... Beck Depression Inventory-BDI [14]. This questionnaire is comprised of 21 items which express affective, cognitive, somatic, and behavioral aspects of depression. ...
... I am sad; 2. I am always sad, and I can't get over it; 3. I am so sad or miserable that I can't bear it). Scores yielded for the entire questionnaire ranged from 0 to 63, where scores of 0-8 indicate a normal mood with no depressive symptoms; scores of 9-21 indicate depressive symptoms at a low level; scores of 22-29 indicate depressive symptoms; and scores of 30-63 indicate severe depression [14]. ...
... One sample t test was employed to assess significance between known population threshold (cut-off ) values and study population means. We used the value 8.00 as the cut off for depression (BDI) [14], and 38 for anxiety (STAI) [15]. Mean values of depression and anxiety were compared to these values, and were dichotomized by it for further analyses. ...
Background: The exposure to war scenes via screens, despite offering a degree of detachment, can be stressful for
the operator. The aim of the current study is to examine the existence of anxiety, depression, and post traumatic stress
disorder (PTSD) symptoms among unmanned aerial vehicle (UAV) Israeli operators.
Methods: Participants comprised 41 UAV operators (87.2% male), aged 22–38 (Mage = 26.05, SD = 3.54). Most (78.0%)
reported having viewed battlefield scenes. All participants completed a total of five questionnaires: Beck Depression
Inventory, State-Trait Anxiety Inventory, and three questionnaires of PTSD: Post Trauma Questionnaire (CAPS), the Post�Traumatic Cognition Inventory (CTPI), and the Post-Traumatic Symptom Scale (PSS).
Results: Mean scores of depression and anxiety were found significantly lower than diagnosis cut-off points
(p < .001). Senior operators showed higher means for depression (5.69 vs. 2.58, p = .040), of stress level (PSS; 3.17 vs.
0.25, p = .020) and for distress intensity (3.79 vs. 0.57, p = 0.041) than less-experienced operators.
Conclusions: Investigating and monitoring the impact of battlefield exposure in UAV operators are highly beneficial
for preventing psychopathology.
Keywords: UAV, Unmanned aerial vehicle, Anxiety, Depression, Post-traumatic stress disorder, PTSD
... Neuropsychological testing was conducted to evaluate individual differences in cognition and mood disturbances in pwMS, and were used to identify factors possibly affecting speech discrimination performance. The Beck's Depression Inventory (BDI) (Beck and Steer, 1987) as well as two sensitive and validated tests of cognition in MS, the Paced Auditory Serial Addition Test (PASAT) (Gronwall, 1977) and the Symbol Digits Modalities Test (SDMT) (Smith, 1982), were administered using standard instructions. The BDI is a self-rating inventory of depressive state (Beck and Steer, 1987). ...
... The Beck's Depression Inventory (BDI) (Beck and Steer, 1987) as well as two sensitive and validated tests of cognition in MS, the Paced Auditory Serial Addition Test (PASAT) (Gronwall, 1977) and the Symbol Digits Modalities Test (SDMT) (Smith, 1982), were administered using standard instructions. The BDI is a self-rating inventory of depressive state (Beck and Steer, 1987). Total scores between 1 and 10 are considered normal; scores from 11 to 16 indicate a mild mood disturbance; and any score over 31 is regarded as indicating severe/ extreme depression. ...
People with multiple sclerosis (pwMS) frequently present with deficits in binaural processing used for sound localization. This study examined spatial release from speech-on-speech masking in pwMS, which involves binaural processing and additional higher level mechanisms underlying streaming, such as spatial attention.
26 pwMS with mild severity (Expanded Disability Status Scale score <3) and 20 age-matched controls listened via headphones to pre-recorded sentences from a standard list presented simultaneously with eight-talker babble. Virtual acoustic techniques were used to simulate sentences originating from 0⁰, 20⁰, or 50⁰ on the interaural horizontal plane around the listener whilst babble was presented continuously at 0⁰ azimuth, and participants verbally repeated the target sentence. In a separate task, two simultaneous sentences both containing a colour and number were presented, and participants were required to report the target colour and number. Both competing sentences could originate from 0⁰, 20⁰, or 50⁰ on the azimuthal plane. Participants also completed a series of neuropsychological assessments, an auditory questionnaire, and a three-alternative forced-choice task that involved the detection of interaural time differences (ITD) in noise bursts.
Spatial release from masking was observed in both pwMS and controls, as response accuracy in the two speech discrimination tasks improved in the spatially separated conditions (20⁰ and 50⁰) compared with the co-localised condition. However, pwMS demonstrated significantly less spatial release (18%) than controls (28%) when discriminating colour/number coordinates. At 50⁰ separation, pwMS discriminated significantly fewer coordinates (77%) than controls (89%). In contrast, pwMS had similar performances to controls when sentences were presented in babble, and for the basic ITD discrimination task. Significant correlations between speech discrimination performance and standardized neuropsychological scores were observed across all spatial conditions.
Our findings suggest that spatial hearing is likely to be implicated in pwMS, thereby affecting the perception of competing speech originating from various locations.
... 3,4 They can cause different problems, one of the most concerning being suicidal intentions. According to a metaanalysis among health science students, 22.0 % of students had suicidal intention, compared to 18.0 % recorded for the general university population. 3 The transitional period that occurs from adolescence to adult age and changes related to the changing environment, friends, and the role of graduating from high school to university can all be difficult for students. ...
... indicate no or minimal depression; scores from 10 to 18 indicate mild to moderate depression; scores from 19 to 29 indicate moderate to severe depression, and scores from 30 to 63 indicate severe depression.22 ...
BACKGROUND In the first year of studies, students face many changes. On one side is the demanding medical education, and on the other side, is to find a balance with old friends, parents, and a new social environment. These changes may result in psychological symptoms such as anxiety or depression, which is the most commonly, reported mental disorder among students. This study intended to explore the presence of anxiety and depression symptoms in first-year medical students and investigate how family cohesion, flexibility and psychosocial factors influence anxiety and depression. METHODS 149 medical students (76.5 % females and 23.5 % males) took part in a crosssectional study. The survey was conducted via the sociodemographic questionnaire, Multidimensional Scale of Perceived Social Support, Rosenberg Self-esteem Scale, the short version of Loneliness Scale, Family Adaptability & Cohesion Scale, Beck Anxiety Inventory, and Beck Depression Inventory. RESULTS The prevalence of moderate and severe anxiety and depression symptoms among medical students was 53.8 % and 19.5 %, respectively. Female students experienced higher levels of anxiety and depression compared to their male colleagues. Students who had physical activities at least once a week showed significantly lower anxiety and depression scores. Anxiety and depression were positively associated with loneliness and negatively associated with perceived social support from family and self-esteem. Depression was also negatively associated with family cohesion and adaptability. Moreover, the results revealed that family cohesion was a strong predictor of the severity of depression symptoms. CONCLUSIONS This study shows that variables such as gender, physical activities, feeling of loneliness, low self-esteem, and perceived social support from family play an important role in the experience of anxiety and depression among medical students. This study raises awareness about mental disorders in medical students, especially anxiety and depression, and invites the placement of these problems among the top priorities of public health policies. KEY WORDS Anxiety; Depression, Family Relations, Students
... The German version of the Children's Global Assessment Scale (C-GAS; Shaffer et al. 1983) was employed to assess the level of psychosocial functioning in the past three months. Participants were also asked to complete several self-reports, including the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), the Beck Depression Inventory II (BDI-II; Beck et al. 1996), and the State Trait Anxiety Inventory (STAI; Spielberger et al., 1983). All interviews and self-reports were computerized using LimeSurvey. ...
Major depressive disorder (MDD) is associated with autonomic nervous system (ANS) dysfunction, characterized by decreased parasympathetic (PNS) and increased sympathetic (SNS) activity. Although findings on reduced PNS activity in adult MDD have been replicated in adolescents, comprehensive studies assessing PNS and SNS proxies in underage patients with MDD are scarce. Proxies of resting PNS (heart rate variability (HRV) and SNS activity (skin conductance response [SCR] and salivary alpha amylase [sAA], as well as mixed activity (heart rate [HR]) were collected in adolescents with MDD (n = 29) and non-depressed controls (n = 29). Primary analyses addressed differences between groups and correlations with depression severity. Patients with MDD showed significantly decreased HRV (g = − 0.87; 95% CI [− 1.39; − 0.35]) and increased HR (g = 0.66; 95% CI [0.14; 1.18]). Proxies of pure SNS activity showed no significant differences between groups. HR (positive) and HRV (negative) were significantly correlated with self- and clinician-rated depression severity. Alterations of ANS activity are evident in adolescent MDD, but characterized by decreased PNS activity only. We found no evidence for altered SNS activity. Findings suggest that ANS dysfunction early in the course of MDD might be predominantly driven by decreased PNS activity.
... 23 To investigate subclinical depressive symptoms, subjects were administered the Beck Depression Inventory-II (BDI), 24 which quantifies the intensity of depressive symptoms (a score ⩾ 10 corresponding to at least mild depression symptoms). 24,25 MRI acquisition All participants underwent a 3.0 T brain MRI scan (Philips Intera, Best, The Netherlands), following a standardized protocol: (1) T2*-weighted single-shot echo-planar imaging sequence for RS fMRI acquisition fMRI acquisition required about 10 minutes. During acquisition, subjects were asked to keep their eyes closed, remain motionless and not to focus on specific thoughts. ...
