226
|
Olino TM, Durbin CE, Klein DN, Hayden EP, Dyson MW. Gender differences in young children's temperament traits: comparisons across observational and parent-report methods. J Pers 2013; 81:119-29. [PMID: 22924826 DOI: 10.1111/jopy.12000] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Evidence supporting the continuity between child temperament and adult personality traits is accumulating. One important indicator of continuity is the presence of reliable gender differences in traits across the lifespan. A substantial literature demonstrates gender differences on certain adult personality traits and recent meta-analytic work on child samples suggests similar gender differences for some broad and narrow domains of temperament. However, most existing studies of children rely only on parent-report measures. The present study investigated gender differences in temperament traits assessed by laboratory observation, maternal-report, and paternal-report measures. Across three independent samples, behavioral observations, maternal-report, and paternal-report measures of temperament were collected on 463 boys and 402 girls. Across all three methods, girls demonstrated higher positive affect and fear and lower activity level than boys. For laboratory measures, girls demonstrated higher levels of sociability and lower levels of overall negative emotionality (NE), sadness, anger and impulsivity than boys. However, girls demonstrated higher levels of overall NE and sadness than boys when measured by maternal reports. Finally, girls demonstrated lower levels of sociability based on paternal reports. Results are discussed in relation to past meta-analytic work and developmental implications of the findings.
Collapse
|
227
|
Shankman SA, Campbell ML, Klein DN, Leon AC, Arnow BA, Manber R, Keller MB, Markowitz JC, Rothbaum BO, Thase ME, Kocsis JH. Dysfunctional attitudes as a moderator of pharmacotherapy and psychotherapy for chronic depression. J Psychiatr Res 2013; 47:113-21. [PMID: 23102821 PMCID: PMC3501539 DOI: 10.1016/j.jpsychires.2012.09.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 08/23/2012] [Accepted: 09/20/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Individuals with chronic depression exhibit heterogeneous responses to treatment. Important individual differences may therefore exist within this particularly difficult to treat population that act as moderators of treatment response. METHOD The present study examined whether pretreatment levels of dysfunctional attitudes (DA) moderated treatment response in a large sample of chronically depressed individuals. Data were taken from the Research Evaluating the Value of Augmenting Medication with Psychotherapy (REVAMP) treatment study--a multi-site treatment and augmentation study of 808 chronically depressed individuals. REVAMP comprised two phases: 1) a 12-week open-label antidepressant trial and 2), a subsequent phase, in which phase 1 non-remitters (N = 491) were randomized to either receive an ongoing medication algorithm alone, medication plus cognitive behavioral analysis system of psychotherapy, or medication plus brief supportive psychotherapy. RESULT In phase 1, compared to the pharmacotherapy response of patients with lower DA scores, the response for patients with higher DA scores was steeper, but leveled off toward the end of the phase. In phase 2, DA predicted a differential response in the medication only arm, but not in the two psychotherapy + medication conditions. Specifically, in the phase 2 medication only condition, patients with higher DA improved while those with lower DA scores did not. CONCLUSION These results indicate that the relation between DA and treatment response in chronic depression is complex, but suggest that greater DA may be associated with a steeper reduction and/or better response to pharmacotherapy.
Collapse
|
228
|
Rohde P, Lewinsohn PM, Klein DN, Seeley JR, Gau JM. Key Characteristics of Major Depressive Disorder Occurring in Childhood, Adolescence, Emerging Adulthood, Adulthood. Clin Psychol Sci 2013; 1. [PMID: 24273703 DOI: 10.1177/2167702612457599] [Citation(s) in RCA: 186] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper summarizes characteristics of major depressive disorder (MDD) in the Oregon Adolescent Depression Project, using data from 816 participants (56% female; 89% White). Contrasting four developmental periods (Childhood [5-12.9], Adolescence [13-17.9], Emerging Adulthood [18-23.9], Adulthood [24-30]), we examine MDD incidence/recurrence, gender, comorbidity, duration, and suicide attempts across periods. MDD first incidence was lower in Childhood compared to subsequent periods, and higher in Emerging Adulthood than Adulthood. Cumulative incidence was 51%. Recurrence was lower during Childhood than remaining periods, which were comparable. Female gender predicted first incident MDD in all four periods but was unassociated with recurrence. Comorbidity rates were comparable across periods. MDD duration was greater in Childhood than remaining periods. Suicide attempt rates were significantly higher during Adolescence than either Emerging Adulthood or Adulthood. Depression research should focus on MDD during Emerging Adulthood, adolescent suicidal behavior, the continuing role of gender into adulthood, and the ubiquity of MDD.
