Anxiety, affect, self-esteem, and stress: mediation and moderation effects on depression

Testing the effectiveness of the culturally adapted skills training START NOW to reduce mental health problems in adolescent refugees: study protocol for a randomized controlled trial

Background

Adolescent refugees are particularly vulnerable to mental health problems, as they experience many risk factors associated with their resettlement at crucial stages of their physical and emotional development. However, despite having a greater healthcare needs than others, they face significant barriers to accessing healthcare services. Therefore, this study aims to test the effectiveness of a low-threshold, culturally adapted version of the skills training START NOW - START NOW Adapted - in reducing mental health problems among adolescent refugees.

Methods

We will recruit 80 adolescent refugees (15-18 years) with symptoms of anxiety and depression or high perceived stress in Northwestern Switzerland. They will be randomly assigned to one of two study groups: an intervention group, receiving START NOW Adapted, and a control group, receiving treatment as usual (TAU). The intervention will last 10 weeks and will consist of one-hour sessions per week provided by a trained facilitator with the same cultural background, in the respective language. Assessments to collect depressive and anxious symptoms, perceived stress, social-ecological resilience, and emotion recognition abilities will be conducted pre-intervention, post-intervention (11 weeks later) and at the 3-month follow-up. Multilevel models will be computed with primary and secondary outcome measures as dependent variables. An effect of at least moderate size will be considered clinically relevant.

Discussion

This randomized controlled trial aims to investigate the effectiveness of a culturally adapted version of START NOW, providing valuable insights to improve current health promotion for adolescent refugees in Switzerland (or rather lack thereof). Ultimately, the effects of START NOW may facilitate integration and promote healthy development while decreasing costs associated with treating migration- or conflict-related trauma.Clinical trial registration: ClinicalTrials.gov, identifier: NCT06324864.

Moderating effect of negative emotion differentiation in chronic stress and fatigue among Chinese employees

Introduction

According to the reactivity hypothesis and the diathesis-stress model, repeated activation of the stress system has a negative effect on health, and this effect may differ because of individual characteristics. Thus, the present study explores the effect of chronic stress on fatigue and investigates its mechanism.

Methods

A questionnaire survey of 288 participants selected from the northwest part of China was conducted (13.89% females; ages ranged from 18 to 34 years, with M ± SD = 23.14 ± 3.79 years) on chronic stress, fatigue, depression, anxiety, and negative emotion differentiation. SPSS 28.0 was used to process descriptive statistics and correlation analysis and the PROCESS macro was used to analyze the moderated chained multi-mediation.

Results

Chronic stress was found to be positively correlated with fatigue, depression, and anxiety; depression and anxiety played a chained multi-mediating role between chronic stress and fatigue, and negative emotion differentiation played a moderating role in the chained multi-mediation model.

Discussion

Compared with depression, anxiety plays a more important role in the influence of chronic stress on fatigue. Therefore, it is necessary to pay more attention to anxiety symptoms and take appropriate intervention measures. Negative emotion differentiation plays a moderating role. Improving negative emotion differentiation through mindfulness and adaptive emotion regulation is an effective way to reduce the influence of chronic stress on fatigue.

Feeling our place in the world: an active inference account of self-esteem

Self-esteem, the evaluation of one's own worth or value, is a critical aspect of psychological well-being and mental health. In this paper, we propose an active inference account of self-esteem, casting it as a sociometer or an inferential capacity to interpret one's standing within a social group. This approach allows us to explore the interaction between an individual's self-perception and the expectations of their social environment.When there is a mismatch between these perceptions and expectations, the individual needs to adjust their actions or update their self-perception to better align with their current experiences. We also consider this hypothesis in relation with recent research on affective inference, suggesting that self-esteem enables the individual to track and respond to this discrepancy through affective states such as anxiety or positive affect. By acting as an inferential sociometer, self-esteem allows individuals to navigate and adapt to their social environment, ultimately impacting their psychological well-being and mental health.

Statistical analysis of mental influencing factors for anxiety and depression of rural and urban freshmen

The freshmen stage is a high incidence period for psychological issues. With the increasing gap between urban and rural areas in China, the mental problems of rural freshmen are more prominent in recent years due to the huge contrast of campus life with their growth environment and other reasons. The concern for the mental well-being of both rural and urban freshman students prompted our comprehensive five-year study (2018-2022) on psychological issues in a group of 12,564 first-year students from dozens of public universities in Shandong province. The investigation employed PPS (probability proportional to size) sampling and was conducted near the the end of the first semester. Using the data gathered, we analyzed and compared the indicators of psychological problems in rural and urban freshmen by Duncan's Multiple Range Test. We also conducted a canonical correlation analysis and pathway analysis to examine the psychological factors that contribute to anxiety and depression in both rural and urban freshmen. According to the findings, rural freshmen exhibit significantly higher levels of anxiety and depression than their urban counterparts. Inferiority, obsession, and internet addiction were identified as the primary influencing factors of anxiety and depression in both rural and urban freshmen. Social phobia was found to be a significant influencing factor for anxiety in rural freshmen, while bigotry was identified as a specific influencing factor for urban freshmen. Furthermore, the results of the path analysis suggest that anxiety plays a crucial role as a mediating factor between the main influencing factors and depression. These results substantially extend former research in this area and have important implications for the development of effective intervention strategies to address anxiety and depression. According to these results, policymakers should assess and intervene of anxiety and depression as a whole, and provide mental health education according to main effect factors of freshmen from rural and urban areas. Detailed policy recommendations are in discussion and conclusion.

Examining the impact of perceived stress, anxiety, and resilience on depression among medical staff after COVID-19 quarantine: a chain mediation analysis

Introduction

The COVID-19 pandemic and subsequent quarantine measures have led to a significant impact on mental health worldwide. Medical staff, in particular, have been exposed to high levels of stress due to their frontline work during the crisis. However, there is still limited research on the psychological mechanism among medical staff after quarantine.

Methods

In this cross-sectional observational study, 150 medical staff from Shanghai YangZhi Rehabilitation Hospital, Shanghai, China, were enrolled in October 2022. SPSS 26.0 and PROCESS 4.0 model 6 were used to analyze the chain mediating effect of perceived stress, anxiety, resilience and depression among medical staff after quarantine. Anxiety and depression were compared during and after the quarantine. All scales have high validity and reliability in a Chinese population.

Results

Our findings revealed a positive correlation between perceived stress and anxiety (r = 0.60, p < 0.001) and depression (r = 0.60, p < 0.001) levels among medical staff. Conversely, resilience was found to have a negative correlation with perceived stress (r = -0.67, p < 0.001), anxiety (r = -0.57, p < 0.001) and depression (r = -0.61, p < 0.001). The score of depression during the quarantine was higher than the score after the quarantine, but the p-value is only marginally significant (p = 0.067). The score of anxiety during the quarantine was significantly higher than the score after the quarantine (p < 0.05). Moreover, the chain mediation model suggested that anxiety and resilience could mediate the association between perceived stress and depression among medical staff following quarantine. Specifically, perceived stress had no direct effect on depression (β = 0.025, t = 0.548, p = 0.59) but positively predicted anxiety (β = 0.381, t = 8.817, p < 0.001) and resilience (β = -1.302, t = -6.781, p < 0.001), which influenced depression levels indirectly through multiple pathways. The three indirect paths: the mediating role of anxiety, the mediating role of resilience, and the chain mediating role of both anxiety and resilience.

Discussion

This study emphasizes the importance of psychological interventions aimed at protecting medical staff's psychological resilience and promoting coping mechanisms to manage stress during and after crises such as the COVID-19 pandemic. Additionally, our findings suggest that both anxiety and resilience play critical roles in mitigating the detrimental effects of perceived stress on mental health and further highlight the need for continued research to better understand the complex interplay of these factors.

