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Ferreira-Maia AP, Gorenstein C, Wang YP. Comprehensive investigation of factor structure and gender equivalence of the Beck Depression Inventory-II among nonclinical adolescents. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02478-8. [PMID: 38849669 DOI: 10.1007/s00787-024-02478-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 05/18/2024] [Indexed: 06/09/2024]
Abstract
The Beck Depression Inventory-II (BDI-II) is a widely used tool for rating the severity of depressive symptoms. Studies on the factor structure of the BDI-II in adolescents have yielded controversial findings. Most studies have reported an oblique two-factor model that describes the 'cognitive' and 'somatic-affective' dimensions. However, there is variation in the item composition of each factor across studies. Alternative factor structures have been proposed, including one-factor, three-factor, hierarchical, and bifactor models. Additionally, there is limited data on measurement invariance across genders. This study aimed to examine hypothetical factor structures and gender equivalence of the BDI-II in a sample of Brazilian nonclinical adolescents (N = 1,184, aged 13-18 years, 59.1% females). Cross-validation of the BDI-II was performed through exploratory (EFA) and confirmatory factor analysis (CFA). Measurement invariance was evaluated using multigroup-CFA (MG-CFA). EFA suggested an oblique two-factor model depicting "affective-cognitive" and "somatic" dimensions. CFA tested competing models for the structure of BDI-II, including the simple one- and two-factor models, a bifactor model, and the EFA model along with its corresponding bifactor model. All models demonstrated adequate and similar fitness, well-defined factors, and good reliability. Bifactor analyses indicated a robust general factor with low reliable variance in total scores attributed to multidimensionality caused by the group factors in bifactor models. MG-CFA supported invariance across gender, suggesting that the same BDI-II construct could be applied to both female and male adolescents. This study provides evidence that the BDI-II could be used as a unidimensional measure of depressive symptoms in adolescents by researchers and clinicians.
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Affiliation(s)
- Ana Paula Ferreira-Maia
- Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Clarice Gorenstein
- Institute of Biomedical Sciences, Department of Pharmacology, University of São Paulo Medical School, São Paulo, Brazil
| | - Yuan-Pang Wang
- Institute & Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.
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Brás M, Cunha A, Antunes J, Carmo C. The Positive and Negative Suicidal Ideation Inventory among Portuguese Adolescents: Factor Structure and Gender Invariance. Eur J Investig Health Psychol Educ 2024; 14:1002-1011. [PMID: 38667820 PMCID: PMC11048955 DOI: 10.3390/ejihpe14040065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Suicide worldwide is an issue that needs to be addressed, and adolescents are an at-risk group. Assessing suicidal ideation is central to tackling the issue of suicide. The Positive and Negative Suicidal Ideation inventory is a widely validated measure of suicidal ideation, and yet, very little is known about its invariance across various groups. The present study aimed to adapt and test the PANSI's structure in a Portuguese sample while testing its gender invariance. A total of 750 middle and high school students were recruited for the study, and data were collected on various suicide risk and protective factors, including the Portuguese-translated PANSI. Data were put through exploratory and confirmatory factor analysis. Kaiser's criterion and scree plot both extracted two factors (64.10% variance explained). Confirmatory factor analysis also supported the PANSI's structure (TLI = 0.943). The PANSI showed good reliability (α ≥ 0.83) and good construct and discriminative validity. The PANSI also exhibited scalar, but not strict, invariance. Overall, these results were similar to previous versions of this scale. The PANSI is a reliable measure of suicide risk among Portuguese adolescents. Future studies should further replicate these results in other cultures and expand on them by testing for invariance across other demographic variables.
