The State-Trait Depression Scales: An International Comparison

Clarifying the Links between Perceived Stress and Depressiveness: a Longitudinal Study of COVID-19's Effects on Adolescents in Germany

Young people are navigating an increasingly uncertain and unstable social and economic environment, further complicated by COVID-19. Individual resources and vulnerabilities, such as mental health and sensitivity to stress, play a significant role in how well youth adapt to the career paths and living conditions altered by the pandemic, a dynamic that is not yet well understood. This study examined the role of COVID-19 on the intertwined relation between perceived stress and depressiveness (negative and positive affect) in adolescents, focusing on gender differences. Longitudinal data from 673 German adolescents (Mage = 16.8 years, SDage = 0.91; female = 59%) were collected in three waves, before (T1) and during the pandemic (T2, T3). Using Latent Change Score models, the bidirectional relation between perceived stress and depressiveness was analyzed, considering gender as a moderator. The results showed that adolescents who found their situation stressful were at risk of developing depressiveness at the outbreak of the pandemic and throughout its progression. As the pandemic progressed, an increase in positive affect was linked to heightened perceived stress. Gender-specific differences were particularly evident in the levels of perceived stress and depressiveness, with women being more vulnerable. This study highlights how vulnerabilities in stress perception affect adolescents' mental health, with gender-specific differences underscoring the need for tailored mental health measures.

Depression, Contraception, and Ambivalence Concerning Fertility

Individuals suffering from depression exhibit a higher rate of unintended pregnancies, which are associated with negative outcomes for both parents and children. Often, unintended pregnancies result from contraceptive mistakes. Here, we examine the relationship between depression and the consistency of contraceptive behavior, testing ambivalence as a possible mediator. The analyses were based on cross-sectional data from the second and third waves of the German Relationship and Family Panel Pairfam. A German-speaking sample without children (N = 190; 117 female, 73 male), who reported not attempting to conceive or become pregnant during the last 12 months, was analyzed in comparison with a propensity score matched sample. Ambivalence was operationalized as the difference between the ideal and realistic number of children in wave 2. Data from wave 3 were used to assess contraceptive behavior. Depressed mood in wave 2 and consistency of contraceptive behavior in wave 3 were negatively correlated. After including ambivalence in wave 2 as a mediator in the model, the direct path between depressed mood and consistency of contraceptive behavior remained significant, with no significant mediation found. For men only, we observed a significant negative association of ambivalence with the consistency of contraceptive behavior in the last 3 months. No significant relationship was found between depressed mood and ambivalence. We conclude that future research aiming to better understand the consistency of contraceptive behavior should incorporate measures of ambivalence.

The Relationship Between Work-Related Stress and Depression: A Scoping Review

Objectives

Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge.

Methods

We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria.

Results

Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified.

Conclusion

The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

A qualitative investigation of the hearing and hearing-aid related emotional states experienced by adults with hearing loss

OBJECTIVE

Despite previous research into the psychosocial impact of hearing loss, little detail is known regarding the hearing and hearing-aid-related emotional states experienced by adults with hearing loss in everyday life, and how they occur.

DESIGN

Individual remote semi-structured interviews were audio-recorded, transcribed verbatim and qualitatively analysed with reflexive and inductive thematic analysis.

STUDY SAMPLE

Seventeen participants (9 female) with hearing loss (age range 44-74 years) participated. Ten used bilateral hearing aids, four unilateral and three used no hearing aids at the time of interviews.

RESULTS

The four main themes which emerged from the data were: identity and self-image, autonomy and control, personality and dominant emotional states and situational cost/benefit analysis with respect to use of hearing aids.

CONCLUSIONS

This study goes beyond previous literature by providing a more detailed insight into emotions related to hearing and hearing-aids in adults. Hearing loss causes a multitude of negative emotions, while hearing aids generally reduce negative emotions and allow for more positive emotions. However, factors such as lifestyle, personality, situational control, the relationship with those in conversation and the attribution of blame are key to individual emotional experience. Clinical implications include the important role of social relationships in assessment and counselling.

