Depressive Symptom Trajectories and Early Adult Education and Employment: Comparing Longitudinal Cohorts in Canada and the United States.
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ABSTRACT:
SUBMITTER: Minh A
PROVIDER: S-EPMC8073553 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objective: Psychotherapy for depression is effective for many veterans, but the relationship between number of treatment sessions and symptom outcomes is not well established. The Dose-Effect model predicts that greater psychotherapeutic dose (total sessions) yields greater symptom improvement with each additional session resulting in smaller session-to-session improvement. In contrast, the Good-Enough Level (GEL) model predicts that rate of symptom improvement varies by total psychotherapeutic dose with faster improvement associated with earlier termination. This study compared the dose-effect and GEL model among veterans receiving psychotherapy for depression within the Veterans Health Administration. Method: The sample included 13,647 veterans with ≥2 sessions of psychotherapy for depression with associated Patient Health Questionnaire-9 (PHQ-9) scores in primary care (n = 7,502) and specialty mental health clinics (n = 6,145) between October 2014 and September 2018. Multilevel longitudinal modeling was used to compare the Dose-Effect and GEL models within each clinic type. Results: The GEL model demonstrated greater fit for both clinic types relative to dose-effect models. In both treatment settings, veterans with fewer sessions improved faster than those with more sessions. In primary care clinics, veterans who received 4-8 total sessions achieved similar levels of symptom response. In specialty mental health clinics, increased psychotherapeutic dose was associated with greater treatment response up to 16 sessions. Veterans receiving 20 sessions demonstrated minimal treatment response. Conclusions: These findings support the GEL model and suggest a flexible approach to determining length of psychotherapy for depression may be useful for optimizing treatment response and allocation of clinical resources. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Project description:BackgroundDepressive symptoms show different trajectories throughout childhood and adolescence that may have different consequences for adult outcomes.AimsTo examine trajectories of childhood depressive symptoms and their association with education and employment outcomes in early adulthood.MethodWe estimated latent trajectory classes from participants with repeated measures of self-reported depressive symptoms between 11 and 24 years of age and examined their association with two distal outcomes: university degree and those not in employment, education or training at age 24.ResultsOur main analyses (n = 9399) yielded five heterogenous trajectories of depressive symptoms. The largest group found (70.5% of participants) had a stable trajectory of low depressive symptoms (stable-low). The other four groups had symptom profiles that reached full-threshold levels at different developmental stages and for different durations. We identified the following groups: childhood-limited (5.1% of participants) with full-threshold symptoms at ages 11-13; childhood-persistent (3.5%) with full-threshold symptoms at ages 13-24; adolescent onset (9.4%) with full-threshold symptoms at ages 17-19; and early-adult onset (11.6%) with full-threshold symptoms at ages 22-24. Relative to the majority 'stable-low' group, the other four groups all exhibited higher risks of one or both adult outcomes.ConclusionsAccurate identification of depressive symptom trajectories requires data spanning the period from early adolescence to early adulthood. Consideration of changes in, as well as levels of, depressive symptoms could improve the targeting of preventative interventions in early-to-mid adolescence.
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Project description:Using five waves of the Taiwanese Longitudinal Study of Aging (1996-2011), we investigate (1) the association between family members' education and the age trajectories of individuals' depressive symptoms and (2) gender differences in those relationships. Our examination is guided by several theoretical frameworks, including social capital, social control, age as leveler, and resource substitution. Nested models show that having a more educated father is associated with lower depressive symptoms, but the relationship disappears after controlling for respondent's education. Including spouse's education attenuates the coefficient for respondent's education. A similar pattern appears when children's education is added to the model. Among all the family members, children's education has the strongest association with depressive symptoms, with a similar magnitude for both genders, although its strength gradually weakens as respondents age. Our findings suggest the importance of the transfer of resources from children to parents and how it may affect mental health at older ages.
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Project description:This study analyzed China Health and Retirement Longitudinal Study data to explore the HbA1c-depression link, including depressive trajectories, while considering the mitigating impact of healthy lifestyles. Cross-lagged panel models and group-based trajectory modeling were performed to investigate the temporal relationship between HbA1c levels and depressive symptoms, as well as the depressive trajectories. Structural equation models were used to assess the mediating effects of healthy lifestyles. The mean age of the participants was 57.66 ± 9.04 years, with 53.68% being female. Analyzing 8826 participants across three waves, we observed a significant prediction of subsequent depressive symptoms by the preceding HbA1c levels (β = 0.296; p < 0.001). Four distinct trajectories of depressive symptoms were distinguished: stable low, stable moderate, increasing, and stable high. Elevated HbA1c levels were associated with a higher risk of developing stable high (OR 1.12 and 95% CI 1.02-1.23), increasing (OR 1.21 and 95% CI 1.11-1.32), and stable moderate depressive symptoms (OR 1.07 and 95% CI 1.01-1.13). Engaging in two healthy life behaviors reduced stable high and increasing depressive pattern risks by 32% and 30%, respectively. Adherence to a healthy lifestyle lessened 7.2% of the impact of high HbA1c levels on the subsequent depressive symptoms. These findings highlight the potential benefits of incorporating adequate sleep and light physical activities, which might reduce the adverse impact of elevated HbA1c levels on depressive symptoms.
