Negative thinking mediates the effect of self-esteem on depressive symptoms in college women

Psychosocial adjustment of U.S. college students in the early months of the COVID-19 pandemic

Objective: Examine the psychosocial adjustment of U.S. college and university students during the early months of the COVID-19 pandemic. Participants: Higher education students in the U.S. (N = 228), recruited between March 2020 and May 2020. Methods: Participants completed self-report measures regarding their psychosocial functioning online. Qualitative and quantitative methods were used to explore participants' psychosocial adjustment. Results: Participants reported increased concerns about such stressors as academics, job loss, health, and social isolation. They reported significantly elevated symptoms of depression, anxiety, perceived stress, and somatization, and prior history of psychological counseling was associated with greater levels of distress. Approximately one-third of participants reported inadequate perceived social support, which in turn was linked to psychosocial adjustment. Conclusions: College students reported experiencing a wide range of stressors related to the pandemic. Increasing access to mental health services and providing supportive services in such areas as social connection and employment are encouraged.

Mean Scores of Depression, Anxiety and Stress in Iranian University Students Based on DASS-21: A Systematic Review and Meta-analysis

Background and aims: Depression is the most common psychiatric disorder, and students are more predisposed to depression than other populations. This meta-analysis was conducted to estimate the mean depression score in Iranian students based on DASS-21. Methods: The search was carried out using keywords Depression, Student, DASS-21 and Iran in domestic databases, including SID, Medlib, IranMedex, Irandoc, and Magiran. Data were analyzed using a meta-analysis (random effects model). The heterogeneity of studies was studied using the I2 index. Data were analyzed using the Stata software version 11. DASS-21 had been used in all reviewed studies. Results: The sample size was 3229 people included in 17 studies. The mean depression score in Iranian students based on DASS-21 was 9.30 (95% CI: 12.57-6.03), 8.90 in female students (95% CI: 4.50-13.29) and 8.45 in male students (95% CI: 4.03-12.86). The mean scores of anxiety and stress in students were 8.58 (95% CI: 5.95-12.86) and 9.91 (95% CI: 11.28-8.54), respectively. Conclusion: The mean depression score is higher in female students than in male students, and the mean score of stress is slightly higher than those of anxiety and depression.

The Efficacy of Internal Family Systems Therapy in the Treatment of Depression Among Female College Students: A Pilot Study

College women are vulnerable to depression due to developmental and transitional life changes. Early diagnosis and effective treatment is critically important. Empirical support exists for the effectiveness of select treatment options (i.e., antidepressant medication, cognitive-behavioral therapy [CBT], and interpersonal psychotherapy [IPT]), yet a significant percentage of those treated do not benefit. In this pilot study, Internal Family Systems (IFS) therapy was tested as an alternative approach. College women (N = 37) were randomly allocated to IFS treatment or treatment as usual (CBT or IPT). Results demonstrated a decline in depressive symptoms for both conditions and no significant differences in the magnitude or rate of change. The results provide preliminary evidence for the efficacy of IFS in the treatment of depressive symptoms.

Depressive Symptoms in College Women: Examining the Cumulative Effect of Childhood and Adulthood Domestic Violence

The purpose of this study was to examine the cumulative effect of childhood and adulthood violence on depressive symptoms in a sample of Jordanian college women. Snowball sampling technique was used to recruit the participants. The participants were heterosexual college-aged women between the ages of 18 and 25. The participants were asked about their experiences of childhood violence (including physical violence, sexual violence, psychological violence, and witnessing parental violence), partner violence (including physical partner violence and sexual partner violence), experiences of depressive symptoms, and about other demographic and familial factors as possible predictors for their complaints of depressive symptoms. Multiple linear regression analysis was implemented to identify demographic- and violence-related predictors of their complainants of depressive symptoms. Logistic regression analysis was further performed to identify possible type(s) of violence associated with the increased risk of depressive symptoms. The prevalence of depressive symptoms in this sample was 47.4%. For the violence experience, witnessing parental violence was the most common during childhood, experienced by 40 (41.2%) women, and physical partner violence was the most common in adulthood, experienced by 35 (36.1%) women. Results of logistic regression analysis indicated that experiencing two types of violence (regardless of the time of occurrence) was significant in predicting depressive symptoms (odds ratio [OR] = 3.45, p < .05). Among college women's demographic characteristics, marital status (single vs. engaged), mothers' level of education, income, and smoking were significant in predicting depressive symptoms. Assessment of physical violence and depressive symptoms including the cumulative impact of longer periods of violence on depressive symptoms is recommended to be explored in future studies.

