Reliable Change in Depression During Behavioral Weight Loss Treatment Among Women With Major Depression.

Reliable change in depression during behavioral weight loss treatment among women with major depression.

Obesity (Silver Spring). 2013 Mar; 21(3): E211-E218
Busch AM, Whited MC, Appelhans BM, Schneider KL, Waring ME, Debiasse MA, Oleski JL, Crawford SL, Pagoto SL

Objective: Although behavioral weight loss interventions generally have been shown to improve depressive symptoms, little is known as to whether some people with major depressive disorder experience worsening of depression during a weight loss intervention. Design and Methods: Rates and predictors of change in depression symptoms among 148 obese women with major depressive disorder who participated in a trial comparing depression treatment plus behavioral weight loss treatment (Behavioral Activation; BA) to behavioral weight loss treatment alone (Lifestyle Intervention; LI) were examined. A statistically reliable change in depression was calculated as ?9 points on the Beck Depression Inventory in this sample. Results: At 6 months, 73% of participants in BA and 54% of participants in LI showed reliable improvement in depression symptoms and 1.5% of participants in BA and 1.3% of participants in LI showed reliable worsening in depression symptoms. Rates of reliable change were similar at 12 months. Participants who experienced reliable improvement in depression lost significantly more weight than those who did not in both conditions. In the LI condition, baseline psychiatric variables and change in physical activity during treatment were also related to reliable improvement in depression. Conclusion: No evidence for an iatrogenic effect of behavioral weight loss treatment on depressive symptoms among obese women with major depressive disorder was detected; rather, behavioral weight loss treatment appears to be associated with significant concurrent improvement in depression. Even greater rates of reliable improvement were observed when depression treatment was added to weight loss treatment. HubMed – depression


The relationship between fatigue and subsequent physical activity among older adults with symptomatic osteoarthritis.

Arthritis Care Res (Hoboken). 2013 Apr 16;
Murphy SL, Alexander NB, Levoska M, Smith DM

OBJECTIVE.: Although it has been well established that fatigue is a common complaint among older adults with osteoarthritis (OA), relatively little is known about how fatigue in daily life affects physical activity. The purposes of this study were to examine the relationship between momentary fatigue and subsequent physical activity among people with OA who report clinically relevant levels of fatigue and to examine moderators of this relationship. METHODS.: People with knee or hip OA and clinically relevant fatigue participated in physical performance assessments, completed questionnaires, and underwent a home monitoring period in which fatigue severity was measured 5 times per day over 5 days (N = 159). Physical activity was concurrently measured via a wrist-worn accelerometer. Multilevel modeling was used to examine the relationship of momentary fatigue and subsequent activity controlling for other factors (e.g., age, body mass index, pain, depression). RESULTS.: Fatigue was the strongest predictor of reduced subsequent activity. Only functional mobility (TUG) moderated the relationship between fatigue and activity. The relationship between fatigue and activity was strongest for people with high functional mobility. CONCLUSIONS.: Momentary fatigue is a robust and important variable associated with decreased physical activity. Further, the moderating effect of functional mobility suggests this is a factor that should be considered when intervening on fatigue. While people with better functional mobility may benefit from an activity-based treatment approach (such as learning activity pacing techniques to reduce fatigue’s impact on activity), those with worse functional mobility may benefit from treatment focusing on underlying impairments. © 2013 by the American College of Rheumatology. HubMed – depression



Depress Anxiety. 2013 Apr 16;
Desrosiers A, Vine V, Klemanski DH, Nolen-Hoeksema S

BACKGROUND: The current study seeks to investigate the mechanisms through which mindfulness is related to mental health in a clinical sample of adults by examining (1) whether specific cognitive emotion regulation strategies (rumination, reappraisal, worry, and nonacceptance) mediate associations between mindfulness and depression and anxiety, respectively, and (2) whether these emotion regulation strategies operate uniquely or transdiagnostically in relation to depression and anxiety. METHODS: Participants were 187 adults seeking treatment at a mood and anxiety disorders clinic in Connecticut. Participants completed a battery of self-report measures that included assessments of depression and anxiety (Mood and Anxiety Symptom Questionnaire), and emotion regulation (Ruminative Response Scale, Penn State Worry Questionnaire, Emotion Regulation Questionnaire, Difficulties in Emotion Regulation Scale). RESULTS: Simple mediation analyses indicated that rumination and worry significantly mediated associations between mindfulness and anxiety symptoms, whereas rumination and reappraisal significantly mediated associations between mindfulness and depressive symptoms. Multiple mediation analyses showed that worry significantly mediated associations between mindfulness and anxiety symptoms and rumination and reappraisal significantly mediated associations between mindfulness and depressive symptoms. CONCLUSIONS: Findings suggest that mindfulness operates through distinct and common mechanisms depending on clinical context. HubMed – depression



Depress Anxiety. 2013 Apr 16;
Dunn EC, McLaughlin KA, Slopen N, Rosand J, Smoller JW

BACKGROUND: Child maltreatment is a potent risk factor for psychopathology. Although the developmental timing of first exposure to maltreatment is considered important in shaping risk of future psychopathology, no consensus exists on whether earlier or later exposures are more deleterious. This study examines whether age at first exposure to abuse is associated with subsequent depression and suicidal ideation. METHODS: Data were drawn from the National Longitudinal Study of Adolescent Health (n = 15,701). Timing of first maltreatment exposure was classified using: (1) a crude measure capturing early childhood (ages 0-5), middle childhood (ages 6-10), or adolescence (ages 11-17); and (2) a refined measure capturing infancy (ages 0-2), preschool (ages 3-5), latency (ages 6-8), prepubertal (ages 9-10), pubertal (ages 11-13), or adolescence (ages 14-17). We examined whether timing of first exposure was associated with depression and suicidal ideation in early adulthood in the entire sample and among those exposed to maltreatment. RESULTS: Respondents exposed to abuse, particularly physical abuse, at any age had a higher odds of depression and suicidal ideation in young adulthood than nonmaltreated respondents. Among maltreated respondents, exposure during early childhood (ages 0-5), particularly preschool (ages 3-5), was most strongly associated with depression. Respondents first exposed to physical abuse during preschool had a 77% increase in the odds of depression and those first exposed to sexual abuse during early childhood had a 146% increase in the odds of suicidal ideation compared to respondents maltreated as adolescents. CONCLUSIONS: Developmental timing of first exposure to maltreatment influences risk for depression and suicidal ideation. Whether these findings are evidence for biologically based sensitive periods requires further study. HubMed – depression



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