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Project description:Resilient, undercontrolled, and overcontrolled personality types have been identified across the life span and are associated with psychiatric symptoms and functioning. However, it is unknown whether these types are identifiable in preschool-aged children using observational indices or whether they predict longitudinal outcomes. The current study used observationally coded five-factor model (FFM) traits in a sample of preschoolers to identify whether personality traits cluster into types, whether types predict psychiatric symptoms and impairment across development, and whether types better predict outcomes than trait dimensions. Using a validated "thin slice" approach, preschool personality was observationally coded in a clinically enriched sample oversampled for depression (N = 299). Latent class analysis tested how FFM dimensions organized into types, identifying resilient, undercontrolled, and overcontrolled preschoolers. Types demonstrated baseline diagnostic differences and multilevel models indicated above baseline diagnoses, undercontrolled children exhibited elevated externalizing symptoms and worse functioning across development, whereas overcontrolled and resilient children did not differ. Personality types and dimensions both provided similar predictive utility. Resilient, undercontrolled, and overcontrolled personality types are identifiable using FFM observational coding in clinically heterogeneous preschoolers and undercontrolled children demonstrated the most severe trajectories. Findings highlight that personality types are detectable at early ages and have unique predictive power for psychiatric outcomes across development compared with dimensions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Project description:The inhomogeneity of postpartum mood and mother-child attachment was estimated from immediately after childbirth to 12 weeks postpartum in a cohort of 598 young mothers. At 3-week intervals, depressed mood and mother-child attachment were assessed using the EPDS and the MPAS, respectively. The diagnosis was based on clinical interviews at the end of the 12-week follow-up. The latent class mixed model estimated multiple distinct patterns in depressed mood and mother-child attachment. The baseline EPDS cluster contained 72% of the study population and showed low EPDS values during the follow-up period, while the five remaining clusters showed either deterioration or improvement of the EPDS levels. The majority of women with postpartum depression showed deteriorating, and the majority of adjustment disorder cases improving, behavior. While the cases with more pronounced EPDS values were found to constitute more homogeneous clusters in terms of diagnosis, subclinical or only temporarily increased EPDS levels represented less homogeneous clusters. Higher EPDS levels correlated with the higher risk factor profiles. The four MPAS/EPDS clusters demonstrated that higher EPDS lead to lower mother-child attachment, and vice versa.
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Project description:BackgroundAdverse childhood experiences (ACEs) tend to cluster together in daily life, and most studies focus on the level of depression at certain points, but the dynamic process of depression is often neglected. Thus, research is urgently needed to explore the relationship between ACEs pattern and trajectory of depressive symptom levels at multiple time points in order to provides early targeted interventions to those who are most at risk.ObjectiveWe aimed to explore patterns of ACEs, including types and timing, associated with depression trajectories in college students.MethodsA school-based health survey was used to collect data as part of a longitudinal study in two medical college in Anhui province, China. Questionnaires were issued to 3,662 participants aged 17-22 and recorded details of ACEs (types and timing) and depression. Latent class analysis (LCA) was used to identify "patterns" of ACEs type and timing. Depressive symptom trajectories employed latent class growth analysis (LCGA). Multiple logistic regressions were employed to evaluate the relationships between ACEs patterns and depressive symptom trajectories.ResultsWe identified five ACEs patterns: "High neglect/emotional abuse/community violence," "High neglect/emotional abuse," "High neglect/family dysfunction," "High neglect," "Low ACEs." We traced three depression trajectories: "High depressive symptom" "Moderate depressive symptom," "Low depressive symptom." "High neglect/emotional abuse/community violence," "High neglect/emotional abuse" and "High neglect/family dysfunction" demonstrated a high risk for "High depressive symptom" and "Moderate depressive symptom." "High neglect" showed a high risk for "Moderate depressive symptom" but not for "High depressive symptom" (P < 0.05).ConclusionsThe findings address the need for a comprehensive consideration of exposure to childhood adversity associated with the risk of depression in young adults through identifying more problematic ACEs patterns amongst exposed children.
