1
|
Trivedi MH, Jha MK, Elmore JS, Carmody T, Chin Fatt C, Sethuram S, Wang T, Mayes TL, Foster JA, Minhajuddin A. Clinical and sociodemographic features of the Texas resilience against depression (T-RAD) study: Findings from the initial cohort. J Affect Disord 2024; 364:146-156. [PMID: 39134154 DOI: 10.1016/j.jad.2024.08.006] [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: 02/12/2024] [Revised: 06/11/2024] [Accepted: 08/09/2024] [Indexed: 08/18/2024]
Abstract
OBJECTIVE The burden of major depressive disorder is compounded by a limited understanding of its risk factors, the limited efficacy of treatments, and the lack of precision approaches to guide treatment selection. The Texas Resilience Against Depression (T-RAD) study was designed to explore the etiology of depression by collecting comprehensive socio-demographic, clinical, behavioral, neurophysiological/neuroimaging, and biological data from depressed individuals (D2K) and youth at risk for depression (RAD). METHODS This report details the baseline sociodemographic, clinical, and functional features from the initial cohort (D2K N = 1040, RAD N = 365). RESULTS Of the total T-RAD sample, n = 1078 (76.73 %) attended ≥2 in-person visits, and n = 845 (60.14 %) attended ≥4 in-person visits. Most D2K (84.82 %) had a primary diagnosis of any depressive disorder, with a bipolar disorder diagnosis being prevalent (13.49 %). RAD participants (75.89 %) did not have a psychiatric diagnosis, but other non-depressive diagnoses were present. D2K participants had 9-item Patient Health Questionnaire scores at or near the moderate range (10.58 ± 6.42 > 24 yrs.; 9.73 ± 6.12 10-24 yrs). RAD participants were in the non-depressed range (2.19 ± 2.65). While the age ranges in D2K and RAD differ, the potential to conduct analyses that compare at-risk and depressed youth is a strength of the study. The opportunity to examine the trajectory of depressive symptoms in the D2K cohort over the lifespan is unique. LIMITATIONS As a longitudinal study, missing data were common. CONCLUSION T-RAD will allow data to be collected from multiple modalities on a clinically well-characterized sample. These data will drive important discoveries on diagnosis, treatment, and prevention of depression.
Collapse
Affiliation(s)
- 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.
| | - Manish K Jha
- 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
| | - Joshua S Elmore
- 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
| | - Thomas Carmody
- 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'Donnel Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cherise Chin Fatt
- 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
| | - Sangita Sethuram
- 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
| | - Tianyi Wang
- 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
| | - Jane A Foster
- 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
| | - 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'Donnel Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
2
|
Gittins Stone DI, Elkins RM, Gardner M, Boger K, Sperling J. Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis. Child Psychiatry Hum Dev 2024; 55:1398-1412. [PMID: 36749490 PMCID: PMC9902833 DOI: 10.1007/s10578-023-01500-5] [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] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.
Collapse
Affiliation(s)
| | - R Meredith Elkins
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | | | - Kathryn Boger
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Jacqueline Sperling
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| |
Collapse
|
3
|
Bryant BR, Sisk MR, McGuire JF. Efficacy of Gamified Digital Mental Health Interventions for Pediatric Mental Health Conditions: A Systematic Review and Meta-Analysis. JAMA Pediatr 2024:2823863. [PMID: 39312259 PMCID: PMC11420825 DOI: 10.1001/jamapediatrics.2024.3139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/26/2024] [Indexed: 09/26/2024]
Abstract
Importance Anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) affect up to 20% of children and adolescents. Despite demonstrated efficacy, evidence-based treatments for these conditions are often inaccessible; innovative solutions are essential to meet the demand for pediatric mental health care. Objective To examine the efficacy and moderators of gamified DMHIs for anxiety, depression, and ADHD in randomized clinical trials (RCTs) for children and adolescents. Data Sources A systematic search of PubMed, PsycInfo, and Web of Science was conducted for RCTs published before March 20, 2024. Study Selection RCTs that evaluated the efficacy of gamified DMHIs for treating pediatric ADHD, depression, or anxiety were included. Studies were excluded if they did not use a gamified DMHI, provide sufficient data for effect sizes, or were unavailable in English. Data Extraction and Synthesis Efficacy data were extracted from rating scales for ADHD, depression, and anxiety. Extracted moderator variables included participant characteristics (eg, age and sex), intervention characteristics (eg, delivery modality and time limit), and trial design characteristics (eg, outcome measure and risk of bias). Main Outcomes and Measures The primary outcome was change in ADHD, depression, or anxiety severity in the treatment group compared to the control group. Hedges g quantified treatment effects. Results The search strategy identified 27 RCTs that included 2911 participants across ADHD, depression, and anxiety disorders. There were modest significant effects of gamified DMHIs on ADHD (g, 0.28; 95% CI, 0.09 to 0.48) and depression (g, 0.28; 95% CI, 0.08 to 0.47) but small, nonsignificant effects for anxiety disorders (g, 0.07; 95% CI, -0.02 to 0.17). Moderator analyses revealed that DMHIs for ADHD delivered on a computer and those RCTs that had a greater preponderance of male participants produced larger treatment effects. DMHIs for depressive disorders that used preset time limits for gamified DMHIs also exhibited larger treatment effects. Conclusions and Relevance The findings suggest a benefit of gamified DMHIs for youth with ADHD or depressive disorder. Pediatricians and other health care professionals have new information about novel, accessible, and efficacious options for pediatric mental health care.
Collapse
Affiliation(s)
- Barry R. Bryant
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Morgan R. Sisk
- Department of Psychiatry, University of Alabama at Birmingham Heersink School of Medicine, Birmingham
| | - Joseph F. McGuire
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
4
|
Kim DH, Kim Y. Factors associated with generalized anxiety disorder in adolescents with cultural diversity: secondary data analysis. BMC Public Health 2024; 24:2562. [PMID: 39300398 DOI: 10.1186/s12889-024-20078-8] [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: 06/19/2024] [Accepted: 09/13/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND The number of culturally diverse adolescents in South Korea has reached 290,000 and is increasing every year; however, they still represent only 2.5% of the total adolescent population in middle and high schools, making them a minority. Adolescents experiencing cultural diversity are psychologically vulnerable because they grow up in bicultural environments and experience prejudice. Given the nature of generalized anxiety disorder, which can be exacerbated by stress, these adolescents may face an increased risk of developing the disorder not only because of developmental stress but also because of the stress of cultural adaptation. To identify the prevalence of generalized anxiety disorder among adolescents with cultural diversity, we analyzed related factors. Based on the results, strategies have been proposed to reduce anxiety in adolescents with cultural diversity and generalized anxiety disorders. METHODS This study used data from the 16th - 18th Korea Youth Risk Behavior Survey. Factors associated with generalized anxiety disorders were identified based on the social determinants of the health framework. Statistical analyses were conducted using IBM SPSS 25.0, and statistical methods were used for complex samples. RESULTS Among adolescents with cultural diversity, 12.8% exhibited generalized anxiety disorders. Among the structural factors, economic status, mother's education level, and gender were significantly associated with the disorder, whereas among the psychosocial factors, suicidal ideation, depressive mood, loneliness, perceived stress level, and subjective health status were significant factors influencing it. CONCLUSION The factors identified in our research can be used as a resource for the early identification of culturally diverse adolescents who are vulnerable to generalized anxiety disorders. To prevent generalized anxiety disorder among adolescents with cultural diversity, school or community nurses can implement interventions to reduce loneliness or stress management programs.
Collapse
Affiliation(s)
- Dong-Hee Kim
- College of NursingㆍResearch Institute of Nursing Science, Pusan National University, Yangsan-si, Korea
| | - Yujin Kim
- College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, South Korea.
| |
Collapse
|
5
|
Long EE, Johnson MF, Carpenter LA. Autistic Characteristics, Cognitive Impairment, and Sex as Predictors of Anxiety and Depression among Autistic Youth. J Autism Dev Disord 2024:10.1007/s10803-024-06406-2. [PMID: 39093544 DOI: 10.1007/s10803-024-06406-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 08/04/2024]
Abstract
Although it is well established that autistic youth are at high risk for anxiety and depression, factors associated with heightened risk within this population are poorly understood. The purpose of this study was to evaluate whether autistic characteristics and cognitive impairment interact to predict anxiety and depression symptoms, and whether the impacts of autistic characteristics and cognitive impairment on anxiety and depression differ for male and female children. Participants comprised 7989 youth (M = 11.23 years) enrolled in SPARK, a national cohort of autistic individuals. Autistic characteristics were assessed via the Social Communication Questionnaire. Anxiety and depression were assessed via the Child Behavior Checklist. Linear regressions were conducted to examine associations between autistic characteristics, cognitive impairment, and symptoms and to test for interactions. The effect of parent-reported autistic characteristics on anxiety was stronger for males than for females, while the effect of cognitive impairment on anxiety was stronger for females than for males. A different pattern was observed for depression. The effect of autistic characteristics on depression was the same for males and females, while cognitive impairment was not associated with depression per parent report. Findings indicate that both male and female children with high levels of autistic characteristics are susceptible to experiencing anxiety and depression, and that autistic female children with intact cognitive abilities are uniquely vulnerable to experiencing anxiety based on parent report. Results have implications for the prevention of internalizing problems in autistic youth, and highlight future directions for longitudinal work examining mechanisms of comorbidity.
Collapse
Affiliation(s)
- Erin E Long
- Department of Pediatrics, Division of Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, 8915 W. Connell Ct, Milwaukee, WI, 53226, USA.
| | - Mary F Johnson
- Department of Neuroscience, Neuroscience Administration Research Team, Children's Hospital of Colorado, Aurora, CO, USA
| | - Laura A Carpenter
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| |
Collapse
|
6
|
Testani D, McMorris CA, Clark CA, Sanguino H, Condliffe EG, Noel ME, Kopala Sibley DC, Brunton LK. Investigating physiological symptoms associated with mental health symptoms in youth with cerebral palsy: An observational study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 151:104783. [PMID: 38924954 DOI: 10.1016/j.ridd.2024.104783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/29/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Over 50 % of children and youth with cerebral palsy (CP) experience mental health challenges, with anxiety and depression most common. Youth with CP also experience several physiological symptoms such as fatigue, pain, sedentary lifestyle, and sleep disturbances that impact their daily living; however, little is known about the impact of these symptoms on mental health outcomes in these youth. This study addressed this gap and examined the individual and cumulative impacts of physiological symptoms on anxiety and depression symptoms in youth with CP. Forty youth with CP aged 8 to 18 years, and their caregiver, participated in this cross-sectional observational study. Pain, fatigue, anxiety, and depressive symptoms were measured using caregiver- and self-reported questionnaires and participants wore accelerometers for seven consecutive days, providing non-invasive physical activity and sleep pattern data. Youth with CP experienced substantial physiological symptoms and elevated anxiety and depression symptoms. Linear regression models determined that all physiological factors were predictive of caregiver-reported youth anxiety (R2 = 0.23) and youth depressive symptoms (R2 = 0.48). Fatigue, pain severity, sleep efficiency, and physical activity outcomes individually and cumulatively contributed to caregiver-reported youth anxiety and depression symptoms. These findings highlight the important role of physiological symptoms as potential risk factors and potential targets for intervention for mental health issues for in youth with CP.
Collapse
Affiliation(s)
- D Testani
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - C A McMorris
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Calgary, Alberta, Canada; Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - C A Clark
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - H Sanguino
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - E G Condliffe
- Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Calgary, Alberta, Canada; Departments of Clinical Neurosciences & Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - M E Noel
- Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Calgary, Alberta, Canada; Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - D C Kopala Sibley
- Alberta Children's Hospital Research Institute & Hotchkiss Brain Institute, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - L K Brunton
- School of Physical Therapy, Western University, London, Ontario, Canada; CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.
| |
Collapse
|
7
|
Kim JH, Kim J, Jang SY, Park EC. Association between watching eating broadcasts like mukbang and cookbang and generalized anxiety disorder among Korean adolescents. BMC Psychiatry 2024; 24:536. [PMID: 39080570 PMCID: PMC11290270 DOI: 10.1186/s12888-024-05957-z] [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: 03/25/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Anxiety disorders are common during adolescence; therefore, detecting anxiety disorders among adolescents and providing appropriate treatment are crucial. Studies have suggested that watching online audiovisual broadcasts like mukbang and cookbang (hereafter mukbang), where hosts eat or cook food, may influence anxiety disorders. However, there is insufficient research on the association between watching mukbang and generalized anxiety disorder (GAD). Therefore, we investigated the association between watching mukbang and GAD among Korean adolescents. METHODS We analyzed 51,764 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-Based Survey (KYRBS). The participants were asked how frequently they watched mukbang per week over the past 12 months. Anxiety disorders were assessed using the generalized anxiety disorder-7 (GAD-7) questionnaire. A multiple logistic regression analysis was performed after adjusting for confounding variables. RESULTS The prevalence of GAD was higher among adolescents who watched mukbang compared to those who did not (aOR: 1.100, 95% CI: 1.026-1.180, P = 0.008 in male participants; aOR: 1.090, 95% CI: 1.003-1.185, P = 0.042 in female participants). The frequency of watching mukbang showed a dose-dependent relationship with a greater likelihood of GAD in female adolescents. CONCLUSION This study's results showed that watching mukbang is associated with GAD in Korean adolescents. Proper interventions for mental health are needed for adolescents who watch mukbang.
