Socioeconomic status and Aboriginal cultural status are believed to be key risk indicators of mental health status in youth.<p>The main purpose of the study was to explore the role of Aboriginal cultural status as an independent risk indicator associated with depressed mood after controlling for other covariates; including socioeconomic status. <p>Methods<br> A population based cross sectional survey was used. Every student in grades 5-8 in Saskatoon was asked to complete a short self-report questionnaire in their classroom in February of 2007. Depressed mood was measured with a validated depression scale (CES-D-12).<p>Results<br> In total, 4093 adolescents completed the study questionnaire. For youth whose parents were of Aboriginal cultural status, the prevalence rate of moderate or severe depressed mood was 21.6% in comparison to 8.9% for youth whose parents were Caucasian (RR=2.43; 95% CI 1.92-3.08).<p> In the final adjusted multivariate logistic regression model, moderate or severe depressed mood was more likely to be associated with female gender (OR=1.665; 95% CI 1.179-2.352), having low self esteem (OR=3.185; 95% CI 2.084-4.870), feeling like an outsider at school (OR=3.364; 95% CI 2.386-4.743), being bullied within the past year (OR=1.879; 95% CI 1.278-2.761), alcohol usage (OR=2.518; 95% CI 1.730-3.666), high levels of anxiety (OR=22.171; 95% CI 14.170-34.960), suicide ideation (OR=3.734; 95% CI 2.502-5.572), being hungry some or most of the time (OR=2.071; 95% CI 1.357-3.162) and parents having a lower education status (OR=1.503; 95% CI 1.066-2.120). Although Aboriginal cultural status was strongly associated with moderate or severe depressed mood after cross tabulation and stratification, Aboriginal cultural status was not associated with higher levels of depressed mood after full adjustment for other covariates in the final multivariate model (OR= 1.132; 95% CI 0.682-1.881).<p>Conclusions<br>The results demonstrate that Aboriginal cultural status has a more limited and statistically non-significant association with moderate or severe depressed mood in youth after controlling for other covariates. There is a need to transfer the results of this research to the Saskatoon community to allow policy makers and the public at large to know that prevention of disparity in mental health is possible because the determinants of mental health (i.e., education) are now modifiable (in comparison to Aboriginal cultural status).

Socioeconomic status and Aboriginal cultural status are believed to be key risk indicators of mental health status in youth.<p>The main purpose of the study was to explore the role of Aboriginal cultural status as an independent risk indicator associated with depressed mood after controlling for other covariates; including socioeconomic status. <p>Methods<br> A population based cross sectional survey was used. Every student in grades 5-8 in Saskatoon was asked to complete a short self-report questionnaire in their classroom in February of 2007. Depressed mood was measured with a validated depression scale (CES-D-12).<p>Results<br> In total, 4093 adolescents completed the study questionnaire. For youth whose parents were of Aboriginal cultural status, the prevalence rate of moderate or severe depressed mood was 21.6% in comparison to 8.9% for youth whose parents were Caucasian (RR=2.43; 95% CI 1.92-3.08).<p> In the final adjusted multivariate logistic regression model, moderate or severe depressed mood was more likely to be associated with female gender (OR=1.665; 95% CI 1.179-2.352), having low self esteem (OR=3.185; 95% CI 2.084-4.870), feeling like an outsider at school (OR=3.364; 95% CI 2.386-4.743), being bullied within the past year (OR=1.879; 95% CI 1.278-2.761), alcohol usage (OR=2.518; 95% CI 1.730-3.666), high levels of anxiety (OR=22.171; 95% CI 14.170-34.960), suicide ideation (OR=3.734; 95% CI 2.502-5.572), being hungry some or most of the time (OR=2.071; 95% CI 1.357-3.162) and parents having a lower education status (OR=1.503; 95% CI 1.066-2.120). Although Aboriginal cultural status was strongly associated with moderate or severe depressed mood after cross tabulation and stratification, Aboriginal cultural status was not associated with higher levels of depressed mood after full adjustment for other covariates in the final multivariate model (OR= 1.132; 95% CI 0.682-1.881).<p>Conclusions<br>The results demonstrate that Aboriginal cultural status has a more limited and statistically non-significant association with moderate or severe depressed mood in youth after controlling for other covariates. There is a need to transfer the results of this research to the Saskatoon community to allow policy makers and the public at large to know that prevention of disparity in mental health is possible because the determinants of mental health (i.e., education) are now modifiable (in comparison to Aboriginal cultural status).

