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The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Abstract
The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
... However, psychometric data available for Spanish-language mental health assessments in Latin America, and Central America in particular, are not widely available. The goal of the current study was therefore to conduct a psychometric evaluation of often-used measures for evaluating depression (CES-D;Radloff, 1977), posttraumatic stress (PCL-5; Weathers et al., 2013), and difficulties in emotion regulation (DERS; Gratz & Roemer, 2004). For the data collection effort, we selected the CES-D, PCL-5, and DERS as measures used to assess the presence of depression, posttraumatic stress, and difficulties in emotion regulation, respectively. ...
... The CES-D has been used in many large-scale studies on depression (Andresen et al., 1994) and has high internal consistency, retest reliability, and validity (Radloff, 1977). The CES-D has been highlighted as one of the best available tools for screening for depression in Spanishspeaking individuals (Reuland et al., 2009), but no record of CES-D validation was found in Latin America. ...
... The CES-D has been highlighted as one of the best available tools for screening for depression in Spanishspeaking individuals (Reuland et al., 2009), but no record of CES-D validation was found in Latin America. Of note, the CES-D is typically interpreted as a full-scale total score, but the original measure indicated the presence of four factors (Radloff, 1977). Generally speaking, subscales of the CES-D have not demonstrated strong invariance across languages and contexts, suggesting poor invariance at the subscale level (e.g., Leykin et al., 2011). ...
Objective: The objective of this study was to evaluate the psychometric properties of Latin American Spanish-language versions of the Center for Epidemiologic Studies Depression Scale (CES-D), PTSD Checklist for the DSM-5 (PCL-5), and Difficulties in Emotion Regulation Scale (DERS). Methods: Measures were translated, backtranslated, and adapted for use with a Honduran sample ( N = 970). Results: Support for the construct validity of the PCL-5 and moderate support for the CES-D were evident. Internal consistency, correlations, and mean differences across groups demonstrated good evidence of internal consistency and convergent validity. The original factor structure for the DERS did not show evidence of construct validity, but internal consistency for the overall scale was good, and there was evidence of convergent validity. Conclusions: The findings provide support for these versions of the PCL-5 but suggest that future work should examine exploratory factor analyses of the CES-D and DERS.
... Predictor Variable: Maternal Depressive Symptoms (Age 5 Months). Mothers completed the abridged 13-item version of the Center for Epidemiologic Studies Depression Scale (CES-D), a clinically sensitive instrument that detects the clinical impairment threshold of a major depressive disorder [23]. Example items include poor appetite; could not shake off blues; felt depressed; everything seems effortful; restless sleep (α = 0.81 for male QLSCD infants and α = 0.78 for female QLSCD infants at 5 months) [23]. ...
... Mothers completed the abridged 13-item version of the Center for Epidemiologic Studies Depression Scale (CES-D), a clinically sensitive instrument that detects the clinical impairment threshold of a major depressive disorder [23]. Example items include poor appetite; could not shake off blues; felt depressed; everything seems effortful; restless sleep (α = 0.81 for male QLSCD infants and α = 0.78 for female QLSCD infants at 5 months) [23]. The French version of this established instrument has been found valid and reliable as a population-based screening tool in the assessment of severity of depressive symptomatology [24]. ...
... Frequency of symptoms were rated on a Likert scale: 1 = rarely or never (less than 1 day), 2 = some or a little of the time (1-2 days), 3 = occasionally or a moderate (3-4 days), and 4 = most or all of the time (5-7 days). Higher values are correlated with the depressive symptom severity [23]. ...
Maternal health represents an important predictor of child development; yet it often goes unnoticed during pediatric visits. Previous work suggests that mental state affects parenting. The relationship between infant exposure to maternal depressive symptoms suggests conflicting findings on physical growth. Body mass index (BMI) has not been rigorously examined across development. Using a prospective-longitudinal birth cohort of 2120 infants (50.7% boys), we estimated the prospective relationship between symptoms of maternal depressive symptoms at 5 months postpartum and later BMI in typically developing children. We hypothesized that maternal depressive symptom severity would predict later BMI through to adolescence. Mothers self-reported depressive symptoms at 5 months. Child BMI was measured by a trained research assistant at ages 6, 8, 10, 13, and 15 years. We estimated a series of sex-stratified regressions in which BMI was linearly regressed on maternal symptoms, while controlling for potential pre-existing/concurrent individual and family confounding factors. Boys born to mothers with more severe depressive symptoms at age 5 months had a significantly lower BMI than other boys at subsequent ages. There were no such associations observed for girls. Maternal depressive symptoms were prospectively associated with later BMI for sons and not daughters, predicting risk of faltering in growth through to adolescence. Health practitioners should routinely assess maternal psychological functioning during pediatric visits to optimize parent and child flourishment.
... According to previous literature, there is no evidence that one measure is better than the others, and the choice may depend on numerous considerations [7,16,17]. For instance, Beck Depression Inventory (BDI) may be a more accurate measure of mild or "neurotic" depressions [16,18], Patient Health Questionnaire-9 (PHQ-9) may be used to diagnose depressive symptoms and evaluate their severity [17], while the Center for Epidemiologic Studies Depression Scale (CES-D) is appropriate for measuring depressive symptoms in the general population [19]. Considering the purpose of screening depressive symptoms among general adolescents, this study focused on the CES-D. ...
... The original CES-D consisted of 20 items, measuring four factors including "depressed affect", "positive affect", "somatic and retarded activity" and "interpersonal" [19]. The scale was widely used in the Chinese context and showed adequate reliability and validity [20,21]. ...
... Therefore, from the statistical point of view, Model 5 could be selected as the most appropriate model. From the substantive point of view, Model 5 suggested two substantive components, including Negative Symptoms factor and Diminished Happiness Feeling factor, which was preferred because (1) in the original article, Radloff argued that the positive items were used to break tendencies toward response set and evaluate positive affect [19]; (2) with depression, both the World Health Organization (WHO) and American Psychiatric Association (APA) considered that it involved depressed mood or loss of interest or pleasure, implying that diminished positive emotions was not just a wording effect but an important dimension [1, 68]; (3) in a broader perspective, the WHO noted that, "Mental health is an integral component of health and well-being and is more than the absence of mental disorder" [69]. In line with this, a dual-factor model of mental health including associated positive and negative factors was recommended to better explain mental health [70,71]. ...
Background
The 8-item Center for Epidemiologic Studies Depression Scale (CES-D 8) has been widely used to measure depressive symptoms in many large-scale surveys. Due to its brevity, it can lower costs, relieve respondent burdens, and ensure data quality. However, its factor structure and measurement invariance across gender and time among adolescents have not been adequately evaluated. This study investigated its factor structure and measurement invariance across gender and time among adolescents.
Methods
The data was drawn from the China Family Panel Studies (CFPS) conducted in 2018 and 2020, with 3099 participants (46.82% girls) aged 11 to 18 in 2018. First, exploratory and confirmatory factor analyses were used to examine the factor structure of the CES-D 8. Next, multi-group confirmatory factor analysis was conducted to test its measurement invariance across gender and time. Finally, a longitudinal cross-gender test was conducted to further confirm the stability of the scale.
Results
A two-factor structure was identified among the adolescents, including Negative Symptoms and Diminished Happiness Feeling. Measurement invariance across gender and time, as well as the longitudinal cross-gender invariance, was supported, with configural, factor loadings, thresholds and residual invariance.
Conclusions
The factor structure of the CES-D 8 remains stable across gender and time among adolescents, indicating that it is a promising instrument for measuring depressive symptoms, especially in large-scale and longitudinal surveys.
... Psychological constructs are unobservable and often indirectly measured by scales with multiple items. For example, the Center for Epidemiologic Studies Depression Scale (CES-D Scale; Radloff, 1977) measures the construct of depression using 20 items that assess depressive symptoms (e.g., how often one had a poor appetite during the past week). Social and behavioral researchers commonly use the sum or mean scores of scale items to compare a psychological construct across groups. ...
... As many psychological scale items are not continuous but categorical, researchers have adapted the above multistage procedure to evaluating MI for ordered-categorical items (e.g., Likert-scale questionnaire items; Millsap & Tein, 2004). For example, unlike a continuous measure that can take on an unlimited number of values, a Likert-scale item on "how often one had a poor appetite during the past week" in CES-D often consists of four response categories: rarely, sometimes, occasionally, and most of the time (Radloff, 1977). Under the item factor model (Birnbaum, 1968;Wirth & Edwards, 2007), latent responses to ordered-categorical items are continuous but discretized into observed categories by a set of thresholds. ...
Measurement invariance (MI) of a psychometric scale is a prerequisite for valid group comparisons of the measured construct. While the invariance of loadings and intercepts (i.e., scalar invariance) supports comparisons of factor means and observed means with continuous items, a general belief is that the same holds with ordered-categorical (i.e., ordered-polytomous and dichotomous) items. However, as this paper shows, this belief is only partially true—factor mean comparison is permissible in the correctly specified scalar invariance model with ordered-polytomous items but not with dichotomous items. Furthermore, rather than scalar invariance, full strict invariance—invariance of loadings, thresholds, intercepts, and unique factor variances in all items—is needed when comparing observed means with both ordered-polytomous and dichotomous items. In a Monte Carlo simulation study, we found that unique factor noninvariance led to biased estimations and inferences (e.g., with inflated type I error rates of 19.52%) of (a) the observed mean difference for both ordered-polytomous and dichotomous items and (b) the factor mean difference for dichotomous items in the scalar invariance model. We provide a tutorial on invariance testing with ordered-categorical items as well as suggestions on mean comparisons when strict invariance is violated. In general, we recommend testing strict invariance prior to comparing observed means with ordered-categorical items and adjusting for partial invariance to compare factor means if strict invariance fails.
