51
|
Vancampfort D, Stubbs B, Firth J, Van Damme T, Koyanagi A. Sedentary behavior and depressive symptoms among 67,077 adolescents aged 12-15 years from 30 low- and middle-income countries. Int J Behav Nutr Phys Act 2018; 15:73. [PMID: 30089487 PMCID: PMC6083627 DOI: 10.1186/s12966-018-0708-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is common and burdensome in adolescents. Understanding modifiable environmental risk factors is essential. There is evidence that physical activity is protective of depression. However, the impact of sedentary behavior (SB) on depression is relatively under-researched especially in low- and middle-income countries (LMICs). In this cross-sectional study, we explored the association between SB and depressive symptoms in adolescents from 30 LMICs, controlling for confounders including physical activity. METHOD Data from the Global school-based Student Health Survey were analyzed in 67,077 adolescents [mean (SD) age 13.8 (0.9) years; 50.6% girls). Self-report measures assessed depressive symptoms during the past 12 months, and SB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework. Multivariable logistic regression analysis was conducted and a countrywide meta-analysis undertaken. RESULTS The prevalence of depressive symptoms and ≥ 3 h/day of SB were 28.7 and 30.6%, respectively. There was a linear increase in the prevalence of depressive symptoms with increasing sedentary time beyond ≥3 h/day (vs. < 1 h/day). Among boys, 1-2 h/day of SB was associated with lower odds for depression (vs. < 1 h/day). Countrywide meta-analysis demonstrated that spending ≥3 h/day versus < 3 h/day was associated with a 20% increased odds for depressive symptoms (OR = 1.20; 95% CI = 1.16-1.24) with low between-country heterogeneity (I2 = 27.6%). CONCLUSION Our data indicate that being sedentary for ≥3 h/day is associated with increased odds for depressive symptoms in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public interventions which aim to limit the time spent being sedentary in adolescents.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, Box SE5 8AF UK
| | - Joseph Firth
- NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 0883 Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029 Madrid, Spain
| |
Collapse
|
52
|
Guo L, Tian L, Scott Huebner E. Family dysfunction and anxiety in adolescents: A moderated mediation model of self-esteem and perceived school stress. J Sch Psychol 2018; 69:16-27. [PMID: 30558751 DOI: 10.1016/j.jsp.2018.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 01/10/2018] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
This 18-month longitudinal study examined a moderated mediation model addressing the psychosocial mechanisms that account for the association between family dysfunction and anxiety. A sample of 847 Chinese early adolescents (M age = 12.96 years, SD = 0.67) completed questionnaires assessing family dysfunction, self-esteem, perceived school stress, and anxiety on three occasions at 6-month intervals. After gender and socioeconomic status were included as covariates, the results revealed that family dysfunction was significantly associated with adolescents' anxiety. Moreover, self-esteem partially mediated the relation between family dysfunction and anxiety, and perceived school stress moderated the mediation process in the family dysfunction to anxiety path and in the self-esteem to anxiety path. The findings suggested that both social contextual factors (e.g., family dysfunction and school stress) and self-system factors (e.g., low self-esteem) are risk factors for increased anxiety levels in adolescents. Limitations and practical applications of the study were discussed.
Collapse
Affiliation(s)
- Leilei Guo
- School of Psychology, South China Normal University, Guangzhou 510631, People's Republic of China; Center for Studies of Psychological Application, South China Normal University, Guangzhou 510631, People's Republic of China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, People's Republic of China
| | - Lili Tian
- School of Psychology, South China Normal University, Guangzhou 510631, People's Republic of China; Center for Studies of Psychological Application, South China Normal University, Guangzhou 510631, People's Republic of China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, People's Republic of China.
| | - E Scott Huebner
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
53
|
Self-concept, Social Skills, and Resilience as Moderators of the Relationship Between Stress and Childhood Depression. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9268-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
54
|
Gundel LK, Pedersen CB, Munk-Olsen T, Dalsgaard S. Longitudinal association between mental disorders in childhood and subsequent depression - A nationwide prospective cohort study. J Affect Disord 2018; 227:56-64. [PMID: 29053976 DOI: 10.1016/j.jad.2017.10.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/20/2017] [Accepted: 10/04/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression ranges among the most impairing mental disorders worldwide, and early detection is a global health priority. Little is known about the association between non-affective mental disorders in childhood/adolescence and later depression. METHODS Nationwide register-based prospective cohort study, estimating cumulative incidences and incidence rate ratios (IRR) for later depression in individuals with and without non-affective mental disorders in early life. RESULTS 475,213 females and 484,813 males born 1990-2007 were followed for a mean of 9.14 years (contributing a total of 8778,331 person-years of observation). In the cohort, 7963 (5451 females) were diagnosed with depression. Depression was more common in individuals with prior non-affective mental disorders in adolescence (15.98% in females and 7.02% in males) and in childhood (4.98% in females and 1.6% in males), than in the background population (3.94% and 1.3% in females; 1.37% and 0.47% in males). Eating and anxiety disorders in childhood/adolescence carried the highest absolute risk of depression. The relative risk of depression was particularly high the first year after the first non-affective disorder (IRR = 15.5; 14.07-17.10), but remained highly elevated more than five years after the first non-affective diagnosis (IRR = 2.05; 1.84-2.28), when compared to young people without such disorders. LIMITATIONS This study only included diagnoses given at hospital departments, representing the more severe mental disorders. CONCLUSIONS Children and adolescents with non-affective mental disorders were at substantially increased absolute and relative risk of developing depression in young adulthood, especially females diagnosed with anxiety- or eating disorders in adolescence. These findings may help identify groups of children and adolescents at very high risk of developing depression.