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Affiliation(s)
- Marta Brás
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
- Psychology Research Center, Rua de Santa Marta, 47-3°, 1169-023 Lisboa, Portugal
| | - Ana Cunha
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
| | - João Antunes
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
- Psychology Research Center, Rua de Santa Marta, 47-3°, 1169-023 Lisboa, Portugal
| | - Cláudia Carmo
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
- Psychology Research Center, Rua de Santa Marta, 47-3°, 1169-023 Lisboa, Portugal
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Navarro JL, Brown M, Jensen T, Weinstein M, Jensen M. It isn't just Mom: Gendered provision of family and home responsibilities among emerging adults during COVID-19. Front Psychiatry 2024; 15:1330424. [PMID: 38463426 PMCID: PMC10920304 DOI: 10.3389/fpsyt.2024.1330424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/09/2024] [Indexed: 03/12/2024] Open
Abstract
Media and research reports have highlighted the disproportionate burden of home and family responsibilities shouldered by women and mothers due to COVID-19-related school/childcare shutdowns. This cross-sectional study extends this line of inquiry to emerging adults. Our study of 329 diverse emerging adults suggests that young women took on more home/family responsibilities than young men amidst the pandemic, and that these duties were associated with symptoms of depression. However, results also indicate that emerging adults who reported greater home/family responsibilities amidst the pandemic also experienced more quality family time, suggesting that pandemic-related challenges may have also been accompanied by opportunities for family connection. Contrary to previous research that has shown home/family responsibilities to be concentrated by SES and race/ethnicity, we found that participants uniformly endorsed COVID-19-related impacts on home/family responsibilities across these demographic distinctions. This could reflect the ubiquity of COVID-19's impact; across race/ethnicity and class-but differentially by gender-young adults faced significant challenges in taking on new home/family roles.
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Affiliation(s)
- Jessica L. Navarro
- Department of Human Service Studies, Elon University, Elon, NC, United States
| | - Morgan Brown
- Department of Psychology, The University of North Carolina Greensboro, Greensboro, NC, United States
| | - Todd Jensen
- School of Social Work, The University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Mariani Weinstein
- Department of Psychology, The University of North Carolina Greensboro, Greensboro, NC, United States
| | - Michaeline Jensen
- Department of Psychology, The University of North Carolina Greensboro, Greensboro, NC, United States
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Schick MR, Hostetler KL, Kirk-Provencher KT, Spillane NS. Depressive symptoms, alcohol use, and alcohol-related consequences: the moderating role of gender among American Indian adolescents. J Ethn Subst Abuse 2023:1-17. [PMID: 37222686 PMCID: PMC10667562 DOI: 10.1080/15332640.2023.2216162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Depression, alcohol use, and alcohol-related consequences are experienced disproportionately by American Indian (AI) adolescents. The co-occurrence of depression and alcohol use is clinically relevant, as it is associated with increased risk for suicide, among other negative consequences. Understanding how the association between depressive symptoms and alcohol use and related consequences is influenced by gender is important to understand for whom intervention efforts might be particularly relevant. Thus, the present study seeks to evaluate gender differences in these associations among AI adolescents. METHODS Participants were a representative sample of AI adolescents (N = 3,498, Mage=14.76, 47.8% female) residing on or near reservations who completed self-report questionnaires in school classrooms. Study activities were approved by IRB, school boards, and tribal authorities. RESULTS The interaction of depressive symptoms and gender was significant in predicting past-year alcohol use frequency (b=.02, p=.02) and, among youth reporting lifetime alcohol use, alcohol-related consequences (b=.03, p=.001). Analysis of simple slopes revealed that, for females, depressive symptoms were significantly associated with past-year alcohol use frequency (b=.02, p<.001) and alcohol-related consequences (b=.05, p<.001). For males, depressive symptoms were only significantly associated with alcohol-related consequences (b=.02, p=.04), and this effect was weaker than for females. CONCLUSIONS Results of the present study may inform the development of gender-sensitive recommendations for the assessment and treatment of alcohol use and alcohol-related consequences among AI adolescents. For instance, results suggest that treatments focusing on depressive symptoms may subsequently reduce alcohol use and related consequences for female AI adolescents.
