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Gruhn M, Miller AB, Machlin L, Motton S, Thinzar CE, Sheridan MA. Child Anxiety and Depression Symptom Trajectories and Predictors over 15 Months of the Coronavirus Pandemic. Res Child Adolesc Psychopathol 2023; 51:233-246. [PMID: 36048373 PMCID: PMC9435416 DOI: 10.1007/s10802-022-00963-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2022] [Indexed: 01/25/2023]
Abstract
Repeated measures are required to monitor and map trajectories of mental health symptoms that are sensitive to the changing distal and proximal stressors throughout the coronavirus (COVID-19) pandemic. Understanding symptoms in young children is particularly important given the short- and long-term implications of early-onset internalizing symptoms. This study utilized an intensive longitudinal approach to assess the course and environmental correlates of anxiety and depression symptoms in 133 children, ages 4-11 (Mage = 7.35, SD = 1.03), in the United States during the COVID-19 pandemic. Caregivers completed 48 repeated assessments from April 7, 2020, to June 15, 2021, on child and caregiver mental health symptoms, family functioning, and COVID-19-related environmental changes. Results from a series of multilevel growth models demonstrate that child depression symptoms were highest following initial stay-at-home orders (April 2020) and linearly decreased over time, while child anxiety symptoms were variable over the 15-month period. Caregiver depression symptoms and family conflict significantly predicted levels of child depression symptoms. In contrast, caregiver depression symptoms, caregiver anxiety symptoms, and time spent home quarantining significantly predicted levels of child anxiety symptoms. Results suggest that depression and anxiety symptoms in young children may have unique trajectories over the course of the coronavirus pandemic and highlight symptom-specific risk factors for each symptom.
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Affiliation(s)
- Meredith Gruhn
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
| | - Adam Bryant Miller
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- RTI International, Research Triangle Park, NC, USA
| | - Laura Machlin
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
| | - Summer Motton
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
| | - Crystal Ei Thinzar
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- University of North Carolina at Greensboro, Greensboro, NC, USA
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2
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Li M, Gong H. Spare the rod, spoil the child?--Predictive effects of parental adult attachment on adolescent anxiety: The mediating role of harsh parenting. J Affect Disord 2022; 312:107-112. [PMID: 35728678 DOI: 10.1016/j.jad.2022.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/23/2022] [Accepted: 06/16/2022] [Indexed: 11/30/2022]
Abstract
Based on family system theory, this study explores the relationship between parental adult attachment and adolescent anxiety, and the mediating effect of harsh parenting. A total of 997 families participated in the survey. The Experiences in Close Relationships Scale, Harsh Parenting Scale, and Trait Anxiety Scale were used to investigate students and their parents. The results showed that: (1) both paternal and maternal adult attachment avoidance positively predicted adolescent anxiety. (2) Parental harsh parenting mediates the relationship between parental attachment and adolescent anxiety. The results show that adult attachment and harsh parenting have important effects on adolescents' anxiety and family harmony.
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Affiliation(s)
- Mengge Li
- School of Psychology, Henan University, China
| | - Huoliang Gong
- Institute of Psychology and Behavior, Henan University, KaiFeng, China.
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3
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Dadashi M, Bateni R, Ghoreishi A. Personality disorders, depression and anxiety in mothers of children with ADHD and anxiety disorders in Iran. JOURNAL OF MOTHER AND CHILD 2022; 26:50-57. [PMID: 36317794 PMCID: PMC10032326 DOI: 10.34763/jmotherandchild.20222601.d-22-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/24/2022] [Indexed: 02/23/2023]
Abstract
BACKGROUND/AIM This study aims to assess and compare personality disorders and psychiatric disorders (depression and anxiety) in mothers of children with ADHD and anxiety disorders aged 2-16 years living in Iran. MATERIAL AND METHODS This is a descriptive cross-sectional study. Participants were 168 mothers (100 with children having ADHD and 68 with children having anxiety disorders). The Millon Clinical Multiaxial Inventory-III, the Depression Anxiety Stress Scale (DASS-21) and the Symptom Checklist-90-Revised (SCL-90-R) were used for assessing personality disorders, depression and anxiety in mothers. Collected data were analysed in SPSS software. RESULTS Of 168 mothers, only 100 completed the questionnaires completely (68 having children with ADHD and 32 with anxious children). Of 100 mothers, 61 had personality disorders, where 21 had children with anxiety disorders and 40 had children with ADHD. The most common personality disorder was depressive personality disorder (n = 27) followed by compulsive personality disorder (n = 15). No antisocial, borderline and paranoid personality disorders were observed in mothers. Based on DASS-21, 72 mothers had depression, and 84 had anxiety. Based on the SCL-90-R, 86 had depression, and 81 had anxiety. We found no statistically significant difference between the two groups of mothers in terms of personality disorders, depression and anxiety. CONCLUSION Prevalence of depression, anxiety and personality disorders in mothers of children with anxiety disorders and ADHD in Iran is high, and there is no difference between them. It is recommended that psychiatric and psychological counseling be provided for these mothers.
