Validity of the Beck Depression Inventory as a screening tool for a clinical mood disorder in Bariatric surgery candidates

Background : The Beck Depression Inventory (BDI) is one of the most commonly used instruments to assess depression in persons with obesity. While it has been validated in normal and psychiatric populations, in obese populations, its validity remains uncertain. This study aimed to investigate the validity and reliability of the BDI-IA and BDI-II in severely obese bariatric surgery candidates.

Methods : Consecutive new candidates at a bariatric surgery clinic were invited to participate in the study by their consulting surgeon. All candidates were assessed using the Structured Clinical Interview for DSM-IV Disorders (SCID-I); 118 completed the BDI-IA and 83 completed the BDI-II. Two hundred one patients (response rate, 88 %) participated in the study. The current sample (82 % female) had an average body mass index of 42.83 ± 6.34 and an average age of 45 ± 12 years.

Results : Based on the SCID-I, 54 candidates (26.9 %) met the criteria for a mood disorder, with 37 meeting the criteria for current major depressive disorder. Individuals diagnosed with a clinical mood disorder had significantly higher scores on the BDI (BDI-IA, 23.59 ± 9.69 vs. 12.76 ± 8.29; BDI-II, 22.93 ± 5.22 vs. 11.25 ± 8.44). Our results indicated that, as a screening tool for a clinical mood disorder, the BDI-II had an optimal cutoff of 13, with a sensitivity of 100 and specificity of 67.75.

Conclusions : Results indicated that the BDI-IA should not be used as a tool to measure depressive symptomatology in obese bariatric surgery candidates. No cutoff was identified with adequate sensitivity and specificity, and over 20 % of patients were misclassified. As a screening tool for a clinical mood disorder, the BDI-II was adequate; however, prevalence rates were significantly overestimated.

Confirmatory factor analysis of the Beck Depression inventory in obese individuals seeking surgery

Background : The Beck Depression Inventory (BDI) is frequently employed as measure of depression in studies of obesity. The aim of the study was to assess the factorial structure of the BDI in obese patients prior to bariatric surgery.

Methods : Confirmatory factor analysis was conducted on the current published factor analyses of the BDI. Three published models were initially analysed with two additional modified models subsequently included. A sample of 285 patients presenting for Lap-Band® surgery was used.

Results : The published bariatric model by Munoz et al. was not an adequate fit to the data. The general model by Shafer et al. was a good fit to the data but had substantial limitations. The weight loss item did not significantly load on any factor in either model. A modified Shafer model and a proposed model were tested, and both were found to be a good fit to the data with minimal differences between the two. A proposed model, in which two items, weight loss and appetite, were omitted, was suggested to be the better model with good reliability.

Conclusions : The previously published factor analysis in bariatric candidates by Munoz et al. was a poor fit to the data, and use of this factor structure should be seriously reconsidered within the obese population. The hypothesised model was the best fit to the data. The findings of the study suggest that the existing published models are not adequate for investigating depression in obese patients seeking surgery.

Ulrich Beck's cosmopolitanisation thesis : a philosophical critique

For Ulrich Beck, the Enlightenment project aimed to subordinate religious truth to the authority of reason in questions of the true and the good, and thus to replace religious conflict with peace. Although the ‘First Modernity’ delivered risks like climate change rather than progress like peace, Beck discerns signs of hope for the Enlightenment project in the processes of individualisation and cosmopolitanisation. I argue, first, that Beck exaggerates his claims about the relative influence of tradition on religion and reason; second, that his cosmopolitanisation thesis fails to identify triggers for a paradigm conversion; third, that the thesis relies upon essentialist commitments of the kind he condemns; and finally, that only the classicist view of essentialism is vulnerable to his attack.

Grassroots energy: a case study of active citizenship and public communication in risk society

In 2001, the Victorian state government approved the construction of a 500-megawatt power station at Stonehaven by US multinational corporation, AES Power One. In 2002 plans had stalled and the company had withdrawn from the process. By March, 2002 the state government flagged that the power station was no longer required to meet power supply demands. This paper applies Beck’s theories of risk society and reflexive modernisation to a case study. It asks to what extent is Australia a risk society? Is the Stonehaven case part of a larger-scale cultural and political movement and if so what are the consequences for corporate and civil citizenship and public communication in Australia?

The Archaeology of No man's land: Indigenous camps at Corindi Beach, mid-north coast New South Wales

At Corindi Beach on the mid-north coast of New South Wales are five twentieth century campsites located on the fringes of the township, beside the town racecourse, an area called by local Aboriginal people 'No man's land'. These campsites are important symbols of the self-sufficient lifestyle followed by the Corindi Beach Indigenous community in the twentieth century and are a physical reminder of cross-cultural relationships between local people over the last hundred years. In a collaborative research project with Yarrawarra Aboriginal Corporation, these places are being documented through studying oral history, the cultural landscape and the material culture left behind at these places.