Adolescent Loneliness and Negative Affect during the COVID-19 Pandemic: The Role of Extraversion and Neuroticism

The COVID-19 pandemic had varied but significant effects on the lives of adolescents. This study aimed to examine the effects of extraversion and neuroticism on changes in loneliness and negative affect among adolescents during the pandemic. Longitudinal data were collected in three waves from 673 German adolescents and young adults (Mage = 16.8 years, SDage = 0.91; female = 59%), affected by local lockdowns. The data collection was one time before (T1) and two times during the pandemic (T2, T3). Change score models were used to assess the relationship between loneliness and negative affect with consideration of extraversion and neuroticism. Results showed that pre-pandemic loneliness was predictive of changes in negative affect during the pandemic, with higher loneliness predicting increases in negative affect. Negative affect did not predict later loneliness. Extraverts showed an increase in negative affect over time, particularly between pre-pandemic measurement and the first phase of the pandemic. Higher neuroticism appeared to have increased vulnerability for negative affect during the pandemic, as a rise in negative affect were found among these adolescents throughout the course of the pandemic. In conclusion, the study highlights the significant impact of the COVID-19 pandemic on the mental health of adolescents and suggests that managing the pandemic during this specific developmental period is a challenge.

Network Analysis of the Relationship Between Trait Depression and Impulsiveness Among Youth

Objective

Both impulsiveness and trait depression are the trait-level risk factors for depressive symptoms. However, the two traits overlap and do not affect depressive symptoms independently. This study takes impulsiveness and trait depression into a whole construct, aiming to find the complex associations among all facets and explore their relative importance in a trait network. It can help us find the key facets that need consideration in preventing depression.

Materials and Methods

We used the Barratt Impulsiveness Scale (BIS) and Trait Depression Scale (T-DEP) as measuring tools, conducted network analysis, and applied the Graphic Least Absolute Shrinkage and Selection Operator (GLASSO) algorithm to estimate the network structure and compute the linkage and centrality indexes. The accuracy and stability of the indexes were estimated through bootstrapping. All the computations were performed by R script and packages.

Results

We found that "trait anhedonia" was connected with "non-planning" and "cognitive" impulsiveness, while "trait dysthymia" was connected with "motor" impulsiveness. "Cognitive" impulsiveness had a statistically significant higher expected influence than "motor" impulsiveness and had the trend to be dominant in the network. "Trait dysthymia" had a statistically significant higher bridge expected influence than "cognitive" impulsiveness and had the trend to be the key facet linking impulsiveness with trait depression. "Non-only children" had higher network global strength than "only children." All indexes were accurate and stable.

Conclusion

The present study confirms the complex associations among facets of trait depression and impulsiveness, finding that "cognitive" impulsiveness and "trait dysthymia" are the two key factors in the network. The results imply that different facets of impulsiveness should be considered respectively regarding anhedonia and dysthymia. "Cognitive" impulsiveness and "trait dysthymia" are critical to the prevention of depression.

Semantics-Prosody Stroop Effect on English Emotion Word Processing in Chinese College Students With Trait Depression

This study explored the performance of Chinese college students with different severity of trait depression to process English emotional speech under a complete semantics-prosody Stroop effect paradigm in quiet and noisy conditions. A total of 24 college students with high-trait depression and 24 students with low-trait depression participated in this study. They were required to selectively attend to either the prosodic emotion (happy, sad) or semantic valence (positive and negative) of the English words they heard and then respond quickly. Both prosody task and semantic task were performed in quiet and noisy listening conditions. Results showed that the high-trait group reacted slower than the low-trait group in the prosody task due to their bluntness and insensitivity toward emotional processing. Besides, both groups reacted faster under the consistent situation, showing a clear congruency-induced facilitation effect and the wide existence of the Stroop effect in both tasks. Only the Stroop effect played a bigger role during emotional prosody identification in quiet condition, and the noise eliminated such an effect. For the sake of experimental design, both groups spent less time on the prosody task than the semantic task regardless of consistency in all listening conditions, indicating the friendliness of basic emotion identification and the difficulty for second language learners in face of semantic judgment. These findings suggest the unneglectable effects of college students' mood conditions and noise outside on emotion word processing.