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Affiliation(s)
- Melissa R. Schick
- Divisision of Prevention and Community Research, Yale School of Medicine Department of Psychiatry, New Haven CT 06511
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston RI 02881
| | | | - Katelyn T. Kirk-Provencher
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston RI 02881
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO 80045
| | - Nichea S. Spillane
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston RI 02881
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Gronemann FH, Jacobsen RK, Wium-Andersen MK, Jørgensen MB, Osler M, Jørgensen TSH. Association of Familial Aggregation of Major Depression With Risk of Major Depression. JAMA Psychiatry 2023; 80:350-359. [PMID: 36753297 PMCID: PMC9909579 DOI: 10.1001/jamapsychiatry.2022.4965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/28/2022] [Indexed: 02/09/2023]
Abstract
Importance Major depression (MD) aggregates within families, but how family history of MD confers risk of MD over the life course is unclear. Such knowledge is important to identify and prevent possible depressogenic effects of family environment. Objective To examine the association between family MD history and risk of MD including association with age, sex, type of kinship, and age of the affected family member. Design, Setting, and Participants This cohort study included all Danish citizens born from 1960 to 2003 with known parental identity followed up from their 15th birthday until time of MD, censoring, or December 31, 2018. Analysis took place between April 2022 and December 2022. Exposures Family members with first-time MD using International Classification of Diseases, Eighth Revision codes 296.09, 296.29, 298.09, and 300.49 or 10th Revision codes F32.0-F33.9, family members' age at MD onset, and individuals' age at exposure to family MD. Main Outcomes and Measures Multivariable Poisson regression was applied to estimate the incidence rate ratio (IRR) with 95% CI of first-time MD. Results Of 2 903 430 individuals (1 486 574 [51.2%] men), 37 970 men (2.6%) and 70 223 women (5.0%) developed MD during follow-up. For men, exposure to maternal, paternal, or full sibling MD were associated with a 2-times higher risk of MD (IRR, 2.10 [95% CI, 2.02-2.19]; IRR, 2.04 [95% CI, 1.94-2.14]; IRR, 2.08 [95% CI, 1.97-2.19]) and the associated risk increased with number of affected family members. This pattern was similar for women. For men, family members' age at MD onset was not associated with MD. For women, maternal MD onset at 69 years or younger was associated with higher IRRs of MD (age <40 years: IRR, 1.64 [95% CI, 1.28-2.10]; age 40-49 years: IRR, 1.62 [95% CI, 1.27-2.07]; age 50-59 years: IRR, 1.56 [95% CI, 1.22-2.00]; and age 60-69 years: IRR, 1.67 [95% CI, 1.28-2.16]) compared with women with maternal MD onset at 70 years or older. For men, exposure to maternal MD younger than 30 years (age <1 year: IRR, 1.95 [95% CI, 1.70-2.25]; age 1 to <12 years: IRR, 2.31 [95% CI, 2.16-2.47]; age 12 to <19 years: IRR, 2.18 [95% CI, 2.03-2.35]; age 19 to <30 years: IRR, 1.42 [95% CI, 1.32-1.53]) was associated with increased IRRs, while exposure to maternal MD at 30 years or older was associated with a lower IRR (0.77 [95% CI, 0.70-0.85]). The findings were similar across type of kinships and for women. Conclusions and Relevance In this study, risk of MD was associated with increased numbers of affected family members but did not vary by gender or type of kinship. Exposure to family MD during childhood and adolescence was associated with increased risk.
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Affiliation(s)
- Frederikke Hørdam Gronemann
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Rikke Kart Jacobsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Marie Kim Wium-Andersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Martin Balslev Jørgensen
- Mental Health Centre Copenhagen, Copenhagen, Denmark, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Terese Sara Høj Jørgensen
- Center for Clinical Research and Prevention, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Wang D, Deng Q, Chen H, Wang M, Liu Z, Wang H, Ouyang X. Profiles of depressive symptoms and influential factors among people living with HIV in China. BMC Public Health 2023; 23:151. [PMID: 36690976 PMCID: PMC9869583 DOI: 10.1186/s12889-023-15057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Depressive symptoms are highly prevalent among people living with HIV (PLWH). We leveraged Latent Profile Analysis (LPA) to identify profiles of depressive symptoms among PLWHs. We also investigated differences in psychological factors of interest, demographic characteristics, and HIV-related factors across patients' profiles. METHODS A cross-sectional study was conducted at one hospital and two designated prison facilities in Hunan province, China. A total sample of 533 PLWHs (320 recruited from the hospital, 213 recruited from prisons) completed the survey. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9). Family function, resilience, childhood trauma, demographic characteristics, and HIV-related factors were also evaluated. We conducted LPA and multinomial logistic regression analyses to: 1) identify distinct profiles for depressive symptoms; 2) identify demographic characteristics, and HIV-related, and psychological factors predicting PLWHs' likelihood to express a specific profile. RESULTS We identified three distinct profiles of depressive symptoms among PLWHs: severe symptoms (11.8%), moderate symptoms (40.5%), and low/no symptoms (47.7%). Moderate/ severe family dysfunction, low resilience, experiencing emotional abuse and neglect were more likely to fall in the "severe symptoms" rather than the "low/no symptoms" profile. In addition, severe family dysfunction, low resilience, and experiencing emotional neglect indicated a higher likelihood of being classified in the "moderate symptoms" profile, compared to the "low/no symptoms" profile. CONCLUSION Identifying profiles of depressive symptoms among PLWHs using the PHQ-9 items allows for understanding of the distinct paths of development of depressive symptoms and for developing tailored prevention and intervention programs for PLWHs.