The State of Measurement of Self-Esteem of African American Women

This article critically reviews the state of measurement of self-esteem in African American women. The Rosenberg Self-Esteem Scale, the Tennessee Self-Concept Scale, and the Coopersmith Self-Esteem Inventory are three commonly used measures. However, their validity for African American women has not been adequately tested. Given the unique nature of the self-esteem of this group, related to experiences of racism and sexism, the accurate measurement of this construct is important. This review provided support for the internal consistency of each measure with alpha coefficients ranging from .74 to .87. However, the validity of the measures was not fully supported. Suggestions for further research specific to the unique needs of this population are discussed.

Stressful Life Events and Risk of Depression 25 Years Later: Race and Gender Differences

BACKGROUND

Although stressful life events (SLEs) predict subsequent risk of developing a major depressive episode (MDE), limited information exists on whether or not race and gender alters the predictive role of SLE on risk of MDE over a long-term period. The current study explored race and gender differences in the long-term predictive role of SLE at baseline (1986) on subsequent risk of MDE 25 years later (2011) in a nationally representative cohort in the United States.

METHODS

Using a life course epidemiological approach, this longitudinal study borrowed data from the Americans' Changing Lives (ACL) Study 1986-2011. Main predictor of interest was baseline SLE over the last 3 years measured at 1986. Main outcome was risk of MDE [Composite International Diagnostic Interview (CIDI)] 25 years later (2011). Covariates included demographics, socioeconomics, depressive symptoms [Center for Epidemiological Studies-Depression Scale (CES-D)], chronic medical conditions, and health behaviors measured at baseline (1986). Gender and race were the focal moderators. We employed logistic regressions in the pooled sample, and specific to race and gender, to test whether or not SLE × race and SLE × gender interactions are significant.

RESULTS

In the pooled sample, baseline SLE (1986) predicted risk of MDE 25 years later (2011). We also found a gender by SLE interaction, suggesting a stronger predictive role of SLE for subsequent clinical depression for men compared to women. Race did not modify the predictive role of SLE on subsequent risk of MDE 25 years later.

CONCLUSION

How SLE predicts MDE 25 years later differs for men and women, with a stronger predictive role for men compared to women. More research is needed to better understand the complex links between gender, sex, stress, and depression.

Investigating Factors Associated with Depression of Type 2 Diabetic Retinopathy Patients in China

Aims and objectives

To assess the depression status of type 2 diabetic retinopathy patients in Nantong China and to identify factors associated with depression.

Methods

Two hundred and ninety-four patients with type 2 diabetic retinopathy were recruited from the Affiliated Hospital of Nantong University. The severity of DR was measured in the worse eye. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D); the quality of life was measured with the Medical Outcomes Study Short Form 36 (SF-36). The logistic regression analyses were used to identify the independent factors of depression.

Results

The mean age of the study subjects was 57.77 years (SD: 9.64). Approximately 35.7% of subjects reported depressive symptoms (n = 105).Multiple logistic regression analyses showed that female gender (p = 0.014), low monthly income (p = 0.01), poor vision in the better eye (P = 0.002), laser treatment history (p = 0.01) were significant risk factors for depression. The quality of life of individuals with CES-D score<16 was significantly better compared with individuals with CES-D score≥16.

Conclusion

The reported depressive symptoms among type 2 diabetic retinopathy population is higher in Nantong China. Gender, salary, vision acuity and treatment history were important risk factors linked to this disorder in the Chinese type 2 diabetic retinopathy population from Nantong. More attention by medical care personnel needs to be paid to the psychological health of this population.