Fall From Grace: Increased Loneliness and Depressiveness Among Extraverted Youth During the German COVID-19 Lockdown

The COVID-19 pandemic has substantially affected young people's social and emotional life. Based on longitudinal data provided by 843 adolescents (57.3% female) of the German Family Panel (pairfam), we investigated effects of extraversion on changes in loneliness and depressiveness between 2018 and 2019 and the first German COVID-19 lockdown in the first half of 2020. Findings of latent change modeling show that highly extraverted adolescents experienced a larger rise in depressiveness, and a third of this total effect was mediated through increases in loneliness. These results contradict previous work evidencing lower depressiveness among extraverted youth and challenge the notion of extraversion as a mere protective factor. Under conditions of restricted access to others, this personality trait may become a burden.

Euthymia: a neglected aspect of trait depression and its role in predicting subjective well-being

BACKGROUND

Besides its relationship with clinical depression, depressiveness may be conceptualized as a personality trait that includes dysthymia (negative emotional experiences) and euthymia (positive emotional experiences). Euthymia, when reverse scored, makes the construct of trait depression more sensitive to milder levels of depressiveness observed in non-clinical samples. We hypothesised that euthymia is a more important predictor of subjective well-being than dysthymia and this effect is retained when basic positive and negative affect are controlled.

PARTICIPANTS AND PROCEDURE

Participants were 213 adults (56% females) aged between 19 and 61 (M = 35.85, SD = 11.30). They completed self-report measures of: (a) euthymia and dysthymia as two facets of trait depression, (b) satisfaction with life, and (c) positive and negative affect.

RESULTS

The results showed that positive affect and euthymia contributed independently to explaining the variance of satisfaction with life, but the predictive role of euthymia was stronger. In contrast, dysthymia turned out not to predict satisfaction with life when controlled for basic affect and euthymia.

CONCLUSIONS

Theoretical implications of the results are discussed with their applications for counselling and clinical practice. We point to the need of monitoring the level of euthymia in the prevention programmes against depression, which is in line with the well-established role of positive interventions in psychotherapy and counselling.

Perioperative predictability of unsatisfactory functional outcomes 6 months after hip arthroplasty

Background

Aiming at an early identification of patients with an unsatisfactory outcome after hip arthroplasty we investigated the pre-, intra- and early postoperative predictability.

Methods

Using logistic regression models at nine different time points we calculated the area under the curve of the receiver operating characteristic (ROC-AUC) to compare the predictability of an unsatisfactory outcome.

Results

The predictability of unsatisfactory outcomes increased significantly from a ROC-AUC (95% CI) of 0.73 (0.62-0.84) in the preoperative setting to 0.85 (0.77-0.94) on day 2 after surgery.

Conclusion

Most of the patients with unsatisfactory outcomes can be identified during the first days after surgery.

Effects of awareness material featuring individuals with experience of depression and suicidal thoughts on an audience with depressive symptoms: Randomized controlled trial

BACKGROUND AND OBJECTIVE

Suicide prevention plans support individuals with personal experience of mental disorders and suicidality to provide their narratives of coping in the media. The evidence how such portrayals impact on individuals with similar symptoms is limited and there are concerns about unwanted side effects.

METHODS

This was a double-blinded randomized controlled online trial conducted from August to November 2018. N = 158 young adults aged 18-24 with current depressive symptoms and suicidal thoughts were randomized to watch a short film featuring a young individual with personal experience of depression and suicidality (n = 81), or a thematically unrelated control film (n = 77) with similar stylistic elements. Questionnaire data were collected before and immediately after exposure and analysed with ANOVA. The primary outcome was suicidal ideation; secondary outcomes were depressed mood and help-seeking intentions. We also tested the moderating effects of the degree of depressive symptoms on the effects.

RESULTS

Depressed mood was significantly lower, with small-to medium effect size, in the intervention group compared to the control group (F(1,111) = 4.13, P < .05, η_p² = .036). There was no effect on suicidal ideation or help-seeking intentions in the total sample. Participants screening positive for moderately severe depression or higher experienced an increase in suicidal ideation in the control group.

LIMITATIONS

Self-reported variables in an online setting.

CONCLUSIONS

Videos featuring personal experience of coping with depression appear safe for young individuals with similar or higher symptoms of depression and suicidal ideation on the short run, and might have some benefits.

TRIAL REGISTRATION

German Clinical Trial Registry, DRKS00015095 (registration date: 2018-07-16).