Collapse
Affiliation(s)
- Jung-Hwan Kim
- Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
| |
Collapse
|
8
|
Ysbæk-Nielsen AT. Exploring volumetric abnormalities in subcortical L-HPA axis structures in pediatric generalized anxiety disorder. Nord J Psychiatry 2024; 78:402-410. [PMID: 38573199 DOI: 10.1080/08039488.2024.2335980] [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: 05/15/2023] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Pediatric generalized anxiety disorder (GAD) is debilitating and increasingly prevalent, yet its etiology remains unclear. Some believe the disorder to be propagated by chronic dysregulation of the limbic-hypothalamic-pituitary-adrenal (L-HPA) axis, but morphometric studies of implicated subcortical areas have been largely inconclusive. Recognizing that certain subcortical subdivisions are more directly involved in L-HPA axis functioning, this study aims to detect specific abnormalities in these critical areas. METHODS Thirty-eight MRI scans of preschool children with (n = 15) and without (n = 23) GAD underwent segmentation and between-group volumetric comparisons of the basolateral amygdala (BLA), ventral hippocampal subiculum (vSC), and mediodorsal medial magnocellular (MDm) area of the thalamus. RESULTS Children with GAD displayed significantly larger vSC compared to healthy peers, F(1, 31) = 6.50, pFDR = .048. On average, children with GAD presented with larger BLA and MDm, Fs(1, 31) ≥ 4.86, psFDR ≤ .054. Exploratory analyses revealed right-hemispheric lateralization of all measures, most notably the MDm, F(1, 31) = 8.13, pFDR = .024, the size of which scaled with symptom severity, r = .83, pFDR = .033. CONCLUSION The BLA, vSC, and MDm are believed to be involved in the regulation of anxiety and stress, both individually and collectively through the excitation and inhibition of the L-HPA axis. All were found to be enlarged in children with GAD, perhaps reflecting hypertrophy related to hyperexcitability, or early neuronal overgrowth. Longitudinal studies should investigate the relationship between these early morphological differences and the long-term subcortical atrophy previously observed.
Collapse
|
9
|
Inci Izmir SB, Korkmazlar Ü, Ercan ES. Eye Movement Desensitization and Reprocessing Therapy in Adolescents With Panic Disorder: A Twelve-Week Follow-Up Study. Clin Child Psychol Psychiatry 2024; 29:966-981. [PMID: 37328192 DOI: 10.1177/13591045231184757] [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: 06/18/2023]
Abstract
The aim of this study is to investigate the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) treatment in adolescents with panic disorder (PD). This follow-up study consists of 30 adolescents with PD without agoraphobia, aged 14-17 (15.53 ± .97). They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, also the Panic and Agoraphobia Scale (PAS) and Beck Anxiety Inventory (BAI) were administered at baseline, at the end of the 4th and 12th weeks of treatment. EMDR therapy which is an eight-phase treatment approach composed of standardized protocols and procedures was applied for 12 weeks, one session per week. The baseline mean of the total PAS score decreased from 40.06 to 13.13 at fourth week and 1.2 at the end of 12th week of treatment. In addition, BAI score decreased significantly from 33.67 to 13.83 at 4 weeks and 5.31 at the end of 12th week of treatment. Overall, our results underscore the effectiveness of EMDR in adolescents with PD. Moreover, the current study suggests that EMDR may represent an effective intervention technique for PD in adolescents to protect against relapses and to overcome a fear of future attacks.
Collapse
Affiliation(s)
- Sevim Berrin Inci Izmir
- Department of Clinical Psychology, Institute on Social Science, Isık University, İstanbul, Turkey
| | - Ümran Korkmazlar
- Child and Adolescent Psychiatry Department, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Eyüp Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey
| |
Collapse
|
10
|
Reinhard J, Mittermeier A, Brandstetter L, Mowat K, Slyschak A, Reiter AMF, Gamer M, Romanos M. Fear conditioning and fear generalization in children and adolescents with anxiety disorders. Eur Child Adolesc Psychiatry 2024; 33:2163-2172. [PMID: 37794273 PMCID: PMC11255079 DOI: 10.1007/s00787-023-02304-7] [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: 03/03/2022] [Accepted: 09/10/2023] [Indexed: 10/06/2023]
Abstract
Overgeneralization of conditioned fear is associated with anxiety disorders (AD). Most results stem from studies done in adult patients, but studies with children are rare, although the median onset of anxiety disorders lies already in childhood. Thus, the goal of the present study was to examine fear learning and generalization in youth participants, aged 10-17 years, with AD (n = 39) compared to healthy controls (HC) (n = 40). A discriminative fear conditioning and generalization paradigm was used. Ratings of arousal, valence, and US expectancy (the probability of an aversive noise following each stimulus) were measured, hypothesizing that children with AD compared to HC would show heightened ratings of arousal and US expectancy, and decreased positive valence ratings, respectively, as well as overgeneralization of fear. The results indicated that children with AD rated all stimuli as more arousing and less pleasant, and demonstrated higher US expectancy ratings to all stimuli when compared to HC. Thus, rather than displaying qualitatively different generalization patterns (e.g., a linear vs. quadratic slope of the gradient), differences between groups were more quantitative (similar, but parallel shifted gradient). Therefore, overgeneralization of conditioned fear does not seem to be a general marker of anxiety disorders in children and adolescents.
Collapse
Affiliation(s)
- Julia Reinhard
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany.
| | - Anna Mittermeier
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Lisa Brandstetter
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Kimberly Mowat
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Anna Slyschak
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Andrea M F Reiter
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Matthias Gamer
- Department of Psychology (Experimental Clinical Psychology), University of Würzburg, Würzburg, Germany
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| |
Collapse
|
11
|
Phillips KE, Buinewicz SAP, Kagan E, Frank HE, Dunning E, Benito KG, Kendall PC. The Pediatric Accommodation Scale: Psychometric Evaluation of a Therapist-Report Format. Child Psychiatry Hum Dev 2024; 55:667-679. [PMID: 36149550 DOI: 10.1007/s10578-022-01447-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/03/2022]
Abstract
Anxiety disorders are the most common mental health problem in youth, and accommodation is prevalent among youth with anxiety disorders. The Pediatric Accommodation Scale (PAS) is an interview administered by trained evaluators and a parent-report form (PAS-PR) to assess accommodation and its impact. Both have strong psychometric properties including internal consistency, inter-rater reliability, and data supporting construct validity. The present study evaluates the Pediatric Accommodation Scale - Therapist Report (PAS-TR), a therapist-reported version of the PAS-PR. Participants were 90 youth enrolled in cognitive behavioral therapy for anxiety. Therapists completed the PAS-TR over 16 therapy sessions. Internal consistency at baseline, convergent validity, divergent validity, and parent-therapist agreement were evaluated. Results suggest that the PAS-TR has mixed psychometric qualities suggesting that while not strong prior to the initiation of treatment, the PAS-TR may be a useful measure for therapists to rate accommodation as treatment progresses. Implications for assessment, treatment, and research are discussed.
Collapse
Affiliation(s)
- Katherine E Phillips
- Department of Psychology, Temple University, Temple University, 1701 North 13th St, 19122, Philadelphia, PA, USA.
| | | | - Elana Kagan
- Massachusetts General Hospital, Boston, MA, USA
| | - Hannah E Frank
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Erin Dunning
- Department of Psychology, Temple University, Temple University, 1701 North 13th St, 19122, Philadelphia, PA, USA
| | - Kristen G Benito
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Temple University, 1701 North 13th St, 19122, Philadelphia, PA, USA
| |
Collapse
|
12
|
Spytska L. Anxiety and depressive personality disorders in the modern world. Acta Psychol (Amst) 2024; 246:104285. [PMID: 38642453 DOI: 10.1016/j.actpsy.2024.104285] [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: 02/01/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
The study's significance lies in the multitude of challenges facing individuals today, such as the COVID-19 pandemic, military conflicts like the war in Ukraine, and the escalating rates of cancer morbidity and mortality. These factors contribute to the onset of anxiety and depressive disorders, disrupting various aspects of individuals' mental functioning and social interactions. Addressing these disorders effectively necessitates a comprehensive approach, combining pharmacological interventions with psychotherapeutic strategies under the guidance of specialized professionals. In this regard, the study is aimed at identifying aspects and features of the development of psychological problems and personality disorders in the modern world filled with various stressors. The leading methods of studying this problem are analysis, synthesis, induction, deduction, comparison, experiment and systematisation of approaches that will help determine a wide range of mental disorders. Theoretical methods were used to analyze the literature and summarize theoretical material on anxiety and depressive disorders. Diagnostic methods were used to assess the psychological state of the study population. The study examines significant clinical syndromes and vegetative disorders that disrupt normal lifestyle, hinder daily activities, and impede professional growth. It evaluates the roles of psychologists, psychiatrists, and social workers in assisting individuals with anxiety disorders. It outlines preventive measures for anxiety and depression, while also delving into various types of anxiety disorders. The research proposes diverse methods to prevent emotional anxiety and instability. It underscores the importance of devising novel strategies for diagnosis and therapy, emphasizing a comprehensive approach involving psychotherapeutic support, medical intervention, and adaptive behavioral techniques. The findings of the study hold both practical and theoretical significance for professionals in psychology, psychiatry, psychoanalysis, and sociology who provide support for individuals with anxiety and depressive disorders. Furthermore, the insights provided may be pertinent to researchers and scholars investigating the psychological well-being of contemporary society amidst adverse external circumstances.
Collapse
Affiliation(s)
- Liana Spytska
- Department of Psychology and Pedagogy, Kyiv International University, 03179, 49 Lvivska Str., Kyiv, Ukraine.
| |
Collapse
|
13
|
Grieshaber A, Silver J, Bufferd SJ, Dougherty L, Carlson G, Klein DN. Early childhood anxiety disorders: continuity and predictors in adolescence. Eur Child Adolesc Psychiatry 2024; 33:1817-1825. [PMID: 37620672 DOI: 10.1007/s00787-023-02287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7-15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety.
Collapse
Affiliation(s)
- Alexander Grieshaber
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11790-2500, USA.
| | - Jamilah Silver
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11790-2500, USA
| | - Sara J Bufferd
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Lea Dougherty
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Gabrielle Carlson
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11790-2500, USA
| |
Collapse
|
14
|
Wu B, Long X, Cao Y, Xie H, Wang X, Roberts N, Gong Q, Jia Z. Abnormal intrinsic brain functional network dynamics in first-episode drug-naïve adolescent major depressive disorder. Psychol Med 2024; 54:1758-1767. [PMID: 38173122 DOI: 10.1017/s0033291723003719] [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: 01/05/2024]
Abstract
BACKGROUND Alterations in brain functional connectivity (FC) have been frequently reported in adolescent major depressive disorder (MDD). However, there are few studies of dynamic FC analysis, which can provide information about fluctuations in neural activity related to cognition and behavior. The goal of the present study was therefore to investigate the dynamic aspects of FC in adolescent MDD patients. METHODS Resting-state functional magnetic resonance imaging data were acquired from 94 adolescents with MDD and 78 healthy controls. Independent component analysis, a sliding-window approach, and graph-theory methods were used to investigate the potential differences in dynamic FC properties between the adolescent MDD patients and controls. RESULTS Three main FC states were identified, State 1 which was predominant, and State 2 and State 3 which occurred less frequently. Adolescent MDD patients spent significantly more time in the weakly-connected and relatively highly-modularized State 1, spent significantly less time in the strongly-connected and low-modularized State 2, and had significantly higher variability of both global and local efficiency, compared to the controls. Classification of patients with adolescent MDD was most readily performed based on State 1 which exhibited disrupted intra- and inter-network FC involving multiple functional networks. CONCLUSIONS Our study suggests local segregation and global integration impairments and segregation-integration imbalance of functional networks in adolescent MDD patients from the perspectives of dynamic FC. These findings may provide new insights into the neurobiology of adolescent MDD.
