Is low positive emotionality a specific risk factor for depression? A meta-analysis of longitudinal studies

Relationship Between Father-Child Attachment and Adolescents' Anxiety: The Bidirectional Chain Mediating Roles of Neuroticism and Peer Attachment

Background

Adolescent anxiety is closely associated with the quality of parent-child attachment. However, previous studies have predominantly focused on the impact of mother-child attachment. Little is known about the direct and indirect associations of father-child attachment on adolescent anxiety.

Purpose

This study aims to investigate the association and underlying mechanisms that link father-child attachment and adolescent anxiety. A bidirectional chain mediating model was constructed to test whether neuroticism and peer attachment play bidirectional mediating roles in father-child attachment and adolescent anxiety.

Methods

The proposed model was examined among 763 adolescents aged 11-16 years (male 53.1%) from four middle schools in Central China. Students completed questionnaires on father-child attachment, anxiety, neuroticism and peer attachment. The correlation and bidirectional chain mediating effect analyses were conducted using SPSS Process.

Results

(1) Father-child attachment negatively correlated with adolescent anxiety and neuroticism, and positively correlated with peer attachment; (2) Father-child attachment had an indirect association on adolescent anxiety through three pathways: a partial mediating effect on neuroticism, a partial mediating effect on peer attachment, and a bidirectional chain mediating effect involving both neuroticism and peer attachment.

Conclusion

This study revealed father-child attachment has an indirect association with adolescent anxiety through the bidirectional chain mediation of neuroticism and peer attachment. These empirical findings shed light on the intricate dynamic between father-child attachment and anxiety among Chinese adolescents, highlighting the crucial role of fathers in the prevention and reduction of adolescent anxiety from the perspectives of father-child dynamics, personal traits, and interpersonal relationships.

Age of onset of major depressive episode and association with lifetime psychiatric disorders, health-related quality of life and impact of gender: A cross sectional and retrospective cohort study

OBJECTIVE

To assess the long-term impact of the age of onset (AOO) of the first major depressive episode (MDE) according to 3 age groups and considering gender.

METHODS

Data were extracted from NESARC III, a representative U.S.

SAMPLE

We included 8053 participants with an MDE history in a cross-sectional and retrospective cohort study. We defined 3 AOO groups: childhood-onset (< 13 yo), adolescence-onset (13-18 yo), and adult-onset (> 18 yo). We compared sociodemographic characteristics, lifetime psychiatric disorders per DSM-5 criteria, and health-related quality of life (HRQOL) in each group and performed gender-stratified analyses.

RESULTS

Prevalence of childhood-onset MDE was 10.03 %, adolescence-onset was 14.12 %, and adult-onset was 75.85 %. Suicide attempts (AOR = 3.61; 95 % CI 2.90-4.50), anxiety disorders (AOR = 1.92; 95 % CI 1.62-2.27), and personality disorders (AOR = 3.08; 95 % CI 2.56-3.71) were more frequent in the childhood-onset than in the adult-onset one. Adolescence-onset group showed similar results. Physical Disability scale (p < 0.001) and Mental Disability scale (p < 0.001) were significantly lower in the childhood-onset group. Results were more nuanced in the adolescence-onset group. Women in childhood-onset and adolescence-onset groups had poorer outcomes than the adult-onset group. Differences were less pronounced in men.

LIMITATIONS

Recall and classification biases inherent to survey design.

CONCLUSION

Individuals, particularly women, who experienced their first MDE during childhood or adolescence exhibit higher lifetime psychiatric disorder prevalence and poorer HRQOL than those with adult-onset MDE. These findings highlight the importance of preventive measures, early diagnosis, and treatment of youth depression.

Everyday emotion, naturalistic life stress, and the prospective prediction of adolescent depression

BACKGROUND AND OBJECTIVES

Increasing research underscores low positive emotion (PE) as a vital component of depression risk in adolescence. Theory also suggests that PE contributes to adaptive coping. However, it is unclear whether naturalistic experiences of emotions contribute to long-term depression risk, or whether daily PE levels equip adolescents to cope with later naturalistic stressors, reducing risk for depression. The current study examines whether PE (and negative emotion [NE]) assessed via ecological momentary assessment (EMA) (a) predict prospective increases in depression, and (b) moderate the association between later life stressors and depression.

DESIGN

Longitudinal study of community-recruited adolescents, with EMA at baseline.

METHOD

Adolescents (n = 232) completed contextual threat life stress interviews, interview and self-report measures of depression at baseline and 1.5 year follow-up. At baseline, they completed a seven-day EMA of emotion.

RESULTS

Preregistered analyses showed that daily NE, but not PE, predicted increased depression over time and moderated the association between interpersonal episodic stress and self-reported depression.

CONCLUSIONS

Results did not support daily PE as a buffer against depressogenic effects of life stress, but point to daily NE as a marker of depression risk.

An integrative analysis of potential mechanisms of reduced positive affect in daily life in depression: an ESM study

Decreased levels of positive affect (PA) are a hallmark of depression. Current models propose as potential main mechanisms a dysfunctional use of emotion regulation (ER) strategies (i.e. dampening, positive rumination), and a maladaptive activation of pro-hedonic goals. However, the role of these mechanisms in PA in daily life remains understudied. We used a 10-day ESM design to assess how these mechanisms influence each other and contribute to depressive symptomatology-related low momentary PA in 139 individuals. Higher depressive symptoms were associated with lower PA, pro-hedonic goals, more frequent use of positive rumination, and higher use of dampening. Further, experiencing higher levels of PA predicted lower following time point use of dampening in individuals with higher symptoms. Finally, using positive rumination was more beneficial (i.e. predicted higher PA increases one moment later) for individuals with higher symptomatology. Our findings suggest that moment-to-moment changes in PA daily life are affected by, and have an effect on, both pro-hedonic goals and the use of dampening and positive rumination, highlighting specific cognitive-affective mechanisms that should be considered when designing interventions aimed at improving low PA characterising depression symptomatology.

A randomized controlled trial of brief behavioral activation plus savoring for positive affect dysregulation in university students

Rising rates of depression on university campuses accentuate the need for specific intervention. Interventions targeting disturbances in positive affect, in particular, remain sparse, yet such deficits interfere substantially with functioning and further exacerbate or maintain negative symptoms. The current study aimed to evaluate the impact of a virtual, two-session Behavioral Activation augmented with Savoring (BA + S) intervention compared to an Emotional Awareness (EA) control group in increasing positive affect. Sixty university students with low positive affect were randomized to BA + S or EA and completed 21 days of experience-sampling of positive affect. Weekly measures of positive and negative valence symptoms were assessed at baseline, sessions one and two, and at one-week follow-up. Through a prori analyses utilizing multilevel and multivariate multilevel models, our results demonstrate that daily positive affect measured via experience-sampling significantly improved in BA + S, whereas positive affect did not change for those receiving EA, though the interaction of condition and time was not significant. Furthermore, interactions in weekly variables were significant. Increases in positive valence symptoms (affect, anhedonia, etc.) were only reported for students receiving BA + S but not EA. Negative valence symptoms (affect, depression, general distress) improved in both conditions but with superior improvements in BA + S compared to EA. BA + S shows promise for a scalable and accessible intervention to university students with clinical levels of positive and negative affect. ClinicalTrials ID: NCT05234476.

