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Voltmer K, von Salisch M. Longitudinal prediction of primary school children's COVID-related future anxiety in the second year of the pandemic in Germany. PLoS One 2024; 19:e0302065. [PMID: 38718073 PMCID: PMC11078412 DOI: 10.1371/journal.pone.0302065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 03/27/2024] [Indexed: 05/12/2024] Open
Abstract
Although research has confirmed that the first COVID-19-related lockdown has increased stress and mental health problems in children, less is known about the longer-term effects of the pandemic on children's COVID-related future anxiety (CRFA). Because of CRFA's potentially debilitating effects, risk and resilience factors against this anxiety were investigated. To this end, n = 140 children (49% female) in 3rd and 4th grade classrooms in Germany were asked to perform a working memory task and to self-report about their CRFA and emotion regulation in December 2020 and in May 2021. More maladaptive emotion regulation in December 2020 contributed to the explanation of a high CRFA score in May 2021, whereas a better performance on working memory updating contributed a lower CRFA score later when controls were in place. These results were confirmed when children's CRFA in December 2020 was included in the prediction of their later CRFA. They suggest that maladaptive strategies of emotion regulation, such as rumination, may explain higher or increasing levels of CRFA, whereas efficient working memory updating may be an indicator of processing information in a way which shields children from CRFA-related thoughts. The concepts underlying these variables should be included in prevention and intervention efforts.
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Affiliation(s)
- Katharina Voltmer
- Institute for Sustainability Psychology, Leuphana University Lueneburg, Lueneburg, Lower Saxony, Germany
| | - Maria von Salisch
- Institute for Sustainability Psychology, Leuphana University Lueneburg, Lueneburg, Lower Saxony, Germany
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2
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Rost K, Gossmann E, Fegert JM, Ziegenhain U, Köhler-Dauner F. Long-term consequences of childhood emotional abuse in mothers on parental load and child mental health. Acta Psychol (Amst) 2024; 244:104169. [PMID: 38341882 DOI: 10.1016/j.actpsy.2024.104169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Childhood emotional maltreatment can be associated with long-term consequences on mental health. In addition, transgenerational transmission of adverse childhood experiences to the next generation can occur and thus have an impact on the mental health of one's own children. OBJECTIVE The purpose of this study was to examine the role of stress on the association between childhood emotional maltreatment and parental load what is referred to in this study as limitations in parental functioning that affect the resources available to parents to cope with the demands of raising, caring for, and providing for their child. Furthermore the effect of parental load on the mental health of one's own children will be examined. PARTICIPANTS AND SETTING N = 237 mother-child dyads (age mother M = 33.76, SD = 4.07 years; age child M = 11.91 months, SD = 0.89 months) from a longitudinal cohort study were examined at two different measuring points. METHODS Emotional abuse, perceived stress, parental load and child mental health were assessed using self and external report questionnaires. RESULTS The calculation of a mediation showed that the association of emotional abuse and parental load was completely mediated by perceived stress (indirect effect ab = 0.44, 95 %-CI[0.17, 0.78]). In addition, effects of parental load on the child's mental health (β = 0.13, 95%CI [0.07;0.20]), mainly hyperactivity (β = 0.06, 95%CI [0.03;0.11]) and prosocial behavior (β = -0.04, 95%CI [-0.07; -0.01]), were evident. CONCLUSIONS The results of this study provide evidence that the mental health of children can be influenced in the long term by increased parental load.
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Affiliation(s)
- Katharina Rost
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany.