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Affiliation(s)
- Mohsen Dadashi
- Social Determinants of Health Research Center, Department of Clinical Psychology, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Abolfazl Ghoreishi
- Social Determinant of Health Research Center, Metabolic Diseases Research Center, Department of Psychiatry, Zanjan University of Medical Sciences, Zanjan, Iran
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Chen X, Li M, Gong H, Zhang Z, Wang W. Factors Influencing Adolescent Anxiety: The Roles of Mothers, Teachers and Peers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13234. [PMID: 34948841 PMCID: PMC8701175 DOI: 10.3390/ijerph182413234] [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] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Abstract
Grounded in social-ecological system theory, the present study tested the mediating effects of maternal psychological flexibility and mother-adolescent attachment on the relationship between maternal adult attachment and adolescent anxiety as well as the moderating effects of teacher support and peer support on the relationship between mother-adolescent attachment and adolescent anxiety. In total, 1139 Chinese mothers and adolescents completed a set of questionnaires, including the Experiences in Close Relationships Scale, Parental Psychological Flexibility Questionnaire, Inventory of Parent and Peer Attachment, Trait Anxiety Inventory, and Multidimensional Scale of Perceived Social Support. The results revealed that maternal adult attachment had a positive impact on adolescent anxiety. The relationship between maternal adult attachment and adolescent anxiety was chain mediated by maternal psychological flexibility and mother-adolescent attachment. In addition, teacher support and peer support had moderating effects on the relationship between mother-adolescent attachment and adolescent anxiety. These findings support the systematic social ecosystem perspective and highlight the differences in the effects of different maternal adult attachment styles, teacher support, and peer support on adolescent anxiety.
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Affiliation(s)
| | - Mengge Li
- School of Psychology, Henan University, Kaifeng 475001, China; (X.C.); (H.G.); (Z.Z.); (W.W.)
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Fjermestad KW, Lium C, Heiervang ER, Havik OE, Mowatt Haugland BS, Bjelland I, Henningsen Wergeland GJ. Parental internalizing symptoms as predictors of anxiety symptoms in clinic-referred children. Scand J Child Adolesc Psychiatr Psychol 2021; 8:18-24. [PMID: 33520775 PMCID: PMC7685498 DOI: 10.21307/sjcapp-2020-003] [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] [Indexed: 11/23/2022] Open
Abstract
Background: Mothers’ and fathers’ internalizing symptoms may influence children’s anxiety symptoms differently. Objective: To explore the relationship between parental internalizing symptoms and children’s anxiety symptoms in a clinical sample of children with anxiety disorders. Method: The sample was recruited through community mental health clinics for a randomized controlled anxiety treatment trial. At pre-intervention, children (n = 182), mothers (n = 165), and fathers (n = 72) reported children’s anxiety symptoms. Mothers and fathers also reported their own internalizing symptoms. The children were aged 8 to 15 years (Mage = 11.5 years, SD = 2.1, 52.2% girls) and all had a diagnosis of separation anxiety, social phobia, and/or generalized anxiety disorder. We examined parental internalizing symptoms as predictors of child anxiety symptoms in multiple regression models. Results: Both mother and father rated internalizing symptoms predicted children’s self-rated anxiety levels (adj. R2 = 22.0%). Mother-rated internalizing symptoms predicted mother-rated anxiety symptoms in children (adj. R2 = 7.0%). Father-rated internalizing symptoms did not predict father-rated anxiety in children. Conclusions: Clinicians should incorporate parental level of internalizing symptoms in their case conceptualizations.
