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Sandler I, Tein JY, Zhang N, Wolchik SA. Developmental Pathways of the Family Bereavement Program to Prevent Major Depression 15 Years Later. J Am Acad Child Adolesc Psychiatry 2023; 62:1233-1244. [PMID: 36898606 PMCID: PMC10485172 DOI: 10.1016/j.jaac.2023.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To examine the developmental pathways through which the Family Bereavement Program (FBP) reduces major depression and generalized anxiety disorder 15 years later. METHOD A randomized trial of the FBP included 5 assessments, at pretest, posttest (98% retention), and follow-ups at 11 months (90% retention), 6 years (89% retention), and 15 years (80% retention) following the program. Participants included 244 children and adolescents (from 156 families) 8 to 16 years of age who were randomly assigned to the FBP (135 children/adolescents, 90 families), a 12-session program that included a caregiver component and a child/adolescent component or a literature comparison condition (109 children/adolescents, 66 families). In-home interviews assessed mediators directly targeted for change at post-test and 11 months (eg, parenting and coping); 6-year theoretical mediators (ie, internalizing problems, aversive views of the self) and 15-year children's/adolescents' major depression and generalized anxiety disorder. Data analysis tested 3 path mediation models in which FBP effects at post-test and 11 months led to effects on 6-year theoretical mediators, which in turn lad to reductions in major depression and generalized anxiety disorder at 15 years. RESULTS The FBP had a significant effect on reducing the prevalence of major depression (odds ratio = 0.332, p < .01) at 15 years. Significant 3-path mediation models found that multiple variables that were targeted by the caregiver and child components of the FBP at post-test and 11 months mediated FBP effects on depression at 15 years through their impact on aversive self-views and internalizing problems at 6 years. CONCLUSION The findings support the 15-year impact of the Family Bereavement Program on major depression and for maintaining components of the FBP that affect aspects of parenting and children's coping, grief, and self-regulation as the program is disseminated. CLINICAL TRIAL REGISTRATION INFORMATION 6-Year Follow-up of a Prevention Program for Bereaved Families; https://clinicaltrials.gov/; NCT01008189. DIVERSITY & INCLUSION STATEMENT We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.
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Affiliation(s)
| | | | - Na Zhang
- University of Connecticut, Mansfield, Connecticut
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2
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Therriault D, Lane J, Houle A, Dupuis A, Gosselin P, Thibault I, Dionne P, Morin P, Dufour M. Effects of the HORS‐PISTE universal anxiety prevention program measured according to initial level of student problems. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Danyka Therriault
- Department of Psychoeducation Université de Sherbrooke Sherbrooke Quebec Canada
| | - Julie Lane
- RBC Centre of Academic Expertise in Mental Health Université de Sherbrooke Sherbrooke Quebec Canada
| | - Andrée‐Anne Houle
- RBC Centre of Academic Expertise in Mental Health Université de Sherbrooke Sherbrooke Quebec Canada
| | - Audrey Dupuis
- RBC Centre of Academic Expertise in Mental Health Université de Sherbrooke Sherbrooke Quebec Canada
| | - Patrick Gosselin
- Department of Psychology Université de Sherbrooke Sherbrooke Quebec Canada
| | - Isabelle Thibault
- Department of Psychoeducation Université de Sherbrooke Sherbrooke Quebec Canada
| | - Patricia Dionne
- Department of Vocational Guidance Université de Sherbrooke Sherbrooke Quebec Canada
| | - Pascale Morin
- Department of Anthropokinetics Université de Sherbrooke Sherbrooke Quebec Canada
| | - Magali Dufour
- Department of Psychology Université du Québec à Montréal Montréal Quebec Canada
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Deep learning paired with wearable passive sensing data predicts deterioration in anxiety disorder symptoms across 17-18 years. J Affect Disord 2021; 282:104-111. [PMID: 33401123 PMCID: PMC7889722 DOI: 10.1016/j.jad.2020.12.086] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/01/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recent studies have demonstrated that passive smartphone and wearable sensor data collected throughout daily life can predict anxiety symptoms cross-sectionally. However, to date, no research has demonstrated the capacity for these digital biomarkers to predict long-term prognosis. METHODS We utilized deep learning models based on wearable sensor technology to predict long-term (17-18-year) deterioration in generalized anxiety disorder and panic disorder symptoms from actigraphy data on daytime movement and nighttime sleeping patterns. As part of Midlife in the United States (MIDUS), a national longitudinal study of health and well-being, subjects (N = 265) (i) completed a phone-based interview that assessed generalized anxiety disorder and panic disorder symptoms at enrollment, (ii) participated in a one-week actigraphy study 9-14 years later, and (iii) completed a long-term follow-up, phone-based interview to quantify generalized anxiety disorder and panic disorder symptoms 17-18 years from initial enrollment. A deep auto-encoder paired with a multi-layered ensemble deep learning model was leveraged to predict whether participants experienced increased anxiety disorder symptoms across this 17-18 year period. RESULTS Out-of-sample cross-validated results suggested that wearable movement data could significantly predict which individuals would experience symptom deterioration (AUC = 0.696, CI [0.598, 0.793], 84.6% sensitivity, 52.7% specificity, balanced accuracy = 68.7%). CONCLUSIONS Passive wearable actigraphy data could be utilized to predict long-term deterioration of anxiety disorder symptoms. Future studies should examine whether these methods could be implemented to prevent deterioration of anxiety disorder symptoms.
