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Task-irrelevant threatening faces (e.g., fearful) are difficult to filter from visual working memory (VWM), but the difficulty in filtering non-threatening negative faces (e.g., sad) is not known. Depressive symptoms could also potentially affect the ability to filter different emotional faces. We tested the filtering of task-irrelevant sad and fearful faces by depressed and control participants performing a color-change detection task. The VWM storage of distractors was indicated by contralateral delay activity, a specific event-related potential index for the number of objects stored in VWM during the maintenance phase. The control group did not store sad face distractors, but they automatically stored fearful face distractors, suggesting that threatening faces are specifically difficult to filter from VWM in non-depressed individuals. By contrast, depressed participants showed no additional consumption of VWM resources for either the distractor condition or the non-distractor condition, possibly suggesting that neither fearful nor sad face distractors were maintained in VWM. Our control group results confirm previous findings of a threat-related filtering difficulty in the normal population while also suggesting that task-irrelevant non-threatening negative faces do not automatically load into VWM. The novel finding of the lack of negative distractors within VWM storage in participants with depressive symptoms may reflect a decreased overall responsiveness to negative facial stimuli. Future studies should investigate the mechanisms underlying distractor filtering in depressed populations. publishedVersion

Since parental burnout can have detrimental consequences for parents, couples, and children, easy-to-use, reliable, and valid practical tools for the early detection of parental burnout are required. We developed and validated a brief scale to identify burned-out parents and parents at burnout risk. In Study 1, we developed the 5-item Brief Parental Burnout scale (BPBs) based on the gold standard measure of parental burnout, the Parental Burnout Assessment (PBA). We applied Item Response Theory Graded Response Model (GRM) analyses on the data of 1,725 Finnish parents. Compared against the PBA total score, the five selected items showed both high sensitivity and specificity in screening parental burnout. As expected, burned-out parents and those at burnout risk according to the BPBs displayed higher depressive symptoms, lower self-esteem, and more frequent sleep disruptions than non-burned-out parents. In Study 2, we tested the sensitivity and specificity of the BPBs by using both the BPBs and the PBA as independent assessment tools in a sample of 1,088 Finnish parents. In Study 3, the high sensitivity and specificity of the BPBs found in Study 2 were replicated in an independent sample of 104 Belgian parents. We further demonstrated the concurrent validity of the BPBs test score interpretations by showing that burned-out parents, or those at burnout risk, reported higher child neglect and parental violence than non-burned-out parents. Because of its user-friendliness and the strong psychometric properties of its test score, the BPBs is a good candidate to use as a screening tool for parental burnout. (PsycInfo Database Record (c) 2021 APA, all rights reserved). peerReviewed

In this study, we examined whether maternal perceived job insecurity (JI) affected depressive symptoms in their adolescent children. Specifically, we tested a mediator-moderator model in which we hypothesized that maternal JI was related to adolescent depressive symptoms indirectly via maternal depressive symptoms. Most importantly, we also explored whether this indirect path was moderated by two buffering resources, i.e., maternal off-job recovery and adolescent self-esteem. There is little research on the effects of parental JI on adolescent children from the viewpoint of buffering moderators. Due to growing insecurity in the labor markets we need more information about resources that mitigate the harmful effects of JI within families. We tested the model via structural equation modeling among Finnish mother-adolescent dyads (N = 601, mothers aged 32–60 years; adolescents aged 14–18 years). Our results showed that mothers’ depressive symptoms did not mediate the relationship between mothers’ JI and adolescents’ depressive symptoms, but mothers’ JI was directly related to increased depressive symptoms among both adolescents and their mothers. Mothers’ off-job recovery and adolescents’ self-esteem buffered against mothers’ JI in relation to depressive symptoms. When off-job recovery (in mothers) and self-esteem (in adolescents) were high, the higher level of JI was not associated with increased depressive symptoms. Off-job recovery among working mothers should be improved as it has potential to protect against JI. Moreover, adolescents’ self-esteem should be boosted as it mitigates the effects of mothers’ job stress (e.g., JI) on adolescents’ well-being.

Depressed individuals exhibit an attentional bias towards mood-congruent stimuli, yet evidence for biased processing of threat-related information in human interaction remains scarce. Here, we tested whether an attentional bias towards interpersonally aggressive pictures over interpersonally neutral pictures could be observed to a greater extent in depressed participants than in control participants. Eye movements were recorded while the participants freely viewed visually matched interpersonally aggressive and neutral pictures, which were presented in pairs. Across the groups, participants spent more time looking at neutral pictures than at aggressive pictures, probably reflecting avoidance behaviour. When the participants could anticipate the stimulus valence, depressed participants – but not controls – showed an early attentional bias towards interpersonally aggressive pictures, as indexed by their longer first fixation durations on aggressive pictures than on neutral pictures. Our results thus preliminarily suggest both an early attentional bias towards interpersonal aggression, which is present, in depressed participants, also when aggression contents are anticipated, and a later attentional avoidance of aggression. The early depression-related bias in information processing may have maladaptive effects on the way depressed individuals perceive and function in social interaction and can therefore maintain depressed mood. peerReviewed

