This article provides benchmark data on within-group effect sizes from published randomized clinical trials supporting the efficacy of cognitive–behavioural therapy (CBT) in the treatment of adult depression. Data from 84 studies that met the inclusion criteria were recorded independently by the two authors, with a 95.8% agreement rate. Aggregate within-group effect size benchmarks are provided for CBT groups and control groups and are broken down by level of depression, type of control group, type of CBT approach, type of depression measure, type of data analysis (intent-to-treat versus completers, only), and whether participants had any comorbidity. Overall, the aggregate within-group effect size estimates for CBT groups were 1.19 for self-report outcome measures and 1.52 for interviews.
(Edited publisher abstract)
This article provides benchmark data on within-group effect sizes from published randomized clinical trials supporting the efficacy of cognitive–behavioural therapy (CBT) in the treatment of adult depression. Data from 84 studies that met the inclusion criteria were recorded independently by the two authors, with a 95.8% agreement rate. Aggregate within-group effect size benchmarks are provided for CBT groups and control groups and are broken down by level of depression, type of control group, type of CBT approach, type of depression measure, type of data analysis (intent-to-treat versus completers, only), and whether participants had any comorbidity. Overall, the aggregate within-group effect size estimates for CBT groups were 1.19 for self-report outcome measures and 1.52 for interviews. For control groups the estimate was 0.48 for self-reports and interviews. When treating depressed adult clients, community-based practitioners can use these benchmarks as a comparison tool to evaluate the adequacy of the way they are adopting or adapting CBT and in making decisions about whether to continue providing CBT in the same manner or to modify or replace it.
(Edited publisher abstract)
Subject terms:
cognitive behavioural therapy, adults, depression, group therapy;
International Journal of Geriatric Psychiatry, 32(9), 2017, pp.1009-1016.
Publisher:
Wiley
Objective: The generalisability of antidepressant efficacy trials (AETs) has been questioned. No studies have examined the inclusion/exclusion criteria used in placebo-controlled studies of late life depression and compared them to the criteria used in non-late life AETs.
Method: The authors conducted a comprehensive literature review of placebo-controlled AETs published from January, 1995 through December, 2014. They compared the inclusion/exclusion criteria used in the 18 studies of late life depression to those used in non-late life depression.
Results: There were nine inclusion/exclusion criteria that were used in more than half of the late life depression AETs: minimum severity on a symptom severity scale (100.0%), significant suicidal ideation (77.8%), psychotic features during the current episode of depression or history of a psychotic disorder (94.4%), history of bipolar disorder (77.8%), diagnosis of alcohol or drug abuse or dependence (83.3%), presence of a comorbid nondepressive, nonsubstance use Axis I disorder (55.6%), episode duration too short (66.7%), and an insufficient score on a cognitive screen (88.3%) or the presence of a cognitive disorder (55.6%). There were some differences between the late life and non-late life depression studies—use of a screening measure of cognitive functioning, presence of a cognitive disorder such as dementia, and the minimum depression severity cutoff score required at baseline.
Conclusions: The inclusion/exclusion criteria in AETs of late life depression were generally similar to the criteria used in non-late life depression
(Edited publisher abstract)
Objective: The generalisability of antidepressant efficacy trials (AETs) has been questioned. No studies have examined the inclusion/exclusion criteria used in placebo-controlled studies of late life depression and compared them to the criteria used in non-late life AETs.
Method: The authors conducted a comprehensive literature review of placebo-controlled AETs published from January, 1995 through December, 2014. They compared the inclusion/exclusion criteria used in the 18 studies of late life depression to those used in non-late life depression.
