Psychometric properties of the Beck Self-Esteem Scales

Evaluating the Cognitive Effects of Video-Induced Negative Affect in College Students: A Comparative Study between Acute Exercise and Music Listening

Background: Video-induced negative affect may have an impact on cognition. In this study, acute exercise and music listening are used to explore their impact on individual cognition with video-induced negative affect. Method: All the participants were randomly divided into six groups. Group 1 (n = 19, average age = 20.15) was not given any form of acute exercise or music listening; Group 2 (n = 20, average age = 21.33) was given music listening; Group 3 (n = 20, average age = 20.89) was given acute exercise; Group 4 (n = 20, average age = 21.03) only watched a video without being given any acute exercise or music listening; Group 5 (n = 19, average age = 20.68) was given music listening after watching a video; Group 6 (n = 18, average age = 21.32) was given acute exercise after watching a video. Results: In the pre-test, we found that there was no significant difference in negative affect, positive affect, and cognitive performance among the groups (p > .05). The post-test indicated that the negative affect of college students who watched the video (20.16 ± 8.34) was higher than that of college students who did not watch the video (11.12 ± 3.29). Acute exercise and music listening improved the cognitive performance of college students with video-induced negative affect. Acute exercise improved the cognitive performance of college students with non-video-induced negative affect, while music listening did not. Conclusion: The acute decline in the cognitive performance of college students caused by video-induced negative affect can be ameliorated by means of acute exercise and music listening.

Fixed Intelligence Mindset, Self-Esteem, and Failure-Related Negative Emotions: A Cross-Cultural Mediation Model

A growing body of literature supports that fixed intelligence mindset promotes the emergence of maladaptive emotional reactions, especially when self-threat is imminent. Previous studies have confirmed that in adverse academic situations, students endorsing fixed intelligence mindset experience higher levels of negative emotions, although little is known about the mechanisms through which fixed intelligence mindset exerts its influence. Thus, the present study (N_total = 398) proposed to investigate self-esteem as a mediator of this relationship in two different cultural contexts, in Hungary and the United States. Structural equation modeling revealed that self-esteem fully mediated the relationship between fixed intelligence mindset and negative emotions. Furthermore, results of the invariance testing conferred preliminary evidence for the cross-cultural validity of the mediation model. These findings suggest that, students adhering to fixed intelligence beliefs tend to experience greater self-esteem loss when experiencing academic failure, which leads to higher levels of negative emotions.

Physical Exercise Ameliorates Anxiety, Depression and Sleep Quality in College Students: Experimental Evidence from Exercise Intensity and Frequency

Background: The main purpose of this study was to investigate the effects of exercise intensity and exercise frequency on anxiety, depression and sleep quality in college students. Methods: All participants came from a university in northeastern China. All participants were tested for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and were diagnosed with anxiety disorders. The research subjects were divided into six groups, namely the low-intensity and low-frequency group (group 1), low-intensity and moderate-frequency group (group 2), low-intensity and high-frequency group (group 3), high-intensity and low-frequency group (group 4), and high-intensity and moderate-frequency group (group 5) and high-intensity and high-frequency group (group 6). The duration of each physical exercise for each group was 1 h. Participants’ exercise intensity was monitored using Polar H10 HR sensors and the Borg RPE scale. The experiment was carried out for a total of 6 weeks. The researchers conducted pre- and post-test scores on the subjects’ anxiety, depression and sleep quality through questionnaires. Results: Exercise intensity improved anxiety and decreased symptoms of depression better than exercise frequency; sleep quality was more closely related to exercise intensity. Conclusion: Exercise intensity and exercise frequency have different effects on anxiety, depression and sleep quality improvement, indicating that exercise intensity and exercise frequency have different effects on anxiety, depression and sleep quality of college students.

Effects of exercise on symptoms of anxiety in primary care patients: A randomized controlled trial

BACKGROUND

There is a need for high-quality research regarding exercise interventions for persons with anxiety disorders. We investigate whether a 12-week exercise intervention, with different intensities, could reduce anxiety symptoms in patients with anxiety disorders.

METHODS

286 patients were recruited from primary care in Sweden. Severity of symptoms was self-assessed using the Beck Anxiety Inventory (BAI) and the Montgomery Åsberg Depression Rating Scale (MADRS-S). Participants were randomly assigned to one of two group exercise programs with cardiorespiratory and resistance training and one control/standard treatment non-exercise group, with 1:1:1 allocation.

RESULTS

Patients in both exercise groups showed larger improvements in both anxiety and depressive symptoms compared to the control group. No differences in effect sizes were found between the two groups. To study a clinically relevant improvement, BAI and MADRS-S were dichotomized with the mean change in the control group as reference. In adjusted models the odds ratio for improved symptoms of anxiety after low-intensity training was 3.62 (CI 1.34-9.76) and after moderate/high intensity 4.88 (CI 1.66-14.39), for depressive symptoms 4.96 (CI 1.81-13.6) and 4.36 (CI 1.57-12.08) respectively. There was a significant intensity trend for improvement in anxiety symptoms.

LIMITATIONS

The use of self-rating measures which bears the risk of an under- or overestimation of symptoms.

CONCLUSIONS

A 12-week group exercise program proved effective for patients with anxiety syndromes in primary care. These findings strengthen the view of physical exercise as an effective treatment and could be more frequently made available in clinical practice for persons with anxiety issues.

