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Booth RW, Mackintosh B, Hasşerbetçi S. Probability, cost, and interpretation biases' relationships with depressive and anxious symptom severity: differential mediation by worry and repetitive negative thinking. Cogn Emot 2024:1-16. [PMID: 38693727 DOI: 10.1080/02699931.2024.2348031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/20/2024] [Indexed: 05/03/2024]
Abstract
People high in depressive or anxious symptom severity show repetitive negative thinking, including worry and rumination. They also show various cognitive phenomena, including probability, cost, and interpretation biases. Since there is conceptual overlap between these cognitive biases and repetitive negative thinking - all involve thinking about potential threats and misfortunes - we wondered whether repetitive negative thinking could account for (mediate) these cognitive biases' associations with depressive and anxious symptom severity. In three studies, conducted in two languages and cultures, cost bias and (in two studies) interpretation bias only predicted symptom severity via worry and repetitive negative thinking; this suggests these biases are actually associated with repetitive negative thinking, rather than with symptoms. In contrast, probability bias showed direct relationships with depressive (all studies) and anxious (two studies) symptom severity, suggesting its relationships with symptoms are partly independent of repetitive negative thinking. These results show the value of studying relationships among the various cognitive features of psychopathology. Furthermore, new interventions which target cognitive biases in depression or anxiety must show that they can improve upon cognitive behavioural therapy, which is already widely available, targets both repetitive negative thinking and probability bias, and is highly effective.
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Affiliation(s)
- Robert W Booth
- Faculty of Arts and Social Sciences, Sabanci University, Istanbul, Turkey
| | | | - Servet Hasşerbetçi
- Faculty of Arts and Social Sciences, Sabanci University, Istanbul, Turkey
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Gayman MD, Stover S, Tsukerman K, Nielsen K, Wilkin H. Physical Limitations, Health Rumination/Worry, and Depressive Symptoms: Gender Differences among African Americans. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01721-3. [PMID: 37490211 DOI: 10.1007/s40615-023-01721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 06/23/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023]
Abstract
Although studies have documented the relationships between physical health, health rumination/worry, and mental health, few investigations have assessed these linkages within African American communities. Using a community-based sample of residents in historically lower-income, African American communities (N = 306), this study assesses the mediating role of health rumination/worry in the physical limitation-depressive symptom relationship, and the moderating effect of gender on the relationship between health rumination/worry-depressive symptoms. Findings demonstrate that health rumination/worry explains half of the physical limitation-depressive symptom relationship, and the relationship between health rumination/worry and depressive symptoms is stronger for African American men than women. The findings underscore the importance of intersectional research for policy efforts aimed at reducing mental health morbidities within African American communities.
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Affiliation(s)
- Mathew D Gayman
- Georgia State University, Atlanta, GA, USA.
- Department of Sociology, Georgia State University, P.O. Box 5020, Atlanta, GA, 30302-5020, USA.
