The Impact of Decreased Environmental Reward in Predicting Depression Severity: Support for Behavioral Theories of Depression

Abstract Introduction Military personnel are at an increased risk for suicide compared to the general population, making it important to develop a deeper understanding of which factors contribute to this elevated risk. Given that suicidal ideation (SI) is one of the strongest predictors of suicide attempts, understanding factors that underlie SI may improve prevention efforts. Insomnia and depression both serve as independent risk factors for SI, and therefore the aim of this study was to examine the extent to which depressive symptoms moderate the association between insomnia and SI. Methods Data were obtained from the All Army Study of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS). Soldiers (n=21,450) completed questions related to suicidal ideation (5 items), depressive symptoms (9 items), and insomnia (5 items) based on symptom presence in the past 30 days. Items in each domain were summed to create a total severity score. GEE models using a negative binomial linking function were conducted to examine the impact of depression, insomnia, and their interaction on SI. Results Both depression (χ2 =117.56, p<0.001) and insomnia (χ2=11.79, p=0.0006) were found to have significant main effects on SI, and there was a significant interaction effect (χ2=4.52, p=0.0335). Follow up simple effects revealed that insomnia was no longer significantly associated with SI when depression severity was low, but was associated with SI in the presence of greater depression severity (χ2=2.91, p=0.0882). Conclusion In a large sample of Army soldiers, depression significantly moderated the association between SI and insomnia, such that insomnia seems to amplify the effects of depression on SI. These findings highlight the importance of addressing insomnia severity as a mean of reducing SI in those with depression, potentially allowing for intervention prior to a suicide attempt. Support (if any) Perlis: K24AG055602 & R01AG041783. This publication is based on public use data from Army STARRS (Inter-university Consortium for Political and Social Research, University of Michigan- http://doi.org/10.3886/ICPSR35197-v1), funded by U.S. NIMH-U01MH087981.

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Time is of essence - Abnormal time perspectives mediate the impact of childhood trauma on depression severity

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2020.10.039 ◽

2020 ◽

Author(s):

Yingying Wang ◽

Xiwen Hu ◽

Jinfang Han ◽

Andrea Scalabrini ◽

Yuting Hu ◽

...

Keyword(s):

Childhood Trauma ◽

Depression Severity ◽

Time Perspectives ◽

The Impact

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Depressive symptoms and web user experience

PeerJ ◽

10.7717/peerj.4439 ◽

2018 ◽

Vol 6 ◽

pp. e4439 ◽

Cited By ~ 9

Author(s):

Meinald T. Thielsch ◽

Carolin Thielsch

Keyword(s):

Depressive Symptoms ◽

Mental Disorders ◽

User Experience ◽

Structural Equation ◽

Drop Out ◽

Equation Modeling ◽

Subjective Perception ◽

Depression Severity ◽

Symptoms Of Depression ◽

The Impact

Background Depression, as one of the most prevalent mental disorders, is expected to become a leading cause of disability. While evidence-based treatments are not always easily accessible, Internet-based information and self-help appears as a promising approach to improve the strained supply situation by avoiding barriers of traditional offline treatment. User experience in the domain of mental problems therefore emerges as an important research topic. The aim of our study is to investigate the impact of depressive symptoms on subjective and objective measures of web user experience. Method In this two-part online study (Ntotal = 721) we investigate the relationship between depressive symptoms of web users and basic website characteristics (i.e., content, subjective and objective usability, aesthetics). Participants completed search and memory tasks on different fully-functional websites. In addition, they were asked to evaluate the given websites with standardized measures and were screened for symptoms of depression using the PHQ-9. We used structural equation modeling (SEM) to determine whether depression severity affects users’ perception of and performance in using information websites. Results We found significant associations between depressive symptoms and subjective user experience, specifically of website content, usability, and aesthetics, as well as an effect of content perception on the overall appraisal of a website in terms of the intention to visit it again. Small yet significant negative effects of depression severity on all named subjective website evaluations were revealed, leading to an indirect negative effect on the intention to revisit a website via impaired content perceptions. However, objective task performance was not influenced by depressiveness of users. Discussion Depression emerges as capable of altering the subjective perception of a website to some extend with respect to the main features content, usability, and aesthetics. The user experience of a website is crucial, especially as it facilitates revisiting a website and thus might be relevant in avoiding drop-out in online interventions. Thus, the biased impression of persons affected by symptoms of depression and resulting needs of those users should be considered when designing and evaluating E-(Mental)-Health-platforms. The high prevalence of some mental disorders such as depression in the general population stresses the need for further investigations of the found effects.