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Leyro TM, Versella MV, Yang MJ, Brinkman HR, Hoyt DL, Lehrer P. Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression. Clin Psychol Rev 2021; 84:101980. [PMID: 33540222 PMCID: PMC8302658 DOI: 10.1016/j.cpr.2021.101980] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. METHODS The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. RESULTS Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. CONCLUSIONS Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.
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Affiliation(s)
- Teresa M Leyro
- Department of Psychology, Rutgers, The State University of New Jersey, United States.
| | - Mark V Versella
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Min-Jeong Yang
- Department of Psychology, Rutgers, The State University of New Jersey, United States; Department of Health Outcomes and Behavior, Moffitt Cancer Center, United States
| | - Hannah R Brinkman
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Danielle L Hoyt
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Paul Lehrer
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, United States
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Ding X, Wang J, Li N, Su W, Wang H, Song Q, Guo X, Liang M, Qin Q, Sun L, Chen M, Sun Y. Individual, Prenatal, Perinatal, and Family Factors for Anxiety Symptoms Among Preschool Children. Front Psychiatry 2021; 12:778291. [PMID: 34987428 PMCID: PMC8721098 DOI: 10.3389/fpsyt.2021.778291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/19/2021] [Indexed: 01/21/2023] Open
Abstract
Anxiety is one of the most common psychological disorders among children. Few studies have investigated the prevalence and comprehensive factors for anxiety among preschool children in China. This study aimed to assess the prevalence of anxiety and explore influential factors at multiple levels including individual, prenatal and perinatal, and family factors, associated with anxiety symptoms among preschool children. The multisite cross-sectional study was conducted in Anhui Province and included 3,636 preschool children aged 3-6 years. Anxiety symptoms of children were assessed using the Chinese version of the Spence Preschool Anxiety Scale. Logistic regression analyses were performed to explore associations between factors at multiple levels and significant anxiety symptoms, and the model was validated internally using 10-fold cross-validation. Among the participants, 9.1% of children had significant anxiety symptoms. Girls reported more significant anxiety symptoms. Children's poor dietary habits, sleep disturbances, autistic tendencies, and left-behind experience; maternal poor prenatal emotional symptoms; and more caregivers' anxiety symptoms were significantly associated with anxiety symptoms among children. The result of 10-fold cross-validation indicated that the mean area under the curve, sensitivity, specificity, and accuracy were 0.78, 70.45%, 78.18%, and 71.15%, respectively. These factors were slightly different among different subtypes of anxiety symptoms. The results of this study suggested that anxiety symptoms in preschool children were prevalent, particularly in girls. Understanding early-life risk factors for anxiety is crucial, and efficient prevention and intervention strategies should be implemented in early childhood even pregnancy.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jun Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, Ma'anshan, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, Fuyang, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Changfeng, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
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Stokholm JR, Lykke K. The Strengths and Difficulties Questionnaire is a usable way to address mental health at well-child visits in general practice - a qualitative study of feasibility. BMC FAMILY PRACTICE 2020; 21:126. [PMID: 32611309 PMCID: PMC7329505 DOI: 10.1186/s12875-020-01156-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/30/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Mental health problems is frequent among children and psychopathology in early childhood seems to predict mental disorders in adulthood. All Danish children are offered seven free well-child visits at their General Practitioner (GP) during their first 5 years of life. GPs have a unique position to address mental health problems at the well-child visits, but they lack a systematic approach when assessing children's mental health. The purpose of this study was to investigate if the Strengths and Difficulties Questionnaire (SDQ) is a usable way to address preschool children's mental health in general practice. METHODS A qualitative study of feasibility. Parents completed an online version of the SDQ at home. At the well-child visit, the GP used the SDQ results as a basis for a talk about the child's mental health. Afterwards the author JS conducted semistructured interviews with both the parent and the GP over the phone. The interviews were descriptively analyzed using the Framework Approach. RESULTS Five primary care centres with 22 general practitioners in both Copenhagen and Region Zealand participated. Twenty four parents completed the SDQ and were interviewed. Participating parents and GPs agreed, that the SDQ introduced mental health as a natural and important part of the well-child visit. Online access had clear advantages: time for reflection at home and preparation, plus a clear result summary for the GP. Some of the GPs were worried that the questionnaire would be too time consuming, and might compromise the individualistic style of general practice. Some parents were worried if children with minor problems would be diagnosed. CONCLUSIONS The online SDQ was well-accepted and feasible in daily practice. Implementing the SDQ into the well-child visit could strengthen the focus on the child's mental health. However, before the SDQ can be generally implemented a guideline on how to utilize it in the well-child visit is needed, as well as studies of efficacy in this setting. TRIAL REGISTRATION Not relevant.
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Affiliation(s)
- Julie Ravneberg Stokholm
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, Faculty of Health Sciences, University of Copenhagen, Denmark, Copenhagen, Denmark
| | - Kirsten Lykke
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, Faculty of Health Sciences, University of Copenhagen, Denmark, Copenhagen, Denmark
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Beesdo‐Baum K, Voss C, Venz J, Hoyer J, Berwanger J, Kische H, Ollmann TM, Pieper L. The Behavior and Mind Health (BeMIND) study: Methods, design and baseline sample characteristics of a cohort study among adolescents and young adults. Int J Methods Psychiatr Res 2020; 29:e1804. [PMID: 31808242 PMCID: PMC7051848 DOI: 10.1002/mpr.1804] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 04/14/2019] [Accepted: 08/16/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The Behavior and Mind Health (BeMIND) study is a population-based cohort study of adolescents and young adults from Dresden, Germany. The aim is to investigate psychological and behavioral factors linked to a range of mental disorders and health behaviors and their interaction with social-environmental and genetic/biologic factors. METHODS A random sample of 14-21 year olds was drawn from the population registry in 2015. The baseline investigation was completed 11/2015-12/2016 (N = 1,180). Assessments include standardized diagnostic interview, cognitive-affective tasks, questionnaires, biosamples, and ecologic momentary assessment in real life with combined actigraphic/geographic monitoring. In the family study component, parents completed similar assessments and provided information on child's early development. RESULTS The participation rate (minimum response proportion) was 21.7%; the cooperation rate was 43.4%. Acceptance and completion of study components were high. General health data indicate that more than 80% reported no or only mild impairment due to mental or somatic health problems in the past year; about 20% ever sought treatment for mental health problems or chronic somatic illnesses, respectively. CONCLUSIONS Data from BeMIND baseline and follow-up investigations will provide novel insights into contributors to health and disease as adolescents grow into adulthood.
