451
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Ehrenreich-May J, Rosenfield D, Queen AH, Kennedy SM, Remmes CS, Barlow DH. An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. J Anxiety Disord 2017; 46:46-55. [PMID: 27771133 DOI: 10.1016/j.janxdis.2016.10.006] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 09/27/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022]
Abstract
A substantial proportion of adolescents are non-responders to well-established treatments for anxiety and depression, and many existent approaches do not adequately address comorbidity. There is a need to develop and evaluate unified treatments for adolescents that flexibly address higher order factors shared among internalizing or emotional disorders. The Unified Protocol for the Treatment of Emotional Disorders in Adolescents (UP-A) is a transdiagnostic treatment that targets shared vulnerability and maintenance factors in a flexible format. This study examined initial outcomes of a randomized, waitlist-controlled trial of the UP-A. The UP-A outperformed waitlist at mid-treatment with respect to disorder severity and functional impairment, and there was a significant treatment effect in favor of the UP-A on all outcome measures at post-treatment. Within-subjects analyses collapsing across participants revealed significant improvements on outcome measures over time. Results support further study of the UP-A and its potential efficacy in treating adolescent anxiety and depression.
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Affiliation(s)
- Jill Ehrenreich-May
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Flipse Building, Room 315, Coral Gables, FL 33146, United States.
| | - David Rosenfield
- Southern Methodist University, Department of Psychology, PO Box 750442, Dallas, TX 75275-0442, United States.
| | - Alexander H Queen
- Tufts University, Department of Psychology, 490 Boston Avenue, Medford, MA 02155, United States.
| | - Sarah M Kennedy
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd., Flipse Building, Coral Gables, FL 33146, United States.
| | - Cara S Remmes
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd., Flipse Building, Coral Gables, FL 33146, United States.
| | - David H Barlow
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, Boston, MA 02215, United States.
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452
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Is there an association between diet and depression in children and adolescents? A systematic review. Br J Nutr 2017; 116:2097-2108. [PMID: 28093091 DOI: 10.1017/s0007114516004359] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This review critically evaluates previous studies investigating the association between dietary intake of children and young people and depression and related mental health problems. A systematic literature search was conducted using electronic databases such as PsycINFO, MEDLINE, PubMed and Cochrane. A total of twenty studies were identified that met inclusion criteria and were subsequently rated for quality. The studies used a range of methods to measure dietary intake and mental health. Important potential confounding variables (e.g. socio-economic status) were often not included or controlled. There were also inconsistencies in the use of key constructs, which made comparisons between studies difficult. Despite some contradictory results, overall there was support for an association between healthy dietary patterns or consumption of a high-quality diet and lower levels of depression or better mental health. Similarly, there was a relationship between unhealthy diet and consumption of low-quality diet and depression or poor mental health. However, where significant relationships were reported, effect sizes were small. Future research on the relationship between diet and mental health in young people should use more clearly defined constructs to define diet and include or control for important confounders.
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453
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Etiologic specificity of waking Cortisol: Links with maternal history of depression and anxiety in adolescent girls. J Affect Disord 2017; 208:103-109. [PMID: 27756045 PMCID: PMC5154865 DOI: 10.1016/j.jad.2016.08.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/28/2016] [Accepted: 08/24/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Many previous studies have indicated that individuals who are depressed or at risk for depression are characterized by increased levels of morning cortisol and a greater cortisol awakening response (CAR). However, despite the high comorbidity between depressive and anxiety disorders, fewer studies have examined whether these diurnal cortisol abnormalities are also characteristic of anxiety or risk for anxiety. METHODS In the present study we examined cortisol in a community sample of 476 female adolescents and related it to maternal history of depression and/or anxiety disorders. Salivary cortisol was collected at waking, 30min post waking, and in the evening on three weekdays. RESULTS Contrary to prior results, offspring at risk for depression did not have increased morning cortisol or CAR. However, offspring at risk for anxiety disorders had elevated 30min cortisol and total cortisol produced throughout the day; this effect was primarily driven by offspring of mothers with panic disorder or agoraphobia. Additionally, levels of cortisol were highest among offspring of mothers with multiple anxiety diagnoses. LIMITATIONS The study is limited to female adolescents and maternal diagnostic history. Additionally, some diagnoses could not be examined as a result of too few cases (e.g. GAD). CONCLUSIONS Overall, these results underscore the importance of considering anxiety when examining the association of diurnal cortisol abnormalities with risk for psychopathology, as it may have influenced prior observations of elevated morning cortisol in depression.
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454
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Holfeld B, Sukhawathanakul P. Associations Between Internet Attachment, Cyber Victimization, and Internalizing Symptoms Among Adolescents. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2017; 20:91-96. [PMID: 28080133 DOI: 10.1089/cyber.2016.0194] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
With increasing frequency of Internet use among adolescents, there are growing concerns about their risk for becoming attached to these forms of communication and increased vulnerability for negative online experiences, including cyber victimization. The effect of these experiences on adolescent mental health is not well understood. In this study, we examine how Internet attachment is related to anxiety and depression and assess the mediating effect of cyber victimization on these associations. Participants included 1,151 middle school students (51.4 percent males) aged 10 to 16 (M = 12.7, SD = 0.93). Structural equation models show that greater Internet attachment was associated with more cyber victimization and greater symptoms of anxiety and depression. Cyber victimization mediated the associations between Internet attachment and anxiety and between Internet attachment and depression. Implications for online awareness efforts are discussed.
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Affiliation(s)
- Brett Holfeld
- Department of Psychology, University of Victoria , Victoria, British Columbia
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455
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Problematic smartphone use: A conceptual overview and systematic review of relations with anxiety and depression psychopathology. J Affect Disord 2017; 207:251-259. [PMID: 27736736 DOI: 10.1016/j.jad.2016.08.030] [Citation(s) in RCA: 583] [Impact Index Per Article: 83.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/30/2016] [Accepted: 08/27/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Research literature on problematic smartphone use, or smartphone addiction, has proliferated. However, relationships with existing categories of psychopathology are not well defined. We discuss the concept of problematic smartphone use, including possible causal pathways to such use. METHOD We conducted a systematic review of the relationship between problematic use with psychopathology. Using scholarly bibliographic databases, we screened 117 total citations, resulting in 23 peer-reviewer papers examining statistical relations between standardized measures of problematic smartphone use/use severity and the severity of psychopathology. RESULTS Most papers examined problematic use in relation to depression, anxiety, chronic stress and/or low self-esteem. Across this literature, without statistically adjusting for other relevant variables, depression severity was consistently related to problematic smartphone use, demonstrating at least medium effect sizes. Anxiety was also consistently related to problem use, but with small effect sizes. Stress was somewhat consistently related, with small to medium effects. Self-esteem was inconsistently related, with small to medium effects when found. Statistically adjusting for other relevant variables yielded similar but somewhat smaller effects. LIMITATIONS We only included correlational studies in our systematic review, but address the few relevant experimental studies also. CONCLUSIONS We discuss causal explanations for relationships between problem smartphone use and psychopathology.
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456
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The Temporal Sequence of Social Anxiety and Depressive Symptoms Following Interpersonal Stressors During Adolescence. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 44:495-509. [PMID: 26142495 DOI: 10.1007/s10802-015-0049-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Social anxiety and depressive symptoms dramatically increase and frequently co-occur during adolescence. Although research indicates that general interpersonal stressors, peer victimization, and familial emotional maltreatment predict symptoms of social anxiety and depression, it remains unclear how these stressors contribute to the sequential development of these internalizing symptoms. Thus, the present study examined the sequential development of social anxiety and depressive symptoms following the occurrence of interpersonal stressors, peer victimization, and familial emotional maltreatment. Participants included 410 early adolescents (53% female; 51% African American; Mean age =12.84 years) who completed measures of social anxiety and depressive symptoms at three time points (Times 1-3), as well as measures of general interpersonal stressors, peer victimization, and emotional maltreatment at Time 2. Path analyses revealed that interpersonal stressors, peer victimization, and emotional maltreatment predicted both depressive and social anxiety symptoms concurrently. However, depressive symptoms significantly mediated the pathway from interpersonal stressors, peer victimization, and familial emotional maltreatment to subsequent levels of social anxiety symptoms. In contrast, social anxiety did not mediate the relationship between these stressors and subsequent depressive symptoms. There was no evidence of sex or racial differences in these mediational pathways. Findings suggest that interpersonal stressors, including the particularly detrimental stressors of peer victimization and familial emotional maltreatment, may predict both depressive and social anxiety symptoms; however, adolescents who have more immediate depressogenic reactions may be at greater risk for later development of symptoms of social anxiety.
