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Objectives: Swann's self-verification theory proposes that negative feedback seeking (NFS)-the solicitation of negative feedback from others that confirms one's self-views-works in a negative cycle to maintain and exacerbate depression in the face of interpersonal stress. We propose a cognitive-interpersonal integration account of NFS such that this maladaptive behavior prospectively predicts depression only among those with a trait tendency to ruminate on the causes and consequences of depressed mood and stress., Method: Participants included 91 young adults who were over-sampled for a lifetime history of a unipolar depressive disorder (age 17-33; 69% women; 67% lifetime depressive disorder). At baseline, participants completed a structured diagnostic interview and self-report measures of NFS, rumination, and depression symptoms. In addition, participants engaged in an interpersonal rejection task (the Yale Interpersonal Stressor) followed by a behavioral measure of NFS. At a 3-month follow-up, depression symptoms were again assessed by self-report and exposure to stressful interpersonal life events in the intervening period were assessed with a rigorous contextual interview and independent rating system., Results: Controlling for baseline depression severity, greater self-reported, and behaviorally assessed NFS predicted greater follow-up depression severity, but only among those with higher trait tendency to ruminate. For self-reported NFS, this association was further moderated by level of interpersonal, but not noninterpersonal, life events experienced over follow-up., Conclusion: These findings suggest that rumination may represent a modifiable intervention target that could break the vicious interpersonal cycle of depression and, thus, mitigate the depressogenic effects of NFS., (© 2023 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.)

Childhood maltreatment is widely implicated as the strongest developmental risk factor for depression onset. The current research is novel in examining the fine-grained associations of childhood emotional versus physical versus sexual maltreatment to indices of the severity, course, and presence of anxiety and trauma-related psychopathology in depression. An amalgamation across 6 previous investigations resulted in a sample of 575 adolescents and adults (76% female; age range 12-70, M = 27.88, SD = 13.58). All participants were in a current episode of a unipolar depressive disorder. Retrospective reports of childhood maltreatment were assessed using a rigorous contextual interview with independent, standardized ratings. Higher levels of emotional maltreatment and/or sexual maltreatment emerged as significantly associated with greater depression severity, number of previous episodes, and risk for posttraumatic stress disorder (PTSD), and were significantly more strongly associated with these characteristics than was physical maltreatment. Further, emotional maltreatment perpetrated by mothers was significantly associated with depression severity and history, whereas emotional maltreatment perpetrated by fathers was significantly associated with a greater risk of PTSD. These latter results suggest that prevention and intervention efforts may need to focus on the unique roles of mothers versus fathers on the development of depressive- versus threat-related psychopathology, respectively. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Depression is the most common mental disorder in pregnancy. An important risk factor in the development of prenatal depression is lifetime history of abuse. The current review quantitatively synthesized research on the association between history of abuse and prenatal depressive symptoms using a meta-analytic technique. A total of 3322 articles were identified through electronic searches of the following databases: PsycINFO, PubMed, CINAHL, and EMBASE Cochrane Collaboration databases between the years of 1980 and 2016. All were independently screened against the following inclusion criteria: articles reporting on original data that included measures of prenatal depression and abuse. Data were extracted by the first and second authors. Descriptive analyses were conducted using Excel version 15.32, and all analyses involving effect sizes were conducted using comprehensive meta-analysis (CMA) version 3.0. Seventy articles met the inclusion criteria and were included in the meta-analyses. Meta-bias detected no publication bias. Abuse had a significant positive relation with prenatal depressive symptoms, with effect sizes in the moderate range for any abuse ([Formula: see text] = 0.287), physical abuse ([Formula: see text] = 0.271), sexual abuse ([Formula: see text] = 0.259), and emotional abuse ([Formula: see text] = 0.340; Cohen 1969. Statistical power analysis for the behavioral sciences. Academic Press, New York). The meta-analyses found a robust relation between abuse and prenatal depressive symptoms holding across a variety of demographic and study design characteristics. These results reinforce the established association between trauma victimization and subsequent psychopathology, extending current knowledge to specifically address the under-studied area of prenatal depression. These findings highlight the need for women who have survived child or adulthood abuse to receive appropriate referral and psychological treatment to mitigate their risk for prenatal depression.

