A meta-analytic review of the relations between anxiety and empathy.

Although theory suggests that empathy may signal a risk for anxiety (Tone & Tully, 2014), the relation between these constructs remains unclear due to the lack of a quantitative synthesis of empirical findings. We addressed this question by conducting three meta-analyses assessing anxiety and general, cognitive, and affective empathy (k's = 70-102 samples; N's = 19,410-25,102 participants). Results suggest that anxiety has a small and significant association with general empathy (r = .08). The relation of clinical anxiety with cognitive empathy was significant but very weak (r = -.03), and small for affective empathy (r = .16). Geographic region and the type of cognitive (e.g., perspective taking, fantasy) and affective empathy (e.g., affective resonance, empathic concern) emerged as moderators. Results suggest that anxiety has a weaker association with general empathy but a stronger association with affective empathy in participants from predominantly collectivistic geographic regions. Further, greater anxiety was weakly associated with less perspective-taking and greater fantasy, and anxiety had a more modest association with empathic concern than other types of affective empathy. Targeting affective empathy (e.g., promoting coping strategies when faced with others' distress) in interventions for anxiety may be beneficial.

Association between decentering and reductions in relapse/recurrence in mindfulness-based cognitive therapy for depression in adults: A randomized controlled trial.

OBJECTIVE: "Decentering" is defined as the ability to observe one's thoughts and feelings as temporary, objective events in the mind (Safran & Segal, 1990), and is increasingly regarded as a candidate mechanism in mindfulness-based interventions. The present study sought to examine the role of decentering, and other related variables, in the efficacy of Mindfulness-based cognitive therapy (MBCT) as compared to two active comparison conditions. METHOD: Formerly depressed individuals (N = 227), randomly assigned to MBCT (n = 74), relaxation group therapy (RGT; n = 77) or Treatment as usual (TAU; n = 76), completed self-report measures of decentering and symptoms of depression at pre-, mid-, and posttreatment, and relapse was assessed at 3, 6, 9, and 12 months, posttreatment. RESULTS: With regard to the acute treatment phase, results indicated that, whereas levels of depression increased in both RGT and TAU, MBCT patients remained free from symptom gains. Moreover, gains in decentering from mid- to posttreatment predicted reductions in depression from pre- to posttreatment for MBCT and TAU, but not for RGT. Participants who experienced increases in decentering, measured from mid- to posttreatment, generally evidenced the lowest levels of relapse/recurrence (during the four follow-up assessments), largely irrespective of treatment group. However, results related to change in decentering should be considered exploratory due to small cell sizes among participants who did not experience gains in decentering. CONCLUSIONS: Taken together, these results suggest that decentering is a potent mechanism for reduction of relapse in major depression, albeit one that is nonspecific to MBCT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Physicians' and Patients' Ratings of the Physician-Patient Working Alliance, Adherence, Satisfaction, and Treatment Outcome.

The physician-patient relationship is important and essential to the delivery of effective healthcare. The current study examined a measure of this relationship, which we call the physician-patient working alliance (PPWA). We examined it from both perspectives of the medical dyad, simultaneously, which to date has not been done. Data were analyzed via the Actor Partner Interdependence Model to account for the possibility of interdependence in the ratings provided by each member of the dyad. The sample consisted of sixty-eight physician-patient dyads. Patients' ratings of the PPWA were significantly associated with their ratings of adherence to, and satisfaction with treatment. Physicians' ratings of the PPWA were significantly associated with their ratings of patient adherence and to their own satisfaction with treatment. Significant "partner" effects were uncovered, in that physicians' ratings of the PPWA were significantly associated with patients' ratings of adherence. Significant zero-order correlations were also observed for physician-rated outcome; particularly, significant correlations with patient-rated and physician-rated adherence. We conclude that the PPWA is a significant factor in patients' and physicians' ratings of adherence and satisfaction. This study also provides initial evidence that the PPWA is a dyadic phenomenon (e.g., the perception of the strength of the PPWA in one member of the medical dyad impacts the other member's perception) and that both parts of the medical dyad should be considered in future research and in clinical practice.

Facial emotion recognition in major depressive disorder: A meta-analytic review.

