Perceptualand Motor Skills, 1990, 71, 1389-1390.
O Perceptual and Motor Skills 1990
NURSING STUDENTS' ANTICIPATION OF EXPERIENCING SYMPTOMS OF SEASONAL AFFECTIVE DISORDER ' MARY L. WOLFE School of Nursing University of Marylond at Baltimore Summary.-40 nursing students rated the likelihood of experiencing symptoms of Seasonal Affective Disorder on a typical day during each of four seasons. Analysis suggests that these normal college students may expect to experience many of the symptoms, although less intensely than clinically depressed patients. Circannual rhythms in many physiologic functions have been observed in mammals and other vertebrates (1). Although seasonality in human behavior has also been noted, it has not ,generally attracted the attention of clinicians. However, recent studies have shown that certain individuals show marked seasonal changes m mood and behavior (4). Depression occurs every fall and winter and then remits, often glvlng way to hypomania or mania during spring and summer. A strong relationship has been noted between frequency of reported symptoms and two environmental variables, length of daylight time (photoperiod) and ambient temperature. This condition has been termed Seasonal Affective Disorder (SAD); it has been treated with some success by artificially extending the photoperiod during fall and winter. Murray (3) has reviewed a large number of studies in which patients' characteristics, experimental therapeutic procedures and explanations for their mechanisms are described. Given certain similarities between the behavior of patients with Seasonal Affective Disorder and hibernating animals (hypersomnia, hyperphagia, change in food preference, weight gain), it has been suggested that symptoms may be a manifestation of an atavistic seasonal rhythm. Lacoste and Wirz-Justice (2), in a study of 284 healthy individuals, found significant seasonal variation on a number of personality dimensions and concluded that even relatively stable traits in normal subjects vary with the time of year. There is some speculation that the disorder is related to patterns of secretion of melatonin and serotonin, which in turn are influenced by the intensity and duration of light to which persons are exposed (4). Although there is little evidence to date that the disorder may also be mediated by cognitive processes, an interesting question can be posed: could the simple act of invoking a mental image of a particular environment influence mood? The present study examined the effect of "imaging" typical winter, spring, summer, and fall days on nursing students' judgments of the likelihood of experiencing a variety of depressive symptoms. Method.-Forty nursing students (3 men, 37 women) participated. They ranged in age from 20 to 35 yr., with an average age of 24.4 yr. Data were obtained on a questionnaire which contained four short paragraphs, each describing a typical day in winter, spring, summer, and fall. Each descriptive was followed by a list of 20 symptoms of depression falling into four broad categories: Affect, Physical Activity/Appetite, Quality of Sleep, and Social/InteUectual Functioning. Results.-For each of the four symptom categories, a two-factor analysis of variance with repeated measures on both factors was performed. The factors in each case were symptom and
'Address correspondence to Mary L. Wolfe, W.D., School of Nursing, University of Maryland, Baltimore, 655 W. Lombard Street, Baltimore, MD 21201. A detailed account with tabled and raphical data is on file in Document NAPS-04818. Remit $9.55 for photocopy or $4.00 for fiche to Microfiche Publications, POB 3513, Grand Central Station, New York, NY 10017.