Collapse
Affiliation(s)
- Louise Krarup Gundel
- National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark.
| | - Carsten Bøcker Pedersen
- National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Centre for Integrated Register-based Research at Aarhus University, CIRRAU, Denmark.
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark.
| | - Søren Dalsgaard
- National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Centre for Integrated Register-based Research at Aarhus University, CIRRAU, Denmark; Department for Child and Adolescent Psychiatry, Hospital of Telemark, Kragerø, Norway.
| |
Collapse
|
55
|
Nourkova VV, Vasilenko DA. On the advantage of autobiographical memory pliability: implantation of positive self-defining memories reduces trait anxiety. Memory 2017; 26:869-881. [PMID: 29284340 DOI: 10.1080/09658211.2017.1420195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This paper is devoted to the mechanism of the positive construction of autobiographical memory. Positive construction consists of the spontaneous transformation of memories in the direction of the subjective enhancement of self-competence in past activities to anticipate improvement over time. We speculated that trait anxiety may indicate a failure to exhibit this mechanism that results in a deficit of affirmative self-esteem. We hypothesised that the implantation of positive self-defining memories in anxiety-evoking domains would decrease trait anxiety. One hundred twenty adults recollected three negative self-defining memories. Then, half of the participants imagined episodes of desired behaviour that differed from the originally recollected ones either in discussion or in hypnosis. Thirty participants experienced a hypnotic state without any references to memories, and the rest formed the control group. Subjects from the "Memory Implantation in Hypnosis" group became unable to distinguish the originally reported memories from the imagined ones, exhibited decreased trait anxiety scores after a 4-month delay, and reported enhanced self-esteem. In contrast, the participants from the "Hypnosis with no reference to the past" group exhibited decreased scores at a short delay but later returned to their original scores. These findings highlight the power of cured episodic-like autobiographical memory for updating the self.
Collapse
Affiliation(s)
- Veronika V Nourkova
- a Department of General Psychology , Lomonosov Moscow State University , Moscow , Russia
| | - Darya A Vasilenko
- a Department of General Psychology , Lomonosov Moscow State University , Moscow , Russia
| |
Collapse
|
56
|
Sun B, Zhang Z, Liu X, Hu B, Zhu T. Self-esteem recognition based on gait pattern using Kinect. Gait Posture 2017; 58:428-432. [PMID: 28910655 DOI: 10.1016/j.gaitpost.2017.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 08/19/2017] [Accepted: 09/04/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Self-esteem is an important aspect of individual's mental health. When subjects are not able to complete self-report questionnaire, behavioral assessment will be a good supplement. In this paper, we propose to use gait data collected by Kinect as an indicator to recognize self-esteem. METHODS 178 graduate students without disabilities participate in our study. Firstly, all participants complete the 10-item Rosenberg Self-Esteem Scale (RSS) to acquire self-esteem score. After completing the RRS, each participant walks for two minutes naturally on a rectangular red carpet, and the gait data are recorded using Kinect sensor. After data preprocessing, we extract a few behavioral features to train predicting model by machine learning. Based on these features, we build predicting models to recognize self-esteem. RESULTS For self-esteem prediction, the best correlation coefficient between predicted score and self-report score is 0.45 (p<0.001). We divide the participants according to gender, and for males, the correlation coefficient is 0.43 (p<0.001), for females, it is 0.59 (p<0.001). CONCLUSION Using gait data captured by Kinect sensor, we find that the gait pattern could be used to recognize self-esteem with a fairly good criterion validity. The gait predicting model can be taken as a good supplementary method to measure self-esteem.
