Individuals with Major Depressive Disorder Report High Scores of Insecure-Avoidant and Insecure-Anxious Attachment Styles, Dissociative Identity Symptoms, and Adult Traumatic Events

DMN network and neurocognitive changes associated with dissociative symptoms in major depressive disorder: a research protocol

Introduction

Depression is a heterogeneous disorder with diverse clinical presentations and etiological underpinnings, necessitating the identification of distinct subtypes to enhance targeted interventions. Dissociative symptoms, commonly observed in major depressive disorder (MDD) and linked to early life trauma, may represent a unique clinical dimension associated with specific neurocognitive deficits. Although emerging research has begun to explore the role of dissociation in depression, most studies have provided only descriptive analyses, leaving the mechanistic interplay between these phenomena underexplored. The primary objective of this study is to determine whether MDD patients with prominent dissociative symptoms differ from those without such symptoms in clinical presentation, neurocognitive performance, and markers of functional connectivity. This investigation will be the first to integrate comprehensive clinical evaluations, advanced neurocognitive testing, and high-resolution brain imaging to delineate the contribution of dissociative symptoms in MDD.

Methods

We will recruit fifty participants for each of three groups: (1) depressive patients with dissociative symptoms, (2) depressive patients without dissociative symptoms, and (3) healthy controls. Diagnostic assessments will be performed using the Structured Clinical Interview for DSM-5 (SCID) alongside standardized scales for depression severity, dissociation, and childhood trauma. Neurocognitive performance will be evaluated through a battery of tests assessing memory, attention, executive function, and processing speed. Structural and functional magnetic resonance imaging (MRI) will be conducted on a 3 Tesla scanner, focusing on the connectivity of the Default Mode Network with key regions such as the orbitofrontal cortex, insula, and posterior cingulate cortex. Data analyses will employ SPM-12 and Matlab-based CONN and PRONTO tools, with multiclass Gaussian process classification applied to differentiate the three groups based on clinical, cognitive, and imaging data.

Discussion

The results of this study will introduce a novel perspective on understanding the connection between major depressive disorder and dissociation. It could also aid in pinpointing a distinct form of depression associated with dissociative symptoms and early childhood stressors.

Conclusion

Future research, aiming to forecast the response to biological and psychological interventions for depression, anticipates this subtype and provides insights.

Comparison of Insomnia, Depression, and Perceived Social Support among Individuals with Amphetamine Use Disorder (AUD) and Healthy Controls

Background

Compared to the general population, individuals with substance use disorders (SUD) report more frequently to suffer from sleep disturbances and symptoms of depression, and to perceive lower social support. Here, we investigated whether this pattern of mental health issues could be confirmed and replicated among individuals with amphetamine use disorder (AUD). We also assessed the degree of perceived social support from their families, friends and significant others, always compared to healthy controls (HC) of the general population.

Method

Individuals with AUD attending the Outpatient Department for Substance Abuse of the Kermanshah University of Medical Sciences (Kermanshah, Iran) (n = 468; 30.8% females; mean age: 29.16 years) and healthy controls (HC; n = 376; 34.6% females; mean age: 24.11 years) participated in the study. Participants completed a series of self-rating questionnaires covering sociodemographic information, symptoms of insomnia and depression, and perceived social support from their families, friends and significant others.

Results

Compared to HC, individuals with AUD reported higher scores for insomnia and depression, and lower scores for perceived social support (families; friends; significant others). Older age and higher severity scores for depression and insomnia were the predictors in the binary logistic regression model to identify individuals with AUD and HC with a precision of 97.4%.

Conclusions

Individuals with AUD additionally suffer from insomnia and depression, along with lower perceived social support. Given that standardized intervention programs for insomnia, depression and social competencies exist, such interventions might mitigate mental health issues among individuals with AUD and improve their psychosocial behavior.

Exploring the psychometric properties of the Persian Depression Anxiety Stress Scale for Youth (DASS-Y): factor structure and reliability in Iranian children and adolescents

Background

The Depression Anxiety Stress Scale for Youth (DASS-Y) is a self-report instrument recently developed to evaluate negative emotional states in children and adolescents. However, the Persian version's factor structure and psychometric properties have yet to be investigated in Iranian youth. The study aimed to assess the factor structure and reliability of the Persian DASS-Y in a sample of Iranian children and adolescents.

