51
|
Kaeppler AK, Erath SA, Hinnant JB, El-Sheikh M. Coping Responses in the Context of Family Stress Moderate the Association Between Childhood Anxiety and Adolescent Depressive Symptoms. Res Child Adolesc Psychopathol 2024; 52:429-441. [PMID: 37897676 PMCID: PMC11097902 DOI: 10.1007/s10802-023-01135-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 10/30/2023]
Abstract
Anxiety and depressive symptoms are common and highly interrelated. A relatively consistent temporal pattern of anxious and depressive symptoms has emerged from previous studies, such that the development of anxiety tends to precede and predict the development of depression rather than the other way around. Whether high levels of childhood anxiety predict depressive symptoms in late adolescence may depend, in part, on the ways in which children cope with stressful events. Accordingly, the present study used latent intercept models to examine involuntary and voluntary coping responses to familial stress as potential moderators of the association between childhood anxiety and adolescent depressive symptoms. Two hundred twenty-seven participants completed questionnaires measuring demographic variables as well as anxiety, depressive symptoms, and coping responses at a minimum of one time point over four waves of data collection (T1 Mage = 10.26 years, T2 Mage = 15.77 years, T3 Mage = 16.75 years, T4 Mage = 17.68 years). We found that childhood anxiety was positively associated with adolescent depressive symptoms when children reported higher levels of involuntary responses to family stress (e.g., rumination or physiological arousal) in conjunction with either lower levels of voluntary engaged responses (e.g., problem solving or emotion regulation) or higher levels of voluntary disengaged responses (e.g., avoidance or denial). These results shed light on the conditions under which childhood anxiety is associated with adolescent depressive symptoms and underscore the need for continued longitudinal and developmental research on this topic.
Collapse
Affiliation(s)
- Alexander K Kaeppler
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | - Stephen A Erath
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA.
| | - J Benjamin Hinnant
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| |
Collapse
|
52
|
Sicouri G, Daniel EK, Spoelma MJ, Salemink E, McDermott EA, Hudson JL. Cognitive bias modification of interpretations for anxiety and depression in children and adolescents: A meta-analysis. JCPP ADVANCES 2024; 4:e12207. [PMID: 38486951 PMCID: PMC10933640 DOI: 10.1002/jcv2.12207] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/19/2023] [Indexed: 03/17/2024] Open
Abstract
Background Evidence suggests that cognitive bias modification of interpretations (CBM-I) is effective in modifying interpretation biases and has a small effect on reducing anxiety in children and adolescents. However, most evidence to date is based on studies which report anxiety or general distress using ad-hoc Likert-type or Visual Analogue Scales, which are useful but do not reliably index symptoms of clinical importance. This meta-analysis aimed to establish the effects of CBM-I for children and adolescents on both anxiety and depression using psychometrically validated symptom measures, as well as state negative affect and negative and positive interpretation bias. Methods We identified studies through a systematic search. To be eligible for inclusion, studies needed to target interpretation biases, not combine CBM-I with another intervention, randomly allocate participants to CBM-I or a control condition, assess a mental health outcome (i.e., anxiety or depression symptoms using validated measures or state measures of negative affect) and/or interpretation bias and have a mean age less than 18 years. Results We identified 36 studies for inclusion in the meta-analysis. CBM-I had a small and non-significant unadjusted effect on anxiety symptoms (g = 0.16), no effect on depression symptoms (g = -0.03), and small and non-significant unadjusted effects on state negative affect both at post-training (g = 0.16) and following a stressor task (g = 0.23). In line with previous findings, CBM-I had moderate to large unadjusted effects on negative and positive interpretations (g = 0.78 and g = 0.52). No significant moderators were identified. Conclusions CBM-I is effective at modifying interpretation bias, however there were no effects on mental health outcomes. The substantial variability across studies and paucity of studies using validated symptom measures highlight the need to establish randomized controlled trial protocols that evaluate CBM-I in clinical youth samples to determine its future as a clinical intervention.
Collapse
Affiliation(s)
- Gemma Sicouri
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
| | - Emily K. Daniel
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Michael J. Spoelma
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- Discipline of Psychiatry and Mental HealthSchool of Clinical MedicineFaculty of Medicine and HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Elske Salemink
- Department of Clinical PsychologyUtrecht UniversityUtrechtthe Netherlands
| | - Emma A. McDermott
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Jennifer L. Hudson
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
| |
Collapse
|
53
|
Rizeq J. Affective forecasting and psychopathology: A scoping review. Clin Psychol Rev 2024; 108:102392. [PMID: 38244480 DOI: 10.1016/j.cpr.2024.102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/12/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
Affective forecasting - estimations of future emotional reactions - is an important aspect of future thinking that informs judgement and decision making. Biases in affective forecasting have been noted generally and with people with emotional disturbances specifically. Still, the role of affective forecasting within models of psychopathology has received little attention. Given the state of the literature, a scoping review method was adopted to summarize and synthesize the methodological approaches used in measuring affective forecasting within the context of psychopathology and the scope of the evidence on this association. Three databases were searched for research published on or before November 13th, 2023. Original quantitative research that examined affective forecasting and its association with psychopathology was reviewed. Data were charted using a form designed for this study. Overall, the review highlights the heterogeneity in operationalization of affective forecasting. The majority of the evidence supports an association between severity of psychopathology and intensity of affective forecasts, with notable exceptions, which are discussed within the scope of methodology and operationalization of affective forecasting. This remains an important process to investigate in information processing models of psychopathology to elucidate its role in the development and maintenance of psychopathology and potential as a target for intervention.
Collapse
Affiliation(s)
- Jala Rizeq
- School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
| |
Collapse
|
54
|
Iannattone S, Mignemi G, Pivetta E, Gatta M, Sica C, Cardi V, Canale N, Spoto A, Bottesi G. Are anxiety, depression, and stress distinguishable in Italian adolescents? an examination through the Depression Anxiety Stress Scales-21. PLoS One 2024; 19:e0299229. [PMID: 38412147 PMCID: PMC10898757 DOI: 10.1371/journal.pone.0299229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024] Open
Abstract
The adolescents' ability to discriminate between different negative emotional states is still under debate. The Depression Anxiety Stress Scales-21 (DASS-21) serves as a useful tool to unravel this issue, yet the literature on its structural validity in young people is ambiguous. Therefore, this study aimed to expand knowledge on the emotional experience of youth by investigating the factor structure and psychometric properties of the DASS-21 in Italian adolescents. Six hundred fifty-five students (60.6% girls) aged 14-18 (M = 16.3 ± 1.29) completed an online survey containing the DASS-21 and Positive and Negative Affect Schedule (PANAS). To evaluate the factor structure of the DASS-21, several alternative models were tested, also adopting an Exploratory Structural Equation Modeling (ESEM) procedure. Measurement invariance, reliability, validity, and latent means differences were addressed. The ESEM model with three correlated factors of Depression, Anxiety, and Stress yielded the best fit to the data, supporting a hierarchical structure of the DASS-21. In addition, this model was invariant across sex and age groups. The Anxiety scale predicted both positive and negative affect, while Depression predicted positive affect only. Finally, girls scored higher than boys on Anxiety and Depression, but no age differences emerged. Overall, our results indicate that anxiety, depression, and stress are distinguishable in Italian adolescents but, simultaneously, share an underlying condition of general distress, which may explain the comorbidity between internalizing problems. Such findings are discussed in terms of clinical and preventive implications for the adolescent population.
Collapse
Affiliation(s)
- Sara Iannattone
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giuseppe Mignemi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Pivetta
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Michela Gatta
- Woman and Child's Health Department, Padova University Hospital, Padova, Italy
| | - Claudio Sica
- Department of Health Sciences, University of Firenze, Firenze, Italy
| | - Valentina Cardi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Andrea Spoto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| |
Collapse
|
55
|
Suo X, Zhang Y, Liu Y, Liu Y, Wang K, Li H, Zhai J, Liu Y, Zhang Y. Effects of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity during the COVID-19 pandemic lockdown among 3117 Chinese junior high school students. J Affect Disord 2024; 347:549-556. [PMID: 38072163 DOI: 10.1016/j.jad.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/08/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Depressive symptoms, anxiety symptoms, and comorbidity increased in junior high school students due to the outbreak of COVID-19. The objective of this study was to measure the impacts of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity in Chinese junior high school students during the COVID-19 pandemic lockdown period. METHODS An online survey was conducted in June 2020 among 3117 junior high school students from Shandong Province, China. The Egna Minnen av Barndoms Uppfostran scale was used to measure parenting styles. The 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale were used to measure depressive symptoms and anxiety symptoms, respectively. Multinomial logistic regression was conducted with SPSS 25.0 Version. RESULTS 3117 junior school students enrolled in this study. The prevalence of depressive symptoms only, anxiety symptoms only, and comorbidity among junior high school students was 11.55 %, 5.29 %, and 22.97 %. Paternal over-protection was a risk factor not only for depressive symptoms only (OR = 1.075, 95 % CI = 1.020-1.134) but for anxiety symptoms only (OR = 1.090, 95 % CI = 1.016-1.170) and comorbidity (OR = 1.098, 95 % CI = 1.050-1.148). Paternal over-interference was a protective factor for depressive symptoms only (OR = 0.947, 95 % CI = 0.908-0.987) and comorbidity (OR = 0.953, 95 % CI = 0.921-0.986). However, maternal over-interference and over-protection were risk factors for depressive symptoms only (OR = 1.039, 95 % CI = 1.011-1.068). LIMITATIONS This was a cross-sectional study and the causal inferences could not be conducted. CONCLUSIONS Junior high school students with poorer family environmental factors were more likely to suffer from the comorbidity of anxiety symptoms and depressive symptoms during the COVID-19 pandemic lockdown. Decision-makers from the government, educational, and healthcare institutions should pay more attention to junior high school students at higher risk of mental disorders due to poor parenting styles. We should discuss family interventions in the future to prevent mental disorders in junior high school students.
Collapse
Affiliation(s)
- Xingbo Suo
- School of Mental Health, Jining Medical University, Jining, Shandong, China; The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China; Department of Psychosomatic Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Yang Zhang
- Department of Clinical Psychology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, China
| | - Yujia Liu
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yanzhi Liu
- School of Clinical Medicine, Jining Medical University, Jining, Shandong, China
| | - Kejin Wang
- The First Senior Middle School of Jining City, Jining, Shandong, China
| | - Hanyun Li
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jinguo Zhai
- School of Mental Health, Jining Medical University, Jining, Shandong, China.
| | - Yan Liu
- School of Public Health, Jining Medical University, Jining, Shandong, China.
| | - Ying Zhang
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
56
|
Wagner KM, Sanchez D, Valdez CR. Maternal and Child Depressive Symptoms in a Sample of Low-income Families of Color: The Mediating Role of Child Adaptability. Child Psychiatry Hum Dev 2024; 55:287-294. [PMID: 35904678 PMCID: PMC10351487 DOI: 10.1007/s10578-022-01404-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 05/12/2022] [Accepted: 07/05/2022] [Indexed: 11/03/2022]
Abstract
Maternal depressive symptoms are linked with child internalizing concerns, such as depressive symptoms. The impact that maternal depressive symptoms have on the onset and maintenance of child depressive symptoms might be especially salient in families of color who are low-income because of elevated rates of maternal depressive symptoms and environmental stressors in those populations. The relationship between maternal and child depressive symptoms might be partially explained by a child's capacity to flexibly respond to stressors in the environment, a construct known as adaptability. A simple mediation model was conducted with a sample of low-income, Black/African American and Latina mothers and their children (n = 128). Results suggested that child adaptability partially mediated the link between maternal and child depressive symptoms. We discussed how this study can inform research and practice that aim to assist low-income families of color with mental health needs.
