Associations of negative cognitions, emotional regulation, and depression symptoms across four continents: International support for the cognitive model of depression

Caregiver Psychological Burden in Pediatric Chronic Pain: A Systematic Review and Meta-Analysis of Associations with Caregiver Sociodemographic and Biopsychosocial Variables

OBJECTIVE

To investigate, via systematic review and meta-analysis, caregiver sociodemographic and biopsychosocial factors associated with anxiety, depression, posttraumatic stress symptoms, and stress of caregivers in the pediatric chronic pain context.

METHODS

EMBASE, Medline, and PsycINFO databases were searched from their inception to the search date (April 4, 2022). Studies were included if they examined caregivers of youth with chronic pain, were published in a peer-reviewed journal and assessed at least one quantitative association between relevant variables. Qualitative and intervention studies were excluded. A total of 3,052 articles were screened. Risk of bias was assessed using the JBI Checklist for analytical cross-sectional studies. Meta-analyses were conducted using robust variance estimation for associations reported in at least three studies, as well as a narrative synthesis of the evidence.

RESULTS

Fourteen studies assessing 1,908 caregivers were included in this review. Meta-analytic results showed a positive pooled correlation coefficient between caregiver catastrophizing about their child's pain and caregiver anxiety (r = 0.51; 95% CI: 0.35-0.65; p<.01) and depression (r = 0.45; 95% CI: 0.29-0.58; p < .01). Self-blame and helplessness were related to increased caregiver anxiety (r = 0.55; 95% CI: 0.40-0.67; p<.01), but not depression. No significant relationship was found for pain-promoting behavior and anxiety or depression. The qualitative synthesis of all other eligible studies showed associations between relevant psychological burden variables and various caregiver factors, which were mainly psychosocial.

CONCLUSION

Results should be interpreted with caution due to the small number of studies. Further research is needed to get a better understanding of these relationships and to examine the causal direction of effects.

Distorted thoughts as a mediator of depressive symptoms in patients with major depressive disorder: a longitudinal study

BACKGROUND

Distorted thoughts are common in Major Depressive Disorder (MDD), and can impact patients' perceptions of depression severity, and predict chronicity and treatment response. This study aimed to investigate whether distorted thoughts mediate depressive symptoms in MDD over a 6-month period.

METHOD

These are secondary results from a study that followed 119 patients diagnosed with moderate to severe MDD for 6 months. Diagnoses were confirmed by the Structured Interview for DSM-IV (SCID-CV). The analysis was composed of results from the Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS), the second edition of the Beck Depression Inventory (BDI-II), and the Depression Thoughts Scale (DTS) collected at weeks 1, 8, 12 and 24.

RESULTS

Results showed that the DTS mediated the relationship between depressive symptoms experienced approximately 3 months after starting antidepressant treatment.

CONCLUSION

Cognitive distortions were linked as a mediator to depressive symptoms, highlighting the importance of early psychological interventions in patients with MDD who exhibit these distortions.

TRIAL REGISTRATION

NCT02268487.

Feasibility, Acceptability, and Preliminary Effectiveness of Cognitive-Reminiscence Therapy among Jordanian People with Major Depressive Disorders: A Mixed Methods Study

Depression is a major public health problem around the world. Negative automatic thoughts are cognitive errors that build in the mind, leading to depression. Cognitive-reminiscence therapy is one of the most effective psychosocial methods for managing cognitive errors. This study aimed to evaluate cognitive reminiscence therapy's feasibility, acceptability, and preliminary effectiveness among Jordanian patients with major depressive disorder. A convergent-parallel design was employed. A convenience sampling method was used to recruit 36 participants (Site 1: n = 16, Site 2: n = 20). A total of 31 participants were included in the analysis, divided into six groups, with 5-6 participants in each group. Cognitive-reminiscence therapy included eight supported sessions of up to 2 h each, delivered over 4 wk. Recruitment, adherence, retention, and attrition rates of 80%, 86.1%, and 13.9%, respectively, indicated the feasibility of the therapy. The acceptability of therapy was reflected in the following four themes: Positive Cognitive Reminiscence Therapy Perspectives and Outcomes; Cognitive Reminiscence Therapy Sessions Challenge; Suggestions for Improving Cognitive Reminiscence Therapy Sessions; and Motivational Home Activities. A significant reduction in the mean of depressive symptoms and negative automatic thoughts and a significant increase in the self-transcendence mean demonstrated the effectiveness of the intervention. The study's results suggest that cognitive reminiscence therapy is feasible and acceptable among patients with major depressive disorder. This therapy is a promising nursing intervention to reduce depressive symptoms and negative automatic thoughts and increase self-transcendence for those patients.

