Longitudinal association between perceived stress and depression among community-dwelling older adults: Findings from the Irish Longitudinal Study on Ageing

The clinical perspective on late-onset depression in European real-world treatment settings

The clinical phenotype of the so-called late-onset depression (LOD) affecting up to 30% of older adults and yielding heterogeneous manifestations concerning symptoms, severity and course has not been fully elucidated yet. This European, cross-sectional, non-interventional, naturalistic multicenter study systematically investigated socio-demographic and clinical correlates of early-onset depression (EOD) and LOD (age of onset ≥ 50 years) in 1410 adult in- and outpatients of both sexes receiving adequate psychopharmacotherapy. In a total of 1329 patients (94.3%) with known age of disease onset, LOD was identified in 23.2% and was associated with unemployment, an ongoing relationship, single major depressive episodes, lower current suicidal risk and higher occurrence of comorbid hypertension. In contrast, EOD was related to higher rates of comorbid migraine and additional psychotherapy. Although the applied study design does not allow to draw any causal conclusions, the present results reflect broad clinical settings and emphasize easily obtainable features which might be characteristic for EOD and LOD. A thoughtful consideration of age of onset might, hence, contribute to optimized diagnostic and therapeutic processes in terms of the globally intended precision medicine, ideally enabling early and adequate treatment allocations and implementation of respective prevention programs.

Modeling the relationship between depression in people with cancer and perceived stress, with the mediating role of eating problems, sexual satisfaction, emotion regulation and self-compassion

Aim

With the rising prevalence of cancer and the adverse physical and psychological experiences endured by affected individuals, this study aims to establish a model illustrating the relationship between depression in people with cancer and perceived stress. Additionally, it examines the mediating influence of eating problems, sexual satisfaction, emotional regulation, and self-compassion.

Method

This study employs a descriptive-correlational research method, utilizing structural equation analysis (modeling) to explore the role of mediators. The research sample comprised 200 individuals diagnosed with cancer, selected based on predetermined inclusion and exclusion criteria. Participants completed Beck's 13-item depression questionnaire, a 10-item perceived stress questionnaire, an 8-item appetite measurement questionnaire, a 25-item sexual satisfaction questionnaire, a 10-item emotion regulation questionnaire, and a 12-item compassion questionnaire. The data were subsequently analyzed using SPSS-24 and Lisrel 80/8 software.

Findings

The research findings indicate a significant positive relationship between perceived stress and depression in people with cancer. Furthermore, eating problems exhibited a mediating role in the relationship between perceived stress and depression, with a direct effect coefficient of (t = 0.28, ß = 0.02). However, the path from perceived stress to depression, mediated by sexual satisfaction, was found to be statistically insignificant, with a standard coefficient of 0.01 at the p < 0.05 level. Emotion regulation demonstrated a direct effect coefficient of (t = -3.52, ß = -0.33) on depression. Likewise, self-compassion exhibited a direct effect coefficient of (t = -3.08, ß = -0.28) on depression, while the path from perceived stress to depression was mediated by self-compassion, with a standard coefficient of 0.12 at the p < 0.05 level.

Conclusion

In conclusion, this study sheds light on the interplay between depression and perceived stress in individuals with cancer, revealing a significant positive association. Eating problems emerged as a mediating factor, directly influencing the manifestation of depressive symptoms. However, the mediation pathway through sexual satisfaction was found to be statistically insignificant. Emotion regulation and self-compassion were identified as influential factors, with direct effects on depression and self-compassion also serving as a mediator in the relationship between perceived stress and depression. The findings emphasize the importance of targeted interventions addressing eating problems, enhancing emotion regulation, and fostering self-compassion to alleviate the impact of depression and perceived stress in individuals facing cancer-related challenges. Further research is encouraged to refine and expand upon these insights, advancing holistic care for this population.