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Affiliation(s)
| | - Christina Lium
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Odd E Havik
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Ingvar Bjelland
- Department of Psychiatry, Haukeland University Hospital, Bergen, Norway
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The Co-occurrence of Pediatric Chronic Pain and Anxiety: A Theoretical Review of a Developmentally Informed Shared Vulnerability Model. Clin J Pain 2020; 35:989-1002. [PMID: 31513056 DOI: 10.1097/ajp.0000000000000763] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The development and maintenance of pediatric chronic pain and anxiety are complex, underscoring the need to better understand the interactive forces contributing to their co-occurrence. The shared vulnerability model (SVM) was developed to explain the co-occurrence of chronic pain and posttraumatic stress disorder in adults. Although many core tenets have been well supported by pediatric research, the SVM has yet to be extended to pediatric pain populations. We propose a developmentally informed pediatric SVM for advancing our understanding of the co-occurrence of pediatric chronic pain and anxiety disorders. The proposed SVM postulates that youth at increased risk for the development of chronic pain and/or anxiety share predisposing vulnerabilities, including anxiety sensitivity, and that these shared vulnerabilities give rise to negative emotional responses (child and parent) in the context of stressful events. Consequences of fear and anxiety, including avoidance behavior, further contribute to the development of chronic pain, anxiety, and their co-occurrence. The parental, school, and peer contexts in which these problems develop and are maintained in youth are pertinent to integrate into a SVM, as pediatric chronic pain and anxiety disorders share several social-contextual risk and maintenance factors. We also highlight new areas of inquiry.
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Nefs G, Nguyen L, Winterdijk P, Hartman E, Sas T, Nuboer R, De Kruijff I, Bakker-van Waarde W, Aanstoot HJ, Pouwer F. Study protocol of Diabetes LEAP: a longitudinal study examining emotional problems in adolescents with type 1 diabetes and their parents/caregivers. BMC Pediatr 2019; 19:377. [PMID: 31651275 PMCID: PMC6813041 DOI: 10.1186/s12887-019-1743-9] [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: 01/28/2019] [Accepted: 09/20/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) is a chronic metabolic condition requiring intensive daily self-care to avoid both high and low blood glucose levels. Self-care and glycemic outcomes are particularly problematic in adolescence, a period known for its increased risk of emotional problems. However, the true scope of mood and anxiety disorders in adolescents with T1D is unknown. Earlier studies are limited by a small sample size, lack of diagnostic interview data, a focus on depression only, non-adolescent specific estimates, lack of information about parental emotional problems and/or a cross-sectional design. Diabetes LEAP is a two-year prospective observational cohort study examining (a) the prevalence and course of depression and anxiety in adolescents with T1D and their parents/caregivers, (b) the risk factors predicting the presence of these emotional problems, (c) their longitudinal relation with diabetes outcomes, and (d) the psychosocial care currently in place. METHODS Adolescents (12-18 years) from 8 Dutch pediatric diabetes clinics are interviewed using the DISC-IV to establish the presence of mood and anxiety disorders in the previous 4 weeks, the previous 12 months, and lifetime. They also complete questionnaires, including CDI-2, GAD-7, and PAID-T. Parents/caregivers complete PHQ-9, GAD-7, and PAID-PR. Follow-up assessments take place after 1 and 2 years. DISCUSSION This longitudinal study with diagnostic interviews in a large cohort of adolescents with T1D in the Netherlands will provide much needed information regarding the prevalence and course of depression and anxiety in this group, thereby opening avenues for proper recognition, prevention and timely treatment.