New Paths for Parental Warmth and Subjective Well-Being: The Mediator Roles of Automatic Negative Thoughts

A growing number of studies have pointed out that parental acceptance-rejection, which is the degree of warmth in parenting, is an important factor that influences not only children's but also adults' subjective well-being. However, few studies have analyzed subjective well-being in adulthood based on the emergence of cognitive automatic thinking processes that are triggered by the level of parental warmth. Specifically, the mediator role of negative automatic thoughts in the relationship between parental warmth and subjective well-being is still under debate. This present study extended the parental acceptance and rejection theory by integrating automatic negative thoughts into the core concept of cognitive behavioral theory. The present study attempts to examine the mediator role of negative automatic thoughts in the relationship between retrospective reports of emerging adults' parental warmth and their subjective well-being. The participants consist of 680 of 49.4% women and 50.6% men Turkish-speaking emerging adults. The Adult Parental Acceptance-Rejection Questionnaire Short-Form was used to measure parental warmth for their past experience, the negative automatic thoughts measured by the Automatic Thoughts Questionnaire, and life satisfaction, negative and positive emotions of participants were measured by the Subjective Well-being Scale for their present level. Mediation analysis through the bootstrap sampling method via indirect custom dialog was used to examine data. The models supported the hypotheses, the retrospective reports of parental warmth in childhood predict the subjective well-being of emerging adults. The automatic negative thoughts had competitive mediation on this relationship. The perceived parental warmth in childhood decreases automatic negative thoughts, then turns to affect greater subjective well-being in adulthood. The current study results contribute to the counselling practice by suggesting that decreasing negative automatic thoughts could benefit the subjective well-being of emerging adults. Further, parental warmth interventions and family counselling have the potential to enhance these benefits.

The influence of psychological need on rehabilitation outcomes for people with spinal cord injury

STUDY DESIGN

Single-centre, retrospective study of people with a spinal cord injury or disorder (PwSCI/D) and identified psychological need.

OBJECTIVES

To examine the effect of psychological need on rehabilitation outcomes.

SETTING

National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, United Kingdom.

METHODS

Self-reported data from the Stoke Mandeville Spinal Needs Assessment Checklist (SMS-NAC) were used to examine identified psychological need (characterised by referral for psychological treatment, or scoring above clinical threshold in admission psychometric measures) on SCI rehabilitation outcome domains. Participants were grouped according to whether they were referred, not referred, scored above or below clinical threshold.

RESULTS

234 participants were included (Mean age at injury (years) = 53, 70% Male, 29% tetraplegia, 38% paraplegia, 33% ASIA D). There was a significant improvement in outcome scores from admission to discharge across all domains irrespective of participant group, however individuals with identified psychological need scored lower across all rehabilitation domains than those without. While individuals with psychological need demonstrated longer rehabilitation stays, more frequent and longer discharge delays, they also showed comparatively greater rehabilitation improvements. Psychological screening measures were more effective at detecting psychological need than individuals identified via referral, and participants scoring above clinical threshold had poorest overall rehabilitation outcomes.

CONCLUSIONS

Individuals with psychological need have greater rehabilitation need and may require longer rehabilitation and benefit from additional discharge planning. Early, proactive psychometric screening can better facilitate improvements for delivering rehabilitation. Future research should consider specific contributing factors to psychological need, such as pre-existing mental health conditions or socio-demographic influences.

