ECHO Researchers Create a Common Measure of Adult Depression

Courtney K. Blackwell, PhD
Courtney K. Blackwell, PhD

More than 264 million people experience depression worldwide. In the United States alone, more than 17 million adults experience depression each year. And women, especially those who are currently or recently pregnant, are at higher risk for a depressive episode. As such, regular depression screenings for women during and after pregnancy is a recommended practice, and doctors may want to continue screening women throughout their lives. Consistent measurement of depression throughout a woman’s lifetime can be difficult because the measurement tools used around pregnancy are scored differently from the common measures of adult depression. Linking these measurement tools together will help doctors track the changes in depression across a woman’s lifetime.

To address this research gap, Courtney K. Blackwell, PhD, and her ECHO colleagues conducted a study aimed at linking the Edinburgh Postnatal Depression Scale (EPDS)—a measure of depression in women during or after pregnancy—with the Patient-Reported Outcomes Measurement Information System Depression (PROMIS-D), a general measure of adult depression.

This study included approximately 1,200 mothers from two ECHO sites in the Northern Plains of the US who each completed the EPDS and PROMIS-D surveys. All data were collected using an online survey. Most of the participants were white, but the sample also included American Indian/Alaska Natives. On average, the participants were 35 years old, and about half had a 4-year college degree or higher.

While the EPDS includes more specific measures of postpartum depression symptoms, the study found that the EPDS and PROMIS-D gave depression scores that were highly correlated for women around pregnancy. Both surveys asked questions about increased depressed mood and decreased interest and engagement in daily activities. The researchers were able to convert EPDS scores to PROMIS-D scores for consistent tracking of depression in women throughout adulthood. The converted scores held for different ages, ethnicities, races, and study sites.

“To know about someone’s depression across time, it is important to have a way to use data from different measures that may have been used at different timepoints,” said Blackwell. “This study provides a way to convert scores from a measure used during and after pregnancy to a measure that is used at any time in adulthood.”

The conversion table may also be useful to ECHO researchers who want to standardize depression measurements from multiple cohort sites. Additional studies may examine how different depression measures can be converted using similar methods.

The conversion table is available on prosettastone.org.

 

Access the research summary.

ECHO Study Unifies Two Popular Surveys for Screening Adult Depression

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ECHO Study Unifies Two Popular Surveys for Screening Adult Depression

Authors: Courtney K. Blackwell, Xiaodan Tang, Amy J. Elliott, Tracy Thomes, Hannah Louwagie, Richard Gershon, Benjamin D. Schalet, David Cella 

 

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health, with co-funding from the Office of Behavioral and Social Sciences Research (OBSSR).

 

What were the study results?

The EPDS and PROMIS-D both ask about increased sadness and decreased interest in daily activities. While the EPDS has additional content related to anxiety and suicidal ideation, the results of the two surveys were strongly linked. The researchers were able convert scores from the EPDS to PROMIS-D scores. The scoring conversion worked for different ages, ethnicities, races, and study sites.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

 

What was the study's impact?

Adults are encouraged to get regular depression screenings. The EPDS survey is often used to detect depression in women during and after pregnancy. Doctors who want to continue long-term screening for women after pregnancy may want to convert EPDS scores into more general PROMIS-D scores for consistent tracking. Within ECHO, depression research spanning more than one cohort may need to convert between the EPDS and PROMIS-D surveys to combine data from multiple sites.

 

Why was this study needed?

Depression affects more than 17 million adults in the U.S. each year, and women are at higher risk for depression, particularly during and after pregnancy. Regular screening of adults for symptoms of depression is important for early intervention. Different surveys are used to track depression symptoms in adults, including ones specific to women during and after pregnancy. However, researchers need a uniform set of survey measures to track depression over a long time and to conduct nationwide research on depression. This study tried to unify two popular depression surveys: the Edinburgh Postnatal Depression Scale (EPDS), which is used during and after pregnancy; and the Patient-Reported Outcomes Measurement Information System Depression (PROMIS-D), which is used at any time in adulthood.

 

Who was involved?

Around 1,200 mothers from two study sites in the Northern Plains of the United States completed the EPDS and PROMIS-D surveys. Most of the participants were around 35 years old and white, but this sample also included American Indian/Alaska Natives. About half of the participants had a 4-year college degree or higher.

 

What happened during the study?

The participants filled out the EPDS and PROMIS-D. Researchers collected data and demographics using an online survey.

 

What happens next?

The survey conversion table made through this study may be useful for doctors and researchers interested in tracking depression symptoms over time. New studies may seek to confirm the link between EPDS and PROMIS-D using bigger, more diverse groups. Studies may also look at linking other depression surveys with the PROMIS-D for easier, more unified tracking of depression.

