Self-devaluative dysphoric experience and the prediction of persistent first-episode major depressive disorder in adolescents

A Meta-Analysis of the Influence of Cue Valence on Overgeneral Memory and Autobiographical Memory Specificity Among Youth

Overgeneral memory (OGM), or difficulty recalling specific memories when recounting autobiographical events, is associated with psychopathology. According to functional avoidance theory, OGM-or reduced autobiographical memory specificity (AMS)-may serve as an emotion regulation strategy that aids in the avoidance of painful, negative memories (Sumner, 2012; Williams et al., 2007). Some researchers argue that there may be a valence effect for OGM, such that there is a higher frequency of overgenerality when recalling negative memories compared to positive memories. Although not supported among adults, valence effects may be present among children and adolescents if OGM initially develops in response to negative cues and then generalizes to all memory recall over time. This meta-analysis examined differences in child and adolescent OGM and AMS based on cue valance; standardized mean differences between negative and positive valence cues for OGM and AMS indices were calculated. Following PRISMA guidelines, a systematic literature search resulted in 26 studies assessing OGM and 30 assessing AMS. There was a significant effect of valence on OGM (d = 0.17, p = 0.01) and AMS (d = -0.20, p = 0.01). There was a higher frequency of overgeneral responses to negative cue words than positive cue words. Similarly, there was a higher frequency of specific responses for positive cue words than negative cue words. Subgroup analyses considering differences in valence effects by participant age (childhood vs. adolescence), sample type (clinical vs. community), and task instructions (verbal vs. written) were not significant. Theoretical advancements for our understanding of OGM and AMS and clinical implications are discussed.

The relationship between osteoporosis and depression

Osteoporosis is the most common metabolic bone disease. The complications of osteoporosis have influence on people's lives and lead to anxiety and depression. The aim of this study was to determine the relationship between osteoporosis and depression among Iranian patients. This cross-sectional analytical survey study conducted among 500 patients referred to a Bone Densitometry Center in Iran. They were assigned into with osteoporosis group (n = 250) and non-affected group (n = 250). The Persian version of the 13-item Beck Depression Inventory (BDI) was used to assess depression. ANOVA, independent t-test, chi-square were used to compare the data. All analyses were done using SPSS version 22 software. A P value ≤ 0.05 represented statistical significance. The majority of people with osteoporosis (86.9%), suffered from mild to moderate depression and the majority of normal people (84.6%) were non-depressed. The mean scores (SD) of depressions in the patients with osteoporosis and normal status was 6.94 (2.39) and 2.50 (1.01), respectively. Statistical analyses showed that the mean scores of depressions significantly different between the two groups (P < 0.05). The results indicate that depression is associated with osteoporosis. As a result, physicians are expected to pay attention to depression in people with osteoporosis and to treat it.

A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial

OBJECTIVES

Despite the gains made by current first-line interventions for major depressive disorder (MDD), modest rates of treatment response and high relapse indicate the need to augment existing interventions. Following theory and initial research indicating the promise of mindful yoga interventions (MYIs), this study examines mindful yoga as a treatment of MDD.

METHODS/DESIGN

This randomized controlled trial uses a sample of young females (18-34 years) to examine the efficacy and cost-effectiveness of a 9-week manualized MYI added to treatment as usual (TAU) versus TAU alone. Primary outcome measures consist of clinician-administered (Hamilton Depression Rating Scale) and self-report (Depression-Anxiety-Stress Scales) measures of depression. Underlying mechanisms will be examined, including rumination, negative self-evaluation, intolerance of uncertainty, interoceptive awareness, and dispositional mindfulness. Assessments were conducted at preintervention and will be conducted at postintervention, 6-, and 12-month follow up.

RESULTS

The baseline sample consists of 171 females (88 were randomized into the MYI), reporting a baseline Mage = 25.08 years (SDage = 4.64), MHamilton-depression = 18.39 (SDHamilton = 6.00), and a MDASS-depression = 21.02 (SDDASS = 9.36).

CONCLUSION

This trial will provide important information regarding the benefits of adding yoga-based interventions to TAU for young women with MDD and the mechanisms through which such benefits may occur.

Rumination, anxiety, depressive symptoms and subsequent depression in adolescents at risk for psychopathology: a longitudinal cohort study

BACKGROUND

A ruminative style of responding to low mood is associated with subsequent high depressive symptoms and depressive disorder in children, adolescents and adults. Scores on self-report rumination scales correlate strongly with scores on anxiety and depression symptom scales. This may confound any associations between rumination and subsequent depression.

