning-based prediction for self-harm and suicide attempts in adolescents

This study aimed to use machine learning (ML) models to predict the risk of self-harm and suicide attempts in adolescents. We conducted secondary analysis of cross-sectional data from the Longitudinal Study of Australian Children dataset. Several key variables at the age of 14-15 years were used to predict self-harm or suicide attempt at 16-17 years. Random forest classification models were used to select the optimal subset of predictors and subsequently make predictions. Among 2809 participants, 296 (10.54%) reported an act of self-harm and 145 (5.16%) reported attempting suicide at least once in the past 12 months. The area under the receiver operating curve was fair for self-harm (0.7397) and suicide attempt (0.7220), which outperformed the prediction strategy solely based on prior suicide or self-harm attempt (AUC: 0.6). The most important factors identified were similar, and included depressed feelings, strengths and difficulties questionnaire scores, perceptions of self, and school- and parent-related factors. The random forest classification algorithm, an ML technique, can effectively select the optimal subset of predictors from hundreds of variables to forecast the risks of suicide and self-harm among adolescents. Further research is needed to validate the utility and scalability of ML techniques in mental health research.

Trends in social inequality and how mental wellbeing vary and covary among Norwegian adolescents and their families: the Young-HUNT Study

BACKGROUND

The study had two aims: first, to investigate trends in socioeconomic inequalities in psychological distress and loneliness among Norwegian adolescents, and second, to study variation and covariation of psychological distress and loneliness within adolescents and between siblings within families.

METHODS

Multivariate mixed models were used to investigate trends in socioeconomic inequality in psychological distress and loneliness using three separate cohorts of Norwegian adolescents from the Young-HUNT study conducted in 1995-1997 (Young-HUNT1, n = 8980), 2006-2008 (Young-HUNT3, n = 8199) and 2017-2019 (Young-HUNT4, n = 8066). Register data on parental education level was used as a marker of socioeconomic position (SEP), and a unique family number was used to identify adolescents belonging to the same family. A three-level multivariate mixed model was created, consisting of the outcomes at level 1, adolescents at level 2 and families at level 3.

RESULTS

No statistically significant difference in scores on loneliness and psychological distress was observed between low and high parental education level in Young-HUNT1, whereas in Young-HUNT4, low parental education level was associated with a higher score on both psychological distress (β = 0.09; 95% confidence interval (CI), 0.03-0.14) and loneliness (β = 0.12; 95% CI 0.07-0.17). Analyses of covariation between psychological distress and loneliness showed that they were correlated within adolescents and strongly correlated within families across all timepoints.

CONCLUSIONS

Increasing socioeconomic inequalities in psychological distress and loneliness among Norwegian adolescents is worrisome. Further, the family seems to be an important arena for potential prevention of psychological distress and loneliness among adolescents, regardless of parental education level.

The Role of Anger Expression in Unmet Expectations and Depressive Symptoms

Background and Objectives. Depression is associated with unmet relational expectations, but little is known about how both partners experience meeting expectations and how this relates to anger expression and depressive symptoms. The aim of study 1 was to explore the role of anger expression in explaining the link between relational expectations and depression using the actor-partner interdependence mediation model. Additionally, social expectations beyond romantic relationships are associated with societal demands. Study 2 is aimed at investigating the role of anger expression in the relationship between internalized social demands (i.e., outer self-awareness) and depressive symptoms. Design and Methods. Online self-report data were collected from N = 194 romantic partners (97 dyads) in study 1 and N = 407 individuals in study 2. Results. In study 1, unmet expectations were associated with both actor and partner effects on depressive symptoms and anger expression. In particular, inwardly directed anger was linked to depressive symptoms in the case of the individual experiencing unmet expectations, whereas outwardly directed anger predicted such symptoms in the case of the partner's unmet expectations. In study 2, there was a positive association between outer self-awareness and directing anger inwards and outwards, which was linked to higher depressive symptoms. Furthermore, while directing anger inwards seemed to be a universal mechanism underlying the association, the interpersonal mechanism (i.e., directing anger outwards) was found to be dependent on gender.

The role of perceived social norms in non-suicidal self-injury and suicidality: A systematic scoping review

Social norms are an important influence on health-related behaviours and intention formation. As both suicidal behaviour and non-suicidal self-injury (NSSI) can be motivated by intentions, perceived social norms may have an important role in suicide and NSSI outcomes, although no existing reviews of this association exist. Following the PRISMA Scoping Review extension guidance, a scoping review based on systematic searches of key databases was conducted to identify published English language studies investigating the role of perceived social norms in suicidality and NSSI. Information regarding the types of social norms studied, their relationship to suicidality/NSSI outcomes, study samples and designs was charted. Thirty-six eligible studies (31 quantitative, 4 qualitative, 1 mixed methods) sampling various populations across mostly non-clinical settings were identified and narratively synthesised. Studies varied in how social norms were operationalised, measured, and investigated/explored. Most studies focused on the role of conformity to perceived masculine social norms or to some form of subjective, descriptive, or injunctive norms; there were limited studies on female/feminine norms, pro-social/protective norms, or broader gender/sexuality norms. Most studies (n = 31) were cross-sectional (quantitative) in design, few were based on existing theories of suicide/NSSI or social norms, and none concurrently tested theories of social norms and NSSI/suicidality. Perceived social norms and stronger conformity to norms were generally associated with worse NSSI/suicidality, although some pro-social norms appeared to be protective (e.g., perceived parental norms for adolescents). Whilst conformity to restrictive perceived social norms may be related to poorer suicide and NSSI outcomes, there is a lack of consistency in the literature in how social norms are defined and measured, a lack of theory-based hypothesis testing, and few longitudinal studies. There is a need for more nuanced, theory-based, investigations of how, when, where, why, and for whom, perceived norms have a causal role in NSSI and suicidality outcomes.

Sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China: the mediating role of entrapment and defeat

BACKGROUND

The COVID-19 pandemic increases the risk of psychological problems, especially for the infected population. Sleep disturbance and feelings of defeat and entrapment are well-documented risk factors of anxiety symptoms. Exploring the psychological mechanism of the development of anxiety symptoms is essential for effective prevention. This study aimed to examine the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China.