Potential paths to suicidal ideation and suicide attempts among high-risk women

Although men are more likely to die by suicide, women experience a greater and more rapidly increasing rate of suicidal ideation (SI) and are 3 times more likely to attempt suicide than men. Despite this increased risk, little is known about factors that contribute to SI or suicide attempts (SA) among women. We examined factors associated with SI and SA among women and identified mood-related symptoms that differentiate women who reported attempting suicide from those who did not. Women at elevated risk for depression from across the U.S. (N = 3372; age 18 to 90) completed a survey regarding depression, anxiety, sociodemographic and reproductive status, behavioral/mental health history, and exposure to adversity. Structural equation modeling and logistic regression were used to analyze the data. Variables with the most significant relationships to SI were severity of depression (OR = 5.2, p = 0.000) and perceived stress (OR = 1.18, p = 0.000) while frequency of suicidal thoughts (OR = 3.3, p = 0.000), family history of a depression diagnosis (OR = 1.6, p = 0.000) and exposure to violence (OR = 1.9, p = 0.000) had the strongest association with SA. Childhood abuse/trauma was associated with SA (OR = 1.13, p = 0.000) but not SI. 'Feeling bad about themselves, a failure, or having let themselves or their family down' was the symptom that most clearly differentiated women who attempted suicide from women who reported suicidal ideation but no SA. The salience of childhood abuse and domestic/community violence to women's risk for a suicide attempt reinforces previous findings that these adversities may differentiate suicide risk for women versus men. Continued research is essential to understand varied paths that may lead to suicidal behavior among women, some which appear unrelated to the frequency or intensity of their suicidal thoughts.

Positive Cognitive Reappraisal in Stress Resilience, Mental Health, and Well-Being: A Comprehensive Systematic Review

Stress-related psychopathology is on the rise, and there is a pressing need for improved prevention strategies. Positive appraisal style, the tendency to appraise potentially threatening situations in a positive way, has been proposed to act as a key resilience mechanism and therefore offers a potential target for preventive approaches. In this article, we review n  =  99 studies investigating associations of positive cognitive reappraisal, an important sub-facet of positive appraisal style, with outcome-based resilience and relevant other outcomes, which are considered resilience-related. According to the studies reviewed, positive cognitive reappraisal moderates the relation between stressors and negative outcomes and is positively related to several resilience-related outcomes. It also mediates between other resilience factors and resilience, suggesting it is a proximal resilience factor.

Mental health correlates of quitting cigarette smoking in youth experiencing homelessness

Smoking prevalence among youth experiencing homelessness (YEH) is three times higher than smoking prevalence among the general population. Many YEH who smoke are interested in quitting smoking, but also report smoking to cope with mental health symptoms. Research on factors that facilitate or impede successful smoking cessation among YEH is limited. This study examined mental health correlates (i.e., anxiety and depression symptoms) of quitting-related factors (i.e., quit attempts, perceived barriers to quitting) and whether smoking to cope moderates these relationships among this vulnerable population. The sample consisted of 77 YEH cigarette smokers between the ages of 18-25 who were interested in quitting. Participants completed a survey assessing various behavioral and cognitive factors related to tobacco use. Analyzing two separate models, hierarchical negative binomial and hierarchical linear regression were used to examine hypothesized correlates of the number of past year quit attempts and perceived barriers to quitting. Smoking to cope moderated the relationships of depression with past year quit attempts and perceived barriers to quitting. Those high in depression and smoking to cope had the fewest number of quit attempts and reported the greatest perceived barriers. Anxiety symptoms were not significantly associated with quit attempts or perceived barriers. Smoking cessation interventions that address using smoking to cope with mental health symptoms may be important for YEH with depression.

