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Stress Reactivity, Depressive Symptoms, and Mindfulness: A Gulf Arab Perspective

Published Online:https://doi.org/10.1037/ipp0000055

Explorations of the relationship between stress reactivity and depression are relatively scarce outside of Europe and North America. This research examined the relationship between emotional reactivity to daily life stressors (stress reactivity) and depressive symptoms among citizens of the United Arab Emirates (UAE). Emirati college students (N = 286, 76% females) completed a culturally grounded measure of daily life stress, along with measures of depression and anxiety symptoms. Stress reactivity was associated with elevated depression and anxiety symptoms. In a second study, we examined the efficacy of a Mindfulness-Based Stress Reduction (MBSR) program within the same population. Emirati College women (N = 24) were randomly assigned to either an 8-week MBSR program or a waiting list control group (WLC). MBSR participants demonstrated significantly greater reductions in stress reactivity and depressive symptoms compared with the WLC group. These findings extend the stress reactivity literature to an Arabian Gulf nation. Interventions that help young adults better manage responses to daily life stress may play an important role in reducing the prevalence of depressive illness in the region.

References

  • Abdel-Khalek, A. M. (2000). The Kuwait University Anxiety Scale: Psychometric properties. Psychological Reports, 87, 478–492. 10.2466/pr0.2000.87.2.478 First citation in articleCrossrefGoogle Scholar

  • Abdel-Khalek, A. M. (2007). Anxiety levels in East and West: 18 Arab countries, Germany, Spain, U.K., and U.S.A. Paper presented at the European Psychiatry, Madrid, Spain. First citation in articleGoogle Scholar

  • Abou-Saleh, M. T., Ghubash, R., & Daradkeh, T. K. (2001). A1 Ain Community Psychiatric Survey. I. Prevalence and socio-demographic correlates. Social Psychiatry and Psychiatric Epidemiology, 36, 20–28. 10.1007/s001270050286 First citation in articleCrossrefGoogle Scholar

  • Alansari, B. (2005). Beck depression inventory (BDI-II) items characteristics among undergraduate students of nineteen Islamic countries. Social Behavior and Personality, 33, 675–684. First citation in articleCrossrefGoogle Scholar

  • Al-Musawi, N. M. (2001). Psychometric properties of the beck depression inventory-II with university students in Bahrain. Journal of Personality Assessment, 77, 568–579. 10.1207/S15327752JPA7703_13 First citation in articleCrossrefGoogle Scholar

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression: A treatment manual. New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • Beck, A. T., Steer, R. A., & Brown, G. (1996). BDI-II manual. San Antonio, TX: Harcourt Brace & Company. First citation in articleGoogle Scholar

  • Bener, A., Ghuloum, S., & Abou-Saleh, M. T. (2012). Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in Qatar. Social Psychiatry and Psychiatric Epidemiology, 47, 439–446. 10.1007/s00127-011-0349-9 First citation in articleCrossrefGoogle Scholar

  • Bouteyre, E., Maurel, M., & Bernaud, J.-L. (2007). Daily hassles and depressive symptoms among first year psychology students in France: The role of coping and social support. Stress and Health: Journal of the International Society for the Investigation of Stress, 23, 93–99. 10.1002/smi.1125 First citation in articleCrossrefGoogle Scholar

  • Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: Results from a randomized controlled trial. Behavior Therapy, 43, 365–380. 10.1016/j.beth.2011.08.006 First citation in articleCrossrefGoogle Scholar

  • Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848. 10.1037/0022-3514.84.4.822 First citation in articleCrossrefGoogle Scholar

  • Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Research, 187, 441–453. 10.1016/j.psychres.2010.08.011 First citation in articleCrossrefGoogle Scholar

  • Crane, R. (2009). Mindfulness-based cognitive therapy. New York, NY: Routledge. First citation in articleGoogle Scholar

  • Cummins, R. (1990). Social insecurity, anxiety, and stressful events as antecedents of depressive symptoms. Behavioral Medicine, 16, 161–164. 10.1080/08964289.1990.9934604 First citation in articleCrossrefGoogle Scholar

  • DeLongis, A., Coyne, J. C., Dakof, G., Folkman, S., & Lazarus, R. S. (1982). Relationship of daily hassles, uplifts, and major life events to health status. Health Psychology, 1, 119–136. 10.1037/0278-6133.1.2.119 First citation in articleCrossrefGoogle Scholar