Collapse
Affiliation(s)
- Bingli Sun
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Zhan Zhang
- School of Computer and Control Engineering, University of Chinese Academy of Sciences, Beijing, China
| | - Xingyun Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Bin Hu
- School of Information Science & Engineering, Lanzhou University, Gansu, China
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
57
|
Piqueras JA, Martín-Vivar M, Sandin B, San Luis C, Pineda D. The Revised Child Anxiety and Depression Scale: A systematic review and reliability generalization meta-analysis. J Affect Disord 2017; 218:153-169. [PMID: 28475961 DOI: 10.1016/j.jad.2017.04.022] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 02/20/2017] [Accepted: 04/16/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Anxiety and depression are among the most common mental disorders during childhood and adolescence. Among the instruments for the brief screening assessment of symptoms of anxiety and depression, the Revised Child Anxiety and Depression Scale (RCADS) is one of the more widely used. Previous studies have demonstrated the reliability of the RCADS for different assessment settings and different versions. The aims of this study were to examine the mean reliability of the RCADS and the influence of the moderators on the RCADS reliability. METHODS We searched in EBSCO, PsycINFO, Google Scholar, Web of Science, and NCBI databases and other articles manually from lists of references of extracted articles. RESULTS A total of 146 studies were included in our meta-analysis. The RCADS showed robust internal consistency reliability in different assessment settings, countries, and languages. We only found that reliability of the RCADS was significantly moderated by the version of RCADS. However, these differences in reliability between different versions of the RCADS were slight and can be due to the number of items. LIMITATIONS We did not examine factor structure, factorial invariance across gender, age, or country, and test-retest reliability of the RCADS. CONCLUSIONS The RCADS is a reliable instrument for cross-cultural use, with the advantage of providing more information with a low number of items in the assessment of both anxiety and depression symptoms in children and adolescents.
Collapse
Affiliation(s)
| | | | - Bonifacio Sandin
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - David Pineda
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| |
Collapse
|
58
|
de Hullu E, Sportel BE, Nauta MH, de Jong PJ. Cognitive bias modification and CBT as early interventions for adolescent social and test anxiety: Two-year follow-up of a randomized controlled trial. J Behav Ther Exp Psychiatry 2017; 55:81-89. [PMID: 28013069 DOI: 10.1016/j.jbtep.2016.11.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 09/04/2016] [Accepted: 11/22/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES This two-year follow-up study evaluated the long-term outcomes of two early interventions that aimed at reducing social and test anxiety in young adolescents at risk for developing social anxiety disorder. METHODS In this RCT, moderately socially anxious adolescents (N=240, mean age 13.6 years) were randomly assigned to a 10-week internet-based multifaceted cognitive bias modification training (CBM), a 10-week school-based cognitive behavioral group training (CBT), or a no-intervention control condition. Using multiple imputation, this study examined the changes in primary and secondary outcome measures from pretest to follow-up in a repeated measures design. RESULTS Primary outcome: Self-reported social and test anxiety generally decreased from pre-test to two-year follow-up, regardless of treatment condition. The percentage of adolescents who developed a social anxiety disorder was very low (6%) and similar across conditions. Secondary outcome: There were beneficial changes in self-esteem, self-reported prosocial behaviors, and fear of negative evaluation, but none of these were related to treatment condition. Automatic social-threat associations did not significantly change. The CBM intervention was effective in changing interpretative bias as indexed by the Recognition Task but this long-term effect did not transfer to the Adolescent Interpretation and Belief Questionnaire. LIMITATIONS There was a substantial (50%) though seemingly non-selective attrition at follow-up. CONCLUSIONS This RCT does not support the longer-term efficacy of school-based CBT or CBM as an early intervention for social and test anxiety. Rather, it emphasizes the positive 'natural' course of highly socially anxious adolescents over two years.
Collapse
Affiliation(s)
- Eva de Hullu
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
| | - B Esther Sportel
- Department of Psychiatry, University Medical Center Groningen, University of Groningen P.O. Box 30.001, 9700 RB Groningen, The Netherlands; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
| | - Maaike H Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
| | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
| |
Collapse
|
59
|
Lu FY, Wen S, Deng G, Tang YL. Self-concept mediate the relationship between childhood maltreatment and abstinence motivation as well as self-efficacy among drug addicts. Addict Behav 2017; 68:52-58. [PMID: 28088744 DOI: 10.1016/j.addbeh.2017.01.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/02/2017] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Childhood maltreatment is widely accepted as a risk factor for drug addiction from adolescence to adulthood. However, the influence of childhood maltreatment on drug treatment related variables, such as drug abstinence motivation and self-concept, as well as self-efficacy, remains unclear. This study aims at exploring whether self-concept mediates the relationship between childhood maltreatment and abstinence motivation, as well as self-efficacy, among drug addicts. METHODS This study involves 816 (550 males, 226 females, mean age=34.59, range=16-58 years) drug addicts from compulsory detoxification units. Participants completed questionnaires, including the childhood trauma questionnaire 28 - item short form (CTQ - SF), Tennessee self-concept scale (TSCS), general self-efficacy scale (GSES), and drug abstinence motivation questionnaire (DAMQ). RESULTS The structural equation model (SEM) analysis, including total and specific forms of maltreatment scores, showed that childhood maltreatment was negatively associated with self-concept, self-efficacy, and abstinence motivation. Self-concept was positively associated with self-efficacy and abstinence motivation. Conversely, significant association between self-efficacy and abstinence motivation did not exist. An indirect analysis showed that self-concept mediated the relationship between childhood maltreatment and self-efficacy. Critically, self-concept arbitrated the relationship between childhood maltreatment and abstinence motivation. The indirect effect of self-concept between childhood maltreatment and abstinence motivation still existed when the total scores of maltreatment were replaced by the scores of specific forms of maltreatment. CONCLUSIONS These results demonstrated that self-concept is a critical factor in understanding the relationship between childhood maltreatment and abstinence motivation, as well as self-efficacy, among drug addicts. Improving the sense of self-worth may be an effective intervention therapy among drug addicts with childhood maltreatment history.
