Perceived parenting and risk for major depression in Chinese women

Associations between parental bonding and health-related quality of life in a clinical sample of youths aged 14-35 years in Singapore

INTRODUCTION

Individuals with psychiatric disorders tend to report having poorer bonds with their parents during their early years. These individuals often experience lower quality of life as well. This study investigated the associations between aspects of parental bonding and health-related quality of life (HRQOL) in a clinical sample of youths. It was hypothesised that high parental care and low parental overprotectiveness would be associated with higher levels of HRQOL.

METHODS

Data were obtained from a larger cross-sectional study. The sample consisted of 400 psychiatric outpatients: 191 patients aged 14-21 (mean ± standard deviation 18.1 ± 2.22) years and 209 patients aged 22-35 (28.0 ± 4.33) years. The Parental Bonding Instrument was used to measure parental care and overprotectiveness. Short Form-12 measured physical health (physical component summary [PCS]) and mental health (mental component summary [MCS]) components of HRQOL, and the 8-item Patient Health Questionnaire assessed depressive symptoms. These scales and a sociodemographic form were self-administered. Multivariable linear regression was used for analysis.

RESULTS

About half of the sample reported affectionless control for mothers (46.6%) and fathers (45.9%). After controlling for sociodemographic variables, no significant relationship was found between aspects of parental bonding and PCS scores. Maternal care was associated with MCS scores (β = 0.32, P < 0.01) and PHQ-8 scores (β = -0.12, P < 0.05).

CONCLUSION

Our results suggest that youths who experienced quality care from their mothers exhibit better mental health functioning despite their clinical diagnoses, which suggests that early maternal care exerts an overall long-term protective effect. Early parental education that promotes positive parenting practices could improve the overall HRQOL of individuals in adulthood despite their clinical diagnoses.

Childhood parental bonding and depression in adulthood: A study of mothers in rural Pakistan

BACKGROUND

Parent-child relationship quality can have long-term impacts on child mental health into adulthood. The impact of parental behaviors on the future mental health of children has been understudied in South Asia, where parenting approaches differ from the dominant western approaches often represented in the literature.

METHODS

Mothers in rural Pakistan (N = 828) reported on their own mothers' parenting behaviors using the Parental Bonding Instrument (PBI) and were assessed for depression using the Structured Clinical Interview for DSM Disorders (SCID). The PBI includes scales for warmth (care scale) and over-control (protection scale), as well as subscales for behavioral control and psychological control. We used structural equation modeling to test the associations between depression and all PBI scales/subscales.

RESULTS

Increased parental care was associated with lower probability of depression (B = -0.19, SE = 0.09). Parental protection was associated with higher probability of depression (B = 0.25, SE = 0.11). Among the protection subscales, behavioral control was associated with increased risk of depression (B = 0.24, 95 % SE = 0.11) and psychological control was associated with decreased risk of depression (B = -0.28, SE = 0.12).

LIMITATIONS

This cross-sectional study used retrospective self-reports of parenting experiences. Participants only reported on their mothers, not fathers or other caregivers.

CONCLUSIONS

In a rural Pakistani sample, maternal warmth was protective against adulthood depression. The association between maternal control and depression varied based on the type of control (behavioral or psychological), emphasizing the importance of nuanced measures of parental control in this context.

Epidemiology of depressive disorders among youth during Gaokao to college in China: results from Hunan Normal University mental health survey

BACKGROUND

Given the serious consequences of depression and the lack of information about it during the crucially developmental period from the National College Entrance Exam (CEE, i.e., Chinese gaokao) to college, this study aimed to estimate the cumulative incidence, prevalence, age of onset, correlates, and service use of depressive disorders (DDs) among youth who passed the CEE and were enrolled at Hunan Normal University in China.

METHODS

A two-stage cross-sectional epidemiological survey of DDs was conducted from October to December, 2017 among 6,922 incoming college students (98.5% effective response, N = 6,818, 71.4% female, age range: 16-25 years, mean age = 18.6). Using a stratified sampling method based on the risk of depression, 926 participants (mean age = 18.5, 75.2% female) were selected and subsequently interviewed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and lifetime version (K-SADS-PL).

