Mentalization and depressive symptoms in a clinical sample of adolescents and young adults.

BACKGROUND: Increasing evidence supports that mentalization deficits may have a role in the genesis of young age depression; however, few studies examined this issue in clinical populations. METHODS: Outpatients aged 14-21, suffering from various psychiatric disorders, were assessed using the Mentalization Questionnaire (MZQ), the Beck Depression Inventory (BDI), and the Childhood Trauma Questionnaire (CTQ), using data from age-matched healthy students for comparison. The relationship between CTQ, MZQ, and BDI scores was examined at the cross-sectional level, including mediation analyses, and longitudinally, in a subsample who underwent a psychotherapy intervention. RESULTS: Of 83 subjects, 33 (39.8%) had mentalization levels that were 1 standard deviation below those of comparison subjects. In the whole sample, the levels of mentalization were inversely associated with BDI (r = -.68, p < .001) and CTQ scores (r = -.30, p = .006). Moreover, MZQ scores mediated a large part of the effect of childhood trauma on depression (total effect: 10.6, 95% CI: 5.3, 15.9; direct effect: 6.5, 95% CI: 2.1, 10.8; indirect effect: 4.1, 95% CI: 1.5, 7.4). This effect was almost entirely explained by the Affect Regulation subscale. In patients re-evaluated after four sessions (n = 37), the decrease in BDI scores correlated with the increase in MZQ scores (r = .40, p = .02). CONCLUSIONS: In a juvenile clinical sample, deficits of mentalization abilities were associated with the severity of depression and explained part of the depressogenic effects of childhood trauma.

Sensory processing patterns, coping strategies, and quality of life among patients with unipolar and bipolar disorders

Objective: To compare sensory processing, coping strategies, and quality of life (QoL) in unipolar and bipolar patients; to examine correlations between sensory processing and QoL; and to investigate the relative contribution of sociodemographic characteristics, sensory processing, and coping strategies to the prediction of QoL. Methods: Two hundred sixty-seven participants, aged 16-85 years (53.6±15.7), of whom 157 had a diagnosis of unipolar major depressive disorder and 110 had bipolar disorder type I and type II, completed the Adolescent/Adult Sensory Profile, Coping Orientations to Problems Experienced, and 12-item Short-Form Health Survey version 2. The two groups were compared with multivariate analyses. Results: The unipolar and bipolar groups did not differ concerning sensory processing, coping strategies, or QoL. Sensory processing patterns correlated with QoL independently of mediation by coping strategies. Correlations between low registration, sensory sensitivity, sensation avoidance, and reduced QoL were found more frequently in unipolar patients than bipolar patients. Higher physical QoL was mainly predicted by lower age and lower sensory sensitivity, whereas higher mental QoL was mainly predicted by coping strategies. Conclusion: While age may predict physical QoL, coping strategies predict mental QoL. Future studies should further investigate the impact of sensory processing and coping strategies on patients’ QoL in order to enhance adaptive and functional behaviors related to affective disturbances.

Sensory processing patterns, coping strategies, and quality of life among patients with unipolar and bipolar disorders.

OBJECTIVE: To compare sensory processing, coping strategies, and quality of life (QoL) in unipolar and bipolar patients; to examine correlations between sensory processing and QoL; and to investigate the relative contribution of sociodemographic characteristics, sensory processing, and coping strategies to the prediction of QoL. METHODS: Two hundred sixty-seven participants, aged 16-85 years (53.6±15.7), of whom 157 had a diagnosis of unipolar major depressive disorder and 110 had bipolar disorder type I and type II, completed the Adolescent/Adult Sensory Profile, Coping Orientations to Problems Experienced, and 12-item Short-Form Health Survey version 2. The two groups were compared with multivariate analyses. RESULTS: The unipolar and bipolar groups did not differ concerning sensory processing, coping strategies, or QoL. Sensory processing patterns correlated with QoL independently of mediation by coping strategies. Correlations between low registration, sensory sensitivity, sensation avoidance, and reduced QoL were found more frequently in unipolar patients than bipolar patients. Higher physical QoL was mainly predicted by lower age and lower sensory sensitivity, whereas higher mental QoL was mainly predicted by coping strategies. CONCLUSION: While age may predict physical QoL, coping strategies predict mental QoL. Future studies should further investigate the impact of sensory processing and coping strategies on patients' QoL in order to enhance adaptive and functional behaviors related to affective disturbances.

Extreme sensory processing patterns and their relation with clinical conditions among individuals with major affective disorders.

Previous studies highlighted the involvement of sensory perception in emotional processes. However, the role of extreme sensory processing patterns expressed in hyper- or hyposensitivity was not thoroughly considered. The present study, in real life conditions, examined the unique sensory processing patterns of individuals with major affective disorders and their relationship with psychiatric symptomatology. The sample consisted of 105 participants with major affective conditions ranging in age from 20 to 84 years (mean=56.7±14.6). All participants completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A), the second version of the Beck Depression Inventory (BDI-II), and Adolescent/Adult Sensory Profile (AASP). Sensory sensitivity/avoiding hypersensitivity patterns and low registration (a hyposensitivity pattern) were prevalent among our sample as compared to normative data. About seventy percent of the sample showed lower seeking tendency. Stepwise regression analyses revealed that depression and anxious/cyclothymic affective temperaments were predicted by sensory sensory/avoiding. Anxious and irritable affective temperaments were predicted by low registration. Hyperthymic affective temperament and lower severity of depression were predicted by sensation seeking. Hyposensitivity or hypersensitivity may be "trait" markers of individuals with major affective disorders. Interventions should refer to the individual unique sensory profiles and their behavioral and functional impact in the context of real life.

Life adversities and suicidal behavior in young individuals: a systematic review.

Suicidal behavior in young people is a significant public health problem. However, it is not yet clear whether adversities (adverse life events) may be related to suicidality in adolescence and early adulthood. This paper aimed to investigate systematically the association between the type/number of adverse life events and experiences and suicidal behavior in young people. We developed a detailed strategy to search relevant articles in Pubmed, Scopus, PsycInfo, and Science Direct (January 1980-January 2015) about adverse life events and suicidal behavior. Adverse life events and experiences included maltreatment and violence, loss events, intra-familial problems, school and interpersonal problems. Studies were restricted to suicidal behavior in young people aged 10-25 years. The search yielded 245 articles, of which 28 met our inclusion criteria. Most studies reported a strong association between adversities and suicidality (both suicidal ideation and attempts). Based on the main results, the number of adversities or negative life events experienced seemed to have a positive dose-response relationship with youth suicidal behavior. However, the type of event experienced also appeared to matter: one of the most consistent findings was the association between suicidal behavior and experience of sexual abuse. More prospective studies are needed to elucidate the relative importance of risk accumulation and risk specificity for youth suicide.