Associations of temporal and energetic characteristics of behavior with depressive symptoms: A population-based longitudinal study within Strelau's Regulative Theory of Temperament.

BACKGROUND: Individual dispositions have previously been associated with increased risk for depressive symptoms. The direction of the association has been found to be sometimes reciprocal. We examined whether temperament traits are associated with depressive symptoms and whether depressive symptoms contribute to changes in temperament. METHODS: Participants (n=674-811) were from a population-based Young Finns Study. Temperament was assessed by a Finnish version of the Formal Characteristics of Behavior - Temperament Inventory. Depressive symptoms were assessed with modified BDI (mBDI) in 1997, 2001, 2007 and 2012, and BDI-II in 2012. RESULTS: Higher perseveration and emotional reactivity were associated with higher level of depressive symptoms, and higher endurance was associated with lower level of depressive symptoms in 2007 and 2012. These associations were independent of several potential confounders and baseline depressive symptoms. The results of cross-lagged structural equation modeling showed that the associations between temperament and depressive symptoms were reciprocal: briskness, endurance and activity decreased the risk for depressive symptoms while depressive symptoms decreased the level of these characteristics. Perseveration, emotional reactivity and depressive symptoms reinforced each other over time. LIMITATIONS: The depressive symptoms scales we used are not meant for measuring clinically diagnosed depression. The relationships between temperament traits and depressive symptoms were not strong enough to provide a clinical basis for guiding treatment. CONCLUSIONS: Lower perseveration, lower emotional reactivity and higher endurance seem to be health protective temperament characteristics that reduce the risk for depressive symptoms. The reciprocal associations between temperament and depressive symptoms imply mutual health protective and health declining effects. Clinical relevance of the study is that enhancing positive loops and self-concept, and supporting individual stress management might be helpful in prevention of depressive symptoms.

Influence of wheelchair footrest height on ischial tuberosity pressure in individuals with paraplegia.

OBJECTIVE: To describe the effect of wheelchair footrest height on sitting pressures in persons with paraplegia. METHODS: Seventeen manual wheelchair users with paraplegia underwent a seat pressure examination while footrests were elevated from the initial position with the thighs parallel to the seat (p0), by 10% (position p10) and by 20% of the fibula length (position p20). We analyzed average pressure (AP), the contact surface of the body with the seat (CS), pressures on the ischial tuberosities-left (LIP) and right (RIP)--and average pressure on both ischial tuberosities (AIP). RESULTS: A gradual increase in footrest elevation was accompanied by significant increases in AP (p0: 57.24±14.31; p10: 60.65±14.85; p20: 62±15.3 mm Hg; Kendall coefficient of concordance W=0.962), AIP (p0: 159.35±54.95; p10: 176.35±53.3; p20: 184.26±54.09 mm Hg; W=0.896), LIP (p0: 165.24±54.05; p10: 183±52.08; p20: 193.18±56.32 mm Hg; W=0.751) and RIP (p0: 153.71±71.23; p10: 167.35±72.19; p20: 175.35±70.84 mm Hg; W=0.524) and a significant decrease in CS (p0: 1218.2±100.8; p10: 1131.8±134.6; p20: 1065±142.6 cm(2); W=0.985). There was a moderate correlation between the relative increase in LIP and RIP between p0 and p10, and between p10 and p20 (Pearson's correlation coefficient for LIP r=0.66; P=0.04, for RIP r=0.77; P=0.003), and a high correlation between relative changes in AIP (r=0.87; P<0.0001). CONCLUSION: Wheelchair footrest elevation caused a steady rise in AIP; however, left to right side pressure differences changed variably, suggesting that the risk of pressure ulcers may increase disproportionately with footrest elevation.