Prepubescent boys are, if anything, more likely than girls to be depressed. During adolescence, however, a dramatic shift occurs: between the ages of 11 and 13 years, this trend in depression rates is reversed. By 15 years of age, females are approximately twice as likely as males to have experienced an episode of depression, and this gender gap persists for the next 35 to 40 years. We offer a theoretical framework that addresses the timing of this phenomenon. First, we discuss the social and hormonal mechanisms that stimulate affiliative needs for females at puberty. Next, we describe how heightened affiliative need can interact with adolescent transition difficulties to create a depressogenic diathesis as at-risk females reach puberty. This gender-linked vulnerability explains why adolescent females are more likely than males to become depressed when faced with negative life events and, particularly, life events with interpersonal consequences.

Sexual self-schemas are cognitive generalizations about sexual aspects of oneself that are derived from past experience, manifest in current experience, influential in the processing of sexually relevant social information, and guide sexual behavior. In Part I, a measure of a cognitive self-view of women's sexuality was developed. The construct includes 2 positive aspects, an inclination to experience passionate-romantic emotions and a behavioral openness to sexual experience, and a negative aspect, embarrassment or conservativism, which may be a deterrent to sexual-romantic affects and behaviors. In Part II, the role of sexual schema in intrapersonal and interpersonal aspects of sexuality was examined. In Part III, a bivariate model was explored and 4 self-views-positive, co-schematic, aschematic, and negative-were proposed and compared.

Background It is unclear whether risk for major depression during the menopausal transition or immediately thereafter is increased relative to premenopause. Objectives To examine whether the odds of experiencing major depression were greater when women were perimenopausal or postmenopausal compared to when they were premenopausal, independent of a history of major depression at study entry and annual measures of vasomotor symptoms, serum levels or changes in estradiol, follicular stimulating hormone, or testosterone and relevant confounders. Methods Participants included the 221 African American and Caucasian women, aged 42–52, who were premenopausal at entry into the Pittsburgh site of a community-based study of menopause, the Study of Women’s Health Across the Nation (SWAN). We conducted the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) to assess diagnoses of lifetime, annual, and current major depression at baseline and annual follow-ups. Psychosocial and health factors, and blood samples for assay of reproductive hormones were obtained annually. Results Women were two to four times more likely to experience major depression episode when they were perimenopausal or early postmenopausal. Repeated measures logistic regression analyses showed that the effect of menopausal status was independent of history of major depression and annually measured upsetting life events, psychotropic medication use, vasomotor symptoms and serum levels of or changes in reproductive hormones. History of major depression was a strong predictor of major depression throughout the study. Conclusions The risk of major depression is greater for women during and immediately after the menopausal transition than when they are premenopausal.

One of the goals of the NIH Toolbox for Assessment of Neurological and Behavioral Function was to identify or develop brief measures of emotion for use in prospective epidemiologic and clinical research. Emotional health has significant links to physical health and exerts a powerful effect on perceptions of life quality. Based on an extensive literature review and expert input, the Emotion team identified 4 central subdomains: Negative Affect, Psychological Well-Being, Stress and Self-Efficacy, and Social Relationships. A subsequent psychometric review identified several existing self-report and proxy measures of these subdomains with measurement characteristics that met the NIH Toolbox criteria. In cases where adequate measures did not exist, robust item banks were developed to assess concepts of interest. A population-weighted sample was recruited by an online survey panel to provide initial item calibration and measure validation data. Participants aged 8 to 85 years completed self-report measures whereas parents/guardians responded for children aged 3 to 12 years. Data were analyzed using a combination of classic test theory and item response theory methods, yielding efficient measures of emotional health concepts. An overview of the development of the NIH Toolbox Emotion battery is presented along with preliminary results. Norming activities led to further refinement of the battery, thus enhancing the robustness of emotional health measurement for researchers using the NIH Toolbox. Neurology In everyday terms, the word "emotion" evokes connotations of strong feelings, often negative and distressing when they tax our capacity to maintain our poise. It is unpleasant when we are extended beyond our usual resources by stressful life events including poverty, unemployment, oppression, discrimination, and disease. However, positive emotions can be reflections of well-being in our lives, and positive social relationships can buffer stress and enhance health. Recognizing the full spectrum of emotional life and its impact on health, the mandate for the NIH Toolbox was to develop assessments with a broad focus, beyond just negative emotion, or emotional distress. The original Request for Proposals alluded to several additional aspects of the experience and expression of emotion relevant to health in the general population including the importance of psychological well-being, the role of important aspects of positive functioning, such as adaptability, resilience, and self-efficacy, and the importance of the interpersonal and social context in which emotions arise and may be expressed.Feedback provided through an NIH Toolbox Expert Request for Information (RFI) was also consistent with this desire for a broad emphasis on emotional health. As part of this RFI, we obtained input from 147 experts (64% of 232 invited experts), including key opinion leaders from the NIH research program staff and NIH-funded investigators with a broad focus in neurologic and behavioral