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Affiliation(s)
- Giesje Nefs
- Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, LE, Tilburg, The Netherlands. .,Diabeter, National Treatment and Research Center for Children, Adolescents and Young Adults with type 1 diabetes, Blaak 6, 3011, TA, Rotterdam, The Netherlands. .,Radboud university medical center, Radboud Institute for Health Sciences, Department of Medical Psychology, Huispost 840, Postbus 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Linh Nguyen
- Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, LE, Tilburg, The Netherlands
| | - Per Winterdijk
- Diabeter, National Treatment and Research Center for Children, Adolescents and Young Adults with type 1 diabetes, Blaak 6, 3011, TA, Rotterdam, The Netherlands
| | - Esther Hartman
- Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, LE, Tilburg, The Netherlands
| | - Theo Sas
- Diabeter, National Treatment and Research Center for Children, Adolescents and Young Adults with type 1 diabetes, Blaak 6, 3011, TA, Rotterdam, The Netherlands.,Department of Pediatrics, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318, AT, Dordrecht, The Netherlands.,Department of Pediatric Endocrinology, Erasmus Medical Center - Sophia Childrens' Hospital, Rotterdam, The Netherlands
| | - Roos Nuboer
- Department of Pediatrics, Meander Medical Center, Maatweg 3, 3813, Amersfoort, TZ, Netherlands
| | - Ineke De Kruijff
- Department of Pediatrics, Diabetes Centraal, St. Antonius Hospital, Soestwetering 1, 3543, AZ, Utrecht, The Netherlands
| | - Willie Bakker-van Waarde
- Diabeter, National Treatment and Research Center for Children, Adolescents and Young Adults with type 1 diabetes, Blaak 6, 3011, TA, Rotterdam, The Netherlands
| | - Henk-Jan Aanstoot
- Diabeter, National Treatment and Research Center for Children, Adolescents and Young Adults with type 1 diabetes, Blaak 6, 3011, TA, Rotterdam, The Netherlands
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,School of Psychology, Deakin University, Locked Bag 20001, Geelong, VIC, 3220, Australia.,STENO Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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8
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Reyes S, Giovannoni G, Thomson A. Social capital: Implications for neurology. Brain Behav 2019; 9:e01169. [PMID: 30536750 PMCID: PMC6346418 DOI: 10.1002/brb3.1169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 09/16/2018] [Accepted: 10/25/2018] [Indexed: 01/26/2023] Open
Abstract
Social capital (SC) is a broad term that encompasses the many resources derived from social connections. The contemporary study of SC in public health has deep roots in the related fields of sociology, economics, and politics. Its multidisciplinary nature and the varying potential ways it could affect individuals have resulted in different but overlapping models to approach SC in the health field. There are currently no standardized measures of SC, and even more challenging its impact on health outcomes seems to vary according to the level of analysis. Despite the accumulating evidence that supports a protective effect of SC on mental and physical health, and mortality, not enough attention has been paid to the potential drawbacks of SC. The role of SC in neurological disease is just beginning to be explored. Concerted efforts are needed to ensure that empirical evidence on SC could be properly translated into interventions for health-promoting purposes. In this paper, we review the current state of scientific knowledge on the subject of SC, with a focus on its application in the field of neurology.
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Affiliation(s)
- Saúl Reyes
- Queen Mary University of London, Blizard Institute, London, UK
| | - Gavin Giovannoni
- Queen Mary University of London, Blizard Institute, London, UK.,Barts and The London School of Medicine and Dentistry, London, UK
| | - Alison Thomson
- Queen Mary University of London, Blizard Institute, London, UK
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9
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Kuckertz JM, Mitchell C, Wiggins JL. Parenting mediates the impact of maternal depression on child internalizing symptoms. Depress Anxiety 2018; 35:89-97. [PMID: 28962070 PMCID: PMC5760303 DOI: 10.1002/da.22688] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/19/2017] [Accepted: 08/29/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To examine the potential mediating role of parenting behaviors in the longitudinal, bidirectional relationships between maternal depression and child internalizing symptoms (i.e. depression and anxiety). METHODS We analyzed data from 4,581 mother-child dyads from the Fragile Families and Child Wellbeing Study, assessed when the child was 3, 5, and 9 years old. Data included maternal depression diagnosis, child internalizing symptoms, and parenting behaviors (i.e. psychological aggression, nonviolent discipline, and physical assault). Data were analyzed using cross-lagged panel models. RESULTS Results indicated bidirectional relationships between maternal depression and child internalizing symptoms over childhood. Mediation analyses suggested that maternal depression led to subsequent increased psychological aggression toward their child, which in turn led to increased child internalizing symptoms. Nonviolent discipline and physical assault did not mediate this relationship. However, greater use of nonviolent discipline at age 5 among all parents predicted higher child internalizing symptoms at age 9. No parenting behaviors were both predicted by earlier child internalizing symptoms and predictive of subsequent maternal depression. CONCLUSIONS Our results suggest a bidirectional relationship between child and maternal internalizing psychopathology that is partially explained by depressed mothers' greater use of psychological aggression toward their children. It is important to note that the size of these effects were small, suggesting that the relationship between parent and child psychopathology is likely additionally explained by factors not assessed in the current study. Nonetheless, these results have implications for prevention and intervention strategies targeting child anxiety and depression.