Risk factors for internalizing symptoms: The influence of empathy, theory of mind, and negative thinking processes

Internalizing symptoms such as elevated stress and sustained negative affect can be important warning signs for developing mental disorders. A recent theoretical framework suggests a complex interplay of empathy, theory of mind (ToM), and negative thinking processes as a crucial risk combination for internalizing symptoms. To disentangle these relationships, this study utilizes neural, behavioral, and self-report data to examine how the interplay between empathy, ToM, and negative thinking processes relates to stress and negative affect. We reanalyzed the baseline data of N = 302 healthy participants (57% female, Mage  = 40.52, SDage  = 9.30) who participated in a large-scale mental training study, the ReSource project. Empathy and ToM were assessed using a validated fMRI paradigm featuring naturalistic video stimuli and via self-report. Additional self-report scales were employed to measure internalizing symptoms (perceived stress, negative affect) and negative thinking processes (rumination and self-blame). Our results revealed linear associations of self-reported ToM and empathic distress with stress and negative affect. Also, both lower and higher, compared to average, activation in the anterior insula during empathic processing and in the middle temporal gyrus during ToM performance was significantly associated with internalizing symptoms. These associations were dependent on rumination and self-blame. Our findings indicate specific risk constellations for internalizing symptoms. Especially people with lower self-reported ToM and higher empathic distress may be at risk for more internalizing symptoms. Quadratic associations of empathy- and ToM-related brain activation with internalizing symptoms depended on negative thinking processes, suggesting differential effects of cognitive and affective functioning on internalizing symptoms. Using a multi-method approach, these findings advance current research by shedding light on which complex risk combinations of cognitive and affective functioning are relevant for internalizing symptoms.

Negative Association of Lignan and Phytosterol Intake with Stress Perception during the COVID-19 Pandemic-A Polish Study on Young Adults

BACKGROUND

There has been an increasing global prevalence of depression and other psychiatric diseases in recent years. Perceived stress has been proven to be associated with psychiatric and somatic symptoms. Some animal and human studies have suggested that consuming foods abundant in lignans and phytosterols may be associated with lower levels of stress, depression, and anxiety. Still, the evidence is not yet strong enough to draw firm conclusions. Thus, we investigated the association between dietary intake of these phytochemicals and the level of stress experienced by adult individuals.

METHODS

Diet was assessed using self-reported 7-day dietary records. The intakes of lignans and phytosterols were estimated using databases with their content in various food products. The Perceived Stress Scale (PSS) was implemented to measure the level of perceived stress. A logistic regression analysis was used to test for associations.

RESULTS

The odds of elevated PSS were negatively associated with dietary intake of total phytosterols, stigmasterol, and β-sitosterol, with evidence of a decreasing trend across tertiles of phytochemicals. The analysis for doubling the intake reinforced the aforementioned relationships and found protective effects against PSS for total lignans, pinoresinol, and campesterol.

CONCLUSIONS

Habitual inclusion of lignans and phytosterols in the diet may play a role in psychological health. To address the global outbreak of depression and other mental health issues triggered by stress, it is important to take a holistic approach. There is a need to develop effective strategies for prevention and treatment, among which certain dietary interventions such as consumption of products abundant in lignans and phytosterols may play a substantial role.

Purpose in life and stress: An individual-participant meta-analysis of 16 samples

Background

Purpose in life is a psychological resource that has been associated with better regulation of stress. The present research reports a coordinated analysis of the association between purpose in life and subjective stress and evaluates potential sociodemographic and mental health moderators of this association.

Methods

With individual participant data from 16 samples (total N=108,391), linear regression examined the association between purpose in life and general subjective feelings of stress, controlling for sociodemographic characteristics.

Results

Greater purpose in life was associated with less subjective stress (meta-analytic estimate=-.228, 95% Confidence Interval=-.292, -.164; p<.001). Interaction terms between sociodemographic factors and purpose tested in the individual samples and synthesized with meta-analysis were not significant, which indicated that the association between purpose and stress was similar across age, sex, race, ethnicity, and education. The association was also not moderated by psychological distress. Meta-regressions further indicated that this association was generally similar across scale length, content of the purpose measure, and across samples from Eastern and Western countries.

Limitations

The associations reported are observational. Experimental work is needed to evaluate causality.