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Affiliation(s)
- Katja Beesdo‐Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
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Camilleri C, Beiter RM, Puentes L, Aracena-Sherck P, Sammut S. Biological, Behavioral and Physiological Consequences of Drug-Induced Pregnancy Termination at First-Trimester Human Equivalent in an Animal Model. Front Neurosci 2019; 13:544. [PMID: 31191234 PMCID: PMC6549702 DOI: 10.3389/fnins.2019.00544] [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] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/13/2019] [Indexed: 12/31/2022] Open
Abstract
Given the significant physiological changes that take place during and resulting from pregnancy, as well as the relative absence of such information in relation to pregnancy termination, this study investigated the potential for developing a valid animal model to objectively assess the biological, physiological and behavioral consequences of drug-induced pregnancy termination. Female Long-Evans rats were divided into four groups (n = 19-21/group), controlling for drug [mifepristone (50 mg/kg/3 ml, i.g.)/misoprostol (0.3 mg/kg/ml, i.g.) or vehicle (1% Carboxymethylcellulose Sodium/0.2% Tween® 80 suspension, i.g.)] and pregnancy. Drug administration took place on days 12-14 of gestation (days 28-40 human gestational equivalent). Vehicle was administered to the controls on the same days. Parameters measured included rat body weight, food intake, vaginal impedance, sucrose consumption/preference, locomotor activity, forced swim test, and home-cage activity. At the termination of the study, rats were deeply anesthetized using urethane, and blood, brain, and liver were collected for biochemical analysis. Following drug/vehicle administration, only the pregnancy termination group (pregnant, drug) displayed a significant decrease in body weight, food intake, locomotor activity-related behaviors and home-cage activity relative to the control group (non-pregnant, vehicle). Additionally, the pregnancy termination group was the only group that displayed a significant reduction in sucrose consumption/preference during Treatment Week relative to Pre-Treatment Week. Vaginal impedance did not significantly decrease over time in parous rats in contrast to all other groups, including the rats in the pregnancy termination group. Biochemical analysis indicated putative drug- and pregnancy-specific influences on oxidative balance. Regression analysis indicated that pregnancy termination was a predictor variable for body weight, food intake and all locomotor activity parameters measured. Moreover, pertaining to body weight and food intake, the pregnancy termination group displayed significant changes, which were not present in a group of naturally miscarrying rats following pregnancy loss. Overall, our results appear to suggest negative biological and behavioral effects following pregnancy termination, that appear to also be distinct from natural miscarriage, and potential benefits of parity pertaining to fecundity. Thus, our findings indicate the importance for further objective investigation of the physiological and behavioral consequences of medical abortion, in order to provide further insight into the potential implications in humans.
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Affiliation(s)
- Christina Camilleri
- Department of Psychology, Franciscan University of Steubenville, Steubenville, OH, United States
| | - Rebecca M. Beiter
- Department of Psychology, Franciscan University of Steubenville, Steubenville, OH, United States
| | - Lisett Puentes
- School of Medicine, Universidad San Sebastián, Conceptión, Chile
| | | | - Stephen Sammut
- Department of Psychology, Franciscan University of Steubenville, Steubenville, OH, United States
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Bufferd SJ, Dougherty LR, Olino TM. Mapping the frequency and severity of anxiety behaviors in preschool-aged children. J Anxiety Disord 2019; 63:9-17. [PMID: 30731395 PMCID: PMC6414242 DOI: 10.1016/j.janxdis.2019.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/09/2019] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
Abstract
Although anxiety can be early-emerging, impairing, and persistent, behaviors relevant to anxiety mirror typical development in early childhood. To better understand the spectrum of typical to problematic behavior, this study characterizes the range of frequency and severity of separation and social anxiety behaviors and associated impairment in preschool-aged children using a novel daily diary method. Primary caregivers of 291 3-5-year-old children reported the frequency of children's daily separation and social anxiety behaviors and related impairment for 14 days. Frequencies of each separation and social anxiety behavior were computed and item response theory analyses revealed the specific frequencies at which the behavior was considered psychometrically severe/rare. Patterns varied across items; for example, worry that caregiver would not return and shyness with familiar adults had to occur at least 3-4 times over 14 days for the behavior to be considered severe/rare, whereas shyness around peers and new people were not severe at any frequency. In addition, behaviors were associated with impairment. To our knowledge, these data are the first to delineate empirical, dimensional information about the frequency and severity of anxiety behaviors and associated impairment in early childhood. Such data could be useful for clinical practice to enhance empirically-driven assessment of anxiety.