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Affiliation(s)
- Jennie M. Kuckertz
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego San Diego, CA
| | - Colter Mitchell
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Jillian Lee Wiggins
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego San Diego, CA
- Psychology Department, San Diego State University, San Diego, CA
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Bellamy S, Hardy C. Factors predicting depression across multiple domains in a national longitudinal sample of Canadian youth. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:633-43. [PMID: 25240908 PMCID: PMC4397358 DOI: 10.1007/s10802-014-9940-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This prospective longitudinal study aimed to investigate the strength and relative importance of multiple predictors of depression in youth aged 16 to 20 years. Data were drawn from Statistics Canada's National Longitudinal Survey of Children and Youth (Statistics Canada 2007a, b). Hierarchical regressions were conducted separately by child gender (N = 796 boys; N = 919 girls) for two overlapping samples: mixed parent-child dyads (e.g., biological mothers, fathers and other caregivers; N = 1,715) and a subsample containing only biological mother-child dyads (N = 1,425). Parent-reported data were used from Cycle 1 when the children were aged 4 to 8 years. Parent and child-reported data were used from Cycle 4 when children were aged 10 to 14 years. The outcome measure of depressive symptoms was taken from Cycle 7 when the youth were aged 16 to 20 years. Adolescents reported more depression symptoms than young adults and girls reported more than boys. For boys, higher anxiety/depression scores at ages 4 to 8 years and 10 to 14 years, along with lower self-esteem at 10 to 14 years, predicted higher depression scores. Girls' depression was predicted by loss of a parent by ages 4 to 8 years and higher self-reported anxiety/depression and aggression at ages 10 to 14 years. Among biological mother-child dyads, maternal depression reported by mother when child was aged 4 to 8 years and 10 to 14 years significantly predicted depression for girls. At 10 to 14 years, child-reported lower parental monitoring (girls only) and greater parental rejection (boys and girls) predicted depression at ages 16 to 20 years.
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Affiliation(s)
- Sherry Bellamy
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada,
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A Possible Role of Anhedonia as Common Substrate for Depression and Anxiety. DEPRESSION RESEARCH AND TREATMENT 2016; 2016:1598130. [PMID: 27042346 PMCID: PMC4793100 DOI: 10.1155/2016/1598130] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 01/30/2016] [Accepted: 02/11/2016] [Indexed: 02/08/2023]
Abstract
Depression and anxiety are often comorbid, in up to 70% of cases, and the level of one or the other may fluctuate, leading now to a diagnosis of depression, now to a diagnosis of anxiety. For these reasons, and for the presence of many other common factors, it has been suggested that both are part of the same continuum of problems and that they have a common substrate. This paper proposes the possibility that anhedonia may be an important component of this possible common substrate, and it tries to identify the mechanism with which anhedonia could contribute to causing both depression and anxiety. It also proposes an explanation why an intense pleasure could improve both depression and anxiety.