BACKGROUND: Major depressive disorder (MDD) has been associated with difficulties in social and interpersonal functioning. Deficits in emotion processing may contribute to the development and maintenance of interpersonal difficulties in MDD. Although some studies have found that MDD is associated with deficits in recognition of emotion in faces, other studies have failed to find any impairment. METHODS: The present meta-analysis of 23 studies, with 516 dysthymic/depressed participants and 614 euthymic control participants, examined facial emotion recognition accuracy in MDD. Several potential moderators were investigated, including type of emotion, symptom severity, patient status, method of diagnosis, type of stimulus, and stimulus duration. RESULTS: Results showed that participants with MDD in inpatient settings (Hedges' g = -0.35) and with severe levels of symptom severity (g = -0.42) were less accurate in recognizing happy facial expressions of emotion (g = -0.25) compared to participants in outpatient settings (g = -0.24) and with mild symptoms of depression (g = -0.17). Studies that presented stimuli for longer durations (g = -0.26) tended to find lower accuracy levels in dysthymic/depressed, relative to euthymic, participants. LIMITATIONS: Limitations include a lack of studies which examined gender identity, as well as other potential moderators. CONCLUSIONS: Results of the current study support the existence of a broad facial emotion recognition deficit in individuals suffering from unipolar depression. Clinicians should be mindful of this and other research which suggests broad-based deficits in various forms of information processing, including attention, perception, and memory in depression.

Psychological and relational factors in ESRD hemodialysis treatment in an underserved community.

OBJECTIVE: The researchers investigated the association of depression with treatment adherence, and examined the possible moderating roles of social support and of the physician-patient working alliance (PPWA) on treatment adherence, satisfaction with treatment, and quality of life. METHODS: The current study sampled ninety-five patients with End Stage Renal Disease who were receiving outpatient hemodialysis (HD) treatment. RESULTS: Findings indicated that higher levels of depression were significantly associated with lower ratings of adherence, quality of life, and social support. In contrast, higher levels of social support and of the PPWA were significantly associated with higher ratings of adherence, satisfaction with treatment, and quality of life. Analyses of moderation showed no effect for PPWA between depression and adherence, satisfaction, or quality of life; however, there was a significant moderation effect for social support. CONCLUSION: There are mild but significant associations between PPWA and social support. Positive associations between the PPWA and social support on adherence, satisfaction, and quality of life indicate that each one, PPWA and social support, plays its own role on patients' experiences of and behavior in treatment. Affective social support significantly limits the negative influence of depression on adherence. PRACTICE IMPLICATIONS: Assessment of depression and social support is essential in hemodialysis treatment.

A comparison of decentering across demographic groups and meditation experience: Support for the measurement invariance of the Experiences Questionnaire.

Theory and prior research suggests that decentering-an objective, distanced perspective on one's internal experiences-may vary based upon characteristics such as age, gender, race/ethnicity, and meditation experience. However, little is known about whether decentering measures are comparable in their meaning and interpretation when administered to individuals with different group membership (e.g., men or women; younger or older adults, etc.). The current study examined the measurement invariance of the Experiences Questionnaire (Fresco et al., 2007), a commonly used measure of decentering, evaluating age, gender, race/ethnicity, and meditation experience in three samples (students, community members, and clinical participants). Each sample was tested separately to assess the generalizability of results. The Experiences Questionnaire demonstrated full or partial measurement invariance in all cases, suggesting that scores are not biased based upon group membership and may be compared across individuals who vary in age, race/ethnicity, gender, and meditation experience. The current study also examined mean differences in decentering by groups, finding some evidence that decentering scores are higher for men, racial/ethnic minorities, older adults, and individuals with more meditation experiences. Implications are discussed for assessing decentering in diverse samples. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Symptoms of depression and the discrepancy between implicit and explicit self-esteem.

BACKGROUND AND OBJECTIVES: While the role of explicit self-esteem (ESE) in depression has been well established, the relationship between implicit self-esteem (ISE) and depression is more uncertain. Recently, it has been suggested that a simultaneous consideration of both ESE and ISE may provide a more comprehensive understanding of the development and maintenance of depression than considering either ESE or ISE in isolation. The present paper tested whether the absolute discrepancy between ESE and ISE and the direction of the discrepancy are important factors to consider in relation to depressive symptoms. METHODS: 87 university students from the northeastern U.S. were recruited for the present study. The Beck Depression Inventory, the Rosenberg Self-Esteem Scale, and Implicit Association Test were used to assess participants' severity of depressive symptoms, explicit self-esteem, and implicit self-esteem, respectively. RESULTS: Results revealed a negative association between ESE and symptoms of depression. In addition, a positive relationship was found between the degree of discrepancy between ISE and ESE and depression. However, this relationship was only found among participants with higher ISE than ESE (i.e., damaged self-esteem), but not among participants with higher ESE than ISE (i.e., defensive or fragile self-esteem). CONCLUSIONS: While damaged self-esteem may be a meaningful marker of depressive symptoms, it should be noted that the association between symptoms of depression and the interaction of ISE and ESE may be driven primarily by the strong link between ESE and depression. As prior studies of ESE and ISE have not looked, specifically, at the relative contributions of both constructs, this issue needs further investigation in future research.