Efficacy of cognitive behavioral therapy after the surgical treatment of women with endometriosis: A preliminary case-control study

BACKGROUND

Regardless of unique status or symptoms, any woman with endometriosis is at risk of developing mental health issues such as anxiety and depression. Cognitive behavioral therapy (CBT) is an effective psychological treatment for depression, anxiety, and stress. The objectives of the study were to see whether usual care combined with CBT improves depression, anxiety, and stress in patients after surgery for endometriosis as compared to usual care alone.

METHODS

Patients aged 18 to 50 years old with endometriosis who were scheduled for surgery were received usual care (Chinese martial arts) with CBT (1 pre-surgery and 6 post-surgery CBT sessions; Case or Intervention group, n = 48) or usual care only (Control group, n = 48). The demographic characteristics questionnaire was given to all individuals. Depression, anxiety, and stress were evaluated at baseline (within 24 hours after admission to the hospital) and postintervention (immediately before discharged) in both groups using the Chinese short version of Depression Anxiety and Stress scale (DASS-21).

RESULTS

At postintervention DASS-21 scores for depression, anxiety, and stress of the case group and the control group were decreased as compared to baseline (P < .0001 for all). At postintervention DASS-21 score for anxiety of the case group was decreased compared to the control group (P = .0091). Usual care plus CBT significantly increased the number of females with no symptoms of depression as compared to baseline at postintervention(s) (P = .0356). At postintervention(s), there was no female with extremely severe depression in both groups. Usual care plus CBT significantly decreased the number of females with symptoms of extremely severe anxiety as compared to baseline at postintervention(s) (P = .035). Unlike the control group, in the case group, there were no females with extremely severe stress at postintervention.

CONCLUSIONS

females with endometriosis who had surgery reported high levels of depression, anxiety, and stress at the time of hospital admission. Patients with endometriosis can benefit from CBT.

An explanatory model of depressive symptoms from anxiety, post-traumatic stress, somatic symptoms, and symptom perception: the potential role of inflammatory markers in hospitalized COVID-19 patients

BACKGROUND

The context of the COVID-19 pandemic has harmed the mental health of the population, increasing the incidence of mental health problems such as depression, especially in those who have had COVID-19. Our study puts forward an explanatory model of depressive symptoms based on subjective psychological factors in those hospitalized for COVID-19 with and without biological markers (i.e., inflammatory markers). Therefore, we aim to evaluate the hypotheses proposed in the model to predict the presence of depressive symptoms.

METHOD

We conducted a cross-sectional study, using a simple random sampling. Data from 277 hospitalized patients with COVID-19 in Lima-Peru, were collected to assess mental health variables (i.e., depressive, anxiety, post-traumatic stress, and somatic symptoms), self-perception of COVID-19 related symptoms, and neutrophil/lymphocyte ratio (NLR) such as inflammatory marker. We performed a structural equation modeling analysis to evaluate a predictive model of depressive symptoms.

RESULTS

The results showed a prevalence of depressive symptoms (11.2%), anxiety symptoms (7.9%), somatic symptoms (2.2%), and symptoms of post-traumatic stress (6.1%) in the overall sample. No association was found between the prevalence of these mental health problems among individuals with and without severe inflammatory response. The mental health indicators with the highest prevalence were sleep problems (48%), low energy (47.7%), nervousness (48.77%), worry (47.7%), irritability (43.7%) and back pain (52%) in the overall sample. The model proposed to explain depressive symptoms was able to explain more than 83.7% of the variance and presented good goodness-of-fit indices. Also, a different performance between the proposed model was found between those with and without severe inflammatory response. This difference was mainly found in the relationship between anxiety and post-traumatic stress symptoms, and between the perception of COVID-19 related symptoms and somatic symptoms.

CONCLUSIONS

Results demonstrated that our model of mental health variables may explain depressive symptoms in hospitalized patients of COVID-19 from a third-level hospital in Peru. In the model, perception of symptoms influences somatic symptoms, which impact both anxiety symptoms and symptoms of post-traumatic stress. Thus, anxiety symptoms could directly influence depressive symptoms or through symptoms of post-traumatic stress. Our findings could be useful to decision-makers for the prevention of depression, used to inform the creation of screening tools (i.e., perception of symptoms, somatic and anxiety symptoms) to identify vulnerable patients to depression.

COVID-19 IDD: Findings from a global survey exploring family members’ and paid staff’s perceptions of the impact of COVID-19 on individuals with intellectual and developmental disabilities (IDD) and their caregivers

Background: A growing body of evidence attests to the disproportionate impact of COVID-19 on persons with intellectual and developmental disabilities (IDD) during the pandemic. This study asked caregivers about their perceptions of how COVID-19 impacted them and the people they support.

Method: An online survey was conducted in 12 countries during August-September 2020 and sought information on demographics, support practices, information and training, experiences of COVID-19, social distancing, and wellbeing, as measured by the DASS12. This study reports on 3,754 family members, direct support professionals, and managers who participated in the survey.

Results: Caregivers observed increases in depression/anxiety, stereotyped behaviours, aggression towards others and weight gain in the person(s) they supported. They also reported difficulties supporting the person(s) to access healthcare.  Families reported reducing or ceasing employment and absorbed additional costs when supporting their family member. Direct support professionals experienced changes in staff shifts, staff absences, increased workload and hiring of casual staff. Caregivers’ wellbeing revealed high levels of stress, depression, and less so anxiety. The strongest predictor of wellbeing among families was observation of changes in mood in the person(s) they supported, while for direct support professionals, the strongest predictors of wellbeing were reorganisation of staff shifts and increases in new direct support staff. 

Discussion: Findings support the contention of this population experiencing a disproportionate burden during the COVID-19 pandemic, reflecting historical inequities in access to healthcare and other human rights violations which are now protected under the United Nations Convention on the Rights of Persons with Disabilities.

Unhappy or unsatisfied: distinguishing the role of negative affect and need frustration in depressive symptoms over the academic year and during the COVID-19 pandemic

Mental health problems are becoming increasingly prevalent across college campuses. Past research has found that negative affect and frustration of basic psychological needs contribute to the development of depressive symptoms, but there is limited research which compares whether these are antecedents or concomitants of depressive symptoms. The present set of studies aimed to distinguish the differential associations of affect and need frustration on depressive symptoms. Students (N_study1 = 379; N_study2 = 235) completed measures on negative affect, need frustration (e.g., relatedness, competence, and autonomy), and depressive symptoms over an academic year and during the start of the COVID-19 pandemic. In both samples, fully cross-lagged path models were used to examine the relation between need frustration, negative affect, and depressive symptoms over time. Across both studies, basic psychological need frustration was the only consistent predictor of both negative affect and depressive symptoms over time, suggesting that need frustration is an antecedent of depressive symptoms over time, and especially during vulnerable time periods. Additionally, in Study 2, reports from close others confirm that need frustration is the largest indicator of depressive presentation in students. These results highlight the relative importance of basic psychological need frustration in predicting depressive symptoms in university students.

Associations of Maternal-Infant Bonding with Maternal Mental Health, Infant's Characteristics and Socio-Demographical Variables in the Early Postpartum Period: A Cross-Sectional Study

(1) Background: There is a continuing discussion concerning the impact of preterm birth on Maternal-Infant bonding with inconsistent results. The large burden of preterm births calls for research to evaluate the impact of it on material psychological outcome in the early postpartum period. Thus, the aim of this study was to evaluate the relationship between maternal postpartum bonding with maternal mental health, socio-demographical factors, and child's characteristics. (2) Methods: A cross-sectional study design was used. In total, 72 women (a mean age of 31.44 years old) of preterm infants (mean gestational age = 33.54; range 24-36) filled out socio-demographic questionnaires, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS) 1-3 days post-delivery; (3) Results: The results analyses have shown positive correlations between the overall result of maternal postpartum bonding with stress (p < 0.01), maternal educational level (p < 0.01), maternal age (p < 0.05) and the number of children (p < 0.01). However, there were no significant relationships between other investigated variables. The results of linear regression have revelated the important role of the overall scores in experience of stress among mothers (explaining 49% of the variability). The mediating role of maternal stress on maternal postpartum bonding was not found. That relationship of maternal postpartum bonding and maternal stress was not moderated through socio-demographic variables. (4) Conclusions: In this study mothers of prematurely born children had a good level of Maternal-Infant bonding. Maternal stress was found to be a predictor of maternal postpartum bonding among the tested variables. Surprisingly, the study results did not show significant relationships between maternal postpartum bonding and maternal mental health (depression and anxiety).

