Frequency of infant stroking reported by mothers moderates the effect of prenatal depression on infant behavioural and physiological outcomes

Animal studies find that prenatal stress is associated with increased physiological and emotional reactivity later in life, mediated via fetal programming of the HPA axis through decreased glucocorticoid receptor (GR) gene expression. Post-natal behaviours, notably licking and grooming in rats, cause decreased behavioural indices of fear and reduced HPA axis reactivity mediated via increased GR gene expression. Post-natal maternal behaviours may therefore be expected to modify prenatal effects, but this has not previously been examined in humans. We examined whether, according to self-report, maternal stroking over the first weeks of life modified associations between prenatal depression and physiological and behavioral outcomes in infancy, hence mimicking effects of rodent licking and grooming. From a general population sample of 1233 first time mothers recruited at 20 weeks gestation we drew a stratified random sample of 316 for assessment at 32 weeks based on reported inter-partner psychological abuse, a risk to child development. Of these 271 provided data at 5, 9 and 29 weeks post delivery. Mothers reported how often they stroked their babies at 5 and 9 weeks. At 29 weeks vagal withdrawal to a stressor, a measure of physiological adaptability, and maternal reported negative emotionality were assessed. There was a significant interaction between prenatal depression and maternal stroking in the prediction of vagal reactivity to a stressor (p = .01), and maternal reports of infant anger proneness (p = .007) and fear (p = .043). Increasing maternal depression was associated with decreasing physiological adaptability, and with increasing negative emotionality, only in the presence of low maternal stroking. These initial findings in humans indicate that maternal stroking in infancy, as reported by mothers, has effects strongly resembling the effects of observed maternal behaviours in animals, pointing to future studies of the epigenetic, physiological and behavioral effects of maternal stroking.

The specific role of relationship life events in the onset of depression during pregnancy and the postpartum

Background The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events. Methods A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders. Results 52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044). Conclusions The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum.

Associations between interpretation bias and depression in adolescents

Interpretation biases have been shown to play a role in adult depression and are a target in cognitive behavioural therapy. Adolescence is a key risk period for the development of depression and a period of rapid cognitive and emotional development but little research has investigated the relationship between interpretation biases and depression in adolescents. This study adapted a measure of interpretation bias, the Ambiguous Scenarios Test for Depression, for adolescents and evaluated its reliability and validity. A community sample of 206 young people aged 12 to 18 years completed a validated measure of depression symptoms (Mood and Feelings Questionnaires) and the adapted Ambiguous Scenarios Test. The Ambiguous Scenarios Test for Depression in Adolescents had good internal consistency and split half reliability. Depression symptoms were associated with participants’ ratings of the valence of ambiguous situations and with interpretation biases. Importantly, symptoms of depression and anxiety were independently associated with interpretation bias. This research suggests that interpretation biases can be measured in this age group, that negative interpretation biases exist in adolescents and that these are associated with depression symptoms.

Economic recovery from the Argentine great depression : institutions, expectations, and the change of macroeconomic regime

This work explores how Argentina overcame the Great Depression and asks whether active macroeconomic interventions made any contribution to the recovery. In particular, we study Argentine macroeconomic policy as it deviated from gold-standard orthodoxy after the final suspension of convertibility in 1929. As elsewhere, fiscal policy in Argentina was conservative, and had little power to smooth output. Monetary policy became heterodox after 1929. The first and most important stage of institutional change took place with the switch from a metallic monetary regime to a fiduciary regime in 1931; the Caja de Conversión (Conversion Office, a currency board) began rediscounting as a means to sterilize gold outflows and avoid deflationary pressures, thus breaking from orthodox "mIes of the game." However, the actual injections of liquidity were small' and were not enough to fully offset the incipient monetary contractions: the "Keynes" effect was weak or negative. Rather, recovery derived from changes in beliefs and expectations surrounding the shift in the monetary and exchange-rate regime,and the delinking of gold flows and the money base. Agents perceivod a new regime, as shown by the path of consumption, investment, and estimated ex ante real interest rates: the "Mundell" effect was dominant. Notably, this change of regime predated a later, and supposedly more significant, stage of institutional reform, namely the creation of the central bank in 1935. Still, the extent of intervention was weak, and insufficient to fully offset externaI shocks to prices and money. Argentine macropolicy was heterodox in terms of the change of regime, but still conservative in terms of the tentative scope of the measures taken .