Psychophysiological concomitants of burnout: Evidence for different subtypes

BACKGROUND

There is evidence that chronic stress and emotional exhaustion are related to physiological dysregulations, which could negatively impact physical and mental health. This study aimed to identify the specific physiological clusters which are most reliable and prominently associated with burnout. Emphasis was placed on variables of the autonomic nervous system and hypothalamic-pituitary-adrenal axis. Burnout was assessed using the Emotional Exhaustion subscale of the German version of the Maslach Burnout Inventory (MBI-GS).

METHODS

A sample of 105 individuals aged between 28 and 60 years (M = 42.7, SD = 7.75) and working under highly demanding conditions participated in this study. 46 participants reported a low risk of burnout, and 58 participants a high risk. They underwent 24 h of ECG monitoring, had cortisol awakening response collected, and had blood pressure measured two times within a week.

RESULTS

Compromised HRV, higher cortisol values, and higher blood pressure were found in individuals with high burnout symptoms. Furthermore, a discriminant function analysis on cardiac and neuroendocrine variables suggested two subgroups within the high burnout individuals, with only one group showing evidence for autonomic dysfunction as indicated by lower vagal efference.

CONCLUSIONS

Results suggest that burnout might not necessarily imply physiological disturbances, thus calling for a more differentiated and individualized view of burnout.

Anxiety-Related Coping Styles, Social Support, and Internet Use Disorder

Objective: The Internet can offer a seemingly safe haven for those being disappointed by relationships in the "offline world". Although the Internet can provide lonely people with opportunities to seek for help and support online, complete withdrawal from the offline world comes with costs. It is discussed if people can even become "addicted" to the Internet. Of note, meanwhile, many researchers prefer the term Internet use disorder (IUD) instead of using the term "Internet addiction". To illustrate the importance of one's own social network supporting a person in everyday life, we investigated, for the first time to our knowledge, how social resources in terms of quality and quantity might represent a buffer against the development of IUD. Furthermore, anxiety related coping styles are investigated as a further independent variable likely impacting on the development of an IUD. Method: In the present work, N = 567 participants (n = 164 males and n = 403 females; M_age = 23.236; SD_age = 8.334) filled in a personality questionnaire assessing individual differences in cognitive avoidant and vigilant anxiety processing, ergo, traits describing individual differences in everyday coping styles/modes. Moreover, all participants provided information on individual differences in tendencies toward IUD, the perceived quality of social support received, and the size of their social network (hence a quantity measure). Results: Participants with larger social networks and higher scores in the received social support reported the lowest tendencies toward IUD in our data. A vigilant coping style was positively correlated with tendencies toward IUD, whereas no robust associations could be observed between a cognitive avoidant coping style and tendencies toward IUD. Hierarchical linear regression underlined an important predictive role of the interaction term of vigilance in ego-threat scenarios and perceived quality of social support. Conclusion: The current study not only yields support for the hypothesis that the size of one's own social network as well as the perceived quality of social support received in everyday life present putative resilience factors against developing IUD. It also supports the approach that special coping styles are needed to make use of the social support offered.

Recover your smile: Effects of a beauty care intervention on depressive symptoms, quality of life, and self-esteem in patients with early breast cancer

OBJECTIVE

Medical cancer treatment is often accompanied by appearance-related side effects such as hair loss, skin irritation, and paleness, which can subsequently lead to psychosocial distress. Initial evidence suggests that beauty care interventions may reduce distress and improve quality of life (QoL), body image, and self-esteem immediately.

METHODS

We investigated the effects of a brief beauty care intervention on self-reported symptoms of depression, quality of life, body image, and self-esteem in 39 female primary breast cancer patients with appearance-related treatment side effects. Patients were randomly assigned either to an immediate intervention group (IG) or to a wait-list control (WL). The intervention consisted of a single-session group makeup workshop, a photo shooting, and of receiving professionally edited portrait and upper-body photos.

RESULTS

While groups did not differ regarding any measure at the pretreatment baseline assessment, IG patients reported less symptoms of depression, higher QoL, and higher self-esteem compared with baseline and compared with WL. Follow-up at 8 weeks indicated moderate stability of these improvements.

CONCLUSIONS

In contrast to previous research, results indicate beneficial short-term and midterm effects of beauty care on psychological outcomes in patients with early breast cancer. These results emphasize the utility of this type of brief, low-cost intervention in women undergoing medical cancer treatment in order to improve their well-being.

