The social competition hypothesis of depression

Depressive and Anxious Symptoms, Experimentally Manipulated Acute Social-Evaluative Threat, and Cortisol Reactivity

OBJECTIVE

Exposure to social-evaluative threat (SET) can elicit greater physiological responses, including cortisol, compared to non-SET stressors. An individual's level of depressive and anxious symptoms predicts variability in cortisol responses to stressors, and other research suggests that these individual differences may predict vulnerability to social evaluation. The current study integrates both lines of research, testing if there are different relationships between depressive and/or anxious symptoms and cortisol reactivity in the presence or absence of SET.

METHODS

Healthy undergraduate students ( N = 158, 65% female) were randomly assigned to deliver a speech in the presence (SET) or absence (non-SET) of two evaluators. Salivary cortisol was collected throughout, and self-reported depressive and anxious symptoms were assessed. We hypothesized that in the SET condition, higher levels of depressive and/or anxious symptoms would predict dysregulated cortisol responses compared to lower levels of symptoms and/or assignment to the non-SET group.

RESULTS

In spite of inconclusive p values (which might be attributed to low statistical power), individuals with high depressive or high anxious symptoms appeared to have exaggerated cortisol responses in the SET condition, as indicated by more concave trajectories.

CONCLUSIONS

This study suggests that both depression and anxiety could be associated with increased cortisol reactivity to SET.

Evaluation and test of the reliability and validity of the Chinese defeat scale in the elite athletes of Chinese universities

To test the reliability and validity of the "Defeat Scale" and explore whether the scale is suitable for use in surveys of college athletes. A total of 226 athletes from five universities in China were selected for evaluation using the defeat scale. Factor analysis and correlation analysis were used to explore the reliability and validity of the defeat scale. Exploratory factor analysis showed that two factors could be extracted from this scale, namely a sense of decadence and a sense of low achievement. Confirmatory factor analysis showed that the model fit of the two factors was excellent (X2/DF = 2.809, RMSEA = 0.092, SRMR = 0.054, NFI = 0.891, IFI = 0.927, CFI = 0.926, GFI = 0.919, TLI = 0.910) . The convergent validity AVE values are 0.579 and 0.505 respectively, AVE > 0.5, and the combined reliability is 0.946 and 0.746 respectively. Both > 0.7 indicate good convergence effect. The arithmetic square roots of AVE, 0.760 and 0.710, are both higher than the absolute value of the correlation coefficient between the two dimensions, 0.30, indicating good discriminant validity; and the Cronbach's alpha coefficient of defeat is 0.931, and the Spearman-Brown coefficient is 0.888. The defeat scale has good reliability and validity among college athletes.

Prefrontal Regulation of Social Behavior and Related Deficits: Insights From Rodent Studies

The prefrontal cortex (PFC) is well known as the executive center of the brain, combining internal states and goals to execute purposeful behavior, including social actions. With the advancement of tools for monitoring and manipulating neural activity in rodents, substantial progress has been made in understanding the specific cell types and neural circuits within the PFC that are essential for processing social cues and influencing social behaviors. Furthermore, combining these tools with translationally relevant behavioral paradigms has also provided novel insights into the PFC neural mechanisms that may contribute to social deficits in various psychiatric disorders. This review highlights findings from the past decade that have shed light on the PFC cell types and neural circuits that support social information processing and distinct aspects of social behavior, including social interactions, social memory, and social dominance. We also explore how the PFC contributes to social deficits in rodents induced by social isolation, social fear conditioning, and social status loss. These studies provide evidence that the PFC uses both overlapping and unique neural mechanisms to support distinct components of social cognition. Furthermore, specific PFC neural mechanisms drive social deficits induced by different contexts.

Depressive symptoms and visual attention to others' eyes in healthy individuals

BACKGROUND

Eye contact is a fundamental part of social interaction. In clinical studies, it has been observed that patients suffering from depression make less eye contact during interviews than healthy individuals, which could be a factor contributing to their social functioning impairments. Similarly, results from mood induction studies with healthy persons indicate that attention to the eyes diminishes as a function of sad mood. The present screen-based eye-tracking study examined whether depressive symptoms in healthy individuals are associated with reduced visual attention to other persons' direct gaze during free viewing.

METHODS

Gaze behavior of 44 individuals with depressive symptoms and 49 individuals with no depressive symptoms was analyzed in a free viewing task. Grouping was based on the Beck Depression Inventory using the cut-off proposed by Hautzinger et al. (2006). Participants saw pairs of faces with direct gaze showing emotional or neutral expressions. One-half of the face pairs was shown without face masks, whereas the other half was presented with face masks. Participants' dwell times and first fixation durations were analyzed.

RESULTS

In case of unmasked facial expressions, participants with depressive symptoms looked shorter at the eyes compared to individuals without symptoms across all expression conditions. No group difference in first fixation duration on the eyes of masked and unmasked faces was observed. Individuals with depressive symptoms dwelled longer on the mouth region of unmasked faces. For masked faces, no significant group differences in dwell time on the eyes were found. Moreover, when specifically examining dwell time on the eyes of faces with an emotional expression there were also no significant differences between groups. Overall, participants gazed significantly longer at the eyes in masked compared to unmasked faces.

CONCLUSIONS

For faces without mask, our results suggest that depressiveness in healthy individuals goes along with less visual attention to other persons' eyes but not with less visual attention to others' faces. When factors come into play that generally amplify the attention directed to the eyes such as face masks or emotions then no relationship between depressiveness and visual attention to the eyes can be established.

Peer popularity and self-discipline as protective factors against depressive symptoms in Chinese adolescents: Do boys and girls benefit equally?

The current study examined the concurrent and longitudinal protective effects of peer popularity and self-discipline (control, planning, and the ability to prioritize important things) against depressive symptoms among adolescents. We used multilevel modeling to examine the data of 1676 adolescents aged 12-15 years from the China Family Panel Studies (CFPS) survey, a large-scale panel survey with a nationally representative sample. Results showed that both peer popularity and self-discipline predicted lower levels of depressive symptoms measured concurrently. The buffering effect of self-discipline against concurrent depressive symptoms was stronger for girls than for boys, especially in middle adolescence. Peer popularity additionally predicted lower levels of depressive symptoms 4 years later, and this effect was stronger for girls than for boys. These patterns of results were maintained after controlling for self-rated physical health and society-level factors. We discuss these findings against the background of distinct traditional gender roles.