The central objective of this thesis was to explore relationships between personal values, and depressed mood and subjective wellbeing, and to determine if the notion of values can be more useful in the fields of clinical and positive psychology. An initial literature review of values identified the potential importance of values in relation to mood and wellbeing, but also showed that more research was required to clearly establish such links. Two survey studies using Schwartz’s model of values (Schwartz, 1992), and one longitudinal study investigating relational aspects of values, were conducted to explore these relationships. Study 1 was a New Zealand paper-based study and investigated links between the importance of, and satisfaction with, values and depressed mood and subjective wellbeing. Study 2 was a larger international internet-based study which sought to replicate important findings from Study 1 and investigate links between people’s knowledge of their values and the extent to which they were living in alignment with values. Study 3 consisted of a sub-sample of participants from Study Two who completed a subset of Study 2 assessment measures six months later. This study explored how relational aspects of values (knowledge of values, living in alignment with values) related to changes in depressed mood and SWB over time. Cumulatively the results from these studies re-orientate our thinking towards an increased utility for the notion of values in the areas of clinical and positive psychology. Regarding depressed mood, these studies found links between greater depressed mood and lesser importance of Self-Direction, Stimulation and Hedonism value types. The importance of values as a whole was not associated with depressed mood; however being satisfied, knowing values, and living in alignment with values were associated with less depressed mood. Regarding subjective wellbeing, these studies found links between greater subjective wellbeing and greater importance of Self-Direction, Stimulation, Hedonism, and Benevolence value types. The importance of values as a whole was not associated with subjective wellbeing; however being satisfied, knowing values, and living in alignment with values were associated with greater subjective wellbeing. A causal relationship was found between living in alignment with values and latter subjective wellbeing, but not for knowledge of values and later subjective wellbeing. In addition, no major deviations in the coherence of values’ systems between individuals with and without depressed mood, or for individuals with and without high subjective wellbeing, were found. Strengths, implications, and limitations of the studies are noted for the fields of clinical and positive psychology, and suggestions for future research are made.

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Background: Research on adolescent mental health suggests that prevalence rates for depressed mood are not uniformly distributed across all populations. This study examined demographic difference in depressed mood among a nationally representative sample of high school adolescents. Methods: The 2003 National Youth Risk Behavior Survey was utilized to examine the association between depressed mood and demographic variables. To examine demographic associations, chi-square and follow-up logistic regression models were created for the sample of high school adolescents (N = 15,214). Results: Caucasians and African Americans were significantly less likely to report depressed mood when compared to Hispanics and Others. Women were also more likely than men to report depressed mood. No significant differences were observed among levels of urbanicity and age. Conclusions: An understanding of the difference in the prevalence and correlates of depressed mood among adolescents of various ethnic/racial and gender groups deserves increased attention. Given the fact that challenges with depressed mood in adolescents can be substantial and relatively unrecognized, there is an increased need to identify these adolescents early and intervene with culturally appropriate interventions.

Objectives: To examine the association between depressed mood and clusters of health risk behaviors. Methods: A nationally representative sample of adolescents (N=15,214) was utilized to construct 10 pseudocontinuous health risk behaviors. Cluster analysis was performed to group adolescents, and subsequent multivariable logistic models were created. Results: Compared to non-risk takers, belonging to risk clusters significantly increased the odds of reporting depressed mood. African Americans in high-risk clusters appeared to be more vulnerable to depressed mood, when compared to remaining racial groups. Conclusions: Results suggest that adolescents engaging in multiple health-risk behaviors do so in the context of depressed mood.

Ms. K is a 19-year-old Caucasian female with no prior psychiatric diagnoses who presented to outpatient clinic with chief complaint of depressed mood. She reports depressed mood, low energy, low motivation, low self-esteem, anhedonia, and loss of appetite for past 2 months. She reports sleeping only 4 hours per night and denies daytime naps. She was diagnosed with major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorder, 5 edition in our outpatient clinic. She denies suicidal thought, homicidal thoughts, or plan. She denies hopelessness, worthlessness, and recurrent thoughts of death. She denies history of mania, psychosis, PTSD, eating disorder or OCD. She works as a server at a local restaurant. She denies tobacco, alcohol use and other illicit substance use. She doesn’t have history of inpatient hospitalization, suicide attempt or homicide attempt. She had not tried psychotropics in the past. She doesn’t have any medical illness and not on any current medications. She has history of nocturnal enuresis at age 6 improved and remitted with minimizing fluid intake before bedtime and enuresis alarm. She was started on fluoxetine 10mg daily for 7 days and increase to 20mg daily for depression. She came for follow up 4 weeks later. She reported significant improvement in her mood, energy, interest, and sleep. She has been sleeping 8 hours per night. During the follow up she denied depressed and other depressive symptoms. She reported onset of nocturnal enuresis 1 weeks after start of fluoxetine. She is reporting nocturnal enuresis 4 times a week. fluoxetine 20mg daily was decreased to 10mg daily however enuresis persisted. After discussing with patient, we decided to discontinue fluoxetine and start escitalopram 10mg daily for depression. 4 days later, patient reported that nocturnal enuresis resolved completely. Patient reached remission of her depressive symptoms on escitalopram 10mg daily. Case reports describing SSRI induced incontinence with paroxetine, sertraline have been published. Escitalopram is extremely selective for serotonergic transport proteins when compared with other antidepressant such as sertraline, fluoxetine, paroxetine, and fluvoxamine. Clinicians should keep in mind the possibility that enuresis may possible be either precipitated or exacerbated by SSRI. In this poster, we discuss fluoxetine induced enuresis, possible mechanism and bladder pathophysiology.

