¿Cómo ha sido el humor popular en tiempos de crisis? Esa parece ser la invitación que nos hace el autor del texto al revisar los episodios más notables del teatro cómico y del humor revisteril chileno durante los años más duros de la Gran Depresión. El espacio físico, los artistas, incluso los títulos de las obras hacen referencia a una vida nocturna que ha desaparecido de Santiago. A través de la prensa, Maximiliano Salinas nos hace testigos de las disputas entre (...) los representantes de la cultura de elite y los defensores del humor criollo, representado en la figura del personaje Juan Verdejo. Como en un carnaval, comprendemos que la dureza y el sufrimiento de la vida se convierten, por medio de estos artesanos del gesto y la palabra ingeniosa, en una explosión de creación artística y combate de la depresión económica y también sicológica. (shrink)

The body of measures promulgated to deal with the emergency of the depression is frequently linked up with the idea of a planned economy. That emergency measures have little or no essential connection with planning is the central thesis of this essay.The author discusses the four most important premises of the emergency measures : the intensity of the depression, the degree of organization reached by the country in depression, its social stratification, and its political set-up. Two emergency methods are distinguished. (...) On the one hand, an attempt is made to set the price mechanism in operation by lowering production costs, principally wages but also interest rates, rents, etc. The same adaption is aimed at by measures of state intervention which try to boost prices particularly by restriction of production and of imports. The second method, which has been used in an unprecedented manner during the present depression, attempts to stop the cumulative deflationary process by credit and monetary measures, as well as by public works.The effects of the emergency measures in some of the more important countries are discussed briefly. The author believes that a major part of these measures was necessitated by the course of events, but that their effect will be conflicting and of only short duration.Le but du travail est d'indiquer les idées les plus importantes pour comprendre et juger la politique de crise et de montrer qu'il ne saurait être question de considérer aucune des mesures prises comme un véritable plan. Par politique de crise, on entend les mesures destinées à atténuer ou surmonter une crise économique existante, par opposition à une „politique de conjoncture“ qui tend à une économie sans crise.L'auteur analyse les quatre prémisses fondamentales d'une politique de crise : profondeur de la dépression, degré d'organisation économique, structure sociale et organisation politique du pays atteint par la crise. On distingue deux méthodes employées pour combattre la crise. La politique d'adaptation, sous sa forme libérale, cherche à renforcer l'automatisme du marché, en diminuant les frais de production, etc. Les procédés d'intervention, dans la politique d'adaptation, ont pour objet l'augmentation des prix, avant tout à l'aide de restrictions de production et d'importation. La deuxième méthode, appliquée dans la crise actuelle avec une ampleur jamais encore connue, tâche d'arrêter le processus de déflation par des mouvements contraires. Les moyens principaux sont des mesures qui concernent le crédit et la monnaie, et des travaux publics. L'action d'ensemble de la politique de crise dans quelques pays importants est rapidement étudiée, à la fin de l'article. Encore que l'auteur considère une grande partie des mesures prises contre la crise comme inévitables, il tient leur action pour contradictoire et à courte échéance. (shrink)

Quelle est la signification historique de l’implosion du néolibéralisme, moins de vingt ans après l’effondrement de l’Union soviétique? Une hypothèse troublante vient à l’esprit. On sait que l’URSS est parvenue au sommet de sa puissance dans les années 1970, juste avant de s’enfoncer dans une spirale de retranchement, de dérive et d’effondrement. Se pourrait-il, par une de ces bonnes vieilles ironies de l’histoire, qu’un revers de fortune comparable guette la superpuissance occidentale? Après tout, on peut voir une forme d’unité des (...) contraires dans l’opposition entre un capitalisme débridé et les économies industrielles planifiées de l’ancien COMECON. La dépression qui s’annonce révélera peut-être que les statistiques économiques nationales de la période de l’économie des bulles étaient des fictions assez comparables à celles qui avaient cours dans le vieux système soviétique. (shrink)

L'auteur cherche à expliquer la gravité exceptionnelle de la crise économique par la rencontre de trois éléments de perturbation : la crise normale du cycle économique, aggravée à la fois par des foyers de perturbation occasionnels, apparemment „uniques“, et par des modifications structurelles qui menacent de suspendre le fonctionnement du mécanisme du marché et des crises.Cependant la crise est arrivée à tel point qu'une politique économique énergique et consciente pourrait contribuer à surmonter la dépression. On peut (...) toutefois se demander combien de temps un nouvel essor serait susceptible de durer, et si les mesures destinées à combattre la crise n'entraîneraient pas elles-mêmes des crises nouvelles et encore plus graves.Pour éclaircir ce problème, l'auteur cherche à discerner quels sont les moyens que pourrait employer le système économique actuel, basé sur la propriété privée des moyens de production, pour s'adapter aux circonstances, sans renier son principe fondamental. Les résultats de cette recherche fournissent des points de repère sur l’état de l'économie et de la société dans la nouvelle phase du système capitaliste inauguré par la guerre mondiale.An explanation for the extraordinary severity of the economic crisis is sought in the conjunction of three groups of disturbing factors. The normal crisis of the business cycle is accentuated not only by seemingly „unique“ accidental conglomerations of disturbing factors, but also by structural changes which call into question the functioning of the market and crisis mechanism.The crisis, however, has reached a point where a clear-sighted economic policy may lead to overcome the crisis. Meanwhile it is questionable how long a new prosperity will last, and whether the measures taken to overcome the crisis, will not themselves bring about new and still more severe crises.To throw light on this problem reflections are presented as to which suitable method an economic system, based on the private ownership in the means of production, can apply without disturbing this basis. The results of this investigation furnish facts which may help to form an opinion as to the conditions of the economic system and society in this new phase of Capitalism, which the world war has introduced. (shrink)