 

Where can I learn more?

The conversion table is available at prosettastone.org.

Access the journal abstract, titled, “Developing a common metric for depression across adulthood: Linking PROMIS Depression with the Edinburgh Postnatal Depression Scale,” in Psychological Assessment.

 

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published: May 31, 2021

 

Access the associated article.

Read more research by Courtney Blackwell

 

The influence of sleep on children’s well-being

Author(s): Courtney K. Blackwell

General health and life satisfaction in children with chronic illness

Author(s): Courtney K. Blackwell, Amy J. Elliott, Jody Ganiban, et al

ECHO Review Finds Air Pollution May Be Associated with Child Brain Development, Behavior

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ECHO Review Finds Air Pollution May Be Associated with Child Brain Development, Behavior

Author(s): Heather E. Volk, Frederica Perera, Joseph M. Braun, Samantha L. Kingsley, Kim Gray, Jessie Buckley, Jane E. Clougherty, Lisa A. Croen, Brenda Eskenazi, Megan Herting, Allan C. Just, Itai Kloog, Amy Margolis, Leslie A. McClure, Rachel Miller, Sarah Levine, Rosalind Wright

 

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

 

What were the study results?

ECHO provides a unique opportunity to study how air pollution can affect children’s brain development and behavior in a large, diverse study population. It also has the ability to study pollutant exposures by geographic area, which has been a limitation in previous research.

 

What was the study's impact?

This study sets up the possibility of future work in ECHO on the effect of prenatal air pollution exposure on brain development in children.

 

Why was this study needed?

This study summarized information on different ways to measure prenatal air pollution exposure and what we know about how air pollution affects children’s behavior and brain development. It also helps create a plan for ECHO to study how being exposed to air pollution in the womb may affect children’s behavior.

 

Who was involved?

This paper uses summary data from ECHO to learn if there may be enough participants in the future to study how air pollution can affect children’s brain development and behavior.

 

What happened during the study?

Researchers reviewed earlier papers on air pollution and child development to summarize what those studies found. Then, they used that information to develop a plan that ECHO might use to fill gaps in that earlier work to advance children’s health.

 

What happens next?

Future studies will do the work described here – to examine air pollution exposure in ECHO participants by geographic area to determine how air pollution can affect the brain.

 

Where can I learn more?

Access the full journal article, titled “Prenatal air pollution exposure and neurodevelopment: A review and blueprint for a harmonized approach within ECHO.”

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 

Published: May 2021

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Author(s): Brian Hallmark, et al.

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Author(s): Timothy Choi, James E. Gern and Yury A. Bochkov

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Manish Arora: Application of Tooth Matrix Biomarkers to Environmental Biodynamics

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Application of Tooth Matrix Biomarkers to Environmental Biodynamics

Speakers:

Manish Arora, PhD

Icahn School of Medicine at Mount Sinai

 

 

 

 

Speaker Bio: 

Dr. Arora is an exposure biologist and environmental epidemiologist with training in advanced analytical chemistry methods. He was awarded an Australian government scholarship to study the uptake of environmental metal toxicants and its impact on human health. He was later accepted as postdoctoral fellow at the Environmental and Occupational Medicine and Epidemiology program at the Harvard School of Public Health. He is current a Professor and Vice Chairman of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai in New York, as well as Division Chief of Environmental Health, and Director of the Laboratory for Exposomic Innovation and Precision Environmental Medicine.

Dr. Arora has developed sophisticated laboratory methods to measure chemical signatures in teeth and hair as markers of environmental chemical exposures, with a focus on reconstructing early life exposure history.

Date: Wednesday, January 13, 1 to 2pm

 

Identifying and Addressing Limitations: The Effects of Air Pollution on Children’s Behavior and Brain Development

Heather Volk, PhD
Johns Hopkins Bloomberg School of Public Health

In a recent article published in Environmental Research, ECHO researcher Heather Volk, PhD, of Johns Hopkins Bloomberg School of Public Health and her team summarized information on different ways to measure prenatal air pollution exposure. They also reviewed what scientists know about how air pollution affects children’s behavior and brain development.

To collect this information, the team reviewed previous publications on air pollution and child development and summarized the study results. They then took these findings and developed a plan to address shortcomings of the earlier work to advance children’s health.

The plan involves using advanced geographic models for common air pollutant exposures. Since more than 90% of ECHO cohorts have collected a physical address for their participants, ECHO has the ability to study pollutant exposures by geographic area. This has been a limitation commonly seen in this area of research. This summary data also allows researchers to determine if there may be enough ECHO participants in the future to study how air pollution can affect children’s brain development and behavior.

