The Mediating Effect of Stress Reactivity in the 18-Year Bidirectional Relationship between Generalized Anxiety and Depression Severity

Background: Generalized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Stress reactivity theories of psychopathology posit that patterns of heightened emotional reactions to stressors can result in increased vulnerability to the development of anxiety and depression. However, cross-sectional studies on this topic have hindered causal inferences. Method: The present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults. GAD and MDD symptom severity (Composite International Diagnostic Interview-Short Form) was assessed at two time points (T1 and T3), approximately 18 years apart. Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2. Results: Structural equation mediation modeling demonstrated that higher T1 GAD severity positively predicted more severe T3 MDD symptoms via T2 stress reactivity (d = 0.45–0.50). After controlling for T1 GAD, T2 stress reactivity was not a significant mediator in the relationship between higher T1 MDD symptoms and worse T3 GAD symptoms. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later, and vice versa (d = 1.29–1.65). Limitations: Stress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. behaviorally indexed) stress reactivity. Conclusions: These findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, our results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.

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The French Version of the Revised Child Anxiety and Depression Scale (RCADS) in a Nonclinical Sample

Swiss Journal of Psychology ◽

10.1024/1421-0185/a000158 ◽

2015 ◽

Vol 74 (3) ◽

pp. 119-127 ◽

Cited By ~ 10

Author(s):

Martine Bouvard ◽

Anne Denis ◽

Jean-Luc Roulin

Keyword(s):

Factor Analysis ◽

Anxiety Disorder ◽

Confirmatory Factor Analysis ◽

Generalized Anxiety Disorder ◽

Child Anxiety ◽

Depression Scale ◽

Anxiety And Depression ◽

Generalized Anxiety ◽

French Version ◽

Confirmatory Factor

This article investigates the psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS). A group of 704 adolescents completed the questionnaires in their classrooms. This study examines potential confirmatory factor analysis factor models of the RCADS as well as the relationships between the RCADS and the Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-R). A subsample of 595 adolescents also completed an anxiety questionnaire (Fear Survey Schedule for Children-Revised, FSSC-R) and a depression questionnaire (Center for Epidemiological Studies Depression Scale, CES-D). Confirmatory factor analysis of the RCADS suggests that the 6-factor model reasonably fits the data. All subscales were positively intercorrelated, with rs varying between .48 (generalized anxiety disorder-major depression disorder) and .65 (generalized anxiety disorder-social phobia/obsessive-compulsive disorder). The RCADS total score and all the RCADS scales were found to have good internal consistency (> .70). The correlations between the RCADS subscales and their SCARED-R counterparts are generally substantial. Convergent validity was found with the FSSC-R and the CES-D. The study included normal adolescents aged 10 to 19. Therefore, the findings cannot be extended to children under 10, nor to a clinical population. Altogether, the French version of the RCADS showed reasonable psychometric properties.

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Comparison of PROMIS Anxiety and Depression, PHQ-8, and GAD-7 to screen for anxiety and depression among patients presenting for spine surgery

Journal of Neurosurgery Spine ◽

10.3171/2018.9.spine18521 ◽

2019 ◽

Vol 30 (4) ◽

pp. 524-531

Author(s):

Taylor E. Purvis ◽

Brian J. Neuman ◽

Lee H. Riley ◽

Richard L. Skolasky

Keyword(s):