RESULTS

The sex-adjusted 9-month (i.e., 3 months pre-CEE, 3 months after CEE, and 3 months post-matriculation) incidence of new-onset DDs was 2.3% (standard error [S.E.] 0.3%), and the sex-adjusted 1-month, 6-month and lifetime prevalence were 0.7 (S.E. 0.3%), 1.7 (S.E. 0.2%) and 7.5% (S.E. 1.3%), respectively. The median age of onset was 17 (interquartile range: 16-18) years. Critically, over one-third (36.5%, S.E. 0.6) of depressed youth had their new onset during the 9-month period. The risk factors for depression included having mothers with higher education, experiencing major life events, being female, and experiencing parental divorce or death. The adjusted lifetime treatment rate was 8.7%.

CONCLUSION

The 9-month incidence of new-onset depression from gaokao to college among the youth sample in China is similar to the global annual incidence (3.0%), but the 1-month and lifetime prevalence are significantly lower than the global point (7.2%) and lifetime prevalence (19%). These findings suggest a high proportion of new-onset depression during the CEE to college among the sample youth in China. The risk of depression is associated with familial and stress correlates. Low treatment is a serious concern. Emphasis on early prevention and available treatment for adolescent and young adult depression is a critical need in China.

A Cross-Sectional Study: Structural and Related Functional Connectivity Changes in the Brain: Stigmata of Adverse Parenting in Patients with Major Depressive Disorder?

Background: There is a high correlation between the risk of major depressive disorder (MDD) and adverse childhood experiences (ACEs) such as adverse parenting (AP). While there appears to be an association between ACEs and changes in brain structure and function, there have yet to be multimodal neuroimaging studies of associations between parenting style and brain developmental changes in MDD patients. To explore the effect of AP on brain structure and function. Methods: In this cross-sectional study, 125 MDD outpatients were included in the study and divided into the AP group and the optimal parenting (OP) group. Participants completed self-rating scales to assess depressive severity, symptoms, and their parents' styles. They also completed magnetic resonance imaging within one week of filling out the instruments. The differences between groups of gender, educational level, and medications were analyzed using the chi-squared test and those of age, duration of illness, and scores on scales using the independent samples t-test. Differences in gray matter volume (GMV) and resting-state functional connectivity (RS-FC) were assessed between groups. Results: AP was associated with a significant increase in GMV in the right superior parietal lobule (SPL) and FC between the right SPL and the bilateral medial superior frontal cortex in MDD patients. Limitations: The cross-cultural characteristics of AP will result in the lack of generalizability of the findings. Conclusions: The results support the hypothesis that AP during childhood may imprint the brain and affect depressive symptoms in adulthood. Parents should pay attention to the parenting style and avoid a style that lacks warmth.

Long-term trends in the incidence of depressive disorders in China, the United States, India and globally: A comparative study from 1990 to 2019

Background

Depressive disorders have become an increasingly significant public health issue. This study is intended to show the trend of the incidence of depressive disorders in China, the United States, India and the world from 1990 to 2019, as well as the impact of age, period and cohort on it.

Methods

Extracting incidence data from the Global Burden of Disease Study 2019, we determined trends in the age-standardized incidence rate (ASIR) using Joinpoint regression. An age-period-cohort analysis was implemented to describe the effects of age, period, and cohort, as well as the long-term tendencies.

Results

From 1990 to 2019, the ASIR of depressive disorders in China was lower than that in the United States; India is lower than the United States in the first 5 years, showing a downward trend. The incidence in India and the United States is higher than the global average. The ASIR of women in the three countries is higher than that of men. In China, the elderly, early period and people born around 1954 have a higher risk of depressive disorders. In the United States, young people born around 1999 have a higher risk of depressive disorders. India is similar to China.

Conclusion

From 1990 to 2019, the age effect of China as a whole increased, and the period became stable, and the cohort effect declined. The overall age and period effects of the United States reduced, while the cohort effect increased. The age effect in India increased, while the period and cohort effects decreased. Depressive disorders are becoming ever more serious worldwide, and we'd better take measures to reduce its incidence according to the cohort effect of each age group.