Rawls intended the difference principle to be a liberal egalitarian principle of justice. By that I mean he intended it to provide a moral justification for a moderate amount of redistribution of income from the most advantaged members of society to the least. But since the difference principle was introduced, economic inequality has increased dramatically, reaching levels now not seen since just before the Great Depression, levels that Rawls surely would have thought perverse. Many blame this increase on the rise (...) of supply-side economics and the dramatic cuts in marginal tax rates enacted by the supply-siders for corporations and those already at the top of the income distribution. But I contend that the difference principle, or at least the ethos that the difference principle embodies and represents, is also partially to blame. Accordingly, the purpose of this paper is to explain how the difference principle, the ideas and arguments of the supply-siders, and this dramatic rise in inequality are connected, to identify where the difference principle went wrong, and to discuss what those who remain committed to the liberal egalitarian ideals that the difference principle was thought to represent might do about it. (shrink)

The development of artificial intelligence (AI) in medicine raises fundamental ethical issues. As one example, AI systems in the field of mental health successfully detect signs of mental disorders, such as depression, by using data from social media. These AI depression detectors (AIDDs) identify users who are at risk of depression prior to any contact with the healthcare system. The article focuses on the ethical implications of AIDDs regarding affected users’ health-related autonomy. Firstly, it presents the (ethical) discussion of AI (...) in medicine and, specifically, in mental health. Secondly, two models of AIDDs using social media data and different usage scenarios are introduced. Thirdly, the concept of patient autonomy, according to Beauchamp and Childress, is critically discussed. Since this concept does not encompass the specific challenges linked with the digital context of AIDDs in social media sufficiently, the current analysis suggests, finally, an extended concept of health-related digital autonomy. (shrink)

Recently, several authors have argued that assisted dying may be ethically appropriate when requested by a person who suffers from serious depression unresponsive to treatment. We here present four arguments to the contrary. First, the arguments made by proponents of assisted dying rely on notions of “treatment-resistant depression” that are problematic. Second, an individual patient suffering from depression may not be justified in believing that chances of recovery are minimal. Third, the therapeutic significance of hope must be acknowledged; when mental (...) healthcare opens up the door to admitting hopelessness, there is a danger of a self-fulfilling prophecy. Finally, proponents of assisted dying in mental healthcare overlook the dangers posed to mental-health services by the institutionalization of assisted dying. (shrink)

We propose an action-oriented understanding of emotion. Emotions are modifications of a basic form of goal-oriented striving characteristic of human life. They are appetitive orientations: pursuits of the good, avoidances of the bad. Thus, emotions are not truly distinct from, let alone opposed to, actions -- as erroneously suggested by the classical understanding of emotions as 'passions'. In the present paper, we will outline and defend this broadly enactive approach and motivate its main claims. Our proposal gains plausibility from a (...) literature- and interview-based investigation of emotional changes characteristic of clinical depression. Much narrative evidence from patient reports points towards the conclusion that many of those changes might result from a catastrophic alteration of the basic form of goal-pursuit at the root of human emotionality. The experience of profound depression could in this respect be a kind of inverted image of non-pathological emotionality--a highly unnatural passivity, giving rise to a profound -- and quite horrifying -- sense of incapacity. (shrink)

This paper utilizes the enactivist notion of ‘sense-making’ to discuss the nature of depression and examine some implications for treatment. As I understand it, sensemaking is fully embodied, fundamentally affective, and thoroughly embedded in a social environment. I begin by presenting an enactivist conceptualization of affective intentionality and describing how this general mode of intentional directedness to the world is disrupted in cases of major depressive disorder. Next, I utilize this enactivist framework to unpack the notion of ‘temporal desituatedness,’ and (...) maintain that the characteristic symptoms of depression result from a disruption to the future-directed structure of affective intentionality. This can be conceptualized as a loss of “online intelligence” and a shrinking of the field of affordances. Then, I argue that two of the standard modes of treatments for depression, medication and cognitive behavioral therapy, are not fully sufficient means of restoring online intelligence, and that these limitations stem partly from the approaches’ implicit commitment to a brain-bound, overly cognitivist view of the mind. I recommend expressive arts interventions such as dance-movement therapy and music therapy as important supplementary treatment methods that deserve further consideration. Insofar as they revitalize subjects’ bodies and emotions, cultivate an openness to the future, and promote self-insight and social synchrony, these treatment modes not only reflect key insights of enactivism, but also offer great potential for lasting healing. (shrink)