Collapse
Affiliation(s)
- Baolin Wu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xipeng Long
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Cao
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Hongsheng Xie
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Xiuli Wang
- Department of Clinical Psychology, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Neil Roberts
- The Queens Medical Research Institute (QMRI), School of Clinical Sciences, University of Edinburgh, Edinburgh, UK
| | - Qiyong Gong
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China
| | - Zhiyun Jia
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
15
|
Uher R, Pavlova B, Najafi S, Adepalli N, Ross B, Howes Vallis E, Freeman K, Parker R, Propper L, Palaniyappan L. Antecedents of major depressive, bipolar, and psychotic disorders: A systematic review and meta-analysis of prospective studies. Neurosci Biobehav Rev 2024; 160:105625. [PMID: 38494121 DOI: 10.1016/j.neubiorev.2024.105625] [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: 12/31/2023] [Revised: 03/05/2024] [Accepted: 03/13/2024] [Indexed: 03/19/2024]
Abstract
Major depressive, bipolar, or psychotic disorders are preceded by earlier manifestations in behaviours and experiences. We present a synthesis of evidence on associations between person-level antecedents (behaviour, performance, psychopathology) in childhood, adolescence, or early adulthood and later onsets of major depressive disorder, bipolar disorder, or psychotic disorder based on prospective studies published up to September 16, 2022. We screened 11,342 records, identified 460 eligible publications, and extracted 570 risk ratios quantifying the relationships between 52 antecedents and onsets in 198 unique samples with prospective follow-up of 122,766 individuals from a mean age of 12.4 to a mean age of 24.8 for 1522,426 person years of follow-up. We completed meta-analyses of 12 antecedents with adequate data. Psychotic symptoms, depressive symptoms, anxiety, disruptive behaviors, affective lability, and sleep problems were transdiagnostic antecedents associated with onsets of depressive, bipolar, and psychotic disorders. Attention-deficit/hyperactivity and hypomanic symptoms specifically predicted bipolar disorder. While transdiagnostic and diagnosis-specific antecedents inform targeted prevention and help understand pathogenic mechanisms, extensive gaps in evidence indicate potential for improving early risk identification.
Collapse
Affiliation(s)
- Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
| | - Barbara Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Sara Najafi
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Nitya Adepalli
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Briana Ross
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Emily Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Kathryn Freeman
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Robin Parker
- WK Kellogg Health Sciences Library, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lukas Propper
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Quebec, Montreal, Canada; Robarts Research Institute, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Canada
| |
Collapse
|
16
|
Amir N, Holbrook A, Kallen A, Santopetro N, Klawohn J, McGhie S, Bruchnak A, Lowe M, Taboas W, Brush CJ, Hajcak G. Multiple Adaptive Attention-Bias-Modification Programs to Alter Normative Increase in the Error-Related Negativity in Adolescents. Clin Psychol Sci 2024; 12:447-467. [PMID: 39040548 PMCID: PMC11262561 DOI: 10.1177/21677026231170563] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
In the current article, we examined the impact of two home-delivered attentional-bias-modification (ABM) programs on a biomarker of anxiety (i.e., the error-related negativity [ERN]). The ERN is sensitivity to ABM-related changes; however, it is unclear whether ABM exerts its influence on the ERN and anxiety by increasing general attentional control or by disengaging spatial allocation of attention. In this study, we measured the ERN, anxiety, attention bias, and attention control before and after two versions of ABM training and a waitlist control group in 546 adolescents. An ABM designed to increase attention control modulated the ERN but had no impact on anxiety. An ABM designed to reduce attentional bias changed bias and self-reported anxiety in youths but had no impact on the ERN or parent-reported anxiety. These results suggest that the ERN and normative anxiety may be modified using attention training.
Collapse
Affiliation(s)
- Nader Amir
- Department of Psychology, San Diego State University
| | | | - Alex Kallen
- Department of Psychology, Florida State University
| | | | | | - Shaan McGhie
- Department of Psychology, San Diego State University
| | | | - Magen Lowe
- Department of Psychology, Florida State University
| | | | - C. J. Brush
- Department of Psychology, Florida State University
| | - Greg Hajcak
- Department of Psychology, Florida State University
| |
Collapse
|
17
|
Girela-Serrano B, Miguélez-Fernández C, Abascal-Peiró S, Peñuelas-Calvo I, Jiménez-Muñoz L, Moreno M, Delgado-Gómez D, Bello HJ, Nicholls D, Baca-García E, Carballo JJ, Porras-Segovia A. Diagnostic trajectories of mental disorders in children and adolescents: a cohort study. Eur Child Adolesc Psychiatry 2024; 33:1481-1494. [PMID: 37422547 DOI: 10.1007/s00787-023-02254-0] [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: 02/07/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
Mental disorders in children and adolescents may follow different trajectories, such as remission, change of diagnosis, or addition of two or more comorbid diagnoses, showing a heterotypic pattern. This study aims to describe the main diagnostic trajectories across a broad range of mental disorder diagnostic categories, from childhood to adolescence and from adolescence to young adulthood in a clinical population. A prospective study was conducted among a clinical sample of children and adolescents who were aged 3-17 years at the face-to-face baseline interview. Electronic health records of these participants were reviewed 10 years later. The diagnostic stability over time was examined using the kappa coefficient, and factors associated with stability were explored using simple logistic regression. The study included a sample of 691 participants. The kappa coefficient for diagnostic stability across all diagnoses was 0.574 for the transition from childhood to adulthood, 0.614 from childhood to adolescence, and 0.733 from adolescence to adulthood. Neurodevelopmental diagnoses had the highest stability. Factors associated with higher diagnostic stability included family history of mental disorders, receiving psychopharmacological treatment, and symptom severity at baseline. We found a variable diagnostic stability across different diagnoses and age categories. The different life transitions represent complex periods that should not be overlooked from a clinical standpoint. An appropriate transition from child and adolescent mental health services to adult mental health services may have a positive impact on children and adolescents with mental disorders.
Collapse
Affiliation(s)
- Braulio Girela-Serrano
- Westminster Child and Adolescent Mental Health Service, Central and Northwest London NHS Foundation Trust, London, UK
- Division of Psychiatry, Imperial College London, London, UK
| | | | - Sofía Abascal-Peiró
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - David Delgado-Gómez
- Department of Statistics, University Carlos III of Madrid, 28911, Leganés, Spain
| | - Hugo J Bello
- Department of Applied Mathematics, Universidad de Valladolid, Valladolid, Spain
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK
| | - Enrique Baca-García
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital Universitario 12 de Octubre, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
- Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
- CIBERSAM, Madrid, Spain
- Centre Hospitalier Universitaire de Nîmes, Nîmes, France
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alejandro Porras-Segovia
- Division of Psychiatry, Imperial College London, London, UK.
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain.
| |
Collapse
|
18
|
Wu B, Zhang X, Xie H, Wang X, Gong Q, Jia Z. Disrupted Structural Brain Networks and Structural-Functional Decoupling in First-Episode Drug-Naïve Adolescent Major Depressive Disorder. J Adolesc Health 2024; 74:941-949. [PMID: 38416102 DOI: 10.1016/j.jadohealth.2024.01.015] [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: 07/06/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Major depressive disorder (MDD) tends to emerge during adolescence, but the neurobiology of adolescent MDD is still poorly understood. This study aimed to explore the topological organization of white matter structural networks and the relationship between structural and functional connectivity in adolescent MDD. METHODS Structural and functional magnetic resonance imaging data were acquired from 94 first-episode drug-naïve adolescent MDD patients and 78 healthy adolescents. Whole brain structural and functional brain networks were constructed for each subject. Then, the topological organization of structural brain networks and the coupling strength between structural and functional connectivity were analyzed. RESULTS Compared with controls, adolescent MDD patients showed disrupted small-world, rich-club, and modular organizations. Nodal centralities in the medial part of bilateral superior frontal gyrus, bilateral hippocampus, right superior occipital gyrus, right angular gyrus, bilateral precuneus, left caudate nucleus, bilateral putamen, right superior temporal gyrus, and right temporal pole part of superior temporal gyrus were significantly lower in adolescent MDD patients compared with controls. The coupling strength between structural and functional connectivity was significantly lower in adolescent MDD patients compared with controls. DISCUSSION Our findings suggest widespread disruption of structural brain networks and structural-functional decoupling in adolescent MDD, potentially leading to reduced network communication capacity.
Collapse
Affiliation(s)
- Baolin Wu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xun Zhang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Hongsheng Xie
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Xiuli Wang
- Department of Clinical Psychology, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Qiyong Gong
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Departmentof Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
| | - Zhiyun Jia
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.
| |
Collapse
|
19
|
Gao Y, Yu Q, Schuch FB, Herold F, Hossain MM, Ludyga S, Gerber M, Mullen SP, Yeung AS, Kramer AF, Taylor A, Schinke R, Cheval B, Delli Paoli AG, Ng JL, Van Damme T, Block M, Cunha PM, Olds T, Haegele JA, Zou L. Meeting 24-h movement behavior guidelines is linked to academic engagement, psychological functioning, and cognitive difficulties in youth with internalizing problems. J Affect Disord 2024; 349:176-186. [PMID: 38190861 DOI: 10.1016/j.jad.2024.01.017] [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: 08/10/2023] [Revised: 11/28/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND This study aimed to investigate associations of meeting 24-h movement behavior (24-HMB: physical activity [PA], screen time [ST] in the school-aged youth, and sleep) guidelines with indicators of academic engagement, psychological functioning, and cognitive function in a national representative sample of U.S. youth. METHODS In this cross-sectional study, 1794 participants aged 6 to 17 years old were included for multivariable logistic regression to determine the above-mentioned associations, while adjusting for sociodemographic and health covariates. RESULTS The proportion of participants who met 24-HMB guideline(s) varied greatly (PA+ ST+ sleep = 34 [weighted 1.17 %], PA + ST = 23 [weighted 1.72 %], PA + sleep = 52 [weighted 2.15 %], PA = 34 [weighted 2.88 %], ST = 142 [weighted 7.5 %], ST+ sleep = 209 [weighted 11.86 %], sleep = 725 [weighted 35.5 %], none = 575 [weighted 37.22 %]). Participants who met ST guideline alone and integrated (ST + Sleep and ST + sleep + PA) guidelines demonstrated the consistently beneficial associations with learning interest/curiosity, caring for school performance, completing required homework, resilience, cognitive difficulties, self-regulation (ps < 0.05). CONCLUSION Meeting 24-HMB guidelines in an isolated or integrative manner was associated with improved academic engagement, psychological functioning, and reduced cognitive difficulties. These findings highlight the importance of the promotion of 24-HMB guidelines in youth with internalizing problems. Future longitudinal studies are needed to investigate whether changes or modifications of meeting specific 24-HMB guidelines (especially ST) is beneficial for youth with internalizing problems.