Collapse
|
60
|
Winter D, Bohus M, Lis S. Understanding Negative Self-Evaluations in Borderline Personality Disorder-a Review of Self-Related Cognitions, Emotions, and Motives. Curr Psychiatry Rep 2017; 19:17. [PMID: 28290062 DOI: 10.1007/s11920-017-0771-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Self-conscious emotions, such as guilt, shame, or self-disgust, as well as self-related motives, such as self-enhancement or self-verification, influence how people perceive, evaluate, memorize, and respond to self-related information. They not only influence peoples' concepts of themselves but may also affect their behavior in social environments. In the current review, we describe alterations of self-related processing in borderline personality disorder (BPD). We chose BPD as an example of a mental disorder of which impairments in self-functioning and identity constitute a major feature. Since terminology used in clinical research on self-referential processing is diverse and often confusing, we start with reviewing some of the main concepts in this area of research using a conceptual framework provided from social psychology. Most studies on self-referential processing in BPD focused on descriptions of self-esteem and revealed a negative self-concept, particularly expressed by explicitly reported low self-esteem. Moreover, self-esteem is unstable in BPD and likely reactive to self-relevant cues. BPD patients are prone to negative emotions with respect to themselves, such as self-disgust and shame. First data point to altered self-related motives, too. In conclusion, although explicit self-esteem is widely studied as a global and trait-like feature of BPD, there is a strong lack of studies that take the complexity of the construct self-esteem into account. Further studies on alterations in self-related processes are required to deepen our understanding of impairments of the self-concept in BPD and enable the improvement of psychosocial therapeutic approaches.
Collapse
Affiliation(s)
- Dorina Winter
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Faculty of Health, University of Antwerp, Antwerp, Belgium
| | - Stefanie Lis
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
61
|
Keane L, Loades M. Review: Low self-esteem and internalizing disorders in young people - a systematic review. Child Adolesc Ment Health 2017; 22:4-15. [PMID: 32680408 DOI: 10.1111/camh.12204] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cognitive behavioural therapy for low self-esteem (LSE) has shown promise as a trans-diagnostic model for treating mental health difficulties in adults. To ascertain the potential value of this treatment approach in working with young people with internalizing disorders, we need to develop our understanding of LSE within these mental health conditions. The aim of this review is to explore (a) the co-occurrence of clinically significant anxiety/depression and LSE in young people (aged 18 years and younger), and (b) the association between LSE in childhood and adolescence and mental health difficulties in later adolescence and emerging adulthood. METHOD A systematic search of three electronic databases (PsychInfo/Pubmed/Google Scholar) was conducted to identify relevant studies. RESULTS Ten studies examining the association between LSE and clinically significant anxiety/depression in young people met the inclusion criteria, as did eight studies investigating the association between LSE in young people with internalizing difficulties in later adolescence/emerging adulthood. Although relatively few studies were identified, studies consistently supported the co-occurrence of LSE and internalizing disorders in young people, particularly in young people with co-morbid anxiety and depression. LSE in childhood and adolescence appears to be a relatively weak predictor of the development of anxiety and depression in later adolescence and early adulthood. CONCLUSIONS Further research investigating the relationship between low self-esteem and mental health difficulties in young people and its implications for treatment in this age group is indicated.
Collapse
Affiliation(s)
- Lisa Keane
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, UK
| | - Maria Loades
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, UK
| |
Collapse
|
62
|
Self-evaluations in social anxiety: The combined role of explicit and implicit social-rank. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.08.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
63
|
Calvete E, Riskind JH, Orue I, Gonzalez-Diez Z. Recursive Associations Among Maladaptive Cognitions and Symptoms of Social Anxiety and Depression: Implications for Sex Differences. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2016. [DOI: 10.1521/jscp.2016.35.10.807] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
64
|
Romera EM, Gómez-Ortiz O, Ortega-Ruiz R. The Mediating Role of Psychological Adjustment between Peer Victimization and Social Adjustment in Adolescence. Front Psychol 2016; 7:1749. [PMID: 27891108 PMCID: PMC5102899 DOI: 10.3389/fpsyg.2016.01749] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
There is extensive scientific evidence of the serious psychological and social effects that peer victimization may have on students, among them internalizing problems such as anxiety or negative self-esteem, difficulties related to low self-efficacy and lower levels of social adjustment. Although a direct relationship has been observed between victimization and these effects, it has not yet been analyzed whether there is a relationship of interdependence between all these measures of psychosocial adjustment. The aim of this study was to examine the relationship between victimization and difficulties related to social adjustment among high school students. To do so, various explanatory models were tested to determine whether psychological adjustment (negative self-esteem, social anxiety and social self-efficacy) could play a mediating role in this relationship, as suggested by other studies on academic adjustment. The sample comprised 2060 Spanish high school students (47.9% girls; mean age = 14.34). The instruments used were the scale of victimization from European Bullying Intervention Project Questionnaire, the negative scale from Rosenberg Self-Esteem Scale, Social Anxiety Scale for Adolescents and a general item about social self-efficacy, all of them self-reports. Structural equation modeling was used to analyze the data. The results confirmed the partial mediating role of negative self-esteem, social anxiety and social self-efficacy between peer victimization and social adjustment and highlight the importance of empowering victimized students to improve their self-esteem and self-efficacy and prevent social anxiety. Such problems lead to the avoidance of social interactions and social reinforcement, thus making it difficult for these students to achieve adequate social adjustment.