The Mediating Role of Temperamental Traits on the Relationship between Age of Puberty and Eating Disorders: A Mediating Analysis through Structural Equation Modelling of Australian Eating Disorder Outpatients

The current study had the aim to assess whether temperamental traits mediate the relationship between time of puberty and eating disorder (ED) severity using a sample of 292 outpatients with EDs [68 with Anorexia Nervosa Restrictive Type (AN-R), 101 with Anorexia Nervosa Binge Purging Type (AN-BP), 72 with Bulimia Nervosa (BN) and 51 with Other Specified Feeding and Eating Disorder (OSFED)]. Age of puberty, the severity of EDs, and temperamental traits were assessed through Demographic and Medical History Form, Eating Disorder Examination 17.0d (EDE-17.0d) and Temperament and Character Inventory-Revised (TCI-R), with a focus on the temperament scales: novelty seeking (TCI-NS), harm avoidance (TCI-HA), reward dependence (TCI-RD) and persistence (TCI-P). One-way ANOVA, correlation, and mediating analyses through structural equation modeling were performed to test the relationship between variables under investigation and assess if the four temperamental traits act as mediators in the relationship between time of puberty and ED severity. The results show a full mediating effect of the temperamental sub-scales on the relationship between puberty and EDE-17. In particular, TCI-R HA showed a complementary mediation on the relationship between age of puberty and EDE-17.0d, meaning that age of puberty increases the level of TCI-R HA, which in turn increases the severity of ED, confirming that this temperamental trait plays an important role in the development of ED after puberty. To conclude, temperamental traits seem to play a full mediating role in the relationship between puberty and ED severity, but more research is needed.

Mediating Role of Affective Experiences in the Relationship between Perceived Social Support and Life Satisfaction among Breast Cancer Patients

Aim:

The role of social support network in managing psychological symptoms in cancer patients is widely acknowledged. The purpose of this study was to investigate the potential mediating role of Affective experiences in the relationship between perceived social support (PSS) and life satisfaction (LS) among breast cancer patients in India.

Methods:

A total of 100 breast cancer patients from S. S. Hospital, Banaras Hindu University participated in the study. They were tested using the PGI Social Support questionnaire, Satisfaction with Life Scale and Scale of Positive and Negative Experiences.

Results:

Co-relational results indicated that PSS was positively associated with positive affect and LS, while inversely related to negative affect. Affect was also associated with LS. Results showed that the mediation of affective experiences in the relationship between PSS and LS was significant (P <.01 level).

Conclusion:

Both PSS played a big role in LS among breast cancer patients. Besides focusing on improvement of the social support network, the psychologists and counsellors should adopt an integrated approach for evidence-based intervention strategies to enhance their ability to effectively balance their positive and negative emotions to promote LS among cancer patients.

Paternal Postpartum Bonding and Its Predictors in the Early Postpartum Period: Cross-Sectional Study in a Polish Cohort

Introduction: Parental postpartum bonding has been studied by many researchers focusing on maternal bonding. The objective of this study was to examine the psychological and socio-demographic predictors of paternal postpartum bonding in the early postpartum period. Methods: In this cross-sectional study, 131 couples (fathers median age of 32.37 years, SD = 4.59; mothers median age of 30.23 years, SD = 3.90) of newborns from full-term pregnancies were recruited from November 2019 until March 2020. The primary outcome was paternal postpartum bonding as measured by the Postpartum Bonding Questionnaire (PBQ). Secondary outcomes included: maternal and paternal anxiety [with the Generalized Anxiety Disorder (GAD) Assessment]; maternal and paternal stress [with the Parental Stress Scale (PSS)]; maternal depressive symptoms [with the Edinburgh Postpartum Depression Scale (EPDS)]; and maternal and paternal socio-demographic variables as fathers' presence at childbirth, education level, age, and parental experience. Results: Paternal postpartum bonding was significantly correlated with paternal anxiety (moderate strength), maternal stress (strong correlation), and maternal postpartum bonding. No significant correlations between paternal postpartum bonding, maternal depression symptoms, and maternal anxiety were found. The mediating role of paternal stress in paternal postpartum bonding was proven. Paternal anxiety strengthens paternal stress (b = 0.98). Further, a high level of paternal stress disrupts paternal postpartum bonding (b = 0.41). Results of regression analyses have revelated that maternal infant bonding (p < 0.01) and paternal stress (p < 0.01) are the only predictors of parental postpartum bonding across all included variables. None of investigated socio-demographic variables were associated with paternal postpartum bonding. Conclusion: Notwithstanding limitations, the current findings add to a growing body of literature on paternal postpartum bonding. The results have shown that paternal mental health is related to parental postpartum bonding directly after delivery. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04118751.

Professional quality of life as potential mediators of the association between anxiety and depression among Chinese health-care clinicians

OBJECTIVE

Building upon the tripartite model of anxiety and depression, the current study aims to examine mechanisms of comorbidity between anxiety and depression using the ProQOL (Professional Quality of Life; including the constructs of burnout, secondary traumatic stress, and compassion satisfaction) in a sample of Chinese health-care clinicians.

METHOD

A randomized cross-sectional survey was distributed to 1620 participants who were recruited from eight state-owned hospitals in a city in southern China between January and May 2017. A total of 1562 questionnaires were returned (a response rate of 96.4%). After the cases with more than 10% missing variables and multivariate outliers being removed, 1423 valid cases remained. Multiple mediator models were used for mediation analysis that was conducted using the PROCESS v3.1 macro for SPSS.

RESULTS

The indirect effects of anxiety upon depression through burnout (a1 = . 601 (95% confidence interval (CI): .552, .650), p < .001; b1 = .137 (95% CI: .101, .174), p < .001) and compassion satisfaction (a3= -.297 (95% CI: -.352, -.241), p < .001; b3 = -.069 (95% CI: -.100, -.039), p < .001) were significant, while there was no evidence that anxiety influenced depression by changing secondary traumatic stress. The indirect effects of depression upon anxiety through secondary traumatic stress (a2 = . 535 (95% CI: .483, .588), p < .001); b2 = .154 (95% CI: .120, .188), p < .001) were both positive and significant, while there was no evidence that depression influenced anxiety by changing burnout and compassion satisfaction.

CONCLUSIONS

In the current sample, burnout and compassion satisfaction mediated the effect of anxiety upon depression and secondary traumatic stress mediated the effect of depression upon anxiety. The findings of the current study offer support to the tripartite model.

Influence of Mothers' Habits on Reading Skills and Emotional Intelligence of University Students: Relationships in the Social and Educational Context

Numerous studies show that the family plays a crucial role not only in the education of children but also in the acquisition of skills in the process of teaching and formal learning, especially in their reading competence. Furthermore, within the family, studies point to the basic role of the mother as the main axis of both educational and social teaching. The approach of this research aims to analyze whether maternal habits can influence the reading competence of their children. On the other hand, numerous studies point to the relationship between reading skills and emotional intelligence. Its inclusion in the equation of this construct can give information that will nuance the learning process in this evolutionary process. Thus, in this research, the objective is to establish the existence of a relationship between maternal reading habits with respect to reading competence and emotional intelligence in post-adolescents. Four-hundred-twenty first-year university students participated between the ages of 18 and 20 (43.8% men and 56.2% women) from the Andalusian universities of Granada, Malaga, and Jaen, all of them located in areas of medium socio-cultural context. Moderate mediation and factorial ANCOVA analyses have been carried out. The results point to the fact that the profile of the post-adolescents with the best score in reading competence also scores better in emotional intelligence and their mothers are those who score highest in reading habits. Thus, the role of the mother within the family is even more important than it appears in a society that seeks parity. New forms of work-family conciliation are necessary in order not to break the mother-child bond.