| | - Emily Gossmann
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
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3
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Yadlosky LB, Mowrey WB, Pimentel SS. Risky business: Considerations of emotion regulation and high-risk behaviors in anxious adolescents. J Anxiety Disord 2023; 99:102760. [PMID: 37672917 DOI: 10.1016/j.janxdis.2023.102760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/11/2023] [Accepted: 08/10/2023] [Indexed: 09/08/2023]
Abstract
A growing body of empirical literature connects anxiety symptoms and high-risk suicidal and self-harming behaviors in youth. Emotion regulation (ER) processes and deficits have been identified as important factors in the etiology, maintenance, and treatment of both youth anxiety and high-risk behaviors. The present study assessed the association between these variables using an acute, socio-demographically diverse clinical sample of youth presenting to an outpatient mental health clinic. Ninety-nine youth aged 12-20 years old completed measures of anxiety symptoms, ER difficulties, and lifetime history of high-risk behaviors including non-suicidal self-injury (NSSI) and suicide attempts. Unadjusted analyses show that more severe anxiety symptoms were associated with more ER difficulties and history of risk behavior. Multivariate linear regression models considering age, sex, race/ethnicity, and risk history show that more severe anxiety symptoms remained significantly associated with more ER difficulties (p < 0.0001) and positive suicide attempt history (p < 0.01). Findings highlight the importance of integrating considerations of ER into the case conceptualization and treatment planning of high-risk, anxious youth to inform evidenced-based care with this population. The need for targeted, ongoing risk assessment with anxious youth to identify and mitigate risk is also demonstrated.
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Affiliation(s)
- Lauren B Yadlosky
- Montefiore Medical Center | Albert Einstein College of Medicine, USA.
| | - Wenzhu B Mowrey
- Montefiore Medical Center | Albert Einstein College of Medicine, USA
| | - Sandra S Pimentel
- Montefiore Medical Center | Albert Einstein College of Medicine, USA
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4
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Marino C, Manari T, Vieno A, Imperato C, Spada MM, Franceschini C, Musetti A. Problematic social networking sites use and online social anxiety: The role of attachment, emotion dysregulation and motives. Addict Behav 2023; 138:107572. [PMID: 36502744 DOI: 10.1016/j.addbeh.2022.107572] [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: 07/25/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/10/2022]
Abstract
Problematic Social Networking Sites Use (PSNSU) and social anxiety are associated. SNSs users may develop online social anxiety that may become a standalone problem. The present study aims to test the mediating role of emotion dysregulation and motives (coping, conformity, social, and enhancement) between attachment (anxiety and avoidance) and two outcomes (PSNSU and online social anxiety) in an integrated theory-driven model. Self-report questionnaires were completed by 756 SNSs users (50.4 % females; mean age = 28.74 years, SD = 8.00). Results of the path analysis supported the partial mediating role of emotion dysregulation in the association between attachment anxiety and both the outcomes and the serial mediating role via four and three motives in the association with PSNSU and online social anxiety, respectively. This study highlighted the role of several relational, emotional, and motivational factors that should be taken into account to tackle PSNSU and online social anxiety through clinical and prevention interventions.
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Affiliation(s)
- Claudia Marino
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università degli Studi di Padova, Padova, Italy; Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Alessio Vieno
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università degli Studi di Padova, Padova, Italy
| | - Chiara Imperato
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | | | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy.
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5
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The Role of Emotion Regulation and Executive Functioning in the Intervention Outcome of Children with Emotional and Behavioural Problems. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010139. [PMID: 36670689 PMCID: PMC9857297 DOI: 10.3390/children10010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/08/2023] [Accepted: 01/08/2023] [Indexed: 01/13/2023]
Abstract
Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem scores post-intervention, and further explore the extent to which emotion regulation mediates these outcomes. Participants were 41 primary school children who exhibited emotional and/or behavioural problems, aged 8 to 11 years. All the children completed measures of emotional and behavioural problems, cognitive emotion regulation, anxiety symptoms, and performed two experimental tasks to measure working memory and response inhibition before and after participating in a transdiagnostic Cognitive Behaviour Therapy-based programme, "Super Skills for Life" (SSL), and at 3-months follow-up. Results revealed significant reduction in the use of maladaptive emotion regulation strategy catastrophising and other blame following the intervention. Additionally, EF and emotion regulation was associated with outcomes for emotional problems and conduct problems. More specifically maladaptive emotion regulation strategy such as catastrophising and other blame was closely related with self-reports of emotional problems, likewise other blame, was also linked with scores of conduct problems. This study provides preliminary empirical support for EF and emotion regulation in predicting outcomes of emotional and behavioural problems in children following intervention.