Introduction Discussions about sexual health are uncommon in clinical encounters, despite the sexual dysfunction associated with many common health conditions. Understanding of the importance of sexual health and sexual satisfaction among US adults is limited. Aim To provide epidemiologic data on the importance of sexual health for quality of life and people’s satisfaction with their sex lives and to examine how each is associated with demographic and health factors. Methods Data are from a cross-sectional, self-report questionnaire from a sample of 3515 English-speaking US adults recruited from an online panel that uses address-based probability sampling. Main Outcome Measures We report ratings of importance of sexual health to quality of life (single item with 5-point response) and the PROMIS® Satisfaction with Sex Life score (5 items, each with 5-point responses, scores centered on the US mean). Results High importance of sexual health to quality of life was reported by 62.2% of men (95% CI, 59.4%–65.0%) and 42.8% of women (95% CI, 39.6%–46.1%; P < .001). Importance of sexual health varied by sex, age, sexual activity status, and general self-rated health. For the 55% of men and 45% of women who reported sexual activity in the previous 30 days, satisfaction with sex life differed by sex, age, race/ethnicity (among men only), and health. Men and women in excellent health had significantly higher satisfaction than participants in fair or poor health. Women with hypertension reported significantly lower satisfaction (especially younger women), as did men with depression or anxiety (especially younger men). Conclusion In this large study of US adults’ ratings of the importance of sexual health and satisfaction with sex life, sexual health was a highly important aspect of quality of life for many participants, including participants in poor health. Moreover, participants in poorer health reported lower sexual satisfaction. Accordingly, sexual health should be a routine part of clinicians’ assessments of their patients. Health care systems that state a commitment to improving patients’ overall health must have resources in place to address sexual concerns. These resources should be available for all patients across the life span.

Objective Oxytocin is a hypothalamic neuropeptide that plays a key role in mammalian female reproductive function. Animal research indicates that central oxytocin facilitates adaptive social attachments and modulates stress and anxiety responses. Major depression is prevalent among postpubertal females, and is associated with perturbations in social attachments, dysregulation of the hypothalamic-pituitary-adrenal stress axis, and elevated levels of anxiety. Thus, depressed women may be at risk to display oxytocin dysregulation. The current study was developed to compare patterns of peripheral oxytocin release exhibited by depressed and nondepressed women. Methods Currently depressed (N = 17) and never-depressed (N = 17) women participated in a laboratory protocol designed to stimulate, measure, and compare peripheral oxytocin release in response to two tasks: an affiliation-focused Guided Imagery task and a Speech Stress task. Intermittent blood samples were drawn over the course of two, 1-hour sessions including 20-minute baseline, 10-minute task, and 30-minute recovery periods. Results The 10-minute laboratory tasks did not induce identifiable, acute changes in peripheral oxytocin. However, as compared with nondepressed controls, depressed women displayed greater variability in pulsatile oxytocin release over the course of both 1-hour sessions, and greater oxytocin concentrations during the 1-hour affiliation-focused imagery session. Oxytocin concentrations obtained during the imagery session were also associated with greater symptoms of depression, anxiety, and interpersonal dysfunction. Conclusions Depressed women are more likely than controls to display a dysregulated pattern of peripheral oxytocin release. Further research is warranted to elucidate the clinical significance of peripheral oxytocin release in both depressed and nondepressed women.

Sexual self-schemas are cognitive generalizations about sexual aspects of oneself. In Part 1, a measure of men's sexual self-schema is developed. Studies of test-retest and internal consistency reliability and validity studies of factor analysis, internal structure, convergent and discriminant validity, process, group difference, and change are provided. The construct consists of 3 dimensions: passionate-loving, powerful-aggressive, and open-minded-liberal traits. In Part 2, the data suggest that men's sexual schema is derived from past sexual experience, is manifest in current sexual experience, and guides future sexual behavior. In Part 3, the data document the cognitive processing aspects of sexual schema. Consistent with the investigators' schema research with women, these data substantiate the importance of cognitive representations of sexuality.

Objective The quality of our daily social interactions – including perceptions of support, feelings of loneliness, and distress stemming from negative social exchanges – influence physical health and well-being. Despite the importance of social relationships, brief yet precise, unidimensional scales that assess key aspects of social relationship quality are lacking. As part of the NIH Toolbox for the Assessment of Neurological and Behavioral Function, we developed brief self-report scales designed to assess aspects of social support, companionship, and social distress across age cohorts. This report details the development and psychometric testing of the adult NIH Toolbox Social Relationship scales. Methods Social relationship concepts were selected, and item sets were developed and revised based on expert feedback and literature review. Items were then tested across a community-dwelling U.S. internet panel sample of adults aged 18 and above (N=692) using traditional (classic) psychometric methods and item response theory (IRT) approaches to identify items for inclusion in 5–8 item unidimensional scales. Finally, concurrent validity of the newly-developed scales was evaluated with respect to their inter-relationships with classic social relationship validation instruments. Results Results provide support for the internal reliability and concurrent validity of resulting self-report scales assessing Emotional Support, Instrumental Support, Friendship, Loneliness, Perceived Rejection, and Perceived Hostility. Conclusion These brief social relationship scales provide the pragmatic utility and enhanced precision needed to promote future epidemiological and social neuroscience research on the impact of social relationships on physical and emotional health outcomes.