... The "Center for Epidemiologic Studies Depression Scale Revised (CESD-R)" (20 items) was adopted to measure depressive disorder referring to "The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)" (Radloff, 1977;Eaton et al., 2004). The students reported how frequently they have displayed the symptom described in each item through a rating measure ("0" = "Not at all or less than 1 day" to "4" = "Nearly every day for 2 weeks"). ...
... Based on the DASS-21 criteria, 60.8, 54, and 33.2% of the participants showed mild to extremely severe levels of anxiety, depression, and stress, respectively. Regarding CESD-R, 41.6% of the participants were identified as experiencing depression (scored 16 or above) (Radloff, 1977). Besides, based on IAT-10 criteria (Pawlikowski Frontiers 3.3 Psychosocial correlates of psychological morbidity and positive well-being Table 4 demonstrates the results of correlation analyses among major variables. ...
Although the COVID-19 pandemic has caused many problems for university students, there are several research gaps in the study of psychological well-being of Hong Kong university students. First, few studies have examined different ecological correlates of mental health in a single study. Second, few studies have used both psychological morbidity and positive well-being as indicators of mental health. Third, we know little about the relationships between university students’ perceived need satisfaction, difficulties, service utilization, and their mental health. Hence, we conducted a study ( N = 1,020 university students) in the later stage of the COVID-19 pandemic in Hong Kong. For mental health, we included measures of negative mental health (psychological morbidity) and positive mental health. We addressed several research questions in this study: (1) what is the mental health status of Hong Kong university students? (2) what is the relationship between COVID-19 stress and student mental health? (3) what are the intrapersonal correlates of student mental health? (4) are interpersonal factors related to student mental health? (5) are need satisfaction, difficulties encountered, and service utilization related to students’ mental health? (6) are there gender differences in the effects of correlates in different ecological systems? Analyses using structural equation modeling showed several observations. First, the prevalence of mental health symptoms among university students was alarming. Second, COVID-19 related socio-economic stress positively predicted psychological morbidity but negatively predicted well-being. Third, beliefs about adversity, resilience, and emotional competence predicted mental health. Fourth, family functioning was related to psychological morbidity negatively but connected with well-being positively. Fifth, while need satisfaction predicted psychological morbidity negatively, difficulties encountered showed the opposite direction. Besides, the perceived usefulness of university services positively predicted mental health. Finally, there were no gender differences in the effects of different predictors. The present findings enable public health researchers to formulate theoretical models on different ecological determinants of university students’ mental health under the pandemic. For public health practitioners, the study highlights the importance of reducing COVID-19 associated stress, strengthening internal and external developmental assets, and meeting the psychosocial needs of university students as strategies to promote their mental health under the pandemic.
... The Center for Epidemiological Studies Depression Scale (CES-D), a 20-item self-report depressive symptom scale, was administered at 24 months (Radloff, 1977). Participants rate how often over the past week they have experienced symptoms on a 4-point scale. ...
... Higher scores indicate higher severity of symptoms. Scores >15 are in the clinical range (Radloff, 1977); 27.53% (n = 19) of caregivers met the clinical criteria for depression. ...
Early adversities, including prenatal drug exposure (PDE) and a negative postnatal emotional caregiving environment, impact children’s long-term development. The protracted developmental course of memory and its underlying neural systems offer a valuable framework for understanding the longitudinal associations of pre- and postnatal factors on children with PDE. This study longitudinally examines memory and hippocampal development in 69 parent–child dyads to investigate how the early caregiving emotional environment affects children with PDE’s neural and cognitive systems. Measures of physical health, drug exposure, caregiver stress, depression, and distress were collected between 0 and 24 months At age 14 years, adolescents completed multiple measures of episodic memory, and at ages 14 and 18 years, adolescents underwent magnetic resonance imaging (MRI) scans. Latent constructs of episodic memory and the caregiving environment were created using Confirmatory Factor Analysis. Multiple regressions revealed a negative emotional caregiving environment during infancy was associated with poor memory performance and smaller left hippocampal volumes at 14 years. Better memory performance at 14 years predicted larger right hippocampal volume at 18 years. At 18 years, the association between the emotional caregiving environment and hippocampal volume was moderated by sex, such that a negative emotional caregiving environment was associated with larger left hippocampal volumes in males but not females. Findings suggest that the postnatal caregiving environment may modulate the effects of PDE across development, influencing neurocognitive development.
... Seven items of the German version (Kohlmann & Gerbershagen, 2006) of the Center for Epidemiologic Studies Depression Scale (CES-D; Radlo , 1977) measured the extent to which participants reported depressive symptoms (e.g., 'I felt like a bad person'; α = 0.89) on a scale ranging from 1 (not at all or less then 1 day last week) to 4 ( ve to seven days last week). Self-esteem was assessed with four items (e.g., 'On the whole, I am satis ed with myself'; α = 0.81) of the revised German version of the Rosenberg Self-esteem scale (Collani & Herzberg, 2003) on a 4-point Likert-scale from 1 (strongly disagree) to 4 (strongly agree). ...
Due to rising Islamophobia in Europe today, Muslim ethnic minority adolescents are at great risk of experiencing identity-based harassment at school. We extend previous research on ethnic discrimination by focusing on religious discrimination of Muslim adolescents and its effect on their psychological (i.e., depressive symptoms and self-esteem) and behavioural adjustment (i.e., disruptive behaviour at school). Further, we consider Muslim adolescents’ ethnic and religious identification as two factors that may promote adolescents’ adjustment and protect them from the negative consequences of discrimination. We used data from N = 105 Muslim ethnic minority adolescents (Mage = 13.30, SD = 0.75, 45% female). Factor analysis revealed that adolescents did not differentiate between ethnic and religious discrimination. Results show that higher perceived ethno-religious discrimination (PERD) was related to more depressive symptoms. While higher ethnic identification was associated with greater self-esteem, higher religious identification was related to fewer depressive symptoms. Contrary to our expectation, Muslim adolescents who were highly identified with their ethnic group reported more depressive symptoms when experiencing more PERD. Their self-esteem was negatively affected by higher PERD when possessing high religious identification, while for low religious identification a positive effect of higher PERD on self-esteem emerged. Results highlight the importance of developing evidence-based intervention programmes for schools to tackle identity-based harassment.
... Emotional distress was found to significantly relate to depression in this study; to prevent collinearity, emotional distress was not included in linear regression models. The present study also used the Center for Epidemiologic Studies Depression Scale (CES-D) [37,38] to evaluate participants' frequency of depressive symptoms in the preceding month on a 4-point Likert scale, with a higher total score indicating more severe depression. ...
Individuals with schizophrenia are more likely to be infected with COVID-19 than are members of the general population. No prospective study has examined the associations of multi-dimensional factors with the motivation to receive vaccination against COVID-19. This follow-up study investigated the effects of individual (sociodemographic and illness characteristics, depression, and self-esteem), environmental (perceived social support), and individual–environmental interaction factors (self-stigma and loneliness) on the motivation to receive vaccination against COVID-19 and the number of COVID-19 vaccine doses received one year later among 300 individuals with schizophrenia. The associations of baseline factors with motivation to receive vaccination against COVID-19 and the number of vaccine doses received 1 year later were examined through linear regression analysis. The results indicated that greater loneliness (p < 0.01) and being married or cohabitating (p < 0.05) at baseline were significantly associated with lower motivation to receive vaccination against COVID-19 at follow-up. Disorganization (p < 0.05) at baseline was significantly associated with fewer COVID-19 vaccine doses at follow-up; greater motivation to receive vaccination was significantly associated with more COVID-19 vaccine doses at follow-up (p < 0.001). Health professionals should consider the identified predictors while developing intervention programs aimed at enhancing vaccination against COVID-19 in individuals with schizophrenia.
... The PAID scale has been psychometrically validated among a diverse array of populations. [35][36][37] Diabetes self-care: The Summary of Diabetes Self-Care Activities (SDSCA) measure was administered to assess key self-care domains including general and specialized diet, exercise, blood sugar testing, and footcare. The SDSCA tends to be highly correlated with other measures of diet and exercise, and it has been employed in a variety of settings with validity and reliability. ...
Introduction
Appalachian residents are more likely than other populations to have Type 2 Diabetes Mellitus (T2DM) and to experience more severe complications from the disease, including excess and premature mortality.
Methods
This study examines health alongside sociodemographic factors, psychosocial factors (including knowledge, empowerment, social support/function, religiosity, distress), and perceived problems in diabetes management that may influence self-care and HbA1c among vulnerable rural residents. A survey of a community–based sample of 356 adults with diagnosed diabetes or HbA1c > 6.5 was conducted in six counties in Appalachian Kentucky.
Results
Findings suggest that neither religiosity nor social support/function mediate/moderate the relationship between psychosocial factors and dependent variables (problem areas in diabetes, T2DM self-care or HbA1c). Results also suggest that distress is a predictor of problem areas in diabetes, and both distress and empowerment are predictors of T2DM self-care.
Implications
This study addresses the gap in the literature concerning the influence of psychosocial factors on problem areas in diabetes, T2DM self-care and HbA1c among vulnerable rural residents, as well as the potential mediating/modifying effects of religiosity and social function/support. Future research is needed to inform strategies for identifying and addressing distress among vulnerable populations burdened by T2DM, including Appalachian adults.
... The frequency of depressive symptoms individuals experienced in the week prior to participating in the study was measured by the Center for Epidemiologic Studies Depression Scale (CES-D) compiled by Radloff and revised by Chen Zhiyan. 31,32 The scale consists of 20 items, and the reverse scoring questions are 4, 8, 12, and 16. It includes four factors: depression, positive emotions, somatic symptoms, and interpersonal relationships. ...
Purpose
High school students face various pressures such as academic and interpersonal relationships, which can easily lead to depression. Social exclusion is one of the important influencing factors for adolescent depression, but there is still limited research on the mechanisms of the impact that social exclusion has on depression. Therefore, this study aimed to explore the effect of social exclusion on depression among high school students, as well as the mediating role of thwarted belongingness and the moderating role of cognitive reappraisal.
