Major depression and life satisfaction: a population-based twin study

Identification of novel endoplasmic reticulum-related genes and their association with immune cell infiltration in major depressive disorder

BACKGROUND

Several lines of evidence point to an interaction between genetic predisposition and environmental factors in the onset of major depressive disorder (MDD). This study is aimed to investigate the pathogenesis of MDD by identifying key biomarkers, associated immune infiltration using bioinformatic analysis and human postmortem sample.

METHODS

The Gene Expression Omnibus (GEO) database of GSE98793 was adopted to identify hub genes linked to endoplasmic reticulum (ER) stress-related genes (ERGs) in MDD. Another GEO database of GSE76826 was employed to validate the novel target associated with ERGs and immune infiltration in MDD. Moreover, human postmortem sample from MDD patients was utilized to confirm the differential expression analysis of hub genes.

RESULTS

We discovered 12 ER stress-related differentially expressed genes (ERDEGs). A LASSO Cox regression analysis helped construct a diagnostic model for these ERDEGs, incorporating immune infiltration analysis revealed that three hub genes (ERLIN1, SEC61B, and USP13) show the significant and consistent expression differences between the two groups. Western blot analysis of postmortem brain samples indicated notably higher expression levels of ERLIN1 and SEC61B in the MDD group, with USP13 also tending to increase compared to control group.

LIMITATIONS

The utilization of the MDD gene chip in this analysis was sourced from the GEO database, which possesses a restricted number of pertinent gene chip samples.

CONCLUSIONS

These findings indicate that ERDEGs especially including ERLIN1, SEC61B, and USP13 associated the infiltration of immune cells may be potential diagnostic indicators for MDD.

Gender, society and mental health: The moderated mediating role of depression and gender on national resilience and life satisfaction among emerging adults

Recent threats to human security (i.e., COVID-19 pandemic, conflicts, climate change events) call for nurses to have an increased understanding of how sociopolitical environments induce mental health problems and impact the well-being of citizens. This study examines the relationship between national resilience and life satisfaction among Filipino emerging adults, how depression mediates this relationship, and how these correlations are moderated by gender. Drawing from an online survey sample of 1020 Filipino emerging adults (18-29 years old), this cross-sectional study utilised a moderated mediation analysis. Key constructs were measured using the short version of the National Resilience Scale (NR-13), the depression component of the Kessler Psychological Distress (K10) scale and the Satisfaction with Life Scale (SWLS). Gender was measured as sex assigned at birth. Descriptive results show that more than half of the respondents are female (64.2%) and demonstrate below-average levels of national resilience and depression, and high levels of life satisfaction. Also, findings indicate that depression has significant negative relationships with, and partially mediates the positive relationship between national resilience and life satisfaction. Moreover, moderation analysis results suggest that being female synergizes the negative relationship between depression and life satisfaction, and being male strengthens the positive relationship between national resilience and life satisfaction (p < 0.01). The results highlight how the national resilience of emerging adults neutralises their risk for depression and, ultimately, improves life satisfaction. Moreover, the findings emphasise the importance of nursing advocacy actions to ensure that social policies for improving public mental health are gender-sensitive, given that macro-social and psychological factors have varied effects on individuals' lives based on gender.

Associations between Social Experiences and Psychological Health for Autistic Youth with Low IQ

PURPOSE

Social experiences are consistently associated with psychological health among autistic individuals. However, most extant studies on this topic exclude individuals with autism who have lower IQ or are otherwise unable to self-report. The current study addresses this gap by examining associations of negative peer experiences and social participation with psychological health among autistic youth with low IQ.

METHODS

An online survey was collected from 268 parents of autistic adolescents and adults ages 15-25. Negative peer experiences included measures of peer victimization and being ignored. Social participation was assessed by the amount of participation and parents' perceptions of whether their youth felt the amount of participation was meeting their needs. Psychological health was assessed by parents' report of their youth's psychological quality of life, as well as whether they felt their son/daughter was currently depressed.

RESULTS

Results suggested low rates of social participation in this sample, with relatively high rates of being ignored. Regression analysis found that lower rates of peer victimization and more activities in which parents perceived that the amount of time was meeting their youth's needs was associated with higher psychological quality of life and lower likelihood that parents felt their son/daughter was depressed.

CONCLUSION

Though youth with autism and low IQ are often excluded from interventions aimed at improving social experiences, these findings suggest that promoting positive social experiences and ameliorating negative ones might be an avenue to improving psychological health in this group.

Genetic influences on depression and selection into adverse life experiences

Genome-wide association studies find that a large number of genetic variants jointly influence the risk of depression, which is summarized by polygenic indices (PGIs) of depressive symptoms and major depression. But PGIs by design remain agnostic about the causal mechanisms linking genes to depression. Meanwhile, the role of adverse life experiences in shaping depression risk is well-documented, including via gene-environment correlation. Building on theoretical work on dynamic and contingent genetic selection, we suggest that genetic influences may lead to differential selection into negative life experiences, forging gene-environment correlations that manifest in various permutations of depressive behaviors and environmental adversities. We also examine the extent to which apparent genetic influences may reflect spurious associations due to factors such as indirect genetic effects. Using data from two large surveys of middle-aged and older US adults, we investigate to what extent a PGI of depression predicts the risk of 27 different adversities. Further, to glean insights about the kinds of processes that might lead to gene-environment correlation, we augment these analyses with data from an original preregistered survey to measure cultural understandings of the behavioral dependence of various adversities. We find that the PGI predicts the risk of majority of adversities, net of class background and prior depression, and that the selection risk is greater for adversities typically perceived as being dependent on peoples' own behaviors. Taken together, our findings suggest that the PGI of depression largely picks up the risk of behaviorally-influenced adversities, but to a lesser degree also captures other environmental influences. The results invite further exploration into the behavioral and interactional processes that lie along the pathways intervening between genetic differences and wellbeing.

The effect of neighborhood social cohesion on life satisfaction in type 2 diabetes mellitus patients: the chain mediating role of depressive symptoms and sleep quality

Objective

Although most studies have shown that neighborhood social cohesion (NSC) is associated with life satisfaction among patients with type 2 diabetes mellitus (T2DM), it remains unclear how NSC is linked to life satisfaction. The present study aims to examine the potential mediation effect of depressive symptoms and sleep quality on the relationship between NSC and life satisfaction among Chinese individuals with T2DM.

Methods

A cross-sectional survey was conducted from August 2019 to November 2020 involving 1747 T2DM patients. The main information was obtained using the Center for Epidemiological Survey Depression Scale (CES-D), self-report sleep quality and life satisfaction questionnaire and NSC scales. Mediation analyses were performed using the PROCESS macro in SPSS.