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Affiliation(s)
- Dongfang Wang
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Qijian Deng
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Huilin Chen
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Min Wang
- Institute for HIV/AIDS, the First Hospital of Changsha, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Honghong Wang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xuan Ouyang
- Department of Psychiatry, National Clinical Research Center on Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China.
- National Technology Institute On Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, China.
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Houghton S, Marais I, Kyron M, Lawrence D, Page AC, Gunasekera S, Glasgow K, Macqueen L. Screening for depressive symptoms in adolescence: A Rasch analysis of the short-form childhood depression inventory-2 (CDI 2:SR[S]). J Affect Disord 2022; 311:189-197. [PMID: 35597465 DOI: 10.1016/j.jad.2022.05.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/28/2022] [Accepted: 05/15/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Screening for depressive symptoms during adolescence is of high clinical significance. The shorter 12-item version of the Children's Depression Inventory (CDI 2:SR[S]) was specifically developed for this purpose. Evaluations of the CDI 2:SR[S] psychometrics are limited, however. The purpose of this study was to validate the CDI 2: SR[S] for use as a screening measure using Rasch analysis. METHODS The CDI 2: SR[S] was administered online to 1513 10-17 year old Western Australian adolescents (635 males, 878 females) from 11 schools. Overall fit, individual item fit, local response dependence, dimensionality, operation of response categories, and differential item functioning (DIF) were examined. RESULTS The Rasch analysis demonstrated the CDI 2: SR[S] has good reliability. Thresholds for all items were ordered, showing its three response categories functioned as intended. One item (I have to push myself to do schoolwork) showed misfit. No items were locally dependent. Two items (I am sad) and (I have to push myself to do schoolwork) showed DIF for gender. At the same level of depression, females reported being sad more than males, while males pushed themselves more to do schoolwork than did females. Adolescents (14-17 years) reported significantly higher mean depressive symptom scores than early adolescents (10-13 years). LIMITATIONS Sole reliance on adolescent's self-report and limited data about cultural backgrounds are limitations. CONCLUSIONS The results support the interval scale measurement properties of the CDI 2: SR[S] and provides educators, clinicians and researchers with a screening measure to assess depressive symptoms in adolescents.
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Affiliation(s)
- Stephen Houghton
- Graduate School of Education, The University of Western Australia, Australia; School of Psychological and Health Sciences, The University of Strathclyde, Glasgow, Scotland, UK.
| | - Ida Marais
- School of Medicine, The University of Western Australia, Australia
| | - Michael Kyron
- Graduate School of Education, The University of Western Australia, Australia; School of Psychological Science, University of Western Australia, Australia
| | - David Lawrence
- Graduate School of Education, The University of Western Australia, Australia
| | - Andrew C Page
- School of Psychological Science, University of Western Australia, Australia
| | - Sashya Gunasekera
- Graduate School of Education, The University of Western Australia, Australia
| | - Ken Glasgow
- Graduate School of Education, The University of Western Australia, Australia
| | - Leslie Macqueen
- Graduate School of Education, The University of Western Australia, Australia
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Adedeji A, Otto C, Kaman A, Reiss F, Devine J, Ravens-Sieberer U. Peer Relationships and Depressive Symptoms Among Adolescents: Results From the German BELLA Study. Front Psychol 2022; 12:767922. [PMID: 35046870 PMCID: PMC8761859 DOI: 10.3389/fpsyg.2021.767922] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Poor mental health affects adolescent development and is associated with health and social outcomes in later life. The current study uses cross-sectional data to explore the understudied aspects of peer relationships as a predictor of depressive symptom severity of adolescents in Germany. Method: Data from the German BELLA study were analyzed. We focused on the most recent measurement point of the BELLA study and analyzed data of 446 adolescents (aged 14-17 years). Peer relationship was measured using four items from the internationally established Patient-Reported Outcome Measurement Information System (PROMIS). Depressive symptoms were assessed via seven items of the German version of the Centre for Epidemiological Studies Short Depression Scale (CES-D). Hierarchical linear regression models were computed to explore the association between depressive symptoms and peer relationships. Hierarchical linear regression models served to determine the added predictive effects of each aspect of peer relationships. Result: The regression model showed that 22% of the variance of the severity of depressive symptoms could be explained by the quality of adolescents' peer relationships (F(1,444) = 125.65, p < 0.001). Peer acceptance has the most substantial unique contribution to peer relationship as a predictor of depressive symptom severity (Change in R 2 = 0.05; Change in F = 27.01, p < 0.001). The gender-specific analysis shows different trends for boys and girls. Conclusion: The quality of peer relationships is a significant predictor of adolescents' depressive symptoms severity. Improved peer acceptance, dependability, and ease of making new friends are significantly associated with reduced depression symptoms for Germany's adolescent population.