Diagnostic accuracy and clinical utility of the PHQ-2 and GAD-2: a comparison with long-format measures for depression and anxiety

Background

Anxiety and depression are highly prevalent and often comorbid mental disorders that are encompassed within the broad category of emotional disorders. The frequent comorbidity of anxiety and depression can pose challenges for accurate diagnosis and treatment which, in turn, highlights the need for reliable measurements that are simultaneously responsive to change and prevent non-response bias. Brief measures of anxiety and depression can potentially increase response rates due to their brevity and ease of administration. This study evaluates the psychometric characteristics, discriminative accuracy, and sensitivity to change of the Generalized Anxiety Disorder 2-item scale (GAD-2) and the Patient Health Questionnaire 2-item scale (PHQ-2) within a clinical population.

Method

The sample comprised treatment-seeking participants (n = 3,411), screened (n = 2,477) to receive an internet-based psychotherapeutic intervention (cognitive-behavioral, psychodynamic, or waitlist).

Results

Brief measures can effectively detect individuals who may be eligible for a diagnosis of depression and anxiety, not only prior to but also during and following the completion of psychological treatment. The discriminative ability of the GAD-2 was significantly greater during active treatment and at post-assessment compared with pre-treatment screening, although no such differences were found for the PHQ-2. Finally, endorsing the most severe response option on the GAD-2 and PHQ-2 was associated with a high probability of presenting with clinically relevant anxiety and depressive symptoms.

Conclusion

Brief measures of anxiety and depression are viable instruments to screen for and monitor anxiety and depressive symptoms.

Clinical trial registration

ClinicalTrials.gov, identifier NCT05016843.

What Do We Know About Depression Among Youth and How Can We Make Progress Toward Improved Understanding and Reducing Distress? A New Hope

This paper summarizes many findings about depression among children and adolescents. Depression is prevalent, highly distressing, and exerts considerable burden worldwide. Rates surge from childhood through young adulthood and have increased over the last decade. Many risk factors have been identified, and evidence-based interventions exist targeting mostly individual-level changes via psychological or pharmacological means. At the same time, the field appears stuck and has not achieved considerable progress in advancing scientific understanding of depression's features or delivering interventions to meet the challenge of youth depression's high and growing prevalence. This paper adopts several positions to address these challenges and move the field forward. First, we emphasize reinvigoration of construct validation approaches that may better characterize youth depression's phenomenological features and inform more valid and reliable assessments that can enhance scientific understanding and improve interventions for youth depression. To this end, history and philosophical principles affecting depression's conceptualization and measurement are considered. Second, we suggest expanding the range and targets of treatments and prevention efforts beyond current practice guidelines for evidence-based interventions. This broader suite of interventions includes structural- and system-level change focused at community and societal levels (e.g., evidence-based economic anti-poverty interventions) and personalized interventions with sufficient evidence base. We propose that by focusing on the FORCE (Fundamentals, Openness, Relationships, Constructs, Evidence), youth depression research can provide new hope.

Positive affect and resilience in tertiary education students

Mental illnesses are the greatest health problems faced by younger people. As a group, tertiary education students demonstrate higher levels of distress than their age matched peers who are not tertiary students, making them an at-risk group for the development of psychopathology. Therefore, this study investigates existing theories of resilience in order to determine how it may be promoted in tertiary education students. Data relating to affect, depression, anxiety, distress, and resilience were collected from 1072 tertiary education students during the COVID-19 pandemic. The results of this study found that positive affect was responsible for approximately 25% of the variance in depressive symptoms but less than 10% of the variance in symptoms of anxiety in tertiary students. The results further showed that positive affect was responsible for 21% of variance in overall distress and the 15% of variance in resilience. The findings of this study suggest that positive affect is more closely associated with symptoms of depression than with symptoms of anxiety in tertiary students. The results further suggest that positive affect may be a useful tool for relieving symptoms of depression and overall distress, and improving levels of resilience in this population.

Exploration of a Psychological Defensive Syndrome Against Depressive Symptomatology in a Community Sample of Indian Women

The prevalence of depressive symptomatology in Indian women and the associated treatment gap are alarming and require interventions at a community level. Such interventions may succeed if the specific risk and protective factors are appropriately identified and addressed. Identifying such factors may suggest a Psychological Defensive Syndrome (PDS) against depressive symptomatology, and inculcating this PDS through specific interventions may help individuals manage depressive symptomatology. For evaluating the feasibility of such an idea, a two-phase research project was initiated, and the current paper presents findings of its first phase. The primary aim of the first phase was to explore the predictive relationship between depressive symptomatology and rumination, reappraisal, resilience, self-efficacy, neuroticism, and extraversion. A total of 671 women (Mage = 23.71) responded to standardized questionnaires in a semi-structured interview setting. The obtained data were subjected to correlational, regression, and path analysis. The findings support all the hypotheses; women, who reported less engagement in rumination and more in reappraisal, who scored low on neuroticism and high on extraversion, resilience and self-efficacy, showed less severe depressive symptoms than their counterparts. This pattern can be thought of as a PDS against depressive symptoms in Indian women. These results highlight the importance of addressing these factors in preventing and assuaging depressive symptomatology in Indian women.

Feasibility and efficacy of a digital resilience training: A pilot study of the strengths-based training RESIST

Background

Work-related stress is a risk factor for a number of adverse health and work outcomes. Resilience trainings are a promising approach for adequately dealing with work stress and keeping employees mentally healthy. However, results of previous resilience trainings have been heterogeneous, ranging from null findings to large effects. Existing digital resilience interventions show a lack of consistency in terms of an underlying theoretical framework and methods used to foster resilience. Positive Appraisal Style Theory of Resilience offers an innovative conceptualization of resilience. Strengths-based cognitive behavioral therapy is a corresponding therapeutically method reflecting resilience as a resource-oriented process of dealing with stress. Based on this background, a new hybrid web-and app-based digital resilience intervention for employees named RESIST was developed.

Objective

The first aim of the study was to investigate the feasibility of the newly developed training RESIST regarding its usability, user behavior, user experience and motivation to use. Second, the study sought to explore preliminary effects of the intervention on reducing stress and enhancing resilience by conducting a pilot randomized controlled trial.

Methods

The feasibility study was conducted in three phases. First, the usability of the app was investigated in a pre-test with five participants using a thinking-aloud method. Second, the preliminary efficacy of the training was examined in a pilot randomized controlled trial. A sample of 30 employees were randomized either to receive the resilience training (n = 15) or to be member of a control group (n = 15). The primary outcome was measuring perceived stress. Secondary outcomes included measures of resilience and depressive symptoms. Third, semi-structured interviews were undertaken with six participants of the resilience training group on training content, motivation for use, and user experience.

Results

Overall, results indicate that RESIST can be a feasible training for resilience promotion and stress reduction with high user satisfaction. Analysis of covariance showed that, relative to controls, participants who received RESIST reported significantly lower stress scores at post-intervention (F1,27 = 16.91, p < 0.001; Cohen's d = 1.57; 95 % CI 0.71-2.43) than controls. Significant differences, with moderate-to-large effect sizes, were also detected for general resilience and various resilience factors.

Conclusions

Results are promising and provide hope that a hybrid web- and app-based resilience intervention based on strengths-based cognitive behavioral therapy can have a positive impact on dealing adequately with stress and improve resilience of employees.

Positive affect improves a transdiagnostic model of perinatal depression symptoms

INTRODUCTION

Accurate measurement of perinatal depression is vital. We aimed to 1) test whether a factor that measured positive affect (PA) bettered a transdiagnostic model of depression symptoms and 2) replicate the model in a second sample.

METHODS

We conducted secondary analyses from two samples (n's = 657 and 142) of women in treatment at perinatal psychiatric clinics. Data were derived from items from seven commonly used measures. We compared fit indices from our original factor model-one general and six specific factors derived from the Research Domain Criteria (Loss, Potential Threat, Frustrative Nonreward, and Sleep-Wakefulness) and depression literatures (Somatic and Coping)-to our novel factor model with a PA factor. The PA factor was created by recategorizing items that measured affective states with a positive valence into a new factor. Sample 1 data were split into six perinatal periods.