Methods
Researchers assessed 1041 high school students using the Center for Epidemiologic Studies Depression Scale (CES-D), Adolescent Social Exclusion Scale, Interpersonal Needs Scale, and Emotion Regulation Scale.
Results
(1) Social exclusion was negatively associated with cognitive reappraisal (r = −0.224, p < 0.001), and positively associated with thwarted belongingness and depression (r = 0.657, 0.490, p <0.001). Thwarted belongingness was positively associated with depression (r = 0.617, p <0.001), and negatively associated with cognitive reappraisal (r = −0.325, p <0.001). Cognitive reappraisal was negatively associated with depression (r = −0.280, p < 0.01). (2) Social exclusion could directly predict depression, 95% CI [0.08, 0.21]. Thwarted belongingness played a partial mediating role between social exclusion and depression, 95% CI [0.30, 0.40]. (3) Cognitive reappraisal moderated the predictive effect of thwarted belongingness on depression.
Conclusion
Social exclusion can influence depression through thwarted belongingness and cognitive reappraisal, and educators can reduce depression by decreasing thwarted belongingness and promoting the use of cognitive reappraisal strategies by high school students.
... We will use the Centre for Epidemiological Studies Depression Scale, a commonly used screening tool for depressive symptoms [45]. ...
Background
Limited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15–24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient physical activity. Evidence shows that increasing physical activity by 50 min of moderate intensity physical activity in sedentary older adults with mobility limitations can improve mobility and reduce the incidence of mobility disability. To maximize the healthy life span of older adults, it is necessary to find effective and efficient interventions that can be delivered widely to prevent mobility limitations, increase physical activity participation, and improve quality of life in older adults. We propose a randomized controlled trial to assess the effect of a physical activity health coaching intervention on mobility in older adults with mobility limitations.
Methods
This randomized controlled trial among 290 (145 per group) community-dwelling older adults with mobility limitations, aged 70–89 years old, will compare the effect of a physical activity health coaching intervention versus a general healthy aging education program on mobility, as assessed with the Short Physical Performance Battery. The physical activity health coaching intervention will be delivered by exercise individuals who are trained in Brief Action Planning. The coaches will use evidence-based behavior change techniques including goal-setting, action planning, self-monitoring, and feedback to improve participation in physical activity by a known dose of 50 min per week. There will be a total of 9 health coaching or education sessions delivered over 26 weeks with a subsequent 26-week follow-up period, wherein both groups will receive the same duration and frequency of study visits and activities.
Discussion
The consequences of limited mobility pose a significant burden on the quality of life of older adults. Our trial is novel in that it investigates implementing a dose of physical activity that is known to improve mobility in older adults utilizing a health coaching intervention.
Trial registration
ClinicalTrials.gov Protocol Registration System: NCT05978336; registered on 28 July 2023.
... The 20-item Epidemiologic Studies Depression Scale (Radloff, 1977) was used to assess adolescents' depressive symptoms at T1 and T2, respectively. A sample item is "My mother/father seems to check their phones for messages and social media updates." ...
A growing body of research indicates that phubbing can negatively influence adolescent development, it is not clear how perceived parental phubbing, adolescent phubbing, and adolescents’ adjustment problems concurrently relate to each other at the dimension level. This study conducted the contemporaneous network analyses and cross-lagged network analysis to examine the distinct relationships between the various dimensions of perceived father phubbing, perceived mother phubbing, adolescent phubbing and adolescent’s adjustment problems. A total of 1447 Chinese students (60.5% females; Mean age = 16.15, SD = 0.65) completed a survey at two-time points. The results of the contemporaneous network analyses indicated that perceived father/mother ignorance have the strongest links with the dimensions of adolescent phubbing and adolescents’ adjustment problems, suggesting that adolescents who reported high levels of perceived father/mother ignorance are more likely to concurrently face other issues and thus should be a primary focus of concern. The cross-lagged panel network analysis revealed that academic burnout is the primary catalyst in this dynamic network, which underscores a child-driven effect within the network. This emphasizes the importance of addressing adolescent academic burnout as a pivotal intervention point, both to alleviate phubbing in parent-adolescent interactions and to tackle adolescents’ adjustment problems.
... They were recruited through an advertisement in the "students and part-time work" section of an online classified service. Respondents to the advertisement were first taken through a short telephone screening, followed by an in-person semi- (Radloff, 1977) for depression screening (cut-off at CES-D > 15) and the morningness-eveningness questionnaire (MEQ) (Horne and Ostberg, 1976) (Buysse et al., 1989) the Epworth sleepiness scale (ESS, <8) (Johns, 1991) and the insomnia severity index (ISI, <8) (Morin et al., 2011). Psychological questionnaires consisted of Beck's depression inventory (BDI, <10) and the Beck Anxiety Inventory (BAI, <8) (Beck et al., 1996). ...
There is growing evidence in humans linking the temporal coupling between spindles and slow oscillations during NREM sleep with the overnight stabilization of memories encoded from daytime experiences in humans. However, whether the type and strength of learning influence that relationship is still unknown. Here we tested whether the amount or type of verbal word-pair learning prior to sleep affects subsequent phase-amplitude coupling (PAC) between spindles and slow oscillations (SO). We measured the strength and preferred timing of such coupling in the EEG of 41 healthy human participants over a post-learning and control night, to compare intra-individual changes with inter-individual differences. We leveraged learning paradigms of varying word-pair (WP) load: 40 WP learned to a minimum criterion of 60% correct (n=11); 40 WP presented twice (n=15); 120 WP presented twice (n=15). There were no significant differences in the preferred phase or strength between the control and post-learning nights, in all learning conditions. We observed an overnight consolidation effect (improved performance at delayed recall) for the criterion learning condition only, and only in this condition was the overnight change in memory performance significantly positively correlated with the phase of SO-spindle coupling. These results suggest that the coupling of brain oscillations during human NREM sleep are stable traits that are not modulated by the amount of pre-sleep learning, yet are implicated in the sleep-dependent consolidation of memory.
... The eight-item version of the CES-D was administered at all nine waves [37]. The CES-D-8 is a shortened version of the CES-D 20-item selfreport questionnaire [41]. It displays similar psychometric properties as the longer version in different populations, including adults aged 50 and above in Ireland [42] and adults aged 70 and above in the United States [37]. ...
An increased understanding of the interrelations between depressive symptoms among older populations could help improve interventions. However, studies often use sum scores to understand depression in older populations, neglecting important symptom dynamics that can be elucidated in evolving depressive symptom networks. We computed Cross-Lagged Panel Network Models (CLPN) of depression symptoms in 11,391 adults from the English Longitudinal Study of Ageing. Adults aged 50 and above (mean age 65) were followed over 16 years throughout this nine-wave representative population study. Using the eight-item Center for Epidemiological Studies Depression Scale, we computed eight CLPNs covering each consecutive wave. Across waves, networks were consistent with respect to the strength of lagged associations (edge weights) and the degree of interrelationships among symptoms (centrality indices). Everything was an effort and could not get going displayed the strongest reciprocal cross-lagged associations across waves. These two symptoms and loneliness were core symptoms as reflected in strong incoming and outgoing connections. Feeling depressed was strongly predicted by other symptoms only (incoming but not strong outgoing connections were observed) and thus was not related to new symptom onset. Restless sleep had outgoing connections only and thus was a precursor to other depression symptoms. Being happy and enjoying life were the least central symptoms. This research underscores the relevance of somatic symptoms in evolving depression networks among older populations. Findings suggest the central symptoms from the present study (everything was an effort, could not get going, loneliness) may be potential key intervention targets to mitigate depression in older adults.
... We assessed the severity of depression using the Center for Epidemiological Studies Depression Scale (CES-D) developed by Radloff,38 which includes 20 questions about the level of depressive symptoms to assess symptom frequency and severity rated on a 4-point Likert scale from 0 to 3 with a cutoff score of 16. The Korean version was developed in 2001 by Jeon et al., 39 and the Cronbach's α was shown to be high (α=0.86). ...
Objective:
This study aimed to identify the factors affecting posttraumatic stress disorder (PTSD) symptom remission prospectively through a 1-year follow-up of sexual assault (SA) victims.
Methods:
A total 65 female SA victims who visited the crisis intervention center were included. Self-administered questionnaires regarding PTSD symptoms and PTSD related prognostic factors were conducted at both recruitment (T1) and 1 year after recruitment (T2). The multivariate analyses were used to determine the significant predictors of PTSD remission/non-remission state 1 year after SA.
Results:
In logistic regression analysis, both anxiety and secondary victimization were identified as significant factors explaining the results on PTSD remission/non-remission state at T2 (Beck's Anxiety Inventory [BAI], p=0.003; Secondary Victimization Questionnaire, p=0.024). In a linear mixed analysis, both depression and anxiety were found to be significant variables leading to changes in Posttraumatic Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition from T1 to T2 (BAI, p<0.001; Center for Epidemiological Studies Depression Scale, p<0.001).
Conclusion:
Depression, anxiety symptoms, and secondary victimization after SA were associated with PTSD symptom non-remission 1 year after SA.
... Affective wellbeing was assessed using the Centre for Epidemiological Studies Depression Scale (CES-D) (Radloff, 1977). This 20-item instrument captures a range of emotions including positive and negative affect, as well as feelings of guilt and worthlessness. ...
Introduction
Previous research has established a positive correlation between income and subjective wellbeing (SWB). This correlation is attributed to income’s ability to provide material circumstances and influence one’s perceived socioeconomic rank in society, known as subjective socioeconomic status (SES).
Objective
This study sought to examine whether social comparison processes could mediate the relationship between income and SWB. Specifically, we aimed to explore the impact of comparing one’s current socioeconomic situation to individuals from a similar socioeconomic background (referred to as Comsim) on SWB, based on the similarity hypothesis of social comparison theory.
