Gender differences in the relationship between medical students' emotional intelligence and stress coping: a cross-sectional study

BACKGROUND

Given the increasing stress levels among medical students due to the impact of COVID-19, it is crucial to effectively reduce their stress levels for their future development. To better understand medical students' stress coping, this study investigated how their emotional intelligence is related to stress coping and whether this relationship is moderated by gender differences.

METHODS

A cross-sectional study was conducted. A random sample of 744 medical students from Hebei Province, China, was investigated via an emotional intelligence scale and stress coping questionnaire from March-May 2023. The response rate was 93%. SPSS and Mplus statistical software were used for the data analysis.

RESULTS

The self-emotional appraisal of medical students had a significant negative effect on avoidant coping (β = -0.173, CI 95% = [-0.243, -0.099], p < .001). However, the other dimensions of emotional intelligence (others' emotional appraisal, use of emotion, and regulation of emotion) had a significant positive impact on the active coping of female medical students (β = 0.146, CI 95% = [0.082,0.214], p < .001; β = 0.235, CI 95% = [0.167,0.304], p < .001; β = 0.165, CI 95% = [0.084,0.247], p < .001). In contrast to those of female medical students, other dimensions of emotional intelligence had a significant positive impact on the avoidant coping of male medical students (β = -0.161, CI 95% = [-0.284, -0.062]; p < 0.01; β = 0.126, CI 95% = [0.043,0.246], p < 0.001; β = 0.159, CI 95% = [0.054,0.277], p < 0.05; β = -0.221, CI 95% = [-0.363, -0.129], p < 0.001). Moreover, the use of emotion had a significant positive impact on the active coping of male medical students (β = 0.272, CI 95% = [0.182,0.382], p < .001). Furthermore, gender differences had a moderating effect on the relationship between emotional intelligence dimensions and stress coping (β = 0.178; CI 95% = [0.068,0.292]; p < 0.05). Others' emotional appraisal has a greater impact on female students' active coping. In addition, with increasing regulation of emotion ability, female medical students reduce avoidant coping (β = 0.169, CI 95% = [0.002,0.326]; p < 0.05).

CONCLUSIONS

The current study revealed that gender is a significant moderator of the relationship between medical students' emotional intelligence and stress coping. These findings may help medical colleges focus on gender differences when improving medical students' ability to cope with stress.

When money and mental health problems pile up: The reciprocal relationship between income and psychological distress

Background

Longitudinal studies suggest that socioeconomic status (SES) and mental health have a bidirectional relationship such that SES declines lead to a deterioration of mental health (social causation), while worsening mental health leads to SES declines (social drift). However, the dynamic relationship between income and psychological distress has not been sufficiently studied.

Methods

We use cross-lagged panel models with unit fixed effects (FE-CLPM) and data from a five-wave representative panel (n = 3103) of working-age (18-64) New York City adults. Yearly measures include individual earnings, family income (income-to-needs), and psychological distress. We also examine effects by age, gender, education, and racial/ethnic identification.

Results

We find significant bidirectional effects between earnings and distress. Increases in past-year individual earnings decrease past-month psychological distress (social causation effect [SCE], standardized β= -0.07) and increases in psychological distress reduce next-year individual earnings (social drift effect [SDE], β= -0.03). Family income and distress only have a unidirectional relationship from past-year family income to distress (SCE, β= -.03). Strongest evidence of bidirectional effects between earnings and distress is for prime working-age individuals (SCE, β= -0.1; SDE, β= -0.03), those with less than bachelor's degrees (SCE, β= -0.08; SDE, β= -0.05), and Hispanics (SCE, β= -0.06; SDE, β= -0.08). We also find evidence of reciprocal effects between family income and distress for women (SCE, β= -0.03; SDE, β= -0.05), and Hispanics (SDE, β= -0.04; SDE, β= -0.08).

Conclusions

Individual earnings, which are labor market indicators, may be stronger social determinants of mental health than family income. However, important differences in social causation and social drift effects exist across groups by age, education, gender, and racial/ethnic identities. Future research should examine the types of policies that may buffer the mental health impact of negative income shocks and the declines in income associated with worsening mental health, especially among the most vulnerable.

Longitudinal relationships in the psychopathology of depressive symptoms in middle-aged and older adults in China

OBJECTIVES

To develop symptom networks and examine the longitudinal relationships of depressive symptoms among middle-aged and older adults in China.

METHOD

This study used three-wave data from the China Health and Retirement Longitudinal Study (2013 (T1), 2015 (T2), and 2018 (T3)). Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). A multilevel vector autoregression model (VAR) was used to identify ten depressive symptoms dynamically interacting with each other over time.

RESULTS

A total of 3,558 participants were included in the final analysis. The strongest direct effects were 'D10: felt fearful' -> 'D6: felt everything I did was an effort' (β = 0.14). 'D10: felt fearful' reported the largest value of out-predictability (r = 0.064) and out-strength (r = 0.635). 'D3: felt depressed' reported the largest value of in-predictability (r = 0.077) and in-strength (r = 0.545). Substantial heterogeneity in the network may stem from an individual's sex and place of residence.

CONCLUSIONS

'Felt fearful' was the strongest predictor compared to the other nine depressive symptoms based on node centrality. Our study suggests that, after understanding the causes of fear, strategies to reduce fear should be incorporated into multimodal interventions for middle-aged and older adults with depressive symptoms.

