Depression and dysphoria are associated with attention and memory biases for emotional information (Williams et al. 1997; Yiend in Cogn Emot 24:3-47, 2010), which are postulated to reflect stable vulnerability factors for the development and recurrence of depression (Gotlib and Joormann in Annu Rev Clin Psychol 6:285-312, 2010). The present study looked for evidence of attention and memory biases in individuals with a self-reported history of depression, compared to individuals with dysphoria and individuals with no history of depression. Participants viewed sets of depression-related, anxiety-related, positive, and neutral images while their eye fixations were tracked and recorded. Incidental recognition of the images was assessed 7 days later. Consistent with previous studies (Kellough et al. in Behav Res Therapy 46:1238-1243 Sears et al. in Cogn Emot 24:1349-1368, 2010, dysphoric individuals spent significantly less time attending to positive images than never depressed individuals, and it was also found that previously depressed individuals exhibited the same attentional bias. Previously depressed individuals also attended to anxiety-related images more than never depressed individuals. A bias in the initial orienting of attention was observed, with previously depressed and dysphoric individuals orienting to depression-images more frequently than never depressed participants. The recognition memory data showed that previously depressed and dysphoric individuals had poorer memory than never depressed individuals, but there was no evidence of a memory bias for either group. Implications for cognitive models of depression and depression vulnerability are discussed.
Background Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders. Objective To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain. Methods Participants included 147 youth (66.7% female) aged 8–18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms. Results As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships. Discussion For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.
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