Intergenerational transmission of child-rearing styles mediated by adult attachment: A structural equation model approach

Aim

Parenting styles are determinants of psychosocial maladjustment in the subsequent generation. Modifiable factors that positively impact intergenerational transmission should be identified. Thus, this study investigated the mediating effects of adult attachment on the transmission of child-rearing styles and the combined impact of fathers' and mothers' styles on their offspring's parenting.

Methods

Overall, 396 fathers and 733 mothers participated. They were married or cohabiting when their children aged 0-10 years attended a pediatric office in Japan. The pediatricians distributed the self-report questionnaires to examine perceived rearing (the Parental Bonding Instrument), adult attachment (the Relationship Questionnaire), and demographic characteristics. We then analyzed the data using structural equation modeling that illustrated intergenerational transmission of rearing styles between grandparents and parents.

Results

Overall, 385 fathers (M age = 35.5 years, SD = 6.0) and 699 mothers (M age = 33.5 years, SD = 5.1) satisfied the eligibility criteria. The path models showed that adult attachment to partners mediated grandparental and parental care. However, no mediating effect was observed in other intergenerational patterns that transmitted overprotective rearing styles. Additionally, combined grandfather and grandmother care were positively associated with parental overprotection.

Conclusion

This study suggested the potential of adult attachment in mediating loving, empathic, and warm rearing styles and the combined effects of both parents' styles on promoting the next-generation parents' overprotective styles. Our findings clarify how to terminate the negative chain of the parent-child transmission.

The relationship between parental bonding and mood, anxiety and related disorders in adulthood: A systematic review and meta-analysis

BACKGROUND

A strong bond between parents and their children is essential in promoting healthy psychological development. Poor quality parent-child relationships can render children vulnerable to various adverse outcomes. Although extensive research has highlighted the association between abnormal parent-child bonding and mood and anxiety-related psychopathology in offspring, no systematic review or meta-analysis has assessed this relationship in adults.

METHODS

A literature search was conducted in five databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science) on January 4th, 2021. Studies that assessed the relationship between parental bonding and the presence of a mood or anxiety disorder in adults were eligible for inclusion.

RESULTS

Fifty-seven studies were included in the systematic review (n = 44 in the meta-analysis). Quantitative results indicated that individuals with major depression, panic disorder, or persistent depressive disorder reported lower parental care and higher overprotection compared to individuals without psychiatric diagnoses. Qualitative results indicated that individuals with diagnoses of mood or anxiety disorders tended to report higher parental abuse than controls.

LIMITATIONS

The measures of parental bonding used by the included studies are retrospective and subject to biases. All studies had a case-control design and thus, causal-relationships cannot be drawn from the results.

CONCLUSIONS

Our findings suggest that poor-quality parental bonding early in life may place offspring at greater risk for mood and anxiety disorders during adulthood. Future research should extend these results by confirming the relationship between parental bonding and other psychiatric disorders, as well as identifying which factors mediate the relationship between abnormal parental bonding and psychiatric disorders.

Bidirectional Effects Between Parental Care and Depression Among Adolescent Boys: Results From the Chinese Family Panel Studies

Background

Research has consistently shown the adverse effects of inappropriate parenting on adolescent depression. Meanwhile, interpersonal theories of depression suggest that depressed individuals elicit frustration and rejection from their relational partners.

Method

Using two-wave data from the Chinese Family Panel Studies (CFPS), the present study examined the prospective relationships between parental care and adolescent depression. Participant were 426 adolescents (54.9% male) born in 1999 (ages at T1 and T2 were 11 and 13).

Results

Results from the structural equation model showed that parental care prospectively and negatively predicted depression among both adolescent boys and girls. Inversely, adolescent boys’ depression, but not girls’ depression, negatively predicted subsequent parental care.

Conclusion

The results suggest the interactive dynamic between parental care and adolescent depression as well as parents’ gendered responses to adolescent depression.

Incidence trends of major depressive disorder in China: an age-period-cohort modeling study

BACKGROUND

Major depressive disorder (MDD) is a common public health problem in China. However, few studies have focused on its incidence and separated age, period, and cohort effects. This study aimed to assess the age, period, and cohort effects on the incidence trends of MDD in China between 1993 and 2017.