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Glenn DE, Merenstein JL, Bennett IJ, Michalska KJ. Anxiety symptoms and puberty interactively predict lower cingulum microstructure in preadolescent Latina girls. Sci Rep 2022; 12:20755. [PMID: 36456602 PMCID: PMC9713745 DOI: 10.1038/s41598-022-24803-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Preadolescence is a period of increased vulnerability for anxiety, especially among Latina girls. Reduced microstructure (fractional anisotropy; FA) of white matter tracts between limbic and prefrontal regions may underlie regulatory impairments in anxiety. However, developmental research on the association between anxiety and white matter microstructure is mixed, possibly due to interactive influences with puberty. In a sample of 39 Latina girls (8-13 years), we tested whether pubertal stage moderated the association between parent- and child-reported anxiety symptoms and FA in the cingulum and uncinate fasciculus. Parent- but not child-reported anxiety symptoms predicted lower cingulum FA, and this effect was moderated by pubertal stage, such that this association was only significant for prepubertal girls. Neither anxiety nor pubertal stage predicted uncinate fasciculus FA. These findings suggest that anxiety is associated with disruptions in girls' cingulum white matter microstructure and that this relationship undergoes maturational changes during puberty.
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Affiliation(s)
- Dana E. Glenn
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA
| | - Jenna L. Merenstein
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA ,grid.26009.3d0000 0004 1936 7961Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Ilana J. Bennett
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA
| | - Kalina J. Michalska
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA
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7
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Adolescent social anxiety undermines adolescent-parent interbrain synchrony during emotional processing: A hyperscanning study. Int J Clin Health Psychol 2022; 22:100329. [PMID: 36111264 PMCID: PMC9449656 DOI: 10.1016/j.ijchp.2022.100329] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/20/2022] [Indexed: 11/22/2022] Open
Abstract
Social anxiety severely impacts adolescents’ social interactions with others; however, the underlying neural mechanism has not been revealed. This study examined how adolescent's social anxiety level influences the interbrain synchrony within adolescent-parent dyads during emotional processing by using electroencephalograph (EEG) hyperscanning. A sample of 25 adolescent-parent dyads completed the picture processing task. Adolescents’ ages ranged from 10 to 14 years old. The results showed that (1) at parietal areas, greater gamma interbrain synchrony was observed in the high social anxiety adolescent-parent dyads (HSAs) than the low social anxiety adolescent-parent dyads (LSAs) in the positive conditions. However, greater gamma interbrain synchrony of the picture processing task was observed in the LSAs than the HSAs in the negative conditions. (2) Compared with the neutral condition, LSAs induced greater interbrain synchronization in the negative condition than in the neutral condition at central and parietal areas. However, HSAs induced greater interbrain synchronization in the positive condition than in the negative condition at parietal areas. (3) HSAs induced greater interbrain synchronization at parietal areas than in the central areas in positive conditions. The results provide neurological evidence that the way parent and adolescent process different emotions in the same emotional episode could be affected by the adolescent's anxiety level.
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Melfsen S, Jans T, Romanos M, Walitza S. Emotion regulation in selective mutism: A comparison group study in children and adolescents with selective mutism. J Psychiatr Res 2022; 151:710-715. [PMID: 35690008 DOI: 10.1016/j.jpsychires.2022.05.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 04/20/2022] [Accepted: 05/20/2022] [Indexed: 10/18/2022]
Abstract
A deficit in emotion regulation skills could be an important factor influencing the vulnerability and maintenance of symptoms in selective mutism (SM). Unfortunately, to date only a few studies have examined emotion regulation in SM. Therefore, the present study investigated whether SM is associated with dysfunctional emotion regulation strategies. We compared a sample of 28 children and adolescents with SM (M = 12.66 years, SD = 3.98; 18 females) to 33 controls without SM (M = 12.45 years, SD = 3.18; 21 females). Both groups were investigated for the assessment of SM, social anxiety and emotion regulation using self and parent report questionnaires. We assumed that the disorder is associated with less adaptive and more maladaptive strategies, especially maladaptive cognitive strategies. Instead of significant differences in these overall values, only significant differences in individual emotion regulation strategies were found. In terms of adaptive strategies, children and adolescents with SM reported less problem-oriented behaviour and less cognitive problem-solving. Instead, they reported the maladaptive strategy of abandonment more often than the control group. In contrast to other anxiety disorders, children and adolescents with SM did neither report maladaptive cognitive strategies nor seek support more frequently than the control group. Their emotion regulation strategies are qualitatively closely related to the symptoms of SM, which makes it difficult to determine their independent significance. Trial registration: This study is registered with the ClinicalTrials.gov number NCT04233905.