Collapse
Affiliation(s)
- Yanping Gao
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Qian Yu
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China; Faculty of Education, University of Macau, 999078, Macau, China
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Fabian Herold
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China; Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
| | - M Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, TX, USA
| | - Sebastian Ludyga
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Sean P Mullen
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, USA
| | - Albert S Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA 02115, USA; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Alyx Taylor
- School of Rehabilitation, Sport and Psychology, AECC University College, Bournemouth BH5 2DF, United Kingdom of Great Britain and Northern Ireland
| | - Robert Schinke
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Boris Cheval
- Department of Sport Sciences an d Physical Education, Ecol e Normal e Supérieure Rennes, Bruz, France; Laboratory VIPS2, University of Rennes, Rennes, France
| | | | - Jonathan Leo Ng
- Department of Health, Physical Education, and Sport, School of Education, College of Design and Social Context, RMIT University, Melbourne, VIC, Australia
| | - Tine Van Damme
- Research Group for Adapted Physical Activity and Psychomotor Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, O&N IV Herestraat49, Mailbox 1510, 3000 Leuven, Belgium; UPC KU Leuven, Kortenberg, Leuven, Belgium; Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Martin Block
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22904-4407, USA
| | - Paolo M Cunha
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide SA5001, Australia
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, USA
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China.
| |
Collapse
|
20
|
Veenman M, Janssen LHC, van Houtum LAEM, Wever MCM, Verkuil B, Epskamp S, Fried EI, Elzinga BM. A Network Study of Family Affect Systems in Daily Life. MULTIVARIATE BEHAVIORAL RESEARCH 2024; 59:371-405. [PMID: 38356299 DOI: 10.1080/00273171.2023.2283632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Adolescence is a time period characterized by extremes in affect and increasing prevalence of mental health problems. Prior studies have illustrated how affect states of adolescents are related to interactions with parents. However, it remains unclear how affect states among family triads, that is adolescents and their parents, are related in daily life. This study investigated affect state dynamics (happy, sad, relaxed, and irritated) of 60 family triads, including 60 adolescents (Mage = 15.92, 63.3% females), fathers and mothers (Mage = 49.16). The families participated in the RE-PAIR study, where they reported their affect states in four ecological momentary assessments per day for 14 days. First, we used multilevel vector-autoregressive network models to estimate affect dynamics across all families, and for each family individually. Resulting models elucidated how family affect states were related at the same moment, and over time. We identified relations from parents to adolescents and vice versa, while considering family variation in these relations. Second, we evaluated the statistical performance of the network model via a simulation study, varying the percentage missing data, the number of families, and the number of time points. We conclude with substantive and statistical recommendations for future research on family affect dynamics.
Collapse
Affiliation(s)
- Myrthe Veenman
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Loes H C Janssen
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | | | - Mirjam C M Wever
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Bart Verkuil
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Sacha Epskamp
- Department of Psychology, National University of Singapore
| | - Eiko I Fried
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Bernet M Elzinga
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| |
Collapse
|
21
|
Guidetti C, Serra G, Apicella M, Andracchio E, Iannoni ME, Trasolini M, Della Santa G, Maglio G, Vicari S. Childhood Clinical Features Preceding the Onset of Bipolar Versus Major Depressive Disorders During Adolescence. J Atten Disord 2024; 28:648-663. [PMID: 38327097 PMCID: PMC11421195 DOI: 10.1177/10870547231225819] [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] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To identify childhood psychopathological features that predict the onset of adolescent Bipolar (BD) versus Unipolar Major Depressive Disorder (UD) during adolescence. METHOD We analyzed clinical data from 495 juveniles diagnosed with DSM-5 UD (n = 359), and BD (n = 136), using bivariate analysis and multivariate logistic regression model. RESULTS BD subjects exhibited earlier onset of any psychiatric feature compared to UD. Antecedents associated with later BD were: oppositional defiant > specific phobias > ADHD > obsessive compulsive (OCD). Antecedents selectively associated with later UD were: social anxiety and separation anxiety. Factors significantly and independently associated with later BD diagnosis were: [a] emotional dysregulation at onset of the mood disorder; [b] first depressive episode with mixed features; [c] antecedent ADHD; [d] antecedent OCD, and [e] antecedent oppositional-defiance. CONCLUSION Identifying developmental differences in BD and UD symptoms can aid clinicians in early identification and treatment planning for bipolar disorder in youth.
Collapse
Affiliation(s)
- Clotilde Guidetti
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Giulia Serra
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Massimo Apicella
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Elisa Andracchio
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Maria Elena Iannoni
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Monia Trasolini
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giorgia Della Santa
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Gino Maglio
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
22
|
Zugman A, Ringlein GV, Finn ES, Lewis KM, Berman E, Silverman WK, Lebowitz ER, Pine DS, Winkler AM. Brain Functional Connectivity and Anatomical Features as Predictors of Cognitive Behavioral Therapy Outcome for Anxiety in Youths. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.29.24301959. [PMID: 38352528 PMCID: PMC10862993 DOI: 10.1101/2024.01.29.24301959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Background Because pediatric anxiety disorders precede the onset of many other problems, successful prediction of response to the first-line treatment, cognitive-behavioral therapy (CBT), could have major impact. However, existing clinical models are weakly predictive. The current study evaluates whether structural and resting-state functional magnetic resonance imaging can predict post-CBT anxiety symptoms. Methods Two datasets were studied: (A) one consisted of n=54 subjects with an anxiety diagnosis, who received 12 weeks of CBT, and (B) one consisted of n=15 subjects treated for 8 weeks. Connectome Predictive Modeling (CPM) was used to predict treatment response, as assessed with the PARS; additionally we investigated models using anatomical features, instead of functional connectivity. The main analysis included network edges positively correlated with treatment outcome, and age, sex, and baseline anxiety severity as predictors. Results from alternative models and analyses also are presented. Model assessments utilized 1000 bootstraps, resulting in a 95% CI for R2, r and mean absolute error (MAE). Outcomes The main model showed a mean absolute error of approximately 3.5 (95%CI: [3.1-3.8]) points a R2 of 0.08 [-0.14 - 0.26] and r of 0.38 [0.24 - 0.511]. When testing this model in the left-out sample (B) the results were similar, with a MAE of 3.4 [2.8 - 4.7], R2-0.65 [-2.29 - 0.16] and r of 0.4 [0.24 - 0.54]. The anatomical metrics showed a similar pattern, where models rendered overall low R2. Interpretation The analysis showed that models based on earlier promising results failed to predict clinical outcomes. Despite the small sample size, the current study does not support extensive use of CPM to predict outcome in pediatric anxiety.
Collapse
Affiliation(s)
- Andre Zugman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Grace V. Ringlein
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Emily S. Finn
- Psychological and Brain Sciences, Dartmouth College, 3 Maynard St, Hanover, NH, 03755, USA
| | - Krystal M. Lewis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Erin Berman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Wendy K. Silverman
- Child Study Center, Yale University, 230 South Frontage Rd., New Haven, CT 06520, USA
| | - Eli R. Lebowitz
- Child Study Center, Yale University, 230 South Frontage Rd., New Haven, CT 06520, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA
| | - Anderson M. Winkler
- Division of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, 1 West University Blvd, Brownsville, TX 78520, USA
| |
Collapse
|
23
|
Higgins B, Jones L, Devraj K, Kilduff C, Moosajee M. 'It would help people to help me': Acceptability of digital phenotyping among young people with visual impairment and their families. Digit Health 2024; 10:20552076231220804. [PMID: 38188864 PMCID: PMC10771050 DOI: 10.1177/20552076231220804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
Objectives To explore the acceptability of an eHealth App for vision-related monitoring and symptom reporting among young people with a visual impairment and their parents. Methods Qualitative investigation using virtual semi-structured focus groups (via Zoom software) of seven young participants with a genetic eye disorder including inherited retinal disease and structural eye abnormalities (e.g. microphthalmia), and 7 parents; all recruited from ocular genetic clinics at Moorfields Eye Hospital. Audio transcripts were analysed using thematic analysis. Results Data were coded into six key themes: (1) increased involvement in care, (2) opportunity for less hospital-centric care, (3) better representation of visual impairment in a real-world setting, (4) trust in a reputable service provider, (5) harnessing data for health purposes and (6) intended purpose of the app. Both young people and their families were accepting of an eHealth app and felt they would be empowered by greater involvement in their care plan, if privacy of the data was retained, and information was managed correctly. While parents endorsed the opportunity for mental health tracking, young people were hesitant towards its inclusion. Conclusion In summary, there was overall acceptability of an eHealth app among young people with a visual impairment and their parents. These findings will help to maximise the effective integration of digital phenotyping when monitoring and supporting young people experiencing sight loss.
Collapse
Affiliation(s)
- Bethany Higgins
- Institute of Ophthalmology, University College London, London, UK
- Division of Optometry and Vision Sciences, City, University of London, London, UK
| | - Lee Jones
- Institute of Ophthalmology, University College London, London, UK
- Research Directorate, BRAVO VICTOR, London, UK
| | - Kishan Devraj
- Institute of Ophthalmology, University College London, London, UK
| | | | - Mariya Moosajee
- Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- The Francis Crick Institute, London, UK
| |
Collapse
|
24
|
Tan E, Zeytinoglu S, Morales S, Buzzell GA, Almas AN, Degnan KA, Chronis-Tuscano A, Henderson H, Pine DS, Fox NA. Social versus non-social behavioral inhibition: Differential prediction from early childhood of long-term psychosocial outcomes. Dev Sci 2024; 27:e13427. [PMID: 37345685 PMCID: PMC10739650 DOI: 10.1111/desc.13427] [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] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 04/14/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
Behavioral inhibition (BI) is a temperamental style characterized by cautious and fearful behaviors in novel situations. The present multi-method, longitudinal study examined whether young children's observed and parent-reported BI in social versus non-social contexts predicts different long-term psychosocial outcomes. Participants (N = 279) were drawn from a longitudinal study of socioemotional development. BI in social contexts ("social BI") was measured via children's observed wariness toward unfamiliar adults and peers at 24 and 36 months and parents' reports of children's social fear/shyness at 24, 36, and 48 months. BI in non-social contexts ("non-social BI") was measured via children's observed fearful responses to masks and novel toys, and parents' reports of children's distress to non-social novelty at 9 months and non-social fear at 48 months. At 15 years, anxiety was assessed via adolescent- and parent-reports, and global internalizing and externalizing problems were assessed via parent-reports. Confirmatory factor analysis showed that a two-factor model fit the BI data significantly better than a single-factor model, providing evidence for the dissociation of BI in social versus non-social contexts. Social BI was uniquely associated with adolescent social anxiety, whereas non-social BI was specifically associated with adolescent separation anxiety. Neither social BI nor non-social BI predicted global internalizing and externalizing problems, providing evidence for the specific relations between BI and anxiety problems. Together, these results suggest that young children's inhibited responses in social versus non-social situations predict different subtypes of anxiety problems in adolescence, highlighting the multifaceted nature of BI and the divergent trajectories of different anxiety problems.
Collapse
Affiliation(s)
- Enda Tan
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
- Neuroscience and Cognitive Science Program, University of Maryland, College Park
| | - Selin Zeytinoglu
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
| | | | | | - Alisa N. Almas
- School of Population and Public Health, University of British Columbia
| | | | | | | | - Daniel S. Pine
- Emotion and Development Branch, Section on Development and Affective Neuroscience, National Institute of Mental Health
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park
- Neuroscience and Cognitive Science Program, University of Maryland, College Park
| |
Collapse
|
25
|
Sylvester CM, Luby JL, Pine DS. Novel mechanism-based treatments for pediatric anxiety and depressive disorders. Neuropsychopharmacology 2024; 49:262-275. [PMID: 37608220 PMCID: PMC10700626 DOI: 10.1038/s41386-023-01709-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: 03/31/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
Pediatric anxiety and depressive disorders are common, can be highly impairing, and can persist despite the best available treatments. Here, we review research into novel treatments for childhood anxiety and depressive disorders designed to target underlying cognitive, emotional, and neural circuit mechanisms. We highlight three novel treatments lying along a continuum relating to clinical impact of the disorder and the intensity of clinical management required. We review cognitive training, which involves the lowest risk and may be applicable for problems with mild to moderate impact; psychotherapy, which includes a higher level of clinical involvement and may be sufficient for problems with moderate impact; and brain stimulation, which has the highest potential risks and is therefore most appropriate for problems with high impact. For each treatment, we review the specific underlying cognitive, emotional, and brain circuit mechanisms that are being targeted, whether treatments modify those underlying mechanisms, and efficacy in reducing symptoms. We conclude by highlighting future directions, including the importance of work that leverages developmental windows of high brain plasticity to time interventions to the specific epochs in childhood that have the largest and most enduring life-long impact.
Collapse
Affiliation(s)
- Chad M Sylvester
- Washington University Department of Psychiatry, St. Louis, MO, USA.
