Social and individual influences on eating in preadolescents:the role of friends’ eating behaviours and individual anxiety and depression

Background: Friends are important role models for the formation of social norms and behaviour comparisons, particularly in children. This study examined the similarities between pre-adolescent children’s own eating behaviours with the eating behaviours of those in their friendship group. It also evaluated whether symptoms of anxiety and depression were related to eating behaviours in this age group. Methods: Three hundred and forty three children (mean age 8.75 years) completed questionnaires designed to measure dietary restraint, emotional eating and external eating, as well as general and social anxiety, and symptoms of depression. Children also provided details about their friendship groups. Results: Pre-adolescents’ dietary restraint was positively predicted by the dietary restraint of members of their friendship groups, and their individual levels of anxiety and depression. The levels of general anxiety exhibited by pre-adolescents predicted emotional and external eating behaviours. Younger children were significantly more likely to report higher levels of emotional and external eating than older children, and boys were more likely to report more external eating behaviours than girls. Conclusions: These results suggest that greater dieting behaviours in pre-adolescents are related to their friends’ reports of greater dieting behaviours. In contrast, greater levels of eating governed by emotions, and eating in response to external hunger cues, are related to greater symptoms of anxiety in pre-adolescent children. Such findings underline the importance of friends’ social influences on dieting behaviours in this age group and highlight the value of targeting healthy eating and eating disorder prevention interventions at pre-adolescents.

From depressive symptoms to depressive disorders:the relevance of thresholds

BACKGROUND: Nosological boundaries for depressive disorders as well as the prevalence and impact of 'subsyndromal' depression remain unclear. AIMS: To examine the impact of subsyndromal depressive disorders on health status and to assess if depressive disorders lie on a continuum of severity. METHOD: The sample was composed of randomly selected respondents from the general population in 68 countries from across the world participating in the World Health Organization's World Health Survey. RESULTS: The pattern of risk factors for depressive disorders was consistent across all types of depression (subsyndromal, brief depressive episode and depressive episode): odds ratios for females ranged between 1.49 and 1.80, and for the unemployed from 1.19 to 1.25. All types of depression produced a significant decrement in health status compared with no depression after controlling for demographic variables, income and country. CONCLUSIONS: Subthreshold depressive disorders occur commonly all across the world and are associated with the same risk factors everywhere. They produce significant decrements in health and do not qualitatively differ from full-blown episodes of depression as currently defined, and lie on a continuum with more severe forms of depressive episodes but are distinct from normal mood changes.

Optimising the diagnostic performance of the Geriatric Depression Scale

The aim of this work is to empirically generate a shortened version of the Geriatric Depression Scale (GDS), with the intention of maximising the diagnostic performance in the detection of depression compared with previously GDS validated versions, while optimizing the size of the instrument. A total of 233 individuals (128 from a Day Hospital, 105 randomly selected from the community) aged 60 or over completed the GDS and other measures. The 30 GDS items were entered in the Day Hospital sample as independent variables in a stepwise logistic regression analysis predicting diagnosis of Major Depression. A final solution of 10 items was retained, which correctly classified 97.4% of cases. The diagnostic performance of these 10 GDS items was analysed in the random sample with a receiver operating characteristic (ROC) curve. Sensitivity (100%), specificity (97.2%), positive (81.8%) and negative (100%) predictive power, and the area under the curve (0.994) were comparable with values for GDS-30 and higher compared with GDS-15, GDS-10 and GDS-5. In addition, the new scale proposed had excellent fit when testing its unidimensionality with CFA for categorical outcomes (e.g., CFI=0.99). The 10-item version of the GDS proposed here, the GDS-R, seems to retain the diagnostic performance for detecting depression in older adults of the GDS-30 items, while increasing the sensitivity and predictive values relative to other shortened versions.

Differences between younger and older adults in the structure of suicidal intent and its correlates

OBJECTIVE: To analyze differences in the variables associated with severity of suicidal intent and in the main factors associated with intent when comparing younger and older adults. DESIGN: Observational, descriptive cross-sectional study. SETTING: Four general hospitals in Madrid, Spain. PARTICIPANTS: Eight hundred seventy suicide attempts by 793 subjects split into two groups: 18-54 year olds and subjects older than 55 years. MEASUREMENTS: The authors tested the factorial latent structure of suicidal intent through multigroup confirmatory factor analysis for categorical outcomes and performed statistical tests of invariance across age groups using the DIFFTEST procedure. Then, they tested a multiple indicators-multiple causes (MIMIC) model including different covariates regressed on the latent factor "intent" and performed two separate MIMIC models for younger and older adults to test for differential patterns. RESULTS: Older adults had higher suicidal intent than younger adults (z = 2.63, p = 0.009). The final model for the whole sample showed a relationship of intent with previous attempts, support, mood disorder, personality disorder, substance-related disorder, and schizophrenia and other psychotic disorders. The model showed an adequate fit (chi²[12] = 22.23, p = 0.035; comparative fit index = 0.986; Tucker-Lewis index = 0.980; root mean square error of approximation = 0.031; weighted root mean square residual = 0.727). All covariates had significant weights in the younger group, but in the older group, only previous attempts and mood disorders were significantly related to intent severity. CONCLUSIONS: The pattern of variables associated with suicidal intent varies with age. Recognition, and treatment of geriatric depression may be the most effective measure to prevent suicidal behavior in older adults.