Methods
Data stem from two separate two-wave surveys. Study 1 comprised 588 participants, with 294 men and 294 women; age range 25–60 years; mean age 41.5 years). Study 2 comprised 614 participants, with 312 men and 302 women; age range 25–60 years; mean age 43.5 years. In both studies, data on predictors and SWB were collected 3 months apart.
Results
In both study 1 and study 2, bivariate analysis demonstrated a positive correlation between income and SWB. However, multivariate regression models revealed that income did not have a direct effect on SWB. Instead, in both studies, subjective SES and Comsim emerged as significant predictors of SWB, with Comsim being the most influential. Furthermore, our formal mediation analysis indicated that subjective SES and Comsim fully mediated the relationship between income and SWB, when combined. Additionally, in study 2, we found that cognitive factors such as personal control, as well as affective factors like self-esteem, played a mediating role between the social comparison processes and SWB.
Conclusion
This study contributes to existing research by emphasizing the importance of two distinct social comparison mechanisms in mediating the relationship between income and SWB.
Implications
Therapeutic interventions to improve SWB should also consider social comparison processes. From a political standpoint, policies addressing income inequality can mitigate the negative effects of social comparisons on wellbeing. Providing support to those in lower socioeconomic positions can also enhance SWB.
... At the end of 4-week follow-up, all questionnaires including center for epidemiological studies-depression scale (CES-D) [14], profile of mood states (POMS) [15], and Pittsburgh sleep quality index (PSQI) [16] questionnaires were applied again and the results were compared with the baseline. ...
This study was performed to investigate the effect of omega-3 administration on the treatment of mood and sleep problem induced by menopausal complications due to hormone therapy in patients with breast cancer.
A pilot, randomized, double-blinded and placebo-controlled clinical trial was designed in oncology-hematology outpatient’s clinic of Omid Hospital, Isfahan, Iran. First, 60 patients were screened by Hospital Anxiety and Depression Scale (HADS) for any non-identified baseline mood problems and then divided into either intervention group which received 2 g’ omega-3 daily for 4 weeks or placebo group which received identical supplement. Then, the patients were considered to assess by center for epidemiological studies—depression scale (CES-D), profile of mood states (POMS), and Pittsburgh sleep quality index (PSQI) questionnaires at the baseline and after 4-week follow-up.
The mean scores of CES-D (P = 0.002), POMS (P = 0.03), and PSQI (P = 0.04) were significantly lower in the intervention group than the control group. In the intervention group, mean scores of CES-D (P < 0.001), POMS (P < 0.001), and PSQI (P = 0.003) were significantly lower after intervention than pre-intervention. Mean changes in scores of CES-D (P = 0.01), POMS (P = 0.001), and PSQI (P = 0.02) were significantly higher in the intervention group than the control group.
Our findings revealed that omega-3 supplementation have the potential to reduce mood problems complications induced by hormone therapy in breast cancer patients, and it could also improve sleep quality items in terms of subjective sleep quality, delay in falling asleep, sleep delay, and sleep disturbance.
... Psychological stress was assessed using the Centre for Epidemiologic Studies Depression Scale (CES-D), a validated self-report psychometric scale [42]. Items 1-20 are scored on a four-point Likert scale and then summed to obtain a total score that ranges from 0-60, whereby a higher score indicates more depressive symptomatology. ...
We explored how dietary behaviors (sucrose, fructose, sodium, and potassium consumption) and endured psychological stress in young adult males and females impact the vascular aging index (VAI) and CVD risk by mid-life. Data were obtained from the Coronary Artery Risk Development in Young Adults Study, an ongoing longitudinal study. Included participants (n=2,656) had un-dergone carotid artery ultrasound at year 20 allowing VAIs to be calculated. Demographics, di-etary data and depression scores were obtained at baseline and year 20. Regression analyses were used to assess the predictors of VAI. Cox regression analyses were conducted to assess the risk of CVD, stroke and all-cause mortality. Predictors of vascular aging were found to be sex-specific. In females, CES-D scores at baseline were positively associated with VAI (B-weight=0.063, p=0.015). In males, sodium intake at year 20 positively predicted VAI (B-weight=0.145, p=0.003) and potassium intake inversely predicted VAI (B-weight=-0.160, p<0.001). BMI significantly predicted CVD, stroke, and death. Fructose consumption at year 20 was a significant predictor of CVD risk while having high blood pressure at baseline was signif-icantly associated with stroke risk. Our findings support the promotion of nutrient- specific be-havior changes to prevent vascular aging in early adulthood and CVD risk in mid-life.
... Finally, we measured depressive symptoms with the Center for Epidemiological Studies Depression scale (CES-D, Radloff, 1977). As mentioned in our preregistration, this was an exploratory variable meant for future use. ...
How feelings change over time is a central topic in emotion research. To study these affective fluctuations, researchers often ask participants to repeatedly indicate how they feel on a self-report rating scale. Despite widespread recognition that this kind of data is subject to measurement error, the extent of this error remains an open question. Complementing many daily-life studies, this study aimed to investigate this question in an experimental setting. In such a setting, multiple trials follow each other at a fast pace, forcing experimenters to use a limited number of questions to measure affect during each trial. A total of 1398 participants completed a probabilistic reward task in which they were unknowingly presented with the same string of outcomes multiple times throughout the study. This allowed us to assess the test–retest consistency of their affective responses to the rating scales under investigation. We then compared these consistencies across different types of rating scales in hopes of finding out whether a given type of scale led to a greater consistency of affective measurements. Overall, we found moderate to good consistency of the affective measurements. Surprisingly, however, we found no differences in consistency across rating scales, which suggests that the specific rating scale that is used does not influence the measurement consistency.
... Depression. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D) 48 . Items were rated on a 0 (rarely or none of the time) to 3 (most or all the time) scale. ...
Evidence on the harms and benefits of social media use is mixed, in part because the effects of social media on well-being depend on a variety of individual difference moderators. Here, we explored potential neural moderators of the link between time spent on social media and subsequent negative affect. We specifically focused on the strength of correlation among brain regions within the frontoparietal system, previously associated with the top-down cognitive control of attention and emotion. Participants (N = 54) underwent a resting state functional magnetic resonance imaging scan. Participants then completed 28 days of ecological momentary assessment and answered questions about social media use and negative affect, twice a day. Participants who spent more than their typical amount of time on social media since the previous time point reported feeling more negative at the present moment. This within-person temporal association between social media use and negative affect was mainly driven by individuals with lower resting state functional connectivity within the frontoparietal system. By contrast, time spent on social media did not predict subsequent affect for individuals with higher frontoparietal functional connectivity. Our results highlight the moderating role of individual functional neural connectivity in the relationship between social media and affect.
... During the 20-min delay, both groups completed a demographic and health history questionnaire. Salthouse's Synonym and Antonym Test (Salthouse, 1993) and the Center for Epidemiologic Screening-Depression Scale (CES-D) (Radloff, 1977) were also administered during the delay to examine general intellectual functioning and depressive symptoms, respectively, for the American sample only. No parallel standardized Italian measures were available for the Italian participants, but they were given unstandardized direct translations of the Synonym and Antonym test and CES-D to fill the 20-min time delay. ...
Objective
Word list-learning tasks are commonly used to evaluate auditory-verbal learning and memory. However, different frequencies of word usage, subtle meaning nuances, unique word phonology, and different preexisting associations among words make translation across languages difficult. We administered lists of consonant-vowel-consonant (CVC) nonword trigrams to independent American and Italian young adult samples. We evaluated whether an auditory list-learning task using CVC nonword trigrams instead of words could be applied cross-culturally to evaluate similar learning and associative memory processes.
Participants and Methods
Seventy-five native English-speaking (USA) and 104 native Italian-speaking (Italy) university students were administered 15-item lists of CVC trigrams using the Rey Auditory Verbal Learning Test paradigm with five study-test trials, an interference trial, and short- and long-term delayed recall. Bayesian t tests and mixed-design ANOVAs contrasted the primary learning indexes across the two samples and biological sex.
Results
Performance was comparable between nationalities on all primary memory indices except the interference trial (List B), where the Italian group recalled approximately one item more than the American sample. For both nationalities, recall increased across the five learning trials and declined significantly on the postinterference trial, demonstrating susceptibility to retroactive interference. No effects of sex, age, vocabulary, or depressive symptoms were observed.
Conclusions
Using lists of unfamiliar nonword CVC trigrams, Italian and American younger adults showed a similar performance pattern across immediate and delayed recall trials. Whereas word list-learning performance is typically affected by cultural, demographic, mood, and cognitive factors, this trigram list-learning task does not show such effects, demonstrating its utility for cross-cultural memory assessment.
Objective
To examine whether the age stereotypes of older individuals would become more negative or else show resiliency following stressful events and to examine whether age-stereotype negativity would increase the likelihood of experiencing a stressful event (i.e., hospitalization).
Method
Age stereotypes of 231 participants, 70 years and older, were assessed across 10 years, before and after the occurrence of hospitalizations and bereavements.
Results
Age-stereotype negativity was resilient despite encountering stressful events. In contrast, more negative age stereotypes were associated with a 50% greater likelihood of experiencing a hospitalization.
Discussion
The robustness of negative age stereotypes was expressed in their capacity to resist change as well as generate it.
The coronavirus disease (COVID‐19) has caused social isolation and loneliness among Japanese university students. Stress mindset, namely, beliefs about stress and its consequences, is related to mental health through emerging evidence. This study investigated the relationship between stress mindset and mental health during the COVID‐19 pandemic and assessed the mediating effect of coping behaviors. An online survey was conducted in mid‐October 2021 with 4,120 university students from 47 prefectures in Japan. Stress mindset (stress‐is‐enhancing and stress‐is‐debilitating mindsets), coping behaviors, and mental health (loneliness and depression) were measured. The results showed that the positive path from a stress‐is‐debilitating mindset to depression and loneliness, and the negative path from a stress‐is‐enhancing mindset to loneliness, were significant. Furthermore, the stress‐is‐enhancing mindset was mediated by vaccination status, inducing a decrease in loneliness; the stress‐is‐debilitating mindset was mediated by a decrease in part‐time jobs and extracurricular activities, and inducing an increase in loneliness and depression. Current findings indicate that stress mindset may influence the behavioral tendencies and mental health of Japanese university students during COVID‐19, comprising an internal resource to protect their mental health.
