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Different profiles of depression emerge over time depending on initial levels of depressive symptoms, rumination, and stressors as well as the occurrence rate for stressors; levels of rumination and occurrence of stressors are stronger contributors to long-term depression.
We hypothesize that higher initial levels of depressive symptoms, and more pronounced growth in these symptoms, will be associated with harmful alcohol use [ 11, 12].
Consistent with previous studies [ 23, 24], initial levels of depressive symptoms are similar across the sexes; however, sex-specific mean symptom levels quickly diverge.
Previous studies have explored this question, with inconsistent results: while Marmorstein found that higher initial levels of depressive symptoms were associated with more pronounced increases in alcohol use over time among males, Needham found that, for both males and females, higher depressive symptoms were inversely related to increases in binge drinking over time [ 3, 12].
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Using logistic regression, we also found that initial level of depressive symptoms significantly (p = .0330) predicted the first episode of depression and/or dysthymia among TAU subjects.
Controlling initial levels of depression, a ruminative response style predicts future depressive symptoms in response to events such as the Lomo Prieta earthquake (Nolen-Hoeksema & Morrow, 1991) or the death of a loved one (Nolen-Hoeksema, Parker, & Larson, 1994).
Although initial levels of depression were low (6.5 %), Besier and Hou [ 11] recorded further reduction in depressive symptoms over time with the rates falling to below that of the host population by the end of the 10-year period (2.3 %).
In a study of Southeast Asian refugees in Vancouver more economically integrated refugees showed higher initial levels of subclinical depressive symptomatology, but greater declines over time [ 62].
Furthermore, the availability of a broad range of other relevant phenotypes, including socio-demographic, familial, and individual risk variables, enables us to control for potential confounding and draw conclusions that are specific to the role of initial levels of and increases in depressive symptoms.
The alternative to this hypothesis was also evaluated by testing whether lower initial levels of executive functioning predicted increases in rumination or depressive symptoms at follow-up.
This is affecting initial levels of interest.
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