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Affiliation(s)
- Sara J Bufferd
- California State University San Marcos, Department of Psychology, 333 S. Twin Oaks Valley Road, San Marcos, CA, 92096-0001, United States.
| | - Lea R Dougherty
- Department of Psychology, University of Maryland, 4094 Campus Dr., College Park, MD, 20742, United States.
| | - Thomas M Olino
- Department of Psychology, Temple University, 1701 N 13th St, Philadelphia, PA, 19122, United States.
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Orgilés M, Fernández-Martínez I, Lera-Miguel S, Marzo JC, Medrano L, Espada JP. Spanish Validation of the School Anxiety Scale-Teacher Report (SAS-TR). Child Psychiatry Hum Dev 2017; 48:714-720. [PMID: 27815719 DOI: 10.1007/s10578-016-0695-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study aimed to examine the factorial structure and psychometric properties of the School Anxiety Scale-Teacher Report (SAS-TR) in a community sample of 315 Spanish children aged 5 to 12 years. Thirty-seven teachers from eleven schools completed the SAS-TR and the Strengths and Difficulties Questionnaire (SDQ) for each child. Confirmatory factor analysis supported the original two-factor structure, but a better fit model was obtained after removing four items. The scale was found to have high internal consistency (α = 0.91) and satisfactory test-retest reliability (ICC = 0.87) for the Spanish sample. Convergent validity was supported by positive significant correlations between the SAS-TR and the Emotional Symptoms subscale of the SDQ. Lower correlations between the SAS-TR and the SDQ Conduct Problems subscale supported the divergent validity. Overall, the findings suggest that the Spanish version of the SAS-TR is a reliable and valid instrument for teachers to assess anxiety in Spanish children.
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Affiliation(s)
- Mireia Orgilés
- Department of Health Psychology, Miguel Hernández University of Elche, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain.
| | - Iván Fernández-Martínez
- Department of Health Psychology, Miguel Hernández University of Elche, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain
| | | | - Juan Carlos Marzo
- Department of Health Psychology, Miguel Hernández University of Elche, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain
| | | | - José Pedro Espada
- Department of Health Psychology, Miguel Hernández University of Elche, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain
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Raknes S, Pallesen S, Himle JA, Bjaastad JF, Wergeland GJ, Hoffart A, Dyregrov K, Håland ÅT, Haugland BSM. Quality of life in anxious adolescents. Child Adolesc Psychiatry Ment Health 2017; 11:33. [PMID: 28814971 PMCID: PMC5517841 DOI: 10.1186/s13034-017-0173-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 06/19/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To examine associations between health-related quality of life (HRQoL) and anxiety symptoms across anxiety domains (obsessions/compulsions, social anxiety, panic disorder, agoraphobia, separation anxiety, physical injury fears, generalised anxiety, and posttraumatic stress) in a general adolescent population. Expanded knowledge about these associations can provide valuable information for improving interventions and prevention strategies for adolescent anxiety. METHODS Cross-sectional data about anxiety were collected via a school survey from a community sample of Norwegian adolescents aged 12-17 (N = 1719). Based on scores from the Spence Children's Anxiety Scale (SCAS), each adolescent was categorized as reporting a low, medium, or high level of anxiety. Each adolescent's HRQoL was then measured using the Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents Revised Version (KINDL-R). Hierarchical regression analyses were performed to determine any relationship between anxiety symptoms and HRQoL. RESULTS Across domains of anxiety, anxiety symptoms were inversely associated with overall HRQoL. All HRQoL-dimensions were inversely associated with overall level of anxiety symptoms. In adolescents with medium and high anxiety symptoms, poor HRQoL was documented in all HRQoL dimensions with the exception of the family dimension. CONCLUSIONS The strong association between elevated levels of anxiety symptoms and poor HRQoL demonstrate the importance of improved mental health interventions and prevention initiatives targeting anxious adolescents.
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Affiliation(s)
- Solfrid Raknes
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health/University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- 0000 0004 1936 7443grid.7914.bDepartment of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Joseph A. Himle
- 0000000086837370grid.214458.eSchool of Social Work, University of Michigan, Ann Arbor, USA
| | - Jon Fauskanger Bjaastad
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health/University of Bergen, Bergen, Norway ,0000 0004 0627 2891grid.412835.9Division of Psychiatry, Stavanger University Hospital, 4068 Stavanger, Norway
| | - Gro Janne Wergeland
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health/University of Bergen, Bergen, Norway ,0000 0000 9753 1393grid.412008.fDepartment of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Asle Hoffart
- 0000 0004 1936 8921grid.5510.1Research Institute, Modum Bad Psychiatric Center and Department of Psychology, University of Oslo, Oslo, Norway
| | - Kari Dyregrov
- grid.477239.cFaculty of Health and Social Sciences and Center for Crisis Psychology, Bergen University College, Bergen, Norway
| | - Åshild Tellefsen Håland
- 0000 0004 0627 3712grid.417290.9Clinic of Mental Health, Psychiatry and Addiction Treatment, Sørlandet Hospital HF, Kristiansand, Norway
| | - Bente Storm Mowatt Haugland
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health/University of Bergen, Bergen, Norway
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Paulus FW, Ohmann S, Popow C. Practitioner Review: School-based interventions in child mental health. J Child Psychol Psychiatry 2016; 57:1337-1359. [PMID: 27445203 DOI: 10.1111/jcpp.12584] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND School-based interventions (SBIs) are well-established and effective treatments for improving child mental health. Specific school-based topics include prevention (Tier I-III) and interventions (e.g. cognitive-behavioural programmes and daily report cards). METHODS We performed a systematic literature search in five commonly used online databases (ERIC, MEDLINE, PsycARTICLES, PsycINFO and PSYNDEX) for English-language articles published between 1993 and 2015. Additional sources included reference lists of relevant articles and book chapters. RESULTS We identified a number of successful behavioural or cognitive-behavioural programmes yielding moderate to strong effects for a range of emotional and behavioural problems. The implementation of these programmes and the collaboration of the involved settings (school and home) and persons are important factors for their effectiveness under real-life conditions. CONCLUSIONS Effective SBIs are valuable tools for students with mental health problems if evidence-based cognitive-behavioural interventions are applied and rules of translational algorithms and implementation science are respected.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
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13