Suicidality in Obsessive-Compulsive Disorder: Prevalence and Relation to Symptom Dimensions and Comorbid Conditions

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relations between Depression, Alcohol and Gender in the Metropolitan Region of São Paulo, Brazil

Como parte do projeto GENACIS, este artigo visou estimar a prevalência de depressão em amostra urbana de São Paulo, Brasil, assim como a associação entre depressão e padrão de uso de álcool segundo gênero. Para tanto, foi realizado inquérito epidemiológico com amostra probabilística e por conglomerados, com um total de 2083 adultos. Utilizou-se o CIDI SF para identificação de depressão. A análise estatística utilizou o teste de Rao Scott e regressão logística multivariada. A taxa de resposta foi de 74,9%. Predominaram mulheres (58,8%), menores de 40 anos de idade (52%). A prevalência de depressão foi de 28,3% para as mulheres e 12,7% para os homens. Entre os homens, 61,1% são de bebedores no último ano e a depressão esteve associada ao padrão de consumo de álcool, à maior frequência de binge drinking e à presença de problemas decorrentes do álcool. Entre as mulheres, 69,5% são abstinentes e a depressão se associou à convivência com cônjuge com problemas devidos ao álcool. Os resultados ressaltam que a associação entre depressão e consumo de álcool é distinta entre os gêneros.

Repetition of Suicide Attempts Data from Emergency Care Settings in Five Culturally Different Low- and Middle-Income Countries Participating in the WHO SUPRE-MISS Study

Background: Attempted suicide is a strong risk factor for subsequent suicidal behaviors. Innovative strategies to deal with people who have attempted suicide are needed, particularly in resource-poor settings. Aims: To evaluate a brief educational intervention and periodic follow-up contacts (BIC) for suicide attempters in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, People's Republic of China) as part of the WHO Multisite Intervention Study on Suicidal Behaviors (SUPRE-MISS). Methods: Among the 1,867 suicide attempters enrolled in the emergency departments of the participating sites, 922 (49.4%) were randomly assigned to a brief intervention and contact (BIC) group and 945 (50.6%) to a treatment as usual (TAU) group. Repeated suicide attempts over the 18 months following the index attempt - the secondary outcome measure presented in this paper - were identified by follow-up calls or visits. Subsequent completed suicide - the primary outcome measure has been reported in a previous paper. Results: Overall, the proportion of subjects with repeated suicide attempts was similar in the BIC and TAU groups (7.6% vs. 7.5%, chi(2) = 0.013; p = .909), but there were differences in rates across the five sites. Conclusions: This study from five low-and middle-income countries does not confirm the effectiveness of brief educational intervention and follow-up contacts for suicide attempters in reducing subsequent repetition of suicide attempts up to 18 months after discharge from emergency departments.

Depression severity levels and cognitive functions in institutionalized elderly patients

Depression is a highly prevalent illness among institutionalized aged and assumes peculiar characteristics such as the risk for progressing to dementia. The aims of this study was to assess the cognitive functions of institutionalized elderly with clinical diagnosis of depression and compare the severity of depressive symptoms with cognitive performance. From 120 residents at a nursing home in Rio Claro, Brazil, we study 23 individuals (mean age: 74.3 years; mean schooling: 4.0 years) with diagnosis of depression. At first, a clinical diagnosis of depression and measurement of its symptoms using the Geriatric Depression Scale were performed. The patient then underwent a neuropsychological assessment based on the following tests: Mini-Mental Examination, Verbal Fluency, Visual Perception, Immediate Memory, Recent Memory, Recognition, Clock Drawing Test. The patients were divided into two groups: those with less severe depression symptoms (Group 1: N=9) and more severe symptoms (Group 2: N=14). The significant difference between symptom severity of the two groups was p=0.0001. Patients with more severe symptoms revealed a slightly inferior cognitive performance in most of the tests when compared to those with less severe symptoms (p>0.05). In relation to Verbal Fluency, patients with more severe depression symptoms presented a significantly inferior cognitive performance when compared to those with less severe symptoms (p=0.0082). Verbal Fluency revealed to be a more sensitive test for measuring early cognitive alterations in institutionalized aged with depression, and appears to be a useful resource in monitoring the cognitive functions of patients faced with the risk of dementia. © Copyright Moreira Jr. Editora.

