A daily diary study on the independent and interactive effects of headache and self-regulatory factors on daily affect among adolescents.

OBJECTIVE: The relationship between recurrent headache and reduced psychological well-being among adolescents has been well documented. Evidence also suggests that headache is associated with greater impediment to successful goal pursuits, which in turn is related to reduced well-being. The aim of this study was to investigate both the independent and interactive effects of headache and self-regulatory processes on daily positive and negative affect. DESIGN AND METHODS: In order to be able to investigate both concurrent and prospective relationships a daily diary design was employed. Independent variables were headache occurrence, daily goal frustration, and strategies to cope with these setbacks. Dependent variables were daily negative and positive affect. Eighty-nine adolescents from the general population aged 13-21 completed an on-line diary for 3 weeks. Data were analysed using multi-level modelling. RESULTS: Negative affect was related to same day headache occurrence, high daily goal frustration, rumination, catastrophizing, other blame, and low coping efficacy beliefs. Furthermore, in the context of headache, coping efficacy appears to buffer the effects of goal frustration on same day negative affect. Negative affect on the next day was predicted by high daily goal frustration, rumination, catastrophizing, and low coping efficacy. In contrast, positive affect was related to no same day headache occurrence; low daily goal frustration, and high acceptance, positive refocusing, and coping efficacy. Positive affect on the following day was related to low daily goal frustration, rumination, and high positive refocusing. CONCLUSIONS: Daily goal frustration and cognitive coping strategies may provide important targets for interventions aimed at adolescent with reduced well-being due to headache.

Predictors of response to the 'Coping with Depression' course for older adults. A field study.

This field study explored the prognostic factors of the immediate and long-term effects of the Coping with Depression course for older adults (CWD). With the aim of both indicated as well as secondary prevention, the course is provided by the prevention departments of the community mental health care system in the Netherlands. A total of 317 course participants (age 55-85 years; 69% female) took part in this study; 41% had a major depressive disorder (MDD). A variety of demographic, clinical, psychosocial and treatment factors of possible relevance for indicated and secondary prevention were investigated. Random coefficient regression models and logistic regression models were used to examine their contribution to the immediate and maintenance effect. The course was beneficial for all participants, and the level of depression reached at the end of the course was maintained over the next 14-months. Current MDD, high levels of anxiety, less previous depressive episodes and more education predicted a larger benefit. However, the clinical significance of these predictors was too small to justify further triage. Further treatment should be considered for the participants with a post-treatment score >/=16. Group-membership was not a significant predictor of the variation in effect.