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Mason MJ, Coatsworth JD, Zaharakis N, Russell M, Brown A, McKinstry S. Testing Mechanisms of Change for Text Message-Delivered Cognitive Behavioral Therapy: Randomized Clinical Trial for Young Adult Depression. JMIR Mhealth Uhealth 2023; 11:e45186. [PMID: 37432723 PMCID: PMC10369163 DOI: 10.2196/45186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/24/2023] [Accepted: 06/06/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Current psychiatric epidemiological evidence estimates that 17% of young adults (aged 18-25 years) experienced a major depressive episode in 2020, relative to 8.4% of all adults aged ≥26 years. Young adults with a major depressive episode in the past year are the least likely to receive treatment for depression compared with other age groups. OBJECTIVE We conducted a randomized clinical trial following our initial 4-week SMS text message-delivered cognitive behavioral therapy (CBT-txt) for depression in young adults. We sought to test mechanisms of change for CBT-txt. METHODS Based on participant feedback, outcome data, and the empirical literature, we increased the treatment dosage from 4-8 weeks and tested 3 mechanisms of change with 103 young adults in the United States. Participants were from 34 states, recruited from Facebook and Instagram and presenting with at least moderate depressive symptomatology. Web-based assessments occurred at baseline prior to randomization and at 1, 2, and 3 months after enrollment. The primary outcome, the severity of depressive symptoms, was assessed using the Beck Depression Inventory II. Behavioral activation, perseverative thinking, and cognitive distortions were measured as mechanisms of change. Participants were randomized to CBT-txt or a waitlist control condition. Those assigned to the CBT-txt intervention condition received 474 fully automated SMS text messages, delivered every other day over a 64-day period and averaging 14.8 (SD 2.4) SMS text messages per treatment day. Intervention texts are delivered via TextIt, a web-based automated SMS text messaging platform. RESULTS Across all 3 months of the study, participants in the CBT-txt group showed significantly larger decreases in depressive symptoms than those in the control group (P<.001 at each follow-up), producing a medium-to-large effect size (Cohen d=0.76). Over half (25/47, 53%) of the treatment group moved into the "high-end functioning" category, representing no or minimal clinically significant depressive symptoms, compared with 15% (8/53) of the control condition. Mediation analysis showed that CBT-txt appeared to lead to greater increases in behavioral activation and greater decreases in cognitive distortions and perseverative thinking across the 3-month follow-up period, which were then associated with larger baseline to 3-month decreases in depression. The size of the indirect effects was substantial: 57%, 41%, and 50% of the CBT-txt effect on changes in depression were mediated by changes in behavioral activation, cognitive distortions, and perseverative thinking, respectively. Models including all 3 mediators simultaneously showed that 63% of the CBT-txt effect was mediated by the combined indirect effects. CONCLUSIONS Results provide evidence for the efficacy of CBT-txt to reduce young adult depressive symptoms through hypothesized mechanisms. To the best of our knowledge, CBT-txt is unique in its SMS text message-delivered modality, the strong clinical evidence supporting efficacy and mechanisms of change. TRIAL REGISTRATION ClinicalTrials.gov NCT05551702; https://clinicaltrials.gov/study/NCT05551702.
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Affiliation(s)
- Michael J Mason
- Center for Behavioral Health Research, College of Social Work, University of Tennessee, Knoxville, TN, United States
| | - J Douglas Coatsworth
- Center for Behavioral Health Research, College of Social Work, University of Tennessee, Knoxville, TN, United States
| | - Nikola Zaharakis
- Center for Behavioral Health Research, College of Social Work, University of Tennessee, Knoxville, TN, United States
| | - Michael Russell
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States
| | - Aaron Brown
- College of Social Work, University of Kentucky, Lexington, KY, United States
| | - Sydney McKinstry
- Center for Behavioral Health Research, College of Social Work, University of Tennessee, Knoxville, TN, United States
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Collett G, Godec T, Gupta AK. Factors influencing attitudes toward vaccine safety and vaccine effectiveness amongst UK healthcare professionals prior to and at the time of COVID-19 vaccine rollout: Insights from the CoPE-HCP cohort study. Hum Vaccin Immunother 2023; 19:2188823. [PMID: 36977613 PMCID: PMC10078128 DOI: 10.1080/21645515.2023.2188823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Given the potential for nosocomial outbreaks, we must understand factors associated with negative vaccine attitudes amongst healthcare professionals (HCPs) before the rollout of a newly developed vaccine in a pandemic setting. The aim of this prospective cohort study was to study the impact of preexisting and prevailing mental health on United Kingdom HCPs' attitudes towards a newly developed COVID-19 vaccine. Two online surveys were distributed: first during vaccine development (July-September, 2020) and second during nationwide vaccine rollout (December 2020-March 2021). Mental health (PHQ-9 for depression; GAD-7 for anxiety) was assessed in both surveys. Negative attitude regarding vaccine safety and vaccine effectiveness was assessed at vaccine rollout. A series of logistic regression models were developed relating mental health (preexisting during vaccine development, ongoing and new-onset during rollout, and changes in symptom severity) to negative vaccine attitudes. In 634 HCPs, the presence of depression and/or anxiety during vaccine development was associated with elevated negative attitude towards vaccine safety (adj. OR 1.74 [95% CI 1.10-2.75], p = .02), but not vaccine effectiveness (1.13 [0.77-1.66], p = .53) at rollout. This was independent of other characteristics: age, ethnicity, professional role, and history of contracting COVID-19. Ongoing depression and/or anxiety (1.72 [1.10-2.69], p = .02) was associated with elevated negative attitude regarding vaccine effectiveness, but not vaccine safety. Worsened combined symptom scores over time were associated with elevated negative vaccine effectiveness attitudes (1.03 [1.00-1.05], p < .05), but not vaccine safety. Overall, adverse mental health can impact on HCPs' attitudes towards a newly developed vaccine. Further work is required to understand how this translates to vaccine uptake.