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Affiliation(s)
- Siebke Melfsen
- University Hospital of Psychiatry, Zurich, Switzerland; University Hospital of Wuerzburg, Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Germany.
| | - Thomas Jans
- University Hospital of Wuerzburg, Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Germany
| | - Marcel Romanos
- University Hospital of Wuerzburg, Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Germany
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9
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Emotion regulation, negative self-evaluation, and social anxiety symptoms: The mediating role of depressive symptoms. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03225-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Pedrini L, Rossi R, Magni LR, Lanfredi M, Meloni S, Ferrari C, Macis A, Lopizzo N, Zonca V, Cattaneo A. Emotional Regulation in Teens and Improvement of Constructive Skills (EmoTIConS): study protocol for a randomized controlled trial. Trials 2021; 22:920. [PMID: 34906222 PMCID: PMC8670183 DOI: 10.1186/s13063-021-05886-2] [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: 05/19/2021] [Accepted: 11/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional dysregulation (ED) constitutes a relevant factor involved in the onset and maintenance of many mental disorders. Targeting ED during adolescence could be a determinant both to identify high-risk individuals and to promote preventive interventions. This study will aim to evaluate the impact of a brief Dialectical Behavioral Therapy (DBT)-based intervention for adolescent students by measuring changes in emotional regulation skills and impulsive behaviors. Moreover, alterations in biological features related to stress response and inflammation will be assessed as potential biological variables associated with ED. METHODS This is a randomized trial. A total of 20 classes of adolescent students will be recruited among high schools in Brescia, a city in northern Italy. They will be randomized to the psychoeducational intervention (experimental group) or to a control condition (control group). The intervention will be based on DBT Skills Training for Emotional Problem Solving for Adolescents, and will consist of four monthly, 2-h sessions (for a total of 8 h) scheduled during regular school time. Participants will be assessed at baseline, post-intervention, and at 3 and 6 months of follow-up. The primary outcome measures will be represented by changes in the use of emotional regulation skills and by changes in the frequency of impulsive behaviors. Salivary samples will be collected at baseline and post-intervention to explore possible biological features underlying ED. DISCUSSION Data from the present project will offer the opportunity to better understand the complex phenomenon of ED. Repeated assessment will cover several domains (emotional, behavioral, social, biological) as potential factors associated with ED. Moreover, it will be possible to establish the effect of the proposed intervention, thus helping to improve knowledge on the impact of school-based universal preventive programs. Finally, the current trial will propose an integrated screening and intervention-based model. Ultimately, this could reduce barriers to youths' mental health care by fostering collaboration between schools and mental health services. TRIAL REGISTRATION ClinicalTrials.gov NCT04349709 . Registered on April 16, 2020.
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Affiliation(s)
- Laura Pedrini
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Roberta Rossi
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Laura Rosa Magni
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mariangela Lanfredi
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Lopizzo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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11
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Zimmer-Gembeck MJ. Coping flexibility: Variability, fit and associations with efficacy, emotion regulation, decentering and responses to stress. Stress Health 2021; 37:848-861. [PMID: 33720506 DOI: 10.1002/smi.3043] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 11/10/2022]
Abstract
Coping flexibility is a promising approach to understanding risk and resilience, but it has been conceptualized in various ways. The aim of this study was to test convergence of coping-related flexibility measures with other coping-related competencies (coping self-efficacy, emotion regulation, decentering) and ways of coping. Participants were 885 students (Mage = 21.5 years) who completed measures of flexibility (seven subscales), coping self-efficacy, emotion dysregulation, decentering, and ways of coping with recent interpersonal stressors. Breadth of coping was also examined, given its past use as a measure of flexibility. The seven flexibility subscales converged with each other as expected, and all were associated with greater coping-related competence, with moderate or large positive associations between the four measures of coping flexibility ability and other measures of coping-related competence. Regarding associations with ways of coping, multivariate models showed that perceived ability in coping flexibility had positive associations with engagement and negative associations with disengagement coping, but multiple situational/adaptive coping flexibility subscales were associated positively with both engagement and disengagement ways of coping. In addition, some findings were weak or counterintuitive, especially when ways of coping and breadth were considered, suggesting a need for more attention to precisely conceptualizing and appropriately measuring coping flexibility.