Background Family caregivers often report high levels of distress, including depressive symptoms, anxiety, and reduced quality of life. There is a need for a greater understanding of the factors influencing, explaining, and maintaining psychological distress in family caregivers. Aim The aim of this study was to examine whether avoidance strategies such as thought suppression (WBSI), psychological inflexibility (AAQ-II), and, and caregiver experiential avoidance (EACQ) predict psychological distress (BDI-II, GAD-7) and quality of life (WHOQOL) in family caregivers aged 60 and over. We hypothesized that these avoidance strategies would explain elevated levels of psychological symptoms and lower quality of life. Method Altogether, 149 family caregivers completed self-report measures of depressive symptoms, anxiety, quality of life, thought suppression, psychological inflexibility and caregiver experiential avoidance. We conducted correlation and regression analyses to assess the associations and the predictive ability of these constructs. Results Together, psychological inflexibility and thought suppression accounted for between 40 and 46% of the variance in the depression and anxiety outcomes and 15% of the variance in the physical domain of quality of life. Unwanted thoughts, the subcomponent of thought suppression, was strongly associated with symptoms of depression and anxiety, and with physical and psychological quality of life. Conclusion Thought suppression and psychological inflexibility played a significant role in explaining family caregivers’ symptoms of depression and anxiety. In addition, psychological inflexibility was significantly related to quality of life. This suggests the need for acceptance-based strategies to handle thought suppression and psychological inflexibility.

There is an existing link between two of the most common diseases, obesity and depression. These are both of great public health concern, but little is known about the relationships between the subtypes of these conditions. We hypothesized that non-melancholic depressive symptoms have a stronger relationship with both body composition (lean mass and fat mass) and dysfunctional glucose metabolism than melancholic depression. For this cross-sectional study 1510 participants from the Helsinki Birth Cohort Study had their body composition evaluated as lean mass and fat mass (Lean Mass Index [LMI, kg/m2] + Fat Mass Index [FMI kg/m2] = Body Mass Index). Participants were evaluated for depressive symptoms utilizing the Beck depression inventory, and had laboratory assessments including an oral glucose tolerance test. Higher than average FMI was associated with a higher percentage (mean [%], 95% CI) of participants scoring in the depressive range of the Beck depression inventory (20.2, 17.2–23.2) compared to those with low FMI (16.3, 13.8–18.9; p = 0.048) when adjusted for age, sex, education, and fasting plasma glucose concentration. Higher FMI was associated with a higher likelihood of having depressive symptoms (OR per 1-SD FMI = 1.37, 95% CI 1.13–1.65), whereas higher LMI was associated with a lower likelihood of having depressive symptoms (OR per 1-SD LMI = 0.76, 95% CI 0.64–0.91). Participants with an above average FMI more frequently (mean [%], 95% CI) had non-melancholic depressive symptoms (14.7, 11.8–17.7) as compared to those with low FMI (9.7, 7.6–11.9; p = 0.008) regardless of LMI levels. There was no difference between the body composition groups in the likelihood of having melancholic depressive symptoms. The non-melancholic group had higher (mean [kg/m2], SD) FMI (9.6, 4.1) than either of the other groups (BDI p p = 0.005). As hypothesized, non-melancholic depressive symptoms are most closely related to high fat mass index and dysfunctional glucose metabolism.

This study examined Flow with Nature (FWN) treatment, which is an integrative intervention (rehabilitation) based on eco and environmental psychology, psychotherapeutic theories and professional psychological practice. FWN is intended for depression rehabilitation with the help of social support, nature environments and FWN exercises. Exercises encourage sensing the environment, mindful awareness, psychological processing and focusing on the future. The FWN treatment proceeds in separate stages (horizon, growth and path), which emphasise nature, group (social support) and FWN exercises differently. This study focused on the experiences of the participants in the FWN treatment. Finnish adults who had been diagnosed with clinical depression took part in the FWN treatment (N = 82) and answered feedback questions (by paper, electronic questionnaire or phone discussion). Answers were analysed using theory-based content analysis. Data were collected between spring 2019 and spring 2020. The majority of the participants were women (82%) and on average 44 years old. Content analysis revealed that the participant feedback answers were in agreement with the central theoretical themes of FWN. The participants emphasised the significance of nature, social support and exercises differently. Moreover, the significance of these ingredients differed according to the stages of treatment: in the horizon stage restorative (e.g., fascination) and comprehensive nature experiences (e.g., connectedness with nature), in the growth stage social support (e.g., peer support) and in the path stage environmental self-regulation (e.g., nature as a part of life) were emphasised. These results are in accordance with the objectives of the stages and seem to support the phase-based rationale. The participants’ experiences of the key elements of the intervention, social support and nature environment were experienced mainly positively, which supports their inclusion in future intervention versions. In the future, FWN exercises should be developed to better enable participants’ possibilities for concentration and being present in the moment (mindfulness). Exercises should also be simplified to match the target group’s cognitive abilities.

