Colleen S. Conley

The emerging sex difference in adolescent depression: Interacting contributions of puberty and peer stress

This research investigated the developmental stages (pubertal status) and contexts (early or late timing relative to peers, and a context of stressful versus supportive peer relationships) in which the sex difference in depression unfolds. A sample of 158 youth (ages 9.6-14.8) and their caregivers provided information at two waves, 1 year apart, on puberty, peer stress, and depression. Pubertal status and timing (actual and perceived) interacted with sex to predict depression. Sex differences in depression were evident at particular levels of pubertal status and timing, both actual and perceived. Depression was associated with more mature pubertal status and early timing (both actual and perceived) in girls, but with less mature pubertal status and late timing (actual and perceived) in boys. These patterns held concurrently, and often over time, particularly in a context of stressful peer relationships (peer stress moderated sex-differentiated associations between puberty and depression). Of note, there were no significant sex differences in depression at any particular age. Thus, this research highlights important distinctions among the contributions of age, pubertal status, pubertal timing, and perceived timing to the sex difference in adolescent depression. More broadly, these findings contribute to our growing understanding of the interactions among physical, social, and psychological processes involved in the sex difference in adolescent depression.

Promoting Psychosocial Adjustment and Stress Management in First-Year College Students: The Benefits of Engagement in a Psychosocial Wellness Seminar.

Abstract Objective/Methods: This research evaluates the effectiveness of a psychosocial wellness seminar for first-year college students, from 2009 to 2011, using an 8-month prospective quasi-experimental design. Participants/Results: Compared with controls (n = 22) involved in an alternative seminar, intervention participants (n = 29) showed no differences at baseline, but reported significantly greater perceived improvements over the course of the intervention, in psychosocial adjustment and stress management. Furthermore, specific aspects of intervention engagement (attendance and student-rated skills practice, but not didactic mastery or facilitator-rated skills practice) differentially predicted beneficial outcomes: (1) psychosocial adjustment (increases in psychosocial well-being, decreases in psychological distress), after adjusting for baseline levels of these outcomes; (2) college-related stress management (lower college-related stress, greater adaptation to college); and (3) perceived improvements in psychosocial adjustment and stress management. Conclusions: This research indicates promising avenues for programmatic efforts to promote psychosocial adjustment and stress management in college students, during this critical developmental juncture.

An Evaluative Review of Outcome Research on Universal Mental Health Promotion and Prevention Programs for Higher Education Students

Abstract Objective: This review is the first large-scale attempt to evaluate the effectiveness of universal promotion and prevention programs for higher education students on a range of adjustment outcomes. Participants/Methods: The current review examined 83 controlled interventions involving college, graduate, and professional students, with a focus on 3 main outcomes: social and emotional skills, self-perceptions, and emotional distress. Results/Conclusions: Skill-oriented programs that included supervised practice demonstrated the strongest benefits, thus showing promise as a successful mental health promotion and preventive intervention. In comparing different intervention strategies, mindfulness training and cognitive-behavioral techniques appear to be the most effective. Furthermore, interventions conducted as a class appear to be effective, suggesting the potential for exposing higher education students to skill training through routine curricula offerings. This review offers recommendations for improving the experimental rigor of future research, and implications for enhancing campus services to optimize student success in psychosocial—and thus ultimately academic—domains.

Negotiating the Transition to College Developmental Trajectories and Gender Differences in Psychological Functioning, Cognitive-Affective Strategies, and Social Well-Being

The transition to college, which for the majority of youth coincides with the transition to emerging adulthood, is stressful and disruptive. Using latent growth curve modeling (LGM), this study examines the longitudinal course of psychosocial adjustment in a sample of 2,095 emerging adults, at three time-points across this transition: In the week prior to college entry and at the end of each semester of the first year. Overall, the immediate transition is characterized by steep declines in psychological well-being, cognitive-affective strengths, and social well-being as well as increases in psychological distress and cognitive-affective vulnerabilities. These setbacks generally plateau, but do not resolve, later in the year. Examining gender differences in developmental trajectories revealed that females experience additional elevations in psychological distress even after the immediate transition, while males evidenced worse baseline levels in cognitive-affective vulnerabilities, cognitive-affective strengths, and social well-being. These findings indicate the need for services that promote well-being across this challenging developmental transition.

A Meta-analysis of Universal Mental Health Prevention Programs for Higher Education Students

This meta-analysis investigated the effectiveness of universal mental health prevention programs for higher education students on a range of adjustment outcomes. A systematic literature search identified 103 controlled published and unpublished interventions involving college, graduate, or professional students. As hypothesized, skill-training programs that included a supervised practice component were significantly more effective overall (mean effect size = 0.45, confidence interval (CI) = 0.39 to 0.52) compared to skill-training programs without supervised practice (0.11, CI = −0.01 to 0.22) and psychoeducational (information-only) programs (0.13, CI = 0.06 to 0.21). When comparisons on specific outcomes were possible, skill-training programs including supervised practice were significantly more effective than the other two groups of programs in reducing symptoms of depression, anxiety, stress, and general psychological distress, and in improving social-emotional skills, self-perceptions, and academic behaviors and performance. The magnitude of effects achieved in several outcome areas is comparable to or higher than that reported in other reviews of universal programs, suggesting that skill-training programs for higher education students that incorporate supervised practice now join the ranks of other effective preventive mental health interventions. This review offers several recommendations to improve the experimental rigor of future research.

