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The CES‐D Scale: A self‐report depression scale for research in the general popula‐ tion
... When screening patients/clients, HCSSPs should use evidence-based screening tools to identify patients/clients who are socially isolated and/or lonely, to assess the severity of the problem, and to use in routine follow-up to determine whether the patient's/client's social situation has changed and whether interventions are effective. [GRADE: Evidence: Moderate; Strength: Strong] Several options for screening tools are provided in the Guidelines including four measures of loneliness (17,18,19,20) and three measures of social isolation. (21,22,23,24,25) These tools are listed in Box 3, with details of two of the shortest tools in Table 1. ...
... Single item Loneliness (Radloff, 1977) (17) UCLA 3-item Loneliness Scale (Hughes et al, 2004) (18) UK Campaign to end Loneliness Scale (2015) (19) de Jong-Gierveld & van Tilburg, 2006) (20) Tools Focused Primarily on Social Isolation CARED Social Isolation and Loneliness Referral Tool (Newall & Menec, 2023) (21) Lubben Social Isolation Scale (Lubben, 2006) (22) Structural Social Isolation Scale (Berkman & Syme, 1979 (23) ; Steptoe et al., 2013 (24) ; Newall & Menec, 2019 (25) ) a Details regarding these tools can be found at: https://ccsmh.ca/areas-offocus/social-isolation-and-loneliness/clinical-guidelines/ Total scores can range from 1-9. ...
... Single item Loneliness (Radloff, 1977) (17) UCLA 3-item Loneliness Scale (Hughes et al, 2004) (18) UK Campaign to end Loneliness Scale (2015) (19) de Jong-Gierveld & van Tilburg, 2006) (20) Tools Focused Primarily on Social Isolation CARED Social Isolation and Loneliness Referral Tool (Newall & Menec, 2023) (21) Lubben Social Isolation Scale (Lubben, 2006) (22) Structural Social Isolation Scale (Berkman & Syme, 1979 (23) ; Steptoe et al., 2013 (24) ; Newall & Menec, 2019 (25) ) a Details regarding these tools can be found at: https://ccsmh.ca/areas-offocus/social-isolation-and-loneliness/clinical-guidelines/ Total scores can range from 1-9. ...
Background
Preventing and addressing social isolation and loneliness among older adults is important because of the known associations with negative health outcomes. The Canadian Coalition for Seniors’ Mental Health (CCSMH) took on the task of creating clinical guidelines.
Method
A multidisciplinary working group was established. The process was guided by an initial rapid scoping review of the literature focused on older adults. An adapted GRADE approach was utilized.
Results
CCSMH has produced first-ever clinical guidelines on social isolation and loneliness in older adults. Prevention, including recognition of risk factors and educational approaches focused on clinicians and students, is recommended. Targeted screening with validated tools is recommended. A comprehensive assessment is optimal to treat any underlying conditions and to identify contributing factors that may be responsive to psychosocial interventions. An individualized approach to interventions with shared decision-making is recommended. A variety of possible interventions include social prescribing, social activity, physical activity, psychological therapies, animal-assisted therapies and ownership, leisure skill development and activities, and the use of technology.
Conclusion
The problem of social isolation and loneliness is a “geriatric” giant that needs to be recognized and addressed. Because of its complexity, it will require the collective attention of many individuals and organizations working together at multiple levels of society, to raise awareness and find solutions. We recommend that health-care and social service providers use these guidelines as a comprehensive tool to identify, assess, and implement strategies to reduce the negative impact of social isolation and loneliness.
... Depressive symptom count was measured using a composite score of the 20-item Centers for Epidemiological Studies-Depression (CES-D; (Radloff 1977) scale, which has a raw score range of 0-60. The instrument asks participants to self-report how often they feel a certain way "during the past week." ...
... Example items from the scale include: "I had trouble keeping my mind on what I was doing," "I felt hopeful about the future (reverse-scored)," "I enjoyed life (reverse-scored)," "People were unfriendly," and "I felt depressed." All 20 CES-D items were scored on a four-point scale ("Rarely (Less than 1 day)" [0], "Some (1-2 days)" [1], "Occasionally (3-4 days)" [2], and "Most of the time (5-7 days)" [3], with higher scores indicating more depressive symptoms. Calculated internal consistency for this scale was high (Alpha = 0.89). ...
... Self-esteem was assessed using the Rosenberg Self-Esteem Scale, a 10-item scale measuring global self-worth more than spending it on entertainment or thrills (reversescored)." Items were scored true [1] or false [0]. The total novelty seeking score was the mean number of "true" responses across the 18 items, with higher scores indicating greater novelty seeking. ...
Risky sexual behavior (RSB) has been linked to externalizing problems, substance use, and, in a recent study by our lab, internalizing problems. The current study builds upon previous work investigating the relationship between RSB and internalizing problems (INT) by controlling for externalizing problems (EXT) to account for the correlation between INT and EXT. We used a twin sample from Colorado (N = 2,544) to investigate phenotypic and genetic relationships between the three latent constructs, as well as potential sex differences in those relationships. We hypothesized that the relationship between RSB and INT would be stronger for females than for males, whereas the relationship between RSB and EXT would be stronger for males than for females. We used phenotypic confirmatory factor analysis and multivariate twin analyses to address research questions. Our results show significant phenotypic relationships among RSB, INT, and EXT and provide modest evidence in males for a significant association between RSB and INT that persists when controlling for EXT, a finding which we interpret with caution. Our sex differences hypothesis was not fully supported, although the direction of effects was in the direction hypothesized for the association between RSB and INT. We discuss the complexity of RSB as a phenotype and the potential implications for public health.
... Moreover, a weeklong diary study involving 121 Belgian adolescents, examined the association between daily depressive symptoms, self-criticism, dependence, and psychosocial needs (Vandenkerckhove et al., 2021). Participants completed the siX-item version of the Center for Epidemiologic Studies-Depression Scale (Radloff, 1977) for seven consecutive days, among other measures. Multilevel models (adjusted for gender and age) showed apparent variations in daily symptoms, which were significantly associated with fluctuations in self-criticism, dependency, and psychosocial needs. ...
... Epidemiologic Studies-Depression Scale (CES-D), assessing symptoms (e.g., "I thought my life had been a failure") over the past week (Radloff, 1977) on a four-point Likert scale (0 = Rarely or None of the Time to 3 = Most or Almost All the Time). The measure is well-established in research and clinical settings with excellent validity and reliability (Eaton et al., 2004;Weissman et al., 1977), including internal consistency (α = 0.93) at intake in the current study. ...
... The measure is well-established in research and clinical settings with excellent validity and reliability (Eaton et al., 2004;Weissman et al., 1977), including internal consistency (α = 0.93) at intake in the current study. Sum scores, ranging from 0 to 60, were calculated after reverse coding items, excluding cases with >4 missing items following validated scoring instructions (Radloff, 1977). Scores ≥16 suggest risk for clinical depression (Weissman et al., 1977). ...
Background
Depression is a global health burden, disproportionately affecting women. A lack of contextual, real-life assessments considering the oft-gendered context (e.g., expression) of daily symptom fluctuations may contribute to this disparity. The current study examines: a) gender differences in daily depressive symptoms – and fluctuations; and b) daily links between self-perceived gender expression and depressive symptoms.
Methods
Established adults (N = 96; Mage = 28.19, SDage = 8.43) participated in an ecologically-valid multi-wave 100-day intensive longitudinal study. They reported daily on their depressive symptoms, and on their self-expression in the final study wave. Gender differences in daily symptoms fluctuations (intraindividual standard deviations) and their links to gender expression (person-specific residualized correlations) were examined.
Results
Women experienced greater day-to-day symptom fluctuations than men, after accounting for the gender difference in baseline symptoms (b = −0.05; 95 % CI: [−0.093, −0.012]). Results from a subsample (n = 28) showed that daily links between gender expression and depressive symptoms were heterogeneous: For 38.5 % of men and 53.3 % of women, daily increases in congruent gender expressions (i.e., masculine for men and feminine for women) corresponded with daily symptom decreases, but many individuals (46.4 %) did not show meaningful relations.
Conclusions
Results highlight the utility of intensive longitudinal approaches for the study of depression and, for some people, the daily psychological relations with gender self-perceptions. Results also emphasize heterogeneity in depression etiology and the need for personalized basic and applied science.
Limitations
Future research on individuals with varying gender identities and clinical experiences is needed.
... The CES-D Scale was developed by Radloff in 1977 to determine the depressive symptoms of the general population. 18 The scale consists of 20 items questioning feelings and thoughts about the past week. ...
... The CES-D Scale was developed by Radloff in 1977 to determine the depressive symptoms of the general population. 18 The scale consists of 20 items questioning feelings and thoughts about the past week. The items in the questionnaire are evaluated on a 4point Likert scale as 0: Never-Rarely (less than one day), 1: A little-A few times (1-2 days), 2: Occasionally-Sometimes (3-4 days), and 3: Often-Most Often (5-7 days). ...
... 19 The CES-D Scale determines the depressive symptoms of the general population, and a score ≥16 is considered a symptom of depression. 18,20 In a study, it was determined that 37.0% of the participants had a risk of depression and the authors emphasized that eating disorders are associated with depression. 14 According to a study, an eating disorder is a risk factor for depression, and depression is also a risk factor for an eating disorder. ...
... Section B: Comprised 20-items center for epidemiological studies-depression scale (Radloff, 1977). This scale was developed at the American Institute of Mental Health designed to measure symptoms of depression in the general population (Radloff, 1977). ...
... Section B: Comprised 20-items center for epidemiological studies-depression scale (Radloff, 1977). This scale was developed at the American Institute of Mental Health designed to measure symptoms of depression in the general population (Radloff, 1977). The instrument was validated in Nigeria by Okafor (1997) with reliability index of 0. 85, Ugwu (1998) with concurrent validity index of 0. 41 and Omeje (2000) with reliability and validity index of 0.85 and 0.92 respectively. ...