METHODS

A cross-sectional study was conducted from March to April, 2022. Participants were 1,283 asymptomatic COVID-19 carriers enrolled from the Ruijin Jiahe Fangcang Shelter Hospital, Shanghai (59.6% male; mean age = 39.6 years). Questionnaire measures of sleep disturbance, entrapment, defeat, anxiety symptoms, and background characteristics were obtained. A mediation model was constructed to test the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms.

RESULTS

The prevalence rates of sleep disturbance and anxiety symptoms were 34.3% and 18.8%. Sleep disturbance was positively associated with anxiety symptoms (OR [95%CI] = 5.013 [3.721-6.753]). The relationship between sleep disturbance and anxiety symptoms (total effect: Std. Estimate = 0.509) was partially mediated by entrapment (indirect effect: Std. Estimate = 0.129) and defeat (indirect effect: Std. Estimate = 0.126). The mediating effect of entrapment and defeat accounted for 50.3% of the association between sleep disturbance and anxiety symptoms.

CONCLUSION

Sleep disturbance and anxiety symptoms were prevalent among asymptomatic COVID-19 carriers. Entrapment and defeat mediate the association between sleep disturbance and anxiety symptoms. More attention is needed to monitoring sleep conditions and feelings of defeat and entrapment to reduce the risk of anxiety.

Financial strain and depression in the U.S.: a scoping review

While the association between assets and depression has been established, less is known about the link between financial strain and depression. Given rising financial strain and economic inequity due to the COVID-19 pandemic, understanding the role that financial strain plays in shaping population depression in the United States is particularly salient. We conducted a scoping review of the peer-reviewed literature on financial strain and depression published from inception through January 19, 2023, in Embase, Medline via PubMed, and PsycINFO, PsycArticles, SocINDEX, and EconLit via Ebsco. We searched, reviewed, and synthesized the literature on longitudinal studies on financial strain and depression conducted in the United States. Four thousand and four unique citations were screened for eligibility. Fifty-eight longitudinal, quantitative articles on adults in the United States were included in the review. Eighty-three percent of articles (n = 48) reported a significant, positive association between financial strain and depression. Eight articles reported mixed results, featuring non-significant associations for some sub-groups and significant associations for others, one article was unclear, and one article reported no significant association between financial strain and depression. Five articles featured interventions to reduce depressive symptoms. Effective interventions included coping mechanisms to improve one's financial situation (e.g., mechanisms to assist in finding employment), to modify cognitive behavior (e.g., reframing mindset), and to engage support (e.g., engaging social and community support). Successful interventions were tailored to participants, were group-based (e.g., they included family members or other job seekers), and occurred over multiple sessions. While depression was defined consistently, financial strain was defined variably. Gaps in the literature included studies featuring Asian populations in the United States and interventions to reduce financial strain. There is a consistent, positive association between financial strain and depression in the United States. More research is needed to identify and test interventions that mitigate the ill effects of financial strain on population's mental health.

Socioeconomic status and depressive symptoms and suicidality: The role of subjective social status

BACKGROUND

Low socioeconomic status (SES) confers access to material resources and social standing and is an established risk factor of both depressive symptoms and suicidality. Subjective social status (SSS) assesses how people perceive their position within the social hierarchy and has been proposed to impact mental health. This study examined the relationship between SES and depressive symptoms and suicidality and tested whether SSS mediated these associations.

METHODS

This study drew on publicly available survey data from the US National Longitudinal Study of Adolescent to Adult Health (Add Health). Participants were surveyed at baseline in 2008 (N = 4948; aged 28.8 years) and at followed up in 2016-2018 (N = 3509; aged 37.8 years). SES was gauged using personal and household income, assets, education, and job prestige. SSS was assessed using the MacArthur Scale. Depressive symptoms were assessed using four-items from the Centre for Epidemiological Studies Scale of Depression (CESD) and participants reported suicidal ideation and suicide attempts in the past year.

RESULTS

Both low SES and SSS were associated with elevated levels of depressive symptoms, suicidal ideation, and suicide attempts in cross-sectional and prospective analyses. SSS explained 27 % of the association between SES and depressive symptoms, 51 % of the relationship between SES and suicidal ideation, and 37 % of the link between SES and suicide attempts on average.

CONCLUSIONS

These findings contribute to understanding the long-term effects of SSS and suggest that perceptions of status may be a key mechanism through which low SES forecasts the development of depressive symptoms and suicidality.

Association Between Social Networking Site Use Intensity and Depression Among Chinese Pregnant Women: Cross-sectional Study

BACKGROUND

Despite extensive debates about the mental health impacts of the use of social networking sites (SNSs), including WeChat, the association and mechanisms between social interaction of WeChat use intensity and antenatal depression are unclear.

OBJECTIVE

We aimed to test the mediating roles of upward social comparison on social interaction of WeChat and rumination in the association between social interaction of WeChat use intensity and antenatal depression.

METHODS

A cross-sectional survey was conducted in four hospitals with the self-reported measures of social interaction of WeChat use intensity, upward social comparison on social interaction of WeChat, rumination, antenatal depression, and control variables. The mediation analysis was performed through Model 6 from the PROCESS macro 4.0 in SPSS 26.

RESULTS

Results from 2661 participants showed that antenatal depression was unrelated to social interaction of WeChat use intensity (P=.54), but was significantly positively related to the attitude toward social interaction of WeChat (P=.01). The direct effect of attitude toward social interaction of WeChat use on antenatal depression was not statistically significant (β=-.03, P=.05). The results supported an indirect relationship between attitude toward social interaction of WeChat use and antenatal depression via (1) upward social comparison on social interaction of WeChat (indirect effect value=0.04, 95% CI 0.03 to 0.06); (2) rumination (indirect effect value=-0.02, 95% CI -0.04 to -0.01); and (3) upward social comparison on social interaction of WeChat and rumination in sequence (indirect effect value=0.07, 95% CI 0.06 to 0.08).

CONCLUSIONS

Our findings highlight the necessity of focusing on attitudes toward SNS use, and the importance of upward social comparison and rumination in understanding the effect of SNS use on antenatal depression.