Is it ever right to prescribe placebos to patients in clinical practice? The General Medical Council is ambivalent about the issue; the American Medical Association asserts that placebos can be administered only if the patient is (somehow) ‘informed’. The potential problem with placebos is that they may involve deception: indeed, if this is the case, an ethical tension arises over the patient's autonomy and the physician's requirement to be open and honest, and the notion that medical care should be the (...) primary concern. This paper examines the case of depression as an entry point for understanding the complexities of the prescription of placebos. Recent important meta-analyses of antidepressants claim that they are not significantly more effective in a clinical setting than placebos. Given that antidepressants have numerous adverse side effects and are hugely expensive, this provocative research has serious potential ethical and practical implications for patients and medical providers. Should placebos be prescribed in place of antidepressants? The case of depression highlights another important issue which medical ethical codes have hitherto overlooked: well-being is not synonymous with being realistic about oneself, one's circumstances and the future. While severely depressed individuals are unduly pessimistic about themselves and the world around them, treatment of depressed individuals can be deemed successful when patients have successfully attained those positive illusions that are indicative of psychological health. This is exactly what successful psychological treatments of depression seem to achieve. It is therefore possible that there may be a limited unavoidable role for deception in medicine. (shrink)

Three negative affective dispositions—anger, anxiety, and depression—are hypothesized to increase physical disease risk and have been the subject of epidemiological studies. However, the overlap among the major negative affective dispositions, and the superordinate construct of trait negative affectivity are only beginning to be tested. Presented here is a narrative review of recent prospective studies that simultaneously tested anger, anxiety, depression, and trait NA as risk factors for cardiac outcomes. Anxiety and depression emerged as independent risk factors for premature heart disease (...) in population studies of persons nominally healthy at baseline, and for recurrence/mortality among patients with existing heart disease. General trait NA also was a cardiac risk factor in population samples. (shrink)

In Moody Minds Distempered philosopher Jennifer Radden assembles several decades of her research on melancholy and depression. The chapters are ordered into three categories: those about intellectual and medical history of melancholy and depression; those that emphasize aspects of the moral, psychological and medical features of these concepts; and finally, those that explore the sad and apprehensive mood states long associated with melancholy and depressive subjectivity. A newly written introduction maps the conceptual landscape, and draws out the analytic and thematic (...) interconnections between the chapters. Radden emphasizes and develops several new themes: the implications, theoretical phenomenological and moral, of recognizing melancholy and depressive states as mood states; questions of method, as they affect how we understand and characterize claims about melancholy and depression; and the persistence and force of cultural tropes linking such states to brilliance, creativity, and sagacity. Insights from literature and the history of medicine, psychology, and psychiatry are woven together with those from the more recent disciplines of feminist theory and cultural studies. This is interdisciplinary writing at its best-part analytic philosophy, and part history of ideas. (shrink)

IntroductionDuring the COVID-19 outbreak, many citizens were asked to stay at home in self-quarantine, which can pose a significant challenge with respect to remaining physically active and maintaining mental health. This study aimed to evaluate the prevalence of inadequate physical activity, anxiety, and depression and to explore the relationship of physical activity with anxiety and depression symptoms among Chinese college students during quarantine.MethodUsing a web-based cross-sectional survey, we collected data from 1,396 Chinese college students. Anxiety and depression were assessed with (...) the Self-Rating Anxiety Scale and the Self-Rating Depression Scale, respectively. The data on physical activity were collected by types of physical activity and the International Physical Activity Questionnaire.ResultsDuring the COVID-19 outbreak, about 52.3% of Chinese college students had inadequate physical activity. The rates of anxiety and depression symptoms were 31.0 and 41.8%, respectively. A high level of physical activity was significantly closely associated with low anxiety, while a moderate, or high level of physical activity was significantly closely associated with reduced depression after adjusting confounding demographic factors. Moreover, specific types of physical activity, such as stretching and resistance training, were negatively correlated with both anxiety and depression; doing household chores was negatively correlated with depression.ConclusionOur findings highlight specific levels and types of home-based physical activities that need to be taken into consideration to protect the mental health of college students during the COVID-19 epidemic. (shrink)

This dissertation argues that the desire satisfaction theory, arguably the dominant theory of well-being at present, fails to explain why depression is bad for a person. People with clinical depression desire almost nothing, but the few desires they do have are almost all satisfied. So it appears the theory must say these people are relatively well-off. A number of possible responses on behalf of the theory are considered, and I argue that each response either fails outright, or requires modifications to (...) the desire satisfaction theory which make the theory unattractive for other reasons. Advisors: Joseph Mendola and John Brunero. (shrink)