The Role of Genetics in the Development and Pharmacotherapy of Depression and Its Impact on Drug Discovery

Complex disorders, such as depression, remain a mystery for scientists. Although genetic factors are considered important for the prediction of one's vulnerability, it is hard to estimate the exact risk for a patient to develop depression, based only on one category of vulnerability criteria. Genetic factors also regulate drug metabolism, and when they are identified in a specific combination, may result in increased drug resistance. A proper understanding of the genetic basis of depression assists in the development of novel promising medications and effective disorder management schemes. This review aims to analyze the recent literature focusing on the correlation between specific genes and the occurrence of depression. Moreover, certain aspects targeting a high drug resistance identified among patients suffering from major depressive disorder were highlighted in this manuscript. An expected direction of future drug discovery campaigns was also discussed.

Point prevalence and sex-specific associated factors of depression in Latvian general population

Background

This cross-sectional study aimed to determine the current prevalence of depression, and analyze sex-specific associated socio-demographic and health-related factors for depression in a representative sample of the general adult population of Latvia.

Methods

Specially trained professional interviewers conducted computer-assisted face-to-face interviews with a multistage stratified probability sample from the general Latvian adult population (n = 2,687). A 9-item Patient Health Questionnaire (PHQ) was used for assessment of depression. Respondents were interviewed using the specially developed questionnaire about sociodemographic factors as well as the alcohol use disorder module of the Mini International Neuropsychiatric Interview. Binary logistic regression was used to calculate the odds ratios (OR) for the univariate and multivariate logistic analyses.

Results

The point prevalence of depression according to the PHQ-9 was 6.4% (95% CI 5.8-7.6). After adjustment for all independent variables analyzed, being divorced, widowed, or living separately increased the odds of depression [aOR 2.6 (95% CI, 1.2-5.8), p = 0.02] in males. For females, unfinished primary education [aOR 5.2 (95% CI 2.0-13.6), p = 0.001] and economically inactive status [aOR 2.0 (95% CI, 1.1-3.6), p = 0.03] were strongly associated with depression.

Limitations

The cross-sectional design of the study did not allow us to draw conclusions about causality. Patients with bipolar, organic, and symptomatic depression states were not excluded.

Conclusion

The prevalence of depression in the general adult population is 6.4%, with the most significant sex-specific factors associated with depression for males - being divorced, widowed, or living separately, and for females it was poor education and economic inactivity.

Prevalence of depressive symptoms among dental students is influenced by sex, academic performance, smoking exposure, and sexual orientation

Aim: To estimate the prevalence and associated factors of self-reported depressive symptoms in undergraduate and graduate dental students. Methods: The Depression, Anxiety and Stress Scale (DASS-21) was applied, and only the depression domain was verified. A structured questionnaire was used to collect sociodemographic, behavioral, and COVID-19 pandemic-related fear variables. Academic performance was assessed based on academic records, ranging from 0 (worst possible grade) to 10 (best possible grade). Respondents included 408 regularly enrolled dental students. Bi- and multivariate analyses were performed using Poisson regression with robust variance to verify the association between at least moderate depressive symptoms and independent variables. Results: The prevalence of at least moderate depression was 40.5% among undergraduate students and 26% among graduate students. The prevalence of fear and anxiety due to the COVID-19 pandemic was 96.1% among undergraduate students and 93.5% among graduate students. In the final multivariate analysis, being female (prevalence ratio [PR]:2.01; 95% confidence interval [95%CI]:1.36–2.96) was associated with a higher PR for depression. Conversely, no exposure to smoking (PR:0.54; 95%CI:0.36–0.82) and a final academic performance average ≥7.0 (PR:0.56; 95%CI:0.41–0.76) was associated with a lower PR for depression. Finally, among graduate students, a non-heterosexual orientation was associated with a higher PR for depression (PR:6.70; 95%CI:2.21–20.29). Conclusion: Higher rates of depression symptoms were observed in female undergraduates, students with lower academic performance and smoking exposure, and graduate dental students with a non-heterosexual orientation.

Trait attributions and threat appraisals explain why an entity theory of personality predicts greater internalizing symptoms during adolescence

Adolescents who hold an entity theory of personality - the belief that people cannot change - are more likely to report internalizing symptoms during the socially stressful transition to high school. It has been puzzling, however, why a cognitive belief about the potential for change predicts symptoms of an affective disorder. The present research integrated three models - implicit theories, hopelessness theories of depression, and the biopsychosocial model of challenge and threat - to shed light on this issue. Study 1 replicated the link between an entity theory and internalizing symptoms by synthesizing multiple datasets (N = 6,910). Study 2 examined potential mechanisms underlying this link using 8-month longitudinal data and 10-day diary reports during the stressful first year of high school (N = 533, 3,199 daily reports). The results showed that an entity theory of personality predicted increases in internalizing symptoms through tendencies to make fixed trait causal attributions about the self and maladaptive (i.e., "threat") stress appraisals. The findings support an integrative model whereby situation-general beliefs accumulate negative consequences for psychopathology via situation-specific attributions and appraisals.

Socio-Economic Development and Mental Health: Case Study of the Spanish Region of Aragon (2010-20)

Introduction

Considering health as a cross-cutting element of all public policies leads to rethinking its interactions with the environment in which people live. The collection of large volumes of data by public administrations offers the opportunity to monitor and analyze the possible associations between health and territory. The increase in the incidence and prevalence of mental health diseases, particularly depression, justifies the need to develop studies that seek to identify links with the socioeconomic and environmental setting.

Objective

The objective of this study is to explain the behavior of the depression in a mediterranean region of Northeastern Spain from an ecological and diachronic perspective.

Methods

We conducted a correlation and multivariate logistic regression analysis to identify explanatory factors of the prevalence of depression in 2010 and 2020 and in the variation rate. Potential explanatory factors are related to the socioeconomic status and to the territorial development level.