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12
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Masters M, Zimmer-Gembeck MJ, Farrell LJ, Modecki KL. Coping and emotion regulation in response to social stress tasks among young adolescents with and without social anxiety. APPLIED DEVELOPMENTAL SCIENCE 2021. [DOI: 10.1080/10888691.2021.1990060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Morgado T, Loureiro L, Rebelo Botelho MA, Marques MI, Martínez-Riera JR, Melo P. Adolescents' Empowerment for Mental Health Literacy in School: A Pilot Study on ProLiSMental Psychoeducational Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8022. [PMID: 34360315 PMCID: PMC8345420 DOI: 10.3390/ijerph18158022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 01/07/2023]
Abstract
Adolescence is a critical life phase for mental health and anxiety an emerging challenge for adolescents. Psychoeducational interventions to promote mental health literacy (MHL) on anxiety in adolescents are needed. This study aimed to test the primary outcome of a future full-scale trial: improvement of adolescents' anxiety MHL components on recognition, prevention strategies, and self-help strategies. A sample of 38 adolescents, 24 (63.2%) females and 14 (36.8%) males, with an average age of 14.50 years (SD = 0.89) participated in this study. Each class was allocated to the intervention group (IG, n = 21) or the waiting list control group (WLCG, n = 17) with single-blinded randomization. MHL was assessed using the QuALiSMental. The ProLiSMental psychoeducational intervention consists of four or eight weekly sessions of 90 or 45 min for adolescents, using different active pedagogical methods and techniques. There also are initial and final sessions with adolescents, legal guardians, and teachers. There was a significant improvement with a small to relatively strong effect size in many dimensions of anxiety MHL components. This study suggests the progression to the full-scale trial and values the important role of mental health and psychiatric nurses in the adolescents' empowerment for MHL in schools.
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Affiliation(s)
- Tânia Morgado
- Centro Hospitalar e Universitário de Coimbra—Hospital Pediátrico, Av. Afonso Romão, 3000-062 Coimbra, Portugal
- Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Av. Bissaya Barreto, 3004-011 Coimbra, Portugal; (L.L.); (M.I.M.)
- NursID: Innovation & Development in Nursing, Center for Health Technology and Services Research, 4200-450 Porto, Portugal
| | - Luís Loureiro
- Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Av. Bissaya Barreto, 3004-011 Coimbra, Portugal; (L.L.); (M.I.M.)
- Escola Superior de Enfermagem de Coimbra, Av. Bissaya Barreto, 3004-011 Coimbra, Portugal
| | | | - Maria Isabel Marques
- Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Av. Bissaya Barreto, 3004-011 Coimbra, Portugal; (L.L.); (M.I.M.)