Objective
To identify the factors influencing longitudinal changes in patients' scores across 6 domains of the Quality of Life after Brain Injury (QOLIBRI) instrument 1 year after mild traumatic brain injury (mTBI).
Design
This was a longitudinal cohort study.
Participants and Setting
Eligible patients with a new diagnosis of mTBI were recruited from the outpatient clinics of the neurosurgery departments of 3 teaching hospitals in Taipei City, Taiwan. In total, 672 patients participated in the baseline assessment. Postinjury follow-up was conducted at 6 and 12 months.
Main Outcome Measure
Six domains of the 37-item QOLIBRI: Cognition, Self, Daily Life and Autonomy, Social Relationships, Emotions, and Physical Problems.
Results
Linear mixed-effects analyses revealed that, among patients younger than 60 years, the scores of the Cognition, Self, Daily Life and Autonomy, and Social Relationships domains significantly increased 6 months after injury; furthermore, their scores of the Cognition, Self, and Daily Life and Autonomy significantly increased 12 months after injury. By contrast, among patients 60 years and older, the scores of these domains reduced from baseline to 6 and 12 months. No significant sex-based difference was observed in the changes in scores of any QOLIBRI domain. At 6 and 12 months post-injury, the scores of the Cognition, Emotions, and Physical Problems domains were significantly higher for patients with postconcussive symptoms than for those without these symptoms.
Conclusions
Although multiple characteristics of patients significantly affected their baseline scores on the 6 domains of the QOLIBRI, only age and postconcussive symptoms were significantly associated with longitudinal changes in their scores 6 and 12 months after mTBI.
Importance
Cognitive impairment is prevalent in survivors of stroke, affecting approximately 30% of individuals. Physical exercise and cognitive and social enrichment activities can enhance cognitive function in patients with chronic stroke, but their cost-effectiveness compared with a balance and tone program is uncertain.
Objective
To conduct a cost-effectiveness and cost-utility analysis of multicomponent exercise or cognitive and social enrichment activities compared with a balance and tone program.
Design, Setting, and Participants
This economic evaluation used a Canadian health care systems perspective and the Vitality study, a randomized clinical trial aimed at improving cognition after stroke with a 6-month intervention and a subsequent 6-month follow-up (ie, 12 months). The economic evaluation covered the duration of the Vitality trial, between June 6, 2014, and February 26, 2019. Participants were community-dwelling adults aged 55 years and older who experienced a stroke at least 12 months prior to study enrollment in the Vancouver metropolitan area, British Columbia, Canada. Data were analyzed from June 1, 2022, to March 31, 2023.
Interventions
Participants were randomly assigned to twice-weekly classes for 1 of the 3 groups: multicomponent exercise program, cognitive and social enrichment activities program, or a balance and tone program (control).
Main Outcomes and Measures
The primary measures for the economic evaluation included cost-effectiveness (incremental costs per mean change in cognitive function, evaluated using the Alzheimer Disease Assessment Scale–Cognitive-Plus), cost-utility (incremental cost per quality-adjusted life-year gained), intervention costs, and health care costs. Since cognitive benefits 6 months after intervention cessation were not observed in the primary randomized clinical trial, an economic evaluation at 12 months was not performed.
Results
Among 120 participants (mean [SD] age, 71 [9] years; 74 [62%] male), 34 were randomized to the multicomponent exercise program, 34 were randomized to the social and cognitive enrichment activities program, and 52 were randomized to the balance and tone control program. At the end of the 6-month intervention, the cost per mean change in Alzheimer Disease Assessment Scale–Cognitive-Plus score demonstrated that exercise was more effective and costlier compared with the control group in terms of cognitive improvement with an incremental cost-effectiveness ratio of CAD −$8823. The cost per quality-adjusted life-year gained for both interventions was negligible, with exercise less costly (mean [SD] incremental cost, CAD −$32 [$258]) and cognitive and social enrichment more costly than the control group (mean [SD] incremental cost, CAD $1018 [$378]). The balance and tone program had the lowest delivery cost (CAD $777), and the exercise group had the lowest health care resource utilization (mean [SD] $1261 [$1188]) per person.
Conclusions and Relevance
The findings of this economic evaluation suggest that exercise demonstrated potential for cost-effectiveness to improve cognitive function in older adults with chronic stroke during a 6-month intervention.
Background
Adolescent depression has grown to be a major social concern in China. During the coronavirus pandemic, the incidence of depression among Chinese adolescents increased substantially. More research is required to inform the prevention and intervention of adolescent depression in China. Depression is associated with Early Maladaptive Schemas (EMSs). Childhood abuse and neglect are distal antecedents of adolescent depression. It is not known how depression and EMSs interact in adolescence and how childhood abuse and neglect contribute to this relationship. This study aimed to examine the reciprocal relationships between depression and EMSs, as well as the long-term effects of childhood abuse and neglect on depression and EMSs during adolescence. The work also investigates gender differences in these mechanisms.
Methods
Using a two-wave longitudinal design, we recruited 3,485 Chinese adolescents (Mage = 13.2; 43.2% females) from three Shanxi Province, China middle schools. All participants completed self-report questionnaires addressing childhood abuse and neglect, depression, and EMSs. Structural equation models examined reciprocal relationships between depression and EMS, as well as the effect of childhood abuse and neglect on depression and EMSs. Multi-group analysis addressed gender differences.
Results
Results indicated that greater depression predicted more EMSs measured later, but EMSs did not predict subsequent depression. Childhood abuse and neglect had different effects on depression and EMSs during adolescence. Specifically, exposure to childhood abuse related to more severe depression and EMSs in adolescence and contributed to the perpetuation of EMSs by increasing depression. Exposure to childhood neglect showed a direct effect on depression and indirectly reinforced subsequent EMSs through depression. There were no gender differences.
Conclusion
These findings contribute to a better understanding of the emergence and course of depression in early adolescence, suggesting that childhood abuse and neglect are critical early risk factors. Additionally, depression plays a key role in promoting schema perpetuation among adolescents exposed to childhood maltreatment, providing important implications for relevant prevention and intervention in early adolescence.
Background
Food insecurity (FI) remains a global public health problem. FI is more prevalent in low-and middle-income countries than high-income countries. FI is related with worse cognitive outcomes including cognitive function, cognitive decline, and cognitive impairment. Few studies have sought to identify how patterns of FI relate with cognitive function in old age and the potential mechanisms underlying this association.
Methods
Data from the 2015 and 2018 waves of the Mexican Health and Aging Study (n = 9,654, age 50+) were used in this study. Reports of FI in 2015 and 2018 were combined to create four patterns of FI groups: “persistently food secure”, “became food secure”, “became food insecure”, and “persistently food insecure”. Linear regression was used to estimate associations between patterns of FI and cognitive task performance. The mediating roles of depressive symptoms, body mass index, and chronic conditions were tested using Karlson, Holm, and Breen methodology.
Results
Approximately half of the sample were persistently food secure, 17% became food secure, 14% became FI, and 15% experienced persistent FI. When adjusting for demographic/socioeconomic confounders, persistent FI related with worse Verbal Learning, Verbal Recall, Visual Scanning, and Verbal Fluency performance compared to the persistently food secure. Becoming FI related with worse Verbal Learning, Visual Scanning, and Verbal Fluency. Mediation analyses provided support for depressive symptoms mediating associations between FI and poorer cognition, where 48% of the association between persistent FI and worse Verbal Recall performance was attributed to higher depressive symptoms. Becoming food secure was not associated with cognitive performance compared to the persistently food secure.
Conclusions
FI may represent an important modifiable risk factor for poorer cognitive outcomes among older adults. Public health efforts should focus on providing stable food access to older adults, especially those living in poverty.
A focal point in the acculturation literature is the so-called “integration hypothesis,” whereby integration (high mainstream cultural engagement and heritage cultural maintenance) is associated with higher psychosocial adjustment, compared to other strategies. Yet, the vast majority of this literature is cross-sectional, raising questions about how best to understand associations between integration and adjustment. Does greater integration lead to greater psychosocial adjustment, as proposed by the integration hypothesis? Or is it the other way around, with more adjustment leading to greater integration, consistent with what we name the “mental resources hypothesis?” This study tests these 2 competing hypotheses in a 4-wave longitudinal study of 278 international students in their first weeks and months in Canada. The results replicate well-documented cross-sectional acculturation-adjustment associations. They also show that baseline adjustment is prospectively associated with later integration and mainstream acculturation, but not vice versa, supporting the mental resources hypothesis but not the integration hypothesis.
Importance
Blood-based biomarkers associated with increased risk of Alzheimer disease (AD) are understudied in people living with and without HIV, particularly women.
Objective
To determine whether baseline or 1-year changes in plasma amyloid-β40 (Aβ40), Aβ42, ratio of Aβ42 to Aβ40, total tau (t-tau), phosphorylated tau 231 (p-tau 231 ), glial fibrillary acidic protein (GFAP), and/or neurofilament light chain (NFL) are associated with neuropsychological performance (NP) among women living with HIV (WLWH) and women living without HIV (WLWOH).
Design, Setting, and Participants
This longitudinal, prospective, cohort study with 1-year repeated clinical measures (NP only measured once) and biospecimen collection occurred between 2017 and 2019. Participants were women aged 40 years or older from 10 clinical research sites in cities across the US that were part of the Women’s Interagency HIV Study. Data analysis was conducted from April to December 2022.
Exposure
Laboratory-confirmed HIV status and AD biomarkers.
Main Outcomes and Measures
Sociodemographically adjusted NP T-scores (attention and working memory, executive function, processing speed, memory, learning, verbal fluency, motor function, and global performance) were the primary outcomes. Baseline and 1-year fasting plasma Aβ40, Aβ42, t-tau, p-tau 231 , GFAP, and NFL levels were measured and analyzed using multivariable linear regression.
