Shadi Beshai

Mental Disorder Symptoms among Public Safety Personnel in Canada

Background: Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP. Methods: An online survey was made available in English or French from September 2016 to January 2017. The survey assessed current symptoms, and participation was solicited from national PSP agencies and advocacy groups. Estimates were derived using well-validated screening measures. Results: There were 5813 participants (32.5% women) who were grouped into 6 categories (i.e., call center operators/dispatchers, correctional workers, firefighters, municipal/provincial police, paramedics, Royal Canadian Mounted Police). Substantial proportions of participants reported current symptoms consistent with 1 (i.e., 15.1%) or more (i.e., 26.7%) mental disorders based on the screening measures. There were significant differences across PSP categories with respect to proportions screening positive based on each measure. Interpretation: The estimated proportion of PSP reporting current symptom clusters consistent with 1 or more mental disorders appears higher than previously published estimates for the general population; however, direct comparisons are impossible because of methodological differences. The available data suggest that Canadian PSP experience substantial and heterogeneous difficulties with mental health and underscore the need for a rigorous epidemiologic study and category-specific solutions.

A Cross-Cultural Study of the Cognitive Model of Depression: Cognitive Experiences Converge between Egypt and Canada.

Introduction Models of depression that arise in the West need to be examined in other regions of the world. This study examined a set of foundational hypotheses generated by Beck’s cognitive model of depression among depressed individuals in Egypt and Canada. Method We recruited 29 depressed and 29 non-depressed Egyptians and compared their results with those of 35 depressed and 38 non-depressed Canadians. Depression status was ascertained using a structured interview, scores on the Beck Depression Inventory, and scores on the Psychiatric Diagnostic Screening Questionnaire. Participants completed questionnaires designed to measure the frequency of negative and positive automatic thoughts (ATQ–N, BHS, and ATQ–P), and dysfunctional attitudes (DAS). Results Depressed individuals in both countries had significantly more negative thoughts about self and future, greater frequency of dysfunctional attitudes, and diminished positive self-thoughts in comparison to non-depressed individuals. Egyptians generally showed significantly more dysfunctional attitudes than their Canadian counterparts. Discussion The four hypotheses that were tested were supported among the depressed Egyptian sample, which is consistent with the cognitive model. Implications for the cognitive-behavioral model and treatment for this group of sufferers are discussed.

Reduced Contact Cognitive-Behavioral Interventions for Adult Depression: A Review

ABSTRACT Depression is a highly prevalent and debilitating mental health condition. Evidence suggests that there is a widening gap between the demand for and availability of effective treatments. As such, there is a vast need for the development and dissemination of accessible and affordable treatments for depression. In the past decade, there has been a proliferation of reduced client-therapist contact protocols for depression. In this article, the authors review and compare the efficacy of reduced contact cognitive-behavioral interventions for adult depression across two degrees of therapist-client contact (i.e., no therapist-client contact versus minimal therapist-client contact interventions). The authors also discuss the methodological and theoretical limitations of this research base. The present review suggests that a) reduced contact interventions for depression can be effective in remediating the symptoms of depression; b) the effect sizes of some reduced contact protocols may approximate those reported in traditional protocols involving significantly greater client-therapist contact; and c) protocols which employ some form of client-therapist contact, on average, generate higher effect sizes than those that are purely self-help in nature. A discussion of the theoretical and applied implications of such findings, as well as areas in need of further research, is provided.

The effects of the gender-culture interaction on self-reports of depressive symptoms: cross-cultural study among Egyptians and Canadians

Purpose Research in depression has revealed differences in the way depressed individuals across cultures report their symptoms. This literature also points to possible differences in symptom reporting patterns between men and women. Using data from a larger dataset (Beshai et al. 2016), the current study examined whether non-depressed and depressed Egyptian and Canadian men and women differed in their self-report of the various domains of the Beck Depression Inventory –II (BDI-II). Method We recruited a total of 131 depressed and non-depressed participants from both Egypt (n = 29 depressed; n = 29 non-depressed) and Canada (n = 35 depressed; n = 38 non-depressed). Depression status was ascertained using a structured interview. All participants were asked to complete the BDI-II along with other self-report measures of depression. BDI-II items were divided into two subscales in accordance with Dozois, Dobson & Ahnberg (1998) factor analysis: cognitive-affective and somatic-vegetative subscales. Results We found a significant three-way interaction effect on the cognitive-affective (F(1,121) = 9.51, p = .003) and main effect of depression status on somatic-vegetative subscales (F(1,121) = 42.80, p < .001). Post hoc analyses revealed that depressed Egyptian men reported lower scores on the cognitive-affective subscale of the BDI-II compared to their depressed Canadian male counterparts. Conclusions These results suggest that males across cultures may differentially report cognitive symptoms of depression. These results also suggest that clinicians and clinical scientists need to further examine the interaction effect of culture and gender when investigating self-reported symptoms of depression.

