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Tuncay S, Sarman A. Late-night eating and inactivity: Links to depression and suicide risk in adolescents living in Turkey. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12474. [PMID: 38924640 DOI: 10.1111/jcap.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Depression, anxiety, and eating disorders are all common during adolescence. This study aims to investigate the potential relationship between eating at night, physical activity, and depression/suicide risk in adolescents. METHODS This study followed a cross-sectional descriptive design and involved collecting data from adolescents aged 13-18 years who attend four different high schools. The data collection was done through an online survey using Google Forms. Sociodemographic form, eating at night questionnaire, International Physical Activity Questionnaire (Short Form), Reynolds Adolescent Depression Scale, and Suicide Probability Scale were used for data collection. The data collected were analyzed electronically using descriptive statistics and correlation tests to examine relationships between different parameters. RESULTS The study revealed significant associations between academic achievement, daily sleep duration, and daily walking distance with depression and suicide probability (p < 0.05) among the participants. Adolescents who consumed food after 10 pm exhibited higher depression and suicide probability scores than their counterparts (p < 0.05). Additionally, an analysis of physical activity levels demonstrated that highly active adolescents had lower depression and suicide probability scores. CONCLUSIONS In conclusion, this study suggests that there is a significant relationship between eating at night, physical activity, and depression/suicide risk in adolescents. Specifically, academic success, daily sleep duration, daily walking distance, and eating habits were found to be associated with depression and suicide probability. Encouraging physical activity and healthy eating habits, particularly avoiding eating late at night, may be beneficial in reducing the risk of depression and suicide among adolescents.
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Affiliation(s)
- Suat Tuncay
- Department of Pediatric Nursing, Faculty of Health Science, Bingöl University, Bingöl, Turkey
| | - Abdullah Sarman
- Department of Pediatric Nursing, Faculty of Health Science, Bingöl University, Bingöl, Turkey
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Carollo A, De Marzo S, Esposito G. Parental care and overprotection predict worry and anxiety symptoms in emerging adult students. Acta Psychol (Amst) 2024; 248:104398. [PMID: 39025031 DOI: 10.1016/j.actpsy.2024.104398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/20/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024] Open
Abstract
Anxiety disorders represent a prevalent mental health concern, with escalating rates, especially among emerging adults. University students, in particular, face a myriad of academic and life stressors that can amplify feelings of worry and anxiety. While early parental bonding seem to predict anxiety disorders later in life, the applicability to emerging adult students and its applicability to predict sub-clinical and transdiagnostic anxiety features remain unclear. This study aims to examine i) the relationship between demographic variables and key features of anxiety disorders (i.e., worry and anxiety symptoms); and ii) the predictive association between early parental bonding and anxiety-related features. A sample of 370 university students in Italy (n = 279 females; M age = 20.84 years, SD age = 1.81 years) completed the Parental Bonding Instrument, the Penn State Worry Questionnaire, and the Beck Anxiety Inventory. Females reported higher levels of worry and anxiety compared to males. Significantly higher worry and anxiety symptoms were reported by individuals who experienced affectionless control (low care and high overprotection) as compared to those exposed to optimal parenting (high care and low overprotection). Predictive models indicated that scores of parental care (i.e., the principal component between maternal and paternal care scores) and parental overprotection (i.e., the principal component between maternal and paternal overprotection scores) are robust predictors of worry and anxiety symptoms. However, this relationship showed a gender-specific pattern: lower parental care was more significant in predicting anxiety features in males, while high overprotection was more significant in females. The findings contribute to the comprehension of the risk factors influencing the susceptibility of emerging adult students to anxiety disorders.
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Affiliation(s)
- Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Sonia De Marzo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.
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3
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Hua Y, Jiang W, He Y, Zheng X, Huang C, Guo L, Guo Y, Guo L. Associations of recent stressful life events with anxiety symptoms among Chinese adolescents with a consideration of family functioning. Eur J Psychotraumatol 2024; 15:2337577. [PMID: 38597558 PMCID: PMC11008314 DOI: 10.1080/20008066.2024.2337577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
Background: The association between stressful life events (SLEs) and adolescent anxiety symptoms has been extensively studied, but the specific impacts of different SLEs domains remain inconclusive. Moreover, limited research has examined the role of family functioning in these associations.Objective: This study aimed to investigate the associations between various recent SLEs and adolescent anxiety symptoms and explore the role of family functioning.Methods: Data were obtained from the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research in Guangzhou, China. A total of 10,985 students (51.9% boys; mean [SD] age, 15.3 [1.5] years) from forty middle schools participated in the study in 2022 and completed a self-report questionnaire assessing anxiety symptoms, SLEs, and family functioning using the Generalized Anxiety Disorder-7 (GAD-7), Adolescent Self-rating Life Events Checklist (ASLEC; including five subscales: interpersonal stress, academic stress, punishment-related stress, loss-related stress, and adaptation-related stress), and the adapted Chinese version of the Family Assessment Device (FAD), respectively. Linear mixed-effects models were performed and the moderation role of family functioning was also examined.Results: The fully adjusted model revealed that a 1-SD increase in the overall ASLEC score was associated with higher levels of anxiety symptoms (β = 2.23, 95%CI: 2.15-2.32). Among various SLEs domains, the academic domain shows the most significant association (β = 2.25, 95%CI: 2.17-2.33). Family functioning exerted an independent protective influence on anxiety symptoms, with each 1-SD increase in FAD scores negatively associated with anxiety symptoms (β = -2.11, 95%CI: - 2.29 to - 1.93) in the adjusted model. Moreover, family functioning significantly buffered the impacts of overall SLEs and each domain, except for adaptation-related SLEs, on anxiety symptoms.Conclusion: Higher recent SLEs levels were associated with increased anxiety symptoms among adolescents, with academic SLEs showing the greatest association. Positive family functioning had both direct and buffering influences on anxiety symptoms.
