Correlation Analysis Between Attentional Bias and Somatic Symptoms in Depressive Disorders

Time-dynamic associations between symptom-related expectations, self-management experiences and somatic symptom severity in everyday life: an ecological momentary assessment study with university students

OBJECTIVE

The present study investigated the associations between symptom-related expectations, self-management experiences and expectation framing on somatic symptom severity in university students in two conditions (positive or standard expectation framing). We hypothesised that symptom-related expectations are significantly associated with concurrent and subsequent levels of somatic symptom depending on expectation framing.

DESIGN

A smartphone-based micro-longitudinal ecological momentary assessment study with randomisation to one of two expectation framing groups (positive vs negative) was carried out. Multilevel mixed-effects linear regression analyses were conducted for data analysis.

SETTING

Data was collected in real-time from university students via smartphones, with three predetermined assessments per day over seven consecutive days.

PARTICIPANTS

A total of 104 students (63.5% male, 0% diverse) who were 18 years or older, possessing sufficient German language skills and had access to an Android-powered smartphone were included.

INTERVENTIONS

Participants were randomised to one of two different expectation framing groups, either receiving questionnaires for the expected impairment due to somatic symptoms (negative framing) or for the expected freedom from impairment due to somatic symptoms (positive framing).

PRIMARY OUTCOME MEASURES

Somatic symptom severity was assessed using an adapted version of the Patient Health Questionnaire, with 11-point instead of 3-point Likert-scales. Symptom-related expectations were assessed using 11-point Numerical Rating Scales and self-management experiences were assessed using binary variables.

RESULTS

Concurrent analysis revealed a significant association between symptom-related expectations and symptom severity (β=0.934, p<0.001), but no significant associations between self-management experiences and symptom severity. Regarding expectation framing, participants in the negative group reported higher symptom severity levels than those in the positive group (β=-0.071, p<0.001). Results indicated a stronger association between symptom-related expectations and symptom severity in the negative framing group (β=-0.088, p<0.001). Time-lagged analysis showed higher levels of symptom-related expectations predicted higher subsequent symptom severity levels (β=0.502, p<0.001), whereas preceding symptom severity levels or self-management experiences did not predict subsequent symptom severity levels. Negative framing was associated with higher subsequent symptom severity levels (β=-0.158, p<0.001). The effect of symptom-related expectations on subsequent symptom severity levels was independent of expectation framing.

CONCLUSIONS

Our findings highlight the impact of expectations and expectation framing on somatic symptom severity among university students and expand the knowledge needed for the development of expectation management techniques.

TRIAL REGISTRATION NUMBER

ISRCTN36251388.

The relationship between psychological resilience, neuroticism, attentional bias, and depressive symptoms in college Chinese students

In recent years, the incidence of depressive symptoms among Chinese college students has been increasing. Studies have shown that depressive symptoms are related to a variety of psychosocial factors, among which neuroticism, resilience, and attention bias are most notably related, but the correlation among the three is not clear. This study aimed to investigate the influence mechanisms of different degrees of resilience, attentional bias, and neuroticism in the formation of depressive symptoms. The college freshmen of this study were selected through stratified multi-stage cluster sampling. Students provided informed consent and then completed a general situation questionnaire and four scales: the Chinese version of the Connor-Davidson Resilience Scale, the Attention to Positive and Negative Information Scale, the Eysenck Personality Questionnaire, and the Zung Self-Rating Depressive Symptoms Scale. In total, 1,493 freshmen participated in the research group. Our results showed that low resilience, negative attention bias, and high neuroticism jointly increased the risk of depressive symptoms. There is a significant correlation between these three factors and depressive symptoms. Additionally, strength, tenacity, and attention bias all had more significant effects on the occurrence of depressive symptoms. These findings indicate that there may be an important psychological mechanism for the occurrence, development, and poor prognosis of depressive symptoms.

Does the Preoperative Depression Affect Clinical Outcomes in Adults With Following Lumbar Fusion?: A Retrospective Cohort Study

STUDY DESIGN

This was a retrospective cohort review.

OBJECTIVE

The objective of this study was to analyze depression using Beck Depression Inventory (BDI) and Hamilton Depression Scale (HAMD-24), and to correlate with clinical outcomes and improvement in adults with following lumbar fusion.

SUMMARY OF BACKGROUND DATA

Psychological factors such as depression are found to influence outcomes and improvement following spinal surgery. It is still unclear whether there are differences during screening for depression by different implementations to predict outcomes for spine surgery.

MATERIALS AND METHODS

Between July 2016 and May 2018, patients with degenerative lumbar disease, who underwent lumbar fusion were enrolled in this study. The patient's characteristics, preoperative BDI and HAMD-24 score, and preoperative and postoperative outcomes were collected, respectively. Depressed patients were identified by a score of BDI≥15 or HAMD-24>20, respectively. Preoperative and postoperative outcome scores, absolute changes, and recovery ratios of disability and pain were compared within and between groups. Finally, univariate and multiple linear regression analyses was performed to reveal the relationship between preoperative depressive states and outcomes and improvement.

RESULTS

A total of 125 patients were eligible in the study, with 113 (90.4%) patients without depressive symptoms and 12 (9.6%) depressed patients by BDI, and 97 (77.6%) patients without depressive symptoms and 28 (22.4%) depressed patients by HAMD-24. Both higher BDI and HAMD-24 group was found to have significant worse preoperative and postoperative outcomes as well as less recovery ratios than the patients without depressive symptoms. Univariate and multiple linear regression analyses suggested that preoperative depression might be a potential predictor of worse surgical outcomes.

CONCLUSIONS

Depressive symptoms might lead to smaller magnitude of improvement. Moreover, both preoperative BDI and HAMD-24 score was a negative predictor of postoperative outcomes and can be regarded as a candidate to screen for depression preoperatively.