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Depressionen gehören zu den häufigsten psychischen Erkrankungen. Neben Symptomen wie Niedergeschlagenheit, Interessenlosigkeit oder Schlafstörungen sind Depressionen auch durch Defizite in kognitiven Funktionen, wie z.B. Aufmerksamkeitsprozessen oder der Wahrnehmung, und eine negativ verzerrte Informationsverarbeitung gekennzeichnet. Aufgrund der hohen Prävalenz, der starken psychosozialen Funktionseinschränkungen durch depressive Erkrankungen und deren rezidivierenden Charakter besteht die Notwendigkeit, die therapeutischen Interventionen zur Behandlung affektiver Störungen zu verbessern, dadurch die Krankheitsphase der Patienten zu verkürzen und letztendlich auch die Kosten für das Gesundheitssystem zu reduzieren. In diesem Zusammenhang werden in den letzten Jahren verstärkt mögliche Prädiktoren und Korrelate des Therapieerfolgs untersucht. Hierfür könnten negativ verzerrte Informationsverarbeitungsprozesse und Defizite in kognitiven Funktionen objektive Marker darstellen. Im ersten Teil dieser Arbeit wurde der Covariation Bias, der als Überschätzung des Zusammenhangs zwischen einem krankheitsrelevanten Stimulus und einer aversiven Konsequenz definiert wird, in einem Querschnittsdesign bei schwer depressiven Patienten zu Behandlungsbeginn im Vergleich zu einer Gruppe von Patienten nach einer sechswöchigen Behandlung sowie einer gesunden Kontrollgruppe untersucht. Diese kognitive Verzerrung war bei Patienten mit schwererer Symptomatik unabhängig vom Behandlungszeitpunkt stärker ausgeprägt. Zudem prädizierte der Covariation Bias zu Behandlungsbeginn das Therapieoutcome nach sechs Behandlungswochen dahingehend, dass Patienten mit einer stärkeren kognitiven Verzerrung ein schlechteres Ansprechen auf die Therapie zeigten. Im zweiten Teil dieser Arbeit wurde das Emotional Processing Paradigma, das aus Aufgaben zur Emotionserkennung und zur Aufmerksamkeitslenkung besteht, zum ersten Mal bei schwer depressiven Patienten im intraindividuellen Verlauf der Behandlung eingesetzt und in Zusammenhang mit dem Therapieerfolg gestellt. Neben Hinweisen darauf, dass Patienten, bei denen sich in den ersten Behandlungswochen unter anderem die Salienz negativer Emotionen verringerte, mit höherer Wahrscheinlichkeit remittierten, zeigten sich vor allem zeitlich stabile Unterschiede im Sinne einer Trait-Variablen zwischen Patienten, die auf die initiale Therapie ansprachen, und Patienten, die keine bedeutsame Verbesserung erfuhren, in den globalen kognitiven Funktionen: Patienten, bei denen es zu keiner klinisch relevanten Verbesserung durch die Therapie kam, wiesen stärkere Defizite auf. Zusammengenommen weisen die Ergebnisse der vorliegenden Arbeit auf ein stabiles Muster von Defiziten in globalen kognitiven Funktionen bei Patienten mit Depressionen hin. Diese Abweichungen liegen jedoch nicht bei allen schwer depressiven Patienten gleichermaßen vor. Bei Patienten mit Defiziten scheint das Therapieoutcome schlechter zu sein. Somit könnten diese Prozesse der Informationsverarbeitung und kognitive Defizite auf neuropsychologischer Ebene Prädiktoren und Korrelate des Therapieoutcomes darstellen. Im Sinne der personalisierten Medizin könnte in Zukunft die Diagnostik um die Parameter der Informationsverarbeitungsprozesse ergänzt werden und so die Prognose des Therapieerfolgs verbessert und die Behandlung der Patienten individualisiert werden. / Depressive disorders are among the most frequent mental disorders. In addition to symptoms such as depressed mood, diminished interest or insomnia, depression is characterized by deficits in cognitive functions, e.g. attention or perception, and a negative biased information processing. Due to the high prevalence, severe impairments in social and occupational functioning and the recurring character of the disorder, there is a growing necessity of improving therapeutic interventions of affective disorders, in order to shorten time of suffering and to reduce costs in the health care system. In this context, potential predictors and correlates of therapy outcome were studied in recent years. Negative biases in information processing and cognitive deficits might represent objective markers. In the first part of this thesis, the covariation bias, defined as an overestimation of the relationship between disease-relevant stimulus and an aversive consequence, was investigated in patients with a severe depressive episode at admission, patients after a six-weeks antidepressant treatment and healthy controls in a between-group design. This type of cognitive bias was more pronounced in patients with a more severe symptomatic independent of course of treatment. Moreover, covariation bias at admission predicted therapy outcome after six weeks of treatment: Patients with a stronger bias showed an impaired treatment response. In the second part of this thesis, the emotional processing paradigm, which consists of emotion recognition and attentional vigilance tasks, was studied in severe depressive patients, and their intraindividual course of treatment and parameters were linked to therapy outcome. In addition to evidence that patients with a reduced salience of negative emotions after the first weeks of treatment remit with a higher probability, there were temporally stable differences in global cognitive functions between patients who responded to initial treatment and patients who did not improve: Patients without a clinically relevant improvement showed more severe deficits. In summary, the present findings suggest a stable pattern of global cognitive deficits in patients with depression. However, these deviations are not equally present in all patients with a severe depressive episode. In patients with deficits, therapy outcome seems to be impaired. Thus, information processing and cognitive deficits might constitute predictors and correlates of therapy outcome on neuropsychological level. In terms of personalized medicine, information processing parameters might thus complement the diagnostic process and individualize therapeutic interventions.