Objectives: The objective of the present study was to investigate whether an acceptance and commitment therapy (ACT)-based web-intervention (Group 1, CareACT), or a standardized rehabilitation in a rehabilitation center (Group 2) was effective in enhancing the psychological well-being of family caregivers aged 60 and over compared to support provided by voluntary caregiver associations (Group 3). Methods: Altogether, 149 family caregivers participated in this quasi-experimental study. Primary outcome measure was depression. Secondary outcomes included anxiety, sense of coherence, quality of life, psychological flexibility, experiential avoidance, and thought suppression. The questionnaires were administered at baseline, and four, and 10 months post-measurement. We investigated differences in the changes between the groups using Mplus modeling techniques. Results: Regarding the main outcome of depression, the results suggest that the CareACT intervention was superior to standardized rehabilitation and to the support given by caregiver associations at four months, both showing a medium-sized difference between the groups. However, the change from four to 10 months post-intervention was not significantly different between these groups (d = 0.32–0.36). Thought suppression showed a significantly different change between the three groups from baseline to four months and to 10 months post-measurement (p = .038). Conclusions: Web-based ACT may have beneficial effects on depressive symptoms and thought suppression in older caregivers. Clinical implications: Web-based ACT could be a feasible alternative to institutional rehabilitation and support provided by voluntary caregiver associations. Web-based ACT responds flexibly to the needs of caregivers and provides them an opportunity for learning new skills to promote well-being. peerReviewed

Music therapy is efficacious for the treatment of depression. Compared to other psychotherapeutic forms, it allows for the emergence of various modes of mutual interaction, thus enabling multiple channels for emotional expression and fostering therapeutic alliance. Although musical interaction patterns between client and therapist have been regarded as predictors of therapeutic outcome in depression, this has not yet been systematically investigated. We aim to address this gap by analyzing the possible linkage between musical interaction features and changes in depression score. In a clinical trial, digital piano improvisations from 58 Finnish clients and their therapists were recorded over 12 sessions of music therapy lasting 6 weeks. Subsequently, a variety of symbolic features describing pitch, rhythm, duration, and velocity were extracted from the improvisations. We observed a number of relationships between client–therapist interaction and clinical improvement. Clients with largest improvements displayed higher overall interaction, particularly more musical interaction in the middle of the therapy process than in the beginning and end. In contrast, clients with lower depression change score exhibited overall lower interaction and yielded other temporal profiles of interaction. The association between clinical improvement and an inverted U-shaped curve of musical interaction is discussed in the light of process-outcome literature.

Though previous research has extensively reported that sudden gains are associated with superior treatment results, research on the long-term effects and stability of sudden gains is not as consistent. The current study explored the long-term stability of early sudden gains (ESGs) observed in a brief acceptance and values-based intervention for depression provided by novice therapists. The participants were 56 volunteers diagnosed with major depressive disorder. Among the participants, 23% experienced ESGs, i.e. they reached the status of improved or recovered in the Reliable Change Index (RCI; Jacobson & Truax, 1991) classification after only two sessions. The current study examined the level of depressive symptoms (BDI-II), psychological flexibility (AAQ-II), believability of depressive thoughts (ATQ-B), and hopefulness (ASHS) 6 and 12 months after the intervention. Of the original participants, 77% (n = 43) took part in the 12-month follow-up. The results showed that positive changes achieved during the two first sessions in the ESG group were maintained up to 12 months after the intervention. The ESG group remained improved or recovered in the RCI classification through the 12-month follow-up period. However, at the 12-month follow-up, there were only small differences between the ESG and the non-ESG groups. The results suggest that participants achieving ESGs show stable improvements lasting up to 12 months after the treatment. peerReviewed

This research identified participant profiles in level and changes in depression among working age (18–64 years old) clients (N = 137) diagnosed with depression, who participated in a 20-session dance movement therapy (DMT) intervention. Using Latent Profile Analysis Mild, sharply reducing depression (9%), Mild, reducing depression (58%) and Severe, reducing depression (33%) profiles were established, using Beck Depression Inventory scores gathered at pre-intervention, post-intervention, and follow-up points. At the pre-intervention point, being in full-time work was related to the Mild, sharply reducing depression profile. Being on a disability pension, having a history of one's own or a close person's substance abuse, a more fearful attachment style, and deficiencies in mindfulness skills were related to the Severe, reducing depression profile. All participants benefited from the short-term DMT intervention, which may offer a good outcome for patients with less complex depression, whereas those with more complicated symptomology may require longer treatment. publishedVersion

Introduction: There is evidence from earlier trials for the efficacy of music therapy in the treatment of depression among working-age people. Starting therapy sessions with relaxation and revisiting therapeutic themes outside therapy have been deemed promising for outcome enhancement. However, previous music therapy trials have not investigated this issue.Objective: To investigate the efficacy of two enhancers, resonance frequency breathing (RFB) and listening homework (LH), when combined with an established music therapy model (trial registration number ISRCTN11618310).Methods: In a 2 × 2 factorial randomised controlled trial, working-age individuals with depression were allocated into groups based on four conditions derived from either the presence or absence of two enhancers (RFB and LH). All received music therapy over 6 weeks. Outcomes were observed at 6 weeks and 6 months. The primary outcome was the Montgomery Åsberg Depression Rating Scale (MADRS) score.Results: There was a significant overall effect of treatment for the primary outcome favouring the breathing group (d = 0.50, 95% CI 0.07 to 0.93, p = 0.02). The effect was larger after adjustment for potential confounders (d = 0.62, 95% CI 0.16 to 1.08, p = 0.009). Treatment effects for secondary outcomes, including anxiety (anxiety scale of Hospital Anxiety and Depression Scale) and quality of life (RAND-36), were also significant, favouring the breathing group. The homework enhancer did not reach significant treatment effects.Conclusion: We found that the addition of RFB to a music therapy intervention resulted in enhanced therapeutic outcome for clients with depression.