Maladaptive and Adaptive Cognitions About the Self and Others: Confirmatory Factor Analysis of the Brief Core Schemas Scales

The presence of dysfunctional cognitions about how individuals see themselves and others is a hallmark of psychopathology. The Brief Core Schemas Scale (BCSS) was developed to evaluate adaptive and dysfunctional beliefs about the self and others. This study describes the first psychometric analysis of the BCSS in the Portuguese population. Participants were recruited from community (N = 320, Mage=27.31, DP = 12.75). Confirmatory factor analysis (CFA) was used to confirm the BCSS factorial structure. Four-factor model revealed moderate to adequate goodness-of-fit indices (χ²/df = 717.1, (246) p = .01; SRMR = .044; RMSEA = .077; CFI/TLI < .90). Negative views of the self and others correlated positively with early maladaptive schemas, distress, and symptomatology and correlated negatively with psychological well-being. An inversed correlational pattern was found with the positive views of the self and others. Despite the model's moderate adherence to the data, results suggest that the BCSS may be an asset in the assessment of dysfunctional and adaptive cognitions about the self and others. Further analysis is required to deepen the psychometric properties of the BCSS in the Portuguese population.

Anxiety severity and cognitive function in primary care patients with anxiety disorder: a cross-sectional study

BACKGROUND

Deficits in cognitive performance are reported in patients with anxiety disorders, but research is limited and inconsistent. We aimed to investigate cross-sectional associations between cognitive function, with focus on executive function, and anxiety severity in primary care patients diagnosed with anxiety disorders.

METHODS

189 Swedish patients aged 18-65 years (31% men) with anxiety disorders diagnosed according to Mini International Neuropsychiatric Interview were included. Severity of anxiety was assessed using Beck Anxiety Inventory self-assessment scale. Digit span, block design and matrix reasoning tests from the Wechsler Adult Intelligence Scale IV, and the design fluency test from the Delis-Kaplan Executive Function System were used. Multivariable linear regression models were applied to investigate the relationship of anxiety severity and cognitive functioning. Comparisons were also performed to a normed non-clinical population, using the Wilcoxon signed rank test.

RESULTS

More severe anxiety was associated with lower digit span test scores (R² = 0.109, B = -0.040, p = 0.018), but not with block design, matrix reasoning or design fluency tests scores, after adjustment for comorbid major depression in a multivariable model. When compared to a normed population, patients with anxiety performed significantly lower on the block design, digit span forward, digit span sequencing and matrix reasoning tests.

CONCLUSIONS

Severity of anxiety among patients with anxiety disorder was associated with executive functions related to working memory, independently of comorbid major depression, but not with lower fluid intelligence. A further understanding of the executive behavioral control in patients with anxiety could allow for more tailored treatment strategies including medication, therapy and interventions targeted to improve specific cognitive domains.

Effect of Marital Status on Depression and Mortality among Patients with Chronic Kidney Disease from National Health and Nutrition Examination Survey 2005-2014

BACKGROUND

The relationship between marital status and CKD is rarely studied. We aimed to explore the effect of marital status on the depression and mortality of patients with CKD.

METHODS

The data sources came from the NHANES database during 2005-2014 and 3,865 participants were included in this study. We used logistic regression models to examine the relationship between marital status and depression of CKD patients. The Cox proportional hazard models were used to evaluate the association between marital status and mortality of CKD patients.

RESULTS

In terms of depression in CKD patients, unmarried patients had a worse situation than married patients. Meanwhile, after adjusting the covariables, unmarried patients had increased risk of depression (OR = 1.26, 95% CI: 1.01-1.57) compared with married CKD patients, especially in males (OR = 1.45, 95% CI: 1.02-2.06) and patients with more than college education level (OR = 12.4, 95% CI: 3.75-41.02). There was a significant relationship between marital status and mortality of general CKD patients (HR = 1.36, 95% CI: 1.17-1.58). Moreover, marriage showed a protective effect against death among male patients, patients with school graduate or less and more than college educational level, patients with high income, and patients in different estimated glomerular filtration rate groups.

CONCLUSIONS

The use of large numbers of participants has revealed the effect of marital status on CKD patients. Unmarried ones had a higher risk of depression than married ones among CKD patients. Meanwhile, the risk of death was higher in unmarried ones than married ones among CKD patients in this study.

Pulmonary Rehabilitation in COVID-19: The Contribution of other Chronic Lung Syndromes for the Intervention of a Novel Disease

Abstract::

COVID-19 has spread throughout the world causing a significant number of cases of pneumonia and SARS. Patients with COVID-19 may also have other cardiovascular, respiratory, and neuromuscular disorders. These multisystemic complications present the need for comprehensive interventions focused on improving symptoms, functional capacity, and quality of life. Pulmonary rehabilitation has the potential to offer some of these benefits. However, the evidence related to specific aspects of pulmonary rehabilitation evaluation and intervention in COVID19 is limited. We have learned from experiences with other types of chronic lung diseases that have used pulmonary rehabilitation successfully. While the evidence of rehabilitation emerges in COVID-19, it is necessary to establish some initial recommendations, prepared according to the sequelae found until now.

