Anxiety and Depressive Symptom Trajectories in Adolescence and the Co-Occurring Development of Cognitive Biases: Evidence from the CogBIAS Longitudinal Study

An intervention study on college students' employment anxiety based on interpretation bias modification: A randomized controlled experiment

External environmental factors and internal cognitive bias affect college students' anxiety while job hunting. The current study is an intervention study on alleviating employment anxiety among college students through an Interpretation Bias Modification (IBM) computer-based intervention. A total of 79 valid participants were recruited. The Interpretation Bias Modification (IBM) group participants were required to complete employment-related IBM Internet training twice a week for three weeks. The placebo control group participants were required to complete neutral Internet training at the same frequency. The waiting list control group did not undergo any training. The groups were tested at three time points: prior to the intervention (pre-test), immediately after (post-test), and one month after the intervention (one-month follow-up). The IBM intervention group [F(2, 72) = 31.68, p < 0.001] showed greater significance in reducing employment anxiety than participants in the placebo control group [F(2, 72) = 9.83, p < 0.001] from the pre-test to one-month follow-up. There was no significant difference in employment anxiety among the waiting-list control group over time. The IBM intervention for college students can effectively decrease employment anxiety and reduce interpretation bias, which can be maintained at the one-month follow-up.

The relationship between anxiety and depression in adolescent depression patients: The mediating effect of hope level and coping modes

Background

Adolescents diagnosed with depression are particularly susceptible to anxiety and depressive symptoms, this vulnerability often diminishes their future expectations and overall outlook on life. The objective of this research was to scrutinize the associated risk factors of adolescent depression and delineated the interplay between anxiety and depressive symptoms. Concurrently, it sought to ascertain the latent mediating effects of hope levels and coping strategies within this framework.

Methods

A mixed-methods research approach was employed. For the qualitative component, 18 adolescents with depression were interviewed following a semi-structured interview guide, with sessions audio-recorded. The data were subsequently transcribed and subjected to thematic content analysis. In the quantitative phase, a cross-sectional online survey was administered to 210 adolescents diagnosed with depression using Questionnaire Star, with data analysis performed using SPSS25.0 and AMOS 24.0.

Results

The qualitative analysis identified three major themes and nine categories as key risk factors influencing the onset of adolescent depression. Three major themes were generated: school factors, family factors, and other factors. Nine categories were generated: heavy academic load, strained peer, and teacher-student relationships; unstable family structures, internal familial conflicts, and high parental expectations; a strong sense of social isolation, insufficient sexual education, and prevalent suicidal ideation or attempts. A nurturing and supportive school environment significantly bolsters adolescents' sense of hope and coping abilities, while a warm and encouraging family setting effectively mitigates psychological stress. Conversely, heightened loneliness and the onset of suicidal ideation are frequently linked to diminished hope and the adoption of maladaptive coping strategies. Hence, to comprehensively understand the intricate interplay of these factors, this study concentrated on the levels of hope and coping mechanisms, investigating their potential mediating role in adolescent anxiety and depression. Quantitative analysis revealed a positive correlation between anxiety and depression (r = 0.767, p＜0.01). Additionally, it was found that hope levels and coping strategies mediated the relationship between anxiety and depressive symptoms (β = -0.24-0.84 = 0.20, p < 0.001; β = 0.19-0.51 = -0.10, p < 0.01), with the mediating influence of hope levels being more significant than that of coping strategies.

Conclusion

Enhancing hope levels and fostering positive coping strategies are instrumental in aiding adolescents with depression to alleviate their anxiety and depressive symptoms. Moreover, this study underscored the importance of focusing on adolescents' mental health and providing them with emotional support, thereby increasing their hope levels and encouraging the adoption of positive coping mechanisms to effectively address their challenges.