Background
The precuneus is involved in cognition and depression; static functional connectivity (SFC) abnormalities of this region have been observed in neuromyelitis optica spectrum disorders (NMOSD). Time-varying functional connectivity (TVC) underpins dynamic variations of brain connectivity.
Objective
The aim of this study was to explore precuneus SFC and TVC in NMOSD patients and their associations with neuropsychological features.
Methods
This retrospective study includes 27 NMOSD patients and 30 matched healthy controls undergoing resting state functional magnetic resonance imaging (MRI) and a neuropsychological evaluation of cognitive performance and depressive symptoms. A sliding-window correlation analysis using bilateral precuneus as seed region assessed TVC, which was quantified by the standard deviation of connectivity across windows. Mean connectivity indicated SFC.
Results
Compared to controls, patients had reduced SFC between precuneus, temporal lobe, putamen and cerebellum, and reduced TVC between precuneus and prefronto-parietal-temporo-occipital cortices and caudate. Patients also had increased intra-precuneal TVC and increased TVC between the precuneus and the temporal cortex. More severe depressive symptoms correlated with increased TVC between the precuneus and the temporal lobe; worse cognitive performance mainly correlated with higher TVC between the precuneus and the parietal lobe.
Conclusion
TVC rather than SFC of the precuneus correlates with NMOSD neuropsychological features; different TVC abnormalities underlie depressive symptoms and cognitive impairment.
... The Beck Depression Inventory, Second Edition (BDI-II; Beck, Steer, & Brown, 1996) is a 21-item questionnaire that assesses the presence and severity of unipolar depressive symptomatology. Each item is rated on a 4-point scale from 0 (indicating a lack of depressive symptomatology) to 3 (indicating high depressive symptomatology) with summary scores ranging from 0 to 63. Considerable psychometric evidence supports the internal reliability, concurrent, and discriminant validity of this questionnaire as a measure of depression in both clinical and undergraduate samples (Beck & Steer, 1987;Dozois, Dobson, & Ahnberg, 1998). The internal consistency (Cronbach's alpha) of the BDI-II in this sample was 0.91 in women and 0.89 in men. ...
The current daily diary study examined the moderating impact of attachment style on the association between excessive reassurance seeking (ERS) behavior and trust in romantic dyads. A sample of 110 heterosexual couples completed measures of attachment, ERS, and relationship trust. In line with prior research, an anxious attachment style was associated with higher daily ERS, and an avoidant attachment style with lower daily ERS. Lower levels of trust were also associated with greater daily ERS. Moreover, analyses remained significant while controlling for symptoms of depression. This study extended the literature by demonstrating that for women with an anxious attachment style, and men with an avoidant attachment style, ERS was related to lower next day trust. In contrast, the partners of men with an avoidant attachment style, who also engaged in ERS, reported higher levels of next day trust. This study was also the first to examine how individual attachment styles influenced the perception of, and reactions to, ERS. Women with an anxious attachment style liked when their male partners engaged in ERS, as illustrated by higher levels of reported trust. These results support the idea that attachment styles play an important role in determining whether or not ERS leads to negative interpersonal consequences. They also suggest that it is the combination of relationship insecurities and ERS that leads to negative interpersonal consequences.
... Maternal depression (rated via the Beck Depression Inventory II-BDI-II; Beck & Steer, 1987) was also assessed during Phase I (when children were 12-42 months old) since major depressive disorder (MDD) is often comorbid with PTSD (Flory & Yehuda, 2015). We controlled for maternal history of depression in our analyses. ...
Background:
Previous studies demonstrated that when the violence-exposed child becomes a mother and interacts with her own child during early sensitive periods for social-emotional development, she may have difficulties providing sensitive responsiveness to the child's emotional communication. Such difficulties place the child's development of emotional comprehension (EC) and related self-regulation at risk. The aim of this study was to examine how mothers' interpersonal violence-related posttraumatic disorder (IPV-PTSD) would affect their children's EC and their own ability to predict their children's EC. We also investigated how mothers' predictive ability would correlate with child psychopathology.
Methods:
Sixty-one mother-child dyads (36 with IPV-PTSD) participated in this study. Children's (mean age = 7.0 years, SD = 1.1) EC was assessed with the Test of Emotion Comprehension (child TEC) and their psychopathology as reported by the mother was assessed with the Child Behaviour Checklist (CBCL) and as evaluated by a clinician using selected modules of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Mothers were measured for IPV-PTSD with the Clinician Administered PTSD Scale (CAPS) and for their capacity to predict their child's emotional comprehension (mother-responding-as-child TEC; mTEC).
Results:
We found no significant between-group differences in children's level of EC. Maternal PTSD was associated with lower scores on the mTEC, however. Reduced maternal scores on the mTEC were significantly associated with maternal report of increased aggressive child behaviour and with depression symptoms on the K-SADS. Further, scores on the mTEC interacted with maternal report of child aggression on child oppositional defiant disorder (ODD) symptoms on the K-SADS.
Conclusion:
These findings support that improving maternal emotional comprehension may help reduce child risk for psychiatric morbidity in this population.
... The presence of personality disorders was assessed using the Structured Clinical Interview for DSM-IV Axis II (SCID-II) (Wittchen et al., 1997). Depression severity was measured using the 21-item Hamilton rating scale for depression (HAMD) (Hamilton, 1967) and the 21-item self-report Beck Depression Inventory (BDI-II) (Beck et al., 1996). Psychomotor symptoms were assessed with the CORE (Parker and Hadzi-Pavlovic, 1996). ...
Background
: Structural and functional alterations of the anterior cingulate cortex (ACC) have been related to emotional, cognitive and behavioral domains of major depressive disorder. In this study, we investigate cortical thickness of rostral and caudal ACC. In addition, we explore white matter microstructure of the cingulum bundle (CB), a white matter pathway connecting multiple segments of the ACC. We hypothesized reduced cortical thickness and reduced white matter microstructure of the CB in MDD, in particular in the melancholic subtype. In addition, we expect an association between depression severity and CB microstructure.
Methods
: Fifty-four patients with a current depressive episode and 22 healthy controls matched for age, gender and handedness underwent structural and diffusion-weighted MRI-scans. Cortical thickness of rostral and caudal ACC were computed. The CB was reconstructed bilaterally using manual tractography. Cortical thickness and fractional anisotropy (FA) of bilateral CB were compared first between all patients and healthy controls and second between healthy controls, melancholic and non-melancholic patients. Correlations between FA and depression severity were calculated.
Results
: We found no group differences in rostral and caudal ACC cortical thickness or in FA of the CB comparing all patients with healthy controls. Melancholic patients had reduced cortical thickness of bilateral caudal ACC compared to non-melancholic patients and compared to healthy controls. Across all patients, depression severity was associated with reduced FA in bilateral CB.
Limitations
: Impact of medication
Conclusions
: Cortical thickness of the caudal ACC is associated with the melancholic syndrome. CB microstructure may represent a marker of depression severity.
... Total scores obtained from the three visits were averaged to compute an overall BDI-II score. Higher scores reflect greater depressive symptoms (Beck et al., 1996). ...
Background
Dysregulated stress responsivity is implicated in adolescent risk for depression and self-injurious thoughts and behaviors (STBs). However, studies often examine levels of the stress response in isolation, precluding understanding of how coordinated disturbance across systems confers risk. The current study utilized a novel person-centered approach to identify stress correspondence profiles and linked them to depressive symptoms, STBs, and neural indices of self-regulatory capacity.
Method
Adolescents with and without a major depressive disorder diagnosis (N=162, Mage=16.54, SD=1.96, 72.8% White, 66.5% female) completed the Trier Social Stress Test (TSST), questionnaires, and clinical interviews. Stress experience (self-report), expression (observed), and physiology (salivary cortisol) were assessed during the experimental protocol. Adolescents also underwent a magnetic resonance imaging scan.
Results
Multitrajectory modeling revealed four profiles. High Experience–High Expression–Low Physiology (i.e., lower stress correspondence) adolescents were more likely to report depressive symptoms, lifetime nonsuicidal self-injury, and suicidal ideation relative to all other subgroups reflecting higher stress correspondence: Low Experience–Low Expression–Low Physiology, Moderate Experience–Moderate Expression–Moderate Physiology, High Experience–High Expression–High Physiology. High Experience–High Expression–Low Physiology adolescents also exhibited less positive amygdala–ventromedial prefrontal cortex resting state functional connectivity relative to Moderate Experience–Moderate Expression–Moderate Physiology.
Limitations
Data were cross-sectional, precluding inference about our profiles as etiological risk factors or mechanisms of risk.
Conclusions
Findings illustrate meaningful heterogeneity in adolescent stress correspondence with implications for multimodal, multilevel assessment and outcome monitoring in depression prevention and intervention efforts.
... For SCZ, we further conducted the Positive-and-Negative-Syndrome-Scale (PANSS) 37 and computed Wallworks' PANSSpositive-factor (consisting of items P1, P3, P5, and G9) 38 . In case of MDD, we surveyed Beck-Depression-Inventory (BDI) 39 and Hamilton-Major-Depression-Rating-Scale (H-MDRS) 40 . ...
