Self-criticism and self-esteem in early adolescence: Do they predict depression?

Beck's theory suggests that forming negative self-cognitions is a key early step in the development of depression. However, others have suggested the reverse, arguing that depression leads to development of negative self-beliefs. As such, there is debate about whether these cognitions are precursors to, or alternatively are caused by, depression. Although Beck's theory is supported in older adolescents, it has not been clearly seen in younger adolescents. This study aimed to assess the relation between two major self-cognitions (self-esteem and self-criticism) and depressive symptoms in early adolescence. Two-hundred and forty-three Australian adolescents (mean age = 12.08, 52% female) completed measures of self-esteem, self-criticism and depressive symptoms at baseline, then approximately 12- and 24-months later. Growth-curve modelling was used to assess changes in the variables. Cross-lagged analysis assessed whether either of the self-cognition variables predicted depressive symptoms, or if depressive symptoms predicted self-cognitions. Results indicated that self-criticism and depressive symptoms increased over the time period, while self-esteem decreased, and these changes were all related. Self-esteem predicted depressive symptoms from Time 2 to Time 3, while depressive symptoms predicted self-esteem from Time 1 to Time 2. Self-criticism did not predict depressive symptoms, nor did depressive symptoms predict self-criticism. These links appeared largely independent of gender. Self-esteem and depressive symptoms during the early adolescent period thus appear to have a somewhat reciprocal relation, while self-criticism does not appear to predict the development of depression. As such, while low self-esteem does appear to have an important role of in the development of depression in this age group, it is not strictly predictive, nor is this effect seen across all negative self-cognitions.

Parental behavioural control in adolescence: How does it affect self-esteem and self-criticism?

INTRODUCTION: Parental behavioural control is believed to be beneficial for young children. However, with increased need for independence during adolescence, parental rules may undermine self-beliefs. METHODS: The current study examined the effect of behavioural control, plus parental support and psychological control, on the self-esteem and self-criticism of 243 Australian adolescents (mean age = 12.08, 52% female) over two years. RESULTS: Behavioural control largely did not predict self-esteem. Furthermore, in girls it predicted higher self-criticism 12 and 24 months later. Behavioural control does not appear to benefit adolescents' self-cognitions and, in fact, increases self-criticism in girls. CONCLUSIONS: By providing copious rules around appropriate behaviours, parents may possibly indicate to girls that they are not capable of becoming independent, thus reducing feelings of competence.

How does immediate recall of a stressful event affect psychological response to it?

BACKGROUND AND OBJECTIVES: In forensic settings, individuals who experience a traumatic event are often encouraged to recall it soon afterwards to preserve their memory for it. Some theories of the development of post-traumatic stress disorder (PTSD) suggest that this may increase psychopathology. The primary aim of the study was to examine the effect of immediate recall of a trauma analogue video on psychopathology. METHOD: Eighty-five undergraduate students were randomised to view a video of a car accident, described as either a real event (high stress) or training event (low stress). They then completed either the Self-Administered Interview (SAI©, Gabbert, Hope, & Fisher, 2009) or a filler task. All participants returned one week later to provide an account of the event. RESULTS: As predicted, participants in the SAI early recall task condition remembered the video content better one week after seeing the video, shown both by their greater recall of correct details and greater rejection of misinformation. However, completing the SAI resulted in higher anxiety immediately afterwards, and more severe PTSD-like symptoms one week later, compared to control condition. PTSD intrusion-like symptoms also predicted more accurate recall, while avoidance predicted poorer memory. LIMITATIONS: While the trauma analogue video used in this study has been previously used, and did effectively trigger post-traumatic-like symptoms, it is unclear how well these results generalise to actual trauma situations. CONCLUSIONS: These results suggest the relationship between PTSD symptoms and memory might be more complex than previously recognised, with intrusive phenomena possibly promoting memory and avoidance symptoms compromising memory.

The contribution of nocturnal sleep to the consolidation of motor skill learning in healthy ageing and Parkinson's disease.

The benefits of sleep for the consolidation of procedural motor skills are less robust in older adults, although the precise reasons for this remain unclear. To date, even less is known about these processes in older adults with neurodegenerative diseases, particularly those which impact on motor functioning. While sleep disturbance and motor symptoms are frequent disabling features of Parkinson's disease, no known studies have directly probed sleep-dependent memory consolidation for motor skill learning in Parkinson's disease. Forty patients with idiopathic Parkinson's disease (age = 63.7 years ± 7.7; disease duration 4.1 years ± 4.4) completed a motor skill learning task pre- and post-sleep and were compared to 20 age- and sex-matched controls recruited from the community. Polysomnography was undertaken during the post-training night and measures of sleep architecture were derived. Parkinson's disease patients did not demonstrate any apparent deficits in within-session learning and overnight stabilization compared to controls, with both groups failing to demonstrate offline improvements in performance (i.e. memory consolidation). In controls, longer duration in slow wave sleep was associated with improved next-day session learning (P = 0.007). However, in Parkinson's disease, no relationships between sleep parameters and learning measures were found. Slow wave sleep microarchitecture and the use of dopaminergic medications may contribute to impaired sleep-dependent multi-session acquisition of motor skill learning in Parkinson's disease.

Problem-solving versus cognitive restructuring of medically ill seniors with depression (PROMISE-D trial): study protocol and design.

BACKGROUND: With an ageing population in most Western countries, people are living longer but often with one or more chronic physical health problems. Older people in physically poor health are at greater risk of developing clinical depression. Cognitive Behavioural Therapy (CBT) and Problem Solving Therapy (PST) have both been found to be efficacious in treating late-life depression, however patients with "multi-morbidity" (i.e. more than one chronic condition) are often excluded from these trials. The aim of this study is to compare the efficacy of CBT and PST in treating older adults who have one or more chronic physical health conditions and a diagnosable depressive disorder. This study will be the first to explicitly target the treatment of depression in older people in primary care settings presenting with a range of health problems using behavioural interventions. METHODS/DESIGN: The PROMISE-D study is a randomised controlled trial of two evidence-based treatments for late-life major or minor depression for patients who also have at least one co-morbid chronic health problem. Participants will be randomised to two active interventions (PST or CBT) or enhanced treatment-as-usual (E-TAU). Primary outcomes will be depression diagnostic status and severity of depression (according to the Hamilton Depression Rating Scale and the Geriatric Depression Scale). Secondary outcomes will be anxiety severity, quality of life and health care utilisation. Assessments will be conducted by a researcher who remains blind to the patient's treatment allocation and will be conducted pre and post-treatment and at six and 12 months follow-up. Health care utilisation will be assessed throughout a two year period following entry to the trial. Executive function, rumination and emotion regulation will also be measured to determine the impact of these factors on treatment response in two treatment groups. DISCUSSION: Multi-morbidity, the experience of two or more chronic health problems, is becoming an increasing problem internationally, particularly amongst the elderly. Evidence-based psychological treatments exist for late-life depression and these have been shown to be effective for participants with individual health problems and depression. However, there are no studies that have compared the two leading psychotherapies shown to be effective in the treatment of late-life depression. In addition, many trials of psychotherapy with older adults exclude those with multi-morbidity. Hence, this trial will confirm whether CBT and PST are efficacious in the treatment of depression in the context of complex medical needs and determine which of these two interventions is most efficacious. TRIAL REGISTRATION: ACTRN12612000854831.