Associations of Internalized Skin Bias With Age, Adverse Psychopathology, and Health-Related Quality of Life Among Patients With Hidradenitis Suppurativa: A Cross-sectional Analysis

Importance

Hidradenitis suppurativa (HS) is a chronic autoinflammatory disease that is highly associated with affective disorders such as depression and anxiety. Recent studies have shown that patients with HS may also endorse high levels of internalized skin bias (ISB). This redirection of skin disease-related social stigma toward oneself may also play an important role in the associations between adverse psychopathology (eg, depression, anxiety) and health-related quality of life (HRQOL).

Objectives

To evaluate the associations of ISB with other core outcomes in HS and to determine if ISB may mediate the associations between adverse psychopathological outcomes and impaired HRQOL.

Design, Setting, and Participants

A cross-sectional study of adult patients with HS recruited from 1 academic medical center as well as through virtual social and recruitment networks. Eligible participants completed an online survey comprised of 4 survey instruments along with demographic and disease history information from April 1, 2021, to July 15, 2021.

Main Outcomes and Measures

Measures included the Internalized Skin Bias Questionnaire (ISBQ), Burns Anxiety Inventory, the Beck Depression Inventory-II, the Hidradenitis Suppurativa Quality of Life (HiSQOL) instrument, along with demographic and disease history information. The primary outcome was HRQOL as measured by the HiSQOL. Data were analyzed in July through August 2021.

Results

The survey was completed by 230 of 279 patients (82.4%; mean [SD] age, 39.2 [11.2] years; 209 [90.9%] identified as female, 203 [88.7%] as not Hispanic, 178 [77.7%] as White). Depression and anxiety were shown to be a substantial burden in this sample, with 56.5% of participants' scores qualifying for moderate or greater anxiety and 45.7% moderate or greater depression. The mean (SD) HRQOL scores were moderately high at 34.5 (16.7), indicating strong levels of impairment. There was a moderate correlation between ISBQ score and depression (r = 0.67); and fair correlations with HRQOL (r = 0.52) and anxiety (r = 0.56). Therefore, ISB appears to positively mediate the associations between depression and anxiety (estimated proportions of total effect that were mediated, 38.7% and 24.9%, respectively) and HRQOL. After controlling for age, disease severity, and disease duration, both ISB and anxiety were positive predictors of impaired HRQOL.

Conclusions and Relevance

This cross-sectional study found that ISB was associated with adverse psychopathology and impaired HRQOL in patients with HS. Furthermore, ISB appears to mediate the associations of depression and anxiety with HRQOL. Future studies are needed to design interventions targeted at addressing adverse psychopathology associated with ISB and improving HRQOL and well-being for patients with HS.

Internalized skin bias: Validation study to explore the impact of the internalization of social stigma on those with hidradenitis suppurativa

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic auto-inflammatory disease that is highly associated with adverse psychopathology and impaired body image. Previous studies show that patients with HS are also impacted by social stigma associated with their skin disease. Over time, these experiences can influence the way in which patients feel about themselves, leading to internalized skin bias (ISB).

OBJECTIVES

To evaluate the validity and reliability of the Internalized Skin Bias Questionnaire (ISBQ) in an HS population, and to determine the association of this instrument with markers of HS severity.

METHODS

A cross-sectional survey with 72-hour retest was sent to adult patients with HS from March to November 2021. Reliability for the ISBQ was evaluated using Cronbach's alpha and the Concordance Correlation Coefficient (CCC). Construct validity was evaluated using Pearson Correlation Coefficients with similar measures.

RESULTS

Internal consistency for the ISBQ instrument was 0.89 with a CCC of 0.88. The ISBQ had moderate correlation (r = 0.63) with the experienced skin stigma questionnaire as well as the BDI-II (r = 0.66) and the psychosocial subscale of the HiSQOL (r = 0.65). ISBQ scores differed significantly across different stages of disease severity (p=0.04). There was no significant difference between those with different durations of disease (p=0.47).