Collapse
Affiliation(s)
- Eva M Romera
- Department of Psychology, University of Córdoba Córdoba, Spain
| | | | - Rosario Ortega-Ruiz
- Department of Psychology, University of CórdobaCórdoba, Spain; Department of Psychology, Social Work and Counselling, University of GreenwichLondon, UK
| |
Collapse
|
65
|
Krug S, Wittchen HU, Lieb R, Beesdo-Baum K, Knappe S. Family functioning mediates the association between parental depression and low self-esteem in adolescents. J Affect Disord 2016; 203:184-189. [PMID: 27295375 DOI: 10.1016/j.jad.2016.06.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/30/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The negative impact of parental depression on offsprings' development has been repeatedly documented. There is however little research on the potential pathways contributing to this association. The present study examined the relationship between parental depressive disorders, family functioning and adolescents' self-esteem. METHODS A community-based sample of 1040 participants aged 14-17 years and their parents was assessed including direct and indirect information on parental psychopathology based on the Munich-Composite International Diagnostic Interview (M-CIDI). Family functioning and youth self-esteem were assessed by self-report questionnaires using the McMaster Family Assessment Device (FAD) in parents and the "Aussagen-Liste zum Selbstwertgefühl" in adolescents. RESULTS Findings from multiple regression analyses indicated positive associations between parental depressive disorders and dimensions of dysfunctional family functioning as well as between dysfunctional familial affective involvement and youth's positive self-esteem. The relationship between parental depression and self-esteem was partly mediated by familial affective involvement. LIMITATIONS Associations may be underestimated, since incidence for depressive disorders spans to the third decade of life. Consensus diagnoses for parental depressive disorders were based on direct and indirect information for maximum use of available data, neglecting familial load, chronicity of parental depressive disorders or comorbid conditions. Thus, specificity of the findings for the family transmission of depressive disorders remains yet to be determined. CONCLUSIONS Findings contribute to understanding of the pathways on how parental depression impairs offsprings' view of themselves, and to consider family functioning as a possible target for preventive interventions.
Collapse
Affiliation(s)
- Susann Krug
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Max Planck Institute of Psychiatry, Munich, Germany
| | - Roselind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Technische Universität Dresden, Behavioral Epidemiology, Dresden, Germany
| | - Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| |
Collapse
|
66
|
Martinsen KD, Neumer SP, Holen S, Waaktaar T, Sund AM, Kendall PC. Self-reported quality of life and self-esteem in sad and anxious school children. BMC Psychol 2016; 4:45. [PMID: 27624487 PMCID: PMC5022161 DOI: 10.1186/s40359-016-0153-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 08/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background Anxiety and depressive symptoms are common in childhood, however problems in need of intervention may not be identified. Children at risk for developing more severe problems can be identified based on elevated symptom levels. Quality of life and self-esteem are important functional domains and may provide additional valuable information. Methods Schoolchildren (n = 915), aged 9–13, who considered themselves to be more anxious or sad than their peers, completed self-reports of anxiety (Multidimensional Anxiety Scale for children (MASC-C), depression (The Short Mood and Feelings Questionnaire; SMFQ), quality of life (Kinder Lebensqualität Fragebogen; KINDL) and self-esteem (Beck self-concept inventory for youth (BSCI-Y) at baseline of a randomized controlled indicative study. Using multivariate analyses, we examined the relationships between internalizing symptoms, quality of life and self-esteem in three at-risk symptom groups. We also examined gender and age differences. Results 52.1 % of the screened children scored above the defined at-risk level reporting elevated symptoms of either Anxiety and Depression (Combined group) (26.6 %), Depression only (15.4 %) or Anxiety only (10.2 %). One-way ANOVA analysis showed significant mean differences between the symptom groups on self-reported quality of life and self-esteem. Regression analysis predicting quality of life and self-esteem showed that in the Depression only group and the Combined group, symptom levels were significantly associated with lower self-reported scores on both functional domains. In the Combined group, older children reported lower quality of life and self-esteem than younger children. Internalizing symptoms explained more of the variance in quality of life than in self-esteem. Symptoms of depression explained more of the variance than anxious symptoms. Female gender was associated with higher levels of internalizing symptoms, but there was no gender difference in quality of life and self-esteem. Conclusion Internalizing symptoms were associated with lower self-reported quality of life and self-esteem in children in the at-risk groups reporting depressive or depressive and anxious symptoms. A transdiagnostic approach targeting children with internalizing symptoms may be important as an early intervention to change a possible negative trajectory. Tailoring the strategies to the specific symptom pattern of the child will be important to improve self-esteem. Trial registration Trial registration in Clinical trials: NCT02340637, June 12, 2014.