Deep brain stimulation (DBS) to different sites allows interfering with dysfunctional network function implicated in major depression. Because a prominent clinical feature of depression is anhedonia--the inability to experience pleasure from previously pleasurable activities--and because there is clear evidence of dysfunctions of the reward system in depression, DBS to the nucleus accumbens might offer a new possibility to target depressive symptomatology in otherwise treatment-resistant depression. Three patients suffering from extremely resistant forms of depression, who did not respond to pharmacotherapy, psychotherapy, (...) and electroconvulsive therapy, were implanted with bilateral DBS electrodes in the nucleus accumbens. Stimulation parameters were modified in a double-blind manner, and clinical ratings were assessed at each modification. Additionally, brain metabolism was assessed 1 week before and 1 week after stimulation onset. Clinical ratings improved in all three patients when the stimulator was on, and worsened in all three patients when the stimulator was turned off. Effects were observable immediately, and no side effects occurred in any of the patients. Using FDG-PET, significant changes in brain metabolism as a function of the stimulation in fronto-striatal networks were observed. No unwanted effects of DBS other than those directly related to the surgical procedure (eg pain at sites of implantation) were observed. Dysfunctions of the reward system--in which the nucleus accumbens is a key structure--are implicated in the neurobiology of major depression and might be responsible for impaired reward processing, as evidenced by the symptom of anhedonia. These preliminary findings suggest that DBS to the nucleus accumbens might be a hypothesis-guided approach for refractory major depression. (shrink)

BackgroundThe COVID-19 pandemic has led governments worldwide to implement unprecedented response strategies. While crucial to limiting the spread of the virus, “social distancing” may lead to severe psychological consequences, especially in lonely individuals.MethodsWe used cross-sectional and longitudinal designs to investigate the links between loneliness, anxiety, and depression symptoms and COVID-19 risk perception and affective response in young adults who implemented social distancing during the first 2 weeks of the state of epidemic threat in Poland.ResultsLoneliness was correlated with ADS and with (...) affective response to COVID-19’s threat to health. However, increased worry about the social isolation and heightened risk perception for financial problems was observed in lonelier individuals. The cross-lagged influence of the initial affective response to COVID-19 on subsequent levels of loneliness was also found.ConclusionThe reciprocal connections between loneliness and COVID-19 response may be of crucial importance for ADS during the COVID-19 crisis. (shrink)

Should people suffering from untreatable psychiatric conditions be eligible for physician-assisted death? This is possible in Belgium and the Netherlands, where PAD for psychiatric conditions is permitted, though rare, so long as the criteria of due care are met. Those opposed to all instances of PAD point to Belgium and the Netherlands as a dark warning that once PAD is legalized, restricting it will prove impossible because safeguards, such as the requirement that a patient be terminally ill, will inevitably be (...) eroded or discarded. However, some supporters respond that limiting PAD to those suffering from terminal illness, or physical illnesses generally, is arbitrary and illogical. In addition, precisely because such patients are not terminally ill, their suffering may last for years, even the rest of their lives. Finally, severe depression may not be treatable. If PAD is justifiable under some conditions—as I shall assume in this article—then why wouldn't it be justifiable for these patients? Why shouldn't psychiatrists who have nothing else to offer their suffering patients be able to help them to die, if that is what they want? (shrink)

Evidence-Based Medicine has little consideration for mechanisms and philosophers of science and medicine have recently made pleas to increase the place of mechanisms in the medical evidence hierarchy. However, in this debate the notions of mechanisms seem to be limited to 'mechanistic processes' and 'complex-systems mechanisms,' understood as 'componential causal systems'. I believe that this will not do full justice to how mechanisms are used in biological, psychological and social sciences and, consequently, in a more biopsychosocial approach to medicine. Here, (...) I propose, following (Kuorikoski, 2009), to pay more attention to 'abstract forms of interaction' mechanisms. The present work scrutinized review articles on depression and medically unexplained pain, which are considered to be of multifactorial pathogenesis, for their use of mechanisms. In review articles on these disorders there seemed to be a range of uses between more 'abstract forms of interaction' and 'componential causal system' mechanisms. I therefore propose to expand the notions of mechanisms considered in medicine to include that of more 'abstract forms of interaction' to better explain and manage biopsychosocial disorders. (shrink)

While social interaction and play in a VR environment are becoming ever more popular, little is known about how social VR games affect users. The purpose of this study was to elucidate the role of several contingent factors in social VR games by modeling the relationships between involvement, well-being, depression, self-esteem, and social connectedness. A conditional process-moderated mediation model of the measured variables was analyzed with 220 pieces of collected data. The result showed that: the direct effect of involvement on (...) well-being was significant, and the index of moderated mediation involving depression, self-esteem, and social connectedness was significant. We conclude that high levels of involvement in social VR games by socially isolated users with low self-esteem can negatively affect their well-being. The findings of this study contribute in several ways to our understanding of the effect of social VR games upon users and provide important practical implications. (shrink)