Social anxiety and accumulation of status loss events: The role of adulthood experiences

OBJECTIVES

The association between social anxiety (SA) and early-life status loss events (SLEs) is well documented. However, such an association in adulthood is yet to be examined.

METHODS

Two studies (N = 166 and N = 431) were conducted to address this question. Adult participants filled out questionnaires regarding SLEs accumulation during childhood, adolescence, and adulthood, along with depression and SA severity measures.

RESULTS

SA was associated with SLEs in adulthood over and above SLEs in childhood and adolescence, and depression.

CONCLUSION

The adaptive role of SA in adulthood in the face of concrete and relevant status threats is discussed.

Envy, Social Comparison, and Depression on Social Networking Sites: A Systematic Review

This study aims to review the evidence for the reciprocal relationship between envy and social comparison (SC) on social networking sites (SNSs) and depression. We searched PsychINFO, PubMed, and Web of Science from January 2012 to November 2022, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 9 articles met our inclusion criteria. In all articles reviewed, a simple correlation was found between SC on SNSs, envy, and depression. Three cross-sectional studies successfully tested a model with envy as a mediator between SNSs and depression. The moderating role of additional variables such as self-efficacy, neuroticism, SC orientation, marital quality, and friendship type was also evident. The only two studies that were suitable to determine direction found that depression acted as a predictor rather than an outcome of SC and envy, and therefore depression might be a relevant risk factor for the negative emotional consequences of SNSs use.

A systematic review of compassion-based interventions for individuals struggling with body weight shame

OBJECTIVE

This systematic review investigated compassion-based interventions and the extent to which they can assist with addressing body weight shame.

DESIGN

The systematic review was pre-registered and conducted according to PRISMA guidelines. Seven electronic databases (PsycNET, Pubmed, Web of science, CINAHL, Scopus, ProQuest, Social Science Database) were searched. The methodological quality of studies was also assessed.

MAIN OUTCOME MEASURES

Main outcomes were body weight shame, and compassion. Secondary outcomes assessed were mental health, eating attitudes and behaviours, physical exercise and Body Mass Index and weight.

RESULTS

25 studies (23 papers) met inclusion criteria and results indicated promise for compassion-based interventions for body weight shame, compassion, and health related behaviour. Mixed results were found for BMI and weight. The studies varied considerably in terms of populations targeted, the duration of interventions, and intervention delivery.Conclusion: Overall, compassion-based interventions were found to reduce body weight shame and improve levels of compassion. However, the impact of compassion-based interventions on BMI and weight is less promising. Recommendations for future research are provided.

How we compare: A new approach to assess aspects of the comparison process for appearance-based standards and their associations with individual differences in wellbeing and personality measures

We introduce a novel approach to assess habitual comparison processes, while distinguishing between different types of comparison standards. Several comparison theories (e.g., social) suggest that self-evaluations use different standards to inform self-perception and are associated with wellbeing and personality. We developed the Comparison Standards Scale for Appearance (CSS-A) to examine self-reported engagement with social, temporal, criteria-based, dimensional, and counterfactual comparisons for upward and downward standards in relation to appearance. The scale was completed by three hundred participants online alongside measures of appearance schemas, social comparison evaluations, depression, anxiety, stress, self-esteem, physical self-concept, narcissism, and perfectionism. The CSS-A was found to reliably assess individual differences in upward and downward comparison frequency and affective impact for multiple comparison standards. In line with theory, CSS-A upward comparisons were more frequent than downward comparisons and coincided with negative (versus positive) affective impact. Comparison intensity (i.e., comparison frequency × discrepancy) predicted negative and positive affective impact for upward and downward comparisons, respectively. This relationship was partially mediated by appearance concern for upward comparisons (a composite of appearance schemas and physical self-concept), yet moderated by negativity for downward comparisons (a composite of depression, anxiety, stress, and self-esteem). We offer a framework for measuring the comparison process that warrants further research on underlying comparison processes, for which the CSS(-A) and experience sampling methods should serve as useful tools.

Social Group Identification as a Predictor of Pretreatment Suicidal Ideation and Intent in those Receiving cCBT: Evidence from a Scottish Primary Care Sample

Suicidal ideation and intent are strongly linked with suicidal attempts and completions; however, no study to date has explored the predictors of ideation and intent within a sample receiving computerized cognitive behavioral therapy (cCBT) as an intervention for mild to moderate depression. The current study investigates the impact of social group identification and socioeconomic deprivation, together with a number of important clinical and demographic factors, on suicidal ideation and intent within a Scottish primary care sample. Participants (N = 1062) were recruited from referrals to a cCBT program, "Beating the Blues" (BtB), over a 33-month period. Participants completed three versions of the group identifications scale (GIS), one for each of three groups: family, community, and a social group of choice. Single-item questions on suicidal ideation and intent were delivered through the BtB program, and demographic and clinical information were collected on commencing BtB. More severe psychological distress, fewer group identifications, younger age, and being male, all significantly predicted the presence of suicidal ideations, however only greater severity of psychological distress was associated with more serious suicidal intent. These results provide valuable insight into factors associated with suicidal ideation and intent within a clinical population from a psychosocial, psychopharmacological, and demographic perspective.

The influence of perceived government corruption on depressive symptoms with social status as a moderator

Perceived government corruption is an important indicator of depressive symptoms. Recent studies have explored the relationship between perceived government corruption and depressive symptoms in a cross-cultural context, but the underlying mechanisms need further research. This paper examines the impact of perceived government corruption on depressive symptoms in China and the moderating role of social status. Based on the 2018 wave of China Family Panel Studies (CFPS2018), 14,116 respondents aged between 16 and 96 were selected. The results revealed: (1) Perceived government corruption was significantly positively correlated with depressive symptoms. (2) Social class had an inhibitory effect in moderating the relationship between perceived government corruption and depressive symptoms. (3) The moderating effect was only significant for respondents who received education between junior high school and a bachelor's degree. The findings provide policy implications for developing countries and transitional societies like China. To build a more psychologically healthy society, we need to strengthen anti-corruption, stimulate social mobility, and improve people's sense of gain in the future.