Collapse
Affiliation(s)
- Kristin D Martinsen
- Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway.
| | - Simon-Peter Neumer
- Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Solveig Holen
- Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Trine Waaktaar
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Anne Mari Sund
- NTNU, Regionalt kunnskapssenter for barn og unge (RKBU), Klostergata 46, 7030 Trondheim/St. Olav's Hospital, Trondheim, Norway
| | - Philip C Kendall
- Temple University, 1701 North 13th Street, Weiss Hall, Philadelphia, PA, USA
| |
Collapse
|
67
|
Romero N, Sanchez A, Vázquez C, Valiente C. Explicit self-esteem mediates the relationship between implicit self-esteem and memory biases in major depression. Psychiatry Res 2016; 242:336-344. [PMID: 27341330 DOI: 10.1016/j.psychres.2016.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 06/03/2016] [Accepted: 06/05/2016] [Indexed: 01/26/2023]
Abstract
This study examines the relationships between explicit and implicit self-esteem and self-referent memory biases in depression. We specifically tested the hypothesis that implicit self-esteem would influence depression-related memory biases via its association with explicit self-esteem. Self-esteem was assessed in patients with a current Major Depressive Disorder (MDD; n=38) and in a control group of participants who had never experienced depression (ND; n=40) by using explicit (Rosenberg Self-esteem Questionnaire) and implicit (Go/No-go Association Task) measures. A self-referent processing task of negative and positive adjectives was used to assess memory bias. Our analyses revealed that participants diagnosed with MDD showed lower levels of both explicit and implicit self-esteem in comparison to ND participants. MDD compared to ND participants also recalled a greater number of depressed self-referent adjectives and lower recall of positive self-referent information. Mediation analyses showed an indirect effect of explicit self-esteem on the relationship between implicit self-esteem and depression-related memory biases in the MDD group. These findings suggest an association between implicit and explicit self-esteem in depression that may result in negative cognitive processing, as reflected by self-referent memory biases.
Collapse
Affiliation(s)
- Nuria Romero
- Department of Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium; Department of Psychology, Complutense University of Madrid, Somosaguas Campus, 28223 Madrid, Spain.
| | - Alvaro Sanchez
- Department of Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium; Department of Psychology, Complutense University of Madrid, Somosaguas Campus, 28223 Madrid, Spain
| | - Carmelo Vázquez
- Department of Psychology, Complutense University of Madrid, Somosaguas Campus, 28223 Madrid, Spain
| | - Carmen Valiente
- Department of Psychology, Complutense University of Madrid, Somosaguas Campus, 28223 Madrid, Spain
| |
Collapse
|
68
|
Staring A, van den Berg D, Cath D, Schoorl M, Engelhard I, Korrelboom C. Self-esteem treatment in anxiety: A randomized controlled crossover trial of Eye Movement Desensitization and Reprocessing (EMDR) versus Competitive Memory Training (COMET) in patients with anxiety disorders. Behav Res Ther 2016; 82:11-20. [DOI: 10.1016/j.brat.2016.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 03/31/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
|
69
|
Zhang P, Deng Y, Yu X, Zhao X, Liu X. Social Anxiety, Stress Type, and Conformity among Adolescents. Front Psychol 2016; 7:760. [PMID: 27242649 PMCID: PMC4873518 DOI: 10.3389/fpsyg.2016.00760] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/06/2016] [Indexed: 11/13/2022] Open
Abstract
Social anxiety and stress type can influence strong conformity among adolescents; however, the interaction between them is not clear. In this study, 152 adolescents were recruited and assigned one of two conditions: an interaction and a judgment condition. In the interaction condition, adolescents with high social anxiety (HSA) were less likely to conform when completing a modified Asch task, compared to adolescents who had low social anxiety. In the judgment condition, adolescents with HSA were more likely to conform to the opinions from the unanimous majority. The results suggest that adolescents with HSA may show different styles of strong conformity with the change of stress type. We believe that socially anxious adolescents avoid potential social situations with weaker conformity, while avoiding negative evaluations from others with stronger conformity. These findings contribute to a better understanding of the social dysfunctions among adolescents with HSA and provide a new direction for clinical interventions.