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Assessment of family function impact on depression severity among infertile women attending a teaching hospital in South-South Nigeria

Future Science OA ◽

10.2144/fsoa-2020-0033 ◽

2020 ◽

Vol 6 (8) ◽

pp. FSO595

Author(s):

Alex A Adelosoye ◽

Olumuyiwa J Fasipe ◽

Elihu I Medunoye ◽

Onyekachukwu C Adelosoye ◽

Elisha O Sunday

Keyword(s):

Teaching Hospital ◽

Significant Relationship ◽

Severe Depression ◽

Family Dysfunction ◽

University Teaching ◽

Depression Severity ◽

Family Function ◽

Severity Of Depression ◽

Husband Support ◽

The Impact

Aim: Family function and husband support can impact depression severity in women with infertility disorder. The aim of this study was to assess the impact of family function and husband support on depression severity among women with infertility disorder at the fertility clinics of a University Teaching Hospital, South-South, Nigeria. Methodology: A cross-sectional descriptive study was carried out among 341 female respondents attending the University of Benin Teaching Hospital fertility clinics over a 3-month period, using a semistructured interviewer administered questionnaire. Data obtained were analyzed. Result: Respondents mean age was 36 ± 5.3 years. The overall prevalence for depression in this study was 42.5% with a breakdown of 64.2%, 30.4% and 5.4% of these depressed participants having mild, moderate and severe depression, respectively. Family dysfunction had a statistically significant relationship with severity of depression in women with infertility (p < 0.001). A statistically significant relationship was established between poor husband support and the severity of depression (p < 0.001). Conclusion: Depression is highly prevalent among women with infertility disorder, severe depression was associated with family dysfunction. Good family function would reduce the severity of depression.

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Gender Differences in Depression: Assessing Mediational Effects of Overt Behaviors and Environmental Reward through Daily Diary Monitoring

Depression Research and Treatment ◽

10.1155/2012/865679 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 13

Author(s):

Marlena M. Ryba ◽

Derek R. Hopko

Keyword(s):

Gender Differences ◽

Undergraduate Students ◽

Behavioral Activation ◽

Depression Severity ◽

Behavioral Models ◽

Sedentary Behaviors ◽

Daily Diaries ◽

Reinforcement Sensitivity ◽

Environmental Reward ◽

Behavioral Domains

Gender differences in the prevalence of depression are well documented. To further explore the relation between gender and depression, this study used daily diaries to examine gender differences within thirteen behavioral domains and whether differential frequency of overt behaviors and environmental reward mediated the relationship between gender and depression severity. The sample included 82 undergraduate students [66% females; 84% Caucasian; Mean age = 20.2 years]. Overall, females engaged in a significantly greater breadth of behavioral domains and reported a higher level of environmental reward. Females spent more time in the domains of health/hygiene, spiritual activities, and eating with others. Males spent more time in the domains of physical activity, sexual activity, and hobbies and recreational experiences. Females found social activities, passive/sedentary behaviors, eating with others, and engagement in “other” activities more rewarding. Gender had a significant direct effect on depression severity, with females reporting increased depression. This effect was attenuated by the mediator (total environmental reward) such that to the extent females exhibited increased environmental reward, the gender effect on depression was attenuated. These data support behavioral models of depression, indicate increased reinforcement sensitivity among females, and have clinical relevance in the context of assessment and behavioral activation interventions for depression.