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12
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Bradbury AR, Patrick-Miller L, Schwartz L, Egleston B, Sands CB, Chung WK, Glendon G, McDonald JA, Moore C, Rauch P, Tuchman L, Andrulis IL, Buys SS, Frost CJ, Keegan TH, Knight JA, Terry MB, John EM, Daly MB. Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer. Pediatrics 2015; 136:927-37. [PMID: 26482668 PMCID: PMC4972044 DOI: 10.1542/peds.2015-0498] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Understanding how young girls respond to growing up with breast cancer family histories is critical given expansion of genetic testing and breast cancer messaging. We examined the impact of breast cancer family history on psychosocial adjustment and health behaviors among >800 girls in the multicenter LEGACY Girls Study. METHODS Girls aged 6 to 13 years with a family history of breast cancer or familial BRCA1/2 mutation (BCFH+), peers without a family history (BCFH-), and their biological mothers completed assessments of psychosocial adjustment (maternal report for 6- to 13-year-olds, self-report for 10- to 13-year-olds), breast cancer-specific distress, perceived risk of breast cancer, and health behaviors (10- to 13-year-olds). RESULTS BCFH+ girls had better general psychosocial adjustment than BCFH- peers by maternal report. Psychosocial adjustment and health behaviors did not differ significantly by self-report among 10- to 13-year-old girls. BCFH+ girls reported higher breast cancer-specific distress (P = .001) and were more likely to report themselves at increased breast cancer risk than BCFH- peers (38.4% vs 13.7%, P < .001), although many girls were unsure of their risk. In multivariable analyses, higher daughter anxiety was associated with higher maternal anxiety and poorer family communication. Higher daughter breast cancer-specific distress was associated with higher maternal breast cancer-specific distress. CONCLUSIONS Although growing up in a family at risk for breast cancer does not negatively affect general psychosocial adjustment among preadolescent girls, those from breast cancer risk families experience greater breast cancer-specific distress. Interventions to address daughter and mother breast cancer concerns and responses to genetic or familial risk might improve psychosocial outcomes of teen daughters.
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Affiliation(s)
- Angela R. Bradbury
- Division of Hematology/Oncology, Department of Medicine, and,Department of Medical Ethics and Health Policy, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania;,Address correspondence to Angela R. Bradbury, MD, Perelman School of Medicine at the University of Pennsylvania, 3 West Perelman Center, 3400 Civic Center Blvd, Philadelphia, PA 19104. E-mail:
| | - Linda Patrick-Miller
- Division of Hematology-Oncology, Department of Medicine, and the Center for Clinical Cancer Genetics and Global Health, The University of Chicago, Chicago, Illinois
| | - Lisa Schwartz
- Department of Pediatrics, Division of Oncology, The Children’s Hospital of Philadelphia and Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | | | - Gord Glendon
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Jasmine A. McDonald
- Mailman School of Public Health, Columbia University Medical Center, New York, New York
| | - Cynthia Moore
- Department of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Paula Rauch
- Department of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Lisa Tuchman
- Department of Adolescent Medicine, Children’s National Medical Center, Washington, District of Columbia
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada;,Departments of Molecular Genetics and Laboratory Medicine, and
| | - Saundra S. Buys
- Department of Medicine, Division of Oncology, The University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Caren J. Frost
- College of Social Work, The University of Utah, Salt Lake City, Utah
| | - Theresa H.M. Keegan
- Cancer Prevention Institute of California, Fremont, California; and,Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada;,Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada
| | - Mary Beth Terry
- Herbert Irving Comprehensive Cancer Center, and,Mailman School of Public Health, Columbia University Medical Center, New York, New York
| | - Esther M. John
- Cancer Prevention Institute of California, Fremont, California; and,Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania
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Weems CF, Scheeringa M. Maternal depression and treatment gains following a cognitive behavioral intervention for posttraumatic stress in preschool children. J Anxiety Disord 2013; 27:140-6. [PMID: 23376601 PMCID: PMC3578069 DOI: 10.1016/j.janxdis.2012.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 11/02/2012] [Accepted: 11/24/2012] [Indexed: 12/21/2022]
Abstract
The evidence base for cognitive behavioral therapy (CBT) to treat child emotional and behavioral symptoms following exposure to trauma in youth is compelling, but relatively few studies are available on preschool children and on moderators of treatment outcomes. This paper examines maternal and child characteristics as moderators of posttraumatic stress (PTS) treatment outcomes in preschool children. Outcome data from a previously published randomized trial in three to six year old preschool children with diagnostic interview data from participating mothers were used. Hypotheses were tested via hierarchical linear modeling. Maternal depression was associated with higher initial child posttraumatic stress disorder (PTSD) symptoms, and was associated with increasing PTSD symptom trends at follow up suggesting potential child PTSD symptom relapse. Maternal PTSD symptoms similarly predicted differential child separation anxiety symptom change but not child PTSD symptom change. Targeting dyads with child PTSD symptoms and maternal depression or PTSD symptoms with enhanced interventions may be a useful strategy to improve treatment maintenance.