  • Felsten, G. (2004). Stress reactivity and vulnerability to depressed mood in college students. Personality and Individual Differences, 36, 789–800. First citation in articleCrossrefGoogle Scholar

  • Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J. L., … Whiteford, H. A. (2013). Burden of depressive disorders by country, sex, age, and year: Findings from the global burden of disease study 2010. PLoS Medicine, 10, e1001547. 10.1371/journal.pmed.1001547 First citation in articleCrossrefGoogle Scholar

  • Ghubash, R., Daradkeh, T. K., Al Naseri, K. S., Al Bloushi, N. B., & Al Daheri, A. M. (2000). The performance of the Center for Epidemiologic Study Depression Scale (CES-D) in an Arab female community. International Journal of Social Psychiatry, 46, 241–249. 10.1177/002076400004600402 First citation in articleCrossrefGoogle Scholar

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy. New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • Hee-og, S. (2000). Relationship of daily hassles and social support to depression and antisocial behavior among early adolescents. Journal of Youth and Adolescence, 29, 647–659. First citation in articleCrossrefGoogle Scholar

  • Holm, J. E., & Holroyd, K. A. (1992). The daily hassles scale (Revised): Does it measure stress or symptoms? Behavioral Assessment, 14, 465–482. First citation in articleGoogle Scholar

  • Holsboer, F. (2000). The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology, 23, 477–501. 10.1016/S0893-133X(00)00159-7 First citation in articleCrossrefGoogle Scholar

  • Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47. 10.1016/0163-8343(82)90026-3 First citation in articleCrossrefGoogle Scholar

  • Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York, NY: Hyperion. First citation in articleGoogle Scholar

  • Katz, D., & Toner, B. (2013). A systematic review of gender differences in the effectiveness of mindfulness-based treatments for substance use disorders. Mindfulness, 4, 318–331. 10.1007/s12671-012-0132-3 First citation in articleCrossrefGoogle Scholar

  • Kaymaz, N., van Os, J., Loonen, A. J. M., & Nolen, W. A. (2008). Evidence that patients with single versus recurrent depressive episodes are differentially sensitive to treatment discontinuation: A meta-analysis of placebo-controlled randomized trials. Journal of Clinical Psychiatry, 69, 1423–1436. 10.4088/JCP.v69n0910 First citation in articleCrossrefGoogle Scholar

  • Keller, M. B., Lavori, P. W., Mueller, T. I., Endicott, J., Coryell, W., Hirschfeld, R. M., & Shea, T. (1992). Time to recovery, chronicity, and levels of psychopathology in major depression. A 5-year prospective follow-up of 431 subjects. Archives of General Psychiatry, 49, 809–816. 10.1001/archpsyc.1992.01820100053010 First citation in articleCrossrefGoogle Scholar

  • Keng, S.-L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31, 1041–1056. 10.1016/j.cpr.2011.04.006 First citation in articleCrossrefGoogle Scholar

  • King, M., Nazareth, I., Levy, G., Walker, C., Morris, R., Weich, S., … Torres-Gonzalez, F. (2008). Prevalence of common mental disorders in general practice attendees across Europe. The British Journal of Psychiatry, 192, 362–367. 10.1192/bjp.bp.107.039966 First citation in articleCrossrefGoogle Scholar

  • Kohn, P. M., Lafreniere, K., & Gurevich, M. (1990). The Inventory of College Students’ Recent Life Experiences: A decontaminated hassles scale for a special population. Journal of Behavioral Medicine, 13, 619–630. 10.1007/BF00844738 First citation in articleCrossrefGoogle Scholar

  • Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • Lovejoy, M. C., & Steuerwald, B. L. (1997). Subsyndromal unipolar and bipolar disorders II: Comparisons on daily stress levels. Cognitive Therapy and Research, 21, 607–618. 10.1023/A:1021800106223 First citation in articleCrossrefGoogle Scholar

  • MacCoon, D. G., Imel, Z. E., Rosenkranz, M. A., Sheftel, J. G., Weng, H. Y., Sullivan, J. C., … Lutz, A. (2012). The validation of an active control intervention for Mindfulness Based Stress Reduction (MBSR). Behaviour Research and Therapy, 50, 3–12. 10.1016/j.brat.2011.10.011 First citation in articleCrossrefGoogle Scholar

  • Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007). Depression, chronic diseases, and decrements in health: Results from the World Health Surveys. Lancet, 370, 851–858. 10.1016/S0140-6736(07)61415-9 First citation in articleCrossrefGoogle Scholar