Mental Defeat and Suicidality in Chronic Pain: A Prospective Analysis

Living with chronic pain has been identified as a significant risk factor for suicide. Qualitative and cross-sectional studies have reported an association between mental defeat and suicidal thoughts and behavior in patients with chronic pain. In this prospective cohort study, we hypothesized that higher levels of mental defeat would be associated with increased suicide risk at a 6-month follow-up. A total of 524 patients with chronic pain completed online questionnaires measuring variables related to suicide risk, mental defeat, sociodemographic, psychological, pain, activity, and health variables. At 6 months, 70.8% (n = 371) of respondents completed the questionnaires again. Weighted univariate and multivariable regression models were run to predict suicide risk at 6 months. The clinical suicide risk cutoff was met by 38.55% of the participants at baseline and 36.66% at 6 months. Multivariable modeling revealed that mental defeat, depression, perceived stress, head pain, and active smoking status significantly increased the odds of reporting higher suicide risk, while older age reduced the odds. Receiver operating characteristic (ROC) analysis showed that assessment of mental defeat, perceived stress, and depression is effective in discriminating between 'low' and 'high' suicide risk. Awareness of the prospective links from mental defeat, depression, perceived stress, head pain, and active smoking status to increased suicide risk in patients with chronic pain may offer a novel avenue for assessment and preventative intervention. PERSPECTIVE: Results from this prospective cohort study suggest that mental defeat is a significant predictor of increased suicide risk among patients with chronic pain, along with depression, perceived stress, head pain, and active smoking status. These findings offer a novel avenue for assessment and preventative intervention before risk escalates.

Endocannabinoid system and aggression across animal species

This narrative review article summarizes the current state of knowledge regarding the relationship between the endocannabinoid system (ECS) and aggression across multiple vertebrate species. Experimental evidence indicates that acute administration of phytocannabinoids, synthetic cannabinoids, and the pharmacological enhancement of endocannabinoid signaling decreases aggressive behavior in several animal models. However, research on the chronic effects of cannabinoids on animal aggression has yielded inconsistent findings, indicating a need for further investigation. Cannabinoid receptors, particularly cannabinoid receptor type 1, appear to be an important part of the endogenous mechanism involved in the dampening of aggressive behavior. Overall, this review underscores the importance of the ECS in regulating aggressive behavior and provides a foundation for future research in this area.

Relationships of work stress and interpersonal needs with industrial workers' mental health: a moderated mediation model

OBJECTIVES

This study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support.

METHOD

A cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms.

RESULT

Both the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B = 0.035, p < .001, Work stress→ Defeat→ Depression: B = 0.034, p < .001; Work stress→ Anxiety: B = 0.038, p < .001, Work stress→ Defeat→ Anxiety: B = 0.045, p < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B = 0.010, p = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect.

CONCLUSION

The mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.

Framing depression as a functional signal, not a disease: Rationale and initial randomized controlled trial

Depression is often framed as a disease or dysfunctional syndrome, yet this framing has unintended negative consequences including increased stigma. Here, we consider an alternative messaging framework - that depression serves an adaptive function. We describe the historical development of popular messages about depression and draw from the fields of evolutionary psychiatry and social cognition to describe the alternative framework that depression is a "signal" that serves a purpose. We then present data from a pre-registered, online randomized-controlled study in which participants with self-reported depression histories viewed a series of videos that explained depression as a "disease like any other" with known biopsychosocial risk factors (BPS condition), or as a signal that serves an adaptive function (Signal condition). In the entire sample (N = 877), three of the six hypotheses were supported: The Signal condition led to less self-stigma, greater offset efficacy, and more adaptive beliefs about depression. Exploratory analyses revealed these Signal effects were stronger among females (N = 553), who also showed a greater growth mindset of depression after the Signal explanation. Results suggest that framing depression as an adaptive signal can benefit patients and avoid harmful consequences of popular etiological presentations. We conclude that alternative framings of depression are worthy of further study.

Evolutionary psychiatry: foundations, progress and challenges

Evolutionary biology provides a crucial foundation for medicine and behavioral science that has been missing from psychiatry. Its absence helps to explain slow progress; its advent promises major advances. Instead of offering a new kind of treatment, evolutionary psychiatry provides a scientific foundation useful for all kinds of treatment. It expands the search for causes from mechanistic explanations for disease in some individuals to evolutionary explanations for traits that make all members of a species vulnerable to disease. For instance, capacities for symptoms such as pain, cough, anxiety and low mood are universal because they are useful in certain situations. Failing to recognize the utility of anxiety and low mood is at the root of many problems in psychiatry. Determining if an emotion is normal and if it is useful requires understanding an individual's life situation. Conducting a review of social systems, parallel to the review of systems in the rest of medicine, can help achieve that understanding. Coping with substance abuse is advanced by acknowledging how substances available in modern environments hijack chemically mediated learning mechanisms. Understanding why eating spirals out of control in modern environments is aided by recognizing the motivations for caloric restriction and how it arouses famine protection mechanisms that induce binge eating. Finally, explaining the persistence of alleles that cause serious mental disorders requires evolutionary explanations of why some systems are intrinsically vulnerable to failure. The thrill of finding functions for apparent diseases is evolutionary psychiatry's greatest strength and weakness. Recognizing bad feelings as evolved adaptations corrects psychiatry's pervasive mistake of viewing all symptoms as if they were disease manifestations. However, viewing diseases such as panic disorder, melancholia and schizophrenia as if they are adaptations is an equally serious mistake in evolutionary psychiatry. Progress will come from framing and testing specific hypotheses about why natural selection left us vulnerable to mental disorders. The efforts of many people over many years will be needed before we will know if evolutionary biology can provide a new paradigm for understanding and treating mental disorders.

The suffering ape hypothesis

The "fearful ape hypothesis" could be regarded as one aspect of a more general "suffering ape hypothesis": Humans are more likely to experience negative emotions (e.g., fear, sadness), aversive symptoms (e.g., pain, fever), and to engage in self-harming behavior (e.g., cutting, suicide attempts) because these might motivate affiliative, consolatory, and supportive behavior from their prosocial environment thereby enhancing evolutionary fitness.

The single- and dual-brain mechanisms underlying the adviser's confidence expression strategy switching during influence management

Effective influence management during advice-giving requires individuals to express confidence in the advice properly and switch timely between the 'competitive' strategy and the 'defensive' strategy. However, how advisers switch between these two strategies, and whether and why there exist individual differences during this process remain elusive. We used an advice-giving game that manipulated incentive contexts (Incentivized/Non-Incentivized) to induce the adviser's confidence expression strategy switching and measured the brain activities of adviser and advisee concurrently using functional near-infrared spectroscopy (fNIRS). Behaviorally, we observed individual differences in strategy switching. Some advisers applied the 'defensive' strategy when incentivized and the 'competitive' strategy when not incentivized, while others applied the 'competitive' strategy when incentivized and the 'defensive' strategy when not incentivized. This effect was mediated by the adviser's perceived stress in each condition and was reflected by the frequencies of advice-taking in the advisees. Neurally, brain activation in the dorsolateral prefrontal cortex (DLPFC) supported strategy switching, as well as interpersonal neural synchronization (INS) in the temporoparietal junction (TPJ) that supported influence management. This two-in-one process, i.e., confidence expression strategy switching and the corresponding influence management, was linked and modulated by the strength of DLPFC-TPJ functional connectivity in the adviser. We further developed a descriptive model that contributed to understanding the adviser's strategy switching during influence management.