Causal Factors of Anxiety and Depression in College Students: Longitudinal Ecological Momentary Assessment and Causal Analysis Using Peter and Clark Momentary Conditional Independence

BACKGROUND

Across college campuses, the prevalence of clinically relevant depression or anxiety is affecting more than 27% of the college population at some point between entry to college and graduation. Stress and self-esteem have both been hypothesized to contribute to depression and anxiety levels. Although contemporaneous relationships between these variables have been well-defined, the causal relationship between these mental health factors is not well understood, as frequent sampling can be invasive, and many of the current causal techniques are not well suited to investigate correlated variables.

OBJECTIVE

This study aims to characterize the causal and contemporaneous networks between these critical mental health factors in a cohort of first-year college students and then determine if observed results replicate in a second, distinct cohort.

METHODS

Ecological momentary assessments of depression, anxiety, stress, and self-esteem were obtained weekly from two cohorts of first-year college students for 40 weeks (1 academic year). We used the Peter and Clark Momentary Conditional Independence algorithm to identify the contemporaneous (t) and causal (t-1) network structures between these mental health metrics.

RESULTS

All reported results are significant at P<.001 unless otherwise stated. Depression was causally influenced by self-esteem (t-1 r_p, cohort 1 [C1]=-0.082, cohort 2 [C2]=-0.095) and itself (t-1 r_p, C1=0.388, C2=0.382) in both cohorts. Anxiety was causally influenced by stress (t-1 r_p, C1=0.095, C2=0.104), self-esteem (t-1 r_p, C1=-0.067, C2=-0.064, P=.002), and itself (t-1 r_p, of C1=0.293, C2=0.339) in both cohorts. A causal link between anxiety and depression was observed in the first cohort (t-1 r_p, C1=0.109) and only observed in the second cohort with a more liberal threshold (t-1 r_p, C2=0.044, P=.03). Self-esteem was only causally influenced by itself (t-1 r_p, C1=0.389, C2=0.393). Stress was only causally influenced by itself (t-1 r_p, C1=0.248, C2=0.273). Anxiety had positive contemporaneous links to depression (t r_p, C1=0.462, C2=0.444) and stress (t r_p, C1=0.354, C2=0.358). Self-esteem had negative contemporaneous links to each of the other three mental health metrics, with the strongest negative relationship being stress (t r_p, C1=-0.334, C2=-0.340), followed by depression (t r_p, C1=-0.302, C2=-0.274) and anxiety (t r_p, C1=-0.256, C2=-0.208). Depression had positive contemporaneous links to anxiety (previously mentioned) and stress (t r_p, C1=0.250, C2=0.231).

CONCLUSIONS

This paper is an initial attempt to describe the contemporaneous and causal relationships among these four mental health metrics in college students. We replicated previous research identifying concurrent relationships between these variables and extended them by identifying causal links among these metrics. These results provide support for the vulnerability model of depression and anxiety. Understanding how causal factors impact the evolution of these mental states over time may provide key information for targeted treatment or, perhaps more importantly, preventative interventions for individuals at risk for depression and anxiety.

Prevalence of Prenatal Depression Among Pregnant Women and the Importance of Resilience: A Multi-Site Questionnaire-Based Survey in Mainland China

BACKGROUND

Prenatal depression is associated with adverse maternal and fetal health consequences, yet it has not raised sufficient concerns in China. Psychological worries and stress may lead to prenatal depression, but resilience could relieve some of the negative effects of worries and stress and mitigate prenatal depression.

AIMS

This study aimed to assess the prevalence of prenatal depression and explore its associated factors.

METHOD

A multisite cross-sectional study was conducted that included 605 pregnant women from three hospitals in two provincial capitals (Shenyang and Zhengzhou) and one municipality (Chongqing). A smartphone questionnaire was employed to assess prenatal depression using the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate logistic regression analysis was performed to explore factors associated with prenatal depression.

RESULTS

The prevalence of prenatal depression (CES-D≥16) among Chinese pregnant women was 28.4%. Logistic regression analyses revealed that prenatal depression was positively associated with worries about appearance (odds ratio [OR] 1.666, 95% confidence interval [CI] 1.043-2.661) and perceived stress (OR 1.156, 95% CI 1.104-1.211) and negatively associated with monthly income, relationship with mother (OR 0.287, 95% CI 0.103-0.796), and resilience (OR 0.935, 95% CI 0.918-0.953).

CONCLUSION

These findings revealed that Chinese pregnant women suffered from high levels of prenatal depression (28.4%). Worries about appearance and perceived stress were risk factors for prenatal depression, whereas a pregnant woman's harmonious relationship with her own mother and resilience could relieve the negative impacts of pregnancy that can lead to prenatal depression. Improving resilience and maintaining harmonious relationships with mothers should be emphasized in order to reduce the detrimental effects of pregnancy and improve the mental well-being of pregnant women.

Fear of missing out predicts repeated measurements of greater negative affect using experience sampling methodology

BACKGROUND

Fear of missing out (FOMO) has been increasingly researched recently, especially in relation to negative affectivity constructs. Our aim was to examine relations between FOMO and repeated measurements of negative affect over one week.

METHOD

We investigated associations between FOMO and prospectively-measured negative affect over one week in an experience sampling study of 93 undergraduate students. Participants completed an initial web survey assessing depression, anxiety and FOMO. Over the week, participants responded to daily text messages, assessing negative affect from earlier in the day.

RESULTS

On a bivariate basis, FOMO, depression and anxiety severity were related to daily negative affect assessments. Using multivariate growth modeling, higher initial negative affect was related to decreasing negative affect over the week. Female sex and higher anxiety related to higher initial negative affect ratings. Higher FOMO levels related to increasing negative affect over the week.

LIMITATIONS

Findings were based on self-report methodology, using university students and only one week of measurement.

CONCLUSIONS

Results suggest that women and more anxious individuals had higher initial negative affect, while FOMO predicted increasing negative affect over the week. Results advance understanding of FOMO in relation to psychopathology, and are discussed in the context of Self-Determination Theory.

The role of familial risk, parental psychopathology, and stress for first-onset depression during adolescence

BACKGROUND

Adolescence represents a critical developmental period during which the initial onset of depression emerges. Family risk for depression is a salient risk factor for the initial onset of Major Depressive Disorder (MDD). We examined the effects of familial risk, stress, and behavior on the risk of developing first-onset depression.

METHODS

Adolescents aged 12 to 15 with high (n = 166) or low (n = 159) familial risk for depression were assessed annually for up to five years. Stress was assessed using the Stressful Life Events Schedule and Childhood Trauma Questionnaire. The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version was administered to the adolescents and their parents to assess lifetime psychiatric conditions and diagnose MDD onset. Survival and path analyses were used in tandem to determine the risk for first-onset depression as well as the contributions of additional direct and indirect pathways to onset.

RESULTS

High-risk adolescents were eight times more likely to develop first-onset depression compared with low-risk adolescents. The path analyses revealed that the presence of maternal behavioral disorders and increased recent life stress directly predicted an initial onset of MDD in high-risk adolescents.

LIMITATIONS

The small samples used in this study limit the generalizability of these findings.

