Anxiety in Early Adolescence: Heterogeneous Developmental Trajectories, Associations with Risk Factors and Depressive Symptoms

Identifying mental health outcomes and evidence-based psychological interventions for supporting pediatric gunshot wound patients: A systematic review and proposed conceptual model

BACKGROUND

Accidental and assault gunshot wounds (GSWs) are the second leading cause of injury in the United States for youth ages 1- to 17-years-old, resulting in significant negative effects on pediatric patients' mental health functioning. Despite the critical implications of GSWs, there has yet to be a systematic review synthesizing trends in mental health outcomes for pediatric patients; a gap the present review fills. Additionally, this review identifies evidence-based psychological interventions shown to be effective in the treatment of subclinical symptoms of psychological disorders in the general population.

METHODS

A comprehensive search was conducted using five databases: American Psychological Association (APA) PsycInfo, APA PsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resource Information Center (ERIC), and Medical Literature Analysis and Retrieval Systems Online (MEDLINE). Twenty-two articles met inclusion criteria.

RESULTS

Findings suggest pediatric GSW patients are at a significantly elevated risk for mental health disorders when compared to other- (e.g., motor vehicle collision) and non-injured youth. Disorders include post-traumatic stress, disruptive behavior, anxiety, depression, and substance use. Hospital-based violence intervention programs, cultivating supportive relationships with adults in one's community, and trauma-focused outpatient services were identified as effective interventions for treating subclinical psychological symptoms.

CONCLUSIONS

Depicted in the proposed conceptual model, the present study delineates a direct association between pediatric GSWs and subsequent onset of mental health disorders. This relation is buffered by evidence-based psychological interventions targeting subclinical symptoms. Results suggest brief psychological interventions can help treat mental health challenges, minimizing risk for significant long-term concerns. Cultural adaptations to enhance the utility and accessibility of interventions for all patients are recommended.

Emotional Profiles of Anxiety, Depression, and Stress: Differences in School Anxiety

INTRODUCTION

This study aims to confirm the existence of profiles according to the combinations of anxiety, depression, and stress, and looks to examine the differences between profiles according to the mean scores obtained in school anxiety.

METHODS

A total of 1,234 Spanish students at the secondary education level with an age range of 13-16 years old (M = 14.52; SD = 1.24) participated in the study by completing the abbreviated version of the Depression, Anxiety, and Stress Scale (DASS-21) and the School Anxiety Inventory.

RESULTS

The results showed positive, statistically significant, and moderate-sized correlations between all the variables analyzed. The Latent Profile Analysis identified four distinct profiles of depression, anxiety, and stress: Low DAS, Moderate DAS, High DAS, and Very High DAS. The results of the MANOVA showed statistically significant differences between these profiles regarding the school anxiety dimensions, with the profiles Very High DAS and Low DAS being the ones that reported, respectively, the highest and lowest levels in all the school anxiety components. Post hoc analyses revealed significant differences for the large part of profile comparisons, with there being large and moderate differences observed in the majority of cases (d = .30 and 1.66).

CONCLUSIONS

The results show the importance of considering social anxiety as a construct that is strongly associated with emotional problems such as depression, anxiety, and stress when developing effective actions to detect them and intervene with adolescents.

Temperamental Change in Adolescence and Its Predictive Role on Anxious Symptomatology

Growing evidence supports the hypothesis that temperamental traits are not static throughout adolescence. The known links between both reactive and regulatory temperament and anxiety symptoms should be investigated bearing this hypothesis in mind. This study collected self-reported data on behavioral inhibition system (BIS) sensitivity, attentional control (AC), and anxiety symptomatology, from 296 adolescents (64.2% girls; M = 12.96 years at the first assessment, SD = 0.47) every six months, four times over eighteen months. The relationships between temperament factors (AC and BIS sensitivity), considered longitudinally (by means of their trajectories) and anxiety symptoms were investigated using Multigroup Latent Growth Modeling (MLGM), as well as the mediating effect of sex on trajectories and anxiety. BIS sensitivity decreased over time and showed differential patterns across sexes. AC remained relatively stable and we found no sex influence on its trajectory. On the other hand, we observed that the BIS sensitivity trajectory was a significant predictor of anxiety symptomatology at age 15. In conclusion, temperamental changes between the ages of 13 and 15 seem to play a relevant role in explaining subsequent anxiety symptomatology, under the mediating influence of sex.