Reflexive modernity and the art of public communication

In 2000, Victoria’s largest regional council, the City of Greater Geelong, allocated $200,000 to fund a community art and place-making project in inner Geelong West. The Walk West project was conceptualised and lobbied by a community group for six years. The project addressed the impact of a large section of freeway installed in the seventies and its consequences for quality of life in the locality.

This article reports on an example of highly developed community relations. It examines public art and placemaking as public communication tools and their relationship to political and social activity in post-amalgamation Victoria. In particular it applies the theories of Ulrich Beck and the notion of reflexive modernity in risk society where citizens’ initiative groups will play an increasingly important role in reclaiming the biological and cultural heritage lost as a result of ‘progress’.

The knowledge economy and innovation: certain uncertainty and the risk economy

The knowledge economy is a dominant force in today's world, and innovation policy and national systems of innovation are central to it. In this article, we draw on different sociological and economic theories of risk to engage critically with innovation policy and national systems of innovation. Beck's understanding of a risk society, Schumpeter's innovation thesis, and Perez's techno-economic paradigm are used to consider the risk economy, and the broader risk implications of knowledge economy policies and their associated innovation systems. Derrida's theory of haunting provides the methodological framework for our discussion. We use his notion of “hauntology” to conceptualize the risk economy as a ghost that haunts knowledge economy policies and systems. The spectral risk economy draws attention to the inherent instability of the knowledge economy, and challenges the certainty of its economic dogma by offering an alternative perspective. The risk economy problematizes knowledge economy policies and systems by revealing the uncertain and “undecidable” future of social, political and cultural hazards ignored in the interest of commercial gain.

Emotional reactions following exposure to idealized bodies predict unhealthy body change attitudes and behaviors in women and men

Objective: We explored the extent to which changes in emotional states following exposure to images of idealized bodies predict unhealthy body change attitudes and behaviors in women and men, and whether particular psychological traits mediate these effects. Method: One hundred thirty-three women and 93 men were assessed for unhealthy attitudes and behaviors related to body weight and muscles using the Eating Disorder Inventory-2 (EDI-2), the Obligatory Exercise Questionnaire, and the strategies to increase muscles subscale of the Body Change Inventory. Psychological traits assessed included body dissatisfaction (EDI-2), internalization of the thin/athletic ideal (Sociocultural Attitudes Towards Appearance Questionnaire-3), body comparison (Body Comparison Scale), self-esteem (Rosenberg Self-Esteem Inventory), depression (Beck Depression Inventory-II), and identity confusion (Self-Concept Clarity Scale). Participants were then exposed to photographs of thin female models and muscular male models, and visual analogue scales were used to measure changes in postexposure state body dissatisfaction, anger, anxiety, and depression.
Results: Postexposure increases in state anger, anxiety, depression, and body dissatisfaction correlated with drive for thinness and disordered eating symptomatology in women, while postexposure increases in state body dissatisfaction correlated with muscle development in men. Analyses revealed that internalization and body comparison mediated these relationships, with trait body dissatisfaction, trait depression, self-esteem, and self-concept/identity confusion serving as mediators for women only. Conclusion: These results are indicative of gender differences in: (a) reactions to idealized bodies; (b) psychological traits that predispose individuals to experience these reactions; and (c) types of body change behavior that are associated with these reactions.

Early detection of depression and associated risk factors in adults with mild/moderate intellectual disability

The aim of this study was to determine the presentation and risk factors for depression in adults with mild/moderate intellectual disability (ID). A sample of 151 adults (83 males and 68 females) participated in a semi-structured interview. According to results on the Beck Depression Inventory II, 39.1% of participants evinced symptoms of depression (2 severe, 14 moderate, and 43 mild). Sadness, self-criticism, loss of energy, crying, and tiredness appeared to be the most frequent indicators of depression or risk for depression. A significant difference was found between individuals with and without symptoms of depression on levels of automatic negative thoughts, downward social comparison and self-esteem. Automatic negative thoughts, quality and frequency of social support, self-esteem, and disruptive life events significantly predicted depression scores in people with mild/moderate ID, accounting for 58.1% of the variance.

Risk and resilience, knowledge and imagination: the enlightenment of David Almond's Skellig

In what Ulrich Beck calls "risk society," and Anthony Giddens a "runaway world," a climate of fear and insecurity has been created by scientific progress, leading to a loss of confidence in the ability of experts to manage risk. Resilience is at the forefront of psychology research informing child-rearing strategies (Luthar, et al.); it entails an approach to child welfare that focuses on fostering internal (psychological) and external (cultural) assets that develop a child's ability to triumph over adversity in the form of individual, familial, and cultural stresses.

