Open Access
Background: Medical training is very demanding and associated with a high prevalence of psychological distress. Compared to the general population, medical students are at a greater risk of developing a psychological disorder. Various attempts of stress management training in medical school have achieved positive results on minimizing psychological distress; however, there are often limitations. Therefore, the use of a rigorous scientific method is needed. The present study protocol describes a randomized controlled trial to examine the effectiveness of a specifically developed mindfulness-based stress prevention training for medical students that includes selected elements of cognitive behavioral strategies (MediMind).
Methods/Design: This study protocol presents a prospective randomized controlled trial, involving four assessment time points: baseline, post-intervention, one-year follow-up and five-year follow-up. The aims include evaluating the effect on stress, coping, psychological morbidity and personality traits with validated measures. Participants are allocated randomly to one of three conditions: MediMind, Autogenic Training or control group. Eligible participants are medical or dental students in the second or eighth semester of a German university. They form a population of approximately 420 students in each academic term. A final total sample size of 126 (at five-year follow-up) is targeted. The trainings (MediMind and Autogenic Training) comprise five weekly sessions lasting 90 minutes each. MediMind will be offered to participants of the control group once the five-year follow-up is completed. The allotment is randomized with a stratified allocation ratio by course of studies, semester, and gender. After descriptive statistics have been evaluated, inferential statistical analysis will be carried out with a repeated measures ANOVA-design with interactions between time and group. Effect sizes will be calculated using partial η-square values.
Discussion: Potential limitations of this study are voluntary participation and the risk of attrition, especially concerning participants that are allocated to the control group. Strengths are the study design, namely random allocation, follow-up assessment, the use of control groups and inclusion of participants at different stages of medical training with the possibility of differential analysis.
Cyber victimization research reveals various personal and contextual correlations and negative consequences associated with this experience. Despite increasing attention on cyber victimization, few studies have examined such experiences among ethnic minority adolescents. The purpose of the present study was to examine the moderating effect of ethnicity in the longitudinal associations among cyber victimization, school-belongingness, and psychological consequences (i.e., depression, loneliness, anxiety). These associations were investigated among 416 Latinx and white adolescents (46% female; M age = 13.89, SD = 0.41) from one middle school in the United States. They answered questionnaires on cyber victimization, school belongingness, depression, loneliness, and anxiety in the 7th grade (Time 1). One year later, in the 8th grade (Time 2), they completed questionnaires on depression, loneliness, and anxiety. Low levels of school-belongingness strengthened the positive relationships between cyber victimization and Time 2 depression and anxiety, especially among Latinx adolescents. The positive association between cyber victimization and Time 2 loneliness was strengthened for low levels of school-belongingness for all adolescents. These findings may indicate that cyber victimization threatens adolescents’ school-belongingness, which has implications for their emotional adjustment. Such findings underscore the importance of considering diverse populations when examining cyber victimization.
Cyber victimization research reveals various personal and contextual correlations and negative consequences associated with this experience. Despite increasing attention on cyber victimization, few studies have examined such experiences among ethnic minority adolescents. The purpose of the present study was to examine the moderating effect of ethnicity in the longitudinal associations among cyber victimization, school-belongingness, and psychological consequences (i.e., depression, loneliness, anxiety). These associations were investigated among 416 Latinx and white adolescents (46% female; M age = 13.89, SD = 0.41) from one middle school in the United States. They answered questionnaires on cyber victimization, school belongingness, depression, loneliness, and anxiety in the 7th grade (Time 1). One year later, in the 8th grade (Time 2), they completed questionnaires on depression, loneliness, and anxiety. Low levels of school-belongingness strengthened the positive relationships between cyber victimization and Time 2 depression and anxiety, especially among Latinx adolescents. The positive association between cyber victimization and Time 2 loneliness was strengthened for low levels of school-belongingness for all adolescents. These findings may indicate that cyber victimization threatens adolescents’ school-belongingness, which has implications for their emotional adjustment. Such findings underscore the importance of considering diverse populations when examining cyber victimization.
While the consequences of cyberbullying victimization have received some attention in the literature, to date, little is known about the multiple types of strains in adolescents’ lives, such as whether cyberbullying victimization and peer rejection increase their vulnerability to depression and anxiety. Even though some research found that adolescents with disabilities show higher risk for cyberbullying victimization, most research has focused on typically developing adolescents. Thus, the present study focused on examining the moderating effect of peer rejection in the relationships between cyberbullying victimization, depression, and anxiety among adolescents with autism spectrum disorder. There were 128 participants (89% male; ages ranging from 11–16 years old) with autism spectrum disorder in the sixth, seventh, or eighth grade at 16 middle schools in the United States. Participants completed questionnaires on cyberbullying victimization, peer rejection, depression, and anxiety. Results revealed that cyberbullying victimization was associated positively with peer rejection, anxiety, and depression among adolescents with autism spectrum disorder. Further, peer rejection was linked positively with depression and anxiety. Peer rejection moderated the positive relationship between cyberbullying victimization and depression, but not anxiety. Implications for prevention programs and future research are discussed.
While the consequences of cyberbullying victimization have received some attention in the literature, to date, little is known about the multiple types of strains in adolescents’ lives, such as whether cyberbullying victimization and peer rejection increase their vulnerability to depression and anxiety. Even though some research found that adolescents with disabilities show higher risk for cyberbullying victimization, most research has focused on typically developing adolescents. Thus, the present study focused on examining the moderating effect of peer rejection in the relationships between cyberbullying victimization, depression, and anxiety among adolescents with autism spectrum disorder. There were 128 participants (89% male; ages ranging from 11–16 years old) with autism spectrum disorder in the sixth, seventh, or eighth grade at 16 middle schools in the United States. Participants completed questionnaires on cyberbullying victimization, peer rejection, depression, and anxiety. Results revealed that cyberbullying victimization was associated positively with peer rejection, anxiety, and depression among adolescents with autism spectrum disorder. Further, peer rejection was linked positively with depression and anxiety. Peer rejection moderated the positive relationship between cyberbullying victimization and depression, but not anxiety. Implications for prevention programs and future research are discussed.
Background: The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices.
Methods: This study was a retrospective database analysis in Germany utilizing the Disease Analyzer (R) Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices. The observation period was between 2004 and 2013. Follow-up lasted up to five years and ended in April 2015. A total of 66,497 HF patients were selected after applying exclusion criteria. The same number of 66,497 controls were chosen and were matched (1:1) to HF patients on the basis of age, sex, health insurance, depression diagnosis in the past, and follow-up duration after index date.
Results: HF was a strong risk factor for diagnosed depression (p < 0.0001). A total of 10.5% of HF patients and 6.3% of matched controls developed depression after one year of follow-up (p < 0.001). Depression was documented in 28.9% of the HF group and 18.2% of the control group after the five-year follow-up (p < 0.001). Cancer, dementia, osteoporosis, stroke, and osteoarthritis were associated with a higher risk of developing depression. Male gender and private health insurance were associated with lower risk of depression.
Conclusions: The risk of diagnosed depression is significantly increased in patients with HF compared to patients without HF in primary care practices in Germany.