RESULTS

In both samples, the addition of a PA factor improved model fit. At least partial metric invariance was found between perinatal periods, with the exception of trimester 3 - postpartum period 1.

LIMITATIONS

Our measures did not operationalize PA in the same way as in the positive valence system in RDoC and we were unable to perform longitudinal analyses on our cross-validation sample.

CONCLUSIONS

Clinicians and researchers are encouraged to consider these findings as a template for understanding symptoms of depression in perinatal patients, which can be used to guide treatment planning and the development of more effective screening, prevention, and intervention tools to prevent deleterious outcomes.

Personality, dietary identity, mental and sleep health in vegans and vegetarians: A preliminary cross-sectional study

Background and Aims

Plant-based diets have gained popularity over the past decade. However, research regarding mental and sleep health benefits of following plant-based diets are conflicting. As there are associations between mental/sleep health and various personality traits, and personality may differ between individuals who follow different diets, in this preliminary study, we examined the associations between mental and sleep health and (i) personality and (ii) dietary identity in individuals who follow vegan and vegetarian diets.

Methods

Cross-sectional data on sociodemographic, personality traits, dietarian identity, overall mental health, depression, anxiety, stress, and sleep quality were collected from 57 vegan/vegetarian participants between the ages of 18-40.

Results

After controlling for various sociodemographic and lifestyle factors, linear regression models revealed that (i) higher dietarian private regard was a significant predictor of better overall mental health, (ii) lower levels of extraversion and higher levels of empathy predicted depression, (iii) higher levels of neuroticism and empathy predicted anxiety, (iv) higher levels of neuroticism, dietarian centrality, and neuroticism × centrality predicted stress, (v) higher levels of conscientiousness, lower levels of dietarian centrality, but higher levels of personal motivation and dietary strictness, as well as conscientiousness × centrality, conscientiousness × personal motivation, and conscientiousness × strictness predicted better sleep quality.

Conclusions

These preliminary findings suggest that not only personality traits, but also dietary identity was indeed related to mental and sleep health in individuals who follow plant-based diets.

Effects of Neuroticism on Differences in Symptom Structure of Life Satisfaction and Depression-Anxiety among College Students: A Network Analysis

Object: Numerous studies show that depression and anxiety have an adverse effect on life satisfaction among college students. Moreover, neuroticism affects depression, anxiety, and life satisfaction. Comparing the low-neuroticism and high-neuroticism groups, the current study used network analysis to examine the relationship between depression, anxiety, and life satisfaction among college students. Methods: A sample consisted of 1233 college students from China who completed the Big Five Inventory-2 (BFI-2), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Satisfaction With Life Scale (SWLS).All students were divided into two groups according to levels of neuroticism. Depression-anxiety symptom networks and flow networks were formed. Results: "Insomnia" (SAS19) and "Sleep disturbance" (SDS4) are bridge symptoms of groups with varying neuroticism. In addition, compared to the group with low levels of neuroticism, the group with high levels of neuroticism showed more depression symptoms in bridge symptoms and greater global strength. Many depression-anxiety symptoms are negatively associated with life satisfaction, and "Emptiness" (SDS18) is an important symptom in the high-neuroticism group's flow network. Conclusion: This study contributes to our understanding of the connection between depression, anxiety, neuroticism, and life satisfaction. In addition, the current study identified the essential symptoms to target in depression and anxiety intervention and life satisfaction enhancement among college students.

The associations of Positive and Negative Valence Systems, Cognitive Systems and Social Processes on disease severity in anxiety and depressive disorders

Background

Anxiety and depressive disorders share common features of mood dysfunctions. This has stimulated interest in transdiagnostic dimensional research as proposed by the Research Domain Criteria (RDoC) approach by the National Institute of Mental Health (NIMH) aiming to improve the understanding of underlying disease mechanisms. The purpose of this study was to investigate the processing of RDoC domains in relation to disease severity in order to identify latent disorder-specific as well as transdiagnostic indicators of disease severity in patients with anxiety and depressive disorders.

Methods

Within the German research network for mental disorders, 895 participants (n = 476 female, n = 602 anxiety disorder, n = 257 depressive disorder) were recruited for the Phenotypic, Diagnostic and Clinical Domain Assessment Network Germany (PD-CAN) and included in this cross-sectional study. We performed incremental regression models to investigate the association of four RDoC domains on disease severity in patients with affective disorders: Positive (PVS) and Negative Valance System (NVS), Cognitive Systems (CS) and Social Processes (SP).

Results

The results confirmed a transdiagnostic relationship for all four domains, as we found significant main effects on disease severity within domain-specific models (PVS: β = -0.35; NVS: β = 0.39; CS: β = -0.12; SP: β = -0.32). We also found three significant interaction effects with main diagnosis showing a disease-specific association.

Limitations

The cross-sectional study design prevents causal conclusions. Further limitations include possible outliers and heteroskedasticity in all regression models which we appropriately controlled for.

Conclusion

Our key results show that symptom burden in anxiety and depressive disorders is associated with latent RDoC indicators in transdiagnostic and disease-specific ways.

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

Purpose

Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association.

Materials and Methods

A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity.

Results

Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI.

Conclusion

This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.

Positive affect treatment targets reward sensitivity: A randomized controlled trial

OBJECTIVE

Determine whether a novel psychosocial treatment for positive affect improves clinical status and reward sensitivity more than a form of cognitive behavioral therapy that targets negative affect and whether improvements in reward sensitivity correlate with improvements in clinical status.

METHOD

In this assessor-blinded, parallel-group, multisite, two-arm randomized controlled clinical superiority trial, 85 treatment-seeking adults with severely low positive affect, moderate-to-severe depression or anxiety, and functional impairment received 15 weekly individual therapy sessions of positive affect treatment (PAT) or negative affect treatment (NAT). Clinical status measures were self-reported positive affect, interviewer-rated anhedonia, and self-reported depression and anxiety. Target measures were eleven physiological, behavioral, cognitive, and self-report measures of reward anticipation-motivation, response to reward attainment, and reward learning. All analyses were intent-to-treat.

RESULTS

Compared to NAT, individuals receiving PAT achieved superior improvements in the multivariate clinical status measures at posttreatment, b = .37, 95% CI [.15, .59], t(109) = 3.34, p = .001, q = .004, d = .64. Compared to NAT, individuals receiving PAT also achieved higher multivariate reward anticipation-motivation, b = .21, 95% CI [.05, .37], t(268) = 2.61, p = .010, q = .020, d = .32, and higher multivariate response to reward attainment, b = .24, 95% CI [.02, .45], t(266) = 2.17, p = .031, q = .041, d = .25, at posttreatment. Measures of reward learning did not differ between the two groups. Improvements in reward anticipation-motivation and in response to reward attainment correlated with improvements in the clinical status measures.

CONCLUSIONS

Targeting positive affect results in superior improvements in clinical status and reward sensitivity than targeting negative affect. This is the first demonstration of differential target engagement across two psychological interventions for anxious or depressed individuals with low positive affect. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Compulsive exercise and its relationship with mental health and psychosocial wellbeing in recreational exercisers and athletes

OBJECTIVES

Better understanding of compulsive exercise is needed in sports medicine. Whilst compulsive exercise may impact mental health, the limited research exploring the relationship between compulsive exercise and psychosocial outcomes is equivocal. The majority of studies have examined eating disorder populations where the eating disorder pathology might account for distress. This study explores relationships between compulsive exercise and mental health.