Collapse
Affiliation(s)
- Kevin M Wagner
- Department of Educational Psychology, The University of Texas at Austin, 1701 Trinity Street, 78712, Austin, TX, USA.
| | - Delida Sanchez
- Department of Educational Psychology, The University of Texas at Austin, 1701 Trinity Street, 78712, Austin, TX, USA
| | - Carmen R Valdez
- Department of Educational Psychology, The University of Texas at Austin, 1701 Trinity Street, 78712, Austin, TX, USA
| |
Collapse
|
57
|
LoParo D, Fonseca AC, Matos APM, Craighead WE. Anxiety and Depression from Childhood to Young Adulthood: Trajectories and Risk Factors. Child Psychiatry Hum Dev 2024; 55:127-136. [PMID: 35763175 DOI: 10.1007/s10578-022-01391-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/03/2022]
Abstract
This study aimed to (1) evaluate how population levels of anxiety and depression grow and correlate from middle childhood through early adulthood, and (2) determine whether sex, family socioeconomic status, parental education, academic achievement, learning disabilities, or externalizing symptoms predict anxiety and/or depression levels and growth trajectory. We used two longitudinal samples (N = 445, 448) of Portuguese children. Mean depression levels increased from mid-childhood through adolescence before stabilizing in early adulthood and were most strongly predicted by academic achievement and learning disabilities. Mean anxiety levels increased until adolescence before decreasing across early adulthood and were most strongly predicted by academic achievement, learning disabilities, and externalizing symptoms. Quadratic models of growth fit best for both depression and anxiety, and depression and anxiety growth trajectories were strongly correlated. Though anxiety and depression trajectories differ in pattern and predictors, the two are highly interrelated and pathways to comorbid anxiety and depression should be characterized.
Collapse
Affiliation(s)
- Devon LoParo
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive NE, 2nd Floor, Atlanta, GA, 30329, USA.
| | | | | | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive NE, 2nd Floor, Atlanta, GA, 30329, USA
- Department of Psychology, Emory University, Atlanta, GA, USA
| |
Collapse
|
58
|
Uzun B, Orman A, Essau CA. Integrating "Super Skills for Exams" Programme in the School Curriculum to Support Adolescents Preparing for Their National Examinations in Turkey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:180. [PMID: 38397292 PMCID: PMC10887824 DOI: 10.3390/children11020180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Examination stress is the most common stressor reported by adolescents across the globe. Exam stress involves mental distress related to anticipated academic challenges or fear of failure in the examinations, test anxiety, or fear of being unable to meet certain expectations of themselves or others. The aim of this study was to determine the effectiveness of a transdiagnostic resilience program (Super Skills for Exams; SSE), when integrated in the school curriculum and delivered by the school counsellors, in reducing exam stress among adolescents who are preparing for their national examinations. SSE is based on the principles of Cognitive Behaviour Therapy (CBT), behavioural activation, and social skills training, and includes sessions in promoting healthy lifestyles. Participants were 7129 (3661 female and 3468 male) adolescents in grades 7 and 8, from all the 245 secondary schools from Ugur College in seven regions and 31 cities across Turkey. All the participants completed a set of questionnaires to measure self-efficacy for learning and test anxiety, academic stress, emotion regulation, and lifestyles. Results revealed significant reduction in academic stress (i.e., test anxiety, work pressure, self-expectation, and despondency) and maladaptive emotion regulation strategies, and significant increase in self-efficacy and adaptive regulation strategies following the intervention. Adolescents who participated in SSE reported an increase in the consumption of healthy food. This study provides preliminary empirical support for the integration of SSE within the school curriculum for helping adolescents cope with exam stress as they prepare for their national exams.
Collapse
Affiliation(s)
- Bilge Uzun
- Faculty of Educational Sciences, Bahcesehir University, 34353 Istanbul, Turkey;
| | - Asli Orman
- Research Department, Ugur College, 34354 Istanbul, Turkey;
| | - Cecilia A. Essau
- School of Psychology, University of Roehampton, London SW15 4JD, UK
| |
Collapse
|
59
|
Guzick A, Storch EA, Smárason O, Minhajuddin A, Drummond K, Riddle D, Hettema JM, Mayes TL, Pitts S, Dodd C, Trivedi MH. Psychometric properties of the GAD-7 and PROMIS-Anxiety-4a among youth with depression and suicidality: Results from the Texas youth depression and suicide research network. J Psychiatr Res 2024; 170:237-244. [PMID: 38169247 DOI: 10.1016/j.jpsychires.2023.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
There is a tremendous need for brief, valid, and free assessments of anxiety in child mental healthcare. The goal of this study was to determine the psychometric properties of two such measures, the GAD-7 and PROMIS-Anxiety-4a, in 1000 children, adolescents, and young adults (8-20 years-old) with depression and/or suicidality. The GAD-7, the PROMIS-Anxiety-4a, and other validated assessments of anxiety, physical functioning, and psychiatric diagnoses were completed. Confirmatory factor analyses showed an acceptable fit for a single factor in both measures via all indices but the RMSEA. They demonstrated measurement invariance across pre-adolescents (8-12 years-old) and adolescents and emerging adults (13-20 years-old), though scalar invariance was not observed for the GAD-7. Both measures showed strong convergent validity, GAD-7: r = 0.68; PROMIS-Anxiety-4a: r = 0.75, divergent validity with a measure of physical function, GAD-7: r = -0.24; PROMIS-Anxiety-4a: r = -0.28, good internal consistency, ω = 0.89 for both, and high test-retest reliability, GAD-7: r = 0.69; PROMIS-Anxiety-4a: r = 0.71. Both measures also showed acceptable sensitivity and specificity in detecting the presence of any anxiety disorder, GAD-7 cut-off score of 10: AUC = 0.75; PROMIS-Anxiety-4a cutoff score of 12: AUC = 0.79. The GAD-7 correlated similarly with the Screen for Child Anxiety Related Disorders total score and generalized anxiety subscale, and also showed similar diagnostic sensitivity and specificity when used to detect the presence of any anxiety disorder vs. generalized anxiety disorder specifically. Results suggest that both of these brief, publicly available instruments are valid and reliable assessments of anxiety among youth in treatment for depression and/or suicidality.
Collapse
Affiliation(s)
- Andrew Guzick
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Orri Smárason
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Faculty of Psychology, University of Iceland, Reykjavik, Iceland
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kendall Drummond
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David Riddle
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - John M Hettema
- Department of Psychiatry, Texas A&M University School of Medicine, Bryan, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shamari Pitts
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cody Dodd
- Department of Psychiatry and Behavioral Sciences, University of Texas-Medical Branch, Galveston, TX, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| |
Collapse
|
60
|
Wall EK, Teo JN, Roth A, Chan ME, Brandt J, Hibri M, Richardson R, Baker KD. Effects of social buffering on fear extinction in adolescent rats. Behav Res Ther 2024; 173:104457. [PMID: 38134498 DOI: 10.1016/j.brat.2023.104457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/12/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
Across social species, the presence of another individual can reduce stress reactions to adverse stimuli, a phenomenon known as social buffering. The present study investigated whether social buffering influences the expression and extinction of learned fear in adolescence, a developmental period of diminished fear inhibition and increased social interaction. Quality of maternal care and degree of social investigation were examined as factors that may influence social buffering. In adolescence, male rats were fear conditioned and then given extinction training either in the presence of a same-age rat or alone. Animals were then tested alone for extinction retention. In two experiments, the presence of a conspecific robustly reduced conditioned fear responses during extinction training. Interestingly, a persistent social buffering effect was observed when the extinction and conditioning contexts had prominent differences in features (Experiment 1), but not when these contexts were relatively similar (Experiment 2). Neither quality of maternal care nor degree of social investigation predicted the effects of social buffering. These findings suggest that social buffering robustly dampens fear responses during adolescence when a peer is present and this suppression can persist, in some instances, even when the peer is absent.
Collapse
Affiliation(s)
- Emily K Wall
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | - Jia Ni Teo
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | | | - Mei E Chan
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | | | - Maya Hibri
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | | | | |
Collapse
|
61
|
Sánchez Hernández MO, Holgado-Tello FP, Carrasco MÁ. The dynamics of psychological attributes and symptomatic comorbidity of depression in children and adolescents. Soc Psychiatry Psychiatr Epidemiol 2024; 59:341-351. [PMID: 37477729 PMCID: PMC10838844 DOI: 10.1007/s00127-023-02532-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE This investigation aimed to explore attribute dynamics and symptomatic comorbidity of depression with internalizing, externalizing, and other personal-contextual problems in children and adolescents from a network analysis. METHODS We tested an attribute network of regularized partial correlations, standard and alternative centrality measures, and comorbidity bridge symptoms according to centrality bridge measures. RESULTS Regularized partial correlation network and a centrality measures graph shown the prominent position of social problems and anxiety-depression. Minimum spanning tree (MST) found a hierarchical dynamics between attributes where mixed anxiety-depression was identified as the core and the other attributes were hierarchically connected to it by being positioned in six branches that are differentiated according to their theoretical contents. The most central connections are established with the attributes of their own community or theoretical groups, and 37 bridge symptoms were identified in all networks. CONCLUSIONS A significant role of mixed anxiety depression as an activator and intermediary of psychopathologies was supported as a central attribute of internalizing problems. Aggressive behavior as part of the broad externalizing dimension was one of the constructs that most intensively activate the network, and social problems were also distinguished as a relevant factor not only in terms of connections and central attributes but also in terms of bridge symptoms and comorbidity. This framework extends to the study of symptomatic "comorbidity."
Collapse
|
62
|
Storch EA, Guzick AG, Ayton DM, Palo AD, Kook M, Candelari AE, Maye CE, McNeel M, Trent ES, Garcia JL, Onyeka OC, Rast CE, Shimshoni Y, Lebowitz ER, Goodman WK. Randomized trial comparing standard versus light intensity parent training for anxious youth. Behav Res Ther 2024; 173:104451. [PMID: 38154287 DOI: 10.1016/j.brat.2023.104451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To examine the efficacy of the parent-led intervention Supportive Parenting for Anxious Childhood Emotions (SPACE) relative to a low-dose version of the protocol among children and adolescents with clinically significant anxiety and/or obsessive-compulsive disorder (OCD). METHOD 68 youth (7-17) with anxiety/OCD and their parents were randomized to receive 12 weekly telehealth SPACE sessions (SPACE-Standard) or bibliotherapy plus 4 telehealth sessions over 12 weeks (SPACE-light). After screening, assessments were conducted via videoconferencing at baseline, post-treatment, and one-month follow-up. Independent evaluators were blind to treatment condition. RESULTS Treatment condition did not predict whether a participant responded to the intervention (SPACE-Standard = 70%; SPACE-Light = 68%), nor was treatment condition a predictor of anxiety severity, parent-reported anxiety, or parent-/child-reported functional impairment at post-treatment or one-month follow-up. Youth in SPACE-Light self-reported higher post-treatment anxiety than youth in SPACE-standard, though this was no longer significant at one-month follow-up. Parent-reported family accommodation total change scores were associated with anxiety severity at post-treatment across both arms. CONCLUSION This is the second randomized controlled trial (RCT) evaluating SPACE and provides further support for the efficacy of this intervention both in standard and low-dose formats. This study provides support for parent-led anxiety treatment targeting family accommodation as a primary mechanism of change and extends evidence of efficacy to a more clinically diverse sample. TRIAL REGISTRATION ClinicalTrials.gov Registry: NCT04922502.https://classic. CLINICALTRIALS gov/ct2/show/NCT04922502.
Collapse
Affiliation(s)
- Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Andrew G Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Daphne M Ayton
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Amanda D Palo
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Minjee Kook
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Abigail E Candelari
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Caitlyn E Maye
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Morgan McNeel
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Erika S Trent
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychology, University of Houston, Houston, TX, USA
| | - Jessica L Garcia
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychology, University of Houston, Houston, TX, USA
| | - Ogechi C Onyeka
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Catherine E Rast
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Yaara Shimshoni
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Eli R Lebowitz
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Wayne K Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
63
|
Allen JP, Pettit C, Costello MA, Hunt GL, Stern JA. A social-development model of the evolution of depressive symptoms from age 13 to 30. Dev Psychopathol 2024; 36:280-290. [PMID: 36453112 PMCID: PMC10232674 DOI: 10.1017/s0954579422001183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
This 17-year prospective study applied a social-development lens to the challenge of identifying long-term predictors of adult depressive symptoms. A diverse community sample of 171 individuals was repeatedly assessed from age 13 to age 30 using self-, parent-, and peer-report methods. As hypothesized, competence in establishing close friendships beginning in adolescence had a substantial long-term predictive relation to adult depressive symptoms at ages 27-30, even after accounting for prior depressive, anxiety, and externalizing symptoms. Intervening relationship difficulties at ages 23-26 were identified as part of pathways to depressive symptoms in the late twenties. Somewhat distinct paths by gender were also identified, but in all cases were consistent with an overall role of relationship difficulties in predicting long-term depressive symptoms. Implications both for early identification of risk as well as for potential preventive interventions are discussed.
