Biomedical subjects

I H Gotlib

Publications and source records attributed to I H Gotlib.

At least 19 recordsLinked to original sources

PubMed2004

Panic attacks and psychopathology among youth.

OBJECTIVE: To determine the association between panic attacks and mental disorders among youth in the community. METHOD: Data were drawn from the Methods for the Epidemiology of Child and Adolescent Mental Disorders study (n = 1285), a community-based sample of youth aged 9-17. Multiple logistic regression analyses were used to determine the association between panic attacks and the range of mental disorders, diagnosed with the Diagnostic Interview Schedule for Children 2.3. RESULTS: Panic attacks were prevalent among 3.3% of the sample. Panic attacks were associated with an increased likelihood of any anxiety disorders [OR = 4.6 (2.5, 8.5)] and any affective disorder [OR = 5.8 (2.8, 11.7)], as well as social phobia [OR = 2.3 (1.0, 5.4)], specific phobia [OR = 3.4 (1.1, 10.1)], agoraphobia [OR = 2.9 (1.1, 7.6)], generalized anxiety disorder [OR = 4.8 (1.9, 12.1)], separation anxiety disorder [OR = 3.1 (1.3, 7.7)], major depression [OR = 3.6 (1.6, 8.3)], dysthymia [OR = 6.7 (2.9, 15.5)], and hypomania [OR = 26.1 (5.5, 124.1)]. CONCLUSION: These data are consistent with, and extend, previous clinical findings by showing that panic attacks are associated with increased likelihood of a range of affective and anxiety disorders, but not substance use disorders, among youth in the community. The use of longitudinal study designs in future investigations may be useful in increasing our understanding of the mechanisms underlying these associations.

Adolescent↗

PubMed2000

Natural course of adolescent major depressive disorder in a community sample: predictors of recurrence in young adults.

OBJECTIVE: The primary purpose was to identify factors related to the recurrence of major depressive disorder during young adulthood (19-23 years of age) in a community sample of formerly depressed adolescents. METHOD: A total of 274 participants with adolescent-onset major depressive disorder were assessed twice during adolescence and again after their 24th birthday. Lifetime psychiatric information was obtained from their first-degree relatives. Adolescent predictor variables included demographic characteristics, psychosocial variables, characteristics of adolescent major depressive disorder, comorbidity, family history of major depressive disorder and nonmood disorder, and antisocial and borderline personality disorder symptoms. RESULTS: Low levels of excessive emotional reliance, a single episode of major depressive disorder in adolescence, low proportion of family members with recurrent major depressive disorder, low levels of antisocial and borderline personality disorder symptoms, and a positive attributional style (males only) independently predicted which formerly depressed adolescents would remain free of future psychopathology. Female gender, multiple major depressive disorder episodes in adolescence, higher proportion of family members with recurrent major depressive disorder, elevated borderline personality disorder symptoms, and conflict with parents (females only) independently predicted recurrent major depressive disorder. Comorbid anxiety and substance use disorders in adolescence and elevated antisocial personality disorder symptoms independently distinguished adolescents who developed recurrent major depressive disorder comorbid with nonmood disorder from those who developed pure major depressive disorder. CONCLUSIONS: Formerly depressed adolescents with the risk factors identified in this study are at elevated risk for recurrence of major depressive disorder during young adulthood and therefore warrant continued monitoring and preventive or prophylactic treatment.

Adolescent↗

PubMed1999

Gender differences in correlates of depressive symptoms in adolescents.

PURPOSE: To determine: (a) what demographic and psychosocial factors are associated with elevated levels of depressive symptoms in adolescence; (b) whether girls and boys show different profiles of correlates and probable risk factors for depressive symptoms; and (c) what the implications are of these results for future research directions and policy decisions. METHODS: Using a nationally representative sample of adolescent school students in Grades 5-12, the Commonwealth Fund Adolescent Health Survey assessed depressive symptoms as well as a number of variables posited to be risk factors and correlates of depression. RESULTS: Depressive symptoms were found to differ by gender, age, socioeconomic status, and ethnicity. In addition, life stress, social support, and coping were associated with depressive symptoms. Importantly, stress and social support appear to be particularly salient aspects of depression among girls. Both physical and sexual abuse were strongly linked with depression for both boys and girls, with sexual abuse having a stronger impact among boys. Finally, high levels of depressive symptoms were associated with increased use of both mental and physical health care resources among boys and girls. CONCLUSIONS: The correlates of depression in this adolescent sample closely resemble those seen in adult samples, including demographic and psychosocial variables. Some psychosocial variables, such as stress and social support, may have a greater impact on depressive symptoms for girls than for boys. Results of this study also have important implications for the health care system, given that higher levels of depressive symptoms were found to be associated with greater utilization of physical health care resources.