Background:
Jumping-to-conclusions (JTC) is a prominent reasoning bias in schizophrenia (SCZ). While it has been linked to not only psychopathological abnormalities (delusions and impulsive decision-making) but also unstable belief formation, its origin remains unclear. We here directly test to which extend JTC is associated with delusional ideation, impulsive decision-making, and unstable belief formation.
Methods:
In total, 45 SCZ patients were compared with matched samples of 45 patients with major depressive disorder (MDD) and 45 healthy controls (HC) as delusions and JTC also occur in other mental disorders and the general population. Participants performed a probabilistic beads task. To test the association of JTC with measures of delusions (Positive and Negative Syndrome Scale [PANSS]positive, PANSSpositive-factor, and Peter Delusions Inventory [PDI]), Bayesian linear regressions were computed. For the link between JTC and impulsive decision-making and unstable beliefs, we conducted between-group comparisons of "draws to decision" (DTD), "decision times" (DT), and "disconfirmatory evidence scores" (DES).
Results:
Bayesian regression obtained no robust relationship between PDI and DTD (all |R2adj| ≤ .057, all P ≥ .022, all Bayes Factors [BF01] ≤ 0.046; α adj = .00833). Compared with MDD and HC, patients with SCZ needed more time to decide (significantly higher DT in ambiguous trials: all P ≤ .005, r2 ≥ .216; numerically higher DT in other trials). Further, SCZ had unstable beliefs about the correct source jar whenever unexpected changes in bead sequences (disconfirmatory evidence) occurred (compared with MDD: all P ≤ .004 and all r2 ≥ .232; compared with HC: numerically higher DES). No significant correlation was observed between DT and DTD (all P ≥ .050).
Conclusions:
Our findings point toward a relationship of JTC with unstable belief formation and do not support the assumption that JTC is associated with impulsive decision-making.
... A questionnaire was administered to each participant concerning demographics, HoC, sporting history and education history. The Beck Depression Inventory was used to measure self-reported depression, 15 and The National Adult Reading Task was used to measure premorbid intelligence. 16 ...
A history of concussion has been linked to long-term cognitive deficits; however the neural underpinnings of these abnormalities are poorly understood.
This study recruited 26 asymptomatic male Australian footballers with a remote history of concussion (i.e. at least six months since last concussion), and 23 non-collision sport athlete controls with no history of concussion. Participants completed three ocular motor tasks (prosaccade, antisaccade, and a cognitively complex switch task) to assess processing speed, inhibitory control, and cognitive flexibility respectively. Diffusion tensor imaging data was acquired using a 3 T MRI scanner, and analyzed using tract-based spatial statistics, to investigate white matter abnormalities and how they relate to ocular motor performance.
Australian footballers had significantly slower adjusted antisaccade latencies compared to controls (p = 0.035). A significant switch cost (i.e. switch trial error > repeat trial error) was also found on the switch task, with Australian footballers performing increased magnitude of errors on prosaccade switch trials relative to prosaccade repeat trials (p = 0.023). Diffusion tensor imaging analysis found decreased fractional anisotropy, a marker of white matter damage, in major white matter tracts (i.e. corpus callosum, corticospinal tract) in Australian footballers relative to controls. Notably, a larger prosaccade switch cost was significantly related to reduced fractional anisotropy in anterior white matter regions found to connect to the prefrontal cortex (i.e. a key cortical ocular motor centre involved in executive functioning and task switching).
Taken together, Australian footballers with a history of concussion have ocular motor deficits indicative of poorer cognitive processing speed and cognitive flexibility, which are related to reduced white matter integrity in regions projecting to important cognitive ocular motor structures. These findings provide novel insights into the neural mechanisms that may underly chronic cognitive impairments in individuals with a history of concussion.
... 4. low et al. (Beck et al., 1979), Beck Depression Inventory (Beck & steer, 1987), and Impulsiveness scale (eysenck & eysenck, 1991). ...
Nonsuicidal self-injury (NSSI) is prevalent among incarcerated women in correctional facilities. This poses a challenge in selecting appropriate intervention. This integrative review aimed to identify effective interventions for managing NSSI among incarcerated women. Whittemore and Knafl’s framework for integrative reviews was used, and eight databases were searched with 11 papers meeting the inclusion criteria. Six interventions for NSSI for incarcerated women were identified as promising in reducing the rate of NSSI. Data did not support the effectiveness of gender-specific interventions for incarcerated women. There is a need for further research to identify appropriate interventions to target NSSI among incarcerated women.
... Covariates Data were collected on mother and child's age and sex, socioeconomic status, as well as depressive symptomatology in mothers. We collected information on sociodemographics using the Geneva Socio-Demographic Questionnaire (GSQ) (38), the family socio-economic status (SES) using the Largo Index (44) and the Beck Depression Inventory II (BDI) (45) to map depressive symptoms. ...
Introduction: Exposure to interpersonal violence (IPV) can lead to post-traumatic stress disorder (PTSD) in mothers, and in turn adversely affect the mother-child relationship during early development, as well as the mental health of their children. Our objectives are to assess: (1) the association of maternal IPV-PTSD to child psychopathology, (2) the association of maternal IPV independently of PTSD to child psychopathology, and (3) the relationship between child exposure to violence to the psychopathology of these children.
Methods: We used data from the longitudinal Geneva Early Childhood Stress Project. The sample included 64 children [mean age at Phase 1 = 2.4 (1.0–3.7) years] of mothers with or without IPV-PTSD. Data on mothers was collected during Phase 1, using the Clinical Administered PTSD Scale (CAPS), the Brief Physical and Sexual Abuse Questionnaire (BPSAQ) and the Conflict Tactics Scale (CTS2). Modules of a semi-structured diagnostic interview, and the Violence Exposure Scale were used to collect information on child at Phase 2, when children were older [mean age = 7.02 (4.7–10)].
Results: A higher CAPS score in mothers when children were toddler-age was associated with an increased risk of symptoms of attention deficit/hyperactivity disorder (ADHD; β = 0.33, p = 0.014) and PTSD in school-age children. The association between maternal IPV-PTSD and child PTSD (β = 0.48, p < 0.001) symptoms remained significant after adjustment for potential confounders. Among children, exposure to violence was associated with an increased risk of symptoms of generalized anxiety (β = 0.37, p = 0.006), major depressive (β = 0.24, p = 0.039), ADHD (β = 0.27, p = 0.040), PTSD (β = 0.52, p < 0.001), conduct (β = 0.58, p = 0.003) and oppositional defiant (β = 0.34, p = 0.032) disorders.
Conclusion: Our longitudinal findings suggest that maternal IPV-PTSD during the period of child development exert an influence on the development of psychopathology in school-aged children. Mothers' IPV was associated with child psychopathology, independently of PTSD. Child lifetime exposure to violence had an additional impact on the development of psychopathology. Careful evaluation of maternal life-events is essential during early childhood to reduce the risk for the development of child psychopathology. Early efforts to curb exposure to violence in children and early intervention are both needed to reduce further risk for intergenerational transmission of trauma, violence, and related psychopathology.
... Covariates Data were collected on mother and child's age and sex, socioeconomic status, as well as depressive symptomatology in mothers. We collected information on sociodemographics using the Geneva Socio-Demographic Questionnaire (GSQ) (38), the family socio-economic status (SES) using the Largo Index (44) and the Beck Depression Inventory II (BDI) (45) to map depressive symptoms. ...
Introduction: Exposure to interpersonal violence (IPV) can lead to post-traumatic stress disorder (PTSD) in mothers, and in turn adversely affect the mother-child relationship during early development, as well as the mental health of their children. Our objectives are to assess: (1) the association of maternal IPV-PTSD to child psychopathology, (2) the association of maternal IPV independently of PTSD to child psychopathology, and (3) the relationship between child exposure to violence to the psychopathology of these children.
Methods: We used data from the longitudinal Geneva Early Childhood Stress Project. The sample included 64 children [mean age at Phase 1 = 2.4 (1.0–3.7) years] of mothers with or without IPV-PTSD. Data on mothers was collected during Phase 1, using the Clinical Administered PTSD Scale (CAPS), the Brief Physical and Sexual Abuse Questionnaire (BPSAQ) and the Conflict Tactics Scale (CTS2). Modules of a semi-structured diagnostic interview, and the Violence Exposure Scale were used to collect information on child at Phase 2, when children were older [mean age = 7.02 (4.7–10)].
Results: A higher CAPS score in mothers when children were toddler-age was associated with an increased risk of symptoms of attention deficit/hyperactivity disorder (ADHD; β = 0.33, p = 0.014) and PTSD in school-age children. The association between maternal IPV-PTSD and child PTSD ( β = 0.48, p < 0.001) symptoms remained significant after adjustment for potential confounders. Among children, exposure to violence was associated with an increased risk of symptoms of generalized anxiety ( β = 0.37, p = 0.006), major depressive ( β = 0.24, p = 0.039), ADHD ( β = 0.27, p = 0.040), PTSD ( β = 0.52, p < 0.001), conduct ( β = 0.58, p = 0.003) and oppositional defiant ( β = 0.34, p = 0.032) disorders.
