Exploring User Experiences of the Mom2B mHealth Research App During the Perinatal Period: Qualitative Study.

BACKGROUND: Perinatal depression affects a significant number of women during pregnancy and after birth, and early identification is imperative for timely interventions and improved prognosis. Mobile apps offer the potential to overcome barriers to health care provision and facilitate clinical research. However, little is known about users' perceptions and acceptability of these apps, particularly digital phenotyping and ecological momentary assessment apps, a relatively novel category of apps and approach to data collection. Understanding user's concerns and the challenges they experience using the app will facilitate adoption and continued engagement. OBJECTIVE: This qualitative study explores the experiences and attitudes of users of the Mom2B mobile health (mHealth) research app (Uppsala University) during the perinatal period. In particular, we aimed to determine the acceptability of the app and any concerns about providing data through a mobile app. METHODS: Semistructured focus group interviews were conducted digitally in Swedish with 13 groups and a total of 41 participants. Participants had been active users of the Mom2B app for at least 6 weeks and included pregnant and postpartum women, both with and without depression symptomatology apparent in their last screening test. Interviews were recorded, transcribed verbatim, translated to English, and evaluated using inductive thematic analysis. RESULTS: Four themes were elicited: acceptability of sharing data, motivators and incentives, barriers to task completion, and user experience. Participants also gave suggestions for the improvement of features and user experience. CONCLUSIONS: The study findings suggest that app-based digital phenotyping is a feasible and acceptable method of conducting research and health care delivery among perinatal women. The Mom2B app was perceived as an efficient and practical tool that facilitates engagement in research as well as allows users to monitor their well-being and receive general and personalized information related to the perinatal period. However, this study also highlights the importance of trustworthiness, accessibility, and prompt technical issue resolution in the development of future research apps in cooperation with end users. The study contributes to the growing body of literature on the usability and acceptability of mobile apps for research and ecological momentary assessment and underscores the need for continued research in this area.

Effects of a Brief Safe Drinking Intervention on Depressive and Anxiety Symptomatology: Examining Potential Side Effects of Deviance Regulation Theory Interventions.

College students are at a heightened risk of experiencing depression and anxiety symptomatology and engaging in maladaptive alcohol use. Understanding how alcohol interventions impact emotional functioning is essential. One such intervention uses Deviance Regulation Theory (DRT), which posits that behavior can be modified using targeted messaging as a function of perceived norms. DRT has been shown to be effective at increasing responsible drinking behaviors and decreasing alcohol-related consequences. However, it is unclear if this intervention influences emotional functioning. The current examines the impact of a DRT intervention on emotional functioning. Participants (n = 147) were recruited from a large Southeastern university. The study included a screening phase, intervention, and six-week follow-up. Participants were randomly assigned to one of three conditions: a positive message condition about people who drink responsibly, a negative message condition about people who do not drink responsibly, and an active control condition. During the study, all participants reported on depression/anxiety symptoms, alcohol use, responsible drinking, and alcohol-related consequences. Mixed-effects regression was used to analyze the data. Results suggest an overall reduction of depressive and anxiety symptomatology in the intervention conditions but not in the control condition. In the positive condition, there was a decrease in depressive and anxiety symptomatology. The messaging was not moderated by normative beliefs. The negative condition also led to decreases in depression and anxiety symptomatology over time. In addition, perceived norms moderated the negative message in the first week after the intervention, an effect consistent with DRT. Prior research indicates this intervention is efficacious for the reduction of adverse alcohol outcomes; these data show that the intervention may also have positive effects on downstream mental health outcomes.

Association of social gatherings and physical exercise with depressive symptoms among middle-aged and older adults during the COVID-19 pandemic.