Results

The results manifested that the NSC was positively associated with sleep quality (r = 0.219) and life satisfaction (r = 0.214), while negatively correlated with depressive symptoms (r = -0.232). Depressive symptoms were found to be negatively associated with life satisfaction (r = -0.263). NSC influenced life satisfaction through three mediating pathways: (a) depressive symptoms (effect = 0.0081); (b) depressive symptoms and sleep quality (effect = 0.0019); and (c) sleep quality (effect = 0.0015). The total mediating effect accounted for 28.1% of the overall effect.

Conclusion

Our findings support the hypothesis that depressive symptoms and sleep quality mediated the relationship between NSC and life satisfaction in patients with T2DM. It is important to encourage T2DM patients to participate in social interactions and enhance their level of NSC. Additionally, efforts should be made to actively reduce depressive symptoms and improve sleep quality, so as to improve their life satisfaction.

Associations between sleep medication use and alcohol consumption over 36 years in Finnish twins

BACKGROUND

Sleep medication use is an indicator of underlying sleep problems that might be induced by various factors such as alcohol use. However, the longitudinal relationship between drinking and sleep problems remains poorly understood. We investigated associations between sleep medication and alcohol use throughout adulthood, and examined the role of familial and potential confounding factors contributing to these associations.

METHODS

We used information of zygosity and self-report questionnaire data over a follow-up period of 36 years from the Older Finnish Twin Cohort (N=13,851).

RESULTS

Logistic regression analyses suggested consistent associations between sleep medication use and heavy/binge drinking at all four time points (OR range =1.36-3.18, P <0.05), implying that increased drinking is associated with increased sleep medication use over time. Cross-lagged path analyses suggested that moderate/heavy and binge drinking predict sleep medication use at most time points (OR range = 1.15-1.94, P <0.05), whilst sleep medication use predicts subsequent abstaining from alcohol (OR range =2.26-2.47, P <0.05). Within-pair analyses implied that familial factors play a role, and quantitative genetic modelling estimated genetic factors to explain approximately 80% of the lifetime association of sleep medication use with moderate/heavy and binge drinking.

CONCLUSIONS

Drinking is associated with sleep medication use throughout adulthood. Further, our results suggest that drinking is likely to predict sleep medication use, thereby potentially constituting a risk factor for sleep problems, and that genetic factors contribute to the association. These findings are important in terms of better understanding the development of sleep and alcohol use disorders.

An assessment of self-rated life satisfaction and its correlates with physical, mental and social health status among older adults in India

Life satisfaction refers to the assessment of one's own life in terms of self-perceived favourable qualities. It is an integral part of healthy and successful course of ageing. It is widely associated with the health status and social well-being. The present study attempted to determine the constructing factors of self-rated life satisfaction, such as socio-demographic, physical, social, and mental well-being of older adults. We analysed information from the Longitudinal Ageing Study in India (LASI-1), the initial phase conducted during 2017-18 for the population of older adults in India. We applied descriptive statistics for prevalence assessment and association was checked using chi-square test. Further, to determine the adjusted outcome of predictor covariates on the likelihood of an individual being satisfied from life estimated by applying hierarchical multiple logistic regression models. Several noteworthy affirmations on the relationship between the socio-demographic variables and health risk behaviours with life satisfaction were observed. The results were consistent with studies showing change in life satisfaction subject to the state of physical and mental health, presence of chronic diseases, friends and family relations, dependency, and events of trauma or abuse. While comparing respondents, we found varying degrees of life satisfaction by gender, education, marital status, expenditure and other socio-economic features. We also found that besides physical and mental health, social support and well-being play a pivotal role in achieving higher life satisfaction among older adults. Overall, this work contributes to the study of the subjective well-being of older adults in India based on self-reported levels of life satisfaction and further narrows the gap in knowledge about associated behaviour. Hence, with on-going ageing scenario, there is need for multi-sectorial policy-oriented approaches at individual, family, and community level, which helps to take care of older-adults' physical, social, and mental health for the betterment of healthy ageing.

The Mediating Role of Depression in Association Between Total Sleep Time and Instrumental Activities of Daily Living in China

Objectives: This study aims to investigate the mediating role of depression and the moderating effect of gender in the relationship between total sleep time (TST) and instrumental activities of daily living (IADL) in middle-aged and elderly people (aged 45 or above).

Methods: The data used in this study is from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 10,460 respondents. Associations between TST, IADL, depression, and gender were analyzed using logistic regression and Karlson, Holm, and Breen (KHB) methods.

Results: Short (OR = 1.42, 95% CI = 1.28–1.58 of ≤6 h) and long TST (OR = 1.16, 95% CI = 1.02–1.32 of 8–9 h; OR = 1.35, 95% CI = 1.19–1.54 of &gt;9 h) were both associated with IADL. The mediation effect analyses observed that depression explained 64.80% of the total effect of short TST (≤6 h) and IADL, but was insignificant in long TST (8–9 h and &gt;9 h). Meanwhile, gender has moderating effects on the mediation effect model.

Conclusion: The study suggests that health interventions that focused on the dimensions of TST and depression are crucial for preventing functional disability while accounting for gender differences.

Mediating role of depressive symptoms on the relationship between sleep duration and cognitive function

Although some studies have shown the association between sleep duration and cognitive impairment is positive, the mechanism explaining how sleep duration is linked to cognition remains poor understood. The current study aims to explore it among Chinese population. A cross-sectional study of 12,589 participants aged 45 or over was conducted, cognition was assessed by three measures to capture mental intactness, episodic memory, and visuospatial abilities. The Center for Epidemiologic Studies Depression Scale 10 (CES-D₁₀) was administered during the face-to-face survey to assess depressive status. Sleep duration was reported by the participants themselves. Partial correlation and linear regression were used to explore the association between sleep duration, cognition, and depression. The Bootstrap methods PROCESS program was used to detect the mediation effect of depression. Sleep duration was positively correlated with cognition and negatively with depression (p < 0.01). The CES-D₁₀ score (r = - 0.13, p < 0.01) was negatively correlated with cognitive function. Linear regression analysis showed sleep duration was positively associated with cognition (p = 0.001). When depressive symptoms were considered, the association between sleep duration and cognition lost significance (p = 0.468). Depressive symptoms have mediated the relationship between sleep duration and cognitive function. The findings revealed that the relationship between sleep duration and cognition is mainly explained by depressive symptoms and may provide new ideas for interventions for cognitive dysfunction.

The association between affective temperaments and insomnia as mediated by satisfaction with life: a cross-sectional study

Background

The primary objectives of this study were to examine whether affective temperaments are associated with satisfac-tion with life; to determine whether satisfaction with life can mediate the relationship between affective tempera-ments and insomnia; and to reaffirm the relationship between affective temperaments and insomnia. We hypothe-sized that affective temperaments were associated directly and indirectly via satisfaction with life with insomnia.

Participants and procedure

A total of 497 participants aged 18 to 67 years, including 435 women and 62 men, were recruited from the general population via an online recruitment platform. We used the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire to evaluate affective temperaments and the Satisfaction with Life Scale to assess satis-faction with life. The Athens Insomnia Scale was used to assess participants’ level of insomnia symptoms.