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Affiliation(s)
- Adekunle Adedeji
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Christiane Otto
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiss
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Janine Devine
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Argora Clinic, Psychosomatic Clinic and Outpatient Center, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Child Public Health, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Quinones S, Palermo TM, Lukongo TM, Luchemba P, Mitti R, Devries K, de Groot R, Khurshid A, Kuper H. Disability status and multi-dimensional personal well-being among adolescents in the Southern Highlands Region of Tanzania: results of a cross-sectional study. BMJ Open 2021; 11:e044077. [PMID: 34016661 PMCID: PMC8141426 DOI: 10.1136/bmjopen-2020-044077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Examine how disability status among adolescents is associated with the following domains of personal well-being: schooling, livelihoods, health, violence and psychosocial well-being. It is hypothesised that adolescents with a disability will have greater deficits in these areas of well-being compared with their healthier counterparts. DESIGN Cross-sectional data from 2018 were obtained from the second round of an on-going study of adolescents living in poor households in two regions of the Southern Highlands of Tanzania (Iringa and Mbeya). We use the Washington Group (WG) Short Set indicators to measure disability and undertook logistic and linear multivariate regressions to understand the association between disability and the outcomes of interest. PARTICIPANTS The sample included 2274 participants aged 15-20 years living in households participating in a government social protection programme targeted to households living in extreme poverty. RESULTS Overall, 310 participants (14%) were classified as having disabilities. Outcomes not associated with disability status included literacy, schooling, livelihoods and self-efficacy. Adolescents with disabilities were less likely to report good or very good health (adjusted OR (aOR)=0.39, 95% CI 0.29 to 0.52) and had increased odds of reporting depressive symptoms in (aOR=1.46, 95% CI 1.11 to 1.90), emotional violence (aOR=2.18, 95% CI 1.49 to 3.20) and physical violence (aOR=1.71, 95% CI 1.13 to 2.59), compared with those without disabilities. Reports of depression were higher among men, and violence was more prevalent among women. Patterns of association were generally similar between men and women, although the association of disability with markers of well-being reached statistical significance more often among men. CONCLUSION This study highlights areas where adolescents with disabilities are falling behind their peers in terms of personal well-being. These findings suggest that interventions may be needed to mainstream disability in programmes and policies aiming to improve well-being, mental health and violence prevention among adolescents. TRIAL REGISTRATION NUMBER Pan African Clinical Trial Registry (PACTR201804003008116).