This study investigates the role of psychological flexibility in relation to glycaemic control (HbA1c) and quality of life among adolescents with poorly-controlled diabetes. Adolescents (n = 65, aged 12–16 years) completed the Children and Adolescents Mindfulness Measure (CAMM), the Diabetes Acceptance and Action Scale for Children and Adolescents (DAAS), the Depression Scale (RBDI), and the Health-Related Quality of Life Scale (KINDL-R). HbA1c values were collected from medical records. A higher level of psychological flexibility was associated with better glycaemic control, better quality of life, and lower levels of depressive and anxiety symptoms. Mediation analysis showed that diabetes-related psychological flexibility mediated the relationship between glycaemic control and depressive symptoms as well as quality of life. The observations in the current study support the view that adolescents with type 1 diabetes would benefit from training their psychological flexibility skills. peerReviewed

Background Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. Aim To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people. Methods The data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants’ life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Physical performance, perceived financial situation, executive functions, loneliness, self-acceptance, and having interests in one’s life were studied as explanatory variables. The data were analyzed using cross-sectional bivariate linear modeling. Results Better physical performance, not perceiving loneliness, having special interests in one’s life, and higher self-acceptance were associated with higher life satisfaction and fewer depressive symptoms. Better financial situation was related only to life satisfaction. Executive functions were not associated with either of the outcomes. Discussion The opposite ends of the same factors underlie positive and negative dimensions of mental well-being. Conclusion Further studies are warranted to better understand how people maintain life satisfaction with aging when many resources may diminish and depressive symptoms become more prevalent.

Listening to music often triggers strong memories of events from our past, which influence how we affectively experience music listening and can therefore contribute to music’s therapeutic capacity. The aim of this study was to examine the valence and content of spontaneous music-evoked autobiographical memories (MEAMs) in listeners with self-reported depression, who typically demonstrate negatively biased autobiographical memory. Eighteen depressed and 21 controls participated in a music-listening experiment where they listened to a personalized music stimulus, described their memories, and thereafter rated the valence of these memories and of their induced affect. Participants’ ratings were statistically analysed, while the memory content was analysed with the use of a computerized text-analysis method and with a qualitative thematic analysis. Quantitative ratings of valence revealed a significant difference between groups: half of the depressed, compared to none of the controls, recalled a negative memory, and these were experienced with negative induced affect. The qualitative thematic analysis of the memory descriptions revealed that both depressed and control participants’ memories could be categorized into three first-level themes: (1) personal, (2) relationships, and (3) activities. Depressed participants’ negative memories were mainly located in the ‘relationships’ theme and included memories about loss and dysfunctional relationships, such as bullying, and in the ‘personal’ theme, including memories of mental health struggles and coping with music. Approximately a third of depressed participants recalled positive memories, and these were either related to loving family relationships or to activities. Limitations concerning the small sample size and implications regarding the function of music listening for depressed individuals are discussed.

This multicenter research investigates the effects of dance movement therapy (DMT) on participants diagnosed with depression. In total, 109 persons participated in the study in various locations in Finland. The participants were 39 years old, on average (range = 18–64 years), and most were female (96%). All participants received treatment as usual (TAU). They were randomized into DMT + TAU (n = 52) or TAU only (n = 57). The participants in the DMT + TAU group were offered 20 DMT sessions twice a week for 10 weeks in addition to standard care. The measurement points included pretreatment measurement at the baseline, posttreatment measurement at the end of the intervention, and a follow-up measurement 3 months afterward. The observed effects of the intervention among participants in the DMT+TAU group were a greater reduction in depression and in indicators of physical and psychological distress in comparison to the participants who received TAU-only. At the 3-month follow-up, the corrected between-group effect sizes (ESs) were medium and in favor of the DMT + TAU group (d = 0.60–0.72). These results are in line with the increasing number of research studies showing the benefits of DMT intervention among participants with depression, and these results indicate that DMT may improve the effectiveness of standard care. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04421651.

We sought to explore how the process between the counsellor and patient for arriving at a case formulation may predict the outcome of manualized interpersonal counselling (IPC) for depression in primary care. Qualitative content analysis and applied conversation analysis (CA) were used to achieve depth in the understanding of case formulation process among five patients who recovered and five who were unchanged according to quantitative post-treatment change rates derived from Clinical Outcomes in Routine Evaluation– Outcome Measure (CORE-OM). Interaction in the case formulations for the recovered group was generally characterized by a joint construction effort between the counsellor and the patient centred on one problem area. The ability to delimit problems to one area was associated with the patient’s role disputes in social relationships. For the unchanged patients, the case formulation typically reflected unilateral construction of the problem area, and more than one problem area was selected as the focus. The problem areas in the unchanged group were associated with complicated grief or loneliness. The process between counsellor and patient of arriving at and agreeing on a case formulation might potentially contribute to recovery, and it deserves greater attention in training counsellors and conducting research. peerReviewed