Health Sciences Libraries Advancing Collaborative Clinical Research Data Management in Universities.

PURPOSE: Medical libraries need to actively review their service models and explore partnerships with other campus entities to provide better-coordinated clinical research management services to faculty and researchers. TRAIL (Translational Research and Information Lab), a five-partner initiative at the University of Washington (UW), explores how best to leverage existing expertise and space to deliver clinical research data management (CRDM) services and emerging technology support to clinical researchers at UW and collaborating institutions in the Pacific Northwest. METHODS: The initiative offers 14 services and a technology-enhanced innovation lab located in the Health Sciences Library (HSL) to support the University of Washington clinical and research enterprise. Sharing of staff and resources merges library and non-library workflows, better coordinating data and innovation services to clinical researchers. Librarians have adopted new roles in CRDM, such as providing user support and training for UW's Research Electronic Data Capture (REDCap) instance. RESULTS: TRAIL staff are quickly adapting to changing workflows and shared services, including teaching classes on tools used to manage clinical research data. Researcher interest in TRAIL has sparked new collaborative initiatives and service offerings. Marketing and promotion will be important for raising researchers' awareness of available services. CONCLUSIONS: Medical librarians are developing new skills by supporting and teaching CRDM. Clinical and data librarians better understand the information needs of clinical and translational researchers by being involved in the earlier stages of the research cycle and identifying technologies that can improve healthcare outcomes. At health sciences libraries, leveraging existing resources and bringing services together is central to how university medical librarians will operate in the future.

Cognitive Performance in Adolescence: Links With Early Maternal Stimulation and Children's Anxious Behaviors.

This study tested a developmental model of cognitive performance in adolescence and explored potential mechanisms explaining the relations of early maternal stimulation and children's anxious behaviors with adolescents' cognitive performance. We utilized the NICHD SECCYD dataset (n = 1,112). Measures included questionnaires, coded observations, and self-report measures from infancy to adolescence. Results revealed that children who experienced greater early maternal stimulation and less anxious behaviors had better cognitive performance at age 15. Children's English self-efficacy, the quality of child-teacher relationships, and children's behavioral classroom engagement in middle childhood mediated the relation between early maternal stimulation and adolescent cognitive performance. Identifying pathways from earlier maternal and children's characteristics to children's later cognitive performance is an important step toward further understanding why early precursors have a long lasting impact on cognitive performance, and has implications for educational settings.

Structural Validity of the Social Problem-Solving Inventory-Revised Short Form: Application to Brooding and Reflection.

Research on social problem-solving ability or the cognitive-behavioral processes used to find successful solutions to everyday problems has been advanced by the availability of easy-to-administer self-report measures. The goal of the current study is twofold: (a) validate the factor structure of the Social Problem-Solving Inventory-Revised: Short Form (SPSI-R:S) and (b) examine the relationship between depressive rumination subtypes and dimensions of social problem solving. An initial confirmatory factor analyses (CFA) in Sample 1 revealed poor model fit. An exploratory factor analysis revealed that several items cross-loaded on more than one factor. These items were removed and a subsequent CFA demonstrated adequate model. The revised model was validated in a second sample and convergent and divergent validity were examined. Brooding was related to more maladaptive problem-solving ability while reflection was generally associated with a more adaptive problem-solving style. No gender differences were found.

Psychometric Evaluation of the IBD-Specific Anxiety Scale: A Novel Measure of Disease-Related Anxiety for Adolescents With IBD.