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Affiliation(s)
- Sarah Quinones
- Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York, USA
| | - Tia M Palermo
- Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York, USA
| | - Tumpe Mnyawami Lukongo
- Research and Development Unit, Tanzania Social Action Fund, Dodoma, United Republic of Tanzania
| | - Paul Luchemba
- Monitoring and Evaluation Unit, Tanzania Social Action Fund, Dodoma, United Republic of Tanzania
| | | | - Karen Devries
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Hannah Kuper
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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10
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Bulhões C, Ramos E, Severo M, Dias S, Barros H. Trajectories of depressive symptoms through adolescence and young adulthood: social and health outcomes. Eur Child Adolesc Psychiatry 2021; 30:65-74. [PMID: 32065326 DOI: 10.1007/s00787-020-01493-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 02/07/2020] [Indexed: 10/25/2022]
Abstract
Depressive symptoms display heterogeneous trajectories across adolescence, which can lead to different consequences. This study aimed to identify trajectories of depressive symptoms from adolescence to young adulthood, assessing the association with social and health outcomes at young adulthood. Adolescents born in 1990, enrolled in schools of Porto, Portugal, in 2003-2004 (EPITeen study) completed the Beck Depression Inventory II (BDI-II) at 13, 17 and 21 years. Mixed models and model-based clustering were used to describe the trajectories in the BDI-II score (n = 2010). Outcomes were assessed at age 21 years with self-administered questionnaires and face-to-face interviews (n = 1594). Odds ratios or regression coefficients, with 95% confidence intervals, were estimated using logistic and linear regression. Three trajectory classes of depressive symptoms were identified, similar in shape in both sexes: High (8.4%), Moderate (31.3%) and Low (60.2%). Participants in High or Moderate classes were more likely to describe lower scores of community involvement, more medical appointments during the last year, higher levels of pain and had higher probability of self-rating health as "good" or "fair or poor". Females in the High and Moderate classes were more likely to be current smokers, to describe ever using drugs and to report more sexual partners, emergency room visits and the use of antidepressants. The risk of depressive symptoms in adulthood is likely to be early determined in adolescence. The trajectory classes with higher levels of symptoms were associated with worse social and health outcomes.
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Affiliation(s)
- C Bulhões
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.
| | - E Ramos
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
| | - M Severo
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
| | - S Dias
- Escola Nacional de Saúde Pública, Centro de Investigação Em Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - H Barros
- EPIUnit, Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
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11
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Carapeto MJ, Domingos R, Veiga G. Is the Effect of Body Dissatisfaction on Depressive Symptoms Dependent on Weight Status? A Study with Early-to-Middle Adolescents. Eur J Investig Health Psychol Educ 2020; 10:1020-1034. [PMID: 34542433 PMCID: PMC8314315 DOI: 10.3390/ejihpe10040072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/24/2022] Open
Abstract
Depression is a recognized mental health problem in adolescence and body dissatisfaction is an important risk factor. The main goal of this study is to examine the relationship between body dissatisfaction and depressive symptoms, and whether it depends on adolescents' weight status, an issue that remains understudied. Two hundred and fourteen adolescents (12-16 years) completed self-report measures of depressive symptoms, body dissatisfaction and weight status (i.e., current body weight and height, to compute body mass index z-scores, BMIz). Hierarchical multiple regression and moderation analyses were conducted, accounting for gender and age effects on depressive symptoms. Body dissatisfaction was found to be a predictor of depressive symptoms for the low and median BMIz adolescents, but not for those with high BMIz. In addition, this interaction of body dissatisfaction and BMIz improved the ability of the regression model to explain depressive symptoms´ variance beyond the effect of gender and age. The high-BMIz adolescents presented higher body dissatisfaction but similar levels of depressive symptoms, compared to the lower BMIz adolescents. These findings suggest the influence of body dissatisfaction in the emergence of depressive symptoms in the first half of adolescence, and the importance of weight status throughout this path.
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Affiliation(s)
- Maria João Carapeto
- Departamento de Psicologia, Escola de Ciências Sociais, Universidade de Évora, 7005-345 Évora, Portugal
| | - Raquel Domingos
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, 7005-345 Évora, Portugal; (R.D.); (G.V.)
| | - Guida Veiga
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, 7005-345 Évora, Portugal; (R.D.); (G.V.)