Results: There were nine inclusion/exclusion criteria that were used in more than half of the late life depression AETs: minimum severity on a symptom severity scale (100.0%), significant suicidal ideation (77.8%), psychotic features during the current episode of depression or history of a psychotic disorder (94.4%), history of bipolar disorder (77.8%), diagnosis of alcohol or drug abuse or dependence (83.3%), presence of a comorbid nondepressive, nonsubstance use Axis I disorder (55.6%), episode duration too short (66.7%), and an insufficient score on a cognitive screen (88.3%) or the presence of a cognitive disorder (55.6%). There were some differences between the late life and non-late life depression studies—use of a screening measure of cognitive functioning, presence of a cognitive disorder such as dementia, and the minimum depression severity cutoff score required at baseline.
Conclusions: The inclusion/exclusion criteria in AETs of late life depression were generally similar to the criteria used in non-late life depression
(Edited publisher abstract)
Subject terms:
depression, older people, literature reviews, mental health problems;
Social Work: A journal of the National Association of Social Workers (NASW), 62(3), 2017, pp.243-250.
Publisher:
Oxford University Press
Hijab or veiling is commonly practiced by Muslim women but remains controversial in the broader secular society. Some Western feminists argue that veiling is an oppressive behavior that negatively affects women by, for example, engendering depression. This article tests this hypothesis with a national sample of American Muslim women (N = 194). The results of the regression analysis did not support the hypothesis. Indeed, women who veiled more frequently reported lower, rather than higher, levels of depressive symptoms. In other words, wearing the hijab appears to be a protective factor in the area of depression. Given the prevalence of depression among women, the results have important implications for practice with Muslim women at both the micro and the macro levels.
(Publisher abstract)
Hijab or veiling is commonly practiced by Muslim women but remains controversial in the broader secular society. Some Western feminists argue that veiling is an oppressive behavior that negatively affects women by, for example, engendering depression. This article tests this hypothesis with a national sample of American Muslim women (N = 194). The results of the regression analysis did not support the hypothesis. Indeed, women who veiled more frequently reported lower, rather than higher, levels of depressive symptoms. In other words, wearing the hijab appears to be a protective factor in the area of depression. Given the prevalence of depression among women, the results have important implications for practice with Muslim women at both the micro and the macro levels.
(Publisher abstract)
British Journal of Clinical Psychology, 56(3), 2017, pp.310-328.
Publisher:
Wiley
... online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.
Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models, being employed and recent experience of depression predicted recovery.
Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.
Conclusions: Interventions aiming
(Edited publisher abstract)
Background: Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.
Design: Cross-sectional online survey.
Method: People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.
Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models, being employed and recent experience of depression predicted recovery.
Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.
Conclusions: Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy.
(Edited publisher abstract)
Subject terms:
bipolar disorder, depression, recovery, therapy and treatment;
British Journal of Clinical Psychology, 56(2), 2017, pp.115-129.
Publisher:
Wiley
Objectives: To examine the role of shame and its relationship to depression in schizophrenia. It was predicted that individuals with a diagnosis of schizophrenia would exhibit higher levels of shame due to the stigma associated with their diagnosis, independently of depression levels, compared with psychiatric and medical control groups.
Design: Cross-sectional design with three groups: individuals with a diagnosis of (1) schizophrenia, (2) depression, and (3) rheumatoid arthritis.
Methods: Sixty individuals participated in the study (20 per group). Groups were compared on questionnaires assessing external shame, trait shame and guilt, and depression.
Results: The pattern of group differences depended on the type of shame measure used. Both the schizophrenia and depression groups exhibited higher levels of external shame, or seeing others as shaming, than the medical group. For individuals with schizophrenia, seeing others as shaming was associated with higher levels of depression, a relationship not found in either control group. They also showed lower levels of trait guilt and shame (at trend level), compared with both control groups. No difference was found between the groups on depression, suggesting that the observed differences were not attributable to differences in levels of depression.
Conclusions: The findings highlight the importance of shame in schizophrenia, especially the link between seeing other people as shaming and depression, which was unique to this group. These results suggest that stigma associated with a diagnosis of mental illness, and schizophrenia
(Publisher abstract)
Objectives: To examine the role of shame and its relationship to depression in schizophrenia. It was predicted that individuals with a diagnosis of schizophrenia would exhibit higher levels of shame due to the stigma associated with their diagnosis, independently of depression levels, compared with psychiatric and medical control groups.