Results

The regression models retained both socioeconomic and territorial development variables as predictors of the prevalence in both years and in the variation rate. Rural areas seem to play a protective role against the prevalence.

Conclusion

It is under the territorial prism that epidemiological studies could offer useful guidelines for proactive decision-making. The integration of data on diseases and territory must be considered when developing policies for the creation of healthier environments and for directing health services with more specific resources to where they may be needed.

Lower Blood Vitamin D Levels Are Associated with Depressive Symptoms in a Population of Older Adults in Kuwait: A Cross-Sectional Study

Low serum vitamin D has been associated with an increased risk of neuropsychiatry disorders. This study aimed to examine the association between vitamin D deficiency and depression in adults aged 65 years and older. This cross-sectional study was conducted in seven primary healthcare centers across Kuwait (November 2020 to June 2021). The participants (n = 237) had their serum vitamin D 25-(OH)-D concentrations (analyzed by LC-MS) classified as sufficient, ≥75 nmol/L (30 ng/mL); insufficient, 50−75 nmol/L (20−30 ng/mL); or deficient, <50 nmol/L (20 ng/mL). Depressive symptoms were evaluated using the 15-Item Geriatric Depression Scale (15-item GDS). The mean serum 25-OH-D levels (nmol/L) in volunteers with normal, mild, moderate, and severe depression were 100.0 ± 31.7, 71.2 ± 38.6, 58.6 ± 30.1 and 49.0 ± 6.93, respectively (p < 0.001). The participants in the vitamin D sufficiency group were significantly less likely to exhibit depressive symptoms (88.2%) than patients with mild (36%) and moderate (21%) depression (p < 0.001). Ordinal logistic regression showed that vitamin D deficiency (OR = 19.7, 95% CI 5.60, 74.86, p < 0.001) and insufficiency (OR = 6.40, 95% CI 2.20, 19.91, p < 0.001) were associated with higher odds of having depressive symptoms. A low serum vitamin D level is a significant predictor of symptoms of depression among older individuals.

Mental distress among young adults - gender differences in the role of social support

Background

The aim of the present study was to examine to what extent observed gender differences in mental health are associated with the protective factors social support, sense of coherence and participation in regular physical activity and more generally, engagement in organized or unorganized activity with other people.

Methods

This study was based upon a cross-sectional regional health survey in Norway, conducted during the winter of 2015–2016, in three southern counties; Aust-Agder, Vest-Agder and Vestfold. The study focused on young adults, comparing three age groups; 18–24 years old (n = 624), 25–31 (n = 582), and 32–38 years old (n = 795).

Results

Sense of coherence was strongly associated with low mental distress in all age groups and for both genders, while the association between low social support and mental distress was significant for young women only. Regular physical activity was not positively associated with low mental distress when sense of coherence and social support were included in the analysis.

Conclusion

Social support appears to have a stronger role as a protective factor for mental distress among young women, compared to young men and older persons. This has implications for health promoting activities that target young women. Sense of coherence showed a strong association with low mental distress scores for all ages studied.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12109-5.

Socioeconomic inequalities in co-morbidity of overweight, obesity and mental ill-health from adolescence to mid-adulthood in two national birth cohort studies

AIM

To examine socioeconomic inequalities in comorbidity risk for overweight (including obesity) and mental ill-health in two national cohorts. We investigated independent effects of childhood and adulthood socioeconomic disadvantage on comorbidity from childhood to mid-adulthood, and differences by sex and cohort.

METHODS

Data were from 1958 National Child Development Study (NCDS58) and 1970 British Cohort Study (BCS70) [total N=30,868, 51% males] assessed at ages 10, 16, 23/26, 34 and 42 years. Socioeconomic indicators included childhood and adulthood social class and educational level. Risk for i. having healthy BMI and mental ill-health, ii. overweight and good mental health, and iii. overweight and mental ill-health was analysed using multinomial logistic regression.

FINDINGS

Socioeconomic disadvantage was consistently associated with greater risk for overweight-mental ill-health comorbidity at all ages (RRR 1.43, 2.04, 2.38, 1.64 and 1.71 at ages 10, 16, 23, 34 and 42 respectively for unskilled/skilled vs. professional/managerial class). The observed inequalities in co-morbidity were greater than those observed for either condition alone (overweight; RRR 1.39 and 1.25, mental ill-health; 1.36 and 1.22 at ages 16 and 42 respectively, for unskilled/skilled vs. professional/managerial class). In adulthood, both childhood and adulthood socioeconomic disadvantage were independently associated with comorbid overweight-mental ill-health, with a clear inverse gradient between educational level and risk for comorbidity. For instance, for the no education group (compared to university education) the RRR is 6.11 (95% CI 4.31-8.65) at age 34 and 4.42 (3.28-5.96) at age 42. There were no differences observed in the extent of inequalities by sex and differences between cohorts were limited.

INTERPRETATION

While socioeconomic disadvantage in childhood and adulthood are consistently and independently associated with greater risk for mental ill-health and being overweight separately, these associations are even larger for their comorbidity across the lifecourse. These findings are significant given the increasing global prevalence of obesity and mental ill-health, and their implications for lifelong health and mortality.

FUNDING

This research was supported by grants from the Wellcome Trust (ISSF3/ H17RCO/NG1) and Medical Research Council (MRC) [MC_UU_00019/3].