- Comprehensive Health Research Centre (CHRC), University of Évora, 7005-345 Évora, Portugal
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12
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Rydberg Sterner T, Gudmundsson P, Falk H, Seidu N, Ahlner F, Wetterberg H, Rydén L, Sigström R, Östling S, Zettergren A, Kern S, Waern M, Skoog I. Depression in relation to sex and gender expression among Swedish septuagenarians-Results from the H70 study. PLoS One 2020; 15:e0238701. [PMID: 32925927 PMCID: PMC7489509 DOI: 10.1371/journal.pone.0238701] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/21/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Little is known about the role of gender expression (femininity, masculinity, or androgyny) in relation to sex differences in depression. This study tested if gender expression was associated with depression and burden of depressive symptoms in a 70-year-old population. METHODS A cross-sectional population-based sample of 70-year-olds from The Gothenburg H70 Birth Cohort Study (n = 1203) was examined in 2014-16. Data were collected using psychiatric examinations and structured questionnaires, including the Positive-Negative Sex-Role Inventory to assess gender expression. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders criteria, and symptom burden was assessed with Montgomery Åsberg Depression Rating Scale (MADRS). RESULTS Gender expression was related to MADRS score and depression diagnosis. In fully adjusted models, feminine traits with low social desirability (FEM-) were associated with a higher MADRS score (R2 0.16; B 0.16; CI 0.1-0.2), while androgyny (t ratio) (R2 0.12; B 0.42; CI 0.1-0.7) and masculine traits with high social desirability (MAS+) (R2 0.13; B -0.06; CI -0.1--0.01) were associated with a lower MADRS score. Also, feminine traits with low social desirability (FEM-) were positively associated with depression (OR 1.04; CI 1.01-1.1). No associations between depression and masculinity or androgyny were observed in adjusted models. There were no interactions between sex and gender expression in relation to depression or MADRS score, indicating that the effects of gender expression were similar in men and women. CONCLUSIONS We found that gender expression was associated to both depression and burden of depressive symptoms. More specifically, we found that femininity was associated to higher levels of depression, irrespective of biological sex. In addition, masculinity and androgyny were associated with lower levels of depression. These results highlight the importance of taking gender expression into consideration when studying sex differences in depression among older populations in future studies.
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Affiliation(s)
- Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
- * E-mail:
| | - Pia Gudmundsson
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
| | - Hanna Falk
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Nazib Seidu
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
| | - Felicia Ahlner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
| | - Hanna Wetterberg
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
| | - Lina Rydén
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
| | - Robert Sigström
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Svante Östling
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
| | - Silke Kern
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
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13
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Henderson SEM, Brady EM, Robertson N. Associations between social jetlag and mental health in young people: A systematic review. Chronobiol Int 2019; 36:1316-1333. [DOI: 10.1080/07420528.2019.1636813] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sarah E. M. Henderson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Emer M. Brady
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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14
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Psychodynamic Features Associated With Orthognathic Surgery: A Comparison Between Conventional Orthognathic Treatment and “Surgery-First” Approach. J Oral Maxillofac Surg 2019; 77:157-163. [DOI: 10.1016/j.joms.2018.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/05/2018] [Accepted: 06/05/2018] [Indexed: 11/19/2022]
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15
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de Sá Junior AR, Liebel G, de Andrade AG, Andrade LH, Gorenstein C, Wang YP. Can Gender and Age Impact on Response Pattern of Depressive Symptoms Among College Students? A Differential Item Functioning Analysis. Front Psychiatry 2019; 10:50. [PMID: 30809161 PMCID: PMC6379252 DOI: 10.3389/fpsyt.2019.00050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 01/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the continuum of depression. Potential differential item functioning of the scale items of the BDI-II is investigated, by gender and age, to compare across sub-groups of students. Methods: The 21-item BDI-II was cross-sectionally administered to a representative sample of 12,677 Brazilian college students. Reliability was evaluated based on Cronbach's alpha coefficient. Severity (b i ) and discrimination (a) parameters of each BDI-II items were calculated through the graded response model. The influence of gender and age were tested for differential item functioning (DIF) within the item response theory-based approach. Results: The BDI-II presented good reliability (α = 0.91). Women and younger students significantly presented a higher likelihood of depression (cut-off > 13) than men and older counterparts. In general, participants endorsed more easily cognitive-somatic items than affective items of the scale. "Guilty feelings," "suicidal thoughts," and "loss of interest in sex" were the items that most likely indicated depression severity (b ≥ 3.60). However, all BDI-II items showed moderate-to-high discrimination (a ≥ 1.32) for depressive state. While two items were flagged for DIF, "crying" and "loss of interest in sex," respectively for gender and age, the global weight of these items on the total score was negligible. Conclusions: Although respondents' gender and age might present influence on response pattern of depressive symptoms, the measures of self-reported symptoms have not inflated severity scores. These findings provide further support to the validity of using BDI-II for assessing depression in academic contexts and highlight the value of considering gender- and age-related common symptoms of depression.
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Affiliation(s)
- Antonio Reis de Sá Junior
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil.,Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Graziela Liebel
- Department of Collective Health, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Arthur Guerra de Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Neuroscience, Medical School, ABC Foundation, Santo André, Brazil
| | - Laura Helena Andrade
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
| | - Clarice Gorenstein
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil.,Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Yuan-Pang Wang
- Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, Brazil
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