Xiongzhao Zhu

The Cultural Shaping of Depression: Somatic Symptoms in China, Psychological Symptoms in North America?

The expectation that Chinese people present distress somatically is a central prediction of cultural psychopathology and has been the subject of considerable theoretical speculation. At the same time, empirical studies have been infrequent and have yielded mixed results. The authors examined symptom presentation in Chinese (n=175) and Euro-Canadian (n=107) outpatients, using spontaneous problem report, structured clinical interview, and symptom questionnaire methods. All 3 methods yielded cross-culturally equivalent somatic and psychological symptom subscales. Chinese outpatients reported more somatic symptoms on spontaneous problem report and structured clinical interview compared with Euro-Canadians, who in turn reported more psychological symptoms on all 3 methods. The relation between culture and somatic symptom presentation was mediated by a tendency toward externally oriented thinking. Difficulties with identifying emotions or describing them to others did not differ significantly across cultures, supporting a nonpathological interpretation of observed differences. Psychological symptom effects were larger and more consistent than somatic symptom effects; because other studies have confirmed the ubiquity of somatic presentations worldwide, these results suggest that Western psychologization may be more culturally specific than is Chinese somatization.

Abnormal hippocampal BDNF and miR-16 expression is associated with depression-like behaviors induced by stress during early life.

Some environmental stressors lead to the onset of depression via inhibiting hippocampal BDNF expression, but other environmental stressors-induced depression exhibits no change in BDNF expression. The underlying mechanisms behind the divergence remain unknown. In this study, depression-like behaviors were induced in rats by maternal deprivation (MD) and chronic unpredictable stress (CUPS). Depression-like behaviors were tested by open field test, forced swimming test, and sucrose consumption test. BDNF and miR-16 expressions in the hippocampus were examined by real-time PCR. MD and CUPS rats crawled less distance, exhibited decreased vertical activity, and produced more fecal pellets than control rats in the open field test. However, MD rats crawled less distance and produced significantly less fecal pellets than CUPS rats. In the forced swimming and sucrose consumption tests, CUPS and MD rats exhibited longer floating time and consumed less sucrose than control rats, but MD rats exhibited shorter floating time and consumed less sucrose than CUPS rats. MD but not CUPS rats showed lower BDNF mRNA and higher miR-16 expression than control rats. In MD rats, BDNF mRNA expression negatively correlated with the expression of miR-16. BDNF expression positively correlated with the total distance rats crawled and vertical activity in the open field test while miR-16 expression negatively correlated the two behaviors. BDNF positively correlated with sucrose preference rate while miR-16 negatively correlated with sucrose preference rate of the sucrose consumption test. Our study suggests that MD and CUPS induced different depression-like behaviors in rats. Depression induced by MD but not CUPS was significantly associated with upregulation of miR-16 and possibly subsequent downregulation of BDNF in hippocampus.

An examination of the psychometric properties of the chinese version of the barratt impulsiveness scale, 11th version in a sample of chinese adolescents

The current study examined the psychometric properties of the Chinese translation of the Barratt Impulsiveness Scale 11th version in a sample of adolescents from Hunan province, mainland China. During an initial assessment, 396 secondary school students (Grades 10–12) completed the scale and self-report measures assessing problem behaviors and alcohol use. The scale was re-administered 1 mo. later. Analysis gave Cronbach alpha of .80 and test-retest reliability of .70. Confirmatory factor analysis indicated a model containing six first-order factors and two second-order factors best fit the data. Girls reported higher Total scores than boys as well as higher scores on the motor impulsiveness, self-control, and cognitive instability sub-scales. Scores were associated in the predicted direction with a wide variety of self-reported problem behaviors including alcohol use, gambling, and academic misconduct. Current findings indicate that the translated scale is a promising tool with some further development for assessing impulsiveness with Chinese adolescents.