  • Osman, A., Kopper, B. A., Barrios, F., Gutierrez, P. M., & Bagge, C. L. (2004). Reliability and validity of the Beck depression inventory—II with adolescent psychiatric inpatients. Psychological Assessment, 16, 120–132. 10.1037/1040-3590.16.2.120 First citation in articleCrossrefGoogle Scholar

  • Radloff, L. S. (1977). The CES-D Scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. 10.1177/014662167700100306 First citation in articleCrossrefGoogle Scholar

  • Ravindran, A. V., Griffiths, J., Merali, Z., & Anisman, H. (1996). Primary dysthymia: A study of several psychosocial, endocrine and immune correlates. Journal of Affective Disorders, 40, 73–84. 10.1016/0165-0327(96)00045-6 First citation in articleCrossrefGoogle Scholar

  • Rodgers, M., Asaria, M., Walker, S., McMillan, D., Lucock, M., Harden, M., … Eastwood, A. (2012). The clinical effectiveness and cost-effectiveness of low-intensity psychological interventions for the secondary prevention of relapse after depression: A systematic review. Health Technology Assessment, 16, 1–130. 10.3310/hta16280 First citation in articleCrossrefGoogle Scholar

  • Sayal, K., Checkley, S., Rees, M., Jacobs, C., Harris, T., Papadopoulos, A., & Poon, L. (2002). Effects of social support during weekend leave on cortisol and depression ratings: A pilot study. Journal of Affective Disorders, 71, 153–157. 10.1016/S0165-0327(01)00414-1 First citation in articleCrossrefGoogle Scholar

  • Scott, J., & Dickey, B. (2003). Global burden of depression: The intersection of culture and medicine. The British Journal of Psychiatry, 183, 92–94. 10.1192/bjp.183.2.92 First citation in articleCrossrefGoogle Scholar

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • Sher, L. (2004). Daily hassles, cortisol, and the pathogenesis of depression. Medical Hypotheses, 62, 198–202. 10.1016/S0306-9877(03)00320-7 First citation in articleCrossrefGoogle Scholar

  • Sprinkle, S. D., Lurie, D., Insko, S. L., Atkinson, G., Jones, G. L., Logan, A. R., & Bissada, N. N. (2002). Criterion validity, severity cut scores, and test-retest reliability of the beck depression inventory-II in a University counseling center sample. Journal of Counseling Psychology, 49, 381–385. 10.1037/0022-0167.49.3.381 First citation in articleCrossrefGoogle Scholar

  • Teasdale, J. D., Segal, Z. V., Williams, J. M., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623. 10.1037/0022-006X.68.4.615 First citation in articleCrossrefGoogle Scholar

  • Thomas, J. (2013). Psychological Well-Being in the Gulf States: The New Arabia Felix. London, United Kingdom: Palgrave Macmillan. First citation in articleCrossrefGoogle Scholar

  • van Eck, M., Berkhof, H., Nicolson, N., & Sulon, J. (1996). The effects of perceived stress, traits, mood states, and stressful daily events on salivary cortisol. Psychosomatic Medicine, 58, 447–458. 10.1097/00006842-199609000-00007 First citation in articleCrossrefGoogle Scholar

  • Wichers, M., Geschwind, N., Jacobs, N., Kenis, G., Peeters, F., Derom, C., … van Os, J. (2009). Transition from stress sensitivity to a depressive state: Longitudinal twin study. The British Journal of Psychiatry, 195, 498–503. 10.1192/bjp.bp.108.056853 First citation in articleCrossrefGoogle Scholar

  • Wichers, M., Kenis, G., Jacobs, N., Myin-Germeys, I., Schruers, K., Mengelers, R., … van Os, J. (2008). The psychology of psychiatric genetics: Evidence that positive emotions in females moderate genetic sensitivity to social stress associated with the BDNF Val-sup-6-sup-6Met polymorphism. Journal of Abnormal Psychology, 117, 699–704. 10.1037/a0012909 First citation in articleCrossrefGoogle Scholar

  • Wichers, M., Myin-Germeys, I., Jacobs, N., Peeters, F., Kenis, G., Derom, C., … Van Os, J. (2007). Genetic risk of depression and stress-induced negative affect in daily life. The British Journal of Psychiatry, 191, 218–223. 10.1192/bjp.bp.106.032201 First citation in articleCrossrefGoogle Scholar