Lack of Social Support and Its Role on Self-Perceived Health in a Representative Sample of Spanish Adults. Another Aspect of Gender Inequality

Self-perceived health has been used as a good estimator of health status and receiving affection can be a determining factor for good self-perceived health. The aim of the present study was to assess whether lack of social support (measured through Duke scale, which ranges from 11 to 55) was associated with poorer health status measured as self-perceived health, and whether that association was different between women and men. A cross-sectional study was conducted using data from the 2017 Spanish National Health Survey. A descriptive study was performed, and logistic regression models were applied using self-perceived health as a dependent variable. Mean Duke score was 47.6 for men and 47.9 for women (p = 0.016). Moreover, 36.3% of women and 27.6% of men reported poor self-perceived health (p < 0.001). The multivariate analysis revealed that lower scores in Duke-UNC social support scale were associated with poorer health status. That association was higher in women than in men. Poor self-perceived health was also associated with low level of education and obesity, especially among women. There was gender inequality as regards health status associated with lack of social support. These results can help design prevention strategies to improve health.

Trajectories of Depression between 30s and 50s: Latent Growth Modeling

Objectives: Previous studies have primarily focused on depression among older adults. Given that middle age links young adulthood to older adulthood and encompasses a variety of changes in roles and status, which influence depression, it is important to understand the changes of depression during this period. Methods: This study used data from the National Longitudinal Survey of Youth 1979. The final sample consisted of 834 individuals, and four points in time were used: 34, 36, 40, and 50 years of age. The Latent Growth Model (LGM) was used to estimate the trajectories of depression. Results: The trajectories of depression present a non-linear change, referring to V-shaped curve. The conditional model shows that there are significant individual differences on initial status. Males were negatively associated with the latent initial level of depression. Individuals who showed higher self-esteem and cognitive ability were negatively associated with the latent initial level of depression. In addition, health insurance was negatively associated with the latent initial levels of depression. Both employment and net worth predicted lower intercepts of depression. Discussion: As the 40s is a bridge between the lowest levels of depression and a gradual increase of depression, service providers should be aware of changes of depression among middle-aged adults and spend more time and resources to encourage those individuals to prepare for changes in depression. Prevention programs for depression and providing more opportunities for employment and education to save money should be more focused on young adults.

Gender differences in the association between functional limitation and depressive symptoms: the salience of food insecurity

The present study evaluated gender differences in the associations of functional limitation with food insecurity and depressive symptoms. Using data from 3,624 respondents ages 18to 80 years from two pooled cross-sectional cycles (2011-2012 and 2013-2014) of the National Health and Nutrition Examination Survey (NHANES), a structural equation model was estimated to assess gender differences in the association between physical limitation and food insecurity, and whether indicators of economic resources mediated an observed interaction. Results demonstrate that food insecurity accounted for about one-tenthof the association between functional limitation and depressive symptoms. Furthermore, these associations were more pronounced among women and were not explained by variation in economic resources. Food insecurity thus appears to be an indicator of psychological adversity among people with functional limitations, especially women, independent of other indicators of economic resources and hardship. Health promotion and social programs should address food insecurity as a unique dimension of adversity in efforts to improve health and well-being.

Association between appendicular skeletal muscle mass and depressive symptoms: Review of the cardiovascular and metabolic diseases etiology research center cohort

BACKGROUND

The effects of skeletal muscle mass on depressive symptoms remain poorly understood, especially in the middle-aged population. We examined the relationship between skeletal muscle mass and depressive symptoms according to sex and menopausal status in the middle-aged Korean population.

METHODS

Herein, 1,151 men and 2,176 women aged 30-64 years completed questionnaires and underwent health examinations in the Cardiovascular and Metabolic Disease Etiology Research Center study. Appendicular skeletal muscle mass (ASM) was measured via bioelectrical impedance analysis and adjusted for height squared (ASM/Ht²). Both continuous values and tertile groups of ASM/Ht² were used for analysis. Depressive symptoms were assessed using the Beck Depressive Inventory-II (BDI), and the prevalence of depressive symptoms was determined as a BDI score ≥ 20.

RESULTS

Multiple logistic regression analysis using a fully adjusted model showed that depressive symptoms were more frequently observed among men in the lower ASM/Ht² tertile and middle ASM/Ht² tertile than among those in the higher ASM/Ht² tertile. Each 1-kg/m² decrease in ASM/Ht² was significantly associated with the presence of depressive symptoms in men. Such significant association was not observed among premenopausal and postmenopausal women.

LIMITATIONS

The cross-sectional nature of the study design, measurement of skeletal muscle mass and depressive symptoms only once, estimation of skeletal muscle mass using bioelectrical impedance analysis, assessing depressive symptoms by self-reported questionnaire, and potential unknown confounding variables constitute the limitations of our study.

CONCLUSIONS

The independent association between low skeletal muscle mass and depressive symptoms was observed in men but not in women.

Social support in the general population: standardization of the Oslo social support scale (OSSS-3)

BACKGROUND

The objectives of the study were to generate normative data for the Oslo Social Support Scale (OSSS-3) for different age groups for men and women and to further investigate the factor structure in the general population.

METHODS

Nationally representative face-to face household surveys were conducted in Germany in 2008 (n = 2524).

RESULTS

Normative data for the Oslo Social Support Scale were generated for men and women (52.3% female) and different age levels (mean age (SD) of 48.9 (18.3) years). Men had mean scores comparable to women (10.1 [SD = 2.3] vs. 10.2 [SD = 2.2]). The EFA resulted in a clear one-factor solution for the OSSS-3.

CONCLUSIONS

The normative data provide a framework for the interpretation and comparisons of social support with other populations.