Background Depression is a common debilitating psychiatric disorder that is associated with high rates of mortality and morbidity and is a risk factor for type 2 diabetes and cardiovascular disease. Previous studies have shown that an increasing number of veterans have reported mental health or cognitive problems, with 19.5-22.8% reporting traumatic brain injury and 24.4% reporting Post Traumatic Stress Disorder. However, there are only limited studies reporting the trends of depression among U.S. veterans. Therefore, the aim of this study was to evaluate the prevalence and trend of depression among U.S. veterans. Methods Data used were from six biennial surveys of the National Health and Nutrition Examination Survey. The status of depression was screened using the Patient Health Questionnaire (PHQ-9). The weighted prevalence and its 95% confidence interval were calculated. Rao-Scott chi-square test measured bivariate association of depression and each exploratory variable. Cochran-Armitage trend test assessed depression prevalence trends. All analyses were performed with SAS 9.4 (SAS Institute, Inc). Results Between 2005 and 2016, 16.3% of veterans spent more than half of the days feeling tired or having little energy. Over 15.0% of veterans also reported having trouble sleeping more than half of the days in the past two weeks. The overall prevalence of depression among veterans peaked in 2011-2012 with 12.3% of veterans scoring 10 or greater on the PHQ-9. Among female veterans, there is a general increasing prevalence of depression, escalating from 9.0% in the 2007-2008 cycle to 14.8% in the 2015-2016 cycle. White veterans consistently had a higher prevalence of depression when compared to Black and Hispanic veterans. Conclusion Depression disparities existed in U.S. veterans and an increasing trend in prevalence were observed. Further research is needed to assess veterans that seek care outside of Veterans Affairs hospitals, as NHANES data only assess institutionalized individuals.

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The impact of environmental influences on depression has been well established by research. In particular, it is known that receiving/perceiving adequate social support has a protective influence on depression. Less is known about the protective benefits of providing support to others, namely in the form of altruistic, empathetic, or prosocial behavior. While research has shown that having altruistic attitudes and engaging in altruistic behaviors has a positive impact on physical health and mental well-being, studies on the association between altruistic attitudes and/or behavior and depression are limited. The present study examined the relationship between altruism and depression, and hypotheses were tested that allow for explanation of why altruism may protect against depression. A sample of 303 participants was recruited from the University of North Texas and the surrounding community. Participants completed an online survey that examined their altruistic activities, details regarding these activities, their prosocial attitudes, and their current level of depression. Results did not support that level of involvement in altruistic activities is directly related to depression severity. However, outcomes from involvement in altruistic activities, including sense of overburden from participating in altruistic activities, level of social interaction with other helpers and those helped during altruistic activities, and sense of life satisfaction and purpose gained from participating in altruistic activities, were significantly related to depression severity. These results suggest that participating in altruistic activities that are not perceived as overburdening may lead to outcomes that could positively impact depression. Limitations and directions for future research are discussed.