BackgroundPsychological resilience may reduce the impact of psychological distress to some extent. We aimed to investigate the mental health status of the public during the outbreak of coronavirus disease 2019 and explore the level and related factors of anxiety and depression.MethodsFrom February 8 to March 9, 2020, 3,180 public completed the Zung’s Self-Rating Anxiety Scale for anxiety, Zung’s Self-Rating Depression Scale for depression, the Connor–Davidson resilience scale for psychological resilience, and the Simplified Coping Style Questionnaire for the attitudes and coping (...) styles.ResultsThe number of people with depressive symptoms was 1,303. The number of people with anxiety symptoms was 1,184. The depressed group and anxiety group had less education, more unmarried and younger age, as well as had significant different in SDS total score, SAS total score, CD-RISC total score, and SCSQ score. The binary logistic regression showed that female, strength, and the subscales of active coping style in SCSQ remained protective factors and passive coping style and higher SAS score were risk factors for depression. Optimism in CD-RISC was a protective factor, and passive coping styles and higher SDS score were risk factors for anxiety.LimitationsThis study adopted a cross-sectional design and used self-report questionnaires.ConclusionThe mental health of the public, especially females, the younger and less educational populations, and unmarried individuals, should be given more attention. Individuals with high level of mental resilience and active coping styles would have lower levels of anxiety and depression during the outbreak of COVID-19. (shrink)

It is now an ethical dictum that patients should be informed by physicians about their diagnosis, prognosis and treatment options. In this paper, I ask: ‘How informed are the ‘informers’ in clinical practice?’ Physicians have a duty to be ‘well-informed’: patient well-being depends not just in conveying adequate information to patients, it also depends on physicians keeping up-to-date about: popular misunderstandings of illnesses and treatments; and the importance of patient psychology in affecting prognosis. Taking the case of depression as an (...) entry point, this paper argues that medical researchers and physicians need to pay serious attention to the explanations given to patients regarding their diagnosis. Studies on lay understanding of depression show that there is a common belief that depression is wholly caused by a ‘chemical imbalance’ that can be restored by chemically restorative antidepresssants, a claim that has entered ‘folk wisdom’. However, these beliefs oversimplify and misrepresent the current scientific understanding of the causes of depression: first, there is consensus in the scientific community that the causes of depression include social as well as psychological triggers ; second, there is significant dissensus in the scientific community over exactly what lower level, biological or biochemical processes are involved in causing depression; third, there is no established consensus about how antidepressants work at a biochemical level; fourth, there is evidence that patients are negatively affected if they believe their depression is wholly explained by of ‘biochemical imbalance’. I argue that the medical community has a duty, to provide patients with adequate information and to be aware of the negative health impact of prevalent oversimplifications—whatever their origins. (shrink)

Aim: The aim of this paper is to present the development and evaluation of an art psychotherapy brief treatment method for complex depression for patients referred to mental health services.Background: Art Psychotherapy literature describes a range of processes of relational change through the use of arts focused and relationship focused interventions. Complex depression has a prevalence of 3% of the population in the West and it is recorded that in 2016 only 28% of that population were receiving psychological treatment. This (...) study was developed to test the hypothesis of whether an accessible and acceptable approach to the treatment of complex depression could be developed in relation to existing evidence-based practice within mental health services.Method: The United Kingdom Medical Research Council phased guidance for complex intervention development was used to develop the intervention. The process included producing a literature overview, systematic description of clinical practice, including a logic model and a clinical protocol. The art psychotherapy protocol described an arts-based dynamic interpersonal therapy approach, offered 1:1 over 24 sessions. Further to this the intervention was tested for referrer acceptability. The intervention is in the early stages of evaluation, using changes to the patient's depression and anxiety measured pre- and post-treatment with a follow-up measure at 3 months following completion of treatment.Results: Phase I of the study provided a good basis for developing a logic model and protocol. The authors found that there was good clinical consensus about the use of a structured clinical art psychotherapy method and the literature overview was used to support specific examples of good practice. The verification of clinical coherence was represented by a logic model and clinical protocol for delivering the intervention. The acceptability study demonstrated very high levels of acceptability for referrers reporting that ADIT was acceptable for patients with complex/major depression, that they were likely to refer to ADIT in the future that the use of arts was likely to improve accessibility the use of arts was likely to improve outcomes and that offering ADIT was an effective use of mental health resources.Discussion: Phase I of this intervention development study demonstrated theoretical and practice coherence resulting in a clinical protocol and logic model. Whilst Phase II of this study showed promising results, Phase II would need to be sufficiently scaled up to a full trial to further test the intervention and protocol. (shrink)