Positive Self-Relation Scale - development and psychometric properties

PURPOSE

Self-relation is a profound connection that influences one's life. As such, it presents an important topic for various areas of research and psychotherapy. The goal of this study was to develop and evaluate a brief scale that would assess positive aspects of self-relation.

SAMPLE AND METHODS

The Positive Self-Relation Scale (PSRS) consists of 16 items divided into 4 subscales - Self-Acceptance, Self-Confidence, Authenticity and Assertiveness, and Fulfilled Experience. Two samples were used for the evaluation of its content and factor structure. The final sample's data used for validation assessment. This sample consisted of 1234 adults from a general population (mean age 34.8±14.2 years, 70.8% women). All participants completed PSRS. Subgroups also filled in Rosenberg Self-Esteem Scale (RSES), Adult Dispositional Hope Scale (ADHS), Beck Depression Inventory-II (BDI-II), Liebowitz Social Anxiety Scale (LSAS), and Dissociative Experiences Scale (DES).

RESULTS

Differences in scores among demographic groups were small to none. Internal consistency was good (Composite Reliability Coefficients - the whole scale: 0.93; the subscales: 0.73-0.80). Temporal stability, assessed 2 weeks apart, was satisfactory (intraclass correlation coefficients - the whole scale: 0.86, the subscales: 0.60-0.82). Factor loadings in confirmatory factor analysis were 0.45-0.80, fit indices mostly showed an adequate model. The correlation coefficients between PSRS and RSES/ADHS were strong (r=0.79/0.55). The scale also strongly correlated with LSAS, BDI-II, and DES (r=-0.61/-0.48/-0.30, all ps<0.001).

CONCLUSION

PSRS showed adequate psychometric properties in the general population. Future studies should include clinical samples. The areas of application lie mainly in research and psychotherapy.

Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study

OBJECTIVES

Studies exploring work-related risk factors of common mental disorders (CMDs), such as major depressive disorder (MDD), generalised anxiety disorder (GAD) or alcohol abuse, have generally focused on a limited set of work characteristics. For the first time in a primary care setting, we examine simultaneously multiple work-related risk factors in relation to CMDs.

METHOD

We use data from a study of working individuals recruited among 2027 patients of 121 general practitioners (GPs) representative of the Nord-Pas-de-Calais region in the North of France (April-August 2014). CMDs (MDD; GAD; alcohol abuse) were assessed using the Mini-International Neuropsychiatric Interview. Six worked-related factors were examined (work intensity, emotional demands, autonomy, social relations at work, conflict in values and job insecurity). Several covariates were considered (patient, GP and contextual characteristics). To study the association between workplace risk factors and CMDs, we used multilevel Poisson regression models adjusted for covariates.

RESULTS

Among study participants, 389 (19.1%) met criteria for MDD, 522 (25.8%) for GAD and 196 (9.7%) for alcohol abuse. In multivariable analyses adjusted for covariates, MDD/GAD was significantly associated with work intensity (RR 1.16, 95% CI 1.06 to 1.27) (absolute risk=52.8%), emotional demands (RR 1.24, 95% CI 1.13 to 1.35) (absolute risk=54.9%) and social relations at work (RR 0.78, 95% CI 0.70 to 0.87) (absolute risk=15.0%); alcohol abuse was associated with social relations at work (RR 1.25, 95% CI 1.01 to 1.53) (absolute risk=7.6%) and autonomy (OR 0.82, 95% CI 0.67 to 0.99) (absolute risk=8.9%).

CONCLUSIONS

Several workplace factors are associated with CMDs among working individuals seen by a GP. These findings confirm the role of organisational characteristics of work as a correlate of psychological difficulties above and beyond other sources of risk.

Beck Self-Esteem Scale-Short Form: Development and psychometric evaluation of a scale for the assessment of self-concept in schizophrenia

A requisite step for testing cognitive theories regarding the role of self-concept in schizophrenia is the development of measures that follow a cognitive conceptualization and better capture the multifaceted nature of this construct. The purpose of this study was to examine the psychometric properties a new self-concept measure, the Beck Self-Esteem Scale-Short Form (BSES-SF), based on a sample of 204 individuals with schizophrenia or schizoaffective disorder. We evaluated the BSES-SF's dimensionality, internal consistency reliability, and construct and divergent validity using confirmatory factor analysis, Cronbach's alpha, Pearson correlations, independent samples t-tests, and one-way analysis of variance. Findings indicate that the 10-item BSES-SF is a reliable and valid measure of self-concept that is appropriate for a broad group of individuals with schizophrenia spectrum disorders. Following cognitive theory, the scale demonstrated significant relationships with delusion severity, motivation, and depression, further signifying its utility for research and practice efforts that are designed to address psychopathology in schizophrenia.

Depression and Handgrip Strength Among U.S. Adults Aged 60 Years and Older from NHANES 2011-2014

OBJECTIVES

Sarcopenia is a gradual loss of muscle mass and strength that occurs with aging. This muscle deterioration is linked to increased morbidity, disability, and other adverse outcomes. Although reduced handgrip strength can be considered a marker of sarcopenia and other aging-related decline in the elderly, there is limited research on this physical health problem in at-risk groups with common biopsychosocial conditions such as depression. Our primary objective was to ascertain level of combined handgrip strength and its relationship with depression among adults aged 60 years and older.