Mental illnesses, especially depression, are a global problem that require new treatment options to those whose symptoms are resistant to the current ones. Psilocybin, which is a naturally occurring drug in mushrooms, has become a potential candidate. It affects the brain by deactivating certain areas, causing not only changes in perception and consciousness but antidepressive responses as well, thereby improving well-being. Previous studies have looked at psilocybin and how it affects the brain, and also shown that short trials with psilocybin can cause long-lasting improvement. Here, I conducted an analysis including nine experimental articles that had studied psilocybin’s effects on depressive symptoms. Results confirm that psilocybin does decrease depressive symptoms, even long-lastingly, while only transient mild side effects being fairly common. Some conclusions could also be drawn of which types of patients will benefit of psilocybin treatment most likely. Future research with bigger sample sizes is needed, as well as more focus on identifying the ideal settings and patients of psilocybin-assisted therapy. Mental ohälsa och särskilt depression är globala problem. Nya behandlingsalternativ behövs för de som inte får hjälp av nuvarande behandlingar. Psilocybin är ett ämne som finns i så kallade magiska svampar och har blivit en potentiell kandidat. Psilocybin påverkar hjärnan genom att inaktivera vissa delar, vilket leder till förändringar i perception, medvetandet och antidepressiva responser bland annat. Tidigare forskning har fokuserat på hur psilocybin påverkar hjärnan samt visat att även kortvarig behandling med psilocybin kan framkalla en långvarig förbättring av hur man mår. Denna analys inkluderar nio experiementella studier om psilocybins effekter på depressiva symtom. Resultatet visar att psilocybin minskar depressiva symptom, även långvarigt. Endast kortvariga milda bieffekter var rapporterade. Framtida forskning bör ha ett större antal av deltagare samt fokusera på att identifiera idealgruppen för denna typ av behandling.

This mixed-methods study analyzed the body image quality of 143 patients with depression. The participants received a 20 × 75 min dance movement therapy (DMT) group treatment, sessions twice a week. Body Image Assessment (BIA) was the data collection tool, with pre-, post-, and 3-mos follow-up assessments. Pre-intervention body image quality characteristics were low energy and activity levels, discomfort, shame and disgust toward the body, tension in social interactions. On the BIA scores, a statistical method of Latent Profile Analysis was utilized to identify participant profiles in the data. The two identified profiles were participant with initial negative body image and participant with initial neutral body image. Depression symptoms were measured with BDI, and symptoms decreased for both participant profiles following the DMT intervention. The neutral profile participants had a significantly lower depression level, better energy level, and more frequently used mindfulness factors of acting aware, non-judgmentality and non-reactivity (measured with FFMQ). Findings suggest a systemic interaction between depression symptoms, body image, attachment style, activity level, and mindfulness skills. In an interactive DMT setting it is possible to address all of these factors simultaneously. publishedVersion

Objective The aim of this study was to explore early temporal patterns of change in a treatment delivered by novice therapists. We examined if early sudden gains (ESGs) in a six-session acceptance and values-based intervention would produce superior treatment outcomes when compared to slower improvements. Method The temporal patterns of change of 56 clients diagnosed with depression were analyzed. ESGs were defined as reaching the status of recovered or improved in the Reliable Change Index (RCI) (Jacobson & Truax (1991)) classification after two sessions. The group with ESGs was then compared to participants without ESGs for differences in treatment outcome on measures of symptomatology and measures of therapeutic processes. Results The results reflected significant differences between the groups in treatment outcomes. The ESG group (23.2% of participants) showed superior results both on the level of depressive symptomatology and psychological flexibility. Participants with ESGs also reported more hopefulness and less-believable depression-related thoughts after two sessions. Conclusions The results suggest that the early, clinically significant change is associated with superior treatment results both on the level of reduced symptom severity and therapeutic processes.

Aims: To apply the findings of neurolinguistic research to the practical technological artifact design, the cognitive mechanism of verbal humour is comprehensively investigated and designed with EEG-based Brain Computer interfaces and Mobile Health, under the guidance of technology design theory, to help with the adjustment of depressive mood. Application Base: The intervention effect of verbal humour on depressive mood is rooted in their cognitive mechanisms. The right hemisphere of the brain has a dominant effect on both verbal humour and depressive mood; some specific brain regions, such as amygdala, nucleus accumbens, hippocampus etc., are particularly activated during the processing of both verbal humour and depressive mood. The elicitation by verbal humour positively activate the brain regions related with depressive mood and even help to normalise them. In addition, the cognitive model of verbal humour processing greatly contributes to the transformation from the fixed and unchangeable mindset grounded in a depressive mood to the innovative and flexible way of thinking. Application Methods: To integrate humour intervention into a set of solutions to objectively monitor and effectively mediate mood problems under the premise of privacy protection, Life-Based Design theory, a multi-dimensional design theory putting emphasis on the significance of comprehensively understanding people's life, provides the basis of the solutions. Portable Brainimaging techniques are available to assist us in evaluating the real-time mood state. Mobile phone, as the most popular and indispensable Information Communication Technology device, allowing for bidirectional communication and on-demand access to resources with the precondition of privacy protection. Conclusion: The merger of Life-Based Design theory and EEG-based Brain Computer Interfaces, combined with Mobile Health, presents a creative way to apply the verbal humour research to the technology design, bridging the gap between the cognitive linguistic studies and practical applications. peerReviewed

