'Who will I become?': possible selves and depression symptoms in adolescents

BACKGROUND

Adolescence is an important period for the development of the possible self. It is also a time when depression is prevalent. The cognitive theory of depression proposes that a negative view of the future is a key feature of depression. Targeting these negative thoughts about the future during cognitive behavioural therapy may be helpful in depression. However, little is known about how adolescents envisage their future (i.e. possible) self, or if the content is associated with affect. The aim of this quantitative study is to describe how adolescents describe their 'possible self' and examine the relationship between the valence of the possible self and depression in adolescents.

METHOD

Adolescents (n = 584) aged 13-18 years were recruited via opportunity sampling via their schools and completed measures of depression symptoms (the Mood and Feelings Questionnaire) and the 'possible self' (a variant of the 'I Will Be' task). Possible selves were coded for content and valence.

RESULTS

Despite depression severity, the most common possible selves generated by adolescents were positive and described interpersonal roles. The valence of the possible self was associated with depression severity but only accounted for 3.4% of the variance in severity.

CONCLUSION

The results support the cognitive model of depression. However, adolescents with elevated symptoms of depression were able to generate positive, possible selves and therefore may remain somewhat 'hopeful' about their future despite clinically significant depression symptoms. Future-oriented treatment approaches such as cognitive behavioural therapy that focus on changing unhelpful negative future thinking may not be appropriate for this population.

Early life stress is associated with the default mode and fronto-limbic network connectivity among young adults

Exposure to early life stress (ELS) is associated with a variety of detrimental psychological and neurodevelopmental effects. Importantly, ELS has been associated with regional alterations and aberrant connectivity in the structure and functioning of brain regions involved in emotion processing and self-regulation, creating vulnerability to mental health problems. However, longitudinal research regarding the impact of ELS on functional connectivity between brain regions in the default mode network (DMN) and fronto-limbic network (FLN), both implicated in emotion-related processes, is relatively scarce. Neuroimaging research on ELS has mostly focused on single nodes or bi-nodal connectivity instead of functional networks. We examined how ELS is associated with connectivity patterns within the DMN and FLN during rest in early adulthood. The participants (n = 86; 47 females) in the current functional magnetic resonance imaging (fMRI) study were young adults (18-21 years old) whose families had participated in a longitudinal study since pregnancy. ELS was assessed both prospectively (parental reports of family relationship problems and mental health problems during pregnancy and infancy) and retrospectively (self-reported adverse childhood experiences). Inter-subject representational similarity analysis (IS-RSA) and multivariate distance matrix regression (MDMR) were used to analyze the association between ELS and the chosen networks. The IS-RSA results suggested that prospective ELS was associated with complex alterations within the DMN, and that retrospective ELS was associated with alterations in the FLN. MDMR results, in turn, suggested that that retrospective ELS was associated with DMN connectivity. Mean connectivity of the DMN was also associated with retrospective ELS. Analyses further showed that ELS-related alterations in the FLN were associated with increased connectivity between the prefrontal and limbic regions, and between different prefrontal regions. These results suggest that exposure to ELS in infancy might have long-lasting influences on functional brain connectivity that persist until early adulthood. Our results also speak for the importance of differentiating prospective and retrospective assessment methods to understand the specific neurodevelopmental effects of ELS.

Fearful Temperament, Catastrophizing, and Internalizing Symptoms in Clinically Anxious Youth

A fearful temperament in childhood is associated with child internalizing symptoms. However, the cognitive mechanisms explaining this association are poorly understood. We examined the effects of child fearful temperament on child internalizing symptoms and the underlying role of catastrophizing cognitions among clinically anxious youth. Children (N = 105; M age = 10.09 years, SD = 1.22; 56.7% female; 62% ethnic minority) completed a diagnostic interview; self-report measures of temperament, catastrophizing, and internalizing symptoms; and behaviorally-indexed measures of catastrophizing and anxiety. Indirect effects were found for child fearful temperament on child self-reported internalizing symptoms by way of self-reported (but not behaviorally-indexed) catastrophizing cognitions. Models predicting behaviorally-indexed child anxiety were not significant. Our findings suggest that targeting fearful temperament during childhood before catastrophizing cognitions develop may have clinical utility. Likewise, among children temperamentally at-risk, addressing catastrophic cognitions may prevent later internalizing psychopathology.

