Association between Cognitive Distortion, Type D Personality, Family Environment, and Depression in Chinese Adolescents

Personality, Behavior Characteristics, and Life Quality Impact of Children with Dyslexia

Dyslexia is one of the most common neurobehavioral disorders. Children with dyslexia usually suffer from negative, behavior personality problems, and impacted life quality. We aimed to identify family environment factors for dyslexia, and to evaluate the personality, behavior characteristics and life quality of children with dyslexia. A total of 60 children diagnosed with dyslexia and 180 normal children that were aged 7-12 who speak Chinese were recruited from four primary schools in Shantou City, China. Self-designed questionnaire, children's edition of the Eysenck Personality Questionnaire (EPQ), Conners' Parent Rating Scale (CPRS), and Quality of Life scale for children and adolescents (QLSCA) were employed for investigation. Multiple logistic regressions show that antenatal training (OR = 0.36), higher household income, higher parents' educational levels, and parents engaging in white-collar jobs were negatively associated with dyslexia; while, family members also suffering from dyslexia (OR = 12.17), lower frequency of communication between parents and children, and worse parent-child relationship were positively associated with dyslexia. Children with dyslexia scored higher in psychoticism and neuroticism (p = 0.040, 0.008), but lower in extroversion and dissimulation than normal children (p = 0.025, 0.007) in the EPQ test. They tended to be more introversion (68.3% vs. 43.0%), psychoticism (25.0% vs. 13.3%), and neuroticism (46.7% vs. 18.8%) than the controls. In addition, children with dyslexia had higher scores in conduct problem, learning problem, hyperactivity, and Conners' index of hyperactivity (CIH) in CPRS test; and, lower scores of psychosocial function, physical and mental health, and satisfaction of living quality in QLSCA test (all p < 0.05). Several family environment and parenting factors were associated with children's dyslexia significantly. Children with dyslexia had the personality of psychoticism, neuroticism, introversion, and more behavioral problems. Dyslexia significantly impacted the children's quality of life. Our findings provide multiple perspectives for early intervention of dyslexia in children, particularly in family factors and the parenting environment.

Design, rationale and feasibility of a multidimensional experimental protocol to study early life stress

There is a rapidly accumulating body of evidence regarding the influential role of early life stress (ELS) upon medical and psychiatric conditions. While self-report instruments, with their intrinsic limitations of recall, remain the primary means of detecting ELS in humans, biological measures are generally limited to a single biological system. This paper describes the design, rationale and feasibility of a study to simultaneously measure neuroendocrine, immune and autonomic nervous system (ANS) responses to psychological and physiological stressors in relation to ELS. Five healthy university students were recruited by advertisement. Exclusion criteria included chronic medical conditions, psychotic disorders, needle phobia, inability to tolerate pain, and those using anti-inflammatory medications. They were clinically interviewed and physiological recordings made over a two-hour period pre, during and post two acute stressors: the cold pressor test and recalling a distressing memory. The Childhood Trauma Questionnaire and the Parental Bonding Index were utilised to measure ELS. Other psychological measures of mood and personality were also administered. Measurements of heart rate, blood pressure, respiratory rate, skin conductance, skin blood flow and temporal plasma samples were successfully obtained before, during and after acute stress. Participants reported the extensive psychological and multisystem physiological data collection and stress provocations were tolerable. Most (4/5) participants indicated a willingness to return to repeat the protocol, indicating acceptability. Our protocol is viable and safe in young physically healthy adults and allows us to assess simultaneously neuroendocrine, immune and autonomic nervous system responses to stressors in persons assessed for ELS.

An exploratory study of adolescent response to fluoxetine using psychological and biological predictors

Background

Not enough is known about predicting therapeutic response to serotonin-specific reuptake inhibitors, and specifically to fluoxetine. This exploratory study used psychological and biological markers for (retrospective) prediction of treatment-response to fluoxetine in depressed and/or anxious adolescents.

Methods

Forty-one consecutive adolescent outpatients with a primary diagnosis of severe affective and/or anxiety disorders were assessed and treated with an open-label 8-week trial of fluoxetine. Type D personality was assessed with the 14-item questionnaire, the DS14. In addition, TNFα, IL-6, and IL-1b were measured pre- and post-treatment.

Results

There was an elevation of Type D personality in patients, compared to the adolescent population rate. Post-treatment, 44% of patients were classified as non-responders; the relative risk of non-response for Type D personality patients was 2.8. Binary logistic regression predicting response vs. non-response showed a contribution of initial TNFα levels as well as Type D personality to non-response.

Conclusions

In this exploratory study, the most significant contributor to non-response was Type D personality. However, the measurement of Type D was not prospective, and thus may be confounded with psychiatric morbidity. The measurement of personality in psychiatric settings may contribute to the understanding of treatment response and have clinical utility.