Prevalence and correlates of depressive symptoms and resiliency among African American women in a community-based primary health care center

The purpose of this cross-sectional pilot study was to determine the prevalence and correlates of depressive symptoms and resiliency among 290 African American women (AAW) in a community-based primary health care center. Descriptive statistics, Pearson product-moment correlation, and logistic regression analyses were conducted. Findings indicate that depressive symptoms are experienced by 49% of the participants, while 10% indicated a history of suicidal ideation. Participants had moderately high resiliency scores that had a statistically significant inverse relationship with depressive symptoms. This suggests that resiliency is potentially a protective factor for depressive symptoms. Depressive symptoms were positively correlated with participants' diagnosis of at least one chronic disease. The strongest predictors of depressive symptoms were previous diagnoses of a mental health condition and unemployment. This study identifies risk and potential protective factors for depression among a clinic sample of AAW.

Psychosocial and sociocultural correlates of depressive symptoms among diverse African American women

African American women are faced with many challenges regarding their historical, cultural, and social structural position in the United States that may heighten their vulnerability for depression, one of the most prevalent disorders that can engender poor functionality. The purpose of this cross-sectional pilot study was to foster greater understanding about the occurrence and correlates of depressive symptoms among a diverse convenience sample of 63 African American women recruited from a comprehensive primary health care clinic (n = 23), a small private academic institution (n = 25), and an urban community setting (n = 15). Self-report data concerning selected psychological, sociocultural, and biological factors were collected. Descriptive statistics, Pearson product moment correlation, and analysis of variance were used to analyze data. Results indicated several similarities and differences among the 3 groups of women concerning levels of depressive symptoms and their correlates. Among the total sample, symptoms of depression were mild among 65% of the women. Depressive symptoms were significant and positively associated with negative and ruminative thinking (r = 0.79, p < .01), low self-esteem (r = 0.58, p < .01), stressful life events (r = 0.43, p < .05), low social support (r = 0.46, p <.01), depression stigma (r = 0.36, p < 01), and indication of chronic diseases (r = 0.34, p < .01). Depressive symptoms were significant and negatively associated with resiliency (r = -0.48, p < .01) and spiritual well-being (r = -.47, p < .01). This research adds to the empirical data concerning contributors to depressive symptoms for African American women.

Translating research into practice: targeting negative thinking as a modifiable risk factor for depression prevention in the college student population

This article describes the effects of an evidence-based depression prevention intervention on the depressive symptomatology, negative thinking, and self-esteem in college students. A feasibility study was conducted using pre-test post-test design sampling a total of 12 college students. Participants underwent 4-weeks of psychological treatment using Peden's cognitive behavioral group intervention. The Beck Depression Inventory, Crandell Cognitions Inventory, and Rosenberg Self-Esteem Scale were administered at two time points: prior to the intervention (T1) and 4weeks later (T2). Paired t-test analysis found participants had significantly decreased depressive symptoms and negative thinking, and significantly increased self-esteem from T1 to T2.

Executive functions, depressive symptoms, and college adjustment in women

Many students have difficulty adjusting to college, and the contribution of academic and relational factors have been considered in previous research. In particular, depression commonly emerges among college women at this time and could be related to poor adjustment to college. This study examined the relationship between executive functions, depressive symptoms, and college adjustment in college women. Seventy-seven female participants from a midsize urban university completed the Wechsler Abbreviated Scale of Intelligence, College Adjustment Scale, Beck Depression Inventory-Second Edition, Behavior Rating Inventory of Executive Function-Adult Version, and four subtests from the Delis-Kaplan Executive Function System: the Trail-Making Test, Design Fluency Test, Verbal Fluency Test, and Color-Word Interference Test. After controlling for IQ score, hierarchical regression analyses showed that subjective and objective measures of executive functioning and depressive symptoms were significantly related to college adjustment problems in academic, relational, and psychological areas. The current study provides evidence for a relationship between cognitive abilities, psychiatric symptoms, and college adjustment.

Developing a shortened measure of negative thinking for use in patients with heart failure

OBJECTIVE

Negative thinking is a target for treatment of depressive symptoms in patients with heart failure (HF). A brief instrument is needed to measure negative thinking in these patients. The study objective was to shorten the Crandell Cognitions Inventory (CCI) for use in patients with HF.

METHODS

Baseline data from outpatients with HF (N = 179, 30% were female, age 60 ± 13 years) were used to evaluate psychometrics of the CCI. Internal consistency reliability was measured with Cronbach's alpha construct validity with hypothesis testing. Principal components analysis was used in shortening. A separate sample of hospitalized patients with HF (N = 77, 49% were female, age 66 ± 11 years) was used to validate the shortened CCI (CCI-SF).