Daily fluctuations in social status, self-esteem, and clinically relevant emotions: Testing hierometer theory and social rank theory at a within-person level

INTRODUCTION

Grounded in hierometer theory and social rank theory, this research examined how within-person fluctuations in social status relate to within-person fluctuations in self-esteem and several clinically relevant emotions. Both hierometer theory and social rank theory postulate that particular psychological mechanisms help individuals to navigate social hierarchies adaptively. However, hierometer theory emphasizes self-esteem, whereas social rank theory emphasizes emotions-specifically, depression, anxiety, and shame.

METHODS

We conducted a 10-day diary study and analyzed the data using multilevel modeling. Participants (N = 345) completed daily measures of their social status, self-esteem, depression, anxiety, shame, and guilt.

RESULTS

On days when their status was higher, participants reported higher self-esteem and lower depression, anxiety, and shame. On days when their self-esteem was higher, participants reported lower depression, anxiety, and shame. These patterns persisted after controlling for baseline individual differences. Furthermore, multilevel mediation analyses indicated that daily self-esteem mediated the links between daily status, and, individually, daily depression, anxiety, and shame, but not guilt.

CONCLUSIONS

Supporting hierometer theory and social rank theory, self-esteem, and the clinically relevant emotions (except for guilt) appear to serve a status-tracking function. Self-esteem plays a more primary role, accounting for the link between status and depression, anxiety, and shame.

Association Between Social Networking Site Use Intensity and Depression Among Chinese Pregnant Women: Cross-sectional Study

BACKGROUND

Despite extensive debates about the mental health impacts of the use of social networking sites (SNSs), including WeChat, the association and mechanisms between social interaction of WeChat use intensity and antenatal depression are unclear.

OBJECTIVE

We aimed to test the mediating roles of upward social comparison on social interaction of WeChat and rumination in the association between social interaction of WeChat use intensity and antenatal depression.

METHODS

A cross-sectional survey was conducted in four hospitals with the self-reported measures of social interaction of WeChat use intensity, upward social comparison on social interaction of WeChat, rumination, antenatal depression, and control variables. The mediation analysis was performed through Model 6 from the PROCESS macro 4.0 in SPSS 26.

RESULTS

Results from 2661 participants showed that antenatal depression was unrelated to social interaction of WeChat use intensity (P=.54), but was significantly positively related to the attitude toward social interaction of WeChat (P=.01). The direct effect of attitude toward social interaction of WeChat use on antenatal depression was not statistically significant (β=-.03, P=.05). The results supported an indirect relationship between attitude toward social interaction of WeChat use and antenatal depression via (1) upward social comparison on social interaction of WeChat (indirect effect value=0.04, 95% CI 0.03 to 0.06); (2) rumination (indirect effect value=-0.02, 95% CI -0.04 to -0.01); and (3) upward social comparison on social interaction of WeChat and rumination in sequence (indirect effect value=0.07, 95% CI 0.06 to 0.08).

CONCLUSIONS

Our findings highlight the necessity of focusing on attitudes toward SNS use, and the importance of upward social comparison and rumination in understanding the effect of SNS use on antenatal depression.

Investigating mental defeat in individuals with chronic pain: Protocol for a longitudinal experience sampling study

INTRODUCTION

Previous qualitative and cross-sectional research has identified a strong sense of mental defeat in people with chronic pain who also experience the greatest levels of distress and disability. This study will adopt a longitudinal experience sampling design to examine the within-person link between the sense of mental defeat and distress and disability associated with chronic pain.

METHODS AND ANALYSIS

We aim to recruit 198 participants (aged 18-65 years) with chronic pain, to complete two waves of experience sampling over 1 week, 6 months apart (time 1 and time 2). During each wave of experience sampling, the participants are asked to complete three short online surveys per day, to provide in-the-moment ratings of mental defeat, pain, medication usage, physical and social activity, stress, mood, self-compassion, and attention using visual analogue scales. Sleep and physical activity will be measured using a daily diary as well as with wrist actigraphy worn continuously by participants throughout each wave. Linear mixed models and Gaussian graphical models will be fit to the data to: (1) examine the within-person, day-to-day association of mental defeat with outcomes (ie, pain, physical/social activity, medication use and sleep), (2) examine the dynamic temporal and contemporaneous networks of mental defeat with all outcomes and the hypothesised mechanisms of outcomes (ie, perceived stress, mood, attention and self-compassion).

ETHICS AND DISSEMINATION

The current protocol has been approved by the Health Research Authority and West Midlands-Solihull Research Ethics Committee (Reference Number: 17/WM0053). The study is being conducted in adherence with the Declaration of Helsinki, Warwick Standard Operating Procedures and applicable UK legislation.

Neural mechanism underlying depressive-like state associated with social status loss

Downward social mobility is a well-known mental risk factor for depression, but its neural mechanism remains elusive. Here, by forcing mice to lose against their subordinates in a non-violent social contest, we lower their social ranks stably and induce depressive-like behaviors. These rank-decline-associated depressive-like behaviors can be reversed by regaining social status. In vivo fiber photometry and single-unit electrophysiological recording show that forced loss, but not natural loss, generates negative reward prediction error (RPE). Through the lateral hypothalamus, the RPE strongly activates the brain's anti-reward center, the lateral habenula (LHb). LHb activation inhibits the medial prefrontal cortex (mPFC) that controls social competitiveness and reinforces retreats in contests. These results reveal the core neural mechanisms mutually promoting social status loss and depressive behaviors. The intertwined neuronal signaling controlling mPFC and LHb activities provides a mechanistic foundation for the crosstalk between social mobility and psychological disorder, unveiling a promising target for intervention.

Physical and social trauma: Towards an integrative transdiagnostic perspective on psychological trauma that involves threats to status and belonging

Current theories of psychological trauma assume that posttraumatic symptoms originate from stress reactions caused by extremely adverse life experiences. Since the diagnosis of PTSD is restricted to events that involve threats to the physical or sexual integrity of a person, such as accidents and physical and sexual violence, these theories are not well suited to explain the psychopathological consequences of severe violations of one's social integrity, such as emotional abuse and bullying. However, it is evident that social threats contribute to a broad range of mental disorders and increase symptom severity in patients with posttraumatic stress disorder. The aim of the Physical and Social Trauma (PAST) framework is to extend current memory theories of psychological trauma to incorporate threats to a person's social integrity. Within this perspective, the harmful effects of events that involve social threats result from violations of core social motives such as the need for status and belonging that bring about intense affective reactions, including despair and defeat. Within associative threat structures, these emotions are tied to the stimulus characteristics of the experiences and can be re-activated in social situations. The resulting psychopathology transcends PTSD criteria and other current classifications and suggests a transdiagnostic perspective of psychological trauma. Implications for treatment and further directions for research are discussed.