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Affiliation(s)
- Yilin Hua
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yitong He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Xinyu Zheng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Cuihong Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Liling Guo
- Department of Prevention and Treatment of Common Diseases among Students, Health Promotion Center for Primary and Secondary Schools in Guangzhou, Guangzhou, People's Republic of China
| | - Yangfeng Guo
- Department of Prevention and Treatment of Common Diseases among Students, Health Promotion Center for Primary and Secondary Schools in Guangzhou, Guangzhou, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
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Hai Y, Kou W, Gu Z, Zhang C, Zou Q, Wang F, Yao H, Wei P. Obstructive sleep apnea affects the psychological and behavioural development of children-a case-control study. J Sleep Res 2024; 33:e13924. [PMID: 37194421 DOI: 10.1111/jsr.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/18/2023]
Abstract
This study aims to investigate the effects of obstructive sleep apnea on paediatric psychological and behavioural abnormalities. A total of 1086 paediatric patients with obstructive sleep apnea and 728 sample snoring controls were enrolled in the study. Patients with obstructive sleep apnea underwent bilateral tonsillectomy plus adenoidectomy or adenoidectomy alone. Repeated Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory were performed to assess the autism symptoms, anxiety level and depressive symptoms before and after surgery. The score of Autism Behaviour Checklist in preschool children with obstructive sleep apnea was higher than that in control. In school children with obstructive sleep apnea, the score of Spence Children's Anxiety Scale was also higher. School children with obstructive sleep apnea with depressive symptoms were significantly higher than that in control. The scores of Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory in the obstructive sleep apnea group after surgery were significantly lower than that before surgery. Our study showed that the score of Spence Children's Anxiety Scale and Children's Depression Inventory had a close correlation with the illness course and hypoxia duration. The Spence Children's Anxiety Scale and Children's Depression Inventory scores are also closely associated with the Autism Behaviour Checklist score. These results suggest that obstructive sleep apnea may have a significant impact on autism symptoms, anxiety levels and depressive symptoms in children. We found that the longer the duration of the obstructive sleep apnea course and hypoxia, the greater the impact on anxiety level and depressive symptoms. The suspected autism symptoms, anxiety level and depressive symptoms in children with obstructive sleep apnea were also significantly correlated. Thus, early detection and timely treatment may often reverse the psychological and behavioural abnormalities caused by obstructive sleep apnea.
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Affiliation(s)
- Yang Hai
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
- Department of Otolaryngology, Chongqing Youyou Baobei Women and Children's Hospital, Chongqing, China
| | - Wei Kou
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Zheng Gu
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Cheng Zhang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Qiyuan Zou
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Fan Wang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Hongbing Yao
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Ping Wei
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
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Warner EN, Ammerman RT, Glauser TA, Pestian JP, Agasthya G, Strawn JR. Developmental Epidemiology of Pediatric Anxiety Disorders. Child Adolesc Psychiatr Clin N Am 2023; 32:511-530. [PMID: 37201964 DOI: 10.1016/j.chc.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.
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Affiliation(s)
- Emily N Warner
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati.
| | - Robert T Ammerman
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy A Glauser
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John P Pestian
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Greeshma Agasthya
- Oak Ridge National Laboratory, Computational Sciences and Engineering Division, Advanced Computing for Health Sciences Section
| | - Jeffrey R Strawn
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Psychiatry, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Arnaud Y, Drouin O, Borgès Da Silva R. COVID-19 related information seeking: The impact of media on parental concerns. Front Public Health 2022; 10:977634. [PMID: 36311607 PMCID: PMC9608445 DOI: 10.3389/fpubh.2022.977634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023] Open
Abstract
The expansion of information sources and their use has accelerated since the beginning of the COVID-19 pandemic, sometimes provoking significant concern in the daily lives of parents. The objective of this study was to investigate the association between COVID-19 related information sources and the level of concern about COVID-19 among parents of school-aged children. Using factor analysis and hierarchical ascending classification, we constructed groups according to the information sources they used. We performed ANOVA analysis and then binomial logistic regression to compare concern levels among the groups created. Overall, the 3,459 participants were mainly women (79.2%) and 59.5% reported being between 35 and 44 years old. The mean concern score in our sample was 9.5/15 (s.d. = 3.87). The whole sample fell into three groups: (1) Traditional Media (n = 1,610), who mainly used newspapers; (2) Online Social Networks and Entourage (n = 776), who mostly consulted online social media as well as friends and family; and (3) the Unplugged (n = 1,073), who consulted few or no information sources. Compared to the Unplugged, individuals in the other two groups had a higher risk of being concerned (Traditional Media, OR = 2.2; p < 0.001; Social Networks and Entourage, OR = 3.1; p < 0.001). Communication about pandemic risk should be conveyed based on reliable information and at moderate intervals to safeguard the mental health of individuals.
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Affiliation(s)
- Yann Arnaud
- Center for Interuniversity Research and Analysis on Organizations (CIRANO), Montreal, QC, Canada,*Correspondence: Yann Arnaud
| | - Olivier Drouin
- Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Roxane Borgès Da Silva
- Center for Interuniversity Research and Analysis on Organizations (CIRANO), Montreal, QC, Canada,Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, QC, Canada
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Uka F, Gashi S, Gashi A, Gllogu D, Musliu A, Krasniqi A, Statovci A, Sopjani V, Perçuku V, Sadikovic I, Wiium N. The effectiveness of internal cohesion psychotherapy in treating young clients with depression and anxiety disorders: The role of developmental assets in Kosovo context. Front Psychol 2022; 13:1005709. [PMID: 36312183 PMCID: PMC9597360 DOI: 10.3389/fpsyg.2022.1005709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/22/2022] [Indexed: 11/25/2022] Open
Abstract
The positive youth development approach (PYD) is widely used as a meaningful framework to guide research, policy, and intervention, to support young people to develop their full potential. Psychotherapy, on the other hand, is a verbal and psychological procedure that can be a suitable solution to mental health concerns, which are prevalent among youth. This study aimed to explore the potential role of developmental assets in treating clients with depression and anxiety disorders using Internal Cohesion Psychotherapy (ICP). In total, 10 young people who took at least five sessions of ICP were part of this study. In-depth semi-structured interviews were conducted to gather information about clients’ experiences with ICP and their perception/opinions on the presence of developmental assets in their lives. The results confirm the effectiveness of ICP in treating depression and anxiety, while clients acknowledge the role of developmental assets in their psychotherapeutic process. The current study has important theoretical, practical, and research implications. It provides evidence on how clients use their developmental assets in maximizing the effectiveness of the ICP process. The usage of developmental assets to enhance the effectiveness of psychotherapy opens a new path for further research and can serve as a foundation ground for intervention on mental health among youth.