RESULTS

The CCI showed evidence of reliability and validity, but there was item redundancy in outpatients with HF. The 12-item CCI-SF showed good evidence of reliability and validity in inpatients with HF.

CONCLUSION

The results support the reliability and validity of the CCI-SF to measure negative thinking in hospitalized patients with HF.

Measurement of negative thinking in patients with heart failure: a critical review and analysis

BACKGROUND

Depression is a significant clinical problem among patients with heart failure (HF). Cognitive therapy is a potential treatment for symptoms of depression in patients with HF. Cognitive therapy focuses on the reduction of negative thinking, a modifiable risk factor for depressive symptoms; however, researchers have not identified the best instrument for measuring negative thinking in patients with HF.

OBJECTIVE

The purpose of this paper is to review the state of the science in the measurement of negative thinking in order to provide direction for the measurement of negative thinking in patients with HF.

FINDINGS

Three of the most widely used instruments for negative thinking were selected for review. The Crandell Cognitions Inventory, Automatic Thoughts Questionnaire, and Cognitive Checklist- Depression all have strong evidence for validity and reliability. The Crandell Cognitions Inventory (CCI) has the best potential for measuring negative thinking in patients with HF. The CCI has the advantages of being developed with a clinical population and captures a wide range of negative thinking content. However, the CCI is lengthy (45 items) and needs to undergo rigorous psychometric testing among patients with HF before it can be recommended for use.

CONCLUSIONS

Future studies are needed to develop a shortened version of the CCI for use in clinical research and to test the CCI's reliability and validity for measuring negative thinking in patients with HF.

Determinants of depressive symptoms in Jordanian working women

Depressive symptoms are an epidemic problem affecting different subgroups of women in clinical and non-clinical settings. However, depressive symptoms experienced by working women have rarely been studied. This study aimed at identifying depressive symptoms and their determinants in a sample of 101 Jordanian working women recruited from a higher educational institution. Data about women's depressive symptoms, their educational level, presence of children, sharing a job with an intimate partner, health status, diagnosis with chronic illnesses, and complaints of spousal abuse were collected. Logistic regression analysis was used to test for the significance of the selected factors on women's experiences of depressive symptoms. Findings indicated that 51.2% (n = 42) women complained of moderate and severe levels of depressive symptoms. Factors identified as significant in predicting depressive symptoms were women's experiences of spousal abuse (odds ratio adjusted = 3.5, 95% confidence interval = 1.05-11.7) and being diagnosed with chronic illnesses (odds ratio adjusted = 7.09, 95% confidence interval = 1.2-42.2). It was concluded that causes of women's depressive symptoms were imbedded in their familial and social environment, rather than their job per se. Mental health nurses can change the practice of nursing to better standards. Being familiarized with causes of depressive symptoms can empower nurses to be active advocates for depressed women.

Screening depressive symptoms in Jordanian women: evaluation of the Center for Epidemiologic Studies-Depression scale (CES-D)

This study examined the psychometric qualities of the Center for Epidemiologic Studies-Depression scale (CES-D) in Jordanian women. Cronbach's alpha for the 20-item CES-D was .90. Factor analysis yielded three components. Four of the items had poor factor loadings and, therefore, were dropped. Cronbach's alpha for the remaining 16 items was .85. Validity testing using independent samples t-test provided evidence of discriminant validity for the 20-item and the 16-item CES-D. Attributes of the CES-D items indicated that depression status can be easily identified by clinicians. Co morbidity of depressive symptoms with physical and mental problems necessitates routine screening for depressed mood.

Depression and health-promoting lifestyles of persons with mental illnesses

This descriptive study examined relationships between depression, health-promoting lifestyles, and physical illnesses in a sample of persons living in the community who self-reported being diagnosed with mental illnesses. Variables of age, gender, and participation in psychiatric rehabilitation services were investigated to determine significant relationships to depression and lifestyles. Fifty adults completed a demographic survey, the CES-Depression scale, and the Health-Promoting Lifestyle Profile II. The findings emphasize the importance of psychiatric nurses assessing health-promoting lifestyles comprehensively in persons with serious mental illnesses and facilitating changes to improve both physical and mental health.