CONCLUSIONS

This study shows that the ISBQ is a valid and reliable instrument that can be used to assess the psychosocial construct of ISB especially in a population of HS patients. Further, ISB places a prevalent negative impact on the psychopathology of patients with HS.

Interpersonal sensitivity on college freshmen's depression: A moderated moderation model of psychological capital and family support

BACKGROUND

The prevalence of depressive symptoms has become very high among college freshmen, with interpersonal sensitivity serving as an important predictor of depression. Combining internal and external positive resources can effectively prevent and alleviate depression. This study explores the moderating role of psychological capital (PsyCap) in the relationship between interpersonal sensitivity and depression, as well as the moderating effect of familial support on the conditional influence of PsyCap among Chinese college freshmen.

METHODS

A cross-sectional mental health survey was performed and the anonymous self-reported questionnaires, including the Patient Health Questionnaire, interpersonal sensitivity subscale of Symptom Checklist-90, Psychological Capital Questionnaire 24, and Perceived Social Support from Family, were distributed to the freshmen. Pearson's coefficient was employed to describe correlations between variables. The PROCESS macro and slope difference tests were used to explore the moderating role of PsyCap and family support in the relationship between interpersonal sensitivity and depression.

RESULTS

The prevalence of depression among freshmen was 30.89% (694/2,247). The correlation analysis revealed that depression negatively related to PsyCap (r = -0.187, p < 0.001) and family support (r = -0.193, p < 0.001) and positively related to interpersonal sensitivity (r = 0.399, p < 0.001). The moderation analysis showed that PsyCap negatively moderated the positive relationship between interpersonal sensitivity and depression (β = -0.159, p < 0.001). We also found that family support played a moderating role in the conditional influence of PsyCap (β = 0.076, p < 0.01). The slope difference test further showed that family support weakened the effect of interpersonal sensitivity on depression in freshmen when they had low PsyCap.

CONCLUSION

More attention should be paid to freshmen's mental health and interpersonal interaction problems. For freshmen with interpersonal sensitivity and depression, mental health departments can conduct PsyCap development interventions to alleviate psychological symptoms. Freshmen themselves should also seek family support in time, but those individuals with high PsyCap should seek an appropriate level of family support to maintain their autonomy.

Stress events and Changes in Dysfunctional Attitudes and Automatic Thoughts Following Recovery from Depression in Inpatient Psychotherapy: Mediation Analyses with Longitudinal Data

Background

Stressful event exposure, dysfunctional attitudes (DA), negative automatic thoughts (NAT), and declining positive automatic thoughts (PAT) have been associated with depressive relapse/recurrence. Few studies have investigated the course of these variables and their relevance for relapse/recurrence in remitted depression.

Methods

Following successful inpatient treatment, in 39 remitted depressive patients, stressful events, DA, NAT, PAT, and depressive relapse/recurrence were assessed five times during a 16-month follow-up. Data were analyzed with mixed effect models, and mediation effects were tested.

Results

Stressful events after discharge correlated with depressive relapse/recurrence. This association was mainly mediated by a stress-related decline of PAT within four months post discharge. Patients’ DA were relatively stable during the observation period and did not depend on stressful events, indicating DA as a risk trait for depressive relapse/recurrence. Mediation analyses revealed that independent of stress, DA were linked to depressive relapse/recurrence through more NAT.

Conclusion

Our findings suggest stressful events evoke relapse/recurrence in remitted depression through rapid deterioration of PAT after discharge from inpatient therapy. DA are expressed through NAT which additionally contribute to higher risk of depressive relapse/recurrence. Consequently, maintenance therapy requires techniques to promote the maintenance of PAT, and to effectively restructure DA and NAT.