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Affiliation(s)
- George Collett
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Thomas Godec
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Ajay K Gupta
- William Harvey Research Institute, Queen Mary University of London, London, UK
- Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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O'Driscoll C, Buckman JEJ, Saunders R, Ellard S, Naqvi SA, Singh S, Wheatley J, Pilling S. Symptom-specific effects of counselling for depression compared to cognitive-behavioural therapy. BMJ MENTAL HEALTH 2023; 26:e300621. [PMID: 36792174 PMCID: PMC10035778 DOI: 10.1136/bmjment-2022-300621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Cognitive-behavioural therapy (CBT) and counselling for depression (CfD) are recommended first-line treatments for depression. While they approach change differently, there is little understanding of the impact those approaches have on change during treatment. OBJECTIVES This study aimed to identify whether CBT and CfD target different symptoms and explore the implications of modelling choices when quantifying change during treatment. METHODS Symptom-specific effects of treatment were identified using moderated network modelling. This was a retrospective cohort study of 12 756 individuals who received CBT or CfD for depression in primary/community care psychological therapy services in England. Change was modelled several ways within the whole sample and a propensity score matched sample (n=3446). FINDINGS CBT for depression directly affected excessive worry, trouble relaxing and apprehensive expectation and had a stronger influence on changes between suicidal ideation and concentration. CfD had a stronger direct influence on thoughts of being a failure and on the associated change between being an easily annoyed and apprehensive of expectation. There were inconsistencies when modelling change using the first and second appointments as the baseline. Residual score models produced more conservative findings than models using difference scores. CONCLUSIONS CfD and CBT for depression have differential effects on symptoms demonstrating specific mechanisms of change. CLINICAL IMPLICATIONS CBT was uniquely associated with changes in symptoms associated with anxiety and may be better suited to those with anxiety symptoms comorbid to their depression. When assessing change, the baseline should be the first therapy session, not the pretreatment assessment. Residual change scores should be preferred over difference score methods.
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Affiliation(s)
- Ciarán O'Driscoll
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Joshua E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- iCope-Camden & Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Rob Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Syed Ali Naqvi
- North East London NHS Foundation Trust, Rainham, Havering, UK
| | - Satwant Singh
- North East London NHS Foundation Trust, Rainham, Havering, UK
| | - Jon Wheatley
- Talk Changes: City and Hackney IAPT Service, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Stephen Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Camden & Islington NHS Foundation Trust, London, UK
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Yang M, Meng Z, Qi H, Duan X, Zhang L. The reciprocal relationships between Chinese children’s perception of interparental conflict, negative thinking, and depression symptoms: A cross-lagged study. Front Psychol 2022; 13:857878. [PMID: 36248573 PMCID: PMC9561413 DOI: 10.3389/fpsyg.2022.857878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
The present longitudinal study used the traditional cross-lagged panel model (CLPM) and autoregressive latent trajectory model with structured residuals (ALT-SR) to examine the relationships between perceived interparental conflict (IPC), negative thinking (NT), and depression symptoms in Chinese children. Changes in these three variables over time were also examined, as well as the trait and state aspects of the relationships between them. A sample of 516 third-grade primary students completed questionnaires about IPC, NT, and depression three times over a period of 1 year, at 6-month intervals. The CLPM findings indicated that, assuming that stability of each variable across time was controlled, Chinese children’s perception of IPC significantly affected their level of depression through the mediating path of NT. After taking trait factors into account, among all the significant autoregressive and cross-lagged paths originally found in the CLPM, only one third remained significant in the ALT-SR model. More specifically, the ALT-SR model, revealed a driving effect of children’s NT on perceived IPC and depression symptoms. The CLPM model although elucidated the interplay among three variables, the ALT-SR model showed little evidence of their interrelated growth across time. Taken together, these results indicate that children’s perceived IPC in the long term are a stable trait, with few state-level fluctuations, and is not a significant within-person predictor of subsequent children’s internalization problems. These perceptions appear to contribute more to children’s general