The Role of Sexual and Gender Identity in Long-Term Psychodynamic Therapy for Comorbid Social Anxiety and Depression in an Adolescent Female

2018 ◽  
Vol 17 (5) ◽  
pp. 311-327
Author(s):  
Gretchen Kurdziel ◽  
Leticia Y. Flores ◽  
Jenny Macfie
Keyword(s):  
Depressive Symptoms ◽  
Social Anxiety ◽  
Gender Identity ◽  
Anxiety And Depression ◽  
Adolescent Female ◽  
Social Settings ◽  
Social Discomfort ◽  
And Gender

Adolescence is a time of significant change with social, cognitive, and emotional alternations, and growth of autonomy and identity. This is a single clinical case study that uses long-term psychodynamic psychotherapy with an adolescent female diagnosed with comorbid social anxiety and persistent depression. The treatment initially focused on addressing the patient’s self-esteem, perfectionism, and self-criticism. During the treatment it was revealed that the patient’s sexual and gender identity contributed to social anxiety and depressive symptoms, and the therapy conceptualized the role of these identities as contributing to social discomfort which perpetuated her depressive symptoms. Through accepting her budding sexual and gender identity, the patient successfully became more comfortable in social settings which ultimately alleviated her depressive symptoms. This treatment highlights the unique nature of working with an adolescent apart of the sexual and gender minority, and how these identities contributed to her experience of social anxiety and depression.

Interpersonal Stress Generation—A Girl Problem? The Role of Depressive Symptoms, Dysfunctional Attitudes, and Gender in Early Adolescent Stress Generation

2017 ◽  
Vol 39 (1) ◽  
pp. 41-66 ◽  
Author(s):  
Susanne Meiser ◽  
Günter Esser
Keyword(s):  
Depressive Symptoms ◽  
Stressful Life Events ◽  
Depressive Symptomatology ◽  
Community Sample ◽  
Dysfunctional Attitudes ◽  
Stress Generation ◽  
Interpersonal Stress ◽  
German Children ◽  
And Gender

To provide further insight into stress generation patterns in boys and girls around puberty, this study investigated longitudinal reciprocal relations between depressive symptoms, dysfunctional attitudes, and stress generation, the process by which individuals contribute to the occurrence of stress in interpersonal contexts (e.g., problematic social interactions) or in noninterpersonal contexts (e.g., achievement problems). A community sample of N = 924 German children and early adolescents (51.8% male) completed depressive symptoms and dysfunctional attitudes measures at T1 and again 20 months later (T2). Stressful life events were reported at T2. Dysfunctional attitudes were unrelated to stress generation. Interpersonal, but not noninterpersonal, dependent stress partially mediated the relationship between initial and later depressive symptoms, with girls being more likely to generate interpersonal stress in response to depressive symptoms. Findings underscore the role of interpersonal stress generation in the early development of depressive symptomatology, and in the gender difference in depression prevalence emerging around puberty.

scholarly journals The Developmental Role of Serotonin: A Comparison of Short- and Long-term Blockade of the Serotonin Transporter on Behavioural Outcomes in Adulthood

2021 ◽  
Author(s):  
◽  
Amy O'Connell
Keyword(s):  
Animal Model ◽  
Serotonin Transporter ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Critical Periods ◽  
Significant Group ◽  
Fluoxetine Treatment ◽  
Short And Long Term

<p>Serotonin is an important neurotransmitter that regulates a range of processes within the brain and is implicated in several psychiatric disorders. In addition, serotonin acts as a developmental signal during critical periods of prenatal development, influencing processes such as neuronal proliferation, migration, and synaptogenesis (Gaspar et al., 2003). The serotonin transporter (5- HTT) plays a key role in regulating extracellular serotonin levels and is the main target of selective-serotonin reuptake inhibitors (SSRIs), a class of drugs that have anti-anxiety and anti- depressive activity. SSRIs cause an acute increase in extracellular serotonin and are commonly prescribed as a treatment for depression and anxiety during pregnancy (Tran & Robb, 2015). Given that these drugs alter serotonin transmission and can pass to the developing fetus via the placenta, it is vital that the outcomes of prenatal SSRI exposure are investigated. In humans, a genetic variant of the gene that codes for the 5-HTT (SLC6A4) has been linked to increased risk for developing depression and anxiety (Caspi et al., 2003). The functional consequences of this genetic polymorphism are life-long alterations in 5-HTT activity, resulting in increased extracellular levels of serotonin (Nakamura et al., 2000). Given prenatal SSRI exposure results in a time-locked blockade of 5-HTT during critical periods of development, it follows that alterations in serotonin during development might similarly result in enhanced risk for depression and anxiety later in life. Outcomes in children prenatally exposed to SSRIs are difficult to study due to confounds of pre- existing maternal depression. Therefore, the current thesis presents two experiments that aimed to further investigate the role of altered extracellular serotonin levels during development in an animal model. Experiment one aimed to develop a method of voluntary oral administration of the SSRI fluoxetine to pregnant rat dams. This method was then applied in experiment two to create a time-locked blockade of 5-HTT during critical periods of development in an animal model of life-long 5-HTT blockade. The aim of experiment two was to directly assess the contribution of short- and long-term 5-HTT blockade on anxiety and depression phenotypes in adult male offspring. In addition, maternal behaviour was assessed to determine whether fluoxetine treatment had an influence on mother-pup interactions that could confound results. To test for anxiety and depression phenotypes, the novel affective disorder test (ADT) was used to assess anxiety behaviour and the deficits in anticipatory pleasure indicative of anhedonia. In the current study, fluoxetine treatment did not have an effect on litter outcomes or mother-pup interactions. Crucially, no significant group differences were found indicating that neither short- nor long- term blockade of 5-HTT resulted in increased anxiety- or depressive-like behaviours in the current experiment. However, limitations with methodological design limit the translatability of these results to the broader literature, and validation of the ADT is required before these results can be generalised beyond this thesis.</p>