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Bufferd SJ, Dougherty LR, Olino TM, Dyson MW, Carlson GA, Klein DN. Temperament Distinguishes Persistent/Recurrent from Remitting Anxiety Disorders Across Early Childhood. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 47:1004-1013. [PMID: 27705002 DOI: 10.1080/15374416.2016.1212362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Up to 20% of preschool-age children meet criteria for anxiety disorders and, for a large subset, anxiety appears to persist throughout early childhood. However, little is known about which factors predict persistence/recurrence of anxiety in young children. Temperament, including behavioral inhibition (BI), negative emotionality (NE), and positive emotionality (PE), predict the onset of anxiety disorders, but to our knowledge no study has examined whether temperament predicts the course of anxiety in young children. From a community sample of 3-year-olds, we identified 89 children (79.8% White, non-Hispanic; 41.6% female) who met criteria for an anxiety disorder and examined whether observed and parent-reported BI, NE, and PE at age 3 distinguished children who continued to meet criteria for an anxiety disorder from those who remitted by age 6. Higher levels of BI and lower levels of PE assessed in the laboratory and higher parent-reported BI and shyness and lower surgency at age 3 significantly predicted persistence/recurrence of anxiety disorders from age 3 to 6. These data are the first to demonstrate the influence of temperament on the course of anxiety disorders in young children. These findings can enhance assessment and treatment of anxiety by focusing intervention efforts on children who are at risk for persistent or recurring anxiety rather than children who are displaying transient, and possibly developmentally normative, anxiety.
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Affiliation(s)
- Sara J Bufferd
- a Department of Psychology , California State University San Marcos
| | - Lea R Dougherty
- b Department of Psychology , University of Maryland, College Park
| | | | | | - Gabrielle A Carlson
- e Department of Psychiatry and Behavioral Science , Stony Brook University School of Medicine
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Korte KJ, Allan NP, Gros DF, Acierno R. Differential treatment response trajectories in individuals with subclinical and clinical PTSD. J Anxiety Disord 2016; 38:95-101. [PMID: 26874291 PMCID: PMC5097342 DOI: 10.1016/j.janxdis.2016.01.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/04/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
Abstract
Subclinical presentations of posttraumatic stress disorder (PTSD), wherein patients are one or two symptom criteria short of the full disorder, are prevalent and associated with levels of distress and impaired functioning approximating that of full PTSD. Nonetheless, research examining treatment efficacy for this group is in the nascent stage. The purpose of the present study was to examine whether the subclinical PTSD group would: (1) show a greater reduction in PTSD symptoms at pre and post treatment in response to an exposure based treatment and (2) show a greater rate of change over the course of treatment, when compared to the full criteria PTSD group. We also examined whether differences would emerge when examining PTSD symptom clusters. Consistent with predictions, the subclinical PTSD group demonstrated a greater reduction in PTSD symptoms at post-treatment (29%) than those with a PTSD diagnosis (14%). Further, the groups had different treatment trajectories, with the subclinical PTSD group showing a marginally greater rate of change during the course of treatment. Findings also varied by symptom cluster with the subclinical group showing a greater rate of change in the intrusions, hypervigilance, and avoidance symptom clusters. There was not a significant between group difference in the numbing symptom cluster. This study provides preliminary evidence that treating PTSD symptoms at the subclinical level may result in a larger, and more rapid symptom reduction, and thus has implications supporting treatment earlier in the developmental trajectory of the disorder.
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Affiliation(s)
- Kristina J. Korte
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States
| | - Nicholas P. Allan
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States
| | - Daniel F. Gros
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States,Corresponding author at: Mental Health Service 116, Ralph H. Johnson VAMC, 109 Bee Street, Charleston, SC 29401, United States. Fax: +1 843 805 5782. (K.J. Korte), (D.F. Gros)
| | - Ron Acierno
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States
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15
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Urao Y, Yoshinaga N, Asano K, Ishikawa R, Tano A, Sato Y, Shimizu E. Effectiveness of a cognitive behavioural therapy-based anxiety prevention programme for children: a preliminary quasi-experimental study in Japan. Child Adolesc Psychiatry Ment Health 2016; 10:4. [PMID: 26884810 PMCID: PMC4754865 DOI: 10.1186/s13034-016-0091-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 01/17/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND As children's mental health problems become more complex, more effective prevention is needed. Though various anxiety and depression prevention programmes based on cognitive behavioural therapy (CBT) were developed and evaluated in Europe, North America, and Australia recently, there are no programmes in Japan. This study developed a CBT programme for Japanese children and tried to verify its effectiveness in reducing anxiety. METHODS A CBT-based anxiety prevention programme, 'Journey of the Brave', was developed to prevent anxiety disorders for Japanese children. Children from 4th through 6th grades (9-12 years old) in Japanese elementary schools and their parents (13 sample pairs) were the intervention group. For comparison purposes, 16 pairs were the control group. Ten weekly programme sessions and two follow-ups were conducted. Children's anxiety levels in both groups were evaluated by child and parent self-reports using the spence children anxiety scale (SCAS) three times: pre-programme (baseline), post-programme, and 3 months following the end of the programme. RESULTS At 3-month follow-up, no significant difference was shown between the intervention and control groups on children's SCAS scores in changes from baseline by using mixed-effects model for repeated measures analysis (SCAS-C: -8.92 (95 % CI = -14.12 to -3.72) and -3.17 (95 % CI = -8.02 to 1.66) respectively; the between group difference was 5.747 (95 % CI = -1.355 to -12.85, p = 0.062). On the other hand, significant reduction was shown in the intervention group on parents' SCAS (SCAS-P) scores in change from baseline -9.554 (95 % CI = -12.91 to -6.19) and 0.154 (95 % CI = -2.88 to 3.19) respectively; the between group difference was 9.709 (95 % CI = 5.179 to 14.23, p = 0.0001). CONCLUSION These preliminary results suggest this anxiety prevention programme for Japanese children was partially effective from parents' evaluations. However, it is important to note that this study was conducted on a small sample with unbalanced groups at pre-intervention with no randomization. The positive results may require discounting due to the research limitations. A larger-scale study of the programme in elementary school classes to verify its effectiveness with a more rigorous research design is necessary. TRIAL REGISTRATION UMIN-CTR UMIN000009021.