Psychometric properties of a Persian-language version of the Automatic Thoughts Questionnaire: ATQ-Persian

AIMS

To examine the psychometric properties of a Persian-language version of Hollon and Kendall's (1980) Automatic Thoughts Questionnaire (ATQ-Persian)--a measure of negative automatic thoughts in depression.

METHODS

In a sample of 125 student volunteers from two Iranian universities we assessed the internal consistency and test-retest reliability of ATQ-Persian, and examined its concurrent validity against the Beck Depression Inventory (Beck et al., 1996). We also examined the factor structure of the test through comparing the fit of various proposed factor-analytic models to the data using confirmatory factor analysis.

RESULTS

ATQ-Persian had excellent internal consistency (Cronbach's alpha = 0.96), test-retest reliability (r = 0.84) and correlation with the Beck Depression Inventory (r = 0.77). Using a receiver operating characteristics curve, a score of 53 on ATQ-Persian was associated with a sensitivity of 89% and a specificity of 78% for detecting moderate to severe depression defined through Beck Depression Inventory. None of the proposed factorial models fitted the data well. However, models with correlated factors generally provided better fit than models with orthogonal factors, suggesting that the latent factors underlying ATQ-Persian are highly correlated.

CONCLUSIONS

These data support the reliability and validity of ATQ-Persian as a measure of negative automatic thoughts in depression.

Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN

The Beck Depression Inventory (BDI) is perhaps the most commonly used screening instrument for depression in the general population. We examined the psychometric properties of a Persian-language version of the second edition of this instrument (BDI-II) [Beck et al., 1996] in an Iranian college-student sample. In a sample of 125 student volunteers from two Iranian universities, we compared mean item scores on the BDI-II-Persian with those on the English-language version administered to North American college students, and assessed internal consistency and test-retest reliability of the BDI-II-Persian and its concurrent validity against a measure of negative automatic thoughts in depression, the Automatic Thoughts Questionnaire [Hollon and Kendall, 1980]. We also examined the factor structure of the BDI-II-Persian through comparing the fit of various proposed models to the data using confirmatory factor analysis. The BDI-II-Persian had high internal consistency (Cronbach's alpha=0.87) and acceptable test-retest reliability (r=0.74). The instrument correlated strongly with the Automatic Thoughts Questionnaire. In factor analysis, models with strongly correlated affective-cognitive and somatic-vegetative factors provided a better fit than models with one global factor. These data support the reliability and concurrent validity of the BDI-II-Persian as a measure of depressive symptoms in nonclinical samples.

Testing an intervention to reduce negative thinking, depressive symptoms, and chronic stressors in low-income single mothers

PURPOSE

To test the effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, negative thinking, and chronic stressors in low-income, single mothers at risk for depression.

DESIGN AND METHODS

A randomized, controlled prevention trial was conducted with 136 low-income, single mothers with children between the ages of 2 and 6 years. Each participant was screened before enrollment and was determined to be at risk for depression. Participants were randomly assigned to either the control or experimental group. The experimental group was invited to participate in a 4- to 6-week cognitive-behavioral group intervention. Data on depressive symptoms, negative thinking, and chronic stressors were collected via self-report questionnaires from control and experimental groups at baseline, 1 month, and 6 months after the intervention to assess the effects of the intervention.

FINDINGS

Compared with those in the control group, women who received the intervention had a greater decrease in depressive symptoms, negative thinking, and chronic stressors; these beneficial effects were maintained over a 6-month period.

CONCLUSIONS

The findings indicate the effectiveness of this cognitive-behavioral group intervention and show the beneficial effects of reducing negative thinking via the use of affirmations and thought-stopping techniques.

Depressive Symptoms in Adolescents Living in Rural America

PURPOSE

The purposes of this pilot study were to examine prevalence of depressive symptoms among rural adolescents and identify related social and environmental variables.

METHODS

A convenience sample of 299 14- to 18-year-old agriculture class students at 5 rural high schools in Kentucky and Iowa completed a survey that included demographic information, family farm history, experience with suicide, perception of school environment, and indicators of farm injuries and risky behaviors. Participants also completed the Center for Epidemiologic Studies Depression Scale (CES-D) as well as scales to assess the number of major life events in the last year, active coping use, and family closeness.