We examined amygdala subregion volumes in patients with a first episode of major depression and in healthy subjects. Covariate-adjusted linear regression was performed to compare the MD and healthy groups, and adjustments for age, gender, and total estimated intracranial volume showed no differences in amygdala subregion volumes between the healthy and MD groups. Within the MD group, we examined the association between amygdala subregion volume and the 17-item Hamilton Rating Scale for Depression score and the HAMD subscale score, and found (...) no association in the left amygdala. In the right amygdala, however, there was an inverse linear association between the HAMD total and the HAMD core and lateral nucleus and anterior-amygdaloid-regions. Furthermore, an inverse linear association was seen between the HAMD psychic and the lateral nucleus, anterior-amygdaloid-regions, transition, and whole amygdala. The findings of this study suggest that the severity of MD and some symptoms of MD are associated with right amygdala volume. There have been few reports on the relationship between MD and amygdala subregional volume, and further research is needed to accumulate more data for further validation. (shrink)

Cognitive reappraisal is one of the core treatment components of cognitive behavioral therapy and is the gold standard treatment for major depressive disorders. Accumulating evidence indicates that cognitive reappraisal could function as a protective factor of cognitive vulnerability to depression. However, the neural mechanism by which CR training reduces cognitive vulnerability to depression is unclear. There is ample evidence that the prefrontal–amygdala circuit is involved in CR. This study proposes a novel cognitive bias model of CR training which hypothesizes that (...) CR training may improve the generation ability of CR with altered prefrontal–amygdala functional activation/connectivity, thus reducing negative cognitive bias and alleviating depressive symptoms. This study aims to explore whether there is abnormal CR strategy generation ability in individuals who are cognitively vulnerable to depression; test the hypothesis that CR training alleviates depressive symptoms through the mediators of cognitive bias ; explore the neural mechanism by which CR training may enhance the ability of CR strategy generation; and examine the short- and long-term effects of CR training on the reduction in depressive symptoms in individuals who are cognitively vulnerable to depression following intervention and 6 months later. The study is promising, providing theoretical and practical evidence for the early intervention of depression-vulnerable individuals. (shrink)

The aim of the present study was to examine whether offspring at high and low familial risk for depression differ in the immediate and more lasting behavioural and physiological effects of hedonica...

Recently, interest in the unique pathways linking discrete positive emotions to specific health outcomes has gained increasing attention, but the role of awe is yet to be elucidated. Awe is a complex and transformative emotion that can restructure individuals' mental frames so deeply that it could be considered a therapeutic asset for major mental health major issues, including depression. Despite sparse evidence showing a potential connection between depression and awe, this link has not been combined into a proposal resulting in (...) specific intervention guidelines. The aim of this perspective was three-fold: to provide a new unifying model of awe's functioning—the Matryoshka model; to show systematic and explicit connections between this emotion and depression; and to suggest specific guidelines of intervention utilizing the potential therapeutic role of awe for mental health, specifically for depression. This theoretical endeavor in its entirety has been framed within the health domain. (shrink)

Aversive experiences have been thought to provoke or exacerbate clinical depression. The present review provides a brief survey of the stress-depression literature and suggests that the effects of stressful experiences on affective state may be related to depletion of several neurotransmitters, including norepinephrine, dopamine, and serotonin. A major element in determining the neurochemical changes is the organism's ability to cope with the aversive stimuli through behavioral means. Aversive experiences give rise to behavioral attempts to cope with the stressor, coupled with (...) increased utilization and synthesis of brain amines to contend with environmental demands. When behavioral coping is possible, neurochemical systems are not overly taxed, and behavioral pathology will not ensue. However, when there can be no behavioral control over the stressful stimuli, or when the aversive experience is perceived as uncontrollable, increased emphasis is placed on coping through endogenous neurochemical mechanisms. Amine utilization increases appreciably and may exceed synthesis, resulting in a net reduction of amine stores, which in turn promotes or exacerbates affective disorder. The processes governing the depletions may be subject to sensitization or conditioning, such that exposure to traumatic experiences may have long-term repercussions when the organism subsequently encounters related stressful stimuli. With continued uncontrollable stimulation, adaptation occurs in the form of increased activity of synthetic enzymes, and levels of amines approach basal values. It is suggested that either the initial amine depletion provoked by aversive experiences or a dysfunction of the adaptive processes, resulting in persistent amine depletion, contributes to behavioral depression. Aside from the contribution of behavioral coping, several organismic, experiential, and environmental variables will influence the effects of aversive experiences on neurochemical activity, and may thus influence vulnerability to depression. (shrink)