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457
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Rousseau S, Scharf M, Smith Y. Achievement-oriented and dependency-oriented parental psychological control: An examination of specificity to middle childhood achievement and dependency-related problems. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2016. [DOI: 10.1080/17405629.2016.1265501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sofie Rousseau
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Miri Scharf
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Yael Smith
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
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458
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Fletcher AC, Buehler C, Buchanan CM, Weymouth BB. Parenting stressors and young adolescents' depressive symptoms: Does high vagal suppression offer protection? Physiol Behav 2016; 170:78-87. [PMID: 27979628 DOI: 10.1016/j.physbeh.2016.11.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 11/10/2016] [Accepted: 11/26/2016] [Indexed: 01/04/2023]
Abstract
Grounded in a dual-risk, biosocial perspective of developmental psychopathology, this study examined the role of higher vagal suppression in providing young adolescents protection from four parenting stressors. It was expected that lower vagal suppression would increase youth vulnerability to the deleterious effects of these parenting stressors. Depressive symptoms were examined as a central marker of socioemotional difficulties during early adolescence. The four parenting stressors examined were interparental hostility, maternal use of harsh discipline, maternal inconsistent discipline, and maternal psychological control. Participants were 68 young adolescents (Grade 6) and their mothers. Greater vagal suppression provided protection (i.e., lower depressive symptoms) from interparental hostility, harsh discipline, and maternal psychological control for boys but not for girls.
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Affiliation(s)
- Anne C Fletcher
- The University of North Carolina at Greensboro, Human Development & Family Studies, 228 Stone Building, HDFS, United States.
| | - Cheryl Buehler
- The University of North Carolina at Greensboro, Human Development & Family Studies, 228 Stone Building, HDFS, United States
| | | | - Bridget B Weymouth
- The University of North Carolina at Greensboro, Human Development & Family Studies, 228 Stone Building, HDFS, United States
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459
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Gonzalez MA, Jones DJ. Cascading effects of BPT for child internalizing problems and caregiver depression. Clin Psychol Rev 2016; 50:11-21. [PMID: 27676702 PMCID: PMC5118177 DOI: 10.1016/j.cpr.2016.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 09/12/2016] [Accepted: 09/18/2016] [Indexed: 11/18/2022]
Abstract
Behavioral Parent Training (BPT) is the standard of care for early onset (3 to 8years old) disruptive behavior disorders (DBDs). Preliminary evidence suggests that BPT may also produce cascading treatment effects for comorbid and interrelated symptomatology in children, primarily internalizing problems, as well as symptomatology in multiple systems of the family, including caregiver depressive symptomatology. What is less well understood, however, is why and how BPT functions to impact these multiple symptom clusters within and between family members. Accordingly, this manuscript aims to serve as a conceptual and theoretical consideration of the mechanisms through which BPT may produce generalized treatment effects among children with early onset DBDs and internalizing problems, as well as the psychosocial difficulties among their caregivers. It is our intention that the hypothesized mechanisms highlighted in this review may guide advances in clinical research, as well as assessment and practice.
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Affiliation(s)
- Michelle A Gonzalez
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States.
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460
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Swan AJ, Kendall PC. Fear and missing out: Youth anxiety and functional outcomes. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/cpsp.12169] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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461
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Anxious and Depressive Symptomatology Among Male Youth: The Joint and Interactive Contribution of Temperament and Executive Functioning. Child Psychiatry Hum Dev 2016; 47:925-937. [PMID: 26754748 PMCID: PMC5839135 DOI: 10.1007/s10578-016-0623-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Few studies have investigated the combined effects of temperament and executive functioning (EF) on anxious and depressive symptomatology in youth. The current study is the first to investigate the joint and interactive contribution of mother- and youth self-reported affective dimensions of temperament and EF to the explanation of anxious and depressive symptomatology. Participants included 174 adolescent males (M age = 13.6 ± 1.35). Results confirmed the joint and interactive contribution of temperament in the explanation of anxious and depressive symptomatology. Further, EF contributed to the explanation of anxious/depressive symptomatology via interaction with youth-, but not mother-reported, temperament; it was not a unique predictor. Results support the need to consider both affective dimensions of temperament and EF in etiological models of anxious and depressive symptomatology, which has implications for identifying at-risk youth and developing early intervention and targeted problem-specific prevention programs.
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462
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Ip P, Chim D, Chan KL, Li TMH, Ho FKW, Van Voorhees BW, Tiwari A, Tsang A, Chan CWL, Ho M, Tso W, Wong WHS. Effectiveness of a culturally attuned Internet-based depression prevention program for Chinese adolescents: A randomized controlled trial. Depress Anxiety 2016; 33:1123-1131. [PMID: 27618799 DOI: 10.1002/da.22554] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/24/2016] [Accepted: 08/16/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Depression prevention among adolescents is crucial for reducing the global disease burden. Internet-based depression prevention approaches are found to be effective but they were mostly evaluated in a Western context. Grasping the Opportunity is a Chinese Internet intervention, which was translated and modified from CATCH-IT developed in the West. We aimed to evaluate the effectiveness of Grasp the Opportunity in reducing depressive symptoms in Chinese adolescents. METHODS In this randomized controlled trial, Chinese adolescents aged 13 to 17 years with mild-to-moderate depressive symptoms were recruited from three secondary schools in Hong Kong. The participants (n = 257) were randomly assigned to receive either intervention or attention control. The primary outcome was the improvement in depressive symptoms according to the revised Center for Epidemiologic Studies Depression Scale (CESD-R) at the 12-month follow-up. Analyses were performed using intention to treat (ITT). RESULTS The participants were randomly assigned to receive the intervention (n = 130) or attention control (n = 127). Follow-up data were obtained from 250 (97%) participants. Only 26 (10%) participants completed the intervention. Compared to the attention control, Grasp the Opportunity led to reductions in depressive symptoms at the 12-month follow-up with a medium effect size using ITT analysis (mean difference 2.6, 95% CI 0.59-5.55, effect size d = 0.36). CONCLUSIONS Grasp the Opportunity is effective in reducing depressive symptoms in Chinese adolescents over a long follow-up period. Poor completion rate is the major challenge in the study.
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Affiliation(s)
- Patrick Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - David Chim
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Ko Ling Chan
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong
| | - Tim M H Li
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Frederick Ka Wing Ho
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | | | - Agnes Tiwari
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Anita Tsang
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | | | - Matthew Ho
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Winnie Tso
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wilfred Hing Sang Wong
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
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463
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Sweeney S, MacBeth A. The effects of paternal depression on child and adolescent outcomes: A systematic review. J Affect Disord 2016; 205:44-59. [PMID: 27414953 DOI: 10.1016/j.jad.2016.05.073] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 05/30/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Paternal depression has been associated with suboptimal developmental outcomes in offspring. We sought to systematically review the research evidence from prospective studies for an association between paternal depression and child adolescent emotional and behavioral outcomes. We also reviewed potential mediators of this association and sources of methodological bias. METHODS A systematic review was conducted using the following databases: Medline, EMBASE, PsycINFO and Google Scholar. Reference lists of the included papers were also searched. RESULTS Twenty-one studies were included in the review. Findings suggested that paternal depression does negatively impact upon offspring development. This impact is observable when paternal depression is present in the antenatal and postnatal stages and during offspring adolescence. The strength of this association is strongly reliant upon a number of contextual mediators, namely; paternal negative expressiveness, hostility and involvement and marital conflict. A quality assessment rating showed the studies were relatively strong methodologically. LIMITATIONS Heterogeneity regarding method of assessment and the magnitude and timing of exposure hinder attempts to make strong conclusions regarding the trajectory of paternal depression and its effects on child and adolescent outcomes. CONCLUSIONS Paternal mental health screening during pregnancy is necessary in order to identify and prevent depression negatively impacting offspring functioning. Including both parents in this process should encourage the alleviation of the environmental mediators which dominate the negative association outlined within the review. Research examining gene-environment interaction is necessary to uncover more accurate details regarding paternal depression and subsequent offspring vulnerability.
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464
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Snyder HR, Hankin BL. Spiraling out of control: Stress generation and subsequent rumination mediate the link between poorer cognitive control and internalizing psychopathology. Clin Psychol Sci 2016; 4:1047-1064. [PMID: 27840778 PMCID: PMC5102509 DOI: 10.1177/2167702616633157] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Poor cognitive control is associated with nearly every mental disorder and has been proposed as a transdiagnostic risk factor for psychopathology, including depression and anxiety. What specific mechanisms might cause individuals with poor cognitive control to experience higher levels of psychopathology? The current research tests a new process model linking poor cognitive control to depression and anxiety symptoms via increased dependent stress (i.e., self-generated stressors) and subsequent rumination. This model was supported across two studies in youth during the key period for emergence of internalizing psychopathology. Study 1 provides longitudinal evidence for prospective prediction of change in symptoms. Study 2 confirms this model using well-established executive function tasks in a cross-sectional study. These finding have potential implications for understanding why cognitive control impairments may be broadly associated with psychopathology, and suggest that interventions to prevent stress generation might be effective in preventing negative consequences of poor cognitive control.