Thesis (Ph.D.)--Boston University / This study represents an attempt to investigate the nature of depressive psychopathology within the context of psychoanalytic theory. It poses two major research questions: can depressed patients be differentiated on the basis of particular ego states according to Bibring's theory; and will such a classification system be useful clinically and theoretically?

TITLE: Gender differences in substance use and depression among caregivers AUTHOR INFO Memunat Ogunmefun Manik Ahuja Author Affiliations: College of Public Health, East Tennessee State University, Johnson City, TN 37614, United States Background: Around 20% of adults in the United States provide care for a loved one, with approximately 61% of these caregivers identifying as women. Typically, a caregiver is defined as someone who provides help and support to a family member or friend who is facing illness or disability as a result of a medical condition. Caregiving may be rewarding, but it can also cause significant psychological strain, leading to adverse consequences, such as turning to substance use to cope with stress. Increased levels of stress in caregivers can make them more susceptible to various health problems, such as depression and anxiety disorders, sleep disturbances, compromised physical health, cardiovascular disease, and substance use disorders. The aim of this study is to examine the gender differences in substance use and depression among caregivers using a nationally representative sample. Methods: We used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System a nationally representative U.S. telephone-based survey of adults aged 18 years and extracted data for non-metropolitan/rural counties. Logistic regression analyses were conducted separately to test the association between self-identified caregiver status and three outcomes, including depression and current alcohol use. We controlled for past month’s income, race, educational status, and age. Caregiver status was identified based on providing care or assistance to a friend or family member over the last 30 days. Results: Overall, 21.7% (n=13,653) of our participants self-identified as a caregiver, while 19.5% reported depression, past month alcohol use (48.2%), past month smoking (13.5%), and past month marijuana use (4.2%). Significant interactions were found between caregiver status and gender (p=.0001). We then stratified by gender. Among males, self-identified caregiver status was associated with higher odds of depression (OR=1.48, 95% CI, 1.41,1.55). Among females, caregiver status was associated with higher odds of depression (OR=1.48, 95% CI, 1.29, 1.39). Caregiver status did not predict alcohol use. Conclusion: Caregiving has been known to cause psychological strain which may be associated with alcohol use and depression. According to this study, being a caregiver may contribute to depression regardless of gender, but it does not necessarily affect alcohol consumption. The gender differences observed in this study highlight the need for interventions and support programs that are tailored to meet the unique needs and challenges faced by male and female caregivers. It is important for healthcare professionals to consider caregiver status and gender when assessing mental health risk factors.

The specific aim of this research is to discuss ways that LGBTQ+ Asian Americans’ depression is measured and if there is a correlation into assimilating with U.S. Culture. Additionally, a review the current literature will be conducted on factors that contribute to identifying characteristics that are tied to adolescent depression and determine if increased levels of depression are found in Asian American immigrants and their families. This research will delve into the reasons why Asian-Americans who identify as LGBTQ+ have increased depression levels and what factors contribute to an elevated level of depression. Furthermore, we discover what further actions in research can be implemented to guide research in depression intervention specifically in LGBTQ+ youth in America.

Grit, or the ability to persevere toward a long-term goal despite adversity, has been linked to academic success. Grit may also potentially buffer against the negative effects of depressive symptoms in an academic domain. The current study explores the relationship between depression, grit, and GPA, while also accounting for defensive responding, which has been proposed as a confound of grit but not empirically assessed in this context. We examined how social desirability affects the relationship between grit and GPA and hypothesized that social desirability would moderate the effect of grit between depressive symptoms and GPA. We found support for all hypothesized direct relationships. However, the interaction between depression, grit, social desirability, and GPA was non-significant. Results suggested modest construct validity of grit with it predicting GPA at low levels of social desirability but demonstrated no buffering effect against depression on GPA, highlighting the complexity of the relationship between these variables.