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Affiliation(s)
- Fitim Uka
- Department of Psychology, University of Prishtina, Prishtina, Kosovo
- Research Department, Empatia Multidisciplinary Clinic, Prishtina, Kosovo
- Munich Center of the Learning Sciences, Ludwig Maximilians University, Munich, Bavaria, Germany
| | - Shkumbin Gashi
- Departement Gesundheit, Berner Fachhochschule, Bern, Switzerland
| | - Arlinda Gashi
- Research Department, Empatia Multidisciplinary Clinic, Prishtina, Kosovo
- *Correspondence: Arlinda Gashi,
| | - Diellza Gllogu
- Research Department, Empatia Multidisciplinary Clinic, Prishtina, Kosovo
| | - Arian Musliu
- Faculty of Education, University of Prishtina, Prishtina, Kosovo
| | - Albina Krasniqi
- Research Department, Empatia Multidisciplinary Clinic, Prishtina, Kosovo
| | - Albina Statovci
- Research Department, Empatia Multidisciplinary Clinic, Prishtina, Kosovo
| | - Vanesa Sopjani
- Research Department, Empatia Multidisciplinary Clinic, Prishtina, Kosovo
| | - Veronë Perçuku
- Psycho-Social and Medical Research Center, Prishtina, Kosovo
| | - Irma Sadikovic
- Research Department, Empatia Multidisciplinary Clinic, Prishtina, Kosovo
| | - Nora Wiium
- Faculty of Psychology, University of Bergen, Bergen, Norway
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Anxiety and Depression in a Non-Clinical Sample of Young Polish Adults: Presence of Meaning in Life as a Mediator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106065. [PMID: 35627602 PMCID: PMC9140330 DOI: 10.3390/ijerph19106065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/10/2022]
Abstract
Early adulthood, between 18 and 25, is viewed as a decisive period of life for the prevention and treatment of anxiety and depression. Although the topic of their mutual relationship is well-known, little has been uncovered about the mechanism underlying this connection. To understand the indirect pathways between anxiety and depression, we chose the sense of meaning of life as a mediator because people's beliefs that their lives are or can be purposeful may protect against depression. The sample was composed of 277 Polish young adults. A small majority of the participants were women (58.8%). The mean age was M = 22.11 (SD = 1.72). We used in the research the Direct Behavior Rating-Scale Items Scale, the Meaning in Life Questionnaire, and the Brief Screen for Depression. Correlational analysis showed that, consistent with past findings, anxiety correlated positively with depression and searching for meaning. It was also negatively associated with presence of meaning. Moreover, depression was negatively linked to presence of meaning and positively with searching for meaning. Regression-based mediation analyses (PROCESS macro 3.4) proved that the relationship between anxiety and depression was mediated by presence of meaning in life, suggesting that having a sense of meaning may be a pathway by which feelings of tension relative to adverse events protect against depression.
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9
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Depression and Anxiety Symptoms in Adolescents and Young Adults in Greece: prevalence and associated factors. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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10
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Bokma WA, Zhutovsky P, Giltay EJ, Schoevers RA, Penninx BW, van Balkom AL, Batelaan NM, van Wingen GA. Predicting the naturalistic course in anxiety disorders using clinical and biological markers: a machine learning approach. Psychol Med 2022; 52:57-67. [PMID: 32524918 PMCID: PMC8711102 DOI: 10.1017/s0033291720001658] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/25/2020] [Accepted: 05/12/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Disease trajectories of patients with anxiety disorders are highly diverse and approximately 60% remain chronically ill. The ability to predict disease course in individual patients would enable personalized management of these patients. This study aimed to predict recovery from anxiety disorders within 2 years applying a machine learning approach. METHODS In total, 887 patients with anxiety disorders (panic disorder, generalized anxiety disorder, agoraphobia, or social phobia) were selected from a naturalistic cohort study. A wide array of baseline predictors (N = 569) from five domains (clinical, psychological, sociodemographic, biological, lifestyle) were used to predict recovery from anxiety disorders and recovery from all common mental disorders (CMDs: anxiety disorders, major depressive disorder, dysthymia, or alcohol dependency) at 2-year follow-up using random forest classifiers (RFCs). RESULTS At follow-up, 484 patients (54.6%) had recovered from anxiety disorders. RFCs achieved a cross-validated area-under-the-receiving-operator-characteristic-curve (AUC) of 0.67 when using the combination of all predictor domains (sensitivity: 62.0%, specificity 62.8%) for predicting recovery from anxiety disorders. Classification of recovery from CMDs yielded an AUC of 0.70 (sensitivity: 64.6%, specificity: 62.3%) when using all domains. In both cases, the clinical domain alone provided comparable performances. Feature analysis showed that prediction of recovery from anxiety disorders was primarily driven by anxiety features, whereas recovery from CMDs was primarily driven by depression features. CONCLUSIONS The current study showed moderate performance in predicting recovery from anxiety disorders over a 2-year follow-up for individual patients and indicates that anxiety features are most indicative for anxiety improvement and depression features for improvement in general.