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465
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Perera F, Nolte ELR, Wang Y, Margolis AE, Calafat AM, Wang S, Garcia W, Hoepner LA, Peterson BS, Rauh V, Herbstman J. Bisphenol A exposure and symptoms of anxiety and depression among inner city children at 10-12 years of age. ENVIRONMENTAL RESEARCH 2016; 151:195-202. [PMID: 27497082 PMCID: PMC5071142 DOI: 10.1016/j.envres.2016.07.028] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/28/2016] [Accepted: 07/19/2016] [Indexed: 05/09/2023]
Abstract
BACKGROUND Experimental and epidemiological studies suggest that gestational exposure to Bisphenol A (BPA), an ubiquitous endocrine disrupting chemical, may lead to neurobehavioral problems in childhood; however, not all results have been consistent. We previously reported a positive association between prenatal BPA exposure and symptoms of anxiety/depression reported by the mother at child age 7-9 years in boys, but not girls. OBJECTIVES Here, in the same birth cohort, we investigated the association of prenatal BPA exposure with symptoms of depression and anxiety self-reported by the 10-12 year olds, hypothesizing that we would observe sex-specific differences in anxiety and depressive symptoms. METHODS African-American and Dominican women living in Northern Manhattan and their children were followed from mother's pregnancy through children's age 10-12 years. BPA was quantified in maternal urine collected during the third trimester of pregnancy and in child urine collected at ages 3 and 5 years. Children were evaluated using the Revised Children's Manifest Anxiety Scale (RCMAS) and Children's Depression Rating Scale (CDRS). We compared the children in the highest tertile of BPA concentration to those in the lower two tertiles. Associations between behavior and prenatal (maternal) BPA concentration or postnatal (child) BPA concentration were assessed in regression models stratified by sex. RESULTS Significant positive associations between prenatal BPA and symptoms of depression and anxiety were observed among boys. Postnatal BPA exposure was not significantly associated with outcomes. There was substantial co-occurrence of anxiety and depressive symptoms in this sample. CONCLUSION These results provide evidence that prenatal BPA exposure is associated with more symptoms of anxiety and depression in boys but not in girls at age 10-12 years.
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Affiliation(s)
- Frederica Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA.
| | - Emily L Roen Nolte
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Ya Wang
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Amy E Margolis
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Division of Child & Adolescent Psychiatry and the Center for Developmental Neuropsychiatry, Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F17, Atlanta, GA 30341, USA
| | - Shuang Wang
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Wanda Garcia
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; The Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Avenue, New York, NY 10032, USA
| | - Lori A Hoepner
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
| | - Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles and Keck School of Medicine at the University of Southern California, USA
| | - Virginia Rauh
- Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; The Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Avenue, New York, NY 10032, USA
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA
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466
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Scharf M, Mayseless O, Rousseau S. When somatization is not the only thing you suffer from: Examining comorbid syndromes using latent profile analysis, parenting practices and adolescent functioning. Psychiatry Res 2016; 244:10-8. [PMID: 27455145 DOI: 10.1016/j.psychres.2016.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 07/07/2016] [Accepted: 07/07/2016] [Indexed: 11/15/2022]
Abstract
Understanding somatization presents a challenge to clinicians because it is often associated with other syndromes. We addressed somatization's comorbidity with other internalizing syndromes (anxiety, depression, withdrawal) using latent profile analysis. A representative sample of 3496 Israeli middle and high-school youths reported their internalizing symptoms, perceived parenting practices, psychosocial functioning, and health behaviors. Four profiles, similar across age and gender, were identified: overall-low (65.4%), moderately-high anxiety/depression/withdrawal (24.4%), high somatization (4.8%), and overall-high (5.4%). MANOVAs and follow-up ANOVAs revealed that for the most part the overall-high profile evinced the worst parenting, psychosocial functioning, and health behaviors (smoking and drinking), while the overall-low group evinced the best. For most variables the high somatization and moderately high profiles displayed midway results. However, the moderately-high profile reported higher levels of harsh parenting than the high somatization profile. The high somatization profile reported similar or higher levels of smoking, risk taking, vandalism, and rule violation than the overall-high group. High somatization, either alone or alongside anxiety, depression, and withdrawal, was associated with disruptive and risk-taking behaviors. This link might reflect problems in emotion and anger regulation and become stronger in adolescence because of dysregulation processes characterizing this period. Implications for practice are discussed.
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Affiliation(s)
- Miri Scharf
- Department of Counseling and Human Development, University of Haifa, Haifa 3498838, Israel.
| | - Ofra Mayseless
- Department of Counseling and Human Development, University of Haifa, Haifa 3498838, Israel.
| | - Sofie Rousseau
- Department of Counseling and Human Development, University of Haifa, Haifa 3498838, Israel.
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467
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Shaw T, Campbell M, Runions K, Zubrick SR. Properties of the DASS‐21 in an Australian Community Adolescent Population. J Clin Psychol 2016; 73:879-892. [DOI: 10.1002/jclp.22376] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 06/23/2016] [Accepted: 08/14/2016] [Indexed: 11/10/2022]
Affiliation(s)
- T. Shaw
- Telethon Kids Institute
- The University of Western Australia
| | | | - K.C. Runions
- Telethon Kids Institute
- The University of Western Australia
| | - S. R. Zubrick
- Telethon Kids Institute
- Faculty of Education The University of Western Australia
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468
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Bettis AH, Forehand R, Sterba SK, Preacher KJ, Compas BE. Anxiety and Depression in Children of Depressed Parents: Dynamics of Change in a Preventive Intervention. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 47:581-594. [PMID: 27768384 DOI: 10.1080/15374416.2016.1225503] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The current study examined effects of a preventive intervention on patterns of change in symptoms of anxiety and depression in a sample of children of depressed parents. Parents with a history of depression (N = 180) and their children (N = 242; 50% female; Mage = 11.38; 74% Euro-American) enrolled in an intervention to prevent psychopathology in youth. Families were randomized to a family group cognitive behavioral intervention (FGCB) or a written information (WI) control condition. Parents and youth completed the Child Behavior Checklist and Youth Self Report at baseline, 6-, 12-, 18-, and 24-month follow up. Youth in the FGCB intervention reported significantly greater declines in symptoms of both anxiety and depression at 6, 12, and 18 months compared to youth in the WI condition. Youth with higher baseline levels of each symptom (e.g., anxiety) reported greater declines in the other symptom (e.g., depression) from 0 to 6 months in the FGCB intervention only. Changes in anxiety symptoms from 0 to 6 months predicted different patterns of subsequent changes in depressive symptoms from 6 to 12 months for the two conditions, such that declines in anxiety preceded and predicted greater declines in depression for FGCB youth but lesser increases in depression for WI youth. Findings inform transdiagnostic approaches to preventive interventions for at-risk youth, suggesting that both initial symptom levels and initial magnitude of change in symptoms are important to understand subsequent patterns of change in response to intervention.
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Affiliation(s)
- Alexandra H Bettis
- a Department of Psychology and Human Development , Vanderbilt University
| | - Rex Forehand
- b Department of Psychology , University of Vermont
| | - Sonya K Sterba
- a Department of Psychology and Human Development , Vanderbilt University
| | | | - Bruce E Compas
- a Department of Psychology and Human Development , Vanderbilt University
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469
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Betts KS, Baker P, Alati R, McIntosh JE, Macdonald JA, Letcher P, Olsson CA. The natural history of internalizing behaviours from adolescence to emerging adulthood: findings from the Australian Temperament Project. Psychol Med 2016; 46:2815-2827. [PMID: 27439384 DOI: 10.1017/s0033291716001495] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The aims of the study were to describe the patterning and persistence of anxiety and depressive symptoms from adolescence to young adulthood and to examine long-term developmental relationships with earlier patterns of internalizing behaviours in childhood. METHOD We used parallel processes latent growth curve modelling to build trajectories of internalizing from adolescence to adulthood, using seven waves of follow-ups (ages 11-27 years) from 1406 participants of the Australian Temperament Project. We then used latent factors to capture the stability of maternal reported child internalizing symptoms across three waves of early childhood follow-ups (ages 5, 7 and 9 years), and examined relationships among these patterns of symptoms across the three developmental periods, adjusting for gender and socio-economic status. RESULTS We observed strong continuity in depressive symptoms from adolescence to young adulthood. In contrast, adolescent anxiety was not persistent across the same period, nor was it related to later depressive symptoms. Anxiety was, however, related to non-specific stress in young adulthood, but only moderately so. Although childhood internalizing was related to adolescent and adult profiles, the associations were weak and indirect by adulthood, suggesting that other factors are important in the development of internalizing symptoms. CONCLUSIONS Once established, adolescent depressive symptoms are not only strongly persistent, but also have the potential to differentiate into anxiety in young adulthood. Relationships with childhood internalizing symptoms are weak, suggesting that early adolescence may be an important period for targeted intervention, but also that further research into the childhood origins of internalizing behaviours is needed.