Strict social isolation and physical distancing measures implemented during the COVID-19 pandemic had significant implications for the psychological well-being of middle-aged and older adults. This study aimed to investigate factors associated with depressive symptoms during the pandemic period among individuals who reported no significant depressive symptoms before the pandemic. Individuals from the Korean Longitudinal Study of Aging without a previous report of significant depressive symptoms across Waves 6 (2016) and 7 (2018) were investigated for the development of depressive symptoms in Wave 8 (2020). The multivariable logistic regression results revealed that both men and women who participated in social gatherings and physical exercise less than once a week were associated with an increase in the likelihood of depressive symptoms (odds ratio [OR] 2.88; 95% confidence interval [CI] 1.80-4.61 and OR 2.61; 95% CI 1.64-4.15, respectively for men and OR 2.58; 95% CI 1.80-3.70 and OR 1.51; 95% CI 1.02-2.23, respectively for women). In addition, unmarried men (OR 2.38; 95% CI 1.37-4.14) and women with one chronic disease (OR 1.98; 95% CI 1.14-3.43) or two or more chronic diseases (OR 2.28; 95% CI 1.31-3.99) reported a significant increase in the likelihood of depressive symptoms. Regular social gatherings and physical exercise were identified as key factors in mitigating depressive symptoms among middle-aged and older adults. The findings can inform the development of public health strategies that promote regular social interactions and physical activity to enhance the psychological resilience and overall well-being of middle-aged and older adults in the endemic era.

Caregiver burden, mental health, quality of life and self-efficacy of family caregivers of persons with dementia in Malaysia: baseline results of a psychoeducational intervention study.

BACKGROUND: The majority of persons with dementia (PWD) are mainly cared for by their family members in the home. Evidence is however scarce on family caregivers' psychosocial burden and quality of life in Asian countries including Malaysia. This study describes the baseline data of a telephone-delivered psychoeducational intervention study and examines the determinants of outcome measures (caregiver burden, depressive and anxiety symptoms, quality of life and caregiving self-efficacy) among Malaysian family caregivers to PWD. METHODS: This was a cross-sectional study originated from the baseline survey of a randomized control trial of 121 family caregivers recruited from lists of PWD who were registered at memory and psychiatry clinics in three tertiary care hospitals in Malaysia. The participants were assessed for caregiver burden by the Zarit Burden Interview, depressive and anxiety symptoms by the Hospital Anxiety and Depression Scale, quality of life by the Control, Autonomy, Self-Realization, and Pleasure Scale, and caregiving self-efficacy by the Revised Scale for Caregiving Self-Efficacy. RESULTS: Prevalence of caregiver burden was 69.4%, depressive symptoms 32.2% and anxiety symptoms 32.2%. Family caregivers to PWD having perceived peer support e.g., social/family/friend/significant other supports were less likely to report caregiver burden, depressive and anxiety symptoms, and more likely to report higher levels of quality of life and caregiving self-efficacy. Being married and PWD's ability to self-care were associated with lesser likelihood of experiencing caregiver burden, depressive and anxiety symptoms. The other determinants of greater probability of reporting better quality of life were caregivers' employment and having Islamic faith. Marital status (married), PWD's ability to self-care, spousal relationship with PWD and shared caregiving process were associated with higher likelihood of reporting caregiving self-efficacy. CONCLUSION: Caregiver burden, depressive and anxiety symptoms are prevalent in family caregivers to PWD in Malaysia. Social support and caregiving related factors influence family caregivers' quality of life and caregiving self-efficacy. Implementing psychoeducational intervention and support in the psychiatry and memory clinics may help improve the psychosocial burden, quality of life and caregiving self-efficacy in family caregivers of PWD. TRIAL REGISTRATION: ISRCTN14565552 (retrospectively registered).

From stress communication to depressive symptoms among couples facing vision impairment: The mediating role of dyadic coping.

Vision impairment is considered one of the most common disability worldwide, can induce considerable stress for both patients and their spouses and may subsequently affect couples' psychological functioning. This study examined whether dyadic coping (DC) mediated the association between stress communication (SC) and depressive symptoms among couples coping with one partner's vision impairment. A total of 99 Swiss couples completed questionnaires assessing SC, various types of DC, and depressive symptoms. An Actor-Partner Interdependence Mediation Model was performed. Results showed that (1) the more one partner communicated stress, the less the other partner perceived negative DC and, consequently, the less the partner perceiving negative DC reported depressive symptoms; (2) the more partners communicated stress, the more they and their partners engaged in common DC and, consequently, the less the partner engaging in common DC reported depressive symptoms; (3) the more partners communicated stress, the less they and their partners engaged in protective buffering and, consequently, the less the partner engaging in protective buffering reported depressive symptoms. This pattern of associations occurred similarly for patients and their spouses. Our findings underline the interpersonal experience of vision impairment within couples and the importance of fostering explicit SC and common DC in psychosocial rehabilitation interventions directed at couples facing one partner's vision impairment.