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Affiliation(s)
- Wicher A. Bokma
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Paul Zhutovsky
- Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Erik J. Giltay
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Robert A. Schoevers
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Anton L.J.M. van Balkom
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Guido A. van Wingen
- Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
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11
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Parents still matter! Parental warmth predicts adolescent brain function and anxiety and depressive symptoms 2 years later. Dev Psychopathol 2021; 33:226-239. [PMID: 32096757 DOI: 10.1017/s0954579419001718] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Anxiety is the most prevalent psychological disorder among youth, and even following treatment, it confers risk for anxiety relapse and the development of depression. Anxiety disorders are associated with heightened response to negative affective stimuli in the brain networks that underlie emotion processing. One factor that can attenuate the symptoms of anxiety and depression in high-risk youth is parental warmth. The current study investigates whether parental warmth helps to protect against future anxiety and depressive symptoms in adolescents with histories of anxiety and whether neural functioning in the brain regions that are implicated in emotion processing and regulation can account for this link. Following treatment for anxiety disorder (Time 1), 30 adolescents (M age = 11.58, SD = 1.26) reported on maternal warmth, and 2 years later (Time 2) they participated in a functional neuroimaging task where they listened to prerecorded criticism and neutral statements from a parent. Higher maternal warmth predicted lower neural activation during criticism, compared with the response during neutral statements, in the left amygdala, bilateral insula, subgenual anterior cingulate (sgACC), right ventrolateral prefrontal cortex, and anterior cingulate cortex. Maternal warmth was associated with adolescents' anxiety and depressive symptoms due to the indirect effects of sgACC activation, suggesting that parenting may attenuate risk for internalizing through its effects on brain function.
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12
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Cerveira de Baumont A, Hoffmann MS, Bortoluzzi A, Fries GR, Lavandoski P, Grun LK, Guimarães LSP, Guma FTCR, Salum GA, Barbé-Tuana FM, Manfro GG. Telomere length and epigenetic age acceleration in adolescents with anxiety disorders. Sci Rep 2021; 11:7716. [PMID: 33833304 PMCID: PMC8032711 DOI: 10.1038/s41598-021-87045-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/16/2021] [Indexed: 02/01/2023] Open
Abstract
Evidence on the relationship between genetics and mental health are flourishing. However, few studies are evaluating early biomarkers that might link genes, environment, and psychopathology. We aimed to study telomere length (TL) and epigenetic age acceleration (AA) in a cohort of adolescents with and without anxiety disorders (N = 234). We evaluated a representative subsample of participants at baseline and after 5 years (n = 76) and categorized them according to their anxiety disorder diagnosis at both time points: (1) control group (no anxiety disorder, n = 18), (2) variable group (anxiety disorder in one evaluation, n = 38), and (3) persistent group (anxiety disorder at both time points, n = 20). We assessed relative mean TL by real-time quantitative PCR and DNA methylation by Infinium HumanMethylation450 BeadChip. We calculated AA using the Horvath age estimation algorithm and analyzed differences among groups using generalized linear mixed models. The persistent group of anxiety disorder did not change TL over time (p = 0.495). The variable group had higher baseline TL (p = 0.003) but no accelerated TL erosion in comparison to the non-anxiety control group (p = 0.053). Furthermore, there were no differences in AA among groups over time. Our findings suggest that adolescents with chronic anxiety did not change telomere length over time, which could be related to a delay in neuronal development in this period of life.
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Affiliation(s)
- Angelica Cerveira de Baumont
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil.
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil.
- Serviço de Psiquiatria, Hospital de Clínicas de Porto Alegre, HCPA, Rua Ramiro Barcelos, 2350-sala 400N, Rio Branco, Porto Alegre, RS, 90035-903, Brazil.
| | - Mauricio Scopel Hoffmann
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Departamento de Neuropsiquiatria, Universidade Federal de Santa Maria, Avenida Roraima 1000, Santa Maria, 97105-900, Brazil
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, RS, Brazil
| | - Andressa Bortoluzzi
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Gabriel R Fries
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, (UTHealth), Houston, TX, USA
| | - Patrícia Lavandoski
- Graduate Program in Biochemistry, Laboratoy of Molecular Biology and Bioinformatics, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Lucas K Grun
- Group of Inflammation and Cellular Senescence, Graduate Program in Cellular and Molecular Biology, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Luciano S P Guimarães
- Unit of Epidemiology and Biostatistics, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
| | - Fátima T C R Guma
- Graduate Program in Biochemistry, Laboratoy of Molecular Biology and Bioinformatics, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Giovanni Abrahão Salum
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, RS, Brazil
| | - Florencia M Barbé-Tuana
- Graduate Program in Biochemistry, Laboratoy of Molecular Biology and Bioinformatics, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Group of Inflammation and Cellular Senescence, Graduate Program in Cellular and Molecular Biology, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Gisele G Manfro
- Anxiety Disorders Outpatient Program for Children and Adolescents, Protaia, Federal University of Rio Grande do Sul, UFRGS/Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Basic Research and Advanced Investigations in Neurosciences, BRAIN Laboratory, Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, RS, Brazil
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Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report. Eur Child Adolesc Psychiatry 2021; 30:1969-1982. [PMID: 33113027 PMCID: PMC8563629 DOI: 10.1007/s00787-020-01669-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 10/19/2020] [Indexed: 01/04/2023]
Abstract
Anxiety disorders are a common problem in adolescent mental health. Previous studies have investigated only a limited number of risk factors for the development of anxiety disorders concurrently. By investigating multiple factors simultaneously, a more complete understanding of the etiology of anxiety disorders can be reached. Therefore, we assessed preadolescent socio-demographic, familial, psychosocial, and biological factors and their association with the onset of anxiety disorders in adolescence. This study was conducted among 1584 Dutch participants of the TRacking Adolescents' Individual Lives Survey (TRAILS). Potential risk factors were assessed at baseline (age 10-12), and included socio-demographic (sex, socioeconomic status), familial (parental anxiety and depression), psychosocial (childhood adversity, temperament), and biological (body mass index, heart rate, blood pressure, cortisol) variables. Anxiety disorders were assessed at about age 19 years through the Composite International Diagnostic Interview (CIDI). Univariate and multivariate logistic regression analyses were performed with onset of anxiety disorder as a dependent variable and the above-mentioned putative risk factors as predictors. Of the total sample, 25.7% had a lifetime diagnosis of anxiety disorder at age 19 years. Anxiety disorders were twice as prevalent in girls as in boys. Multivariate logistic regression analysis showed that being female (OR = 2.38, p < .01), parental depression and anxiety (OR = 1.34, p = .04), temperamental frustration (OR = 1.31, p = .02) and low effortful control (OR = 0.76, p = .01) independently predicted anxiety disorders. We found no associations between biological factors and anxiety disorder. After exclusion of adolescents with an onset of anxiety disorder before age 12 years, being female was the only significant predictor of anxiety disorder. Being female was the strongest predictor for the onset of anxiety disorder. Psychological and parental psychopathology factors increased the risk of diagnosis of anxiety, but to a lesser extent. Biological factors (heart rate, blood pressure, cortisol, and BMI), at least as measured in the present study, are unlikely to be useful tools for anxiety prevention and intervention strategies.