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Affiliation(s)
- Yuko Urao
- />Research Centre for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
- />Department of Nursing, Chiba Prefectural University of Health Sciences, 2-10-1 Wakaba, Mihama-Ku, Chiba, 261-0014 Japan
| | - Naoki Yoshinaga
- />Organization for Promotion of Tenure Track, General Education and Research Building (G704), University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692 Japan
| | - Kenichi Asano
- />Research Centre for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Ryotaro Ishikawa
- />Department of Cognitive and Behavioral Science, Graduate School of Arts and Sciences, University of Tokyo, 3-8-1 Komana Meguro-ku, Tokyo, 153-8902 Japan
| | - Aya Tano
- />Japanese Red Cross Narita Hospital, 90-1, Iidacho, Narita, 286-8523 Japan
| | - Yasunori Sato
- />Department of Global Clinical Research, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Eiji Shimizu
- />Research Centre for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
- />Department of Cognitive Behavioural Physiology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
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Stockings EA, Degenhardt L, Dobbins T, Lee YY, Erskine HE, Whiteford HA, Patton G. Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention. Psychol Med 2016; 46:11-26. [PMID: 26315536 DOI: 10.1017/s0033291715001725] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Depression and anxiety (internalizing disorders) are the largest contributors to the non-fatal health burden among young people. This is the first meta-analysis to examine the joint efficacy of universal, selective, and indicated preventive interventions upon both depression and anxiety among children and adolescents (5-18 years) while accounting for their co-morbidity. We conducted a systematic review of reviews in Medline, PsycINFO and the Cochrane Library of Systematic Reviews, from 1980 to August 2014. Multivariate meta-analysis examined the efficacy of preventive interventions on depression and anxiety outcomes separately, and the joint efficacy on both disorders combined. Meta-regressions examined heterogeneity of effect according to a range of study variables. Outcomes were relative risks (RR) for disorder, and standardized mean differences (Cohen's d) for symptoms. One hundred and forty-six randomized controlled trials (46 072 participants) evaluated universal (children with no identified risk, n = 54) selective (population subgroups of children who have an increased risk of developing internalizing disorders due to shared risk factors, n = 45) and indicated prevention (children with minimal but detectable symptoms of an internalizing disorder, n = 47), mostly using psychological-only strategies (n = 105). Reductions in internalizing disorder onset occurred up to 9 months post-intervention, whether universal [RR 0.47, 95% confidence interval (CI) 0.37-0.60], selective (RR 0.61, 95% CI 0.43-0.85) or indicated (RR 0.48, 95% CI 0.29-0.78). Reductions in internalizing symptoms occurred up to 12 months post-intervention for universal prevention; however, reductions only occurred in the shorter term for selective and indicated prevention. Universal, selective and indicated prevention interventions are efficacious in reducing internalizing disorders and symptoms in the short term. They might be considered as repeated exposures in school settings across childhood and adolescence. (PROSPERO registration: CRD42014013990.).