This study reports on the body image of depressed psychiatric outpatients, and the impact thereon of a dance movement therapy (DMT) group. Body image is perceived as a tri-partite construct consisting of image-properties, body-self, and body memory. Depressed patients in an outpatient mental health service participated in a DMT group treatment consisting of twelve 90-min long sessions in groups of 4–7 patients. Patients (N = 18) responded to a structured Body Image Assessment (BIA) before and after the treatment. Initially, the depressed patients’ body image was characterized by fragmentation, distortions, and shallowness of body awareness. The DMT group treatment aimed to offer the patients a safe space for exploring their embodied experiences in a validating social setting. This produced positive changes in the body image: finding a better sensation of one’s body, tolerating the sensations, settling in the body, finding pleasure and meaningfulness in the experiences. BIA scores indicated large effect sizes in the change between pre- and post-treatment assessments. Change for more positive body image during the treatment predicted fewer depressive symptoms at the follow-up measurement.

Objective This study examined the outcomes of a brief Acceptance and Commitment Therapy (ACT) intervention for depression delivered by novice therapists. Method Participants (N = 115) were randomized either to the brief (six sessions) ACT or to a waitlist control condition (WLC). Outcomes were assessed with diagnoses of depressive episodes (ICD-10) and questionnaires. Results After the 6-week intervention, diagnostic remission rates were 60% in the ACT and 22% in the control group. Further, 70% of the ACT participants were classified as either recovered or improved. The post-measurement between-group effect size for depression symptoms was large and favored the ACT group (BDI-II, d = 1.25). At the 3-year follow-up, the within-group effect sizes were encouraging (d = 1.11–1.77). Conclusions A 6-h ACT intervention delivered by novice therapists can lead to improvement in approximately 60–70% of depressed clients.

Background The research aim was to study the associations of nature diversity with quality of life (QoL) and depressive symptoms among older people, and whether physical activity explains the associations. Methods Community-dwelling people aged 75–90 years (n = 848) living in Central Finland were interviewed in their homes. QoL was assessed with a short version of the World Health Organization Quality-of-Life Assessment (range 0–130, higher score indicates better QoL) and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (range 0–30, higher scores indicate more depressive symptoms). Self-reported physical activity was assessed by intensity and duration using a single question with seven response options ranging from mostly resting to competitive sports. Nature diversity (Shannon Diversity Index) was assessed objectively within a 500-m buffer around participants’ homes using a geographic information system (GIS). Results Mean QoL was 100.3 (SD 11.8) and mean CES-D 9.6 (SD 6.8). Those in the highest nature diversity tertile had better QoL than those in the lowest tertile (p = .022). Physical activity did not explain the association between nature diversity and QoL. Adjustment for health indicators did not change the results. Nature diversity was not associated with depressive symptoms. Conclusion A diverse environment, especially when this includes elements of nature, is associated with better QoL. Good quality of the green infrastructure and adding natural elements to residential areas may enhance well-being among community-dwelling older people. peerReviewed

Prior studies have shown that student burnout becomes more prevalent during adolescence and is associated with both depressive symptoms and school engagement. Little is known about how burnout, engagement, and depressive symptoms jointly affect students’ school achievement in terms of grades and skipping class. The main purpose of the current study was to analyse these variables within a full model in order to examine the direct and indirect effects of burnout, engagement and depression on student achievement, while controlling for gender and age. Participants were 210 Italian high school students aged 14 to 16. Student burnout was found to exert the strongest effect on school achievement, both directly, and indirectly via depressive symptoms and school engagement.

Chronic pain is a widespread issue accompanied commonly by depression and anxiety. Chronic pain has been shown to alter brain processing within the emotional and reward circuits, pointing towards a possible link between pain and comorbid mood disorders. Pain relief may be achieved by alleviating depressive and anxious symptoms. Relaxation is important for pain relief and eliciting relaxation through music listening is shown to relieve pain, depression, anxiety, and discomfort among others. In addition to auditory stimuli, Vibroacoustic treatment – the tactile application of low frequency sinusoidal sound vibration, plus music listening and therapeutic interaction – has been shown to be beneficial for relieving these symptoms. Although the combination of music listening and low frequencies has been previously explored, the role of the music listening within the vibroacoustic treatment context is unknown. A single-case, mixed method crossover study was conducted with a client suffering from chronic pain and comorbid mood disorders, four sessions with music listening, and four sessions without. Quantitative outcomes showed the client was more relaxed, less anxious, and had less pain after the music sessions. Qualitative findings showed that the client at first could not relax without the music listening because of her severe anxiety, but learned to use music as a distractor from her thoughts to relax, but also that silence was equally important for her; these hinged on her making the choice based on her needs, which had previously been difficult for her.