- Washington University Department of Radiology, St. Louis, MO, USA.
| | - Joan L Luby
- Washington University Department of Psychiatry, St. Louis, MO, USA
| | - Daniel S Pine
- National Institute of Mental Health, Emotion and Development Branch, St. Louis, MO, USA
| |
Collapse
|
26
|
Soo CA, Tate RL, Catroppa C, Benson S, McDonald S, Rapee RM, Anderson V. A randomized controlled trial of cognitive behavioural therapy for managing anxiety in adolescents with acquired brain injury. Neuropsychol Rehabil 2024; 34:74-102. [PMID: 36534593 DOI: 10.1080/09602011.2022.2154811] [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: 05/10/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
The aim of this randomized controlled trial was to evaluate an adapted cognitive behavioural therapy (CBT) programme for treating anxiety in adolescents with acquired brain injury (ABI). Participants with ABI (12-19 years, N = 36) recruited from two sites were randomly allocated into either the intervention receiving 11 sessions of CBT (n = 19) or a wait-list control group (n = 17). The primary outcome was participants' anxiety and secondary outcomes were participants' depression, self-perception, and participation in daily activities, and parental stress, measured at (i) pre-intervention, (ii) immediately post-intervention, (iii) 2 months post-intervention and (iv) 6 months post-intervention. Repeated measures ANOVAs revealed significant treatment effects with the intervention group demonstrating greater improvements in self-reported anxiety, as well as self- and parent-reported depression from pre- to immediately post-treatment, compared to wait-list controls. Little evidence of treatment effects was found for the remaining outcomes (parent-reported anxiety, self-perception, daily participation, and parental stress). Significant improvement in self-reported anxiety found immediately post-treatment was maintained at two- and six-month follow-up. Findings provide support for adapted CBT as an effective means of reducing anxious and depressive symptomatology in adolescents with ABI compared to waitlist controls, and offer support for the use of these techniques to manage anxiety in this population.
Collapse
Affiliation(s)
- Cheryl A Soo
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Robyn L Tate
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, St Leonards, Australia
| | - Cathy Catroppa
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Suzanne Benson
- Rehabilitation Department, Children's Hospital at Westmead, Sydney, Australia
| | - Skye McDonald
- School of Psychology, University of NSW, Sydney, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Vicki Anderson
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
| |
Collapse
|
27
|
Radoeva PD, Milev VT, Hunt JI, Legere CH, Deoni SCL, Sheinkopf SJ, Mazefsky CA, Philip NS, Dickstein DP. Systematic Review: White Matter Microstructural Organization in Adolescents With Depression. JAACAP OPEN 2023; 1:233-245. [PMID: 38576601 PMCID: PMC10994197 DOI: 10.1016/j.jaacop.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Objective A growing body of literature has focused on the neural mechanisms of depression. Our goal was to conduct a systematic review on the white matter microstructural differences in adolescents with depressive disorders vs adolescents without depressive disorders. Method We searched PubMed and PsycINFO for publications on August 3, 2022 (original search conducted in July 2021). The review was registered on PROSPERO (registration number: CRD42021268200), and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Eligible studies were original research papers comparing diffusion tensor/spectrum imaging findings in adolescents with vs without depression (originally ages 12-19 years, later expanded to 11-21 years). Studies were excluded if they focused on depression exclusively in the context of another condition, used only dimensional depressive symptom assessment(s), or used the same dataset as another included publication. Results The search yielded 575 unique records, of which 14 full-text papers were included (824 adolescents with depression and 686 without depression). The following white matter regions showed significant differences in fractional anisotropy in at least 3 studies: uncinate fasciculus, cingulum, anterior corona radiata, inferior fronto-occipital fasciculus, and corpus callosum (genu and body). Most studies reported decreased, rather than increased, fractional anisotropy in adolescents with depression. Limitations include the possibility for selective reporting bias and risk of imprecision, given the small sample sizes in some studies. Conclusion Our systematic review suggests aberrant white matter microstructure in limbic-cortical-striatal-thalamic circuits, and the corpus callosum, in adolescents with depression. Future research should focus on developmental trajectories in depression, identifying sources of heterogeneity and integrating findings across imaging modalities.
Collapse
Affiliation(s)
- Petya D Radoeva
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island
| | | | - Jeffrey I Hunt
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island
| | - Christopher H Legere
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Emma Pendleton Bradley Hospital, East Providence, Rhode Island
| | - Sean C L Deoni
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Stephen J Sheinkopf
- Thompson Center for Autism & Neurodevelopment, University of Missouri, Columbia, Missouri
| | - Carla A Mazefsky
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Noah S Philip
- VA Providence Healthcare System, Providence, Rhode Island
| | - Daniel P Dickstein
- Pediatric Mood, Imaging, and NeuroDevelopment (Ped-iMIND) Program, McLean Hospital, Belmont, Massachusetts and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
28
|
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
|
29
|
San Martín C, Laborda MA, Miguez G, Sánchez A, Vervliet B, Quezada-Scholz V. Relation among, trait anxiety, intolerance to uncertainty and early maltreatment experiences on fear discrimination learning and avoidance generalization online task. J Behav Ther Exp Psychiatry 2023; 81:101886. [PMID: 37343426 DOI: 10.1016/j.jbtep.2023.101886] [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: 12/13/2022] [Revised: 05/20/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Early aversive experiences, which have been associated with elevated anxiety and intolerance of uncertainty (IUS), may contribute negatively to fear conditioning learning. The aim of the present study was to analyze the relation among individual differences in childhood maltreatment experiences, trait anxiety, and IUS in adulthood; and to determine how these variables could affect fear learning discrimination and avoidance generalization. METHODS We adapted an avoidance procedure in an online fear learning task. Two pictures of different lamp colors (CS+) were first associated with two aversive images (US), while a third color was not (CS-). Next, clicking a button during one CS + could effectively avoid the US (CS + av), but not during the other (CS + unav). Finally, avoidance generalization was tested to lamp colors that were between CS- and CS + av (safety dimension) and CS + av and CS + unav (avoidability dimension). With a sample of 67 participants, we measured ratings of relief, expectancy, and anxiety, as well as button presses and individual differences (STAI, IUS and MAES). RESULTS Aversive early experiences were positively related to trait anxiety and intolerance of uncertainty. The results of the task further suggested that maltreatment experience contributes to be more attentive to aversive signals, which could be implicated in leading to difficulties in discrimination learning. LIMITATIONS Online experiments implies some loss of control over subjects and environment that can threaten internal validity. Likewise, the commitment of participants may be low. CONCLUSIONS Results suggest that early aversive experience and anxiety could contribute to the development of IUS, which likely contributes to the development of avoidance behavior.
Collapse
Affiliation(s)
- Consuelo San Martín
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile; Universidad de los Andes, Escuela de Psicología, Chile
| | - Mario A Laborda
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
| | - Gonzalo Miguez
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
| | - Andrea Sánchez
- Multimodal Functional Brain Imaging and Neurorehabilitation Hub, Diagnostic Imaging department, St. Jude Children's research Hospital, USA
| | - Bram Vervliet
- Department of Brain and Cognition, KU, Leuven, Belgium; Leuven Brain Institute, KU, Leuven, Belgium
| | - Vanetza Quezada-Scholz
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile.
| |
Collapse
|
30
|
Ramsey KA, Essoe JKY, Boyle N, Patrick AK, McGuire JF. Immersive Virtual Reality Exposures for the Treatment of Childhood Anxiety. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01628-4. [PMID: 37985621 DOI: 10.1007/s10578-023-01628-4] [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: 10/27/2023] [Indexed: 11/22/2023]
Abstract
Exposure-based cognitive behavior therapy (CBT) has demonstrated efficacy and is recommended as a front-line treatment for childhood anxiety. Unfortunately, challenges exist that impact the effective implementation of exposure-based CBT in clinical practice. One of the primary challenges is the accessibility and availability of exposure stimuli (e.g., spiders, storms, heights) in CBT sessions. Immersive virtual reality (VR) has shown promise as a scalable and sustainable solution to address this clinical need, but remains largely untested in youth with anxiety disorders. Here, we examine the use of VR exposures in the treatment of youth with an anxiety disorder (i.e., specific phobias). We aimed to investigate: (1) the feasibility and clinical benefit of VR exposures; (2) whether VR exposures elicit changes in physiological arousal and/or subjective distress; and (3) whether habituation serves as a mechanism across physiological and subjective outcomes for VR exposures. Three youth and their parents completed a clinical evaluation, which was followed by a one session treatment (OST) with VR exposures. Afterward, youth and parents completed clinical assessments one-week and 1-month after treatment. Immersive VR exposures were found to be feasible and demonstrated clinical benefit for reducing anxiety severity. Additionally, VR exposures elicited changes in both physiological and subjective outcomes. Finally, physiological habituation to VR exposures was observed among participants who exhibited treatment response at follow-up. Collectively, these findings demonstrate preliminary evidence that VR exposures are feasible, tolerable, and show some therapeutic benefit for treating youth with anxiety.
Collapse
Affiliation(s)
- Kesley A Ramsey
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 550 N Broadway, Suite 206, Baltimore, MD, 21205, USA.
| | - Joey Ka-Yee Essoe
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychology, University of Maine at Farmington, Farmington, ME, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 550 N Broadway, Suite 206, Baltimore, MD, 21205, USA
| | - Nathan Boyle
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- University of Maryland College Park, College Park, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 550 N Broadway, Suite 206, Baltimore, MD, 21205, USA
| | - Ainsley K Patrick
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychology, University of Kansas, Lawrence, KS, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 550 N Broadway, Suite 206, Baltimore, MD, 21205, USA
| | - Joseph F McGuire
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 550 N Broadway, Suite 206, Baltimore, MD, 21205, USA
| |
Collapse
|
31
|
Ismail N, Isa KAM, Hamzah SH, Mokhtar IW. A Randomized Cross-over Trial of Behavior Guidance Techniques on Children with Special Needs during Dental Treatment: The Caregivers' Perceived Mannerisms. J Int Soc Prev Community Dent 2023; 13:500-508. [PMID: 38304538 PMCID: PMC10829288 DOI: 10.4103/jispcd.jispcd_52_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 02/03/2024] Open
Abstract
Aim To compare caregivers' acceptance, consent, and concern toward utilization of a combination of basic behavior guidance technique (CBBGT) and Papoose Board (PB) for their special needs children and to evaluate the impact of PB usage on the caregiver's attitude and the association between their education level, monthly household income, and previous dental experience. Materials and Methods This cross-over study incorporated 90 special needs children who were recruited to receive dental treatment with two ways of behavior guidance exposures consecutively in the order of A-B/B-A design. Exposure A is CBBGT (distraction, tell-show-do, and positive reinforcement), while Exposure B is PB. The dental procedures were either dental prophylaxis or restoration with a handpiece. Caregivers need to answer a paper-based questionnaire before and after exposure. The Wilcoxon sign rank test and logistic regression were utilized in order to establish the comparability, impacts, and association. Result About 88 caregivers of special needs children aged between 2 and 15 years completed the sequence. Overall, 98.9% of the children presented with neurodevelopmental disorders. Twenty-seven caregivers were significantly concerned when the combination of basic BGT was applied to their children, and 14 caregivers felt the same for PB. However, the Wilcoxon sign rank test revealed insignificant caregiver scores on acceptance and consent for both methods but significantly improved attitudes towards the use of PB after observing the placement of their children. Conclusion The studied caregiver demonstrated equivalent acceptance, consent, and concern toward the use of PB and a combination of basic BGT with improved attitudes after comprehensive explanation and real-time observation of PB usage during their children's dental treatment.
Collapse
Affiliation(s)
- Norsaima Ismail
- Centre for Paediatric Dentistry & Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, Selangor, Malaysia
| | - Khairil Anuar Md Isa
- Department of Basic Sciences, Faculty of Health Science, Universiti Teknologi MARA, Selangor, Malaysia
| | - Siti Hajar Hamzah
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Ilham Wan Mokhtar
- Centre for Comprehensive Care Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, Selangor, Malaysia
| |
Collapse
|
32
|
Waters AM, Gibson L, Sluis RA, Modecki KL. Using Nightly Sleep Guidelines to Address Links Between Adolescents' Self-Reported Weekly Sleep Patterns and Anxiety and Depression Symptoms. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01610-0. [PMID: 37823958 DOI: 10.1007/s10578-023-01610-0] [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: 09/12/2023] [Indexed: 10/13/2023]
Abstract
Short and long nightly sleep durations are associated with anxiety and depression symptoms among adolescents. However, studies have not used recommended hours of nightly sleep or focused on sleep patterns across weekdays and weekends in examining links with anxiety and depression symptoms. The present study included 709 adolescents in Grade 11 (402 females; 307 males) who self-reported hours of sleep on weeknights and weekends and anxiety and depression symptoms. Using the recommended 8-10 h to define average nightly sleep for adolescents, sleep patterns across weekdays and weekends were categorised into seven classes: short stable, short increasing, average decreasing, average stable, average increasing, long decreasing, and long stable. Relative to average stable sleepers, short stable, short increasing, and long stable sleepers had significantly higher anxiety and depression. Adolescents require 8-10 h of sleep on weeknights, regardless of weekends, for optimal emotional wellbeing.