The Impact of Household Economic Deterioration Caused by the COVID-19 Pandemic and Socioeconomic Status on Suicidal Behaviors in Adolescents: A Cross-sectional Study Using 2020 Korea Youth Risk Behavior Web-based Survey Data

OBJECTIVES

Economic hardship has a serious impact on adolescents' mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents' suicidal behaviors.

METHODS

This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions.

RESULTS

The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively.

CONCLUSIONS

ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.

Resting-state functional connectivity of the amygdala in major depressive disorder with suicidal ideation

Suicide is a common issue among major depressive disorder (MDD) patients and suicidal ideation (SI) is the first step toward it. There are no definitive objective biomarkers of SI relative to MDD. In this study, a seed-based correlation analysis was performed among 36 MDD patients with SI, 66 MDD patients without SI (NSI), and 57 healthy controls (HCs) using amygdala resting-state functional connectivity (RSFC). Furthermore, the correlation between amygdala RSFC and clinical features was examined in the SI group. When compared to the NSI group, SI group exhibited increased RSFC between the left amygdala seed and left medial superior frontal gyrus (SFGmed) as well as left middle frontal gyrus (MFG). In turn, a decreased RSFC was observed between the left amygdala seed and the following brain regions including the left inferior parietal lobule (IPL), right precentral gyrus (PrCG), and left superior parietal lobule (SPL) in SI group compared to NSI group. Moreover, the SI group exhibited increased RSFC of the right amygdala with left middle temporal gyrus (MTG); In addition, the RSFC of the left amygdala with left MFG was negatively associated with learning and memory (VSM), speed of processing (SOP). The RSFC of the amygdala is distinct between MDD patients with SI and without SI. Our findings reveal the neurobiological characteristics of MDD with respect to SI and provide new clues regarding vulnerability to mental illness. It is necessary to carry out repeated and more longitudinal researches using multimodal approaches on SI in the future.

Suicide and other causes of death among working-age and older adults in the year after discharge from in-patient mental healthcare in England: matched cohort study

BACKGROUND

Evidence for risk of dying by suicide and other causes following discharge from in-patient psychiatric care throughout adulthood is sparse.

AIMS

To estimate risks of all-cause mortality, natural and external-cause deaths, suicide and accidental, alcohol-specific and drug-related deaths in working-age and older adults within a year post-discharge.

METHOD

Using interlinked general practice, hospital, and mortality records in the Clinical Practice Research Datalink we delineated a cohort of discharged adults in England, 2001-2018. Each patient was matched to up to 20 general population comparator patients. Cumulative incidence (absolute risks) and hazard ratios (relative risks) were estimated separately for ages 18-64 and ≥65 years with additional stratification by gender and practice-level deprivation.

RESULTS

The 1-year cumulative incidence of dying post-discharge was 2.1% among working-age adults (95% CI 2.0-2.3) and 14.1% (95% CI 13.6-14.5) among older adults. Suicide risk was particularly elevated in the first 3 months, with hazard ratios of 191.1 (95% CI 125.0-292.0) among working-age adults and 125.4 (95% CI 52.6-298.9) in older adults. Older patients were vulnerable to dying by natural causes within 3 months post-discharge. Risk of dying by external causes was greater among discharged working-age adults in the least deprived areas. Relative risk of suicide in discharged working-age women relative to their general population peers was double the equivalent male risk elevation.

CONCLUSIONS

Recently discharged adults at any age are at increased risk of dying from external and natural causes, indicating the importance of close monitoring and provision of optimal support to all such patients, particularly during the first 3 months post-discharge.

Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study

Background

Compassion focused therapy (CFT) is an evolutionary informed, biopsychosocial approach to mental health problems and therapy. It suggests that evolved motives (e.g., for caring, cooperating, competing) are major sources for the organisation of psychophysiological processes which underpin mental health problems. Hence, evolved motives can be targets for psychotherapy. People with certain types of depression are psychophysiologically orientated towards social competition and concerned with social status and social rank. These can give rise to down rank-focused forms of social comparison, sense of inferiority, worthlessness, lowered confidence, submissive behaviour, shame proneness and self-criticism. People with bipolar disorders also experience elevated aspects of competitiveness and up rank status evaluation. These shift processing to a sense of superiority, elevated confidence, energised behaviour, positive affect and social dominance. This is the first study to explore the feasibility of a 12 module CFT group, tailored to helping people with a diagnosis of bipolar disorder understand the impact of evolved competitive, status-regulating motivation on their mental states and the value of cultivating caring and compassion motives and their psychophysiological regulators.

Methods

Six participants with a history of bipolar disorder took part in a CFT group consisting of 12 modules (over 25 sessions) as co-collaborators to explore their personal experiences of CFT and potential processes of change. Assessment of change was measured via self-report, heart rate variability (HRV) and focus groups over three time points.

Results

Although changes in self-report scales between participants and across time were uneven, four of the six participants consistently showed improvements across the majority of self-report measures. Heart rate variability measures revealed significant improvement over the course of the therapy. Qualitative data from three focus groups revealed participants found CFT gave them helpful insight into: how evolution has given rise to a number of difficult problems for emotion regulation (called tricky brain) which is not one's fault; an evolutionary understanding of the nature of bipolar disorders; development of a compassionate mind and practices of compassion focused visualisations, styles of thinking and behaviours; addressing issues of self-criticism; and building a sense of a compassionate identity as a means of coping with life difficulties. These impacted their emotional regulation and social relationships.

Conclusion

Although small, the study provides evidence of feasibility, acceptability and engagement with CFT. Focus group analysis revealed that participants were able to switch from competitive focused to compassion focused processing with consequent improvements in mental states and social behaviour. Participants indicated a journey over time from 'intellectually' understanding the process of building a compassionate mind to experiencing a more embodied sense of compassion that had significant impacts on their orientation to (and working with) the psychophysiological processes of bipolar disorder.

Cognitive mechanisms underlying the association between trauma exposure, mental health and social engagement in refugees: A longitudinal investigation

BACKGROUNDS

Refugees and asylum-seekers are at heightened risk for developing psychological symptoms following exposure to trauma and displacement. Despite this, relatively little is known about the cognitive mechanisms that underlie common mental disorders in refugees.