Endothelial function, assessed by flow-mediated dilation (FMD), may be transiently attenuated in healthy adults following acute mental stress. However, the impact of acute mental stress on endothelial function in the context of clinical depression is unknown. This study examined the impact of acute mental stress on FMD in women with a diagnosis of a depressive disorder. Forty-three otherwise healthy women (33 ± 14 years) participated. Brachial artery diameter and blood velocity were assessed with ultrasound. FMD was assessed immediately prior to and 15 min following the Trier Social Stress Test (TSST). The FMD protocol included 5 min of forearm cuff occlusion (pressure = 250 mm Hg), followed by release. Shear stress was estimated by calculating shear rate (SR = brachial artery blood velocity/diameter). Stress reactivity was assessed via changes in mean arterial pressure (MAP), heart rate (HR) and salivary cortisol. Results are mean ± SD. A significant stress response was elicited by the TSST [MAP, HR and salivary cortisol increased (p < 0.05)]. Neither the SR stimulus nor FMD response differed pre-versus post-stress (p = 0.124 and p = 0.641, respectively). There was a modest negative correlation between cortisol reactivity and change in FMD from pre- to post-stress (R = -0.392, p = 0.011). To conclude, acute mental stress did not consistently impair endothelial function in women diagnosed with a depressive disorder; however, higher cortisol reactivity may increase the likelihood of post-stress endothelial dysfunction. Further research is required to better understand the factors influencing the relationship between acute mental stress, cortisol and endothelial function in women with depression., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The current study is the first to examine the relation of childhood abuse and neglect history to theory of mind decoding accuracy as moderated by depression. Fifty-five young adults with current or lifetime unipolar depression diagnosis and 70 never-depressed young adults completed the 'Reading the Mind in the Eyes task,' (RMET). Childhood emotional abuse, physical abuse, and neglect were assessed with a gold-standard contextual interview with standardized, independent ratings. Poorer RMET accuracy was associated with a history of emotional abuse in the depressed group and a history of physical abuse in the non-depressed group. In contrast, across both groups, those with a history of neglect showed significantly enhanced theory of mind decoding accuracy compared to those without. Further, differential accuracy across positive, negative, and neutral valenced stimuli in the RMET was observed in each model. These findings indicate that distinct theory of mind performance results from early experiences of threat versus deprivation, and suggest that early intervention may be most successful in preventing negative interpersonal outcomes of maltreatment by focusing on remediating theory of mind deficits resulting from abuse, and tempering heightened sensitivity in those exposed to neglect., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Theory of mind-the ability to decode and reason about others' mental states-is a universal human skill and forms the basis of social cognition. Theory of mind accuracy is impaired in clinical conditions evidencing social impairment, including major depressive disorder. The current study is a preliminary investigation of the association of polymorphisms of the serotonin transporter (SLC6A4), dopamine transporter (DAT1), dopamine receptor D4 (DRD4), and catechol-O-methyl transferase (COMT) genes with theory of mind decoding in a sample of adults with major depression. Ninety-six young adults (38 depressed, 58 non-depressed) completed the 'Reading the Mind in the Eyes task' and a non-mentalistic control task. Genetic associations were only found for the depressed group. Specifically, superior accuracy in decoding mental states of a positive valence was seen in those homozygous for the long allele of the serotonin transporter gene, 9-allele carriers of DAT1, and long-allele carriers of DRD4. In contrast, superior accuracy in decoding mental states of a negative valence was seen in short-allele carriers of the serotonin transporter gene and 10/10 homozygotes of DAT1. Results are discussed in terms of their implications for integrating social cognitive and neurobiological models of etiology in major depression.