The Impact of Social Support on Depressive Symptoms Through Mindfulness and Resilience Among Chinese Parents Who Lost Their Only Child.

The number of Shidu parents (parents over the age of 45 years who have lost their only child) has been increasing in China, which is important because Shidu parents experience depressive symptoms. This study investigated the potential mediating roles of mindfulness and resilience in the relation between social support and depressive symptoms among Shidu parents. From June to December 2021, 111 Shidu parents in Baoji city, China, completed a web-based survey on social support, depressive symptoms, mindfulness, and resilience. The results indicated that Shidu parents suffer from a high risk of depressive symptoms, and significant correlations were found between the study variables. Path analysis models showed that the relation between social support and depressive symptoms in Shidu parents was fully mediated by a combination of mindfulness and resilience. These findings further highlighted the significance of social support, mindfulness, and resilience in potentially alleviating depressive symptoms among Shidu parents.

Effect of spiritual intelligence and employment status on the association between education and depressive symptoms among adults in rural Puducherry, India: A mediation analysis.

BACKGROUND: Depression is a major global health concern, particularly in India, where it significantly impacts the population's well-being. The interplay of various factors, including education, employment status, and spiritual intelligence, contributes to the complex landscape of depressive symptoms among adults. METHODOLOGY: A community-based cross-sectional study was conducted in the rural service areas of a tertiary care medical institution in rural India from March 2021 to September 2022. The study employed structured questionnaires and validated scales to assess depressive symptoms, spiritual intelligence, educational status, and occupational status among participants. Structural equation modelling was used for mediation analysis to evaluate the effect of spiritual intelligence and employment status on the association between education and depressive symptoms. RESULTS: The study included 381 participants, with a prevalence of depressive symptoms at 14.4%. Higher educational attainment was associated with lower odds of depressive symptoms (aOR = 0.34, 95% CI [0.17, 0.67]). Employment status mediated the relationship between education and depression, with employed individuals exhibiting lower odds of depressive symptoms (aOR = 0.42, 95% CI [0.22, 0.82]). While spiritual intelligence was higher among those with formal education, its direct impact on depression was not statistically significant. The mediation analysis revealed that a significant portion (77.5%) of the total effect of education on depression was mediated through employment status and spiritual intelligence. CONCLUSION: The study underscores the importance of education and employment opportunities in mitigating depressive symptoms among rural adults. It suggests targeted interventions that promote education and employment support to enhance mental health resilience. While spiritual intelligence may influence mental health outcomes, its exact role requires further investigation.

Longitudinal Relations among Self-Compassion, Self-Esteem, and Depressive Symptoms in College Students: Disentangling the Within-Person Process from Stable Between-Person Differences.

Although previous studies have shown that self-compassion is associated with self-esteem and depressive symptoms, little is known about the intra-individual processes and the temporal dynamics of these variables. This study used a longitudinal design to explore the association between self-compassion, self-esteem and depressive symptoms among 5785 college students (aged 17-22 years; Mage = 18.63, SD = 0.88; 48.2% females). The participants were assessed six times in a six-month interval over three years. The random intercept cross-lagged panel models (RI-CLPMs) were used to disentangle within-person processes from stable between-person differences. Results of RI-CLPMs indicated that at the within-person level, self-compassion can positively predict subsequent self-esteem and negatively predict subsequent depressive symptoms, and vice versa. Self-esteem played a longitudinal mediating role in the prediction from self-compassion to depressive symptoms at the within-person level. These results indicate that cultivating self-compassion in college students is crucial as it can bolster their self-esteem and alleviate depressive symptoms.

Income rank and depressive symptoms among employees in Germany - A 5-year cross-lagged panel analysis.