... Longitudinal Study of Adolescent to Adult Health (ADDH) is a nationally representative sample of United States adolescents that began in 1994-1995(Harris, 2013. Participants completed the Center for Epidemiologic Studies Depression Scale (CES-D) (Radloff, 1977) Simonson et al., 2023). Participants completed the 20-item version of the Positive and Negative Affect Schedule (PANAS) (Watson et al., 1988(Watson et al., ) in 1996(Watson et al., , 2002(Watson et al., , 2008(Watson et al., , 2011(Watson et al., , 2014(Watson et al., , 2017, and 2020/2021 to gauge their positive and negative affect at the present moment. ...
... The operationalization and measurement of a construct should be driven by its definition (Flake & Fried, 2020). The current study used the CES-D, a measure that assesses constructs beyond discrete positive and negative emotions (i.e., assesses depressed affect, positive activity, somatic activity, interpersonal functioning; Radloff et al., 1977). For example, though the CES-D captures experiences of emotions (e.g., "I felt sad"; "I was scared"), this measure also reflects both cognitive (e.g., "I worried about things I normally don't worry about") and behavioral (e.g., "I cried") aspects of emotional experience and expression. ...
Lifespan developmental theories suggest age-related shifts in motivation, cognition, emotion regulation, and stressor experience lead to changes in mean levels of negative and positive affect across the lifespan. The present research used coordinated data analysis to examine mean-level affective trajectories in 186,752 participants ranging from 11-104 years old across 14 longitudinal studies. Random-effects models were used to estimate meta-analytic effect sizes. On average, negative affect decreased until early older adulthood, then remained stable throughout older adulthood. Meanwhile, positive affect remained stable across most of the younger and middle-aged adult lifespan, before starting its descent in later middle-aged adulthood and continuing to decline throughout older adulthood. Studies with older samples showed a clearer flattening effect of negative affect and steeper decline of positive affect in late-life relative to younger samples. These findings suggest that lifespan developmental affect trajectories are nuanced and not a direct inverse of each other.
... The Center for Epidemiological Studies Depression Scale (CES-D) is employed to assess depressive symptoms in adolescents over the past week [37]. The CES-D consists of 20 items (e.g., "I feel like I've been a failure all along") rated on a 4-point scale, where 0 represents "not at all" and 3 represents "most of the time. ...
Background
The more rapid adoption of the Internet in education settings has raised concerns about its impact on adolescents who may suffer from cyberbullying victimization. As a negative life experience, cyberbullying victimization can adversely affect adolescents’ mental health. Particularly, it can lead to more adolescents developing depression. Based on this, we developed and tested a moderated mediation model to examine whether approach and avoidance coping strategies mediate the relationship between cyberbullying victimization and depression, and whether this mediating process was moderated by face consciousness.
Method
This study used a cross-sectional survey design with a sample of 1,586 middle school students from northwestern China, including 782 females (mean age 13.76 ± 1.03 years; age range 12–16). Participants completed an anonymous paper-and-pencil survey that assessed their experiences with cyberbullying victimization, approach and avoidance coping strategies, face consciousness, and depressive symptoms.
Result
The findings revealed that cyberbullying victimization (Beta = 0.37, SE = 0.02, p < 0.001) was significantly positively correlated with depression in adolescents. The avoidance coping strategies (Effect = 0.16, p < 0.001), rather than approach coping strategies, mediate the relationship between cyberbullying victimization and depression. Additionally, face consciousness (Beta = 0.05, t = 2.28, p = 0.009) moderated the mediation: as face consciousness increased, the impact of avoidance coping strategies on depression became stronger.
Conclusion
These findings provide valuable insights into how and when cyberbullying affects adolescent depression, offering potential guidance for prevention and intervention strategies aimed at reducing the impact of cyberbullying on depressive symptoms in this vulnerable population.
... Second, although researchers typically use wellvalidated assessments to measure symptoms of emotional and behavioural health problems such as the Center for Epidemiological Studies Depression scale (Radloff, 1977) or the Behaviour Problems Index (Peterson & Zill, 1986), the studies we reviewed did not measure mental health disorders per se. This limits the conclusions that researchers can draw about the impact of cash transfer programs on clinically significant levels of mental health problems. ...
Worldwide, more than one in 10 children or adolescents is diagnosed with a mental disorder. Cash transfer programs, which aim to reduce poverty and improve life outcomes by providing direct cash assistance to families and incentivizing or enabling spending on education, health service use, dietary diversity and savings, have been shown to improve the mental health and well‐being of young people in low‐ and middle‐income countries. The goal of this review is to describe cash transfer programs in the United States, to describe potential mechanisms by which cash transfer programs could improve child and adolescent mental health and to summarize any evidence of the impact of cash transfer programs. We conclude that much of the evidence on the relationship between cash transfer programs and child and adolescent mental health in the United States is based on a relatively small set of studies. Although most of these studies find that cash transfer programs are associated with reductions in emotional or behavioural health problems, effect sizes are small. For potential mechanisms of cash transfer effects, the strongest evidence is that cash transfer programs increase child‐related expenditures and savings and increase time spent with children. Evidence is mixed on whether cash transfer programs improve maternal mental health, parental disciplinary practices or children's exposure to violence.
... " We also asked about previous and current experiences with PHC, current use of ancillary health services (e.g., substance use treatment), and their top three health concerns. We enquired about recent substance use using the ASSIST scale [18], and participants were systematically surveyed for symptoms of anxiety using the Generalized Anxiety Disorder 7-item (GAD-7) [19] and depression using the Centre for Epidemiologic Studies Depression Scale 10-item version (CESD-10) [20]. ...
Introduction
Access to and engagement with primary healthcare can be difficult for marginalized low-income populations residing in inner cities in high-income countries. We designed a study to examine retention in primary care among clients of a novel interdisciplinary primary care clinic in the Downtown Eastside of Vancouver, Canada who did not previously have access to care.
Methods
Beginning in June 2021, clients of the Hope to Health clinic were offered enrolment in a cohort study which involved a baseline and follow-up surveys every six months, and linking their data to information from the clinic’s electronic medical records. We used Chi-square or Fisher’s Exact test and Wilcoxon rank sum test to compare clients who were lost to follow-up (LTFU) or deceased, with clients who were retained in care at the end of follow-up, Cox proportional hazards modeling was used to examine independent associations with mortality or LTFU.
Results
Among 425 participants enrolled, the median age was 50 years (IQR 40–59), 286 (67.3%) participants were men and 128 (25.4%) were unstably housed at enrollment. Among 338 participants with at least six months of follow-up after enrolment, 262 participants (67.5%) were retained in care, 20 (5.2%) had moved, 57 (14.7%) were classified as LTFU, and 28 (7.2%) had died with a median of 19.9 months of follow-up time. The risk of death or LTFU was independently associated diagnosed with alcohol use disorder (AUD) (adjusted hazard ratio [AHR] = 2.23 vs. not; 1.38–3.60), frequency of medical doctor visits (AHR = 0.69 per visit per 3 months; 0.60–0.79) and social work visits (AHR = 0.73 per visit per 3 months; 0.59–0.90. Stimulant use disorder or asthma were not significantly associated with retention in care.
Conclusion
We found that a primary healthcare model of care was successful in retaining over two-thirds of clients in primary healthcare after more than 18 months of follow-up. Additional supports for those diagnosed with alcohol use disorder are needed to retain them in care.
... Sex was categorized as (1) men or (2) women. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D; range 0-60, higher scores indicate more depressive symptoms) [38]. Self-rated health was assessed with one question and six possible responses categorized into three: (1) good or very good, (2) moderate or fair, and (3) poor or very poor. ...
Background
Outdoor mobility supports functioning and active life in old age. There is scarce knowledge about the outdoor mobility of senior housing residents, and it remains unclear whether outdoor mobility is dependent on one’s home location.
Aims
We investigated outdoor mobility among senior housing residents and community-dwelling older adults in different population-density areas.
Methods
We pooled data from two Finnish studies: a senior housing survey (N = 322) and a population-based cohort study among community-dwelling older adults (N = 1018). Life-space mobility (higher score indicating greater mobility) and autonomy outdoors (lower score indicating greater autonomy) were used as markers of outdoor mobility. Population density was used as an indicator of service availability and outdoor mobility enabling infrastructure. Data were analyzed with linear regression and moderation analyses.
Results
The mean life-space mobility scores were 70.5 (standard deviation, SD 20.0) among community-dwelling older adults and 54.8 (SD 27.6) among senior housing residents. For autonomy outdoors, the scores were 5.3 (SD 3.7) and 7.4 (SD 4.9), respectively. Population density moderated the association of housing type with outdoor mobility. In the highest and lowest population-density areas, senior housing residents had lower life-space mobility and poorer autonomy outdoors than community-dwelling older adults, whereas in the intermediate population-density areas, no such differences were found.
Conclusions
The location of a senior house is meaningful and optimal for outdoor mobility when within easy reach but not too near amenities. Poorer outdoor mobility among senior housing residents may reflect their adjustment to a new home environment and life situation, e.g., becoming a widow.
... Center for Epidemiological Studies-Depression [20]: CES-D captures the frequency of feelings and behaviors over the past seven days and rated on a 4-point scale ranging from 0 (rarely or none of the time) to 3 (most or all of the time). The CES-D contains 20 items that are summed so that scores have a potential range from 0 to 60, with higher scores indicating greater frequency of depressive experiences. ...
Introduction
Vaccine hesitancy among marginalized populations particularly in the Hispanic community over the course of the COVID-19 pandemic has presented as a public health issue. This study examined the relationship between political affiliation and vaccination decisions of Hispanic adults in Pima County, Arizona.
Methods
Between January and October 2022, 623 participants completed surveys in English or Spanish after completing informed consent process. Information collected included sociodemographic, political affiliation and philosophy and COVID vaccination uptake. Participants were recruited at different community events in Southern Tucson, Pima County, Arizona. Participants received five dollars for completing the surveys. Data were analyzed with Stata version 16.1.