The health and mental health status of rural populations has often been neglected as a research priority; particularly in the case of rural youth. The purpose of this study is to examine the differences in depressed mood and suicide ideation of urban and rural youth and to determine what factors are associated with depressed mood and suicide ideation. More specifically, this study will examine depressed mood and suicide ideation of urban and rural youth (grades 5 to 8) in the Saskatoon Health Region (SHR) using data from the Student Health Survey. This project involved secondary data analysis of SHR’s Student Health Survey. There were 5,783 grade 5-8 students that participated in the survey. The final logistic regression models revealed similarities and differences between urban and rural youth in the risk factors that predicted the likelihood of students reporting symptoms of depressed mood and suicide ideation. For depressed mood, both urban and rural youth reported their relationship with their parents, their general mental health, low self-esteem, and suicide ideation as risk factors for depressed mood. Gender, age, having been drunk, and feeling like an outsider at school were risk factors for depressed mood in urban youth, while rural students reported that their living situation, their perception of their weight, being physically bullied, and being electronically bullied increased their likelihood of reporting symptoms of depressed mood. In terms of suicide ideation, both urban and rural youth were more likely to report depressed mood and a poor relationship with their parents as risk factors. Urban youth also reported being Aboriginal, that they had tried smoking, and being victims of physical bullying as risk factors. No additional risk factors were found for rural youth. This data will help to address local and national gaps in the literature about the mental health status of youth in rural populations. This research may inform policies and programming in both the health and education sectors.

The first year postpartum is often a challenging time for romantic partners. During this time, couples tend to experience less relationship intimacy and sexual satisfaction, which may be further exacerbated by individual stressors and vulnerabilities. Little is known about whether a maternal history of adverse life events and mental health prior to the infant’s birth negatively interfere with postpartum relationship and sexual well-being. Accordingly, the current study examined whether maternal trauma history, prenatal posttraumatic stress, and prenatal depressed mood were risk factors for poor postpartum couple adjustment. It also investigated whether perceiving a partner as motivated to meet one’s interest and disinterest in sexual activity, referred to as sexual communal strength for having sex (SCS for having sex) and sexual communal strength not having sex (SCS for not having sex), were buffers to relationship deterioration among mothers with this history of adversity. One hundred and sixty women (N = 160) who had completed an earlier study during pregnancy participated in a subsequent online survey between six and twelve months postpartum. Using path analysis to investigate the prospective relationships between maternal trauma history, prenatal mental health difficulties, and postpartum relationship and sexual well-being, trauma history was found to significantly predict sexual satisfaction and desire. Specifically, childhood maltreatment predicted poorer sexual well-being following childbirth, whereas adult sexual victimization predicted improved sexual well-being. No other pathways in the model were significant. Additionally, contrary to predictions, sexual communal strength did not moderate associations between maternal prenatal adversity and postpartum relationship outcomes in the primary analyses. However, follow-up analyses including only mothers who reported some symptoms of PTSD revealed that SCS for having sex moderated the association between these symptoms and relationship satisfaction. Results from this research highlight that childhood maltreatment likely has enduring detrimental implications for women’s sexual well-being as they transition- either again or for the first time - to motherhood. Further implications and directions for future research in this area are discussed. / Graduate

Labor may perhaps be the most painful a woman might experience, although characterized by large inter-individual variability. The perceived pain during labor is the result of diverse factors, i.e. her previous pain experiences, the analgesia she receives and maybe also her genes. The overall aim of this thesis was to investigate biological and psychological mechanisms underlying inter-individual differences in labor pain related behaviors. The mechanisms that characterize endogenous pain relief during labor are not fully understood, though it is known to be partly explained by the effects of β-endorphin (BE). BE plasma levels were followed longitudinally in a cohort of pregnant women and were found to remain unchanged between early and late pregnancy, although with a nadir in the beginning of the third trimester. Furthermore, women with low levels of BE in plasma at the end of the third trimester, required second line labor analgesia to a significantly higher extent than women with normal levels. In a population-based sample of 814 pregnant women we investigated if inter-individual differences in labor pain related behavior was influenced by the pain-protective single nucleotide polymorphism (SNP) combination of guanosine triphosphate cyclohydrolase (GCH1) and the opioid receptor µ-1 gene (OPRM1) A118G SNP. We identified a possible association between the pain-protective SNP combination of GCH1 and use of second line analgesia. No association was found between the OPRM1 and use of analgesia or labor pain related behavior. The association between self-rated antenatal depressed mood and anxiety in relation to pain behaviors and self-reported pain during labor was investigated. We found that depressed mood during pregnancy is associated with early arrival to the delivery department, whereas antenatal anxiety is associated with increased self-rated pain prior to labor analgesia.  In conclusion, although an increasing number of studies strongly suggest that genetic predisposition plays an important role in pain and pain-related mechanisms, GCH1 and OPRM1 has little to offer in terms of individual counseling on labor analgesia. To enable the future use of genetic variability for pre-labor testing and counseling, a number of different genes reflecting pain mediation pathways, involving biological and psychological mechanisms, need to be analyzed in combination.