Results

Depressive, cyclothymic, irritable and anxious temperaments correlated positively with insomnia symptoms, but hyperthymic temperament correlated negatively with insomnia symptoms. Satisfaction with life correlated negative-ly with insomnia symptoms. Hyperthymic temperament correlated positively with satisfaction with life, but depres-sive, cyclothymic, irritable and anxious temperaments correlated negatively with satisfaction with life. Hierarchical regression analysis indicated that 30% of the variance in insomnia symptoms was attributable to satisfaction with life level and the presence of cyclothymic and anxious temperaments. The mediation analysis suggested a significant indirect effect of cyclothymic and anxious temperaments on insomnia through satisfaction with life as a mediator between affective temperaments and insomnia.

Conclusions

Cyclothymic and anxious temperaments can influence the symptoms of insomnia directly and indirectly as mediated by satisfaction with life.

Polygenic risk scores for schizophrenia and major depression are associated with socio-economic indicators of adversity in two British community samples

Schizophrenia (SCZ) and major depressive disorder (MDD) are complex psychiatric disorders which contribute substantially to the global burden of disease. Both psychopathologies are heritable with some genetic overlap between them. Importantly, SCZ and MDD have also been found to be associated with environmental risk factors. However, rather than being independent of genetic influences, exposure to environmental risk factors may be under genetic control, known as gene-environment correlation (rGE). In this study we investigated rGE in relation to polygenic risk scores for SCZ and MDD in adults, derived from large genome-wide association studies, across two different British community samples: Understanding Society (USoc) and the National Child Development Study (NCDS). We tested whether established environmental risk factors for SCZ and/or MDD are correlated with polygenic scores in adults and whether these associations differ between the two disorders and cohorts. Findings partially overlapped between disorders and cohorts. In NCDS, we identified a significant correlation between the genetic risk for MDD and an indicator of low socio-economic status, but no significant findings emerged for SCZ. In USoc, we replicated associations between indicators of low socio-economic status and the genetic propensity for MDD. In addition, we identified associations between the genetic susceptibility for SCZ and being single or divorced. Results across both studies provide further evidence that the genetic risk for SCZ and MDD were associated with common environmental risk factors, specifically MDD's association with lower socio-economic status.

Analysing the role of sleep quality, functional limitation and depressive symptoms in determining life satisfaction among the older Population in India: a moderated mediation approach

Background:

Life satisfaction (LS), a useful construct in the study of psycho-social well-being, is an important indicator of healthy aging. With a view to investigate whether the improved longevity in India is accompanied by commensurate levels of well-being and contentment among the older adults , this study aimed to examine (1) the association between LS and sleep quality among older Indian adults aged 60 years and above (2) the mediating role of depression that accounts for the association and (3) the moderating role of functional limitation in this mediation.

Methods:

Cross-sectional data from the Longitudinal Ageing Study in India (LASI), Wave-1 (2017-18) was used. Pearson’s correlation coefficients were calculated to investigate the pair-wise relationship between sleep quality, depressive symptoms, functional limitation, and LS. Structural Equation Model was employed to analyse the moderated-mediated association between sleep quality and the level of LS.

Results:

Sleep quality had a direct effect (β=-0.12) as well as an indirect effect (β=-0.024) via depressive symptoms on LS, accounting for 83.6 and 16.4 per cent of the total effects, respectively. Also, the interaction term between poor seep quality and functional limitation was positive (β = 0.03, p < 0.001) in determining depressive symptoms, suggesting that higher level of functional limitation aggravated the indirect effect of poor sleep quality on LS.

Conclusion:

The findings of the study suggested that ensuring both the physical as well as the mental well-being of the population during the life course may confer in later life the desired level of life satisfaction.

Combination of physical activity and screen time on life satisfaction in adults: A cross-sectional survey

Background

Sufficient physical activity (PA) and limited screen time (ST) have been shown to be positively associated with a variety of mental health outcomes. It has been known that PA and ST are independently associated with life satisfaction. Whereas, little is known about the association between combinations of PA and ST with life satisfaction in adults. This study aimed to explore the associations between PA and ST (in insolation or combination) and life satisfaction in adults.

Methods

Data from the 2014 European Social Survey (ESS) round 7 consisting of 22 countries were analyzed in this study. In total, self-reported data from 40,185 adults were included in the final analysis. The self-administered method was used to collect demographic information, PA, ST, and life satisfaction. The prevalence of meeting PA guidelines (at least 150 min per week) and ST guidelines (no more than 3 h per day) was calculated according to Canadian 24-h Movement Guidelines for Adults.

Results

Adults who were engaged in sufficient PA and limited ST were more likely to report a higher level of life satisfaction. Meeting PA or ST guidelines was more likely to report higher life satisfaction scores [odds ratio (OR) = 1.31, 95% CI: 1.16–1.47]. Compared with not meeting any guidelines, those who met both PA and ST guidelines had a higher OR (OR = 1.55, 95% CI: 1.37–1.76).

Conclusion

This study found that participating PA while limiting ST concurrently was linked with better life satisfaction. Creating an active lifestyle is important to population’s well-being.

Association between physical activity and life satisfaction among adults with multimorbidity in Canada

OBJECTIVE

Maintaining life satisfaction may aid in multimorbidity resilience. As the prevalence of multimorbidity continues to rise in Canada, understanding modifiable factors that can influence life satisfaction among people with multimorbidity is warranted. This study aimed to examine the relationship between physical activity and life satisfaction among adults affected by multimorbidity.

METHODS

Cross-sectional data from the 2015-2018 cycles of the Canadian Community Health Survey were used; 22,851 respondents with multimorbidity aged 20 years and older were included. Multiple linear regression models were used to investigate the relationship between physical activity (sedentary, somewhat active, moderately active, active) and life satisfaction for the whole population and for those having specific types of chronic conditions, controlling for self-perceived health status and sociodemographic factors.

RESULTS

Respondents affected by multimorbidity who were somewhat active (β = 0.20, 95% CI: 0.08, 0.32), moderately active (β = 0.28, 95% CI: 0.13, 0.44), and active (β = 0.29, 95% CI: 0.17, 0.41) were more satisfied with life than respondents who had a sedentary lifestyle. The relationship between physical activity and life satisfaction was also found to be statistically significant in sub-populations of respondents affected by cancer, diabetes, chronic respiratory diseases, and mental health disorders but not cardiovascular diseases.

CONCLUSION

Physical activity may contribute to better life satisfaction among adults with multimorbidity. As multimorbidity increases in Canada, further investigation on the relationship between physical activity and life satisfaction is warranted to help improve interventions to cope with the effects of multimorbidity.