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Affiliation(s)
- K S Betts
- The University of Queensland, School of Population Health,Herston,QLD,Australia
| | - P Baker
- The University of Queensland, School of Population Health,Herston,QLD,Australia
| | - R Alati
- The University of Queensland, School of Population Health,Herston,QLD,Australia
| | - J E McIntosh
- Centre for Social and Early Emotional Development, School of Psychology,Faculty of Health,Deakin University, Geelong,VIC,Australia
| | - J A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology,Faculty of Health,Deakin University, Geelong,VIC,Australia
| | - P Letcher
- Department of Paediatrics, Faculty of Medicine,Dentistry and Health Sciences,The University of Melbourne, Parkville,VIC,Australia
| | - C A Olsson
- Centre for Social and Early Emotional Development, School of Psychology,Faculty of Health,Deakin University, Geelong,VIC,Australia
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470
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Wu AMS, Li J, Lau JTF, Mo PKH, Lau MMC. Potential impact of internet addiction and protective psychosocial factors onto depression among Hong Kong Chinese adolescents - direct, mediation and moderation effects. Compr Psychiatry 2016; 70:41-52. [PMID: 27624422 DOI: 10.1016/j.comppsych.2016.06.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 06/12/2016] [Accepted: 06/13/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Internet addiction (IA) is a risk factor while some psychosocial factors can be protective against depression among adolescents. Mechanisms of IA onto depression in terms of mediations and moderations involving protective factors are unknown and were investigated in this study. METHODS A representative cross-sectional study was conducted among Hong Kong Chinese secondary school students (n=9518). RESULTS Among males and females, prevalence of depression at moderate or severe level (CES-D≥21) was 38.36% and 46.13%, and that of IA (CIAS>63) was 17.64% and 14.01%, respectively. Adjusted for socio-demographics, depression was positively associated with IA [males: adjusted odds ratio (AOR)=4.22, 95% CI=3.61-4.94; females: AOR=4.79, 95% CI=3.91-5.87] and negatively associated with psychosocial factors including self-esteem, positive affect, family support, and self-efficacy (males: AOR=0.76-0.94; females: AOR=0.72-0.92, p<.05). The positive association between IA and depression was partially mediated by the protective psychosocial factors (mainly self-esteem) across sexes. Through significant moderations, IA also reduced magnitude of protective effects of self-efficacy and family support among males and that of positive affect among both sexes against depression. CONCLUSIONS The high IA prevalence contributes to increased risk of prevalent depression through its direct effect, mediation (reduced level of protective factors) and moderation (reduced magnitude of protective effects) effects. Understanding to mechanisms between IA and depression through protective factors is enhanced. Screening and interventions for IA and depression are warranted, and should cultivate protective factors, and unlink negative impact of IA onto levels and effects of protective factors.
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Affiliation(s)
- Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
| | - Jibin Li
- Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Mason M C Lau
- Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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471
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Elhai JD, Levine JC, Dvorak RD, Hall BJ. Fear of missing out, need for touch, anxiety and depression are related to problematic smartphone use. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.05.079] [Citation(s) in RCA: 390] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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472
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Garber J, Brunwasser SM, Zerr AA, Schwartz KTG, Sova K, Weersing VR. Treatment and Prevention of Depression and Anxiety in Youth: Test of Cross-Over Effects. Depress Anxiety 2016; 33:939-959. [PMID: 27699941 PMCID: PMC5094283 DOI: 10.1002/da.22519] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 04/04/2016] [Accepted: 04/08/2016] [Indexed: 11/06/2022] Open
Abstract
Anxiety and depression are highly comorbid and share several common etiological processes. Therefore, it may be more efficient to develop interventions that treat or prevent these problems together rather than as separate entities. The present meta-analytic review examined whether interventions for children and adolescents that explicitly targeted either anxiety or depression showed treatment specificity or also impacted the other outcome (i.e. cross-over effects). We addressed this question both within the same type of study (i.e. treatment, prevention) and across study types. Only randomized controlled trials (RCTs) that assessed both constructs with dimensional measures were included in this review. For treatment studies, RCTs targeting anxiety (n = 18) showed significant effects on both anxious and depressive symptoms, although more strongly on anxiety than depression; similarly, RCTs treating depression (n = 9) yielded significant effects on both depressive and anxious symptoms, but stronger effects on depression than anxiety. Thus, there were cross-over effects in treatments purportedly targeting either anxiety or depression, and also treatment specificity, such that larger effects were seen for the target problem at which the treatment was aimed. Anxiety prevention studies (n = 14) significantly affected anxious, but not depressive symptoms, indicating no cross-over effect of anxiety prevention trials on depression. For depression prevention studies (n = 15), the effects were not significant for either depressive or anxiety symptoms, although the effect was significantly larger for depressive than for anxious symptoms. Post-hoc analyses revealed that the effect on depressive symptoms was significant in depression preventions trials of targeted but not universal samples. Implications for transdiagnostic interventions are discussed.
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Affiliation(s)
- Judy Garber
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee.
| | - Steven M Brunwasser
- Division of Allergy, Pulmonary, & Critical Care Medicine, Vanderbilt University School of Medicine
| | - Argero A Zerr
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology
| | - Karen T G Schwartz
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology
| | - Karen Sova
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - V Robin Weersing
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology
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473
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Wolk CB, Carper MM, Kendall PC, Olino TM, Marcus SC, Beidas RS. Pathways to anxiety-depression comorbidity: A longitudinal examination of childhood anxiety disorders. Depress Anxiety 2016; 33:978-986. [PMID: 27433887 PMCID: PMC5050087 DOI: 10.1002/da.22544] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety disorders are prevalent in youth and associated with later depressive disorders. A recent model posits three distinct anxiety-depression pathways. Pathway 1 represents youth with a diathesis to anxiety that increases risk for depressive disorders; Pathway 2 describes youth with a shared anxiety-depression diathesis; and Pathway 3 consists of youth with a diathesis for depression who develop anxiety as a consequence of depression impairment. This is the first partial test of this model following cognitive-behavioral treatment (CBT) for child anxiety. METHOD The present study included individuals (N = 66; M age = 27.23 years, SD = 3.54) treated with CBT for childhood anxiety disorders 7-19 years (M = 16.24; SD = 3.56) earlier. Information regarding anxiety (i.e., social phobia (SoP), separation anxiety disorder (SAD), generalized anxiety disorder (GAD)) and mood disorders (i.e., major depressive disorder (MDD) and dysthymic disorders) was obtained at pretreatment, posttreatment, and one or more follow-up intervals via interviews and self-reports. RESULTS Evidence of pathways from SoP, SAD, and GAD to later depressive disorders was not observed. Treatment responders evidenced reduced GAD and SoP over time, although SoP was observed to have a more chronic and enduring pattern. CONCLUSIONS Evidence for typically observed pathways from childhood anxiety disorders was not observed. Future research should prospectively examine if CBT treatment response disrupts commonly observed pathways.
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Affiliation(s)
- Courtney Benjamin Wolk
- Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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474
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Garnefski N, Kraaij V. Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety. Cogn Emot 2016; 32:1401-1408. [DOI: 10.1080/02699931.2016.1232698] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Nadia Garnefski
- Department of Clinical Psychology, University of Leiden, RB Leiden, The Netherlands
| | - Vivian Kraaij
- Department of Clinical Psychology, University of Leiden, RB Leiden, The Netherlands
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475
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Palmer CA, Alfano CA. Sleep Architecture Relates to Daytime Affect and Somatic Complaints in Clinically Anxious but Not Healthy Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 46:175-187. [PMID: 27610927 DOI: 10.1080/15374416.2016.1188704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
It is increasingly clear that seminal sleep-affective relationships begin to take root in childhood, yet studies exploring how nighttime sleep characteristics relate to daytime affective symptoms, both in clinical and healthy populations of children, are lacking. The current study sought to explore these relationships by investigating whether trait-like and/or daily reports of affective and somatic symptoms of children with generalized anxiety disorder and matched controls relate to sleep architecture. Sixty-six children (ages 7-11; 54.4% female; 56.1% Caucasian; 18.2% biracial; 6.1% African American; 3% Asian; 16.7% Hispanic) participated including 29 with primary generalized anxiety disorder (without comorbid depression) and 37 healthy controls matched on age and race/ethnicity. Participants underwent structured diagnostic assessments including child-report measures and subsequently reported on their negative affect and somatic symptoms over the course of 1 week. Children also completed 1 night of polysomnography. Among children with generalized anxiety disorder only, greater amounts of slow wave sleep corresponded with less negative affect, and greater amounts of rapid eye movement sleep was related to more somatic complaints across the week. Similarly, for trait-like measures, more rapid eye movement sleep and shorter latency to rapid eye movement sleep were related to greater depressive symptoms in the anxious group only. The current findings suggest that physiologic sleep characteristics may contribute in direct ways to the symptom profiles of clinically anxious children. The functional relevance of such findings (e.g., how specific sleep characteristics serve to either increase or reduce long-term risk) is a vital direction for future research.