Design: Cross-sectional design with three groups: individuals with a diagnosis of (1) schizophrenia, (2) depression, and (3) rheumatoid arthritis.
Methods: Sixty individuals participated in the study (20 per group). Groups were compared on questionnaires assessing external shame, trait shame and guilt, and depression.
Results: The pattern of group differences depended on the type of shame measure used. Both the schizophrenia and depression groups exhibited higher levels of external shame, or seeing others as shaming, than the medical group. For individuals with schizophrenia, seeing others as shaming was associated with higher levels of depression, a relationship not found in either control group. They also showed lower levels of trait guilt and shame (at trend level), compared with both control groups. No difference was found between the groups on depression, suggesting that the observed differences were not attributable to differences in levels of depression.
Conclusions: The findings highlight the importance of shame in schizophrenia, especially the link between seeing other people as shaming and depression, which was unique to this group. These results suggest that stigma associated with a diagnosis of mental illness, and schizophrenia in particular, has negative emotional consequences that may impede recovery, and should be addressed by psychological and social interventions.
(Publisher abstract)
Subject terms:
schizophrenia, depression, stigma, mental health problems;
AVILA Maria Priscila Wermelinger, LUCCHETTI Alessandra Lamas Granero, LUCCHETTI Giancarlo
Journal article citation:
International Journal of Geriatric Psychiatry, 32(3), 2017, pp.237-246.
Publisher:
Wiley
... restrictions, using a Boolean expression. For inclusion in the study, articles had to assess the older population (60 years or older), assess both depressive and resilience symptoms, and investigate the association between these two variables. Articles not employing validated resilience and depression scales or assessing populations younger than 60 years were excluded. The quality of the selected studies was assessed using the Quality Assessment Tool for Quantitative Studies.
Results: A total of 1094 articles were retrieved from the three databases, 367 of which were duplicates and therefore excluded, giving 727 articles for analysis. Of these articles, seven met the eligibility criteria. All of the included articles were observational and cross-sectional, found an inverse relationship between depression
(Publisher abstract)
Objective: The objective of this study is to determine whether resilience is associated with depressive symptoms in geriatric populations.
Method: A systematic review and meta-analysis were performed (up to March 2015) following the Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations on three databases (PubMed/Medline, Scopus, and Web of Science) with no language restrictions, using a Boolean expression. For inclusion in the study, articles had to assess the older population (60 years or older), assess both depressive and resilience symptoms, and investigate the association between these two variables. Articles not employing validated resilience and depression scales or assessing populations younger than 60 years were excluded. The quality of the selected studies was assessed using the Quality Assessment Tool for Quantitative Studies.
Results: A total of 1094 articles were retrieved from the three databases, 367 of which were duplicates and therefore excluded, giving 727 articles for analysis. Of these articles, seven met the eligibility criteria. All of the included articles were observational and cross-sectional, found an inverse relationship between depression and resilience, and were conducted in three countries: the USA, China, and Belgium. A moderate inverse correlation was found on the meta-analysis (r = −0.35, 95% confidence interval: −0.41 to −0.28).
Conclusion: Few studies were found on this subject in the older population. An association between greater resilience and less depressive symptomatology was identified, albeit based on cross-sectional studies. These results highlight the need for further studies in the area and the importance of fostering the use of interventions to promote resilience in older adults as a means of preventing and managing depressive symptoms in this population.
(Publisher abstract)
International Journal of Geriatric Psychiatry, 32(2), 2017, pp.193-200.
Publisher:
Wiley
... of depressive symptoms using the 15-item Geriatric Depression Scale. During the baseline assessment, the participants were also asked about their sedentary behaviour on weekdays over the past 7 days and, from there, categorised into three groups (<240, 240–480, ≥480 min/day). Demographic data and the other health behaviours were also assessed at the baseline.