Coupled changes between ruminating thoughts and resting-state brain networks during the transition into adulthood

Perseverative negative thoughts, known as rumination, might arise from emotional challenges and preclude mental health when transitioning into adulthood. Due to its multifaceted nature, rumination can take several ruminative response styles, that diverge in manifestations, severity, and mental health outcomes. Still, prospective ruminative phenotypes remain elusive insofar. Longitudinal study designs are ideal for stratifying ruminative response styles, especially with resting-state functional MRI whose setup naturally elicits people's ruminative traits. Here, we considered self-rated questionnaires on rumination and psychopathology, along with resting-state functional MRI data in 595 individuals assessed at age 18 and 22 from the IMAGEN cohort. We conducted independent component analysis to characterize eight single static resting-state functional networks in each subject and session and furthermore conducted a dynamic analysis, tackling the time variations of functional networks during the entire scanning time. We then investigated their longitudinal mediation role between changes in three ruminative response styles (reflective pondering, brooding, and depressive rumination) and changes in internalizing and co-morbid externalizing symptoms. Four static and two dynamic networks longitudinally differentiated these ruminative styles and showed complemental sensitivity to internalizing and co-morbid externalizing symptoms. Among these networks, the right frontoparietal network covaried with all ruminative styles but did not play any mediation role towards psychopathology. The default mode, the salience, and the limbic networks prospectively stratified these ruminative styles, suggesting that maladaptive ruminative styles are associated with altered corticolimbic function. For static measures, only the salience network played a longitudinal causal role between brooding rumination and internalizing symptoms. Dynamic measures highlighted the default-mode mediation role between the other ruminative styles and co-morbid externalizing symptoms. In conclusion, we identified the ruminative styles' psychometric and neural outcome specificities, supporting their translation into applied research on young adult mental healthcare.

An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context

Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.

Anxiety disorders in children and adolescents: A summary and overview of the literature

Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.

Parent-adolescent informant discrepancy on the Strengths and Difficulties Questionnaire in the UK Millennium Cohort Study

BACKGROUND

Developmental researchers often use a multi-informant approach to measure adolescent behaviour and adjustment, but informant discrepancies are common. In general population samples, it is often found that parents report more positive and less negative outcomes than adolescents themselves. This study aimed to investigate factors associated with informant discrepancy, including adolescent sex, and parental level of psychological distress and education.

METHODS

Informant discrepancy on the Strengths and Difficulties Questionnaire was investigated using a Latent Difference Score (LDS) approach, which estimates the true difference between parent and adolescent reports in a structural equation model. The sample were parent-adolescent dyads from the seventh wave of the UK Millennium Cohort Study (N = 6947, 49.3% female, aged 17 years).

RESULTS

Parents reported lower levels of difficulties (emotion symptoms, peer problems, conduct problems), and higher levels of pro-social behaviour than adolescents themselves. Conditional effects were found, as discrepancy was greater amongst parent-daughter dyads for emotion and peer problems, and greater amongst parent-son dyads for conduct problems and pro-social behaviour. Parent-adolescent discrepancy was also greater generally if parents had a lower level of psychological distress or a higher level of education.

CONCLUSIONS

In a large general population sample from the UK, it was found that adolescents tended to report more negative and less positive outcomes than parents reported about them. Conditional effects were found at the parent and adolescent level suggesting that specific informant biases are likely to impact the measurement of adolescent behaviour and adjustment across reporters.

Profiles of Anxious and Depressive Symptoms Among Adolescent Boys and Girls: Associations with Coping Strategies