Conclusion: Our longitudinal findings suggest that maternal IPV-PTSD during the period of child development exert an influence on the development of psychopathology in school-aged children. Mothers' IPV was associated with child psychopathology, independently of PTSD. Child lifetime exposure to violence had an additional impact on the development of psychopathology. Careful evaluation of maternal life-events is essential during early childhood to reduce the risk for the development of child psychopathology. Early efforts to curb exposure to violence in children and early intervention are both needed to reduce further risk for intergenerational transmission of trauma, violence, and related psychopathology.
... This could be done by using other measuring instruments that have the same construct. For example, the Beck Depression Inventory-II (Beck et al., 1996), the Patient Health Questionnaire-9 (Kroenke, Spitzer, & Williams, 2001), or the Center for Epidemiologic Studies Depression Scale-Revised (Radloff, 1977) could be used to measure depression. In addition, the Beck Anxiety Inventory (Beck, Epstein, Brown, & Steer, 1988), Generalized Anxiety Disorder (Spitzer, Kroenke, Williams, & Löwe, 2006), the Mood and Anxiety Symptom Questionnaire-90 (Watson et al., 1995), or the State-Trait Anxiety Inventory Y-II (Spielberger, Goruch, & Lushene, 1970) could also be used to measure anxiety. ...
Measurement instruments that have satisfactory psychometric properties are needed to improve mental health research and services, especially in the effort to measure, identify, and monitor the psychological problems experienced by individuals. The purpose of this study is to examine the psychometric properties of the Indonesian version of the Depression Anxiety Stress Scale (DASS). The study involved 1,922 participants from Surabaya aged between 16 and 26. The data were obtained using the convenience sampling method. Testing of the factor structure, reliability, and measurement invariance of the Indonesian DASS was performed using a confirmatory factor, composite reliability, and multi-group analysis. It was found that a bifactor model consisting of specific (depression, anxiety, and stress) and general (psychological distress) factors was the best structure for the DASS. Furthermore, the model also showed satisfactory composite reliability and measurement invariance across genders. The results indicated that the Indonesian version of the DASS was a valid and reliable instrument for measuring and comparing depression, anxiety, stress, and psychological distress between genders in the Indonesian sample.
... Además, hallaron coeficientes de correlación de .48 y .25 con las puntuaciones obtenidas a partir del Inventario de ISSN (Digital): 2223-7666 Liberabit, 2021, 27(1), e450 (enero -junio) Depresión de Beck (BDI;Beck & Steer, 1993) y la Escala de Depresión de Hamilton (1960, versión revisada), respectivamente. ...
Antecedentes
: los trastornos de ansiedad son los de mayor prevalencia a nivel mundial seguidos por los trastornos depresivos. El Inventario de Ansiedad de Beck (BAI; Beck et al., 1988) ha sido elaborado para evaluar la severidad de los síntomas ansiosos y realizar diagnóstico diferencial entre trastornos de ansiedad y depresión.Objetivo: examinar la estabilidad temporal del BAI en su versión adaptada a Argentina y obtener evidencias de validez discriminante.Método: en una muestra de 52 personas se analizó el coeficiente de correlación intraclase. Luego, en una muestra de 225 personas se realizó un análisis de correlaciones entre puntajes del BAI y el Inventario de Depresión de Beck-II (BDI-II; Beck et al., 2006); posteriormente se realizó un análisis factorial exploratorio (AFE) con reactivos de ambos instrumentos y se calculó la proporción Heterotrait-Monotrait Ratio (HTMT).Resultados: el coeficiente de correlación intraclase fue de .82 (IC 95% = .69 - .90). La correlación entre el BAI y el BDI fue de .56 (tamaño de efecto moderado), el AFE evidenció dos factores bien diferenciados y se halló una proporción HTMT de .66 (IC 95% = .55 - .74).Conclusiones: se observa una adecuada estabilidad temporal y se aporta evidencia de la validez discriminante del instrumento.
... Positive variables were those psychological factors that may play a protective role against obesity and include trait emotional intelligence (trait EI) measured with the Trait Emotional Intelligence Questionnaire-Short Form [27]; cognitive reappraisal as emotion regulation strategy measured with the Emotion Regulation Questionnaire [28]; and happiness, measured with the Oxford Happiness Inventory [29]. Negative variables were instead potential risk-factors for the development and maintenance of obesity, and included: expressive suppression as emotion regulation strategy, binge eating, assessed with the Binge Eating Scale [30], depression, assessed with the Beck Depression Inventory [31], trait and state anxiety, assessed with the State Trait Anxiety Inventory-Y [32]. Each of these questionnaires used to measure a certain psychological variable returns an integer value. ...
This study investigates on the relationship between affect-related psychological variables and Body Mass Index (BMI). We have utilized a novel method based on machine learning (ML) algorithms that forecast unobserved BMI values based on psychological variables, like depression, as predictors. We have employed various machine learning algorithms, including gradient boosting and random forest, with psychological variables relative to 221 subjects to predict both the BMI values and the BMI status (normal, overweight, and obese) of those subjects. We have found that the psychological variables in use allow one to predict both the BMI values (with a mean absolute error of 5.27–5.50) and the BMI status with an accuracy of over 80% (metric: F1-score). Further, our study has also confirmed the particular efficacy of psychological variables of negative type, such as depression for example, compared to positive ones, to achieve excellent predictive BMI values.
... To measure anxiety and depressive symptomatology, different questionnaires were selected by the various authors: the Beck Depression Inventory (BDI) [44,45] to measure depressive symptomatology and the State-Trait Anxiety Inventory (STAI) to measure anxiety symptomatology [46]. The BDI is a 21-item questionnaire measuring symptomatology of depression. ...
Background:
Many people with eating disorders often report having suffered some kind of childhood trauma. For this reason, many studies have attempted to explore the mediating factors between traumatic experiences and the development of eating disorders. The aim of our study is to conduct a systematic review of published works on the mediating factors between childhood trauma and the development of eating disorders.
Method:
This review was carried out up to 5 December, 2020, using the databases PsycInfo and PubMed, combining the keywords, and applying a set of inclusion and exclusion criteria.
Results:
A total of 18 articles were retrieved. After the articles were analyzed, a set of mediating factors between childhood trauma and the development of eating disorders was established, including pathological dissociation, difficulty with emotion self-regulation, body dissatisfaction, negative affect/depression, anxiety, general distress, self-criticism, and alexithymia, among others.
Conclusions:
In addition to evaluating trauma in eating disorders, these results highlight the importance of paying special attention to the presence of various possible mediating factors, which must be taken into account in the planning of therapeutic treatment. Identifying symptoms of trauma or eating disorders early on could prevent onset of more severe psychopathology during adulthood.
... The Beck Depression Inventory-Revised (BDI-II) is a 21-item self-report inventory, designed to examine the severity of depressive symptoms in the past two weeks for those aged 13 to 80 (Beck et al., 1996). Each item is rated on a 4-point Likert scale, ranging from 0 (least severe) to 3 (most severe). ...
Non-suicidal self injury (NSSI) is a transdiagnostic maladaptive behavior that is highly prevalent in adolescence. A greater understanding of the mechanisms leading to NSSI is needed to guide the development of prevention efforts. The current study examined the relationship between maternal socialization of emotions and NSSI behaviors in their children. Female adolescents (N = 90, 12–17 years old) who demonstrated a range of NSSI lifetime episodes from none to very frequent were included in this sample. Maternal responses to their children’s displays of sadness, anger, and happiness were assessed. Principal components analysis was used to categorize items into supportive and unsupportive maternal emotion socialization responses for the three emotions. Adolescents whose mothers reported less supportive maternal responses to child’s expressions of sadness and anger had more lifetime NSSI episodes. Many of these patterns remained when follow-up analyses considered an extreme group approach (e.g., high counts of NSSI versus no NSSI), when analyses focused on specific diagnostic subgroups (e.g., depression and anxiety), and to some extent (socialization of anger) when current NSSI was considered. While the cross-sectional study design prevents causal conclusions, transactional theories raise the possibility that mothers’ emotion socialization may impact offspring NSSI and offspring engagement in NSSI may result in mothers altering their socialization practices to accommodate their child’s unique needs. Future research should employ longitudinal methodology to examine the time course, consider the role of emotion regulation as an explanatory mechanism, and consider intervention methods that may teach effective emotion socialization for parents.
... The scores on both scales are distributed between 20 and 80. Higher values refer higher level of anxiety. Depression level was evaluated with Beck Depression Inventory (BDI), disease severity and dyspnea level was evaluated by BODE index and modified Medical Research Council dyspnea scale (mMRC) (20,21). All parameters were evaluated before and after treatment (at week 8). ...
... The G factor is comprised of a total score of all items; the S factor is comprised of five items; and the C factor is comprised of 8 items. The BDI-II is used widely in research and clinical settings and has been found to have strong psychometric properties (Beck & Steer, 1987;Beck et al., 1996). ...