Results: Cross-sectional analysis revealed
(Edited publisher abstract)
Objective: This study aimed to investigate whether sitting time, as a form of sedentary behaviour, is related to incident depressive symptoms in older people.
Methods: This study included 3503 participants (mean age 71.7 years, 50.1% female) from the ‘Obu Study of Health Promotion for the Elderly' cohort study. At baseline and then 15 months later, the participants reported their status of depressive symptoms using the 15-item Geriatric Depression Scale. During the baseline assessment, the participants were also asked about their sedentary behaviour on weekdays over the past 7 days and, from there, categorised into three groups (<240, 240–480, ≥480 min/day). Demographic data and the other health behaviours were also assessed at the baseline.
Results: Cross-sectional analysis revealed that 437 participants (12.0%) had depressive symptoms. In a prospective analysis, the logistic regression model revealed that the odds ratio for depressive symptom incidence was higher in participants who, at baseline, spent 480 min or more per day sitting, and in those who spent 240-480 min in comparison with those who spent less than 240 min.
Conclusions: Sedentary behaviour significantly affects the risk of incident depressive symptoms. Further research is needed to develop an intervention strategy to manage depressive symptoms, as the second most common cause of burden of disease among older adults.
(Edited publisher abstract)
Child and Youth Care Forum, 46(6), 2017, pp.841-856.
Publisher:
Springer
Objective: This study aims to concurrently compare intrapersonal variables between adolescents with and without a lifetime history of non-suicidal self-injury (NSSI), and to longitudinally test whether NSSI over lifetime history predicts 6-months NSSI through self-criticism and depressive symptoms among Portuguese adolescents with a self-reported history of NSSI.
Methods: Adolescents (N = 418, 12–19 years-old) from middle and secondary schools completed self-report questionnaires to assess self-criticism (particularly, the most severe form: hated self), depressive symptoms, and the frequency of NSSI in two points in time over the 6-months interval.
Results: Adolescents who reported a lifetime history of NSSI tend to experience greater harsh and persecutory criticism towards themselves and elevated depressive symptoms than adolescents without a history of NSSI. Results from path analysis showed that lifetime NSSI predicts subsequent NSSI, and this association is mediated by self-hatred and depressive symptoms among adolescents with lifetime NSSI.
Conclusions: Findings suggest that NSSI is maintained through a sense of self-focused on hatred and disgust feelings and depressive symptoms.
(Edited publisher abstract)
Objective: This study aims to concurrently compare intrapersonal variables between adolescents with and without a lifetime history of non-suicidal self-injury (NSSI), and to longitudinally test whether NSSI over lifetime history predicts 6-months NSSI through self-criticism and depressive symptoms among Portuguese adolescents with a self-reported history of NSSI.
Methods: Adolescents (N = 418, 12–19 years-old) from middle and secondary schools completed self-report questionnaires to assess self-criticism (particularly, the most severe form: hated self), depressive symptoms, and the frequency of NSSI in two points in time over the 6-months interval.
Results: Adolescents who reported a lifetime history of NSSI tend to experience greater harsh and persecutory criticism towards themselves and elevated depressive symptoms than adolescents without a history of NSSI. Results from path analysis showed that lifetime NSSI predicts subsequent NSSI, and this association is mediated by self-hatred and depressive symptoms among adolescents with lifetime NSSI.
Conclusions: Findings suggest that NSSI is maintained through a sense of self-focused on hatred and disgust feelings and depressive symptoms.