Social Stigma and Depression among Asymptomatic COVID-19 Carriers in Shanghai, China: The Mediating Role of Entrapment and Decadence

INTRODUCTION

Since the advent of 2019 novel coronavirus (COVID-19), the coexistence between social stigma and depression symptoms (depression hereafter) in COVID-19 patients has been mentioned, but the mechanisms involved remains unclear. This study aimed to explore how the stigma affects depression during the mid-pandemic period.

METHODS

A cross-sectional survey using non-probability sampling was conducted among asymptomatic COVID-19 carriers in Shanghai, China (April 2022). An online questionnaire was used to obtain information on demographic characteristics and psychological traits. Logistic regression and path analysis were performed to analyze the depression risk factors and examine the mediation model, respectively.

RESULTS

A total of 1283 participants (59.6% men) were involved in this study, in which 44.7% of carriers reported having depression. Univariate analyses found that education level (OR 0.575; 95% CI 0.448-0.737) and doses of vaccine (OR 1.693; 95% CI 1.042-2.750), were significantly associated with depression among asymptomatic carriers. The association between social stigma and depression was fully mediated by their feelings of entrapment and decadence (indirect effect = 0.204, p < 0.001; direct effect = -0.059, p = 0.058). The mediating role of entrapment between stigma and depression was moderated by age group (estimate = 0.116, p = 0.008).

CONCLUSION

Mental health issues resulting from the COVID-19 pandemic are increasingly apparent in China and require urgent attention and responses. These findings provide new perspectives for the early prevention of depression in asymptomatic carriers.

Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study

Background

Compassion focused therapy (CFT) is an evolutionary informed, biopsychosocial approach to mental health problems and therapy. It suggests that evolved motives (e.g., for caring, cooperating, competing) are major sources for the organisation of psychophysiological processes which underpin mental health problems. Hence, evolved motives can be targets for psychotherapy. People with certain types of depression are psychophysiologically orientated towards social competition and concerned with social status and social rank. These can give rise to down rank-focused forms of social comparison, sense of inferiority, worthlessness, lowered confidence, submissive behaviour, shame proneness and self-criticism. People with bipolar disorders also experience elevated aspects of competitiveness and up rank status evaluation. These shift processing to a sense of superiority, elevated confidence, energised behaviour, positive affect and social dominance. This is the first study to explore the feasibility of a 12 module CFT group, tailored to helping people with a diagnosis of bipolar disorder understand the impact of evolved competitive, status-regulating motivation on their mental states and the value of cultivating caring and compassion motives and their psychophysiological regulators.

Methods

Six participants with a history of bipolar disorder took part in a CFT group consisting of 12 modules (over 25 sessions) as co-collaborators to explore their personal experiences of CFT and potential processes of change. Assessment of change was measured via self-report, heart rate variability (HRV) and focus groups over three time points.

Results

Although changes in self-report scales between participants and across time were uneven, four of the six participants consistently showed improvements across the majority of self-report measures. Heart rate variability measures revealed significant improvement over the course of the therapy. Qualitative data from three focus groups revealed participants found CFT gave them helpful insight into: how evolution has given rise to a number of difficult problems for emotion regulation (called tricky brain) which is not one's fault; an evolutionary understanding of the nature of bipolar disorders; development of a compassionate mind and practices of compassion focused visualisations, styles of thinking and behaviours; addressing issues of self-criticism; and building a sense of a compassionate identity as a means of coping with life difficulties. These impacted their emotional regulation and social relationships.

Conclusion

Although small, the study provides evidence of feasibility, acceptability and engagement with CFT. Focus group analysis revealed that participants were able to switch from competitive focused to compassion focused processing with consequent improvements in mental states and social behaviour. Participants indicated a journey over time from 'intellectually' understanding the process of building a compassionate mind to experiencing a more embodied sense of compassion that had significant impacts on their orientation to (and working with) the psychophysiological processes of bipolar disorder.

Low Perceived Social Rank Increases the Impact of Mental Health Symptoms on Suicidal Ideation: Evidence among Young Adults from the Philippines

Studies on social factors that could influence the mental health-suicidal ideation link remain scarce, especially in non-Western contexts. This study examined the relationship between mental health symptoms (i.e., depression, anxiety, and stress) and suicidal ideation and whether one's perceived social rank moderates such a relationship. Data from 631 students from two universities in the Philippines collected between October to December 2018 was analyzed. Bivariate correlations show that greater symptoms of depression, anxiety, and stress are associated with increased suicidal ideation. Hierarchical linear regression models supported the direct relationship between mental health symptoms and suicidal ideation and demonstrated that perceived social rank significantly moderated such a relationship. Johnson-Neyman plots and simple slopes analyses further illustrate how mental health symptoms and perceived social rank interact to impact suicidal ideation. The results show that as one's perceived social rank lowers, the strength of the positive association between depression, anxiety, and stress symptoms to suicidal ideation strengthens. The results held while controlling for age, gender, college year level, and family income. The findings are discussed using the social rank theory and the Integrated Motivational-Volitional (IMV) model of suicide to view suicidal ideation from both an individual and a social perspective. We expound on the role of low perceived social rank on suicidal ideation among young adults.HIGHLIGHTSHigher depression, anxiety, and stress symptoms are associated with higher suicidal ideation.Perceived social rank moderates the link between mental health symptoms and suicidal ideation.One's perception of being inferior to others can exacerbate suicidal ideation.

The association between entrapment and depression among migrant workers in China: a social rank theory based study

BACKGROUND

Migrant workers are a group susceptible for depression evolution due to occupational maladaptive triggers. The social rank theory illustrates the pathology process from defensive adaptation to depression, pointing out the early prevention of depression by discovering entrapment. This study aims to reveal the relationship between migrant workers' entrapment and depressive symptoms.

METHODS

A total of 1805 migrant workers in Shenzhen were recruited by stratified multi-stage sampling. Sample's demographic, behavioral and psychosocial characteristics were described and analyzed to reveal the relationship between entrapment and depressive symptoms. The Receiver Operator Characteristic was performed to find the optimal cut-off point of Entrapment Scale for predicting depressive symptoms.