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Affiliation(s)
- E A Stockings
- National Drug and Alcohol Research Centre (NDARC),University of New South Wales (UNSW),Randwick,New South Wales,Australia
| | - L Degenhardt
- National Drug and Alcohol Research Centre (NDARC),University of New South Wales (UNSW),Randwick,New South Wales,Australia
| | - T Dobbins
- National Drug and Alcohol Research Centre (NDARC),University of New South Wales (UNSW),Randwick,New South Wales,Australia
| | - Y Y Lee
- Queensland Centre for Mental Health Research (QCMHR),The Park Centre for Mental Health,Wacol,Queensland,Australia
| | - H E Erskine
- Institute for Health Metrics and Evaluation (IHME),University of Washington,Seattle,Washington,USA
| | - H A Whiteford
- Institute for Health Metrics and Evaluation (IHME),University of Washington,Seattle,Washington,USA
| | - G Patton
- Centre for Adolescent Health,Murdoch Children's Research Institute (MCRI),Royal Children's Hospital,Parkville,Victoria,Australia
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Dijkstra-Kersten SMA, Sitnikova K, van Marwijk HWJ, Gerrits MMJG, van der Wouden JC, Penninx BWJH, van der Horst HE, Leone SS. Somatisation as a risk factor for incident depression and anxiety. J Psychosom Res 2015; 79:614-9. [PMID: 26253293 DOI: 10.1016/j.jpsychores.2015.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 07/14/2015] [Accepted: 07/31/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE In this study, we aimed to examine somatisation as a risk factor for the onset of depressive and anxiety disorders. METHODS 4-year follow-up data from the Netherlands Study of Depression and Anxiety (NESDA), a multisite cohort study of the course of depression and anxiety, was analysed. Participants (18-65 years) without a lifetime depressive or anxiety disorder at baseline were included (n=611). Somatisation was measured at baseline with the somatisation subscale of the 4 Dimensional Symptoms Questionnaire. Onset of depression and anxiety was assessed with the CIDI interview at 2-year and 4-year follow-up. RESULTS Somatisation was a risk factor for the incidence of depression [Hazard Ratio per unit increase (HR); 95% Confidence Interval (CI): 1.13; 1.09-1.17] and anxiety [HR; 95% CI: 1.14; 1.09-1.18]. Associations attenuated but remained statistically significant after adjusting for socio-demographic characteristics, chronic somatic disorders, and baseline levels of (subclinical) depressive or anxiety symptoms [adjusted HR for depression; 95% CI: 1.06; 1.00-1.12, adjusted HR for anxiety; 95% CI: 1.13; 1.07-1.20]. CONCLUSION Persons who somatise have an increased risk of becoming depressed or anxious in subsequent years, over and above baseline levels of depressive or anxiety symptoms. They may represent a target group for prevention of depressive and anxiety disorders.
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Affiliation(s)
- Sandra M A Dijkstra-Kersten
- Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Kate Sitnikova
- Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Harm W J van Marwijk
- Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Marloes M J G Gerrits
- Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Johannes C van der Wouden
- Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, GGZ inGeest, Amsterdam, The Netherlands; Department of Psychiatry, Leiden University Medical Center, The Netherlands; Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Stephanie S Leone
- Department of Public Mental Health, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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18
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Morgan AJ, Rapee RM, Tamir E, Goharpey N, Salim A, McLellan LF, Bayer JK. Preventing anxiety problems in children with Cool Little Kids Online: study protocol for a randomised controlled trial. Trials 2015; 16:507. [PMID: 26541812 PMCID: PMC4635535 DOI: 10.1186/s13063-015-1022-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/21/2015] [Indexed: 01/12/2023] Open
Abstract
Background Anxiety disorders are the most common type of mental health problem and begin early in life. Early intervention to prevent anxiety problems in young children who are at risk has the potential for long-term impact. The ‘Cool Little Kids’ parenting group program was previously established to prevent anxiety disorders in young children at risk because of inhibited temperament. This group program was efficacious in two randomised controlled trials and has recently been adapted into an online format. ‘Cool Little Kids Online’ was developed to widen and facilitate access to the group program’s preventive content. A pilot evaluation of the online program demonstrated its perceived utility and acceptability among parents. This study aims to evaluate the efficacy of Cool Little Kids Online in a large randomised controlled trial. Methods/Design Parents of young children who are 3–6 years old and who have an inhibited temperament will be recruited (n = 385) and randomly assigned to either immediate access to Cool Little Kids Online or delayed access after a waiting period of 24 weeks. The online program contains eight modules that help parents address key issues in the development of anxiety problems in inhibited children, including children’s avoidant coping styles, overprotective parenting behaviours, and parents’ own fears and worries. Intervention participants will be offered clinician support when requested. The primary outcome will be change in parent-reported child anxiety symptoms. Secondary outcomes will be child internalising symptoms, child and family life interference due to anxiety, over-involved/protective parenting, plus child anxiety diagnoses assessed by using a new online diagnostic tool. Assessments will take place at baseline and 12 and 24 weeks after baseline. Discussion This trial expands upon previous research on the Cool Little Kids parenting group program and will evaluate the efficacy of online delivery. Online delivery of the program could result in an easily accessible evidence-based resource to help families with young children at temperamental risk for anxiety disorders. Trial registration Australian New Zealand Clinical Trials Registry 12615000217505 (registered 5 March 2015) Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-1022-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amy J Morgan
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
| | - Ronald M Rapee
- Centre for Emotional Health, Building C3A, Level 7, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Elli Tamir
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
| | - Nahal Goharpey
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
| | - Agus Salim
- Department of Mathematics and Statistics, School of Engineering and Mathematical Sciences, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia.
| | - Lauren F McLellan
- Centre for Emotional Health, Building C3A, Level 7, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Jordana K Bayer
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Victoria, 3086, Australia. .,Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia. .,Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3010, Australia.
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19
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Capron DW, Allan NP, Ialongo NS, Leen-Feldner E, Schmidt NB. The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation. J Adolesc 2015. [PMID: 25754194 DOI: 10.1016/j.adolescence.2015.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
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Affiliation(s)
- Daniel W Capron
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA.
| | - Nicholas P Allan
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
| | - Nicholas S Ialongo
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | | | - Norman B Schmidt
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
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20
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Capron DW, Allan NP, Ialongo NS, Leen-Feldner E, Schmidt NB. The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation. J Adolesc 2015; 41:17-24. [PMID: 25754194 DOI: 10.1016/j.adolescence.2015.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 01/14/2015] [Accepted: 02/13/2015] [Indexed: 11/17/2022]
Abstract
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
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Affiliation(s)
- Daniel W Capron
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA.