Gender differences in the prevalence and impact factors of hysterical tendencies in adolescents from three eastern Chinese provinces

BACKGROUND

Few studies have attempted to compare the differences in the prevalence and impact factors of hysterical tendencies (HTs) in adolescents. Thus, the aim of this study was to examine gender differences in the prevalence and impact factors of adolescents' HTs across three eastern Chinese provinces (Anhui, Jiangsu, and Zhejiang).

METHODS

A multicenter, school-based, cross-sectional study was conducted in three provinces (Anhui, Jiangsu, and Zhejiang) in China in 2014. The sample included 10,131 middle-school students aged 13-18 years who were randomly selected using a multiphase, stratified, cluster sampling technique. A two-stage appraisal procedure was used to determine the adolescents' HTs. We also designed a multicenter, school-based, case control (1329 cases with 2661 control individuals) study to collect data on the common factors affecting this population using a common protocol and questionnaire.

RESULTS

An overall positive rate of HTs among adolescents across the three eastern Chinese provinces studied was found at 13.1% (95% confidence interval (CI) 12.5-13.8%), at 14.5% (95% CI 13.3-15.7%) for females, and at 12.2% (95% CI 11.1-13.4%) for males. Gender-stratified, multiple conditional regression analyses revealed that superstitious beliefs pertaining to life, somatotype, teacher-student satisfaction, and family achievement orientation were significantly linked to HTs only in males, while left-behind adolescents, emotional and social adaptation, teacher-student support, family cohesion, and the Hospital Anxiety and Depression Scale - depression scores were significantly associated with female HTs only. The models indicated that of all the independent variables studied, family medical history was the strongest impact factor for both male HTs (adjusted matched odds ratio (amOR) = 2.92, 95% CI = 1.84-4.86) and female HTs (amOR = 2.74, 95% CI = 1.59-4.98).

CONCLUSIONS

HTs are prevalent among adolescents in the three eastern Chinese provinces studied. Gender differences in the prevalence and impact factors of HTs are significant in adolescents, and HTs seem to affect more females than males. Therefore, sex-specific intervention programs against HTs in adolescents should be considered to reduce HT prevalence in adolescents by modifying influential social, school, and family factors.

Gender differences in mental health problems among adolescents and the role of social support: results from the Belgian health interview surveys 2008 and 2013

BACKGROUND

To investigate how social support relates to mental health problems for Belgian late adolescents and young adults 15-25 years of age. Additionally, we examine changes in mental health problems between 2008 and 2013 and investigate gender differences.

METHODS

Multivariate analysis of variance was used to investigate (1) psychological distress, (2) anxiety and (3) depression among 713 boys and 720 girls taken from two successive waves (2008 and 2013) of a representative sample of the Belgian population (Belgian Health Interview survey). Psychological distress was measured by the General Health Questionnaire, anxiety and depression by the Symptom Check-List-90-Revised.

RESULTS

Gender differences were found for psychological distress, anxiety and depression with girls reporting significantly higher scores than boys. Multivariate analysis of variance (MANOVA) revealed that adolescents who are dissatisfied with their social contacts and experience poor social support reported more psychological distress, anxiety and depression. In addition, young adult boys (20-25 years of age) were more likely to experience psychological distress when compared to late adolescent boys (15-19 years of age). Finally, the prevalence of anxiety and depression increased substantially between 2008 and 2013 for girls and to a lesser extent for boys.

CONCLUSIONS

Especially girls and young people with poor social support experience mental health problems more frequently than boys and those with strong social support. Improving social support among young people may serve as a protective buffer to mental health problems.

Reviewing the Assumptions About Men's Mental Health: An Exploration of the Gender Binary

Many researchers take for granted that men's mental health can be explained in the same terms as women's or can be gauged using the same measures. Women tend to have higher rates of internalizing disorders (i.e., depression, anxiety), while men experience more externalizing symptoms (i.e., violence, substance abuse). These patterns are often attributed to gender differences in socialization (including the acquisition of expectations associated with traditional gender roles), help seeking, coping, and socioeconomic status. However, measurement bias (inadequate survey assessment of men's experiences) and clinician bias (practitioner's subconscious tendency to overlook male distress) may lead to underestimates of the prevalence of depression and anxiety among men. Continuing to focus on gender differences in mental health may obscure significant within-gender group differences in men's symptomatology. In order to better understand men's lived experiences and their psychological well-being, it is crucial for scholars to focus exclusively on men's mental health.

Gender differences in health-related quality of life at the time of a positive HIV test - a cross-sectional study in a resource-poor, high prevalence setting in Nairobi, Kenya

Few studies have examined gender differences in sub-Saharan Africa, where HIV disproportionately affects women. Objectives of this cross-sectional study were to determine gender differences in HRQoL at the time of a positive HIV test, and whether factors associated with HRQoL differed between men and women. Adults testing HIV-positive were recruited from two clinics located in informal settlements. HRQoL was measured with the SF-12. Multiple linear regression was used to test whether there were gender differences in physical (PCS) and mental composite summary (MCS) scores. Separate models were built for men and women to examine factors associated with HRQoL. Between April 2013 and June 2015, 775 individuals from were recruited. The mean PCS score was higher in women (adjusted mean difference 2.49, 95% CI 0.54 to 4.44, p = 0.012). There was no significant gender difference in MCS scores. Similar factors were associated with better physical HRQoL in men and women: secondary education, younger age, higher CD4, and employment. Employment was the only factor associated with MCS in men, while less social support and low CD4 were associated with poorer MCS scores in women. Gender differences in factors related to HRQoL should be considered in broader policy and interventions to improve the HRQoL in those diagnosed with HIV.