METHODS

The incidence data of MDD were obtained from the Global Burden of Diseases Study 2017. Age-period-cohort modeling method was used to separate the age, period, and cohort effects on MDD incidence rate.

RESULTS

The incidence number of MDD increased by 22.8% while the age-standardized incidence rate decreased by 15.6% over 25 years. Age-period-cohort analysis indicated that the net drift was -0.433% per year, with -0.486% for females and -0.385% for males. For both sexes, the local drifts were all <0 in 10 to 54 years age groups but >0 in 55 to 94 years age groups. The longitudinal age curves of MDD incidence basically showed an increasing trend, except for a subpeak at 20-24 years age group. The period rate ratio largely declined over time, except for an uptick after 2003-2007. The cohort rate ratio followed an inverted U-shaped pattern and was highest in 1951-1955 birth cohort.

LIMITATIONS

The MDD data were estimated and wide social factors were not included in the analyses.

CONCLUSION

The changes of MDD incidence rate in China are likely to be related to rapid social and economic development, and major historical events. However, the associations need to be interpreted with caution.

Parenting Style and Emotional Distress Among Chinese College Students: A Potential Mediating Role of the Zhongyong Thinking Style

Previous studies suggested that parenting style was associated with college student’s emotional distress. However, little is known about the underlying mechanisms of this relation in Chinese culture. The present study investigated the associations between parenting style and college student’s emotional distress (depression and anxiety symptoms), examined the mediating effects of Confucian personality-Zhongyong thinking, and explored whether gender, age, and socioeconomic status (SES) moderated the direct and/or indirect effects of parenting style on emotional distress. Results from a large representative sample of Chinese college students (n = 3943) indicated that (a) parental rejection and overprotection was positively and mildly associated with depressive and anxiety symptoms and negatively and mildly related to Zhongyong thinking. Parental warmth significantly correlated with the three variables in the opposite direction; Zhongyong thinking correlated negatively and moderately with depression, and mildly with anxiety; (b) Zhongyong thinking partially mediated the associations of parental rejection and warmth with emotional distress. Specifically, to the extent that students perceived less rejection and more warmth, they were more likely to develop Zhongyong thinking associated with decreased emotional distress; (c) gender and SES moderated the association between parenting style and Zhongyong thinking. Specifically, for students with low SES, the negative relationship between parental overprotection and Zhongyong thinking was stronger; for males and high SES students, the positive link between parental warmth and Zhongyong thinking were stronger. Results highlight the importance of researching potential effects of college student’s Zhongyong thinking within the family system in Chinese culture.

Parenting styles and emerging adult depressive symptoms in Cebu, the Philippines

Incidence of depressive disorders and symptoms increases during the transition to adulthood. The parenting relationship is a potential target for interventions to reduce risk for depression in offspring during this time period, and a four-category typology of parenting styles (authoritative, permissive, authoritarian, and neglectful) has been found to correlate with offspring psychological functioning. The majority of studies, however, have examined this four-category parenting style typology in Western populations. We used the Cebu Longitudinal Health and Nutrition Survey (CLHNS) from the Philippines to assess associations between parenting styles reported by offspring at age 18 and depressive symptoms reported by offspring at age 21 ( N = 1,723). Using adjusted linear regression models, we found that authoritarian and neglectful mothering styles were positively associated with daughters' depressive symptoms, whereas authoritarian mothering was negatively associated with sons' depressive symptoms. Findings suggest both cross-cultural similarities and variability in positive parenting. Results may have implications for family-based depression prevention interventions in the Philippines.