Collapse
Affiliation(s)
- Joseph P Allen
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Corey Pettit
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Meghan A Costello
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Gabrielle L Hunt
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Jessica A Stern
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
64
|
Pishdar S, Kalantari S, Kalantari S, Sheikhi HR, Kuchaki Z. Impact of the Integrated Program of Transdiagnostic Treatment and Parent Education on the Social Anxiety of Female Students. Cureus 2024; 16:e55299. [PMID: 38562264 PMCID: PMC10982126 DOI: 10.7759/cureus.55299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE The objective of this study was to assess the efficacy of the combined program of transdiagnostic treatment and parent education in reducing social anxiety among female students. METHODOLOGY This descriptive cross-sectional study was conducted among all female elementary school students in Bandar Abbas, Iran, during the academic year 2022-2023. The social phobia questionnaire was given to all female students in grades three to six to assess individuals in terms of the social anxiety disorder (SAD) variable. We used the social anxiety scale developed by Leibovitz as the questionnaire in this investigation. This self-assessment questionnaire was designed for individuals aged 18 and above. It consists of 24 statements, divided into two subscales: performance anxiety (13 statements) and social settings (11 statements). Each item is individually assessed for fear intensity on a scale of 0 to 3, ranging from no to extreme. Similarly, avoidance behavior is evaluated on a scale of 0 to 3, representing the frequency ranging from never to always. RESULTS The mean general anxiety levels among both groups (students vs. parents) during the pre-test were similar (48.06 ± 4.39 vs. 48.06± 4.1). However, in the post-test, the mean of the experimental groups was lower than that of the pre-test (32.13 ± 3.77 vs. 47.2 ± 3.6). The normality assumption for the pre-test and post-test variables of generalized anxiety was verified with a significance level over 0.05 (p ≥ 0.05). CONCLUSION The findings demonstrated that the integrated meta-diagnostic treatment program for parents had a more pronounced effect on alleviating their social anxiety in comparison to students. These findings imply that if parents possess a comprehensive understanding of the factors contributing to their children's anxiety, it will significantly enhance their ability to mitigate their child's social anxiety.
Collapse
Affiliation(s)
- Sedigheh Pishdar
- Clinical Psychology, Islamic Azad University of Bandar Abbas, Bandar Abbas, IRN
| | - Solaleh Kalantari
- Personality Psychology, Islamic Azad University Sari Branch Campus, Mazandaran, IRN
| | - Sara Kalantari
- Family Therapy, University of Science and Culture, Tehran, IRN
| | - Hamid Reza Sheikhi
- Department of Nursing, Islamic Azad University, Qaenat Branch, Qaenat, IRN
| | - Zeinab Kuchaki
- Department of Nursing, Ilam University of Medical Sciences, Ilam, IRN
| |
Collapse
|
65
|
Ernst J, Rückert F, Ollmann TM, Voss C, Kische H, Knappe S, Beesdo-Baum K. Social Interactions in Everyday Life of Socially Anxious Adolescents: Effects on Mental State, Anxiety, and Depression. Res Child Adolesc Psychopathol 2024; 52:207-222. [PMID: 37768440 PMCID: PMC10834615 DOI: 10.1007/s10802-023-01121-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
Unfavorable interpersonal behavior in social anxiety disorder (SAD) contributes to the maintenance of the disorder and may also be related to the development of secondary depression. Since there is limited research on daily life behavior in SAD, this study aimed to describe social interaction behavior and analyze the effect of positive interactions on depression, anxiety, and mental state. Data were obtained from the Behavior and Mind Health study (11/2015-12/2016), an epidemiological cohort study of adolescents and young adults (n = 1,180, aged 14-21 years) from Dresden, Germany. Interpersonal behavior, current mental state, anxiety, and depression were assessed eight times per day over four days using smartphone-based ecological momentary assessments. The analyzed subsample consisted of n = 723 participants, comparing 12-month SAD (n = 60) and healthy controls (HC; n = 663). The interaction behavior of participants with SAD did not differ substantially from that of HC in terms of frequency of social interactions, type of interaction partner, and time spent communicating, although they reported fewer real-life interaction partners (SAD: M = 2.49, SD = 4.78; HC: M = 3.18, SD = 6.43; F(17,044) = 23.92, p < 0.001). When comparing mental state, anxiety, and depression after interactions with familiar people to no interaction, no differences were found between SAD and HC. However, interactions with unfamiliar people negatively affected depressive symptoms in individuals with SAD (b = 0.53; SE = 0.25; 95%CI: 0.04-1.03; p = 0.036). In adolescents with SAD, social situations with unfamiliar people seem to be processed in a dysfunctional way, contributing to increased depressive mood in everyday life. This is particularly interesting given the high rate of secondary depression in SAD.
Collapse
Affiliation(s)
- Julia Ernst
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany.
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
- Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| |
Collapse
|
66
|
Vandermeer MRJ, Liu P, Mohamed Ali O, Daoust AR, Joanisse MF, Barch DM, Hayden EP. Children's neural reactivity to maternal praise and criticism: Associations with early depressive symptoms and maternal depression. Dev Psychopathol 2024; 36:12-27. [PMID: 36039979 DOI: 10.1017/s0954579422000840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Caregiving experiences are implicated in children's depression risk; however, children's neural reactivity to positive and negative feedback from mothers, a potential mediator of depression risk, is poorly understood. In a sample of 81 children (Mage = 11.12 years, SDage = 0.63), some of whom were recruited based on a maternal history of depression (n = 29), we used fMRI to characterize children's neural responses to maternal praise and criticism. Maternal history of depression was unrelated to children's brain activity during both the praise and criticism conditions; however, ROI analyses showed that children's self-reported depressive symptoms were negatively associated with functional activity in the left anterior insula and right putamen while hearing maternal criticism. Whole-brain analyses showed that children's depressive symptoms were positively associated with left inferior frontal gyrus activity while listening to maternal praise. These findings complement past work implicating these brain regions in the processing of emotionally salient stimuli, reward processing, and internal speech. Given associations between early depressive symptoms and later disorder, findings suggest that maladaptive neural processing of maternal feedback may contribute to children's early emerging risk for depression.
Collapse
Affiliation(s)
- Matthew R J Vandermeer
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Pan Liu
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Ola Mohamed Ali
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Andrew R Daoust
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Marc F Joanisse
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2100, St. Louis, MO, USA
- Department of Psychology, Washington University, St. Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Elizabeth P Hayden
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| |
Collapse
|
67
|
Wang A, Zhang J, Hu L, Yu Z, Lai S, Liu Y, Mai Z, Xu M. Trace analysis of 47 psychotropic medications in environmental samples by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). J Chromatogr A 2024; 1715:464627. [PMID: 38171065 DOI: 10.1016/j.chroma.2023.464627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/19/2023] [Accepted: 12/30/2023] [Indexed: 01/05/2024]
Abstract
Psychotropic medications are one of the most prescribed pharmaceuticals in the world. Given their frequent detection and ecotoxicity to the no-target organism, the emission of these medications into environments has gradually draw attention. The study developed a sensitive and reliable analytic method to simultaneously investigate 47 psychotropic medications in four matrices: wastewater, surface water, activated sludge, and sediment by ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC-ESI-MS/MS). These 47 target analytes include 24 antidepressants, 17 antianxiety drugs, 5 anticonvulsants, and 1 relevant hormone. Solid phase extraction (SPE) was employed to extract analytes from water-phase samples. Ultrasonic Solvent Extraction method with Enhanced Matrix Removal clean-up (USE-EMR) was utilized to extract target compounds from solid-phase samples, which requires more straightforward and convenient procedures than previous methods. The extraction recoveries of all analytes ranged from 80 % to 120 % in these four sample matrices. In this study, The limit of quantitation for 47 psychotropic medications were 0.15 ng/L (estazolam) to 2.27 ng/L (lorazepam), 0.08 ng/L (desvenlafaxine) to 2 ng/L (mianserin), 0.22 ng/g (dry weight, dw) (nordiazepam) to 3.65 ng/g (dw) (lorazepam), and 0.07 ng/g (dw) (carbamazepine) to 2.85 ng/g (lorazepam), in wastewater, surface water, sludge, and sediment, respectively. In addition, the developed method was employed to analyse actual samples in two wastewater treatment plants and their receiving rivers. Carbamazepine, escitalopram, clozapine, desvenlafaxine, diazepam, lamotrigine, sertraline, temazepam, and venlafaxine were nearly ubiquitous in all matrices. Moreover, this study indicated that the inadequate removal efficiencies of psychotropic medications in wastewater treatment plants (WWTPs) had resulted in a persistent discharge of these contaminants from human sources into environments.
Collapse
Affiliation(s)
- Anguo Wang
- State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, PR China; Guangdong Environmental Protection Key Laboratory of Microbiology and Ecological Safety, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, PR China; University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Jinna Zhang
- Guangdong Environmental Protection Key Laboratory of Microbiology and Ecological Safety, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, PR China
| | - Lixin Hu
- SCNU Environmental Research Institute, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Environmental Theoretical Chemistry, South China Normal University, Guangzhou 510006, PR China
| | - Zhiqiang Yu
- State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, PR China
| | - Sihua Lai
- Guangdong Environmental Protection Key Laboratory of Microbiology and Ecological Safety, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, PR China
| | - Yousheng Liu
- SCNU Environmental Research Institute, Guangdong Provincial Key Laboratory of Chemical Pollution and Environmental Safety & MOE Key Laboratory of Environmental Theoretical Chemistry, South China Normal University, Guangzhou 510006, PR China
| | - Zhiyuan Mai
- Guangdong Environmental Protection Key Laboratory of Microbiology and Ecological Safety, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, PR China
| | - Meiying Xu
- Guangdong Environmental Protection Key Laboratory of Microbiology and Ecological Safety, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou 510070, PR China.
| |
Collapse
|
68
|
Garza C, Chapa D, Hernandez C, Aramburu H, Mayes TL, Emslie GJ. Measurement-Based Care for Depression in Youth: Practical Considerations for Selecting Measures to Assess Depression, Associated Features and Functioning. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01652-4. [PMID: 38217644 DOI: 10.1007/s10578-023-01652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
Identification and management of major depressive disorder (MDD) in children and adolescents remains a significant area of public health need. The process for identifying depression (e.g. screening) and management (e.g. measurement based care [MBC]) is substantially enhanced by utilization of clinical measures and rating scales. Measures can be self- or caregiver reported or clinician rated. They can aid recognition of at-risk individuals for future assessment and assist in clinical diagnosis and management of depression. In addition to assessing symptoms of depression, rating scales can be used to assess important associated features (e.g. anxiety, trauma) and functional outcomes (e.g. quality of life, performance/productivity). In this manuscript, we discuss practical considerations for clinicians and researchers when selecting rating instruments for assessing depression, associated factors, functioning, and treatment outcomes (i.e. adherence and side effects) as part of MBC in youth and provide a summary of rating scales commonly used in research and clinical settings.