Collapse
|
229
|
Bress JN, Foti D, Kotov R, Klein DN, Hajcak G. Blunted neural response to rewards prospectively predicts depression in adolescent girls. Psychophysiology 2012; 50:74-81. [DOI: 10.1111/j.1469-8986.2012.01485.x] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 09/18/2012] [Indexed: 11/30/2022]
|
230
|
Bufferd SJ, Dougherty LR, Carlson GA, Rose S, Klein DN. Psychiatric disorders in preschoolers: continuity from ages 3 to 6. Am J Psychiatry 2012; 169:1157-64. [PMID: 23128922 PMCID: PMC3513401 DOI: 10.1176/appi.ajp.2012.12020268] [Citation(s) in RCA: 198] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Recent studies indicate that many preschoolers meet diagnostic criteria for psychiatric disorders. However, data on the continuity of these diagnoses are limited, particularly from studies examining a broad range of disorders in community samples. Such studies are necessary to elucidate the validity and clinical significance of psychiatric diagnoses in young children. The authors examined the continuity of specific psychiatric disorders in a large community sample of preschoolers from the preschool period (age 3) to the beginning of the school-age period (age 6). METHOD Eligible families with a 3-year child were recruited from the community through commercial mailing lists. For 462 children, the child's primary caretaker was interviewed at baseline and again when the child was age 6, using the parent-report Preschool Age Psychiatric Assessment, a comprehensive diagnostic interview. The authors examined the continuity of DSM-IV diagnoses from ages 3 to 6. RESULTS Three-month rates of disorders were relatively stable from age 3 to age 6. Children who met criteria for any diagnosis at age 3 were nearly five times as likely as the others to meet criteria for a diagnosis at age 6. There was significant homotypic continuity from age 3 to age 6 for anxiety, attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder, and heterotypic continuity between depression and anxiety, between anxiety and oppositional defiant disorder, and between ADHD and oppositional defiant disorder. CONCLUSIONS These results indicate that preschool psychiatric disorders are moderately stable, with rates of disorders and patterns of homotypic and heterotypic continuity similar to those observed in samples of older children.
Collapse
|
231
|
Steidtmann D, Manber R, Arnow BA, Klein DN, Markowitz JC, Rothbaum BO, Thase ME, Kocsis JH. Patient treatment preference as a predictor of response and attrition in treatment for chronic depression. Depress Anxiety 2012; 29:896-905. [PMID: 22767424 PMCID: PMC3463778 DOI: 10.1002/da.21977] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 06/04/2012] [Accepted: 06/09/2012] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Findings regarding the relationship between patient treatment preference and treatment outcome are mixed. This is a secondary data analysis investigating the relationship between treatment preference, and symptom outcome and attrition in a large two-phase depression treatment trial. METHODS Patients met DSM-IV criteria for chronic forms of depression. Phase I was a 12-week, nonrandomized, open-label trial in which all participants (n = 785) received antidepressant medication(s) (ADM). Phase I nonremitters were randomized to Phase II, in which they received 12 weeks of either cognitive-behavioral system of psychotherapy (CBASP) + ADM (n = 193), brief supportive psychotherapy (BSP) + ADM (n = 187), or ADM only (n = 93). Participants indicated their treatment preference (medication only, combined treatment or no preference) at study entry. Symptoms were measured at 2-week intervals with the 24-item Hamilton Rating Scale for Depression (HAM-D). RESULTS A large majority of patients reported a preference for combined treatment. Patients who preferred medication only were more likely to endorse a chemical imbalance explanation for depression, whereas those desiring combined treatment were more likely to attribute their depression to stressful experiences. In Phase I, patients who expressed no treatment preference showed greater rates of HAM-D symptom reduction than those with any preference, and patients with a preference for medication showed higher attrition than those preferring combined treatment. In Phase II, baseline treatment preference was not associated with symptom reduction or attrition. CONCLUSIONS Treatment preferences may moderate treatment response and attrition in unexpected ways. Research identifying factors associated with differing preferences may enable improved treatment retention and response.
