Aug 2026· Universitas Médica· Vol 67· 0 citations· 16 references
Abstract
Introduction: Anxiety and depression are the most prevalent mental health disorders worldwide, placing an increasing burden on public health systems. However, certain transdiagnostic factors may modulate vulnerability to these disorders: personality traits, emotional regulation, and social support. Objective: To examined these factors, classifying them as either risk or protective through correlation analyses and qualitative comparative analyses in a clinical sample. Methods: After applying inclusion and exclusion criteria, the final sample consisted of 61 participants (73.8% female, 24.6% male, 1.6% other genders) aged between 20 and 66 years (M = 43.79; SD = 12.75). Results: Neuroticism was associated with higher levels of anxiety and depression, whereas extraversion predicted better mental health. Additionally, emotion dysregulation correlated positively with both psychopathologies. Finally, perceived social support emerged as a sufficient condition for lower anxiety levels; conversely, its absence was linked to higher levels of both anxiety and depression. Conclusions: These findings highlight the importance of further investigating risk and protective factors related to highly prevalent mental health problems like anxiety and depression. Better understanding these factors can help improve assessment, diagnosis, and treatment within clinical practice.
BACKGROUND
Depression is a leading global health concern and is projected to become one of the major contributors to the global burden of disease in the coming decades. Increasing evidence highlights the role of social determinants-including socioeconomic conditions, social relationships, life stressors, discrimination, and environmental influences-in shaping the risk and clinical expression of depressive disorders. This study aimed to investigate social determinants associated with the presence and severity of depressive symptoms in Italian general population.
METHODS
A cross-sectional survey was conducted among 1,036 adults from the Italian general population, recruited through personal networks and online platforms using snowball sampling. Participants completed a structured questionnaire assessing sociodemographic characteristics, social support, stressful life events, quality of life, minority stress experiences, social media use, environmental and societal concerns, substance use, and mental health symptoms. Comparative analyses were performed between individuals reporting a clinician-diagnosed depressive disorder (n = 143; 13.8%) and those without a diagnosis (n = 893).
RESULTS
Participants with a depressive disorder reported significantly higher exposure to multiple adverse social determinants. They were more likely to experience stressful life events, reduced perceived social support, poorer quality of life, minority stress, and negative psychosocial effects related to social media use. Concerns regarding broader socio-environmental issues, including political instability and climate change, were also more prevalent in the diagnosed group. These social vulnerabilities were accompanied by greater severity of depressive symptoms, anxiety-related manifestations, impulse-control difficulties, aggressive behaviors, and the use of substances as a coping strategy (all p ⩽ .003).
CONCLUSIONS
The findings support social determinants framework for understanding depression, highlighting the contribution of social adversity, environmental stressors, and relational factors to the development and severity of depressive symptoms. Population-based surveys can help identify vulnerable groups and inform preventive strategies and public health interventions aimed at addressing the social conditions that contribute to depression.
Stefania Chiappini, Valerio Ricci, Francesco Di Carlo et al.· International Journal of Soc...· 0 citations
Major depressive disorder (MDD) and anxiety disorders are among the most common psychiatric conditions, with their co-occurrence associated with increased severity, functional impairment, and relapse risk. However, not all individuals with depressive symptoms experience co-occurring anxiety symptoms, highlighting the need to identify mechanisms that explain this variability. Childhood maltreatment, including emotional, physical, and sexual abuse and neglect, is a well-established transdiagnostic risk factor for internalizing psychopathology, yet its role in shaping dynamic co-occurrence of symptoms and disorders remains poorly understood. This study will examine childhood maltreatment as a predictor of Depression-Anxiety Coupling Strength (DACS), a construct reflecting the extent to which fluctuations in anxiety and depressive symptoms co-vary over time. Archival data (N=250) will be drawn from the LAUREL cohort in the Mood Research Laboratory at Queen’s University. Participants completed the Childhood Experience of Care and Abuse (CECA) interview at baseline and the Mood and Anxiety Symptom Questionnaire (MASQ-D30) at two follow-ups over eight months. Multilevel modeling (MLM) will estimate within-person DACS and test whether childhood maltreatment severity and subtype predict stronger coupling and more persistent symptom trajectories. I hypothesize that individuals with greater childhood maltreatment severity, particularly severity of emotional abuse and neglect, will exhibit stronger DACS, reflecting greater temporal coupling between depression and anxiety symptoms. Clarifying how early adversity shapes these dynamic processes may enhance prediction of illness trajectories and inform more precise interventions for individuals who experience comorbidity.