With a little help from my friends?: racial and gender differences in the role of social support in later-life depression medication adherence

BACKGROUND

Social support has been shown to be an important factor in improving depression symptom outcomes, yet less is known regarding its impact on antidepressant medication adherence. This study sought to evaluate the role of perceived social support on adherence to new antidepressant medication prescriptions in later-life depression.

METHODS

Data from two prospective observational studies of participants ≥60 years old, diagnosed with depression, and recently prescribed a new antidepressant (N = 452). Perceived social support was measured using a subscale of the Duke Social Support Index and medication adherence was assessed using a validated self-report measure.

RESULTS

At four-month follow up, 68% of patients reported that they were adherent to antidepressant medication. Examining the overall sample, logistic regression analysis demonstrated no significant relationship between perceived social support and medication adherence. However, when stratifying the sample by social support, race, and gender, adherence significantly differed by race and gender in those with inadequate social support: Among those with low social support, African-American females were significantly less likely to adhere to depression treatment than white females (OR = 4.82, 95% CI = 1.14-20.28, p = 0.032) and white males (OR = 3.50, 95% CI = 1.03-11.92, p = 0.045).

CONCLUSIONS

There is a significant difference in antidepressant medication adherence by race and gender in those with inadequate social support. Tailored treatment interventions for low social support should be sensitive to racial and gender differences.

Association between serum 25-hydroxyvitamin D concentrations and depressive symptoms in an older Korean population: A cross-sectional study

BACKGROUND

This study aims to examine associations between serum 25-hydroxyvitamin D [25(OH)D] concentrations and depressive symptoms in an older Korean population.

METHODS

The study used data from the Korean Urban Rural Elderly study, which enrolled 2942 participants aged 65 years or older from urban and rural communities. After excluding those treated with antidepressants, we conducted cross-sectional analysis of 2853 participants (962 men and 1891 women). Serum 25(OH)D was analyzed as both a continuous and categorized variable. Depressive symptoms were assessed using the Korean version of the Geriatric Depression Scale - Short Form. Multivariate logistic regression analyses were conducted to examine relationships between serum 25(OH)D and depressive symptoms for men and women separately.

RESULTS

In men, ORs (95% CIs) for depressive symptoms were 1.74 (0.85, 3.58), 2.50 (1.20, 5.18), and 2.81 (1.15, 6.83) for those with a 25(OH)D concentration of 20.0-29.9, 10.0-19.9, and <10.0ng/mL, respectively (P-trend=0.013), compared with those with a 25(OH)D concentration of ≥30.0ng/mL, after adjustment for study year, month of assay, age, parathyroid hormone, body mass index, number of comorbidities, smoking status, alcohol intake, exercise, sleep duration, income, education, cohabitation status, and residential area. In women, the associations between 25(OH)D and depressive symptoms were significant neither before nor after adjustment.

LIMITATIONS

Due to the cross-sectional study design, causal association is uncertain. Intake of vitamin D supplements and outdoor activity were not examined.

CONCLUSIONS

Our findings suggest that lower concentrations of vitamin D are independently associated with depressive symptoms in older Korean adults.

Intergenerational support and depression among Chinese older adults: do gender and widowhood make a difference?

Using four-wave panel data of 1,327 older adults in rural China, this study examined potential gender and marital status differences in the relationships between three forms of intergenerational support (monetary, instrumental and emotional support) and the level of depression of the older adults. Results from a pooled time-series fixed-effects model showed that receiving and providing monetary support had a comparable beneficial effect on mothers and fathers, but mothers benefited more psychologically than fathers from closer relationships with their children. Exchanges in instrumental support was not related to either mothers' or fathers' level of depression. Widowhood further affected the gendered relationships between support and depression in that recently widowed fathers had a significantly higher level of depression when they received more monetary support from their children. In contrast, providing monetary support to children was associated with a significantly higher level of depression among recently widowed mothers. We explained the findings in the context of familial and gender norms in the Chinese culture and temporal needs for family support that link with bereavement coping stages among older adults. We argued that the gender and marital status patterns observed in this study are attributive to more fundamental differences in men's and women's social positions in the Chinese society.

Social relationships play a role in sleep status in Chinese undergraduate students

The purpose of this study was to examine whether social relationships were associated with sleep status in Chinese undergraduate students. A cross-sectional questionnaire survey was conducted in November 2012 at Huzhou Teachers College, China. The questionnaire involved demographic characteristics, personal lifestyle habits, social relationships and Pittsburgh Sleep Quality Index (PSQI). The associations between social relationships and sleep status were analyzed by using regression models after adjustment for potential factors. Poor sleep quality was prevalent among Chinese undergraduate students. Men tended to have better sleep than women. Lower social stress, better management of stress and good social support were correlated with better sleep status, and stress or support from friends, family and classmates were all related with sleep variables. While only weak associations between number of friends and sleep were detected. The results were consistent in men and women. Educators and instructors should be aware of the importance of social relationships as well as healthy sleep in undergraduates.

Defining subgroups of low socioeconomic status women at risk for depressive symptoms: the importance of perceived stress and cumulative risks

BACKGROUND

Most disadvantaged women are exposed to risk factors for depression, but not all necessarily have an identical risk for this mental health problem. A better prediction of which low socioeconomic status (SES) women are most at risk for depressive symptoms can help target preventive interventions at high-risk subgroups most in need of support.

AIMS

Exploring which demographic, socioeconomic and psychological risk factors are associated with self-reported depressive symptoms in a sample of low-SES women and whether the number of risk factors might expose them to an accumulated risk.

