A Dyadic Investigation of Depressed Affect and Interspousal Behavior in Couples With Chronic Back Pain

Background Depression and marital discord are characteristic not only of individuals with chronic low back pain (ICPs) but also of their spouses. Purpose We examined actor–partner interdependence models to evaluate associations among depressed affect and criticism and support of partners at the same time point (concurrent effects) and 3 hr later (lagged effects). Fully dyadic models were used to account for both within-person and cross-spouse associations among depressed affect, criticism, and support for ICPs and spouses. We also examined the direction of the relationships (depressed affect predicting behavior and behavior predicting depressed affect) all while controlling for pain intensity, pain behavior, and the prior dependent variable. Methods ICPs (n = 105) and their spouses completed electronic diary measures of depressed affect and behavior (criticism and support) five times a day for 2 weeks. Hierarchical linear modeling with person-mean centering was used for data analysis. Results Within the same 3 hr epoch, more depressed affect was related to higher criticism and generally less support. Lagged analyses suggested bidirectional relationships between spouse’s own depressed affect and spouse’s own criticism of ICPs. Spouse depressed affect was also associated with decreased support received from ICPs. Pain behavior and pain intensity were also related to depressed affect, criticism, and support especially concurrently. Conclusions Theories and interventions need to address not only ICP depressed affect but also spouse depressed affect, as spouse depressed affect may be a stress generating precursor to criticism and support.

Gender Differences in Depressive Traits among Rural and Urban Chinese Adolescent Students: Secondary Data Analysis of Nationwide Survey CFPS

Many previous studies have indicated that urban adolescents show a higher level of mental health in China compared to rural adolescents. Specifically, girls in rural areas represented a high-risk group prior to the 21st century, demonstrating more suicidal behaviour and ideation than those in the urban areas because of the severe gender inequality in rural China. However, because of the urbanisation process and centralised policy to eliminate gender inequality in recent decades, the regional and gender differences in mental health might decrease. This research aimed to probe the gender and regional differences in depressive traits among adolescent students currently in China. We adopted the national survey dataset Chinese Family Panel Studies (CFPS) conducted in 2018. Accordingly, 2173 observations from 10–15-year-old subjects were included. CFPS utilised an eight-item questionnaire to screen individuals’ depressive traits. Two dimensions of depressive traits were confirmed by CFA, namely depressed affect and anhedonia. The measurement invariance tests suggested that the two-factor model was applicable for both males and females and rural and urban students. Based on the extracted values from the CFA model, MANOVA results revealed that, compared to boys, girls experienced more depressed affect. Moreover, rural students demonstrated more anhedonia symptoms. There was no interaction between gender and region. The results suggest that, even though the gender and regional differences are small, being a female and coming from a rural area are still potential risk factors for developing depressive traits among adolescent students in China.

Greater Post-Surgical Pain Predicts Long-Term Depressed Affect in Breast Cancer Patients

Background: Depressed affect is observed during primary treatment for early-stage breast cancer and often persists into survivorship. Pain can influence the long-term emotions of women with breast cancer. Behavioral mechanisms explaining this relationship are less clear. Coping during primary treatment may play a role in the association between pain and depressed affect. Aims: Our observational study examined a longitudinal mediation model testing whether post-surgical pain intensity predicted depressed affect 5 years later via disengagement and/or engagement coping at the end of treatment. Method: Women ( N = 240) with stage 0–III breast cancer completed measures of pain, coping, and depressed affect 4–10 weeks post-surgery, and 12 months and 5 years later. Results: Structural modeling yielded measurement models of 12-month disengagement and engagement coping. Direct effects emerged between post-surgical pain intensity and 12-month disengagement (β = .37, p < .001) and engagement coping (β = .16, p < .05). Post-surgical pain intensity was also related to 5-year depressed affect (β = .25, p < .05). Disengagement and engagement coping were not associated with depressed affect at 5-year follow-up, and there was no evidence of mediation. Limitations: This is a secondary analysis of data from a trial conducted several years ago, and may not generalize due to a homogenous sample with attrition at long-term follow-up. Conclusions: Greater post-surgical pain intensity predicts more disengagement and engagement coping at the end of primary treatment, as well as depressed affect during survivorship. Managing post-surgical pain may influence the emotions of survivors of breast cancer up to 5 years later, possibly through coping or non-coping processes.