Measuring Adolescent Psychopathology: Psychometric Properties of the Self-Report Strengths and Difficulties Questionnaire in a Sample of Chinese Adolescents

PURPOSE The Strengths and Difficulties Questionnaire (SDQ) is a brief but comprehensive screening tool for adolescent psychopathology. The current study examined the psychometric properties of the Chinese version of the self-report form of the SDQ (SDQ-C). METHODS Participants included 1135 adolescents (15.1 +/- 1.8 years, 561 boys and 574 girls) recruited from five schools in mainland China. During a single school-based assessment, participants completed the SDQ-C and the Youth Self Report (YSR). RESULTS Chinese adolescents scored significantly higher on the peer problems subscale and significantly lower on the emotional symptoms, hyperactivity, and prosocial behavior subscales than did the British normative sample. Girls scored higher on the emotional symptoms subscale and lower on the conduct and peer problems subscales than did boys. Participants between the ages of 15 and 18 years scored higher on the hyperactivity and prosocial behavior subscales and lower on the peer problems subscale than did participants between the ages of 11 and 14. The SDQ-C exhibited strong internal consistency (overall Cronbachs alpha coefficient was .81) and moderate test-retest reliability (Pearsons correlation coefficient was .71 over an 8-week interval). Each SDQ-C subscale score was highly correlated with the corresponding subscale score of the YSR. Confirmatory factor analysis indicated that both the five-factor structure and the higher-order structure of the SDQ-C were suitable and invariant across sex and age. CONCLUSIONS The SDQ-C exhibited high levels of reliability and validity, indicating that the SDQ-C is appropriate for assessing psychopathology in Chinese adolescents.

Psychometric properties of the Cognitive Emotion Regulation Questionnaire : Chinese version

The aim of the present study was to develop a Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C) and to examine its psychometric properties in a sample of Chinese university students. The English version of the Cognitive Emotion Regulation Questionnaire was translated and back-translated prior to its administration to 791 participants recruited from two universities in Changsha, Hunan (China). Internal consistency, test–retest reliability, inter-scale reliability, and factorial validity were analysed. The CERQ-C exhibited: (1) moderate internal consistency (Cronbachs α=.83); (2) a mean inter-class correlation coefficient of .79; (3) a mean inter-item correlation coefficient of .09; and (4) moderate test–retest reliability (.64). Confirmatory factor analyses supported the original CERQ nine-factor model. Finally, with respect to criterion validity, several CERQ-C subscales were uniquely associated with symptoms of depression and anxiety.

First-Episode Medication-Naive Major Depressive Disorder Is Associated with Altered Resting Brain Function in the Affective Network

Background Major depressive disorder (MDD) has been associated with abnormal structure and function of the brains affective network, including the amygdala and orbitofrontal cortex (OFC). However, it is unclear if alterations of resting-state function in this affective network are present at the initial onset of MDD. Aims To examine resting-state function of the brains affective network in first-episode, medication-naive patients with MDD compared to healthy controls (HCs). Methods Resting-state functional magnetic resonance imaging (rs-fMRI) was performed on 32 first-episode, medication-naive young adult patients with MDD and 35 matched HCs. The amplitude of low-frequency fluctuations (ALFF) of the blood oxygen level-dependent (BOLD) signal and amygdala-seeded functional connectivity (FC) were investigated. Results Compared to HC, MDD patients showed reduced ALFF in the bilateral OFC and increased ALFF in the bilateral temporal lobe extending to the insular and left fusiform cortices. Enhanced anti-correlation of activity between the left amygdala seed and the left OFC was found in MDD patients but not in HCs. Conclusions Reduced ALFF in the OFC suggests hypo-functioning of emotion regulation in the affective network. Enhanced anti-correlation of activity between the amygdala and OFC may reflect dysfunction of the amygdala-OFC network and additionally represent a pathological process of MDD.