Dystopian visions of global capitalism : Philip Reeve's Mortal Engines and M. T. Anderson's Feed

This article examines Philip Reeve’s novel for children, Mortal Engines, and M.T. Anderson’s young adult novel, Feed, by assessing these dystopias as prototypical texts of what Ulrich Beck calls risk society. Through their visions of a fictional future, the two narratives explore the hazards created by contemporary techno-economic progress, predatory global politics and capitalist excesses of consumption. They implicitly pose the question: “In the absence of a happy ending for western civilisation, what kind of children can survive in dystopia?”

The relationship between emotional state and other variables influencing successful reintegration of ex-prisoners

This study investigated the multiple, complex, dynamic and interactive variables influencing successful reintegration of ex-prisoners, with a particular focus on the role of emotional state in the reintegration process. This involved conduct of a survey to a large group of prisoners approaching release and subsequently following release from prisons in Victoria and Queensland. Participants were 101 adult prisoners who completed a pre-release questionnaire one month prior to their release that focused on prison-related variables, participant background, and anticipated conditions upon release. A post-release questionnaire was administered to the same participants at one to four weeks and three to four months post-release, focusing on the quality of life conditions experienced following release. As well, the Beck Depression Inventory, Beck Anxiety Inventory, and the State-Trait Anger Expression Inventory were completed at each interview. Of interest, was the level and degree of change in prisoner ratings of depression, anxiety, and anger at pre-release and extending over the post-release period. As well, the strength of relationship between emotional state and the main variables influencing reintegration was investigated; that is, the degree to which reintegration variables (such as social support, drug use, post-release program participation, rated health) are associated with depression, anxiety, and anger among ex-prisoners. The report commences with the description of an ecological model of community reintegration that enables the main variables that may influence reintegration of ex-prisoners to be easily conceptualised and understood. A review of the international and Australian literature relevant to community reintegration of ex-prisoners is then presented, consistent with this conceptual framework, with a specific emphasis on the role of emotional state in post-release outcomes for this group. In the second section, the study design and method are described, with the results presented in the third section. The fourth and final section of the report includes a discussion of the results, implications for reintegration theory, and practical implications for promoting successful reintegration of ex-prisoners.

No effect of n - 3 long-chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function : a randomised controlled trial

Low dietary intakes of the n-3 long-chain PUFA (LCPUFA) EPA and DHA are thought to be associated with increased risk for a variety of adverse  outcomes, including some psychiatric disorders. Evidence from  observational and intervention studies for a role of n-3 LCPUFA in depression is mixed, with some support for a benefit of EPA and/or DHA in major depressive illness. The present study was a double-blind randomised controlled trial that evaluated the effects of EPA+DHA supplementation (1.5 g/d) on mood and cognitive function in mild to moderately depressed  individuals. Of 218 participants who entered the trial, 190 completed the planned 12 weeks intervention. Compliance, confirmed by plasma fatty acid concentrations, was good, but there was no evidence of a difference between supplemented and placebo groups in the primary outcome - namely, the depression subscale of the Depression Anxiety and Stress Scales at 12 weeks. Mean depression score was 8.4 for the EPA+DHA group and 9.6 for the placebo group, with an adjusted difference of - 1.0 (95 % CI - 2.8, 0.8; P = 0.27). Other measures of mood, mental health and cognitive function, including Beck Depression Inventory score and attentional bias toward threat words, were similarly little affected by the intervention. In conclusion, substantially increasing EPA+DHA intake for 3 months was found not to have beneficial or harmful effects on mood in mild to moderate depression. Adding the present result to a meta-analysis of previous relevant randomised controlled trial results confirmed an overall negligible benefit of n-3 LCPUFA supplementation for depressed mood.

Power of darkness : narrative and biographical reflexivity in "A series of unfortunate events"

This paper investigates the high-earning children's series, A Series of Unfortunate Events, in relation to the skills young people require to survive and thrive in what Ulrich Beck calls risk society. Children's textual culture has been traditionally informed by assumptions about childhood happiness and the need to reassure young readers that the world is safe. The genre is consequently vexed by adult anxiety about children's exposure to certain kinds of knowledge. This paper discusses the implications of the representation of adversity in the Lemony Snicket series via its subversions of the conventions of children's fiction and metafictional strategies. Its central claim is that the self-consciousness or self-reflexivity of A Series of Unfortunate Events} models one of the forms of reflexivity children need to be resilient in the face of adversity and to empower them to undertake the biographical project risk society requires of them.