Epidemiology and evolution of the diagnostic classification of factitious disorders in DSM-5

A systematic search for all case reports and case series of adult patients with factitious disorders (FD) in the databases MEDLINE, Scopus, and PsycINFO was conducted. FD is a psychiatric disorder in which sufferers intentionally fabricate physical or psychological symptoms in order to assume the role of a patient, without any obvious gain. The clinical and demographic profile of patients with FD has not been sufficiently clear. Thus, the aims of this study were to outline a demographic and clinical profile of a large sample of patients with FD and to study the evolution of the position of FD in the Diagnostic and Statistical Manual of Mental Disorders. One thousand six hundred thirty-six records were obtained based on key search terms, after exclusion of duplicate records. Five hundred seventy-seven articles were identified as potentially eligible for the study, of which 314 studies were retrieved for full-text review. These studies included 514 cases. Variables extracted included age, gender, reported occupation, comorbid psychopathology, clinical presentation, and factors leading to the diagnosis of FD. In the sample, 65.4% of patients were females. Mean age at presentation was 33.5 years. A health care profession was reported most frequently (n=113). Patients were most likely to present in psychiatry, neurology, emergency, and internal medicine departments. The broad survey of sociodemographic profile of the sample has highlighted some important points for early diagnosis and early psychiatric treatment. The study showed that the patients did not meet Diagnostic and Statistical Manual of Mental Disorders-5 diagnostic criteria in 11.3% of cases.

Factitious disorder: a systematic review of 455 cases in the professional literature

OBJECTIVE

Patients with factitious disorder (FD) fabricate illness, injury or impairment for psychological reasons and, as a result, misapply medical resources. The demographic and clinical profile of these patients has yet to be described in a sufficiently large sample, which has prevented clinicians from adopting an evidence-based approach to FD. The present study aimed to address this issue through a systematic review of cases reported in the professional literature.

METHOD

A systematic search for case studies in the MEDLINE, Web of Science and EMBASE databases was conducted. A total of 4092 records were screened and 684 remaining papers were reviewed. A supplementary search was conducted via GoogleScholar, reference lists of eligible articles and key review papers. In total, 372 eligible studies yielded a sample of 455 cases. Information extracted included age, gender, reported occupation, comorbid psychopathology, presenting signs and symptoms, severity and factors leading to the diagnosis of FD.

RESULTS

A total of 66.2% of patients in our sample were female. Mean age at presentation was 34.2 years. A healthcare or laboratory profession was reported most frequently (N=122). A current or past diagnosis of depression was described more frequently than personality disorder in cases reporting psychiatric comorbidity (41.8% versus 16.5%) and more patients elected to self-induce illness or injury (58.7%) than simulate or falsely report it. Patients were most likely to present with endocrinological, cardiological and dermatological problems. Differences among specialties were observed on demographic factors, severity and factors leading to diagnosis of FD.

CONCLUSIONS

Based on the largest sample of patients with FD analyzed to date, our findings offer an important first step toward an evidence-based approach to the disorder. Future guidelines must be sensitive to differing methods used by specialists when diagnosing FD.

Children's Bonding with Parents and Grandparents and Its Associated Factors

Previous literature has focused on the importance of both parental and grandparental bonding. However, few studies have been conducted to measure children's bonding with parents and grandparents simultaneously, especially tested by the same instrument that offers more comparable results. Therefore, we studied the relationships between parental and grandparental bonding using the Parental Bonding Instrument (PBI), and possible associations between these bonds and sociodemographic variables in 905 Chinese children aged 10-14 years. Children's bonding with mother, father, and grandparents were positively correlated, and the final mixed-effect model showed that several sociodemographic factors (e.g., gender, only children, parents' marital status, and mother's occupation) were associated with parental and grandparental bonding.

Differential parenting and risk for psychopathology: a monozygotic twin difference approach

PURPOSE

Consistent and non-specific associations have been found between parenting style and major depression, anxiety disorders, and externalizing behavior. Although often considered part of twins' shared environment, parenting can also be conceptualized as non-shared environment. Non-shared environmental influences have important effects on development but are difficult to test and sort out because of the possible confounding effects of gene-environment interactions and evocative gene-environment correlations. The monozygotic (MZ) differences approach is one way to analytically investigate non-shared environment.

METHODS

The aim of the present study is to use the MZ differences approach to investigate the relationship between differential parenting among 1303 twin pairs (mean age 36.69 ± 8.56) and differences in total symptom counts of major depression (MD), generalized anxiety disorder (GAD), conduct disorder (CD), and anti-social behavior (ASB) during adulthood.