Collapse
Affiliation(s)
- Allison M Waters
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia.
| | - Lily Gibson
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| | - Rachel A Sluis
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| | - Kathryn L Modecki
- School of Applied Psychology and Centre for Mental Health, Griffith University, Mount Gravatt Campus, Brisbane, Australia
| |
Collapse
|
33
|
Li M, Lu Z, Xu L. Influences of High School Physical Learning Environments on Students' Anxiety in China. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:187-205. [PMID: 37464584 DOI: 10.1177/19375867231187151] [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] [Indexed: 07/20/2023]
Abstract
BACKGROUND High school students are at an increased risk of developing generalized anxiety disorder (GAD) due to significant pressure to achieve academic success. AIM Although it is known that a school's physical learning environment can influence students' GAD, there is limited research examining this relationship. To fill this knowledge gap, a cross-sectional study was conducted among 230 students from two high schools in China. METHODS A survey questionnaire captured students' GAD self-evaluations (dependent variables), perceptions/preferences of their school physical environment (independent variables), and social and personal conditions (confounding variables). Bivariate analysis showed that students' GAD scores were associated with multiple factors related to the learning environment, physical activities, and personal characteristics. The multivariate analysis examined the relationship between GAD scores and physical learning environment variables while controlling for confounding variables. RESULTS The results indicated that adequate lighting (B = -0.154, p = .029) and perceived effectiveness of using self-service cafeterias in reducing anxiety (B = -0.138, p = .044) were significantly associated with GAD scores. CONCLUSIONS These findings provide evidence for the importance of designing high schools with students' mental health in mind. Specifically, school administrators and designers should consider how to improve the physical learning environment by incorporating natural light, a self-service cafeteria, and spaces for physical activities to promote students' mental well-being.
Collapse
Affiliation(s)
- Mengqi Li
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
- School of Architecture, Texas A&M University, College Station, TX, USA
| | - Zhipeng Lu
- School of Architecture, Texas A&M University, College Station, TX, USA
| | - Leiqing Xu
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| |
Collapse
|
34
|
Silk JS, Sequeira SS, Jones NP, Lee KH, Dahl RE, Forbes EE, Ryan ND, Ladouceur CD. Subgenual Anterior Cingulate Cortex Reactivity to Rejection Vs. Acceptance Predicts Depressive Symptoms among Adolescents with an Anxiety History. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:659-674. [PMID: 35072560 PMCID: PMC9308833 DOI: 10.1080/15374416.2021.2019048] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The goal of this study was to examine whether neural sensitivity to negative peer evaluation conveys risk for depression among youth with a history of anxiety. We hypothesized that brain activation in regions that process affective salience in response to rejection, relative to acceptance, from virtual peers would predict depressive symptoms 1 year later and would be associated with ecological momentary assessment (EMA) reports of peer connectedness. METHOD Participants were 38 adolescents ages 11-16 (50% female) with a history of anxiety, recruited from a previous clinical trial. The study was a prospective naturalistic follow-up of depressive symptoms assessed 2 years (Wave 2) and 3 years (Wave 3) following treatment. At Wave 2, participants completed the Chatroom Interact Task during neuroimaging and 16 days of EMA. RESULTS Controlling for depressive and anxiety symptoms at Wave 2, subgenual anterior cingulate (sgACC; β = .39, p = .010) activation to peer rejection (vs. acceptance) predicted depressive symptoms at Wave 3. SgACC activation to rejection (vs. acceptance) was highly negatively correlated with EMA reports of connectedness with peers in daily life (r = - .71, p < .001). CONCLUSION Findings suggest that elevated sgACC activation to negative, relative to positive, peer evaluation may serve as a risk factor for depressive symptoms among youth with a history of anxiety, perhaps by promoting vigilance or reactivity to social evaluative threats. SgACC activation to simulated peer evaluation appears to have implications for understanding how adolescents experience their daily social environments in ways that could contribute to depressive symptoms.
Collapse
Affiliation(s)
| | | | - Neil P Jones
- Department of Psychology, University of Pittsburgh
| | - Kyung Hwa Lee
- Department of Psychiatry, Seoul National University College of Medicine
| | - Ronald E Dahl
- School of Public Health, University of California at Berkeley
| | | | - Neal D Ryan
- Department of Psychology, University of Pittsburgh
| | | |
Collapse
|
35
|
Baumel WT, Mills JA, Schroeder HK, Neptune Z, Levine A, Strawn JR. Gastrointestinal Symptoms in Pediatric Patients with Anxiety Disorders and Their Relationship to Selective Serotonin Reuptake Inhibitor Treatment or Placebo. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01586-x. [PMID: 37659029 DOI: 10.1007/s10578-023-01586-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
Gastrointestinal symptoms are commonly reported as adverse effects of selective serotonin reuptake inhibitors (SSRIs), the first-line pharmacologic treatment for pediatric anxiety disorders; however, the temporal course of these symptoms during treatment, although believed to be transient, has never been prospectively evaluated. Additionally, rates of gastrointestinal symptoms and functional gastrointestinal syndromes in anxious youth are poorly understood. We examined gastrointestinal symptoms in youth with anxiety disorders during a double-blind, placebo-controlled trial of escitalopram (n = 51). Then, in a separate sample of prospectively treated children and adolescents with generalized, social and/or separation anxiety disorders (n = 56), we examined the frequency of gastrointestinal symptoms based on the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS) and ROME III criteria and the association of these symptoms with clinical and demographic characteristics using logistic regression. The frequency/severity of abdominal pain, diarrhea, bloating constipation or total gastrointestinal symptoms did not differ between patients receiving placebo (n = 25) or escitalopram (n = 26). However, escitalopram-treated youth had transient changes in nausea/vomiting and total upper gastrointestinal symptoms during the first two weeks of treatment. ROME III criteria for functional gastrointestinal syndromes were present in 12/56 patients (21.4%). QPGS-related functional gastrointestinal syndromes and symptoms were unrelated to treatment, treatment type, or clinical or demographic variables. Gastrointestinal symptoms are common in youth with anxiety and SSRIs produce transient-rather than sustained-gastrointestinal symptoms. Assessing gastrointestinal symptoms prior to pharmacotherapy and discussing factors that increase (or decrease) the likelihood of transient SSRI-related symptoms in youth may decrease patient uncertainty related to side effects and decrease medication-related anxiety.
Collapse
Affiliation(s)
- W Thomas Baumel
- Department of Psychiatry, University of North Carolina, 77 Vilcom Center Dr, Chapel Hill, NC, 27514, USA.
| | - Jeffrey A Mills
- Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, OH, USA
| | - Heidi K Schroeder
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Zoe Neptune
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Amir Levine
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Department of Pediatrics, Division of Child & Adolescent Psychiatry, Divisions of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
36
|
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: 7] [Impact Index Per Article: 7.0] [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
|
37
|
Wang J, Liu M, Bai J, Chen Y, Xia J, Liang B, Wei R, Lin J, Wu J, Xiong P. Prevalence of common mental disorders among medical students in China: a systematic review and meta-analysis. Front Public Health 2023; 11:1116616. [PMID: 37719741 PMCID: PMC10501456 DOI: 10.3389/fpubh.2023.1116616] [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: 12/05/2022] [Accepted: 08/04/2023] [Indexed: 09/19/2023] Open
Abstract
Background The prevalence of mental distress is common for medical students in China due to factors such as the long duration of schooling, stressful doctor-patient relationship, numerous patient population, and limited medical resources. However, previous studies have failed to provide a comprehensive prevalence of these mental disorders in this population. This meta-analysis aimed to estimate the prevalence of common mental disorders (CMDs), including depression, anxiety, and suicidal behaviors, among medical students in China. Methods We conducted a systematic search for empirical studies on the prevalence of depression, anxiety, suicide attempt, suicide ideation, and suicide plan in Chinese medical students published from January 2000 to December 2020. All data were collected pre-COVID-19. The prevalence and heterogeneity estimations were computed by using a random-effects model and univariate meta-regression analyses. Results A total of 197 studies conducted in 23 provinces in China were included in the final meta-analysis. The prevalence data of depression, anxiety, suicide attempt, suicide ideation, and suicide plan were extracted from 129, 80, 21, 53, and 14 studies, respectively. The overall pooled crude prevalence for depression was 29% [38,309/132,343; 95% confidence interval (CI): 26%-32%]; anxiety, 18% (19,479/105,397; 95% CI: 15%-20%); suicide ideation, 13% (15,546/119,069; 95% CI: 11%-15%); suicide attempt, 3% (1,730/69,786; 95% CI: 1%-4%); and suicide plan, 4% (1,188/27,025; 95% CI: 3%-6%). Conclusion This meta-analysis demonstrated the high prevalence of CMDs among Chinese medical students. Further research is needed to identify targeted strategies to improve the mental health of this population.
Collapse
Affiliation(s)
- Jinxingyi Wang
- The Second Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Min Liu
- Zhuhai Center for Maternal and Child Health Care, Zhuhai Women and Children's Hospital, Zhuhai, China
| | - Jian Bai
- School of Medicine, Jinan University, Guangzhou, China
| | - Yuhan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Jie Xia
- The Second Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Baolin Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Ruixuan Wei
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Jiayin Lin
- School of Stomatology, Jinan University, Guangzhou, China
| | - Jiajun Wu
- School of Nursing, Jinan University, Guangzhou, China
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| |
Collapse
|
38
|
Shahidullah JD, Roberts H, Parkhurst J, Ballard R, Mautone JA, Carlson JS. State of the Evidence for Use of Psychotropic Medications in School-Age Youth. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1454. [PMID: 37761415 PMCID: PMC10528957 DOI: 10.3390/children10091454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Psychotropic medications are commonly prescribed to school-aged youth for the management of mental health concerns. This paper describes the current state of evidence for psychotropic medications in school-aged youth. More specifically, the following sections summarize relevant medication research trials and practice parameters pertaining to psychotropic medication prescribing as well as the specific medications indicated for a range of commonly presenting disorders and symptom clusters in school-aged youth. For each of these disorders and symptom clusters, key findings pertaining to the current state of science and practice are highlighted for the purpose of offering patients, clinicians, researchers, and policymakers with nuanced considerations for the role of psychopharmacology within the context of a larger "whole-child" approach to care that relies on the collaboration of providers and services across systems of care to promote optimal child and family health and wellness. The paper concludes with a discussion about supporting the use of medication treatments in schools, including considerations for ensuring effective family-school-health system collaboration to best meet youth mental health needs.
Collapse
Affiliation(s)
- Jeffrey D. Shahidullah
- Department of Psychiatry & Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Holly Roberts
- Department of Psychology, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - John Parkhurst
- Pritzker Department of Psychiatry & Behavioral Sciences, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (J.P.); (R.B.)
| | - Rachel Ballard
- Pritzker Department of Psychiatry & Behavioral Sciences, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; (J.P.); (R.B.)
| | - Jennifer A. Mautone
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19146, USA;
| | - John S. Carlson
- Department of Counseling, Educational Psychology, & Special Education, Michigan State University, East Lansing, MI 48824, USA
| |
Collapse
|
39
|
Connor M, Hargreaves EA, Scanlon OK, Harrison OK. The Effect of Acute Exercise on State Anxiety: A Systematic Review. Sports (Basel) 2023; 11:145. [PMID: 37624125 PMCID: PMC10459808 DOI: 10.3390/sports11080145] [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: 06/22/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023] Open
Abstract
Acute exercise has been shown to induce a small reduction in state anxiety, yet the most beneficial exercise stimulus is not clear. This review provides an update on the papers published since the last comprehensive review in 2015, with specific emphasis on whether study quality has improved. Randomised control trials, conducted in samples of healthy adults with non-clinical anxiety, were sourced from PubMed, PsycInfo, and Scopus. Study characteristics and study quality were assessed in nine studies comprising thirteen exercise conditions. Acute exercise significantly reduced anxiety in 53% (N = 7/13) of the exercise conditions. In comparison to a control condition, four showed exercising to be more effective, and one was as effective as the control. Two of the effective studies did not contain a control group. Six conditions were ineffective in reducing anxiety. There was no clear pattern of what combination of exercise mode, duration, and intensity was most effective, suggesting a variety may be effective in reducing anxiety. Methodological limitations still exist within the research, e.g., participant recruitment not considering baseline anxiety; variations in the control condition content. Future research should include participant samples exhibiting moderate-to-high levels of anxiety and examine self-selected exercise intensities.