Results
Participants were 81.8 % Hispanic and 18.2 % non-Hispanic. On average, participants were 32.9 (SD ± 11.8) years of age with a median age of 31 (IQR: 23, 41). Participants who had a bachelor's degree or above had 2.9 times greater odds of being vaccinated compared to those who had less than a high school education (Adjusted odds ratio (aOR): 2.84; 95 % CI: 1.12, 7.22). Individuals identifying as politically liberal had 3.28 times higher odds of being vaccinated compared to those identifying as conservative (OR = 3.28; 95 % CI: 1.5, 7.16). Similarly, Democrats had 3.36 times higher odds of being vaccinated than Republicans (OR = 3.36; 95 % CI: 1.61, 7.01). People who were strongly religious had statistically significantly lower odds of recommending the vaccine to others as compared to those who self-reported as not being religious.
Conclusions
There was an association with Hispanic adults who aligned liberal or Democrat to express more favorable views toward vaccinations. Additionally, individuals who were more educated, less religious, and in better financial situations tended to be more favorable toward vaccinations in Arizona.
... Additionally, as we aim to assess caregiving burden, we asked whether the informant provides care on an ongoing basis and whether they are primarily responsible for helping the respondent with their daily activities. Caregivers' stress was then assessed through four items from the Perceived Stress Scale, 28 five items from the Center for Epidemiological Studies Depression Scale (CESD), 22 and two questions on psychological overload. 29 Finally, questions measuring positive effects of caregiving, 30 as well as spirituality and religiosity, were included. ...
... The Mainz Pain Staging System (MPSS or "Gerbershagen Grad") 17 was used to record the degree of chronification and the Fibromyalgia Impact Questionnaire (FIQ). 5 Patients were further assessed with the "Allgemeine Depressionsskala" (ADS) 35 and the State-Trait Anxiety Inventory (STAI-S, STAI-T). 44 We determined the Ocular Surface Disease Index (OSDI) 39 to screen for xerophthalmia. ...
Introduction
Small fiber pathology may be involved in the pathophysiology of pain in women with fibromyalgia syndrome (FMS).
Objectives
This prospective single-center case-control study provides detailed pain phenotyping and small fiber pathology data in a cohort of men with FMS on a morphological and functional level.
Methods
Forty-two men with FMS underwent a comprehensive pain-related interview and neurological examination, a questionnaire and neurophysiological assessment, and specialized small fiber tests: skin punch biopsy, quantitative sensory testing including C-tactile afferents, and corneal confocal microscopy. Data were compared with those of healthy male controls.
Results
Men with FMS reported generalized and permanent pain with additional pain attacks and a mostly pressing pain character. Intraepidermal nerve fiber density was reduced at ≥1 biopsy site in 35 of 42 (83%) men with FMS (controls: 32/65, 49%). Compared with male controls, men with FMS had elevated cold ( P < 0.05) and warm detection thresholds ( P < 0.001) and an increased mechanical pain threshold ( P < 0.05) as well as an impairment of C-tactile afferents ( P < 0.05). Corneal nerve fiber density was lower in male patients with FMS vs healthy men ( P < 0.01). Male FMS patients with pathological skin innervation at ≥1 biopsy site compared with those with normal skin innervation had a higher clinical Widespread Pain Index ( P < 0.05) indicating an association between the severity of cutaneous denervation and symptom load.
Conclusion
We show a distinct pain phenotype and small nerve fiber dysfunction and pathology in male patients with FMS. These findings may have implications for the diagnosis and management of men with FMS.
... Additionally, as we aim to assess caregiving burden, we asked whether the informant provides care on an ongoing basis and whether they are primarily responsible for helping the respondent with their daily activities. Caregivers' stress was then assessed through four items from the Perceived Stress Scale, 28 five items from the Center for Epidemiological Studies Depression Scale (CESD), 22 and two questions on psychological overload. 29 Finally, questions measuring positive effects of caregiving, 30 as well as spirituality and religiosity, were included. ...
... Additionally, as we aim to assess caregiving burden, we asked whether the informant provides care on an ongoing basis and whether they are primarily responsible for helping the respondent with their daily activities. Caregivers' stress was then assessed through four items from the Perceived Stress Scale, 28 five items from the Center for Epidemiological Studies Depression Scale (CESD), 22 and two questions on psychological overload. 29 Finally, questions measuring positive effects of caregiving, 30 as well as spirituality and religiosity, were included. ...
The rising burden of dementia calls for high-quality data on cognitive decline and dementia onset. The second wave of the Harmonized Diagnostic Assessment for the Longitudinal Aging Study in India (LASI-DAD) was designed to provide longitudinal assessments of cognition and dementia in India. All Wave 1 participants were recruited for a follow-up interview, and a refresher sample was drawn from the Longitudinal Aging Study in India, a nationally representative cohort of Indians aged 45 and older. Respondents underwent a battery of cognitive tests, geriatric assessments, and venous blood collection. Their health and cognitive status were also assessed through an interview with a close family member or friend. Clinical consensus diagnosis was made based on the Clinical Dementia Rating ® , and comprehensive data on risk factors of dementia were collected, including neurodegenerative biomarkers, sensory function, and environmental exposures. A total of 4635 participants were recruited between 2022 and 2024 from 22 states and union territories of India, accounting for 97.9% of the population in India. The response rate was 84.0%, and 71.5% of the participants provided venous blood specimen. LASI-DAD provides rich new data to study cognition, dementia, and their risk factors longitudinally in a nationally representative sample of older adults in India. Longitudinal cognitive data, together with longitudinally assessed biomarker data and novel data on sensory function and environmental exposures, provide a unique opportunity to establish associations between risk factors and biologically defined cognitive aging phenotypes.
... Depressive symptoms The Center for Epidemiologic Studies-Depression Scale (CES-D) will be employed to assess depressive symptoms over a one-week recall period [30]. This scale comprises 20 items, each rated on a 4-point Likert scale (0 = less than a day, 1 = 1-2 days, 2 = 3-4 days, and 3 = 5-7 days). ...
Background
Caregiver stress can pose serious health and psychological concerns, highlighting the importance of timely interventions for family caregivers of people with dementia. Single-session mindfulness-based interventions could be a promising yet under-researched approach to enhancing their mental well-being within their unpredictable, time-constrained contexts. This trial will evaluate the effectiveness and feasibility of a blended mindfulness-based intervention consisting of a single session and app-based follow-up in reducing caregiver stress.
Methods/Design
The study is a single-blinded randomized controlled trial with two arms (intervention versus an education session on dementia care) and assessments at baseline, 8 weeks, and 6 months. The eligibility criteria include: family caregivers aged 18 years or older; providing care for an individual with a confirmed medical diagnosis of dementia for at least 3 months prior to recruitment, with a minimum of 4 hours of daily contact; and exhibiting a high level of caregiver stress. The intervention comprises a 90-minute group-based session with various mindfulness practices and psychoeducation. Participants will receive a self-practice toolkit to guide their practice over a duration of 8 weeks. Sharing activities will be implemented through an online social media platform. The primary outcome is perceived caregiving stress. The secondary outcomes include depressive symptoms, positive aspects of caregiving, dyadic relationship, trait mindfulness, and neuropsychiatric symptoms of care recipients. The feasibility outcomes include eligibility and enrollment, attendance, adherence to self-practice, and retention, assessed using mixed methods.
Discussion
The study will contribute to the evidence base by investigating whether a single-session mindfulness intervention is effective and feasible for reducing caregiver stress among family caregivers of people with dementia.
Trial registration
ClinicalTrials.gov, NCT06346223. Registered on April 3, 2024.
... Working status was used as a proxy for economic status and measured by a yes or no response to the question 'During the past 4 weeks, did you work at a paying job?' in the KDQOL [21]. Depression was assessed using the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D) [24,25]. The CES-D consists of 20 items scored using a 4-point scale. ...
Background
In chronic kidney disease (CKD), the durability of patient adherence to fluid and dietary restrictions may depend on the degree to which they have hope that they will enjoy life. Previous cross-sectional studies have shown that higher hope was associated with lower distress from fluid and dietary restrictions and better adherence in the short term. In this study, we aimed to examine the long-term relationship of hope with distress from fluid and dietary restrictions.
Methods
This prospective observational cohort study included 444 patients with CKD undergoing dialysis in one of five Japanese nephrology centers. Hope as a predictor was measured using an 18-item health-related hope scale. Outcomes were two-item measures of distress from fluid and dietary intake restrictions using the Japanese version of the Kidney Disease Quality of Life Short Form, Version 1.3 (higher scores indicate lower levels of distress). Multivariate linear mixed models were used to estimate the association of baseline health-related hope with distress from fluid and dietary restrictions at baseline and follow-up.
Results
The mean age of the participants was 67 years, and 31.1% of them were females. In total, 124, 98, and 222 had non-dialysis CKD, peritoneal dialysis, and hemodialysis, respectively. Higher levels of baseline health-related hope were associated with lower levels of distress from fluid restriction after one year (per 10-point increase, 2.6 points (95% confidence interval, 1.0 to 4.1)); whereas the baseline score was not associated with the distress from fluid restriction at 2 years. Similarly, higher levels of baseline health-related hope were associated with lower levels of distress from dietary restriction after one year (per 10-point increase, 2.0 points (95% confidence interval, 0.3 to 3.6)); whereas the baseline score was not associated with the distress from dietary restriction at 2 years.
Conclusions
Health-related hope, regardless of depression, can potentially mitigate long-term distress from fluid and dietary restrictions in patients with a wide range of CKD severities.
Trial registration
UMIN000054710.
... Furthermore, the lack of consensus on measuring well-being is exacerbated by the focus on single dimensions such as energy and vitality (12), 'affect balance' (13), self-esteem (14), depression (15), attitudes to aging (16), and satisfaction with life (17). A holistic wellbeing assessment requires more sophisticated multidimensional scales that include physical and psychological health, emotional well-being, and social functioning. ...
Introduction
China is one of the world’s fastest-aging countries. Continuing Care Retirement Communities (CCRCs) have emerged as a viable option for accommodating and serving older adults. However, Chinese CCRCs are still in the early stages, and comprehensive research on resident well-being is still deficient. The study aims to assess how well residents in CCRCs are faring in terms of their psychological and physical health, considering China’s aging population and changing societal structures.
Methods
After a thorough literature review to pinpoint relevant well-being measures in psychological and physical health, the study implemented a survey to capture residents’ experiences and perceptions, and subsequently analyzed how well-being correlates with demographic characteristics.