Collapse
Affiliation(s)
- Peng Zhang
- School of Psychology, Beijing Normal University, BeijingChina; Behavior Rehabilitation Training Research Institution, School of Psychology, Northwest Normal University, LanzhouChina
| | - Yanhe Deng
- School of Psychology, Beijing Normal University, Beijing China
| | - Xue Yu
- School of Psychology, Beijing Normal University, Beijing China
| | - Xin Zhao
- Behavior Rehabilitation Training Research Institution, School of Psychology, Northwest Normal University, Lanzhou China
| | - Xiangping Liu
- School of Psychology, Beijing Normal University, Beijing China
| |
Collapse
|
70
|
McInnis MG, Greden JF. Longitudinal studies: An essential component for complex psychiatric disorders. Neurosci Res 2016; 102:4-12. [DOI: 10.1016/j.neures.2015.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/17/2015] [Accepted: 05/12/2015] [Indexed: 12/27/2022]
|
71
|
Cheng G, Zhang D, Ding F. Self-esteem and fear of negative evaluation as mediators between family socioeconomic status and social anxiety in Chinese emerging adults. Int J Soc Psychiatry 2015; 61:569-76. [PMID: 25550327 DOI: 10.1177/0020764014565405] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The social causation hypothesis suggests that the stress in connection with a depressing social position results in the development of mental disorders. This study examines the psychological mechanisms underlying the link between family socioeconomic status (SES) and social anxiety in Chinese emerging adults. METHODS A self-administered questionnaire was given to a representative sample (N = 717) of undergraduate students (17-23 years old) at three universities in China. Correlational and structural equation modeling analyses were employed to test the hypothesized three-path effect of self-esteem and fear of negative evaluation (FNE) as mediators between family SES and social anxiety. RESULTS Findings suggest the following: (1) the emerging adults belonging to families with low SES are at an increased risk of social anxiety, and (2) lower family SES caused lower self-esteem, which, in turn, serves to enhance the levels of FNE, thereby increasing social anxiety. CONCLUSION In addressing the prevention and treatment of social anxiety, we conclude that preventive efforts toward improving self-esteem may help reduce social anxiety in individuals with low family SES.
Collapse
Affiliation(s)
- Gang Cheng
- School of Psychology, Southwest University, Chongqing, China Center for Mental Health Education, Southwest University, Chongqing, China School of Educational Science, Guizhou Normal University, Guiyang, China
| | - Dajun Zhang
- School of Psychology, Southwest University, Chongqing, China Center for Mental Health Education, Southwest University, Chongqing, China
| | - Fangyuan Ding
- School of Psychology, Southwest University, Chongqing, China
| |
Collapse
|
72
|
Wu L, Gu R, Cai H, Zhang J. Electrophysiological evidence for executive control and efficient categorization involved in implicit self-evaluation. Soc Neurosci 2015; 11:153-63. [DOI: 10.1080/17470919.2015.1044673] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
73
|
Pastore V, Colombo K, Maestroni D, Galbiati S, Villa F, Recla M, Locatelli F, Strazzer S. Psychological problems, self-esteem and body dissatisfaction in a sample of adolescents with brain lesions: A comparison with a control group. Brain Inj 2015; 29:937-45. [DOI: 10.3109/02699052.2015.1008045] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
74
|
Iancu I, Bodner E, Ben-Zion IZ. Self esteem, dependency, self-efficacy and self-criticism in social anxiety disorder. Compr Psychiatry 2015; 58:165-71. [PMID: 25556952 DOI: 10.1016/j.comppsych.2014.11.018] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/20/2014] [Accepted: 11/24/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Social anxiety disorder (SAD) is characterized by fear and avoidance in social situations where one perceives being in danger of scrutiny by others. Low self-esteem, low self-efficacy, high self-criticism and high dependency are additional potential features of SAD, and thus their examination is warranted, as is the elucidation of their inter-relationship. METHOD Thirty-two SAD subjects diagnosed with the Mini-International Neuropsychiatric Interview and 30 healthy controls, were administered the Liebowitz Social Anxiety Scale (LSAS), the Rosenberg Self Esteem Scale, the Depressive Experiences Questionnaire (DEQ) that assesses self-criticism, dependency and self-efficacy, and a socio-demographic questionnaire. We hypothesized that the SAD group would present higher scores of dependency and self-criticism and lower self-esteem and self-efficacy. We also hypothesized that low self-esteem, low self-efficacy, high self-criticism and high dependency will predict the severity of SAD. RESULTS In line with the hypotheses, SAD patients had higher scores of self-criticism and dependency and lower scores of self-esteem. The social anxiety score correlated negatively with self-esteem and self-efficacy, and positively with dependency and self-criticism. Self-criticism, but not the other measures, predicted the total LSAS score. CONCLUSIONS Self-esteem, self-criticism, dependency and self-efficacy are related to SAD and their relations should be examined in future studies that will employ larger samples. It is suggested to search for ways to affect these factors through cognitive-behavioral interventions and additional psychotherapeutic treatments. Research should also focus on the specific role of self-criticism in SAD.