Depression and anxiety contribute substantially to the mental health burden in low- and middle-income countries, yet clinic-based evidence from Pakistan remains limited. This study examined the distribution of depressive and anxiety symptom severity and their sociodemographic correlates in outpatient mental health clinics in Pakistan. This cross-sectional study included 267 participants recruited through consecutive sampling from four urban outpatient mental health clinics in Pakistan. Depression and anxiety were assessed using Hamilton Depression Rating Scale-17 and Generalized Anxiety Disorder Scale-7, respectively. Symptom severity was categorized as low, moderate, and high based on cut-offs (HDRS-17: 0–13, 14–26, ≥ 27; GAD-7: 0–9, 10–14, ≥ 15). Sociodemographic correlates included gender, age, marital status, educational attainment, employment status, and socioeconomic status. Multinomial logistic regression was used to estimate adjusted associations. Moderate-to-high symptom severity was common for both depression and anxiety. For depression, 64.8% of participants had high depressive symptom severity and 22.3% had moderate symptom severity. For anxiety, 32.6% had high anxiety symptom severity and 30.3% had moderate symptom severity. In adjusted analyses, unemployment was significantly associated with higher depression severity (OR = 2.55, 95% CI: 1.23–5.29). Low socioeconomic status was associated with moderate anxiety severity (OR = 6.08, 95% CI: 1.97–8.75), while middle socioeconomic status was associated with higher anxiety severity (OR = 6.11, 95% CI: 2.79–13.23). Gender, age, marital status, and education showed no consistent adjusted associations. This study extends clinic-based mental health evidence from Pakistan by showing that depressive and anxiety symptom severity is strongly patterned by socioeconomic disadvantage. The findings shift attention from individual symptom burden alone to the broader social conditions shaping clinical mental health presentations.
Anwar Khan, Amalia Bt Madihie· Discover Public Health· 0 citations
BACKGROUND
Anxiety and depression are prevalent mental health disorders, but traditional treatments often have limited effectiveness. Process-Based Therapy (PBT), which targets the underlying mechanisms driving these conditions, offers a promising alternative. The purpose of this retrospective study was to examine how processes of change relate to changes in anxiety and depressive symptoms in patients with elevated anxiety and/or depression symptoms who underwent PBT at Lightfully Behavioral Health, a behavioral health treatment clinic.
METHODS
This retrospective study analyzed data from adults (≥ 18 years) with elevated anxiety (n = 396) and depression (n = 434) who received treatment at Lightfully Behavioral Health, a PBT-based behavioral health treatment clinic. Mental health symptoms and PBT processes (i.e., psychological inflexibility, emotion dysregulation, thwarted belongingness, self-compassion, and personal values alignment) were measured at admission and discharge. Multiple logistic regression models, including stepwise models, tested associations between changes in processes and achievement of remission at discharge (yes vs. no) among those with elevated anxiety and depression. Bayesian structural equation models assessed whether changes in processes mediated the relationship between treatment dose and achieving anxiety and depression remission.
RESULTS
Improvements in all PBT processes were related to achieving anxiety and depression remission (p < 0.001). However, only improvements in self-compassion (OR 2.92, p < 0.001) and psychological inflexibility (OR 1.05, p = 0.007) were associated with greater likelihood of achieving anxiety symptom remission, and self-compassion (OR 2.33, p < 0.001), alignment with personal values (OR 1.06, p = 0.006), psychological inflexibility (OR 1.08, p < 0.001), with greater likelihood of achieving depression symptom remission. Self-compassion was supported as a mediator in the relationship between treatment dose and anxiety remission, while both self-compassion and psychological inflexibility were supported as mediators for depression remission, as their 95% credible intervals excluded zero.
CONCLUSION
Self-compassion and psychological inflexibility may be important for the remission of anxiety and depression symptoms among patients receiving PBT. These findings suggest that changes in self-compassion and psychological inflexibility are associated with remission and may represent important targets for intervention. While this study contributes to the limited evidence on PBT, further research is needed to better understand the long-term effects of these therapeutic processes.