CONCLUSIONS

Adolescents at high familial risk for depression had an increased risk for the emergence of first-onset depression during adolescence. Stress and maternal behavioral psychopathology directly contributed to depression onset independently of familial risk, while childhood trauma exerted an indirect effect on first-onset MDD through recent stress.

Trait Anxiety as a Mediator of the Association between Attention Deficit Hyperactivity Disorder Symptom Severity and Functional Impairment

Objective

Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined.

Methods

The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners’ Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson’s correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses.

Results

Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales.

Conclusion

Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

The Relationship Between Family Caregiving and the Mental Health of Emerging Young Adult Caregivers

Caring for dependent relatives has become a normative challenge for families in the USA and throughout the world. The study objective was to examine the relationship of family caregiving responsibilities and the mental health and well-being of individuals, ages 18-24 years, referred to as emerging young adults. It was hypothesized that young adult caregivers with past and present responsibilities would report significantly more symptoms of depression and anxiety, have lower self-esteem, and use less adaptive coping styles than non-caregiving peers. The sample consisted of 353 undergraduates (81 past caregivers, 76 current/past caregivers, and 196 non-caregivers). Caregivers were also evaluated in terms of care recipients, duration of caregiving, tasks, and hours of effort. Caregivers had significantly higher levels of symptoms of depression and anxiety than non-caregivers. Research to clarify how caregiving interacts with other stressors in emerging young adults and influences behavioral health should be a priority.

Peace of mind and anxiety in the waking state are related to the affective content of dreams

Waking mental well-being is assumed to be tightly linked to sleep and the affective content of dreams. However, empirical research is scant and has mostly focused on ill-being by studying the dreams of people with psychopathology. We explored the relationship between waking well-being and dream affect by measuring not only symptoms of ill-being but also different types and components of well-being. Importantly, this is the first time peace of mind was investigated as a distinct aspect of well-being in a Western sample and in relation to dream content. Healthy participants completed a well-being questionnaire, followed by a three-week daily dream diary and ratings of dream affect. Multilevel analyses showed that peace of mind was related to positive dream affect, whereas symptoms of anxiety were related to negative dream affect. Moreover, waking measures were better related to affect expressed in dream reports rather than participants' self-ratings of dream affect. We propose that whereas anxiety may reflect affect dysregulation in waking and dreaming, peace of mind reflects enhanced affect regulation in both states of consciousness. Therefore, dream reports may possibly serve as markers of mental health. Finally, our study shows that peace of mind complements existing conceptualizations and measures of well-being.

Psychometric evaluation of the Swedish version of Rosenberg's self-esteem scale

BACKGROUND

The widely used Rosenberg's self-esteem scale (RSES) has not been evaluated for psychometric properties in Sweden.

AIMS

This study aimed at analyzing its factor structure, internal consistency, criterion, convergent and discriminant validity, sensitivity to change, and whether a four-graded Likert-type response scale increased its reliability and validity compared to a yes/no response scale.

METHODS

People with mental illness participating in intervention studies to (1) promote everyday life balance (N = 223) or (2) remedy self-stigma (N = 103) were included. Both samples completed the RSES and questionnaires addressing quality of life and sociodemographic data. Sample 1 also completed instruments chosen to assess convergent and discriminant validity: self-mastery (convergent validity), level of functioning and occupational engagement (discriminant validity). Confirmatory factor analysis (CFA), structural equation modeling, and conventional inferential statistics were used.

RESULTS

Based on both samples, the Swedish RSES formed one factor and exhibited high internal consistency (>0.90). The two response scales were equivalent. Criterion validity in relation to quality of life was demonstrated. RSES could distinguish between women and men (women scoring lower) and between diagnostic groups (people with depression scoring lower). Correlations >0.5 with variables chosen to reflect convergent validity and around 0.2 with variables used to address discriminant validity further highlighted the construct validity of RSES. The instrument also showed sensitivity to change.

CONCLUSIONS

The Swedish RSES exhibited a one-component factor structure and showed good psychometric properties in terms of good internal consistency, criterion, convergent and discriminant validity, and sensitivity to change. The yes/no and the four-graded Likert-type response scales worked equivalently.

Development of a Self Report Stress Scale Using Item Response Theory-I: Item Selection, Formation of Factor Structure and Examination of Its Psychometric Properties

INTRODUCTION

Due to the absence of Turkish psychometric devices assessing stress, in the present study it was aimed to develop a stress scale, and examine its basic psychometric properties.

METHODS

Current study included two processes, formation of item pool and examination of psychometric properties of the selected items through three studies. In the first study, 611 individuals aged between 18 and 77 responded to 130 selected items. In the second study, 2223 individuals aged between 18 and 68 responded to 80 items. In the third study, 1969 individuals aged between 18 and 79 responded to the final form of 36 items. Further, in study 3 for criterion related validity 163 individuals completed the Coopersmith Self-Esteem Inventory, 113 individuals completed the Beck Anxiety Inventory, 104 individuals completed the Hospital Anxiety and Depression Scale, 107 individuals completed the Beck Depression Inventory, and 265 individuals completed the Perceived Stress Scale. Moreover, in the investigation of test-retest reliability, 119 individuals took the final form of the test after 2 weeks, and 111 individuals took the final form of the test after 3 weeks.

RESULTS

In the first study, out of 130 items, 54 that showed item-total score correlations below 0.30 were excluded from the scale. Fifty-seven items were preserved exactly, and 19 items' sentence structures were changed. Furthermore, by adding 4 new items, 80 were prepared for the second study. In the second study, two factors structure namely "Physiological Reactions/Strain" and "Psychological/Cognitive Appraisals" sub-dimensions were identified, and 36 items were selected via Item Response Theory representing these sub-dimensions. In study 3, exploratory factor analysis provided strong support for our hypothesized two factors structure. Confirmatory factor analysis indicated hypothesized model had a better fit to the data. Internal consistency coefficients were 0.94 for the entire scale, 0.90 for Physiological Reactions/Strain sub-dimension, and 0.91 for Psychological/Cognitive Appraisals sub-dimension. Correlation coefficients between the entire scale and other criterion scales ranged from 0.22 to 0.63. Test-retest correlation coefficients between the first administration of the scale, and the administrations at two and three week intervals were 0.88.

CONCLUSION

Results showed that the scale has basic psychometric requirements provided that the scale will be supported by validity studies.

High sex ratios in rural China: declining well-being with age in never-married men

In parts of rural China male-biased sex ratios at birth, combined with out-migration of women, have led to highly male-biased adult sex ratios, resulting in large numbers of men being unable to marry, in a culture where marriage and reproduction are an expectation. The aim of this study was to test the hypotheses that older unmarried men are more predisposed to depression, low self-esteem and aggression than both those who are married, and those who are younger and unmarried. Self-completion questionnaires were administered among men aged 20-40 in 48 villages in rural Guizhou province, southwestern China. Tools used included the Beck Depression Inventory, the Rosenberg's Self-esteem Scale and the Bryant-Smith Aggression Questionnaire. Regression models assessed psychological wellbeing while adjusting for socio-demographic variables. Completed questionnaires were obtained from 957 never-married men, 535 married men aged 30-40, 394 partnered men and 382 unpartnered men aged 20-29. After adjusting for socio-demographic variables, never-married men were more predisposed to depression (p < 0.05), aggression (p < 0.01), low self-esteem (p < 0.05) and suicidal tendencies (p < 0.001). All the psychological measures deteriorated with age in never-married men. In contrast, married men remained stable on these dimensions with age. Never-married men are a psychologically highly vulnerable group in a society where marriage is an expectation. Since the highest birth sex-ratio cohorts have not yet reached reproductive age, the social tragedy of these men will last for at least another generation.This article is part of the themed issue 'Adult sex ratios and reproductive decisions: a critical re-examination of sex differences in human and animal societies'.