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A longitudinal exploration of the impact of social anxiety and individual attachment on depression severity

Journal of Affective Disorders ◽

10.1016/j.jad.2019.07.051 ◽

2019 ◽

Vol 257 ◽

pp. 250-256

Author(s):

G. Camelia Adams ◽

Andrew J Wrath ◽

Thuy Le ◽

Mariam Alaverdashvili

Keyword(s):

Social Anxiety ◽

Depression Severity ◽

The Impact

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Threat-Modulation of Executive Functions—A Novel Biomarker of Depression?

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.670974 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jari Peräkylä ◽

Kaija Järventausta ◽

Piia Haapaniemi ◽

Joan A. Camprodon ◽

Kaisa M. Hartikainen

Keyword(s):

Working Memory ◽

Emotion Regulation ◽

Executive Function ◽

Executive Functions ◽

Cognitive Performance ◽

Performance Measures ◽

Cognitive Outcome ◽

Objective Measures ◽

Depression Severity ◽

The Impact

Background: Alterations in executive functions, emotion regulation, and their interaction are common concomitants of depression. Executive dysfunction frequently lingers after treatment, has adverse effects on daily life, and predisposes to recurrence of depression. Yet, sensitive measures of executive function for reliable assessment of cognitive outcomes are still lacking in clinical practice. To better understand the impact of depression and its most effective treatment, electroconvulsive therapy (ECT), on cognition, we assessed executive functions pre- and post-ECT and whether objective measures reflecting alterations in emotion–executive function interaction correlate with depression severity or with cognitive outcome.Methods: Executive functions were assessed in 21 patients with major depressive disorder (MDD) before and after ECT using subjective measures from the Behavior Rating Inventory of Executive Function—Adult version (BRIEF-A) and objective cognitive performance measures derived from computer-based test of executive function, Executive Reaction Time (RT) Test. In addition, we created novel indices reflecting emotional modulation of cognitive performance by subtracting different performance measures in the context of neutral distractors from those in the context of threat-related distractors. We correlated these indices with Beck Depression Inventory (BDI) and BRIEF-A scores.Results: Depression was significantly alleviated, and executive functions improved post-ECT, as seen in reduced BDI scores, BRIEF-A scores, and number of errors in Executive RT Test. Pre-ECT BDI scores correlated with threat modulation of RT (tmRT) and threat modulation of working memory (tmWM). Post-ECT tmRT correlated with several Behavioral Regulation scales and tmWM with several Metacognition scales of BRIEF-A.Conclusion: While caution is warranted, results from both subjective and objective measures suggest that ECT significantly improves executive functions and emotion regulation along with alleviation of depression. Novel indices derived from threat modulation of executive function and working memory show promise as objective biomarkers of depression severity pre-ECT and cognitive outcome post-ECT with potential for guiding depression treatments.

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Depression in the Mirror: Depression Severity and Its Link to Negative Judgments of Symptoms

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.621282 ◽

2021 ◽

Vol 12 ◽

Author(s):

Federica Visco-Comandini ◽

Andrea Gragnani ◽

Mauro Giacomantonio ◽

Giuseppe Romano ◽

Manuel Petrucci ◽

...

Keyword(s):