psychological tendency than do changes over time. The research is the first to test the reciprocal relationships between Chinese children’s perceived IPC, NT, and depression symptoms. The findings demonstrate that previously proposed theories about the bidirectional relation between IPC and children’s social adjustment, to some extent, may reflect a correlation at a trait level. Put another way, it is IPC’s central tendency to be sensitive in the long term as a stable trait that is associated with their children’s general tendency to show well adjustment. The study contributes to our understanding of that extend previous results and have implications for complementary theoretical and practical interventions. The complementary techniques of CLPM and ALT-SR models offer different insights into children’s internalization problems, and hold promise for supporting the building of more comprehensive children’s developmental theories that acknowledge the interconnectedness of different domains of mental health.
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Affiliation(s)
- Meirong Yang
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Zhaoyan Meng
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Huan Qi
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiangfei Duan
- School of Educational Science, Ludong University, Yantai, Shandong, China
| | - Libin Zhang
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
- *Correspondence: Libin Zhang,
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Akbar SA, Mattfeld AT, Laird AR, McMakin DL. Sleep to Internalizing Pathway in Young Adolescents (SIPYA): A proposed neurodevelopmental model. Neurosci Biobehav Rev 2022; 140:104780. [PMID: 35843345 PMCID: PMC10750488 DOI: 10.1016/j.neubiorev.2022.104780] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/28/2023]
Abstract
The prevalence of internalizing disorders, i.e., anxiety and depressive disorders, spikes in adolescence and has been increasing amongst adolescents despite the existence of evidence-based treatments, highlighting the need for advancing theories on how internalizing disorders emerge. The current review presents a theoretical model, called the Sleep to Internalizing Pathway in Young Adolescents (SIPYA) Model, to explain how risk factors, namely sleep-related problems (SRPs), are prospectively associated with internalizing disorders in adolescence. Specifically, SRPs during late childhood and early adolescence, around the initiation of pubertal development, contribute to the interruption of intrinsic brain networks dynamics, both within the default mode network and between the default mode network and other networks in the brain. This interruption leaves adolescents vulnerable to repetitive negative thought, such as worry or rumination, which then increases vulnerability to internalizing symptoms and disorders later in adolescence. Sleep-related behaviors are observable, modifiable, low-stigma, and beneficial beyond treating internalizing psychopathology, highlighting the intervention potential associated with understanding the neurodevelopmental impact of SRPs around the transition to adolescence. This review details support for the SIPYA Model, as well as gaps in the literature and future directions.
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Affiliation(s)
- Saima A Akbar
- Department of Psychology, Florida International University, Miami, FL, USA.
| | - Aaron T Mattfeld
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
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Rahrig H, Vago DR, Passarelli MA, Auten A, Lynn NA, Brown KW. Meta-analytic evidence that mindfulness training alters resting state default mode network connectivity. Sci Rep 2022; 12:12260. [PMID: 35851275 PMCID: PMC9293892 DOI: 10.1038/s41598-022-15195-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/20/2022] [Indexed: 11/09/2022] Open
Abstract
This meta-analysis sought to expand upon neurobiological models of mindfulness through investigation of inherent brain network connectivity outcomes, indexed via resting state functional connectivity (rsFC). We conducted a systematic review and meta-analysis of rsFC as an outcome of mindfulness training (MT) relative to control, with the hypothesis that MT would increase cross-network connectivity between nodes of the Default Mode Network (DMN), Salience Network (SN), and Frontoparietal Control Network (FPCN) as a mechanism of internally-oriented attentional control. Texts were identified from the databases: MEDLINE/PubMed, ERIC, PSYCINFO, ProQuest, Scopus, and Web of Sciences; and were screened for inclusion based on experimental/quasi-experimental trial design and use of mindfulness-based training interventions. RsFC effects were extracted from twelve studies (mindfulness n = 226; control n = 204). Voxel-based meta-analysis revealed significantly greater rsFC (MT > control) between the left middle cingulate (Hedge's g = .234, p = 0.0288, I2 = 15.87), located within the SN, and the posterior cingulate cortex, a focal hub of the DMN. Egger's test for publication bias was nonsignificant, bias = 2.17, p = 0.162. In support of our hypothesis, results suggest that MT targets internetwork (SN-DMN) connectivity implicated in the flexible control of internally-oriented attention.