Emotional reactivity and blood pressure elevations: anxiety as a mediator

There is a strong link between emotional reactivity and hypertension, yet little research to date has examined mediators of this relationship. Ourstudy  investigated the mediating roleof anxiety on the relationship between emotional reactivity and blood pressure elevations. Participants were226 hypertensive patients (93 men and 133 women, Mean age = 53.09, SD = 13.88 years), purposivelydrawn from the General Outpatient Department in University of Calabar Teaching Hospital, Calabar, , Nigeria. .  Measures for data collection were Emotional Reactivity Scale, State Trait Anxiety Inventory, and the Mercury Sphygmomanometer. Hayes PROCESS macro for SPSS which uses a regression-based, path-analytical framework, was employed in analysing the data. Results showed that emotional reactivity was positively associated with blood pressure elevations. Anxiety was positively associated with blood pressure elevations. Anxiety also fully mediated the relationship between emotional reactivity and blood pressure elevations, even after adjusting for the control variables (e.g., age, family history of hypertension, and educational status). The finding suggests that being less emotionally reactive is associated with a decrease in disabling influences of anxiety, thereby contributing to lower levels of mean arterial blood pressure. The findings may be helpful  in improving prevention, control and management of hypertension in healthcare.

The Long-term Effects of Self-Esteem on Depression: The Roles of Alcohol and Substance Uses during Young Adulthood

Using the National Longitudinal Surveys of Youth 1979, this study examines the roles of alcohol and substance use as mediators in the mechanism between self-esteem and depression, and investigates whether the mechanism works for both men and women. Results demonstrate that alcohol and substance use during young adulthood mediates the effect of self-esteem on depression among men. Furthermore, self-esteem during young adulthood remains a determinant of high depression in middle adulthood. However, we did not find evidence to support that same mechanism among women. Our findings provide insight into how self-esteem affects depression over the transition from young to middle adulthood, and elucidate potential gendered responsivity to low self-esteem.

Roles of Self-Stigma, Social Support, and Positive and Negative Affects as Determinants of Depressive Symptoms Among HIV Infected Men who have Sex with Men in China

Poor mental health was prevalent among HIV positive men who have sex with men (HIVMSM), and a tremendous burden extents on their families and society. The present study investigated the prevalence of depression and its relationship with social support, HIV self-stigma, positive affect and negative affect among 321 HIVMSM in Chengdu, China. The study was conducted during July 2013 through October 2013. Findings showed that 55.8 % of the participants had mild to severe depression. The results of structural equation modeling showed that social support and positive affect were negatively associated with depression, while HIV self-stigma and negative affect were positively associated with depression. Social support, positive affect, and negative affect mediated the association between HIV self-stigma and depression. The hypothesized model had a satisfactory fit. Interventions improving mental health among this population are warranted.

Environmental and perceived stress in Australian dental undergraduates: Preliminary outcomes

Background. Dental students have reported a high prevalence of psychological stress and the causes are associated with the challenging dental environmental and demographic factors. This study aimed to conduct a preliminary investigation on dental students’ stress status, using a sample of first-to-third-year Bachelor of Dental Surgery students in an Australian university. Special interests included causes of dental environmental stress and access to help services.

Methods. A sample of 145 students was surveyed with a modified Dental Environmental Survey and Depression Anxiety Stress Scale in 2014. The participants’ demographic information was also collected.

Results. The response rate was 95.4%. Second-year (P = 0.042), third-year (P < 0.001) and employed students (P = 0.027) were more likely to report stress resulting from transition to clinical learning. Third-year students were more often stressed about communicating and approaching staff (P = 0.023) as well as different opinions between staff (P < 0.001) and reduced holidays (P < 0.001). Students that were younger than 21 years of age (P = 0.001), that were first years (P < 0.001), and that were not in a relationship (P = 0.010) more often found difficulty of course work stressful. Students who were not in a relationship more often considered learning manual dexterity a source of stress (P = 0.034). Students previously seeking professional help were more likely to be stressed (P = 0.010).

Conclusion. Causes of dental environment stress varied among years of study and demographic backgrounds. Professional support to stressed students should be enhanced. Further investigation is indicated.

Questions of time and affect: a person's affectivity profile, time perspective, and well-being

Background. A “balanced” time perspective has been suggested to have a positive influence on well-being: a sentimental and positive view of the past (high Past Positive), a less pessimistic attitude toward the past (low Past Negative), the desire of experiencing pleasure with slight concern for future consequences (high Present Hedonistic), a less fatalistic and hopeless view of the future (low Present Fatalistic), and the ability to find reward in achieving specific long-term goals (high Future). We used the affective profiles model (i.e., combinations of individuals’ experience of high/low positive/negative affectivity) to investigate differences between individuals in time perspective dimensions and to investigate if the influence of time perspective dimensions on well-being was moderated by the individual’s type of profile.

Method. Participants (N = 720) answered to the Positive Affect Negative Affect Schedule, the Zimbardo Time Perspective Inventory and two measures of well-being: the Temporal Satisfaction with Life Scale and Ryff’s Scales of Psychological Well-Being-short version. A Multivariate Analysis of Variance (MANOVA) was conducted to identify differences in time perspective dimensions and well-being among individuals with distinct affective profiles. Four structural equation models (SEM) were used to investigate which time perspective dimensions predicted well-being for individuals in each profile.

Results. Comparisons between individuals at the extreme of the affective profiles model suggested that individuals with a self-fulfilling profile (high positive/low negative affect) were characterized by a “balanced” time perspective and higher well-being compared to individuals with a self-destructive profile (low positive/high negative affect). However, a different pattern emerged when individuals who differed in one affect dimension but matched in the other were compared to each other. For instance, decreases in the past negative time perspective dimension lead to high positive affect when negative affect is high (i.e., self-destructive vs. high affective) but to low negative affect when positive affect was high (i.e., high affective vs. self-fulfilling). The moderation analyses showed, for example, that for individuals with a self-destructive profile, psychological well-being was significantly predicted by the past negative, present fatalistic and future time perspectives. Among individuals with a high affective or a self-fulfilling profile, psychological well-being was significantly predicted by the present fatalistic dimension.

Conclusions. The interactions found here go beyond the postulation of a “balanced” time perspective being the only way to promote well-being. Instead, we present a more person-centered approach to achieve higher levels of emotional, cognitive, and psychological well-being.

Determinants of Psychosocial Difficulties Experienced by Persons with Brain Disorders: Towards a 'Horizontal Epidemiology' Approach

BACKGROUND

Persons with brain disorders experience significant psychosocial difficulties (PSD) in daily life, e.g. problems with managing daily routine or emotional lability, and the level of the PSD depends on social, physical and political environments, and psychologic-personal determinants. Our objective is to determine a brief set of environmental and psychologic-personal factors that are shared determinants of PSD among persons with different brain disorders.

METHODS

Cross-sectional study, convenience sample of persons with either dementia, stroke, multiple sclerosis, epilepsy, migraine, depression, schizophrenia, substance dependence or Parkinson's disease. Random forest regression and classical linear regression were used in the analyses.

RESULTS

722 subjects were interviewed in four European countries. The brief set of determinants encompasses presence of comorbidities, health status appraisal, stressful life events, personality changes, adaptation, self-esteem, self-worth, built environment, weather, and health problems in the family.

CONCLUSIONS

The identified brief set of common determinants of PSD can be used to support the implementation of cross-cutting interventions, social actions and policy tools to lower PSD experienced by persons with brain disorders. This set complements a recently proposed reliable and valid direct metric of PSD for brain disorders called PARADISE24.