The Suicide Cognitions Scale (SCS) assesses suicide-specific cognitions which may drive suicide risk. Nonetheless, prior work has been mixed regarding optimal factor structure. Additionally, this measure has not been validated for use with veterans with military sexual trauma-related posttraumatic stress disorder (MST-related PTSD), a population that is at elevated risk for suicidal self-directed violence (SDV). This study sought to determine the optimal factor structure of the SCS for use with veterans with MST-related PTSD as well as its psychometric properties. An exploratory factor analysis revealed a four-factor structure, including unlovability, unbearability, unsolvability, and negative urgency. The SCS also demonstrated excellent internal consistency and good convergent validity. This study identified a novel factor, negative urgency, which may explain some of the predictive power of the SCS found in previous research. This paper provides initial support for a four-factor structure of the SCS among those with MST-related PTSD. Additional work remains necessary in evaluating the SCS as a tool for detecting risk for future suicidal SDV among veterans with MST-related PTSD.
... Participants' depressive symptoms (using the Beck Depression Inventory II-BDI-II; Beck and Steer, 1987) were also assessed during Phase 1 since major depressive disorder (MDD) is often comorbid with PTSD in as many as 40-50% of cases (Flory and Yehuda, 2015). We controlled for history of lifetime depression in our analyses. ...
Introduction: The present study investigates the association of lifetime interpersonal violence exposure (IPV), related posttraumatic stress disorder (IPV-PTSD), and appraisal of the degree of threat posed by facial avatars.
Methods: We recorded self-rated responses and high-density electroencephalography (HD-EEG) among women, 16 of whom with lifetime IPV-PTSD and 14 with no PTSD, during a face-evaluation task that displayed male face-avatars varying in their degree of threat as rated along dimensions of dominance and trustworthiness.
Results: The study found a significant association between lifetime IPV exposure, under-estimation of dominance and over-estimation of trustworthiness. Characterization of EEG microstates supported that lifetime IPV-PTSD modulates emotional appraisal, specifically in encoding and decoding processing associated with N170 and LPP evoked potentials. EEG source localization demonstrated an overactivation of the limbic system, in particular the parahippocampal gyrus, in response to non-threatening avatars. Additionally, dysfunctional involvement of attention-related processing anterior prefrontal cortex was found in response to relatively trustworthy avatars in IPV-PTSD individuals compared to non-PTSD controls.
Discussion: This study showed that IPV exposure and related PTSD modulate individuals’ evaluation of facial characteristics suggesting threat. Atypical processing of these avatar characteristics were marked by group differences in brain regions linked to facial processing, emotion regulation and memory.
https://www.frontiersin.org/articles/10.3389/fpsyg.2020.576852/abstract
... A factor analysis (Cacioppo, Hughes, et al., 2006) was conducted on the relationship between loneliness (as measured by the UCLA Loneliness scale; Russell et al., 1980) and depression (as measured by the Beck Depression Inventory; Beck & Steer, 1987) in a study. Oblique factor analysis following the principal component analysis showed that the loading of the factor of depression in loneliness item was extremely low (<0.10), the same was true for the loading of the factor of loneliness in depression item (<0.19). ...
This article aims to explore the possible causal relationship between loneliness and depression in college students. Two hundred and fifty-nine college students had been investigated four times in 2 years with UCLA and CES-D, and cross-lagged regression analysis was used. ① there was a significant positive correlation between loneliness and depression of college students; ② cross-lagged regression analysis showed that after controlling the related variables and the stability of variables themselves, loneliness, and depression could positively predict each other at points-in-time T1 and T2; Depression could significantly positively predict loneliness at points-in-time T2, T3, and T4. There is a bidirectional relationship between loneliness and depression of college students, and the effect of depression on loneliness is stronger than that of loneliness on depression.
... To verify that SiN performance was associated with cognition abilities in MS, neuropsychological testing was conducted in pwMS only. Beck's Depression Inventory (BDI) (Beck and Steer, 1987), a self-rating inventory of depression, evaluated the presence of depressive symptoms in MS. Total scores between 1 and 10 are considered normal; 11-16 a mild mood disturbance; and any score over 31 suggests severe/extreme depression. ...
There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (<5 years) and late (>10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score < 3]. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All speech and noise were presented via headphones to controls ( n = 38), early MS ( n = 23), and late MS ( n = 12) who were required to verbally repeat the target speech. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble – but not speech-weighted noise. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of −1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed.
... Both the EDE and EDE-Q have good testeretest reliability in patients with BED 26,27 and converge adequately. 28,29 The Beck Depression Inventory (BDI) 30 is a well-established measure of depression level. 31 The BDI was administered at baseline, monthly, at posttreatment, and at follow-up. ...
Purpose
Binge-eating disorder (BED), the most prevalent eating disorder, is associated strongly with obesity and functional impairments. Few evidence-based treatments for BED exist; a pharmacotherapy effective in reducing both binge eating and weight needs to be identified. This placebo-controlled double-blind pilot RCT evaluated the acute effects of naltrexone + bupropion (NB) on BED with obesity and examined the longer-term effects through 6-month follow-up after the discontinuation of medication.
Methods
Twenty-two adult patients with BED were randomized to receive 12 weeks of double-blind treatment with fixed-dose NB (naltrexone + bupropion XL 50/300 mg) or placebo. Independent (blinded) researcher–clinicians evaluated patients at major outcome time points (baseline, posttreatment, and 6-month follow-up after the treatment period); patients were also evaluated for the tracking of course/tolerability throughout treatments and at 3-month follow-up. Primary outcomes were changes from baseline in binge-eating frequency and percentage weight. Secondary outcomes were changes in eating-disorder psychopathology and depression.
Findings
A total of 22 patients were enrolled (86.4% women; mean age, 50.4 years), with 77.3% of patients completing treatments; completion rates (NB, 83.3%; placebo, 70.0%) and adverse events did not differ significantly between NB and placebo. Analyses revealed significant reductions from baseline in binge-eating, eating-disorder psychopathology, depression, and weight during treatment, but these changes with NB did not differ significantly from those with placebo. The percentage of patients who attained 3% weight loss was significantly greater with NB than with placebo (45.5% vs 0%); weight-loss and binge-eating reductions were significantly correlated in the group that received NB. At 6-month follow-up, outcomes remained improved relative to baseline, with no significant differences between NB and placebo.
Implications
The findings from this pilot RCT suggest that NB was well-tolerated in these patients with BED and comorbid obesity. Most outcomes were not statistically different between NB and placebo. A larger-scale, adequately powered RCT is needed for determining the efficacy of NB in the treatment of BED. ClinicalTrials.gov identifier: NCT02317744.
... Severity of depression symptoms was measured by the Chinese version (Zheng & Lin, 1991) of the 21-item Beck Depression Inventory-Second Edition (BDI-II) (Beck & Steer, 1987). Each of the 21 questions on the BDI-II is rated on a four-point scale ranging from 0 (symptom absent) to 3 (severe symptom). ...
Suicide is a major public health concern, especially in prisoners. This study aims to investigate the prevalence of current suicidal ideation in a sample of Chinese female prisoners and examine the mediating role of negative emotions and social support in the link between childhood trauma and suicidal ideation. A cross-sectional study was conducted in five main jails of the district of Zhejiang province in China and a total of 626 female prisoners were surveyed by using cluster sampling. Childhood Trauma Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale and Multidimensional Scale of Perceived Social Support were applied. The estimated prevalence of current suicide ideation among Chinese female prisoners was 33.4%. Structural equation modeling analyses revealed that social support and negative emotions acted as chain mediators between childhood trauma and current suicidal ideation. Results emphasize the importance of stress-diathesis theory of suicidality in understanding the possible mechanisms underlying the relationship between childhood trauma and suicidal ideation among female prisoners.
Substantial body of empirical evidence supports the Interpersonal Theory of Suicide (IPTS; Joiner, 2005 Joiner, T. E. (2005). Why people die by suicide. Cambridge: Harvard University Press.[Crossref] , [Google Scholar]); however, the association between personality vulnerability factors and IPTS constructs had yet to be examined in Asian college students. The present study examined Blatt’s (1974) model of personality in relation to Joiner’s (2005) IPTS in a sample of 403 college students in Taiwan. Findings indicated that the interaction of the two interpersonal needs factors predicted suicidal ideation; the effect of the interpersonal needs factor on suicidal ideation was mainly due to perceived burdensomeness. Moreover, perceived burdensomeness emerged as the sole mediator in the link between self-criticism and suicidal ideation, as well as between dependency and suicidal ideation. The findings underscore the potential value of targeting perceived burdensomeness in suicide prevention and intervention programs for college students. Specific advice for the practice of cognitive-behavioral therapy are discussed.
Background
dmissions to secure mental health services aim to treat both mental illness and the offending behaviour of service users. Dialectical Behaviour Therapy (DBT) is an emerging therapy within secure services for personality disordered service users. This pilot study explores the impact DBT had with female patients located in a secure service in Wales.
Aims
To identify any treatment benefits of DBT for a sample of female forensic patients in Wales.
Methods
DBT was adapted to meet the needs of the forensic setting and patient needs. Measures exploring anger, anxiety, depression, hopelessness and social problem solving were gathered from participants pre and post intervention.
Results
Results indicated significant reduction in post intervention ratings for depression, hopelessness and anxiety, with large effect sizes in the desired direction reported on other measures, excluding social problem solving.
Conclusions and implications for practice
DBT appears to have had a greater impact on the affective experiences of participants and less impact on the cognitive processes related to social problem solving. Findings are discussed in terms of clinical practice significance.