This study examined the relation between a history of maltreatment and the presence of psychotic symptoms in a community sample of adolescents and young adults with major depressive disorder. One hundred and twenty-nine depressed adolescents and young adults (M = 16.02 years, 77% female, 92% White) were recruited through community advertisement and clinician referral. Clinical diagnoses and psychotic symptoms (i.e., hallucinations and delusions) were assessed using a structured diagnostic interview. Childhood maltreatment was assessed using a contextual interview and standardized rating system. Logistic regression analyses examined the relation between childhood maltreatment and psychotic symptoms. As hypothesized, individuals with psychotic symptoms were significantly more likely to report a history of severe sexual maltreatment than those without psychotic symptoms (Wald = 5.44, odds ratio = 3.86, p = .020), 95% confidence interval [1.24, 12.01]. Further, those with psychotic symptoms were more likely to report being the victims of more than one type of maltreatment than those without, χ2(2) = 6.66, p = .036 (ϕ = .23; 40% vs. 16%). Results held upon adjusting for overall level of depression symptoms. A history of severe sexual maltreatment is related to a severe presentation of major depressive disorder even in the initial onset of the syndrome in adolescence and young adulthood. These findings underscore the importance of early assessment of both depression and maltreatment history to implement interventions that have the potential to prevent the emergence of psychotic psychopathology in young people at risk.

This study represents the first replication of the BDNF Val66Met ⁎ 5-HTTLPR ⁎ childhood maltreatment effect on self-reported depression symptoms using a rigorous maltreatment interview. Participants included a community sample of 339 adolescents/young adults (age 12-33; 265 female). In the context of childhood neglect, among BDNF Met-carriers, s-allele carriers of 5-HTTLPR reported significantly higher depression than l/l homozygotes, whereas a differential relation of 5-HTTLPR genotype to depression was not seen among BDNF Val/Val homozygotes., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Given substantial rates of major depressive disorder among college and university students, as well as the growing cultural diversity on many campuses, establishing the cross-cultural validity of relevant assessment tools is important. In the current investigation, we examined the Beck Depression Inventory-Second Edition (BDI-II; Beck, Steer, & Brown, 1996) among Chinese-heritage (n = 933) and European-heritage (n = 933) undergraduates in North America. The investigation integrated 3 distinct lines of inquiry: (a) the literature on cultural variation in depressive symptom reporting between people of Chinese and Western heritage; (b) recent developments regarding the factor structure of the BDI-II; and (c) the application of advanced statistical techniques to the issue of cross-cultural measurement invariance. A bifactor model was found to represent the optimal factor structure of the BDI-II. Multigroup confirmatory factor analysis showed that the BDI-II had strong measurement invariance across both culture and gender. In group comparisons with latent and observed variables, Chinese-heritage students scored higher than European-heritage students on cognitive symptoms of depression. This finding deviates from the commonly held view that those of Chinese heritage somatize depression. These findings hold implications for the study and use of the BDI-II, highlight the value of advanced statistical techniques such as multigroup confirmatory factor analysis, and offer methodological lessons for cross-cultural psychopathology research more broadly., (2015 APA, all rights reserved)

Childhood maltreatment has been shown to have a stronger etiological relation to depression onset in adolescence than in adulthood. We propose that a maltreatment history may more strongly sensitize individuals to the depressogenic effects of proximal stressful life events in adolescence compared to adulthood. In an amalgamated sample of 176 unipolar depressed adolescents (age 12-17) and emerging adults (age 18-29), we examined the moderating role of age group on the relation of childhood maltreatment to sensitization to stressors that occurred just prior to episode onset. Among adolescents, but not among adults, those with a maltreatment history reported a lower severity level of life events prior to episode onset than reported by those without such a history. Further, this relation was specific to emotional abuse, and not physical or sexual abuse. We suggest that the pathological mechanisms associated with translating childhood maltreatment to depression may differ across developmental periods., (Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Background: One of the strongest predictors of depression recurrence in those who respond to treatment is the presence of residual depressive symptoms. Our goal was to examine stressful life event exposure as a mechanism of recurrence in previously depressed patients with residual depression symptoms. That is, we predicted that higher levels of residual symptoms will significantly predict exposure to acute life events that will then heighten prospective recurrence risk., Methods: Participants included 68 adult outpatients with major depression (42 women; age 18-60) who completed a 12-month naturalistic follow-up after achieving remission in a 20-week randomized, open label trial of interpersonal psychotherapy, cognitive-behavioral therapy, or antidepressant medication. Depression recurrence was defined as the reemergence of an episode of major depression as determined by structured interview. Acute life events and chronic stressors were assessed at the end of follow-up using a contextual interview., Results: Posttreatment depression scores significantly prospectively predicted an increased risk for recurrence, and acute life events in the follow-up period. Cox regression survival analyses modeling life events as time-dependent covariates showed that life event exposure mediated the relation of residual symptoms to recurrence even controlling for chronic stress., Conclusions: Our findings implicate residual symptoms in heightening depression recurrence risk through exposure to stressful life events. Depression recurrence adds significantly to the burden of the disorder. Therefore, rigorous follow-up of patients targeting the stressful context has the potential to prevent a lifelong pattern of illness., (© 2013 Wiley Periodicals, Inc.)