DESIGN

Unadjusted and adjusted linear regression models were conducted with a cross-sectional survey dataset.

SETTING

Secondary dataset from the 2011-2014 National Health and Nutrition Examination Survey (NHANES).

PARTICIPANTS

Community-dwelling, non-institutionalized adults ≥60 years old (n=3,421).

MEASUREMENTS

The predictor variables included a positive screen for clinically relevant depression (referent=PHQ-9 score <10). The criterion variable of combined handgrip strength (kg) was determined using a dynamometer.

RESULTS

Mean age and BMI were 69.9 years (51.5% female) and 28.8 kg/m2, respectively. Mean combined handgrip strength in the overall cohort was 73.5 and 46.6 kg in males and females, respectively. Three hundred thirty-six (9.8%) reported symptoms of depression. In unadjusted and fully adjusted models, depression was significantly associated with reduced handgrip strength (B = -0.26±0.79 and B = -0.19±0.08, respectively; p<0.001).

CONCLUSION

Our findings demonstrate handgrip strength has a significant inverse association with depression. Future longitudinal studies should investigate the causal processes and potential moderators and mediators of the relationships between depression and reduced handgrip strength. This information may further encourage the use of depression and handgrip strength assessments and aid in the monitoring and implementation of health care services that address both physical and mental health limitations among older adult populations.

Rapid improvement in beliefs, mood, and performance following an experimental success experience in an analogue test of recovery-oriented cognitive therapy

BACKGROUND

Negative symptoms significantly contribute to disability and lack of community participation for low functioning individuals with schizophrenia. Cognitive therapy has been shown to improve negative symptoms and functional outcome in this population. Elucidation of the mechanisms of the therapy would lead to a better understanding of negative symptoms and the development of more effective interventions to promote recovery. The objective of this study was to determine (1) whether guided success at a card-sorting task will produce improvement in defeatist beliefs, positive beliefs about the self, mood, and card-sorting performance, and (2) whether these changes in beliefs and mood predict improvements in unguided card-sorting.

METHODS

Individuals with schizophrenia having prominent negative symptoms and impaired neurocognitive performance (N = 35) were randomized to guided success (n = 19) or a control (n = 16) condition.

RESULTS

Controlling for baseline performance, the experimental group performed significantly better, endorsed defeatist beliefs to a lesser degree, reported greater positive self-concept, and reported better mood than the control condition immediately after the experimental session. A composite index of change in defeatist beliefs, self-concept, and mood was significantly correlated with improvements in card-sorting.

CONCLUSIONS

This analogue study supports the rationale of cognitive therapy and provides a general therapeutic model in which experiential interventions that produce success have a significant immediate effect on a behavioral task, mediated by changes in beliefs and mood. The rapid improvement is a promising indicator of the responsiveness of this population, often regarded as recalcitrant, to cognitively-targeted behavioral interventions.

The nature of self-esteem and its relationship to anxiety and depression in adult acquired brain injury

Acquired brain injury (ABI) has a negative impact on self-esteem, which is in turn associated with mood disorders, maladaptive coping and reduced community participation. The aim of the current research was to explore self-esteem as a multi-dimensional construct and identify which factors are associated with symptoms of anxiety or depression. Eighty adults with ABI aged 17-56 years completed the Robson Self-Esteem Scale (RSES), of whom 65 also completed the Hospital Anxiety and Depression Scale; 57.5% of the sample had clinically low self-esteem. The RSES had good internal consistency (α =   .89), and factor analysis identified four factors, which differed from those found previously in other populations. Multiple regression analysis revealed anxiety was differentially predicted by "Self-Worth" and "Self-Efficacy", R² =   .44, F(4, 58) =   9, p <   .001, and depression by "Self-Regard", R² =   .38, F(4, 58) =   9, p <   .001. A fourth factor, "Confidence", did not predict depression or anxiety. In conclusion, the RSES is a reliable measure of self-esteem after ABI. Self-esteem after ABI is multidimensional and differs in structure from self-esteem in the general population. A multidimensional model of self-esteem may be helpful in development of transdiagnostic cognitive behavioural accounts of adjustment.

Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services

BACKGROUND

A common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse.

METHOD

Of the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η(2)), and Wilcoxon Signed Ranks tests.

RESULTS

Participants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η(2) = 0.03, ISI, η(2) = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months.

CONCLUSION

No evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study.

TRIAL REGISTRATION

Clinical Trials NCT02604706 (retrospectively registered).

Intimate Partner Sexual Coercion Mediates the Childhood Sexual Abuse–Suicidal Ideation Link Among African American Women

Suicide is a leading cause of morbidity and mortality among women. Childhood sexual abuse (CSA) and intimate partner violence are significant risk factors for suicidal ideation among women. The purpose of this study was to examine the interrelationships among these three constructs and test if intimate partner sexual coercion may explain the CSA–suicidal ideation link. African American women ( N = 141) completed an assessment of childhood trauma, intimate partner sexual coercion, and suicide ideation. A significant positive correlation was found between CSA and sexual coercion, between CSA and suicidal ideation, and between sexual coercion and suicidal ideation. Also, intimate partner sexual coercion was found to mediate the relationship between CSA and suicidal ideation when controlling for covariates such as spiritual well-being, self-esteem, and barriers to services. The association between CSA and suicidal ideation may be explained by sexual revictimization in the context of an intimate relationship among African American women. Clinically, practitioners should engage in regular screening for suicide ideation among African American women who have experienced CSA and intimate partner sexual coercion.