- Escola Superior de Enfermagem de Coimbra, Av. Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - José Ramón Martínez-Riera
- Departamento Enfermeria Comunitaria, Medicina Preventiva y Salud Publica e Historia de la Ciencia, Universidad de Alicante, E-03080 Alicante, Spain;
| | - Pedro Melo
- Centre for Interdisiplinary Research in Health, Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
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14
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Al-Ezzi A, Kamel N, Faye I, Gunaseli E. Analysis of Default Mode Network in Social Anxiety Disorder: EEG Resting-State Effective Connectivity Study. SENSORS (BASEL, SWITZERLAND) 2021; 21:4098. [PMID: 34203578 PMCID: PMC8232236 DOI: 10.3390/s21124098] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 12/27/2022]
Abstract
Recent brain imaging findings by using different methods (e.g., fMRI and PET) have suggested that social anxiety disorder (SAD) is correlated with alterations in regional or network-level brain function. However, due to many limitations associated with these methods, such as poor temporal resolution and limited number of samples per second, neuroscientists could not quantify the fast dynamic connectivity of causal information networks in SAD. In this study, SAD-related changes in brain connections within the default mode network (DMN) were investigated using eight electroencephalographic (EEG) regions of interest. Partial directed coherence (PDC) was used to assess the causal influences of DMN regions on each other and indicate the changes in the DMN effective network related to SAD severity. The DMN is a large-scale brain network basically composed of the mesial prefrontal cortex (mPFC), posterior cingulate cortex (PCC)/precuneus, and lateral parietal cortex (LPC). The EEG data were collected from 88 subjects (22 control, 22 mild, 22 moderate, 22 severe) and used to estimate the effective connectivity between DMN regions at different frequency bands: delta (1-3 Hz), theta (4-8 Hz), alpha (8-12 Hz), low beta (13-21 Hz), and high beta (22-30 Hz). Among the healthy control (HC) and the three considered levels of severity of SAD, the results indicated a higher level of causal interactions for the mild and moderate SAD groups than for the severe and HC groups. Between the control and the severe SAD groups, the results indicated a higher level of causal connections for the control throughout all the DMN regions. We found significant increases in the mean PDC in the delta (p = 0.009) and alpha (p = 0.001) bands between the SAD groups. Among the DMN regions, the precuneus exhibited a higher level of causal influence than other regions. Therefore, it was suggested to be a major source hub that contributes to the mental exploration and emotional content of SAD. In contrast to the severe group, HC exhibited higher resting-state connectivity at the mPFC, providing evidence for mPFC dysfunction in the severe SAD group. Furthermore, the total Social Interaction Anxiety Scale (SIAS) was positively correlated with the mean values of the PDC of the severe SAD group, r (22) = 0.576, p = 0.006 and negatively correlated with those of the HC group, r (22) = -0.689, p = 0.001. The reported results may facilitate greater comprehension of the underlying potential SAD neural biomarkers and can be used to characterize possible targets for further medication.
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Affiliation(s)
- Abdulhakim Al-Ezzi
- Centre for Intelligent Signal and Imaging Research (CISIR), Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Malaysia; (A.A.-E.); (N.K.)
| | - Nidal Kamel
- Centre for Intelligent Signal and Imaging Research (CISIR), Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Malaysia; (A.A.-E.); (N.K.)
| | - Ibrahima Faye
- Centre for Intelligent Signal and Imaging Research (CISIR), Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Malaysia; (A.A.-E.); (N.K.)
| | - Esther Gunaseli
- Psychiatry Discipline Sub Unit, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh 30450, Malaysia;
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15
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Herpers PCM, Neumann JEC, Staal WG. Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence. Child Psychiatry Hum Dev 2021; 52:515-532. [PMID: 32748274 PMCID: PMC8113221 DOI: 10.1007/s10578-020-01036-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/28/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Abstract
Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance transdiagnostic interventions, such as addressing non-compliance, restoration of trust between parents and their child, and limitation of avoidance behaviour. These may be seen as higher order interventions within the HiTOP framework.
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Affiliation(s)
- Pierre C M Herpers
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands.
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands.