To examine the electrophysiological underpinnings of the functional networks involved in music listening, previous approaches based on spatial independent component analysis (ICA) have recently been used to ongoing electroencephalography (EEG) and magnetoencephalography (MEG). However, those studies focused on healthy subjects, and failed to examine the group-level comparisons during music listening. Here, we combined group-level spatial Fourier ICA with acoustic feature extraction, to enable group comparisons in frequency-specific brain networks of musical feature processing. It was then applied to healthy subjects and subjects with major depressive disorder (MDD). The music-induced oscillatory brain patterns were determined by permutation correlation analysis between individual time courses of Fourier-ICA components and musical features. We found that (1) three components, including a beta sensorimotor network, a beta auditory network and an alpha medial visual network, were involved in music processing among most healthy subjects; and that (2) one alpha lateral component located in the left angular gyrus was engaged in music perception in most individuals with MDD. The proposed method allowed the statistical group comparison, and we found that: (1) the alpha lateral component was activated more strongly in healthy subjects than in the MDD individuals, and that (2) the derived frequency-dependent networks of musical feature processing seemed to be altered in MDD participants compared to healthy subjects. The proposed pipeline appears to be valuable for studying disrupted brain oscillations in psychiatric disorders during naturalistic paradigms.

We studied irony comprehension and emotional reactions to irony in dysphoric and control participants. Electroencephalography (EEG) and facial electromyography (EMG) were measured when spoken conversations were presented with pictures that provided either congruent (non-ironic) or incongruent (ironic) contexts. In a separate session, participants evaluated the congruency and valence of the stimuli. While both groups rated ironic stimuli funnier than non-ironic stimuli, the control group rated all the stimuli funnier than the dysphoric group. N400-like activity, P600, and EMG activity indicating smiling were larger after the ironic stimuli than the non-ironic stimuli for both groups. Further, in the dysphoric group the irony modulation was evident in the electrode cluster over the right hemisphere, while no such difference in lateralization was observed in the control group. The results suggest a depression-related alteration in the P600 response associated to irony comprehension, but no alterations were found in emotional reactivity specifically related to irony. peerReviewed

It is not known to what extent the automatic encoding and change detection of peripherally presented facial emotion is altered in dysphoria. The negative bias in automatic face processing in particular has rarely been studied. We used magnetoencephalography (MEG) to record automatic brain responses to happy and sad faces in dysphoric (Beck’s Depression Inventory ≥ 13) and control participants. Stimuli were presented in a passive oddball condition, which allowed potential negative bias in dysphoria at different stages of face processing (M100, M170, and M300) and alterations of change detection (visual mismatch negativity, vMMN) to be investigated. The magnetic counterpart of the vMMN was elicited at all stages of face processing, indexing automatic deviance detection in facial emotions. The M170 amplitude was modulated by emotion, response amplitudes being larger for sad faces than happy faces. Group differences were found for the M300, and they were indexed by two different interaction effects. At the left occipital region of interest, the dysphoric group had larger amplitudes for sad than happy deviant faces, reflecting negative bias in deviance detection, which was not found in the control group. On the other hand, the dysphoric group showed no vMMN to changes in facial emotions, while the vMMN was observed in the control group at the right occipital region of interest. Our results indicate that there is a negative bias in automatic visual deviance detection, but also a general change detection deficit in dysphoria., Frontiers in Human Neuroscience, 12, ISSN:1662-5161

Experiential avoidance, cognitive defusion, and mindfulness have all been associated with psychological disorders and well-being. This study investigates whether they predict psychological distress, i.e., symptoms of burnout, depression, stress and anxiety, in parents of children with chronic conditions. We hypothesized that these factors would exhibit a large degree of common variance, and that when compared to mindfulness and defusion, experiential avoidance on its own would predict a larger proportion of unique variance. 75 parents of children with chronic conditions having burnout symptoms who participated in an intervention study completed measures of burnout, stress, anxiety, depression, experiential avoidance, cognitive defusion, and mindfulness at the beginning of the intervention study (baseline). We ran several regression analyses to assess the predictive ability of these different constructs. Experiential avoidance on its own accounted for 28–48% of the variance in different psychological symptoms. Cognitive defusion and mindfulness did not make a significant contribution to explaining burnout, stress and anxiety, but cognitive defusion contributed to explaining depression. The results confirmed our hypothesis, supporting research on the importance of psychological flexibility as a central factor in understanding the occurrence of psychological distress. peerReviewed

Depression is associated with bias in emotional information processing, but less is known about the processing of neutral sensory stimuli. Of particular interest is processing of sound intensity which is suggested to indicate central serotonergic function. We tested weather event-related brain potentials (ERPs) to occasional changes in sound intensity can dissociate first-episode depressed, recurrent depressed and healthy control participants. The first-episode depressed showed larger N1 amplitude to deviant sounds compared to recurrent depression group and control participants. In addition, both depression groups, but not the control group, showed larger N1 amplitude to deviant than standard sounds. Whether these manifestations of sensory over-excitability in depression are directly related to the serotonergic neurotransmission requires further research. The method based on ERPs to sound intensity change is fast and low-cost way to objectively measure brain activation and holds promise as a future diagnostic tool. acceptedVersion