Sexual and Relationship Satisfaction associated with Shifts in Dyadic Trajectories of Depressive Symptoms in German Couples across Four Years

Depression is a pervasive mental health concern; thus, it is important to identify modifiable factors associated with reducing depressive symptoms across time. Using 1,876 heterosexual couples assessed annually across 4 years from the Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam) study, time-varying covariate growth models tested if sexual and relationship satisfaction were linked with shifts in trajectories of depressive symptoms across time. For both men and women, higher sexual and relationship satisfaction scores were significantly associated with decreasing their own depressive symptom trajectories, but only relationship satisfaction was linked with their partners' depressive symptom trajectories. Potential clinical implications include the treatment of depressive symptoms by making changes across time in their own relationship satisfaction and sexual satisfaction.

Life Satisfaction and Hemodynamic Reactivity to Mental Stress

BACKGROUND

Satisfaction with life has been considered a health-protective variable, which could impact cardiovascular morbidity and mortality. However, few studies have examined the physiological pathways involved in the potentially salutary effect of life satisfaction. It was hypothesized that life satisfaction should be associated with a cardiovascular response profile that signals challenge (i.e., higher cardiac output, lower peripheral resistance), rather than threat during a mental stress task.

METHODS

A sample of 75 healthy, medication-free men without clinical signs of psychological disorders who worked full-time and occupied highly demanding positions participated in this study. They performed two mental stress tasks (n-back) with varying degrees of difficulty. The tasks were embedded between a baseline and a recovery period. Cardiovascular and hemodynamic variables (heart rate, blood pressure, cardiac output, total peripheral resistance) were recorded by means of impedance cardiography.

RESULTS

Individuals who were more satisfied with their life displayed higher cardiac output and lower peripheral resistance levels during the stress tasks, indicating a challenge rather than a threat profile. Findings were robust when controlled for physical activity, smoking, age, and depressive symptoms.

CONCLUSIONS

Life satisfaction could be positively correlated with beneficial hemodynamic stress reactivity, indicating that individuals with higher levels of life satisfaction can more adaptively cope with stress. Increased cardiac output and decreased peripheral resistance during stress may constitute one route through which life satisfaction can benefit health.

Tracking the impact of depression in a perspective-taking task

Research has identified impairments in Theory of Mind (ToM) abilities in depressed patients, particularly in relation to tasks involving empathetic responses and belief reasoning. We aimed to build on this research by exploring the relationship between depressed mood and cognitive ToM, specifically visual perspective-taking ability. High and low depressed participants were eye-tracked as they completed a perspective-taking task, in which they followed the instructions of a 'director' to move target objects (e.g. a "teapot with spots on") around a grid, in the presence of a temporarily-ambiguous competitor object (e.g. a "teapot with stars on"). Importantly, some of the objects in the grid were occluded from the director's (but not the participant's) view. Results revealed no group-based difference in participants' ability to use perspective cues to identify the target object. All participants were faster to select the target object when the competitor was only available to the participant, compared to when the competitor was mutually available to the participant and director. Eye-tracking measures supported this pattern, revealing that perspective directed participants' visual search immediately upon hearing the ambiguous object's name (e.g. "teapot"). We discuss how these results fit with previous studies that have shown a negative relationship between depression and ToM.

Personality predictors of anger. The role of FFM traits, shyness, and self-esteem

The present study was designed to verify hypothesized predictor effects for five anger-related variables, i.e. trait anger, anger expression-out, anger expression-in, anger control-out, and anger-control-in. A sample of 138 students completed measures for FFM personality traits (NEO-FFI), self-esteem (SES), shyness (RCBS), and anger (STAXI-2). The study confirmed the effects of neuroticism and agreeableness as being the chief personality predictors of anger; however, for the domain of anger expression-in, an unexpected role of extraversion was revealed. Furthermore, introducing self-esteem and shyness changed some effects of FFM traits. Entering self-esteem as an additional predictor improved the predictability of anger control-in. Additionally, a mediation effect of shyness was revealed for the relation between extraversion and anger expression-in.

The associations of supervisor support and work overload with burnout and depression: a cross-sectional study in two nursing settings

AIMS

To investigate the moderating effects of work overload and supervisor support on the emotional exhaustion-depressive state relationship.