Results and discussion
The results show that while Chinese CCRCs can enhance residents’ well-being through personalized care and social activities, challenges such as psychological distress and declining physical health remain. Demographic factors, including living situation and length of stay, also affect residents’ well-being. The study emphasizes the importance of ongoing research and evaluation to guide evidence-based practices and improve CCRCs continuously. Overall, it offers a comprehensive analysis of the wellbeing of Chinese CCRCs residents, shedding light on both psychological and physical health aspects and providing valuable insights for enhancing CCRCs design, implementation, and evaluation in China and elsewhere.
... 26 A higher score represents poorer cognitive performance, and a positive change from baseline indicates worsening cognitive impairment. Secondary outcomes, including the Korean version of the prospective and retrospective memory questionnaire (K-PRMQ), 27 the Center for Epidemiological Studies-Depression (CES-D) questionnaire, 28 the State-Trait Anxiety Intervention-X-1 (STAI-X-1), 29 the Perceived Stress Scale (PSS), 30 ...
Background
The heterogeneous etiology of mild cognitive impairment (MCI) presents significant challenges in monitoring its progression and impeding its advancement toward dementia. Digital multidomain lifestyle interventions have shown promise as potential solutions for their ability to treat MCI.
Objective
This study is the first phase in a series of evaluations aimed at assessing various components of Silvia-Rx, which was originally designed as a digital multidomain lifestyle intervention. Specifically, this study focused on a 60-session core cognitive training program to evaluate its feasibility and efficacy in addressing cognitive decline in individuals with MCI.
Methods
Individuals aged 60 to 80 years diagnosed with MCI were enrolled to participate in a 60-session tablet-based cognitive regimen of Silvia-Rx. Feasibility was assessed through adherence and retention rates, while the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog) scale was utilized to measure cognitive function as the primary indicator of efficacy.
Results
The mean age of the participants was 71.11 years, and 13 (68.42%) were women. Only one withdrawal occurred, resulting in a 95% retention rate (19 participants) post-intervention. The completion rate was excellent at 100%, indicating that the 60-session core cognitive program in Silvia-Rx was well tolerated by older participants with MCI. Regarding efficacy, there was a statistically significant improvement in cognitive function among MCI participants after the intervention, as evidenced by changes in total ADAS-cog scores.
Conclusions
Results demonstrated excellent adherence throughout the program and significant cognitive improvements after the intervention. This pilot study indicates that Silvia-Rx's digital cognitive program is feasible for people diagnosed with MCI, suggests potential for improving cognitive function, though further research with large sample size is needed to confirm these results.
... The mean and standard deviation of the total scores were calculated. The proportion of participants scoring 16 or greater was also determined as this score is suggestive of signi cant depression [14]. ...
Background: Vascular diseases are recognized as a modifiable risk factor for the development of cognitive impairment. One potential underlying mechanism for this may be due to chronic alterations to cerebral blood flow (CBF), which has been linked to downstream consequences. Global decreases in CBF following a change in position are often manifested clinically as orthostatic hypotension, with changes in systolic blood pressure (SBP). This study describes clinical symptoms of orthostasis, depression, and dysautonomia in older adults and correlates these symptoms with objective measures of CBF velocity and systolic blood pressure following a supine to stand transition.
Methods: 88 adult participants were recruited from a longitudinal, observational study. Participants completed standardized questionnaires for orthostatic, depression and autonomic symptoms. Participants were fitted with standardized equipment to measure SBP and CBF at baseline, nadir, 1 minute standing, and 3 minutes standing, during a protocol defined supine to stand transition and subsequent 3-minute stand.
Results: Changes in CBF were not associated with any of the collected symptom scales. Changes in SBP were negatively associated with orthostatic symptoms. Change in SBP from baseline to stand after 1 minute was negatively associated with depression symptoms.
Discussion: Symptoms of orthostatic hypotension, dysautonomia, and depression are common in older adults. Participants reported more nonspecific symptoms of orthostasis such as fatigue, trouble concentrating, and head and neck discomfort than traditional symptoms such as dizziness or light-headedness. Our results suggest that changes in CBF may be asymptomatic, while changes in SBP are correlated with reported orthostatic hypotension symptoms.
... The scores range from 0 to 60 with higher scores indicating more severe symptoms of depression. The score ≥16 was used to differentiate between depressed and non-depressed individuals (Cronbach α=0.90) 13 . ...
... The prenatal psychobiological risk (PPBR) index captured 14 risk indicators during pregnancy. Indicators were derived from questionnaires (i.e., modified WHO ASSIST,31 Community Epidemiological Survey-Depression,32 trait subscale of State Trait Anxiety Inventory,33 Stressful Life Events Questionnaire 34 ), lab anthropometric assessments, medical records, and serum assays. Indicators spanned five substantive domains: weight status (pre-pregnancy BMI, excessive weight gain during pregnancy), pregnancy complications (pre-eclampsia, gestational diabetes, gestational hypertension), hormonal risk (leptin, adiponectin, insulin), substance use (alcohol, cannabis, tobacco) and prenatal stress (depressive symptoms, trait anxiety, stressful life events). ...
Background
Childhood obesity remains a public health crisis and identification of unique prenatal and early infancy predictors of obesity risk are critically needed.
Objectives
We test a comprehensive biopsychosocial model of the predictors of rapid weight gain (RWG) in the first 6 months of life.
Methods
Two hundred and ninety nine pregnant women and their infants participated. Maternal prenatal psychobiological risk (PPBR) was assessed during the third trimester via maternal anthropometrics, serum biomarkers (insulin, leptin, adiponectin), and maternal report of pregnancy complications, substance use, mental health and stress. Infant stress reactivity was measured at 2 months (cortisol output, resting RSA, observed irritability, negative emotionality). At 2 and 6 months, maternal self‐report of obesogenic feeding practices and observed maternal sensitivity during three tasks were collected. RWG was classified based on change in weight‐for‐age z scores from birth to 6 months (>0.67 SD).
Results
Obesogenic feeding practices predicted greater likelihood of RWG, β = 0.30, p = .0.01, independent of other predictors and covariates. Obesogenic feeding practices was the only proposed intervening mechanism that produced a significant indirect effect of PPBR on RWG, b = 0.05, S.E. = 0.04, 95% CI [0.002, 0.15], β = 0.06.
Conclusion
Identifying proclivity towards obesogenic feeding practices and providing support to reduce these behaviours may enhance childhood obesity prevention efforts.
... It is a 20-item self-report instrument that assesses severity of depressive symptoms over the past week on a 4-point scale and lakes around 10 minutes for application. 23 A 10 item short version was translated and used in Malayalam for a study among community dwelling elder. 24 In a study among 400 participants the CES-D scale were translated into Tamil language the internal consistency was high which indicated acceptable measurement properties. ...
Mood disorders are amongst the more prevalent psychiatric disorders which contribute significantly to the disability adjusted life years arising from psychiatric disorders. It is imperative to state that prompt and appropriate management of the disorders can be very helpful in assuaging the effects of these disorders. Rating scales should be considered as a very important tool in the proper management of these disorders. In our review we could identify considerable number of tools that are available for the management of mood disorders (depressive disorders and bipolar disorders) and also tools catering to the special populations with mood disorders. Some of the tools have been translated to Indian languages, whereas significant others have not been used in Indian context. We could also observe popularity of a few tools amongst researchers as compared to others. The lacunae of the existing literature have been highlighted.
... Psychological: Psychological function was evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D), a widely used tool for assessing depression and an independent diagnostic indicator of depression [52]. The CES-D's reliability with the Chinese elderly population has been validated [53]. ...
Background
The decline in intrinsic capacity (IC) among older adults is a significant global health challenge, impacting their well-being and quality of life. Despite global efforts to promote healthy aging, research on factors contributing to IC decline in the Chinese population is limited. This study aims to investigate the decline of intrinsic capacity in Chinese older adults and to explore the influence of sociodemographic, health status, and lifestyle factors on the decline of intrinsic capacity.
Methods
Prevalence of intrinsic capacity decline was described using frequency analysis, while chi-square tests were used to analyze its associations with sociodemographic characteristics, health status, and lifestyle factors. Binary logistic regression analysis was used to identify significant factors influencing the decline of intrinsic capacity (α = 0.05).
Results
Among 6,941 respondents aged 60 years and above, 83.8% reported a decline in intrinsic capacity. Cognitive impairment was predominant (71.8%), followed by psychological (40.4%), locomotion (19.8%), vitality (17.2%), and sensory impairments (8.9%). Sociodemographic factors associated with a decline in intrinsic capacity included female gender, age 80 and older, unmarried, divorced or widowed status, rural residence, low education, and lack of health or pension insurance (p < 0.05). From the perspective of health status, factors associated with higher rates of intrinsic capacity decline include poor self-rated health, multiple chronic conditions, recent falls, frequent physical pain, recent outpatient visits, hospitalizations, and pessimistic life expectancy (p < 0.05). Lifestyle factors such as alcohol consumption, lack of social participation, prolonged sleep duration, and no Internet use were also linked to higher rates of intrinsic capacity decline (p < 0.05). The results of the binary logistic regression indicated that age, marital status, residence address, education level, pension insurance status, self-rated health, the presence of multiple chronic conditions, frequency of perceived physical pain, subjective life expectancy, social participation, sleep duration, and Internet access significantly influenced the decline of intrinsic capacity in older adults (p < 0.05).
Conclusions
The decline in intrinsic capacity among older adults in China, particularly in cognitive impairment, is concerning. Targeted interventions are necessary for vulnerable populations, especially those who are older, divorced or widowed, living in rural areas, or have lower education levels. Enhancing social pensions, promoting social participation, encouraging healthy sleep patterns, and improving digital inclusion to improve intrinsic capacity among older adults is important.
... Depression symptoms was measured using the Center for Epidemiological Studies Depression Scale (CES-D) [39] Participants were asked to rate the frequency of depression symptoms in the past week on a four-point Likert scale (0 for occasional or none, 3 for persistent). The Chinese version of the CES-D has good reliability [40]. ...