scholarly journals Role of methyleprednisolone succinate in the management of acute spinal cord injury

1970 ◽  
Vol 9 (3) ◽  
pp. 168-172
Author(s):  
NK Karn ◽  
BP Shrestha ◽  
GP Khanal ◽  
R Rijal ◽  
P Chaudhary ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Status ◽  
Acute Spinal Cord Injury ◽  
Cord Injury ◽  
And Gender ◽  
One Year

Objective: To see the role of methyleprednisolone succinate in the management of acute spinal cord injury. Methods: A randomized control trial was done including the patients with acute spinal cord injury. They were divided into age and gender matched two groups. Patients with presence of active infection, associated open fracture, those on long term steroid and those who did not give consent to participate in the trial were excluded. One group received methyleprednisolone succinate within 8 hours of injury and another group did not receive the drug. Both the groups were managed nonoperatively. The neurological status of the patients was assessed at presentation, once spinal shock was over, at 6th week and 6th month and after one year according to ASIA scoring. Frankel grading was also assessed in every follow up. Conclusion: Methylprednisolone succinct prevents secondary cord injury to a great extent and hence its administration within 8 hours of injury results in a better functional (motor and sensory) outcome. Keywords: acute spinal cord injury; methyleprednisolone succinate DOI: http://dx.doi.org/10.3126/hren.v9i3.5585   HR 2011; 9(3): 168-172

A-121 Functional Outcomes in Bilingual Persons with Traumatic Brain: The Role of Mood

2021 ◽  
Vol 36 (6) ◽  
pp. 1171-1171
Author(s):  
Winter Olmos ◽  
Daniel W Lopez-Hernandez ◽  
Isabel Munoz ◽  
Laura Schierholz ◽  
Rachel A Rugh-Fraser ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Outcomes ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Anxiety Levels ◽  
The Relationship ◽  
Pearson Correlations

Abstract Introduction We examined the relationship between depression and anxiety, language, and functional outcomes in persons with traumatic brain injury (TBI). Methods The sample consisted of 48 acute TBI (ATBI: 23 Spanish-English Bilinguals; 25 English monolinguals), 30 chronic TBI (CTBI: 17 Spanish English Bilinguals; 12 English monolinguals), and 47 healthy comparison (HC: 29 Spanish-English Bilinguals; 18 English monolinguals) participants. The Hospital Anxiety and Depression Scale was used to measure depression (HADS-D) and anxiety (HADS-A). The Mayo Portland Adaptability Inventory-4 (MPAI-4) was used to measure functional outcomes (ability, adjustment, participation). Results An ANCOVA, controlling for age, revealed the ATBI group reported lower anxiety levels compared to the CTBI group, p = 0.034 np2 = 0.06. HC participants demonstrated significantly higher functional ability compared to both TBI groups, p &lt; 0.05, np2 = 0.08–0.19. The ATBI group demonstrated worse participation scores compared to the CTBI and HC groups, p = 0.001, np2 = 0.11. Pearson correlations revealed mood was related to functional status in ATBI monolinguals (HADS-A: r = 0.29–0.64; HADS-D, r = 0.49–0.62). Monolingual participants with ATBI demonstrated correlations between depressive symptoms and functional adjustment (r = 0.57, p = 0.005) and ability (r = 0.44, p = 0.034). For monolinguals with CTBI, HADS-A correlated with functional outcomes, r = 0.60–0.66, p &lt; 0.05. For bilinguals with CTBI, functional outcomes correlated with HADS-A, r = 0.53–0.66, p &lt; 0.05, and HADS-D, r = 0.54–0.66, p &lt; 0.05. For HC monolinguals, functional outcomes correlated with HADS-A, r = 0.53–0.70, p &lt; 0.05, and HADS-D, r = 0.50–0.72, p &lt; 0.05. Finally, for HC bilinguals, functional outcomes correlated with HADS-A, r = 0.59–0.68, p &lt; 0.05. Conclusion Our results suggest that a relationship between anxiety and depressive symptoms is related more to functional outcomes in monolingual TBI survivors compared to bilingual TBI survivors.