BACKGROUND

Burnout and depression are prevalent in human service professionals and have a detrimental impact on clients. Work overload and supervisor support are two key job demands and job resources, whose role and interplay for the development and maintenance of burnout and depression are not fully understood yet.

DESIGN

Two consecutive cross-sectional surveys: survey 1 investigated 111 hospital nursing professionals and survey 2 examined 202 day care professionals. Data collection was completed in 2010.

RESULTS

After controlling for general well-being and sociodemographic characteristics, nurses' emotional exhaustion was associated with increased depressive state in both samples. We found a meaningful three-way interaction: our results show consistently that the relationship between emotional exhaustion and depressive state was strongest for nurses with high work overload and low supervisor support. Additionally, nurses with low work overload and low supervisor support were also found to have stronger associations between emotional exhaustion and depressive state.

CONCLUSION

The findings indicate that nurses' reported supervisor support exerts its buffering effect on the burnout-depression link differentially and serves as an important resource for nurses dealing with high self-reported work stress.

Neural correlates of reflection on actual versus ideal self-discrepancy

Subjective feelings of actual/ideal self-discrepancy vary across individuals and influence one's own affective states. However, the neural correlates of actual/ideal self-discrepancy and their genetic individual differences remain unknown. We investigated neural correlates of actual/ideal self-discrepancy and their associations with the serotonin transporter promoter polymorphism (5-HTTLPR) that moderates human affective states during self-reflection. We scanned short/short and long/long allele carriers of 5-HTTLPR, using functional MRI, during reflection on the distance between actual and ideal self in personality traits. We found that larger actual/ideal self-discrepancy was associated with activations in the ventral/dorsal striatum and dorsal medial and lateral prefrontal cortices. Moreover, these brain activities were stronger in short/short than long/long allele carriers and predicted self-report of life satisfaction in short/short carriers but trait depression in long/long carriers. Our findings revealed neural substrates of actual/ideal self-discrepancy and their associations with affective states that are sensitive to individuals' genetic makeup.

Assessment of trait and state aspects of depression in schizophrenia

Depression and negative symptoms can be difficult to distinguish in schizophrenia. Assessments for negative symptoms usually account for the longitudinal nature of these symptoms, whereas instruments available to measure depression mainly assess current or recent symptoms. This construct difference may confound comparison of depressive and negative symptoms in schizophrenia because both domains may have trait-like aspects. We developed an instrument to measure both longitudinal "trait" as well as recent "state" symptoms of depression and tested this instrument (Maryland Trait and State Depression [MTSD] scale) in a sample of 98 individuals with schizophrenia or schizoaffective disorder and 115 community participants without psychotic illness. Exploratory factor analysis of the MTSD revealed 2 factors accounting for 73.4% of the variance; these 2 factors corresponded with "trait" and "state" depression inventory items. Neither MTSD-state nor MTSD-trait was correlated with negative symptoms as measured with the Brief Negative Symptom Scale (r = .07 and -.06, respectively) in schizophrenia patients. MTSD state and trait scores were significantly correlated with the Brief Psychiatric Rating Scale depression subscale (r = .58 and .53, respectively) as well as the Profile of Mood States depression subscale (r = .57 and .44). Persons with schizophrenia had significantly greater trait depressive symptoms than controls (P = .031). Individuals with schizoaffective disorder had significantly higher trait depression (P = .001), but not state depression (P = .146), compared with schizophrenia patients. Trait depressive symptoms are prominent in schizophrenia and are distinct from negative symptoms.

Changes in psychosocial work environment and depressive symptoms: a prospective study in junior physicians

BACKGROUND

We examined the impact of changes in the psychosocial work environment on depressive symptoms in a sample of junior physicians, a high risk group for stress and mental disorders.

METHODS

This is a three-wave prospective study in 417 junior physicians during their residency in German hospitals. The psychosocial work environment was measured by the Effort-Reward Imbalance (ERI) Questionnaire at Waves 1 and 2, and the depressive symptoms were assessed with the State-Trait Depression Scales at all three waves. Multivariate linear regression was applied for prospective associations between ERI across Waves 1 and 2, and baseline-adjusted depressive symptoms at Wave 3.