RESULTS

In the binary logistic regression of sociodemographic variables, migrant workers who were married (univariate odds ratio (ORu) = 0.69, 95% Confidence Interval (CI) = 0.56-0.84), owned 1 or 2 children (ORu = 0.71, 95% CI = 0.58-0.86), had been working over 10 years (ORu = 0.71, 95% CI = 0.54-0.95), earned > 4999 yuan per month (ORu = 0.68, 95% CI = 0.47-0.99; multivariate odds ratio (ORm) = 0.57, 95% CI = 0.38-0.87) or with low risks of alcohol use disorders (ORu = 0.51, 95% CI = 0.34-0.75) had lower risks of depressive symptoms. After adjusted the aforementioned significant sociodemographic variables, migrant workers with severer entrapment were more likely to have depressive symptoms (adjusted odds ratio (ORa) = 1.13, 95% CI = 1.12-1.15). Besides, the study proved the reliability and validity of the Chinese version Entrapment Scale, preferring a two-dimensional structure, and 11 was the optimal cut-off value of this scale for predicting depressive symptoms among migrant workers.

CONCLUSIONS

This result indicates the potential value of entrapment according to the social rank theory on facilitating early prevention of migrant works' depression and the application value of Entrapment Scale for effectively measuring mental status among migrant workers.

Aggressive interactions and consistency of dominance hierarchies of the native and nonnative cichlid fishes of the Balsas basin

Dominance hierarchies are generally established based on the levels of aggressiveness that animals present. Frequently, animals fight to establish a dominance hierarchy and obtain a disputed resource. The Mexican mojarra Cichlasoma istlanum is a native species of the Balsas river basin and coexists there with four nonnative cichlids: tilapia Oreochromis sp., convict cichlid Amatitlania nigrofasciata, spotcheek cichlid Thorichthys maculipinnis, and green terror Andinoacara rivulatus. These five cichlid species compete for spaces for reproduction, feeding, and shelter and frequently engage in aggressive interactions to obtain these resources. We quantified dominance indices to evaluate the hierarchical structure of dominance among these five cichlids and the duration of aggressive behaviors of the Mexican mojarra during experimental contests between the native species and each of the four nonnative species. The Mexican mojarra was consistently dominant over the other four cichlid species, performing a larger number of aggressive behaviors and investing more time in attacking than the nonnative cichlids, which resulted in a higher hierarchical position. Our results show that the native fish, Mexican mojarra, established dominance over all four nonnative cichlid fish of the Balsas basin. Thus, the establishment of nonnative cichlid species in the Balsas basin is likely associated with factors other than behavioral dominance.

Affective and Autonomic Reactivity During Parent-Child Interactions in Depressed and Non-Depressed Mothers and Their Adolescent Offspring

Depression presents risks that are profound and intergenerational, yet research on the association of depression with the physiological processes that might be associated with impaired mental and physical health has only recently been contextualized within the family environment. Participants in this multi-method case-control study were 180 mother-adolescent dyads (50% mothers with a history of depression treatment and current depressive symptoms). In order to examine the association between maternal depression and affective and autonomic reactivity amongst these mothers and their adolescent offspring we collected self-reported measures of positive and negative affect, as well as measures of cardiovascular and electrodermal autonomic activity, during mother-adolescent interaction tasks. Findings indicated that depressed mothers and their adolescent offspring exhibited greater self-reported negative affect reactivity during a problem-solving interaction and blunted (i.e., low) sympathetic activity as measured via skin conductance level across both interaction tasks. These effects remained significant after controlling for a range of potential covariates, including medication use, sex, age, adolescents own mental health symptoms, and behavior of the other interactant, along with correcting for multiple comparisons. Findings indicate that depressed mothers and their adolescent offspring both exhibit patterns of affect and physiology during interactions that are different from those of non-depressed mothers and their offspring, including increased negative affect reactivity during negative interactions and blunted sympathetic activity across both positive and negative interactions. These findings have potential implications for understanding the role of family processes in the intergenerational transmission of risk for depressive disorders.

Converging evidence for enduring perceptions of low social status in individuals in remission from depression

BACKGROUND

The risk of depressive relapse and recurrence is associated with social risk factors that may be amplified by a submissive socio-cognitive profile.

METHODS

In Study 1 we aimed to identify perceptions of low social status in a community sample (N = 613) with a self-reported history of mental health difficulties (n = 232) and, more specifically in Study 2 (N = 122), in individuals in clinical remission from depression (n = 18), relative to a never-depressed control group (n = 64), and relative to a group experiencing a current depressive episode (n = 40).

RESULTS

In Study 1, a total of 225 of the 232 participants in the self-reported mental health difficulties group opted to provide further information regarding their mental health history, of whom 153 (68%) reported a history of anxiety, 168 (74.7%) reported a history of depression, and 13 (5.8%) reported an unspecified mental health history. Elevated depressive symptoms were associated with perceptions of low social status which significantly differed between individuals with and without a self-reported history of mental health difficulties. In Study 2 we found enduring perceptions of low social status in remitted depressed individuals.

LIMITATIONS

We were unable to discern between historical or current clinical diagnosis in the community sample of Study 1, as we were reliant on self-report. We were unable to explore the effects of medication or causal relationships between depressive symptoms and social status as the studies were cross-sectional in nature.

CONCLUSIONS

These findings suggest that evolutionarily rooted socio-cognitive profiles could impact affiliative processes and may confer increased vulnerability to future depressive episodes.

Is Political Skill Always Beneficial? Why and When Politically Skilled Employees Become Targets of Coworker Social Undermining

The benefits of political skill at work have been extensively documented and highlighted. Existing research also reports unexpectedly equivocal and even positive relationships between employee political skill and coworker social undermining, suggesting that politically skilled employees can become targets of coworker social undermining. However, there is a lack of research explaining why and when employee political skill can lead to coworker social undermining. This research, drawing from social rank theory and the theory of rivalry, offers a novel lens to answer these questions. Specifically, I theorize that employee political skill evokes coworker social undermining by affecting coworker perception of status threat, particularly when the coworker views the focal politically skilled employee as a personal rival. Findings from four studies—one correlational two-wave study and three experiments—provide support for these predictions. Further, nonrival competition and interpersonal disliking as alternative potential explanations to the hypothesized moderating effects of rivalry were ruled out. This study provides a theory-driven explanation of an unintended consequence of employee political skill and offers a more balanced understanding of the effects of political skill at work. Theoretical and future research implications are discussed.

Stressed, depressed, and rank obsessed: Individual differences in compassion and neuroticism predispose towards rank-based depressive symptomatology

OBJECTIVES

As social creatures, we monitor our relative rank and/or status with others via social comparisons. Whilst research has identified perceptions of inferiority or 'low rank' relative to others is a robust predictor of depressive, anxious, and stress symptomology, to date individual differences have been ignored. We wish to provide empirical evidence to outline how differences across personality traits may interact with social rank variables to buffer or predispose towards depressive symptomology.