Frontal asymmetry (FA), the difference in brain activity between the left versus right frontal areas, is thought to reflect approach versus avoidance motivation. This study (2012–2021) used functional near‐infrared spectroscopy to investigate if infant (Mage = 7.63 months; N = 90; n = 48 male; n = 75 White) FA in the dorsolateral prefrontal cortex relates to psychopathology in later childhood (Mage = 62.05 months). Greater right FA to happy faces was associated with increased internalizing (η2 = .09) and externalizing (η2 = .06) problems at age 5 years. Greater right FA to both happy and fearful faces was associated with an increased likelihood of a lifetime anxiety diagnosis (R2 > .13). FA may be an informative and early‐emerging marker for psychopathology.
p>Research into schemata in depression has found little evidence for schematic activity in the absence of a depressed or low mood. This has led to a widespread view that schemata in depression are latent and only influence information processing in the presence of a low or depressed mood (Segal, 1988). The lack of evidence of schematic activity in the absence of a depressed mood may be due to traditional conceptualisation of schema and the methodological difficulties inherent in the implicit tasks that are used. The aim of this thesis was to investigate schematic activity using two relatively new automatic self-evaluation tasks (the IAT and EAST). It was found that positive automatic self-evaluation was weaker in analogue depressed individuals, high-trait depressives, and recovered clinical depressives compared to non-depressed individuals and low-trait depressives. More importantly, these differences in automatic self-evaluation were not affected by mood or levels of depression. This thesis provides some support that vulnerability to depression or schematic activity can be measured in the absence of a depressed mood. These results also provide support for the growing evidence that automatic self-evaluation may be implicated as a vulnerability factor related to affective disorders (De Raedt, Schacht, Franck, & De Houwer, 2006; de Jong, 2000, Tanner, Stopa, & De Houwer, in press), and why SSRI antidepressant treatment may not be effective in preventing relapse in depression (Hensley, Nadiga, & Uhlenhuth, 2004). Suggestions for further research into schemata include further examination into the role of positive automatic self-evaluation in healthy individuals, the ratio of and different kinds of positive and negative schematic content in individuals who are, and who are not, vulnerable to depression, and investigating schemata from the ontological and neuroscientific perspectives.</p
Objective
This study aimed to investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in treating suicidal ideation in patients with mental illness.
Method
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Major electronic databases were systematically searched from the time of their inception until July 22, 2021. The primary outcome was the mean change in the scores for suicidal ideation. The secondary outcome was the mean change in depression severity.
Results
Ten randomized controlled trials were eligible with 415 participants in the active treatment group (mean age = 53.78 years; mean proportion of women = 54.5%) and 387 participants in the control group (mean age = 55.52 years; mean proportion of women = 51.78%). rTMS significantly reduced suicidal ideation (k = 10, n = 802, Hedges' g = −0.390, 95% confidence interval [CI] = −0.193 to −0.588, p <.001) and severity of depressive symptoms (k = 9, n = 761, Hedges' g = −0.698, 95% CI = −1.023 to −0.372, p < 0.001) in patients with major mental disorders. In the subgroup analysis, rTMS reduced suicidal ideation among patients with non-treatment-resistant depression (non-TRD) (−0.208) but not in those with TRD. rTMS as combination therapy had a larger effect than did monotherapy (−0.500 vs. −0.210). Suicidal ideation significantly reduced in patients receiving more than ten treatment sessions (-0.255). Importantly, the rTMS group showed favorable tolerability without major adverse events.
Conclusion
The study showed that rTMS was effective and well-tolerated in reducing suicidal ideation and depression severity in patients with major mental disorders.
Depresif kız ergenlerde intihar davranışının şiddeti, algılanan cinsiyet eşitliği ve çocukluk çağı travmalarının ilişkisi: Türkiye'nin bölgelerine göre farklılıklar The association between suicidal behavior severity, perceived gender equality, and childhood traumas among depressive adolescent girls: Differences between the regions of Turkey ÖZET Amaç: Son 1 yıl içerisinde intihar girişiminde bulunmuş olan depresif kız ergenlerde intihar davranışı şiddeti, algılanan cinsiyet eşitliği ve çocukluk çağı travmalarının ilişkisinin araştırılmasıdır. Yöntem: 12-18 yaş aralığında 84 kız ergenin (Doğu Anadolu illeri n=34, Batı illeri n=50) intihar davranışının şiddeti Columbia İntihar Şiddetini Değerlendirme Ölçeği ile belirlenmiştir. Katılımcıların Toplumsal Cinsiyet Algısı Ölçeği (TCAÖ), Çocukluk Çağı Travmaları Ölçeği (ÇÇTÖ) ve Beck Depresyon Envanteri (BDE)'ni doldurmaları, annelerinin ise TCAÖ'yü tamamlaması sağlanmıştır. Bulgular: Doğu illerinde ikamet eden gençler batıdakilere göre daha fazla oranda yüksek intihar şiddeti kümesinde sınıflandırılmışlardı (X 2 (1)=6.215, p=0.01), bu gençlerin TCAÖ skorları daha düşük (U=473.500, p=0.006); BDE (t=-2.081, p=0.04) ve ÇÇTÖ-duygusal ihmal skorları (U=537.500, p=0.03) daha yüksekti. TCAÖ skoru, ÇÇTÖ-duygusal ihmal skoru (rho=-0.240, p=0.03), katılımcıların annelerinin eğitim düzeyi (rho=0.282, p=0.001) ve annelerin TCAÖ skoru (rho=0.430, p<0.001) korelasyon göstermekteydi. Yüksek intihar şiddeti kümesindeki katılımcıların düşük intihar şiddeti kümesindekilere göre TCAÖ skoru (U=473.500, p=0.02) ve anne-TCAÖ skoru (t=-2.138, p=0.03) daha düşük, ÇÇTÖ-toplam puanı ise daha yüksekti (t=2.195, p=0.03). Lojistik regresyon analizine göre yüksek şiddetli intihar kümesine dahil olmayı yordayan tek anlamlı değişken anne-TCAÖ skoruydu (B=-0.051, p=0.02). Sonuç: Depresif kız ergenlerin ve annelerinin cin-siyet eşitsizlik algısı, bu gençlerin daha yüksek şiddette inti-har davranışında bulunması ile ilişkiliydi. Daha geleneksel toplumsal rollerin olduğu ailelerde yetişmek, bu gençlerin daha fazla duygusal ihmale uğramalarına, daha şiddetli depresif belirti ve intihar davranışı göstermelerine neden olmuş olabilir. SUMMARY Objective: To investigate the association between suicidal behavior, perceived gender equality, and childhood traumas among depressive adolescent girls who have attempted suicide in the last 1 year. Method: 84 adolescent girls aged between 12-18 (Eastern Provinces n=34, Western Provinces n=50) were assessed via Columbia Suicide Severity Scale by clinicians to determine the severity of their suicidal behavior. Participants and their mothers filled the Perception of Gender Scale (PGS); participants completed Childhood Trauma Questionnaire (CTQ), and Beck Depression Inventory (BDI). Results: Participants from the eastern provinces had significantly lower PGS scores (t=-2.369, p=0.02) and higher BDE (t=-2.081, p=0.04), and CTQ-Emotional Neglect (U=537.500, p=0.03) scores than those from the western provinces. Participants from the eastern provinces more frequently classified into high-severity suicide cluster than those from the western provinces (X2(1)=6.215, p=0.01). PGS score was significantly correlated with both CTQ-emotional neglect score (rho=-0.240, p=0.03), maternal education level (rho=0.282, p=0.001), and maternal-PGS score (rho=0.430, p<0.001). Adolescents in high-severity suicide cluster had lower PGS (t=-2.369, p=0.02) and maternal-PGS scores (t=-2.138, p=0.03) and higher CTQ scores (t=2.195, p=0.03) than those in low-severity suicide cluster. In the logistic regression analysis, the only significant variable that predicted being in the high-severity suicide cluster was maternal-PGS score (B=-0.051, p=0.02). Discussion: The current study showed that more traditional gender role perception in mothers and adolescents was associated with more severe suicide attempts among depressive adolescent girls. Having been raised in families with more traditional social roles may have caused these adolescents to experience more emotional neglect, higher depression severity, thus more severe suicidal behavior.
Background: Patients with panic disorder (PD) have an abnormal function in brain regions related to fear network is well recognised. However, the traditional fear network model (FNM) which was based on animals’ horrible behaviours has been found that it’s not enough to explain the pathological mechanism of PD. This study aims to explore brain regions’ abnormalities in the new advanced FNM, and estimate whether it can better explain PD.
Methods: Magnetic resonance imaging resting-state scans were acquired in 40 patients with PD (35 drug-naïve and 5 drug-free) and 40 healthy controls (HCs). Twelve brain regions in the advanced FNM were chosen as regions of interest (ROIs) to examine the group difference in the ROIs and whole-brain resting-state functional connectivity (rsFC).
Results: We found significantly increased thalamic rsFC with the insula, compared with HCs. And it was significantly correlated with HAMA-somatic score. We also found increased thalamic rsFC with occipital gyrus, temporal gyrus, and frontal gyrus when compared with HCs.