Two different approaches to the affective profiles model: median splits (variable-oriented) and cluster analysis (person-oriented)

Background. The notion of the affective system as being composed of two dimensions led Archer and colleagues to the development of the affective profiles model. The model consists of four different profiles based on combinations of individuals’ experience of high/low positive and negative affect: self-fulfilling, low affective, high affective, and self-destructive. During the past 10 years, an increasing number of studies have used this person-centered model as the backdrop for the investigation of between and within individual differences in ill-being and well-being. The most common approach to this profiling is by dividing individuals’ scores of self-reported affect using the median of the population as reference for high/low splits. However, scores just-above and just-below the median might become high and low by arbitrariness, not by reality. Thus, it is plausible to criticize the validity of this variable-oriented approach. Our aim was to compare the median splits approach with a person-oriented approach, namely, cluster analysis.

Method. The participants (N = 2, 225) were recruited through Amazons’ Mechanical Turk and asked to self-report affect using the Positive Affect Negative Affect Schedule. We compared the profiles’ homogeneity and Silhouette coefficients to discern differences in homogeneity and heterogeneity between approaches. We also conducted exact cell-wise analyses matching the profiles from both approaches and matching profiles and gender to investigate profiling agreement with respect to affectivity levels and affectivity and gender. All analyses were conducted using the ROPstat software.

Results. The cluster approach (weighted average of cluster homogeneity coefficients = 0.62, Silhouette coefficients = 0.68) generated profiles with greater homogeneity and more distinctive from each other compared to the median splits approach (weighted average of cluster homogeneity coefficients = 0.75, Silhouette coefficients = 0.59). Most of the participants (n = 1,736, 78.0%) were allocated to the same profile (Rand Index = .83), however, 489 (21.98%) were allocated to different profiles depending on the approach. Both approaches allocated females and males similarly in three of the four profiles. Only the cluster analysis approach classified men significantly more often than chance to a self-fulfilling profile (type) and females less often than chance to this very same profile (antitype).

Conclusions. Although the question whether one approach is more appropriate than the other is still without answer, the cluster method allocated individuals to profiles that are more in accordance with the conceptual basis of the model and also to expected gender differences. More importantly, regardless of the approach, our findings suggest that the model mirrors a complex and dynamic adaptive system.

Positive affect and age as predictors of exercise compliance

Physical exercise is linked to individuals whose affect profiles are invariably positive and it induces anti-apoptotic and anti-excitotoxic effects, buttressing blood–brain barrier intactness in both healthy individuals and those suffering from disorders accompanying overweight and obesity. In this regard, exercise offers a unique non-pharmacologic, non-invasive intervention that incorporates different regimes, whether dynamic or static, endurance, or resistance. In this brief report we present a self-reported study carried out on an adolescent and adult population (N = 280, 144 males and 136 females), which indicated that the propensity and compliance for exercise, measured as the “Archer ratio”, was predicted by a positive affect. This association is discussed from the perspective of health, well-being, affect dimensions, and age.

Understanding Group and Leader (UGL) trainers' personality characteristics and affective profiles

BACKGROUND

The Understanding Group and Leader (UGL), provided by the Swedish National Defense College and mentored by UGL-trainers, is one of the most popular management programs among civilians in Sweden. However, there is a lack of scientific evidence regarding the training. We used the affective profile model (i.e., the combination of positive, PA, and negative affect, NA) to mapp important markers of empowerment, self-awareness, adaptive coping skills, and maturity among the UGL-trainers. The aims were: (1) to compare profiles between UGL-trainers and managers/supervisors and (2) to investigate differences in personal characteristics.

METHOD

UGL-trainers (N = 153) and the comparison group (104 Swedish Chiefs of Police) completed an online survey on optimism, self-esteem, locus of control, and affect. The four profiles are: self-fulfilling (high PA, low NA), high affective (high PA, high NA), low affective (high PA, low NA), and self-destructive (low PA, high NA).

RESULTS

The self-fulfilling profile was more common among UGL-trainers (25.70%) than among Chiefs of Police (19.20%). UGL-trainers, compared to Chiefs of Police, were more likely to express a self-fulling than a low affective profile (OR = 2.22, p < 0.05) and a high affective than a low affective profile (OR = 1.43, p < 0.001). UGL-trainers with a self-fulfilling profile, compared to those with a self-destructive profile, scored higher in optimism, higher in self-esteem, and lower in external locus of control.

CONCLUSIONS

The probability of self-fulfillment rather than low affectivity was higher among UGL-trainers. Self-fulfillment was associated to markers of self-awareness and adaptive coping skills. However, the most common profile was the low affective, which is associated to low performance during stress, low degree of personal development, low degree of purpose in life, and low resilience. Hence, it might be important for UGL-trainers to have a continuous training in awareness after certification.

Online social networking and mental health

During the past decade, online social networking has caused profound changes in the way people communicate and interact. It is unclear, however, whether some of these changes may affect certain normal aspects of human behavior and cause psychiatric disorders. Several studies have indicated that the prolonged use of social networking sites (SNS), such as Facebook, may be related to signs and symptoms of depression. In addition, some authors have indicated that certain SNS activities might be associated with low self-esteem, especially in children and adolescents. Other studies have presented opposite results in terms of positive impact of social networking on self-esteem. The relationship between SNS use and mental problems to this day remains controversial, and research on this issue is faced with numerous challenges. This concise review focuses on the recent findings regarding the suggested connection between SNS and mental health issues such as depressive symptoms, changes in self-esteem, and Internet addiction.

Outcomes, feasibility and acceptability of a group support psychotherapeutic intervention for depressed HIV-affected Ugandan adults: a pilot study

BACKGROUND

Psychotherapy is the recommended first line treatment for mild to moderate depression. However, its availability in low resource settings is limited. We developed a manualized culturally sensitive group support psychotherapeutic intervention for depressed HIV affected Ugandan adults. In this study, we aimed to assess its feasibility, acceptability and impact on depression, functioning, social support and self-esteem.

METHODS

A total of 77 depressed individuals were assigned to the group intervention (n=48) and a wait-list control group (n=29), and assessed before, during and at the end of the intervention. The self-reporting questionnaire, a locally relevant function assessment instrument, the Rosenberg self-esteem scale, and the multiple dimensions perceived social support scale were administered to assess depression symptoms, functioning, self-esteem and social support at three assessment periods. Multivariate longitudinal regression models were used to determine change in outcomes over time between the two groups. Participants were asked to evaluate the intervention.

RESULTS

Post -intervention assessments indicate that, in comparison to the wait-list control group, the intervention group had a faster reduction in depression symptom scores [OR=0.00,95% CI, 0.00-0.003] and faster increase in functioning scores [OR=4.82, 95% CI, 2.39 to 9.75], social support scores [OR=2.68, 95% CI, 1.50-4.78] and self-esteem [OR=1.90, 95% CI 1.48-2.44]. Sixty-three percent of participants strongly agreed that the intervention had reduced their depression and would recommend it to other depressed individuals.

LIMITATIONS

Inadequate study power due to small sample sizes may result in imprecise confidence intervals even when there are significant differences. The use of non-random samples could have resulted in selection bias.

CONCLUSIONS

This intervention appears feasible, acceptable and promising in treating depression and restoring function, enhancing social support and self-esteem. Larger and randomized evaluations are warranted.