METHODS

Across three independent samples (N = 595), we replicated a social rank model of mental health, and with our third sample (N = 200), we sought to investigate attenuating roles for neuroticism versus compassion with multiple moderated regression models.

RESULTS

Neuroticism predicted greater levels of rank-associated depression, and compassion failed to function as a protective factor for rank-associated depression. However, a closer inspection of the original Big-5 factor structure positions this scale as a measure of 'interpersonal submissiveness' or 'conflict appeasement' rather than genuine compassion.

CONCLUSIONS

Whilst it is necessary to delineate the conditions where compassion is appropriate and able to lead to positive mental health outcomes, we argue this cannot be addressed with the Big-5 measure of trait compassion. We call for future work to consider valid and reliable measures for compassion, such as the self-compassion scale, submissive compassion scale, and fears of compassion scale, to more fully address how compassion may protect against both rank-based comparisons and severity of depression.

PRACTITIONER POINTS

Social rank mechanisms are robustly implicated in depression, anxiety, and stress. Clients who present as higher in neuroticism, inferiority, or submissiveness may be more prone towards rank-associated depression symptoms. Preliminary evidence suggests cultivation of genuine compassion can shift clients from a rank-focussed to a compassionate-focussed mentality, which aids mental health and fosters well-being.

Evolutionary theory and the treatment of depression: It is all about the squids and the sea bass

According to the analytical rumination hypothesis, depression is an evolved adaptation (like pain or anxiety) that served in our ancestral past to keep people focused on complex interpersonal problems until they could arrive at a resolution (spontaneous remission). If this is true, then those clinical treatments that most facilitate the functions that depression evolved to serve are likely to be more advantageous in the long run than others that simply relieve distress. For example, antidepressant medications may be efficacious in the treatment of depression but only work for so long as they are taken. They may also have an iatrogenic effect that prolongs the duration of the underlying episode. Cognitive and behavioral interventions are as efficacious as medications in terms of reducing acute distress and also appear to have an enduring effect that protects against the return of subsequent symptoms. However, the bulk of the evidence for this effect comes from comparisons to prior medication treatment and it remains unclear whether these psychosocial interventions are truly preventative, or antidepressant medications iatrogenic. A study is described that could resolve this issue and test evolutionary theory with respect to the purported role of rumination in bringing about spontaneous remission.

An exploratory investigation into the effects of mental defeat on pain threshold, pain rating, pain anticipation, and mood

In chronic pain, mental defeat is considered as a disabling type of self-evaluation triggered by repeated episodes of debilitating pain. This exploratory study experimentally tested the effect of an activated sense of defeat, as well as its interaction with pain catastrophizing, on pain and mood. Participants (N = 71) were allocated to either high or low pain catastrophizing groups and then randomly assigned to receive either defeat or neutral manipulations. A cold pressor task administered before and after the thought manipulation measured pain threshold, alongside visual analogue scales for mental defeat, attention, pain intensity, pain anticipation as well as mood. Thought manipulation checks supported successful defeat activation. Defeat activation was associated with increased negative mood and attentional disengagement from the nociceptive stimuli, irrespective of pain catastrophizing tendency. There were no changes in pain threshold, pain or pain anticipation ratings. The results suggest that mental defeat can be experimentally activated using an autobiographical memory task and that an activated sense of defeat appears to operate independently from pain catastrophizing in influencing mood and attentional disengagement from the nociceptive stimuli. Future research can utilize our experimental approach to evaluate the effect of an activated sense of mental defeat in people with chronic pain, for whom the magnitude of pain, mood and attentional responses may be stronger and broader.

Teorias evolucionistas da depressão: panorama e perspectivas

Resumo A depressão tem alcançado níveis epidêmicos ao redor do mundo. Seria a depressão um distúrbio mental, como é consenso na saúde mental? Teóricos evolucionistas têm-se questionado quanto à função da depressão e proposto modelos específicos para explicá-la. O objetivo deste artigo é apresentar teorias evolucionistas da depressão, discutir as relações de complementariedade e contraposição entre elas e as implicações sociais e práticas para o tratamento da depressão. Essas reflexões e questionamentos no domínio da saúde mental podem influenciar novos estudos a partir de uma perspectiva não patológica da depressão. No âmbito da psicologia essa perspectiva fornece subsídios para repensar a psicoterapia com o deprimido, enfocando a análise causal e a resolução de problemas. Sugere-se a realização de estudos empíricos com a finalidade de testar e sistematizar as teorias evolucionistas da depressão.

Predictors of poor 6-week outcome in a cohort of major depressive disorder patients treated with antidepressant medication: the role of entrapment

BACKGROUND

Only a small number of consistent processes predict which depressed patients will achieve remission with antidepressant medication. One set of processes is that of social ranking strategies/variables that are related to life events and severe difficulties. Particularly, defeat and entrapment predict poorer response to antidepressants. However, results are inconsistent.

AIM

The current study aimed to evaluate evolutionary strategies, childhood maltreatment, neglect and life events and difficulties (LEDs) as predictors of remission in depressed patients undergoing pharmacological treatment in a psychiatric outpatient sample.

METHODS

A cohort of 139 depressed outpatients undergoing pharmacological treatment was followed prospectively in a naturalistic study for 6 weeks. Two major evaluations were considered at baseline and 6 weeks. We allocated patients to a pharmacological treatment algorithm for depression - the Texas Medication Algorithm Project. Variables evaluated at baseline and tested as predictors of remission included demographic and clinical data, severity of depression, social ranking, evolution informed variables, LEDs and childhood maltreatment.

RESULTS

Of the 139 patients, only 24.5% were remitted at week 6. In univariate analyses, non-remitted patients scored significantly higher in all psychopathology and vulnerability scales except for submissive behaviour and internal entrapment. For the logistic regression, a higher load of LEDs of the entrapment and humiliation dimension in the year before the index episode (OR = 6.62), and higher levels external entrapment in the Entrapment Scale (OR = 1.10) predicted non-remission. These variables accounted for 28.7% of the variance.

CONCLUSIONS

Multivariate analysis revealed that external entrapment was the only predictor of non-remission.