Depressive Symptoms ◽

Community Sample ◽

Emotional Problem ◽

Depression Scale ◽

Emotional Problems ◽

Dysfunctional Attitudes ◽

Depression Severity ◽

Dysfunctional Beliefs ◽

The Impact ◽

Depressive States

Background and Objectives: Depressive states represent a normal and physiological response to the experience of loss. However, it is possible to identify some elements that allow distinguishing physiological depressive states from pathological ones. Over the years, research has confirmed that a stable tendency to negative self-evaluation is a transdiagnostic factor that triggers and amplifies dysfunctional emotional reactivity, thus contributing to the shift from normal to pathological reaction. In this sense, the secondary problem, or meta-emotional problem, referring to the negative evaluation of one's depressive state and the consequent dysfunctional attempts to solve it, seems to play an important role. The aim of the present study is to investigate how dysfunctional beliefs and the evaluations of depressive symptoms (meta-emotional problems) are related to depression severity.Methods: We asked to a community sample to focus on the depressive symptoms they regard as most distressful and evaluate them through specific questionnaires. One-hundred and eighty nine participants were asked to complete a set of questionnaires: (1) the Meta-Emotional Problem Questionnaire; (2) the Center for Epidemiologic Studies Depression Scale; (3) the Beck Depression Inventory; (4) the Dysfunctional Attitude Scale-24 in order to investigate the relation between dysfunctional beliefs, meta-emotional problems, and depressive symptoms severity.Results: Our results show that higher levels of depression are associated both to more pervasive dysfunctional attitudes and increased evaluation of meta-emotional problem. In addition, we conduct a regression analysis to disentangle the impact of the two different measures of depressive symptoms (i.e., BDI-II and CES-D) with two explanatory variables (dysfunctional attitudes and meta-emotional problem). Results show that meta-emotional problem remains a significant and robust predictor of the severity of depressive symptomatology, while dysfunctional beliefs has a rather weak and non-significant relation with the criterion. In other words, meta-emotional problem consistently explains the higher variance of depressive symptoms than dysfunctional beliefs. In conclusion, our study shows a clear link between meta-emotional problem and depression severity. This is relevant for clinical practice, as it highlights the importance of specifically targeting beliefs about the depressive condition in cognitive-behavioral treatment of depression, since they represent crucial factors maintaining depressive symptomatologies.

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Insomnia partially mediates the relationship between pathological personality traits and depression: a case-control study

PeerJ ◽

10.7717/peerj.11061 ◽

2021 ◽

Vol 9 ◽

pp. e11061

Author(s):

Fenglan Chen ◽

Xiujin Lin ◽

Yuli Pan ◽

Xuan Zeng ◽

Shengjie Zhang ◽

...

Keyword(s):

Borderline Personality ◽

Mediating Effect ◽

Personality Pathology ◽

Antisocial Personality ◽

Depression Severity ◽

Chinese Sample ◽

Personality Score ◽

Severity Of Depression ◽

The Impact ◽

Aggressive Personality

Background and Objective Personality disorders are frequently associated with insomnia and depression, but little is known about the inter-relationships among these variables. Therefore, this study examined these inter-relationships and the possible mediating effect of insomnia on the association between specific personality pathologies and depression severity. Methods There were 138 study participants, including 69 individuals with depression and 69 healthy controls. The main variables were measured by the Hamilton Depression Rating Scale-24 (HAMD-24), Athens Sleep Insomnia Scale (AIS), and the Personality Diagnostic Questionnaire (PDQ-4+). Multivariate linear regression and mediation analysis were conducted. Results With the exception of the antisocial personality score, all the PDQ-4+ scores and AIS scores were significantly higher in the depression group than in the healthy control group (p < 0.001). In the total sample, all personality pathology scores (p < 0.001), except the antisocial personality score, had significant positive correlations with the AIS scores and HAMD-24 scores, and the AIS scores and HAMD-24 scores were positively correlated (r = 0.620, p < 0.001). Regression analysis revealed that borderline personality, passive-aggressive personality, and insomnia positively predicted the severity of depression, after adjusting for sociodemographic covariates, and that insomnia partially mediated the associations of borderline personality and passive-aggressive personality with depression severity. Conclusions Borderline personality, passive-aggressive personality, and insomnia tend to increase the severity of depression, and the effect of borderline and passive-aggressive personality on depression severity may be partially mediated by insomnia. This is the first study to report these findings in a Chinese sample, and they may help researchers to understand the pathways from specific personality pathologies to the psychopathology of depression better, which should be useful for designing interventions to relieve depression severity, as the impact of specific personality pathology and insomnia should be considered.

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