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Affiliation(s)
- Cara A Palmer
- a Sleep and Anxiety Center of Houston , University of Houston
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476
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Interpersonal Risk Profiles for Youth Depression: A Person-Centered, Multi-Wave, Longitudinal Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:1415-1426. [PMID: 25907029 DOI: 10.1007/s10802-015-0023-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Independent lines of research illustrate the benefits of social support and the negative consequences of conflict and emotional neglect across family and peer contexts with regard to depression. However, few studies have simultaneously examined negative and positive interactions across relationships. We sought to address this gap in the literature by utilizing a person-centered approach to a) understand empirical, interpersonal profiles in youth and b) understand how these profiles confer risk for prospective depression. At baseline, 678 youth (380 females; 298 males) 3rd (N = 208), 6th (N = 245), and 9th graders (N = 225) completed self-report measures for self-perceived negative/positive relationships across family and peers, anxiety symptoms, and depressive symptoms in a laboratory setting. Next, youth were called every 3 months for 18 months and completed self-report depressive and anxiety symptom forms. Two-step cluster analyses suggested that children and adolescents fell into one of three interpersonal clusters, labeled: Support, Conflict, and Neglect. Our analyses supported a convergence model in which the quality of relationship was consistent across peers and family. Furthermore, mixed-level modeling (MLM) findings demonstrated that youth in the Conflict cluster were at increased risk for prospective depressive symptoms, while the Supported and Neglected profiles demonstrated similar symptom levels. Findings were unique to depressive symptoms and consistent across sex and age. Conflict seemed to uniquely confer risk for depression as findings concerning anxiety were not significant. These findings influence our interpersonal conceptualization of depression as well as clinical implications for how to assess and treat depression in youth.
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477
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Kendall PC, Makover H, Swan A, Carper MM, Mercado R, Kagan E, Crawford E. What steps to take? How to approach concerning anxiety in youth. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016. [DOI: 10.1111/cpsp.12156] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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478
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Social Skills Mediate the Association of ADHD and Depression in Preadolescents. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9569-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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479
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Caporino NE, Herres J, Kendall PC, Wolk CB. Dysregulation in Youth with Anxiety Disorders: Relationship to Acute and 7- to 19- Year Follow-Up Outcomes of Cognitive-Behavioral Therapy. Child Psychiatry Hum Dev 2016; 47:539-47. [PMID: 26384978 PMCID: PMC4798924 DOI: 10.1007/s10578-015-0587-2] [Citation(s) in RCA: 9] [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] [Indexed: 02/04/2023]
Abstract
This study evaluated the impact of dysregulation across cognitive, affective, and behavioral domains on acute and 7- to 19-year follow-up outcomes of cognitive-behavioral therapy (CBT) for anxiety, and explored dysregulation as a predictor of psychopathology and impairment in young adulthood among individuals who received anxiety treatment as youth. Participants (N = 64; 50 % female, 83 % non-Hispanic White) from two randomized clinical trials completed a follow-up assessment 7-19 years later. Latent profile analysis identified dysregulation based on Anxious/Depressed, Attention Problems, and Aggressive Behavior scores on the Child Behavior Checklist. Although pretreatment dysregulation was not related to acute or follow-up outcomes for anxiety diagnoses that were the focus of treatment, dysregulation predicted an array of non-targeted psychopathology at follow-up. Among youth with a principal anxiety disorder, the effects of CBT (Coping Cat) appear to be robust against broad impairments in self-regulation. However, youth with a pretreatment dysregulation profile likely need follow-up to monitor for the emergence of other disorders.
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Affiliation(s)
- Nicole E Caporino
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA.
| | - Joanna Herres
- Department of Couple and Family Therapy, Drexel University, Philadelphia, Pennsylvania
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
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480
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Khubchandani J, Brey R, Kotecki J, Kleinfelder J, Anderson J. The Psychometric Properties of PHQ-4 Depression and Anxiety Screening Scale Among College Students. Arch Psychiatr Nurs 2016; 30:457-62. [PMID: 27455918 DOI: 10.1016/j.apnu.2016.01.014] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 01/07/2016] [Accepted: 01/17/2016] [Indexed: 01/04/2023]
Abstract
Depression and anxiety are some of the most common causes of morbidity, social dysfunction, and reduced academic performance in college students. The combination of improved surveillance and access to care would result in better outreach. Brief screening tools can help reach larger populations of college students efficiently. However, reliability and validity of brief screeners for anxiety and depression have not been assessed in college students. Thus, the purpose of this study was to assess in a sample of college students the psychometric properties of PHQ-4, a brief screening tool for depression and anxiety. Undergraduate students were recruited from general education classes at a Midwestern university. Students were given a questionnaire that asked them whether they had been diagnosed by a doctor or health professional with anxiety or depression. Next, they were asked to respond to the items on the PHQ-4 scale. A total of 934 students responded to the survey (response rate=72%). Majority of the participants were females (63%) and Whites (80%). The internal reliability of PHQ-4 was found to be high (α=0.81). Those who were diagnosed with depression or anxiety had statistically significantly higher scores on PHQ-4 (p<0.01). Corrected item total correlations for PHQ-4 were between r=0.66 and r=0.80. PHQ-4 operating characteristics were estimated and area under the curve (AUC) values were 0.835 and 0.787, respectively for anxiety and depression. The PHQ-4 is a reliable and valid tool that can serve as a mass screener for depression and anxiety in young adults. Widespread implementation of this screening tool should be explored across college campuses.
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481
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Burdwood EN, Infantolino ZP, Crocker LD, Spielberg JM, Banich MT, Miller GA, Heller W. Resting-state functional connectivity differentiates anxious apprehension and anxious arousal. Psychophysiology 2016; 53:1451-9. [PMID: 27406406 DOI: 10.1111/psyp.12696] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/26/2016] [Indexed: 12/14/2022]
Abstract
Brain regions in the default mode network (DMN) display greater functional connectivity at rest or during self-referential processing than during goal-directed tasks. The present study assessed resting-state connectivity as a function of anxious apprehension and anxious arousal, independent of depressive symptoms, in order to understand how these dimensions disrupt cognition. Whole-brain, seed-based analyses indicated differences between anxious apprehension and anxious arousal in DMN functional connectivity. Lower connectivity associated with higher anxious apprehension suggests decreased adaptive, inner-focused thought processes, whereas higher connectivity at higher levels of anxious arousal may reflect elevated monitoring of physiological responses to threat. These findings further the conceptualization of anxious apprehension and anxious arousal as distinct psychological dimensions with distinct neural instantiations.
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Affiliation(s)
- Erin N Burdwood
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA.
| | - Zachary P Infantolino
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Laura D Crocker
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, USA
| | - Jeffrey M Spielberg
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, USA
| | - Marie T Banich
- Department of Psychology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Gregory A Miller
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, USA.,Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Wendy Heller
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, USA
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482
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Waszczuk MA, Coulson AE, Gregory AM, Eley TC. A longitudinal twin and sibling study of the hopelessness theory of depression in adolescence and young adulthood. Psychol Med 2016; 46:1935-1949. [PMID: 27019371 DOI: 10.1017/s0033291716000489] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Maladaptive cognitive biases such as negative attributional style and hopelessness have been implicated in the development and maintenance of depression. According to the hopelessness theory of depression, hopelessness mediates the association between attributional style and depression. The aetiological processes underpinning this influential theory remain unknown. The current study investigated genetic and environmental influences on hopelessness and its concurrent and longitudinal associations with attributional style and depression across adolescence and emerging adulthood. Furthermore, given high co-morbidity between depression and anxiety, the study investigated whether these maladaptive cognitions constitute transdiagnostic cognitive content common to both internalizing symptoms. METHOD A total of 2619 twins/siblings reported attributional style (mean age 15 and 17 years), hopelessness (mean age 17 years), and depression and anxiety symptoms (mean age 17 and 20 years). RESULTS Partial correlations revealed that attributional style and hopelessness were uniquely associated with depression but not anxiety symptoms. Hopelessness partially mediated the relationship between attributional style and depression. Hopelessness was moderately heritable (A = 0.37, 95% confidence interval 0.28-0.47), with remaining variance accounted for by non-shared environmental influences. Independent pathway models indicated that a set of common genetic influences largely accounted for the association between attributional style, hopelessness and depression symptoms, both concurrently and across development. CONCLUSIONS The results provide novel evidence that associations between attributional style, hopelessness and depression symptoms are largely due to shared genetic liability, suggesting developmentally stable biological pathways underpinning the hopelessness theory of depression. Both attributional style and hopelessness constituted unique cognitive content in depression. The results inform molecular genetics research and cognitive treatment approaches.