Explaining the Longitudinal Association between Puberty and Depression: Sex Differences in the Mediating Effects of Peer Stress

This research investigated whether exposure to peer stress serves as one pathway through which pubertal development contributes to depression over time, differentially for girls and boys. Youth (N = 149; 9.6-14.8 years) and their caregivers provided information at two waves, 1 year apart, on puberty (Wave 1), peer stress (occurring between Waves 1 and 2), and depression (Waves 1 and 2). Structural equation modeling analyses examined sex differences in the extent to which peer stress mediated the impact of pubertal status and timing on subsequent depression (i.e., tests of moderated mediation). Significant sex-moderated mediation was found for both pubertal status and timing. As indicated by moderate effect proportions, in girls, heightened peer stress partially mediated the longitudinal association between (a) more advanced pubertal status and depression; and (b) linear, but not curvilinear, pubertal timing (i.e., earlier maturation) and depression. This research contributes to our growing understanding of the interplay among physical, psychological, and social processes involved in the sex difference in adolescent depression.

Perception of control during episodes of eating : relationships with quality of life and eating psychopathology

OBJECTIVE Experience of loss of control (LOC) during eating is an important indicator of pathology, although this concept has not received a great deal of research attention. The present study explores how quality of life (QoL) is related to LOC during eating. METHOD Three hundred and thirty-nine female university students completed measures of eating pathology, general psychiatric symptomatology, and QoL. They were subsequently categorized according to the degree of LOC experienced during eating into one of five groups: no binge eating (NBE); objective overeating (OOE); objective binge eating (OBE); subjective binge eating (SBE); and a mixed OBE/SBE group (Mixed). RESULTS Individuals who experienced LOC during eating reported significantly poorer QoL and more psychiatric symptoms. DISCUSSION In a nonclinical female sample, LOC during eating appeared to be a more important marker of pathology and poorer self-reported QoL than the amount of food eaten.

A Meta-Analysis of the Impact of Universal and Indicated Preventive Technology-Delivered Interventions for Higher Education Students

The uses of technology-delivered mental health treatment options, such as interventions delivered via computer, smart phone, or other communication or information devices, as opposed to primarily face-to-face interventions, are proliferating. However, the literature is unclear about their effectiveness as preventive interventions for higher education students, a population for whom technology-delivered interventions (TDIs) might be particularly fitting and beneficial. This meta-analytic review examines technological mental health prevention programs targeting higher education students either without any presenting problems (universal prevention) or with mild to moderate subclinical problems (indicated prevention). A systematic literature search identified 22 universal and 26 indicated controlled interventions, both published and unpublished, involving 4763 college, graduate, or professional students. As hypothesized, the overall mean effect sizes (ESs) for both universal (0.19) and indicated interventions (0.37) were statistically significant and differed significantly from each other favoring indicated interventions. Skill-training interventions, both universal (0.21) and indicated (0.31), were significant, whereas non-skill-training interventions were only significant among indicated (0.25) programs. For indicated interventions, better outcomes were obtained in those cases in which participants had access to support during the course of the intervention, either in person or through technology (e.g., email, online contact). The positive findings for both universal and indicated prevention are qualified by limitations of the current literature. To improve experimental rigor, future research should provide detailed information on the level of achieved implementation, describe participant characteristics and intervention content, explore the impact of potential moderators and mechanisms of success, collect post-intervention and follow-up data regardless of intervention completion, and use analysis strategies that allow for inclusion of cases with partially missing data.

Expecting to heal through self-expression: a perceived control theory of writing and health

Abstract Writing improves physical and psychological health when done expressively, or in a way characterized by cognitive-emotional engagement (Pennebaker, 1997). While numerous theories attempt to explain the relationship between expressive writing and health, no singular mechanism emerges as conclusive or dominant. This theoretical dilemma is likely due to the paradigms vast and thus self-fulfilling directions, which place a premium on the participants biases and positive expectations (Langens & Schüler, 2007). Accordingly, the current review builds a theory of perceived control, which makes three propositions: (1) Perceived control promotes health; (2) Traumatic and stressful events lead to loss of perceived control and therefore decrements in health; and (3) Expressive writing restores perceptions of control, thereby improving health. Indeed, perceived control is associated with the very process of expressive writing and has extensive ties to both physical and psychological well-being. Unlike other proposed models, a theory of perceived control identifies which individuals should benefit from writing and explains why health benefits are often short-term. Expressive writing, due to its appeal as a healing ritual, is likely to build up confidence in ones health and prospects, without taking into account the uncertainties of day-to-day events and circumstances.

Optimizing the Perceived Benefits and Health Outcomes of Writing about Traumatic Life Events

Expressive writing, which involves disclosing ones deepest thoughts and feelings about a stressful life event by using a first-person perspective, has been linked to gains in health and well-being, though effect sizes range widely. Assuming a third-person perspective is a natural and effective way of coping with highly distressing events. Therefore, the current study examined whether a distanced, third-person approach to expressive writing might be more beneficial than a traditional, first-person intervention for high baseline levels of event-linked intrusive thinking. Randomly assigned participants wrote expressively about traumatic life events by using a first-person or third-person-singular perspective. Linguistic analyses showed that assuming a first-person perspective is linked to higher levels of in-text cognitive engagement, whereas a third-person perspective is linked to lower cognitive engagement. However, in a context of higher levels of intrusive thinking, third-person expressive writing, relative to a traditional first-person approach, yielded (1) greater perceived benefits and positive, long-lasting effects as well as (2) fewer days of activity restriction due to illness. Although more research is needed, these results suggest that third-person expressive writing may be an especially fitting technique for recovering from traumatic or highly stressful life events.