Collapse
Affiliation(s)
- Cynthia Garza
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA.
| | - Diana Chapa
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA
| | - Catherine Hernandez
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA
| | - Hayley Aramburu
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Graham J Emslie
- Children's Health, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
69
|
Cobham VE, Radtke SR, Hawkins I, Jordan M, Ali NR, Ollendick TH, Sanders MR. Piloting a one-day parent-only intervention in the treatment of youth with anxiety disorders: child and family-level outcomes. Child Adolesc Psychiatry Ment Health 2024; 18:8. [PMID: 38218829 PMCID: PMC10787495 DOI: 10.1186/s13034-023-00702-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVE Parent-only cognitive-behavioural therapy (CBT) interventions have promise for youth with anxiety disorders. Fear-Less Triple P (FLTP) is one such intervention that has been found comparable to child-focused CBT. Although traditionally administered in six sessions, a one-day workshop format of FLTP was developed to improve accessibility. The current study compared the effectiveness of the six-session and one-day workshop formats. METHOD Seventy-three youth (mean age, 8.4 years; 74% male) were randomized to traditional FLTP (6-week group) or the one-day workshop format. Anxiety diagnostic status, self- and parent-reported anxiety symptoms scores, independent evaluator-rated improvement, treatment satisfaction, and measures of family functioning were included to assess treatment outcome. Data were collected prior to treatment, and 1-week, 6-months, and 12-months following treatment. RESULTS Both conditions resulted in significant improvement in child anxiety symptom scores per parent report (on both questionnaire and diagnostic interview measures). Furthermore, significant decreases in sibling anxiety were observed in both treatment conditions. There were no statistically significant differences between conditions on any outcome measure. CONCLUSIONS Results of this study add to the growing evidence that brief, low-intensity, parent-only interventions can effectively target child psychopathology. These brief interventions are ideal for families for whom the resources and time required to commit to a standard multi-week intervention are prohibitive. REGISTRATION OF CLINICAL TRIALS This trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN 12615001284550).
Collapse
Affiliation(s)
- Vanessa E Cobham
- School of Psychology, University of Queensland, St. Lucia, QLD, 4072, Australia.
| | - Sarah R Radtke
- Virginia Tech: Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Ingrid Hawkins
- School of Psychology, University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Michele Jordan
- School of Psychology, University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Nasriah Rizman Ali
- School of Psychology, University of Queensland, St. Lucia, QLD, 4072, Australia
| | - Thomas H Ollendick
- Virginia Tech: Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Matthew R Sanders
- School of Psychology, University of Queensland, St. Lucia, QLD, 4072, Australia
| |
Collapse
|
70
|
Martinsen K, Lisøy C, Wentzel-Larsen T, Neumer SP, Rasmussen LMP, Adolfsen F, Sund AM, Ingul JM. School children's mental health during the COVID-19 pandemic. Front Psychol 2024; 14:1290358. [PMID: 38327509 PMCID: PMC10848797 DOI: 10.3389/fpsyg.2023.1290358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/13/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction The COVID-19 pandemic significantly impacted the daily routines of children, with social distancing and quarantine leading to reduced social interactions and potential increased conflicts within families. These factors can increase the risk for anxiety and depression while reducing overall quality of life. Methods Our study included 1843 school children aged 8 to 12 from 56 schools over a 2.5-year period before and during the pandemic. This multi-wave cross-sectional study utilized baseline data from an optimization trial of an indicated preventive intervention. The main outcomes were self-reported symptoms of anxiety and depression, and quality of life was the secondary outcome measure. Furthermore, responses to COVID-relevant questions were measured using a self-composed scale. Our objectives were to compare anxiety and depression symptom levels between cohorts of children who participated in the study before and during the pandemic, to examine if anxiety or depression predicted the COVID response, and whether anxiety and depression and subtypes of anxiety had an impact on quality of life during the pandemic. Linear regression and interaction models were used to examine relevant associations. Results Levels of anxiety and depression were higher in all waves compared to pre-pandemic levels. Quality of life was lower during the pandemic than before the pandemic, particularly among children with generalized anxiety symptoms. Quality of life was negatively associated with loneliness. Discussion Our study revealed that children reported higher anxious and depressive symptoms during the pandemic compared to pre-pandemic levels, as well as reduced quality of life. Lockdowns and restrictions may have contributed to this burden. Additionally, self-reported loneliness was a significant possible consequence of the restrictive measures imposed on children during the pandemic. Additional research is needed to investigate the long-term effects of the pandemic on children, particularly regarding the stability of elevated levels of anxiety and depression. Such studies could examine whether these conditions are indicative of a trajectory toward more severe internalizing disorders.Clinical trial registration: NCT04263558.
Collapse
Affiliation(s)
- Kristin Martinsen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Carina Lisøy
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Tore Wentzel-Larsen
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Simon-Peter Neumer
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Lene-Mari Potulski Rasmussen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Jo Magne Ingul
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| |
Collapse
|
71
|
Chai W, Shek DTL. Mental health profiles and the related socio-demographic predictors in Hong Kong university students under the COVID-19 pandemic: A latent class analysis. Psychiatry Res 2024; 331:115666. [PMID: 38071880 DOI: 10.1016/j.psychres.2023.115666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 01/02/2024]
Abstract
While the COVID-19 pandemic has brought about significant challenges to mental health of university students, there is limited research in this area. Particularly, few studies examined the person-centered mental health symptom profiles such as depression and anxiety and the related socio-demographic predictors. Using Latent Class Analysis (LCA), this study investigated the symptom profiles of depression and anxiety in university students in Hong Kong under the COVID-19 pandemic and the socio-demographic predictors. A total of 978 undergraduate students completed an online questionnaire including socio-demographic factors and measures of depression and anxiety during the summer of 2022. The LCA identified three latent classes: "normal" group, "moderate comorbid depression and anxiety" group and "severe comorbid depression and anxiety" group. Multinominal logistic regression showed that comparing with the "normal" group and the "moderate symptom" group, the "severe symptom" group had higher personal financial difficulties and individual/family member unemployment during the pandemic. In contrast, other socio-demographic factors (age, gender, year of study, living status, and COVID-19 infection status) had no significant association with group status. The study contributes to understanding of person-centered depression and anxiety symptom profiles and the risk role of personal financial difficulty in mental health of university students under the pandemic.
Collapse
Affiliation(s)
- Wenyu Chai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
| | - Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China.
| |
Collapse
|
72
|
Abstract
Though research is inconclusive in being able to determine if young athletes are more or less likely to suffer from mental health disorders compared with their non-athlete peers, there are important psychological considerations that are unique to the athletic population. This includes depression in the context of overtraining and burnout, performance anxiety, perfectionism, psychological sequalae of concussion, and injury as an independent risk factor for depression, anxiety, post-traumatic stress, and high-risk behaviors. Optimization of mental health care in youth athletes requires continued efforts to improve mental health literacy, decrease stigma, encourage help-seeking behaviors, and advance the routine implementation of effective screening practices.
Collapse
Affiliation(s)
- Mary M Daley
- Department of Orthopaedic Surgery, Division of Sports Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Boulevard, Madison, WI 53719, USA
| |
Collapse
|
73
|
Battaglini AM, Grocott B, Jopling E, Rnic K, Tracy A, LeMoult J. Patterns of respiratory sinus arrhythmia and trajectories of anxiety and depressive symptoms in early adolescence. Biol Psychol 2024; 185:108723. [PMID: 37981096 DOI: 10.1016/j.biopsycho.2023.108723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
In children and adults, individual differences in patterns of respiratory sinus arrhythmia (RSA; i.e., interactions between resting RSA and RSA reactivity to stress) have emerged as a central predictor of internalizing symptoms. However, it is unclear whether individual differences in patterns of RSA also contribute to internalizing symptoms during the key developmental period of early adolescence, when rates of internalizing symptoms sharply increase. In the present multi-wave longitudinal study, we assessed whether patterns of RSA predicted trajectories of the two most common types of internalizing symptoms among adolescents: anxiety and depression. In the baseline session, we assessed RSA at rest and in response to a psychosocial stressor (Trier Social Stress Test [TSST]) in a sample of 75 early adolescents (Mage = 12.85). Youth then completed measures of anxiety and depressive symptoms at baseline and four times over approximately two years. Findings indicate that RSA patterns predicted trajectories of anxiety, but not depression. Specifically, region of significance analyses indicated that individuals with high resting RSA who demonstrated RSA augmentation to the lab stressor evinced decreasing anxiety over the follow-up period. In direct contrast, adolescents with high resting RSA in combination with RSA withdrawal to the stressor exhibited a trajectory of increasing anxiety. Findings provide preliminary evidence for understanding RSA as a developmentally salient risk or protective factor.
Collapse
|
74
|
Tao Y, Zou X, Tang Q, Hou W, Wang S, Ma Z, Liu G, Liu X. Mapping network connection and direction between anxiety and depression symptoms across the early, middle, and late adolescents: Insights from a large Chinese sample. J Psychiatr Res 2024; 169:174-183. [PMID: 38039692 DOI: 10.1016/j.jpsychires.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 08/18/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
Depression and anxiety are two mental disorders prevailing among adolescents. However, issues regarding the trajectory of depression and anxiety are still controversial on both the disease and symptom dimensions. The novel method of network analysis was used to provide insight into the symptom dimension. 20,544 adolescents (female = 10,743, 52.3%) aged between 14 and 24 years (age mean ± sd = 16.9 ± 2.94) were divided into three subgroups according to age so that the course of depression and anxiety could be traced. Network analysis and the Bayesian network model were used in the current study. The results indicated that uncontrollable worry - excessive worry was the most significant edge for all adolescents, whereas concentration - motor had the highest edge weights for early adolescents, and anhedonia - energy was the most critical pairwise symptom for middle and late adolescents. Irritability can bridge anxiety and depression in the early and middle stages of adolescence, while suicide plays a bridging role in the early and late stages of adolescence. Restlessness and guilt can bridge anxiety and depression in middle- and late-stage adolescents, and feeling afraid plays a unique role in middle-stage adolescents. Except for sad mood, which can trigger middle adolescents' anxiety and depression, the other three subgroups were mainly triggered by nervousness. In addition, all results in our current study were shown to be stable and accurate. In treatment, targeting central and triggering symptoms at different stages of adolescence may be critical to alleviating the comorbidity of anxiety and depression.
Collapse
Affiliation(s)
- Yanqiang Tao
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Xinyuan Zou
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Qihui Tang
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Wenxin Hou
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Shujian Wang
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| | - Zijuan Ma
- School of Psychology, South China Normal University, Guangzhou, 510631, China.
| | - Gang Liu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, Beijing, 100875, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
| |
Collapse
|
75
|
Li C, Sun B. Statistical analysis of mental influencing factors for anxiety and depression of rural and urban freshmen. Front Public Health 2023; 11:1235262. [PMID: 38186710 PMCID: PMC10766696 DOI: 10.3389/fpubh.2023.1235262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
The freshmen stage is a high incidence period for psychological issues. With the increasing gap between urban and rural areas in China, the mental problems of rural freshmen are more prominent in recent years due to the huge contrast of campus life with their growth environment and other reasons. The concern for the mental well-being of both rural and urban freshman students prompted our comprehensive five-year study (2018-2022) on psychological issues in a group of 12,564 first-year students from dozens of public universities in Shandong province. The investigation employed PPS (probability proportional to size) sampling and was conducted near the the end of the first semester. Using the data gathered, we analyzed and compared the indicators of psychological problems in rural and urban freshmen by Duncan's Multiple Range Test. We also conducted a canonical correlation analysis and pathway analysis to examine the psychological factors that contribute to anxiety and depression in both rural and urban freshmen. According to the findings, rural freshmen exhibit significantly higher levels of anxiety and depression than their urban counterparts. Inferiority, obsession, and internet addiction were identified as the primary influencing factors of anxiety and depression in both rural and urban freshmen. Social phobia was found to be a significant influencing factor for anxiety in rural freshmen, while bigotry was identified as a specific influencing factor for urban freshmen. Furthermore, the results of the path analysis suggest that anxiety plays a crucial role as a mediating factor between the main influencing factors and depression. These results substantially extend former research in this area and have important implications for the development of effective intervention strategies to address anxiety and depression. According to these results, policymakers should assess and intervene of anxiety and depression as a whole, and provide mental health education according to main effect factors of freshmen from rural and urban areas. Detailed policy recommendations are in discussion and conclusion.