Customizing Your Demons: Anxiety Reduction via Anthropomorphizing and Destroying an "Anxiety Avatar"

Character customization is a prominent feature in digital games, affording users the ability to tailor one’s virtual self-representation (avatar) to match aspects of their actual or ideal self, influencing psychological well-being. The mental health implications of character customization can be partially explained by self-discrepancy theory, which argues that achieving congruence with one’s avatar reduces cognitive dissonance. However, the role of undesirable self-concepts such as mental health ailments have largely been overlooked in this context despite forming part of one’s identity. In theory, customization of an avatar representing undesirable self-concepts presents a self-regulatory paradox: individuals desire to reduce discrepancies with a self-representation, yet they also desire to enlarge discrepancies with a disliked-self. To reconcile this, two experiments explored the psychological implications of imbuing avatars with undesirable self-concepts. In Study 1 (N = 90), participants customized an avatar to represent anxiety within themselves (i.e., an anxiety avatar). Customization significantly reduced state anxiety compared to a control group, supporting the proposed discrepancy-reduction mechanism. Study 2 (N = 122) employed a 2 (customization: yes, no) × 2 (destruction: yes, no) between-subjects design, with participants either destroying or observing an anxiety avatar. Destruction of customized anxiety avatars resulted in the largest reduction in anxiety among all conditions, supporting the proposed discrepancy-enlargement mechanism. Theoretical and practical implications for the use of avatar-based e-mental health interventions are discussed.

Status, rivalry and admiration-seeking in narcissism and depression: A behavioral study

Humans seek admiration to boost their social rank and engage in rivalry to protect it when fearing defeat. Traits such as narcissism and affective states such as depression are thought to influence perception of rank and motivation for dominance in opposite ways, but evidence of the underlying behavioral mechanisms is scant. We investigated the effects of dimensionally-assessed narcissism and depression on behavioral responses to social defeat in a rigged video game tournament designed to elicit rivalry (stealing points from opponents) and admiration-seeking (paying for rank). We tested an undergraduate sample (N = 70, mean age = 21.5 years) and a clinical sample of predominantly depressed elderly (N = 85, mean age = 62.6 years). Both rivalry and admiration-seeking increased with time on task and were particularly enhanced in individuals high in narcissism. Participants engaged in more rivalry when pitted against high-ranked opponents, but depression partially mitigated this tendency. Our findings provide behavioral evidence that narcissism manifests in increased rivalry and admiration-seeking during social contests. Depression does not suppress general competitiveness but selectively inhibits upward-focused rivalry.

A loss of status and a sense of defeat: an evolutionary perspective on professional burnout

This longitudinal study among Spanish teachers (N = 558) examined burnout from an evolutionary social rank perspective. The types of stress differed among various school levels, and a sense of defeat was highest among teachers in primary schools. A low status, a loss of status and a sense of defeat were independent cross‐sectional predictors of burnout. Longitudinally a sense of defeat predicted an increase in burnout over time, especially among males and teachers in high schools. The status related variables were in general more important predictors of burnout than stressors that are usually associated with burnout. Copyright © 2007 John Wiley & Sons, Ltd.

The fragility of perceived social rank following exercise in anorexia nervosa: an ecological momentary assessment study of shame and pride

PURPOSE

Pride and shame are self-conscious emotions closely associated with perceived social rank. Goss and Gilbert (In: Gilbert and Miles (eds) Body shame: conceptualization, research & treatment. Brunner-Routledge, Hove, 2002) proposed that weight-control behaviours in anorexia nervosa (AN) provide a temporary sense of increased rank that dissipates afterwards, thereby perpetuating further symptoms. This pilot study tested their theory by examining whether shame increases and pride decreases as time passes post-exercise in individuals with AN. Pre-exercise patterns were also explored.

METHODS

Over 2 weeks, 23 females with AN provided ecological momentary assessment data via six semi-random daily signals and after each exercise episode. The State Shame and Guilt Scale assessed pride and shame. Items modified from the Experience of Shame Scale and the Other as Shame Scale assessed general shame and body/eating shame. Multilevel models analyzed patterns of shame and pride prior to and following exercise episodes.

RESULTS

In the hours after exercise, pride decreased, body/eating shame increased, and general shame increased on one measure. Pride was, therefore, higher and shame lower immediately after exercise as compared to later in the day. In the hours before exercise, pride increased, but shame levels did not change significantly.

CONCLUSION

The anticipation and immediate aftermath of exercise may be associated with higher perceived social rank in people with AN, but their feelings about self may worsen as time passes after exercise. Fluctuations in shame and pride may contribute to the maintenance of exercise in people with AN.

LEVEL OF EVIDENCE

IV, multiple time series analysis.

Perceived family and individual social status and its association with depression and suicidality in an adolescent clinical sample

There is a well-documented association between subjective social status (SSS) and depression among adults. Yet, the research on SSS and suicidal thoughts and behaviors among adolescent minority populations is limited. The aim of this study was to examine the relationship between the adolescent's SSS and mental health in an adolescent sample. A total of 197 adolescents ages 12 to 18 years (M age = 14.58; SD = 1.54) and their parents were recruited in urban outpatient clinics. Sociodemographics and measures of depression, suicidal thoughts and behaviors, and SSS were collected in a cross-sectional survey and through chart review. Univariate and multivariate analyses were conducted to calculate statistical associations with depression and suicidal thoughts and behaviors. Significant negative associations were found between SSS and depression, suicidal ideation, and prior suicidal attempts, independent of socioeconomic status. Consideration should be given to assessing measures of social rank to appraise risk in adolescent outpatient clinical settings.

Self-competence increases the willingness to pay for social influence

Theoretical works in social psychology and neuroscientific evidence have proposed that social rewards have intrinsic value, suggesting that people place a high premium on the ability to influence others. To test this hypothesis, we asked whether, and under what conditions, people are willing to forgo monetary reward for the sake of influencing others' decisions. In four experiments, online and lab-based participants competed with a rival for influence over a client. The majority of participants sacrificed some of their financial reward to increase their chance of being selected over their rival within the experiment. Willingness to pay was affected by the participant's current level of influence and performance, as participants were most likely to pay to promote their competence after having given good advice that had been ignored by the client using a situation where monetary incentives fail to explain human motivations, our experiments highlight the intrinsic value of social influence.

Behavioral and hormonal effects of prolonged Sildenafil treatment in a mouse model of chronic social stress

Chronic social defeat can inhibit the reproductive system of subordinate males and causes behavioral deficits. Sildenafil treatment increases mice testosterone levels through its effects on Leydig cells of mice and it has been found to work as an antidepressant drug both in humans and in animal models. Since previous findings showed that sildenafil can counteract the inhibitory effects of chronic social defeat on agonistic, reproductive and anxiety-like behaviors of subordinate male mice, we investigated whether these behavioral outcomes can be explained by Sildenafil stimulation of testosterone. CD1 mice underwent an intruder-resident paradigm. After the fifth day of test, subordinate mice were injected with either a 10 mg/kg Sildenafil or a saline solution for 4 weeks. The results of the present study showed that Sildenafil treatment increased counterattacking behaviors and sexual motivation of subordinate males in addition to limiting the increase in body weight often observed in subordinate mice following chronic psychosocial stress. Moreover, sildenafil treated mice showed a pattern of behaviors reflecting lower anxiety. In agreement with previous studies, Sildenafil also increased testosterone levels. These data demonstrate that sildenafil can counteract the effects of chronic stress, possibly through its stimulatory effects on Leydig cells. These data demonstrate that sildenafil might counteract the effects of chronic psychosocial stress through centrally and peripherally mediated mechanisms.