FINDINGS

The prevalence of a high level of depressive symptoms (CES-D > or = 16) in this sample was 34%. Nine percent had seriously considered suicide in the last year. Unlike previous reports, boys reported as many depressive symptoms as girls. Although the literature reports that engaging in risky behavior is associated with depressive symptoms, the only risky behavior linked with depressive symptoms in this sample was operating a 4-wheel all-terrain vehicle. Other predictors of depressive symptoms included poor family relationships and poor active coping.

CONCLUSIONS

Interventions to identify and prevent depressive symptoms in rural adolescents are needed. Boosting active coping and improving family function may also prevent the development of clinical depression in rural adolescents.

Negative thinking and the mental health of low-income single mothers

PURPOSE

To test a conceptual model of predictors of depressive symptoms in low-income single mothers with children from 2 to 6 years of age.

DESIGN

Data were collected from September 2000 to October 2002 as part of the baseline data collection for a larger study in the eastern part of the United States. A volunteer sample of 205 women who were at risk for depression was recruited.

METHODS

Each woman completed a survey that included the Center for Epidemiologic Studies-Depression Scale, the Beck Depression Inventory, the Rosenberg Self-Esteem Scale, the Crandall Cognitions Inventory, and the Everyday Stressors Index.

FINDINGS

More than 75% of the participants scored at least in the mild depressive range on the Beck Depression Inventory or in the high depressive range on the CES-D. Negative thinking mediated the relationship between self-esteem and depressive symptoms and partially mediated the relationship between chronic stressors and depressive symptoms.

CONCLUSIONS

These findings are consistent with earlier research by this team. Negative thinking is an important factor in the development of depressive symptoms in at-risk women. As a symptom, negative thinking might be more amenable to nursing intervention than to interventions focused on reducing chronic stress.

Parental bonding: a key factor for mental health of college women

The purpose of this study was to investigate the relationship of parental bonding to the mental health of college women aged 18 to 24 years. A cross-sectional study of a volunteer sample of 246 college women was conducted. Data on depressive symptoms, negative thinking, self-esteem, and parental bonding were collected via self-report. Maternal care was the strongest predictor of all four mental health indices. Paternal overprotection predicted scores of three of the four mental health measures. Women with optimal maternal and paternal bonding profiles (high care/low overprotection) had fewer depressive symptoms, less negative thinking, and higher self-esteem than women with other bonding profiles. The findings have implications for prevention, screening, and intervention to enhance the mental health of college women.

Psychometric characteristics of the Depressive Cognition Scale in African American women

Depression in African-American women frequently goes unnoticed and untreated since commonly used depression scales fail to focus on early symptom recognition, do not address contextual factors, and lack adequate psychometric testing in African-American women. This analysis of the Depressive Cognition Scale was conducted with 213 African-American female caregivers and noncaregivers. Alpha coefficients for both groups (alpha 's = .75 and .87) showed internal consistency. Correlations with resourcefulness, depression, and daily hassles scales in the expected directions demonstrated construct validity (R's = -.36, .26, and .31, respectively). Factor structures for caregivers and noncaregivers differed, suggesting certain depressive cognitions were strongly integrated into the caregiver role. As a reliable and valid measure of depressive cognitions, the DCS would be useful for early detection of depression in African-American women.

Preventing depression in high-risk college women: a report of an 18-month follow-up

The authors tested the long-term effectiveness of a cognitive-behavioral group intervention in reducing depressive symptoms, decreasing negative thinking, and enhancing self-esteem in 92 college women aged 18 to 24 years who ere at risk for clinical depression. The women were randomly assigned to either an experimental or a no-treatment control group. The experimental group participated in a 6-week cognitive-behavioral intervention that targeted identification and reduction of negative thinking, using such techniques as thought stopping and affirmations. Data on depressive symptoms, self-esteem, and negative thinking were collected before the intervention and at intervals of 1, 6, and 18 months postintervention. The women in the intervention group experienced a greater decrease in depressive symptoms and negative thinking and a greater increase in self-esteem than those in the control group. The beneficial effects continued over an 18-month follow-up period. These findings support the importance of thought stopping and affirmations as prevention interventions with at-risk college women.