RESULTS

Compared with the ERI scores at Wave 1, at Wave 2, and mean scores between the two waves, the baseline-adjusted ERI change scores between the two waves showed slightly better statistical power, predicting depressive symptoms at Wave 3 (β = 0.78, 95% CI = 0.38-1.18 for increased ERI per SD, β = 0.64, 95% CI = 0.22-1.06 for increased effort per SD, β = -0.65, 95% CI = -1.06 to -0.24 for increased reward per SD, and β = 0.68, 95% CI = 0.27-1.09 for increased overcommitment per SD).

CONCLUSIONS

Negative changes in the psychosocial work environment, specifically increased ERI, are associated with depressive symptoms in German junior physicians. Reducing the non-reciprocity of working life, particularly improving reward at work, may have beneficial effects on prevention of mental health problems in the hospital workplace.

Effects of temperament and character profiles on state and trait depression and anxiety: a prospective study of a Japanese youth population

Objective. To examine the effects of temperament and character profiles on state and trait depression and anxiety in a Japanese youth population. Method. Japanese university students were solicited for participation in a two-wave study, with assessments performed at Time 1 (T1) and Time 2 (T2), separated by a five-month interval. A total of 184 students completed the Japanese version of the temperament and character inventory (TCI) at T1 and the Hospital Anxiety and Depression Scale (HADS) at T1 and T2. We posited two latent variables, trait depression and anxiety, composed of the T1 and T2 HADS depression and anxiety scores, respectively. We also posited that temperament domain traits would predict character domain traits, and that all the personality traits would be linked to trait depression and anxiety and also predict T2 depression and anxiety. Results. Structural regression modeling showed that (1) only high Novelty Seeking predicted T2 Anxiety score, (2) trait depression and anxiety were linked to high harm avoidance and low self-directedness, and (3) trait depression was linked to high self-transcendence whereas trait anxiety was linked to low reward dependence, persistence, and cooperativeness. Conclusion. The characteristic associations between TCI subscales and depression and anxiety were limited to the trait rather than state aspects of depression and anxiety.

Self-esteem fluctuations and cardiac vagal control in everyday life

It has been proposed that self-esteem buffers threat-responding. The same effect is ascribed to the vagus nerve, which is a primary nerve of the parasympathetic nervous system. Consequently, it has been suggested that self-esteem and cardiac vagal tone are interconnected on a trait, as well as on a state, level. In this study, we examined the relationship of vagal cardiac control and self-esteem fluctuations across a single day using ecological momentary assessment. Eighty-four participants were recruited, and self-esteem, negative affect, and vagal tone were recorded throughout a 22-hour period. Men provided higher self-esteem ratings than women, but the negative relationship between self-esteem and negative affect was stronger in women. Moreover, controlling for potential confounds (e.g., age, BMI, depressive symptoms, smoking status, regular physical activity), we observed that for men, self-esteem was significantly positively associated with cardiac vagal tone, whereas for women it was not. These findings suggest that the relationship between self-esteem and vagal innervation of the heart during daily life is sex-specific and might involve different central-autonomic pathways for men and women, respectively.

Depressive symptoms in junior doctors: a follow-up study on work-related determinants

PURPOSE

The study investigates the long-term effects of accumulated working conditions on depressive symptoms in junior doctors. Drawing on the Job Demand-Control-Support model, this study aims to identify personal and job-related determinants for self-reported depression in junior doctors-a professional group that is vulnerable to depression.

METHODS

We conducted a prospective cohort study with measures of work characteristics and depressive symptoms over three time-points among hospital doctors during postgraduate specialty training in Germany. Participants were 415 junior doctors with full-time contract (47.5% women; mean age, 30.5 years). The outcome was depressive symptoms assessed with the Spielberger State-Depression Scale. Odds ratios (OR) were computed to analyse the cumulative effect of initial depressive symptoms scores, demographic variables, and working characteristics across T1 and T2 on subsequent depressive symptoms at T3.

RESULTS

The percentage of junior doctors reporting depressive symptoms scores above a critical value varied between 12.0% at T1, 10.4% at T2, and 13.3% at T3; N = 34 doctors (8.19%) were classified as incident cases during the observation period. Elevated depressive symptoms at T3 were positively predicted by depressive symptoms scores across T1 and T2 (OR: 1.37; 95% confidence interval: 1.25-1.50) and negatively by professional tenure (0.54; 0.31-0.96), free weekends (0.52; 0.28-0.97), and job autonomy (0.35; 0.18-0.65).