Validating Machine Learning Algorithms for Twitter Data Against Established Measures of Suicidality

BACKGROUND

One of the leading causes of death in the United States (US) is suicide and new methods of assessment are needed to track its risk in real time.

OBJECTIVE

Our objective is to validate the use of machine learning algorithms for Twitter data against empirically validated measures of suicidality in the US population.

METHODS

Using a machine learning algorithm, the Twitter feeds of 135 Mechanical Turk (MTurk) participants were compared with validated, self-report measures of suicide risk.

RESULTS

Our findings show that people who are at high suicidal risk can be easily differentiated from those who are not by machine learning algorithms, which accurately identify the clinically significant suicidal rate in 92% of cases (sensitivity: 53%, specificity: 97%, positive predictive value: 75%, negative predictive value: 93%).

CONCLUSIONS

Machine learning algorithms are efficient in differentiating people who are at a suicidal risk from those who are not. Evidence for suicidality can be measured in nonclinical populations using social media data.

Brain-derived neurotrophic factor (BDNF)-epigenetic regulation in unipolar and bipolar affective disorder

BACKGROUND

Alterations of brain-derived neurotrophic factor (BDNF) DNA methylation at specific BDNF promoters and corresponding gene expressions are associated with pathology and the response to antidepressant (AD) therapy in affective disorders such as major depressive disorder (MDD) and bipolar disorder (BD).

METHODS

Genomic DNA was derived from peripheral blood mononuclear cells (PBMCs) and was bisulfite converted. Percentage of methylated reference (PMR) was calculated based on results from quantitative real-time PCR following the MethyLight protocol. For statistical analysis parametric procedures were performed as appropriate.

RESULTS

In this study 544 subjects were included, 207 MDD subjects, 59 BD subjects and 278 control subjects. The BDNF exon I promoter methylation resulted to be significantly increased in MDD subjects compared to BD subjects (p=0.0089) and control subjects (p<0.001). Furthermore, the increase of methylation in MDD subjects was significantly associated with AD therapy (p=0.0019) but not to the clinical features of depression such as the severity of symptoms (p=n.s.). None of the 12 investigated single nucleotide polymorphisms (SNP) showed significant genotype-methylation interactions.

LIMITATIONS

Although based on previous findings, the DNA methylation was evaluated within only one CpG island of the different alternative BDNF gene transcripts.

CONCLUSIONS

The results suggest that the methylation status might not only be affected by the disease phenotype but might also be further influenced by pharmacological treatment, therefore harbouring the possibility of identifying new insights for treatment options.

Mediators of the childhood emotional abuse-hopelessness association in African American women

Although there is an association between experiencing childhood emotional abuse and feeling hopeless as an adult, it is critical to understand the factors that may be protective in this relationship. The goal of this study was to determine if two protective factors, namely spiritual well-being, including both religious and existential well-being, and positive self-esteem, served to mediate the association between childhood emotional abuse and adult hopelessness. The sample for this investigation was low-income African American women suicide attempters who were abused by a partner in the prior year (N=121). A path analysis revealed that in this sample, the childhood emotional abuse-hopelessness link was mediated by existential well-being and positive self-esteem, as well as by the two-mediator path of emotional abuse on existential well-being on self-esteem on hopelessness. Results suggested that existential well-being may be a more salient protective factor for hopelessness than religious well-being among abused, suicidal African American women who experienced childhood emotional abuse. Findings highlight the value of culturally relevant strategies for enhancing existential well-being and self-esteem in this at-risk population to reduce their vulnerability to feelings of hopelessness.

A cross-sectional study of mental health in UK veterinary undergraduates

Wellbeing (positive mental health) and mental ill-health of veterinary students from a single UK school were quantified using validated psychological scales. Attitudes towards mental ill-health and suicide were also assessed. Results were compared with published data from the UK general population and veterinary profession. Of the total student population (N=1068), 509 (48 per cent) completed a questionnaire. Just over half (54 per cent) of the respondents had ever experienced mental ill-health, with the majority reporting a first occurrence before veterinary school. Student wellbeing was significantly poorer (p<0.0001) than general population estimates, but not significantly different (p=0.2) from veterinary profession estimates. Degree of mental distress in students was significantly higher than in the general population (p<0.0001). Despite the majority (94 per cent) agreeing that 'Anyone can suffer from mental health problems', students were significantly more likely than members of the general population to agree that 'If I were suffering from mental health problems, I wouldn't want people knowing about it' (p<0.0001). Students were more likely to have thought about suicide, but less likely to have made an attempt (p<0.001; p=0.005), than members of the general population. The possibility of non-response bias must be considered when interpreting findings. However, strong similarities between results from this study population and the UK veterinary profession, as well as other veterinary student populations internationally, suggest no substantial school-level bias.

Underreporting in obese inpatients undergoing a psycho-nutritional rehabilitative program

OBJECTIVE

To evaluate the possible correlation between underreporting and anthropometric, psychological and socio-anagraphic characteristics in obese inpatients.

DESIGN

Perspective longitudinal study.