RESULTS

Although effect sizes tended to be small, a number of results were significantly different from zero. Perceived differences in parental coldness was positively associated with internalizing disorders. Differences in protectiveness were negatively associated with MD, GAD, and ASB. Differences in authoritarianism were positively associated with MD and CD, but negatively associated with ASB.

CONCLUSIONS

Perceived differences in parenting style are associated with differences in MD, GAD, CD, and ASB outcomes in a sample of MZ twins. Despite the lack of a basis for making causal inferences about parenting style and psychopathology, these results are suggestive of such a relationship and show that non-shared environmental influence of parenting does in some cases significantly predict adult psychopathology.

The similarity of the structure of DSM-IV criteria for major depression in depressed women from China, the United States and Europe

BACKGROUND

Do DSM-IV diagnostic criteria for major depression (MD) in Chinese and Western women perform in a similar manner?

METHOD

The CONVERGE study included interview-based assessments of women of Han Chinese descent with treated recurrent MD. Using Mplus software, we investigated the overall degree of between-sample measurement invariance (MI) for DSM-IV diagnostic criteria for MD in the CONVERGE sample and samples selected from four major Western studies from the USA and Europe matched to the inclusion criteria of CONVERGE. These analyses were performed one pair at a time. We then compared the results from CONVERGE paired with Western samples to those obtained when examining levels of MI between pairs of the Western samples.

RESULTS

Assuming a single factor model for the nine diagnostic criteria for MD, the level of MI based on global fit indexes observed between the CONVERGE and the four Western samples was very similar to that seen between the Western samples. Comparable results were obtained when using a two-factor structure for MI testing when applied to the 14 diagnostic criteria for MD disaggregated for weight, appetite, sleep, and psychomotor changes.

CONCLUSIONS

Despite differences in language, ethnicity and culture, DSM criteria for MD perform similarly in Chinese women with recurrent MD and comparable subjects from the USA and Europe. The DSM criteria for MD may assess depressive symptoms that are relatively insensitive to cultural and ethnic differences. These results support efforts to compare findings from depressed patients in China and Western countries.

The possible role of maternal bonding style and CHRNB2 gene polymorphisms in nicotine dependence and related depressive phenotype

OBJECTIVES

Neuronal nicotinic acetylcholinergic receptors (nAChR) and especially α4β2 nAChRs are the major targets for cessation medications and also for some promising antidepressant agents. Furthermore, depressive symptoms pose multifacet difficulties during cessation therapy. However, gene encoding for the β2 subunit of nAChRs has been poorly investigated in association with depression. Since both nicotine dependence (ND) and depressive phenotype are complex disorders, we investigated the effects of a significant early life experience, maternal bonding style (MB) and CHRNB2 gene SNPs on smoking-related depression.

METHODS

We recruited two hundred and thirty-two treatment-seeking smokers in our study. Phenotypic variants were evaluated using the Fagerstrom Test for Nicotine Dependence (FTND), the Zung Self-Rating Depression Scale (ZSDS) and the Parental Bonding Instrument (PBI). Besides the total score (TS) of ZSDS, impulsivity (ZSDS-I) and suicidal ideation (ZSDS-S) were distinguished as phenotypic variable. DNAs were extracted from buccal mucosa samples and one SNP in promoter and two SNPs in 3' UTR of CHRNB2 gene were genotyped. GLM and ANOVA tests were performed for genotype associations and interaction analyses.

RESULTS

Maternal bonding had a significant impact on depressive phenotypes. Low care, high protection and affectionless control (ALC) were associated with ZSDS-TS and all subphenotypes of ZSDS. One SNP, the rs2072660 in 3' UTR, had a significant effect on the FTND score (p=0.010). Direct association of CHRNB2 variants and depressive phenotypes were not significant. However, in interaction with ALC, rs2072660 was significantly associated with ZSDS-S (p=0.005). MB had no significant effect on smoking-related phenotype.