Background/Objective: Socioeconomic disparities in mental health are well-established. Previous research suggests that relative income rank is associated with depressive symptoms above and beyond absolute income. This study aimed to investigate the predictive value of income rank for future depressive symptoms while accounting for absolute income. Exploring potential reverse pathways from depressive symptoms to income rank was a secondary objective. Method: A two-wave cross-lagged panel design with a 5-year follow-up was used to analyze data for income rank, absolute income, and two dimensions of depressive symptoms (i.e., cognitive-affective and somatic symptoms) from initially 4,201 employees. Income rank was calculated for reference groups, based on the same gender, the same 5-year age band, and the same occupational skill level. Results: Lower income rank at baseline predicted a higher severity of cognitive-affective depressive symptoms at five-year follow-up, even after adjusting for absolute income. In contrast, income rank did not demonstrate a significant unique longitudinal association with somatic depressive symptoms when simultaneously taking absolute income into account. There was no evidence for the assumption that depressive symptoms are predictive for future income rank (i.e., reverse pathway). Conclusions: Cognitive-affective symptoms of depression might be particularly responsive to social comparisons and a relatively low social rank.

The Mediating Effect of Social Participation Restriction on the Association Between Role Overload and Mental Health Among Caregivers of Older Adults with Dementia.

Caregivers of older adults with dementia (dementia caregivers) often experience high role overload (i.e., feeling overwhelmed by caregiving demands that exceed available resources), which can take a toll on their mental health. Moreover, dementia caregiving can restrict caregivers' participation in valued social activities. This study aims to examine the mediating effect of social participation restriction on the relationship between role overload and mental health among dementia caregivers. A total of 894 dementia caregivers (mean age = 61.77) were selected from the National Study of Caregiving. The sample was predominantly women (64%) and White (78%). Path analysis shows that social participation restriction partially mediated the associations between (1) role overload and psychological distress (indirect effect ß = .08, p < .001) and (2) role overload and psychological wellbeing (indirect effect ß = -.05, p < .05). Interventions targeting coping strategies and healthcare-recreation programs are needed to improve social participation among dementia caregivers.

Financial strain and social support as moderators of the relationship between living alone and depressive symptoms in older people.

This study investigated the moderating effect of financial strain or social support on depressive symptoms among older people living alone in Taiwan. Data were collected from the "Taiwan Longitudinal Study on Aging (TLSA)," which included 1513 participants aged 65 and over, among them, 153 (10.1%) were living alone, while 1360 (89.9%) were living with others. Measurement tools included the Depression scale (CES-D), financial stress scale, social support scale, ADL scale, IADL scale, and stress scale, with Cronbach's α coefficients were 0.85, 0.78, 0.67, 0.91, 0.90, and 0.70 respectively. Hierarchical multiple regression was used to examine the moderator effect. The findings revealed that (1) Financial strain was found to moderate the relationship between living alone and depressive symptoms, acting as a promotive moderator among older men living alone. For older women, financial stress does not moderate the relationship between living alone and depressive symptoms. However, financial strain was also identified as a significant factor associated with depressive symptoms among older women living alone. (2) Social support does not moderate effect on the relationship between living alone and depressive symptoms in older men or older women. These results underscore the importance of considering financial stress in mental health policy development by government agencies. It is imperative to address the unique challenges faced by older individuals living alone, particularly in relation to financial strain, in order to promote their mental well-being.

Prevalence of demoralization and depressive symptoms in a sample of patients with supraventricular tachyarrhythmias: preliminary results.