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Affiliation(s)
- Hadley Rahrig
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA.
| | - David R Vago
- Department of Psychology, Vanderbilt Brain Institute, Vanderbilt University, Nashville, USA, TN
| | - Matthew A Passarelli
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA
| | - Allison Auten
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA
| | - Nicholas A Lynn
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA
| | - Kirk Warren Brown
- Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, Richmond, VA, 23284, USA.
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Social Undermining and Interpersonal Rumination among Employees: The Mediating Role of Being the Subject of Envy and the Moderating Role of Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148419. [PMID: 35886271 PMCID: PMC9319638 DOI: 10.3390/ijerph19148419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/03/2022] [Accepted: 07/08/2022] [Indexed: 01/27/2023]
Abstract
Rumination is a common problem and is associated with reduced psychological well-being. However, little is known about how rumination in the workplace is affected by interpersonal relationships. We propose that negative workplace behavior could serve as a potential influencing factor for rumination. Therefore, the current study constructed a multilevel moderated mediation model to investigate the relationship between workplace unit social undermining and interpersonal rumination. We also examined whether unit social support moderated that relationship and whether being the subject of envy mediated that relationship. Survey data were collected from 630 employees in China. The results indicate that: (1) a high level of unit social undermining by either a supervisor or co-workers has a significant positive influence on interpersonal rumination; (2) being the subject of envy exerts a mediating effect between unit supervisor social undermining and interpersonal rumination, as well as between unit co-worker social undermining and interpersonal rumination; and (3) unit social support moderates the associations between unit supervisor/co-worker social undermining and interpersonal rumination. These findings extend the research on rumination to the field of management and interpersonal relationships and emphasize the potential mechanisms of rumination, providing significant guidance for reducing staff rumination and improving psychological well-being.
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Anxiety and Depression in a Non-Clinical Sample of Young Polish Adults: Presence of Meaning in Life as a Mediator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106065. [PMID: 35627602 PMCID: PMC9140330 DOI: 10.3390/ijerph19106065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/10/2022]
Abstract
Early adulthood, between 18 and 25, is viewed as a decisive period of life for the prevention and treatment of anxiety and depression. Although the topic of their mutual relationship is well-known, little has been uncovered about the mechanism underlying this connection. To understand the indirect pathways between anxiety and depression, we chose the sense of meaning of life as a mediator because people's beliefs that their lives are or can be purposeful may protect against depression. The sample was composed of 277 Polish young adults. A small majority of the participants were women (58.8%). The mean age was M = 22.11 (SD = 1.72). We used in the research the Direct Behavior Rating-Scale Items Scale, the Meaning in Life Questionnaire, and the Brief Screen for Depression. Correlational analysis showed that, consistent with past findings, anxiety correlated positively with depression and searching for meaning. It was also negatively associated with presence of meaning. Moreover, depression was negatively linked to presence of meaning and positively with searching for meaning. Regression-based mediation analyses (PROCESS macro 3.4) proved that the relationship between anxiety and depression was mediated by presence of meaning in life, suggesting that having a sense of meaning may be a pathway by which feelings of tension relative to adverse events protect against depression.