Major Depression ◽

Spine Surgery ◽

Characteristic Curve ◽

Depression Scale ◽

Data Driven ◽

Anxiety And Depression ◽

Measurement Information ◽

Generalized Anxiety ◽

Cut Points ◽

Patient Reported

OBJECTIVEIn this paper, the authors demonstrate to spine surgeons the prevalence and severity of anxiety and depression among patients presenting for surgery and explore the relationships between different legacy and Patient-Reported Outcomes Measurement Information System (PROMIS) screening measures.METHODSA total of 512 adult spine surgery patients at a single institution completed the 7-item Generalized Anxiety Disorder questionnaire (GAD-7), 8-item Patient Health Questionnaire (PHQ-8) depression scale, and PROMIS Anxiety and Depression computer-adaptive tests (CATs) preoperatively. Correlation coefficients were calculated between PROMIS scores and GAD-7 and PHQ-8 scores. Published reference tables were used to determine the presence of anxiety or depression using GAD-7 and PHQ-8. Sensitivity and specificity of published guidance on the PROMIS Anxiety and Depression CATs were compared. Guidance from 3 sources was compared: published GAD-7 and PHQ-8 crosswalk tables, American Psychiatric Association scales, and expert clinical consensus. Receiver operator characteristic curves were used to determine data-driven cut-points for PROMIS Anxiety and Depression. Significance was accepted as p < 0.05.RESULTSIn 512 spine surgery patients, anxiety and depression were prevalent preoperatively (5% with any anxiety, 24% with generalized anxiety screen-positive; and 54% with any depression, 24% with probable major depression). Correlations were moderately strong between PROMIS Anxiety and GAD-7 scores (r = 0.72; p < 0.001) and between PROMIS Depression and PHQ-8 scores (r = 0.74; p < 0.001). The observed correlation of the PROMIS Depression score was greater with the PHQ-8 cognitive/affective score (r = 0.766) than with the somatic score (r = 0.601) (p < 0.001). PROMIS Anxiety and Depression CATs were able to detect the presence of generalized anxiety screen-positive (sensitivity, 86.0%; specificity, 81.6%) and of probable major depression (sensitivity, 82.3%; specificity, 81.4%). Receiver operating characteristic curve analysis demonstrated data-driven cut-points for these groups.CONCLUSIONSPROMIS Anxiety and Depression CATs are reliable tools for identifying generalized anxiety screen-positive spine surgery patients and those with probable major depression.

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Modeling heritability of temperamental differences, stress reactivity, and risk for anxiety and depression: Relevance to Research Domain Criteria (RDoC)

European Journal of Neuroscience ◽

10.1111/ejn.15158 ◽

2021 ◽

Author(s):

Sarah M. Clinton ◽

Elizabeth A. Shupe ◽

Matthew E. Glover ◽

Keaton A. Unroe ◽

Chelsea R. McCoy ◽

...

Keyword(s):

Stress Reactivity ◽

Anxiety And Depression ◽

Research Domain Criteria ◽

Research Domain

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Negative Emotions in Migraineurs Dreams: The Increased Prevalence of Oneiric Fear and Anguish, Unrelated to Mood Disorders

Behavioural Neurology ◽

10.1155/2014/919627 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

F. De Angeli ◽

C. Lovati ◽

L. Giani ◽

C. Mariotti D'Alessandro ◽

E. Raimondi ◽

...

Keyword(s):

Motor Skills ◽

De Novo ◽

Tension Type Headache ◽

Anxiety And Depression ◽

Generalized Anxiety ◽

Migraine Pain ◽

Patient Health ◽

Type Headache ◽

The Brain ◽

Negative Connotation

Background. Migraineurs brain has shown some functional peculiarities that reflect not only in phonophobia, and photophobia, but also in mood and sleep. Dreaming is a universal mental state characterized by hallucinatory features in which imagery, emotion, motor skills, and memory are created de novo. We evaluated dream contents and associated emotions in migraineurs.Materials and Methods. 412 subjects: 219 controls; and 148 migraineurs (66 with aura, MA; 82 without aura, MO), and 45 tension type headache patients (TTH). A semistructured retrospective self-reported questionnaire was used to evaluate dreams. The Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire (PHQ-9) were administered to evaluate anxiety and depression.Results. Migraineurs showed increased levels of anxiety (P=0.0002for MA versus controls,P=0.004for MO versus controls). Fear and anguish during dreaming were more frequently reported by migraine patients compared to controls, independently by anxiety and depression scores.Discussion. The brain of migraineurs seems to dream with some peculiar features, all with a negative connotation, as fear and anguish. It may be due to the recorded negative sensations induced by recurrent migraine pain, but it may just reflect a peculiar attitude of the mesolimbic structures of migraineurs brain, activated in both dreaming and migraine attacks.