Conclusions

Purpose in life is associated with less subjective stress across populations. Less subjective stress may be one mechanism through which purpose contributes to better mental and physical health.

Psychological Stress and Epigenetic Aging in Older Men: The VA Normative Aging Study

Psychological stress remains an important risk factor for morbidity and mortality throughout the life course. However, there have been counterintuitive findings reported in previous studies of older persons that examine the relationships of perceived psychological stress with DNA methylation-based markers of aging, which also serve as predictors of morbidity and mortality (epigenetic age/clocks). We aimed to replicate and expand findings from existing work by examining relationships of self-reported stress with nine epigenetic clocks: Hannum, Horvath, Intrinsic, Extrinsic, SkinBloodClock, PhenoAge, GrimAge, DNAm Telomere Length, and Pace of Aging. We analyzed data from 607 male participants (mean age 73.2 years) of the VA Normative Aging Study with one to two study visits from 1999 to 2007 (observations = 956). Stress was assessed via the 14-item Perceived Stress Scale (PSS). Epigenetic age was calculated from DNA methylation measured in leukocytes with the HumanMethylation450 BeadChip. In linear mixed effects models adjusted for demographic/lifestyle/health factors, a standard deviation (sd) increase in PSS was associated with Horvath (β = -0.35-years, 95%CI: -0.61, -0.09, P=0.008) and Intrinsic (β = -0.40-years, 95%CI: -0.67, -0.13, P=0.004) epigenetic age deceleration. However, in models limited to participants with the highest levels of stress (≥ 75th-percentile), Horvath (β = 2.29-years, 95%CI: 0.16, 4.41, P=0.04) and Intrinsic (β = 2.06-years, 95%CI: -0.17, 4.28, P=0.07) age acceleration associations were observed. Our results reinforce the complexity of psychological stress and epigenetic aging relationships and lay a foundation for future studies that explore longitudinal relationships with other adult stress metrics and factors that can influence stress such as resilience measures.

Depressive symptoms anticipate behavioral and emotional factors among older adults: A prospective cross-lagged panel design

This study examined the temporal relationship among depression, anxiety, insomnia, perceived stress, and physical activity in adults aged 60+ years with a history of major depressive disorder. We conducted a longitudinal study with 12 weeks of follow-up. Assessments consisted of phone or video interviews and included questionnaires evaluating depression, anxiety, insomnia, perceived stress, and physical activity. Our analytic approach consisted of a depression-focused cross-lagged panel model (CLPM) to examine week-to-week correlations among the five measures. The depression-focused CLPM identified statistically significant week-to-week self-predictive effects for each of the five measures. Higher depressive symptom burden was a strong predictor of increased stress, greater insomnia, and less physical activity the following week. No other cross-measure predictions were statistically significant. Our analytical approach clarifies the directional relationship among variables that typically co-occur with depression showing that higher depression symptom burden predisposes older adults to poor sleep, a reduced level of daytime activity, and a greater sense of stress. These findings support the need for longitudinal assessments and targeted interventions for reducing symptoms of depression in older adults.

The Association of Resilience with Mental Health in a Large Population-Based Sample (LIFE-Adult-Study)

Resilience describes a good adaptation to adversity. Strengthening resilience is a promising approach in the prevention of mental health problems. Yet, research on the association of resilience with mental health symptoms in the general population is scarce. The aim of our study is to examine comprehensively the association of resilience with depressive symptoms, anxiety, and perceived stress in a large population-based sample. We analyzed data of n = 3762 participants from the follow-up assessment of the LIFE-Adult-Study, a population-based cohort study in Leipzig. Assessments included resilience (RS-11), depressive symptoms (CES-D), anxiety (GAD-7), and perceived stress (PSQ). The association of resilience with mental health symptoms was examined via multiple linear regression analyses. In our analyses, higher resilience predicted less mental health problems and contributed significantly to the explained variance in mental health outcomes. Women, individuals with previous mental disorders, and those without employment had higher mental health symptoms. Resilience is closely associated with mental health problems in the general population. Vulnerable groups should be targeted with public health measures. Strengthening resilience is a promising approach in the large-scale prevention of mental disorders.