Collapse
Affiliation(s)
- Madeleine Connor
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin 9016, New Zealand; (E.A.H.)
| | - Elaine A. Hargreaves
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin 9016, New Zealand; (E.A.H.)
| | - Orla K. Scanlon
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin 9016, New Zealand; (E.A.H.)
| | - Olivia K. Harrison
- Department of Psychology, University of Otago, Dunedin 9016, New Zealand;
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
- Translational Neuromodeling Unit, University of Zurich and ETH Zurich, 8001 Zurich, Switzerland
| |
Collapse
|
40
|
Barański K, Szemik S, Kaleta-Pilarska A, Kowalska M. General health and its relation to the quality of life and alcohol consumption in a Polish cohort of medical students - preliminary results of POLLEK survey. Front Public Health 2023; 11:1178124. [PMID: 37469698 PMCID: PMC10352118 DOI: 10.3389/fpubh.2023.1178124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/15/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction First-year students of medicine are at higher risk of stress related to the new environment and study overload. Such factors can play a role and have an impact on their quality of life and general health status which can cause possible problems with alcohol use. The aim of the study is to assess the relationship between mentioned factors in the Polish cohort of first-year medical students. Materials and methods The quality of life has been assessed within the WHOQOL-BREF questionnaire, the general health status was assessed via GHQ28, and alcohol consumption was assessed the by AUDIT questionnaire. Due to the lack of signature informed consent and lack of data, 381 (72%) students out of 525 were included in the final analysis. Result The majority of the 1-year students were females 68%; (n = 259) vs. 32% (n = 122) males. Half of the students had lowered risk of distress. However, females had a higher risk of having higher scores in GHQ-28 than males. In relation to the assessment of the quality of life, the students with a lower level of distress (<32 points in GHQ-28) had better results in each WHOQOL domain. There was no association between general health status and alcohol use. For the students who had possible problems with alcohol use the OR was 1.15 95% CI (0.73-1.80) and for students who were probably addicted OR was 1.07 95% CI (0.33-3.41). Conclusion The total quality of life in first-year Polish medical students is relatively high; however, half of them suffer because of distress and around 30% have some alcohol problems. Females are more likely to have higher GHQ-28 scores than males.
Collapse
|
41
|
Hipwell AE, Tung I, Krafty RT, Leong AW, Spada M, Vaccaro H, Homitsky SC, Moses-Kolko E, Keenan K. A lifespan perspective on depression in the postpartum period in a racially and socioeconomically diverse sample of young mothers. Psychol Med 2023; 53:4415-4423. [PMID: 35513948 PMCID: PMC9637236 DOI: 10.1017/s0033291722001210] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/04/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Consistent evidence from retrospective reports and case registry studies indicates that a history of depression is a major risk factor for depression in the peripartum period. However, longitudinal studies with racially and socioeconomically diverse samples of young mothers are lacking, and little is known about developmental patterns of depression across the lifespan that can inform preventive interventions. METHODS Young primiparous mothers (n = 399, 13-25 years, 81% Black) were recruited from a population-based prospective study that began in childhood. Women reported on depression symptoms for at least 3 years prior to their pregnancy, during pregnancy, and at 4 months postpartum. Linear regression models were used to estimate change in pre-pregnancy depression severity and to evaluate associations between patterns of lifetime history and postpartum depression symptoms. RESULTS Results revealed high levels of continuity in depression from pregnancy to postpartum, and across multiple years pre-pregnancy to postpartum. Overall, depression severity leading up to pregnancy decreased over time, but patterns of worsening or improving symptoms were not associated with depression severity in the postpartum period. Instead, area under the pre-pregnancy trajectory curve, representing cumulative lifetime depression burden, was uniquely associated with postpartum depression after adjusting for prenatal depression severity. CONCLUSIONS Depression in the postpartum period should be considered within a lifespan perspective of risk that accumulates before conception. Clinical screening and early interventions are needed in adolescence and young adulthood to prevent the onset and persistence of depressive symptoms that could have long-term implications for peripartum health.
Collapse
Affiliation(s)
- Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Irene Tung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, California State University Dominguez Hills, Carson, CA, USA
| | - Robert T. Krafty
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Audrey W. Leong
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Meredith Spada
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hope Vaccaro
- Department of Psychological Sciences, Case Western University, Cleveland, OH, USA
| | - Sarah C. Homitsky
- Women's Behavioral Health, Allegheny Health Network, Pittsburgh, PA, USA
| | - Eydie Moses-Kolko
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| |
Collapse
|
42
|
Yang W, Sun R, Wang C, Chen J, Zhang C, Yu J, Liu H. Epidemiology of depressive disorders among youth during Gaokao to college in China: results from Hunan Normal University mental health survey. BMC Psychiatry 2023; 23:481. [PMID: 37386434 PMCID: PMC10308668 DOI: 10.1186/s12888-023-04972-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Given the serious consequences of depression and the lack of information about it during the crucially developmental period from the National College Entrance Exam (CEE, i.e., Chinese gaokao) to college, this study aimed to estimate the cumulative incidence, prevalence, age of onset, correlates, and service use of depressive disorders (DDs) among youth who passed the CEE and were enrolled at Hunan Normal University in China. METHODS A two-stage cross-sectional epidemiological survey of DDs was conducted from October to December, 2017 among 6,922 incoming college students (98.5% effective response, N = 6,818, 71.4% female, age range: 16-25 years, mean age = 18.6). Using a stratified sampling method based on the risk of depression, 926 participants (mean age = 18.5, 75.2% female) were selected and subsequently interviewed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and lifetime version (K-SADS-PL). RESULTS The sex-adjusted 9-month (i.e., 3 months pre-CEE, 3 months after CEE, and 3 months post-matriculation) incidence of new-onset DDs was 2.3% (standard error [S.E.] 0.3%), and the sex-adjusted 1-month, 6-month and lifetime prevalence were 0.7 (S.E. 0.3%), 1.7 (S.E. 0.2%) and 7.5% (S.E. 1.3%), respectively. The median age of onset was 17 (interquartile range: 16-18) years. Critically, over one-third (36.5%, S.E. 0.6) of depressed youth had their new onset during the 9-month period. The risk factors for depression included having mothers with higher education, experiencing major life events, being female, and experiencing parental divorce or death. The adjusted lifetime treatment rate was 8.7%. CONCLUSION The 9-month incidence of new-onset depression from gaokao to college among the youth sample in China is similar to the global annual incidence (3.0%), but the 1-month and lifetime prevalence are significantly lower than the global point (7.2%) and lifetime prevalence (19%). These findings suggest a high proportion of new-onset depression during the CEE to college among the sample youth in China. The risk of depression is associated with familial and stress correlates. Low treatment is a serious concern. Emphasis on early prevention and available treatment for adolescent and young adult depression is a critical need in China.
Collapse
Affiliation(s)
- Wenhui Yang
- Department of Psychology, Center for Cultural Psychology and Behavior Research, Cognition and Human Behavior of Key Laboratory of Hunan Province, Hunan Normal University, 36 Lushan Road, Yuelu District, Changsha, Hunan Province, 410081, China.
| | - Rui Sun
- Department of Psychology, Center for Cultural Psychology and Behavior Research, Cognition and Human Behavior of Key Laboratory of Hunan Province, Hunan Normal University, 36 Lushan Road, Yuelu District, Changsha, Hunan Province, 410081, China
| | - Chong Wang
- Department of Statistic and Data Science, Cornel University, Ithaca, NY, 14853, USA
| | - Jie Chen
- Department of Psychology, Center for Cultural Psychology and Behavior Research, Cognition and Human Behavior of Key Laboratory of Hunan Province, Hunan Normal University, 36 Lushan Road, Yuelu District, Changsha, Hunan Province, 410081, China
| | - Chunguang Zhang
- Department of Psychology, Center for Cultural Psychology and Behavior Research, Cognition and Human Behavior of Key Laboratory of Hunan Province, Hunan Normal University, 36 Lushan Road, Yuelu District, Changsha, Hunan Province, 410081, China
| | - Jie Yu
- Student Affairs Department, Center for Education and Mental Health Counsel, Hunan Normal University, 36 Lushan Road, Yuelu District, Changsha, Hunan Province, 410081, China.
| | - Haihong Liu
- Department of Psychosomatic Medicine, Gerontology of Medical Institute, Academy of Medical Science and People's Hospital of Guangdong Province, Guangzhou, China
| |
Collapse
|
43
|
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: 1] [Impact Index Per Article: 1.0] [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
|
44
|
Zhang Y, Li G, Liu C, Guan J, Zhang Y, Shi Z. Comparing the efficacy of different types of exercise for the treatment and prevention of depression in youths: a systematic review and network meta-analysis. Front Psychiatry 2023; 14:1199510. [PMID: 37333923 PMCID: PMC10272399 DOI: 10.3389/fpsyt.2023.1199510] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/03/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose Depression disorder is the most commonly diagnosed type of mental illness among youths. Although a plethora of evidence suggests a positive relationship between exercise and lower levels of depression in youths, the findings regarding the variation in magnitude of this relationship are inconclusive with respect to the preventive and therapeutic effects of different types of exercise. This network meta-analysis aimed to determine the best type of exercise for the treatment and prevention of depression in youths. Methods A comprehensive search of databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, PsychINFO, ProQuest, Wanfang, and CNKI, was conducted to identify relevant research on exercise interventions for depression in youth populations. The risk of bias in the included studies was evaluated using Cochrane Review Manager 5.4 according to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The network meta-analysis was performed using STATA 15.1 to calculate the standardized mean difference (SMD) of all concerned outcomes. The node-splitting method was used to test the local inconsistency of the network meta-analysis. Funnel plots were used to evaluate the potential impact of bias in this study. Result Utilizing data extracted from 58 studies (10 countries, 4,887 participants), we found that for depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = -0.98, 95% CI [-1.50, -0.45]). For non-depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = -0.47, 95% CI [ -0.66, -0.29]). In the treatment of depression, resistance exercise (SMD = -1.30, 95% CI [ -1.96, -0.64]), aerobic exercise (SMD = -0.83, 95% CI [-1.10 -0.72]), mixed exercise (SMD = -0.67, 95% CI [-0.99, -0.35]), and mind-body exercise (SMD = -0.61, 95% CI [-0.84, -0.38]) all showed significant efficacy over usual care. For the prevention of depression, resistance exercise (SMD = -1.18, 95% CI [-1.65, -0.71]), aerobic exercise (SMD = -0.72, 95% CI [-0.98, -0.47]), mind-body exercise (SMD = -0.59, 95% CI [-0.93, -0.26]), and mixed exercise (SMD = -1.06, 95% CI [-1.37 to -0.75]) were all significantly effective compared to usual care. According to the test of the surface under the cumulative ranking score (SUCRA), the ranking of exercises for the treatment of depression in depressed youths is as follows: resistance exercise (94.9%) > aerobic exercise (75.1%) > mixed exercise (43.8%) > mind-body exercise (36.2%) > usual care (0%). For the prevention of depression in non-depressed youths, resistance exercise (90.3%) > mixed exercise (81.6%) > aerobic exercise (45.5%) > mind-body exercise (32.6%) > usual care (0%). Resistance exercise thus had the best comprehensive effect on both the treatment and prevention of depression in youths (clusterank value = 1914.04). Subgroup analyses show that a frequency of 3-4 times per week, a duration of 30-60 min, and a length of more than 6 weeks were found to be the most effective interventions for depression (P > 0.001). Conclusion This study provides compelling evidence that exercise is a viable intervention for improving depression and anxiety in young individuals. In addition, the study emphasizes the importance of selecting the appropriate type of exercise to optimize treatment and prevention. Specifically, the results suggest that resistance exercise, performed 3-4 times per week, with sessions lasting 30-60 min and a length of more than 6 weeks, yields optimal results for the treatment and prevention of depression in young individuals. These findings have significant implications for clinical practice, particularly given the challenges associated with implementing effective interventions and the economic burden of treating and preventing depression in young people. However, it is worth noting that additional head-to-head studies are necessary to confirm these findings and strengthen the evidence base. Nevertheless, this study provides valuable insights into the role of exercise as a potential treatment and preventative measure for depression in young people. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=374154, identifier: 374154.