CONCLUSIONS

Our results highlight the important role of 3' UTR in the CHRNB2 gene in the shared molecular background of ND and depressive phenotype. Parental bonding style can be suggested as a significant environmental factor in further GxE studies of depression. The presented significant GxE interaction on smoking-related suicidal subphenotype may help establish further investigations on development of more effective and safer smoking cessation and antidepressant agents.

Vasopressin, but not oxytocin, increases empathic concern among individuals who received higher levels of paternal warmth: A randomized controlled trial

BACKGROUND

Empathy improves our ability to communicate in social interactions and motivates prosocial behavior. The neuropeptides arginine vasopressin and oxytocin play key roles in socioemotional processes such as pair bonding and parental care, which suggests that they may be involved in empathic processing.

METHODS

We investigated how vasopressin and oxytocin affect empathic responding in a randomized, double-blind, placebo controlled, between-subjects study design. We also examined the moderating role of parental warmth, as reported in the early family environment, on empathic responding following vasopressin, oxytocin, or placebo administration.

RESULTS

Among participants who reported higher levels of paternal warmth (but not maternal warmth), vasopressin (vs. placebo and oxytocin) increased ratings of empathic concern after viewing distressing and uplifting videos. No main or interaction effects were found for individuals who received oxytocin.

CONCLUSIONS

Vasopressin has a role in enhancing empathy among individuals who received higher levels of paternal warmth.

TRIAL REGISTRATION

NCT01680718.

Long-term trajectories of maternal depressive symptoms and their antenatal predictors

BACKGROUND

Depressive symptoms, often long-term or recurrent, are common among mothers of young children and a well-known risk for child well-being. We aimed to explore the antecedents of the long-term trajectories of maternal depressive symptoms and to define the antenatal factors predicting the high-symptom trajectories.

METHODS

The sample comprised 329 mothers from maternity centers. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) antenatally and at two months, six months, 4-5 years, 8-9 years and 16-17 years after delivery. Maternal expectations concerning the baby were assessed with the Neonatal Perception Inventory (NPI). Background information was gathered with questionnaires.

RESULTS

A model including four symptom trajectories (very low, low-stable, high-stable and intermittent) was selected to describe the symptom patterns over time. The high-stable and the intermittent trajectory were both predicted pairwise by a high antenatal EPDS sum score as well as high EPDS anxiety and depression subscores but the other predictors were specific for each trajectory. In multivariate analyses, the high-stable trajectory was predicted by a high antenatal EPDS sum score, a high EPDS anxiety subscore, diminished life satisfaction, loneliness and more negative expectations of babies on average. The intermittent trajectory was predicted by a high antenatal EPDS sum score, a poor relationship with own mother and urgent desire to conceive.

LIMITATIONS

Only self-report questionnaires were used. The sample size was rather small.

CONCLUSIONS

The results suggest a heterogeneous course and background of maternal depressive symptoms. This should be considered in intervention planning.

Acute stress responses in Chinese soldiers performing various military tasks

Background

To examine Chinese soldiers’ acute stress responses, we did this study.

Methods

The soldiers completed the Acute Stress Response Scale (ASRS) when engaged in major tasks, such as earthquake rescue in Wenchuan, Sichuan, and maintaining social stability in Urumchi, Xinjiang. The ASRS has good reliability and validity. The study enrolled 1,832 male soldiers.

Results

The results showed significant differences among five dimensions and the overall response index when comparing four diverse military tasks. Further analysis found that reduced work efficiency and 24 symptom clusters were significantly positively correlated.

Conclusions

The acute stress response of soldiers performing various tasks was influenced by many factors, including the task characteristics and external factors. In addition, the acute stress response affected their work efficiency.

The structure of the symptoms of major depression: exploratory and confirmatory factor analysis in depressed Han Chinese women

BACKGROUND

The symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?

METHOD

Symptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.

RESULTS

The preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.

CONCLUSIONS

MD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.

Childhood sexual abuse and the development of recurrent major depression in Chinese women

BACKGROUND

Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set?

METHOD

Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.