Mediators between Positive and Negative Parenting and Child Depressive and Anxious Symptoms: Findings from a Diverse, At-Risk Sample

Background: Although children’s depressive and anxious symptoms have been broadly construed as internalizing problems, the current study sought to identify factors that may differentially contribute to these two mental health problems in a high-risk sample. Prior research has not adequately tested both depressive versus anxious symptoms simultaneously, nor has it adequately considered the role of negative versus positive parenting simultaneously, thereby neglecting the potential overlap in both sets of constructs. Overlooking such potential statistical overlap obfuscates how factors may differentially contribute to either depressive versus anxious symptoms. Existing research has also focused on lower-risk community samples. Method: The present study investigated whether children’s negative self-concept or maladaptive attributional style mediated the link between both negative and positive parenting in a racially diverse, at-risk sample of 65 primary school-age children recruited from mental health agencies. Results: When tested together, more negative parenting, but not less positive parenting, retained direct effects on both depressive and anxious symptoms. Both negative self-concept and maladaptive attributional style fully mediated the association between less positive parenting and children’s depressive symptoms, whereas positive self-concept, but not attributional style, mediated between less positive parenting and anxious symptoms. Conclusions: The current findings underscore potential differential intervention targets for these two internalizing problems and highlight the need for future research to consider both depressive and anxious symptoms, and related predictors, simultaneously to control for their shared variance.

Coping and Mental Health in Early Adolescence during COVID-19

The current longitudinal study examines changes in overall mental health symptomatology from before to after the COVID-19 outbreak in youth from the southeastern United States as well as the potential mitigating effects of self-efficacy, optimism, and coping. A sample of 105 parent-child dyads participated in the study (49% boys; 81% European American, 1% Alaska Native/American Indian, 9% Asian/Asian American; 4% Black/African American; 4% Latinx; and 4% other; 87% mothers; 25% high school graduate without college education; 30% degree from 4-year college; 45% graduate or professional school). Parents completed surveys when children were aged 6-9, 8-12, 9-13, and 12-16, with the last assessments occurring between May 13, 2020 and July 1, 2020 during the COVID-19 outbreak. Children also completed online surveys at ages 11-16 assessing self-efficacy, optimism, and coping. Multi-level modeling analyses showed a within-person increase in mental health symptoms from before to after the outbreak after controlling for changes associated with maturation. Symptom increases were mitigated in youth with greater self-efficacy and (to some extent) problem-focused engaged coping, and exacerbated in youth with greater emotion-focused engaged and disengaged coping. Implications of this work include the importance of reinforcing self-efficacy in youth during times of crisis, such as the pandemic, and the potential downsides of emotion-focused coping as an early response to the crisis for youth.

The relationship between conventional clinical assessments and momentary assessments of symptoms and functioning in schizophrenia spectrum disorders: A systematic review

BACKGROUND

Symptoms and functioning are critical dimensions in those with schizophrenia and are typically measured using validated conventional clinical assessments. Researchers and clinicians have begun to use real-time digital methods, such as ecological momentary assessment (EMA), to assess symptoms and functioning in the moment and outside of traditional hospital and laboratory settings, which may yield more naturalistic data. Although digital methods have advantages, it is unclear whether these momentary assessments capture core aspects of symptoms and functioning.

OBJECTIVE

This systematic literature review aimed to evaluate the association between conventional clinical and momentary-based assessments of functioning and symptoms in individuals with schizophrenia.

METHODS

Studies were included if they met the following criteria: (1) written or translated into English; (2) peer-reviewed; (3) included primary quantitative data; (4) 60% of the clinical sample included persons with schizophrenia spectrum disorders; (5) included a clinical assessment of functioning and/or symptoms; (6) included active momentary assessment and/or passive data; and (7) assessed the relationship between the momentary and conventional clinical assessments.

RESULTS

A total of 49 studies (87 analyses) were included. Conventional clinical assessments of functioning and positive, negative, and depressive symptoms were related to momentary assessments of these symptom domains. Passive data was beneficial for assessing negative symptoms, but research is warranted for other domains.

CONCLUSIONS

The reviewed studies highlight the utility of EMA methodologies to collect detailed data on symptoms and functioning. Such data is being used to develop more sophisticated models of schizophrenia to enhance our understanding of important mechanisms and develop targeted interventions.