Neuroticism appears to be a factor that triggers social aggression, but the relationship between neuroticism and social aggression and its underlying mechanisms is unclear. Questionnaire data from 942 college students ranging in age from 17 to 24 (Mage = 20.33, SD = 1.03) were analysed to assess whether depression symptoms mediated the relationship between neuroticism and social aggression, and to test a moderating effect of perceived social support. Results showed that neuroticism positively predicted social aggression and this association was mediated by depression symptoms. Moderation was found for the association between neuroticism and depression symptoms, as well as between neuroticism and social aggression, and that neuroticism had a stronger predictive effect on depression symptoms and social aggression under low compared to high perceived social support. These findings may inform prevention and intervention efforts to reduce social aggression.
... All models controlled for participant age (in years), sex assigned at birth (female or male), race (White, East Asian, and other races), educational attainment (Less than Bachelor's degree, Bachelor's degree, or above a Bachelor's degree), and waist-to-hip ratio. Given that previous work has consistently found depressive symptomology to predict subjective cognition and cognitive decline [45,31]; thus, all models controlled for depressive symptoms using the CES-D [46]. To account for potential differences in the proportion of stressor days between participants, analyses controlled for the person's percentage of days on which any stressors were reported. ...
Objective
Growing research indicates that daily stress is associated with poorer same-day cognitive performance, for example, memory and attention. However, it is unclear whether this relationship holds across diverse ages and engagement in physical activity (PA), or whether these factors might buffer the relationship between daily stress and subjective cognitive function.
Methods
Ecological momentary assessment data were collected from adults aged 25-88 across British Columbia, Canada. For 14 days, participants (N = 204) wore a tri-axial physical activity monitor, reported stressor occurrence in mobile surveys 4 times per day, and rated their subjective attention and memory at the end of each day.
Results
Multilevel models evaluated daily stressor occurrence as a predictor of subjective attention and memory, with same-day PA engagement and age as moderators. Subjective attention and memory were lower on days when a stressor had occurred, compared to stressor-free days. Neither PA nor age moderated the within-person associations of daily stressors with subjective cognition.
Conclusion
The lack of stress-buffering effects for same-day PA and age raises questions about the contexts in which PA promotes cognitive functioning and about age-related processes underlying stress and cognition. Future work could examine the mechanisms that might explain the link between daily stress and cognition function, as well as the associations of different intensity and forms of physical activity on stress across age groups.
... Further, we controlled for maternal antepartum mental health in the current study. Depressive symptoms were measured with the Center for Epidemiological Studies Depression scale (CES-D) (Radloff, 1977). Anxiety was assessed with the State-Trait Anxiety Inventory State form (STAI-S) ( Van der Ploeg, 1980). ...
... The simplified version of Center for Epidemiological Research Depression Scale (CES-D) was used to measure depression [89]. The simplified version of CES-D consists of 10 multiple-choice items, and participants were asked about their feelings for 10 aspects during the last week, such as feeling bothered, having trouble concentrating and feeling depressed, with options including: almost none (less than one day), sometimes (1-2 days), often (3-4 days), most of the time (5-7 days). ...
Background
Older migrant workers (OMWs) in China face unique challenges rooted in their early life experiences, which increase their vulnerability to psychological and behavioral problems in adulthood. By utilizing the cumulative disadvantage model and the social-ecological systems theory, this study explored the effect of childhood family adversity on adulthood depression in the mediating roles of OMWs’ social-ecological microsystem and mesosystem and further examined gender differences in these associations.
Methods
Data were collected from the China Health and Retirement Longitudinal Study (CHARLS), involving a sample of 4,309 OMWs aged 50 and above. The measures included the Center for Epidemiological Research Depression Scale, childhood family adversity, socioeconomic status, marital quality, and physical and cognitive health.
Results
Childhood family adversity was positively associated with adulthood depression among OMWs. Social microsystem (physical and cognitive health) and mesosystem (marital quality and socioeconomic status) factors significantly mediated this relationship. Multi-group analysis revealed that the mediating effects of marital quality and socioeconomic status were stronger for female OMWs, while the mediating effects of physical and cognitive health were stronger for male OMWs.
Conclusions
The findings suggest that childhood family adversity has a lasting impact on the mental health of OMWs, and that social-ecological systems factors play an important role in this relationship. The study also highlights the need for gender-specific interventions to address the mental health needs of OMWs.
... Patient Cancer-Specific Symptoms were assessed with the MD Anderson Symptom Inventory-Brain Tumor module (MDASI-BT), which consists of 13 core items and 9 brain tumor-specific items assessing symptom severity, and 6 items assessing interference with daily life on a scale from 0 to 10 [19]. The MDASI-BT measures the severity of six underlying constructs including affective (distress, fatigue, sleep disturbance, sadness, and irritability), cognitive (difficulty understanding, difficulty remembering, difficulty speaking, and difficulty concentrating), neurologic deficit (seizures, numbness, pain, and weakness), treatment-related (dry mouth, drowsiness, and lack of appetite), generalized symptom (change in appearance, change in vision, change in bowel patterns, and shortness of breath), and a gastrointestinal-related factor (nausea and vomiting). ...
Background
Illness-related communication and depressive symptoms within families may play an important role in caregivers’ ability to accurately understand patients’ symptom burden. We examined the associations between these psychosocial factors and symptom accuracy in patients with glioma and their family caregivers.
Methods
Patients and caregivers ( n = 67 dyads) completed measures of depressive symptoms (CES-D), illness communication (CICS), and QOL (SF-36). Patients reported on their own cancer-related symptoms (MDASI-BT) while caregivers reported on their perception of the patients’ symptoms (i.e., proxy reporting). Paired t -tests and difference scores were used to test for agreement (absolute value of difference scores between patients and caregiver proxy symptom and interference severity reports) and accuracy (caregiver underestimation, overestimation, or accurate estimation of patient symptom and interference severity).
Results
Clinically significant disagreement was found for all means scores of the MDASI-BT subscales except for gastrointestinal symptoms and general symptoms. Among caregivers, 22% overestimated overall symptom severity and 32% overestimated overall symptom interference. In addition, 13% of caregivers underestimated overall symptom severity and 21% of caregivers underestimated overall symptom interference. Patient illness communication was associated with agreement of overall symptom severity ( r =−0.27, p = 0.03) and affective symptom subscale ( r =−0.34, p < 0.01). Caregivers’ reporting of illness communication ( r =−0.33, p < 0.01) and depressive symptoms ( r = 0.46, p < 0.0001) were associated with agreement of symptom interference. Caregiver underestimating symptom severity was associated with lower patient physical QOL ( p < 0.01); caregiver underestimating symptom interference was associated with lower patient physical QOL ( p < 0.0001) and overestimating symptom interference was associated with lower patient physical QOL ( p < 0.05). Patient and caregiver mental QOL was associated with caregiver underestimating ( p < 0.05) and overestimating ( p < 0.05) symptom severity.
Conclusion
The psychosocial context of the family plays an important role in the accuracy of symptom understanding. Inaccurately understanding patients experience is related to poor QOL for both patients and caregivers, pointing to important targets for symptom management interventions that involve family caregivers.
... The dependent variables used to compare the two groups were scores from self-report questionnaires including: the Center for Epidemiologic Studies-Depression scale (CES-D) [11], the State Trait Anxiety Inventory (STAI) [12] and the Posttraumatic Diagnostic Scale (PDS) [13]. These questionnaires were completed as part of a comprehensive neuropsychological evaluation completed by a licensed psychologist. ...
Objective: To compare patients with psychogenic non-epileptic seizures (PNES) who requested reinstatement of driving privileges or reported having resumed driving to those who did not. Methods: Diagnosis of PNES was confirmed with video-EEG. Demographic and clinical data and requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Self-report questionnaires of depression, anxiety and PTSD that were administered as part of neuropsychological assessment were analyzed. Results: Of 73 patients with PNES evaluated in 2018-2021, 22 later applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was determined to be significantly less depressed (p = 0.014) when initially assessed than the group that did not. Conclusion: Resumption of driving behavior is an explicit measure of improvement for PNES because patients are advised to discontinue driving until they are seizure-free for a determined time span. Findings revealed that initial lower experienced levels of depression symptoms were associated with subsequent reported seizure-freedom which allowed for the reactivation of driving privileges. This underscores the importance that depression may have on PNES prognosis and supports assessing and treating comorbid mood symptoms in a timely manner.
... Depression was assessed using the 15 items of the Allgemeine Depressionsskala (Hautzinger & Bailer, 1993), which is the German-language adaptation of the short version of the Center for Epidemiologic Studies Depression Scale, or CES-D (Radloff, 1977; example item: "During the past week I felt depressed"; α = .88) on a four-point Likert scale (1 = rarely or none of the time [less than 1 day], 2 = some or a little of the time [1-2 days], 3 = occasionally or a moderate amount of time [3-4 days], 4 = all of the time [5-7 days]). ...
This study examined whether optimism in early adolescence predicts occupational and psychosocial outcomes in early adulthood and explored the functional form of this relation. We also investigated whether these associations continue to hold after accounting for concomitant factors and whether optimism acts as a protective factor that helps early adolescents deal with socioeconomic adversity. We followed a large sample of German seventh graders ( N = 1596; 63.8% females; baseline M age = 12.9) at two measurement points over a period of 18 years and estimated latent regression models. Optimism in early adolescence predicted several adult outcomes, including occupational prestige, social integration, psychosocial symptoms, and depression. Analyses with social integration, depression, and life satisfaction revealed a nonlinear association: Optimism promoted life outcomes, but this positive association reached a plateau in above-average ranges of optimism and a minimum value in below-average optimism ranges. Moreover, optimism in early adolescence buffered the negative effects of low parental socioeconomic status on occupational prestige, job satisfaction, and psychosomatic symptoms in adulthood. The findings offer increased knowledge about the long-term significance of optimism and underscore the necessity of considering these effects from a more comprehensive and interactional point of view.
... The Korean version of the CESD-R, based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), comprises nine symptom groups. Originally developed by Radloff (1977), it was translated into Korean by Lee et al. (2016). The instrument queries a patient's various symptoms of depression over the past week, where higher scores denote higher depression levels. ...