METHODS

Our sample comprised 658 healthy adolescents at elevated risk for psychopathology. This study applied ordinal item (non-linear) factor analysis to pooled items from three self-report questionnaires to explore whether there were separate, but correlated, constructs of rumination, depression and anxiety. It then tested whether rumination independently predicted depressive disorder and depressive symptoms over the subsequent 12 months, after adjusting for confounding variables.

RESULTS

We identified a single rumination factor, which was correlated with factors representing cognitive symptoms of depression, somatic symptoms of depression and anxiety symptoms; and one factor representing adaptive responses to low mood. Elevated rumination scores predicted onset of depressive disorders over the subsequent year (p = 0.035), and levels of depressive symptoms 12 months later (p < 0.0005), after adjustment for prior levels of depressive and anxiety symptoms.

CONCLUSION

High rumination predicts onset of depressive disorder in healthy adolescents. Therapy that reduces rumination and increases distraction/problem-solving may reduce onset and relapse rates of depression.

Overgeneral autobiographical memory as a predictor of the course of depression: a meta-analysis

Overgeneral autobiographical memory (OGM) is a robust phenomenon in depression, but the extent to which OGM predicts the course of depression is not well-established. This meta-analysis synthesized data from 15 studies to examine the degree to which OGM 1) correlates with depressive symptoms at follow-up, and 2) predicts depressive symptoms at follow-up over and above initial depressive symptoms. Although the effects are small, specific and categoric/overgeneral memories generated during the Autobiographical Memory Test significantly predicted the course of depression. Fewer specific memories and more categoric/overgeneral memories were associated with higher follow-up depressive symptoms, and predicted higher follow-up symptoms over and above initial symptoms. Potential moderators were also examined. The age and clinical depression status of participants, as well as the length of follow-up between the two depressive symptom assessments, significantly moderated the predictive relationship between OGM and the course of depression. The predictive relationship between specific memories and follow-up depressive symptoms became greater with increasing age and a shorter length of follow-up, and the predictive relationship was stronger for participants with clinical depression diagnoses than for nonclinical participants. These findings highlight OGM as a predictor of the course of depression, and future studies should investigate the mechanisms underlying this relationship.

Suicide and its association with individual, family, peer, and school factors in an adolescent population in southern Taiwan

A representative sample of 10,233 adolescent students was recruited to examine the rate of suicidal attempt and its correlates in the adolescents living in southern Taiwan. Five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia (Kiddie-SADS-E) were used to inquire about the participants' suicidality. The associations between suicidal attempt and multidimensional factors were examined by using logistic regression analysis: 9.1% of the participants reported a suicidal attempt in the preceding year. Female gender, low self-esteem, weekly alcohol use, illicit drugs use, depression, high family conflict, low maternal education level, poor family function, low connectedness to school, low rank, poor feeling in peer group, and drop out from school were associated with adolescent suicidal attempt. The rate of suicidal attempt was found to be high in Taiwanese adolescents, and multidimensional factors were correlated to adolescent suicidal attempt.

Emanuel Miller Lecture: early onset depressions--meanings, mechanisms and processes

BACKGROUND

Depressive syndromes in children and adolescents constitute a serious group of mental disorders with considerable risk for recurrence. A more precise understanding of aetiology is necessary to improve treatment and management.

METHODS

Three neuroactive agents are purported to be involved in the aetiology of these disorders: serotonin, brain-derived neurotrophic factor and cortisol. A literature review was conducted to determine their contributions to the emergence of unipolar depressions in the adolescent years.

RESULTS

Serotonin, brain-derived neurotrophic factor and cortisol may operate in concert within two distinct functional frameworks: atypical early epigenesis arising in the first few years of life and resulting in the formation of a vulnerable neuronal network involving in particular the amygdala and ventral prefrontal cortex. Individuals with this vulnerability are likely to show impaired mood regulation when faced with environmental demands during adolescence and over the subsequent decades; and acquired neuroendangerment, a pathological brain process leading to reduced synaptic plasticity, in particular in the hippocampus and perhaps the nucleus accumbens and ventral tegmentum. This may result in motivational, cognitive and behavioural deficits at any point in the lifespan most apparent at times of environmental demand.

CONCLUSIONS

The characteristics, course and outcome of a depressive episode may depend on the extent of the involvement of both atypical early neurogenesis and acquired neuroendangerment.

Depression and its association with self-esteem, family, peer and school factors in a population of 9586 adolescents in southern Taiwan

AIMS

The aim of the present study was to gain insight into the prevalence of depression and its association with self-esteem, family, peer and school factors in a large-scale representative Taiwanese adolescent population.