DESIGN

Cross-sectional observational study.

METHODS

Australian recreational exercisers and athletes (N = 1157; M_age 36.4, standard deviation = 12.9, 77 % female) recruited through sporting organisations, clubs, and gyms, completed measures of compulsive exercise, depression, anxiety, stress, life satisfaction, social physique anxiety, and self-esteem. Regression analyses examined relationships between dimensions of compulsive exercise and wellbeing.

RESULTS

After adjustment for eating disorder symptoms and sporting level, compulsive exercise was associated with increased risk of clinically-significant anxiety, depression, and stress symptoms. Compulsive exercise was also associated with lower life satisfaction and self-esteem, and higher social physique anxiety. Notably, different dimensions of compulsive exercise had varying relationships with outcomes, and avoidance and rule-driven behaviour and lack of exercise enjoyment were associated with poorer mental health and wellbeing.

CONCLUSIONS

Results suggest that compulsive exercise is uniquely associated with a range of psychosocial and mental health outcomes. Results support the need to improve identification and treatment of compulsive exercise in sport and exercise settings. Results highlight that mental health intervention is an important component of treatment, and treatments targeting symptoms related to avoidance and rule-driven behaviour, and anhedonia may be valuable treatment components for those with compulsive exercise.

Daily experiences of minority stress and mental health in transgender and gender-diverse individuals

Transgender and gender-diverse people experience various minority stressors although minimal research has examined prospective effects on daily affect or mental health. We explored rates of marginalization for transgender and gender-diverse participants in a daily diary study and the concurrent and prospective associations with daily affect and weekly measures of depression and anxiety symptoms, as well as the mediating effects of internalized stigma, rumination, and isolation. There were 167 participants (82.2% white; M age = 25) retained in the daily surveys. Participants completed surveys for 56 days reflecting exposure to marginalization, gender nonaffirmation, internalized stigma, rumination, isolation, affect (negative, anxious, and positive affect), and mental health (anxiety and depression symptoms). Participants experienced marginalization on 25.1% of the days. Within-person analyses revealed concurrent associations between marginalization and gender nonaffirmation with increased negative and anxious affect and increased anxiety and depression symptoms, as well as associations for gender nonaffirmation and decreased positive affect. At the within-person level, there were prospective associations between marginalization and gender nonaffirmation with increased negative affect on the next day, as well as increased anxiety and depression symptoms the next week. Concurrent analyses revealed significant indirect effects with marginalization and gender nonaffirmation associated with all three affect variables and mental health via increases in internalized stigma, rumination, and isolation. However, only gender nonaffirmation was related to isolation and affect or mental health in the prospective analyses. Clinical considerations include strategies to address the immediate effects of minority stress as well as the long-term interpersonal effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Identifying transdiagnostically relevant risk and protective factors for internalizing psychopathology: An umbrella review of longitudinal meta-analyses

Internalizing mental disorders are highly comorbid with one another, and evidence suggests that etiological processes contributing to these disorders often overlap. This systematic umbrella review aimed to synthesize meta-analytic evidence from observational longitudinal studies to provide a comprehensive overview of potentially modifiable risk and protective factors across the depressive, anxiety, and eating disorder psychopathology domains. Six databases were searched from inception to August 2022. Only meta-analyses of longitudinal studies that accounted for baseline psychopathology (either via exclusion of baseline cases or statistical adjustment for baseline symptoms) were included. Methodological quality of meta-analyses was evaluated using the AMSTAR 2, and quality of evidence for each analysis was rated using GRADE. Study selection, quality assessment, and data extraction were conducted in duplicate by independent reviewers. The protocol for this review was registered with PROSPERO (CRD42020185575). Sixty-one meta-analyses were included, corresponding to 137 meta-analytic estimates for unique risk/protective factor-psychopathology relationships. Most potential risk/protective factors, however, were examined only in relation to depressive psychopathology. Concern over mistakes and self-esteem were the only risk and protective factors, respectively, identified as statistically significant across depressive, anxiety, and eating disorder psychopathology domains. Eight risk factors and four protective factors also emerged as having transdiagnostic relevance across depressive and anxiety domains. Results suggest intervention targets that may be valuable for preventing/treating the spectrum of internalizing psychopathology and reducing comorbidity. However, few factors were identified as transdiagnostically relevant across all three internalizing domains, highlighting the need for more research investigating similar sets of potential risk/protective factors across internalizing domains.

Linguistic distancing predicts response to a digital single-session intervention for adolescent depression

Examining the linguistic characteristics of youths' writing may be a promising method for detecting youth who are struggling. In this study, we examined linguistic patterns of adolescent responses to writing prompts in a large, well-powered trial of an evidence-based, digital single-session intervention teaching malleability beliefs about personal traits and symptoms ("growth mindset"). Participants who completed the intervention as part of a larger randomized control trial were included in this preregistered study (n = 638, https://osf.io/zqmxt). Participants' responses were processed using Linguistic Inquiry and Word Count. We tested correlations between linguistic variables (i.e., linguistic distancing, positive affect, negative affect, insight, certainty), baseline outcome variables, post-intervention outcome variables, and 3-month post-intervention outcome variables. We also used Least Absolute Shrinkage and Selection Operator (LASSO) regression models to identify key predictors of treatment outcomes. As hypothesized, greater use of linguistic distancing was associated with lower levels of baseline hopelessness and higher levels of perceived agency. Additionally, per LASSO models including all linguistic variables, greater use of linguistic distancing predicted larger reductions in depressive symptoms from baseline to three-month follow-up. Linguistic distancing appeared to account for 27% of the variance in depression trajectories when also accounting for baseline depression. CLINICAL REGISTRATION NO: NCT04634903.

Associations between affective factors and high-frequency heart rate variability in primary care patients with depression

OBJECTIVE

Depression is a risk factor for cardiovascular disease (CVD), and subgroups of people with depression may be at particularly elevated CVD risk. Lower high-frequency heart rate variability (HF HRV), which reflects diminished parasympathetic activation, is a candidate mechanism underlying the depression-CVD relationship and predicts cardiovascular events. Few studies have examined whether certain depression subgroups - such as those with co-occurring affective factors - exhibit lower HF HRV. The present study sought to assess associations between co-occurring affective factors and HF HRV in people with depression.

METHODS

Utilizing baseline data from the 216 primary care patients with depression in the eIMPACT trial, we examined cross-sectional associations of depression's co-occurring affective factors (i.e., anxiety symptoms, hostility/anger, and trait positive affect) with HF HRV. HF HRV estimates were derived by spectral analysis from electrocardiographic data obtained during a supine rest period.

RESULTS

Individual regression models adjusted for demographics and depressive symptoms revealed that anxiety symptoms (standardized regression coefficient β = -0.24, p = .002) were negatively associated with HF HRV; however, hostility/anger (β = 0.02, p = .78) and trait positive affect (β = -0.05, p = .49) were not. In a model further adjusted for hypercholesterolemia, hypertension, diabetes, body mass index, current smoking, CVD prevention medication use, and antidepressant medication use, anxiety symptoms remained negatively associated with HF HRV (β = -0.19, p = .02).

CONCLUSION

Our findings suggest that, in adults with depression, those with comorbid anxiety symptoms have lower HF HRV than those without. Co-occurring anxiety may indicate a depression subgroup at elevated CVD risk on account of diminished parasympathetic activation.

Binge Drinking and Alcohol Problems Among Moderate Average-Level Drinkers

INTRODUCTION

A significant amount of binge drinking among adults escapes public health scrutiny because it occurs among individuals who drink at a moderate average level. This observational study examined the role of a binge pattern of drinking in predicting alcohol problems among moderate drinkers in a U.S. national sample of adults.