Introduction: Supraventricular tachyarrhythmias (ST) are the most common cardiac arrhythmias. Little is known about the potential impact of demoralization, which is considered as partially distinct from depression, on the course of ST. A correct assessment of both depressive symptoms and demoralization appears relevant for the treatment of these cardiac diseases, potentially influencing their course. Methods: The sample consisted of 110 subjects affected by different ST, such as atrial fibrillation (AF), atrial flutter (AFL) and paroxysmal supraventricular tachycardia (PSVT). They all underwent a psychiatric evaluation; the Italian version of 9-item Patient Health Questionnaire (PHQ-9) and the Italian version of Demoralization Scale (DS) were administered. Descriptive statistics, pairwise comparisons, and correlational analysis have been implemented. Results: 26 individuals (23.6%) presented high levels of demoralization. Of these, 20 (76.9%) had a diagnosis of AF and six patients (23.1%) received a diagnosis of other ST. No differences in demoralization levels resulted in regard of sex, cardiac diagnoses and anticoagulant therapies. Amongst people with high levels of demoralization, 13 (50%) received no formal psychiatric diagnosis, and 12 (46.2%) showed moderate/severe depressive symptoms. Demoralization levels and PHQ-9 scores showed a significant positive correlation in the whole sample (r=0.550, p<0.001). Discussion: The present study found that in a sample of patients suffering from ST, high levels of demoralization were more frequent than clinically relevant depressive symptoms. We propose that demoralization and depression show partially distinguished psychopathological features, potentially associated with different therapeutic trajectories.

Longitudinal Dynamic Relationships Between Videogame Use and Symptoms of Gaming Disorder and Depression Among Chinese Children and Adolescents.

Although previous studies have shown a close relationship between gaming disorder and depressive symptoms, few have measured normal videogame use, symptoms of gaming disorder, and depressive symptoms concurrently. The longitudinal dynamics between these variables remain unclear. This study used two demographic cohorts to examine the longitudinal relationship between gaming and depressive symptoms: children (n = 1513, 46.9% girls, Mage ± SD = 9.63 ± 0.58 years) and adolescents (n = 1757, 48.5% girls, Mage ± SD = 12.55 ± 0.70 years). Random intercept cross-lagged panel models (RI-CLPMs) were employed to distinguish between within- and between-person levels of gaming and depressive symptoms. The RI-CLPM results showed a stable link between symptoms of gaming disorder and depression at the between-person level for both children and adolescents. At the within-person level, among children, depressive symptoms positively predicted subsequent gaming disorder symptoms, but gaming disorder symptoms were not a significant predictor of depressive symptoms at this level. Among adolescents, there was no significant cross-lagged effect between symptoms of gaming disorder and depression at the within-person level. Additionally, there was no significant cross-lagged effect between normal videogame use and depressive symptoms in either cohort. These results highlight the different effects of normal videogame use and gaming disorder symptoms associated with depressive symptoms. The different effects on children and adolescents underscore the importance of considering the different developmental stages in the study of gaming and mental health outcomes.

Effects of Wisdom-Enhancement Narrative-Therapy and Empathy-Focused interventions on loneliness over 4 weeks among older adults: A Randomized Controlled Trial.

OBJECTIVE: In this three-armed RCT, we tested the effects of a telephone-delivered wisdom enhancement narrative therapy-based intervention (Tele-NT) and a telephone-delivered empathy-focused intervention (Tele-EP) in reducing loneliness against an active control group that received regular call (ACG) at the 4-week follow-up assessment. DESIGN, SETTING, INTERVENTION, AND PARTICIPANTS: To evaluate the effects of the interventions on loneliness, we randomized 287 older adults based in Hong Kong, ages 65 to 90, into Tele-NT (N = 97), Tele-EP (N = 95), or ACG (N = 95). MEASUREMENT: The primary outcome was loneliness, calculated using the De Jong Gierveld Scale and the UCLA Loneliness Scale. Secondary outcomes were sleep quality, depressive symptoms, social network engagement, and perceived social support. Assessments were done before training and 4 weeks after the intervention period. RESULTS: Results from linear mixed models showed significant positive effects of Tele-NT on loneliness measured by the De Jong Gierveld Loneliness Scale compared to ACG. Compared to the ACG, the Tele-NT group significantly reduced loneliness at the 4-week follow-up (mean difference = -0.51, p = 0.019, Cohen's d = 0.60). However, the difference between Tele-EP and the ACG at the 4-week follow-up was not significant (MD = -0.34, p = 0.179, Cohen's d = 0.49). Tele-NT and Tele-EP did not show significant effects on the secondary outcomes, compared to the ACG. CONCLUSIONS: In this randomized clinical trial, we found that a 4-week wisdom enhancement narrative therapy program significantly reduced feelings of loneliness. This effective telephone-based, lay-therapist-delivered program is scalable for broader implementation.