Conclusions: Taken together, PD patients exhibit abnormal rsFC alterations within the advanced FNM, especially the increased rsFC within thalamus-insula loop, suggesting that excessive sensitivity to external information plays an important role in PD. The advanced FNM may provide a fuller explanation about PD.
This cross-sectional study used structural equation modeling to examine the directional relationship between school counselors’ (N = 339) wellness and burnout and whether the latent variables were indirectly mediated by affective distress, while controlling for years of experience, student-to-school counselor ratios, percentage of time spent in counseling duties, and engagement in supervision monthly. Results found that engagement in supervision monthly was positively related to wellness and negatively related to burnout. Percentage of time spent in counseling duties was negative related to affective distress. Based upon the model fit, we found a statistically significant direct effect of wellness on burnout, while controlling for the indirect effect of affective distress (β = −0.32, p < 0.001). Additionally, wellness was significantly and negatively related to burnout (−0.32) and affective distress (−0.51). Affective distress was significantly and positively related to burnout (0.63). We discuss implications for the school counseling profession.
Objective
The effectiveness of ECT under naturalistic conditions has not been well-studied. The current study aimed to 1) characterize a naturalistic sample of ECT patients; and 2) examine the long-term outcomes of ECT on depressive symptoms (Beck Depression Inventory-II; BDI-II) and functional disability symptoms (WHO Disability Assessment Schedule 2.0) in this sample.
Methods
Participants were adults who received ECT for a major depressive episode at an ambulatory ECT clinic between September 2010 and November 2020. Clinical and cognitive assessments were completed at baseline ( n = 100), mid-ECT ( n = 94), 2–4 weeks post-ECT ( n = 64), 6-months post-ECT ( n = 34), and 12-months post-ECT ( n = 19).
Results
At baseline, participants had severe levels of depressive symptoms (BDI-II: M = 41.0, SD = 9.4), and 62.9% screened positive for multiple psychiatric diagnoses on the MINI International Neuropsychiatric Interview. Depressive symptoms ( F(4,49.1) = 49.92, P < 0.001) and disability symptoms ( F(3,40.72) = 12.30, P < 0.001) improved significantly following ECT, and this was maintained at 12-months follow-up. Improvement in depressive symptoms trended towards significantly predicting reduction in disability symptoms from baseline to post-ECT, ( F(1,56) = 3.67, P = 0.061). Although our clinical remission rate of 27% (BDI-II score [Formula: see text] 13 and [Formula: see text] 50% improvement) and overall response rate of 41.3% ([Formula: see text]50% improvement in BDI-II score) were lower than the rates reported in the extant RCT and community ECT literature, 36% of those treated with ECT were lost to follow-up and did not complete post-ECT rating scales. At baseline, remitters had significantly fewer psychiatric comorbidities, lower BDI-II scores, and lower disability symptoms than non-responders ( P < 0.05).
Conclusions
Participants were severely symptomatic and clinically complex. ECT was effective at reducing depressive symptoms and functional disability in this heterogeneous sample. Although a large amount of missing data may have distorted our calculated response/remission rates, it is also likely that clinical heterogeneity and severity contribute to lower-than-expected remission and response rates to ECT.
Perceptions of adolescent–parent and adolescent–peer relationship qualities, and adolescents’ attachment states of mind were examined as predictors of adult social and romantic relationship quality, depressive symptoms, and work performance. Adolescents (86 male, 98 female; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other groups) were followed from age 13 to 24 via observational, self‐, parent‐, and close friend‐reports. Adolescent close friendship quality was a significantly better predictor of adult peer and romantic outcomes, work performance, and depressive symptoms than parental reports of the parent–teen relationship; attachment security was also a strong predictor of numerous outcomes. Results are interpreted as reflecting the difficulty for parents judging parent–teen relationship quality and as reflecting the growing importance of close friendships during this period.
The angular gyrus (AG) is a common hub in the pain networks. The role of the AG during pain perception, however, is still unclear. This crossover study examined the effect of tonic pain on resting state functional connectivity (rsFC) of the AG under eyes closed (EC) and eyes open (EO). It included two sessions (placebo/pain) separated by 24 hours. Pain was induced using topical capsaicin (or placebo as control) on the right forearm. Electroencephalographic rsFC assessed by Granger causality was acquired from 28 healthy participants (14 women) before (baseline) and 1-hour following the application of placebo/capsaicin. Subjects were randomly assigned and balanced to groups of recording sequence (EC-EO, EO-EC). Decreased rsFC at alpha-1 and beta, but not alpha-2, oscillations was found during pain compared to baseline during EC only. For alpha-1, EC-EO group showed a pain-induced decrease only among connections between the right AG and each of the posterior cingulate cortex (PCC, P=0.002), medial prefrontal cortex (mPFC, P=0.005), and the left AG (P=0.023). For beta rsFC, the EC-EO group showed a bilateral decrease in rsFC spanning the connections between the right AG and mPFC (P=0.015) and between the left AG and each of PCC (P=0.004) and mPFC (P=0.026). In contrast, the EO-EC group showed an increase in beta rsFC only among connections between the left AG and each of PCC (P=0.012) and mPFC (P=0.036). No significant change in the AG rsFC was found during EO. These results provide insight into the involvement of the AG in pain perception and reveal methodological considerations when assessing rsFC during EO and EC.
Background: Previously, we reported that the maturity of Psychological Adaptive Mechanism (PAM; alternatively, ego defense mechanism) endorsement, but not depression symptom severity, predicted 5-year survival rates in adult cancer patients and that study controlled for age as a significant variable. In this investigation, we hypothesized that greater PAM maturity would correlate significantly with age and with fewer depression symptoms in a larger sample.
Methods: In this cross-section study, adult cancer outpatients ( N =293) completed the Defense Style Questionnaire (DSQ), the Beck Depression Inventory (BDI), and provided additional clinical data. Spearman’s correlation and multiple regression modeling provided statistical tests of the study hypotheses.
Results: Contrary to our hypothesis, DSQ PAM maturity endorsement did not correlate significantly with increasing age. Greater PAM maturity ratio on the DSQ ( p <0.0001) and current antidepressant use ( p <0.05), however, both provided inverse associations with total BDI symptom frequency ( p <0.01). Age was inversely associated with BDI mood ( p <0.0001) and somatic scores ( p <0.04). Items that worsened BDI symptom frequency included self-reported mood-altering anti-cancer medications and any psychiatric history. Cancer stage, time since diagnosis, and chemotherapy treatment did not correlate with DSQ or BDI scores. Multiple regression analysis found that the correlated items accounted for 17.2% of the variance in mood symptoms and 4.9% in somatic symptoms. Specifically, adaptive maturity and age associated with fewer depression symptoms, while cancer medications affecting mood, and a previous psychiatric history each predicted higher frequency of depression scores.
Conclusion: The results suggest that PAM maturity likely predicts fewer depression symptoms while younger age associates with more depression symptoms in this clinical sample. Centrally, acting cancer medications, such as glucocorticoids, and any history of psychiatric disorder correlated with increased depression symptom frequencies. In this cross-section study, antidepressant medications indicated higher frequencies of depressive symptoms, likely reflecting their use in persons previously diagnosed with depression. Further research should target factors that improve PAM maturity as a potential treatment target, especially in younger age groups.
Research in Psychology has shown that stories people tell about themselves, and how they recall their experiences, reveal a lot about their individual characteristics and mental well-being. The Narrative Coherence Coding Scheme (NaCCS) is a set of guidelines established in psychology research for annotating the “coherence” of a narrative along three dimensions: context, chronology and theme. A significant correlation was found between a narrative’s coherence score and independently collected mental health mark- ers of the narrator. Currently, all coherence annotations are done manually; a time consuming task which drains vital resources. In this paper, we propose an Artificial Intelligence based approach involving Natural Language Processing (NLP) to predict a narra- tive’s coherence score (4-class classification problem). We explore a number of techniques, ranging from traditional machine learning models such as Support Vector Machines (SVM) to pre-trained lan- guage models such as BERT (Bidirectional Encoder Representations from Transformers). BERT produced the best results for all dimen- sions in terms of accuracy: 53.7% (context), 71.8% (chronology), and 69.6% (theme). The location of information in the narratives (beginning, end, throughout) was helpful in improving predictions.
We investigated the relationships between individual and occupational demographic variables, professional quality of life (i.e., compassion satisfaction, burnout, and secondary traumatic stress), and affective distress (i.e., depression, anxiety, and stress) in a sample of 524 prelicensed counselors. Using structural equation analysis, we found statistically significant relationships between the professional quality of life and affective distress latent variables. Implications for supporting the needs of prelicensed counselors in supervision are discussed. Study limitations and suggestions for future research are offered.
Objective
A substantial proportion of patients with binge-eating disorder (BED) do not derive sufficient benefits from available evidence-based psychological interventions. We examined depression scores as predictors and moderators of response to cognitive-behavioral therapy (CBT) and behavioral weight-loss (BWL) for BED. We explored associations between changes in depression scores and changes in treatment outcomes.
Method
Ninety adults with BED with obesity were randomized to CBT or BWL (6 months) and were evaluated independently throughout treatment, at posttreatment, and 12-month follow-up after treatments (18 months post-randomization). Pre-treatment depression scores, early changes in depression, and changes in depression from pre- to post-treatment were tested as predictors/moderators of outcomes (binge-eating frequency and eating-disorder psychopathology).