METHODS

Between April 2005 and November 2007, 519 disadvantaged women from urban neighbourhoods in Maastricht, a southern Dutch city, participated in a cross-sectional survey on stress and depressive symptoms.

RESULTS

Lower education levels, no current employment and lower net monthly family incomes were socioeconomic risk factors associated with higher scores for depressive symptoms. The psychological risk factor 'perceived stress' had the highest explained variance and was most strongly associated with depressive symptoms. Women exposed to multiple risk factors across domains had a cumulated risk for depressive symptomatology.

CONCLUSION

Low-SES women who seem most eligible for targeted preventive action are those with cumulative risks. Depression prevention strategies for this population may benefit from focusing on perceived stress since this is an important modifiable risk factor.

Social contacts and depression in middle and advanced adulthood: findings from a US national survey, 2005-2008

AIM

Empirical evidence has linked social contacts with mental stability. The aim is to assess how social contacts are associated with depression among the general population.

METHODS

We analysed the data of 5,681 adults aged 40 or older, who completed a depression screening as a part of the National Health and Nutrition Examination Survey, 2005-2008. Depression was ascertained using the Patient Health Questionnaire (PHQ), a nine-item screening instrument asking about the frequency of depression symptoms over the past two weeks. A PHQ score of 10 or higher was defined as depression.

RESULTS

The prevalence of depression was 5.54% (SE = 0.64) and 8.49% (SE = 0.71), respectively, among men and women. The association between social contacts and depression were more salient among men than women. The odds ratios (ORs) of depression were 2.43 (95% CI = 1.44-4.10), 2.42 (95% CI = 1.37-4.28), 1.00 (reference) and 1.94 (95% CI = 0.80-4.71), respectively, among men who never attended church, attended occasionally, weekly and more than weekly. The corresponding ORs were 1.79 (95% CI = 1.10-2.91), 1.72 (95% CI = 1.06-2.80), 1.00(reference) and 0.98 (95% CI = 0.52-1.84) for women. Compared with the respondents who had 10 or more friends, the ORs of depression were 4.01 (95% CI = 1.89-8.50) and 1.86 (95% CI = 0.92-3.79), respectively, for men and women who had no close friends.

CONCLUSIONS

The current study concluded that traditional social contacts remain strongly associated with depression in the digital era. Digital social networking is one of the biggest growing industries, creating a new platform to make social contacts. There is an urgent need to explore how to maximize the potential of digital social networking to strengthen social bonds while minimizing its negative effects.

Attention deficit/hyperactivity disorder symptoms and depression symptoms as mediators in the intergenerational transmission of smoking

BACKGROUND

Attention deficit/hyperactivity disorder and depression have been found to be comorbid with smoking behaviors, and all three behavioral syndromes have been shown to be familially transmitted. The present paper reports on the results of analyses testing whether child attention deficit/hyperactivity disorder and depression symptoms were mediators in the intergenerational transmission of cigarette smoking.

METHOD

Path analyses using bootstrapped mediation procedures were conducted on data from a community sample of 764 families (one or both parents and one adolescent offspring) from the Indiana University Smoking Survey. Parents reported on their smoking behaviors, ADHD, and depression and their child's ADHD, while offspring reported on their smoking behaviors and depression.

RESULTS

Although fathers' and mothers' smoking status, depression, and ADHD were not significantly correlated with boys' smoking initiation, there was a significant mediated (indirect) pathway from mothers' depression to boys' smoking initiation through boys' depression. Several parental variables were significantly correlated with smoking initiation in girls, and the pathways from mothers' smoking status, mothers' ADHD, and fathers' smoking status to girls' smoking initiation were significantly mediated by girls' ADHD.

CONCLUSIONS

For adolescent girls, the intergenerational transmission of ADHD appears to be important in understanding the intergenerational transmission of cigarette smoking. Sex differences in the intergenerational transmission of psychopathology as it leads to smoking initiation were also discussed.

Everyday Social Behavior During a Major Depressive Episode

Although social functioning deficits are believed to characterize major depressive disorder (MDD), few studies have examined the social behavior of individuals with MDD in everyday life. The current study’s aim is to assess the everyday social behavior of individuals in a current major depressive episode. Participants with current MDD ( n = 29) and healthy controls ( n = 28) wore the electronically activated recorder (EAR), an ambulatory assessment device, for 3–4 days. The EAR recorded 90-second sound clips from participants’ immediate environments. Participants’ conversations were transcribed and locations and activities coded. Indicators of social isolation and negative emotional expression were examined. Individuals with and without MDD spent similar amounts of time talking, laughing, and with another person. However, depressed people spent less time in groups and used more negative emotion words, particularly in reference to the self, and particularly around romantic partners. Findings suggest depressed people’s social interactions suffer in quality but not quantity.

Social support and suicide in Japanese men and women - the Japan Public Health Center (JPHC)-based prospective study

Although the important role of social support in mental health is acknowledged, no prospective study has yet examined the relation of social support to suicide. Here, we investigated the association between social support and suicide in a cohort of Japanese men and women. A total of 26,672 men and 29,865 women aged 40-69 years enrolled in the Japan Public Health Center-based prospective study in 1993-1994 completed a self-administered questionnaire which included four items of social support, and were followed for death through December 2005. Hazard ratios (HRs) and 95% confidence intervals (95% CI) of suicidal death by social support index were estimated using a Cox proportional hazards regression model. A total of 180 suicidal deaths were recorded during an average of 12 years' follow-up. Men and women with the highest level of social support had a significantly decreased risk of suicide, with HRs (95% CI) for the highest versus lowest social support group of 0.56 (0.33-0.94) and 0.38 (0.16-0.89) in men and women, respectively. Esteem support and having four or more friends were associated with a lower risk of suicide in women [0.32 (0.13-0.77)] and in both sexes [men: 0.56 (0.36-0.88); women: 0.65 (0.32-1.30)], respectively, whereas confident support was not. These findings suggest that social support may be important for suicide prevention. Avoiding social isolation may decrease the incidence of suicide in men and women, and esteem support can provide additional benefit for women.

