Relationship between erythrocyte fatty acid composition and psychopathology in the Vienna omega-3 study

This study investigated the relationship between erythrocyte membrane fatty acid (FA) levels and the severity of symptoms of individuals at ultra-high risk (UHR) for psychosis. Subjects of the present study consisted of 80 neuroleptic-naïve UHR patients. Partial correlation coefficients were calculated between baseline erythrocyte membrane FA levels, measured by gas chromatography, and scores on the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning Scale, and Montgomery-Asberg Depression Rating Scale (MADRS) after controlling for age, sex, smoking and cannabis use. Subjects were divided into three groups according to the predominance of positive or negative symptoms based on PANSS subscale scores; membrane FA levels in the three groups were then compared. More severe negative symptoms measured by PANSS were negatively correlated with two saturated FAs (myristic and margaric acids), one ω-9 monounsaturated FA (MUFA; nervonic acid), and one ω-3 polyunsaturated FA (PUFA; docosapentaenoic acid), and were positively correlated with two ω-9 MUFAs (eicosenoic and erucic acids) and two ω-6 PUFAs (γ-linolenic and docosadienoic acids). More severe positive symptoms measured by PANSS were correlated only with nervonic acid. No associations were observed between FAs and MADRS scores. In subjects with predominant negative symptoms, the sum of the ω-9 MUFAs and the ω-6:ω-3 FA ratio were both significantly higher than in those with predominant positive symptoms, whereas the sum of ω-3 PUFAs was significantly lower. In conclusion, abnormalities in FA metabolism may contribute to the neurobiology of psychopathology in UHR individuals. In particular, membrane FA alterations may play a role in negative symptoms, which are primary psychopathological manifestations of schizophrenia-related disability.

Randomised controlled trial of a digitally assisted low intensity intervention to promote personal recovery in persisting psychosis: SMART-Therapy study protocol

BACKGROUND: Psychosocial interventions have an important role in promoting recovery in people with persisting psychotic disorders such as schizophrenia. Readily available, digital technology provides a means of developing therapeutic resources for use together by practitioners and mental health service users. As part of the Self-Management and Recovery Technology (SMART) research program, we have developed an online resource providing materials on illness self-management and personal recovery based on the Connectedness-Hope-Identity-Meaning-Empowerment (CHIME) framework. Content is communicated using videos featuring persons with lived experience of psychosis discussing how they have navigated issues in their own recovery. This was developed to be suitable for use on a tablet computer during sessions with a mental health worker to promote discussion about recovery.

METHODS/DESIGN: This is a rater-blinded randomised controlled trial comparing a low intensity recovery intervention of eight one-to-one face-to-face sessions with a mental health worker using the SMART website alongside routine care, versus an eight-session comparison condition, befriending. The recruitment target is 148 participants with a schizophrenia-related disorder or mood disorder with a history of psychosis, recruited from mental health services in Victoria, Australia. Following baseline assessment, participants are randomised to intervention, and complete follow up assessments at 3, 6 and 9 months post-baseline. The primary outcome is personal recovery measured using the Process of Recovery Questionnaire (QPR). Secondary outcomes include positive and negative symptoms assessed with the Positive and Negative Syndrome Scale, subjective experiences of psychosis, emotional symptoms, quality of life and resource use. Mechanisms of change via effects on self-stigma and self-efficacy will be examined.

DISCUSSION: This protocol describes a novel intervention which tests new therapeutic methods including in-session tablet computer use and video-based peer modelling. It also informs a possible low intensity intervention model potentially viable for delivery across the mental health workforce.

Examination of a multi-factorial model of body-related experiences during pregnancy : the relationships among physical symptoms, sleep quality, depression, self-esteem, and negative body attitudes

The aim of this cross-sectional study was to investigate relationships among women's body attitudes, physical symptoms, self-esteem, depression, and sleep quality during pregnancy. Pregnant women (N = 215) at 15–25 weeks gestation completed a questionnaire including four body image subscales assessing self-reported feeling fat, attractiveness, strength/fitness, and salience of weight and shape. Women reported on 29 pregnancy-related physical complaints, and completed the Beck Depression Inventory, Rosenberg Self-esteem Scale, and Pittsburgh Sleep Quality Index. In regressions, controlling for retrospective reports of body image, more frequent and intense physical symptoms were related to viewing the self as less strong/fit, and to poorer sleep quality and more depressive symptoms. In a multi-factorial model extending previous research, paths were found from sleep quality to depressive symptoms to self-esteem; self-esteem was found to be a mediator associated with lower scores on feeling fat and salience of weight and shape, and on higher perceived attractiveness.