The aetiological relationship between depressive symptoms and health-related quality of life: A population-based twin study in Sri Lanka

Objective

Depression often co-occurs with poor health-related quality of life (HRQL). Twin studies report genetic and individual-level environmental underpinnings in the aetiology of both depression and HRQL, but there is limited twin research exploring this association further. There is also little evidence on sex differences and non-Western populations are underrepresented. In this paper we explored the phenotypic and aetiological relationship between depressive symptoms and HRQL and possible sex differences in a low-middle-income Sri Lankan population.

Method

Data for 3,948 participants came from the Colombo Twin and Singleton Follow-up Study (CoTaSS-2). Using self-report measures of depressive symptoms and HRQL, we conducted univariate and bivariate sex-limitation twin analyses.

Results

Depressive symptoms showed moderate genetic (33%) and strong nonshared environmental influences (67%). Nonshared environment accounted for the majority of variance in all the subscales of HRQL (ranging from 68 to 93%), alongside small genetic influences (ranging from 0 to 23%) and shared environmental influences (ranging from 0 to 28%). Genetic influences were significant for emotional wellbeing (23%). Shared environmental influences were significant for four out of the eight HRQL variables (ranging from 22–28%), and they were more prominent in females than males. Depressive symptoms were significantly associated with lower HRQL scores. These correlations were mostly explained by overlapping nonshared environmental effects. For traits related to emotional functioning, we also detected substantial overlapping genetic influences with depressive symptoms.

Conclusions

Our study confirmed previous findings of a negative association between depressive symptoms and HRQL. However, some of the aetiological factors of HRQL differed from Western studies, particularly regarding the effects of shared environment. Our findings highlight the importance of cross-cultural research in understanding associations between psychological wellbeing and HRQL.

Flattening the quality of life curve? A prospective person-centred study from Norway amid COVID-19

Purpose

We examined multidimensional, heterogeneous reactions to the COVID-19 pandemic and associated measures to provide further insights into the developmental processes of risk and adaptation.

Method

We used three-wave questionnaire data from 8156 individuals participating in the Norwegian County Public Health Survey assessed 1–5 months before and three (June 2020) and nine (December 2020) months after the outbreak. Latent profile and latent transition analyses were used to identify latent quality of life (QoL) classes and multiform changes, their probabilities, and predictors.

Results

We identified five distinct QoL classes of varying proportions, namely Flourishing (i.e. 24–40%), Content (31–46%), Content-Symptomatic (8–10%), Languishing (14–20%), and Troubled (2–5%). Despite higher levels of negative affect and lower levels of life satisfaction and positive emotions, most individuals remained in their pre-pandemic QoL profiles. Yet, changes occurred for a meaningful proportion, with transition to a less favourable class more common than to a favourable. Between time 1 and 3, the flourishing and troubled groups decreased by 40% and 60%, while the content and languishing groups increased by 48% and 43%, respectively. Favourable pre-pandemic relational (marital status, support, interpersonal trust, and belonging), health, and economy-related status predicted significantly lower odds of belonging to the high-risk groups both pre-pandemic and during the pandemic.

Conclusions

Overall, this study shows lower levels of QoL amid the COVID-19 pandemic, but substantial stability in the QoL distribution, and an overall levelling of the QoL distribution. Our findings also underscore the importance of financial, health-related, and social capital to QoL.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-022-03113-2.

Negative Social Experiences Mediate the Relationship between Sexual Orientation and Mental Health

The lesbian-gay-bisexual (LGB) population experiences a higher rate of psychopathology than the non-LGB population. Minority stress theory (MST) suggests that this pattern of findings is due to the increased negativity that LGB individuals face; however, MST is often employed as a post-hoc explanation for health inequalities as opposed to an a priori approach that explicitly tests this idea and has not been examined in the context of Canadian sexual minorities. Using the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH), we tested the MST on a sample 22,495 Canadians (n = 21,995 non-LGB; n = 500 LGB). Results indicated that respondents' scores on the Negative Social Interactions scale (NSI) partially mediated the relationship between LGB status and both depression and satisfaction with life. The findings suggest that a substantial component of the relationship between sexual orientation and mental health is influenced by deleterious social exchanges.

Association between Sleep Duration and Depression among the Elderly Population in China

OBJECTIVES

The objective of this study was to understand how sleep duration could affect depression among elderly in China.

METHOD

A total of 7103 individuals aged 60 and older were selected from China Health and Retirement Longitudinal Study. A generalized linear mixed-effects model was used to estimate the relationship between sleep duration and depression, and we performed stratified analyses by age: young-old elderly, old-old elderly and oldest-old elderly.

RESULTS

Short sleep duration significantly incresased CES-D10 depression scores. In addition, the participants with middle sleep duration had higher CES-D10 scores compared to the participants with long sleep duration among young-old elderly, and we found that middle sleep duration was not significantly different from CES-D10 scores after adjustment for demographics, frequencies of activities and Chronic diseases.

CONCLUSIONS

These findings suggested that there was a complex association between depression and sleep duration among elderly in China. Different from previous research results on the middle or normal sleep time of the elderly, the middle sleep duration maybe not optimal sleep duration in this study. Investigation of sleep extension to prevent depression may be warranted among the elderly.

Executive Functioning and the Pursuit of Happiness

Executive functioning and happiness are each associated with successful learning and other desirable individual and societal outcomes; however, it is unclear whether a relation exists between them. Executive regulation of happiness pursuits in daily life, operationalized as hedonic (e.g., pursuing pleasure) and eudaimonic (e.g., pursuing personal growth) motives for action, may be a way the constructs relate to each other. In this initial investigation, we aimed to explore whether objectively measured executive functioning skills relate to happiness motives. A sample of 119 college students completed six objective neuropsychological measures of executive functioning and self-reported levels of hedonic and eudaimonic motives for action in daily life. Correlation and regression analyses examined the relations among temporal discounting and two latent executive functioning factors (inhibitory control and working memory) with hedonic and eudaimonic motives, as well as their interaction. Results suggested a possible association between higher levels of eudaimonic motives and preference for higher delayed rewards, as well as poorer working memory. Further analyses suggested that endorsing high levels of eudaimonic and hedonic motives simultaneously (i.e., the "full life") was associated with poorer inhibitory control and working memory performance, whereas endorsing low levels of both simultaneously (i.e., the "empty life") was associated with a preference for more immediate monetary rewards. Findings are discussed in the context of goal conflict and risk assessment among individuals who endorse the "full life". Overall, these findings suggest that complex relations may exist between executive functioning and trait-level happiness pursuits, and have implications for possible interventions aimed at enhancing happiness-related motives and cognitive processes to facilitate learning. Given the exploratory nature of the present study, further investigations are necessary.

Different Components of Subjective Well-being Are Associated With Chronic Nondisabling and Disabling Knee Pain: ELSA-Brasil Musculoskeletal Cohort

BACKGROUND/OBJECTIVE

Chronic knee pain (CKP) is a common pain complaint in older adults that is often associated with disability. This study investigated the relationship between 2 components of subjective well-being (depressive symptoms and life satisfaction) and CKP phenotypes based on the presence of knee disability.