Collapse
|
232
|
Meyer A, Weinberg A, Klein DN, Hajcak G. The development of the error-related negativity (ERN) and its relationship with anxiety: evidence from 8 to 13 year-olds. Dev Cogn Neurosci 2012; 2:152-61. [PMID: 22308177 DOI: 10.1016/j.dcn.2011.09.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Because anxiety disorders appear to follow developmental trajectories that begin early in development, it may be useful to examine the neurodevelopmental correlates of specific cognitive processes that have been linked to anxiety. For instance, the error-related negativity (ERN) is a negative deflection in the event-related potential that is maximal approximately 50 ms following the commission of errors at fronto-central electrode sites,and has consistently been found to be more negative among anxious adults. Much less,however, is known about anxiety and the ERN in children—especially when this relationship develops. We recorded event-related potentials (ERPs) while 55 children aged 8–13 performed an arrow version of the flankers task. Parents and children both reported on children's anxiety. Results suggest that the relationship between the ERN and anxiety changes as a function of age. Among older children, a larger (i.e., more negative) ERN was significantly related to increased anxiety based on parent report. Although the relationship was less robust, the relationship between ERN and anxiety was opposite among younger children.These results are discussed in terms of existing work on anxiety and the ERN, and the need for longitudinal and developmental studies on the relationship between ERN andanxiety
Collapse
|
233
|
Olino TM, Shankman SA, Klein DN, Seeley JR, Pettit JW, Farmer RF, Lewinsohn PM. Lifetime rates of psychopathology in single versus multiple diagnostic assessments: comparison in a community sample of probands and siblings. J Psychiatr Res 2012; 46:1217-22. [PMID: 22739001 PMCID: PMC3411854 DOI: 10.1016/j.jpsychires.2012.05.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 05/30/2012] [Accepted: 05/31/2012] [Indexed: 11/27/2022]
Abstract
Lifetime prevalence rates of psychopathology vary a great deal depending on whether they are estimated from cross-sectional or prospective longitudinal studies, with the former yielding significantly lower rates. Such findings, however, come from comparisons of separate studies from different countries and cohorts. Here, we compare lifetime rates of psychopathology between a community sample of individuals assessed on multiple occasions to their siblings who completed only a single diagnostic evaluation. Data come from the Oregon Adolescent Depression Project. We included 442 original participants who completed four prospective diagnostic assessments over the course of fifteen years, and 657 of their siblings who completed a single lifetime assessment. Comparisons of rates of depressive, bipolar, anxiety, and substance use disorders were made using survival analysis. We found that rates of depressive disorders, specifically major depressive disorder, were elevated among individuals who completed multiple diagnostic assessments relative to individuals who completed a single lifetime assessment. We did not find significant differences in rates of aggregate anxiety, bipolar, or substance use disorders. Within a single cohort, cross-sectional surveys appear to underestimate the lifetime rates of major depression relative to prospective, longitudinal designs. This suggests that disorders with an episodic course may be under-reported in cross-sectional surveys. Rates of anxiety, bipolar, and substance use disorders did not differ across assessment methods. To further evaluate method effects on lifetime estimates of psychopathology, future work may benefit from comparing rates of retrospectively- and prospectively-derived diagnoses in individuals who are repeatedly assessed over a lengthy follow-up period.
Collapse
|
234
|
Kim J, Carlson GA, Meyer SE, Bufferd SJ, Dougherty LR, Dyson MW, Laptook RS, Olino TM, Klein DN. Correlates of the CBCL-dysregulation profile in preschool-aged children. J Child Psychol Psychiatry 2012; 53:918-26. [PMID: 22409304 PMCID: PMC3523168 DOI: 10.1111/j.1469-7610.2012.02546.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A growing literature indicates that the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) identifies youths with heightened risk for severe psychopathology, comorbidity, and impairment. However, this work has focused on school-age children and adolescents; no studies have examined whether preschool-aged children with the CBCL-DP exhibit a similar constellation of problems. METHOD Using a community sample of preschoolers, we compared children with (N = 61) and without (N = 488) the CBCL-DP on a broad range of variables assessed using multiple methods. RESULTS Univariate analyses revealed numerous differences between children with the CBCL-DP and their peers on psychiatric symptomatology, temperament, parenting behavior, and parental personality, psychopathology, and marital functioning. In multivariate analyses, children with the CBCL-DP exhibited greater temperamental negative affectivity and lower effortful control. They also had more depressive and oppositional defiant symptoms, as well as greater functional impairment. Parents of CBCL-DP children reported engaging in more punitive, controlling parenting behavior than parents of non-profile children. CONCLUSIONS In a non-clinical sample of preschoolers, the CBCL-DP is associated with extensive emotional and behavioral dysregulation and maladaptive parenting.