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Manzar MD, Alghadir AH, Anwer S, Alqahtani M, Salahuddin M, Addo HA, Jifar WW, Alasmee NA. Psychometric Properties of the General Anxiety Disorders-7 Scale Using Categorical Data Methods: A Study in a Sample of University Attending Ethiopian Young Adults. Neuropsychiatr Dis Treat 2021; 17:893-903. [PMID: 33790558 PMCID: PMC7997591 DOI: 10.2147/ndt.s295912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/18/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Few studies have investigated the psychometric validation of the General Anxiety Disorders-7 Scale (GAD-7) using appropriate data assumptions. This study examined the reliability, factorial validity, divergent validity, and item analysis of the GAD-7 using categorical data methods in a sample of Ethiopian young adults. METHODS A sample of 270 students in the age group (18-20 years) was recruited during February-May of 2017 in this cross-sectional study using simple random sampling. The participants completed a tool for socio-demographic details, the GAD-7, and the Perceived Stress Scale-10 (PSS-10). RESULTS The cumulative variance rule (> 40%), the scree test, Kaiser's criteria (Eigenvalues > 1), and the parallel analysis found a 1-factor model for the GAD-7 (factor loadings, 0.38 to 0.63). Fit indices suggested a 1-factor model: the tests applied included the weighted root mean square residual (0.030), comparative fit index (1.000), the goodness of fit index (1.00), root mean square error of approximation (0.037) and the non-normed fit index (1.00). McDonald's Omega (0.772) implied that the scores had adequate internal consistency. Divergent validity was supported by significant but weak correlations that were found between the GAD-7 and PSS-10 scores (r = 0.11 to 0.25, p<0.05). CONCLUSION The psychometric validity of the GAD-7 in Ethiopian university attending young adults was supported by the categorical data method.
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Affiliation(s)
- Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Shahnawaz Anwer
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Department of Building and Real Estate, Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Mazen Alqahtani
- Department of Physiotherapy, College of Applied Medical Sciences, Majmaah University, Majmaah 11952, Saudi Arabia
| | - Mohammed Salahuddin
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University (Mizan Campus), Mizan-Aman, Ethiopia.,Pharmacology Division, Department of BioMolecular Sciences, University of Mississippi, Oxford, MS, USA
| | - Habtamu Acho Addo
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University (Mizan Campus), Mizan-Aman, Ethiopia
| | - Wakuma Wakene Jifar
- Department of Pharmacy, College of Health Science, Mettu University, Metu, Ethiopia
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15
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Casline EP, Ginsburg GS, Piacentini J, Compton S, Kendall P. Negative Life Events as Predictors of Anxiety Outcomes: An Examination of Event Type. Res Child Adolesc Psychopathol 2021; 49:91-102. [PMID: 33048267 PMCID: PMC7856832 DOI: 10.1007/s10802-020-00711-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
Long-term follow-up studies of anxiety treatment have found that greater exposure to negative life events (NLEs) predicts poorer anxiety outcomes, but none have examined whether specific types of NLEs are differentially associated with child outcomes. This study examined the frequency of NLEs and whether specific types of NLEs were associated with increased risk of having an anxiety disorder 6.5 years post randomization. Participants were 319 adolescents and adults, ages 11 to 26 (M = 17), enrolled in Child/Adolescent Anxiety Multimodal Extended Long-term Study. At their first follow-up visit, participants completed a diagnostic interview and a 40-item Life Events Scale that reflected whether specific events occurred since their last post treatment assessment. Life events were categorized into domains (i.e., family, academic, health, and social) via researcher consensus. Participants reported having experienced an average of four NLEs. Participants with an anxiety disorder at follow-up were significantly more likely to have failed a grade in school (OR = 5.9) and experienced a negative change in acceptance by peers (OR = 4.9; ps < 0.001). After controlling for gender, age, race, and SES, a greater number of NLEs in the academic domain increased the odds of having an anxiety disorder at follow-up (OR = 2.4, p < 0.001). No other domains were predictive of disorder status at follow-up. Findings highlight the value of examining specific NLEs in relation to the long-term child anxiety outcomes.