METHODS

In this study, we investigated the associations between self-efficacy, beliefs about others (relating to benevolence and trust) and psychological and social outcomes in 1079 refugees from Arabic, Farsi, Tamil or English-speaking backgrounds who were residing in Australia. Participants completed an online survey assessing exposure to potentially traumatic events (PTEs), at baseline (T1), and self-efficacy, beliefs about others, PTSD symptoms, depression symptoms, anger and social engagement at baseline (T1) and six months later (T2).

RESULTS

A path analysis revealed that greater PTE exposure was associated with lower self-efficacy and lower positive beliefs about others at T1. Self-efficacy at T1 was negatively associated with depression and anger at T2, while positive beliefs about others at T1 were positively associated with social engagement and greater depression symptoms at T2.

LIMITATIONS

Limitations of this study included the fact that the study sample was not necessarily representative of the broader refugee population, and in particular may have overrepresented those with higher education levels.

CONCLUSIONS

Findings point to the critical role that cognitive variables play in the maintenance of psychological symptoms in forcibly displaced persons, and highlight the importance of targeting these in psychological interventions to promote positive posttraumatic mental health.

Social Construction and Evolutionary Perspectives on Gender Differences in Post-traumatic Distress: The Case of Status Loss Events

Women report greater post-traumatic distress (PTD) than men following physically threatening events. However, gender differences in PTD following social stressors such as status losses are understudied. Whereas the social construction account points to a general sensitivity in women following any type of stressor, the evolutionary account suggests enhanced sensitivity to status losses in men, especially following inter-males aggressions. These propositions were examined in two studies (Study 1, N = 211; Study 2, N = 436). Participants were asked to recall a status loss and to fill out measures assessing PTD and depression severity. In line with the evolutionary account, men, as compared to women, displayed enhanced PTD following status loss. Status losses conducted by men against men were associated with greater PTD than were instances involving other target-aggressor pairings. Finally, age was negatively associated with PTD in men but not in women. The examination of evolutionary challenges modifies the standard view linking the female gender to enhanced sensitivity to trauma. Thus, the pattern of enhanced sensitivity to stressful events appears to be affected by gender- and development-specific adaptive challenges.

Subjective social status moderates back pain and mental health in older men

OBJECTIVES

Back pain and poor mental health are interrelated issues in older men. Evidence suggests that socioeconomic status moderates this relationship, but less is known about the role of subjective social status (SSS). This study examined if the association between back pain and mental health is moderated by SSS.

METHOD

We used a sample of community-dwelling older men (≥65 years) from the Osteoporotic Fractures in Men Study (N = 5994). Participants self-reported their back pain severity and frequency over the past 12 months. SSS was assessed with the MacArthur Scale of SSS. Mental health was assessed with the SF-12 Mental Component Summary (MCS).

RESULTS

Severe back pain was associated with lower SF-12 MCS scores (p = .03). Back pain frequency was not associated with SF-12 MCS scores. SSS moderated the back pain and mental health relationship. Among men with higher national or community SSS, the association between back pain severity and SF-12 MCS scores was not significant. However, among men with lower national or community SSS, more severe back pain was associated with lower SF-12 MCS scores (p's < .001). Among those with lower national or community SSS, greater back pain frequency was also associated with lower SF-12 MCS scores (p's < .05).

CONCLUSION

Where one ranks oneself within their nation or community matters for the back pain and mental health relationship. Higher SSS may be a psychosocial resource that buffers the negative associations of severe and frequent back pain on mental health in older men.

Nurturing compassion in schools: A randomized controlled trial of the effectiveness of a Compassionate Mind Training program for teachers

OBJECTIVES

Schools are experiencing an unprecedented mental health crisis, with teachers reporting high levels of stress and burnout, which has adverse consequences to their mental and physical health. Addressing mental and physical health problems and promoting wellbeing in educational settings is thus a global priority. This study investigated the feasibility and effectiveness of an 8-week Compassionate Mind Training program for Teachers (CMT-T) on indicators of psychological and physiological wellbeing.

METHODS

A pragmatic randomized controlled study with a stepped-wedge design was conducted in a sample of 155 public school teachers, who were randomized to CMT-T (n = 80) or a waitlist control group (WLC; n = 75). Participants completed self-report measures of psychological distress, burnout, overall and professional wellbeing, compassion and self-criticism at baseline, post-intervention, and 3-months follow-up. In a sub-sample (CMT-T, n = 51; WLC n = 36) resting heart-rate variability (HRV) was measured at baseline and post-intervention.

RESULTS

CMT-T was feasible and effective. Compared to the WLC, the CMT-T group showed improvements in self-compassion, compassion to others, positive affect, and HRV as well as reductions in fears of compassion, anxiety and depression. WLC participants who received CMT-T revealed additional improvements in compassion for others and from others, and satisfaction with professional life, along with decreases in burnout and stress. Teachers scoring higher in self-criticism at baseline revealed greater improvements post CMT-T. At 3-month follow-up improvements were retained.

CONCLUSIONS

CMT-T shows promise as a compassion-focused intervention for enhancing compassion, wellbeing and reducing psychophysiological distress in teachers, contributing to nurturing compassionate, prosocial and resilient educational environments. Given its favourable and sustainable effects on wellbeing and psychophysiological distress, and low cost to deliver, broader implementation and dissemination of CMT-T is encouraged.