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Depression and Anxiety as Mediators of PTSD Symptom Clusters and Pain in Treatment-Seeking Canadian Forces Members and Veterans

Military Medicine ◽

10.1093/milmed/usab532 ◽

2021 ◽

Author(s):

Maya Roth ◽

Lisa King ◽

Don Richardson

Keyword(s):

Symptom Severity ◽

Ptsd Symptom ◽

Symptom Clusters ◽

Anxiety And Depression ◽

Generalized Anxiety ◽

Sf 36 ◽

Pain Subscale ◽

Psychiatric Conditions ◽

Pain Symptoms ◽

The Relationship

ABSTRACT Introduction Chronic pain (CP) commonly presents alongside psychiatric conditions such as depression, PTSD, and generalized anxiety. The current study sought to better understand this complex relationship by determining whether anxiety and depression symptom severity mediated the relationship between DSM-5 PTSD symptom clusters and pain symptoms in a sample of 663 Canadian Armed Forces (CAF) personnel and veterans seeking treatment for mental health conditions. Materials and Methods Generalized anxiety disorder, depression, and PTSD symptom severity were measured using self-report scales provided as part of a standard intake protocol. Pain symptoms were measured using the Bodily Pain subscale of the SF-36 (SF-36 BPS). Linear regressions were used to explore the relationship between PTSD symptom clusters, depression, anxiety, and pain. Bootstrapped resampling analyses were employed to test mediation effects. Results The average SF-36 BPS score in this sample was 36.6, nearly 1.5 SDs below the population health status, enforcing the salience of pain symptoms as a concern for veterans and CAF seeking treatment for military-related psychiatric conditions. The effects of PTSD symptom clusters avoidance, negative mood and cognitions, and arousal on pain were fully mediated by anxiety and depression severity. However, the effect of intrusion on pain was not mediated by depression and only partly mediated by anxiety. Conclusion Findings emphasize the importance of including anxiety and depression in models of PTSD and pain, particularly in samples where psychiatric comorbidity is high. Clinically, results highlight the need for improved treatment regimens that address pain symptoms alongside common psychiatric comorbidities.

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Corporate social responsibility and financial performance: bidirectional relationship and mediating effect of customer loyalty: investigation in Sweden

Corporate Governance ◽

10.1108/cg-10-2020-0472 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Abir Hichri ◽

Moez Ltifi

Keyword(s):

Corporate Social Responsibility ◽

Financial Performance ◽

Customer Loyalty ◽

Mediating Effect ◽

Content Type ◽

Global Context ◽

Bidirectional Relationship ◽

Corporate Social ◽

The Impact

Purpose The study is based on a hybrid model composed of accounting and business data and is amongst the first to test the impact of corporate social responsibility (CSR) performance on the financial performance of the company, as well as the impact of financial performance on CSR performance. The bidirectional logic chosen by the study is rarely adopted in the global context and has never been tested in the Swedish context. Moreover, the purpose of this paper is to test the mediating effect of customer loyalty on the company’s CSR performance-financial performance relationship to assess this effect over the long term. This design has been neglected in previous studies. Design/methodology/approach Data was collected from a sample of 110 Swedish companies during the period 2009–2019. This study collects the data from the Thomson Reuters Eikon database. A multiple regression analysis was performed to test the hypotheses. Findings The results confirmed the bidirectional relationship between CSR performance and company financial performance. This means that CSR performance positively influences the company’s financial performance. Similarly, financial performance positively influences the company’s CSR performance. Moreover, customer loyalty has a positive and significant mediating effect on the company’s CSR performance-financial performance relationship. Originality/value This study adds several inputs. The first contribution of the research is to test a hybrid model composed of accounting and commercial data. This model is amongst the first to test the impact of CSR performance on the financial performance of the company and the impact of financial performance on CSR performance. The second contribution is the bidirectional logic chosen by the study which is rarely adopted in the global context and has never been tested in the Swedish context. The third contribution is to test the mediating effect of customer loyalty on the company’s CSR performance-financial performance relationship to assess this effect over the long term. This design has been neglected in previous studies. The fourth contribution is the choice of the field of investigation for the reliability of the data used and the generalisation of the results obtained.

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