1390
M. L. WOLFE
season. Eight of these symptoms showed significant ( P C .05) quadratic seasonal trends. Students expected Sadness, Decreased Physical Activity, Increased Appetite, Weight Gain, Earlier Onset of Sleep, and Increased Sleep T i e to be maximal during winter, to decrease to a minimum during summer, and increase agam somewhat in the fall. Decreased Appetite and Weight Loss were expected to be minimal durmg the winter, increasing to a maximum during summer, decreasing again in the fall. These findings suggest that healthy, young students expected to experience many of the symptoms of Seasonal Affective Disorder identified by Rosenthal, et al., albeit less intensely than clinically depressed patients. The quadratic form of the trend of ratings is congruent with the circannual nature of the syndrome. Symptoms exhibiting only significant ( p < .05) linear trends were Irritability, Daytime Drowsiness, Interpersonal Difficulty, and Poor Motivation; these symptoms were, in general, expected to decrease from winter to fall. Eight of the symptoms showed no significant trend: Anxiety, Carbohydrate Craving, Later Waking, Sleeplessness, Decreased Quality of Sleep, Decreased Libido, Difficulty with Menses, and Difficulty Concentrating. Differences in students' anticipation of symptoms in the first three categories (Affect, Physical Activity/Appetite, and Quality of Sleep) were most pronounced during winter and summet Symptoms judged most Likely during winter were often judged least likely during summer (Sadness, Increased Appetite, Decreased Activity, Weight Gain, Earlier Onset of Sleep). In contrast, other symptoms judged least likely during winter (Decreased Appetite, Weight Loss) were judged most likely during summer. The greatest anticipated seasonal variation in this sample of normal human subjects occurred in those symptoms usually associated with seasonal rhythms of activity, appetite, and sleep in stud~esamong other mammals. Results, although tentative, suggesr that nursing students may expect to experience many of the symptoms of Seasonal Affectwe D~sorder,although less intensely than patients who are clinicaUy impaired. It must be emphasized that the present study dealt with nursing students' attributions, preconceptions, and biases for each season, rather than actual seasonal variations in mood. Research workers should examine actual symptom patterns over an extended period of time, for example, from entrance as freshmen until graduation. REFERENCES 1. FOLLETT,B. K., & FOLLETT, D. E. (Eds.) Biological clocks in seasonal reproductive systems. New York: Halstead, 1981. 2. LACOSTE,V., & Wmz-JUSTICE, A. Seasonality in personality dimensions. Psychiatry Research, 1987, 21, 181-183. 3 . MURRAY, J. B. Geoph sical variables and behavior: LVII. Seasonal affective disorder and phototherapy. ~syclologicalReports, 1989, 64, 787-801. 4. ROSENTHAL, N. E., SACK,D. A,, CARPENTER, C. J., PARRY,B. L., MENDELSON, W. B., & WEHR,T. A. Antidepressant effects of light in seasonal affective disorder. American lournal of Psychiatry, 1985, 142, 163-170. Accepted January 2, 1991.
O Perceptual and Motor Skills 1990
NURSING STUDENTS' ANTICIPATION OF EXPERIENCING SYMPTOMS OF SEASONAL AFFECTIVE DISORDER ' MARY L. WOLFE School of Nursing University of Marylond at Baltimore Summary.-40 nursing students rated the likelihood of experiencing symptoms of Seasonal Affective Disorder on a typical day during each of four seasons. Analysis suggests that these normal college students may expect to experience many of the symptoms, although less intensely than clinically depressed patients. Circannual rhythms in many physiologic functions have been observed in mammals and other vertebrates (1). Although seasonality in human behavior has also been noted, it has not ,generally attracted the attention of clinicians. However, recent studies have shown that certain individuals show marked seasonal changes m mood and behavior (4). Depression occurs every fall and winter and then remits, often glvlng way to hypomania or mania during spring and summer. A strong relationship has been noted between frequency of reported symptoms and two environmental variables, length of daylight time (photoperiod) and ambient temperature. This condition has been termed Seasonal Affective Disorder (SAD); it has been treated with some success by artificially extending the photoperiod during fall and winter. Murray (3) has reviewed a large number of studies in which patients' characteristics, experimental therapeutic procedures and explanations for their mechanisms are described. Given certain similarities between the behavior of patients with Seasonal Affective Disorder and hibernating animals (hypersomnia, hyperphagia, change in food preference, weight gain), it has been suggested that symptoms may be a manifestation of an atavistic seasonal rhythm. Lacoste and Wirz-Justice (2), in a study of 284 healthy individuals, found significant seasonal variation on a number of personality dimensions and concluded that even relatively stable traits in normal subjects vary with the time of year. There is some speculation that the disorder is related to patterns of secretion of melatonin and serotonin, which in turn are influenced by the intensity and duration of light to which persons are exposed (4). Although there is little evidence to date that the disorder may also be mediated by cognitive processes, an interesting question can be posed: could the simple act of invoking a mental image of a particular environment influence mood? The present study examined the effect of "imaging" typical winter, spring, summer, and fall days on nursing students' judgments of the likelihood of experiencing a variety of depressive symptoms. Method.-Forty nursing students (3 men, 37 women) participated. They ranged in age from 20 to 35 yr., with an average age of 24.4 yr. Data were obtained on a questionnaire which contained four short paragraphs, each describing a typical day in winter, spring, summer, and fall. Each descriptive was followed by a list of 20 symptoms of depression falling into four broad categories: Affect, Physical Activity/Appetite, Quality of Sleep, and Social/InteUectual Functioning. Results.-For each of the four symptom categories, a two-factor analysis of variance with repeated measures on both factors was performed. The factors in each case were symptom and
'Address correspondence to Mary L. Wolfe, W.D., School of Nursing, University of Maryland, Baltimore, 655 W. Lombard Street, Baltimore, MD 21201. A detailed account with tabled and raphical data is on file in Document NAPS-04818. Remit $9.55 for photocopy or $4.00 for fiche to Microfiche Publications, POB 3513, Grand Central Station, New York, NY 10017.