Depressive symptom as a risk factor for cirrhosis in patients with primary biliary cholangitis: Analysis based on Lasso-logistic regression and decision tree models.

BACKGROUND: Depressive symptoms are frequently observed in patients with primary biliary cholangitis (PBC). The role of depressive symptoms on cirrhosis has not been fully noticed in PBC. We aimed to establish a risk model for cirrhosis that took depressive symptoms into account. METHODS: Depressive symptoms were assessed by the 17-item Hamilton Depression Rating Scale (HAMD-17). HAMD-17 score was analyzed in relation to clinical parameters. Least absolute shrinkage and selection operator (Lasso)-logistic regression and decision tree models were used to explore the effect of depressive symptoms on cirrhosis. RESULTS: The rate of depressive symptom in patients with PBC (n = 162) was higher than in healthy controls (n = 180) (52.5% vs. 16.1%; p < .001). HAMD-17 score was negatively associated with C4 levels and positively associated with levels of alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), total bilirubin (TB), Immunoglobulin (Ig) G, and IgM (r = -0.162, 0.197, 0.355, 0.203, 0.182, 0.314, p < .05). In Lasso-logistic regression analysis, HAMD-17 score, human leukocyte antigen (HLA)-DRB1*03:01 allele, age, ALP levels, and IgM levels (odds ratio [OR] = 1.087, 7.353, 1.075, 1.009, 1.005; p < 0.05) were independent risk factors for cirrhosis. Elevated HAMD-17 score was also a discriminating factor for high risk of cirrhosis in patients with PBC in decision tree model. CONCLUSIONS: Depressive symptoms were associated with disease severity. Elevated HAMD-17 score was a risk factor for cirrhosis in patients with PBC.

Race by Sex Intersectional Differences in the Association between Allostatic Load and Depression in US Adults: 2005-2018.

Objective: Previous research has underscored the link between allostatic load-a comprehensive indicator of the cumulative physiological burden of chronic stress-and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated allostatic load (AL>4) and depression among different race-sex intersectional groups within the general population. Methods: This cross-sectional secondary analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. The analysis included variables such as race, sex, age, socioeconomic status, depression (measured via the Patient Health Questionnaire - PHQ), and allostatic load. Linear regression analyses were conducted to examine the interactions between race and sex with allostatic load, focusing on the likelihood of high depression as the outcome. Results: Across the pooled sample, an allostatic load greater than 4 was significantly associated with increased depression. Notably, an interaction effect was observed between race and AL>4 on depression among women, indicating that non-Hispanic Black women with a high allostatic load exhibited more pronounced depressive symptoms (Beta: 1.09, CI: 0.02-2.61). Conversely, among men, allostatic load greater than 4 neither correlated with nor interacted with race to influence depression levels. Conclusion: The study highlights the critical need to consider allostatic load as a key intervention point for preventing or reducing depression, particularly among Black women. These findings underscore the necessity for customized intervention strategies that address the nuanced race-sex disparities in the impact of allostatic load on mental health across populations.

Influences of Social Disengagement and Depressive Symptoms on Sleep Disturbance in Dementia Caregiving Dyads: A Nationally Representative Study.