Collapse
|
235
|
Klein DN, Glenn CR, Kosty DB, Seeley JR, Rohde P, Lewinsohn PM. Predictors of first lifetime onset of major depressive disorder in young adulthood. JOURNAL OF ABNORMAL PSYCHOLOGY 2012; 122:1-6. [PMID: 22889243 DOI: 10.1037/a0029567] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The first onset of major depressive disorder (MDD) most frequently occurs in young adulthood. However, few studies have examined predictors of first lifetime MDD during this high-risk period. The present study examined a broad range of demographic, clinical, and psychosocial variables as prospective predictors of first onset of MDD in a large community sample of young adults (N = 502) from the Oregon Adolescent Depression Project. Between ages 19-31, 35.3% of the sample had a first lifetime MDD episode. Female gender, familial loading of mood disorders, history of childhood sexual abuse, prior history of anxiety disorder, poor self-reported physical health, and subthreshold depressive symptoms significantly predicted MDD onset. In a multivariate model, female gender, familial loading of mood disorders, and subthreshold depression each contributed unique variance in predicting first lifetime MDD. This model had a moderate-to-large effect in predicting MDD onset. Gender did not moderate the other predictors, and the magnitude of the effects did not diminish over the course of the follow-up. These findings indicate that a number of risk factors significantly predict first lifetime MDD in young adulthood, and that simple multivariate risk models may be useful for identifying individuals at high risk for MDD.
Collapse
|
236
|
Smith HJ, Sheikh HI, Dyson MW, Olino TM, Laptook RS, Durbin CE, Hayden EP, Singh SM, Klein DN. Parenting and Child DRD4 Genotype Interact to Predict Children's Early Emerging Effortful Control. Child Dev 2012; 83:1932-44. [PMID: 22862680 DOI: 10.1111/j.1467-8624.2012.01818.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Effortful control (EC), or the trait-like capacity to regulate dominant responses, has important implications for children's development. Although genetic factors and parenting likely influence EC, few studies have examined whether they interact to predict its development. This study examined whether the DRD4 exon III variable number tandem repeat polymorphism moderated the relation between parenting and children's EC. Three hundred and eighty-two 3-year-olds and primary caregivers completed behavioral tasks assessing children's EC and parenting. Children's DRD4 genotypes moderated the relation between parenting and EC: Children with at least one 7-repeat allele displayed lower EC in the context of negative parenting than children without this allele. These findings suggest opportunities for modifying early risk for low EC.
Collapse
|
237
|
May AM, Klonsky ED, Klein DN. Predicting future suicide attempts among depressed suicide ideators: a 10-year longitudinal study. J Psychiatr Res 2012; 46:946-52. [PMID: 22575331 PMCID: PMC3372684 DOI: 10.1016/j.jpsychires.2012.04.009] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 03/10/2012] [Accepted: 04/05/2012] [Indexed: 11/29/2022]
Abstract
Suicidal ideation and attempts are a major public health problem. Research has identified many risk factors for suicidality; however, most fail to identify which suicide ideators are at greatest risk of progressing to a suicide attempt. Thus, the present study identified predictors of future suicide attempts in a sample of psychiatric patients reporting suicidal ideation. The sample comprised 49 individuals who met full DSM-IV criteria for major depressive disorder and/or dysthymic disorder and reported suicidal ideation at baseline. Participants were followed for 10 years. Demographic, psychological, personality, and psychosocial risk factors were assessed using validated questionnaires and structured interviews. Phi coefficients and point-biserial correlations were used to identify prospective predictors of attempts, and logistic regressions were used to identify which variables predicted future attempts over and above past suicide attempts. Six significant predictors of future suicide attempts were identified - cluster A personality disorder, cluster B personality disorder, lifetime substance abuse, baseline anxiety disorder, poor maternal relationship, and poor social adjustment. Finally, exploratory logistic regressions were used to examine the unique contribution of each significant predictor controlling for the others. Comorbid cluster B personality disorder emerged as the only robust, unique predictor of future suicide attempts among depressed suicide ideators. Future research should continue to identify variables that predict transition from suicidal thoughts to suicide attempts, as such work will enhance clinical assessment of suicide risk as well as theoretical models of suicide.
