Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain interference. In mediation models, depression was not related to pain interference via spiritual well-being, or to spiritual well-being via pain interference. Pain interference was related to depression via spiritual well-being and meaning/peace, and to spiritual well-being and meaning/peace via depressive symptoms. Finally, spiritual well-being and meaning/peace were related to depression via pain interference, and to pain interference via depressive symptoms. For patients with MS, a multi-faceted approach to treatment that includes pain reduction and promotion of spiritual well-being may be beneficial, although amelioration of depression remains a critical task.

Objective: Psychological thriving reflects a trajectory of growth over time as opposed to scaling back expectations. Whether thriving is a product, precursor, or process of coping with arthritis-related limitations is unclear. We examined associations between thriving, coping efficacy, and expectations for future growth in individuals with arthritis, and the relations of thriving to depressive symptoms and retrospective perceptions of personal growth over a six-month period. Methods: A sample of 423 people with arthritis completed measures of thriving, coping efficacy, depressive symptoms, and expectations for future growth; 168 individuals completed a six-month follow-up survey. Structural equation modeling analyses compared three possible models of psychological thriving, controlling for disease-related variables. Hierarchical regression analyses of the cross-lagged associations of thriving with retrospective perceptions of positive personal change and depressive symptoms were also conducted. Results: Structural equation analyses suggest that the process model in which thriving and coping efficacy jointly predicted expectations for future growth best fit the data. Baseline thriving was also associated with retrospective perceptions of personal growth at follow-up and fewer depressive symptoms at baseline and follow-up, after controlling for disease-related variables. Conclusion: Overall, these findings suggest that psychological thriving is synergistically related to coping efficacy, and to expectations for future growth and less depression, in people with arthritis. Importantly, our findings support the notion that psychological thriving is more than scaling back expectations, and that thriving may be an important quality to cultivate to address the burden of depression in people with arthritis.

The present study examined dispositional hope as a potential mediator of the association between sexual assault and negative affective conditions, namely, depressive and anxious symptoms in a sample of 223 female college students. Results from conducting bootstrapped mediation analyses indicated that hope agency, but not hope pathways, mediated the link between sexual assault victimization and negative affective conditions in females. Importantly, the associations of sexual assault with both depressive and anxious symptoms remained highly significant independent of hope. Some implications of the present findings are discussed.

The link between interparental conflict and adolescents’ maladjustment has been well established among European Americans; however, relatively few studies examine these relationships in Chinese societies. This study used longitudinal data from the Taiwan Youth Project (TYP), an on-going longitudinal panel research project focused on adolescent development, in order to examine the relationship between interparental conflict and depressive symptoms and externalizing problem behaviors of adolescents. In addition, this study examined parental warmth as a mediating variable for the relationship between interparental conflict and adolescents’ maladjustment. The results showed that interparental conflict predicted depressive symptoms among adolescents two years later. Mediation analysis indicated that parental warmth partially mediated the relationship between interparental conflict and depressive symptoms. However, findings indicated that there was no direct effect between interparental conflict and adolescent externalizing behaviors two years later; rather, the association was indirect through the mediating variable of overall parental warmth. Thus, overall parental warmth fully mediated the relationship between interparental conflict and subsequent externalizing behaviors. These results yield valuable information for clinical intervention and further research.

This study examined academic motivation and basic psychological needs as predictors of suicidal risk (namely, depressive symptoms and suicidal behaviors) in a sample of 348 college students. Results from regression analyses indicated that academic motivation was a significant predictor of suicidal risk. The inclusion of basic psychological needs significantly augmented the prediction model. The authors discuss implications for considering academic motivation and basic psychological needs in college counseling on the basis of the results.