Medication Adherence Mediates the Association between Type D Personality and High HbA1c Level in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study

Aims. To examine the association between Type D personality and HbA1c level and to explore the mediating role of medication adherence between them in patients with type 2 diabetes mellitus (T2DM). Methods. 330 patients went on to complete a self-report measure of medication adherence and the HbA1c tests. Chi-square test, T test, Ordinary Least Square Regression (OLS), and Recentered Influence Function Regression (RIF) were employed. Results. Patients with Type D personality had significantly higher HbA1c value (P < 0.01). When Type D personality was operationalized as a categorical variable, SI was associated with HbA1c (P < 0.01). When NA, SI, and their interaction term were entered into regression, all of them were no longer associated with HbA1c level (P > 0.1). On the other hand, when Type D personality was operationalized as a continuous variable, only SI trait was associated with HbA1c level (P < 0.01). When NA, SI, and NA × SI term together were entered into regression, only SI was not related to HbA1c level. Furthermore, medication adherence had a significant mediation effect between Type D personality and HbA1c, accounting for 54.43% of the total effect. Conclusion. Type D personality was associated with HbA1c in direct and indirect ways, and medication adherence acted as a mediator role.

Prevalence of Depression, Anxiety and Stress among school going adolescent in Chandigarh

Context

Depressive disorders often start at a young age. There is a need for early identification of depression, anxiety, and stress (DAS) and prevention. The present study was undertaken to find the magnitude of DAS among adolescents.

Aims

To find the mental health status of school going adolescents in Chandigarh. The objectives were (i) to study the prevalence of DAS among school going adolescents and (ii) to study the correlates of DAS.

Settings and Design

A Cross-sectional survey of students of four classes from 9^th to 12^th studying in government schools.

Subjects and Methods

Ten government schools in Chandigarh were randomly selected through lottery method. In each school, for each of the four classes, a section was randomly selected again by the lottery method. Forty students were selected from each school reaching sample size of 470. DAS scale 21 questionnaires were used.

Statistical Analysis Used

The data entry was done in MS Office Excel 2007. The analysis was done in the form of frequency tables, charts cross tables. For statistical significance, Chi-square test and correlation was found between various factors.

Results

The prevalence of DAS was 65.53%, 80.85%, and 47.02%, respectively. Overall, comorbidity between depression and anxiety was 57.65%. Extremely severe depression was very less (3%). The prevalence of DAS was higher in females. For depression and anxiety, the peak age was 18 years.

Conclusions

The prevalence of DAS was high among school going adolescents in Chandigarh. There is a need for early and effective identification of DAS that can prevent many psychiatric disorders at their nascent stage.

Type D Personality Predicts Poor Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study

Background

Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM.

Design and Settings

A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing.

Methods

412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed.

Results

Patients with type D personality were significantly more likely to have poor medication adherence (p<0.001). Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable.

Conclusion

Although, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.

Prevalence rate and influencing factors of preoperative anxiety and depression in gastric cancer patients in China: Preliminary study

Objectives

To investigate the prevalence rate and influencing factors of preoperative anxiety and depression in patients with gastric cancer, in China.

Methods

Patients with gastric cancer who were diagnosed by gastroscopy and would accept laparoscopic surgery were eligible for the study. Each participant completed self-administered questionnaires, including the Hospital Anxiety and Depression Scale (HADS), Medical Coping Modes Questionnaire (MCMQ), Social Support Rating Scale, and Type D personality scale before surgery. Routine blood tests were undertaken within 7 days before surgery, to calculate the neutrophil-to-lymphocyte ratio (NLR). Based on HADS, patients were divided into an anxiety/depression group and a nonanxiety/depression group.

Results

Fifty-three patients with gastric cancer were included in the study. The prevalence of preoperative anxiety and/or depression was 20.75% (11/53). Factors influencing preoperative anxiety and depression were a resigned dimension of coping style, type D personality and NLR. Logistic regression analysis showed that a higher score for the resigned dimension of coping style on the MCMQ and a higher NLR were significantly associated with preoperative anxiety and depression.

Conclusions

The prevalence of preoperative anxiety and depression in Chinese patients with gastric cancer may be influenced by both the coping mode and NLR.

Prevalence of depressive symptoms and its correlations with positive psychological variables among Chinese medical students: an exploratory cross-sectional study

BACKGROUND

Knowledge about the prevalence of depressive symptoms among Chinese medical students and its related factors is rather limited. Understanding the correlates of depressive symptoms and the roles that positive psychological variables play in depressive symptoms is of vital importance for future interventions. The main objectives of this study were to investigate the prevalence of depressive symptoms and the integrated effects of resilience, hope and optimism on depressive symptoms among Chinese medical students.

METHODS

This multi-center cross-sectional study was conducted in June 2014. The questionnaires that consisted of the Center for Epidemiologic Studies Depression Scale (CES-D), Wagnild and Young Resilience Scale-14 (RS-14), Adult Dispositional Hope Scale (ADHS), Life Orientation Test-Revised (LOT-R), and socio-demographic characteristics, were distributed to students at four medical colleges or universities in Liaoning province, China. A total of 2925 medical students became the final subjects. Hierarchical linear regression analyses were used to explore the integrated effects of resilience, hope and optimism on depressive symptoms.