Collapse
Affiliation(s)
- Yihan Zhang
- School of Educational Science, Hunan Normal University, Changsha, China
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Geng Li
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Chengzhen Liu
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Jinliang Guan
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Yuantong Zhang
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Zifu Shi
- School of Educational Science, Hunan Normal University, Changsha, China
| |
Collapse
|
45
|
Buckley V, Young AH, Smith P. Child and adolescent anxiety as a risk factor for bipolar disorder: A systematic review of longitudinal studies. Bipolar Disord 2023; 25:278-288. [PMID: 36949612 DOI: 10.1111/bdi.13322] [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] [Indexed: 03/24/2023]
Abstract
OBJECTIVES Several studies have suggested that anxiety disorders in childhood and adolescence often precede the onset of bipolar disorder. We therefore systematically reviewed the relationship between child and adolescent anxiety and later bipolar disorder. METHODS Online databases (Medline [for Ovid], EMBASE and PsychINFO) were searched for original, peer-reviewed studies examining the relationship between child and adolescent anxiety and later bipolar disorder. Studies in both community samples and bipolar offspring samples were included. RESULTS A total of 16 studies were included in the review. The results were broadly consistent and revealed that child and adolescent anxiety disorders are associated with later bipolar disorder in community samples. In bipolar offspring, child and adolescent anxiety disorders are a marker of increased risk and predict the onset of bipolar disorder and other major mood disorders. CONCLUSIONS There is evidence that anxiety disorders in childhood and adolescence increase the risk of later bipolar disorder. Anxiety disorders may be a useful target for early intervention in those at high-risk of bipolar disorder.
Collapse
Affiliation(s)
- Vanessa Buckley
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| | - Patrick Smith
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| |
Collapse
|
46
|
Castagna PJ, Farahdel E, Potenza MN, Crowley MJ. The current state-of-the-art in pharmacotherapy for pediatric generalized anxiety disorder. Expert Opin Pharmacother 2023; 24:835-847. [PMID: 37074259 PMCID: PMC10197951 DOI: 10.1080/14656566.2023.2199921] [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] [Received: 09/04/2022] [Accepted: 04/03/2023] [Indexed: 04/20/2023]
Abstract
INTRODUCTION Anxiety disorders are the most prevalent psychiatric disorders among youth. Among the various anxiety disorders, generalized anxiety disorder is particularly prevalent. Youth with GAD appear at elevated risk of developing other anxiety disorders, mood disorder, and substance use disorders. Functional outcomes of youth with GAD can be improved through early recognition and treatment, thus promoting better longer-term outcomes. AREAS COVERED The current article summarizes evidence-based state-of-the-art pharmacotherapy for pediatric GAD based on open-label, randomized, and controlled trials. Two electronic databases (PubMed and Scopus) were systematically searched in April 2022 for relevant publications. EXPERT OPINION The literature supports a combination of psychotherapy and pharmacotherapy as being associated with better outcomes when compared to mono-therapies. While longer-term follow-ups are limited, one such study does challenge this notion. Both selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) have been found across studies to have moderate effect sizes in the treatment of pediatric anxiety disorders. SSRIs continue to be a first-line intervention, whereas SNRIs may be considered a second-line treatment. While more evidence is needed, there are emerging data indicating that SSRIs are associated with a more rapid and greater reduction in anxiety symptoms when compared to SNRIs.
Collapse
Affiliation(s)
- Peter J. Castagna
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, 06511, USA
| | | | - Marc N. Potenza
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, 06511, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, USA
- Connecticut Mental Health Center, New Haven, CT, 06519, USA
- Wu Tsai Institute, Yale University, New Haven CT, 06510, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06511, US
| | - Michael J. Crowley
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, 06511, USA
| |
Collapse
|
47
|
Krivosova M, Adamcakova J, Kaadt E, Mumm BH, Dvorska D, Brany D, Dankova Z, Dohal M, Samec M, Ferencova N, Tonhajzerova I, Ondrejka I, Hrtanek I, Hutka P, Oppa M, Mokry J, Elfving B. The VEGF protein levels, miR-101-3p, and miR-122-5p are dysregulated in plasma from adolescents with major depression. J Affect Disord 2023; 334:60-68. [PMID: 37127118 DOI: 10.1016/j.jad.2023.04.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/24/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Michaela Krivosova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Jana Adamcakova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Erik Kaadt
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Birgitte Hviid Mumm
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Dana Dvorska
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Dusan Brany
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Zuzana Dankova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Matus Dohal
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Marek Samec
- Department of Pathological Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Peter Hutka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Miloslav Oppa
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic.
| | - Juraj Mokry
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Betina Elfving
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| |
Collapse
|
48
|
Ladouceur CD, Henry T, Ojha A, Shirtcliff EA, Silk JS. Fronto-amygdala resting state functional connectivity is associated with anxiety symptoms among adolescent girls more advanced in pubertal maturation. Dev Cogn Neurosci 2023; 60:101236. [PMID: 36996571 PMCID: PMC10063408 DOI: 10.1016/j.dcn.2023.101236] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/21/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Early adolescence, with the onset of puberty, is an important period when sex differences in anxiety emerge, with girls reporting significantly higher anxiety symptoms than boys. This study examined the role of puberty on fronto-amygdala functional connectivity and risk of anxiety symptoms in 70 girls (age 11-13) who completed a resting state fMRI scan, self-report measures of anxiety symptoms and pubertal status, and provided basal testosterone levels (64 girls). Resting state fMRI data were preprocessed using fMRIPrep and connectivity indices were extracted from ventromedial prefrontal cortex (vmPFC) and amygdala regions-of-interest. We tested moderated mediation models and hypothesized that vmPFC-amygdala would mediate the relation between three indices of puberty (testosterone and adrenarcheal/gonadarcheal development) and anxiety, with puberty moderating the relation between connectivity and anxiety. Results showed a significant moderation effect of testosterone and adrenarcheal development in the right amygdala and a rostral/dorsal area of the vmPFC and of gonadarcheal development in the left amygdala and a medial area of the vmPFC on anxiety symptoms. Simple slope analyses showed that vmPFC-amygdala connectivity was negatively associated with anxiety only in girls more advanced in puberty suggesting that sensitivity to the effects of puberty on fronto-amygdala function could contribute to risk for anxiety disorders among adolescent girls.
Collapse
|
49
|
Noroña-Zhou A, Coccia M, Sullivan A, O’Connor TG, Collett BR, Derefinko K, Renner LM, Loftus CT, Roubinov D, Carroll KN, Nguyen RHN, Karr CJ, Sathyanarayana S, Barrett ES, Mason WA, LeWinn KZ, Bush NR. A Multi-Cohort Examination of the Independent Contributions of Maternal Childhood Adversity and Pregnancy Stressors to the Prediction of Children's Anxiety and Depression. Res Child Adolesc Psychopathol 2023; 51:497-512. [PMID: 36462137 PMCID: PMC10017630 DOI: 10.1007/s10802-022-01002-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 12/05/2022]
Abstract
Women's social experiences can have long-term implications for their offspring's health, but little is known about the potential independent contributions of multiple periods of stress exposures over time. This study examined associations of maternal exposure to adversity in childhood and pregnancy with children's anxiety and depression symptoms in a large, sociodemographically diverse sample. Participants were 1389 mother-child dyads (child age M = 8.83 years; SD = 0.66; 42% Black, 42% White; 6% Hispanic) in the ECHO-PATHWAYS Consortium's three U.S. pregnancy cohorts. Women reported their exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE). Children self-reported on their symptoms of anxiety and depression at age 8-9 years. Regression analyses estimated associations between maternal stressors and children's internalizing problems, adjusting for confounders, and examined child sex as a modifier. Exploratory interaction analyses examined whether geospatially-linked postnatal neighborhood quality buffered effects. In adjusted models, PSLE counts positively predicted levels of children's anxiety and depression symptoms ([ßAnxiety=0.08, 95%CI [0.02, 0.13]; ßDepression=0.09, 95%CI [0.03, 0.14]); no significant associations were observed with CTE. Each additional PSLE increased odds of clinically significant anxiety symptoms by 9% (95%CI [0.02, 0.17]). Neither sex nor neighborhood quality moderated relations. Maternal stressors during pregnancy appear to have associations with middle childhood anxiety and depression across diverse sociodemographic contexts, whereas maternal history of childhood adversity may not. Effects appear comparable for boys and girls. Policies and programs addressing prevention of childhood internalizing symptoms may benefit from considering prenatal origins and the potential two-generation impact of pregnancy stress prevention and intervention.
Collapse
Affiliation(s)
- Amanda Noroña-Zhou
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
- Department of Pediatrics, UCSF, San Francisco, CA USA
- Center for Health and Community, UCSF, San Francisco, CA USA
| | - Michael Coccia
- Center for Health and Community, UCSF, San Francisco, CA USA
| | - Alexis Sullivan
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, Department of Obstetrics & Gynecology, University of Rochester, Rochester, NY USA
| | - Brent R. Collett
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle Children’s Research Institute, Seattle, WA USA
| | - Karen Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | | | - Christine T. Loftus
- Department of Occupational and Environmental Health Sciences, University of Washington, Seattle, WA USA
| | - Danielle Roubinov
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
| | - Kecia N. Carroll
- Departments of Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Ruby H. N. Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN USA
| | - Catherine J. Karr
- Department of Occupational and Environmental Health Sciences, Department of Pediatrics, University of Washington, Seattle, WA USA
| | - Sheela Sathyanarayana
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle Children’s Research Institute, Seattle, WA USA
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Environmental and Occupational Health Sciences Institute, Rutgers University, New Brunswick, NJ USA
| | - W. Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
- Department of Pediatrics, UCSF, San Francisco, CA USA
- Center for Health and Community, UCSF, San Francisco, CA USA
| |
Collapse
|
50
|
Xie YH, Zhang YM, Fan FF, Song XY, Liu L. Functional role of frontal electroencephalogram alpha asymmetry in the resting state in patients with depression: A review. World J Clin Cases 2023; 11:1903-1917. [PMID: 36998965 PMCID: PMC10044961 DOI: 10.12998/wjcc.v11.i9.1903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/10/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
Depression is a psychological disorder that affects the general public worldwide. It is particularly important to make an objective and accurate diagnosis of depression, and the measurement methods of brain activity have gradually received increasing attention. Resting electroencephalogram (EEG) alpha asymmetry in patients with depression shows changes in activation of the alpha frequency band of the left and right frontal cortices. In this paper, we review the findings of the relationship between frontal EEG alpha asymmetry in the resting state and depression. Based on worldwide studies, we found the following: (1) Compared with individuals without depression, those with depression showed greater right frontal EEG alpha asymmetry in the resting state. However, the pattern of frontal EEG alpha asymmetry in the resting state in depressive individuals seemed to disappear with age; (2) Compared with individuals without maternal depression, those with maternal depression showed greater right frontal EEG alpha asymmetry in the resting state, which indicated that genetic or experience-based influences have an impact on frontal EEG alpha asymmetry at rest; and (3) Frontal EEG alpha asymmetry in the resting state was stable, and little or no change occurred after antidepressant treatment. Finally, we concluded that the contrasting results may be due to differences in methodology, clinical characteristics, and participant characteristics.
Collapse
Affiliation(s)
- Yu-Hong Xie
- Psychology College of Teacher Education, Center of Group Behavior and Social Psychological Service, Ningbo University, Ningbo 315211, Zhejiang Province, China
| | - Ye-Min Zhang
- Psychology College of Teacher Education, Center of Group Behavior and Social Psychological Service, Ningbo University, Ningbo 315211, Zhejiang Province, China
| | - Fan-Fan Fan
- Psychology College of Teacher Education, Center of Group Behavior and Social Psychological Service, Ningbo University, Ningbo 315211, Zhejiang Province, China
| | - Xi-Yan Song
- Psychology College of Teacher Education, Center of Group Behavior and Social Psychological Service, Ningbo University, Ningbo 315211, Zhejiang Province, China
| | - Lei Liu
- Psychology College of Teacher Education, Center of Group Behavior and Social Psychological Service, Ningbo University, Ningbo 315211, Zhejiang Province, China
| |
Collapse
|