This study examined the hypothesis that depressed adolescents with a history of childhood maltreatment will show greater cortisol reactivity to psychological stress challenge than those without, and this relation will be moderated by level of depression severity. Seventy-one adolescents were exposed to the Trier Social Stress Test. Salivary cortisol was assessed at baseline, immediately before the challenge, after the challenge, and during an extended recovery period. Childhood maltreatment was assessed with a rigorous contextual interview and rating system. Adolescents with a history of maltreatment produced higher and more prolonged levels of cortisol in response to the challenge than did adolescents with no maltreatment, but only among those with a mild/moderate level of depression severity. Those with moderate/severe depression exhibited a blunted cortisol response regardless of child maltreatment history. These findings indicate that depression is a heterogeneous syndrome, and that both depression severity and child maltreatment history should be considered in studies examining biological stress reactivity., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

The purpose of the present study was to uncover patterns in the generation of life events from symptom profiles and specific depression symptoms in an effort to obtain a fine-grained understanding of the stress-generation phenomenon. A community sample of 161 adolescents completed the Beck Depression Inventory-II (A. T. Beck, 1996) at Time 1, and then 88 returned 1 year later for an assessment of life events using a rigorous contextual interview and rating system. Consistent with hypotheses, and controlling for baseline stress, cognitive-affective symptoms of depression prospectively predicted higher levels of dependent interpersonal life events. In contrast, somatic symptoms prospectively predicted higher levels of independent life events. Further examination of the types of events generated by specific symptoms suggests that different mechanisms may drive specific patterns of symptom-event generation and suggests that broadening the definition of independence may be necessary to capture the full context of event generation.

Major depression is frequently characterized by recurrent episodes over the life course. First lifetime episodes of depression, however, are typically more strongly associated with major life stress than are successive recurrences. A key theoretical issue involves how the role of major life stress changes from an initial episode over subsequent recurrences. The primary conceptual framework for research on life stress and recurrence of depression is the "kindling" hypothesis (R. M. Post, 1992). Despite the strengths of the kindling hypothesis, a review of the research literature reveals inconsistencies and confusion about life stress and its implications for the recurrence of depression. Adopting a life stress perspective, the authors introduce 3 major themes that resolve the inconsistencies in the current literature. They integrate these themes and extrapolate the ideas with available data to develop a preliminary framework for evaluating competing explanatory models and to guide research on life stress and the recurrence of depression.

The COVID-19 pandemic has had a profound impact on the academic work environment. Studies have documented cross-sectional associations between COVID-related stress and mental health symptoms in university faculty and staff. However, longitudinal studies that can establish temporal associations are needed. Further, it is important to determine if relations to mental health symptoms are driven by worries about COVID-19 (i.e., perceptions of stress) or actual impacts of COVID-19 across domains of health, job, and relationships. The present study included 100 faculty and 265 staff at a medium-sized Canadian University who completed an adapted version of the electronic U-Flourish well-being survey at two time points (October, 2020 and March, 2021). Cross-lagged panel modeling provided evidence that levels of COVID-19 worries and COVID-19 impacts at baseline significantly positively predicted follow-up levels of anxiety over and above baseline levels. Further, baseline levels of anxiety were positively associated with follow-up levels of COVID-19 worries, but not with follow-up COVID-19 impacts. In contrast, none of the cross-lagged associations with depressive symptoms were significant. We suggest from these results that post-COVID-19 mental health recovery can be promoted by academic leadership in two main ways. First, reducing the impact of COVID-19 on anxiety could be achieved through strategies that enhance individuals' sense of control and predictability in their environment, including clear, consistent, and consolidated communication. Second, reducing worry about COVID-19 for faculty and staff with preexisting mental health symptoms might be achieved by broadening access to mental health support. [ABSTRACT FROM AUTHOR]