The tendency to get involved in helping one’s family, friends, school, and community has many potential benefits such as greater compassion, concern for others, and social responsibility. Research interest in the benefits of contribution in adolescents has increased recently, but there are not many studies examining the effect of contribution on adolescents’ mental health. The present study focused on whether the contribution is associated with fewer self-rated depression symptoms in adolescents. We further tested whether self-regulation and academic performance can have (...) a mediating role in this association. A total of 423 secondary school students (233 female) from eastern Croatia participated in the study. Mean age was 16.78 (SD= 1.21). Students completed measures of self-regulation, depression symptoms, and contribution (helping one’s family, friends, or neighbors, mentoring peers, volunteering in one’s community, and participating in school organizations or boards), and gave information about age, gender, and academic performance. A hierarchical regression analysis revealed that contribution, self-regulation, and academic performance were related with lower levels of self-rated depression symptoms. Furthermore, mediation analysis indicated a significant indirect effect through two mediators, self-regulation and academic performance, which was stronger than a path containing only self-regulation. Academic performance alone was not a significant mediator. Our findings suggest that contribution could protect against depression by promoting self-regulation, leading to higher academic performance, and consequently fewer depression symptoms. (shrink)

Teacher support makes students feel loved and cared for because they believe that their teachers will provide them with opportunities to make choices, support them in independent problem solving, and understand their inner feelings. High TS levels reduce depression and anxiety, thereby improving students' mental well-being. This cross-sectional study involved 3,573 students from 29 schools in 16 counties/cities of six provinces, namely, Guizhou, Hubei, Jiangxi, Shanxi, Sichuan, and Yunnan. The aim was to examine the impact of TS on students' level (...) of depression. The results indicated that for children in elementary schools, their status as left-behind children played a moderating role between TS and depression. The level of depression in non-LBC children decreased significantly with increases in TS, but the reduction for LBC children was not significant. For children in middle/junior high schools, their LBC status did not play a moderating role between TS and depression. TS was negatively correlated with the children's level of depression, but there was a significant positive relationship between their LBC status and depression. The theoretical and practical significance of the research findings were further discussed. (shrink)

The aims of this study were to examine the effectiveness of a range of smartphone apps for managing symptoms of anxiety and depression and to assess the utility of a single-case research design for enhancing the evidence base for this mode of treatment delivery. The study was serendipitously impacted by the COVID-19 pandemic, which allowed for effectiveness to be additionally observed in the context of significant community distress. A pilot study was initially conducted using theSuperBetter app to evaluate the proposed (...) methodology, which proved successful with the four finishing participants. In the main study, 39 participants commenced, with 29 finishing the intervention phase and completing post-intervention measures. At 6-month follow-up, a further three participants could not be contacted. This study used a digitally enhanced, multiple baseline across-individuals single-case research design. Participants were randomly assigned to the following apps:SuperBetter,Smiling Mind,MoodMission,MindShift, andDestressify. Symptomatology and life functioning were measured at five different time points: pre-baseline/screening, baseline, intervention, 3-week post-intervention, and 6-month follow-up. Detailed individual perceptions and subjective ratings of the apps were also obtained from participants following the study’s completion. Data were analyzed using visual inspection, time-series analysis, and methods of statistical and clinical significance. Positive results were observed for all apps. Overall, more favorable outcomes were achieved by younger participants, those concurrently undertaking psychotherapy and/or psychotropic medication, those with anxiety and mixed anxiety and depression rather than stand-alone depression, and those with a shorter history of mental illness. Outcomes were generally maintained at 6-month follow-up. It was concluded that a diverse range of evidence-based therapies offered via apps can be effective in managing mental health and improving life functioning even during times of significant global unrest and, like all psychotherapies, are influenced by client features. Additionally, this single-case research design is a low-cost/high value means of assessing the effectiveness of mental health apps.Clinical Trial Registration: The study is registered with the Australian and New Zealand Clinical Trials Registry, which is a primary registry in the World Health Organization Registry Network, registration number ACTRN12619001302145p. (shrink)

Objectives: Initially, we analyzed relations between the challenging working conditions of flight attendants with symptoms of depression, anxiety and stress. As the COVID-19 pandemic plunged airlines into an unprecedented crisis, its impact on the mental health of flying cabin crews became the focus of a second survey.Methods: Flight attendants were surveyed online with DASS-21 in May 2019 and April 2020, complemented with questions about working conditions and existential fears and fear of job loss.Results: Sample 1 revealed that symptoms of depression, (...) anxiety and stress highly correlated with the subjective assessment of working conditions, but not with objectifiable parameters. Sample 2 showed significant positive correlations between existential fears and fear of job loss with depression, anxiety and stress. Crew members, grounded in April 2020, showed significantly higher scores in depression and stress, while still flying individuals had more clinically relevant symptoms of anxiety. Mean value comparisons between sample 1 and 2 in DASS-21 revealed a significant increase in symptoms at the time of crisis with effect sizes of d = 0.63 for depression, d = 0.26 for anxiety, and d = 0.52 for stress. The incidence of clinically relevant symptoms among the respondents increased from 8 to 23%, from 6 to 14%, and from 8 to 24%.Conclusion: The COVID-19 pandemic and associated work restrictions coincide with severe impairment of mental health of flying cabin crews, consistent with a mental health protecting function of labor. (shrink)

