Mediating Effect of Resilience on the Association between Emotional Neglect and Depressive Symptoms

OBJECTIVE: Previous studies have reported that childhood maltreatment experiences could induce biological and psychological vulnerability in depressive disorders. However, it is still unclear that type-specific effects of childhood maltreatment on psychological resilience, depressive symptoms and interactions among childhood maltreatment experiences, resilience, and depressive symptoms. METHODS: A total of 438 medical students were included in the study. The Childhood Trauma Questionnaire-Short Form, the Conner-Davidson Resilience Scale, and the Beck Depression Inventory were used for measuring childhood maltreatment experiences, psychological resilience, and depressive symptoms, respectively. We investigated the effects of childhood maltreatment experiences on resilience and depressive symptoms using correlation analysis. In addition, we analyzed the mediating effect of resilience on the association between childhood maltreatment and symptoms of depression. RESULTS: Among childhood maltreatment, emotional neglect was a significant predictor of the scores of low resilience and high depressive symptoms in both gender groups (all ps < 0.05). Furthermore, resilience was found to be a mediator connecting emotional neglect experiences with depressive symptoms. CONCLUSION: Our results suggest that emotional neglect has detrimental effects on mood and resilience, and clinicians need to focus on the recovery of resilience when they deal with depressive symptoms in victims of childhood maltreatment.

Stability of Early Maladaptive Schemas and Their Relationships with Depressive Symptoms : A 2-Year Follow-Up Study / 신경정신의학

OBJECTIVES: Early maladaptive schemas (EMS) are assumed to be stable emotional and cognitive patterns that begin early in our development and are repeated throughout life. The primary aim of this study was to examine the two-year stability of EMS using the Young Schema Questionnaire (YSQ). In addition, we investigated the relationship between EMS and depressive symptoms over time. METHODS: Seventy-nine medical students completed the YSQ-short form 3, the Beck Depression Inventory, and the Symptom Checklist-90-Revised during their first and third years of medical school. RESULTS: After controlling for depression severity, YSQ subscales showed significant test-retest correlations for all of the subscales (r between 0.49 and 0.77, ps<0.001). Mean scores for all of the subscales did not differ significantly at retest, with the exception of a significant reduction of vulnerability to harm/illness (t=3.71, p<0.001). Concerning the relationship with depression, some YSQ subscales showed association with the severity of depressive symptoms at each time point, as well as changes between two time points. In particular, the schemas of Defectiveness/Shame and Dependence/Incompetence showed a strong association with changes of depressive symptoms. CONCLUSION: These findings demonstrated that EMS measured using the YSQ may show con-siderable temporal stability over time, but, in part, may be affected by an individual's state, such as depression.

A Comparative Study on Alexithymia in Depressive, Somatoform, Anxiety, and Psychotic Disorders among Koreans

OBJECTIVE: Little is known about the characteristic differences in alexithymic construct in various psychiatric disorders because of a paucity of direct comparisons between psychiatric disorders. Therefore, this study explored disorder-related differences in alexithymic characteristics among Korean patients diagnosed with four major psychiatric disorders (n=388). METHODS: Alexithymic tendencies, as measured by the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), of patients classified into four groups according to major psychiatric diagnosis were compared. The groups consisted of patients with depressive disorders (DP; n=125), somatoform disorders (SM; n=78), anxiety disorders (AX; n=117), and psychotic disorders (PS; n=68). RESULTS: We found that substantial portions of patients in all groups were classified as having alexithymia and no statistical intergroup differences emerged (42.4%, 35.9%, 35.3%, and 33.3% for DP, SM, PS, and AX). However, patients with DP obtained higher scores in factor 2 (difficulties describing feelings) than those with SM or AX, after adjusting for demographic variables. CONCLUSION: These findings suggest that alexithymia might be associated with a higher vulnerability to depressive disorders and factor 2 of TAS-20K could be a discriminating feature of depressive disorders.

The Comparison of Psychological Characteristics Between Undergraduate and Graduate Medical Students / 신경정신의학

OBJECTIVES: The conversion of medical colleges into medical schools has been attempted by the Korean government since 2005. The aim of this study was to compare psychological characteristics of undergraduate and graduate medical students before and after changes in the medical educational system. METHODS: Four hundred-and-twenty-eight medical students participated in this study; 247 were undergraduates and 181 were graduate students. The participants completed psychological assessments including the Minnesota Multiphasic Personality Inventory (MMPI), the Symptom Checklist-90-Revision (SCL-90-R), the Beck Depression Inventory (BDI), and the Alexithymia Scale. RESULTS: Overall, undergraduate medical students demonstrated significantly higher scores than the graduate medical student on three of MMPI subscales (F, depression, and social introversion) and two of SCL-90-R subscales (somatization and obsessive-compulsive). When comparing the four groups (male undergraduate, female undergraduate, male graduate, female graduate) using analysis of covariance and controlling for age as a covariate, there were significant differences between male graduate and male undergraduate medical students in the same subscales except somatization, whereas there were no significant differences between female groups. CONCLUSION: These findings suggest that male graduate medical students may have better mental health states and less psychological problems than undergraduate medical students even after controlling for age. However, these differences were not found between female groups. Although every score of all items was within normal range regardless of group, distinctive differences between male graduate and undergraduate students were revealed for some psychological profiles such as depression, social introversion, and obsessive-compulsive traits.

The Relationship between Alexithymia and General Symptoms of Patients with Depressive Disorders

OBJECTIVE: Depression has been associated with alexithymic features. However, few studies have investigated the differences in the general symptoms of patients with depressive disorders according to the presence of alexithymia. Thus, the aim of this study was to evaluate the relationship between alexithymia and symptoms experienced by patients with clinically diagnosed depressive disorders. METHODS: A chart review of patients who were evaluated using the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20) and Symptom Checklist 90-Revised (SCL-90-R) at the same time between the years 2003 and 2007 was conducted. A total of 104 patients with depressive disorders were included and divided into two groups: alexithymia (n=52) and non-alexithymia (n=52). A direct comparison between the two groups was carried out. Regression analysis was also carried out for the TAS-20 total and subset scores in order to model the relationship between alexithymia and symptoms. RESULTS: The presence of alexithymia was confirmed in 50% of the patients with depressive disorders, and the symptoms of depressive patients with alexithymia were more severe than those of their non-alexithymic counterparts on all 9 symptom domains of the SCL-90-R. Furthermore, regression analysis revealed that the presence of alexithymia was positively associated with depression, phobic anxiety, and psychoticism but inversely associated with anxiety. CONCLUSION: These results suggest that the clinical features of depression are partially dependent on the presence of alexithymia. Alexithymic patients with depressive disorders are likely to show more severe depressive, psychotic, and phobic symptoms. In other words, clinicians should suspect the presence of alexithymic tendencies if these symptoms coexist in patients with depressive disorders and address their difficulties in effective communication.