Personal relative deprivation associated with functional disorders via stress: An examination of fibromyalgia and gastrointestinal symptoms

Background Personal relative deprivation is a negative social comparison process typified by self-comparison, negative appraisal, and resultant negative emotionality. Personal relative deprivation has been associated with poorer physical and mental health in several domains. It has been hypothesized that the deprivation-health link operates through a stress pathway. Stress has been specifically implicated in the onset and maintenance of functional disorders, including fibromyalgia and functional gastrointestinal disorders. Despite the theoretical links between personal deprivation, stress, and functional disorders, researchers have not assessed relationships between these variables. Methods We recruited community participants (n = 517; 54.9% female) to examine whether personal relative deprivation can account for variance in fibromyalgia and functional gastrointestinal symptoms beyond known demographic correlates of physical health. We also examined whether the relationships between personal relative deprivation and functional disorder symptoms are mediated by stress. Results Consistent with our hypotheses, personal relative deprivation accounted for symptom variance in fibromyalgia and functional gastrointestinal disorders beyond that accounted for by demographic variables alone. Further, self-reported stress was found to mediate relationships between personal relative deprivation and fibromyalgia and gastrointestinal symptoms. Conclusions The current results support biopsychosocial models of physical health and suggest that, for patients presenting with functional disorders symptoms, a combination of biological and psychosocial interventions may be warranted.

Configural and scalar invariance of the center for epidemiologic studies depression scale in Egypt and Canada: Differential symptom emphasis across cultures and genders

BACKGROUND Depression is a significant contributor of global disease burden. Previous studies have revealed cross-cultural and gender differences in the presentation of depressive symptoms. Using the Center for Epidemiologic Studies-Depression Scale (CES-D), the present study examined differences in self-reported somatic, negative affective, and anhedonia symptoms of depression among Egyptian and Canadian university students. METHODS A total of 338 university students completed study questionnaires from two major universities in Egypt (n=152) and Canada (n=186). Symptom domains were calculated based on the 14-item model of the CES-D. RESULTS We found significant culture by gender interactions of total CES-D scores, wherein Egyptian females reported higher scores compared to their Canadian and Egyptian male counterparts. LIMITATIONS Limitations include using analogue student samples and using only one self-report measure to examine different depressive symptom domains. CONCLUSIONS Findings of this study provided support that males and females may differentially report depressive symptoms across cultures. Implications of these results are further discussed.

First episode indices associated with lifetime chronicity of depression among formerly depressed participants: an exploratory study

Abstract Background: Researchers have found that an earlier age of disorder onset and the severity of the first depressive episode are associated with recurrence in depression. Additionally, neuroticism has been shown to be an important factor in the recurrence of the disorder. Aims: This exploratory study aimed to replicate and extend previous research by examining the relationships between features of the first experienced depressive episode (age of onset, severity), the five factors of personality, and lifetime chronicity of depression. Method: Forty-three previously depressed participants completed measures of personality, current depression, hopelessness, and perfectionism. Previous depressive episodes were assessed using a semi-structured interview, and features of these episodes experienced by participants were recorded. Results: Pearson correlations showed that depression chronicity, measured in the number of weeks depressed in a lifetime, was significantly correlated with age of onset and number of symptoms experienced in the first episode. Personality measures were not significantly associated with depression chronicity. Conclusion: Earlier and more severe first episodes of depression may play an important role in the recurrence of the disorder. Future research should focus on replication and determining the causal role of these features.

Trait mindfulness may buffer against the deleterious effects of childhood abuse in recurrent depression: A retrospective exploratory study: Mindfulness as buffer in recurrent depression

Background: Individuals with a history of childhood maltreatment are particularly vulnerable to a longer course of depression. Immunisation theories of resilience suggest that resilience and related factors may buffer against the deleterious effects of early childhood adversity. Trait mindfulness is linked to resilience and may be a pathway to cultivating this dynamic process. In this study, we investigated whether trait mindfulness can buffer against the effects of early childhood maltreatment in predicting lifetime number of months depressed. Methods: We recruited 43 previously depressed, currently remitted patients, and retrospectively examined their depression history (using a structured interview, LIFE-SCID (Longitudinal Interval Follow-Up Evaluation— Structured Clinical Interview for the Diagnostic and Statistical Manual-IV)), their self-reported experience of maltreatment in the first 16 years of life (MOPS (Measure of Parental Style)), and their levels of trait mindfulness (MAAS (Mindfulness Attention Awareness Scale)). Results: We found that number of months depressed in a lifetime was positively associated with reported childhood maltreatment, and negatively associated with trait mindfulness. Second, we found evidence that trait mindfulness significantly moderated the relationship of early childhood maltreatment and number of months depressed. Specifically, it appears that individuals who report severe histories of maltreatment are especially vulnerable to recurrent depression if they are also reporting low levels of trait mindfulness. Conclusions: Increasing mindfulness may be warranted among individuals reporting a history of childhood abuse with lower baselines of trait mindfulness; however, results of this retrospective study require replication in a larger, prospective trial.