Most existing studies investigating profiles of anxious and depressive symptoms in adolescent boys and girls do not consider the high cooccurrence between them, which prevents from identifying how heterogeneous groups might distinctly use coping strategies. To address this gap, the current study relies on a sample of 976 adolescents (56.0% girls (n = 547), aged 12-15 y.o., M = 12.92, SD = 0.75) to identify profiles of self-reported internalizing symptoms while properly disaggregating youth's global levels of internalizing symptoms from their specific levels of anxious and depressive symptoms. The study also assesses whether similar profiles will be identified with the same frequency among boys and girls, as well as the associations between profile membership and coping strategies (problem-solving, social support, cognitive restructuring, cognitive avoidance, and behavioral avoidance) and whether these associations vary between sexes. Bifactor-confirmatory factor analyses confirmed the presence of a global internalizing factor and six specific factors reflecting anxious and depressive symptoms. Latent profile analyses identified three similar profiles among boys and girls but with different prevalence: Low internalizing symptoms (29.97% (n = 164) girls; 70.77% (n = 304) boys), Internalizing and specific anxious symptoms (40.15% (n = 220) girls, 14.75% (n = 63) boys), and Internalizing and specific depressive symptoms (29.86% (n = 163) girls, 14.48% (n = 62) boys). Girls in the Internalizing and specific anxious profile reported more frequent use of four coping strategies compared to boys (problem-solving, social support, cognitive restructuring, and cognitive avoidance). Among boys and girls, the Internalizing and specific depressive profile was associated with the least strategic use of coping strategies (low problem-solving, social support, and cognitive restructuring, and high cognitive and behavioral avoidance). The Internalizing and specific anxious profile was associated with high levels of all coping strategies (except behavioral avoidance). Overall, the study demonstrates that disaggregating global and specific internalizing symptoms allow identifying qualitatively distinct profiles, which then raised questions on the efficacy of the coping strategies used by youth with an Internalizing and specific anxious profile. These results support the adoption of a transdiagnostic approach of treatment based on a holistic representation of all aspects of adolescent boys' and girls' internalizing symptoms to better accompany them in the selection of their coping strategies.

Capturing adolescents in need of psychiatric care with psychopathological symptoms: A population-based cohort study

BACKGROUND

The current study aims to overcome past methodological limitations and capture adolescents in need of psychiatric care with psychopathological symptoms in a cohort with unrestricted access to mental health professionals.

METHODS

The study source population consisted of a random sample of adolescents aged 16-17 years (N=1,369) assessed by the Israeli Draft Board. An adapted version of the Brief Symptom Inventory was used to identify clinically relevant psychopathological symptoms with scores categorized as severe if they were in the top 10th percentile of symptoms, otherwise not severe. An independent interview with a subsequent referral to a mental health professional was used to categorize adolescents in need of psychiatric care. To examine the association between severe psychopathological symptoms and the need for psychiatric care, logistic regression models were fitted unadjusted and adjusted for age, sex, and intellectual assessment scores. Adjusted classification measures were estimated to examine the utility of severe psychopathological symptoms for clinical prediction of need for psychiatric care.

RESULTS

Information on 1,283 adolescents was available in the final analytic sample. Logistic regression modeling showed a statistically significant (p<0.001) association between self-reported severe psychopathological symptoms and the need for psychiatric care (OR adjusted: 4.38; 95% CI: 3.55-5.40). Severe psychopathological symptoms had a classification accuracy of 83% (CI: 81%-85%).

CONCLUSIONS

Severe psychopathological symptoms, although accounting for a fair proportion of treatment seeking, would perhaps be better useful for classification purposes alongside other variables rather than in isolation.

Emotional information-processing correlates of positive mental health in adolescence: a network analysis approach

The combined cognitive bias hypothesis proposes that emotional information-processing biases may conjointly influence mental health. Yet, little is known about the interrelationships amongst cognitive biases, particularly in adolescence. We used data from the CogBIAS longitudinal study (Booth et al., 2017), including 450 adolescents who completed measures of interpretation bias, memory bias, and a validated measure of general mental health in a typically developing population. We used a moderated network modelling approach to examine positive mental health-related moderation of the cognitive bias network. We found that mental health was directly associated with positive and negative memory biases, and positive interpretation biases, but not negative interpretation biases. Further, we observed some mental health-related moderation of the network structure. Network connectivity decreased with higher positive mental health scores. Network approaches allow us to model complex relationships amongst cognitive biases and develop novel hypotheses for future research.