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Hummel KV, Trautmann S, Venz J, Thomas S, Schäfer J. Repetitive negative thinking: transdiagnostic correlate and risk factor for mental disorders? A proof-of-concept study in German soldiers before and after deployment to Afghanistan. BMC Psychol 2021; 9:198. [PMID: 34924023 PMCID: PMC8686273 DOI: 10.1186/s40359-021-00696-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Disorder-specific forms of Repetitive Negative Thinking (RNT) are associated with multiple diagnostic categories, indicating a transdiagnostic nature. Few studies examined content-independent RNT processes across groups of diagnosed mental disorders. Moreover, theory describes RNT processes as critically involved in the etiology of mental disorders, empirical evidence however is scarce. We first tested the transdiagnostic nature by examining levels of RNT across groups of internalizing and externalizing mental disorders compared to healthy individuals and explored RNT levels in a comorbid disorder-group. Second, we examined whether RNT predicts incident psychopathology. METHODS In a sample of German soldiers (n = 425) scheduled for deployment in Afghanistan, we compared RNT levels between diagnosed groups with alcohol use disorders, anxiety disorders and healthy individuals cross-sectionally. Exploratory analyses were conducted comparing a comorbid disorder-group to healthy individuals and to both single-disorder-groups. Longitudinally, we examined the predictive value of pre-deployment RNT levels for incident psychopathology after deployment (n = 167). RNT was measured using the Perseverative Thinking Questionnaire (PTQ), DSM-IV diagnoses were assessed using the standardized Composite International Diagnostic Interview (CIDI). RESULTS Cross-sectional comparisons revealed that soldiers with alcohol use disorders and anxiety disorders showed significantly higher degrees of RNT compared to healthy soldiers. RNT levels in those with comorbid disorders were significantly higher compared to healthy soldiers but also compared to both single-disorder-groups. Longitudinal analyses revealed that higher levels of RNT prior to deployment were associated with a higher risk to have any incidental mental disorder after deployment. This however is only attributable to individuals with a PTQ score above a cut-off of 15. CONCLUSIONS Findings provide evidence for RNT as a transdiagnostic correlate and a vulnerability factor for the development of mental disorders.
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Affiliation(s)
- Katrin V Hummel
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | | | - John Venz
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Sarah Thomas
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Judith Schäfer
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
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Appel JE, Vrijsen JN, Marchetti I, Becker ES, Collard RM, van Eijndhoven P, Schene AH, Tendolkar I. The Role of Perseverative Cognition for Both Mental and Somatic Disorders in a Naturalistic Psychiatric Patient Sample. Psychosom Med 2021; 83:1058-1066. [PMID: 34419995 DOI: 10.1097/psy.0000000000001003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Perseverative cognition (PC) is the repeated or long-term activation of the cognitive representation of psychological stressors and is associated with prolonged stress including somatic and mental consequences. Hence, PC might represent a cognitive process linking mental and somatic pathology, but current research on this link is limited by investigating healthy samples, markers of somatic disease, and single disorders. The present study explored the importance of PC for different mental and somatic disorders in psychiatric patients. METHODS Data from 260 naturalistic psychiatric outpatients were used. Psychiatric diagnoses were based on structured clinical interviews. Somatic diseases were assessed using a well-validated questionnaire and were clustered into (cardio)vascular and immune/endocrine diseases. PC was operationalized using the Perseverative Thinking Questionnaire (PTQ). RESULTS Multiple regression complemented with relative importance analyses showed that the PTQ total and subscale scores were associated with the presence of mood disorders, addiction, and anxiety. Unexpectedly, no relatively important associations were found between the PTQ and autism spectrum disorder, attention-deficit/hyperactivity disorder, or somatic disease. CONCLUSIONS Our data complement previous work linking PC to stress-related mental disorders but question its immediate role in neurodevelopmental and somatic disorders. Targeting PC in the treatment of mood disorders and perhaps also in addiction seems promising.