SUBJECTS

Forty-two obese inpatients enrolled to a multidisciplinary 3-week weight loss program in a psycho-nutritional rehabilitative structure located in Salice Terme, Northern Italy. They underwent anthropometric, dietary, clinical, and psycho diagnostic evaluation.

RESULTS

Forty-two subjects were included in the study of which 29 (70 %) were females and 13 were males. Mean BMI and mean waist circumference were 42.7 ± 9.5 kg/m(2) and 125 ± 18 cm, respectively. The mean weight loss of 4.2 ± 2.2 kg in the whole sample was significantly greater in males compared to females. The waist circumference fell in equal measure in both of the sexes. Thirty patients were classified as underreporters according to Goldberg, two-thirds of which were females. In the course of the three recovery weeks, a third of the 30 subjects identified as underreporters at the beginning continued to underreport energy intake.

CONCLUSION

In our study, the prevalence of underreporting was equal to over 70 % of the original sample. There was no significant difference between the weight losses achieved by the underreporter and non-underreporter groups. All the underreporters initially became partly non-underreporters during treatment. Those who gave up the practice of underreporting were patients who had a more elevated BMI, who were more susceptible to binge eating behavior and who experienced a strong uneasiness both physically and psychologically. They also had a strongly impaired quality of life.

Dysfunctional attitudes and expectancies in deficit syndrome schizophrenia

The deficit syndrome was proposed over 20 years ago as a separate negative symptom syndrome within schizophrenia with a distinct neurobiological pathophysiology and etiology. Recent research, however, has indicated that psychological factors such as negative attitudes and expectancies are significantly associated with the broad spectrum of negative symptoms. Specifically, defeatist beliefs regarding performance mediate between neurocognitive impairment and both negative symptoms and functional outcome. Additionally, asocial beliefs predict asocial behavior and negative expectancies regarding future pleasure are associated with negative symptoms. The present study explored whether these dysfunctional beliefs and negative expectancies might also be a feature of the deficit syndrome. Based on a validated proxy method, 22 deficit and 72 nondeficit patients (from a pool of 139 negative symptom patients) were identified and received a battery of symptom, neurocognitive, and psychological measures. The deficit group scored significantly worse on measures of negative symptoms, insight, emotion recognition, defeatist attitudes, and asocial beliefs but better on measures of depression, anxiety, and distress than the nondeficit group. Moreover, the deficit group showed a trend for higher scores on self-esteem. Based on these findings, we propose a more comprehensive formulation of deficit schizophrenia, characterized by neurobiological factors and a cluster of psychological attributes that lead to withdrawal and protect the self-esteem. Although the patients have apparently opted-out of participation in normal activities, we suggest that a psychological intervention that targets these negative attitudes might improve their functioning and quality of life.

The impact of leadership programme on self-esteem and self-efficacy in school: a randomized controlled trial

Background

Leadership training programs by experiential learning among adolescents are very popular worldwide and in particular developed countries, but there exists few studies which formally assessed their impact on the psychological well-being of program participants. This study evaluated the effectiveness of leadership training programs on self-esteem and self-efficacy among adolescents.

Methodology/Principal Findings

a total of 180 students of the same grade of one secondary school were randomized into an intervention (n = 50) and a control group (n = 130). The students in the intervention group participated in a 6-month program of leadership training and service learning, while the control group did not participate in any training. Their self-esteem and self-efficacy were assessed by Rosenberg Self-Esteem questionnaire and Chinese Adaptation of the General Self-Efficacy Scale, respectively, before and after the program. Both scales have been recognized internationally as valid and reliable survey instruments to measure these psychological attributes. The scores were compared by Student’s tests according to gender. A total of 180 students were enrolled during the study period October, 2009 to May, 2010. Their mean age was 15.18 years (0.62) and 56.7% were male. Students allocated to the intervention and control group had statistically similar demographic characteristics except gender (male 36.0% vs. 64.6%, p = 0.001). Overall, the self-esteem scores increased by 1.28 and decreased by 0.30 (p = 0.161) while the self-efficacy scores increased by 0.26 and decreased by 0.76 (p = 0.429) in the intervention and control group, respectively. Among female students, the intervention group showed significant improvements in both self-esteem (2.38 vs. −0.24, p<0.001) and self-efficacy (1.32 vs. –0.04, p = 0.043).

Conclusions/Significance

Leadership training program were not found to be effective to enhance self-esteem and self-efficacy in adolescents, except girls who showed modest increase in these outcomes. Future research should assess the reasons why these programs are effective among female.

Mental health promotion of Iranian university students: the effect of self-esteem and health locus of control

The purpose of this study was to investigate the effect of self-esteem and health control belief on promoting students' mental health. In so doing, 144 students from two medical universities in the north-east of Iran were recruited into study. They were pair-matched and randomly assigned to case and control groups. The data were collected through Goldberg's General Health Questionnaire-28, Multidimensional Health Locus of Control and Rosenberg's Self-Esteem Scales. The results showed that there were significant differences between the groups before and after the intervention. The external components of health locus of control (chance and powerful others) showed a significant decrease but the internal health locus of control and self-esteem revealed a significant increase after the intervention (P < 0.0001). Moreover, the students' mental health had a significant increase after 3 months of intervention (P < 0.0001). The findings emphasize that the programme can improve the health locus of control beliefs, self-esteem and mental health promotion of the students. This will require additional monitoring and uninterrupted attempts to be effective.