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Velders FP, Dieleman G, Henrichs J, Jaddoe VWV, Hofman A, Verhulst FC, Hudziak JJ, Tiemeier H. Prenatal and postnatal psychological symptoms of parents and family functioning: the impact on child emotional and behavioural problems. Eur Child Adolesc Psychiatry 2011; 20:341-50. [PMID: 21523465 PMCID: PMC3135831 DOI: 10.1007/s00787-011-0178-0] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 04/13/2011] [Indexed: 12/28/2022]
Abstract
Although relations of various parental psychological problems and family functioning with child development are well documented, it remains unclear whether specific prenatal or specific postnatal risk factors are independently associated with child emotional and behavioural problems, or whether observed associations can be explained by general parental psychopathology. Using a stepwise approach, we examined the effects of prenatal and postnatal parental depressive symptoms, prenatal and postnatal hostility of the parents, as well as prenatal family functioning on the risk of child emotional and behavioural problems. This study was embedded in Generation R: a population-based cohort from foetal life onwards. Mothers and fathers of 2,698 children provided information about depressive symptoms, symptoms of hostility and family functioning during pregnancy and 3 years after birth. Mother and father each reported on child behaviour when the child was 3 years old. Parental depressive symptoms increased the risk of child emotional and behavioural problems, but this increase was explained by postnatal parental hostile behaviour. Postnatal symptoms of hostility of mothers (OR = 1.34, p value <0.001) and postnatal symptoms of hostility of fathers (OR = 1.30, p value <0.001) each contributed independently to the risk of child emotional and behavioural problems. Postnatal parental hostility is associated with an increased risk of child emotional and behavioural problems, independent of parental depressive symptoms. These findings suggest that prevention and intervention strategies should focus on psychological symptoms of both mothers and fathers, in particular on hostile behaviour, in families with young children.
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Affiliation(s)
- Fleur P. Velders
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children’s Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands ,The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children’s Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Jens Henrichs
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands ,Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands ,Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands ,Department of Pediatrics, Erasmus Medical Center, Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Frank C. Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children’s Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - James J. Hudziak
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children’s Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands ,Departments of Psychiatry, Medicine and Pediatrics, College of Medicine, University of Vermont, Burlington, VT USA ,Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children’s Hospital, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands ,Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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15
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Colletti CJM, Forehand R, Garai E, McKee L, Potts J, Haker K, Champion J, Compas BE. Associations of Parent-Child Anxious and Depressive Symptoms When a Caregiver Has a History of Depression. JOURNAL OF CHILD AND FAMILY STUDIES 2010; 19:762-770. [PMID: 25844031 PMCID: PMC4381433 DOI: 10.1007/s10826-010-9367-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We examined the associations between parent and child anxious and depressive symptoms controlling for co-occurring symptoms in both. One hundred and four families participated, including 131 9-15 year old children considered at risk for anxiety and/or depression due to a history of depression in a parent. Parents and children completed questionnaires assessing depressive and anxious symptoms. Linear Mixed Models analyses controlling for the alternate parent and child symptoms indicated that both parent and child depressive symptoms and parent and child anxious symptoms were positively associated. Parental depressive symptoms were not positively associated with child anxious symptoms, and parental anxious symptoms were not positively associated with child depressive symptoms. The findings provide evidence for positive specific links between parent and child development of same-syndrome, but not cross-syndrome, symptoms when a caregiver has a history of depression.
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Affiliation(s)
| | - Rex Forehand
- Department of Psychology, University of Vermont, Burlington, VT 05405, USA
| | - Emily Garai
- Department of Psychology, University of Vermont, Burlington, VT 05405, USA
| | - Laura McKee
- Center for Developmental Science, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Jennifer Potts
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN 37203, USA
| | - Kelly Haker
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN 37203, USA
| | - Jennifer Champion
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN 37203, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN 37203, USA
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