Adaptation, Psychological↗

PubMed1999

Ethnic differences in the association between pubertal status and symptoms of depression in adolescent girls.

PURPOSE: To examine the importance of chronologic age versus pubertal status in predicting adolescent girls' depressive symptoms in different ethnic groups. METHODS: A national probability sample was used to obtain a representative cohort of 3216 adolescents, 5th through 8th grades. Subjects completed a questionnaire, which included a modified version of the Children's Depression Inventory (CDI) and an assessment of timing of menarche. RESULTS: Among Caucasians, post-menarcheal adolescent girls had higher depression scores than did same-aged pre-menarcheal girls. Boys and pre-menarcheal girls had similar depression scores in most age groups. Among African-Americans and Hispanics, there were no menarche-associated differences in depressive symptoms. CONCLUSION: In early adolescence pubertal status is a better predictor of depressive symptoms than chronological age in Caucasian, but not African-American or Hispanic girls.

Adolescent↗

PubMed1999

First onset versus recurrence of depression: differential processes of psychosocial risk.

Differential risk factors for the onset of depression were prospectively examined in a community-based sample of adolescents (N = 1,709), some of whom had a history of major depressive disorder (MDD; n = 286) and some of whom did not (n = 1,423). From the theories of J. Teasdale (1983, 1988) and R. Post (1992) concerning the etiology of initial versus recurrent episodes of depression, the authors hypothesized that (a) dysphoric mood and dysfunctional thinking styles would be correlated more highly among those with a previous history of MDD than among those without a history of MDD; (b) dysphoric mood or symptoms and dysfunctional thinking would be a stronger predictor of onset of recurrent episodes (n = 43) than of first onsets (n = 70); and (c) major life stress would be a stronger predictor of first onsets of MDD than of recurrent episodes. The results provide support for the 3 hypotheses and suggest that distinct processes are involved in the onset of first and recurrent episodes of MDD.

Adolescent↗

PubMed1999

Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission.

A large body of literature documents the adverse effects of maternal depression on the functioning and development of offspring. Although investigators have identified factors associated with risk for abnormal development and psychopathology in the children, little attention has been paid to the mechanisms explaining the transmission of risk from the mothers to the children. Moreover, no existing model both guides understanding of the various processes' interrelatedness and considers the role of development in explicating the manifestation of risk in the children. This article proposes a developmentally sensitive, integrative model for understanding children's risk in relation to maternal depression. Four mechanisms through which risk might be transmitted are evaluated: (a) heritability of depression; (b) innate dysfunctional neuroregulatory mechanisms; (c) exposure to negative maternal cognitions, behaviors, and affect; and (d) the stressful context of the children's lives. Three factors that might moderate this risk are considered: (a) the father's health and involvement with the child, (b) the course and timing of the mother's depression, and (c) characteristics of the child. Relevant issues are discussed, and promising directions for future research are suggested.

Child↗

PubMed1998

Gender differences in anxiety disorders and anxiety symptoms in adolescents.

Gender differences in anxiety were examined in a large sample of adolescents that included 1,079 who had never met criteria for any disorder, 95 who had recovered from an anxiety disorder, and 47 who had a current anxiety disorder. Participants were examined on a wide array of psychosocial measures. There was a preponderance of females among current and recovered anxiety disorder cases, but not among those who had never experienced an anxiety disorder. The female preponderance emerges early in life, and retrospective data indicate that at age 6, females are already twice as likely to have experienced an anxiety disorder than are males. Psychosocial variables that were correlated with both anxiety and gender were identified. Statistically controlling for these variables did not eliminate the gender differences in prevalence or anxiety symptom means.

Adolescent↗

PubMed1998

Consequences of depression during adolescence: marital status and marital functioning in early adulthood.

In previous studies, depression has been associated with both marital status and marital distress. Unfortunately, given the cross-sectional design of most of this research, the temporal nature of these associations is unclear. The authors examined the marital functioning of young adults as a function of whether they received psychiatric diagnoses of major depressive disorder or nonaffective psychiatric disorder during adolescence. Depression during adolescence was found to predict higher rates of marriage among younger women and subsequent marital dissatisfaction. This pattern of results appears to be specific to depression: The presence during adolescence of a nonaffective psychiatric disorder was unrelated to subsequent marital functioning. These findings highlight the potentially adverse consequences of depression in adolescence and underscore the importance of prevention and early treatment efforts.

Adolescent↗

PubMed1997

Depression-related psychosocial variables: are they specific to depression in adolescents?