Collapse
|
238
|
Meyer A, Klein DN, Torpey DC, Kujawa AJ, Hayden EP, Sheikh HI, Singh SM, Hajcak G. Additive effects of the dopamine D2 receptor and dopamine transporter genes on the error-related negativity in young children. GENES BRAIN AND BEHAVIOR 2012; 11:695-703. [PMID: 22682503 DOI: 10.1111/j.1601-183x.2012.00812.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The error-related negativity (ERN) is a negative deflection in the event-related potential that occurs approximately 50 ms following the commission of an error at fronto-central electrode sites. Previous models suggest dopamine plays a role in the generation of the ERN. We recorded event-related potentials (ERPs) while 279 children aged 5-7 years completed a simple Go/No-Go task; the ERN was examined in relation to the dopamine D2 receptor (DRD2) and dopamine transporter (DAT1) genes. Results suggest an additive effect of the DRD2 and DAT1 genotype on ERN magnitude such that children with at least one DRD2 A1 allele and children with at least one DAT1 9 allele have an increased (i.e. more negative) ERN. These results provide further support for the involvement of dopamine in the generation of the ERN.
Collapse
|
239
|
Kujawa A, Weinberg A, Hajcak G, Klein DN. Differentiating event-related potential components sensitive to emotion in middle childhood: evidence from temporal-spatial PCA. Dev Psychobiol 2012; 55:539-50. [PMID: 22692816 DOI: 10.1002/dev.21058] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 05/19/2012] [Indexed: 11/10/2022]
Abstract
Event-related potentials (ERPs) may be particularly useful for examining emotional processing across development. Though a number of ERP components are sensitive to emotional content in adults, previous studies have yet to systematically examine the components sensitive to emotion in children. The current study used temporal-spatial principal components analysis (PCA) to identify ERP components in response to complex emotional images in 9-year-old children. Three components were modulated by emotional content and were similar to those previously observed in adults, including: the early posterior negativity, the P300, and a sustained relative positivity similar to the late positive potential (LPP). Compared to those previously observed in adults, the components sensitive to emotion in children were maximal over more occipital regions and the LPP component appeared to be less protracted in time, perhaps indicative of less elaborative processing of emotional stimuli.
Collapse
|
240
|
Weinberg A, Klein DN, Hajcak G. Increased error-related brain activity distinguishes generalized anxiety disorder with and without comorbid major depressive disorder. JOURNAL OF ABNORMAL PSYCHOLOGY 2012; 121:885-96. [PMID: 22564180 DOI: 10.1037/a0028270] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are so frequently comorbid that some have suggested that the 2 should be collapsed into a single overarching "distress" disorder. Yet there is also increasing evidence that the 2 categories are not redundant. Neurobehavioral markers that differentiate GAD and MDD would be helpful in ongoing efforts to refine classification schemes based on neurobiological measures. The error-related negativity (ERN) may be one such marker. The ERN is an event-related potential component presenting as a negative deflection approximately 50 ms following an erroneous response and reflects activity of the anterior cingulate cortex. There is evidence for an enhanced ERN in individuals with GAD, but the literature in MDD is mixed. The present study measured the ERN in 26 GAD, 23 comorbid GAD and MDD, and 36 control participants, all of whom were female and medication-free. Consistent with previous research, the GAD group was characterized by a larger ERN and an increased difference between error and correct trials than controls. No such enhancement was evident in the comorbid group, suggesting comorbid depression may moderate the relationship between the ERN and anxiety. The present study further suggests that the ERN is a potentially useful neurobiological marker for future studies that consider the pathophysiology of multiple disorders in order to construct or refine neurobiologically based diagnostic phenotypes.