METHODS

A cross-sectional study was performed at baseline of ELSA-Brasil Musculoskeletal cohort (2012-2014). Chronic knee pain phenotypes were identified according to the presence of CKP that was accompanied or not by disability, which was assessed by a question on pain-related limitations to perform everyday activities (overall), Western Ontario and McMaster Universities Osteoarthritis Index's physical function subscale (daily tasks) and 5-times sit-to-stand test (objective). Depressive symptoms were assessed by the Clinical Interview Schedule-Revised and life satisfaction by the Satisfaction With Life Scale. Multinomial logistic regressions used CKP phenotypes as response variables (no CKP as reference).

RESULTS

The sample comprised 2898 participants (mean age, 55.9 ± 8.9 years; 52.9% were female). After adjustments for sociodemographic and clinical factors, depressive symptoms were associated with daily tasks disabling CKP (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.45-3.66) and objective disabling CKP (OR, 1.95; 95% CI, 1.29-2.93) and with nondisabling CKP for the overall disability measure (OR, 1.54; 95% CI, 1.17-2.04). Life satisfaction was inversely associated with all phenotypes in fully adjusted models, with strongest magnitude of associations observed for disabling CKP.

CONCLUSIONS

The association of depressive symptoms and life satisfaction with CKP phenotypes suggest the need to address both negative and positive components of subjective well-being in the assessment of individuals with knee complaints.

Self-Esteem as a Mediator between Life Satisfaction and Depression among Cardiovascular Disease Patients

This study explores the association between life satisfaction and depression among patients with cardiovascular diseases and whether this association is mediated by self-esteem. A cross-sectional study was conducted in a third-grade hospital. We examined 300 patients with cardiovascular diseases with a mean age of 62.00 years (females, 133). Life satisfaction was associated with depression. Adding self-esteem to the model weakened the strength of the association between the two. Moreover, 34.2% of the effect of life satisfaction on depression could be explained by self-esteem. We found that self-esteem could totally explain the effect of life satisfaction on depression among patients with cardiovascular diseases.

Introducing two types of psychological resilience with partly unique genetic and environmental sources

Psychological resilience is indicated when individuals demonstrate good mental health despite exposure to significant stress or adversity. Good mental health may involve low levels of illbeing and/or high levels of wellbeing. There is still very limited knowledge about the potential differences between these outcomes in relation to stressors. We propose a distinction between type 1 and type 2 resilience, examine their underlying genetic and environmental architecture, and identify modifiable resilience factors. The data come from a population-based twin sample (N = 1987, mean age = 63) in the Norwegian Twin Registry. Type 1 and type 2 resilience are operationalised as the residual of anxiety/depression symptoms and life satisfaction, respectively, after lifetime cumulative adversity has been regressed out. We used biometric modelling and cotwin-control linear mixed models to estimate underlying factors and identify predictors while controlling for genetic confounding. The results support the notion of two separate, but partly overlapping types of resilience. We find heritabilities of 0.30 (type 1) and 0.24 (type 2) and a genetic correlation of 0.43. Potentially causal resilience factors include, but are not limited to, meaning in life, physical activity, positive affect and relationship satisfaction. Whereas some factors are associated with both resilience types, other factors are unique to each type.

An Explorative Study on the Relationship between Learning Opportunities at School and at Work and Adolescents' Mental Health

Based on the Job Demands-Resources model, this study examined the association of learning opportunities of adolescents at school and work with their mental health, operationalized in terms of life satisfaction and depression. Intrinsic motivation at school and at work were studied as potential mediators. Within a representative sample of adolescents (n = 474), the results supported within domain relationships in the sense that learning opportunities at school and at work were positively related to intrinsic motivation at school and at work, respectively, which in turn were related to higher levels of life satisfaction and lower levels of depression. Cross-domain relationships were not significant, except for a negative relationship between learning opportunities at work and intrinsic motivation at school, suggesting that having a good job can pull students away from school.

Life satisfaction mediates the association between childhood maltreatment and depressive symptoms: a study in a sample of Brazilian adolescents

OBJECTIVE

To evaluate the interrelationships between childhood maltreatment, life satisfaction (LS), and depressive symptoms, and to investigate LS as a mediating factor in the association between childhood maltreatment and depressive symptoms.

METHODS

The sample consisted of 342 adolescents, aged 11 to 17 years (mean = 13.3, SD = 1.52 years), recruited from a public school in Salvador, Brazil. Participants filled out instruments for the collection of sociodemographic data and evaluation of childhood maltreatment, LS, and depressive symptoms. Structural equation modeling (SEM) was used to evaluate the mediating effect of LS.

RESULTS

We detected significant negative correlations between childhood maltreatment and LS and between LS and depressive symptoms. We observed a significant positive correlation between childhood maltreatment and depressive symptoms. LS partially mediated the association between childhood maltreatment and depressive symptoms, mitigating the impact of maltreatment.

CONCLUSION

LS played an important mediating role in the association between childhood maltreatment and depressive symptoms. Longitudinal studies are recommended to fully elucidate these associations, reinforcing the need for attention and care of this vulnerable population.

Does the Spanish version of the SWLS measure the same in Spain and Peru?

AIM

Satisfaction with life is a measure of protection in older adults. There lies the importance of providing quality instruments. The aim of the study was to evaluate the invariance of the life satisfaction scale (SWLS) in two samples of older adults in Spain and Peru.

METHOD

The participants were 857 older adults in Spain (mean age=68.23 years, SD=5.93) and 336 older adults in Peru (average age=72.42, SD=7.07). All multi-group confirmatory factor analyzes were estimated in Mplus 8.0.

RESULTS

The results indicate the presence of a strict invariance of the one-dimensional structure of the SWLS in samples of older adults in Spain and Peru, which allows for meaningful comparisons of latent means and covariances. Comparison of latent means showed small differences in the construct between the cultural groups.

CONCLUSIONS

The SWLS is a valid instrument for intercultural comparisons between Spanish and Peruvian population. The measurement invariance assessment contributes to a better understanding of life satisfaction in populations from different cultural contexts.

The Relationship Between Satisfaction With Life and Depression Symptoms by Gender

Depression is a worldwide public health concern. The World Health Organization (WHO) has recently recommended the implementation of programs for strengthening subjective well-being (SWB) to reduce mental disorders, including depression. Also, in 2013, European member-states agreed on a single measure of SWB, i.e., life satisfaction, for monitoring the progress of SWB in the WHO health policy framework, "Health 2020." Life satisfaction is strongly associated with depression; therefore, its use as health indicator could be suitable to identify individuals at risk for depression. Critical to this use of life satisfaction to target also depression is knowledge on the nature of the association between the two throughout the lifespan and by gender. This study aims at contributing to the knowledge about this association in a sample of 51 individuals screened for major depressive disorder (MDD) and dysthymic disorder (Dys). All individuals were administered the Primary Care Screener for Affective Disorders and the Satisfaction With Life Scale (SWLS). Among individuals negative for MDD or Dys, women displayed similar satisfaction compared with men, whereas among individuals positive for MDD or Dys, women showed greater satisfaction compared with men, whose score denoted life dissatisfaction. Consistently, the regression model for SWLS revealed a significant main effect of positivity for MDD or Dys on life satisfaction as well as a significant interaction between positivity for MDD or Dys and gender. The results of this study do not support the notion that satisfaction with life and depressive symptoms could belong to highly related dimensions, at least among female individuals.