Collapse
Affiliation(s)
- Chang Li
- College of Insurance, Shandong University of Finance and Economics, Jinan, China
| | - Bingchuan Sun
- College of Physical Education, Shandong University of Finance and Economics, Jinan, China
| |
Collapse
|
76
|
Tang P, Pavlopoulou G, Kostyrka-Allchorne K, Phillips-Owen J, Sonuga-Barke E. Links between mental health problems and future thinking from the perspective of adolescents with experience of depression and anxiety: a qualitative study. Child Adolesc Psychiatry Ment Health 2023; 17:143. [PMID: 38129889 PMCID: PMC10740287 DOI: 10.1186/s13034-023-00679-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Depression and anxiety are common during adolescence and could have detrimental impacts on young people's ability to make and implement plans for their future. However, to the best of our knowledge, no other study has adopted a qualitative approach in investigating these effects from the perspective of adolescents with lived experiences of depression and anxiety. We sought to understand how young people perceive and interpret the impact of mental health conditions on their thinking about the future. METHODS We conducted semi-structured interviews with 19 adolescents aged 16-19 years in the UK (median age = 19, IQR = 1.5), who had a history of protracted periods of clinical or subclinical depression and/or anxiety. They were asked to reflect on how their ability to think about the future and the content of the future-related thinking was impacted during periods of poor mental health, compared with periods of feeling well. Interviews were transcribed verbatim and subjected to thematic content analysis. RESULTS Five domains were identified. First, the impact of mood on future thinking capability focuses on reduced ability and motivation to engage in future thinking. Second, the impact of mood on images, thoughts, and feelings about the future includes the emotional valence of future-related thoughts, their vividness, structure, and the extent to which they intimated subjective feelings of control (i.e., agency). Third, social influences focuses on social factors that might ameliorate or exacerbate future thinking. Fourth, reflections on personal worries and expectations about the future captures personal interpretations of past worries and hopes and how future thinking affected mood. Finally, personal coping refers to how young people cope with the negative emotions that come with future thinking. CONCLUSIONS This study provided a nuanced and granular account of how depression and anxiety impacted young people's future thinking based on their lived experiences. By highlighting the different ways that variations in future thinking were experienced as a function of depression and anxiety, our analysis highlighted new factors that should be considered in studies of adolescent mental health risk, which could inform the development of new therapeutic approaches.
Collapse
Affiliation(s)
- Peiyao Tang
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Georgia Pavlopoulou
- Group for Research in Relationships and Neurodiversity (GRRAND), Clinical, Education & Health Psychology, Division of Psychology & Language Sciences, Faculty of Brain Sciences, University College London, London, UK
- Anna Freud Centre, London, UK
| | - Katarzyna Kostyrka-Allchorne
- Department of Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Jacqueline Phillips-Owen
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Edmund Sonuga-Barke
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
- Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
| |
Collapse
|
77
|
Shen J, Wang Y. Correlates of Longitudinal Trajectories of Depressive Symptoms in Adolescents With Traumatic Brain Injuries. J Pediatr Psychol 2023; 48:1021-1029. [PMID: 37846151 PMCID: PMC10733728 DOI: 10.1093/jpepsy/jsad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE Depression poses a significant threat to the health and well-being of adolescents with traumatic brain injury. Existing research has limitations in longitudinal follow-up period, consideration of sample heterogeneity, and outcome measurement modeling. This study aimed to address these gaps by applying the second-order growth mixture model (SO-GMM) to examine the 10-year post-injury depression trajectories in adolescents with TBI. METHODS A total of 1,989 adolescents with TBI 16-21 years old from the Traumatic Brain Injury Model System National Data Bank were analyzed up to 10 years post-injury. Depressive symptoms were measured by Patient Health Questionnaire-9. Covariates included age, sex, race/ethnicity, employment, Functional Independence Measure Cognition, TBI severity, pre-injury disability, and substance use. Longitudinal measurement invariance was tested at the configural, metric, and scalar levels before SO-GMM was fit. Logistic regression was conducted for disparities in depression trajectories by covariates. RESULTS A 2-class SO-GMM was identified with a low-stable group (85% of the sample) and a high-increasing group (15% of the sample) on depression levels. Older age, being a Native American, and having Hispanic origin was associated with a higher likelihood of being in the high-increasing class (odds ratios [ORs] = 1.165-4.989 and 1.609, respectively), while patients with higher education and being male were less likely to be in the high-increasing class (ORs = 0.735 and 0.557, respectively). CONCLUSIONS This study examined the disparities in depression among two distinct longitudinal groups of adolescents with TBI 10 years post-injury. Findings of the study are informative for intervention development to improve long-term mental health in adolescents with TBI.
Collapse
Affiliation(s)
- Jiabin Shen
- Department of Psychology, University of Massachusetts Lowell, USA
| | - Yan Wang
- Department of Psychology, University of Massachusetts Lowell, USA
| |
Collapse
|
78
|
Tao Y, Cheng Z, Wang C, Liu T, Yan M, Huang X, Jian S, Sun L, Chen Z. Perceived stress and psychological disorders in healthcare professionals: a multiple chain mediating model of effort-reward imbalance and resilience. Front Public Health 2023; 11:1320411. [PMID: 38155891 PMCID: PMC10753578 DOI: 10.3389/fpubh.2023.1320411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/01/2023] [Indexed: 12/30/2023] Open
Abstract
Background Healthcare professionals have shown more psychological disorders such as anxiety and depression due to the nature of work, which can cause job burnout, decrease the quality of medical services, and even endanger medical safety. The aim of the study is to explore the serial multiple mediating role of effort- reward imbalance and resilience between perceived stress and psychological disorders among healthcare professionals. Methods A cross-sectional study was conducted in China from February to April 2023. A total of 2098 healthcare professionals at a tertiary general hospital was investigated by the following self-reported questionnaires: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), The Effort-Reward Imbalance (ERI), Healthcare professionals Resilience Scale (MSRS). Results Anxiety and depression are interrelated (r = 0.362, p < 0.01), and they were positively related to perceived stress (r = 0.640/0.607, p < 0.01) and ERI (r = 0.422/0.383, p < 0.01), and negatively related to resilience (r = -0.343/-0.320, p < 0.01). After controlling demographic factors, the variance in anxiety and depression was explained by perceived stress was 37.7 and 35.0%. Bootstrap analyses examining the pathway of perceived stress-ERI-resilience-anxiety revealed significant direct effects [B = 0.560, 95%CI (0.528, 0.591)], as well as indirect effects mediated independently by ERI [B = 0.045, 95%CI (0.029, 0.060)], resilience [B = 0.031, 95%CI (0.017, 0.047)], or a combination of both [B = 0.004, 95%CI (0.002, 0.007)]. Similarly, in the path of perceived stress-ERI-resilience-anxiety-depression, significant direct effects were found [B = -0.310, 95%CI(0.265, 0.351)], along with indirect effects mediated individually by ERI [B = 0.033, 95%CI(0.013, 0.052)], resilience [B = 0.014, 95%CI (0.001, 0.028)], and anxiety [B = 0.218, 95%CI (0.190, 0.246)], or by both or three together (B = 0.032). Conclusion This study proved the hypothesis that ERI and resilience played a mediating role in perceived stress and psychological disorders, revealed the potential mechanism of anxiety in stress and depression, and proposed a solution for perceived stress to psychological distress, which can provide a basis for the intervention of healthcare professionals in the face of mental health crisis.
Collapse
Affiliation(s)
- Yuanling Tao
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zhen Cheng
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Chenxi Wang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Ting Liu
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Mi Yan
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xiaohong Huang
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Shasha Jian
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Li Sun
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zongtao Chen
- Health Management Centre, First Affiliated Hospital of Army Medical University, Chongqing, China
| |
Collapse
|
79
|
He Y, Wu C, LeMoult J, Huang J, Zhao Y, Liang K, Chen S, Wang E, Huang L, Chi X. Exploring symptom-level associations between anxiety and depression across developmental stages of adolescence: a network analysis approach. BMC Psychiatry 2023; 23:941. [PMID: 38093232 PMCID: PMC10720222 DOI: 10.1186/s12888-023-05449-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Anxiety and depression often co-occur during adolescence, but the associations between symptoms of these two disorders in this developmental period are not yet fully understood. Network analysis provides a valuable approach to uncover meaningful associations among symptoms and offers insights for prevention and intervention strategies. This study aimed to investigate symptom-level associations between anxiety and depression using network analysis and to identify core symptoms, bridge symptoms, and differences in network structure across different stages of adolescence. METHODS The cross-sectional study was conducted in March 2022 in Shenzhen, China. Participants completed the Generalized Anxiety Disorder Scale-7 and Patient Health Questionnaire Depression Scale, along with demographic questionnaires assessing age and gender. Chinese adolescents aged 10 to 17 who were in Grades 5 or 6 of elementary school, Grades 1 or 2 of middle school, or Grades 1 or 2 of high school, and who could comprehensively understand and read Chinese were recruited as participants. Students in Grade 3 of middle and high schools were excluded due to their upcoming high school or college entrance examinations. Based on age, participants were categorized into early, middle, and late developmental stages of adolescence. RESULTS "Loss of control" was among the most central symptoms in the comorbidity network throughout all three developmental stages; "excessive worry" and "anhedonia" emerged as the core symptoms in early adolescence, and "restlessness" as the core symptom in late adolescence. "Anhedonia," "sad mood," and "fatigue" were identified as bridge symptoms between anxiety and depression across all three developmental stages of adolescence. The global strength of the network in middle adolescence was significantly higher compared to the other two stages. CONCLUSION These findings highlight the core and bridge symptoms that require special attention and intervention at each stage of adolescence. Moreover, significantly higher network connectivity in middle adolescence suggests this is a critical period for intervention to prevent the development of comorbid mental disorders.
Collapse
Affiliation(s)
- Yunhan He
- School of psychology, Shenzhen University, No. 3688, Nanhai Avenue, Nanshan District, Shenzhen, Guangdong, 518060, China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen, China
| | - Chengrui Wu
- Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA
- Department of Applied Social Science, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joelle LeMoult
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Jiasheng Huang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Yue Zhao
- School of psychology, Shenzhen University, No. 3688, Nanhai Avenue, Nanshan District, Shenzhen, Guangdong, 518060, China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen, China
| | - Kaixin Liang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Shiyun Chen
- Department of Applied Social Science, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Enna Wang
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Liuyue Huang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Xinli Chi
- School of psychology, Shenzhen University, No. 3688, Nanhai Avenue, Nanshan District, Shenzhen, Guangdong, 518060, China.
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen, China.
| |
Collapse
|
80
|
Grothus S, Sommer A, Claus BB, Stahlschmidt L, Chorpita BF, Wager J. The German version of the Revised Children's Anxiety and Depression Scale-Psychometric properties and normative data for German 8- to 17-year-olds. Int J Methods Psychiatr Res 2023; 32:e1965. [PMID: 36920869 DOI: 10.1002/mpr.1965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVES Anxiety and depression are internalizing mental disorders often commencing in childhood and manifesting in adolescence. The Revised Anxiety and Depression Scale (RCADS) is an internationally widely used standardized diagnostic tool, but the German version has only been validated in a pediatric chronic pain sample; normative data are not available. The aim of this study is to test its reliability (internal consistency) and validity (factorial, convergent, known-groups) in a representative German school sample and to provide norm data. METHODS Data were collected from N = 1562 German schoolchildren (Mage = 12.2; SDage = 2.33; range 8-17 years; 52.4% girls). RESULTS Cronbach's α ranged from 0.73 to 0.96 for the total and the six subscales (five anxiety and one depression). Confirmatory factor analysis showed the 6-factor model had acceptable to good model fit with CFI = 0.93, TLI = 0.93, RMSEA = 0.05, SRMR = 0.05, which was better than 1- and 2-factor models. The (sub)scales correlated moderate to high negatively with health-related quality of life (-0.31 ≤ τ ≤ -0.51; p < 0.001) and positively with functional impairment (0.31 ≤ τ ≤ 0.48; p < 0.001). Mean scores of anxiety and depression scales were significantly higher in girls and partly in adolescents. CONCLUSION Findings provide support for the good psychometric properties of the German RCADS in a community sample.