Collapse
|
241
|
Olino TM, Klein DN, Farmer RF, Seeley JR, Lewinsohn PM. Examination of the structure of psychopathology using latent class analysis. Compr Psychiatry 2012; 53:323-32. [PMID: 21757192 PMCID: PMC3196784 DOI: 10.1016/j.comppsych.2011.05.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 05/24/2011] [Indexed: 10/17/2022] Open
Abstract
Several recent studies using factor analytic methods find that the structure of psychopathology reflects broad internalizing and externalizing dimensions, with the internalizing dimension being further divided into fear and distress disorders. Although these variable-centered studies have provided important insights into the structure of psychopathology, they provide limited information about the classification of individual cases. The present study examines patterns of lifetime internalizing and externalizing psychopathology in participants from the Oregon Adolescent Depression Project using latent class analysis that classifies individuals rather than variables. A 4-class solution best fits the data. The largest class (62.5%) included individuals with relatively little psychopathology; 1 class (16.4%) was largely characterized by internalizing disorders, 1 class (16.9%), largely characterized by externalizing disorders; and the final class (4.2%), characterized by both internalizing and externalizing disorders. The validity of the classes was further examined using data on psychiatric morbidity, temperament, and family aggregation of psychopathology. Classes differed on indices of positive, negative, and disinhibited temperament in ways that were consistent with theoretical predictions. Patterns of familial aggregation of psychopathology demonstrated relative specificity of transmission of different disorders. Overall, the findings support conclusions from studies of dimensional models of internalizing and externalizing disorders, and extend them to person-centered approaches to classification.
Collapse
|
242
|
Black SR, Klein DN. Early menarcheal age and risk for later depressive symptomatology: the role of childhood depressive symptoms. J Youth Adolesc 2012; 41:1142-50. [PMID: 22447395 DOI: 10.1007/s10964-012-9758-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 03/14/2012] [Indexed: 02/07/2023]
Abstract
Previous research has investigated the relationship between pubertal timing and depression in girls, with most results suggesting that earlier menarche predicts more depression in adolescence. However, few studies have controlled for the potentially confounding effects of childhood depressive symptoms. The current study uses a prospective, longitudinal sample of 1,185 girls (47.8 % Caucasian) to examine the relationships between pubertal timing, childhood depressive symptoms, and adolescent depressive symptomatology. Using multiple linear regression analyses, our results suggest that higher levels of childhood depressive symptoms and earlier menarche have independent effects on adolescent depressive symptoms. Surprisingly, childhood depressive symptomatology predicted later age of menarche, although the magnitude of this effect was small. Taken together, the results suggest that early childhood depressive symptoms and early menarche represent independent pathways to later depressive symptoms.
Collapse
|
243
|
Olino TM, Yu L, Klein DN, Rohde P, Seeley JR, Pilkonis PA, Lewinsohn PM. Measuring depression using item response theory: an examination of three measures of depressive symptomatology. Int J Methods Psychiatr Res 2012; 21:76-85. [PMID: 22290656 PMCID: PMC3302969 DOI: 10.1002/mpr.1348] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 11/03/2010] [Accepted: 11/18/2010] [Indexed: 11/11/2022] Open
Abstract
Evaluations of assessment instruments using classical test theory typically rely on indices of internal consistency, test-retest reliability, and construct validity. However, the use of models from item response theory (IRT) allows comparison of instruments (and items) in terms of the information they provide and where they provide it along the continuum of severity of the construct being assessed. Such results help to identify the measures most appropriate for specific clinical and research contexts. The present study examined the functioning of the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies-Depression (CES-D) scale, and the nine primary symptoms from the depression module of the Schedule for Affective Disorders and Schizophrenia-Children (K-SADS) using IRT methods. A large sample of adolescents (n = 1709) completed the BDI, CES-D scale, and K-SADS. IRT calibration analyses demonstrated that the BDI and CES-D scale performed well in similar ranges of depressive severity (approximately -1 to +3 standard deviations [SDs]), although the BDI provided more information at higher severity levels and the CES-D scale at lower severity levels. The K-SADS depression items, which are dichotomous and focused on clinical disorder, provided the least information that was restricted to the narrowest range (approximately +1 to +3 SDs). This work finds consistency between past rationale for the use of the BDI in clinical samples while using the CES-D scale in epidemiological studies. The results for the K-SADS suggest that interview measures may benefit from increasing the number of items and/or response options to collect more psychometric information.