ABSTRACTThis is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task, an Emotional Visual Search Task, and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: (...) evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying... (shrink)

Working parents in are struggling to balance the demands of their occupation with those of childcare and homeschooling during the COVID-19 pandemic. Moreover, studies show that women are shouldering more of the burden and reporting greater levels of psychological distress, anxiety, and depression relative to men. However, research has yet to show that increases in psychological symptoms are linked to changes in stress during the pandemic. Herein, we conduct a small-N study to explore the associations between stress and psychological symptoms (...) during the pandemic among mothers using structural equation modeling, namely latent change score models. Thirty-three mothers completed questionnaires reporting current anxious and depressive symptoms, as well as stressful life experiences prior to-versus during the pandemic. Women endorsed significantly more stressful events during the pandemic, relative to the pre-pandemic period. Additionally, 58% of mothers scored as moderate-to-high risk for developing a stress-related physical illness in the near future because of their pandemic-level stress. Depressive symptoms were associated with the degree of change in life stress, whereas anxiety symptoms were more related to pre-pandemic levels of stress. The present study preliminarily sheds light on the nuanced antecedents to mothers’ experiences of anxious and depressive symptoms during the COVID-19 pandemic. Although further work is needed in larger, more diverse samples of mothers, this study highlights the potential need for appropriate policies, and prevention and intervention programs to ameliorate the effects of pandemics on mothers’ mental health. (shrink)

Social media plays a significant role in modern life, but excessive use of it during the COVID-19 pandemic has become a source of concern. Supported by the conservation of resources theory, the current study extends the literature on problematic social media usage during COVID-19 by investigating its association with emotional and mental health outcomes. In a moderated mediation model, this study proposes that problematic social media use by workers during COVID-19 is linked to fear of COVID-19, which is further associated (...) with depression. The current study tested trait mindfulness as an important personal resource that may be associated with reduced fear of COVID-19 despite problematic social media use. The study collected temporally separate data to avoid common method bias. Pakistani employees working in different organizations completed a series of survey questionnaires. The results supported the moderated mediation model, showing that problematic social media use during the current pandemic is linked to fear of COVID-19 and depression among employees. Furthermore, trait mindfulness was found to be an important buffer, reducing the negative indirect association between problematic social media use and depression through fear of COVID-19. These results offer implications for practitioners. The limitations of this study and future research directions are also discussed. (shrink)

Introduction: Electroconvulsive therapy is a commonly used brain stimulation treatment for treatment-resistant or severe depression. This study was planned to find the effects of ECT on brain connectivity by conducting a systematic review and coordinate-based meta-analysis of the studies performing resting state fMRI in patients with depression receiving ECT.Methods: We systematically searched the databases published up to July 31, 2020, for studies in patients having depression that compared resting-state functional connectivity before and after a course of pulse wave ECT. Meta-analysis (...) was performed using the activation likelihood estimation method after extracting details about coordinates, voxel size, and method for correction of multiple comparisons corresponding to the significant clusters and the respective rsFC analysis measure with its method of extraction.Results: Among 41 articles selected for full-text review, 31 articles were included in the systematic review. Among them, 13 articles were included in the meta-analysis, and a total of 73 foci of 21 experiments were examined using activation likelihood estimation in 10 sets. Using the cluster-level interference method, one voxel-wise analysis with the measure of amplitude of low frequency fluctuations and one seed-voxel analysis with the right hippocampus showed a significant reduction in the left cingulate gyrus and a significant increase in the right hippocampus with the right parahippocampal gyrus, respectively. Another analysis with the studies implementing network-wise resting state functional connectivity showed a significant increase in bilateral posterior cingulate cortex. There was considerable variability as well as a few key deficits in the preprocessing and analysis of the neuroimages and the reporting of results in the included studies. Due to lesser studies, we could not do further analysis to address the neuroimaging variability and subject-related differences.Conclusion: The brain regions noted in this meta-analysis are reasonably specific and distinguished, and they had significant changes in resting state functional connectivity after a course of ECT for depression. More studies with better neuroimaging standards should be conducted in the future to confirm these results in different subgroups of depression and with varied aspects of ECT. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

ABSTRACTHedonic deficits are linked to protracted dysphoric affect in depression, a disorder characterised by emotion context insensitivity. Recent findings from daily life studies contradict the ECI view. This study longitudinally investigated DA across laboratory and daily life contexts and the conditions associated with discrepancies in DA reactivity. Thirty-three healthy controls and 41 adults with major depressive disorder provided responses to neutral and positive films viewed in the laboratory and daily events recorded over the course of three days using ecological momentary (...) assessment methodology. The current study reports on participants’ appraisals of films and events and their subsequent DA, both rated individually after each task and daily event. Despite large group similarities in appraisals of the positive film and life events, MDDs appraised the neutral film and neutral life events as less important and less pleasant (film: d =... (shrink)