Association of genetic polymorphisms with personality profile in individuals without psychiatric disorders

OBJECTIVE

Population-based twin studies demonstrate that approximately 40-50% of the variability in personality dimensions results from genetic factors. This study assessed selected polymorphisms in the COMT Val158Met, MAOA 3'VNTR, 5HTTLPR, 102T/C 5-HT2A, DAT 3'VNTR and DRD2 exon 8 genes and evaluated their association with personality profiles, anxiety levels, and depressiveness in healthy subjects.

METHODS

This study included 406 unrelated (mean age 38.51 years), mentally and somatically healthy Caucasian subjects of Polish origin. The prevalence of the gene variants mentioned above and their association with personality profiles, anxiety levels, and depressiveness was assessed using the Temperament and Character Inventory, NEO Five-Factor Inventory, Spielberger's State-Trait Anxiety Inventory and Beck's Depression Inventory.

RESULTS

The effects of the 5HTTLPR gene on the s/s genotype and empathy (C2) were lowest in the entire group. The effects of gender, age and the HT2A gene for the T/T genotype and attachment (RD3) were highest in women. The effects of gender, age and the DAT gene on the 9/9 DAT genotype, compassion (C4) and cooperativeness (C) were lowest in women. The effects of gender, age and the COMT gene on the Met/Met genotype and neuroticism (NEU) NEO-FFI were also lowest in women.

CONCLUSIONS

Our results suggest considerable influence of individual genes on the formation of personality traits.

[Cognitive-behavioural therapy in early psychosis: an open study in a clinical setting]

OBJECTIVE

Meta-analysis results confirm that cognitive-behavioural therapy in psychosis (CBTp) is efficient for persistent symptoms. However, external validity remains unexplored. CBTp in early psychosis (in the first 5 years after diagnosis) seems especially relevant, given a possible impact on long-term course. However, the few studies that experimented with CBTp with this population had poor results. They all introduced therapy during an acute psychotic phase and most of them performed a limited number of sessions. Therefore, our introductory open study aimed to evaluate the efficiency of a 25-session Australian CBTp program, introduced during a stable phase in Quebec patients with early psychosis.

METHOD

The Active Cognitive Psychotherapy for Early Psychosis program was offered to 20 patients aged 14 years or older, at a rate of 1 weekly session during 6 months.

RESULTS

The acceptance rate was 75%, the mean session compliance rate was 84%, and participants were satisfied with the program. Pre- and post-CBTp analyses indicated statistically significant improvements of psychotic symptomatology, which were maintained at 6-month follow-up. Self-criticism improvement was also statistically significant, post-CBTp.

CONCLUSION

CBTp seems to be appropriate in our clinical settings, including with adolescents. Moreover, the treatment dosage used seems to foster session compliance.

Unpacking Social Hypersensitivity: Vulnerability to the Absence of Positive Feedback

Navigating social life requires accurately calibrated sensitivity to external feedback, thus extreme sensitivity to external feedback may be maladaptive. Using a daily diary design, the authors investigated whether the relationship between social hypersensitivity and daily events predicted level, lability, and reactivity of both self-esteem and affect. Relative to their less sensitive peers, socially hypersensitive people exhibited lower levels of self-esteem and greater negative affect and experienced greater fluctuations in self-esteem and negative affect. Although most people were negatively reactive to the presence of negative feedback, socially hypersensitive people were negatively reactive to the absence of positive feedback as well. The authors argue that reactivity to the absence of positive feedback is a fundamental, heretofore untested aspect of what makes social hypersensitivity a pernicious orientation.

Self-esteem and suicide ideation in psychiatric outpatients

Depression, hopelessness, and low self-esteem are implicated as vulnerability factors for suicide ideation. The association of self-esteem with suicide ideation after controlling for depressed mood and hopelessness was examined. Adult psychiatric outpatients (N = 338) completed measures of self-esteem, suicide ideation, hopelessness, and depression. Self-esteem was operationalized as beliefs about oneself (self-based self-esteem) and beliefs about how other people regard oneself (other-based self-esteem). Each dimension of self-esteem was negatively associated with suicide ideation after controlling for depression and hopelessness. Of the two dimensions of self-esteem, other-based self-esteem was the more robust predictor of suicide ideation. These findings suggest that even in the context of depression and hopelessness, low self-esteem may add to the risk for suicide ideation.

Self-esteem reconsidered: Unstable self-esteem outperforms level of self-esteem as vulnerability marker for depression

Previous studies have built up evidence that an unstable self-esteem is associated with vulnerability to depression and that it outperforms level of self-esteem as a predictor for symptoms of depression. However, most of these studies have used student samples exclusively to investigate the role of self-esteem instability in depression vulnerability. Our present study used samples of currently depressed inpatients, formerly depressed individuals, and never-depressed controls to investigate the relationship between self-esteem instability and depression. In addition, we examined the predictive validity of self-esteem instability in predicting future depressive symptoms. The results indicate that self-esteem instability is associated with depression and vulnerability to depression. Furthermore, self-esteem instability interacted with perceived stress variability and depressed mood variability in predicting future depressive symptomatology at six months follow-up. These results are in line with the diathesis-stress model and support the hypothesis that self-esteem instability might be more important than level of self-esteem in predicting vulnerability to depression.