Results
Baseline depression scores did not predict nor moderate outcomes at post-treatment or 12-month follow-up. Changes in depression scores (both early and throughout treatment) were not associated significantly with changes in binge-eating frequency or eating-disorder psychopathology at post-treatment or 12-month follow-up.
Discussion
Findings suggest depression scores do not predict nor moderate acute- or longer-term outcomes in patients with BED receiving CBT or BWL. Findings reinforce need to improve treatments for BED overall, although they provide confidence that patients with elevated depression scores derive benefits from existing CBT and BWL interventions.
Stress is an important consideration for understanding why individuals take part in limited or no physical activity. The negative effects of stress on physical activity do not hold for everyone, so examinations of possible resilience resources that might protect individuals from the harmful effects of stress are required. Accordingly, we conducted a measurement‐burst study with 53 university students over a 6‐month period to examine the dynamics among stress, physical activity, sedentary behavior, and resilience resources. Participants completed three bursts of 6 days, with each burst separated by an 8‐week gap. Expectations regarding the moderating effects of resilience resources were unsupported. Daily reports of academic and general stress were positively associated with sedentary behavior and negatively associated with light and moderate intensity physical activity. Hair cortisol concentration significantly moderated the association between academic stress and sedentary behavior, such that in bursts where cortisol was lower the daily positive association between stress and sedentary behavior was weaker. The finding that academic and general stress are dynamically associated with lower levels of light and moderate intensity physical activity and higher levels of sedentary behavior is an important extension to previous research, which has relied mainly on cross‐sectional designs and self‐report methods. Future research might examine resilience resources that are specific to the outcomes of interest rather than rely on generic resources. This is the first longitudinal measurement‐burst study examining associations between stress, physical activity, sedentary behaviour, and resilience, utilizing objectively measured physical activity and biological and subjective indices of stress. Although the moderating effects of resilience resources were unsupported, stress was associated with lower levels of physical activity and higher levels of sedentary behavior.
Background:
Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. Further components relevant for improved CBT efficacy include raised endogenous GCs and reductions in information-processing biases to threat.
Aims:
To investigate hydrocortisone as an adjunct to CBT for spider fear and the modulating role of threat bias change and endogenous short-term and long-term GCs for treatment response.
Methods:
Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone (n = 17) or placebo (n = 16) one hour prior to single-session predominantly computerised exposure-based CBT. Spider fear was assessed using self-report and behavioural approach measures at baseline, 1-day and 1-month follow-up. Threat processing was assessed at baseline and 1-day follow-up. Cortisol and cortisone were analysed from hair and saliva samples at baseline.
Results/outcomes:
Self-report, behavioural and threat processing indices improved following CBT. Hydrocortisone augmentation resulted in greater improvement of self-report spider fear and stronger increase in speed when approaching a spider, but not on threat bias. Neither threat bias nor endogenous GCs predicted symptom change, and no interactive effects with hydrocortisone emerged. Preliminary evidence indicated higher hair cortisone as predictor of a stronger threat bias reduction.
Conclusions/interpretation:
Our data extend earlier findings by suggesting that GC administration boosts the success of exposure therapy for specific fear even with a low-level therapist involvement. Future studies corroborating our result of a predictive hair GC relationship with threat bias change in larger clinical samples are needed.
Social anxiety disorder (SAD) is a common heterogeneous disorder characterized by excessive fear and deficient positive experiences. Case-control emotion processing studies indicate that altered amygdala and striatum function may underlie SAD; however, links between these regions and symptomatology have yet to be established. Therefore, in the current study, 80 individuals diagnosed with SAD completed a validated emotion processing task during functional magnetic resonance imaging. Anatomy-based regions of interest were amygdala, caudate, putamen, and nucleus accumbens. Neural activity in response to angry>happy faces and fearful>happy faces in these regions were submitted to multiple linear regression analysis with bootstrapping. Additionally, multiple linear regression analysis was performed to explore clinical features of SAD. Results showed greater putamen activity and less amygdala activity in response to angry>happy faces were related to greater social anxiety severity. In the model consisting of caudate and amygdala activity in response to angry>happy faces, results were marginally related to social anxiety severity and the pattern of activity was similar to the regression model comprising putamen and amygdala. Nucleus accumbens activity was not related to social anxiety severity. There was no correspondence between brain activity in response to fearful>happy faces and social anxiety severity. Clinical variables revealed greater levels of anhedonia and general anxiety were related to social anxiety severity, however, neural activity was not related to these features of SAD. Neuroimaging findings suggest that variance in dorsal striatal and amygdala activity in response to certain social signals of threat contrasted with an approach/rewarding social signal may contribute to individual differences in SAD. Clinical findings indicate variance in anhedonia and general anxiety symptoms may contribute to individual differences in social anxiety severity.
Individuals with substance use disorders (SUDs) transition more quickly from goal-directed to habitual action-selection, but the neural mechanisms underlying this phenomenon remain unclear. Data from animal models suggest that drugs of abuse can modify the neurocircuits that regulate action-selection, enhancing circuits that drive inflexible, habit-based stimulus-response (S-R) action-selection, and weakening circuits that drive flexible, goal-directed actions. Here we tested the effect of bilateral 10 Hz transcranial alternating current stimulation (10Hz-tACs) of the dorsolateral prefrontal cortex on action-selection in men and women with a SUD history and an age- and gender-matched control group. We tested the hypothesis that true 10Hz-tACS versus active sham stimulation would reduce perseverative errors after changed response contingencies for well-learned S-R associations, reflecting reduced habit-based action-selection, specifically in the SUD group (McKim et al. 2016). We found that 10Hz-tACS increased perseverative errors in the control group, but in the SUD group, 10Hz-tACS effects on perseverative errors depended on substance abuse duration: a longer addiction history was associated with a greater reduction of perseverative errors. These results suggest that 10Hz-tACs altered circuit level dynamics regulating behavioral flexibility, and provide a foundation for future studies to test stimulation site, frequency, and timing specificity. Moreover, these data suggest that chronic substance abuse is associated with altered circuit dynamics that are ameliorated by 10Hz-tACs. Determining the generalizability of these effects and their duration merits investigation as a direction for novel therapeutic interventions. These findings are timely based on growing interest in transcranial stimulation methods for treating SUDs (Ekhtiari et al. 2019).
Recent research has shown that premature ejaculation (PE) is associated with negative psychological effects (e.g., depression) and the decline of control over ejaculation is accompanied by structural and functional abnormalities in specific brain areas and connections. However, little is known about the alterations of topological organization in the brain network of patients with PE and its relationship with depressive symptom. We acquired diffusion tensor images, sexual function and depression assessment in 16 lifelong PE patients with depressive symptom, 16 lifelong PE patients without depression and 32 age‐ and education matched healthy controls (HC). The differences in nodal centrality and different hub regions among the three groups were compared. Correlation analyses were conducted between the nodal centrality of brain regions displaying significant group differences and the clinical parameters of PE patients. PE patients with depression had increased nodal degree in the right middle frontal gyrus (orbital part) (ORBmid.R) (survived FDR‐correction) compared with HC and PE without depression. PE patients with depression also had increased nodal degree in the left and right posterior cingulate gyrus (PCG.L; PCG.R) compared with HC. In addition, PE with depression had increased nodal betweenness in ORBmid.R compared with HC and PE without depression. Moreover, PE with depression had decreased nodal participation in the right rolandic operculum (ROL.R), postcentral gyrus (PoCG.R) and supramarginal gyrus (SMG.R) compared with HC, and had decreased nodal participation in ROL.R and the right inferior parietal gyrus (IPL.R) compared with PE without depression, while PE without depression had increased nodal participation in the left precuneus (PCUN.L) compared with HC. The degree and betweenness of ORBmid.R were positively correlated with the total scores of Beck depression inventory (BDI) while the participation of IPL.R had a negative association with the total scores of BDI. Different hubs were found among PE patients with and without depression and HC based on nodal degree, betweenness and participation, however, no significant group differences were found in the frequency distribution of high‐degree hubs, high‐betweenness hubs, provincial hubs and connector hubs. These findings demonstrated that PE was a brain disorder with altered structural connectivity pattern of brain network and depressive symptom, which suggested that altered structural connectivities of the fronto‐cingulate‐parietal control network were core neurobiological features associated with PE and depression. Together, these alterations could prove helpful for understanding the pathophysiological mechanisms of PE in depression.
Self-report instruments can provide useful information as part of a thorough clinical assessment. However, their use in forensic settings can be problematic. The State-Trait Anger Expression Inventory (STAXI) has recently been proposed as an effective instrument for screening and outcome measurement in anger management programs. This study evaluated the effectiveness of this instrument in a sample of both voluntary and court-ordered anger-management clients, all of whom were determined through diagnostic interviews to have significant anger problems. Contrary to findings in nonforensic samples, the STAXI Trait Anger scale identified only about half of the participants as having anger-management problems severe enough to require intervention. Supplemental analysis with two additional scales did not significantly improve sensitivity. In addition to thorough diagnostic interviewing, forensic use of the STAXI (like similar assessment methods) may require additional validity scales to detect denial or socially desirable response patterns.
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