Mindfulness and eudaimonic well-being: the mediating roles of rumination and emotion dysregulation

Mindfulness has been widely studied in Western psychology for reducing psychological distress. However, several scholars noted that in the East, where the concept originated, mindfulness may be understood differently. In Eastern cultures such as Thailand, mindfulness is not only employed to deal with suffering but also to promote well-being. To the best of our knowledge, no studies have been undertaken to evaluate the relationship between traditional mindfulness and eudaimonic well-being in Eastern contexts. In the present study, we investigated the relationships between mindfulness and eudaimonic well-being in Thai contexts. We also explored the mediating roles of rumination and emotion dysregulation on this relationship. Data were collected from 312 Thai undergraduates who completed a measure of Eudaimonic Well-Being, the Freiburg Mindfulness Inventory, the Rumination-Reflection Questionnaire, and the Difficulties in Emotion Regulation Scale. Results largely supported our hypotheses. Mindfulness was found to have a positive and direct association with eudaimonic well-being. Rumination and emotion dysregulation partially mediated this association. Additionally, both rumination and emotion dysregulation had negative and direct association with eudaimonic well-being. The findings highlight the positive influences of mindfulness on well-being. The benefits of mindfulness for improvement of eudaimonic well-being through reducing rumination and emotion dysfunction are discussed.

Self-Reported Emotion Regulation Is Associated With Response to Test of Cardiac Vagal Function

Abstract. Parasympathetic function and emotional self-regulation (ESR) share neuroanatomic structures. Based on Porges’ Polyvagal Theory and the Neurovisceral Integration Model (NIM), we compared vagally mediated heart-rate variability (vmHRV) with psychometrically assessed ESR. We hypothesized that vmHRV and ESR would be associated during rest, a vagal function test, and recovery from that test. A significant association would justify the psychometric measuring of parasympathetic health, which is less burdensome than its psychophysiological assessment. Two hundred thirteen healthy males (aged: 18–26 years, M = 20.29 years) took part in the present study. They completed the Emotion Regulation Questionnaire (ERQ) and underwent the Cold Face Test (CFT) for 4 min wearing ambulatory electrocardiograms. A High frequency (HF) band was used as a measure of vmHRV before, during, and after the CFT. Associations between the HF band and ESR were analyzed with partial rank correlations. There was no significant association between ERQ scores and the response to the CFT itself. But there was an almost significant association between the ERQ scale Cognitive Appraisal and baseline vmHRV, and a significant association between Cognitive Appraisal and cardiac recovery from the CFT, that is, participants with higher scores on that ESR scale revealed a tendency to exhibit greater vmHRV during baseline and they exhibited greater vagal withdrawal during recovery from the CFT. Cognitive appraisal as a psychometrically assessed emotion regulatory process was reflected in a more flexible parasympathetic activity (i.e., better cardiac vagal health) during recovery from an exclusively physiological stressor. This lends convergent validity to self-reported emotion regulation, and justification for its use as a measure of ESR as a trait, offering further support for the Polyvagal Theory and NIM.

Antidepressant drugs as emerging contaminants: Occurrence in urban and non-urban waters and analytical methods for their detection

Antidepressants are drugs with a direct action on the brain's biochemistry through their interaction with the neurotransmitters, such as dopamine, norepinephrine, and serotonin. The increasing worldwide contamination from these drugs may be witnessed through their increasing presence in the urban water cycle. Furthermore, their occurrence has been detected in non-urban water, such as rivers and oceans. Some endemic aquatic animals, such as certain fish and mollusks, have bioaccumulated different antidepressant drugs in their tissues. This problem will increase in the years to come because the present COVID-19 pandemic has increased the general worldwide occurrence of depression and anxiety, triggering the consumption of antidepressants and, consequently, their presence in the environment. This work provides information on the occurrence of the most administrated antidepressants in urban waters, wastewater treatment plants, rivers, and oceans. Furthermore, it provides an overview of the analytical approaches currently used to detect each antidepressant presented. Finally, the ecotoxicological effect of antidepressants on several in vivo models are listed. Considering the information provided in this review, there is an urgent need to test the presence of antidepressant members of the MAOI and TCA groups. Furthermore, incorporating new degradation/immobilization technologies in WWTPs will be useful to stop the increasing occurrence of these drugs in the environment.