OBJECTIVES: To examine the influence of social disengagement and depressive symptoms on sleep disturbance among dementia caregiving dyads and the actor-partner interdependence nature of these influences. DESIGN: Actor-partner interdependence model through structural equation modeling for dyadic analyses. SETTING AND PARTICIPANTS: A total of 310 dyads of older adults with dementia and their care partners from 2 national representative studies in the United States, the National Health and Aging Trends Study (NHATS) and its companion study, the National Study of Caregiving (NSOC). METHODS: Data from the NHATS Round 11 and NSOC IV were analyzed using descriptive statistics, Pearson correlation analysis, and the actor-partner interdependence model. Structural equation modeling was used to assess the mediation effects of depressive symptoms within the actor-partner interdependence models. RESULTS: In the model of caregivers, social disengagement had a direct impact on sleep disturbance (ß = 0.49, P < .001) and an indirect impact through depressive symptoms (ß = 0.25, P < .001). In the model of older adults with dementia, social disengagement only had an indirect effect on sleep disturbance through depressive symptoms. In models examining partner effects, caregivers' social disengagement directly influenced their care partners' depressive symptoms (ß = 0.20, P = .019), which subsequently affected caregivers' sleep disturbance (ß = 0.17, P < .001). Social disengagement (ß = 0.17, P = .001) and depressive symptoms (ß = 0.17, P < .001) in older adults with dementia directly impacted their caregivers' sleep disturbance. Depressive symptoms of older adults with dementia served as multiple mediators linking one member's social disengagement to both their own and partner's sleep. CONCLUSIONS AND IMPLICATIONS: This study represents one of the first attempts to investigate the influencing mechanism of sleep disturbances among older adults with dementia and their informal caregivers through a dyadic perspective. The sleep disturbance of caregivers may be directly influenced by the social disengagement and depressive symptoms exhibited by both members of the dyad, whereas the sleep disturbance experienced by older adults with dementia can only be indirectly influenced by the dyad's social disengagement via their own depressive symptoms. Dyadic social activities targeting depressive symptoms could be designed to address sleep disturbances in dementia caregiving dyads.

The mediation role of social support in the relationship between bullying and depressive symptoms among Jordanian adolescents.

BACKGROUND: Bullying in school is a universal psychosocial issue that raises concerns about adolescents' safety and mental health and is positively associated with depressive symptoms. Social support could be a preventive factor that eases bullying and its psychological distress. PURPOSE: The primary purpose of this study was to examine the mediating effect of social support in the relationship between bullying and depressive symptoms among adolescents in Jordan. Another aim was to investigate predictors of depression based on adolescents' sociodemographic factors. METHODS: In this cross-sectional, non-experimental mediational study, a stratified and systematic sampling method was used to recruit 270 Jordanian adolescents. RESULTS: Sociodemographic variables of being female, having divorced parents, having illiterate fathers, and being older in adolescence explained 12.2% of the variance in depressive symptoms. Family social support partially mediated the relationship between bullying and depressive symptoms. CONCLUSION: Our findings showed that a notable proportion of adolescents experienced bullying victimization and depressive symptoms, and a positive relationship exists between these two variables. These results further highlight the role of family social support in buffering the negative impact of bullying on depressive symptoms. IMPLICATIONS TO PRACTICE: The study's results emphasize the significance of developing and implementing family-centered social support initiatives by nurses to lessen adolescents' bullying experiences and depressive symptomatology.

Parent- and Adolescent-Driven Effects in Emotion-Related Communication and Longitudinal Relationships with Depressive Symptoms in Adolescents.

Communication on emotions is an important aspect of parent-adolescent communication, yet its process and effects remain less examined in families of adolescents. This study examined the bidirectional association between parental responses to adolescents' emotions and adolescents' emotional communication behaviors, and further examined their longitudinal predictive effects on adolescent depressive symptoms. The potential moderating role of adolescent gender was also examined. A total of 503 adolescents (Mage = 13.45, SD = 0.50; 44.73% females) participated in this study, with 438 adolescents completing the three-wave longitudinal survey. Adolescents' emotional communication behaviors, parental responses to emotions, and depressive symptoms were reported. The bidirectional relationship was examined using cross-lagged panel models, while the parent- and adolescent-driven effects of emotional communication on adolescent depressive symptoms and the moderation effect of adolescent gender were examined using multi-group structural equation modeling. The findings revealed gender-specific patterns in parent-adolescent communication on emotions. Significant parent- and adolescent-driven effects of positive communication behaviors on adolescent depressive symptoms were found. However, only negative communication behaviors initiated by parents predicted adolescent depressive symptoms, with this effect mediated by adolescents' negative communication behaviors. This study deepened the understanding of characteristics and effects of parent-child emotional communication during adolescence, which has implications for interventions aiming at improving parent-adolescent relationship and adolescents' mental health.