RESULTS

We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19-5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58-3.15), genital (OR 5.24, 95% CI 3.52-8.15) and intercourse (OR 10.65, 95% CI 5.56-23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11-2.27) and phobia (OR 1.41, 95%CI 1.09-1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20-1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02-2.02). Intercourse (OR 3.47, 95%CI 1.66-8.22), use of force and threats (OR 1.95, 95%CI 1.05-3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20-1.64) were significantly associated with recurrent MD.

CONCLUSIONS

In Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD.

Cognitive trio: relationship with major depression and clinical predictors in Han Chinese women

BACKGROUND

Previous studies support Beck's cognitive model of vulnerability to depression. However, the relationship between his cognitive triad and other clinical features and risk factors among those with major depression (MD) has rarely been systematically studied.

METHOD

The three key cognitive symptoms of worthlessness, hopelessness and helplessness were assessed during their lifetime worst episode in 1970 Han Chinese women with recurrent MD. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.

RESULTS

Compared to patients who did not endorse the cognitive trio, those who did had a greater number of DSM-IV A criteria, more individual depressive symptoms, an earlier age at onset, a greater number of episodes, and were more likely to meet diagnostic criteria for melancholia, postnatal depression, dysthymia and anxiety disorders. Hopelessness was highly related to all the suicidal symptomatology, with ORs ranging from 5.92 to 6.51. Neuroticism, stressful life events (SLEs) and a protective parental rearing style were associated with these cognitive symptoms.

CONCLUSIONS

During the worst episode of MD in Han Chinese women, the endorsement of the cognitive trio was associated with a worse course of depression and an increased risk of suicide. Individuals with high levels of neuroticism, many SLEs and high parental protectiveness were at increased risk for these cognitive depressive symptoms. As in Western populations, symptoms of the cognitive trio appear to play a central role in the psychopathology of MD in Chinese women.

Childhood family factors predict developmental trajectories of hostility and anger: a prospective study from childhood into middle adulthood

BACKGROUND

Low socio-economic status (SES), and a conflictive, cold and unsupportive family environment in childhood have been associated with early adulthood hostility. However, it is unknown whether this association changes in magnitude with age from childhood to adulthood. We investigated whether childhood family factors (SES and parental child-rearing style) predicted differential development of offspring hostility and anger from early to middle adulthood.

METHOD

Between 2041 and 2316 participants (age range 3-18 years at baseline) were selected from the longitudinal Young Finns study. The participants were followed for 27 years between 1980 and 2007. Childhood SES and parent's self-reported child-rearing style were measured twice: at baseline and 3 years after baseline. Hostility and anger were assessed with self-report questionnaires at 12, 17, 21 and 27 years after baseline.

RESULTS

Low parental SES and hostile child-rearing style at baseline predicted higher mean levels of offspring anger and hostility. Low parental SES and one of the hostile child-rearing style components (strict disciplinary style) became more strongly associated with offspring hostility with age, suggesting an accumulating effect.

CONCLUSIONS

Childhood family factors predict the development of hostility and anger over 27 years and some of these family factors have a long-term accumulating effect on the development of hostility.

Parenting and risk for mood, anxiety and substance use disorders: a study in population-based male twins

BACKGROUND

Previous studies consistently identified a relationship between parenting behavior and psychopathology. In this study, we extended prior analyses performed in female twins to a large sample of twins from male-male pairs.

METHODS

We used interview data on 2,609 adult male twins from a population-based twin registry. We examined the association between three retrospectively reported parenting dimensions (coldness, protectiveness, and authoritarianism) and lifetime history of seven common psychiatric and substance use disorders. Using univariate structural equation modeling, we also examined the influence of the genetic and environmental factors on parenting.

RESULTS

Examined individually, coldness was consistently associated with risk for a broad range of adult psychopathology. Averaged odds of psychiatric disorders associated with parenting were increased between 26 and 36 %. When the three parenting dimensions were examined together, coldness remained significant for major depression, phobia, and generalized anxiety disorder. Controlling for other disorders, the associations between the parenting dimensions and psychopathology were non-specific. Twin fitting model demonstrated that modest heritability accounted for parenting, whereas most variance resulted from the non-shared environment.

CONCLUSIONS

Based on our current and prior findings, there is broad similarity in the impact of parenting on adult psychopathology between men and women.