Genetics, personality and wellbeing. A twin study of traits, facets and life satisfaction

Human wellbeing is influenced by personality traits, in particular neuroticism and extraversion. Little is known about which facets that drive these associations, and the role of genes and environments. Our aim was to identify personality facets that are important for life satisfaction, and to estimate the contribution of genetic and environmental factors in the association between personality and life satisfaction. Norwegian twins (N = 1,516, age 50-65, response rate 71%) responded to a personality instrument (NEO-PI-R) and the Satisfaction With Life Scale (SWLS). Regression analyses and biometric modeling were used to examine influences from personality traits and facets, and to estimate genetic and environmental contributions. Neuroticism and extraversion explained 24%, and personality facets accounted for 32% of the variance in life satisfaction. Four facets were particularly important; anxiety and depression in the neuroticism domain, and activity and positive emotions within extraversion. Heritability of life satisfaction was 0.31 (0.22-0.40), of which 65% was explained by personality-related genetic influences. The remaining genetic variance was unique to life satisfaction. The association between personality and life satisfaction is driven mainly by four, predominantly emotional, personality facets. Genetic factors play an important role in these associations, but influence life satisfaction also beyond the effects of personality.

Unraveling the Genetic and Environmental Relationship Between Well-Being and Depressive Symptoms Throughout the Lifespan

Whether well-being and depressive symptoms can be considered as two sides of the same coin is widely debated. The aim of this study was to gain insight into the etiology of the association between well-being and depressive symptoms across the lifespan. In a large twin-design, including data from 43,427 twins between age 7 and 99, we estimated the association between well-being and depressive symptoms throughout the lifespan and assessed genetic and environmental contributions to the observed overlap. For both well-being (range 31-47%) and depressive symptoms (range 49-61%), genetic factors explained a substantial part of the phenotypic variance across the lifespan. Phenotypic correlations between well-being and depressive symptoms across ages ranged from -0.34 in childhood to -0.49 in adulthood. In children, genetic effects explained 49% of the phenotypic correlation while in adolescents and young adults, genetic effects explained 60-77% of the phenotypic correlations. Moderate to high genetic correlations (ranging from -0.59 to -0.66) were observed in adolescence and adulthood, while in childhood environmental correlations were substantial but genetic correlations small. Our results suggest that in childhood genetic and environmental effects are about equally important in explaining the relationship between well-being and depressive symptoms. From adolescence onwards, the role of genetic effects increases compared to environmental effects. These results provided more insights into the etiological underpinnings of well-being and depressive symptoms, possibly allowing to articulate better strategies for health promotion and resource allocation in the future.

Shared facial emotion processing functional network findings in medication-naïve major depressive disorder and healthy individuals: detection by sICA

BACKGROUND

The fundamental mechanism underlying emotional processing in major depressive disorder (MDD) remains unclear. To better understand the neural correlates of emotional processing in MDD, we investigated the role of multiple functional networks (FNs) during emotional stimuli processing.

METHODS

Thirty-two medication-naïve subjects with MDD and 36 healthy controls (HCs) underwent an emotional faces fMRI task that included neutral, happy and fearful expressions. Spatial independent component analysis (sICA) and general linear model (GLM) were conducted to examine the main effect of task condition and group, and two-way interactions of group and task conditions.

RESULTS

In sICA analysis, MDD patients and HCs together showed significant differences in task-related modulations in five FNs across task conditions. One FN mainly involving the ventral medial prefrontal cortex showed lower activation during fearful relative to happy condition. Two FNs mainly involving the bilateral inferior frontal gyrus and temporal cortex, showed opposing modulation relative to the ventral medial prefrontal cortex FN, i.e., greater activation during fearful relative to happy condition. Two remaining FNs involving the fronto-parietal and occipital cortices, showed reduced activation during both fearful and happy conditions relative to the neutral condition. However, MDD and HCs did not show significant differences in expression-related modulations in any FNs in this sample.

CONCLUSIONS

SICA revealed differing functional activation patterns than typical GLM-based analyses. The sICA findings demonstrated unique FNs involved in processing happy and fearful facial expressions. Potential differences between MDD and HCs in expression-related FN modulation should be investigated further.

Compulsive buying and quality of life: An estimate of the monetary cost of compulsive buying among adults in early midlife

The aims of this study were to examine the associations between compulsive buying and quality of life and to estimate the monetary cost of compulsive buying for a cohort of men and women at mean age 43. Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. Linear regression analyses showed that compulsive buying was significantly associated with quality of life, despite controlling for relevant demographic and psychosocial factors. The estimated monetary cost of compulsive buying for this cohort was significant. The fact that the monetary cost of CB is not trivial suggests that individuals are both consciously and unconsciously plagued by their CB. The findings are important for interventionists and clinicians for cost-effective intervention and treatment programs.

Predicting Well-Being and Internalizing Symptoms in Late Adolescence From Trajectories of Externalizing Behavior Starting in Infancy

This study aimed to examine the long-term prediction of well-being and internalizing symptoms from trajectories of externalizing behavior problems in 921 children from a population-based sample. We found that a high stable trajectory of externalizing behavior from infancy (age 1.5) to mid-adolescence (age 14.5) predicted lower scores on life satisfaction and flourishing for both girls and boys (age 18.5). The high stable trajectory also predicted higher levels of depressive symptoms in boys and anxiety symptoms in girls (age 18.5). The findings are noteworthy as they document how a person-oriented study of externalizing behavior problems starting in infancy can predict well-being and internalizing in late adolescence. The findings underline the importance of early health promotion and problem intervention efforts.

Another Paradox? The Life Satisfaction of Older Hispanic Immigrants in the United States

Objective: To investigate disparities in life satisfaction among older Hispanic immigrants in the United States relative to their native-born Hispanic and non-Hispanic White counterparts, and to identify factors associated with such disparities. Method: Cross-sectional data from 9,798 individuals age 60 and above from the Health and Retirement Study (HRS) were used to estimate ordinary least squares (OLS) regression models. Results: Hispanic immigrants reported the highest levels of life satisfaction of all groups. Wealthier older adults, who were socially engaged, had social support, and experienced fewer functional limitations and lower exposure to discrimination, were more satisfied with their lives in the overall sample. Interaction effects revealed that although education was associated with greater life satisfaction only among non-Hispanic Whites, co-residing with children was associated with greater life satisfaction only among Hispanics. Discussion: Although older Hispanic immigrants had the least amount of socioeconomic resources of all groups in our study, they were the most satisfied with their lives. Possible explanations and directions for future research are discussed.