Lara M Baez, K. McAlister, Chris Pleman et al.· BMC Psychology· 0 citations
ABSTRACT Impairments in interpersonal functioning are a core transdiagnostic feature of personality disorders (PDs). While interpersonal problems are known to worsen clinical outcomes, their mediating role between PDs and mental health requires further empirical examination. The study aims were: (1) to analyse gender differences in PDs, mental health and interpersonal problems; (2) to study the correlations between study variables; and (3) to examine the mediating role of interpersonal problems in the relationship between PDs and global mental health. The final sample comprised 291 participants (M age = 38.30, SD = 13.80; 66.3% women) from a clinical population who completed the International Personality Disorder Examination (IPDE), the Inventory of Interpersonal Problems (IIP‐32) and the Symptom Checklist (SCL‐90). Women scored higher on the self‐sacrificing dimension (p = 0.023), and a significant gender difference was also found for narcissistic personality disorder, with men scoring slightly higher than women (p = 0.048). Higher scores on PDs and greater interpersonal difficulties were strongly associated with mental health problems (ρ‐values between 0.467 and 0.571). Finally, interpersonal problems mediated the association between personality cluster scores and mental health problems. Interpersonal problems, PDs and mental health symptoms form an interlinked pattern of psychological distress. Consequently, therapeutic interventions for PDs must prioritize the modification of maladaptive relational styles with the aim of preventing or mitigating co‐occurring mental health problems.
L. Macía, G. Aonso-Diego, A. Estévez et al.· Clinical Psychology and Psyc...· 0 citations
This study aims to examine how elevated autistic traits relate to different anxiety response systems in a non-clinical adult sample. Specifically, it explored whether particular dimensions of the autistic trait profile were differentially associated with cognitive, physiological and motor manifestations of anxiety within a dimensional and neurodiversity-informed framework.
A total of 117 adults (45 men, 38.5%; 72 women, 61.5%), aged 18–84 years (M = 34.14, SD = 13.45), completed the abridged version of the Inventory of Situations and Responses of Anxiety (ISRA-B) and the Autism Spectrum Quotient (AQ-50). Correlational analyses and multiple linear regression models were conducted to examine associations and predictors of overall anxiety, its cognitive, physiological and motor components and anxiety across specific situational domains, with age and gender included as covariates.
Sensitivity to change emerged as the most consistent predictor, significantly predicting overall anxiety as well as its cognitive, physiological and motor dimensions and anxiety in test, interpersonal, phobic and daily situations. Communication-related autistic traits significantly predicted motor anxiety and anxiety in phobic contexts. By contrast, attention to detail showed no significant associations and the imagination domain did not emerge as a robust predictor once age and gender were controlled. These results underscore the role of predictability and adaptation to novelty in the expression of anxiety among adults with elevated autistic traits.
This study has several limitations. Its cross-sectional design and exclusive reliance on self-report measures preclude causal inference and may have introduced response biases. In addition, the sample size was relatively modest and diagnostic information was collected through self-report only, without independent clinical verification. Although age and gender were controlled in the regression models, other potentially relevant factors were not systematically assessed. These limitations highlight the need for longitudinal, multimethod studies with larger samples to clarify the mechanisms involved in the relationship between elevated autistic traits and anxiety.
These findings suggest the need to adapt the assessment and treatment of anxiety in adults with elevated autistic traits, even in the absence of a formal diagnosis. In clinical practice, this implies considering the regulatory role that predictability, structure or certain forms of rigidity may serve, as well as tailoring interventions to each person’s attentional, sensory and communicative profile. The results support more individualised formulations that are less reliant on protocols developed exclusively for neurotypical populations.
This study highlights that many adults with elevated autistic traits may experience significant anxiety without having been clinically identified, which can hinder both access to appropriate support and the understanding of their distress. More timely and accurate recognition of these profiles may improve clinical and social responses, reduce misinterpretations of their behaviour and promote environments that are more understanding of and responsive to, neurocognitive diversity.
The study offers a novel approach by analysing anxiety as differentiated response systems (cognitive, physiological and motor) and across situational domains, rather than as a unitary construct, in a dimensional sample that includes adults with elevated autistic traits without a formal diagnosis. The findings support a dimensional understanding of anxiety in autism-related profiles and highlight the need for assessment and clinical intervention to be tailored to these individuals’ mode of functioning, avoiding the unadjusted application of approaches validated primarily in the general population.
Lucía Torices Callejo, M. Á. Pérez Nieto· Advances in Autism· 0 citations