This study examined social anxiety and facial emotion recognition with and without face mask-wearing in a social threat situation. A total of 309 adult males and females were screened using the Korean version of the Social Avoidance and Distress Scale (K-SADS) and the Korean version of the Center for Epidemiologic Studies Depression Scale-Revised (K-CES-DR). Of the participants, 56 individuals were divided into the social anxiety and non-social anxiety groups. Both groups were then exposed to threatening social situations. Using the signal detection theory, the sensitivity and cognitive bias in emotion recognition with and without face mask-wearing was examined. Results showed that the social anxiety group had significantly lower perceptual sensitivity and more negative interpretation bias to faces, with or without face masks. Specifically, the perceptual sensitivity was significantly lower to faces with masks; however, there was no significant difference in interpretation bias. Although both groups showed no significant difference in reaction time with the emotional expression on masked faces, the social anxiety group responded faster to faces wearing masks. As this is the first prospective study to investigate facial emotion recognition with face mask-wearing related to social anxiety, it provides valuable insight and data for future research.
... Health-related factors assessed in the STAGE survey included symptoms of depression and burnout. Depressive symptoms were measured using the Center for Epidemiological Studies-Depression (CES-D) scale [54]. The STAGE survey includes a validated short-form inventory with 11 questions [55] and the variable was handled as continuous. ...
Objectives
The aim of this study was to investigate associations between exposure to work-related violence/threats and harassment, and future sickness absence (SA) due to common mental disorders (CMDs), taking familial factors (shared genetics and early-life environment) and neuroticism into account.
Methods
The study sample included 8795 twin individuals from the Swedish Twin Project of Disability Pension and Sickness Absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE). Self-reported work-related violence and/or threats as well as work-related harassment (including bullying) and national register data on SA due to CMDs were analyzed using standard logistic regression, and conditional logistic regression among complete twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses.
Results
Exposure to work-related violence/threats was associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children, education, type of living area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52–2.95). Higher odds of SA due to CMDs were also found for exposure to harassment (OR 1.52, 95% CI 1.10–2.11) and a combined indicator of exposure to violence/threats and/or harassment (OR 1.98, 95% CI 1.52–2.59), compared with the unexposed. Analyses of twins discordant on exposure, using the unexposed co-twin as reference, showed reduced ORs. These ORs were still elevated but no longer statistically significant, potentially due to a lack of statistical power. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, indicating higher odds of SA due to CMDs in the group scoring lower on neuroticism.
Conclusions
Exposure to work-related offensive behaviors was associated with SA due to CMDs. However, the results indicated that these associations may be partly confounded by familial factors. In addition, an interaction between exposure and neuroticism was suggested. Thus, when possible, future studies investigating associations and causality between offensive behaviors at work and mental health-related outcomes, should consider familial factors and neuroticism.
... We collected all clinical data, neuropsychiatric questionnaires, neuropsychological test results and MRI at one [19]. Educational level was categorized (low/average/high) according to the standardized Dutch classification [20]. ...
Background
Neuropsychiatric symptoms (NPS) may affect cognition, but their burden in cerebral amyloid angiopathy (CAA), one of the main causes of intracerebral hemorrhage (ICH) and dementia in the elderly, remains unclear. We investigated NPS, with emphasis on apathy and irritability in sporadic (sCAA) and Dutch-type hereditary (D-)CAA.
Methods
We included patients with sCAA and (pre)symptomatic D-CAA, and controls from four prospective cohort studies. We assessed NPS per group, stratified for history of ICH, using the informant-based Neuropsychiatric Inventory (NPI-Q), Starkstein Apathy scale (SAS), and Irritability Scale. We modeled the association of NPS with disease status, executive function, processing speed, and CAA-burden score on MRI and investigated sex-differences.
Results
We included 181 participants: 82 with sCAA (mean[SD] age 72[6] years, 44% women, 28% previous ICH), 56 with D-CAA (52[11] years, 54% women, n = 31[55%] presymptomatic), and 43 controls (69[9] years, 44% women). The NPI-Q NPS-count differed between patients and controls (sCAA-ICH+:adj.β = 1.4[95%CI:0.6–2.3]; sCAA-ICH-:1.3[0.6-2.0]; symptomatic D-CAA:2.0[1.1–2.9]; presymptomatic D-CAA:1.2[0.1–2.2], control median:0[IQR:0–3]), but not between the different CAA-subgroups. Apathy and irritability were reported most frequently: n = 12[31%] sCAA, 19[37%] D-CAA had a high SAS-score; n = 12[29%] sCAA, 14[27%] D-CAA had a high Irritability Scale score. NPS-count was associated with decreased processing speed (adj.β=-0.6[95%CI:-0.8;-0.4]) and executive function (adj.β=-0.4[95%CI:-0.6;-0.1]), but not with radiological CAA-burden. Men had NPS more often than women.
Discussion
According to informants, one third to half of patients with CAA have NPS, mostly apathy, even in presymptomatic D-CAA and possibly with increased susceptibility in men. Neurologists should inform patients and caregivers of these disease consequences and treat or refer patients with NPS appropriately.
Context : Athletes with a history of concussion (CON) have been demonstrated to have heightened levels of anxiety and depression that may continue well beyond the resolution of concussion symptoms. The global events of 2020 resulted in elevated levels of anxiety and depression in the general population, which may have unequally presented in collegiate athletes with (CON) than those without a history of concussion (NoCON). Using a deception design, our survey-based study compared levels of anxiety and depression in CON and NoCON collegiate athletes in response to the pandemic and social injustices. We hypothesized that the CON group would have significantly elevated anxiety and depression as compared to the NoCON group in response to events of 2020. Design and Methods : Collegiate athletes (N = 106) during the academic 2020–2021 academic year were divided into CON and NoCON groups based on their preinjury (baseline) concussion assessment. Participants completed the Social Readjustment Rating Scale (SSRS), Center for Epidemiologic Studies Depression Scale (CES-D), and Generalized Anxiety Disorder Scale-7 (GAD-7) via an electronic survey pertaining to the events of 2020. The term “concussion” was not used in any study materials which was the basis for our deception-based design. An analysis of covariance was used to compare group CES-D and GAD-7 outcome scores while controlling for the SSRS outcome score. Results : Our survey response rate was 14.2% (48/337 [77.1% female]) and 10.1% (58/580 [67.2% female]), for the NoCON and CON groups, respectively. The NoCON group had significantly ( F 1 = 5.82, P = .018, ) higher anxiety (8.3 [5.89]) as compared to the CON group (5.5 [2.85]). The NoCON group also had significantly ( F 1 = 13.7, P < .001, ) higher levels of depression (21.0 [12.52]) as compared to the CON group (16.07 [9.10]). Discussion : Our deception-based study revealed NoCON participants had elevated and clinically relevant mood states as compared to CON participants in response to the events of 2020.
PURPOSE: This study aimed to investigate the influence of muscle strength on the association between metabolic syndrome and depressive symptoms in community-dwelling older adults.METHODS: A cross-sectional survey was conducted on 630 randomly selected community-dwelling older adults aged 65 years and older living in Suwon City. After excluding those younger than 65 years and those with mobility limitations or musculoskeletal disorders, 619 participants were included in the final analysis. The 15-item Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms. Metabolic syndrome (MetS) was defined based on the National Cholesterol Education Program Adults Treatment Panel III criteria, which included triglyceride (TG), reduced blood high-density lipoprotein (HDL), high blood pressure (BP), elevated fasting plasma glucose, and waist circumference (WC). A digital dynamometer was used to assess grip strength, and the maximum value was determined.RESULTS: Depressive symptoms were significantly associated with relative hand grip strength (RHGS). Specifically, when comparing groups based on the presence of MetS and RHGS levels, grip strength (RHGS) was confirmed to have an important mediating effect on depressive disorders. The following odds ratios (OR) were observed: normal RHGS with metabolic syndrome (OR: 1.859, 95% CI: 0.867-3.985, p =.111), low RHGS without metabolic syndrome (OR: 3.613, 95% CI: 1.735-6.522, p <.001), and low RHGS with MetS (OR: 4.145, 95% CI: 1.687-10.188, p =.002).CONCLUSIONS: Depression appears to have a strong correlation with MetS in adults aged 65 and older. Among the various factors associated with MetS, muscle strength has the closest and most significant association with depressive symptoms. Therefore, implementing strategies to improve muscle strength may be crucial in reducing the likelihood of depression in the elderly population.
Abstract: This study was conducted to examine the psychometric properties as well as measurement invariance and latent mean differences of the Arabic Scale of Happiness (ASH) in the Saudi Arabian context. A total of 762 individuals have participated in the study. The ASH scale’s internal consistency reliability was assessed by calculating Cronbach’s alpha and McDonald’s omega coefficients. To test convergent and discriminant validity, the ASH was compared with other measures of satisfaction with life, happiness, and depression. Confirmatory factor analysis as well as multi-group confirmatory factor analysis and latent means differences analysis were performed to examine the factor structure and the measurement invariance and means differences of the ASH across sex and marital status. The ASH showed good reliability as well as convergent and discriminant validity. Results also provided support for a one-factor and a full invariant structure of the ASH. Results from latent mean comparison revealed that males were happier than females. With regard to marital status, married people scored higher on the ASH than single people. In sum, these results provided support in the Saudi Arabian cultural context that the ASH is a reliable and valid measure.
Background
The risk–benefit balance of statin use in healthy older people is uncertain. We describe the baseline characteristics of the STAREE (Statins in Reducing Events in the Elderly) trial, which is a randomized, double‐blind, placebo‐controlled trial among community‐dwelling older people; the trial evaluated the effect of atorvastatin 40 mg for the prevention of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction or stroke), and on disability‐free survival (survival free of both dementia and persistent physical disability).