“This research confirms that ECHO provides a unique opportunity to study how air pollution can affect children’s brain development and behavior in a large, diverse study population,” Volk said. Given this information, the team hopes that future studies will examine prenatal air pollution exposure in ECHO participants to examine how it affects the brain.

ECHO Researchers Explore Validity of Shortened Social Communication Questionnaire

Are short questionnaires as valid as longer versions when identifying autism spectrum disorder (ASD) and other social communication behaviors?

Kristen Lyall, Sc. D.

ECHO researchers Kristen Lyall, Craig Newschaffer, and others hoped to answer this question in their research titled, “Distributional properties and criterion validity of a shortened version of the Social Responsiveness Scale: Results from the ECHO program and implications for social communication research.” This publication, featured in Journal of Autism and Developmental Disorders, examines how well a shortened version of a social communication questionnaire identified behaviors related to ASD and social communication compared to the longer, established version.

More than 3,000 parents from across the United States participated in this study, nearly 200 of which had a child with ASD.

In all, the team found that the short form did well predicting ASD diagnosis and measuring social communication behaviors. These results suggest that shorter surveys can provide correct information about ASD, which would be quicker and easier for the participant to complete. However, more research is needed to see how the short questionnaire compares in other ways to the longer version.

This work is especially important because it may help address the needs of people who do not have autism but face challenges in social communication and could benefit from help. Additionally, it may help reduce the time it takes to complete surveys while still accurately capturing and addressing social communication challenges in those with and without ASD.

For more information, read the study summary.

Heather Volk: Moving ECHO Science Toward Gene-Environment Interaction for Neurodevelopmental Outcomes

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Moving ECHO Science Toward Gene-Environment Interaction for Neurodevelopmental Outcomes

Speaker:

Heather Volk. PhD, MPH

Johns Hopkins Bloomberg School of Public Health

 

 

 

Speaker Bio: Heather E. Volk is an Associate Professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. She is also Co-Director of the NICHD-funded Intellectual and Developmental Disabilities Research Center (IDDRC) at the Kennedy Krieger Institute, and Associate Director for Environmental Epidemiology in the Wendy Klag Center for Autism and Developmental Disabilities Research. Dr. Volk additionally is co-Director of the Psychiatric Epidemiology Traning program, supported by a Institutional Training grant (T32) from the National Institute of Mental Health. She also holds a joint appointment in the School’s Department of Environmental Health and Engineering. Dr. Volk earned a MPH in Epidemiology and Biostatistics at Boston University and a PhD in Public Health Studies (Epidemiology) at Saint Louis University, prior to post-doctoral training in Enviornmental Genomics through the Department of Preventive Medicine at the University of Southern California (USC).  She, along with her team, studies how environmental and genetic factors work together to confer risk for neurodevelopmental outcomes, including autism spectrum disorder (ASD).  She is the PI of several NIH-funded research grants which examine how environmental exposures (air pollution, metals) effect brain development, epidemiologic studies of comorbidity with ASD, and leads investigations into joint genetic, epigenetic, and environmental risks for ASD.  Dr. Volk additionally serves as co-PI for the Autism Spectrum Disorder Enriched Risk ECHO Cohort, a collaboration of nine cohorts of infants at high-familial risk for ASD.

Date: Wednesday, September 9, 1 to 2pm

Roz Wright: Advancing Discovery in ECHO: Creating a Transdisciplinary Learning Culture Through Use of Life Course Models

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Advancing Discovery in ECHO: Creating a Transdisciplinary Learning Culture Through Use of Life Course Models

Speaker:

Rosalind (Roz) Wright, MD, MPH

Icahn School of Medicine at Mount Sinai, Department of Pediatrics

 

 

 

About the Speaker: Rosalind J Wright MD, MPH, is the Horace W. Goldsmith Professor of Life Course Health Research in the Departments of Pediatrics and Environmental Medicine & Public Health at the Icahn School of Medicine at Mount Sinai (ISMMS) in New York.  She is also Dean of Translational Biomedical Sciences for the Mount Sinai Health System (MSHS), a clinician scientist and Program Director and Principal Investigator of Conduits, the Institute for Translational Sciences for the Mount Sinai Health System (the NCATs-funded CTSA).

She is an internationally recognized clinician scientist and life course epidemiologist with transdisciplinary training in molecular biology, environmental health, social determinants, and stress mechanisms. Her background includes transdisciplinary training and expertise in environmental exposure assessment as well as genetics, epigenetics, and psychosocial stress measurement applied to environmental health studies across the life course.

Outcome Areas: Neurodevelopment; Pre-, peri, and postnatal; Airways

Date: Wednesday, April 10, 1 to 2pm

Presentation Overview:

Lessons learned from developing a transdisciplinary team science and making discoveries at the intersections of various research disciplines outside of any one individual field.