METHODS

Participants were 1,229 current drinkers aged ≥30 years from 2 waves of the study of Midlife Development in the United States, with a 9-year time lag (2004-2015) (analyzed in 2021‒2022). Negative binomial regression analyses were used to examine the number of alcohol problems, and binary logistic regression analyses were used to examine multiple (≥2) alcohol problems.

RESULTS

Independent of the average level of drinking, binge drinking was linked with an almost 3 times increase in the number of concurrent alcohol problems and a 40% increase in the number of alcohol problems prospectively 9 years later. Moderate average level drinkers accounted for most cases of binge drinking and multiple alcohol problems. Among moderate drinkers, binge drinking was linked with a close to 5 times increase in concurrent multiple alcohol problems and a >2 times increase in multiple alcohol problems prospectively 9 years later.

CONCLUSIONS

These results substantially broaden an increasing recognition that binge drinking is a public health concern among adults. Moderate average-level drinkers should be included in efforts to reduce alcohol problems in adults. These findings are applicable to primary and secondary prevention of alcohol problems with the potential to advance population health.

A possible anti-anxiety effect of appetitive aggression and a possible link to the work of Donald Winnicott

Various pleasant sensations that give a particularly intense pleasure are able to improve anxiety. In the present study I consider the possibility that their anti-anxiety action depends on the strong pleasure they provide, and I propose a possible mechanism of this action. According to some studies, also appetitive aggression (an aggression that provokes a strong pleasure and that is performed only for the pleasure it provides) can improve anxiety, and in this article I consider the possibility that the pleasure of appetitive aggression is able to reduce anxiety by the same mechanism I have proposed for other intense pleasurable sensations.

The aggression performed by a child against the mother or against a substitute for the mother in the first period of life (a period in which this aggression is not dangerous) is a recurring theme throughout the work of of Donald Winnicott. Winnicott stresses that this aggression is necessary for the normal development of the child, and that the child must be free to practise it. According to Winnicott, this aggression is highly pleasurable and is not a response to unpleasant or hostile external situations. For these characteristics it seems to correspond to appetitive aggression in the adult that has been found to be able to reduce anxiety. Consequently, aggression performed by the child in the first period of life may also relieve anxiety, in the same way that appetitive aggression helps against anxiety in the adult.

In his writings, Winnicott returns several times to an unthinkable or archaic anxiety that children experience when they feel abandoned by their mother for a period that is too long for them, and all children, according to Winnicott, live on the brink of this anxiety. In this study I propose the hypothesis that aggression in the early period of life may be necessary for children because the intense pleasure it provides may help them against this continuously impending anxiety.

Enhancing the Psychometric Properties of the Iowa Gambling Task Using Full Generative Modeling

Poor psychometrics, particularly low test-retest reliability, pose a major challenge for using behavioral tasks in individual differences research. Here, we demonstrate that full generative modeling of the Iowa Gambling Task (IGT) substantially improves test-retest reliability and may also enhance the IGT's validity for use in characterizing internalizing pathology, compared to the traditional analytic approach. IGT data ( n = 50 ) was collected across two sessions, one month apart. Our full generative model incorporated (1) the Outcome Representation Learning (ORL) computational model at the person-level and (2) a group-level model that explicitly modeled test-retest reliability, along with other group-level effects. Compared to the traditional 'summary score' (proportion good decks selected), the ORL model provides a theoretically rich set of performance metrics (Reward Learning Rate ( A + ) , Punishment Learning Rate ( A - ) , Win Frequency Sensitivity ( β f ) , Perseveration Tendency ( β p ) , Memory Decay ( K ) ), capturing distinct psychological processes. While test-retest reliability for the traditional summary score was only moderate (r = . 37 , BCa 95% CI [.04, .63]), test-retest reliabilities for ORL performance metrics produced by the full generative model were substantially improved, with test-retest correlations ranging between r = . 64 - . 82 for the five ORL parameters. Further, while summary scores showed no substantial associations with internalizing symptoms, ORL parameters were significantly associated with internalizing symptoms. Specifically, Punishment Learning Rate was associated with higher self-reported depression and Perseveration Tendency was associated with lower self-reported anhedonia. Generative modeling offers promise for advancing individual differences research using the IGT, and behavioral tasks more generally, through enhancing task psychometrics.

Depression in young people

Depression rates in young people have risen sharply in the past decade, especially in females, which is of concern because adolescence is a period of rapid social, emotional, and cognitive development and key life transitions. Adverse outcomes associated with depression in young people include depression recurrence; the onset of other psychiatric disorders; and wider, protracted impairments in interpersonal, social, educational, and occupational functioning. Thus, prevention and early intervention for depression in young people are priorities. Preventive and early intervention strategies typically target predisposing factors, antecedents, and symptoms of depression. Young people who have a family history of depression, exposure to social stressors (eg, bullying, discordant relationships, or stressful life events), and belong to certain subgroups (eg, having a chronic physical health problem or being a sexual minority) are at especially high risk of depression. Clinical antecedents include depressive symptoms, anxiety, and irritability. Evidence favours indicated prevention and targeted prevention to universal prevention. Emerging school-based and community-based social interventions show some promise. Depression is highly heterogeneous; therefore, a stepwise treatment approach is recommended, starting with brief psychosocial interventions, then a specific psychological therapy, and then an antidepressant medication.

Dampening of positive affect and depression: A meta-analysis of cross-sectional and longitudinal relationships

Dampening responses to positive affect have been posited to confer vulnerability to depression, but longitudinal studies have not consistently shown dampening tendencies to predict follow-up depression. The cross-sectional, longitudinal, and cross-lagged relationships between dampening and depression were determined using meta-analytic methods. A systematic literature search of the PsycINFO and PubMed databases supplemented by Google Scholar yielded 60 samples suitable for inclusion in the cross-sectional analyses and 12 samples meeting criteria for the longitudinal analyses. In the first meta-analytic study to examine the relationship between dampening and depression, we found dampening to be associated with depression both cross-sectionally (r = .45) and prospectively (r = 0.34). Crucially, dampening at baseline remained a significant predictor of follow-up depression even after controlling for baseline levels of depression in cross-lagged analyses (β = .09). A bidirectional effect was also found, with baseline levels of depression predicting follow-up tendencies to engage in dampening (r = 0.36). This relationship was again diminished but remained significant after controlling for initial levels of dampening (β = .14). These results suggest that dampening responses to positive affect are a risk factor for the development of depression and highlight the importance of targeting dampening cognitions in treatment.

Drift-Diffusion Model Reveals Impaired Reward-Based Perceptual Decision-Making Processes Associated with Depression in Late Childhood and Early Adolescent Girls

Adolescent girls are a high-risk stratum for the emergence of depression. Previous research has established that depression is associated with blunted responses to rewards. Research using Drift Diffusion Model (DDM) has found that deficits in accumulating reward-based evidence characterize adult depression. However, little is known about how reduced reward sensitivity is reflected in the computational processes involved in reward-based decision-making in late childhood and early adolescent depression.One hundred and sixty-six 8- to 14-year-old girls completed a probabilistic reward-based decision-making task. Participants were instructed to identify which one of two similar visual stimuli were presented, and correct responses were rewarded with unequal probabilities. Analysis using hierarchical DDM quantified rate of evidence accumulation (i.e., drift rate) and starting point. Depression severity was measured using the Children's Depression Inventory.Across all participants, there was a higher drift rate, indicating faster evidence accumulation, for the more frequently rewarded than the less frequently rewarded decision. In addition, the starting point of the evidence accumulation was closer to the more frequently rewarded decision, indicating a starting point bias. Higher depression severity was associated with a slower drift rate for both types of decisions. Higher depression severity was associated with a smaller starting point bias towards the more frequently rewarded decision.The current study uses computational modeling to reveal that late childhood and early adolescent girls with greater depression demonstrate impairments in the reward-related evidence accumulation process.