Major depressive disorder is the leading cause of physical and mental disability worldwide, affecting more than 264 million people. A disproportionate amount of the enormous personal, societal, and economic toll is attributable to recurrent depression, wherein individuals suffer episodes repeatedly throughout their lives. At present, no clinical or scientific evidence can predict who will develop the disorder on an individual basis. We suggest two explanations for this pivotal prognostic impasse. First, a widespread belief that major depression is primarily a highly recurrent disorder is incorrect and misleading. Second, this incorrect belief has biased concepts, definitions, and research practices, further reinforcing the idea that depression usually is highly recurrent. We explain how such a belief and associated research practices stand in the way of progress, and we outline an agenda for discovering who is at greatest risk for recurrences following depression's first onset. [ABSTRACT FROM AUTHOR]

The current study provided a novel investigation of relations among particular types of childhood maltreatment (emotional vs. physical vs. sexual maltreatment), specific cognitive schema themes and the generation of dependent versus independent life events. Participants included 227 adolescents and emerging adults (74% female; aged 12–29) in a current episode of a unipolar depressive disorder drawn from three archival cross‐sectional studies. Childhood maltreatment and life events from the past 6 months were assessed using detailed contextual interviews with independent, standardized ratings. Emotional maltreatment was uniquely associated with schema themes of emotional deprivation and subjugation, and sexual maltreatment was uniquely associated with schema themes of abandonment, vulnerability and dependence/incompetence. Further, subjugation and abandonment cross‐sectionally mediated the relations of emotional and sexual maltreatment, respectively, to greater dependent, but not independent, life events. Physical maltreatment was not associated with cognitive schemas or recent life events after accounting for its overlap with emotional and sexual maltreatment. Results suggest targets for cognitive intervention that may improve outcomes for youth with specific histories of emotional and sexual maltreatment. [ABSTRACT FROM AUTHOR]

According to several interpersonal theories of depression, excessive reassurance-seeking is one way depressed individuals may contribute to relationship deterioration, particularly in romantic relationships. The present study is the first behavioral investigation of the hypothesis that reassurance-seeking induces negative affect in interaction partners in real time. This study also investigates potential affective precursors to reassurance-seeking behaviors. A videotaped discussion task completed by 121 women and their male romantic partners was behaviorally coded to assess reassurance-seeking and affect in both members of the couple. Female depression was measured via self-report. Results indicated that the association between female reassurance-seeking and male partner's subsequent anxiety approached statistical significance, but no other significant relations between reassurance-seeking and partner affect were found. Additionally, female anxious affect positively predicted subsequent reassurance-seeking, and depression symptoms moderated this relation. Unexpectedly, the relation between anxious affect and reassurance-seeking was stronger among women with less severe depression symptoms. Our findings support integrated and revised theories of reassurance-seeking and underscore the need to further investigate reassurance-seeking behavior in real-time interactions. [ABSTRACT FROM AUTHOR]

Children of depressed mothers show substantial social impairment, which increases their risk for developing depression. Theory of mind understanding forms the basis of social functioning, and is impaired in children of currently depressed mothers. Models of risk emphasize that a history of any maternal depression confers risk to later psychopathology. Therefore, we tested a novel model of the impact of lifetime maternal depression on children's false belief understanding that accounts for three primary factors that scaffold this understanding: maternal mental state talk, and children's executive functioning and language abilities. Children aged 41–48 months with a maternal lifetime history of major depressive disorder (MDD; n = 19) performed significantly more poorly on the false belief battery compared to those without (n = 44). Further, lower levels of mental state talk, child executive functioning, and child language ability were significantly associated with poorer false belief scores. However, the relation between maternal MDD and children's false belief performance was not mediated by any of these factors. These results indicate that maternal depression predicts poorer false belief understanding independently of other crucial scaffolding variables, and may be a social cognitive mechanism underlying the intergenerational transmission of depression. [ABSTRACT FROM AUTHOR]