Results
The study consisted of 307 participants (294 aged ≥50 years [96%]; 164 African American or Black women [53%]; 214 women with a high school education or higher [70%]; 238 women who were current or former smokers [78%]; and 236 women [77%] who were overweight or obese [body mass index >25]) including 209 WLWH and 98 WLWOH. Compared with WLWOH at baseline, WLWH performed worse on learning (mean [SD] T - score 47.8 [11.3] vs 51.4 [10.5]), memory (mean [SD] T-score 48.3 [11.6] vs 52.4 [10.2]), verbal fluency (mean [SD] T-score 48.3 [9.8] vs 50.7 [8.5]), and global (mean [SD] T-score 49.2 [6.8] vs 51.1 [5.9]) NP assessments. Baseline median Aβ40, GFAP, and NFL levels were higher among WLWH vs WLWOH. There were no differences in 1-year biomarker change by HIV serostatus. Lower learning, memory, and motor NP were associated with 1-year Aβ40 increase; lower learning and motor with Aβ42 increase; lower motor with p-tau 231 increase; and lower processing speed, verbal fluency and motor with NFL increase in the entire sample. Among WLWH, a 1-year increase in Aβ40 from baseline to follow-up was associated with worse learning, memory, and global NP; a 1-year increase in t-tau with worse executive function; and a 1-year increase in NFL with worse processing speed. Among WLWOH, a 1-year increase in Aβ40 and Aβ42 were associated with poorer memory performance and NFL was associated with poorer motor performance.
Conclusions and Relevance
These findings suggest that increases in certain plasma AD biomarkers are associated with NP in WLWH and WLWOH and may be associated with later onset of AD, and measuring these biomarkers could be a pivotal advancement in monitoring aging brain health and development of AD among women with and without HIV.
Hematopoietic stem cell transplantation (hereafter “HCT”) is a physically and psychologically difficult treatment for patients with hematological cancers. This study examined relationships among patients’ reports of pre-transplant social isolation, social constraints, and psychological distress.
We used baseline data from a multisite randomized controlled trial evaluating the effects of expressive helping writing to reduce physical and emotional symptoms in HCT patients. We collected data prior to randomization and before either allogenic or autologous HCT using validated scales to assess social constraints, social isolation, anxiety, and depressive symptoms. We analyzed data using bivariate analysis and multivariate linear regression. We also explored whether social isolation mediated the effect of social constraints on both of our outcomes: anxiety and depressive symptoms.
Among 259 adults recruited prior to transplant, 43.6% were women (mean age = 57.42 years, SD = 12.34 years). In multivariate analysis controlling for relevant covariates, both social isolation (β = 0.24, p < 0.001) and social constraints (β = 0.28, p < 0.001) were associated with anxiety. When both social constraints and social isolation were in the model, only greater social isolation (β = 0.79, p < 0.001) was associated with depressive symptoms. Social isolation fully mediated the association between social constraints and anxiety and depressive symptoms.
For patients awaiting either allogenic or autologous HCT, the negative association between social constraints and anxiety and depressive symptoms may be related, in part, to the mechanism of perceived social isolation. Interventions prior to and during HCT are needed to support patients’ psychological health and sense of social connectedness.
This study aimed to compare community-dwelling older adults’ physical activity (PA) during the COVID-19 restrictions in 2020 to their PA levels 2 years before and investigate associations between earlier physical performance and PA levels over the follow-up. Participants’ ( n = 809, initial age 75–85 years) self-reported PA was assessed at baseline in 2017–2018 and May/June 2020 as total weekly minutes of walking and vigorous PA. Physical performance was assessed at baseline using the maximal handgrip strength and Short Physical Performance Battery tests. During the first wave of the COVID-19 pandemic, a median change in total weekly minutes of walking and vigorous PA among all participants was + 20.0 (interquartile range: −60.0 to 120.0, p < .001) min per week compared with 2 years earlier. Higher baseline Short Physical Performance Battery total scores were associated with higher total weekly minutes of walking and vigorous PA over the follow-up in men and women, and better handgrip strength in women.
Engaging in a wide range of pleasant activities may provide mental health benefits, particularly for those genetically predisposed to depression. This study examined associations between pleasant activity variety, mental health, and genetic vulnerability in two U.S. cohort studies (N = 2,088). Participants reported depressive symptoms, mental healthcare visits, and engagement in pleasant activities over the past month. Greater variety of pleasant activities was associated with fewer depressive symptoms in both study samples. Individuals engaging in more diverse pleasant activities also had fewer mental health visits. Individuals with a higher genetic risk for depression experienced a stronger negative association between variety of pleasant activities and depressive symptoms compared to those with a lower genetic risk. These results highlight the potential of diverse pleasant activities as a means to enhance well-being, particularly among individuals genetically susceptible to depression.
Background and aims
iCanQuit is a smartphone application (app) proven efficacious for smoking cessation in a Phase III randomized controlled trial (RCT). This study aimed to measure whether medications approved by the US Food and Drug Administration (FDA) for smoking cessation would further enhance the efficacy of iCanQuit, relative to its parent trial comparator—the National Cancer Institute's (NCI's) QuitGuide app.
Design
Secondary analysis of the entire parent trial sample of a two‐group (iCanQuit and QuitGuide), stratified, doubled‐blind RCT.
Setting
United States.
Participants
Participants who reported using an FDA‐approved cessation medication on their own ( n = 619) and those who reported no use of cessation medications ( n = 1469).
Interventions
Participants were randomized to receive iCanQuit app or NCI's QuitGuide app.
Measurements
Use of FDA‐approved medications was measured at 3 months post‐randomization. Smoking cessation outcomes were measured at 3, 6 and 12 months. The primary outcome was 12‐month self‐reported 30‐day point prevalence abstinence (PPA).
Findings
The data retention rate at the 12‐month follow‐up was 94.0%. Participants were aged 38.5 years, 71.0% female, 36.6% minority race/ethnicity, 40.6% high school or less education, residing in all 50 US States and smoking 19.2 cigarettes/day. The 29.6% of all participants who used medications were more likely to choose nicotine replacement therapy (NRT; 78.8%) than other cessation medications (i.e. varenicline or bupropion; 18.3 and 10.5%, respectively) and use did not differ by app treatment assignment (all P > 0.05). There was a significant ( P = 0.049) interaction between medication use and app treatment assignment on PPA. Specifically, 12‐month quit rates were 34% for iCanQuit versus 20% for QuitGuide [odds ratio (OR) = 2.36, 95% confidence interval (CI) = 1.59, 3.49] among participants reporting any medication use, whereas among participants reporting no medication use, quit rates were 28% for iCanQuit versus 22% for QuitGuide (OR = 1.41, 95% CI = 1.09, 1.82). Results were stronger for those using only NRT: 40% quit rates for iCanQuit versus 18% quit rates for QuitGuide (OR = 3.57, 95% CI = 2.20, 5.79).
Conclusions
The iCanQuit smartphone app for smoking cessation was more efficacious than the QuitGuide smartphone app, regardless of whether participants used medications to aid cessation. Smoking cessation medications, especially nicotine replacement therapy, might enhance the efficacy of the iCanQuit app.
Importance
Modifiable risk factors are hypothesized to account for 30% to 40% of dementia; yet, few trials have demonstrated that risk-reduction interventions, especially multidomain, are efficacious.
Objective
To determine if a personalized, multidomain risk reduction intervention improves cognition and dementia risk profile among older adults.
Design, Setting, and Participants
The Systematic Multi-Domain Alzheimer Risk Reduction Trial was a randomized clinical trial with a 2-year personalized, risk-reduction intervention. A total of 172 adults at elevated risk for dementia (age 70-89 years and with ≥2 of 8 targeted risk factors) were recruited from primary care clinics associated with Kaiser Permanente Washington. Data were collected from August 2018 to August 2022 and analyzed from October 2022 to September 2023.
Intervention
Participants were randomly assigned to the intervention (personalized risk-reduction goals with health coaching and nurse visits) or to a health education control.
Main Outcomes and Measures
The primary outcome was change in a composite modified Neuropsychological Test Battery; preplanned secondary outcomes were change in risk factors and quality of life (QOL). Outcomes were assessed at baseline and 6, 12, 18, and 24 months. Linear mixed models were used to compare, by intention to treat, average treatment effects (ATEs) from baseline over follow-up. The intervention and outcomes were initially in person but then, due to onset of the COVID-19 pandemic, were remote.
Results
The 172 total participants had a mean (SD) age of 75.7 (4.8) years, and 108 (62.8%) were women. After 2 years, compared with the 90 participants in the control group, the 82 participants assigned to intervention demonstrated larger improvements in the composite cognitive score (ATE of SD, 0.14; 95% CI, 0.03-0.25; P = .02; a 74% improvement compared with the change in the control group), better composite risk factor score (ATE of SD, 0.11; 95% CI, 0.01-0.20; P = .03), and improved QOL (ATE, 0.81 points; 95% CI, −0.21 to 1.84; P = .12). There were no between-group differences in serious adverse events (24 in the intervention group and 23 in the control group; P = .59), but the intervention group had greater treatment-related adverse events such as musculoskeletal pain (14 in the intervention group vs 0 in the control group; P < .001).
Conclusions and Relevance
In this randomized clinical trial, a 2-year, personalized, multidomain intervention led to modest improvements in cognition, dementia risk factors, and QOL. Modifiable risk-reduction strategies should be considered for older adults at risk for dementia.
Trial Registration
ClinicalTrials.gov Identifier: NCT03683394
Objectives
Swann's self‐verification theory proposes that negative feedback seeking (NFS)—the solicitation of negative feedback from others that confirms one's self‐views—works in a negative cycle to maintain and exacerbate depression in the face of interpersonal stress. We propose a cognitive‐interpersonal integration account of NFS such that this maladaptive behavior prospectively predicts depression only among those with a trait tendency to ruminate on the causes and consequences of depressed mood and stress.