Discrimination in Context: Examining Neighborhood-Level Variation in the Incidence and Adverse Effects of Perceived Racial and Ethnic Discrimination Among Chicago Youth

A growing body of research links interpersonal racial and ethnic discrimination to adverse youth outcomes. Yet, studies examining the relevance of neighborhood context for discrimination are sparse. This study examines neighborhood-level variation in the incidence and impact of perceived racial and ethnic discrimination on depressive symptoms, suicidal behavior, violent behavior, and substance use. Hierarchical regression models on a sample of 1333 African American and Hispanic youth (52.44% female; x̄ = 13.03 years, SD = 3.25 at wave 1) residing in 238 Chicago neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated little to no neighborhood-level variation in the incidence and impact of discrimination. Findings suggest that the experience of discrimination among youth of color is ubiquitous.

Emotional (dys)Regulation and Family Environment in (non)Clinical Adolescents’ Internalizing Problems: The Mediating Role of Well-Being

Adolescence is a period of several changes and a time when young people are confronted with some difficult tasks of dealing with a diversity of emotions and building their own identity. Therefore, it is a period of higher vulnerability for the development of internalizing problems. The present paper aims to study some constructs considered relevant to adolescents’ adjustment and/or internalizing disorders, emphasizing the role of well-being, emotional regulation and family environment. Therefore, this research aims to (1) test the mediating role of well-being in the relationship between emotional regulation difficulties, the family environment, and internalizing problems, and (2) understand the differences between adolescents with a higher and lower risk of presenting internalizing problems. In the study, 723 adolescents of both sexes (12–18 years old) from middle to high school completed self-report questionnaires. The results indicated that the mediating role of well-being was partially established between emotional regulation difficulties and internalizing problems, explaining 31% of the variance in these problems. Well-being was also considered a partial mediator between family environment (cohesion and support and conflict) and internalizing problems, explaining 19 and 26% of the variance, respectively. Furthermore, the group with a higher risk of developing internalizing problems (n = 130) revealed higher levels of emotional regulation difficulties and family conflict. In contrast, this group reported less family cohesion and support and lower levels of well-being. The main results of the present study provide relevant data in the context of clinical practice. Important implications are also discussed for the design of psychopathology prevention programs and the promotion of global well-being with adolescents. Considering the limitations of the present study, such as the nonrandom sampling process and the reduced number of participants included in the clinical group, these results need to be deepened in future research in this area.

Reinforcement sensitivity predicts affective psychopathology via emotion regulation: Cross-sectional, longitudinal and quasi-experimental evidence

The current article presents a model wherein reinforcement sensitivity predicts depression and anxiety via trait preferences for concomitant emotion regulation strategies. In Study 1 (N = 593), BAS sensitivity positively predicted reappraisal and BIS sensitivity negatively predicted it. Reappraisal then negatively predicted depression. BIS sensitivity also predicted rumination, which predicted both depression and anxiety. Study 2a confirmed the model developed in Study 1 with an independent sample (N = 513) and examined the relationships longitudinally. While the cross-sectional relationships were generally maintained, reinforcement sensitivity did not predict reappraisal. In Study 2b, participants (N = 218) were assessed a third time one year later, at the onset of the COVID-19 pandemic. During this stressful time, BAS sensitivity did longitudinally predict reappraisal. These studies highlight the role of emotion regulation in mediating the relationship between reinforcement sensitivity and affective pathology, particularly during times of high stress.

Development of a 50-Item Abridged Form of the Junior Spanish Version of the NEO Questionnaire (JS NEO-A50)

Abstract. The aim of this psychometric study was to construct an abridged 50-item form, 10 for each of the five factors of personality, of the Junior Spanish version of the NEO-PI-R (JS NEO-A50). Two separate studies were conducted. In Study 1, 400 high school students completed two personality scales to examine the factor structure (exploratory factor analysis), convergent validity, and reliability of the JS NEO-A50. In Study 2, an independent sample of 385 adolescents completed the JS NEO-A50 and several outcome measures to replicate the factor structure (exploratory structural equation model) and examine criterion validity, respectively. The five-factor structure found in Study 1 was satisfactorily replicated in the second, independent sample. Sources of reliability (internal consistency and test-retest) and validity (convergent) were adequate. Also, the outcome measures assessed in Study 2 were related to personality traits in the expected direction. Life satisfaction was significantly predicted by emotional stability; symptoms of behavioral problems were predicted by low scores in both agreeableness and conscientiousness while internalizing emotional symptoms were mainly predicted by emotional instability; finally, academic performance was mainly predicted by conscientiousness. We conclude that the JS NEO-A50 is a sound inventory to measure the five broad personality domains in Spanish-speaking adolescents.

Longitudinal associations of physical fitness and affect with depression, anxiety and life satisfaction in adult women with fibromyalgia

PURPOSE

This study analysed the longitudinal associations of physical fitness and affect with depression, anxiety and life satisfaction at 2- and 5-year follow-up.

METHODS

In 312 adult women with fibromyalgia, physical fitness was measured by performance-based tests and affect, depression, anxiety and life satisfaction were self-reported using the Positive and Negative Affect Schedule (PANAS), Beck Depression Inventory-second edition (BDI-II), State Trait Anxiety Inventory-I (STAI) and Satisfaction with Life Scale (SWLS), respectively. We conducted sequential linear regression analyses adjusted for baseline levels of depression, anxiety, life satisfaction, age, body fat percentage and education.

RESULTS

At the 2-year follow-up, all the associations under study were significant. At the 5-year follow-up, a number of associations remained significant. First, lowering negative affect was independently associated with lower depression, anxiety and higher life satisfaction (β's from 0.14 to 0.31). Second, favourable changes in positive affect were independently associated with lower anxiety (β = 0.21) and higher life satisfaction (β = 0.28). Third, enhancing physical fitness was related to higher life satisfaction (β = 0.16).

CONCLUSION

Reductions in negative affect were associated with more favourable depression, anxiety and life satisfaction at the 2- and 5-year follow-up. Improvements in positive affect were associated with more favourable anxiety and life satisfaction and enhancements in physical fitness were associated with higher life satisfaction. If corroborated in clinical-experimental research, these findings may guide the development of interventions that are tailored to the levels of physical fitness, affect and the outcome of interest (i.e. depression, anxiety or life satisfaction) in women with fibromyalgia.

Relationships Among Sleep Disturbance, Reward System Functioning, Anhedonia, and Depressive Symptoms

Recent models propose reward system dysfunction as a key mediator of the relationship between sleep and depression and anhedonia. This study explored interrelationships among sleep disturbance, depressive symptoms, anhedonia, and reward responsiveness. Two-hundred and sixty undergraduate students completed questionnaires and a daily diary paradigm assessing sleep, reward responsiveness, depression, anhedonia, and positive affect over 1 week. Baseline sleep disturbance was associated with depressive symptoms, anhedonia, and reward responsiveness. Daily diary sleep parameters showed differential associations with anticipatory versus consummatory reward responsiveness and positive affect. Poorer sleep quality, shorter sleep duration, and longer awakening after sleep onset predicted blunted anticipatory and consummatory reward responsiveness, while increased sleep onset latency and lower sleep efficiency predicted only decreased consummatory reward responsiveness. All sleep indices, except sleep onset latency, were associated with positive affect. Findings demonstrate unique associations between disparate sleep disturbance and reward responsiveness elements, highlighting new treatment mechanisms for anhedonia and depression.