Collapse
|
244
|
Kujawa A, Hajcak G, Torpey D, Kim J, Klein DN. Electrocortical reactivity to emotional faces in young children and associations with maternal and paternal depression. J Child Psychol Psychiatry 2012; 53:207-15. [PMID: 21895650 PMCID: PMC3522574 DOI: 10.1111/j.1469-7610.2011.02461.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The late positive potential (LPP) is an event-related potential component that indexes selective attention toward motivationally salient information and is sensitive to emotional stimuli. Few studies have examined the LPP in children. Depression has been associated with reduced reactivity to negative and positive emotional stimuli, including reduced LPPs in response to emotional faces. The current study sought to identify the time course and scalp distribution of the LPP in response to emotional faces in young children and to determine whether reduced reactivity is observed among children at risk for depression. METHODS Electrocortical reactivity to emotional faces was examined in a large sample of young children and as a function of maternal and paternal depression. RESULTS In the overall sample, emotional faces were associated with increased positivities compared to neutral faces at occipital sites 200-600 ms after stimulus onset and at parietal sites 600-1,000 ms after stimulus onset. Children of mothers with a history of depressive disorders exhibited reduced differentiation in the early occipital LPP for emotional compared to neutral faces. CONCLUSIONS Results suggest that children as young as 6 years exhibit LPPs to emotional faces, and patterns of electrocortical reactivity to emotional stimuli may be associated with vulnerability to depressive disorders.
Collapse
|
245
|
Dyson MW, Olino TM, Durbin CE, Goldsmith HH, Klein DN. The structure of temperament in preschoolers: a two-stage factor analytic approach. Emotion 2012; 12:44-57. [PMID: 21859196 PMCID: PMC3526001 DOI: 10.1037/a0025023] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The structure of temperament traits in young children has been the subject of extensive debate, with separate models proposing different trait dimensions. This research has relied almost exclusively on parent-report measures. The present study used an alternative approach, a laboratory observational measure, to explore the structure of temperament in preschoolers. A 2-stage factor analytic approach, exploratory factor analyses (n = 274) followed by confirmatory factor analyses (n = 276), was used. We retrieved an adequately fitting model that consisted of 5 dimensions: Sociability, Positive Affect/Interest, Dysphoria, Fear/Inhibition, and Constraint versus Impulsivity. This solution overlaps with, but is also distinct from, the major models derived from parent-report measures.
Collapse
|
246
|
McCullough JP, Lord BD, Martin AM, Conley KA, Schramm E, Klein DN. The significant other history: an interpersonal-emotional history procedure used with the early-onset chronically depressed patient. Am J Psychother 2011; 65:225-48. [PMID: 22032046 DOI: 10.1176/appi.psychotherapy.2011.65.3.225] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An interpersonal-emotional history procedure, the Significant Other History, is administered to the early-onset chronically depressed patient during the second therapy session in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Patients are asked to name up to six significant others and answer two questions: (1) What was it like growing up with or being around this person? (2) What is the emotional "stamp" you take from this relationship that informs who you are today? An interpersonal-emotional theme reflecting the early learning history of the patient is derived from these "stamps" or causal theory conclusions. One transference hypothesis (TH) is derived from the Significant Other History (SOH) and is formulated in one sentence, such as "If I do this, then the therapist will likely do that" (e.g., "If I make a mistake around Dr. E, then Dr. E will label me 'stupid' or 'incompetent"). The transference hypothesis highlights the interpersonal content that most likely informs the patient's expectancy of the therapist's reactions toward him or her. Throughout the therapy process, the therapist will proactively employ the transference hypothesis in a technique known as the Interpersonal Discrimination Exercise to help patients cognitively and emotionally discriminate the practitioner from hurtful significant others. The goal here is to increase the patient's felt safety within the therapeutic dyad and eventually to generalize the felt safety to the patient's other relationships.
Collapse
|
247
|
Glenn CR, Klein DN, Lissek S, Britton JC, Pine DS, Hajcak G. The development of fear learning and generalization in 8-13 year-olds. Dev Psychobiol 2011; 54:675-84. [PMID: 22072276 DOI: 10.1002/dev.20616] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Accepted: 09/23/2011] [Indexed: 11/08/2022]
Abstract
The current study examined developmental changes in fear learning and generalization in 40 healthy 8-13 year-olds using an aversive conditioning paradigm adapted from Lau et al. [Lau et al. [2008] Journal of the American Academy of Child and Adolescent Psychiatry 47:94-102]. In this task, the conditioned stimuli (CS+/CS-) are two neutral female faces, and the unconditioned stimulus is a fearful, screaming face. The second phase of the study also included a generalization stimulus (GS): a 50% blend of the CS± faces. The eye-blink startle reflex was utilized to measure defensive responding. Patterns of fear learning and generalization were qualified by child age. Older children demonstrated greater fear learning (i.e., larger startle during CS+ than CS-) than younger children. In addition, older children exhibited the typical pattern of generalization observed in adults, whereas younger children did not. Finally, fear learning also related to contingency awareness; only children who correctly identified the CS+ demonstrated fear-potentiated startle to the CS+. Clinical implications and future directions are discussed.