Mother’s Concern in the Family about Her Child with Post-Traumatic Due to the Tornado in Central Java, Indonesia – A Qualitative Study

BACKGROUND: Natural disasters continue to occur worldwide, influencing the economy, finances, and psychological problems. Traumatic on children is an impact of the catastrophe likely a burden on the family, especially mothers who accompany their children as caregivers. AIM: The purpose of the study was to explore children’s traumatic experiences from mothers in a family in a rural community in Indonesia. METHODS: We conducted six focus groups with mothers to explore their traumatic children’s experiences using a qualitative research design. Thirty mothers with children 3−10 years old contributed to the focus groups across all sites. We formed focus groups with six mothers and continued in-depth interviews, including nine mothers. RESULTS: The mothers had similar experiences understanding their children’s trauma due to natural tornado disasters. This study revealed three overarching themes shaping the mothers’ experience: anxiety in children, trauma trigger, and lingering distress. All themes lead to the main theme is psychological distress in the face of a child suffering from PTSD. From the hermeneutical perspective, topics can be identified as terms, including being-thrownness, being-fallenness and being-alongside. CONCLUSION: Children with post-traumatic stress disorder may impact family physiological problems, especially the mother. The study found that may place the burden of care for children on the person’s families.

School anxiety profiles in Spanish adolescents and their differences in psychopathological symptoms

School anxiety and psychopathological symptoms tend to co-occur across development and persist in adulthood. The present study aimed to determine school anxiety profiles based on Lang’s model of the triple response system (cognitive anxiety, psychophysiological anxiety, and behavioral anxiety) and to identify possible differences between these profiles in psychopathological symptoms (depression, hostility, interpersonal sensitivity, somatization, anxiety, psychoticism, obsessive-compulsive, phobic anxiety, and paranoid ideation). The School Anxiety Inventory (SAI) and the Symptom Assessment-45 Questionnaire (SA-45) were administered to 1525 Spanish students (49% girls) between 15 and 18 years old (M = 16.36, SD = 1.04). Latent Profile Analysis identified four school anxiety profiles: Low School Anxiety, Average School Anxiety, High School Anxiety, and Excessive School Anxiety. A multivariate analysis of variance revealed statistically significant differences among the school anxiety profiles in all the psychopathological symptoms examined. Specifically, adolescents with Excessive School Anxiety showed significantly higher levels of the nine psychopathological symptoms than their peers with Average School Anxiety and Low School Anxiety. In addition, the Excessive School Anxiety profile scored significantly higher in phobic anxiety than the High School Anxiety group. These findings allow to conclude that it is necessary enhance well-being and reduce psychopathology of those adolescents who manifest high and very high reactivity in cognitive, psychophysiological, and behavioral anxiety.

Profiles and transition of mental health problems among Chinese adolescents: The predictive role of friendship quality, parental autonomy support, and psychological control

INTRODUCTION

Mental health problems have become a global crisis of the 21st century, with adolescence being a typical period of the outbreak of these problems. However, the profiles and transition of mental health problems in Chinese adolescents remain unclear. In addition, protective and risk factors that shape mental health problems require further clarification.

METHODS

We measured depression, anxiety, and stress as indicators to identify the profiles and transition patterns of mental health problems among Chinese adolescents, as well as environment-related predictors (i.e., friendship quality, parental psychological control, and autonomy support). A total of 722 participants (376 females; M_age  = 15.21, SD_age  = 0.74) completed a set of questionnaires at two time points with a 1-year interval (T1: November 2018; T2: November 2019).