Anxiety related to pediatric inflammatory bowel disease (IBD) is a common comorbidity; yet, this construct is understudied because of lack of available valid measurement. Objective: The present study will report the preliminary validation of the 20-item IBD-Specific Anxiety Scale (IBD-SAS) in a large, geographically diverse sample of adolescents aged 12-18 years with IBD. Method: A total of 281 adolescents, ages 12-18 (M = 14.8, SD = 1.78; 51% male), completed the IBD-SAS along with measures of IBD-related quality of life, anxiety, depressive symptoms, and disease activity. Factor structure was assessed using exploratory and confirmatory factor analyses (EFA and CFA). Results: EFA (Sample 1; n = 141) yielded one-, two-, three- and four-factor models. The CFA (Sample 2; n = 140) demonstrated that a four-factor model was superior to three- and two-factor model for the amended scale. In total, the IBD-SAS showed excellent internal consistency (Cronbach's α = .95) and was most strongly associated with health-related quality of life. Moderate to strong associations were observed between IBD-SAS and general measures of anxiety and depressive symptoms, and IBD disease activity providing additional support that health-specific anxiety is a valid and distinct construct. Conclusions: Based on the results of this study, the IBD-SAS displayed adequate psychometric properties and can meaningfully contribute to the assessment of IBD-specific anxiety in adolescents diagnosed with IBD, thus filling an empirical and clinical need in this population.

ChIP and Chips: Introducing the WormPharm for correlative studies employing pharmacology and genome-wide analyses in C. elegans.

We present the WormPharm, an automated microfluidic platform that utilizes an axenic medium to culture C. elegans. The WormPharm is capable of sustaining C. elegans for extended periods, while recording worm development and growth with high temporal resolution ranging from seconds to minutes over several days to months. We demonstrate the utility of the device to monitor C. elegans growth in the presence of varying doses of nicotine and alcohol. Furthermore, we show that C. elegans cultured in the WormPharm are amendable for high-throughput genomic assays, i.e. chromatin-immunoprecipitation followed by next generation sequencing, and confirm that nematodes grown in monoxenic and axenic cultures exhibit genetic modifications that correlate with observed phenotypes. The WormPharm is a powerful tool for analyzing the effects of chemical, nutritional and environmental variations on organism level responses in conjunction with genome-wide changes in C. elegans.

Explanatory flexibility and explanatory style in treatment-seeking clients with Axis I psychopathology.

Cognitive diathesis stress models of depression emphasize individual styles of attributing causal explanations to negative and positive events in life. The Attributional Style Questionnaire (ASQ) has traditionally been used to measure explanatory style, defined as an individual's habitual way of assigning causes to negative events. Explanatory flexibility, rather than focusing on the content of one's thoughts, emphasizes the extent to which individuals are able to make different attributions depending on the particular context of each event. The underlying notion is that individuals who are better able to adapt to the cues and demands of a stressful situation may be able to respond more effectively and are thereby less vulnerable to depression. Despite evidence attesting to its relevance to depression and anxiety disorders, explanatory flexibility has yet to be examined in a purely treatment-seeking sample of patients clinically diagnosed with Axis I psychopathology. The current study examined baseline levels of explanatory flexibility, along with explanatory style, in a sample of 171 treatment-seeking patients diagnosed with either major depressive disorder (MDD), generalized anxiety disorder (GAD), or at least one other Axis I disorder. Overall, the results replicate and extend past results indicating a distinction between explanatory flexibility and explanatory style. Furthermore, patients with MDD and GAD demonstrated lower levels of explanatory flexibility relative to patients with other Axis I disorders. Thus, explanatory flexibility may assist in our understanding of the etiology, maintenance, and treatment of emotional disorders, with particular relevance to MDD and GAD.

Predicting symptoms of depression from social anhedonia and emotion regulation.

The literature examining social anhedonia, emotion regulation, and symptoms of depression in psychiatric inpatients has been limited. However, some studies have shown that difficulties in emotion regulation and social anhedonia were independently associated with depression. The current study attempted to examine the effects of these two potential predictors of unipolar depressed mood. Fifty-nine (73% female) psychiatric inpatients were given the measures of emotion regulation, symptoms of anxiety and depression, and social anhedonia. Results showed that difficulties in emotion regulation, specifically dysfunctional emotion regulation strategies and emotional clarity, served as significant predictors of depressive symptoms above and beyond contributions from social anhedonia. These results highlight the importance of attending to emotion regulation in the study and treatment of depression in inpatient samples.

An exploratory analysis of the factor structure of the Dysfunctional Attitude Scale-Form A (DAS).

A number of studies have attempted to identify the factor structure of the Dysfunctional Attitude Scale (DAS). However, no studies have done so using a clinical sample of outpatients likely to generalize to the clinical trials in which the DAS is commonly used. The current investigation utilized exploratory structural equation modeling in an outpatient sample (N = 982) and found support for a one-factor solution (composed of 19 items). This solution was largely confirmed in a second outpatient sample (N = 301). Construct validity was demonstrated in correlations with measures of depression, social interaction anxiety, and symptoms of obsessive-compulsive disorder.