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Affiliation(s)
- M A Waszczuk
- King's College London,MRC Social, Genetic and Developmental Psychiatry Centre,Institute of Psychiatry, Psychology and Neuroscience,London,UK
| | - A E Coulson
- King's College London,MRC Social, Genetic and Developmental Psychiatry Centre,Institute of Psychiatry, Psychology and Neuroscience,London,UK
| | - A M Gregory
- Department of Psychology,Goldsmiths,University of London,London,UK
| | - T C Eley
- King's College London,MRC Social, Genetic and Developmental Psychiatry Centre,Institute of Psychiatry, Psychology and Neuroscience,London,UK
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483
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Pace U, Zappulla C, Di Maggio R. The mediating role of perceived peer support in the relation between quality of attachment and internalizing problems in adolescence: a longitudinal perspective. Attach Hum Dev 2016; 18:508-24. [DOI: 10.1080/14616734.2016.1198919] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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484
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Hamann C, Schultze-Lutter F, Tarokh L. Web-Based Assessment of Mental Well-Being in Early Adolescence: A Reliability Study. J Med Internet Res 2016; 18:e138. [PMID: 27306932 PMCID: PMC4927803 DOI: 10.2196/jmir.5482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 03/22/2016] [Accepted: 04/17/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The ever-increasing use of the Internet among adolescents represents an emerging opportunity for researchers to gain access to larger samples, which can be queried over several years longitudinally. Among adolescents, young adolescents (ages 11 to 13 years) are of particular interest to clinicians as this is a transitional stage, during which depressive and anxiety symptoms often emerge. However, it remains unclear whether these youngest adolescents can accurately answer questions about their mental well-being using a Web-based platform. OBJECTIVE The aim of the study was to examine the accuracy of responses obtained from Web-based questionnaires by comparing Web-based with paper-and-pencil versions of depression and anxiety questionnaires. METHODS The primary outcome was the score on the depression and anxiety questionnaires under two conditions: (1) paper-and-pencil and (2) Web-based versions. Twenty-eight adolescents (aged 11-13 years, mean age 12.78 years and SD 0.78; 18 females, 64%) were randomly assigned to complete either the paper-and-pencil or the Web-based questionnaire first. Intraclass correlation coefficients (ICCs) were calculated to measure intrarater reliability. Intraclass correlation coefficients were calculated separately for depression (Children's Depression Inventory, CDI) and anxiety (Spence Children's Anxiety Scale, SCAS) questionnaires. RESULTS On average, it took participants 17 minutes (SD 6) to answer 116 questions online. Intraclass correlation coefficient analysis revealed high intrarater reliability when comparing Web-based with paper-and-pencil responses for both CDI (ICC=.88; P<.001) and the SCAS (ICC=.95; P<.001). According to published criteria, both of these values are in the "almost perfect" category indicating the highest degree of reliability. CONCLUSIONS The results of the study show an excellent reliability of Web-based assessment in 11- to 13-year-old children as compared with the standard paper-pencil assessment. Furthermore, we found that Web-based assessments with young adolescents are highly feasible, with all enrolled participants completing the Web-based form. As early adolescence is a time of remarkable social and behavioral changes, these findings open up new avenues for researchers from diverse fields who are interested in studying large samples of young adolescents over time.
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Affiliation(s)
- Christoph Hamann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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485
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Family process and youth internalizing problems: A triadic model of etiology and intervention. Dev Psychopathol 2016; 29:273-301. [DOI: 10.1017/s095457941600016x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDespite major advances in the development of interventions for youth anxiety and depression, approximately 30% of youths with anxiety do not respond to cognitive behavioral treatment, and youth depression treatments yield modest symptom decreases overall. Identifying networks of modifiable risk and maintenance factors that contribute to both youth anxiety and depression (i.e., internalizing problems) may enhance and broaden treatment benefits by informing the development of mechanism-targeted interventions. A particularly powerful network is the rich array of family processes linked to internalizing problems (e.g., parenting styles, parental mental health problems, and sibling relationships). Here, we propose a new theoretical model, the triadic modelof family process, to organize theory and evidence around modifiable, transdiagnostic family factors that may contribute to youth internalizing problems. We describe the model's implications for intervention, and we propose strategies for testing the model in future research. The model provides a framework for studying associations among family processes, their relation to youth internalizing problems, and family-based strategies for strengthening prevention and treatment.
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486
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Parental Attitudes, Beliefs, and Understanding of Anxiety (PABUA): Development and psychometric properties of a measure. J Anxiety Disord 2016; 39:71-78. [PMID: 26970877 PMCID: PMC4811694 DOI: 10.1016/j.janxdis.2016.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/16/2016] [Accepted: 03/03/2016] [Indexed: 11/23/2022]
Abstract
The Parental Attitudes, Beliefs, and Understanding of Anxiety (PABUA) was developed to assess parental beliefs about their child's anxiety, parents' perceived ability to cope with their child's anxiety and to help their child manage anxious symptoms, and to evaluate parents' understanding of various parenting strategies in response to their child's anxiety. The study evaluated the PABUA in mother-child dyads (N=192) seeking treatment for youth anxiety. Exploratory factor analysis yielded a three-factor solution and identified PABUA scales of Overprotection, Distress, and Approach (with Cronbach's alpha ranging from .67 to .83). Convergent and divergent validity of PABUA scales was supported by the pattern of associations with measures of experiential avoidance, beliefs related to children's anxiety, empathy, trait anxiety, and depressive symptoms; parent-reported family functioning; parent- and youth-reported anxiety severity; and parent-reported functional impairment (n=83). Results provide preliminary support for the PABUA as a measure of parental attitudes and beliefs about anxiety, and future studies that investigate this measure with large and diverse samples are encouraged.
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487
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Kunin-Batson AS, Lu X, Balsamo L, Graber K, Devidas M, Hunger SP, Carroll WL, Winick NJ, Mattano LA, Maloney KW, Kadan-Lottick NS. Prevalence and predictors of anxiety and depression after completion of chemotherapy for childhood acute lymphoblastic leukemia: A prospective longitudinal study. Cancer 2016; 122:1608-17. [PMID: 27028090 DOI: 10.1002/cncr.29946] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/08/2015] [Accepted: 01/11/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The months immediately after the completion of treatment for childhood acute lymphoblastic leukemia (ALL) are often regarded as a stressful time for children and families. In this prospective, longitudinal study, the prevalence and predictors of anxiety and depressive symptoms after the completion of treatment were examined. METHODS Participants included 160 children aged 2 to 9 years with standard-risk ALL who were enrolled on Children's Oncology Group protocol AALL0331. Parents completed standardized rating scales of their children's emotional-behavioral functioning and measures of coping and family functioning at approximately 1 month, 6 months, and 12 months after diagnosis and again 3 months after the completion of chemotherapy. RESULTS At 3 months off therapy, approximately 24% of survivors had at-risk/clinically elevated anxiety scores and 28% had elevated depression scores, which are significantly higher than the expected 15% in the general population (P = .028 and .001, respectively). Patients with elevated anxiety 1 month after diagnosis were at greater risk of off-therapy anxiety (odds ratio, 4.1; 95% confidence interval, 1.31-12.73 [P = .022]) and those with elevated depressive symptoms 6 months after diagnosis were at greater risk of off-therapy depression (odds ratio, 7.88; 95% confidence interval, 2.61-23.81 [P = .0002]). In adjusted longitudinal analyses, unhealthy family functioning (P = .008) and less reliance on social support coping (P = .009) were found to be associated with risk of emotional distress. Children from Spanish-speaking families (P = .05) also were found to be at a greater risk of distress. CONCLUSIONS A significant percentage of children experience emotional distress during and after therapy for ALL. These data provide a compelling rationale for targeted early screening and psychosocial interventions to support family functioning and coping skills. Cancer 2016;122:1608-17. © 2015 American Cancer Society.
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Affiliation(s)
- Alicia S Kunin-Batson
- HealthPartners Institute, Minneapolis, Minnesota.,Division of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - Xiaomin Lu
- Division of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.,Department of Biostatistics, Colleges of Medicine, Public Health, and Health Professions, University of Florida, Gainesville, Florida
| | - Lyn Balsamo
- Department of Pediatric Hematology/Oncology, Yale University School of Medicine, Yale Comprehensive Cancer Center, New Haven, Connecticut
| | - Kelsey Graber
- Yale University Child Study Center, New Haven, Connecticut
| | - Meenakshi Devidas
- Department of Biostatistics, Colleges of Medicine, Public Health, and Health Professions, University of Florida, Gainesville, Florida
| | - Stephen P Hunger
- Center for Childhood Cancer Research, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - William L Carroll
- Department of Pediatrics, New York University Langone Medical Center, Stephen D. Hassenfeld Children's Center for Cancer and Blood Disorders, New York, New York
| | - Naomi J Winick
- Department of Pediatric Hematology/Oncology, University of Texas Southwestern School of Medicine, Dallas, Texas
| | | | - Kelly W Maloney
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Nina S Kadan-Lottick
- Department of Pediatric Hematology/Oncology, Yale University School of Medicine, Yale Comprehensive Cancer Center, New Haven, Connecticut
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488
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Liu L, Zhou X, Zhang Y, Liu Y, Yang L, Pu J, Zhu D, Zhou C, Xie P. The identification of metabolic disturbances in the prefrontal cortex of the chronic restraint stress rat model of depression. Behav Brain Res 2016; 305:148-56. [PMID: 26947756 DOI: 10.1016/j.bbr.2016.03.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/26/2016] [Accepted: 03/01/2016] [Indexed: 01/08/2023]
Abstract
Major depressive disorder, with serious impairment in cognitive and social functioning, is a complex psychiatric disorder characterized by pervasive and persistent low mood and a loss of interest or pleasure. However, the underlying molecular mechanisms of depression remain largely unknown. In this study, we used a non-targeted metabolomics approach based on gas chromatography-mass spectrometry of the prefrontal cortex in chronic restraint stress (CRS)-treated rats. CRS was induced in the stress group by restraining rats in a plastic restrainer for 6h every day. This stress paradigm continued for 21 days. Body weight measurement and behavior tests were applied, including the sucrose preference test for anhedonia, the forced swimming test for despair-like behavior, and open field test and the elevated plus-maze to test for anxiety-like behaviors in rats after CRS. Differentially expressed metabolites associated with CRS-treated rats were identified by combining multivariate and univariate statistical analysis and corrected for multiple testing using the Benjamini-Hochberg procedure. A heat map of differential metabolites was constructed using Matlab. Ingenuity Pathways Analysis was applied to identify the predicted pathways and biological functions relevant to the bio-molecules of interest. Our findings showed that CRS induces depression-like behaviors and not anxiety-like behaviors. Thirty-six metabolites were identified as potential depression biomarkers involved in amino acid metabolism, energy metabolism and lipid metabolism, as well as a disturbance in neurotransmitters. Consequently, this study provides useful insights into the molecular mechanisms of depression.