A happier and less sinister past, a more hedonistic and less fatalistic present and a more structured future: time perspective and well-being

Background. Previous studies have established a link between how people relate to their past, present, and future (i.e., time perspective) and subjective well-being (i.e., life satisfaction, positive and negative affect). Time perspective comprises five dimensions: Past Positive, Past Negative, Present Hedonistic, Present Fatalistic, and Future. Life satisfaction can also be evaluated in relation to different time frames. Moreover, approach related positive affect is associated to a different concept of well-being labeled psychological well-being. In the present study we extend previous findings by investigating the effect of time perspective on the time frame of evaluations of life satisfaction (past, present, future) and by investigating the relationship between time perspective and psychological well-being. Method. Questionnaires on time perspective (Zimbardo's Time Perspective Inventory), temporal life satisfaction (Temporal Satisfaction with Life Scale), affect (Positive Affect and Negative Affect Schedule), and psychological well-being (Scales of Psychological Well-Being-short version) were answered by 453 individuals. Two different structural equation models were tested, one of the relationship between time perspective and temporal life satisfaction, and the other of the relationship between time perspective, affect and psychological well-being. Results. Time perspective affected life satisfaction depending on the time scale on which it was evaluated-memory of a negative past influenced life satisfaction in all time frames, and a positive view of the past influenced both past and future life satisfaction. Moreover, less rumination about past negative events (i.e., low score on Past Negative), the tendency to take risks in the present to achieve happy feelings and/or avoid boredom (i.e., high scores on Present Hedonistic), and a less hopeless and pessimistic view about the present (low scores on Present Fatalistic) were associated with higher levels of psychological well-being and positive affect. These same time perspective dimensions were associated with lower levels of negative affect. The Future time perspective dimension (i.e., approaching life with self-control, punctuality, and planning for the future) was associated with both psychological well-being and positive affect. Conclusions. High levels of both subjective and psychological well-being are related to a happier and a less sinister past, a more hedonistic and less fatalistic present, as well as to a more structured future.

The affective profiles, psychological well-being, and harmony: environmental mastery and self-acceptance predict the sense of a harmonious life

Background. An important outcome from the debate on whether wellness equals happiness, is the need of research focusing on how psychological well-being might influence humans’ ability to adapt to the changing environment and live in harmony. To get a detailed picture of the influence of positive and negative affect, the current study employed the affective profiles model in which individuals are categorised into groups based on either high positive and low negative affect (self-fulfilling); high positive and high negative affect (high affective); low positive and low negative affect (low affective); and high negative and low positive affect (self-destructive). The aims were to (1) investigate differences between affective profiles in psychological well-being and harmony and (2) how psychological well-being and its dimensions relate to harmony within the four affective profiles.

Method. 500 participants (mean age = 34.14 years, SD. = ±12.75 years; 187 males and 313 females) were recruited online and required to answer three self-report measures: The Positive Affect and Negative Affect Schedule; The Scales of Psychological Well-Being (short version) and The Harmony in Life Scale. We conducted a Multivariate Analysis of Variance where the affective profiles and gender were the independent factors and psychological well-being composite score, its six dimensions as well as the harmony in life score were the dependent factors. In addition, we conducted four multi-group (i.e., the four affective profiles) moderation analyses with the psychological well-being dimensions as predictors and harmony in life as the dependent variables.

Results. Individuals categorised as self-fulfilling, as compared to the other profiles, tended to score higher on the psychological well-being dimensions: positive relations, environmental mastery, self-acceptance, autonomy, personal growth, and purpose in life. In addition, 47% to 66% of the variance of the harmony in life was explained by the dimensions of psychological well-being within the four affective profiles. Specifically, harmony in life was significantly predicted by environmental mastery and self-acceptance across all affective profiles. However, for the low affective group high purpose in life predicted low levels of harmony in life.

Conclusions. The results demonstrated that affective profiles systematically relate to psychological well-being and harmony in life. Notably, individuals categorised as self-fulfilling tended to report higher levels of both psychological well-being and harmony in life when compared with the other profiles. Meanwhile individuals in the self-destructive group reported the lowest levels of psychological well-being and harmony when compared with the three other profiles. It is proposed that self-acceptance and environmental acceptance might enable individuals to go from self-destructive to a self-fulfilling state that also involves harmony in life.

Differences in prefrontal, limbic, and white matter lesion volumes according to cognitive status in elderly patients with first-onset subsyndromal depression

The purpose of this preliminary study was to test the hypothesis that subsyndromal depression is associated with the volume of medial prefrontal regional gray matter and that of white matter lesions (WMLs) in the brains of cognitively normal older people. We also explored the relationships between subsyndromal depression and medial prefrontal regional gray matter volume, limbic regional gray matter volume, and lobar WMLs in the brains of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). We performed a cross-sectional study comparing patients with subsyndromal depression and nondepressed controls with normal cognition (n = 59), MCI (n = 27), and AD (n = 27), adjusting for sex, age, years of education, and results of the Mini-Mental State Examination. Frontal WML volume was greater, and right medial orbitofrontal cortical volume was smaller in cognitively normal participants with subsyndromal depression than in those without subsyndromal depression. No volume differences were observed in medial prefrontal, limbic, or WML volumes according to the presence of subsyndromal depression in cognitively impaired patients. The absence of these changes in patients with MCI and AD suggests that brain changes associated with AD pathology may override the changes associated with subsyndromal depression.

Iranian and Swedish adolescents: differences in personality traits and well-being

Introduction. This study addresses the need to further contextualize research on well-being (e.g., Kjell, 2011) in terms of cross-cultural aspects of personality traits among adolescents and by examining two different conceptualizations of well-being: subjective well-being (i.e., life satisfaction, positive and negative affect) and psychological well-being (i.e., positive relations with others, environmental mastery, self-acceptance, autonomy, personal growth, and life purpose).

Methods. Iranian (N = 122, mean age 15.23 years) and Swedish (N = 109, mean age 16.69 years) adolescents were asked to fill out a Big Five personality test, as well as questionnaires assessing subjective well-being and psychological well-being.

Results. Swedes reported higher subjective and psychological well-being, while Iranians reported higher degree of Agreeableness, Openness and Conscientiousness. Neuroticism and Extraversion did not differ between cultures. Neuroticism was related to well-being within both cultures. Openness was related to well-being only among Iranians, and Extraversion only among Swedes. A mediation analysis within the Swedish sample, the only sample meeting statistical criteria for mediation analysis to be conducted, demonstrated that psychological well-being mediated the relationship between Neuroticism and subjective well-being as well as between Extraversion and subjective well-being.

Conclusions. Certain personality traits, such as Extraversion, Openness, and Conscientiousness, relate differently to well-being measures across cultures. Meanwhile, Neuroticism seems to relate similarly across cultures at least with regard to subjective well-being. Furthermore, the results give an indication on how psychological well-being might mediate the relationship between certain personality traits and subjective well-being. Overall, the complexity of the results illustrates the need for more research whilst supporting the importance of contextualizing well-being research.

The affective profiles in the USA: happiness, depression, life satisfaction, and happiness-increasing strategies

Background. The affective profiles model categorizes individuals as self-fulfilling (high positive affect, low negative affect), high affective (high positive affect, high negative affect), low affective (low positive affect, low negative affect), and self-destructive (low positive affect, high negative affect). The model has been used extensively among Swedes to discern differences between profiles regarding happiness, depression, and also life satisfaction. The aim of the present study was to investigate such differences in a sample of residents of the USA. The study also investigated differences between profiles with regard to happiness-increasing strategies.

Methods. In Study I, 900 participants reported affect (Positive Affect Negative Affect Schedule; PANAS) and happiness (Happiness-Depression Scale). In Study II, 500 participants self-reported affect (PANAS), life satisfaction (Satisfaction With Life Scale), and how often they used specific strategies to increase their own happiness (Happiness-Increasing Strategies Scales).

Results. The results showed that, compared to the other profiles, self-fulfilling individuals were less depressed, happier, and more satisfied with their lives. Nevertheless, self-destructive individuals were more depressed, unhappier, and less satisfied than all other profiles. The self-fulfilling individuals tended to use strategies related to agentic (e.g., instrumental goal-pursuit), communal (e.g., social affiliation), and spiritual (e.g., religion) values when pursuing happiness.

Conclusion. These differences suggest that promoting positive emotions can positively influence a depressive-to-happy state as well as increasing life satisfaction. Moreover, the present study shows that pursuing happiness through strategies guided by agency, communion, and spirituality is related to a self-fulfilling experience described as high positive affect and low negative affect.