Collapse
Affiliation(s)
- Susanne Grothus
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Ariane Sommer
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Benedikt B Claus
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
| | - Lorin Stahlschmidt
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Bruce F Chorpita
- Department of Psychology, University of California, Oakland, California, USA
| | - Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- PedScience Research Institute, Datteln, Germany
| |
Collapse
|
81
|
Tiraboschi GA, Garon-Carrier G, Smith J, Fitzpatrick C. Adolescent internet use predicts higher levels of generalized and social anxiety symptoms for girls but not boys. Prev Med Rep 2023; 36:102471. [PMID: 37881178 PMCID: PMC10594560 DOI: 10.1016/j.pmedr.2023.102471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/07/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
Past research suggests that internet use can increase the risks of internalizing symptoms in adolescents. However, bidirectional relationships between adolescent internet use and anxiety symptoms have received very little attention. Furthermore, few studies have examined these links according to sex. The present study attempts to fill this gap by investigating longitudinal associations between Canadian boys' and girls' internet use and symptoms of generalized anxiety and social anxiety using data from the Quebec longitudinal Study of Child Development. A sample of 1324 adolescents (698 girls, 626 boys) self-reported the number of hours per week they spent on the internet and their symptoms of generalized and social anxiety at ages 15 and 17. We estimated two cross-lagged panel models with social or generalized anxiety symptoms and internet use at age 15 predicting those same variables at age 17. Sex was used as a grouping variable and socioeconomic status was included as a control variable. Internet use at 15 predicted generalized and social anxiety symptoms at age 17 in girls, but not boys. Social and generalized anxiety symptoms at age 15 did not predict internet use at age 17 for both boys and girls. These results suggest that internet use can be a significant risk factor for the development of anxiety symptoms in adolescent girls. Girls may be more vulnerable to the negative effects of internet use due to increased sensitivity to social comparisons. Thus, helping girls develop healthier internet use habits should be a target for promoting their mental health.
Collapse
Affiliation(s)
- Gabriel A. Tiraboschi
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
- Département de psychoéducation, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Gabrielle Garon-Carrier
- Département de psychoéducation, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Jonathan Smith
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Caroline Fitzpatrick
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| |
Collapse
|
82
|
Greenberg RL, Guzick AG, Schneider SC, Weinzimmer SA, Kook M, Perozo Garcia AB, Storch EA. Depressive Symptoms in Autistic Youth with Anxiety Disorders. J Dev Behav Pediatr 2023; 44:e597-e603. [PMID: 38019467 PMCID: PMC10873531 DOI: 10.1097/dbp.0000000000001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/07/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Anxiety and depression often coexist in youth and share overlapping symptomatology; however, little is known about the comorbidity of anxiety and depression in autistic youth. This study explores (1) the frequency of depressive symptoms among autistic children with clinically significant anxiety, (2) clinical variables that may be associated with elevated depressive symptoms, and (3) whether pretreatment depressive symptoms predict cognitive behavioral therapy (CBT) outcomes for anxiety. METHOD Children aged 7 to 13 years (N = 87) and their parents participated in a randomized controlled trial comparing 2 versions of a parent-led, telehealth-delivered CBT program. Parents and children completed a variety of clinical assessments and self-report questionnaires before and after treatment. RESULTS Fifty-seven percent of the child sample reported experiencing elevated depressive symptoms while roughly 20% of parents reported elevated depressive symptoms in their child. A strong association between anxiety and depression was found. Heightened feelings of loneliness, per child report, and functional impairment, per parent report, were found to be uniquely associated with elevated depressive symptoms. Finally, depressive symptoms were not a significant predictor of CBT outcomes for anxiety. CONCLUSION Findings suggest high degrees of comorbidity between anxiety and depression among autistic children and that feelings of loneliness, anxiety, and functional impairment may be early indicators of mood-related concerns. Further research is needed to determine the full extent of the association between anxiety and depression and additional options for treating depression in autistic children.
Collapse
Affiliation(s)
- Rebecca L Greenberg
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; and
| | - Andrew G Guzick
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; and
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Sophie C Schneider
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; and
| | - Saira A Weinzimmer
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; and
| | - Minjee Kook
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; and
| | - Amanda B Perozo Garcia
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; and
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; and
| |
Collapse
|
83
|
Finn S, Wright LHV, Mak HW, Åström E, Nicholls L, Dingle GA, Warran K. Expanding the social cure: a mixed-methods approach exploring the role of online group dance as support for young people (aged 16-24) living with anxiety. Front Psychol 2023; 14:1258967. [PMID: 37915522 PMCID: PMC10616254 DOI: 10.3389/fpsyg.2023.1258967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023] Open
Abstract
There is an increased interest in whether online arts interventions support mental health and social connections. This study explored eight weeks of online group dance as support for young people (aged 16-24) living with anxiety. The applicability of the 'social cure' theoretical framework to the novel context of an online dance class was sought. The study utilised an embedded QUAL+quan design, incorporating participatory focus group discussions (n = 3 groups; n = 11 participants) and one-on-one interviews (n = 2 participants), creative reflections (n = 16 participants) and ethnographic fieldnotes, and a repeated measures design with surveys at three timepoints (week 1, n = 27; week 4, n = 18; week 8, n = 14). Thematic analysis identified two overarching themes demonstrating how the dance classes (i) provided the opportunity to co-construct a meaningful shared identity and (ii) supported holistic wellbeing. The quantitative findings supported this, suggesting lower anxiety, depression, and loneliness and higher wellbeing, self-esteem, self-efficacy, and group closeness. This study expands the social cure to its application to an online dance context for the first time.
Collapse
Affiliation(s)
- Saoirse Finn
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Laura H. V. Wright
- Childhood and Youth Studies Research Group, Institute for Community, Education, and Society, Moray House School of Education and Sport, The University of Edinburgh, Edinburgh, United Kingdom
| | - Hei Wan Mak
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Emili Åström
- Dance Base, Scotland’s National Centre for Dance, Edinburgh, United Kingdom
| | - Lucy Nicholls
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Genevieve A. Dingle
- Music, Dance and Health Research Group, School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Katey Warran
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| |
Collapse
|
84
|
Zhou Z, Li Y, Zhang Y, Liu J, Ai H, Liu M, Qiu J, Luo YJ, Xu P. Differential effects of generalized anxiety and separation anxiety on brain structural development during adolescence. J Affect Disord 2023; 339:478-485. [PMID: 37442456 DOI: 10.1016/j.jad.2023.07.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/17/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
Excessive anxiety is highly prevalent during childhood and adolescence, with detrimental effects on somatic and mental health, and quality of life. Although structural abnormalities in the brain have been found in people with anxiety disorders, whether anxiety affects the brain development of children and adolescents remains unknown. Here, we applied a multivariate approach to two single-site MRI datasets consisting of 733 and 775 participants aged 5-18 years. Using linear support vector regression and cross-validation, brain age is estimated by predicting the chronological age from the features that combine cortical thickness and surface area of 68 brain regions. We found that gray matter can predict the chronological age of children and adolescents with a low mean absolute error. Compared to specific brain network, the whole structural brain measures predicted brain age better. Importantly, adolescents with higher generalized anxiety and those with lower separation anxiety showed lower brain age, indicating a slow development of brain structures. The relationship between anxiety and brain age of youths could also be found in parent-reported separation anxiety. The findings highlight differential effects of different anxiety types on brain structural development and suggest that different types of anxiety during childhood and adolescence should be treated differently.
Collapse
Affiliation(s)
- Zheyi Zhou
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yiman Li
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Yuqi Zhang
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Jing Liu
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hui Ai
- Institute of Applied Psychology, Tianjin University, Tianjin, China; Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Mingfang Liu
- Community Health Service Center, Beijing Normal University, Beijing, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yue-Jia Luo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Institute for Neuropsychological Rehabilitation, University of Health and Rehabilitation Sciences, Qingdao, China; School of Psychology, Chengdu Medical College, Chengdu, China.
| | - Pengfei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (BNU), Faculty of Psychology, Beijing Normal University, Beijing, China; Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China.
| |
Collapse
|
85
|
Zhang X, Lv T, Leavey G, Zhu N, Li X, Li Y, Chen Y. Does depression affect the association between prosocial behavior and anxiety? A cross-sectional study of students in China. Front Public Health 2023; 11:1274253. [PMID: 37886045 PMCID: PMC10598463 DOI: 10.3389/fpubh.2023.1274253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
Background A growing number of studies have suggested that adolescents' prosocial behavior can protect against depression and anxiety. It is known that anxiety and depression are often comorbid. However, it remains unclear if when depression is present, prosocial behavior remains protective against anxiety, and if when anxiety is present, prosocial behavior remains protective against depression. The purpose of this study was to determine the association of anxiety and depressive with prosocial behavior. Methods A large representative sample of middle-school students was recruited for a cross-sectional study and completed standardized instruments (the Children's Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders-Child version (SCARED-C), and Strengths and Difficulties Questionnaire (SDQ)). We used structural equation modeling (SEM) to examine the protective effect of prosocial behavior against anxiety when depression was present. Results A survey of 3,510 students was conducted, and the final analysis included 3,169 students, comprising 1,616 boys (51.0%) and 1,553 girls (49.0%), with a mean age of 13.09 years (SD = 1.31, range 11-16).The prevalence rates of anxiety and depression in early adolescents were 31.6 and 16.7%, respectively. More than two-thirds of depressed adolescents had comorbid anxiety, while more than one-third of anxious adolescents had comorbid depression. Regression models showed that compared with depressed adolescents, adolescents without depressive symptoms exhibited a significant negative correlation between prosocial behaviors and anxiety and depression (β = -0.01, p > 0.01, β = -0.06, p > 0.01; β = -0.11, p < 0.01, and β = -0.17, p < 0.01). There was no difference in the relationship between prosocial behavior and depression between anxious and non-anxious adolescents (p > 0.05). Conclusion Anxiety and depression are common in adolescence and are often comorbid disorders. However, the comorbidity is not symmetrical. Specifically, the protective effect of prosocial behavior against anxiety is weaker in depressed adolescents. Findings are discussed in light of related research and theory, and insights for intervention programs and future research are presented.
Collapse
Affiliation(s)
- Xiyan Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Tao Lv
- People’s Hospital of Deyang, Deyang, China
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, United Kingdom
| | - Na Zhu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xin Li
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yan Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanhua Chen
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| |
Collapse
|
86
|
Zhang X, Cheng B, Yang X, Suo X, Pan N, Chen T, Wang S, Gong Q. Emotional intelligence mediates the protective role of the orbitofrontal cortex spontaneous activity measured by fALFF against depressive and anxious symptoms in late adolescence. Eur Child Adolesc Psychiatry 2023; 32:1957-1967. [PMID: 35737106 DOI: 10.1007/s00787-022-02020-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/01/2022] [Indexed: 02/05/2023]
Abstract
As a stable personality construct, trait emotional intelligence (TEI) refers to a battery of perceived emotion-related skills that make individuals behave effectively to adapt to the environment and maintain well-being. Abundant evidence has consistently shown that TEI is important for the outcomes of many mental health issues, particularly depression and anxiety. However, the neural substrates involved in TEI and the underlying neurobehavioral mechanism of how TEI reduces depression and anxiety symptoms remain largely unknown. Herein, resting-state functional magnetic resonance imaging and a group of behavioral measures were applied to examine these questions among a large sample comprising 231 general adolescent students aged 16-20 years (52% female). Whole-brain correlation analysis and prediction analysis demonstrated that TEI was negatively linked with spontaneous activity (measured with the fractional amplitude of low-frequency fluctuations) in the bilateral medial orbitofrontal cortex (OFC), a critical site implicated in emotion-related processes. Furthermore, structural equation modeling analysis found that TEI mediated the link of OFC spontaneous activity to depressive and anxious symptoms. Collectively, the current findings present new evidence for the neurofunctional bases of TEI and suggest a potential "brain-personality-symptom" pathway for alleviating depressive and anxious symptoms among students in late adolescence.