Is high self-esteem beneficial? Revisiting a classic question

Debates about the benefits of self-esteem have persisted for decades, both in the scientific literature and in the popular press. Although many researchers and lay people have argued that high self-esteem helps individuals adapt to and succeed in a variety of life domains, there is widespread skepticism about this claim. The present article takes a new look at the voluminous body of research (including several meta-analyses) examining the consequences of self-esteem for several important life domains: relationships, school, work, mental health, physical health, and antisocial behavior. Overall, the findings suggest that self-esteem is beneficial in all these domains, and that these benefits hold across age, gender, and race/ethnicity, and controlling for prior levels of the predicted outcomes and potential third variable confounds. The meta-analytic estimates of self-esteem effects (which average .10 across domains) are comparable in size to estimates for other hypothesized causal factors such as self-efficacy, positive emotionality, attachment security, and growth mindset, and larger than some generally accepted pharmaceutical interventions. Discussion focuses on several issues that are critical for evaluating the findings, including the strength of the evidence for making causal inferences, the magnitude of the effects, the importance of distinguishing between self-esteem and narcissism, and the generalizability of the results. In summary, the present findings support theoretical conceptions of self-esteem as an adaptive trait that has wide-ranging influences on healthy adjustment and adaptation, and suggest that interventions aimed at boosting self-esteem might, if properly designed and implemented, benefit individuals and society as a whole. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The impact of anticipated, vicarious, and experienced racial and ethnic discrimination on depression and suicidal behavior among Chicago youth

There is a growing body of research linking racial and ethnic discrimination to adverse youth outcomes. Beyond experienced racial and ethnic discrimination, this study considers the relevance of anticipated and vicarious racial and ethnic discrimination for depression and suicidal behavior. Hierarchical regression models on a diverse sample of 1147 youth (50.31 % female) within 79 neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated that experienced, anticipated, and vicarious racial and ethnic discrimination were associated with an increased risk of depression and suicidal behavior. Additionally, African American and Hispanic youth were disproportionately exposed to-but not differentially impacted by-racial and ethnic discrimination. Findings suggest that developmental research should account for experienced, anticipated, and vicarious racial and ethnic discrimination.

Validity evidence for the School Subjective Well-Being Scale

Abstract This study gathered validity evidence based on relations to other variables for the School Subjective Well-being Scale. The sample consisted of 434 students of both genders, with age ranging from 12 to 19 years (M = 14.88; SD = 1.70); they were all students from the 7th grade Elementary School to the 2nd grade High School, attending a public school located in Ceará, Brazil. The School Subjective Well-being Scale, a sociodemographic and school questionnaire, was applied, as well as the Baptist Depression Scale for Children and Adolescents, the Global Life Satisfaction Scale for Adolescents, the Social Support Perception Scale for Adolescents. The scale factors showed significant positive and negative, moderate to high correlations and the measure’s scores of school well-being allowed differentiation among groups regarding gender and school issues.

Psychological Treatments for Anhedonia

Anhedonia, a loss of interest or pleasure in activities, is a transdiagnostic symptom that characterizes many individuals suffering from depression and anxiety. Most psychological interventions are designed to decrease negative affect rather than increase positive affect, and are largely ineffective for reducing anhedonia. More recently, affective neuroscience has been leveraged to inform treatments for anhedonia by targeting aspects of the Positive Valence Systems, including impairments in reward anticipation, reward responsiveness, and reward learning. In this chapter, we review the efficacy of treatments and, when possible, highlight links to reward constructs. Augmented behavioral approaches and targeted cognitive interventions designed to target reward anticipation, responsiveness, and learning show preliminary efficacy in reducing anhedonia, while there is a relative lack of treatments that target positive emotion regulation and reward devaluation. In addition to developing treatments that address these targets, the field will benefit from establishing standardized measurement of anhedonia across units of analysis, mapping mechanisms of change onto aspects of reward processing, and examining anhedonia outcomes in the long-term.

Addressing anhedonia to increase depression treatment engagement

Anhedonia, or reward system dysfunction, is associated with poorer treatment outcomes among depressed individuals. The role of anhedonia in treatment engagement, however, has not yet been explored. We review research on components of reward functioning impaired in depression, including effort valuation, reward anticipation, initial responsiveness, reward learning, reward probability, and reward delay, highlighting potential barriers to treatment engagement associated with these components. We then propose interventions to improve treatment initiation and continuation by addressing deficits in each component of reward functioning, focusing on modifications of existing evidence-based interventions to meet the needs of individuals with heightened anhedonia. We describe potential settings for these interventions and times at which they can be delivered during the process of referring individuals to mental health treatment, conducting intakes or assessments, and providing treatment. Additionally, we note the advantages of using screening processes already in place in primary care, workplace, school, and online settings to identify individuals with heightened anhedonia who may benefit from these interventions. We conclude with suggestions for future research on the impact of anhedonia on treatment engagement and the efficacy of interventions to address it. PRACTITIONER POINTS: Many depressed individuals who might benefit from treatment do not initiate it or discontinue early. One barrier to treatment engagement may be anhedonia, a core symptom of depression characterized by loss of interest or pleasure in usual activities. We describe brief interventions to improve treatment engagement in individuals with anhedonia that can be implemented during the referral process or early in treatment. We argue that interventions aiming to improve treatment engagement in depressed individuals that target anhedonia may be particularly effective.

Work Experiences and Self-Esteem Development: A Meta-Analysis of Longitudinal Studies

Theory suggests that people’s work experiences influence their self-esteem and, vice versa, that self-esteem influences work experiences. This meta-analysis of longitudinal studies synthesizes the available evidence on prospective effects between work experiences and self-esteem, controlling for prior levels of the outcomes. The following work variables were examined: job satisfaction, job success, income, job resources, job stressors, and employment status. The analyses were based on 30 independent samples, including data from 53,112 participants. Mean age ranged from 17 to 64 years, spanning most of the work life. For each work variable, we computed random-effects models with standardized regression coefficients as effect size measure. Results suggested reciprocal effects between work experiences and self-esteem. The effects of self-esteem on later work experiences (point estimates ranged from .05 to .10) were slightly larger than the effects of work experiences on later self-esteem (point estimates ranged from .02 to .05). Moderator analyses on the relation between job satisfaction and self-esteem indicated that the effects did not differ across age, gender, sample type, and time lag. Overall, the findings support the corresponsive principle of personality development and suggest that the work domain and people’s self-esteem are interdependent.

A qualitative study exploring adolescents' experience of brief behavioural activation for depression and its impact on the symptom of anhedonia

OBJECTIVES

Anhedonia, the loss of interest and pleasure, is a core symptom of depression and is associated with deficits in reward processing. Behavioural Activation for depression may address this symptom due to its focus on identifying and increasing intrinsically rewarding activities.

DESIGN

This was a qualitative study employing reflexive thematic analysis (TA).

METHODS

Participants were eight treatment-seeking adolescents with a recent primary diagnosis of depression who had received eight sessions of Brief Behavioural Activation. Qualitative semi-structured interviews were conducted after treatment was completed.

RESULTS

Three main themes emerged: (1) connecting, reviewing, and taking action: 'focus on getting better rather than what you're feeling'; (2) struggles, restrictors, and motivators: 'it seemed really unachievable'; and (3) feeling, acting, or seeing things differently: 'looking forwards in a more healthy way'.