Introduction When a person becomes depressed, partnership can either be a source of strength, advancing recovery, or a source of further suffering, harming the health of both partners (Cordova & Gee, 2001). Also, depression in one spouse can create feelings of helplessness and hopelessness in both spouses (Cordova & Gee). These are some of the reasons why couple therapy has been used with persons diagnosed with depression and their spouses. Yet, according to Denton and Burwell's (2006) experience, which is similar to our own, the spouses of depressed patients often are not part of the treatment in psychiatric outpatient care, and hence feel unsupported, uninformed, isolated, confused, and frustrated. When one of the spouses is depressed, a goal in using couple therapy as treatment for depression can be considered to be the development of a stronger sense of agency in both spouses (Holma & Aaltonen, 1998). According to White and Epston (1990), the objective of therapeutic work is to recruit an audience for a new and preferred self-narrative in the medium of the social world. In the couple therapy situation, one could regard both the therapist and the spouse as an audience for the depressed person's narrative. The spouse also can be regarded as a person who shares and who can co-construct the depressed partner's narrative. If the depressed person's spouse is present, the description of life can become more comprehensive and more complex, and in this way it can help the couple acquire a stronger sense of agency, find new ways of seeing their situation as well as new ways of behaving in it (White & Epston). In recent decades, increasing attention has been paid to couple therapy in working with depressed persons (e.g., Beach, 2001; Beach, Finchman, & Katz, 1998; Denton & Burwell, 2006; Gillian & Cottone, 2005; Gupta, Coyne, & Beach, 2003; Keitner & Miller, 1990; Mead, 2002). For example, Gupta et al. recommended that couple therapy should be used when the couple reports significant relationship discord. Researchers such as Cordova and Gee (2001) and Coyne and Benazon (2001) have recommended working with couples whose relationship is satisfactory. Involvement of the spouse in the treatment of a depressed person has been considered to be important (Denton & Burwell). Obstacles and difficulties in involving the spouses in the treatment have been reported (Gupta et al.). Couples may find it difficult or disagreeable if they sense that their relationship is to blame for depression. On the other hand, couples who seek therapy because they have problems in their relationship and who do not collaborate well, may find it senseless if collaboration is the means for addressing their problems. In addition, committing to conjoint sessions can be difficult for couples due to pressures of work and childcare responsibilities (Gupta et al.). Studies dealing with couple therapy for depression have mostly dealt with treatment effectiveness. Beach and O'Leary (1992) studied cognitive-behavioral couple therapy; Emanuels-Zuurveen and Emmelkamp (1996) studied communication-focused couple therapy; Foley, Rounsaville, Weissman, Sholomskas, and Chevron (1989) studied interpersonal couple therapy; Teichman, Bar-el, Shor, Sirota, and Elizur (1995) studied cognitive-systemic couple therapy and Leff, Vearnals, Brewin, Wolff, Alexander, Asen, et al. (2000) studied systemic couple therapy. The authors of these reports have indicated that couple therapy approaches are as effective as individual therapy in helping depressed people, and that couple therapy also increases marital satisfaction. In addition to studying the effectiveness of couple therapy for depression, there is also a need to do more psychotherapy research that would utilize qualitative methods, with a view toward obtaining a more detailed picture of what actually happens in therapy sessions (Moon, Dillon, & Sprenkle, 1990). …

Objectives: We studied the associations between perceived togetherness, depressive symptoms, and loneliness over a six-month period among 222 people aged 75–79 who reported loneliness or depressive mood at baseline. Method: The present cross-lagged models utilized baseline and six-month follow-up data of a randomized controlled trial that examined the effects of a social intervention on loneliness and depression (ISRCTN78426775). Dimensions of perceived togetherness, i.e. attachment, social integration, guidance, alliance, nurturance, and reassurance of worth, were measured with the Social Provisions Scale, depressive symptoms with a short form of the Geriatric Depression Scale, and loneliness with a single item. Results: After controlling for baseline loneliness and depressive symptoms, baseline higher attachment in all participants and baseline higher opportunity for nurturance in the social intervention group predicted lower depressive mood at follow-up. No cross-lagged associations between the dimensions of perceived togetherness at baseline and loneliness at follow-up were observed. In addition, depressive symptoms and loneliness at baseline tended to negatively predict the dimensions of perceived togetherness at follow-up. Discussion: Depressive symptoms and loneliness appear to be precursor for perceived togetherness, rather than dimensions of perceived togetherness to be antecedents of loneliness and depressiveness among older people. peerReviewed

Objectives: This study examined effects of a social intervention on depressive symptoms, melancholy, loneliness, and perceived togetherness in community-dwelling Finnish older people. Method: Promotion of mental well-being in older people (GoodMood; ISRCTN78426775) was a single-blinded randomized control trial lasting 1.5 years. Two hundred and twenty-three persons aged 75–79 years reporting symptoms of loneliness or melancholy were randomized into intervention and control groups. The intervention group was allowed to choose among supervised exercise, social activity, or personal counseling. Follow-up measurements were conducted at the end of 6-month intervention, and at 3, 6, and 12 months post intervention. Results: Number of depressive symptoms remained unchanged, while loneliness and melancholy decreased in both the intervention and control groups during the study (p