Collapse
|
248
|
Kim J, Klein DN, Olino TM, Dyson MW, Dougherty LR, Durbin CE. Psychometric properties of the Behavioral Inhibition Questionnaire in preschool children. J Pers Assess 2011; 93:545-55. [PMID: 21999378 PMCID: PMC3270370 DOI: 10.1080/00223891.2011.608756] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We examined the psychometric properties of the Behavioral Inhibition Questionnaire (BIQ; Bishop, Spence, & McDonald, 2003), a rating scale for children's behavioral inhibition. Parent and teacher ratings, parent interviews, and laboratory observations were obtained for 495 preschoolers. Confirmatory factor analysis yielded 6 factors, each reflecting the BIQ's subscales, and all loading onto a second-order general dimension. Model fit was acceptable for parent ratings, but only marginal for teacher ratings. The convergent and discriminant validity of the BIQ was examined by using a multitrait-multimethod approach. Results indicate that the BIQ displays evidence of reliability and validity that can complement observational paradigms.
Collapse
|
249
|
Bress JN, Smith E, Foti D, Klein DN, Hajcak G. Neural response to reward and depressive symptoms in late childhood to early adolescence. Biol Psychol 2011; 89:156-62. [PMID: 22015709 DOI: 10.1016/j.biopsycho.2011.10.004] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 10/04/2011] [Accepted: 10/04/2011] [Indexed: 11/16/2022]
Abstract
Depression is a major public health concern, and the period from late childhood through early adolescence is a critical time in the development of depressive symptoms. In adults, depression and depressive symptoms are associated with a reduction in the feedback negativity (FN), an ERP component elicited by feedback indicating rewards versus losses. The current study sought to extend these findings to a sample of 64 children aged 8-13, and to examine developmental differences in the FN. Consistent with previous work in adults, higher depressive symptom scores were associated with a blunted FN across the sample. When responses to losses and gains were examined separately, only reduction in the response to monetary gain was associated with increased depressive symptoms. In the current study, the vast majority of children were pre-pubertal, and the FN was unrelated to both age and pubertal development. The FN may be an ideal biomarker for studying changes in reward sensitivity and depression that emerge as children transition through puberty.
Collapse
|
250
|
Torpey DC, Hajcak G, Kim J, Kujawa A, Klein DN. Electrocortical and behavioral measures of response monitoring in young children during a Go/No-Go task. Dev Psychobiol 2011; 54:139-50. [PMID: 21815136 DOI: 10.1002/dev.20590] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2010] [Accepted: 06/24/2011] [Indexed: 11/10/2022]
Abstract
The current study examined behavioral measures and response-locked event-related brain potentials (ERPs) derived from a Go/No-Go task in a large (N = 328) sample of 5- to 7-year-olds in order to better understand the early development of response monitoring and the impact of child age and sex. In particular, the error-related negativity (ERN, defined on both error trials alone and the difference between error and correct trials, or ΔERN), correct response negativity (CRN), and error positivity (P(e)) were examined. Overall, the ERN, CRN, and the P(e) were spatially and temporally similar to those measured in adults and older children. Even within our narrow age range, older children were faster and more accurate; a more negative ΔERN and a more positive P(e) were associated with: increasing age, increased accuracy, and faster reaction times on errors, suggesting these enhanced components reflected more efficient response monitoring of errors over development. Girls were slower and more accurate than boys, although both genders exhibited comparable ERPs. Younger children and girls were characterized by increased posterror slowing, although they did not demonstrate improved posterror accuracy. Posterror slowing was also related to a larger P(e) and reduced posterror accuracy. Collectively, these data suggest that posterror slowing may be unrelated to cognitive control and may, like the P(e), reflect an orienting response to errors.
Collapse
|