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Affiliation(s)
| | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - John Piacentini
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Scott Compton
- Department of Psychiatry and Behavioral Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Philip Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
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16
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Schneider RL, Long EE, Arch JJ, Hankin BL. The relationship between stressful events, emotion dysregulation, and anxiety symptoms among youth: longitudinal support for stress causation but not stress generation. ANXIETY STRESS AND COPING 2020; 34:157-172. [PMID: 33156724 DOI: 10.1080/10615806.2020.1839730] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION There is a clear bi-directional link between stressful events and depressive symptoms in adolescence, but the directionality of this link for anxiety symptoms remains underexamined. We critically evaluate the longitudinal relationship between stressors and anxiety among youth. Specifically, we examine whether stressors predict anxiety symptoms over a 1.5-year period (stress causation), and whether anxiety symptoms predict stressors over this period (stress generation). We examine potential influencing factors, including stressor type (independent vs. dependent) and emotion dysregulation (nonacceptance; goal-directed difficulty). METHODS Social, separation, and physical anxiety symptoms, and frequency and stressor type, were assessed every 3 months for 1.5 years among community youth (n = 528, ages 8-17). Baseline emotion dysregulation was assessed. Time-lagged analyses evaluated the bi-directional relationship of stress and anxiety over time, controlling for previous anxiety and depression. RESULTS Interpersonal stressors predicted subsequent physical and social anxiety symptoms, but anxiety did not predict subsequent stressors. Both nonacceptance and goal-directed difficulties predicted subsequent anxiety symptoms and stressors, but did not moderate the relationship. CONCLUSION The findings supported the stress causation model for youth anxiety, but not the stress generation model. Nonacceptance and goal-directed difficulty predicted greater subsequent anxiety symptoms and stressors. We discuss implications for prevention and intervention.
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Affiliation(s)
- Rebecca L Schneider
- University of Colorado Boulder, Psychology and Neuroscience, Boulder, CO, USA
| | - Erin E Long
- University of Illinois, Psychology, Champaign, IL, USA
| | - Joanna J Arch
- University of Colorado Boulder, Psychology and Neuroscience, Boulder, CO, USA
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17
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Ge F, Zhang D, Wu L, Mu H. Predicting Psychological State Among Chinese Undergraduate Students in the COVID-19 Epidemic: A Longitudinal Study Using a Machine Learning. Neuropsychiatr Dis Treat 2020; 16:2111-2118. [PMID: 32982249 PMCID: PMC7505704 DOI: 10.2147/ndt.s262004] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The outbreak of the 2019 novel coronavirus disease (COVID-19) not only caused physical abnormalities, but also caused psychological distress, especially for undergraduate students who are facing the pressure of academic study and work. We aimed to explore the prevalence rate of probable anxiety and probable insomnia and to find the risk factors among a longitudinal study of undergraduate students using the approach of machine learning. METHODS The baseline data (T1) were collected from freshmen who underwent psychological evaluation at two months after entering the university. At T2 stage (February 10th to 13th, 2020), we used a convenience cluster sampling to assess psychological state (probable anxiety was assessed by general anxiety disorder-7 and probable insomnia was assessed by insomnia severity index-7) based on a web survey. We integrated information attained at T1 stage to predict probable anxiety and probable insomnia at T2 stage using a machine learning algorithm (XGBoost). RESULTS Finally, we included 2009 students (response rate: 80.36%). The prevalence rate of probable anxiety and probable insomnia was 12.49% and 16.87%, respectively. The XGBoost algorithm predicted 1954 out of 2009 students (translated into 97.3% accuracy) and 1932 out of 2009 students (translated into 96.2% accuracy) who suffered anxiety and insomnia symptoms, respectively. The most relevant variables in predicting probable anxiety included romantic relationship, suicidal ideation, sleep symptoms, and a history of anxiety symptoms. The most relevant variables in predicting probable insomnia included aggression, psychotic experiences, suicidal ideation, and romantic relationship. CONCLUSION Risks for probable anxiety and probable insomnia among undergraduate students can be identified at an individual level by baseline data. Thus, timely psychological intervention for anxiety and insomnia symptoms among undergraduate students is needed considering the above factors.
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Affiliation(s)
- Fenfen Ge
- Clinical Psychology Department, Qingdao Municipal Hospital, Qingdao266000, Shandong, People’s Republic of China
| | - Di Zhang
- Mental Health Education and Counseling Center, Ocean University of China, Qingdao266100, Shandong, People’s Republic of China
| | - Lianhai Wu
- Mental Health Education and Counseling Center, Ocean University of China, Qingdao266100, Shandong, People’s Republic of China
| | - Hongwei Mu
- Mental Health Education and Counseling Center, Ocean University of China, Qingdao266100, Shandong, People’s Republic of China
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Bushnell GA, Talati A, Wickramaratne PJ, Gameroff MJ, Weissman MM. Trajectories of childhood anxiety disorders in two generations at high risk. Depress Anxiety 2020; 37:521-531. [PMID: 32058635 PMCID: PMC7292740 DOI: 10.1002/da.23001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/30/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The course of anxiety disorders during childhood is heterogeneous. In two generations at high or low risk, we described the course of childhood anxiety disorders and evaluated whether parent or grandparent major depressive disorder (MDD) predicted a persistent anxiety course. METHODS We utilized a multigenerational study (1982-2015), following children (second generation, G2) and grandchildren (third generation, G3) of generation 1 (G1) with either moderate/severe MDD or no psychiatric illness. Psychiatric diagnoses were based on diagnostic interviews. Using group-based trajectory models, we identified clusters of children with similar anxiety disorder trajectories (age 0-17). RESULTS We identified three primary trajectories in G2 (N = 275) and G3 (N = 118) cohorts: "no/low anxiety disorder" during childhood (G2 = 66%; G3 = 53%), "nonpersistent" with anxiety during part of childhood (G2 = 16%; G3 = 21%), and "persistent" (G2 = 18%; G3 = 25%). Childhood mood disorders and substance use disorders tended to be more prevalent in children in the persistent anxiety trajectory. In G2 children, parent MDD was associated with an increased likelihood of being in the persistent (84%) or nonpersistent trajectory (82%) versus no/low anxiety trajectory (62%). In G3 children, grandparent MDD, but not parent, was associated with an increased likelihood of being in the persistent (83%) versus nonpersistent (48%) and no/low anxiety (51%) trajectories. CONCLUSION Anxiety trajectories move beyond what is captured under binary, single time-point measures. Parent or grandparent history of moderate/severe MDD may offer value in predicting child anxiety disorder course, which could help clinicians and caregivers identify children needing increased attention and screening for other psychiatric conditions.