Childhood trauma in substance use disorder and depression: An analysis by gender among a Brazilian clinical sample

Objective: In this study, we compared the frequency and intensity of childhood traumas in alcohol- or other drug-dependent patients, in patients with depression, and in a control group without psychiatric diagnoses. Methods: The study had a retrospective design of a clinical sample of men and women from the groups listed above. They were evaluated by the same standardized instrument: the Childhood Trauma Questionnaire.. Results: A higher frequency and intensity of emotional, physical, and sexual abuse were found in alcohol- and other drug-dependent patients than in patients with depression, who, in turn, presented significantly higher proportions than the control group. In all of the cases, the frequency was higher among women than men. Conclusion: Because of the high frequency and intensity of childhood traumas among alcohol- or other drug-dependent patients and depressed patients, the assessment of problems due to childhood traumas among these patients is essential to a better understanding of the etiology of those disorders and to their treatment. © 2010 Elsevier Ltd. All rights reserved.

Eating disorders in patients with obsessive-compulsive disorder: Prevalence and clinical correlates

Objective: The objective is to evaluate the prevalence and associated clinical characteristics of eating disorders (ED) in patients with obsessive-compulsive disorder (OCD). Method: This is a cross-sectional study comparing 815 patients with OCD. Participants were assessed with structured interviews and scales: SCID-I, Y-BOCS, (Int J Eat Disord 2010; 43:315-325) Dimensional Y-BOCS, BABS, Beck Depression and Anxiety Inventories. Results: Ninety-two patients (11.3%) presented the following EDs: binge-eating disorders [= 59 (7.2%)], bulimia nervosa [= 16 (2.0%)], or anorexia nervosa [= 17 (2.1%)]. Compared to OCD patients without ED (OCD-Non-ED), OCD-ED patients were more likely to be women with previous psychiatric treatment. Mean total scores in Y-BOCS, Dimensional Y-BOCS, and BABS were similar within groups. However, OCD-ED patients showed higher lifetime prevalence of comorbid conditions, higher anxiety and depression scores, and higher frequency of suicide attempts than did the OCD-Non-ED group. Primarily diagnosed OCD patients with comorbid ED may be associated with higher clinical severity. Discussion: Future longitudinal studies should investigate dimensional correlations between OCD and ED. © 2009 Wiley Periodicals, Inc.

Painful temporomandibular disorders, self reported tinnitus, and depression are highly associated

Objetivo Investigar a associação entre disfunção temporomandibular (DTM) dolorosa, auto-relato de zumbido e níveis de depressão. Método A amostra foi composta por 224 indivíduos com idades de 18 a 76 anos. O Research Diagnostic Criteria for Temporomandibular Disorders , eixo I, foi usado para classificar a DTM e o eixo II para obtenção do auto-relato de zumbido e dos níveis de depressão. Para a análise dos dados, foi aplicado o teste odds ratio (OR) com intervalo de confiança (IC) de 95%. Resultado Somente a presença de DTM dolorosa estava significativamente associada aos níveis de depressão moderado/severo (OR=9,3, 95%; IC: 3,44-25,11). A presença concomitante de DTM dolorosa e auto-relato de zumbido aumentaram a magnitude da associação com os níveis de depressão moderado/severo (OR=16,3; 95% IC: 6,58-40,51). Conclusão Disfunção temporomandibular dolorosa, altos níveis de depressão e auto-relato de zumbido estão fortemente associados. Entretanto, o desenho do estudo não permite estabelecer uma relação causal entre essas três entidades.

Obsessive-compulsive symptoms among alcoholics in outpatient treatment: prevalence, severity and correlates

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Anxiety and depression in brazilian undergraduate students: the role of sociodemographic variables, undergraduate course characteristics and social skills

The prevalence of anxiety and depression disorders in undergraduate students is high and several variables can be influential. The aim is to verify the predictive value of social skills, sociodemographic variables, and course characteristics for depression and anxiety. A total of 1282 students of a public university, of both sexes and from different years and courses, participated in this study. Screening instruments for depression and anxiety were applied, as well as an instrument investigating social skills and a questionnaire covering socio demographic indicators and course characteristics. The data were analyzed using univariate analysis followed by multiple binary regression analysis in order to define the relevance of these depression and anxiety measures. The rates of anxiety and depression were 19.4% and 3.8%, respectively. The social skills and living situation were predictive of depression, with the social skills and course area (with higher prevalence for the exact and human sciences) remaining in the final model for anxiety. Such data have implications for psychological prevention and intervention with this population.