Anxiety and Depression

2014 ◽  
pp. 51-54
Author(s):  
David L Brody
Keyword(s):  
Depressive Symptoms ◽  
Mood Disorder ◽  
Sleep Disturbances ◽  
Anxiety And Depression ◽  
Pharmacological Interventions ◽  
Reactive Anxiety ◽  
Optimal Approach ◽  
Good Plan ◽  
Severe Anxiety

First, assess safety. Severe anxiety and depression can lead to suicide. Second, distinguish between reactive anxiety and depressive symptoms versus an impairing mood disorder. The “treatment” for reactive anxiety and depressive symptoms is education, reassurance, and a good plan to get the patient’s life back on track. If the patient has an impairing (but not immediately dangerous) mood disorder, it can be treated for the most part just like a mood disorder in the absence of concussion. The optimal approach usually involves both nonpharmacological and pharmacological interventions: exercise, treat sleep disturbances, psychological counseling, avoid substances that worsen mood overall such as alcohol and street drugs, consider appropriate long-term antidepressant/antianxiety medications. There are many options, but fluoxetine (Prozac) and venlafaxine (Effexor) may be good choices for patients where low energy is more concerning than anxiety, whereas paroxetine (Paxil) or sertraline (Zoloft) may be preferred when anxiety is a major component.

scholarly journals Emotional Responses to Stressors in Everyday Life Predict Long-Term Trajectories of Depressive Symptoms

2019 ◽  
Vol 54 (6) ◽  
pp. 402-412 ◽  
Author(s):  
Ruixue Zhaoyang ◽  
Stacey B Scott ◽  
Joshua M Smyth ◽  
Jee-Eun Kang ◽  
Martin J Sliwinski
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Everyday Life ◽  
Emotional Responses ◽  
Physical And Mental Health ◽  
Latent Growth ◽  
Assessment Approach ◽  
Ecological Momentary

Abstract Background Individuals’ emotional responses to stressors in everyday life are associated with long-term physical and mental health. Among many possible risk factors, the stressor-related emotional responses may play an important role in future development of depressive symptoms. Purpose The current study examined how individuals’ positive and negative emotional responses to everyday stressors predicted their subsequent changes in depressive symptoms over 18 months. Methods Using an ecological momentary assessment approach, participants (n = 176) reported stressor exposure, positive affect (PA), and negative affect (NA) five times a day for 1 week (n = 5,483 observations) and provided longitudinal reports of depressive symptoms over the subsequent 18 months. A multivariate multilevel latent growth curve model was used to directly link the fluctuations in emotions in response to momentary stressors in everyday life with the long-term trajectory of depressive symptoms. Results Adults who demonstrated a greater difference in stressor-related PA (i.e., relatively lower PA on stressor vs. nonstressor moments) reported larger increases in depressive symptoms over 18 months. Those with greater NA responses to everyday stressors (i.e., relatively higher NA on stressor vs. nonstressor moments), however, did not exhibit differential long-term changes in depressive symptoms. Conclusions Adults showed a pattern consistent with both PA and NA responses to stressors in everyday life, but only the stressor-related changes in PA (but not in NA) predicted the growth of depressive symptoms over time. These findings highlight the important—but often overlooked—role of positive emotional responses to everyday stressors in long-term mental health.

Logics of Gender Justice and Their Meaning for the Study of Sexuality and Gender Identity: A Dialogue

2019 ◽  
Vol 26 (4) ◽  
pp. 519-526
Author(s):  
Phillip M Ayoub
Keyword(s):  
Gender Identity ◽  
Political Science ◽  
Gender Justice ◽  
Open Questions ◽  
Sexuality And Gender ◽  
Theoretical Assumptions ◽  
And Gender ◽  
Definition Of ◽  
Role Of Religion

Abstract This piece dialogues with Htun and Weldon's exceptional new book, The Logics of Gender Justice, as it relates to LGBTI rights. Beyond engaging the authors' questions of when and why governments promote women's rights, I also engage their argument that equality is not one issue but many linked issues, including issues of sexuality and gender identity. My own reflections on their work thus address the contributions the book makes to the study of political science, as well as open questions about how their logic of gender justice might apply across other issue areas less explored in the book. Htun and Weldon's own definition of gender justice also rightly includes space for LGBTQI people, which I see as an invitation to think through the typology in relation to these communities. The piece begins by reflecting on the book's theoretical and methodical innovations around the complexities of gender politics, before moving on to the multi-faceted role of religion in gender justice, and then theoretical assumptions around visibility of the marginalized.

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