Marisol Perez

Evidence-based assessment of depression in adults

From diverse perspectives, there is little doubt that depressive symptoms cohere to form a valid and distinct syndrome. Research indicates that an evidence-based assessment of depression would include (a) measures with adequate psychometric properties; (b) adequate coverage of symptoms; (c) adequate coverage of depressed mood, anhedonia, and suicidality; (d) an approach to suicidality that distinguishes between resolved plans and preparations and desire and ideation; (e) assessment of the atypical, seasonal, and melancholic subtypes; (f) parameters of course and chronicity; and (g) comorbidity and bipolarity. These complexities need to be accounted for when certain assessment approaches are preferred, and when ambiguity exists regarding the categorical versus dimensional nature of depression, and whether and when clinician ratings outperform self-report. The authors conclude that no one extant procedure is ideal and suggest that the combination of certain interviews and self-report scales represents the state of the art for evidence-based assessment of depression.

On fatalism, pessimism, and depressive symptoms among Mexican-American and other adolescents attending an obstetrics-gynecology clinic

There is growing evidence that Mexican-American adolescents may be at increased risk for depressive symptoms. We sought to replicate and explain this result in a study of adolescent girls attending an obstetric-gynecologic clinic. Three hundred and four girls of diverse ethnic backgrounds completed measures of depressive symptoms, negative attributional style, and locus of control. Consistent with predictions, we found that Mexican-American adolescent girls reported more depressive symptoms than adolescent girls from other ethnic backgrounds, and that Mexican-American adolescent girls displayed more negative cognitive styles than girls from other ethnic backgrounds. Depression differences appeared to be partly explained by differences in negative cognitive style. Implications of the results for a theory of increased Mexican-American adolescent depression, and for applied work, were discussed.

Exploring the integration of thin-ideal internalization and self-objectification in the prevention of eating disorders.

Analyses of thin-ideal internalization and self-objectification were conducted within the context of a cognitive dissonance based eating disorder prevention program implemented in an undergraduate sorority. Participants completed self-report assessments at baseline (n=177), post-intervention (n=169), 5-month (n=159), and 1-year follow-up (n=105). Cross-sectional path analysis indicated that thin-ideal internalization and self-objectification predict each other and both predict body dissatisfaction, which in turn, predicts eating disorder symptoms. A longitudinal examination conducted using hierarchical linear modeling indicated that participants showed significant reductions in thin-ideal internalization, self-objectification, body dissatisfaction, and eating disorder symptoms after participating in the prevention program. Reductions of symptoms were maintained 1-year post-intervention, with the exception of self-objectification, which was significantly reduced up to 5-months post-intervention. Collectively, results suggest that targeting both thin-ideal internalization and self-objectification simultaneously within eating disorder prevention programs could increase the reduction of eating disorder symptoms.

Transportability of an empirically supported dissonance-based prevention program for eating disorders.

This study sought to evaluate the degree to which positive effects remained when a well studied cognitive dissonance eating disorder prevention program was disseminated through a large national sorority under naturalistic conditions. All participants underwent a 2-session program run by peer facilitators. The sample included 182 undergraduate women from a local chapter of a national sorority at a large public university. Analyses revealed that the program significantly reduced body dissatisfaction, thin ideal internalization, dietary restraint, and the use of the media as a source of information about beauty, and restrained eating. Importantly, effect sizes were maintained at 5-months and 1-year follow-up. These findings demonstrate that empirically supported programs can remain effective when disseminated with careful training in large social systems.

Anxiety Sensitivity as a Specific and Unique Marker of Anxious Symptoms in Youth Psychiatric Inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.

The relationship between quality of life, binge-eating disorder, and obesity status in an ethnically diverse sample.

This study examined the relationship between obesity status, binge‐eating disorder (BED), and quality of life (QOL) in a large, ethnically diverse community sample of adult men and women. Using data from the Collaborative Psychiatric Epidemiological Surveys (N = 20,013), individuals were categorized into four groups: nonobese with BED (n = 142), nonobese without BED (n = 14,301), obese with BED (n = 136), and obese without BED (n = 4,863). Results indicated obese individuals with BED consistently reported the poorest QOL. Findings suggested that obesity status was more strongly related to physical health‐related QOL variables (e.g., number of physical conditions, mobility impairment) whereas diagnostic status was more predictive of mental health and social functioning QOL variables (e.g., cognitive impairment, social interaction impairment, time out of role). The degree to which lifetime BED diagnosis was associated with impairment in social interaction differed across ethnic groups. For black individuals, the number of physical health conditions was associated with BED presence moreso than weight status.

Relative left-frontal activity is associated with increased depression in high reassurance-seekers

Excessive reassurance-seeking, which has been associated with depression in many studies, can be defined as the relatively stable tendency to seek assurance perseveratively from others. We hypothesized that although depression has been associated with left-frontal EEG hypoactivity, reassurance-seekers may possess a unique diathesis that is more likely to be associated with increased left-frontal activity. Data were collected from 12 volunteers who were receiving therapeutic services from a University Clinic. EEG asymmetry scores were averaged over two measurement occasions at least 3 weeks apart. As predicted, stable relative right-frontal activity was associated with increased depression in those who were low on reassurance-seeking, while stable relative left-frontal activity was associated with increased depression among high reassurance-seekers. Perhaps those who seek reassurance excessively do so because of their inability to alter their behavior even when environmental cues are no longer reinforcing, which can maintain or exacerbate their depressive symptoms.

Affective and attributional features of acculturative stress among ethnic minority college students

Little is known about the affective features of acculturative stress or its relation to attributional styles for negative events. The authors examined associations among acculturative stress, attributional style, and positive and negative affect among 96 ethnic minority college students. They hypothesized that acculturative stress would be characterized by elevated negative affect and global and stable attributions for negative events. Consistent with prediction, acculturative stress was significantly associated with negative affect and global attributions, even when controlling for other relevant predictors. Attributional style did not account for the association between negative affect and acculturative stress. Positive affect and stable and internal attributional styles were not related to acculturative stress. The authors discuss implications for reducing stress associated with acculturation.

Phenylthiocarbamide tasting and family history of depression, revisited: low rates of depression in families of supertasters

Past studies suggest that phenylthiocarbamide (PTC) taste status is related to vulnerability to depression, such that those sensitive to PTC are more vulnerable. We questioned this, reasoning that those insensitive to PTC may be more vulnerable (because they may have lower hedonic tone and higher risk for alcohol abuse). Forty-two volunteers responded to questionnaires regarding family history of depression, and were assigned to supertaster, taster, or non-taster categories based on taste reactions to a 3.80 x 1.43 cm piece of commercially prepared paper treated with PTC. Supertasters were significantly less likely to report first-degree relatives with a history of depression than were tasters and non-tasters. Supertasters may be afforded some protection from depression; elucidating the mechanisms of this protection is a potentially interesting avenue for future research.

Associations of phenylthiocarbamide tasting to alcohol problems and family history of alcoholism differ by gender

Past research associating phenylthiocarbamide/propylthiouracil (PTC/PROP) taste status with alcoholism has produced equivocal results. Some have found higher proportions of nontasters among those with a family history of alcoholism than controls, whereas others have not. The purpose of this study was to investigate the relationship between PTC taste status, alcohol problems, and family history of alcoholism. A total of 244 undergraduate students participated in this study, with a gender distribution of 75% female and 25% male. We found support for our hypothesis that male supertasters would report fewer problems with alcohol and a less significant family history of alcoholism. Interestingly, we also found that female supertasters had a greater family history of alcoholism and more current problems associated with alcohol use. Implications for the genetic link between PTC taste status and alcoholism are discussed.