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Affiliation(s)
- Judith E Appel
- From the Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour (Appel, Vrijsen, Collard, van Eijndhoven, Schene, Tendolkar), Radboud University Medical Center; Behavioural Science Institute (Appel, Becker), Radboud University; Depression Expertise Centre (Vrijsen), Pro Persona Mental Health Care, Nijmegen, the Netherlands; Department of Life Sciences (Marchetti), Psychology Unit, University of Trieste, Trieste, Italy; and LVR-Klinikum Essen (Tendolkar), Department of Psychiatry and Psychotherapy, University Hospital Essen, Essen, Germany
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Song R, Song L. The Dampen Effect of Psychological Capital on Adolescent Depression: a Moderated Mediation Model. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-00626-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Knowles KA, Olatunji BO. Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory. Clin Psychol Rev 2020; 82:101928. [PMID: 33091745 DOI: 10.1016/j.cpr.2020.101928] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/07/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022]
Abstract
The State-Trait Anxiety Inventory - Trait version (STAI-T) was developed to measure an individual's tendency to experience anxiety, but it may lack discriminant evidence of validity based on strong observed relationships with measures of depression. The present series of meta-analyses compares STAI-T scores among individuals with depressive disorders, anxiety disorders, and nonclinical comparison groups, as well as correlations with measures of anxiety and depressive symptom severity, in order to further examine discriminant and convergent validity. A total of 388 published studies (N = 31,021) were included in the analyses. Individuals with an anxiety disorder and those with a depressive disorder displayed significantly elevated scores on the STAI-T compared to nonclinical comparison groups. Furthermore, anxiety and depressive symptom severity were similarly strongly correlated with the STAI-T (mean r = .59 - .61). However, individuals with a depressive disorder had significantly higher STAI-T scores than individuals with an anxiety disorder (Hedges's g = 0.27). Given these findings, along with previous factor analyses that have observed a depression factor on the STAI-T, describing the scale as a measure of 'trait anxiety' may be a misnomer. It is proposed that the STAI-T be considered a non-specific measure of negative affectivity rather than trait anxiety per se.
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Groen RN, Ryan O, Wigman JTW, Riese H, Penninx BWJH, Giltay EJ, Wichers M, Hartman CA. Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks. BMC Med 2020; 18:308. [PMID: 32988400 PMCID: PMC7523307 DOI: 10.1186/s12916-020-01738-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/06/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Comorbidity between depressive and anxiety disorders is common. A hypothesis of the network perspective on psychopathology is that comorbidity arises due to the interplay of symptoms shared by both disorders, with overlapping symptoms acting as so-called bridges, funneling symptom activation between symptom clusters of each disorder. This study investigated this hypothesis by testing whether (i) two overlapping mental states "worrying" and "feeling irritated" functioned as bridges in dynamic mental state networks of individuals with both depression and anxiety as compared to individuals with either disorder alone, and (ii) overlapping or non-overlapping mental states functioned as stronger bridges. METHODS Data come from the Netherlands Study of Depression and Anxiety (NESDA). A total of 143 participants met criteria for comorbid depression and anxiety (65%), 40 participants for depression-only (18.2%), and 37 for anxiety-only (16.8%) during any NESDA wave. Participants completed momentary assessments of symptoms (i.e., mental states) of depression and anxiety, five times a day, for 2 weeks (14,185 assessments). First, dynamics between mental states were modeled with a multilevel vector autoregressive model, using Bayesian estimation. Summed average lagged indirect effects through the hypothesized bridge mental states were compared between groups. Second, we evaluated the role of all mental states as potential bridge mental states. RESULTS While the summed indirect effect for the bridge mental state "worrying" was larger in the comorbid group compared to the single disorder groups, differences between groups were not statistically significant. The difference between groups became more pronounced when only examining individuals with recent diagnoses (< 6 months). However, the credible intervals of the difference scores remained wide. In the second analysis, a non-overlapping item ("feeling down") acted as the strongest bridge mental state in both the comorbid and anxiety-only groups. CONCLUSIONS This study empirically examined a prominent network-approach hypothesis for the first time using longitudinal data. No support was found for overlapping mental states "worrying" and "feeling irritable" functioning as bridge mental states in individuals vulnerable for comorbid depression and anxiety. Potentially, bridge mental state activity can only be observed during acute symptomatology. If so, these may present as interesting targets in treatment, but not prevention. This requires further investigation.