Collapse
Affiliation(s)
- Xun Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
| |
Collapse
|
87
|
Smárason O, Guzick AG, Goodman WK, Salloum A, Storch EA. Predictors and Moderators of Treatment Outcomes for Anxious Children Randomized to Computer-Assisted Cognitive Behavioral Therapy or Standard Community Care. J Child Adolesc Psychopharmacol 2023; 33:316-324. [PMID: 37861988 PMCID: PMC10616955 DOI: 10.1089/cap.2023.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Introduction: Computer-assisted cognitive behavioral therapy (CCBT) for childhood anxiety disorders may aid the dissemination of CBT, while maintaining treatment fidelity. Although CCBT is an effective intervention, not everyone benefits equally from treatment. Identifying patient characteristics that predict who will benefit from treatment and to what extent can help with matching patients to suitable interventions, and allow researchers and clinicians to modify, and individualize, their treatment formats more effectively. Such predictors and moderators have not yet been examined for CCBT outcomes in anxious children and studies of more traditional treatment formats have yielded inconsistent results. Methods: Using data from a randomized clinical trial evaluating CCBT for children with anxiety disorders, this study examined predictors and moderators of treatment outcomes in a sample of 100 children (age: mean [M] = 9.82, standard deviation [SD] = 1.82), randomized to either CCBT (n = 49) or standard community care (n = 51). Potential predictors and moderators were identified from the literature and examined in stepwise multiple linear regression models, using posttreatment anxiety severity and global impairment as outcomes. Results: Parent-rated internalizing symptoms predicted posttreatment anxiety severity for both treatment groups. High pretreatment levels of anxiety severity predicted higher global impairment at posttreatment for the group receiving community care, but not for the CCBT group. Conclusion: Further research is needed to clarify which patient characteristics are associated with CCBT outcomes in a consistent way. ClinicalTrials.gov identifier: NCT01416805.
Collapse
Affiliation(s)
- Orri Smárason
- Faculty of Psychology, University of Iceland, Reykjavik, Iceland
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew G. Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Wayne K. Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Alison Salloum
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
88
|
Fine SL, Blum RW, Bass JK, Lulebo AM, Pinandari AW, Stones W, Wilopo SA, Zuo X, Musci RJ. A latent class approach to understanding patterns of emotional and behavioral problems among early adolescents across four low- and middle-income countries. Dev Psychopathol 2023; 35:1684-1700. [PMID: 35635213 PMCID: PMC9708939 DOI: 10.1017/s0954579422000384] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Early adolescents (ages 10-14) living in low- and middle-income countries have heightened vulnerability to psychosocial risks, but available evidence from these settings is limited. This study used data from the Global Early Adolescent Study to characterize prototypical patterns of emotional and behavioral problems among 10,437 early adolescents (51% female) living in the Democratic Republic of Congo (DRC), Malawi, Indonesia, and China, and explore the extent to which these patterns varied by country and sex. LCA was used to identify and classify patterns of emotional and behavioral problems separately by country. Within each country, measurement invariance by sex was evaluated. LCA supported a four-class solution in DRC, Malawi, and Indonesia, and a three-class solution in China. Across countries, early adolescents fell into the following subgroups: Well-Adjusted (40-62%), Emotional Problems (14-29%), Behavioral Problems (15-22%; not present in China), and Maladjusted (4-15%). Despite the consistency of these patterns, there were notable contextual differences. Further, tests of measurement invariance indicated that the prevalence and nature of these classes differed by sex. Findings can be used to support the tailoring of interventions targeting psychosocial adjustment, and suggest that such programs may have utility across diverse cross-national settings.
Collapse
Affiliation(s)
- Shoshanna L. Fine
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert W. Blum
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Judith K. Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aimée M. Lulebo
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Anggriyani W. Pinandari
- Center for Reproductive Health, Faculty of Medicine, University of Gadjah Mada, Yogyakarta, Indonesia
| | - William Stones
- Center for Reproductive Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Siswanto A. Wilopo
- Center for Reproductive Health, Faculty of Medicine, University of Gadjah Mada, Yogyakarta, Indonesia
| | - Xiayun Zuo
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Rashelle J. Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
89
|
Rapee RM, Creswell C, Kendall PC, Pine DS, Waters AM. Anxiety disorders in children and adolescents: A summary and overview of the literature. Behav Res Ther 2023; 168:104376. [PMID: 37499294 DOI: 10.1016/j.brat.2023.104376] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.
Collapse
Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia.
| | - Cathy Creswell
- Departments of Psychiatry and Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip C Kendall
- Department of Psychology, Temple University, Child and Adolescent Anxiety Disorders Clinic, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program (NIMH-IRP), USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Brisbane, Australia
| |
Collapse
|
90
|
Abend R. Understanding anxiety symptoms as aberrant defensive responding along the threat imminence continuum. Neurosci Biobehav Rev 2023; 152:105305. [PMID: 37414377 PMCID: PMC10528507 DOI: 10.1016/j.neubiorev.2023.105305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023]
Abstract
Threat-anticipatory defensive responses have evolved to promote survival in a dynamic world. While inherently adaptive, aberrant expression of defensive responses to potential threat could manifest as pathological anxiety, which is prevalent, impairing, and associated with adverse outcomes. Extensive translational neuroscience research indicates that normative defensive responses are organized by threat imminence, such that distinct response patterns are observed in each phase of threat encounter and orchestrated by partially conserved neural circuitry. Anxiety symptoms, such as excessive and pervasive worry, physiological arousal, and avoidance behavior, may reflect aberrant expression of otherwise normative defensive responses, and therefore follow the same imminence-based organization. Here, empirical evidence linking aberrant expression of specific, imminence-dependent defensive responding to distinct anxiety symptoms is reviewed, and plausible contributing neural circuitry is highlighted. Drawing from translational and clinical research, the proposed framework informs our understanding of pathological anxiety by grounding anxiety symptoms in conserved psychobiological mechanisms. Potential implications for research and treatment are discussed.
Collapse
Affiliation(s)
- Rany Abend
- School of Psychology, Reichman University, P.O. Box 167, Herzliya 4610101, Israel; Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
| |
Collapse
|
91
|
Godoy R, Macedo AB, Gervazio KY, Ribeiro LR, Lima JLF, Salvadori MGSS. Effects of ortho-eugenol on anxiety, working memory and oxidative stress in mice. BRAZ J BIOL 2023; 83:e271785. [PMID: 37610945 DOI: 10.1590/1519-6984.271785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/21/2023] [Indexed: 08/25/2023] Open
Abstract
Ortho-eugenol is a synthetic derivative from eugenol, the major compound of clove essential oil, which has demonstrated antidepressant and antinociceptive effects in pioneering studies. Additionally, its effects appear to be dependent on the noradrenergic and dopaminergic systems. Depression and anxiety disorders are known to share a great overlap in their pathophysiology, and many drugs are effective in the treatment of both diseases. Furthermore, high levels of anxiety are related to working memory deficits and increased oxidative stress. Thus, in this study we investigated the effects of acute treatment of ortho-eugenol, at 50, 75 and 100 mg/kg, on anxiety, working memory and oxidative stress in male Swiss mice. Our results show that the 100 mg/kg dose increased the number of head-dips and reduced the latency in the hole-board test. The 50 mg/kg dose reduced malondialdehyde levels in the prefrontal cortex and the number of Y-maze entries compared to the MK-801-induced hyperlocomotion group. All doses reduced nitrite levels in the hippocampus. It was also possible to assess a statistical correlation between the reduction of oxidative stress and hyperlocomotion after the administration of ortho-eugenol. However, acute treatment was not able to prevent working memory deficits. Therefore, the present study shows that ortho-eugenol has an anxiolytic and antioxidant effect, and was able to prevent substance-induced hyperlocomotion. Our results contribute to the elucidation of the pharmacological profile of ortho-eugenol, as well as to direct further studies that seek to investigate its possible clinical applications.
Collapse
Affiliation(s)
- R Godoy
- Universidade Federal da Paraíba, Instituto de Pesquisa em Fármacos e Medicamentos, Laboratório de Psicofarmacologia, João Pessoa, PB, Brasil
| | - A B Macedo
- Universidade Federal da Paraíba, Instituto de Pesquisa em Fármacos e Medicamentos, Laboratório de Psicofarmacologia, João Pessoa, PB, Brasil
| | - K Y Gervazio
- Universidade Federal da Paraíba, Instituto de Pesquisa em Fármacos e Medicamentos, Laboratório de Psicofarmacologia, João Pessoa, PB, Brasil
- Universidade Federal da Paraíba, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Bioativos Naturais e Sintéticos - PgPNSB, João Pessoa, PB, Brasil
| | - L R Ribeiro
- Universidade Federal da Paraíba, Instituto de Pesquisa em Fármacos e Medicamentos, Laboratório de Psicofarmacologia, João Pessoa, PB, Brasil
| | - J L F Lima
- Universidade Federal da Paraíba, Instituto de Pesquisa em Fármacos e Medicamentos, Laboratório de Psicofarmacologia, João Pessoa, PB, Brasil
- Universidade Federal da Paraíba, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Bioativos Naturais e Sintéticos - PgPNSB, João Pessoa, PB, Brasil
| | - M G S S Salvadori
- Universidade Federal da Paraíba, Instituto de Pesquisa em Fármacos e Medicamentos, Laboratório de Psicofarmacologia, João Pessoa, PB, Brasil
- Universidade Federal da Paraíba, Centro de Ciências da Saúde, Programa de Pós-graduação em Produtos Bioativos Naturais e Sintéticos - PgPNSB, João Pessoa, PB, Brasil
| |
Collapse
|
92
|
Moller CI, Badcock PB, Hetrick SE, Rice S, Berk M, Witt K, Chanen AM, Dean OM, Gao C, Cotton SM, Davey CG. Predictors of suicidal ideation severity among treatment-seeking young people with major depressive disorder: The role of state and trait anxiety. Aust N Z J Psychiatry 2023; 57:1150-1162. [PMID: 36629043 DOI: 10.1177/00048674221144262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Depression and suicidal ideation are closely intertwined. Yet, among young people with depression, the specific factors that contribute to changes in suicidal ideation over time are uncertain. Factors other than depressive symptom severity, such as comorbid psychopathology and personality traits, might be important contributors. Our aim was to identify contributors to fluctuations in suicidal ideation severity over a 12-week period in young people with major depressive disorder receiving cognitive behavioural therapy. METHODS Data were drawn from two 12-week randomised, placebo-controlled treatment trials. Participants (N = 283) were 15-25 years old, with moderate to severe major depressive disorder. The primary outcome measure was the Suicidal Ideation Questionnaire, administered at baseline and weeks 4, 8 and 12. A series of linear mixed models was conducted to examine the relationship between Suicidal Ideation Questionnaire score and demographic characteristics, comorbid psychopathology, personality traits and alcohol use. RESULTS Depression and anxiety symptom severity, and trait anxiety, independently predicted higher suicidal ideation, after adjusting for the effects of time, demographics, affective instability, non-suicidal self-injury and alcohol use. CONCLUSIONS Both state and trait anxiety are important longitudinal correlates of suicidal ideation in depressed young people receiving cognitive behavioural therapy, independent of depression severity. Reducing acute psychological distress, through reducing depression and anxiety symptom severity, is important, but interventions aimed at treating trait anxiety could also potentially be an effective intervention approach for suicidal ideation in young people with depression.