Method
Participants included 91 young adults who were over‐sampled for a lifetime history of a unipolar depressive disorder (age 17–33; 69% women; 67% lifetime depressive disorder). At baseline, participants completed a structured diagnostic interview and self‐report measures of NFS, rumination, and depression symptoms. In addition, participants engaged in an interpersonal rejection task (the Yale Interpersonal Stressor) followed by a behavioral measure of NFS. At a 3‐month follow‐up, depression symptoms were again assessed by self‐report and exposure to stressful interpersonal life events in the intervening period were assessed with a rigorous contextual interview and independent rating system.
Results
Controlling for baseline depression severity, greater self‐reported, and behaviorally assessed NFS predicted greater follow‐up depression severity, but only among those with higher trait tendency to ruminate. For self‐reported NFS, this association was further moderated by level of interpersonal, but not noninterpersonal, life events experienced over follow‐up.
Conclusion
These findings suggest that rumination may represent a modifiable intervention target that could break the vicious interpersonal cycle of depression and, thus, mitigate the depressogenic effects of NFS.
Psychometrically sound measures of disordered eating during pregnancy are needed, particularly for pregnant individuals with body mass index (BMI) ≥ 25, who are at high risk for disordered eating attitudes/behaviors. We previously adapted the Eating Disorder Examination (EDE) for use among pregnant individuals with BMI ≥ 25. This study examined the factor structure of the EDE-Pregnancy Version (EDE-PV) in a community sample of pregnant individuals with BMI ≥ 25. The EDE-PV was administered to 257 pregnant individuals with pre-pregnancy BMI ≥ 25 between 12 and 20 weeks gestation. The EDE-PV factor structure was determined using an exploratory factor analysis with oblique geomin rotation, internal consistency coefficients were calculated, and convergent and discriminant validity of the EDE-PV factors were assessed. An 11-item, two-factor solution produced an acceptable model fit. The subscales did not replicate those of the EDE and were interpreted as Pregnancy Eating and Weight Change Concerns and Pregnancy Shape and Weight Concerns (αs=.67 and .85; ωs=.70 and .85, respectively). These subscales showed small-to-moderate, positive correlations with weight and psychosocial distress measures and differentiated between participants with and without lifetime histories of any eating disorder diagnosis, demonstrating adequate convergent and discriminant validity. The results indicate that the EDE-PV can more reliably identify factors associated with disordered eating attitudes/behaviors among pregnant individuals with BMI ≥ 25 compared to the EDE and support our call for the development and use of new and/or adapted measures to appropriately assess disordered eating during pregnancy.
OBJECTIVE
The object of this study was to describe the use of patient-reported outcome measures (PROMs) in cerebrovascular neurosurgery and to outline a framework for incorporating them into future cerebrovascular research.
METHODS
Following the standardized PRISMA guidelines, the authors performed a search of the PubMed and Embase databases in February 2023 using filters to investigate six specific cerebrovascular pathologies/procedures: subarachnoid hemorrhage (SAH), intracranial hemorrhage, ischemic stroke, arteriovenous malformation, chronic subdural hematoma, and carotid artery stenosis. PROMs in the identified articles were distinguished and classified as generic, symptom specific, or disease specific.
RESULTS
A total of 259 studies including 51 PROMs were eligible for inclusion in the review. Most of the PROMs were generic or symptom specific. Only 5 PROMs were disease specific, and all of these pertained to stroke or SAH.
CONCLUSIONS
There are only a limited number of disease-specific PROMs available for cerebrovascular pathologies and outcomes. Further validation of existing measures in independent cohorts, expanded incorporation of disease-specific PROMs in prospective trials, and the development of new PROMs specific to cerebrovascular conditions are critical to a better understanding of the impact of cerebrovascular diseases and novel therapies on patient lives.
Background
Among gay, bisexual, and other men who have sex with men (GBM), sexual orientation disclosure to social groups can act as a significant risk for depression. The primary goal of this research is to understand the association between disclosure and depression, the association of social support and intimate partner violence (IPV) experiences, depression, and disclosure.
Methods
This project uses a secondary dataset of Thailand from a larger cross-sectional study distributed in the Greater Mekong Sub-Region. This study utilized web-based answers from 1468 Thai GBM respondents between the ages of 15–24 years.
Results
Prevalence of depression was over 50%. Across the social groups of interest, those who disclosed to everyone had the lowest depression prevalence. This association was statistically significant for all groups ( p <0.050) except for “Family members” ( p = 0.052). There was a statistically significant association illustrated between full disclosure to social groups and increased social support. Most respondents (43.9%) had low social support, and additionally this group had the highest level of depression, compared to those with high social support. There was a statistically significant association for lowered depression outcomes and increased social support. IPV experiences that occurred within the last six months had a statistically significant relationship with depression ( p = 0.002). There was a notable association between those with experiences of being a victim of IPV, alone and in conjunction with experience of being a perpetrator of IPV, which was associated with increased odds of depression. However, the type of IPV experiences an individual had did not differ based on disclosure status.
Discussion
This study provides strengthened evidence of the impact that differences in supportive networks can have on mental health outcomes. In addition, they provided a wider consideration for how people may have different IPV experiences, either as a perpetrator, victim, or both, and how those shapes health outcomes of depression. GBM communities still face adversity and challenges that affect their long-term health outcomes, even if they do live in what is considered an accepting country.
Background
Adolescents often carry their depression well into their adulthood. This creates perpetual difficulties for their family and society. Research on the relationship between positive parenting and adolescent depressive symptoms is rare. The protective effect of positive parenting on adolescent depressive symptoms also remains underexplored. Parents are a vital source of feedback that shapes adolescents’ self-view in crucial ways.
Aims
This study examines the latent relationships between four factors related to positive parenting and adolescent depressive symptoms.
Method
Using data from the Chinese Family Panel Studies (CFPS), Stata MP 17.0 was used for preliminary data processing and descriptive statistics. The structural equation model (SEM) was adopted to test the seven proposed hypotheses.
Results
The study participants were 2,816 adolescents (52.34% male). The SEM showed that positive communication and parental praise can directly reduce depressive symptoms in adolescents (path coefficients of −0.24 and −0.13 [ p < .001], respectively). Additionally, both positive communication and positive parent-adolescent interactions can reduce adolescents’ depressive symptoms by heightening the intermediate factor of parental praise (path coefficients of 0.30 and 0.44 [ p < .001], respectively). Conversely, positive parent-adolescent interactions did not negatively affect adolescents’ depressive symptoms, as we hypothesized.
Conclusions
High level of positive parenting negatively predicts the level of depressive symptoms among adolescents. Specifically, positive communication, positive parent-adolescent communication, and parental praise are the main protective factors related to positive parenting for adolescents’ depressive symptoms.
One of the most common distinctions in long-term memory is that between semantic (i.e., general world knowledge) and episodic (i.e., recollection of contextually specific events from one’s past). However, emerging cognitive neuroscience data suggest a surprisingly large overlap between the neural correlates of semantic and episodic memory. Moreover, personal semantic memories (i.e., knowledge about the self and one’s life) have been studied little and do not easily fit into the standard semantic-episodic dichotomy. Here, we used fMRI to record brain activity while 48 participants verified statements concerning general facts, autobiographical facts, repeated events, and unique events. In multivariate analysis, all four types of memory involved activity within a common network bilaterally (e.g., frontal pole, paracingulate gyrus, medial frontal cortex, middle/superior temporal gyrus, precuneus, posterior cingulate, angular gyrus) and some areas of the medial temporal lobe. Yet the four memory types differentially engaged this network, increasing in activity from general to autobiographical facts, from autobiographical facts to repeated events, and from repeated to unique events. Our data are compatible with a component process model, in which declarative memory types rely on different weightings of the same elementary processes, such as perceptual imagery, spatial features, and self-reflection.
Analyzed scores of 976 persons over 18 yrs of age on the Marlowe-Crowne Social Desirability Scale obtained during a community mental health assessment survey to determine differences in social desirability according to demographic characteristics. In addition, the relationships between social desirability and a battery of mental health measures (e.g., Depression Adjective Checklist, and measures of aggression, satisfaction, life changes, medication, and alcoholism) were examined. Scores differed on the basis of age, education, and race. Small but consistent inverse relationships between symptom reporting and social desirability were found. Implications of these findings for community studies are discussed. (38 ref)
A 10-item Depression Rating Scale was used to rate the severity of depression of 165 patients before and during treatment in four separate antidepressant drug trials. Global assessments of the severity of depression were made simultaneously. Comparison of 529 paired ratings showed a good relation between total scores of the rating scale and the global severity classifications, with satistically highly significant differences between mean scores for adjacent severity classes.In two placebo-controlled studies of antidepressant drugs, scores of the Depression Rating Scale were compared with simultaneously obtained global ratings of response. Improvement curves by the two rating methods were similar in both studies. Differences between treatments in one study were demonstrated equally well by rating scale scores and global ratings. In the second study, statistically highly significant between-treatment differences were demonstrated by rating scale scores at three intervals in the total groups and five intervals in the endogenous subgroups, as compared with one interval and four intervals, respectively, by global ratings. Significance levels of differences by rating scale scores were consistently higher than the differences found in global ratings. Because of its brevity, ease of use, and sensitivity, the Depression Rating Scale was found to be a useful instrument for measuring changes in the severity of depression in antidepressant drug trials.
Separate factor analyses were performed on the interview, ward behavior, and self-report ratings of 124 depressed patients from 10 hospitals. The major categories of psychopathology discernable from these analyses were: (a) interest and involvement in activities, (b) hostility, (c) feelings of guilt and worthlessness, (d) anxiety-tension, (e) sleep disturbance, (f) somatic complaints, (g) retardation in speech and behavior, (h) conceptual disorganization, and (i) depressive mood. (PsycINFO Database Record (c) 2006 APA, all rights reserved).