Literacy Research: Issues of Authority, Ownership, and Representation

With the “social turn” of language in the past decade within English studies, ethnographic and teacher research methods increasingly have acquired legitimacy as a means of studying student literacy. And with this legitimacy, graduate students specializing in literacy and composition studies increasingly are being encouraged to use ethnographic and teacher research methods to study student literacy within classrooms. Yet few of the narratives produced from these studies discuss the problems that frequently arise when participant observers enter the classroom. Recently, some researchers have begun to interrogate the extent to which ethnographic and teacher research methods are able to construct and disseminate knowledge in empowering ways (Anderson & Irvine, 1993; Bishop, 1993; Fine, 1994; Fleischer. 1994; McLaren, 1992). While ethnographic and teacher research methods have oftentimes been touted as being more democratic and nonhierarchical than quantitative methods—-which oftentimes erase individuals lived experiences with numbers and statistical formulas—-researchers are just beginning to probe the ways that ethnographic and teacher research models can also be silencing, unreflective, and oppressive. Those who have begun to question the ethics of conducting, writing about, and disseminating knowledge in education have coined the term “critical” research, a rather vague and loose term that proposes a position of reflexivity and self-critique for all research methods, not just ethnography or teacher research. Drawing upon theories of feminist consciousness-raising, liberatory praxis, and community-action research, theories of critical research aim to involve researchers and participants in a highly participatory framework for constructing knowledge, an inquiry that seeks to question, disrupt, or intervene in the conditions under study for some socially transformative end. While critical research methods are always contingent upon the context being studied, in general they are undergirded by principles of non-hierarchical relations, participatory collaboration, problem-posing, dialogic inquiry, and multiple and multi-voiced interpretations. In distinguishing between critical and traditional ethnographic processes, for instance, Peter McLaren says that critical ethnography asks questions such as “[u]nder what conditions and to what ends do we. as educational researchers, enter into relations of cooperation. mutuality, and reciprocity with those who we research?” (p. 78) and “what social effects do you want your evaluations and understandings to have?” (p. 83). In»the same vein, Michelle Fine suggests that critical researchers must move beyond notions of the etic/emic dichotomy of researcher positionality in order to “probe how we are in relation with the contexts we study and with our informants, understanding that we are all multiple in those relations” (p. 72). Researchers in composition and literacy stud¬ies who endorse critical research methods, then, aim to enact some sort of positive transformative change in keeping with the needs and interests of the participants with whom they work.

Suicide rates and income in Sao Paulo and Brazil: a temporal and spatial epidemiologic analysis from 1996 to 2008

Background: In a classical study, Durkheim noted a direct relation between suicide rates and wealth in the XIX century France. Since that time, several studies have verified this relationship. It is known that suicide rates are associated with income, although the direction of this association varies worldwide. Brazil presents a heterogeneous distribution of income and suicide across its territory; however, evaluation for an association between these variables has shown mixed results. We aimed to evaluate the relationship between suicide rates and income in Brazil, State of Sao Paulo (SP), and City of SP, considering geographical area and temporal trends. Methods: Data were extracted from the National and State official statistics departments. Three socioeconomic areas were considered according to income, from the wealthiest (area 1) to the poorest (area 3). We also considered three regions: country-wide (27 Brazilian States and 558 Brazilian micro-regions), state-wide (645 counties of SP State), and city-wide (96 districts of SP city). Relative risks (RR) were calculated among areas 1, 2, and 3 for all regions, in a cross-sectional approach. Then, we used Joinpoint analysis to explore the temporal trends of suicide rates and SaTScan to investigate geographical clusters of high/low suicide rates across the territory. Results: Suicide rates in Brazil, the State of SP, and the city of SP were 6.2, 6.6, and 5.4 per 100,000, respectively. Taking suicide rates of the poorest area (3) as reference, the RR for the wealthiest area was 1.64, 0.88, and 1.65 for Brazil, State of SP, and city of SP, respectively (p for trend <0.05 for all analyses). Spatial cluster of high suicide rates were identified at Brazilian southern (RR = 2.37), state of SP western (RR = 1.32), and city of SP central (RR = 1.65) regions. A direct association between income and suicide were found for Brazil (OR = 2.59) and the city of SP (OR = 1.07), and an inverse association for the state of SP (OR = 0.49). Conclusions: Temporospatial analyses revealed higher suicide rates in wealthier areas in Brazil and the city of SP and in poorer areas in the State of SP. We further discuss the role of socioeconomic characteristics for explaining these discrepancies and the importance of our findings in public health policies. Similar studies in other Brazilian States and developing countries are warranted.