Although the psychosocial difficulties associated with adolescent depression are relatively well known, the extent to which these problems are specific to depression has received little attention. The authors examined the specificity to depression of a wide range of psychosocial variables in the following 3 groups of adolescents: depressed cases (n = 48), nonaffective disorder cases (n = 92), and never mentally ill participants (n = 1,079). The authors found 3 of the 44 variables assessed in this study to be strongly specific to depression, and only the depressed participants exhibited more problematic functioning than did the never mentally ill controls. Three variables are as follows: self-consciousness, self-esteem, and a reduction in activities because of physical illness or injury. Eight variables were more strongly associated with depression than with nonaffective disorder, and 8 variables characterized both depressed and nonaffective disorder adolescents. Implications of these findings for psychosocial theories of depression are discussed.

Adaptation, Psychological↗

PubMed1997

Temporal variability in global self-esteem and specific self-evaluation as prospective predictors of emotional distress: specificity in predictors and outcome.

Recent studies have found that temporal variability and reactivity in self-esteem (SE) are associated with risk for depressive symptoms subsequent to life stress. It is unclear, however, whether it is variability uniquely in SE that is critical, or whether variability in other domains, such as specific self-evaluation (SSE) and affect, would show similar effects. Further, the specificity of these effects to depression is unknown. In the present study, initially nondepressed women completed 7 daily ratings of SE, SSE, and affect. Over a 6-week prospective interval, the interactions of stressful life events and variability in both SE and SSE predicted changes in depression, particularly in individuals with more severe worst lifetime episodes of depressive symptoms. These effects were independent of average level of SE and SSE, as well as neuroticism and self-concept uncertainty. In contrast, variability in affect failed to predict changes in depression in interaction with life stress. Finally, none of the predictor variables interacted with stressful life events in predicting changes in anxiety.

Adult↗

PubMed1997

Lifetime episodes of dysphoria: gender, early childhood loss and personality.

The roles of gender, early childhood loss and personality as risk factors for lifetime episodes of dysphoria were examined in a large sample of college students (N = 557). Dysphoria classifications were based on the Inventory to Diagnose Depression (IDD) and the IDD-Lifetime Version. Brief dysphoria was defined as meeting DSM-III-R symptom criteria for major depression without meeting the two-week duration criteria, whereas protracted dysphoria required that the duration criteria were also met. Although females reported higher levels of depressive symptoms and neuroticism than did males, and were more likely to have a lifetime history of episodes of dysphoria, males were more susceptible to the adverse effects of early childhood loss. Males with loss were more likely to have a history of protracted dysphoria and to report higher levels of neuroticism than were males who did not experience an early parental loss. Neuroticism, in turn, acted as a trait vulnerability characteristic to episodes of dysphoria in both males and females. Interestingly, the effects of gender on lifetime experience of dysphoria were mediated by neuroticism: females' increased vulnerability to episodes of dysphoria was due to their elevated levels of neuroticism.

Adolescent↗

PubMed1996

Adult attachment security and symptoms of depression: the mediating roles of dysfunctional attitudes and low self-esteem.

Three studies investigated the relation between adult attachment security and symptoms of depression. Study l examined the overall magnitude of the association between adult attachment and depression, and Studies 2 and 3 tested whether this relation was mediated by dysfunctional attitudes and low self-esteem. Results from the three studies were consistent with a mediation model. This model suggests that insecure adult attachment styles are associated with dysfunctional attitudes, which in turn predispose to lower levels of self-esteem. Such depletions in self-esteem are directly associated with increases in depressive symptoms over time. Insecure attachment appears to lead to depressive symptoms in adulthood through its impact on self-worth contingencies and self-esteem.

Adult↗

PubMed1996

Distinguishing between state-dependent and non-state-dependent depression-related psychosocial variables.

The goals of this study were: (a) to determine which among a set of depression-related psychosocial variables are state-dependent; (b) to examine whether state-trait distinctions among psychosocial variables are a function of gender; and (c) to test the hypothesis that state-dependence of psychosocial variables is mostly evident in people with a history of clinical depression. Altogether, 562 participants residing in two communities completed a battery of psychosocial measures at point of entry into the study (T1) and after an average interval of 8.3 months (T2). The state-dependence of psychosocial variables was examined in two groups of participants: (a) low-high (LH: those who were low on the Center for Epidemiologic Studies Depression Scale at T1 and high at T2; N = 45); and (b) high-low (HL: those who were high at T1 and low at T2; N = 64). The following variables were found to be state-dependent: engagement in pleasant and unpleasant events; frequency of social contacts; dissatisfaction with oneself, one's neighborhood dwelling and one's friends; irrational beliefs, and positive and negative expectancies. In contrast, the following variables were not state-dependent: dissatisfaction with family and job, perception of control, and external attributions for positive and negative events. State-dependence was not moderated by age, gender or a history of depression. Possible explanations for why some variables are state-dependent and others are not state-dependent are offered.

Adult↗

PubMed1996

The effects of psychiatric disorders on the probability and timing of first marriage.