Low Perceived Social Rank Increases the Impact of Mental Health Symptoms on Suicidal Ideation: Evidence among Young Adults from the Philippines

Studies on social factors that could influence the mental health-suicidal ideation link remain scarce, especially in non-Western contexts. This study examined the relationship between mental health symptoms (i.e., depression, anxiety, and stress) and suicidal ideation and whether one's perceived social rank moderates such a relationship. Data from 631 students from two universities in the Philippines collected between October to December 2018 was analyzed. Bivariate correlations show that greater symptoms of depression, anxiety, and stress are associated with increased suicidal ideation. Hierarchical linear regression models supported the direct relationship between mental health symptoms and suicidal ideation and demonstrated that perceived social rank significantly moderated such a relationship. Johnson-Neyman plots and simple slopes analyses further illustrate how mental health symptoms and perceived social rank interact to impact suicidal ideation. The results show that as one's perceived social rank lowers, the strength of the positive association between depression, anxiety, and stress symptoms to suicidal ideation strengthens. The results held while controlling for age, gender, college year level, and family income. The findings are discussed using the social rank theory and the Integrated Motivational-Volitional (IMV) model of suicide to view suicidal ideation from both an individual and a social perspective. We expound on the role of low perceived social rank on suicidal ideation among young adults.HIGHLIGHTSHigher depression, anxiety, and stress symptoms are associated with higher suicidal ideation.Perceived social rank moderates the link between mental health symptoms and suicidal ideation.One's perception of being inferior to others can exacerbate suicidal ideation.

The association between entrapment and depression among migrant workers in China: a social rank theory based study

BACKGROUND

Migrant workers are a group susceptible for depression evolution due to occupational maladaptive triggers. The social rank theory illustrates the pathology process from defensive adaptation to depression, pointing out the early prevention of depression by discovering entrapment. This study aims to reveal the relationship between migrant workers' entrapment and depressive symptoms.

METHODS

A total of 1805 migrant workers in Shenzhen were recruited by stratified multi-stage sampling. Sample's demographic, behavioral and psychosocial characteristics were described and analyzed to reveal the relationship between entrapment and depressive symptoms. The Receiver Operator Characteristic was performed to find the optimal cut-off point of Entrapment Scale for predicting depressive symptoms.

RESULTS

In the binary logistic regression of sociodemographic variables, migrant workers who were married (univariate odds ratio (ORu) = 0.69, 95% Confidence Interval (CI) = 0.56-0.84), owned 1 or 2 children (ORu = 0.71, 95% CI = 0.58-0.86), had been working over 10 years (ORu = 0.71, 95% CI = 0.54-0.95), earned > 4999 yuan per month (ORu = 0.68, 95% CI = 0.47-0.99; multivariate odds ratio (ORm) = 0.57, 95% CI = 0.38-0.87) or with low risks of alcohol use disorders (ORu = 0.51, 95% CI = 0.34-0.75) had lower risks of depressive symptoms. After adjusted the aforementioned significant sociodemographic variables, migrant workers with severer entrapment were more likely to have depressive symptoms (adjusted odds ratio (ORa) = 1.13, 95% CI = 1.12-1.15). Besides, the study proved the reliability and validity of the Chinese version Entrapment Scale, preferring a two-dimensional structure, and 11 was the optimal cut-off value of this scale for predicting depressive symptoms among migrant workers.

CONCLUSIONS

This result indicates the potential value of entrapment according to the social rank theory on facilitating early prevention of migrant works' depression and the application value of Entrapment Scale for effectively measuring mental status among migrant workers.

Peer Victimization and Nonsuicidal Self-Injury Among Chinese Left-Behind Children: The Moderating Roles of Subjective Socioeconomic Status and Social Support

Peer victimization is a serious issue among school-aged children. Chinese left-behind children tend to experience peer victimization and associated nonsuicidal self-injury (NSSI) behavior. However, the possible improvement of subjective socioeconomic status (SES) based on increased family income may serve to buffer the relationship between peer victimization and NSSI, and this buffering effect may differ by level of social support. Thus, the current study aimed to examine the moderating effect of subjective SES on the relationship between peer victimization and NSSI by the level of social support among Chinese left-behind children. A total of 431 left-behind children and 447 non-left-behind children (comparison group) completed self-report scales measuring peer victimization, NSSI, subjective SES, and social support. Results showed that peer victimization was positively related to NSSI among left-behind children, but not among non-left-behind children. Moreover, for left-behind children with low levels of social support, high subjective SES intensified the association between peer victimization and NSSI; peer victimization was positively associated with NSSI among left-behind children who reported high subjective SES, but not among those with low subjective SES. However, high levels of social support seemed to protect the left-behind children with high subjective SES who experienced peer victimization from NSSI. For non-left-behind children with both parents present, high subjective SES played a protective role in the association between peer victimization and NSSI, regardless of the levels of social support they enjoyed. These findings contribute to an understanding of subjective SES as a moderating mechanism in the association between peer victimization and NSSI among left-behind children. Social support proved central to the protective role of subjective SES. Intervention programs to enhance social support can help to strengthen the protective effect of subjective SES on NSSI among left-behind children who experience peer victimization.

Choosing Death Over Survival: A Need to Identify Evolutionary Mechanisms Underlying Human Suicide

The act of killing self contradicts the central purpose of human evolution, that is, survival and propagation of one’s genetic material. Yet, it continues to be one of the leading causes of human death. A handful of theories in the realm of evolutionary psychology have attempted to explain human suicide. The current article analyses the major components of certain prominent viewpoints, namely, Inclusive fitness, Bargaining model, Pain-Brain model, Psychological aposematism, and few other perspectives. The article argues that relatively more weightage has been given to understanding ultimate (the “why”) rather than proximate (the “how”) functionality of suicidal acts. Evolutionary theorists have consistently pointed out that to comprehensively understand a trait or behavior, one needs to delineate not only how it supports survival but also the evolution of the mechanisms underlying the trait or behavior. Existing theories on suicide have primarily focused on its fitness benefits on surviving kin instead of providing evolutionary explanations of the more complex mechanisms leading up to such self-destructive motivations. Thus, the current paper attempts to highlight this gap in theorizing while suggesting probable proximate explanations of suicide which stresses the need to diffuse attention paid to fitness consequences of the act alone. We speculate that such explorations are needed in order to build a robust and comprehensive evolutionary theory of human suicide.

Converging evidence for enduring perceptions of low social status in individuals in remission from depression

BACKGROUND

The risk of depressive relapse and recurrence is associated with social risk factors that may be amplified by a submissive socio-cognitive profile.

METHODS

In Study 1 we aimed to identify perceptions of low social status in a community sample (N = 613) with a self-reported history of mental health difficulties (n = 232) and, more specifically in Study 2 (N = 122), in individuals in clinical remission from depression (n = 18), relative to a never-depressed control group (n = 64), and relative to a group experiencing a current depressive episode (n = 40).