Comparison of changes in physical self-concept, global self-esteem, depression and anxiety following two different psychomotor therapy programs in nonpsychotic psychiatric inpatients

BACKGROUND

The first objective of this study was to compare the changes in physical self-concept, global self-esteem, depression and anxiety after participation in one of two 16-week psychomotor therapy programs for nonpsychotic psychiatric inpatients. The second objective was to study the relationship between changes in these variables.

METHODS

One hundred and ninety-nine inpatients were randomly assigned to either a personalized psychomotor fitness program, consisting of aerobic exercise and weight training, or a general program of psychomotor therapy, consisting of different forms of physical exercises and relaxation training. Physical self-concept was evaluated using the Dutch version of the Physical Self-Perception Profile at baseline, after 8 weeks, and after completion of the 16-week interventions. At the same time points, additional variables of global self-esteem, depression and anxiety were assessed by means of the Rosenberg Self-Esteem Inventory, the Beck Depression Inventory and the Trait Anxiety Inventory, respectively.

RESULTS

After 16 weeks, both groups showed significant improvements in all outcome measures (p values ranged from 0.01 to < 0.0001), with no between-group differences. In both groups, the improvement in physical self-concept was correlated with increased global self-esteem and decreased depression and anxiety levels (p < 0.01).

CONCLUSIONS

The results suggest that both psychomotor therapy programs are equally effective in enhancing physical self-concept. The relationship between improvements in physical self-concept and enhancements in global self-esteem, depression and anxiety supports the potential role of the physical self-concept in the recovery process of depressed and anxious psychiatric inpatients.

Outcome of psychiatric treatment: what is relevant for our patients?

This study investigated relevant outcome domains in the patient's perspective following psychiatric outpatient treatment for non-psychotic, non-substance-related disorders. Questionnaires, including the Client Satisfaction Questionnaire (CSQ) and the Bern Inventory of Treatment Goals (BIT-C) applied as a broad typology of outcome domains, were mailed 1 year after treatment to outpatients who had undergone eight or more therapy sessions. Patients reported a wide range of relevant outcomes, including changes with respect to the interpersonal domain, their self-concept, and existential issues. Changes in depressive and anxiety symptoms were rated as particularly important; the reports of both symptomatic and more integral changes were related to treatment characteristics, patient's diagnostic category, and patient's employment status. Patient satisfaction was particularly related to reported changes in the interpersonal domain. This exploratory study provides evidence that traditional outcome measures that include mood, anxiety, and fear symptoms continue to assess the most important areas for change in patients' views. However, they might miss relevant therapeutic achievements in some of our patients, particularly in those suffering from adjustment and personality disorders. The use of measures that include dimensions such as personal growth, purpose of life, and positive relations with others may record important changes in these patients.

The effectiveness of two psychomotor therapy programmes on physical fitness and physical self-concept in nonpsychotic psychiatric patients: a randomized controlled trial

OBJECTIVE

To compare the changes in cardiorespiratory and muscular fitness, and the changes in physical self-concept after participation in one of two psychomotor therapy programmes in a sample group of psychiatric patients. To study the relationship between the changes in physical fitness and the changes in physical self-concept.

DESIGN

Randomized controlled parallel-group trial with repeated measures.

SETTING

Three treatment units of a university psychiatric hospital in Belgium.

SUBJECTS

One hundred and ninety-nine patients with severe symptoms of depression and/or anxiety, and/or personality disorders.

INTERVENTIONS

A general programme of psychomotor therapy, consisting of different forms of physical exercises and relaxation training, and a personalized psychomotor fitness programme, consisting of aerobic and resistance training. These programmes were followed three times a week for a period of 16 weeks.

OUTCOME MEASURES

The maximum dynamic strength, the strength endurance, physical work capacity at 60% and 80% of the estimated maximal heart rate reserve, and the physical self-concept by means of the Dutch version of the Physical Self-Perception Profile.

RESULTS

After eight weeks, both groups exhibited an improvement in muscular fitness (both p-values < 0.0001), but only the psychomotor fitness group had improved in cardiorespiratory fitness (p < 0.01). After 16 weeks, the patients in the general programme of psychomotor therapy had not increased in cardiorespiratory fitness. At the end of the 16-week programmes, both groups showed a more positive physical self-concept (p from 0.01 to < 0.0001). However, these improvements were not related to the progress in physical fitness.

CONCLUSIONS

The main difference in the effectiveness of the two programmes was the increase in cardiorespiratory fitness in the psychomotor fitness group. The gains in fitness did not play an essential role in the enhancement of physical self-concept.

Feedback seeking in children and adolescents: associations with self-perceptions, attachment representations, and depression

Because the feedback children and adolescents receive is important to their development, 2 experimental studies were designed to examine children's (M = 12 years) and adolescents' (M = 17 years) active selection of the quality of feedback they wish to receive. In both studies evidence emerged that participants' self-perceptions influence their feedback seeking. Participants with positive self-perceptions sought more positive feedback than participants with negative self-perceptions and sought more positive feedback than expected by chance. Participants with negative self-perceptions lacked this tendency to seek positive feedback and sometimes sought less positive feedback than expected by chance. As expected, depression and attachment-related measures were also associated with participants' feedback seeking. Contributions of feedback-seeking patterns to stability and change in children's and adolescents' development are discussed.