Methods and Results
STAREE enrolled people aged ≥70 years from 1583 general practices across Australia with no history of clinical cardiovascular disease, diabetes, or dementia. Baseline data collected included demographic, clinical, cognitive (Modified Mini‐Mental State Examination), psychological (Center for Epidemiologic Studies Short Depression Scale), lifestyle, medical, physical, blood and urine measures, and quality of life. Demographic and clinical characteristics of study participants were then compared with publicly available landmark statin trials. A total of 9971 participants were recruited (mean±SD age 74.7±4.5 years, 4023 (40%) ≥75 years, 52% women) between July 2015 and March 2023. The mean low‐density lipoprotein cholesterol was 3.27 mmol/L (SD=0.72; 126 mg/dL). Hypertension was reported by 43% of participants and the mean blood pressure was 136/80 mm Hg. Compared with previous landmark statin trials that included primary prevention cohorts, STAREE is unique in including such a large number of older (≥75 years) independent‐living people.
Conclusions
STAREE is the largest primary prevention trial of statins powered to address the important clinical outcomes of major cardiovascular events, disability‐free survival, and cognition in older people.
Registration
https://www.clinicaltrials.gov ; Unique identifier: NCT02099123.
Depression is a significant concern for people living with HIV and AIDS as it is associated with negative health outcomes and suboptimal adherence to antiretroviral therapy (ART). To this extent, screening for depression is essential for early detection. The CESD-R-20 is a revised four-factor questionnaire developed to assess depressive symptoms in adults. This study explored the factor structure and psychometric properties of the CESD-R-20 among 685 individuals receiving ART. Data were collected at the Infectious Diseases Clinic of a large public hospital outside Cape Town from participants who had been receiving ART for at least six months. Exploratory factor analysis (EFA) of the CESD-R-20 was performed to identify its underlying factor structure. The EFA revealed a one-factor solution termed "depressive affect," comprising 19 items that encompassed the original factors. This finding suggests that depression is a cohesive construct rather than a collection of interconnected dimensions. The scale exhibited high internal consistency (Cronbach's alpha = 0.95) among the sample of persons living with HIV and AIDS. Our findings indicate that the CESD-R-20 can effectively measure depressive affect as a one-factor scale in South Africans receiving ART. The scale demonstrated strong internal consistency and is suitable for screening for depressive symptoms among persons living with HIV and AIDS.
Background: Pregnancy outcomes are influenced by maternal distress but the pathways underlying these effects are still unknown. Mitochondria, crucial for stress adaptation and energy production, may link psychosocial stress to its biological effects, especially during pregnancy when energy demands significantly increase. This study explores two mitochondrial markers-circulating cell-free mitochondrial DNA (cf-mtDNA) and Growth Differentiation Factor-15 (GDF15)-as potential mitochondrial health indicators linking maternal distress to pregnancy outcomes in two longitudinal studies from the USA and Turkey.
Methods: We analyzed biological, demographic, and psychological data from women in two pregnancy studies: EPI (N=187, USA, Mean age=29.6(SD=6.2) and BABIP (N=198, Turkey, Mean age=32.4(SD=4.0)). Data were collected at multiple time points during the perinatal period, including late 2nd and 3rd trimester, with EPI also including additional data at early 2nd trimester and 4-14 months postpartum. Prenatal maternal psychological distress was measured as perceived stress, anxiety, and depressive symptoms. Plasma cf-mtDNA and GDF15 levels were assessed using qPCR and ELISA, respectively. Statistical analyses included Wilcoxon signed-rank tests, Spearman correlations, and Mann-Whitney tests.
Results: Plasma cf-mtDNA levels did not change significantly during pregnancy in either study. Plasma GDF15 levels increased from early to late pregnancy in both studies and significantly decreased postpartum in EPI. Perinatal maternal distress in the late 2nd and 3rd trimesters was not associated with cf-mtDNA or GDF15 in either study. Metabolic distress, measured as higher pre-pregnancy BMI, was negatively correlated with GDF15 in the late 2nd trimester in EPI and showed a similar trend in BABIP. Similarly, higher maternal psychological distress in the early 2nd trimester were associated with lower cf-mtDNA and a trend for lower GDF15 in EPI. Finally, higher pre-pregnancy BMI and maternal distress in late pregnancy were linked to a smaller decline in GDF15 from late pregnancy to postpartum in EPI, suggesting an interaction between metabolic stress, prenatal distress and post-pregnancy physiological recovery.
Conclusions: This study identified distinct patterns of plasma cf-mtDNA and GDF15 levels during the perinatal period across studies from two countries, revealing unique associations between maternal characteristics, prenatal distress, and pregnancy outcomes, suggesting that maternal distress can interact with energy mobilization during pregnancy.
INTRODUCTION
Identifying people at high risk of Alzheimer's disease (AD) dementia allows for timely intervention, which, if successful, will result in preventing or delaying the onset of the disease.
METHODS
Utilizing data from the Chicago Health and Aging Project (CHAP; n = 2130), we externally evaluated four risk‐prediction models for AD dementia, including Cardiovascular Risk Factors, Aging, and Dementia (CAIDE), Australian National University Alzheimer's Disease Risk Index (ANU‐ADRI), Brief Dementia Screening Indicator (BDSI), and Dementia Risk Score (DRS), in Black or African American and White adults.
RESULTS
BDSI had the highest discriminate abilities for AD dementia (c‐statistics of 0.79 in Black and 0.77 in White adults), followed by ANU‐ADRI, within the age range and follow‐up period of the original development cohort. CAIDE had the lowest discriminating power (c‐statistic ≤0.55). With increasing follow‐up periods (i.e., 10–15 years), the discrimination abilities for all models declined.
DISCUSSION
Because of racial disparities in AD dementia and longer preclinical and prodromal stages of disease development, race‐specific models are needed to predict AD risk over 10 years.
Highlights
Utilizing risk‐prediction models to identify individuals at higher risk of Alzheimer's disease (AD) dementia could benefit clinicians, patients, and policymakers. Clinicians could enroll high‐risk individuals in clinical trials to test new risk‐modifiable treatments or initiate lifestyle modifications, which, if successful, would slow cognitive decline and delay the onset of the disease.
Current risk‐prediction models had good discriminative power during the first 6 years of follow‐up but decreased with longer follow‐up time.
Acknowledging the longer preclinical phase of AD dementia development and racial differences in dementia risk, there is a need to develop race‐specific risk‐prediction models that can predict 10 or 20 years of risk for AD and related dementias.
Purpose: The purposes of this study were 1) to investigate the influence of ego-identity and depression on suicidal ideation, 2) assess the mediating effect of depression in the relationship between ego-identity and suicidal ideation for adolescents. Methods: The participants were 940 adolescents. Data were collected through self-report questionnaires, which were constructed to include demographic-environmental factors, ego-identity, depression, and suicidal ideation. The data were analyzed using the SPSS program. Results: Ego-identity negatively related to suicidal ideation, while ego-identity negatively related to depression for adolescents. Depression was significantly related to suicidal ideation for adolescents. A hierarchical strategy in multiple regression was completed to assess the mediating effect of depression. The result indicated that depression mediated the effect of ego-identity on suicidal ideation for adolescents. Conclusion: Based on the outcomes of this study, it is necessary to design an intervention program that emphasizes reducing depression in order to decrease adolescents' suicidal ideation.
En el corredor migratorio México-Estados Unidos durante el 2021 y
ante la pandemia por COVID-19, las poblaciones rurales y migrantes
se encontraban aisladas y con dificultades de acceso a servicios de
salud. Con la intención de conocer lo que ocurría en estos sectores,
se presentan los resultados de un diagnóstico sobre aspectos
relacionados con la presencia del COVID-19 en la salud integral,
tales como ansiedad, depresión, afrontamiento, así como recursos
psicológicos. Se incluyeron diversos grupos sociales con experiencia
migratoria en la familia o provenientes de comunidades rurales-agrícolas
de alta intensidad migratoria o indígenas. Fue elaborado
desde una perspectiva de diseños mixtos de investigación en el que
participaron 1,563 personas que provenían de más de 400 diferentes
localidades, predominantemente de México. Se encontró que el grupo
con mayor afectación en indicadores de salud mental fueron las
personas migrantes en tránsito, seguido por familiares de migrantes
que se quedan en México. La presencia del miedo, preocupación
por la salud y el empleo, además de dificultades económicas
asociadas con el COVID-19 fueron recurrentes. La familia sostuvo
emocionalmente a los participantes durante esta crisis. Existe interés
por recibir capacitación sobre el fortalecimiento de los recursos
psicológicos para el manejo de emociones y sobre crianza de los
hijos. Se requiere desarrollar programas diferenciados por tipo de
experiencia migratoria, así como la necesidad de ampliar la cobertura
de servicios de atención psicológica para estas poblaciones para
manejo de riesgos psicosociales. Los migrantes en tránsito y las
familias de migrantes deben considerarse prioridades para la atención
psicosocial.
Objective
Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations.
Methods
In 2,483 participants of the Amsterdam Born Children and their Development prospective cohort, maternal serum vitamin D and CRP were measured at a median of 13 weeks’ gestation. Vitamin D status was defined as deficient (≤29.9 nM), insufficient (30-49.9 nM), sufficient (50-79.9 nM), or normal (≥80 nM). Maternal depressive symptoms (Center for Epidemiologic Studies-Depression) and anxiety (State-Trait Anxiety Inventory) were assessed 3 months postpartum.
Results
After adjustments for confounders vitamin D deficiency was only associated with increased postpartum anxiety symptoms (B = 0.17, 95% CI [0.03, 0.30], p = .017) compared to normal vitamin D levels ( > 80 nM). In women not taking vitamin D supplementation ( n = 2,303), vitamin D deficiency was associated with increased postpartum depressive and anxiety symptoms (B = 0.14, 95% CI 0.03, 0.28, p = .045; and B = 0.17, 95% CI 0.03, 0.32, p = .015). Antepartum CRP did not mediate these links.
Conclusions
We found some evidence that antepartum vitamin D deficiency was associated with increased postpartum affective symptoms, especially in women not taking vitamin D supplementation. Clinical trials should determine whether vitamin D supplementation can reduce the risk for postpartum affective disorders.