Introduction: According to the interpersonal model of depression, individuals with depression engage in excessive reassurance-seeking (ERS) about others' beliefs regarding their self-worth, which can ultimately result in interpersonal rejection. We present the novel hypothesis that maladaptive ERS behaviors in depression may be driven by difficulties with "theory of mind"—the foundational ability to decode and reason about others' mental states. Method: Participants included 31 young adults in a current episode of a unipolar depressive disorder, and 91 never-depressed adults. Theory of mind was assessed with standard, objective laboratory tasks. Stressful life events were assessed with a gold-standard contextual interview and independent rating system. Results: Consistent with hypotheses, in the depressed group only, lower accuracy of theory of mind decoding was associated with greater ERS, which was significantly associated with exposure to greater interpersonal, but not non-interpersonal, stress. Surprisingly, higher accuracy of theory of mind reasoning was associated with greater ERS. Discussion: The intriguing dissociation is discussed in terms of expanding the interpersonal model of depression to include the foundational social cognitive processes that underlie effective social communication. [ABSTRACT FROM AUTHOR]

Objective This study tested whether core beliefs with themes of abandonment and rejection moderated the link between trait and behavioral excessive reassurance seeking (ERS) and interpersonal rejection. Method Participants were 118 women with high ( n = 43; mean [ M]age = 18.58, standard deviation [ SD]age = 1.24) and low ( n = 75; Mage = 18.58, SDage = 1.24) levels of depression symptoms and their male romantic partners. Couples reported their depression, ERS, abandonment/rejection cognitions, and relationship quality. We also coded women's reassurance-seeking behavior during an audiotaped discussion task. Results Among women with high levels of depression symptoms and low levels of abandonment/rejection core beliefs, behavioral ERS was associated with lower partner-reported relationship quality. Self-reported ERS was significantly associated with partner relationship quality, but the effect was not moderated by depression or core beliefs. Conclusions ERS is a potent predictor of stress and subsequent depression. Our findings underscore the need to better understand factors (e.g., cognitions, partner characteristics) that may determine whether ERS behaviors beget interpersonal stress and rejection. [ABSTRACT FROM AUTHOR]

Emerging evidence suggests that the tendency to generate stressful life events may be, at least in part, genetically determined. However, the role of the early environment in shaping responses to later stressors is crucial to fully specifying biogenetic models of stress generation. The current study examined the moderating role of childhood emotional, physical, and sexual maltreatment on the relation of the serotonin-transporter-linked promoter region (5-HTTLPR) polymorphism of the serotonin transporter gene to proximal independent, dependent, and dependent-interpersonal life events. This question was tested in a cross-sectional community sample of 297 adolescents and young adults. Childhood maltreatment history and proximal life events were assessed with state-of-the-art interviews that provide independent and standardized ratings of the environmental context. Consistent with the stress generation hypothesis, individuals with the risk s-allele of the serotonin transporter gene reported significantly higher rates of dependent and dependent-interpersonal life events than those homozygous for the 1-allele, but only in the context of a history of maternal emotional maltreatment or sexual maltreatment. Neither serotonin transporter gene polymorphisms or childhood maltreatment, or their interaction, were associated with reports of independent life events. The current results demonstrate the importance of considering specificity in the early environmental context when examining the relation of genetic factors to the generation of proximal stress. [ABSTRACT FROM AUTHOR]

Cognitive impairment is experienced by many individuals with major depressive disorder (MDD) and is significantly related to sustained disability. Recent work has begun to explore the relationship between childhood adversity (CA) and cognitive impairment in MDD, but this work is limited by unreliable measures of CA. Furthermore, no previous research has examined whether CA relates to cognitive remediation response. The current study clarifies how CA and clinical characteristics of illness explain cognitive variance. In addition, we investigate whether CA is associated with response to cognitive remediation. Thirty-nine individuals who completed cognitive remediation were rerecruited to complete a retrospective interview on CA. Results showed that CA, repeated depressive episodes, and earlier age at diagnosis were associated with poorer cognition. We did not observe a difference in treatment response based on CA. Findings suggest that CA is an important variable to consider when examining the expression of depressive illness and areas for intervention. [ABSTRACT FROM AUTHOR]