RESULTS

In Study 1, a total of 225 of the 232 participants in the self-reported mental health difficulties group opted to provide further information regarding their mental health history, of whom 153 (68%) reported a history of anxiety, 168 (74.7%) reported a history of depression, and 13 (5.8%) reported an unspecified mental health history. Elevated depressive symptoms were associated with perceptions of low social status which significantly differed between individuals with and without a self-reported history of mental health difficulties. In Study 2 we found enduring perceptions of low social status in remitted depressed individuals.

LIMITATIONS

We were unable to discern between historical or current clinical diagnosis in the community sample of Study 1, as we were reliant on self-report. We were unable to explore the effects of medication or causal relationships between depressive symptoms and social status as the studies were cross-sectional in nature.

CONCLUSIONS

These findings suggest that evolutionarily rooted socio-cognitive profiles could impact affiliative processes and may confer increased vulnerability to future depressive episodes.

Love in a time of anti-Blackness: social rank, attachment, and race in psychotherapy

This paper draws on critical race theory and research on attachment, social rank and dehumanization to theorize the implications of addressing anti-Blackness in psychotherapy with both Black and non-Black clients in the context of White Supremacy. Drawing on and critiquing a recent review of attachment theory and race, the author draws on historical and empirical research outlining the contours of a racial capitalist world. Recontextualizing attachment theory through this critical race theory lens, it will be argued psychotherapy must address anti-Blackness with both Black and non-Black clients, redefining therapeutic action not only as the provision of repair of interpersonal ruptures, but also as the capacity to mentalize about socio-historical ruptures, allowing space to clarify and pursue one's values despite an anti-Black, capitalist and White Supremacist world. This paper will provide case examples illustrating these principles with Black and non-Black clients and conclude with their clinical and political implications.

Perceived Social Status and Suicidal Ideation in Maltreated Children and Adolescents

Recent decades have seen an alarming increase in rates of suicide among young people, including children and adolescents (“youth”). Although child maltreatment constitutes a well-established risk factor for suicidal ideation in youth, few efforts have focused on identifying factors associated with maltreated youths’ increased risk for suicidal ideation, especially across development. The present study examined the relations between maltreated youths' (N = 279, M = 12.06 years, 52% female, 53% Latinx) perceptions of their social status and suicidal ideation and compared those relations between pre-adolescents and adolescents. Findings revealed unique developmental patterns: Perceived social status was associated with suicidal ideation, but only in adolescents, who showed greater risk for suicidal ideation if they viewed themselves as lower ranked in society and lower risk for suicidal ideation if they viewed themselves as higher ranked in society. Findings have implications for scientific and practical efforts aimed at better understanding and preventing suicide in a high-risk developmental population.

Body weight perception outweighs body weight when predicting shame, criticism, depression and anxiety for lower BMI range and higher BMI range adults

This study examined the relationship between body weight shame, self-criticism and mental health for individuals across body weight ranges. In total 1695 participants completed a series of online measures and we used Structural Equation Modelling, to assess for the relationship between weight, perceived weight, social rank (social comparison, body weight shame, submissiveness) self-criticism (inadequate and self-hatred) and anxious and depressive symptoms. Results indicated that perceived body weight is more important than actual body weight in predicting body weight shame. Importantly, individuals classified in higher BMI ranges rely more on the self-hatred form of self-criticism which significantly predicts anxious and depressive symptoms.

Psychological distress in late adolescence: The role of inequalities in family affluence and municipal socioeconomic characteristics in Norway

The present study aims to explore, in the national context of Norway, how municipal socioeconomic indicators affect anxiety and depressive symptom scores among senior high school students and whether this potential municipal effect is dependent on the adolescents' family affluence levels. This cross-sectional study is based on questionnaire data collected in five waves (2014-2018) of the Ungdata survey. The study sample consisted of 97,460 adolescents aged 16-18 years attending high school in 156 municipalities in Norway. Measures of psychological distress, depression, and anxiety symptoms were based on the screening instrument, Hopkins Symptom Checklist-10. Two-level random intercept models were fitted to distinguish the individual and municipality sources of variation in adolescents' mental health. In general, the results indicate substantial psychological symptom load among the study sample. Inequalities in adolescents' psychological distress between family affluence groups were evident, with the lowest symptom loads in the most affluent families. The predicted depressive and anxiety symptoms among the students increased slightly along with the percentage of municipal residents with tertiary educations and with increasing income inequalities in their residential municipality. However, the interaction models suggest that the adverse effects of higher municipal education level and greater income inequality are, to a certain extent, steepest for adolescents with medium family affluence. This study highlights two key findings. Both municipality effects and family affluence account for a relatively small proportion of the total variance in the students' psychological symptoms loads; however, the mental health inequalities we explored between socioeconomic strata on both the individual and municipal levels are not insignificant in a public health perspective. Results are discussed in the context of psychosocial mechanisms related to social comparison and perceptions of social status that may be applicable in egalitarian welfare states such as Norway.

Agreeableness, extraversion and life satisfaction: Investigating the mediating roles of social inclusion and status

We examine inclusion and status as potential mediators in the relationships between extraversion and agreeableness, on the one hand, and life satisfaction, on the other hand. Previous research has shown that agreeableness is less strongly related to life satisfaction compared to extraversion. We argue that the relatively weak association between agreeableness and life satisfaction is due to the fact that, even though this personality trait is positively related to inclusion, it is only weakly related to status. Using structural equation modeling (SEM) and survey data from Australia, Denmark and Sweden, we test five hypotheses about the linkages between these personality traits, inclusion, status and life satisfaction. Our results show that both extraversion and agreeableness are positively associated with life satisfaction and that this association is much stronger for extraversion. Furthermore, our results show that extraversion is reliably associated with both inclusion and status, whereas agreeableness is a reliable predictor of inclusion but not of status. Turning to our mediation analysis, our main results demonstrate that the relationship between extraversion and life satisfaction is fully mediated by both inclusion and status, whereas the relationship between agreeableness and life satisfaction is partially mediated by inclusion. Our mediation analysis further shows that agreeableness has a negative direct effect on life satisfaction over and above the positive indirect effect through inclusion. Our findings highlight the role of both inclusion and status as important mediators in the relationships between extraversion and agreeableness, on the one hand, and life satisfaction, on the other hand.