CONCLUSIONS

Both specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic strategies (e.g., self-monitoring) may be helpful in treating the symptom of anhedonia in adolescent depression. Motivational aspects of anhedonia, as well as anxiety, fatigue, and academic pressures act as potential barriers to recovery. This highlights the need for psychological treatments for adolescent depression to include explicit and targeted strategies to enhance motivation.

PRACTITIONER POINTS

Young people reported that specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic techniques (e.g., self-monitoring) had a role in treating anhedonia. Barriers to engaging in Brief BA included: motivational anhedonia, fatigue, and academic demands.

Emotional Responses to Stressors in Everyday Life Predict Long-Term Trajectories of Depressive Symptoms

BACKGROUND

Individuals' emotional responses to stressors in everyday life are associated with long-term physical and mental health. Among many possible risk factors, the stressor-related emotional responses may play an important role in future development of depressive symptoms.

PURPOSE

The current study examined how individuals' positive and negative emotional responses to everyday stressors predicted their subsequent changes in depressive symptoms over 18 months.

METHODS

Using an ecological momentary assessment approach, participants (n = 176) reported stressor exposure, positive affect (PA), and negative affect (NA) five times a day for 1 week (n = 5,483 observations) and provided longitudinal reports of depressive symptoms over the subsequent 18 months. A multivariate multilevel latent growth curve model was used to directly link the fluctuations in emotions in response to momentary stressors in everyday life with the long-term trajectory of depressive symptoms.

RESULTS

Adults who demonstrated a greater difference in stressor-related PA (i.e., relatively lower PA on stressor vs. nonstressor moments) reported larger increases in depressive symptoms over 18 months. Those with greater NA responses to everyday stressors (i.e., relatively higher NA on stressor vs. nonstressor moments), however, did not exhibit differential long-term changes in depressive symptoms.

CONCLUSIONS

Adults showed a pattern consistent with both PA and NA responses to stressors in everyday life, but only the stressor-related changes in PA (but not in NA) predicted the growth of depressive symptoms over time. These findings highlight the important-but often overlooked-role of positive emotional responses to everyday stressors in long-term mental health.

Multifactorial prediction of depression diagnosis and symptom dimensions

While depression is a leading cause of disability, prior investigations of depression have been limited by studying correlates in isolation. A data-driven approach was applied to identify out-of-sample predictors of current depression from adults (N = 217) sampled on a continuum of no depression to clinical levels. The current study used elastic net regularized regression and predictors from sociodemographic, self-report, polygenic scores, resting electroencephalography, pupillometry, actigraphy, and cognitive tasks to classify individuals into currently depressed (MDE), psychiatric control (PC), and no current psychopathology (NP) groups, as well as predicting symptom severity and lifetime MDE. Cross-validated models explained 20.6% of the out-of-fold deviance for the classification of MDEs versus PC, 33.2% of the deviance for MDE versus NP, but -0.6% of the deviance between PC and NP. Additionally, predictors accounted for 25.7% of the out-of-fold variance in anhedonia severity, 65.7% of the variance in depression severity, and 12.9% of the deviance in lifetime depression (yes/no). Self-referent processing, anhedonia, and psychosocial functioning emerged as important differentiators of MDE and PC groups. Findings highlight the advantages of using psychiatric control groups to isolate factors specific to depression.

Locus of Control and Negative Cognitive Styles in Adolescence as Risk Factors for Depression Onset in Young Adulthood: Findings From a Prospective Birth Cohort Study

Whilst previous observational studies have linked negative thought processes such as an external locus of control and holding negative cognitive styles with depression, the directionality of these associations and the potential role that these factors play in the transition to adulthood and parenthood has not yet been investigated. This study examined the association between locus of control and negative cognitive styles in adolescence and probable depression in young adulthood and whether parenthood moderated these associations. Using a UK prospective population-based birth cohort study: the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the association between external locus of control and negative cognitive styles in adolescence with odds of depression in 4,301 young adults using logistic regression models unadjusted and adjusted for potential confounding factors. Interaction terms were employed to examine whether parenthood (i.e., having become a parent or not) moderated these associations. Over 20% of young adults in our sample were at or above the clinical threshold indicating probable depression. For each standard deviation (SD) increase in external locus of control in adolescence, there was a 19% (95% CI: 8-32%) higher odds of having probable depression in young adulthood, after adjusting for various confounding factors including baseline mood and different demographic and life events variables. Similarly, for each SD increase in negative cognitive styles in adolescence, there was a 29% (95% CI: 16-44%) higher odds of having probable depression in the adjusted model. We found little evidence that parenthood status moderated the relationship between external locus of control or negative cognitive styles in adolescence and probable depression following adjustment for confounding factors. Effect estimates were comparable when performed in the complete case dataset. These findings suggest that having an external locus of control and holding negative cognitive styles in mid- to late adolescence is associated with an increased likelihood of probable depression in young adulthood.

Perceived Social Support Partially Mediates the Impact of Temperament and Character on Postpartum Depression

INTRODUCTION

Temperament and character of pregnant women, especially harm avoidance (HA) and self-directedness (SD) have been identified as risk factors for postpartum depression, in addition to poor social support. However, the relationship between these personality traits and social support for depressive symptoms after delivery has not been examined.

METHODS

Data were extracted from a prospective cohort survey on pregnant women conducted in Nagoya, Japan that included the Temperament and Character Inventory (TCI), the Social Support Questionnaire (J-SSQ), and the Edinburgh Postnatal Depression Scale (EPDS) at approximately week 25 and 1 month postpartum. A mediation analysis using structural equation modeling (SEM) was used to test if social support in pregnancy is a mediator between personality traits and postpartum depressive symptoms.

RESULTS

Thousand five hundred and fifty-nine women were included in the analysis. Both harm avoidance and SD were significantly associated with depressive symptoms (total effect: β [SE], 0.298 [0.041], P < 0.001 for harm avoidance; total effect: β [SE], -0.265 [0.067], P < 0.001 for SD). Mediation analysis showed that the effect of harm avoidance on depressive symptoms was partially mediated by low social support (direct effect: β [SE], 0.193 [0.004], P < 0.001; indirect effect: β [SE], 0.082 [0.034], P = 0.015). Self-directedness on depressive symptoms was not found to be mediated by low social support.

CONCLUSION

Results indicate that poor social support worsens depressive symptoms in women with high HA during pregnancy. Limitations include a possible selection bias due to the limited target facilities; most variables being evaluated based on self-report questionnaires, and different number of samples available for analysis between harm avoidance and SD.

Within-person networks of clinical features of social anxiety disorder during cognitive and interpersonal therapy

Analysis of longitudinal within-person networks over the course of therapy allows an identification of possible targets of treatment. This study examined within-person networks of clinical features in social anxiety disorder (SAD) patients during cognitive (CT) and interpersonal (IPT) therapy. Patients (n = 80) were randomized to either CT or IPT in a 10 week residential program. They completed a measure of clinical features two times a week. The 60 (75 %) patients who had completed at least 18 measurements were included in the analyses. The multilevel vector autoregressive (mlVAR) model was used to analyze the data, producing a temporal, contemporaneous, and between-person network. In the temporal network and as expected, more homework compliance in a half-week predicted less social anxiety and less social avoidance the subsequent half-week. Also better social function predicted less social avoidance, whereas more social anxiety predicted more self-focus. Unexpectedly, less social avoidance predicted more self-focus and less self-focus predicted less social function and social joy. In the contemporaneous network, self-focus, anxiety and avoidance displayed a conditional independence structure. The estimated temporal network suggests that homework compliance and social function are promising targets of treatment.