Joshua Fogel

Internet social network communities: Risk taking, trust, and privacy concerns

Individuals communicate and form relationships through Internet social networking websites such as Facebook and MySpace. We study risk taking, trust, and privacy concerns with regard to social networking websites among 205 college students using both reliable scales and behavior. Individuals with profiles on social networking websites have greater risk taking attitudes than those who do not; greater risk taking attitudes exist among men than women. Facebook has a greater sense of trust than MySpace. General privacy concerns and identity information disclosure concerns are of greater concern to women than men. Greater percentages of men than women display their phone numbers and home addresses on social networking websites. Social networking websites should inform potential users that risk taking and privacy concerns are potentially relevant and important concerns before individuals sign-up and create social networking websites.

Internet use and social support in women with breast cancer.

Many Web sites offer information to breast cancer patients, who are increasingly using these sites. The authors investigated the potential psychological benefits of Internet use for medical information by breast cancer patients. Of the 251 women approached, 188 were successfully interviewed (74.9%). Forty-two percent used the Internet for medical information related to breast health issues and did so for an average of 0.80 hr per week. The Interpersonal Support Evaluation List and the UCLA Loneliness Scale, with results controlled for covariates, showed that Internet use for breast health issues was associated with greater social support and less loneliness than Internet use for other purposes or nonuse. Breast cancer patients may obtain these psychological benefits with only a minimal weekly time commitment.

Randomized clinical trial of an Internet-based depression prevention program for adolescents (Project CATCH-IT) in primary care: 12-week outcomes.

Objective: The authors sought to evaluate 2 approaches with varying time and complexity in engaging adolescents with an Internet-based preventive intervention for depression in primary care. The authors conducted a randomized controlled trial comparing primary care physician motivational interview (MI, 5–10 minutes) + Internet program versus brief advice (BA, 1–2 minutes) + Internet program. Setting: Adolescent primary care patients in the United States, aged 14 to 21 years. Participants: Eighty-four individuals (40% non-white) at increased risk for depressive disorders (subthreshold depressed mood >3–4 weeks) were randomly assigned to either the MI group (n = 43) or the BA group (n = 40). Main Outcome Measures: Patient Health Questionnaire-Adolescent and Center for Epidemiologic Studies Depression Scale (CES–D). Results: Both groups substantially engaged the Internet site (MI, 90.7% vs BA 77.5%). For both groups, CES–D-10 scores declined (MI, 24.0 to 17.0, p < .001; BA, 25.2 to 15.5, p < .001). The percentage of those with clinically significant depression symptoms based on CES–D-10 scores declined in both groups from baseline to 12 weeks, (MI, 52% to 12%, p < .001; BA, 50% to 15%, p < .001). The MI group demonstrated declines in self-harm thoughts and hopelessness and was significantly less likely than the BA group to experience a depressive episode (4.65% vs 22.5%, p = .023) or to report hopelessness (MI group of 2% vs 15% for the BA group, p = .044) by 12 weeks. Conclusions: An Internet-based prevention program in primary care is associated with declines in depressed mood and the likelihood of having clinical depression symptom levels in both groups. Motivational interviewing in combination with an Internet behavior change program may reduce the likelihood of experiencing a depressive episode and hopelessness.

Beliefs and Attitudes Associated With the Intention to Not Accept the Diagnosis of Depression Among Young Adults

PURPOSE Negative attitudes and beliefs about depression treatment may prevent many young adults from accepting a diagnosis and treatment for depression. We undertook a study to determine the association between depressive symptom severity, beliefs about and attitudes toward treatment, subjective social norms, and past behavior on the intent not to accept a physician’s diagnosis of depression. METHODS We conducted a cross-sectional study of 10,962 persons aged 16 to 29 years who participated and had positive screening results on the Center for Epidemiologic Studies Depression (CES-D) score in an Internet-based public health depression screening program. Participants reported whether they would accept their physician’s diagnosis of depression. Based on the theory of reasoned action, we developed a multivariate model of the factors that predict intent not to accept a diagnosis of depression. RESULTS Twenty-six percent of the participants stated their intent not to accept their physician’s diagnosis of depression. Disagreeing that medications are effective in treating depression (strongly disagree, odds ratio ( OR ) = 6.5, 95% confidence interval (CI), 4.6–9.3), that there is a biological cause for depression (strongly disagree, OR = 1.9, 95% CI, 1.3–2.7), and agreeing that you would be embarrassed if your friends knew you had depression were associated with the intent not to accept a diagnosis of depression (strongly agree, OR = 2.3, 95% CI, 1.8–2.9). Beliefs and attitudes, subjective social norms, and past behavior explained most of the variance in this model (84%). CONCLUSIONS Negative beliefs and attitudes, subjective social norms, and lack of past helpful treatment experiences are associated with the intent to not accept the diagnosis of depression and may contribute to low rates of treatment among young adults.

Minor depression as a predictor of the first onset of major depressive disorder over a 15-year follow-up

Objective:  To study the relationship of minor depression to first onset of major depressive disorder (MDD) among 1634 individuals over a 15‐year follow‐up using the Baltimore Epidemiologic Catchment Area cohort.