A new social desirability scale was constructed and correlated with MMPI scales. Comparison was made with correlations of the Edwards Social Desirability scale. The new scale correlated highly with MMPI scales and supported the definition of social desirability. Ss need to respond in "culturally sanctioned ways."
The need for an adequate methodological resolution to the factor-matching (invariance) problem—long recognized as critical by theoretically oriented factor analysts—is also being strongly felt by applied behavioral scientists today. As factor analysis has become more generally utilized in the behavioral sciences, the demand for a valid, general index of factorial similarity has grown proportionally. Recent research has resulted in a number of analytic indices which are purported to represent validly the degree of similarity among factors; the present paper concerns an empirical comparison of three such measures as to how well they perform this task. The congruency coefficient, coefficient of invariance, and Cattell's s-index were chosen for comparison. The 3 coefficients were assessed on a number of distinct data sets which reflected dissimilarities arising from different sources. All 3 techniques were observed to possess validity but also to have limiting conditions. Conclusions suggest that the adequacy of the methods cannot be judged in absolute terms but rather must be assessed in terms of the particular requirements of the data.
The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12 in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations."Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15 These have been well summarized in a review article by Lorr11 on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
This report reviews conflicts in delineating the phenomena of depression with an emphasis on the central criterion role of the symptomatic pattern of the nonprecipitated (endogenous) depression. Depressions with similar symptomatology, regardless of precipitation or severity, are labeled endogenomorphic.
A specific causal model is presented that has testable consequences in drug treatment and maintenance studies. This is a mixed model, combining both categorical and dimensional constructs.
Reviews the use of the 1st author's (1965) Self-rating Depression Scale (SDS) in published studies with the elderly. Also, the authors' files provided publications that used the SDS in geriatric settings not identified in the literature search. Data indicate that (1) the SDS can be used with most aged Ss, (2) increasing SDS scores in life reflect the opinion of many clinicians that vulnerability to depression increases in old age, (3) the SDS can demonstrate significant differences between depressed elderly and normal elderly Ss, and (4) the SDS demonstrates a precipitous drop in scores of elderly Ss who have been treated for depression. However, the accuracy of the SDS in cases of individual assessment is suspect, and readjustment of scoring may produce higher sensitivities and correct classification. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Groups of papers describe (a) research programs on the relations between stressful life events (SLE) and episodes of physical illness, (b) clinical research on SLE as related to types of physical and psychiatric disorder, (c) community research on SLE and psychiatric symptomatology, and (d) methodological research on SLE. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
New procedures are presented for measuring invariance and matching factors for fixed variables and for fixed or different subjects. Two of these, the coefficient of invariance for factor loadings and the coefficient of factor similarity, utilize factor scores computed from the different sets of factor loadings and one of the original standard score matrices. Another, the coefficient of subject invariance, is obtained by using one of the sets of factor loadings in conjunction with the different standard score matrices. These coefficients are correlations between factor scores of the appropriate matrices. When the best match of factors is desired, rather than degree of resemblance, the method of assignment is proposed.
A comparison of self-report vs. observer rating of depressed mood in a heterogenous inpatient population revealed wide variations in concordance among diagnostic groups. Patients diagnosed as having Affective Psychosis and "Other'' illnesses showed the highest correlation between four self-report scales and an observer rating scale. Patients with a diagnosis of depressive Neurosis showed only modest correlation, while Schizophrenics revealed no significant correlation, on these instruments, suggesting inconsistent communication of affect from Schizophrenic patients to observers. In contrast, when self-report scales were intercorrelated, patients in all four diagnostic categories showed highly significant correlations, indicating that they were consistently reporting their affective state on these instruments. The implications of these findings for future research as well as for practical clinical management are discussed.
Synopsis
Histories of depression-related symptoms were obtained from 3845 randomly selected adult residents of Kansas City, Missouri, and Washington County, Maryland. Depressed persons were slightly more common in Kansas City than in Washington County but within the latter area no urban–rural differences were observed. More depressed persons were found among blacks than among whites. Slightly more white females than males were depressed; no significant differences were found between black females and males. After adjustment for the effects of other independent variables, the probability of having symptoms of depression was highest among persons who were young adults, unmarried, not employed outside the home, poorly paid, and not well educated.
Data from 172 college subjects (93 males and 79 females) with mean age = 24.3 yr. (SD, 7.0) were used to replicate and extend previous findings on the alternate form, split-half and test-retest reliability for Set 2 (Forms E, F, G) of the Depression Adjective Check Lists (Lubin, 1967). Findings are reported for complete lists and for the two columns, i.e., "half lists."
A community mental health assessment questionnaire relating largely to depressed mood was administered during 1972 to 1,212 respondents in Washington County, MD, by six interviewers. Analysis of 15 psycho-social tests showed that responses obtained by one interviewer differed significantly from responses obtained the other five. Suggestions for minimizing interviewer effects include 1) selection of interviewers with similar characteristics and backgrounds; 2) adequate training and periodic field assessment of interviewer performance; 3) simplification of questions and reduction in the number of possible responses per question; and 4) allocation of various types of subjects to interviewers as uniformly as possible.
SINCE the initial publications on the development and validation of the Self-Rating Depression Scale (SDS),1,2 there has been continued interest in it. Diversity in the application of this tool is evidenced by its use in the programs of suicide prevention centers, alcoholism clinics, child guidance and adult psychiatric clinics, health and welfare agencies, and by various research groups, including the Veterans Administration Cooperative Studies in Psychiatry and the Early Clinical Drug Evaluation Unit of the Psychopharmacology Research Branch, National Institute of Mental Health.
In a series of studies exploring social structure and mental illness, Redlich et al3-6 reported highly significant relationships between social class position and aspects of psychiatric disorders, such as prevalence of psychiatric patients, types of psychiatric disorders, and choice of treatment modalities.
If these relationships exist as such, is there a significant correlation between social status and results
In a study of community mood in Washington County, Maryland, a representative sample of adult residents was selected for interviews. Among this sample, a total of 649 persons had participated in a previous nonofficial census and for this group, similar information was available both for the 571 who were interviewed and the 78 who refused. Characteristics associated with refusals were poor education, residential stability and small households. There was also suggestive evidence that young adults and males were more likely to refuse. Urban or rural residence, cigarette smoking and frequency of church attendance did not appear to be related to refusal.
In a prior study, we identified factors of psychopathology in the interview, ward behavior and self-report ratings of 124 depressed patients from 9 hospitals. The present study attempts to replicate these findings in a sample of 648 depressed patients from 10 hospitals. The criteria for patient selection and the factor analytic methods employed were identical in both studies. The major factors of psychopathology identified in the first study were replicated in the second study. Further, the loadings of the key items on these factors were highly similar in both studies. However, the factors in the second study encompassed a narrower range of psychopathology than those in the first. As a consequence, more factors were extracted for the same evaluation instruments in the second study. The 12 major categories of psychopathology discernible from these analyses were: 1) depressive mood, 2) feelings of guilt and worthlessness, 3) hostility, 4) anxiety-tension, 5) cognitive loss and subjective uncertainty, 6) interest and involvement in activities, 7) somatic complaints, 8) sleep disturbance, 9) retardation in speech and behavior, 10) bizarre thoughts and behavior, 11) excitement and 12) denial of illness. The break-up of some of the larger, global factors from the first study into smaller and more narrowly defined factors in the second study was a distinct asset in later efforts to discern the differential effects of various antidepressant drugs. The results from both studies also highlighted the advantages of using different rating instruments and sources of information about the patient. First, within a particular category of psycho-pathology, such as hostility, nuances of behavior across rating instruments would have been missed had we sampled only one aspect of patient behavior. Second, some categories of psychopathology, such as depressed mood, emerged as strong factors on certain rating instruments and were either poorly represented or absent on others.
Two major investigations of the prevalence of psychiatric disorder in community groups, the Midtown and Stirling County studies, relied heavily on symptoms the researchers considered psychophysiological. Both found the highest rates of psychiatric disorder in the lowest status groups. The present study of a sample of 1,710 adults in Washington Heights, New York City, indicates that the previous findings are in part a function of a distinct tendency for lower-class groups to express psychological distress in physiological terms. The present results also suggest that the higher rates are confounded with organic illness.
In order to develop a Hebrew version of the Depression Adjective Check Lists (DACL) for use in research, the lists were translated by linguists and the adequacy of the translations determined. Reliability (split-half, alternate form, internal consistency, and test-retest) of translated lists E, F, and G were sufficiently high in the case of the first three and sufficiently low in the case of test-retest reliability of the state DACL. Concurrent validity was determined in three separate samples: correlations with (a)a 7-point self-rating scale of depression, (b)the MMPI-D Scale, (c)the Bradburn Scale of Psychological Well-being, the Cantril Self-anchoring Striving Scale, and the Katz Social Adjustment Symptom Subscale, and demographic variables. Magnitude of correlations were sufficiently high and in the expected direction. Also, correlations with part scores of the Bradburn Scale of Well-being demonstrated the discriminant validity of the Hebrew version of the DACL.
The fact that there is a need for assessing depression, whether as an affect, a symptom, or a disorder is obvious by the numerous scales and inventories available and in use today.
Stressful life events: Their nature and effects Development of a symptom check list for the measurement of depression in a popula-tion. Unpublished, 1968. Hamilton. M. A rating scale for depression
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FMATCH: A program to evaluate the degree of equivalence of factors derived from analyses of different samples
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Characteristics of non-respondents in the Community Mental Health Assessment survey
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Interviewer effects in a community mental health survey
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Comparison of the CES-D with standardized depression rating scales at three points in time
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Depressive mood among middle class urban ethnic groups
- B Trieman
Trieman, B. Depressive mood among middle class urban ethnic groups. Technical Report, 1975, Contract HSM 42-73-238, National Institute of Mental Health.
The influence of social desirability on symptom and mood reporting in a community survey
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