Background
In 2021, more than two-thirds of the world’s children lived in a conflict-affected country. In 2022, 13 million Ukrainians were forced to flee their homes after Russia’s full-scale invasion. Hope Groups are a 12-session psychosocial, mental health, and parenting support intervention designed to strengthen parents, caregivers, and children affected by war and crisis. The primary objective of this study is to evaluate the effectiveness of Hope Groups among Ukrainians affected by war, compared to a wait-list control group. This protocol describes a promising decentralized intervention delivery model and an innovative research design, which estimates the causal effect of Hope Groups while prioritizing prompt delivery of beneficial services to war-affected participants.
Methods
This protocol describes a pragmatic cluster randomized controlled trial (RCT) among Ukrainians externally displaced, internally displaced within Ukraine, and living at home in war-affected areas. This study consists of 90 clusters with 4–7 participants per cluster, totaling approximately n = 450 participants. Intervention clusters will receive 12-session Hope Groups led by peer facilitators, and control clusters will be wait-listed to receive the intervention after the RCT concludes. Clusters will be matched on the facilitator performing recruitment and intervention delivery. Primary outcomes are caregiver mental health, violence against children, and positive parenting practices. Secondary outcomes include prevention of violence against women and caregiver and child well-being. Outcomes will be based on caregiver-report and collected at baseline and endline (one-week post intervention). Follow-up data will be collected among the intervention group at 6–8 weeks post-intervention, with aims for quasi-experimental follow-ups after six and twelve months, pending war circumstances and funding. Analyses will utilize matching techniques, Bayesian interim analyses, and multi-level modeling to estimate the causal effect of Hope Groups in comparison to wait-list controls.
Discussion
This study is the first known randomized trial of a psychosocial, mental health, and parenting intervention among Ukrainians affected by war. If results demonstrate effectiveness, Hope Groups hold potential to be adapted and scaled to other populations affected by war and crisis worldwide. Additionally, methodologies described in this protocol could be utilized in crisis-setting research to simultaneously prioritize estimation of causal effects and prompt delivery of beneficial interventions to crisis-affected populations.
Trial registration
This trial was registered on Open Science Framework on November 9, 2023. Registration: OSF.IO/UVJ67. DOI: https://doi.org/10.17605/OSF.IO/UVJ67.
Background
Adverse cardiovascular events during pregnancy (eg, preeclampsia) occur at higher rates among individuals with overweight or obesity (body mass index ≥25 kg/m ² ) and have been associated with postpartum depression. The present study examined whether changes in cardiovascular health (CVH) during the perinatal period, as defined by the American Heart Association's Life's Essential 8 framework, predicted postpartum psychological functioning among individuals with prepregnancy body mass index ≥25 kg/m ² .
Methods and Results
Pregnant individuals (N = 226; mean ± SD age = 28.43 ± 5.4 years; mean body mass index = 34.17 ± 7.15 kg/m ² ) were recruited at 12 to 20 weeks of gestation (mean, 15.64 ± 2.45 weeks) for a longitudinal study of health and well‐being. Participants completed ratings of depression and perceived stress and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6 months postpartum. Body mass index and CVH behaviors were used to calculate a composite CVH score at both time points. Linear regression analyses were performed to examine whether change in CVH related to postpartum symptom scores. Because sleep was measured in only a subset of participants (n = 114), analyses were conducted with and without sleep. Improved CVH was associated with lower postpartum depression (β = −0.18, P <0.01) and perceived stress (β = −0.13, P =0.02) scores. However, when including sleep, these relationships were no longer significant (all P >0.4).
Conclusions
Improvements in CVH from early pregnancy to 6 months postpartum were associated with lower postpartum depressive symptoms and perceived stress but not when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high‐risk individuals.
Background: Mindful eating is a concept that is increasingly being used to promote healthy eating. Observational studies have suggested associations with healthier eating behaviors, lower weight status, and favorable cardiovascular biomarkers. However, existing scales assessing mindful eating have some limitations. Our study aimed to develop and validate a scale assessing the level of mindful eating in a general population.
Methods: The Mind-Eat Scale was developed in four main steps: 1. Generating an initial item pool covering all aspects of mindful eating; 2. Reviewing items with experts and naive individuals; 3. Administering the scale to a large and representative sample from the NutriNet-Santé cohort (N=3102); 4. Conducting psychometric analyses. Construct validity was assessed using exploratory (EFA) (N1=1302) and confirmatory (CFA) (N2=1302, N3=498) factor analyses. Content, discriminant, convergent, and divergent validity, internal consistency, and test-retest reliability were examined.
Results: The initial pool of 95 items was refined to 24 items using EFA. The EFA highlighted six dimensions: Awareness, Non-reactivity, Openness, Gratitude, Non-judgement, and Hunger/Satiety, consisting of four items per dimension. CFAs showed a good fit for first and second-order models. Adequate content validity was confirmed. Discriminant, convergent, and divergent validity were supported by significant differences between subgroups of individuals, and correlations with eating behaviors and psychological well-being scales. The Mind-Eat Scale showed good reliability for all six dimensions, with high McDonald's ω and adequate intraclass correlation coefficients (ICC).
Conclusions: This study validated the first tool assessing a total mindful eating score and its sub-dimensions in a general population. This scale can be an asset for clinical and epidemiological research on dietary behavior and related chronic diseases.
Asian Americans have been identified as a racial group that is disproportionately affected by childhood trauma. The goal of this study was to assess if religion/spirituality moderate the effects of childhood trauma on adult depressive symptoms among a sample of South Asians in the USA. Our analysis drew from the study on stress, spirituality, and health (SSSH) questionnaire fielded in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 990) during 2016–2018. A series of regression models with multiplicative interaction terms were conducted. Emotional neglect, emotional abuse, and physical neglect were associated with higher depressive symptoms. Higher religious attendance and negative religious coping techniques were found to exacerbate this relationship. There were two findings conditional on gender. Among men, gratitude and positive religious coping also exacerbated the relationship between childhood trauma and depressive symptoms. Negative religious coping also exacerbated the association between childhood trauma and depressive symptoms for women. This is the first community-based study of US South Asians to consider the association between various forms of childhood trauma and depressive symptom outcomes. South Asians remain an understudied group in the religion and health literature, and this study sheds light on the important differences in the function and effectiveness of religion/spirituality for those faced with early life trauma.
Background:
Depression and anxiety occur frequently (with reported prevalence rates of around 40%) in individuals with coronary heart disease (CHD), heart failure (HF) or atrial fibrillation (AF) and are associated with a poor prognosis, such as decreased health-related quality of life (HRQoL), and increased morbidity and mortality. Psychological interventions are developed and delivered by psychologists or specifically trained healthcare workers and commonly include cognitive behavioural therapies and mindfulness-based stress reduction. They have been shown to reduce depression and anxiety in the general population, though the exact mechanism of action is not well understood. Further, their effects on psychological and clinical outcomes in patients with CHD, HF or AF are unclear.
Objectives:
To assess the effects of psychological interventions (alone, or with cardiac rehabilitation or pharmacotherapy, or both) in adults who have a diagnosis of CHD, HF or AF, compared to no psychological intervention, on psychological and clinical outcomes.
Search methods:
We searched the CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL databases from 2009 to July 2022. We also searched three clinical trials registers in September 2020, and checked the reference lists of included studies. No language restrictions were applied.
Selection criteria:
We included randomised controlled trials (RCTs) comparing psychological interventions with no psychological intervention for a minimum of six months follow-up in adults aged over 18 years with a clinical diagnosis of CHD, HF or AF, with or without depression or anxiety. Studies had to report on either depression or anxiety or both.
Data collection and analysis:
We used standard Cochrane methods. Our primary outcomes were depression and anxiety, and our secondary outcomes of interest were HRQoL mental and physical components, all-cause mortality and major adverse cardiovascular events (MACE). We used GRADE to assess the certainty of evidence for each outcome.
Main results:
Twenty-one studies (2591 participants) met our inclusion criteria. Sixteen studies included people with CHD, five with HF and none with AF. Study sample sizes ranged from 29 to 430. Twenty and 17 studies reported the primary outcomes of depression and anxiety, respectively. Despite the high heterogeneity and variation, we decided to pool the studies using a random-effects model, recognising that the model does not eliminate heterogeneity and findings should be interpreted cautiously. We found that psychological interventions probably have a moderate effect on reducing depression (standardised mean difference (SMD) -0.36, 95% confidence interval (CI) -0.65 to -0.06; 20 studies, 2531 participants; moderate-certainty evidence) and anxiety (SMD -0.57, 95% CI -0.96 to -0.18; 17 studies, 2235 participants; moderate-certainty evidence), compared to no psychological intervention. Psychological interventions may have little to no effect on HRQoL physical component summary scores (PCS) (SMD 0.48, 95% CI -0.02 to 0.98; 12 studies, 1454 participants; low-certainty evidence), but may have a moderate effect on improving HRQoL mental component summary scores (MCS) (SMD 0.63, 95% CI 0.01 to 1.26; 12 studies, 1454 participants; low-certainty evidence), compared to no psychological intervention. Psychological interventions probably have little to no effect on all-cause mortality (risk ratio (RR) 0.81, 95% CI 0.39 to 1.69; 3 studies, 615 participants; moderate-certainty evidence) and may have little to no effect on MACE (RR 1.22, 95% CI 0.77 to 1.92; 4 studies, 450 participants; low-certainty evidence), compared to no psychological intervention.
Authors' conclusions:
Current evidence suggests that psychological interventions for depression and anxiety probably result in a moderate reduction in depression and anxiety and may result in a moderate improvement in HRQoL MCS, compared to no intervention. However, they may have little to no effect on HRQoL PCS and MACE, and probably do not reduce mortality (all-cause) in adults who have a diagnosis of CHD or HF, compared with no psychological intervention. There was moderate to substantial heterogeneity identified across studies. Thus, evidence of treatment effects on these outcomes warrants careful interpretation. As there were no studies of psychological interventions for patients with AF included in our review, this is a gap that needs to be addressed in future studies, particularly in view of the rapid growth of research on management of AF. Studies investigating cost-effectiveness, return to work and cardiovascular morbidity (revascularisation) are also needed to better understand the benefits of psychological interventions in populations with heart disease.
ResearchGate has not been able to resolve any references for this publication.