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Affiliation(s)
- Lanxiang Liu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Xinyu Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Yuqing Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Yiyun Liu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Lining Yang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Dan Zhu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chanjuan Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China.
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489
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Martinsen KD, Kendall PC, Stark K, Neumer SP. Prevention of Anxiety and Depression in Children: Acceptability and Feasibility of the Transdiagnostic EMOTION Program. COGNITIVE AND BEHAVIORAL PRACTICE 2016. [DOI: 10.1016/j.cbpra.2014.06.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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490
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Gross M, Pinhasov A. Chronic mild stress in submissive mice: Marked polydipsia and social avoidance without hedonic deficit in the sucrose preference test. Behav Brain Res 2016; 298:25-34. [DOI: 10.1016/j.bbr.2015.10.049] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 10/20/2015] [Accepted: 10/25/2015] [Indexed: 12/15/2022]
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491
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Starr LR, Stroud CB, Li YI. Predicting the transition from anxiety to depressive symptoms in early adolescence: Negative anxiety response style as a moderator of sequential comorbidity. J Affect Disord 2016; 190:757-763. [PMID: 26615364 DOI: 10.1016/j.jad.2015.10.065] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 10/02/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Anxiety often precedes depression. The anxiety response styles theory of comorbidity suggests anxious individuals with a tendency to ruminate or make hopeless attributions about anxiety symptoms (negative anxiety response styles [NARS]) are more vulnerable to subsequent depressive symptoms. However, this theory has never been tested in adolescence, when the anxiety-depression transition may frequently occur, or using an extended (one-year) follow-up period. METHOD 128 early adolescent girls (M=12.39 years) participated with caregivers in a one-year longitudinal study. At baseline and follow-up, participants completed diagnostic interviews and self-report measures assessing child NARS and brooding rumination. RESULTS T1 NARS predicted longitudinal elevations in depressive symptoms and increased associations between T1 anxiety and T2 depressive symptoms. LIMITATIONS This study examines anxiety and depression comorbidity using a community sample. The sample is relatively low on sociodemographic diversity. CONCLUSIONS Results support the anxiety response styles theory, with potential implications for early identification of anxious youth at risk for later development of comorbid depression.
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492
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Papachristou E, Schulz K, Newcorn J, Bédard ACV, Halperin JM, Frangou S. Comparative Evaluation of Child Behavior Checklist-Derived Scales in Children Clinically Referred for Emotional and Behavioral Dysregulation. Front Psychiatry 2016; 7:146. [PMID: 27605916 PMCID: PMC4995201 DOI: 10.3389/fpsyt.2016.00146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/08/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We recently developed the Child Behavior Checklist-Mania Scale (CBCL-MS), a novel and short instrument for the assessment of mania-like symptoms in children and adolescents derived from the CBCL item pool and have demonstrated its construct validity and temporal stability in a longitudinal general population sample. OBJECTIVE The aim of this study was to evaluate the construct validity of the 19-item CBCL-MS in a clinical sample and to compare its discriminatory ability to that of the 40-item CBCL-dysregulation profile (CBCL-DP) and the 34-item CBCL-Externalizing Scale. METHODS The study sample comprised 202 children, aged 7-12 years, diagnosed with DSM-defined attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), and mood and anxiety disorders based on the Diagnostic Interview Schedule for Children. The construct validity of the CBCL-MS was tested by means of a confirmatory factor analysis. Receiver operating characteristics (ROC) curves and logistic regression analyses adjusted for sex and age were used to assess the discriminatory ability relative to that of the CBCL-DP and the CBCL-Externalizing Scale. RESULTS The CBCL-MS had excellent construct validity (comparative fit index = 0.97; Tucker-Lewis index = 0.96; root mean square error of approximation = 0.04). Despite similar overall performance across scales, the clinical range scores of the CBCL-DP and the CBCL-Externalizing Scale were associated with higher odds for ODD and CD, while the clinical range scores of the CBCL-MS were associated with higher odds for mood disorders. The concordance rate among the children who scored within the clinical range of each scale was over 90%. CONCLUSION CBCL-MS has good construct validity in general population and clinical samples and is therefore suitable for both clinical practice and research.
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Affiliation(s)
- Efstathios Papachristou
- Department of Primary Care and Population Health, University College London (UCL) , London , UK
| | - Kurt Schulz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Jeffrey Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Anne-Claude V Bédard
- Ontario Institute for Studies in Education, University of Toronto , Toronto, ON , Canada
| | - Jeffrey M Halperin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychology, Queens College, New York, NY, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
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493
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Cornacchio D, Crum KI, Coxe S, Pincus DB, Comer JS. Irritability and Severity of Anxious Symptomatology Among Youth With Anxiety Disorders. J Am Acad Child Adolesc Psychiatry 2016; 55:54-61. [PMID: 26703910 PMCID: PMC5340317 DOI: 10.1016/j.jaac.2015.10.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/23/2015] [Accepted: 10/26/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Most research on irritability and child psychopathology has focused on depressive disorders, bipolar disorder, and/or oppositional defiant disorder (ODD). Less is known about relationships between child anxiety and irritability and moderators of such associations. METHOD Structural equation modeling (SEM) was used to examine associations between anxiety severity and irritability in a large sample of treatment-seeking youth with anxiety disorders (N = 663, aged 7-19 years, mean = 12.25 years), after accounting for comorbid depressive disorders and ODD. Additional analyses examined whether associations were moderated by child gender, age, and generalized anxiety disorder (GAD) status. RESULTS There was a direct link between child anxiety and irritability even after accounting for comorbid depressive disorders and ODD. Links between child anxiety and irritability were robust across child gender and age. Furthermore, relationships between child anxiety and irritability were comparable across youth with and without GAD, suggesting that the anxiety-irritability link is relevant across child anxiety disorders and not confined to youth with GAD. CONCLUSION Findings add to an increasing body of evidence linking child irritability to a range of internalizing and externalizing psychopathologies, and suggest that child anxiety assessment should systematically incorporate irritability evaluations. Moreover, youth in clinical settings displaying irritability should be assessed for the presence of anxiety. Treatments for childhood anxiety may do well to incorporate new treatment modules as needed that specifically target problems of irritability.
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Affiliation(s)
- Danielle Cornacchio
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami
| | - Kathleen I. Crum
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami
| | - Stefany Coxe
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami
| | - Donna B. Pincus
- Center for Anxiety and Related Disorders (CARD), Boston University, Boston
| | - Jonathan S. Comer
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami
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494
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Kendall PC, Cummings CM, Villabø MA, Narayanan MK, Treadwell K, Birmaher B, Compton S, Piacentini J, Sherrill J, Walkup J, Gosch E, Keeton C, Ginsburg G, Suveg C, Albano AM. Mediators of change in the Child/Adolescent Anxiety Multimodal Treatment Study. J Consult Clin Psychol 2016; 84:1-14. [PMID: 26460572 PMCID: PMC4695375 DOI: 10.1037/a0039773] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). METHOD Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. RESULTS Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. CONCLUSIONS The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator.