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Project description:BackgroundAdolescence is characterized by increasing prevalence of depressive symptomatology, along with significant structural brain development. While much research has examined focal abnormalities in gray matter structure underlying depression, we employed a structural coupling approach to examine whether longitudinal associations between amygdala and cortical development (referred to as maturational coupling) was related to concurrent changes in depressive symptomatology during adolescence.Method166 participants underwent up to three MRI scans (367 scans) between 11 and 20 years of age. Depressive symptoms were measured at three coinciding time points using the Center for Epidemiological Studies-Depression scale. Linear mixed models were employed to identify whether change in amygdala volume was related to development of cortical thickness, and if maturational coupling of these regions was related to changes in depressive symptomatology.ResultsPositive maturational coupling was identified between the right amygdala and (predominantly anterior) prefrontal cortex, as well as parts of the temporal cortices. Greater positive coupling of these regions was associated with reductions in depressive symptoms over time.ConclusionsFindings highlight significant associations between cortico-amygdalar maturational coupling and the emergence of depressive symptoms during adolescence, suggesting that synchronous development of these regions might support more adaptive affect regulation and functioning.
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Project description:Objective This longitudinal study aimed to measure precarious employment in the US using a multidimensional indicator. Methods We used data from the National Longitudinal Survey of Youth (1988-2016) and the Occupational Information Network database to create a longitudinal precarious employment score (PES) among 7568 employed individuals over 18 waves (N=101 290 observations). We identified 13 survey indicators to operationalize 7 dimensions of precarious employment, which we included in our PES (range: 0-7, with 7 indicating the most precarious): material rewards, working-time arrangements, stability, workers' rights, collective organization, interpersonal relations, and training. Using generalized estimating equations, we estimated the mean PES and changes over time in the PES overall and by race/ethnicity, gender, education, income, and region. Results On average, the PES was 3.17 [standard deviation (SD) 1.19], and was higher among women (3.34, SD 1.20), people of color (Hispanics: 3.24, SD 1.23; non-Hispanic Blacks: 3.31, SD 1.23), those with less education (primary: 3.99, SD 1.07; high school: 3.43, SD 1.19), and with lower-incomes (3.84, SD 1.08), and those residing in the South (3.23, SD 1.17). From 1988 to 2016, the PES increased by 9% on average [0.29 points; 95% confidence interval (CI) 0.26-0.31]. While precarious employment increased over time across all subgroups, the increase was largest among males (0.35 points; 95% CI 0.33-0.39), higher-income (0.39 points; 95% CI 0.36-0.42) and college-educated (0.37 points; 95% CI 0.33-0.41) individuals. Conclusions Long-term decreases in employment quality are widespread in the US. Women and those from racialized and less-educated populations remain disproportionately precariously employed; however, we observed the largest increases among men, college graduates and higher-income individuals.
| S-EPMC8126438 | biostudies-literature
Project description:ImportanceDepressive symptoms during pregnancy influence the development and health of the offspring, underscoring the need for timely intervention. However, the course of depressive symptoms across the perinatal period remains unclear, thus complicating screening and referral guidelines.ObjectiveTo examine the course and stability of depressive symptoms across the perinatal period in multiple, ethnically diverse independent observational cohorts.Design, setting, and participantsThis cohort study included self-reported depressive symptoms at multiple time points from 7 prospective cohorts spanning 3 continents (United Kingdom: Avon Longitudinal Study of Parents and Children from 1991 to 1995; Canada: Maternal Adversity, Vulnerability and Neurodevelopment from 2003 to 2007; Montreal Antenatal Well-being Study from 2019 to 2022; Alberta Pregnancy Outcomes and Nutrition from 2009 to 2014; and Singapore: Growing Up in Singapore Toward Healthy Outcomes from 2009 to 2013; Singapore Preconception Study of Long-Term Maternal and Child Outcomes from 2015 to 2019; and Mapping Antenatal Maternal Stress from 2019 to 2022). Participants were recruited either during preconception or pregnancy and observed into the postnatal period. All data from each cohort were analyzed from July 2022 to April 2023.Main outcomes and measuresSelf-reported depressive symptoms from pregnancy to 2 years following childbirth using either the Edinburgh Postnatal Depression Scale or the Center for Epidemiological Studies Depression were analyzed independently within each cohort using item response theory (IRT) techniques. K-means clustering was used to identify groups of participants with similar trajectories.ResultsA total of 11 563 pregnant women (mean [SD] age, 29 [5] years; 569 [4.9%] East Asian women; 304 [2.6%] Southeast Asian women; 10 133 [87.6%] White women) self-reported depressive symptoms from pregnancy to 2 years following childbirth. Analytic methods from Item Response Theory identified 3 groups of mothers based on depressive symptoms: low, mild, and high levels in each of the 7 cohorts. Mothers within and across all cohorts had stable trajectories of maternal depressive symptoms from pregnancy onwards. Mothers with clinical levels of depressive symptoms likewise showed stable trajectories from pregnancy into the postnatal period.Conclusions and relevanceIn this study, trajectories of depressive symptoms remained stable from pregnancy across the perinatal period, a finding that conflicts with a continuing emphasis on postpartum or postnatal onset of depression that persists in some health policy guidelines. Interventions and public health initiatives should focus on reducing depressive symptoms during pregnancy in addition to following birth.
| S-EPMC10603499 | biostudies-literature