CONCLUSIONS

After controlling for demographic and working time influences, findings suggest that junior doctors' perceived job autonomy is negatively associated with future depressive symptoms. Enhancing job control emerges as a promising strategy to lower the risk of depression during first years of professional practice.

Screening depressiver Störungen mittels Allgemeiner Depressions-Skala (ADS-K) und State-Trait Depressions Scales (STDS-T)

Zusammenfassung. Cut-Off-Werte dienen in Screening-Tests einer ökonomischen Identifikation von Erkrankungen bzw. Fällen. In zwei Fall-Kontroll-Studien wurden jeweils Patienten mit depressiven Störungen und klinisch unauffällige Kontrollgruppen untersucht. Zum Screening depressiver Störungen wurde in der ersten Studie (N = 296) die Allgemeine Depressions-Skala in ihrer Kurzversion (ADS-K), in der zweiten (N = 154) die State-Trait Depression Scales in ihrer Traitvariante (STDS-T) eingesetzt. Der Anwendungsbereich der Instrumente wurde zunächst in Rasch-Analysen mittels Item-Person-Map untersucht. Hiernach eignen sich beide Instrumente für Populationen mit leicht überdurchschnittlicher bis hin zu klinisch relevanter Depressivität. Receiver-Operating-Characteristics (ROC)-Kurven zeigten hohe diskriminatorische Fähigkeiten für ADS-K und STDS-T an. Unterschiedliche Cut-Off-Werte wurden hinsichtlich ihrer Sensitivität, Spezifität sowie ihres Youden-Indexes evaluiert. Nach dem Youden-Index lag der optimale Cut-Off-Wert für die Diagnostik einer depressiven Störung bei ADS-K ≥ 18, für die STDS-T bei ≥ 25 Punkten. Die Analyse liefert eine rationale Grundlage für kategoriale diagnostische Entscheidungen.

Psychological distress among American Red Cross disaster workers responding to the terrorist attacks of September 11, 2001

This study investigated American Red Cross disaster workers' symptoms of distress and posttraumatic stress resulting from exposure to disaster stimuli during their response to the September 11, 2001 terrorist attacks. A sample of 3055 Red Cross disaster workers was surveyed 1 year after the terrorist attacks regarding demographic characteristics, function during the response, and exposure to disaster stimuli. Participants were grouped by function and self-reported exposure, with the hypothesis that workers in Direct Services and/or those reporting to be directly exposed to disaster stimuli would experience greater levels of posttraumatic stress symptoms and distress than workers in indirect services or reporting no exposure. Findings revealed that while there were significant differences between both Function and Exposure groups on dependent measures, the multivariate eta2 was very small for both and did not meet medium effect size criteria. The results indicated that workers directly exposed to disaster stimuli reported no more distress than those who were not directly exposed.

Bericht über die deutsche Adaptation der State-Trait Depression Scales (STDS)

Zusammenfassung. Die neu entwickelte deutsche Version der State-Trait Depression Scales (STDS) stellt ein Instrument dar, mit dessen Hilfe in erster Linie depressives Erleben bei gesunden Probandinnen und Probanden der Forschung zugänglich gemacht werden soll. Anhand der Daten von fünf nicht-klinischen Stichproben wurden verschiedene Analysen durchgeführt, um die Güte der Skalen zu prüfen. Die interne Struktur wurde mittels konfirmatorischer Faktorenanalysen untersucht. Daneben wurden die psychometrischen Eigenschaften der Items und Skalen bestimmt. Um die externe Validität der Skalen zu prüfen, wurden die Zusammenhänge zwischen den STDS und anderen Depressionsinstrumenten sowie weiteren State- und Traitskalen analysiert. An einer weiteren Stichprobe durchgeführte Latent-State-Trait-Analysen belegten die den Skalen zugrunde liegende State-Trait-Konzeption. Darüber hinaus wurde in einem Experiment mit kontrollierter Induktion von Erfolg und Mißerfolg die Sensitivität der State-Skala sowie das Zusammenwirken von State- und Trait-Depression untersucht.