Suicide is a significant public health concern and the second leading cause of death for college students. Perceived stress, depression, and mental health stigma are established risk factors for suicidal behavior; however, their interrelationships are unknown. Data were collected from 913 collegiate housing residents (70.8% female; N = 646). Using data from self-report measures, depressive symptoms were examined as a mediator of the relation between stress and suicidal behavior, along with the moderating effect of mental health stigma. Depressive symptoms partially mediated the stress–suicide linkage, and mental health stigma was a significant moderator of the associations between stress and depression, depression and suicidal behavior, and stress and suicidal behavior. Stigmatized attitudes toward mental health treatment, including fear of social repercussion, may exacerbate the deleterious impact of stress on psychopathology and suicide risk. Individual-level therapeutic strategies targeting stress and psychopathology, as well as public health approaches that directly address and attempt to reduce mental health stigma, may reduce suicide risk in college students.

Caregivers (CG) often neglect their own self-care which may have deleterious effects if CG have a chronic illness, such as diabetes. Care demands have been linked to CG health, although the mechanisms are unclear. The purpose of this study was to examine the relationships of CG stress, depressive symptoms, and diabetes self-care practices on CG physical health (PH) and glycemic control (GC) in an underrepresented group of Hispanic CG with diabetes. A correlational design was used in a non-random sample of 42 Hispanic CG with diabetes (Type I or II) recruited from two health centers serving the uninsured. CG had diabetes for ≥ 6 months, were on average 48.0 (± 11.4) years old, 73.8% female, and 54.8 % with < 8th grade education. Care recipients were on average 53.9 (± 14.0) years old, 54.8 % male, and were functionally independent. Standard questionnaires for perceived caregiving stress (Caregiver Burden Scale), depressive symptoms (CES-D), diabetes self-care practices (Diabetes Care Profile), PH (PCS of the SF12v2) and CG characteristics were administered in person. GC was measured using the glycosylated hemoglobin A1c (HgbA1c). Statistical analysis included correlations, t-tests, and multiple linear regression. On average CG had poor GC (HgbAlc M = 9.0, ± 2.12), but rated their PH better than others with diabetes. CG with high stress had more depressive symptoms (M = 23.75 ± 12.75) than CG with lower stress (M = 15.75 ± 12.01; t (40) = 2.00, p = .026). Almost half (40.5%) had depressive symptoms indicating possible clinical depression. The hypothesized models of caregiver stress, depressive symptoms, and self-care practices were not associated with CG PH (p > .05) or GC (p >.05); however, more persons in the household was associated with poor GC. This study provided support for the influence of CG stress on psychological health in the experience of Hispanic CG with diabetes. The findings of high levels of depressive symptoms and poor GC suggest the need for health care professionals to assess the psychological health of Hispanic CG and better educate them about the importance of GC for prevention of serious health problems.

The overall aim of this thesis was to describe the prevalence of depressive symptoms, sleep disordered breathing (SDB) and sleep complaints, as well as to investigate the prognostic value of health-related quality of life (Hr-QoL) and depressive symptoms on mortality in an elderly community living population with a focus on those with impaired systolic function/heart failure (HF). Descriptive, prognostic and explorative study designs were used to examine if a single question about global perceived health (GPH) is associated with the domains of Hr-QoL as assessed by the SF-36 (I), as well as to evaluate whether GPH provided prognostic information concerning cardiovascular mortality (II). The aim was also to evaluate if depressive symptoms are associated with mortality (III), and to describe the prevalence of SDB and its relationship to impaired systolic function, different insomnia symptoms, as well as excessive daytime sleepiness (IV). In primary care elderly patients with HF, GPH correlated to the physical and mental aspects of Hr-QoL. Patients who rated poor GPH also scored worse physical and mental Hr-QoL compared to patients with good GPH, but the mental aspect of Hr-QoL was however not significant (p&lt;0.07) (I). Moreover, GPH also had an independent association with cardiovascular mortality during a ten-year follow-up. Compared to patients with good GPH, those who scored poor GPH had a four times increased risk for cardiovascular mortality (II). A total of 24% of the patients with HF suffered from depressive symptoms, not significantly different compared to 19% among those without HF. Depressive symptoms were a poor prognostic sign during the six-year follow-up and HF patients with depressive symptoms had the highest risk for cardiovascular mortality compared to HF patients without depressive symptoms (III). SDB is common among elderly people living in the community, almost one quarter (23%) had moderate or severe SDB. However, people with moderate impaired systolic function had a median apnea hypopnea index that was more than twice as high compared to those with normal systolic function (10.9 vs. 5.0, p&lt;0.001). No obvious associations between SDB and excessive daytime sleepiness or the insomnia symptoms; difficulties maintaining sleep; non-restorative sleep; or early morning awakenings were detected. Difficulties initiating sleep were however more common in those with moderate or severe SDB (IV). GPH can be used as a simple tool in clinical routine practice as an aid in identifying patients in need of additional management. SDB is a common phenomenon among elderly people and associated with impaired systolic function, but with a limited impact on subjective sleep complaints. Depressive symptoms were shown to be a poor prognostic sign and may amplify the patient’s experience of suffering. Screening for depressive symptoms could therefore be an important action in the management of patients with HF.