Early maladaptive schemas and depression in adulthood: A systematic review and meta-analysis

BACKGROUND

Improved understanding of the specific cognitive risk factors associated with depression is needed to inform prevention and treatment approaches. Recent research has examined the relationship between early maladaptive schemas (EMSs) and depression, but the findings were yet to be integrated using meta-analytic methods. The aim of this review was to synthesize the evidence on the relationship between depression and EMS.

METHOD

A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, by searching the PsycINFO, PubMed and CINAHL databases. Included studies were peer-reviewed journal articles that examined the relationship between one or more EMS and depression in adulthood in participants aged 18 years or older.

RESULTS

A total of 51 studies were included (k = 743; pooled N = 17,830). All 18 EMSs were positively correlated with depression, with effect sizes ranging from small (r = .23 [.17, .29]; Entitlement) to large (r = .53 [.46, .60]; Social Isolation; r = .50, 95% CI [.45, .54]; Defectiveness/Shame).

CONCLUSION

The evidence suggests that individuals who feel like they do not belong, or that they are flawed, bad or unlovable, report higher levels of depression. However, most studies used cross-sectional designs, and further longitudinal research is needed to establish the direction of the relationship between EMS and depression. These findings can guide preventative and treatment approaches. Focusing treatment on the Social Isolation and Defectiveness/Shame EMS may aid in relieving depressive symptoms.

Does Culture Influence Antidepressant Response? A Preliminary Investigation of Randomized Controlled Trials of Fluoxetine

Background

Contemporary models of depression view the disorder as arising from an interaction between genetic vulnerability and adverse life experiences. The nature of these experiences is strongly influenced by social-cultural factors, and there is preliminary evidence that these factors may influence the response to treatment.

Methods

In this pilot study, pooled response rates obtained from 56 randomized controlled trials of fluoxetine for major depression, conducted across 21 countries, were analyzed in relation to Hofstede’s six dimensions of culture in these countries, while controlling for methodological quality.

Results

The cultural dimensions of power distance (r = .62, p = .002), masculinity (r = .45, p = .04) and indulgence (r = -.52, p = .016) were significantly correlated with antidepressant response rates, though only the first of these remained significant after correction for multiple comparisons. On linear regression analysis, the association between power distance and antidepressant response remained significant (β = .62, p = .002).

Conclusions

These preliminary results suggest that certain cultural factors may be significantly associated with cross-national variations in antidepressant response rates during clinical trials.

Stressed, depressed, and rank obsessed: Individual differences in compassion and neuroticism predispose towards rank-based depressive symptomatology

OBJECTIVES

As social creatures, we monitor our relative rank and/or status with others via social comparisons. Whilst research has identified perceptions of inferiority or 'low rank' relative to others is a robust predictor of depressive, anxious, and stress symptomology, to date individual differences have been ignored. We wish to provide empirical evidence to outline how differences across personality traits may interact with social rank variables to buffer or predispose towards depressive symptomology.

METHODS

Across three independent samples (N = 595), we replicated a social rank model of mental health, and with our third sample (N = 200), we sought to investigate attenuating roles for neuroticism versus compassion with multiple moderated regression models.

RESULTS

Neuroticism predicted greater levels of rank-associated depression, and compassion failed to function as a protective factor for rank-associated depression. However, a closer inspection of the original Big-5 factor structure positions this scale as a measure of 'interpersonal submissiveness' or 'conflict appeasement' rather than genuine compassion.

CONCLUSIONS

Whilst it is necessary to delineate the conditions where compassion is appropriate and able to lead to positive mental health outcomes, we argue this cannot be addressed with the Big-5 measure of trait compassion. We call for future work to consider valid and reliable measures for compassion, such as the self-compassion scale, submissive compassion scale, and fears of compassion scale, to more fully address how compassion may protect against both rank-based comparisons and severity of depression.

PRACTITIONER POINTS

Social rank mechanisms are robustly implicated in depression, anxiety, and stress. Clients who present as higher in neuroticism, inferiority, or submissiveness may be more prone towards rank-associated depression symptoms. Preliminary evidence suggests cultivation of genuine compassion can shift clients from a rank-focussed to a compassionate-focussed mentality, which aids mental health and fosters well-being.

Predictors of poor 6-week outcome in a cohort of major depressive disorder patients treated with antidepressant medication: the role of entrapment

BACKGROUND

Only a small number of consistent processes predict which depressed patients will achieve remission with antidepressant medication. One set of processes is that of social ranking strategies/variables that are related to life events and severe difficulties. Particularly, defeat and entrapment predict poorer response to antidepressants. However, results are inconsistent.

AIM

The current study aimed to evaluate evolutionary strategies, childhood maltreatment, neglect and life events and difficulties (LEDs) as predictors of remission in depressed patients undergoing pharmacological treatment in a psychiatric outpatient sample.

METHODS

A cohort of 139 depressed outpatients undergoing pharmacological treatment was followed prospectively in a naturalistic study for 6 weeks. Two major evaluations were considered at baseline and 6 weeks. We allocated patients to a pharmacological treatment algorithm for depression - the Texas Medication Algorithm Project. Variables evaluated at baseline and tested as predictors of remission included demographic and clinical data, severity of depression, social ranking, evolution informed variables, LEDs and childhood maltreatment.

RESULTS

Of the 139 patients, only 24.5% were remitted at week 6. In univariate analyses, non-remitted patients scored significantly higher in all psychopathology and vulnerability scales except for submissive behaviour and internal entrapment. For the logistic regression, a higher load of LEDs of the entrapment and humiliation dimension in the year before the index episode (OR = 6.62), and higher levels external entrapment in the Entrapment Scale (OR = 1.10) predicted non-remission. These variables accounted for 28.7% of the variance.

CONCLUSIONS

Multivariate analysis revealed that external entrapment was the only predictor of non-remission.