Cognitive evolutionary therapy versus standard cognitive therapy for depression: A single-blinded randomized clinical trial

OBJECTIVE

To compare the efficacy of cognitive evolutionary therapy (CET) with cognitive therapy (CT) for depression.

METHODS

Ninety-seven participants (78 females/19 males) were randomized to a single-blinded controlled trial (CET: n = 51 vs. CT: n = 46). Assessments were conducted at baseline, Sessions 4 and 8, posttreatment, and 3-month follow-up. Clinical diagnoses were made with Structured Clinical Interview for DSM-IV (SCID) and self-reports for depression and secondary outcomes.

RESULTS

Although both groups showed significant reductions in depressive symptomatology, the overall Time × Treatment group interaction in the intent to treat analysis was not significant (p = .770, posttreatment: d = 0.39). However, CET was superior to CT at increasing engagement in social and enjoyable activities (p = .040, posttreatment: d = 0.83, p = .040) and showed greater reductions than the CT group in behavioral inhibition/avoidance (p = .047, d = 0.62). The between-group differences generally diminished at the 3-month follow-up.

CONCLUSIONS

CET is a novel therapy for depression that may add therapeutic benefits beyond those of CT.

A Game Theory-Based Model for Predicting Depression due to Frustration in Competitive Environments

A computational model based on game theory is here proposed to forecast the prevalence of depression caused by frustration in a competitive environment. This model comprises a spatially structured game, in which the individuals are socially connected. This game, which is equivalent to the well-known prisoner's dilemma, represents the payoffs that can be received by the individuals in the labor market. These individuals may or may not have invested in a formal academic education. It is assumed that an individual becomes depressed when the difference between the average payoff earned by the neighbors in this game and the personal payoff surpasses a critical number, which can be distinct for men and women. Thus, the transition to depression depends on two thresholds, whose values are tuned for the model accurately predicting the percentage of individuals that become depressed due to a frustrating payoff. Here, this tuning is performed by using data of young adults living in the United Kingdom in 2014-2016.

Compassion-focused therapy for body weight shame: A mixed methods pilot trial

Individuals with bigger bodies (body mass index greater than 30) often experience body weight shame and are at increased risk for mental health vulnerabilities such as depression and anxiety. To date, there have been no studies specifically designed and pilot tested to help with body weight shame for individuals with bigger bodies that do not have a diagnosed clinical condition. The aim of current study is to investigate the initial feasibility of compassion-focused therapy (CFT) as a 12-session group intervention for the reduction in body weight shame for individuals with bigger bodies. The study used a mixed method repeated measure design, with both quantitative and qualitative measures, to assess the initial feasibility of the CFT group-based intervention. Participants (N = 5) attended a 12-session/2-h group CFT programme aimed to directly target body weight shame by cultivating compassion. Measurements were conducted at three time points (pre-, post- and 3-month follow-up intervention). Results indicated that CFT had a positive impact on reducing body weight shame, increasing compassion and improving health-engaging behaviours. Qualitative feedback indicated the importance of the group dynamics to help with the de-shaming of body appearance for individuals. Results from this feasibility trial are promising, and future research using randomized controlled trial methodologies should be conducted to evaluate the effectiveness of CFT as a treatment option for body weight shame for individuals with bigger bodies.

Shame and the psychosis continuum: A systematic review of the literature

OBJECTIVES

Shame is increasingly implicated in the development and maintenance of several psychological problems including psychosis. The aim of the current paper was to review the research literature concerning the relationship between shame and the psychosis continuum, examining the nature and direction of this relationship.

METHOD

Systematic searches of databases PsycINFO, Medline, Scopus, and Web of Science (from the earliest available database date until November 2016) were undertaken to identify papers that examined the relationship between shame and psychosis or psychotic experiences.

RESULTS

A total of 20 eligible papers were identified. Risk of bias assessment identified methodological shortcomings across the research in relation to small, unrepresentative samples and failure to control for confounding variables. Narrative synthesis suggested positive associations between shame and paranoia (n = 10, r = .29-.62), shame and psychosis (n = 1, r = .40), and shame and affiliation with voices (n = 1, β = .26), and suggested that shame was greater in those with psychosis compared to controls (n = 4, d = 0.76-1.16).

CONCLUSIONS

Overall, several studies provide partial support for the theory that shame is an important factor in relation to psychotic experiences in both clinical and non-clinical populations, particularly paranoia. However, the predominance of cross-sectional designs prevents any conclusions being drawn concerning the temporal nature of associations. Additional research is necessary to further delineate the role of shame in relation to specific psychotic experiences such as voice-hearing. Longitudinal research is particularly needed to help establish the directionality and temporal aspects of effects.

PRACTITIONER POINTS

Research indicates moderate-to-strong positive associations between shame and psychotic experiences in the existing literature. The results provide preliminary evidence that shame may play a role in relation to psychosis and, more specifically, paranoia. Findings should be interpreted with caution due to many disparities across the studies reviewed and methodological shortcomings (e.g., small sample sizes). It is not currently possible to determine causality or direction of effect due to the cross-sectional design of all existing studies.

How involuntary subordination and social support influence the association between self-esteem and depression: a moderated mediation model

BACKGROUND

In China, young migrants are at elevated risk of mental health problems, such as depression. The influence of self-esteem on depression is well acknowledged. We examined correlates of depression and their mediating and moderating role in the association between self-esteem and depression to promote a better understanding of depression prevention among young migrants.

METHODS

We conducted a cross-sectional study among young Chinese migrants. A moderated mediation model was used to test the combined effect of involuntary subordination and social support on the association between self-esteem and depression. The Johnson-Neyman method was used to identify the range of scores for which social support acted as a moderator.

RESULTS

A total of 572 participants completed questionnaires. The median depression score was 19 (interquartile range: 14). Self-esteem had a negative effect on involuntary subordination (β = - 2.1440, p < 0.001). Involuntary subordination (β = 0.2406, p < 0.001), self-esteem (β = - 0.3870, p < 0.01), and social support (β = - 0.1221, p < 0.01) all had significant effects on depression. The effect of involuntary subordination on depression was moderated by social support (β = - 0.0041, p < 0.05), and the effect decreased as social support scores increased.

CONCLUSIONS

Our results indicated a mediating role of involuntary subordination and a moderating role of social support in the association between self-esteem and depression among young Chinese migrants. Future intervention strategies should focus on these factors to reduce depressive symptoms.