Green spaces, subjective health and depressed affect in middle-aged and older adults: a cross-country comparison of four European cohorts

BackgroundStudies on associations between urban green space and mental health have yielded mixed results. This study examines associations of green space exposures with subjective health and depressed affect of middle-aged and older adults in four European cohorts.MethodsData came from four Western-European and Central-European ageing cohorts harmonised as part of the Mindmap project, comprising 16 189 adults with an average age of 50–71 years. Green space exposure was based on the distance to the nearest green space and the amount of green space within 800 m buffers around residential addresses. Cohort-specific and one-step individual participant data (IPD) meta-analyses were used to examine associations of green space exposures with subjective health and depressed affect.ResultsThe amount of green spaces within 800 m buffers was lowest for Residential Environment and CORonary heart Disease (Paris, 15.0 hectares) and highest for Health, Alcohol and Psychosocial factors In Eastern Europe (Czech Republic, 35.9 hectares). IPD analyses indicated no evidence of an association between the distance to the nearest green space and depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Likewise, the amount of green space within 800 m buffers did not predict depressed affect (OR 0.98, 95% CI 0.96 to 1.00) or good self-rated health (OR 1.01, 95% CI 0.99 to 1.02). Findings were consistent across all cohorts.ConclusionsData from four European ageing cohorts provide no support for the hypothesis that green space exposure is associated with subjective health or depressed affect. While longitudinal evidence is required, these findings suggest that green space may be less important for older urban residents.

Perceived Partner Responsiveness Attenuate the Link Between Menopausal Symptoms and Depressed Affect

The years around menopause are the time that associates not only with hormonal changes but with psychological and social transitions, and previous studies have consistently revealed the relationship between menopause and depression. The present study examined the moderating effect of perceived partner responsiveness (PPR) on the association between menopausal symptoms (MS) and depressed affect (DA). The sample was middle-aged climacteric women (N = 754, Age=49-60) from the second wave of Midlife in the United States (MIDUSⅡ). Measurement for MS consisted of the frequency of five symptoms in the past 30 days (insomnia, heavy sweating, painful intercourse, hot flashes, and irritability). PPR was assessed using three items matched the core components of responsiveness (understanding, validating, and caring). Results revealed that there were significant interactions between menopausal symptoms and PPR (b = 0.05, p &lt; 0.039). Specifically, the level of elevation of DA in response to MS was smaller in women with higher levels of PPR (b = 2.93, p &lt; 0.001) than in those with lower levels of PPR (b =3.05, p &lt; 0.001). According to the region of significance analysis, the coefficients of MS on DA were significant within the -2SD to +2SD range of PPR, but it decreased as the PPR increased. Findings suggest that partners’ careful responsiveness may mitigate the detrimental effects of MS on DA among climacteric women.

The 70- to 85-Year-Old Sweet Spot: Regression Associations Between Spiritual Experience and Successful Aging Outcomes

Utilizing the MIDUS III dataset, this study conducted linear regression analysis for associations between daily spiritual experience and Successful Aging (N=2605). Age was measured in three groups: young-old (55-69), old (70-85), and old-old (86-100). Successful Aging was operationalized as Self-Reported Physical Health, Self-Reported Memory, Depressed Affect, and Life Satisfaction. Daily spiritual experience was measured with the Fetzer Institute five-item composite scale (Cronbach = .891). Analysis for each Successful Aging outcome was controlled for daily spiritual experience, physical and social neighborhood environment, age group, gender identification, co-habitation, income, education, cultural identification and disability. Regression analysis was undertaken for daily spiritual experience on the same control variables. Results found higher frequency of daily spiritual experience was significantly associated (p = .000) with better self-reported memory (β= .146***) and higher life satisfaction (β= .191***). Further, regression analysis revealed the 70-85 age group was significantly associated (p = .000) with better self-reported physical health (β= .123***), lower depressed affect (β= -.144***), and higher life satisfaction (β= .291***). Finally, the 70-85 age group was a stronger predictor of daily spiritual experience (β= .221***) than all other control variables except female gender identification (β= .244***). This study contributes evidence of associations between daily spiritual experience and Successful Aging outcomes, particularly memory and life satisfaction. This study demonstrates the advantage of measuring separate old age categories to reflect heterogeneity of the life course. Finally, this study underscores, “Why Age Matters”, through new evidence linking the 70-85 year old age group with daily spiritual experience and Successful Aging.