Using the GAD-Q-IV to identify generalized anxiety disorder in psychiatric treatment seeking and primary care medical samples.

The fourth edition of the Generalized Anxiety Disorder Questionnaire (GAD-Q-IV) is a self-report measure that is commonly used to screen for the presence of generalized anxiety disorder (GAD). The current investigation attempted to identify an optimal cut score using samples obtained from an outpatient psychiatric (n=163) and primary care clinic (n=99). Results indicated that a cut score of 7.67 provided an optimal balance of sensitivity (.85) and specificity (.74) comparable to a previously identified cut score (5.7) across both samples (sensitivity=.90, specificity=.66). However, both cut scores were consistently outperformed by a score representing the criteria for GAD described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (sensitivity=.89, specificity=.82).

Are there meaningful differences between major depressive disorder, dysthymic disorder, and their subthreshold variants?

A number of researchers have proposed adding an increasing number of subthreshold variants of major depressive disorder (MDD) as new mood disorder. However, this research has suffered from a number of theoretical and methodological flaws that the current investigation has attempted to address. Individuals with MDD (n = 470) were compared with individuals with subthreshold MDD (n = 57). Individuals with MDD reported consistently more severe symptoms, albeit of small magnitude, as well as differences in comorbidity with only two disorders. Results also indicated that diagnosis did not significantly predict rate of symptom change when MDD was compared with its subthreshold variant. Taken together, the aforementioned evidence suggests that small differences exist between MDD and its subthreshold variant. In addition, the extent to which the latter serves as useful analogs for the former may depend upon the variables under study.

Depressive realism: a meta-analytic review.

The current investigation represents the first meta-analysis of the depressive realism literature. A search of this literature revealed 75 relevant studies representing 7305 participants from across the US and Canada, as well as from England, Spain, and Israel. Results generally indicated a small overall depressive realism effect (Cohen's d=-.07). Overall, however, both dysphoric/depressed individuals (d=.14) and nondysphoric/nondepressed individuals evidenced a substantial positive bias (d=.29), with this bias being larger in nondysphoric/nondepressed individuals. Examination of potential moderator variables indicated that studies lacking an objective standard of reality (d=-.15 versus -.03, for studies possessing such a standard) and that utilize self-report measures to measure symptoms of depression (d=.16 versus -.04, for studies which utilize structured interviews) were more likely to find depressive realism effects. Methodological paradigm was also found to influence whether results consistent with depressive realism were found (d's ranged from -.09 to .14).

Examination of the factor structure and concurrent validity of the Langer Mindfulness/Mindlessness Scale.

Langer's theory of mindfulness proposes that a mindful person seeks out and produces novelty, is attentive to context, and is flexible in thought and behavior. In three independent studies, the factor structure of the Langer Mindfulness/Mindlessness Scale was examined. Confirmatory factor analysis failed to replicate the four-factor model and a subsequent exploratory factor analysis revealed the presence of a two-factor (mindfulness and mindlessness) solution. Study 2 demonstrated that the two factors assessed discrete constructs and were not merely products of acquiescence. Support was also found for a nine-item, one-factor model comprised solely of mindfulness items. On comparing models, Study 3 suggested the superiority of the one-factor mindfulness model. Finally, a preliminary investigation of the concurrent validity of the revised nine-item Langer Mindfulness/Mindlessness Scale is presented. The current article offers researchers a revised version of a mindfulness measure derived from a cognitive perspective.

Brooding and pondering: isolating the active ingredients of depressive rumination with exploratory factor analysis and structural equation modeling.

Depressive rumination, as assessed by Nolen-Hoeksema's Response Styles Questionnaire (RSQ), predicts the onset, chronicity, and duration of depressed mood. However, some RSQ items contain depressive content and result in a heterogeneous factor structure. After the a priori elimination of items potentially confounded with depressed item content, Treynor, Gonzalez, and Nolen-Hoeksema identified two factors within the remaining RSQ rumination sub-scale that were differentially related to depression: brooding and pondering. However, Treynor et al. used a nonstandard form and administration of the RSQ. The present study sought to address these methodological idiosyncrasies and replicate the factor structure of Treynor et al. through exploratory factor analysis and structural equation modeling. Findings support the brooding and pondering solution and demonstrate that brooding relates more strongly to depression and anxiety than does pondering.