Methods

The study recruited 1,277 children and adolescents, 703 (55.1%) being girls and 574 (44.9%) being boys (aged 7-18 years), from schools in Tehran, Iran. Confirmatory factor analysis (CFA) was conducted to evaluate structural validity and test the fit of three-factor models. Internal consistency reliability was examined using Cronbach's alpha and McDonald's omega coefficients for the DASS-Y total and subscale items. Convergent and discriminant validity were also assessed.

Results

The CFA results supported the original 3-factor structure of the DASS-Y, consisting of Depression, Anxiety, and Stress subscales in both groups of Iranian children and adolescents. Subsequently, the Pearson correlation coefficient assessed the scale's convergent and discriminant validity, which was relatively appropriate. Also, the DASS-Y's internal consistency reliability was satisfactory.

Conclusion

The Persian DASS-Y is a reliable and valid Instrument for measuring depression, anxiety, and stress in Iranian children and adolescents. It can be helpful for both research and clinical work, helping to assess psychological distress in children and adolescents.

Evaluation of Early Maladaptive Schemas and Adult Attachment Profiles in Patients Diagnosed with Major Depressive Disorder and Examination of Their Relationship with Disease Variables

Background/Objectives: The study aimed to compare the early maladaptive schemas and adult attachment profiles of patients diagnosed with major depressive disorder with those of healthy controls. Another objective of our study was to investigate the potential relationships between disease-related variables-such as the type of depression, number of depressive episodes, history of hospitalization, and suicidal ideation or attempts-and schema and attachment characteristics in the group of patients with major depressive disorder. Methods: The study included 118 patients who presented to the Psychiatry outpatient clinic at Mersin University Faculty of Medicine Hospital between 1 April 2021 and 1 September 2021 and were diagnosed with major depressive disorder according to DSM-5 diagnostic criteria based on mental state examinations conducted by researchers, as well as 92 healthy volunteers with no history of mental disorders. A sociodemographic data form prepared by the researchers was used to inquire about characteristics such as gender, age, and educational status. Additionally, a clinical data form was designed and implemented by the researchers to gather information regarding DSM-5 specifiers and the patients' clinical histories. The Young Schema Questionnaire Short Form-3 was used to evaluate early maladaptive schemas, while adult attachment profiles were assessed using the Experiences in Close Relationships Inventory II. The severity of depression in the patient group was measured with the Beck Depression Inventory. Statistical analysis of the data was conducted using SPSS 21, with a p-value less than 0.05 considered statistically significant. Results: The study included 118 patients, 84 (71.2%) of whom were women and 34 (28.8%) men, along with 92 healthy volunteers, 60 (65.2%) of whom were women and 32 (34.8%) men. The mean age was 41.9 (±13.2) in the patient group and 40.8 (±11.9) in the control group (p > 0.05). The patient group had higher scores than the control group across all schema subtypes and attachment dimensions. Significant differences in certain schemas were observed between patients with chronic depression and those with recurrent depressive episodes, as well as between patients with a single hospitalization history and those with multiple hospitalizations, and between patients with a history of suicide attempts and those without any suicidal ideation or attempts. Positive significant correlations were found between the attachment and schema scores and the severity of depression in both patients and controls. Conclusions: Further research is needed to determine the role of schemas and attachment styles in the development of depression in more detail and to focus on schema and attachment-based therapies in treatment.

Eye movements and ERP biomarkers for face processing problems in avoidant attachment-style individuals

Background

Avoidant attachment poses a serious risk to intimate relationships and offspring. However, there are few studies on the face-processing characteristics and impairments of avoidant individuals based on basic emotion theory. Therefore, this study investigated the issues of emotional processing and deactivation strategies in individuals with avoidant attachment.

Methods

Avoidant and secure individuals were recruited to participate in an eye-tracking experiment and a two-choice oddball task in which they had to distinguish facial expressions of basic emotions (sadness, anger, fear, disgust, and neutral). Eye fixation durations to various parts of the face, including the eyes, nose, and mouth, were measured, and three event-related potentials (ERP) components (P100, N170, and P300) were monitored.