RESULTS

The profile analysis revealed two groups: healthy and troubled. The development of mental health problems included four trajectories: steady low, steady high, increasing, and decreasing. Results indicated that parental autonomy support and friendship quality exerted protective and buffering effects, whereas parental psychological control acted as a risk factor for mental health problem profiles. Furthermore, friendship quality had a unique predictive effect on the decreasing trajectory.

CONCLUSIONS

The profiles of mental health problems showed high concurrency of depression, anxiety, and stress symptoms, and developmental trajectories were largely stable over time. Friendship quality, parental autonomy support, and psychological control predicted the profiles of the mental health problems of Chinese adolescents, and only friendship quality predicted the transition from a troubled to healthy profile over 1 year.

Cognitive vulnerabilities to anxiety symptoms among Chinese adolescents: A 3-year longitudinal study

OBJECTIVE

This study established cognitive vulnerability of anxiety symptoms among high school students.

METHOD

A total of 72 grade 9-11 students completed measures on levels of anxiety sensitivity (AS), selective attentional processing, and anxiety symptoms annually between 2016 and 2018.

RESULTS

Latent class growth analysis (unconditional model) showed a four-class model: High (stable) (6.94%), low (stable) (11.11%), medium (decreasing) (61.11%), and medium (increasing) (20.83%). The conditioned model controlling for the physical-concerns dimension of AS and negative attentional bias demonstrated that a two-class model consisted of a low anxiety class (n = 59, 81.9%) and a high anxiety class (n = 13, 18.1%) provided the best fit for the data. Negative attentional bias is a significant factor related to the development of anxiety trajectories.

CONCLUSION

Attentional bias modification to disengage from negative stimuli may serve as a potential target of intervention to reduce chronic anxiety among high school students.

Disentangling Associations Among Maternal Lifetime and Prenatal Stress, Psychological Functioning During Pregnancy, Maternal Race/Ethnicity, and Infant Negative Affectivity at Age 6 Months: A Mixtures Approach

Purpose: Maternal stress and psychological dysfunction in pregnancy are independently linked with fetal neurodevelopment. Stress encompasses environmental stressors and psychological and physiological responses. Stressors and psychopathology co-occur with patterns differing by race/ethnicity. We aimed to extend environmental mixtures methodology to elucidate prenatal stress associations with infant negative affectivity (NA) in a racially/ethnically mixed cohort. Methods: Participants were mother/infant dyads (n=445) in a prospective pregnancy cohort study in two urban US settings in 2011-2018. During pregnancy, women completed the Life Stressor Checklist-Revised, Crisis in Family Systems-Revised, Edinburgh Postnatal Depression Scale, and post-traumatic stress disorder (PTSD) Checklist-Civilian version; the Infant Behavior Questionnaire-Revised assessed NA in 6-month olds. Using weighted quantile sum (WQS) regression, we developed a weighted maternal stress index encompassing lifetime and current life events and symptoms of depression and PTSD. Stress-by-race/ethnicity interactions allowed differential contributions of individual stress domains by maternal race/ethnicity. Results: Mothers were majority black (44%) or Hispanic (37%). Stress questionnaire and infant NA scores were similar by race/ethnicity. The WQS prenatal stress score was positively associated with infant NA (β: 0.40 [95% confidence interval 0.16-0.64]). PTSD was the strongest contributor to the WQS score in Hispanic women (59%), whereas in black women, lifetime stress and depressive symptoms accounted for 38% and 35%, respectively, of the association with NA. Conclusions: Extending environmental mixtures methodology to stress research may disentangle complex associations among lifetime and current stressful life events and psychological symptomatology and their contributions to early childhood neurobehavioral outcomes. Consideration of effect modification by race/ethnicity may inform understanding of differing vulnerability across racial/ethnic groups.