Multiple roles, multiple lives: the protective effects of role responsibilities on the health functioning of African American mothers

Using data from 747 rural African American mothers, this study incorporated role accumulation theory to test direct and indirect effects of stressors, coping behaviors, and role responsibilities on health functioning. Results indicated that demands emerging from financial strain were related to compromised mental health and decreases in mothers' use of effective coping strategies and role responsibility engagement. Conversely, mothers who effectively responded to stressors and fulfilled responsibilities to their children and communities experienced enhanced mental health, which in turn promoted optimal physical health. The results can inform research and intervention with African American women.

Comorbidity of depression with chronic diseases: a population-based study in Aleppo, Syria

OBJECTIVE

To assess the comorbidity and correlates of depression in chronic diseases in the community in Aleppo, Syria. This has never been previously investigated in an Arab country.

METHOD

We conducted a cross-sectional, population-based study in Aleppo on adults aged 18-65 (N = 2038). We collected data utilizing a structured interview questionnaire. Socio-demographics, general health information, and self-report of physician-diagnosed depression and chronic diseases active in the past year were obtained. We used logistic regression to estimate the odds of depression in chronic diseases and socio-demographic correlates of depression comorbid with chronic diseases.

RESULTS

Mean age (SD) was 35.3 (12.1) years, 55% were female. In women, predictors of depression were heart disease (OR = 3.95, 95% CI: 1.50-10.40), hypertension (OR = 2.92, 95% CI: 1.53-5.55), and kidney disease (OR = 2.96, 95% CI: 1.64-5.32). Depression comorbidity with any chronic disease decreased in higher socio-economic status (middle vs. low: OR = 0.28, 95% CI: 0.12-0.65; high vs. low: OR = 0.20, 95% CI: 0.05-0.81). In men, predictors of depression were rheumatism (OR = 7.10, 95% CI: 2.58-19.60) and respiratory disease (OR = 3.77, 95% CI: 1.23-11.60). Depression comorbidity decreased in residence in formal zones (OR = 0.22, 95% CI: 0.06-0.80).

CONCLUSION

Depression is associated with many chronic diseases in the community in Aleppo, a finding consistent with reports from other cultures. Potential gender-related risk factors were identified. Findings inform public mental health planning and support the delivery of depression treatment in primary care settings.

Profiles of adolescent stress: the development of the adolescent stress questionnaire (ASQ)

The importance of stress in the understanding of adolescent health and well-being is widely documented. The measurement of adolescent stress has however been subjected to sufficient methodological and conceptual criticism in recent times to warrant a concerted re-evaluation of the exercise. This study sought information on the nature of adolescent stressors, building on a previous instrument developed by the first author to ask adolescents themselves to inform the development of a pool of new items reflecting stressor experience and to advise on the wording of these items to comprehensively assess that experience. This pool of items was then administered as a self-reported questionnaire to a large sample of school-age adolescents (N>1000) together with a scale to assess the intensity of distress arising from stressor occurrence. Principal components analysis of the questionnaire yielded 10 internally reliable dimensions of adolescent stress, the nature of which were consistent with the available literature on adolescent stressor experience. Scales constructed from this PCA related positively to measures of anxiety and depression, and negatively to a measure of self-esteem, suggesting that they were valid measures of adolescent stress. Test-retest reliability was good for all scales. The resultant Adolescent Stress Questionnaire (ASQ) is therefore suggested to have potential for the measurement of adolescent stress in both research and clinical contexts.

Why is discrimination stressful? The mediating role of cognitive appraisal

This study attempts to shed light on past findings that experiences of racial and gender discrimination are associated with poor psychological and physical health outcomes by investigating the role of cognitive appraisal as a mediator of the relationship between experiences of discrimination and affective stress reactions. African American female college students (N = 115) imagined themselves in an audiotaped scenario in which they overheard 2 European American male classmates make negative evaluations of them. Participants then completed measures of causal attributions, cognitive appraisal, and affective stress reactions. Multiple regression analyses supported the hypotheses that attributions to racism and to discrimination that combines racism and sexism were associated with increased stress reactions. This relationship was mediated by cognitive appraisals of centrality.

Age and the gender gap in distress

Women report more psychological distress than men and recent evidence suggests that this gap increases with age. It has been argued that the widening differential in distress reflects the progressive and cumulative nature of women's disadvantaged work and family roles. Drawing on the cumulative disadvantage hypothesis and social stress theory, we test: (1) whether exposure to chronic stress accounts for an increasingly larger proportion of the gender effect on distress with age; and (2) whether women are increasingly more vulnerable to the effects of chronic stress on distress with age. Data are from the 1994 wave of the Canadian National Population Health Survey, a national probability sample of women and men aged 20 and older (N = 13,798). Exposure to long-term stress helps us understand gender differences in distress for those in their pre-retirement years. However, contrary to the cumulative disadvantage hypothesis, the model became increasingly less likely to explain such differences with age. Gendered vulnerability to long-term stress was not evident in the sample. The implications of these findings are discussed with particular reference to our ongoing efforts to understand health in the context of social structure and subjectivity.