Results

Avoidant individuals could not process facial expressions as easily as secure individuals. Avoidant individuals focused less on the eyes of angry faces when compared to secure individuals. They also exhibited a more positive P100 component and a less negative N170 component when processing faces and a larger amplitude of the P300 component than secure individuals when processing emotional expressions.

Conclusion

Avoidant individuals use deactivating strategies and exhibit specific characteristics at different stages, which are of great significance in social interaction.

Post-Traumatic Stress Disorder, Major Depressive Disorder, and Wildfires: A Fifth-Year Postdisaster Evaluation among Residents of Fort McMurray

Background: Over 90,000 residents had to be evacuated from Fort McMurray (FMM), Alberta, Canada due to the wildfire that engulfed the city in May 2016. Overall, about 2400 homes or 10% of the housing stock in Fort McMurray were destroyed. The fire consumed about 200,000 hectors of forest, reaching into Saskatchewan. During major disasters, communities’ infrastructure is disrupted, and psychological, economic, and environmental effects are felt for years afterwards. Objective: Five years after the wildfire disaster, this study assessed the prevalence rate of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in Fort McMurray residents and determined the demographic, clinical, and other risk factors of probable MDD and PTSD. Methodology: A quantitative cross-sectional survey was conducted to collect data through an online questionnaire administered via REDCap between 24 April and 2 June 2021. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of MDD symptoms in respondents. The PTSD Checklist for DSM-5 (PCL-C) was used to assess likely PTSD in respondents. Descriptive, univariate, and multivariate regression analyses were employed. Results: 186 out of 249 individuals who accessed the survey link completed it (74.7% response rate). The median age of the subscribers was 42. The sample included a majority of 159 (85.5%) females; 98 (52.7%) > 40 years of age; 175 (94.1%) employed; and 132 (71%) in a relationship. The overall prevalence of MDD symptoms in our study sample was 45.0% (76). Four variables independently predicted MDD symptoms in the multivariate logistic regression model, including: unemployed (OR = 12.39; 95% CI: 1.21−126.37), have received a mental diagnosis of MDD (OR = 4.50; 95% CI: 1.57−12.92), taking sedative-hypnotics (OR = 5.27; 95% CI: 1.01−27.39), and willingness to receive mental health counseling (OR = 4.90; 95% CI: 1.95−12.31). The prevalence of likely PTSD among our respondents was 39.6% (65). Three independent variables: received a mental health depression diagnosis from a health professional (OR = 4.49; 95% CI: 1.40−14.44), would like to receive mental health counseling (OR = 4.36, 95% CI: 1.54−12.34), and have only limited or no support from family (OR = 11.01, 95% CI: 1.92−63.20) contributed significantly to the model for predicting likely PTSD among respondents while controlling the other factors in the regression model. Conclusions: According to this study, unemployment, taking sleeping pills, having a prior depression diagnosis, and the willingness to receive mental health counseling significantly increase the odds of having MDD and PTSD following wildfires. Family support may protect against the development of these conditions.

Alexithymia and Insecure Attachment among Male Intimate Partner Violence Aggressors in the Dominican Republic

The complexity of intimate partner violence and the impossibility of understanding it from single factors have been studied from different biological, psychological, and socio-cultural factors. A cross-sectional study was conducted on 187 men involved in legal proceedings for problems of violence in their intimate partner relationships in the Dominican Republic in order to explore whether insecure attachment represents a risk factor for alexithymia in men with violent behaviors. The attachment style was determinate by the Casullo and Fernández-Liporace Attachment Styles Scale, and alexithymia was assayed using the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20), a modification of the Toronto Alexithymia Scale (TAS-20). Chi-square test and multiple binary logistic regression analysis were performed to explore the phenomena of alexithymia and attachment styles in the context of a confinement center for male intimate partner offenders in the Dominican Republic. The results showed that insecure attachment represents a risk factor for alexithymia, being highest for avoidant attachment in the population studied. The results also highlight the influence of other factors such as education and maternal–familial relationships as a factor risk for alexithymia.