Negative reactivity and parental warmth in early adolescence, and depressive symptoms in emerging adulthood

ObjectiveCross-sectional research suggests that relationships between temperamental negative reactivity and adolescent depressive symptoms may be moderated by parental warmth. The primary purpose of this study was to conduct the first prospective analysis of this relationship.MethodData from 1,147 families in an Australian population-based longitudinal study were used to examine: (1) temporal relationships between negative reactivity in early adolescence (13–14 years) and depressive symptoms in emerging adulthood (19–20 years); (2) the moderating role of parent-reported warmth in early adolescence (13–14 years); and (3) the moderating role of child gender. Hierarchical multiple regression was conducted to test the hypothesis that parental warmth would moderate the relationship between early adolescent negative reactivity and depressive symptoms in emerging adulthood.ResultsAfter accounting for previous depressive symptoms at age 13–14 years, negative reactivity was positively associated with later depressive symptoms. By contrast, parental warmth at 13–14 years was negatively associated with later depressive symptoms for females but not males. Parental warmth did not moderate the association between early adolescent negative reactivity and subsequent depressive symptoms.ConclusionsThis study was the first to use prospective data to assess the protective effects of early adolescent parental warmth on the association between negative reactive temperaments and early adult depressive symptoms. Findings suggest that parental warmth for negatively reactive children provides only concurrent protection against subsequent depressive risk. This study did not examine parent–child transactional models, which may, in future longitudinal research, improve understanding of how trajectories of parent–child goodness-of-fit contribute to depressive symptoms.

Sex-role traits and the comorbidity of symptoms of disordered eating and problem drinking

The symptoms of problem drinking and disordered eating were studied independently in relation to sex-role traits and also for evidence of comorbidity in a student sample of 217 women. The participants completed surveys that assessed positive and negative sex-role traits, reported drinking levels, alcohol dependence, problem drinking, bulimic symptoms, dietary restraint, and drive for thinness. Eating symptoms were related to both the negative and positive traits of Femininity, but self-descriptions involving negative traits (passivity, dependence, unassertiveness, etc.) showed the strongest relationship. High scores on identification with the traits typically labelled as Masculinity were related to drinking but there was an important difference between drinking per se (which was related to Positive Masculinity) and drinking found to be associated with drinking problems, which was related to Negative Masculinity (aggression, showing-off, rudeness, etc.). Feminine traits were also related to drinking. Low identification with the traits of Negative Femininity was associated with non-problem drinking, whereas low identification with the traits of Positive Femininity were associated with problem-related drinking. Young women who displayed comorbid symptoms described themselves by a high identification with the traits of both Negative Masculinity and Negative Femininity. It was argued that comorbidity reveals a more extreme form of the sex-role conflict previously described in relation to disordered control over both eating and drinking when considered independently.

Negative perceptions about self-control and identification with gender-role stereotypes related to binge eating, problem drinking, and to co-morbidity among adolescents

Purpose
To examine the role of both positive and negative styles of self-control, and gender-role stereotypes in binge eating and problem drinking.

Method
Participants were 428 adolescent boys and 555 girls from predominantly Anglo-Australian backgrounds who attended regional state schools in New South Wales, Australia. Students completed standardized questionnaires that assessed problem drinking, binge eating, self-control styles, and identification with gender-role stereotypes. ANOVA and post hoc Tukey tests were conducted to examine differences among adolescents who reported problems in binge eating, drinking, and both domains.

Results
Adolescents who reported eating and drinking problems also reported a high negative and a low positive sense of self-control coupled with self-identification with the traits that typically describe negative dimensions of gender-role stereotypes. Regardless of gender, problem drinking was mainly related to traits of negative masculinity (bossy, noisy aggressive, etc.) whereas binge eating was mainly related to negative femininity (shy, needs approval from others, etc.). Participants who reported eating and drinking symptoms recorded low scores on positive control, high scores on negative control, and also high scores on the negative dimensions of masculinity and femininity.

Summary
A negative and passive style of self-control coupled with an identification with negative dimensions of gender summarizes the type of self-regulation that is implicated in both binge eating and problem drinking, and co-morbid symptoms. There is a need for interventions working toward a more balanced gender self-concept and a positive sense of self-control.

Psychoeducational approaches to managing behavioural symptoms of dementia

Behavioural symptoms of dementia, such as wandering, aggression, and restlessness, are commonly manifested by residents of long-term residential facilities, and are associated with a range of negative outcomes. This paper reviews the literature on the efficacy of psychoeducation programs to improve the skills of residential care staff in managing these symptoms. The benefits and limitations of this approach are illustrated through presentation of case studies from clinical practice, with a focus on organisational and motivational factors. Preliminary data from a psychoeducation program delivered by an Aged Persons Mental Health Team are presented. Recommendations are made for future research and practice.

Physical activity correlates in young women with depressive symptoms : a qualitative study

Background
Young women are at high risk for developing depression and participation in physical activity may prevent or treat the disorder. However, the influences on physical activity behaviors of young women with depression are not well understood. The aim of this study was to gather in-depth information about the correlates of physical activity among young women with and without depressive symptoms.