The current study examined whether the personality traits of self-criticism or dependency moderated the effect of stressful life events on treatment response. Depressed outpatients (N = 113) were randomized to 16 weeks of cognitive-behavioral therapy, interpersonal psychotherapy, or antidepressant medication (ADM). Stressful life events were assessed with the Bedford College Life Events and Difficulties Schedule. Severe events reported during or immediately prior to treatment predicted poor response in the ADM condition but not in the psychotherapy conditions. In contrast, nonsevere life events experienced prior to Onset predicted superior response to treatment. Further, self-criticism moderated the relation of severe life events to outcome across conditions, such that in the presence of severe stress those high in self-criticism were less likely to respond to treatment than were those low in self-criticism. [ABSTRACT FROM AUTHOR]

This study examined the role of childhood abuse and neglect in sensitizing adolescents to the effects of proximal stressful life events in a cross-sectional sample of 103 depressed and nondepressed adolescents. Consistent with hypotheses, adolescents with a history of childhood abuse and/or neglect reported a lower level of threat of stressful life events prior to episode onset than that reported by those without. This effect was specific to those on their 1st episode of depression and was specific to independent events (i.e., stressors outside of adolescents' control). Further, this effect was robust when controlling for level of chronic difficulties, which was higher in those with childhood abuse and/or neglect. The authors suggest that childhood abuse and/or neglect may be an important risk factor that sensitizes individuals to the effects of acute independent life events. [ABSTRACT FROM AUTHOR]

Research has consistently documented the significance of severe life events for onset of major depression. Theory, however, suggests other forms of stress are relevant for depression's recurrence. Nonsevere life events were tested in relation to depression for 126 patients with recurrent depression in a 3-year randomized maintenance protocol. Life stress was assessed every 12 weeks and rated along dimensions of severity, focus, and independence. A significant interaction between specific types of nonsevere life events and medication was found. For medicated patients, subject-focused independent nonsevere life events predicted recurrence; for unmedicated patients, these events predicted fewer recurrences. Other nonsevere life events did not predict recurrence. The findings underscore the potential importance of specific stressors for triggering recurrences of depression. [ABSTRACT FROM AUTHOR]

Research suggests that negative life events and social support are associated with the course of major depressive episodes. However, the manner in which these variables may be specifically interrelated remains unclear. The present study compared two models of the relation among life events, number of social relationships, and the naturalistic course of major depression in a community sample of women. The life event profiles of 32 women were assessed during their index episode of major depression (T1) and again 1 year later (T2). Measures included the Hamilton Depression Rating Scale, the Beck Depression Inventory, and the Life Events and Difficulties Schedule. Data analysis focused on whether life events and social relationships were independent predictors of depressive symptomatology (i.e., “main effects” model) or whether social relationships moderated the influence of life events on the naturalistic course of participants' major depressive episodes (i.e., “stress buffering” model). The results only partially supported the main effects model and failed to support the buffering model of the relation among life events, social relationships, and naturalistic depression course. In particular, the present findings indicated that number of social relationships was a significantly stronger predictor of naturalistic depression course than were life events. These findings suggest that insufficient social support is a particularly strong prospective predictor of elevated depressive symptomatology. Determining the quality of patients' social support networks should be a regular part of clinical assessment, and efforts should be made to help depressed patients establish supportive relationships both in the therapeutic environment and in their personal lives. Depression and Anxiety 16:104–113 2002. © 2002 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Background: In treatment studies of major depressive disorder (MDD), exposure to major life events predicts less symptom improvement and greater likelihood of relapse. In contrast, the impact of minor life events has received less attention. We hypothesized that the impact of minor events on symptom improvement and risk of relapse would be heightened in the presence of concurrent chronic stress. We also hypothesized that major events would predict less symptom improvement and greater risk of relapse independently of chronic stress.Methods: Adult patients experiencing an episode of MDD were enrolled into a 16-week trial with antidepressant treatments (n = 156). Forty-three fully remitted patients agreed to participate in a naturalistic 18-month follow-up, and 30 had full data for analyses. Life events and chronic stressors were assessed using a contextual life stress interview.Results: Greater exposure to minor events predicted greater improvement in symptoms during acute treatment, but this relation was specific to those who reported greater severity of chronic stress. During follow-up, however, major life events predicted increased risk of relapse, and this effect was not moderated by chronic stress.Limitation: High attrition rates led to a small sample size for the follow-up analyses.Conclusions: Exposure to minor events may provide an opportunity to practice problem-solving skills, thereby facilitating symptom improvement. Nevertheless, acute treatment did not protect patients from relapse when they subsequently faced major events during follow-up. Therefore, adjunctive strategies may be needed to enhance outcomes during pharmacotherapy, consolidating benefits from acute treatment and providing skills to prevent relapse. [ABSTRACT FROM AUTHOR]