| | - Josephine E C Neumann
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Geert Grooteplein 10, Nijmegen, 6525 GA, The Netherlands
- Faculty of Social Sciences, Leiden Institute for Brain and Cognition, Postzone C2-5, P.O. Box 9600, Leiden, 2300 RC, The Netherlands
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16
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Lundervold AJ, Halmøy A, Nordby ES, Haavik J, Meza JI. Current and Retrospective Childhood Ratings of Emotional Fluctuations in Adults With ADHD. Front Psychol 2021; 11:571101. [PMID: 33384637 PMCID: PMC7769943 DOI: 10.3389/fpsyg.2020.571101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/13/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction: Emotional fluctuations and mood swings are common among adults with Attention Deficit/Hyperactivity Disorder (ADHD). Here we investigated if these problems could be retrospectively traced back to childhood behavior. Methods: Adults with an ADHD diagnosis (n = 502, 48% female) and a population-based control sample (n = 818, 59% female) completed the Adult ADHD Self-report Scale (ASRS), the Wender Utah Rating Scale (WURS) and the Mood Disorder Questionnaire (MDQ). All participants also provided self-reported information about co-existent psychiatric and somatic diseases, and demographic data. Reports on the MDQ were used to define subgroups with [MDQ(+)] and without [MDQ(–)] life-time periods of emotional fluctuations and the WURS scale was used to retrospectively assess childhood ADHD related behaviors and symptoms. Results: 50.2% of the ADHD group and 5% of the controls were defined with emotional fluctuations [MDQ(+)]. Childhood behavior ratings of “impulsivity,” “loosing of control,” and “trouble with authorities” independently predicted emotional fluctuations reported in adulthood via logistic regression analyses. Inclusion of these three items in a classification analysis gave an accuracy score around 70% in identifying each of the two MDQ categories in the ADHD group. Discussion: The strong association between self-reported features of emotional problems in childhood and in adulthood suggests a trajectory that should be detected and remediated at an early age. Future longitudinal studies should prioritize the examination of developmental mechanisms explaining the persistence of emotional problems from childhood into adulthood.
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Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Anne Halmøy
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Emilie S Nordby
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Jan Haavik
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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17
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Affiliation(s)
- Melchior Maria
- INSERM Sorbonne Université, IPLESP UMRS 1136, Paris, France.
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18
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Sackl-Pammer P, Jahn R, Özlü-Erkilic Z, Pollak E, Ohmann S, Schwarzenberg J, Plener P, Akkaya-Kalayci T. Social anxiety disorder and emotion regulation problems in adolescents. Child Adolesc Psychiatry Ment Health 2019; 13:37. [PMID: 31583014 PMCID: PMC6771087 DOI: 10.1186/s13034-019-0297-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/17/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Social anxiety disorder (SAD) in adolescents may be associated with the use of maladaptive emotion regulation (ER) strategies. The present study examined the use of maladaptive and adaptive ER strategies in adolescents with SAD. METHODS 30 adolescents with SAD (CLIN) and 36 healthy adolescents for the control group (CON) aged between 11 and 16 years were assessed with the standardized questionnaires PHOKI (Phobiefragebogen für Kinder und Jugendliche) for self-reported fears as well as FEEL-KJ (Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen) for different emotion regulation strategies. RESULTS Compared to controls, adolescents with SAD used adaptive ER strategies significantly less often, but made use of maladaptive ER strategies significantly more often. There was a significant positive correlation between maladaptive ER and social anxiety in adolescents. Examining group differences of single ER strategy use, the CLIN and CON differed significantly in the use of the adaptive ER strategy reappraisal with CLIN reporting less use of reappraisal than CON. Group differences regarding the maladaptive ER strategies withdrawal and rumination, as well as the adaptive ER strategy problem-solving were found present, with CLIN reporting more use of withdrawal and rumination and less use of problem-solving than CON. CONCLUSIONS Promoting adaptive emotion regulation should be a central component of psychotherapy (cognitive behavioral therapy-CBT) for social anxiety in adolescents from the beginning of the therapy process. These findings provide rationale for special therapy programs concentrating on the establishment of different adaptive ER strategies (including reappraisal). As an increased use of maladaptive ER may be associated with SAD in adolescents, it may be paramount to focus on reduction of maladaptive ER (for example withdrawal and rumination) from the beginning of the psychotherapy process. Incorporating more ER components into psychotherapy (CBT) could increase the treatment efficacy. Further investigations of the patterns of emotion regulation in specific anxiety groups like SAD in adolescents is needed to continue to optimize the psychotherapy (CBT) concept.
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Affiliation(s)
- Petra Sackl-Pammer
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Rebecca Jahn
- 0000 0000 9259 8492grid.22937.3dDepartment for Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Zeliha Özlü-Erkilic
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Eva Pollak
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Susanne Ohmann
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Julia Schwarzenberg
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Paul Plener
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Türkan Akkaya-Kalayci
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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