(Edited publisher abstract)
Subject terms:
self-harm, young people, depression, self-esteem, longitudinal studies;
This study aimed to explore the direct and indirect effects of parent alcohol misuse and low family income on risk of supervisory neglect through mediating factors such as parent depressive symptoms and low social support. The study used a sample of 2990 parents of children under 13 years old who completed a listed telephone survey conducted in 50 mid-sized cities within California during 2009. A structural equation model was used to estimate the direct and indirect effects of parent alcohol misuse (defined as heavy drinking frequency) and low family income on supervisory neglect toward a focal child, as well as the indirect effect via parental depressive symptoms and low social support. Mediation analysis to capture direct, indirect, and total effects of these two independent variables was also conducted. Results revealed a significant direct effect of low family income on likelihood of supervisory neglect. Low income also exhibited an indirect effect via increased depressive symptoms and low social support. Annual frequency of heavy drinking showed no direct effect on supervisory neglect likelihood, but an indirect effect was observed via increased depressive symptoms and decreased social support. Parent low income and high frequency heavy drinking likely increase risks for supervisory neglect through distinct pathways. Longitudinal research is needed to confirm the pathways identified within this study.
(Edited publisher abstract)
This study aimed to explore the direct and indirect effects of parent alcohol misuse and low family income on risk of supervisory neglect through mediating factors such as parent depressive symptoms and low social support. The study used a sample of 2990 parents of children under 13 years old who completed a listed telephone survey conducted in 50 mid-sized cities within California during 2009. A structural equation model was used to estimate the direct and indirect effects of parent alcohol misuse (defined as heavy drinking frequency) and low family income on supervisory neglect toward a focal child, as well as the indirect effect via parental depressive symptoms and low social support. Mediation analysis to capture direct, indirect, and total effects of these two independent variables was also conducted. Results revealed a significant direct effect of low family income on likelihood of supervisory neglect. Low income also exhibited an indirect effect via increased depressive symptoms and low social support. Annual frequency of heavy drinking showed no direct effect on supervisory neglect likelihood, but an indirect effect was observed via increased depressive symptoms and decreased social support. Parent low income and high frequency heavy drinking likely increase risks for supervisory neglect through distinct pathways. Longitudinal research is needed to confirm the pathways identified within this study.
(Edited publisher abstract)
Subject terms:
alcohol misuse, low income, child neglect, depression, social networks;
International Journal of Geriatric Psychiatry, 32(6), 2017, p.589–595.
Publisher:
Wiley
... Depressive mood was assessed using the Geriatric Depression Scale (GDS).
Results: The proportion of participants who reported low frequency of going outdoors (LG, every 2–3 days or less) was 36.1%. The LG group showed significantly higher GDS scores than those who reported high (once a day or more) frequency of going outdoors. A multiple linear regression analysis adjusted for potential covariates showed
(Edited publisher abstract)
Objective: Low frequency of going outdoors (e.g. being homebound) is associated with depressive mood; however, the underlying neural mechanism of this association is unclear. The authors therefore investigated the neural substrate involved in the relationship between frequency of going outdoors and depressive mood using positron emission tomography (PET), focusing on the frontal lobe and the limbic system.
Methods: One hundred fifty-eight community-dwelling older adults aged 65–85 years underwent PET with 18F-fluorodeoxyglucose to evaluate regional cerebral metabolic rates of glucose normalised in reference to cerebellar glucose metabolic value (normalized-rCMRglc) in six regions of interest. The authors also assessed depressive mood, frequency of going outdoors, and potential covariates. Depressive mood was assessed using the Geriatric Depression Scale (GDS).
Results: The proportion of participants who reported low frequency of going outdoors (LG, every 2–3 days or less) was 36.1%. The LG group showed significantly higher GDS scores than those who reported high (once a day or more) frequency of going outdoors. A multiple linear regression analysis adjusted for potential covariates showed higher GDS scores were associated with lower normalised-rCMRglc in the ventrolateral prefrontal and orbitofrontal cortices. Adjusting for frequency of going outdoors, the association between GDS score and normalized-rCMRglc in the orbitofrontal cortex was attenuated.
Conclusions: The authors' results suggest that the orbitofrontal cortex may mediate the relationship between low frequency of going outdoors and depressive mood among community-dwelling older adults. These findings may help disentangle the role of going outdoors in regulating brain function to improve and/or maintain mental health among community-dwelling older adults
(Edited publisher abstract)
Subject terms:
older people, depression, environmental factors, mental health problems, communities;