Background: The current study presents a randomized controlled 8-week trial of Bikram yoga, aerobic exercise, and waitlist for depression. Bikram yoga was chosen specifically for its standardized nature. Further, we examined changes in three stress-related constructs-perceived stress, rumination, and mindfulness-as mediators of antidepressant effects.Method: Fifty-three women (age 18-65; 74% White) with a unipolar depressive disorder were randomly assigned to one of the three conditions. Response was defined as >50% reduction on the Hamilton Rating Scale for Depression (HAM-D). Remission was defined as no longer meeting criteria for depression and a HAM-D ≤ 7. Self-reported perceived stress, rumination, and mindfulness were assessed weekly.Results: In the intention-to-treat sample (n = 53), response rates were significantly higher in the Bikram yoga (61.1%; χ2 = 10.48, p = .001) and aerobic exercise (60.0%; χ2 = 10.44, p = .001) conditions relative to waitlist (6.7%). In the completer sample (n = 42), 73.3% (χ2 = 11.41, p = .001) of women in yoga and 80.0% (χ2 = 13.72, p < .001) in exercise achieved response compared to 8.3% in waitlist. Reductions in rumination significantly mediated HAM-D change for both active treatments, and mindful acceptance was a partial mediator in the exercise condition.Limitations: The sample was small in size, consisted of women only, and was ethnically homogenous. Inter-rater reliability was not assessed, aerobic exercise was not standardized, and mediators were assessed by self-report.Conclusions: Bikram yoga showed descriptively similar efficacy to aerobic exercise and both may work, in part, by helping individuals interrupt negative thinking. [ABSTRACT FROM AUTHOR]

Abstract Background Childhood maltreatment is one of the strongest predictors of sexual and peer bullying re-victimization. However, it is not clear which types of maltreatment are associated with the greatest risk. Objective The current study examined the differential relations of maternal- versus paternal-perpetrated emotional maltreatment, neglect, and physical maltreatment, as well as sexual maltreatment, to sexual victimization and peer bullying victimization outside the home. It was hypothesized that paternal-perpetrated emotional maltreatment would be the strongest predictor of later sexual and peer bullying victimization, and that sexual maltreatment would predict sexual re-victimization. Participants and setting Participants included data from 263 adolescent and young adult women who had previously taken part in one of three larger studies conducted in an academic research setting investigating the relation between stress and depression. All participants had been recruited from the wider community or clinician referral and met criteria for a unipolar depressive disorder. Methods Psychiatric diagnoses were assessed with a structured diagnostic interview. Childhood maltreatment and victimization were assessed retrospectively with a semi-structured contextual interview that includes standardized ratings. Results Paternal-perpetrated emotional abuse was the only maltreatment type that was independently associated with sexual (OR = 3.09, p =.004) and peer bullying (OR = 1.41, p =.05) re-victimization over other forms of maltreatment and indicators of depression severity. Conclusions These findings provide an important foundation for future research examining the mechanisms driving the relation between father's hostility, criticism, and rejection and daughters' revictimization that can ultimately provide targets for prevention in girls at highest risk. [ABSTRACT FROM AUTHOR]