Attitudes and illness factors associated with low perceived need for depression treatment among young adults

BackgroundWe do not yet fully understand how low perceived need for treatment leads many young adults to not seek care for their depression.MethodsA cross-sectional study of 10,962 depressed young adults (ages 16–29) who visited a depression screening/education Internet website. Based on the Theory of Reasoned Action, we developed a multivariate model to determine the effects of beliefs and attitudes, social norms, past treatment behavior, and symptom severity on low perceived depression treatment need (i.e., not agreeing that one needs depression treatment).ResultsNegative beliefs and attitudes, social norms, and past treatment behavior predicted low perceived depression treatment need and explained more than half the model variance. Even after adjusting for depression severity and symptoms of other mental disorders, lacking confidence in either a biological or counseling based explanation or treatment approach for depression predicted low perceived depression treatment need.ConclusionsLack of helpful treatment experiences and/or confidence in either of the currently practiced depression treatment models may prevent many young adults from seeking depression treatment.

Metabolite changes resulting from treatment in children with ADHD: a 1H-MRS study.

Previously the authors noted an increase in glutamatergic tone in children with attention deficit hyperactivity disorder compared with age- and gender-matched control subjects. In this study they examine the effect of treatment on metabolite concentrations. Fourteen children with attention deficit hyperactivity disorder were investigated medication free and after treatment, using proton magnetic resonance spectroscopy. In the prefrontal cortex and striatum, metabolite peaks of N-acetyl-aspartate, glutamate/glutamine/&ggr;-aminobutyric acid, creatine/phosphocreatine, and choline compounds were measured, and ratios of the peaks were calculated and compared before and after treatment. The glutamate/glutamine/&ggr;-aminobutyric acid-to-creatine/phosphocreatine ratio decreased significantly in the striatum. No other metabolites demonstrated any change in response to medication. These findings suggest that glutamate may be involved in treatment response in attention deficit hyperactivity disorder, especially in the striatum.

Stigma Beliefs of Asian Americans With Depression in an Internet Sample

Objective: To study the beliefs of Asian Americans with depression about stigma associated with depression treatment among friends, employers, and family. Method: Participants completed the Center for Epidemiologic Studies-Depression Scale (CES-D) anonymously on the Internet. In this cross-sectional design, those who screened positive for depression were asked questions regarding stigma (n = 68 656). We used analysis of variance (ANOVA) and analysis of covariance (ANCOVA) to compare Asian Americans with whites and also to make comparisons by age and sex. Further, we stratified for Asian Americans and used ANOVA and ANCOVA to compare age and sex. We used linear regression to assess how stigma beliefs were associated with self-reported need for depression treatment. Results: Asian Americans overall had greater stigma beliefs than did whites for all 3 stigma outcomes (P < 0.001), especially those related to family. Although this same pattern existed for subjects aged between 16 and 29 years and between 30 and 45 years (P < 0.001), among those aged under 16 years, this existed for family stigma (P < 0.001) but not for friends or employer stigma. In our stratified analyses among Asian Americans, male participants had greater stigma beliefs than did female participants for friends (P < 0.001) and employer (P < 0.05) but not for family. Conclusions: The pattern of Asian Americans having greater stigma levels than whites may be changing among younger Asian Americans because of acculturation. Also, among Asian Americans, unlike previous research showing no sex differences for stigma, we show that male participants had greater stigma levels than did female participants. Future directions should include measuring stigma after culture-specific interventions.

Adolescents With Depressive Symptoms and Their Challenges With Learning in School

We examine school performance among 83 adolescents at risk for major depression. Negative mood interfered with subjective measures of school performance, including ability to do well in school, homework completion, concentrate in class, interact with peers, and going to class. No significant relationships were found for mood and objective measures of school performance (school attendance, English, and Math grades). Students with a college-educated parent had stronger performance in objective measures (school attendance and Math grades), whereas males had lower English grades. In qualitative interviews, adolescents reported that negative thinking led to procrastination, which led to poor school performance, which led to more negative thinking. Adolescents with depressive symptoms that do not meet the threshold for referral report struggles in school. Understanding the specific challenges faced by adolescents with even low levels of depressive symptoms can help school nurses, teachers, and parents identify appropriate interventions to help adolescents succeed in school.

Internet Breast Health Information Use and Coping among Women with Breast Cancer

The objective of this work was to study, among breast cancer patients, if Internet health information use is associated with coping. Questionnaires were completed (n = 178) regarding Internet use and also coping as measured by the Brief Cope. MANOVA analyses were conducted for the 14 coping subscales. Following a significant MANOVA omnibus test, univariate ANOVA and multivariate ANCOVA analyses adjusting for covariates were performed. Univariate ANOVA showed acceptance, active coping, self-blame, and denial coping associated with Internet use but these results were not maintained in the multivariate ANCOVA models. Internet health information use is not associated with psychological coping in breast cancer patients.