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Affiliation(s)
| | | | | | - Martina K Narayanan
- Department of Psychology, The Norwegian Center for Child Behavioral Development
| | | | | | - Scott Compton
- Department of Psychiatry and Behavioral Sciences, Duke University
| | - John Piacentini
- Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles
| | - Joel Sherrill
- Child and Adolescent Mental Health, National Institute of Mental Health
| | - John Walkup
- Department of Child and Adolescent Psychiatry, Cornell University
| | - Elizabeth Gosch
- Department of Psychology, Philadelphia College of Osteopathic Medicine
| | - Courtney Keeton
- Department of Child and Adolescent Psychiatry, Johns Hopkins University
| | - Golda Ginsburg
- Department of Child and Adolescent Psychiatry, Johns Hopkins University
| | - Cindy Suveg
- Department of Psychology, University of Georgia
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495
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Gensthaler A, Maichrowitz V, Kaess M, Ligges M, Freitag CM, Schwenck C. Selective Mutism: The Fraternal Twin of Childhood Social Phobia. Psychopathology 2016; 49:95-107. [PMID: 27089281 DOI: 10.1159/000444882] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/21/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Selective mutism (SM) is an anxiety disorder with a close link to childhood social phobia (SP). Our studies compare behavioral problem profiles in children and adolescents with SM and SP and control groups and assess the comorbidity patterns of SM and SP. METHODS Participants aged 3-18 years with SM (n = 95), SP (n = 74) and internalizing disorders (INT, n = 46) and a typically developing control group (CG, n = 119) were assessed with the Child Behavior Checklist (CBCL); adolescents were additionally assessed with the Youth Self-Report (YSR). Comorbidity was assessed in SM and SP participants with a diagnostic interview. RESULTS SP was detected in 94% of children with SM. SM participants showed different behavioral and psychiatric symptoms than SP: they were more frequently affected by lifetime separation anxiety disorder (SM: 45%, SP: 26%) and oppositional defiant disorder (SM: 22%, SP: 5%), and less by generalized anxiety disorder (SM: 6%, SP: 20%) and major depression (SM: 12%, SP: 26%). Adolescents with SM showed high rates of agoraphobia (SM 27%; SP 10%) and more social problems (YSR), and were more withdrawn (CBCL, YSR) than those with SP alone. Specific behavioral problems of SM and SP compared to INT and CG were observed. CONCLUSION SM and SP represent separate but closely related disorders, distinct from other INT and CG, with specific patterns of lifetime comorbidities.
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Affiliation(s)
- Angelika Gensthaler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, Frankfurt am Main, Germany
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496
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Hoff AL, Kendall PC, Langley A, Ginsburg G, Keeton C, Compton S, Sherrill J, Walkup J, Birmaher B, Albano AM, Suveg C, Piacentini J. Developmental Differences in Functioning in Youth With Social Phobia. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:686-694. [PMID: 26630122 DOI: 10.1080/15374416.2015.1079779] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Social phobia (SoP) in youth may manifest differently across development as parent involvement in their social lives changes and social and academic expectations increase. This cross-sectional study investigated whether self-reported and parent-reported functioning in youth with SoP changes with age in social, academic, and home/family domains. Baseline anxiety impairment data from 488 treatment-seeking anxiety-disordered youth (ages 7-17, N = 400 with a SoP diagnosis) and their parents were gathered using the Child Anxiety Impact Scale and were analyzed using generalized estimating equations. According to youth with SoP and their parents, overall difficulties, social difficulties, and academic difficulties increased with age, even when controlling for SoP severity. These effects significantly differed for youth with anxiety disorders other than SoP. Adolescents may avoid social situations as parental involvement in their social lives decreases, and their withdrawn behavior may result in increasing difficulty in the social domain. Their avoidance of class participation and oral presentations may increasingly impact their academic performance as school becomes more demanding. Implications are discussed for the early detection and intervention of SoP to prevent increased impairment over the course of development.
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Affiliation(s)
| | | | - Audra Langley
- b Department of Psychiatry , University of California , Los Angeles
| | - Golda Ginsburg
- c Department of Psychiatry , University of Connecticut School of Medicine
| | - Courtney Keeton
- d Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine
| | - Scott Compton
- e Department of Psychiatry and Behavioral Science , Duke University Medical Center
| | | | - John Walkup
- g Division of Child and Adolescent Psychiatry , Weill Cornell Medical College
| | - Boris Birmaher
- h Western Psychiatric Institute and Clinic , University of Pittsburgh Medical Center
| | | | | | - John Piacentini
- b Department of Psychiatry , University of California , Los Angeles
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497
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Liu W, Lei H, Li L, Yi J, Zhong M, Yang Y, Zhu X. Factorial invariance of the mood and anxiety symptom questionnaire-short form across gender. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2015.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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498
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Storch EA, Salloum A, King MA, Crawford EA, Andel R, McBride NM, Lewin AB. A RANDOMIZED CONTROLLED TRIAL IN COMMUNITY MENTAL HEALTH CENTERS OF COMPUTER-ASSISTED COGNITIVE BEHAVIORAL THERAPY VERSUS TREATMENT AS USUAL FOR CHILDREN WITH ANXIETY. Depress Anxiety 2015; 32:843-52. [PMID: 26366886 DOI: 10.1002/da.22399] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE This study aims to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. METHODS One hundred children (7-13 years) with clinically significant anxiety were randomized to receive either 12 weekly computer-assisted CBT sessions or TAU for an equivalent duration. Assessments were conducted by independent evaluators at screening/baseline, midtreatment, posttreatment, and 1-month followup (for computer-assisted CBT treatment responders). RESULTS There were significant between-group effects favoring the computer-assisted CBT condition on primary anxiety outcomes. Thirty of 49 (61.2%) children randomized to computer-assisted CBT responded to treatment, which was superior to TAU (6/51, 11.8%). Relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms. Treatment satisfaction and therapeutic alliance in those receiving computer-assisted CBT was high. Treatment gains in computer-assisted CBT responders were maintained at 1-month followup. CONCLUSIONS Within the limitations of this study, computer-assisted CBT is an effective and feasible treatment for anxious children when used in community mental health centers by CBT-naïve clinicians.
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Affiliation(s)
- Eric A Storch
- Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida.,Department of Health Policy and Management, University of South Florida, St. Petersburg, Florida.,Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida.,Department of Psychology, University of South Florida, St. Petersburg, Florida.,Rogers Behavioral Health - Tampa Bay, Florida.,Mind-Body Branch, All Children's Hospital - Johns Hopkins Medicine, St. Petersburg, Florida
| | - Alison Salloum
- School of Social Work, University of South Florida, St. Petersburg, Tampa Bay, Florida
| | - Morgan A King
- Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
| | - Erika A Crawford
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Ross Andel
- School of Aging Studies, University of South Florida, St. Petersburg, Florida
| | - Nicole M McBride
- Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
| | - Adam B Lewin
- Rothman Center for Neuropsychiatry, Department of Pediatrics, University of South Florida, St. Petersburg, Florida.,Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, Florida.,Department of Psychology, University of South Florida, St. Petersburg, Florida
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499
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Lenz AS. Meta-Analysis of The Coping Cat Program for Decreasing Severity of Anxiety Symptoms Among Children and Adolescents. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/23727810.2015.1079116] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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500
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Fernandez Castelao C, Naber K, Altstädt S, Kröner-Herwig B, Ruhl U. Two dimensions of social anxiety disorder: a pilot study of the Questionnaire for Social Anxiety and Social Competence Deficits for Adolescents. Child Adolesc Psychiatry Ment Health 2015; 9:47. [PMID: 26451164 PMCID: PMC4597769 DOI: 10.1186/s13034-015-0079-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 09/04/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Questionnaire for Social Anxiety and Social Competence Deficits for Adolescents (SASKO-J) was developed as an instrument for clinical diagnostics of social anxiety disorder in youths by measuring social anxiety and social deficits in two separate dimensions. The study provides an initial assessment of the scale's psychometric properties in a clinical sample. METHOD The reliability and validity of the SASKO-J were assessed in a mixed clinical sample of 12- to 19-year-old German adolescents (N = 85; mean age 15.71 years; SD = 1.92; 62.4 % girls). In a second step, the diagnostic validity was evaluated in a clinical sample of 31 adolescent patients with social anxiety disorder (mean age 16.10 years; SD = 1.54; 74.2 % girls) and a sample of 115 German high school students (mean age 15.84 years; SD = 1.65; 60.9 % girls) via Receiver Operating Characteristic (ROC) analysis. RESULTS The internal consistencies of the total scale and the subscales were good to excellent (0.80 ≤ α ≤ 0.96), and the results indicated a good convergent and divergent validity. The ROC analysis revealed a satisfying area under curve (AUC = 0.866), and a cutoff of 41.5 for the SASKO-J total score represented the best balance of sensitivity (0.806) and specificity (0.826). CONCLUSIONS The results of this pilot study provide initial support for the clinical use of the SASKO-J in the diagnostic process. Future research should address the question of psychometric properties in a social anxiety disorder sample as well as the questionnaire's sensitivity for detecting change in symptoms during therapy.
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Affiliation(s)
- Carolin Fernandez Castelao
- Department of Clinical Psychology and Psychotherapy, Georg-August-University of Göttingen, Gosslerstr. 14, 37073 Göttingen, Germany
| | - Katharina Naber
- Department of Clinical Psychology and Psychotherapy, Georg-August-University of Göttingen, Gosslerstr. 14, 37073 Göttingen, Germany
| | - Stefanie Altstädt
- Department of Clinical Psychology and Psychotherapy, Georg-August-University of Göttingen, Gosslerstr. 14, 37073 Göttingen, Germany
| | - Birgit Kröner-Herwig
- Department of Clinical Psychology and Psychotherapy, Georg-August-University of Göttingen, Gosslerstr. 14, 37073 Göttingen, Germany
| | - Uwe Ruhl
- Department of Clinical Psychology and Psychotherapy, Georg-August-University of Göttingen, Gosslerstr. 14, 37073 Göttingen, Germany
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