| | - Nicholas P Allan
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
| | - Nicholas S Ialongo
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | | | - Norman B Schmidt
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
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21
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Korte KJ, Schmidt NB. The Use of Motivation Enhancement Therapy to Increase Utilization of a Preventative Intervention for Anxiety Sensitivity. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-014-9668-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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Allan NP, Capron DW, Lejuez CW, Reynolds EK, MacPherson L, Schmidt NB. Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 42:589-600. [PMID: 24062146 DOI: 10.1007/s10802-013-9806-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time. Anxiety sensitivity has been identified as an important risk factor in the development of anxiety psychopathology. This study prospectively examined the development of anxiety symptoms in a sample of 277 adolescents (M age = 11.52; 44 % female, 56 % male) over a 3 year period including the influence of anxiety sensitivity on this development. Further, this study investigated whether there were distinct classes of adolescents based on their anxiety symptom trajectories and including anxiety sensitivity as a predictor. Consistent with other reports, findings indicated an overall decline in anxiety symptoms over time in the sample. However, three classes of adolescents were found with distinct anxiety symptom trajectories and anxiety sensitivity was an important predictor of class membership. Adolescents with elevated anxiety sensitivity scores were more likely to be classified as having high and increasing anxiety symptoms over time versus having moderate to low and decreasing anxiety symptoms over time. There are important implications for identification of adolescents and children who are at risk for the development of an anxiety disorder.
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Affiliation(s)
- Nicholas P Allan
- Department of Psychology, Florida State University, P.O. Box 3064301, Tallahasssee, FL, 32306-4301, USA
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Abstract
BACKGROUND Despite their high prevalence, the global burden of anxiety disorders has never been calculated comprehensively. The new Global Burden of Disease (GBD) study has estimated burden due to morbidity and mortality caused by any anxiety disorder. METHOD Prevalence was estimated using Bayesian meta-regression informed by data identified in a systematic review. Years of life lived with disability (YLDs) were calculated by multiplying prevalent cases by an average disability weight based on severity proportions (mild, moderate and severe). Disability-adjusted life years (DALYs) were then calculated and age standardized using global standard population figures. Estimates were also made for additional suicide mortality attributable to anxiety disorders. Findings are presented for YLDs, DALYs and attributable burden due to suicide for 21 world regions in 1990 and 2010. RESULTS Anxiety disorders were the sixth leading cause of disability, in terms of YLDs, in both high-income (HI) and low- and middle-income (LMI) countries. Globally, anxiety disorders accounted for 390 DALYs per 100,000 persons [95% uncertainty interval (UI) 191-371 DALYs per 100,000] in 2010, with no discernible change observed over time. Females accounted for about 65% of the DALYs caused by anxiety disorders, with the highest burden in both males and females experienced by those aged between 15 and 34 years. Although there was regional variation in prevalence, the overlap between uncertainty estimates means that substantive differences in burden between populations could not be identified. CONCLUSIONS Anxiety disorders are chronic, disabling conditions that are distributed across the globe. Future estimates of burden could be further improved by obtaining more representative data on severity state proportions.
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Affiliation(s)
- A J Baxter
- School of Population Health,University of Queensland,Herston,Australia
| | - T Vos
- University of Washington,Institute for Health Metrics and Evaluation, Seattle, WA,USA
| | - K M Scott
- Department of Psychological Medicine,University of Otago,Dunedin,New Zealand
| | - A J Ferrari
- School of Population Health,University of Queensland,Herston,Australia
| | - H A Whiteford
- School of Population Health,University of Queensland,Herston,Australia
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Wirtz CM, Hofmann SG, Riper H, Berking M. Emotion regulation predicts anxiety over a five-year interval: a cross-lagged panel analysis. Depress Anxiety 2014; 31:87-95. [PMID: 24151095 DOI: 10.1002/da.22198] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 09/01/2013] [Accepted: 09/08/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Emotion regulation (ER) deficits have been linked to symptoms of anxiety in cross-sectional studies. However, the direction of the relationship between ER and anxiety symptom severity (ASS) is unclear. METHODS In order to clarify the relationship between ER skills and ASS symptoms, we assessed skills and symptoms in 131 individuals twice over a 5-year interval. Cross-lagged panel analyses were conducted to test whether ER skills were a significant predictor of subsequent ASS or vice versa. Additionally, we explored whether specific ER skills differed in regard to the strength of prospective associations with subsequent ASS. RESULTS ER skills negatively predicted subsequent ASS over and above the effects of baseline ASS (whereas anxiety symptoms did not predict subsequent ER deficits). Acceptance, tolerance, and willingness to confront had the strongest prospective effects on lower subsequent ASS. CONCLUSIONS General ER skills may play an important role in the development and maintenance of anxiety disorders.
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Affiliation(s)
- Carolin M Wirtz
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Vassilopoulos SP, Brouzos A, Damer DE, Mellou A, Mitropoulou A. A Psychoeducational School-Based Group Intervention for Socially Anxious Children. JOURNAL FOR SPECIALISTS IN GROUP WORK 2013. [DOI: 10.1080/01933922.2013.819953] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Neurodevelopmental changes over the lifespan, from childhood through adulthood into old age, have important implications for the onset, presentation, course, and treatment of anxiety disorders. This article presents data on anxiety disorders as they appear in older adults, as compared with earlier in life. In this article, we focus on aging-related changes in the epidemiology, presentation, and treatment of anxiety disorders. Also, this article describes some of the gaps and limitations in our understanding and suggests research directions that may elucidate the mechanisms of anxiety disorder development later in life. Finally we describe optimal management of anxiety disorders across the lifespan, in "eight simple steps" for practitioners.
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Affiliation(s)
- Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
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