Collapse
Affiliation(s)
- Carl I Moller
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah E Hetrick
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Simon Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Katrina Witt
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew M Chanen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Olivia M Dean
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health and Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Caroline Gao
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
93
|
Badger JR, Rovira A, Freeman D, Bowes L. Developing a virtual reality environment for educational and therapeutic application to investigate psychological reactivity to bullying. VIRTUAL REALITY 2023; 27:2623-2632. [PMID: 37614717 PMCID: PMC10442262 DOI: 10.1007/s10055-023-00829-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 06/21/2023] [Indexed: 08/25/2023]
Abstract
Understanding how bullying victimisation influences cognitive and emotional processes may help to direct early intervention to prevent the development of psychopathology. In a convenience sample of 67 female adolescents, we assessed the potential of a newly developed classroom-set bullying experience in virtual reality (VR) to evoke psychological reactions. Two VR experiences were co-developed with young people, one neutral and one hostile (bullying). Participants were matched and assigned to a condition based on measures of anxiety, depression, paranoia, and previous bullying, before experiencing either the neutral or hostile scenario. Before and after the VR session, participants completed measures of negative affect and levels of distress. All participants remained immersed for the whole duration, which supports the acceptability of using these VR experiences with more vulnerable participants. Those experiencing the hostile version reported greater negative affect post-immersion compared to those experiencing the neutral version (p = .018; d = 0.61). Although non-significant, a similar outcome was found regarding distress (p = .071; d = 0.37). Whilst we did not find a significant relationship between pre-existing internalisation on negative affect and distress, our sample was limited by containing adolescents with relatively low levels of previous bullying experience. Yet we still found evidence that the VR scenario evoked bullying-related psychological reactions. Further testing with a more representative groups of adolescents, especially those with more experience of bullying, would be advised. The VR scenario could potentially be used in educational and therapeutic settings to enhance empathy towards victimised children or enhance resilience following victimisation.
Collapse
Affiliation(s)
- Julia R. Badger
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Aitor Rovira
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Daniel Freeman
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Lucy Bowes
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| |
Collapse
|
94
|
Zhao M, Huang Y, Wang J, Feng J, Zhou B. Internet addiction and depression among Chinese adolescents: anxiety as a mediator and social support as a moderator. PSYCHOL HEALTH MED 2023; 28:2315-2328. [PMID: 37317485 DOI: 10.1080/13548506.2023.2224041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
This study constructed a moderated mediation model to investigate the mediating effect of anxiety and the moderating effect of social support between Internet addiction and depression. A sample of 17 058 middle school students in one district of Chengdu were selected. The Internet Addiction Test (IAT), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Social Support Scale for adolescents were used to investigate their Internet addiction, anxiety, depression and social support. The descriptive statistics and Spearman correlation analysis were performed with SPSS 25.0. An SPSS macro process was used to analyze the data from complex models that contained mediators and moderators. The results show that adolescents with Internet addiction are more likely to suffer from depression. Anxiety partially mediated the relations between Internet addiction and depression. Social support moderated both direct and indirect pathways leading from Internet addiction to depression, and these two effects were stronger for adolescents with low social support than for those with high social support. It will be possible for researchers to gain a better understanding of the conditions, pathways, and effects of Internet addiction on depression in adolescents through the results of this study.
Collapse
Affiliation(s)
- Meng Zhao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yulan Huang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jinyu Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jie Feng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Zhou
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
| |
Collapse
|
95
|
Riddle DB, Guzick A, Minhajuddin A, Smárason O, Armstrong GM, Slater H, Mayes TL, Goodman LC, Baughn DL, Martin SL, Wakefield SM, Blader J, Brown R, Goodman WK, Trivedi MH, Storch EA. Obsessive-compulsive disorder in youth and young adults with depression: Clinical characteristics of comorbid presentations. J Obsessive Compuls Relat Disord 2023; 38:100820. [PMID: 37521713 PMCID: PMC10373162 DOI: 10.1016/j.jocrd.2023.100820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Obsessive-compulsive disorder (OCD), anxiety disorders, and depressive disorders are highly comorbid, and each contribute to significant functional impairment for affected youth. Comorbid anxiety disorders in depressed youth have been associated with greater depressive symptom severity and impairment, but the impact of comorbid OCD in this population remains unclear. Accordingly, the present study examined the differential clinical characteristics of youth with depression and comorbid OCD relative to age/gender matched depressed youth with no such comorbidity and to those with depression and a comorbid (non-OCD) anxiety disorder. A sample of 797 youth and young adults ages 8-20 years who met diagnostic criteria for depression alone, depression with co-occurring OCD or any anxiety disorder were included in the present study. Rates of comorbid anxiety and OCD were very high (60.5% and 15.5%, respectively). Relative to youth with only depression, depressed youth with comorbid OCD or anxiety had greater severity of depression, suicidality, and overall impairment in social, physical, and emotional functioning. These results highlight the contribution of OCD or anxiety comorbidity in more complex clinical presentations for depressed youth.
Collapse
Affiliation(s)
- David B Riddle
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andrew Guzick
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Abu Minhajuddin
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Orri Smárason
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Gabrielle M Armstrong
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Holli Slater
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lynnel C Goodman
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Denise L Baughn
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Sarah L Martin
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Sarah M Wakefield
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Joseph Blader
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ryan Brown
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Madhukar H Trivedi
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
96
|
Xu H, Luo X, Shen Y, Jin X. Emotional abuse and depressive symptoms among the adolescents: the mediation effect of social anxiety and the moderation effect of physical activity. Front Public Health 2023; 11:1138813. [PMID: 37441642 PMCID: PMC10333479 DOI: 10.3389/fpubh.2023.1138813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/01/2023] [Indexed: 07/15/2023] Open
Abstract
Background Childhood maltreatment has been identified as a risk factor for depressive symptoms. Social anxiety is closely associated with depression. Physical activity has been regarded as an underlying protective factor. Little is known about the complex relations among these factors in Chinese middle school students. This study aimed to explore whether social anxiety mediated the association between childhood maltreatment and depressive symptoms and investigate whether physical activity moderated the indirect or direct effect of the mediation model. Methods A total of 1,570 middle school students were recruited and measured for childhood maltreatment (measured by Childhood Trauma Questionnaire-Short Form Chinese version), social anxiety (as the mediator, measured by the Chinese simplified version of Social Anxiety Scale for Adolescents), depressive symptoms (measured by the Chinese version of Depression Anxiety Stress Scales-21), physical activity (as the moderator), and covariates such as age, sex, and nationality. The proposed relationships were tested using mediation and moderated mediation models. Results Emotional abuse was directly associated with depression, and the association between emotional abuse and depression was partially mediated by social anxiety. The associations between emotional abuse with depression and with social anxiety were moderated by physical activity. Conclusion This study revealed the mediating role of social anxiety and the moderating role of physical activity between emotional abuse and depression, which emphasizes the potential benefits of sufficient physical activity to reduce social anxiety and depressive symptoms, and more intervention studies should be conducted to explore the direct influence of sufficient physical activity in the future.
Collapse
Affiliation(s)
- Huiming Xu
- School of Physical Education, Changsha University of Science and Technology, Changsha, Hunan, China
| | - Xuerong Luo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanmei Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xingyue Jin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| |
Collapse
|
97
|
Shi Y, Tang Z, Gan Z, Hu M, Liu Y. Association Between Family Atmosphere and Internet Addiction Among Adolescents: The Mediating Role of Self-Esteem and Negative Emotions. Int J Public Health 2023; 68:1605609. [PMID: 37435194 PMCID: PMC10330727 DOI: 10.3389/ijph.2023.1605609] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
Objectives: Family atmosphere is a significant predictor of internet addiction in adolescents. Based on the vulnerability model of emotion and the compensatory internet use theory, this study examined whether self-esteem and negative emotions (anxiety, depression) mediated the relationship between family atmosphere and internet addiction in parallel and sequence. Methods: A total of 3,065 Chinese middle school and high school students (1,524 females, mean age = 13.63 years, SD = 4.24) participated. They provided self-reported data on demographic variables, family atmosphere, self-esteem, anxiety, depression, and internet addiction through the Scale of Systemic Family Dynamic, Self-Esteem Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Internet Addiction Test, respectively. We employed Hayes PROCESS macro for the SPSS program to scrutinize the suggested mediation model. Results: It revealed that self-esteem, anxiety, and depression mediated the relationship between family atmosphere and internet addiction in parallel and sequence. The pathway of family atmosphere-self-esteem-internet addiction played a more important role than others. Conclusion: The present study confirmed the mediating role of self-esteem and negative emotions between family atmosphere and internet addiction, providing intervention studies with important targeting factors.
Collapse
Affiliation(s)
- Yijian Shi
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Zijun Tang
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Zhilin Gan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Manji Hu
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yang Liu
- Department of Psychology, Shanghai Normal University, Shanghai, China
| |
Collapse
|
98
|
Banerjee S, Lev-Wiesel R, De S. Poverty, Somatisation Tendency and Potency in Low-Income Adolescent Groups of India and Israel: Explorations from the Field. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1104. [PMID: 37508601 PMCID: PMC10377797 DOI: 10.3390/children10071104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023]
Abstract
Poverty increases vulnerability towards somatisation and influences the sense of mastery and well-being. The present study on adolescents living in relative poverty in a high-income group country (Israel) and a low-middle-income group country (India) explored the nature of somatisation tendency (ST) and its relationship with potency and perception of poverty (PP). Potency, a buffer against stress-induced negative health effects, was hypothesized to be negatively related to ST and mediate the link between PP and ST. Purposive sampling was used to collect questionnaire-based data from community youth (12-16 years) of two metropolitan cities-Kolkata (India, N = 200) and Tel-Aviv (Israel, N = 208). The nature of ST, PP and potency was analysed using descriptive and inferential statistics and correlation-regression statistics and mediation analysis were used to understand the relationship among them. A clinically significant level of ST was reported by both Indian and Israeli youth experiencing 5-7 somatic symptoms on average. Potency was found to be a significant predictor of ST in both countries (p < 0.05) and emerged as a significant mediator (p < 0.001) in the PP and ST relationship among Indian adolescents. The present study highlights potency as a protective buffer in economically vulnerable community adolescents and re-establishes a high prevalence of ST among them, irrespective of their country's global economic position.
Collapse
Affiliation(s)
- Saoni Banerjee
- Emili Sagol Research Center for CAT (Creative Arts Therapies), University of Haifa, Haifa 3498838, Israel
| | - Rachel Lev-Wiesel
- Emili Sagol Research Center for CAT (Creative Arts Therapies), University of Haifa, Haifa 3498838, Israel
- Body & Mind Psychotherapy Track, Social Work, Tel Hai Academic Center, Qiryat Shemona 1220800, Israel
- National Center for Children at Risk Assessment, The Sagol Center for Hyperbaric Treatment and Research, Shamir Hospital, Be'er Ya'akov 60930, Israel
- FAA-Emili Sagol Creative Arts Research and Innovation for Well-Being Center at Chulalongkorn University (CARIW), Bangkok 10330, Thailand
| | - Sonali De
- Department of Psychology, Calcutta University, Kolkata 700009, India
| |
Collapse
|
99
|
Wolk N, Bat Or M. The Therapeutic Aspects of Embroidery in Art Therapy from the Perspective of Adolescent Girls in a Post-Hospitalization Boarding School. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1084. [PMID: 37371315 DOI: 10.3390/children10061084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
This phenomenological qualitative study explored the experiences of adolescent girls with emotional disorders from post-hospitalization boarding schools who embroidered in an art therapy open studio group. A Youth Participatory Action Research approach and the bioecological model were used to shed light on the therapeutic process of embroidery. Through a thematic analysis of the focus groups and interviews with 13 participants, we identified five themes specifically related to embroidery: (a) control versus release/freedom; (b) calmness that comes from the repetitive action and focus; (c) the experience of being exceptional versus conventional; (d) the "stitch through time" experience, which involves a dialogue with the past, present, and future through embroidery; and (e) the overt-latent layers of consciousness. The findings suggest that embroidery has therapeutic benefits for this population and supports psychological development. This study reveals that embroidery, whose threads are intricately embedded in society and culture, and may provide a unique and meaningful activity for young people in post-hospitalization boarding schools and enables a social and cultural exploration of self and community. Limitations of this study and recommendations for further research are also discussed.
Collapse
Affiliation(s)
- Nurit Wolk
- School of Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel
| | - Michal Bat Or
- School of Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel
- Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| |
Collapse
|
100
|
Speranza AM, Liotti M, Spoletini I, Fortunato A. Heterotypic and homotypic continuity in psychopathology: a narrative review. Front Psychol 2023; 14:1194249. [PMID: 37397301 PMCID: PMC10307982 DOI: 10.3389/fpsyg.2023.1194249] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as "continuity," "psychopathology," "infancy," "childhood," "adolescence," "adulthood," "homotypic," and "heterotypic" were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.
Collapse
Affiliation(s)
- Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ilaria Spoletini
- Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| |
Collapse
|