RESULTS

The prevalence of depressive symptoms among Chinese medical students was 66.8 % (CES-D ≥ 16). Resilience, hope and optimism were all negatively correlated with depressive symptoms and they accounted for 26.1 % of the variance in depressive symptoms.

CONCLUSIONS

The high prevalence of depressive symptoms among Chinese medical students calls for special attention from all stakeholders, especially university authorities. Intervention strategies that focus on enhancing the positive psychological variables of resilience, hope and optimism can be integrated into depression prevention and treatment programs.

Type D personality parents of children with leukemia tend to experience anxiety: the mediating effects of social support and coping style

The aims were to access anxiety and type D personality (TDP) in parents of children with leukemia, and to determine the mediating effect of social support and coping style on the relationship between TDP and anxiety. A cross-sectional study was conducted among 231 parents of children with leukemia and 261 parents of children with acute diseases in hospitals. Parents completed questionnaires on anxiety, TDP, social support, coping styles, children's clinical characteristics, and demographic characteristics. Parents of children with leukemia showed higher prevalence of anxiety (64.5% vs 40.2%, P < 0.01) and TDP (44.2% vs 24.1%, P < 0.01) compared with controls. TDP (odds ratio [OR] = 4.34, P < 0.01), lower social support (OR = 1.92, P = 0.02), and less positive coping (OR = 1.87, P = 0.02) were independently associated with anxiety. Parents with TDP showed lower social support and less positive coping, but more negative coping compared with those without. Moreover, multiple mediation analyses revealed that the significant effect of TDP on anxiety was partially mediated by social support and positive coping. In conclusion, anxiety and TDP were highly prevalent in parents of children with leukemia. The predictive factors could be used to identify those parents who are at high risk of anxiety and may also be targets for prevention and intervention.

Family functioning in Chinese type 2 diabetic patients with and without depressive symptoms: a cross-sectional study

BACKGROUND

Patients with depression or type 2 diabetes mellitus (T2DM) often have associated impaired family functioning. The purpose of this study was: (1) to explore the family functioning of T2DM patients with and without depressive symptoms and (2) to explore the relationship between depressive symptoms and family impairment in T2DM patients with depressive symptoms. This study used a cross-sectional design.

SAMPLING AND METHODS

A sample of 32 patients with T2DM who had depressive symptoms and 229 patients with T2DM who did not have depressive symptoms completed the Chinese versions of the Family Assessment Device (FAD) and the Beck Depression Inventory.

RESULTS

This study showed that there were differences in duration of diabetes and some FAD dimensions between T2DM patients with and without depressive symptoms (p < 0.01). There were also differences in the frequencies of FAD dimensions between T2DM patients with and without depressive symptoms (p < 0.01). Age, duration of diabetes and family function were predicting factors of depressive symptoms among T2DM patients (p < 0.01).

CONCLUSIONS

The T2DM patients with depressive symptoms had more unhealthy FAD dimensions than the T2DM patients without depressive symptoms. The family functioning of T2DM patients with depressive symptoms was worse than that of T2DM patients without depressive symptoms. Age, duration of diabetes and some dimensions of FAD were associated with depressive symptoms in the T2DM patients.

Depression in parents of children with leukemia in southern China accompanied by the prevalence of type D personality

PURPOSE

The aims of this study were to assess depression and type D personality in parents of children with leukemia in southern China and to investigate the associations between parents' depression and type D personality, social support, coping style, and demographic characteristics.

METHODS

Parents (n=231) of children with leukemia (study group) and parents (n=261) of children with acute respiratory/digestive infections (control group) were recruited from five hospitals in southern China. Children's clinical characteristics and parents' demographic characteristics, depression, type D personality, coping styles, and social support were collected with self-report questionnaires.

RESULTS

Parents of children with leukemia, especially mothers, reported higher levels of depression accompanied by a higher prevalence of type D personality, more negative coping styles, and less subjective social support, but received more objective social support than controls (P<0.05). The depression in parents in the study group was positively correlated with type D personality and negative coping style, but negatively correlated with social support and positive coping styles (P<0.05). Multivariate logistic regression analyses showed that type D personality (OR=5.64, P<0.001), lower social support (OR=2.38, P=0.020), and less positive coping (OR=3.32, P=0.003) were independently associated with depression in parents of children with leukemia. As for demographic characteristics, female, lower education level, unemployed, and paying medical expenses at one's own expenses were independent predictors of depression in parents of children with leukemia.

CONCLUSION

Depression and type D personality were remarkably prevalent in parents of children with leukemia in southern China. Type D personality and multiple social factors were associated with depression in parents of children with leukemia.