Collapse
Affiliation(s)
- Iulian Iancu
- The Yavne Mental Health Clinic and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Ehud Bodner
- The Interdisciplinary Department of Social Sciences, Bar Ilan University
| | | |
Collapse
|
75
|
González-Díez Z, Calvete E, Riskind JH, Orue I. Test of an hypothesized structural model of the relationships between cognitive style and social anxiety: a 12-month prospective study. J Anxiety Disord 2015; 30:59-65. [PMID: 25602785 DOI: 10.1016/j.janxdis.2014.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/23/2014] [Accepted: 12/25/2014] [Indexed: 11/28/2022]
Abstract
The aim of this study was to test whether social looming cognitive style accounts for the predictive association between early maladaptive schema domains and social anxiety. We predicted that early maladaptive schema domains would predict the increase of social anxiety over time and that social looming would act as a mediator between schema domains and social anxiety. A three-wave longitudinal design was used. The participants (N=471, 56.95% women) were Spanish adolescents and young adults aged between 16 and 25 years old (Mage=17.81, SD age=3.19). The results showed that three schema domains (impaired autonomy and performance, impaired limits, and other-directedness) predicted the increase in social anxiety and that LCS for social threat acted as a mediator between other-directedness and social anxiety at T3. These results are important to improve the knowledge of the cognitive mechanisms that are involved in the occurrence and development of social anxiety.
Collapse
Affiliation(s)
- Zahira González-Díez
- University of Deusto, Department of Personality, Psychological Assessment and Treatment, Apdo. 1, 48080 Bilbao, Spain.
| | - Esther Calvete
- University of Deusto, Department of Personality, Psychological Assessment and Treatment, Apdo. 1, 48080 Bilbao, Spain
| | - John H Riskind
- George Mason University, Department of Psychology, 9992 Main Street, Fairfax, VA 22031, United States
| | - Izaskun Orue
- University of Deusto, Department of Personality, Psychological Assessment and Treatment, Apdo. 1, 48080 Bilbao, Spain
| |
Collapse
|
76
|
Leeuwis FH, Koot HM, Creemers DHM, van Lier PAC. Implicit and Explicit Self-Esteem Discrepancies, Victimization and the Development of Late Childhood Internalizing Problems. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 43:909-19. [DOI: 10.1007/s10802-014-9959-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
77
|
Lillevoll KR, Vangberg HCB, Griffiths KM, Waterloo K, Eisemann MR. Uptake and adherence of a self-directed internet-based mental health intervention with tailored e-mail reminders in senior high schools in Norway. BMC Psychiatry 2014; 14:14. [PMID: 24443820 PMCID: PMC3901754 DOI: 10.1186/1471-244x-14-14] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 01/16/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Internet-based cognitive behavioural therapy (ICBT) is a promising approach to the prevention and reduction of depressive symptoms among adolescents. This study aimed to evaluate the feasibility and efficacy of disseminating a self-directed internet-based mental health intervention (MoodGYM) in senior high schools. It also sought to investigate possible effects of tailored and weekly e-mail reminders on initial uptake and adherence to the intervention. METHOD A baseline survey was conducted in four senior high schools in two Norwegian municipalities (n = 1337). 52.8% (707/1337) of the students consented to further participation in the trial and were randomly allocated to one of three MoodGYM intervention groups (tailored weekly e-mail reminder (n = 175), standardized weekly e-mail reminder (n = 176 ) or no e-mail reminder (n = 175)) or a waitlist control group (n = 180). We tested for effects of the intervention on depression and self-esteem using multivariate analysis of variance, effects of tailored e-mail and self-reported current need of help on initial uptake of the intervention using logistic regression and the effect of weekly e-mails on adherence using ordinal regression. RESULTS There was substantial non-participation from the intervention, with only 8.5% (45/527) participants logging on to MoodGYM, and few proceeding beyond the first part of the programme. No significant effect on depression or self-esteem was found among the sample as a whole or among participants with elevated depression scores at baseline. Having a higher average grade in senior high school predicted initial uptake of the intervention, but tailored e-mail and self-reported current need of help did not. Weekly e-mail prompts did not predict adherence. The main reasons for non-use reported were lack of time/forgetting about it and doubt about the usefulness of the program. CONCLUSION Overall, disseminating a self-directed internet-based intervention to a school population proved difficult despite steps taken to reduce barriers in terms of tailoring feedback and dispatching weekly e-mail reminders. Providing mental health interventions within the school environment is likely to ensure better uptake among senior high school students, but there is a need to effectively communicate that such programmes can be helpful. TRIAL REGISTRATION The trial was registered retrospectively as ACTRN12612001106820.
Collapse
Affiliation(s)
| | | | - Kathleen M Griffiths
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Knut Waterloo
- Department of Psychology, University of Tromsø, Tromsø, Norway
| | | |
Collapse
|