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Affiliation(s)
- Greta A. Bushnell
- Department of Epidemiology at the Columbia University
Mailman School of Public Health
| | - Ardesheer Talati
- Department of Psychiatry at the Columbia University Vagelos
College of Physicians and Surgeons,Division of Translational Epidemiology at New York State
Psychiatric Institute
| | - Priya J. Wickramaratne
- Department of Psychiatry at the Columbia University Vagelos
College of Physicians and Surgeons,Division of Translational Epidemiology at New York State
Psychiatric Institute,Department of Biostatistics at the Columbia University
Mailman School of Public Health
| | - Marc J. Gameroff
- Department of Psychiatry at the Columbia University Vagelos
College of Physicians and Surgeons,Division of Translational Epidemiology at New York State
Psychiatric Institute
| | - Myrna M. Weissman
- Department of Epidemiology at the Columbia University
Mailman School of Public Health,Department of Psychiatry at the Columbia University Vagelos
College of Physicians and Surgeons,Division of Translational Epidemiology at New York State
Psychiatric Institute
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19
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Kates WR, Mariano MA, Antshel KM, Chandra S, Gamble H, Giordano M, MacMaster E, Mattar M, St Fleur D, Faraone SV, Fremont WP. Trajectories of psychiatric diagnoses and medication usage in youth with 22q11.2 deletion syndrome: a 9-year longitudinal study. Psychol Med 2019; 49:1914-1922. [PMID: 30226117 DOI: 10.1017/s0033291718002696] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Chromosome 22q11.2 deletion syndrome (22q11DS) is associated with high rates of psychiatric disorders, including schizophrenia in up to 30% of individuals with the syndrome. Despite this, we know relatively little about trajectories and predictors of persistence of psychiatric disorders from middle childhood to early adulthood. Accordingly, we followed youth over four timepoints, every 3 years, to assess long-term trajectories of attention-deficit hyperactivity disorder (ADHD), anxiety, mood, and psychosis-spectrum disorders (PSDs), as well as medication usage. METHODS Eighty-seven youth with 22q11DS and 65 controls between the ages of 9 and 15 years at the first timepoint (T1; mean age 11.88 ± 2.1) were followed for 9 years (mean age of 21.22 ± 2.01 years at T4). Baseline cognitive, clinical, and familial predictors of persistence were identified for each class of psychiatric disorders. RESULTS Baseline age and parent-rated hyperactivity scores predicted ADHD persistence [area under curve (AUC) = 0.81]. The presence of family conflict predicted persistence of anxiety disorders (ADs) whereas parent ratings of child internalizing symptoms predicted persistence of both anxiety and mood disorders (MDs) (AUC = 0.84 and 0.83, respectively). Baseline prodromal symptoms predicted persistent and emergent PSDs (AUC = 0.83). Parent-reported use of anti-depressants/anxiolytics increased significantly from T1 to T4. CONCLUSIONS Psychiatric, behavioral, and cognitive functioning during late childhood and early adolescence successfully predicted children with 22q11DS who were at highest risk for persistent psychiatric illness in young adulthood. These findings emphasize the critical importance of early assessments and interventions in youth with 22q11DS.
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Affiliation(s)
- Wendy R Kates
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Margaret A Mariano
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Kevin M Antshel
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Shanel Chandra
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Hilary Gamble
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Mark Giordano
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Eric MacMaster
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Mirabelle Mattar
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Diane St Fleur
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Stephen V Faraone
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
| | - Wanda P Fremont
- Departments of Psychiatry and Behavioral Sciences,State University of New York at Upstate Medical University,Syracuse, New York,USA
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Schoneveld EA, Lichtwarck-Aschoff A, Granic I. Preventing Childhood Anxiety Disorders: Is an Applied Game as Effective as a Cognitive Behavioral Therapy-Based Program? PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2019; 19:220-232. [PMID: 28956222 PMCID: PMC5801383 DOI: 10.1007/s11121-017-0843-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A large proportion of children experience subclinical levels of anxiety and cognitive-behavioral therapy (CBT) aimed at preventing anxiety disorders is moderately effective. However, most at-risk children do not seek help or drop out of programs prematurely because of stigma, lack of motivation, and accessibility barriers. Applied games have received increased attention as viable alternatives and have shown promising results, but direct comparisons between applied games and the gold-standard CBT are lacking. Our aim was to investigate whether the applied game MindLight is as effective as CBT (i.e., Coping Cat) within an indicated prevention context. We conducted a randomized controlled non-inferiority trial with a sample of 174 children (7- to 12-year olds) with elevated levels of anxiety, comparing MindLight to CBT. Anxiety was assessed with self- and parent-reports at pre- and post-program, and at 3- and 6-month follow-ups. Intention-to-treat and completers-only confidence interval approach and latent growth curve modeling showed an overall significant quadratic decrease in child- and parent-reported anxiety symptoms over time and, as predicted, the magnitude of improvement was the same for MindLight and CBT. The within-group effect sizes were small to medium at post-test (− 0.32 to − 0.63), and medium to large (− 0.60 to − 1.07) at 3- and 6-month follow-ups. Furthermore, MindLight and CBT were rated equally anxiety inducing, difficult, and appealing; CBT was rated as more relevant to daily life than MindLight. The current study adds to the growing research on applied games for mental health and shows that these games hold potential as alternative delivery models for evidence-based therapeutic techniques.