Shared Genetic Factors Underlie Migraine and Depression

Migraine frequently co-occurs with depression. Using a large sample of Australian twin pairs, we aimed to characterize the extent to which shared genetic factors underlie these two disorders. Migraine was classified using three diagnostic measures, including self-reported migraine, the ID migraine™ screening tool, or migraine without aura (MO) and migraine with aura (MA) based on International Headache Society (IHS) diagnostic criteria. Major depressive disorder (MDD) and minor depressive disorder (MiDD) were classified using the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. Univariate and bivariate twin models, with and without sex-limitation, were constructed to estimate the univariate and bivariate variance components and genetic correlation for migraine and depression. The univariate heritability of broad migraine (self-reported, ID migraine, or IHS MO/MA) and broad depression (MiDD or MDD) was estimated at 56% (95% confidence interval [CI]: 53-60%) and 42% (95% CI: 37-46%), respectively. A significant additive genetic correlation (r G = 0.36, 95% CI: 0.29-0.43) and bivariate heritability (h 2 = 5.5%, 95% CI: 3.6-7.8%) was observed between broad migraine and depression using the bivariate Cholesky model. Notably, both the bivariate h 2 (13.3%, 95% CI: 7.0-24.5%) and r G (0.51, 95% CI: 0.37-0.69) estimates significantly increased when analyzing the more narrow clinically accepted diagnoses of IHS MO/MA and MDD. Our results indicate that for both broad and narrow definitions, the observed comorbidity between migraine and depression can be explained almost entirely by shared underlying genetically determined disease mechanisms.

Associations of sleep duration and sleep quality with life satisfaction in elderly Chinese: The mediating role of depression

This study investigated whether sleep duration and quality were related to life satisfaction (LS) among older Chinese adults and whether depression mediated those relationships. Cross-sectional data from the aging arm of the Rugao Longevity and Aging Study were used. Sleep duration, sleep quality, depression, LS and covariates were analyzed using logistic regressions. To assess the potential mediation of depression on the association between sleep duration and quality and LS, Aroian tests were used. Of 1756 older Chinese adults aged 70-84 years, 90.7% of the men and 83.3% of the women reported being satisfied with their lives. After adjusting for covariates, older adults who slept ≤6h per night were more likely to suffer from life dissatisfaction compared with those who slept 7-8h (OR=2.67, 95% CI 1.86-3.79), and individuals who slept poorly were almost 2 times (OR=2.91, 95% CI 2.16-3.91) more likely to have life dissatisfaction. The Aroian tests confirmed that these relationships were partially mediated by depression (p<0.001). Between short sleep and LS, the mediating effect of depression accounted for 13.9% of the total effects. Moreover, the mediating effect of depression on the association between sleep quality and LS was 13.3%. Short sleep duration and poor sleep quality were inversely associated with LS, and the relationships were partially mediated by depression. Our study suggests that both sleep and depression status are important factors for LS among the elderly.

Depressive symptoms, life satisfaction and prevalence of sleep disturbances in the general population of Germany: results from the Heinz Nixdorf Recall study

OBJECTIVES

It appears that not only depression, but also low life satisfaction (LS), is related to sleep disorder in the general population. We evaluate whether the prevalence of sleep disorder attributable to depressed mood is greater among participants with low LS.

SETTING, PARTICIPANTS AND OUTCOME MEASURES

Analysis of cross-sectional data from 3880 cohort members from the German Heinz Nixdorf Recall study (2006-2008) aged 51-81 years. Standard mood (Center for Epidemiological Studies Depression scale (CES-D) for Depressive symptoms and a single-item life satisfaction measure) and sleep quality (Pittsburgh Sleep Quality Index, PSQI) measures were conducted as part of the survey. Multiple imputation was used to deal with missing data in outcome, exposures or covariates. Relative excess risk for interaction (RERI) and its 95% CIs were estimated using adjusted prevalence ORs. Owing to the study size, the precision of the measures of additive interaction is relatively low.

RESULTS

We observed an association between depressed mood (5-units increase in CES-D score) (POR=1.7 (95% CI 1.6 to 1.8)) and sleep disorder, and between low LS (not very satisfied vs very satisfied) (POR=1.5 (1.1 to 2.2)) and sleep disorder. Also, we observed a synergistic effect between lower level of LS (not very satisfied) and depressed mood (score ≥ 16) on prevalence of sleep disorders (RERI=3.7 (-0.2 to 7.1)). Furthermore, these findings were corroborated in sensitivity analysis carried out with the complete case data set and in sex-specific analyses (RERI=5.5 (-0.4 to 11.3), and RERI=2.4 (-2.5 to 7.4) for men and women, respectively).

CONCLUSIONS

Both depressed mood and LS are notably associated with sleep quality, and these relationships are best captured by considering their joint effects. Depression and LS need to be taken into consideration when analysing sleep quality.

Understanding the genetic and environmental specificity and overlap between well-being and internalizing symptoms in adolescence

Moderate inverse correlations are typically found between well-being and mental illness. We aimed to investigate the role of genes and environments in explaining the relationships between two aspects of well-being and two measures of internalizing symptoms. Altogether, 4700 pairs of 16-year-old twins contributed data on subjective happiness and life satisfaction, as well as symptoms of depression and emotional problems. Well-being was moderately correlated with internalizing symptoms (range = -0.45, -0.58). Multivariate twin model-fitting indicated both genetic and environmental overlap. Life satisfaction and happiness demonstrated different patterns of overlap, with stronger genetic links between life satisfaction and depression. Non-shared environmental influences were largely specific to each trait. This study supports the theory of mental health and illness being partly (but not entirely) correlated dimensions. There are also significant genetic and environmental factors to identify for well-being that go beyond the absence of mental illness. It is therefore possible that different interventions are needed for treating mental illness and promoting mental health.

Anxious or Depressed and Still Happy?