METHODS

A total of 12,210 adolescent students were recruited into the present study. Subjects with a score >28 on the Center for Epidemiological Studies' Depression Scale were defined as having significant depression; the Rosenberg Self-Esteem Scale, Adolescent Family and Social Life Questionnaire and Family C-APGAR Index were applied to assess subjects' self-esteem, family, peer and school factors. The association between depression and correlates were examined on t-test and chi(2) test. The significant factors were further included in logistic regression analysis.

RESULTS

Among 9586 participants (response rate: 86.3%), the prevalence of depression was 12.3%. The risk factors associated with depression in univariate analysis included female gender, older age, residency in urban areas, lower self-esteem, disruptive parental marriage, low family income, family conflict, poorer family function, less satisfaction with peer relationships, less connectedness to school, and poor academic performance. After adjusting the effects of sex, age and location, only subjects with lower self-esteem, higher family conflict, poorer family function, lower rank and decreased satisfaction in their peer group, and less connectedness to school were prone to depression on logistic regression.

CONCLUSION

The prevalence of depression is high in Taiwanese adolescents, and the multiple factors of family, peer, school and individuals are associated with adolescent depression. The factors identified in the present study may be helpful when designing and implementing preventive intervention programs.

The effects of cognitive-behavioural therapy on mood-related ruminative response style in depressed adolescents

BACKGROUND

A mood-related ruminative response style increases the risk of onset and persistence of depression. This preliminary study investigated whether, in depressed adolescents, cognitive-behaviour therapy reduces mood-related ruminative response style. Whether specific factors within the rumination scale were differentially affected by CBT is also reported.

METHODS

26 depressed adolescents were randomised to receiving serotonin-specific reuptake inhibitor antidepressants (SSRI) plus psychosocial treatment as usual or SSRI and psychosocial treatment as usual plus CBT. Ruminative response style and depressive symptoms were measured at baseline and after 30 weeks of treatment, with the Responses to Depression Questionnaire and Mood and Feelings Questionnaire.

RESULTS

There were significantly greater reductions in ruminations in the CBT group compared to the non-CBT group (p = .002). There was no significant difference in the reduction in self-reported depressive symptoms between the groups. Rumination was reduced to levels of never-depressed controls in adolescents who had recovered from depression and received CBT. There were greater falls in the CBT group in the more pathological 'brooding' factor of rumination.

CONCLUSION

These findings suggest that adding CBT to SSRI medication in the presence of active clinical care causes a greater reduction in mood-related ruminative response style in depressed adolescents. This may reduce the risk of future relapse.

TRIAL REGISTRATION

Current Controlled Trials ISRCNT83809224.

Osteoporosis and depression: a historical perspective

In the early 1980s, researchers studying osteoporosis noted that depression was one of the major negative consequences of bone loss and fractures. These researchers believed that osteoporosis and fractures occurred first, causing a reactive depression. Meanwhile, a similar but distinct psychiatry literature noted that osteoporosis or bone loss appeared to be an undesirable consequence of major depression. Here, depression was seen as the causal factor, and osteoporosis was the outcome. The psychiatric perspective is more biological, based on the presence of hypercorticoidism in depressed individuals. Those who believe that osteoporosis leads to depression point out that depression is a consequence of many chronic illnesses. Regardless of the correct causal order, the strong positive relationship between osteoporosis and depression merits further clinical and research attention in the future.

Rumination in adolescents at risk for depression

BACKGROUND

Identifying high-risk adolescents and understanding first onset of depression in adolescence are important steps in reducing depression morbidity. There is compelling evidence that the personality dimension neuroticism is a risk factor for depression, but the vulnerability mechanism is not yet understood. This study examined the association between a hypothesized psychological vulnerability factor (rumination) and depression in adolescents.

METHODS

A behavioural high-risk design differentiated a sample of 326 adolescents (aged 14-18) as either at normal or high risk for depression (operationalized as scores on a measure of neuroticism).

RESULTS

Adolescents at risk for depression reported more rumination than adolescents not at risk. We hypothesized that the well established relationship between neuroticism and depression would be mediated by rumination in cross-sectional analyses, and our findings suggest that rumination partially mediated this relationship.

CONCLUSIONS

The findings tentatively suggest that neuroticism acts as a risk factor for adolescent onset depression through increased tendency towards brooding rumination (i.e. moody self-evaluative dwelling) in response to depressed mood. Prospective and experimental research examining this mechanism is required.