While studies of psychopathology have begun to consider social consequences of psychiatric disorders during the past decade, marriage has received little attention, despite evidence that it influences life quality. The present paper examines the effects of clinically significant psychiatric disorders on the probability and timing of first marriage and whether the relationships between psychiatric disorders and marriage differ by type of disorder, gender, and birth cohort. Psychiatric disorders are found to have substantial effects on entry into first marriage. These effects are the same for men and women across all cohorts. Individual psychiatric disorders have similar effects on entry into first marriage. Psychiatric disorders are positively associated with early first marriage, which is strongly related to adverse consequences, and negatively associated with on-time and late first marriage, which are related to benefits such as financial security and social support. These results highlight the importance of early interventions for psychiatric disorders-if not for the purposes of primary prevention, then for the purposes of preventing the cumulation of adversities that occur secondarily through early marriage.

Adolescent↗

PubMed1995

Operant (biofeedback) control of left-right frontal alpha power differences: potential neurotherapy for affective disorders.

Two experiments were done with subjects from a paid pool of undergraduates. In each study, there were five 1-hour sessions on each of 5 days: (1) Baseline: Rewards given for randomly selected 20% of the 700-ms sequential epochs; mean and SD of baseline power differences determined. 2) Exploration: Subjects were rewarded when right minus left alpha differences in an epoch were greater than the baseline mean plus about .85 SD (p = .20); subjects told to discover how to generate rewards. (3)-(5). Training: Subjects were paid (over and above the $8/h flat rate) in proportion to their hit rates. In the first study (in which active filters passed 8-12 Hz activity, and the rectified, integrated amplitude was utilized), 6 of 8 subjects met learning criteria (a significant difference between baseline and training scores). In the second study (in which on-line FFTs were used to extract alpha power), 3 of 5 subjects met learning criteria.

Alpha Rhythm↗

PubMed1995

Selective attention and clinical depression: performance on a deployment-of-attention task.

Clinically depressed and nondepressed individuals completed a deployment-of-attention task developed by I. H. Gotlib, A. L. McLachlan, and A. N. Katz (1988). Results indicated that the clinically depressed individuals perform the task in an unbiased fashion, attending equally to positive-, negative-, and neutral-content stimuli. In contrast, the nondepressed individuals demonstrated a "protective" bias against the perception of negative stimuli by avoiding such material in favor of positive or neutral stimuli. Overall, the results of this study suggest that clinically depressed individuals do not show an attentional bias toward negative information, but rather, fail to demonstrate the positive or protective bias that is evident in nondepressed individuals.

Adult↗

PubMed1995

Symptoms versus a diagnosis of depression: differences in psychosocial functioning.

In studies of clinical depression, individuals who demonstrate elevated levels of symptoms but do not meet interview-based diagnostic criteria are typically labeled as false positive and eliminated from further consideration. However, the implicit assumption that false-positive participants differ in important ways from true-positive (i.e., diagnosed) participants has not been tested systematically. This study compared the functioning of true-positive, false-positive, and true-negative adolescents on clinical and psychosocial functioning. Although the false-positive participants manifested higher levels of current and future psychopathology than did the true-negative participants, they did not differ significantly from the true-positive participants on most of the measures of psychosocial dysfunction. "False positive," therefore, is not a benign condition.

Adolescent↗

PubMed1995

Adolescent psychopathology: IV. Specificity of psychosocial risk factors for depression and substance abuse in older adolescents.

OBJECTIVE: To determine the specificity to major depressive disorder (MDD) of a wide array of psychosocial risk factors in older adolescents (aged 14 through 18 years). METHOD: Diagnostic and psychosocial assessments were conducted with 1,507 randomly selected high school students at T1 and after approximately 1 year (T2). Three diagnostic groups were compared: those who had an episode of MDD during that year (n = 90), those who had an episode of substance use disorder during that year (SUD) (n = 42), and a control group with no disorder (n = 1,189). RESULTS: Risk factors specific to MDD were stress (minor and major events), emotional reliance, physical symptoms and disease, history of suicide attempt, and a past episode of depression or anxiety disorder. Risk factors specific to SUD were tobacco use, academic difficulties, and a past episode of SUD. Risk factors that were shared were current depression symptoms, internalizing and externalizing behavior problems, coping skills, interpersonal conflict with parents, and dissatisfaction with grades. CONCLUSIONS: By determining the number of risk factors for MDD, for SUD, or those that are general to both disorders, clinicians can make informed predictions concerning the probable future onset of a full-fledged episode of MDD and/or SUD in individual cases. The results of this study allow for the identification of adolescents who are at elevated risk for MDD and SUD. The results also have implications for the design of interventions aimed at preventing the occurrence of these disorders. Such interventions should target change on risk factors of the type identified in this study.

Achievement↗