This study aimed to examine cross-sectionally to what extent persons with higher symptom levels or a current or past emotional disorder report to be less happy than controls and to assess prospectively whether time-lagged measurements of extraversion and neuroticism predict future happiness independent of time-lagged measurements of emotional disorders or symptom severity. A sample of 2142 adults aged 18–65, consisting of healthy controls and persons with current or past emotional disorder according to DSM-IV criteria completed self-ratings for happiness and emotional well-being and symptom severity. Lagged measurements of personality, symptom severity and presence of anxiety and depressive disorder at T0 (year 0), T2 (year 2) and T4 (year 4) were used to predict happiness and emotional well-being at T6 (year 6) controlling for demographics. In particular persons with more depressive symptoms, major depressive disorder, social anxiety disorder and comorbid emotional disorders reported lower levels of happiness and emotional well-being. Depression symptom severity and to a lesser extent depressive disorder predicted future happiness and emotional well-being at T6. Extraversion and to a lesser extent neuroticism also consistently forecasted future happiness and emotional well-being independent of concurrent lagged measurements of emotional disorders and symptoms. A study limitation is that we only measured happiness and emotional well-being at T6 and our measures were confined to hedonistic well-being and did not include psychological and social well-being. In sum, consistent with the two continua model of emotional well-being and mental illness, a ‘happy’ personality characterized by high extraversion and to a lesser extent low neuroticism forecasts future happiness and emotional well-being independent of concurrently measured emotional disorders or symptom severity levels. Boosting positive emotionality may be an important treatment goal for persons personally inclined to lower levels of happiness.

Life satisfaction and mental health problems (18 to 35 years)

BACKGROUND

Previous research has found that mental health is strongly associated with life satisfaction. In this study we examine associations between mental health problems and life satisfaction in a birth cohort studied from 18 to 35 years.

METHOD

Data were gathered during the Christchurch Health and Development Study, which is a longitudinal study of a birth cohort of 1265 children, born in Christchurch, New Zealand, in 1977. Assessments of psychiatric disorder (major depression, anxiety disorder, suicidality, alcohol dependence and illicit substance dependence) using DSM diagnostic criteria and life satisfaction were obtained at 18, 21, 25, 30 and 35 years.

RESULTS

Significant associations (p < 0.01) were found between repeated measures of life satisfaction and the psychiatric disorders major depression, anxiety disorder, suicidality, alcohol dependence and substance dependence. After adjustment for non-observed sources of confounding by fixed effects, statistically significant associations (p < 0.05) remained between life satisfaction and major depression, anxiety disorder, suicidality and substance dependence. Overall, those reporting three or more mental health disorders had mean life satisfaction scores that were nearly 0.60 standard deviations below those without mental health problems. A structural equation model examined the direction of causation between life satisfaction and mental health problems. Statistically significant (p < 0.05) reciprocal associations were found between life satisfaction and mental health problems.

CONCLUSIONS

After adjustment for confounding, robust and reciprocal associations were found between mental health problems and life satisfaction. Overall, this study showed evidence that life satisfaction influences mental disorder, and that mental disorder influences life satisfaction.

Does life satisfaction predict five-year mortality in community-living older adults?

OBJECTIVES

Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death.

METHOD

1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible-Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death.

RESULTS

417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity.

CONCLUSION

LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

Genetics of wellbeing and its components satisfaction with life, happiness, and quality of life: a review and meta-analysis of heritability studies

Wellbeing is a major topic of research across several disciplines, reflecting the increasing recognition of its strong value across major domains in life. Previous twin-family studies have revealed that individual differences in wellbeing are accounted for by both genetic as well as environmental factors. A systematic literature search identified 30 twin-family studies on wellbeing or a related measure such as satisfaction with life or happiness. Review of these studies showed considerable variation in heritability estimates (ranging from 0 to 64 %), which makes it difficult to draw firm conclusions regarding the genetic influences on wellbeing. For overall wellbeing twelve heritability estimates, from 10 independent studies, were meta-analyzed by computing a sample size weighted average heritability. Ten heritability estimates, derived from 9 independent samples, were used for the meta-analysis of satisfaction with life. The weighted average heritability of wellbeing, based on a sample size of 55,974 individuals, was 36 % (34–38), while the weighted average heritability for satisfaction with life was 32 % (29–35) (n = 47,750). With this result a more robust estimate of the relative influence of genetic effects on wellbeing is provided.

An early Phase II randomised controlled trial testing the effect on persecutory delusions of using CBT to reduce negative cognitions about the self: the potential benefits of enhancing self confidence

BACKGROUND

Research has shown that paranoia may directly build on negative ideas about the self. Feeling inferior can lead to ideas of vulnerability. The clinical prediction is that decreasing negative self cognitions will reduce paranoia.

METHOD

Thirty patients with persistent persecutory delusions were randomised to receive brief CBT in addition to standard care or to standard care (ISRCTN06118265). The six session intervention was designed to decrease negative, and increase positive, self cognitions. Assessments at baseline, 8 weeks (posttreatment) and 12 weeks were carried out by a rater blind to allocation. The primary outcomes were posttreatment scores for negative self beliefs and paranoia. Secondary outcomes were psychological well-being, positive beliefs about the self, persecutory delusions, social comparison, self-esteem, anxiety, and depression.

RESULTS

Trial recruitment and retention were feasible and the intervention highly acceptable to the patients. All patients provided follow-up data. Posttreatment there was a small reduction in negative self beliefs (Cohen's d=0.24) and a moderate reduction in paranoia (d=0.59), but these were not statistically significant. There were statistically significant improvements in psychological well-being (d=1.16), positive beliefs about the self (d=1.00), negative social comparison (d=0.88), self-esteem (d=0.62), and depression (d=0.68). No improvements were maintained. No adverse events were associated with the intervention.

CONCLUSIONS

The intervention produced short-term gains consistent with the prediction that improving cognitions about the self will reduce persecutory delusions. The improvement in psychological well-being is important in its own right. We recommend that the different elements of the intervention are tested separately and that the treatment is lengthened.

An fMRI study of emotional face processing in adolescent major depression

BACKGROUND

Major depressive disorder (MDD) often begins during adolescence when the brain is still maturing. To better understand the neurobiological underpinnings of MDD early in development, this study examined brain function in response to emotional faces in adolescents with MDD and healthy (HC) adolescents using functional magnetic resonance imaging (fMRI).

METHOD

Thirty-two unmedicated adolescents with MDD and 23 healthy age- and gender-matched controls completed an fMRI task viewing happy and fearful faces. Fronto-limbic regions of interest (ROI; bilateral amygdala, insula, subgenual and rostral anterior cingulate cortices) and whole-brain analyses were conducted to examine between-group differences in brain function.

RESULTS

ROI analyses revealed that patients had greater bilateral amygdala activity than HC in response to viewing fearful versus happy faces, which remained significant when controlling for comorbid anxiety. Whole-brain analyses revealed that adolescents with MDD had lower activation compared to HC in a right hemisphere cluster comprised of the insula, superior/middle temporal gyrus, and Heschl׳s gyrus when viewing fearful faces. Brain activity in the subgenual anterior cingulate cortex was inversely correlated with depression severity.

LIMITATIONS

Limitations include a cross-sectional design with a modest sample size and use of a limited range of emotional stimuli.

CONCLUSIONS

Results replicate previous studies that suggest emotion processing in adolescent MDD is associated with abnormalities within fronto-limbic brain regions. Findings implicate elevated amygdalar arousal to negative stimuli in adolescents with depression and provide new evidence for a deficit in functioning of the saliency network, which may be a future target for early intervention and MDD treatment.