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Affiliation(s)
- Robin N Groen
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen (UMCG), University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Oisín Ryan
- Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen (UMCG), University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Harriëtte Riese
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen (UMCG), University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit and GGZ inGeest, Amsterdam, the Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen (UMCG), University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen (UMCG), University of Groningen, PO Box 30.001, 9700 RB, Groningen, the Netherlands
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Overlapping features between social anxiety and obsessive-compulsive spectrum in a clinical sample and in healthy controls: toward an integrative model. CNS Spectr 2020; 25:527-534. [PMID: 31576793 DOI: 10.1017/s109285291900138x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND While the literature frequently highlighted an association between social anxiety disorder (SAD) and obsessive-compulsive disorder (OCD), few studies investigated the overlapping features of these conditions. The presented work evaluated the relationship between SAD and OCD spectrum in a clinical population and in healthy controls (HC). METHODS Fifty-six patients with OCD, 51 with SAD, 43 with major depressive disorder (MDD), and 59 HC (N = 209) were assessed using the Mini International Neuropsychiatric Interview, the Social Phobia Spectrum (SCI-SHY), and the Obsessive-Compulsive Spectrum (SCI-OBS). RESULTS SAD patients scored significantly higher than other groups on all SCI-SHY domains and total score; OCD patients scored significantly higher than HC. MDD patients scored significantly higher than HC on the SCI-SHY total, Behavioral inhibition, and Interpersonal sensitivity domains. OCD patients scored significantly higher than other groups on all SCI-OBS domains except Doubt, for which OCD and SAD scored equally high. SAD patients scored significantly higher than HC on the SCI-OBS total, Childhood/adolescence, Doubt, and Hypercontrol domains. MDD patients scored significantly higher than HC on the Hypercontrol domain. SCI-OBS and SCI-SHY were widely correlated among groups, although lower correlations were found among OCD patients. Stronger correlations were observed between SCI-SHY Interpersonal sensitivity and SCI-OBS Doubt, Obsessive-compulsive themes, and Hypercontrol; between SCI-SHY Specific anxieties/phobic features and SCI-OBS Obsessive-compulsive themes; and between SCI-SHY Behavioral inhibition and SCI-OBS Doubt, with slightly different patterns among groups. CONCLUSION OCD and SAD spectrums widely overlap in clinical samples and in the general population. Interpersonal sensitivity and obsessive doubts might represent a common cognitive core for these conditions.
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Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination. Behav Res Ther 2020; 127:103573. [DOI: 10.1016/j.brat.2020.103573] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/23/2019] [Accepted: 01/24/2020] [Indexed: 12/11/2022]
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Ruiz FJ, Salazar DM, Suárez-Falcón JC, Peña-Vargas A, Ehring T, Barreto-Zambrano ML, Gómez-Barreto MP. Psychometric Properties and Measurement Invariance Across Gender and Age-Group of the Perseverative Thinking Questionnaire-Children (PTQ-C) in Colombia. Assessment 2019; 27:1657-1667. [PMID: 30991819 DOI: 10.1177/1073191119843580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent research has found that repetitive negative thinking (RNT) is an important transdiagnostic process both in adult and child psychopathology. This finding has led some authors to design content-independent measures of RNT that can be administered across disorders. One of these instruments is the Perseverative Thinking Questionnaire (PTQ) and its version for children (PTQ-C). This study presents the Spanish translation of the PTQ-C and its psychometric analysis in a sample of 1,127 Colombian children and adolescents (8-18 years old). All items obtained good discrimination indexes, and internal consistency was excellent (.93). A cross-validation study was conducted to analyze the factor structure of the PTQ-C, which strongly supported the one-factor structure. Measurement invariances across gender and age-group (8-12 and 13-18 years old) were also found. The PTQ-C scores for older boys were lower than for younger boys, whereas the inverse pattern was found for girls. The PTQ-C showed strong correlations with measures of pathological worry, emotional symptoms, and psychological inflexibility. In conclusion, the Spanish translation of the PTQ-C appears to be a valid and reliable measure of RNT.
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Affiliation(s)
| | | | | | | | - Thomas Ehring
- Ludwig-Maximilians-Universität München, Munich, Germany
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