Methods
A sample of 40 young women (aged 18-30 years), 20 with depressive symptoms (assessed using the CES-D 10) and 20 without depressive symptoms participated in one-on-one semi-structured interviews. A social-ecological framework was used, focusing on the individual, social and physical environmental influences on physical activity. Thematic analyses were performed on transcribed interview data.

Results
The results indicated several key themes that were unique to women with depressive symptoms. These women more often described negative physical activity experiences during their youth, more barriers to physical activity, participating in more spontaneous than planned activity, lower self-efficacy for physical activity and being influenced by their friends' and family's inactivity.

Conclusions
Interventions designed to promote physical activity in this important target group should consider strategies to reduce/overcome early life negative experiences, engage support from family and friends and plan for activity in advance.

Family interactions and the development of borderline personality symptoms

This thesis investigated the emergence of borderline personality disorder in adolescence. It found that adolescent sensitivity to, and maternal socialization of, aggressive behaviour is associated with borderline pathology. Change in pathology over time was related to adolescent dysphoric behaviour and sensitivity to inconsistent displays of maternal negative emotion.

Training patterns and negative health outcomes in triathlon : longitudinal observations across a full competitive season

AIM: Despite heavy training requirements, triathlon is a sport that is rapidly increasing in popularity. Yet, there is limited research detailing the relationship between training, the incidence of injuries and illness, psychological stress, overtraining and athlete burnout amongst triathletes. Six hypotheses relating inter-individual differences to training factors were generated to evaluate change in self-reported measures of these negative health outcomes over a training year.

METHODS: Thirty, well-trained, triathletes (males n=20: age=27.1±9.1 years and females n=10: age=27.4±6.6 years) from a local triathlon club participated in this study. The study commenced during pre-season training, and involved weekly monitoring of each athlete until the end of the competitive season 45 weeks later. Linear Mixed Modelling was used for the analysis.

RESULTS: Signs and symptoms of injury and illness (SAS) were significantly associated with increases in training factors (P≤0.05); however, greatest impact on SAS was produced by psychological stressors (P≤0.001). Common symptoms of overtraining were significantly affected by increases in exposure to both training and psychological stressors (P≤0.05). Mood disturbance was not significantly affected by training factors (P>0.05) but rather increases in psychological stressors (P≤0.001). Finally, each of the three athlete burnout subscales were significantly affected by both psychological (P≤0.001) stressors as well as varying combinations of training factors (P≤0.05).

CONCLUSIONS: Exposure to stressors (either training or psychological) had significant effects on all negative health outcomes assessed.

Characterization of the improvement in depressive symptoms following Bariatric surgery

Background : The Beck Depression Inventory (BDI) has been frequently employed as a measure of depression in studies of obesity, with the majority of studies reporting an improvement in scores following weight loss. Given the potential similarity in obesity-related and depressive symptoms, it is uncertain whether all components of depression would improve equally with weight loss.

Method : The study included obese patients who had undergone laparoscopic adjustable gastric banding (LAGB) surgery and had completed BDIs at baseline and 1 year after surgery. Two groups of patients were included, a general background group (N = 191, mean age = 41 ± 9, mean BMI = 43 ± 8) and a group identified as experiencing elevated depressive symptoms based on BDI scores ≥23 (EDS group; (N = 67, mean age = 40 ± 9, mean BMI = 45 ± 7).

Results : Overall, BDI scores fell for both groups, background group at baseline 17 ± 9–8 ± 7 at 1 year and for the EDS group at baseline 30 ± 5–14 ± 10 at 1 year. Patient scores on the negative self-attitude subscale were significantly greater than the two other subscales and showed the greatest improvement 1 year following LAGB. Preexisting antidepressant therapy had little or no association on the BDI scores or on its change following weight loss.

Conclusion : High rates of depression are continually reported in obesity, as is a remarkable decrease in depressive symptoms following weight loss. Negative attitudes towards one’s self appears to be driving elevated BDI scores rather than the overlap in physical symptoms between obesity and depression.

Metacognitive, cognitive and developmental predictors of generalised anxiety disorder symptoms

Generalised anxiety disorder (GAD) is the most significant and common of the anxiety disorders. Intolerance of uncertainty (IU) and negative metacognitive beliefs are two prominent cognitive factors in models of GAD, however only one study to date has examined the relative contribution of these factors. Therefore, this study aimed to investigate and compare these cognitive factors in their prediction of GAD symptoms, and also to examine possible developmental influences on GAD by examining the link between symptoms and the parentification style of childrearing. In this analogue study, 119 non-clinical participants (M age 22.90 years; 95 females, 24 males) completed measures of these constructs. Results indicated that both IU and negative beliefs about worry significantly related to GAD symptoms, however, the degree to which they predicted GAD symptoms did not significantly differ. Although a weak but significant relationship was found between parentification and GAD, this relationship did not remain significant after controlling for depression. Implications and limitations are discussed.