Traditional Chinese Medicine Body Constitutions and Psychological Determinants of Depression among University Students in Malaysia: A Pilot Study

Depression is commonly observed in university students, who are a high risk group for developing psychiatric disorders during adulthood. This study aimed to determine the prevalence of depression and its traditional Chinese medicine body constitutions and psychological determinants among university students in Malaysia. A cross-sectional pilot study was conducted between 9 and 28 September 2020 among 80 university students in Malaysia. Participants completed online survey questionnaires, including the validated Patient Health Questionnaire (PHQ-9), Constitution in Chinese Medicine Questionnaire (CMCQ), Dysfunctional Attitude Scale (DAS), Depression Anxiety Stress Scale (DASS-21) stress subscale, Perceived Stress Scale (PSS-10), and Rosenberg Self-Esteem Scale (RSES), which assess depression, body constitution, dysfunctional attitude, stress, perceived stress, and self-esteem. Multiple linear regression analyses were performed to determine the associated risk factors for depression. The overall prevalence of depression among university students was 33.8%. The multiple regression analysis showed a significant relationship between depression and qi-stagnation constitution (B = 0.089, p = 0.011), balanced constitution (B = -0.077, p = 0.049), and self-esteem (B = -0.325, p = 0.001). Our findings suggest that some traditional Chinese medicine body constitutions and self-esteem are significant risk factors affecting depression among university students. Identifying risk factors of depression is vital to aid in the early detection of depression among university students.

Do adolescents with chronic fatigue syndrome (CFS/ME) and co-morbid anxiety and/or depressive symptoms think differently to those who do not have co-morbid psychopathology?

BACKGROUND

Co-morbid anxiety and/or depression is common in adolescents with Chronic Fatigue Syndrome (CFS/ME). Adolescents with psychopathology typically endorse more negative cognitive errors. We do not know whether they make negative cognitive errors in response to fatigue. We examined the thinking patterns of adolescents with CFS/ME and co-morbid psychopathology compared to those without this co-morbidity.

METHODS

This cross-sectional study recruited 205 adolescents (age 11-18) with CFS/ME, who completed measures of anxiety and depression, information processing biases and responses to fatigue. We grouped participants as having co-morbid psychopathology (or not) by applying a threshold score. We compared groups' thinking pattern subscale scores using independent samples T tests. We examined the association between psychopathology and general negative thinking and specific responses to fatigue symptoms.

RESULTS

Adolescents with CFS/ME with co-morbid psychopathology more strongly endorsed general negative cognitive errors (d = 0.61-1.31). They also more strongly endorsed damage beliefs (d = 0.49), embarrassment avoidance (d = 1.05), catastrophising (d = 0.97) and symptom focusing (d = 0.75) in response to fatigue but did not differ significantly on fear avoidance from those without co-morbid psychopathology. Both negative cognitive errors and unhelpful responses to symptoms explained 43% of the variance in psychopathology.

CONCLUSIONS

Adolescents with CFS/ME with co-morbid psychopathology tend to be negatively biased in their thinking, both generally and about their symptoms of fatigue specifically. This may have implications for the sequencing of cognitive and behavioural strategies to address both fatigue and psychopathology.

Youth's school experience: Testing the role of symptoms of anxiety and co-occurring symptoms of depression

Although symptoms of anxiety often coexist with symptoms of depression, little is known on how such coexistence affects youth's school experiences.

OBJECTIVES

We tested how the two types of behaviors, when coexisting, were associated with youth's negative attitude toward teachers, school, and poor peer relations.

METHOD

Data were collected from 203 ethnically and socioeconomically diverse youth (male: 24.6%; mean = 15.8 years, standard deviation = 2.4) with the 3rd edition of the Behavioral Assessment for Children: Self-Report of Personality.

RESULTS

Scores for symptoms of depression alone explained negative attitude toward teachers (β = .28; R²  = 17.88%), negative attitude toward school (β = .27; R²  = 14.74%), and poor peer relations (β = .42; R²  = 44.60%) as effectively as scores for both types of behaviors did.

CONCLUSION

The coexistence of symptoms of anxiety and depression did not appear to impair youth's attitude toward teachers, school and peer relations more than symptoms of depression did alone.