SammanfattningSömnproblem är vanligt förekommande hälsoproblem i befolkningen. Kognitiv beteendeterapi (KBT) har visats vara en effektiv behandling för personer med insomni men mindre forskning har bedrivits på effekten av KBT i grupp för personer med insomni (KBT-I) och samtidiga depressiva symtom. Studien syftade till att undersöka effekten av KBT-I i grupp med avseende på graden av insomni, depressiva symtom, och samvariationen med transdiagnostiska processer. En single-subject design användes med dagliga skattningar och för-, mellan- och eftermätningar. Resultatet visade att graden av insomni minskade för samtliga deltagare och graden av depressiva symtom minskade för majoriteten. En samvariation mellan sömnrelaterad oro, selektiv uppmärksamhet, och insomni fanns. Det återstår för framtida forskning att undersöka de transdiagnostiska processernas samband med insomni och depressiva symtom närmare. / AbstractSleep disorders are a common health problem in the population. Cognitive behavior therapy for insomnia (CBT-I) have proved to be an effective treatment for people with insomnia, but less research has been conducted on the efficacy of CBT-I in a group of people with insomnia (CBT-I) and comorbid depressive symptoms. The purpose of this study was to investigate the effect of CBT-I in group with respect to insomnia, depressive symptoms, and transdiagnostic processes. A single-subject design was used with daily estimates and pre- between-and posttest measures. The study concluded that the degree of insomnia symtoms decreased for all participants and the degree of depressive symptoms decreased for the majority. A correlation was found between sleep-related worry, selective attention, and insomnia. It remains for future research to investigate transdiagnostic processes associated with insomnia and depressive symptoms further.

Universitetsstudenter har ofta ett riskabelt alkoholbeteende ochupplever depressiva symtom under studietiden, vilket kan ha svårakonsekvenser. Förklaringarna till alkoholkonsumtion blanduniversitetsstudenter har ofta fokuserat på studenters motivation tillsocialisering med andra studenter. Litteraturen har också fokuserat påförstaårsstudenters övergångsfas i förklaringarna till depression.Denna studie involverade 117 universitetsstudenter i ett medelstortsvenskt universitet. Studiens huvudsyfte var att undersöka omstudenter som bytte ort för att studera dricker mer alkohol ochupplever flera depressiva symtom än studenter som studerar i sinhemort. Resultatet visar på en betydande skillnad i alkoholkonsumtionmellan de två grupperna, vilket tyder på ett samband mellan flyttenfrån hemorten och alkoholkonsumtion. / University students have often a risky alcohol behaviour andexperience depressive symptoms during their studies, which can haveserious consequences. Explanations to why college students drinkalcohol have often focused on the students’ social motivations. Theliterature has also focused on first-year university students’ being in atransitional phase in their lives when explaining their experience ofdepressive symptoms. This study involved 117 university students at amiddle-sized Swedish university. The main purpose of this study wasto investigate if students who moved from their home districts in orderto attend college drink more alcohol and experience more depressivesymptoms than university students who study in their home district.The result of this study shows a significant difference in alcoholconsumption between the two groups, which indicates a relationshipbetween moving from one’s home district and drinking alcohol.