Gender, marital and educational inequalities in mid- to late-life depressive symptoms: cross-cohort variation and moderation by urbanicity degree

BackgroundAlthough ageing populations are increasingly residing in cities, it is unknown whether depression inequalities are moderated by urbanicity degree. We estimated gender, marital and educational inequalities in depressive symptoms among older European and Canadian adults, and examined whether higher levels of urbanicity, captured by population density, heightened these inequalities.MethodsHarmonised cross-sectional data on 97 826 adults aged ≥50 years from eight cohorts were used. Prevalence ratios (PRs) were calculated for probable depression, depressed affect and depressive symptom severity by gender, marital status and education within each cohort, and combined using random-effects meta-analysis. Using a subsample of 73 123 adults from six cohorts with available data on population density, we tested moderating effects measured by the number of residents per square kilometre.ResultsThe pooled PRs for probable depression by female gender, unmarried or non-cohabitating status and low education were 1.48 (95% CI 1.28 to 1.72), 1.44 (95% CI 1.29 to 1.61) and 1.29 (95% CI 1.18 to 1.41), respectively. PRs for depressed affect and high symptom severity were broadly similar. Except for one Dutch cohort with findings in an unexpected direction, there was no evidence that population density modified depressive symptom inequalities.ConclusionsDespite cross-cohort variation in gender, marital status and educational inequalities in depressive symptoms, there was weak evidence that these inequalities differed by levels of population density.

Understanding the nature of association between anxiety phenotypes and anorexia nervosa: a triangulation approach

Background Evidence from observational studies suggests an association between anxiety disorders and anorexia nervosa (AN), but causal inference is complicated by the potential for confounding in these studies. We triangulate evidence across a longitudinal study and a Mendelian randomization (MR) study, to evaluate whether there is support for anxiety disorder phenotypes exerting a causal effect on AN risk. Methods Study One assessed longitudinal associations of childhood worry and anxiety disorders with lifetime AN in the Avon Longitudinal Study of Parents and Children cohort. Study Two used two-sample MR to evaluate: causal effects of worry, and genetic liability to anxiety disorders, on AN risk; causal effects of genetic liability to AN on anxiety outcomes; and the causal influence of worry on anxiety disorder development. The independence of effects of worry, relative to depressed affect, on AN and anxiety disorder outcomes, was explored using multivariable MR. Analyses were completed using summary statistics from recent genome-wide association studies. Results Study One did not support an association between worry and subsequent AN, but there was strong evidence for anxiety disorders predicting increased risk of AN. Study Two outcomes supported worry causally increasing AN risk, but did not support a causal effect of anxiety disorders on AN development, or of AN on anxiety disorders/worry. Findings also indicated that worry causally influences anxiety disorder development. Multivariable analysis estimates suggested the influence of worry on both AN and anxiety disorders was independent of depressed affect. Conclusions Overall our results provide mixed evidence regarding the causal role of anxiety exposures in AN aetiology. The inconsistency between outcomes of Studies One and Two may be explained by limitations surrounding worry assessment in Study One, confounding of the anxiety disorder and AN association in observational research, and low power in MR analyses probing causal effects of genetic liability to anxiety disorders. The evidence for worry acting as a causal risk factor for anxiety disorders and AN supports targeting worry for prevention of both outcomes. Further research should clarify how a tendency to worry translates into AN risk, and whether anxiety disorder pathology exerts any causal effect on AN.