The impact of stress on depressive symptoms is moderated by social support in Chinese adolescents with subthreshold depression: A multi-wave longitudinal study

BACKGROUND Most studies have shown that negative life events and social support are important factors in the development and outcome of depression. It is unknown if these factors are important in adolescents with subthreshold depression. Thus, the current study examined whether high levels of social support from peers buffer adolescents exhibiting subthreshold depressive symptoms against experiencing further increases in such symptoms following the occurrence of negative events. METHODS Participants included 143 adolescents (aged 14 to 18; M=16.07, SD=.66) in Hunan Province China who were selected because they were exhibiting subthreshold depressive symptoms at the time of initial assessment. During an initial assessment, participants completed measures assessing social support from peers and depressive symptoms. Participants subsequently completed measures assessing depressive symptoms and the occurrence of negative events once every three months for the subsequent fifteen months. RESULTS The prevalence of lifetime subthreshold depression in Hunan was 22.9% (n=143). The results of hierarchical linear modeling analyses indicated that lower levels of social support from peers was associated with greater increases in depressive symptoms following the occurrence of negative events. CONCLUSIONS The results suggested that the association between the occurrence of negative events and increased depressive symptoms is moderated by social support from peers in adolescents with subthreshold depression in mainland China, in line with the buffering hypothesis. LIMITATIONS The adolescent sample used in the current study was from Hunan, China, which could limit the generalizability of our results to other populations. In addition, given that it is possible that cultural context shapes symptom manifestation, future research should assess a broader array of symptom outcomes.

Understanding the role of coping in the development of depressive symptoms: symptom specificity, gender differences, and cross-cultural applicability.

OBJECTIVES The primary aim examined whether coping deficits, a greater tendency to utilize maladaptive as opposed to adaptive coping strategies, was associated with increases in depressive symptoms following negative events. The secondary goals examined: the common vulnerability hypothesis, sex differences, and the cross-cultural generalizability. DESIGN Following the initial assessment, Canadian adolescents completed three follow-up assessments every 6 weeks. The Chinese adolescents completed an initial assessment and six follow-up assessments occurring monthly. METHODS At Time 1, 150 Canadian and 397 Chinese adolescents completed self-report measures assessing depressive symptoms, anxious symptoms, negative events, and coping. During each of the follow-up assessments, participants completed self-report measures assessing depressive symptoms, anxious symptoms, and negative events. RESULTS In both samples, higher levels of coping deficits were associated with increases in depressive, but not anxious, symptoms following negative events. Gender differences did not emerge. CONCLUSIONS The present study provides a theoretically driven model to examine the impact of broad-based coping on the development of depressive symptoms.

Gray matter volume abnormalities in individuals with cognitive vulnerability to depression: a voxel-based morphometry study.

BACKGROUND The hopelessness theory of depression posits that individuals with negative cognitive styles are at an increased risk for depression following negative life events. In neuroimaging studies, brain gray matter volume abnormalities correlate with the presence of depressive disorders. However, it is unknown whether changes in gray matter volume also appear in healthy individuals with cognitive vulnerability to depression (CVD). METHODS 30 subjects diagnosed with CVD, 33 first-episode patients with major depressive disorder (MDD), and 32 healthy controls were examined using voxel-based morphometry following magnetic resonance imaging (MRI). RESULTS We found significant volumetric differences between three groups in the left precentral gyrus, right fusiform gyrus and the right thalamus. In these regions, compared to controls, CVD subjects showed reduced gray matter volumes in the left precentral gyrus and right fusiform gyrus. MDD patients demonstrated reduced gray matter volume in the left precentral gyrus and increased gray matter volume in the right thalamus. Additionally, CVD individuals had significantly smaller right fusiform gyrus and right thalamus than MDD patients. The weakest-link scores on CSQ were negatively correlated with gray matter volumes in the left precentral gyrus. CONCLUSIONS Reductions in brain gray matter volume exist widely in individuals with CVD. In addition, there exist similar abnormalities in gray matter volume in both CVD subjects and MDD patients. Reductions of gray matter volume in the left precentral gyrus might be correlated to the negative cognitive styles, as well as an increased risk for depression.

Cognitive emotion regulation strategies as predictors of depressive symptoms in women newly diagnosed with breast cancer.

This study aimed to determine the effects of cognitive emotion regulation strategies on depressive symptoms in women with breast cancer.