1390
M. L. WOLFE
season. Eight of these symptoms showed significant ( P C .05) quadratic seasonal trends. Students expected Sadness, Decreased Physical Activity, Increased Appetite, Weight Gain, Earlier Onset of Sleep, and Increased Sleep T i e to be maximal during winter, to decrease to a minimum during summer, and increase agam somewhat in the fall. Decreased Appetite and Weight Loss were expected to be minimal durmg the winter, increasing to a maximum during summer, decreasing again in the fall. These findings suggest that healthy, young students expected to experience many of the symptoms of Seasonal Affective Disorder identified by Rosenthal, et al., albeit less intensely than clinically depressed patients. The quadratic form of the trend of ratings is congruent with the circannual nature of the syndrome. Symptoms exhibiting only significant ( p < .05) linear trends were Irritability, Daytime Drowsiness, Interpersonal Difficulty, and Poor Motivation; these symptoms were, in general, expected to decrease from winter to fall. Eight of the symptoms showed no significant trend: Anxiety, Carbohydrate Craving, Later Waking, Sleeplessness, Decreased Quality of Sleep, Decreased Libido, Difficulty with Menses, and Difficulty Concentrating. Differences in students' anticipation of symptoms in the first three categories (Affect, Physical Activity/Appetite, and Quality of Sleep) were most pronounced during winter and summet Symptoms judged most Likely during winter were often judged least likely during summer (Sadness, Increased Appetite, Decreased Activity, Weight Gain, Earlier Onset of Sleep). In contrast, other symptoms judged least likely during winter (Decreased Appetite, Weight Loss) were judged most likely during summer. The greatest anticipated seasonal variation in this sample of normal human subjects occurred in those symptoms usually associated with seasonal rhythms of activity, appetite, and sleep in stud~esamong other mammals. Results, although tentative, suggesr that nursing students may expect to experience many of the symptoms of Seasonal Affectwe D~sorder,although less intensely than patients who are clinicaUy impaired. It must be emphasized that the present study dealt with nursing students' attributions, preconceptions, and biases for each season, rather than actual seasonal variations in mood. Research workers should examine actual symptom patterns over an extended period of time, for example, from entrance as freshmen until graduation. REFERENCES 1. FOLLETT,B. K., & FOLLETT, D. E. (Eds.) Biological clocks in seasonal reproductive systems. New York: Halstead, 1981. 2. LACOSTE,V., & Wmz-JUSTICE, A. Seasonality in personality dimensions. Psychiatry Research, 1987, 21, 181-183. 3 . MURRAY, J. B. Geoph sical variables and behavior: LVII. Seasonal affective disorder and phototherapy. ~syclologicalReports, 1989, 64, 787-801. 4. ROSENTHAL, N. E., SACK,D. A,, CARPENTER, C. J., PARRY,B. L., MENDELSON, W. B., & WEHR,T. A. Antidepressant effects of light in seasonal affective disorder. American lournal of Psychiatry, 1985, 142, 163-170. Accepted January 2, 1991.