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Affiliation(s)
- Elke A Schoneveld
- Behavioural Science Institute, Radboud University, Montessorilaan 3, 6525, HR, Nijmegen, The Netherlands.
| | - Anna Lichtwarck-Aschoff
- Behavioural Science Institute, Radboud University, Montessorilaan 3, 6525, HR, Nijmegen, The Netherlands
| | - Isabela Granic
- Behavioural Science Institute, Radboud University, Montessorilaan 3, 6525, HR, Nijmegen, The Netherlands
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21
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Lifetime and 12-month prevalence estimates for mental disorders in northeastern Germany: findings from the Study of Health in Pomerania. Eur Arch Psychiatry Clin Neurosci 2019; 269:341-350. [PMID: 29948253 DOI: 10.1007/s00406-018-0911-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/31/2018] [Indexed: 01/04/2023]
Abstract
Few epidemiological studies presented 12-month and lifetime prevalence estimates for DSM-IV mental disorders in the adult general population by sex and age up to very old age. From 2007 to 2010, DSM-IV mental disorders were assessed with the DIA-X/M-CIDI among N = 2400 participants (aged 29-89 years) from the Study of Health in Pomerania, an epidemiological study based on a two-stage stratified cluster sample randomly drawn from the adult general population in northeastern Germany. 36.3% of the sample was affected by any 12-month and 54.8% by any lifetime mental disorder. The most frequent diagnostic groups were anxiety (12-month: 14.8%, lifetime: 23.4%), substance use (12-month: 14.5%, lifetime: 25.0%), somatoform (12-month: 12.9%, lifetime: 20.4%) and depressive (12-month: 7.3%, lifetime: 18.6%) disorders. Except for substance use (higher prevalence in men) and bipolar disorders (comparable prevalence in men and women), higher 12-month and lifetime prevalence estimates were found in women vs. men. Moreover, lower 12-month and lifetime prevalence estimates were found in older (aged 60-74 or 75-89 years) vs. younger (aged 29-44 or 45-59 years) age groups. 22.6% (men: 21.1%, women: 23.9%) of those affected by any 12-month disorder met criteria for two and 13.6% (men: 9.6%, women: 16.9%) for three or more 12-month diagnoses. Similarly, 26.4% (men: 25.7%, women: 26.9%) of those affected by any lifetime disorder met criteria for two and 22.7% (men: 19.6%, women: 25.2%) for three or more lifetime diagnoses. Our findings demonstrate the frequency of mental disorders in northeastern Germany and emphasize the need for continued prevention and intervention efforts.
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The effects of childhood maltreatment and anxiety proneness on neuropsychological test performance in non-clinical older adolescents. J Affect Disord 2019; 243:133-144. [PMID: 30243193 DOI: 10.1016/j.jad.2018.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 07/30/2018] [Accepted: 09/09/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The effect of childhood maltreatment (CM) on neuropsychological performance is well established, but the effect of anxiety proneness (AP) on such performance has been underexplored. We assessed the predictive ability of CM and AP, and their interaction, in non-clinical adolescents, for a range of previously documented neuropsychological deficits. METHODS Multiple linear regression models were used to assess the unique and combined influences of CM and AP on neuropsychological performance in 104 non-clinical adolescents, who underwent both neuropsychiatric and neuropsychological assessment. RESULTS The interaction of CM and AP was associated with poorer performance in executive functioning skills, processing speed, and estimated IQ. CM and AP were uniquely associated with verbal working memory performance, while verbal and visual memory performance and learning, and visuo-spatial ability, were not associated with either CM, AP or the interaction of CM and AP. LIMITATIONS The use of self-report measures to determine participants' levels of CM, AP, and depression. The CTQ-SF, a retrospective self-report measure, may have introduced recall bias. The neuropsychological evaluation was not conducted in the Xhosa language, the first language of most African participants. Most instruments utilized have not been validated in a South African adolescent sample. The impact of important moderator variables (e.g., age of onset of maltreatment) was not assessed. CONCLUSIONS Increased levels of CM and AP may be risk markers for poor performance in several key neuropsychological domains. Our findings underscore the importance of assessing the impact of both CM and anxiety-related temperamental traits on neuropsychological performance.
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Sapmaz ŞY, Erkuran HÖ, Karaarslan D, Öztürk M, Ülker GY, Demirgören BS, Köroğlu E, Aydemir Ö. Validity and Reliability of the Turkish Version of DSM-5 Level 2 Anxiety Scale (Child Form for 11-17 Years and Parent Form for 6-17 Years). Noro Psikiyatr Ars 2018; 55:152-156. [PMID: 30057457 DOI: 10.5152/npa.2017.15935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 10/28/2016] [Indexed: 11/22/2022] Open
Abstract
Introduction This study aimed to assess the validity and reliability of the Turkish Version of DSM-5 Level 2 Anxiety Scale's child and parent forms. Methods The scale was constructed by carrying out the translation and back translation of DSM-5 Level 2 Anxiety Scale. The study group consisted of a community and clinical sample. The scale was applied to 148 parents and 189 adolescents that represented the clinical and community sample. During the assessment process, Screen for Childhood Anxiety Related Emotional Disorders and Strengths and Difficulties Questionnaire - Parent Form were also used. Results Reliability analyses indicated a high internal consistency regarding Level 2 Anxiety Scales, both for child and parent forms (0.915/0.933). In the meantime, it was shown that child form for Level 2 Anxiety Scale was significantly correlated with Screen for Childhood Anxiety Related Emotional Disorders (r=0.758, p<0.0001) while the parent form was significantly correlated with Strengths and Difficulties Questionnaire - Parent Form (r=0.717, p<0.0001). As for the content validity, one factor was obtained for both forms, and it was observed to be consistent with the original construct of the scale. Conclusion It was concluded that Turkish version of DSM-5 Level 2 Anxiety Scale was a valid and reliable tool to be utilized both for clinical practice, and research purposes.
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Affiliation(s)
- Şermin Yalın Sapmaz
- Department of Child and Adolescent Psychiatry, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Handan Özek Erkuran
- Department of Child and Adolescent Psychiatry, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Dilay Karaarslan
- Department of Child and Adolescent Psychiatry, Uşak State Hospital, Uşak, Turkey
| | - Masum Öztürk
- Department of Child and Adolescent Psychiatry, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Gülsüm Yörük Ülker
- Department of Psychology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Burcu Serim Demirgören
- Department of Child and Adolescent Psychiatry, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | | | - Ömer Aydemir
- Department of Psychiatry, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
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Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA. Social Media Use and Depression and Anxiety Symptoms: A Cluster Analysis. Am J Health Behav 2018; 42:116-128. [PMID: 29458520 DOI: 10.5993/ajhb.42.2.11] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Individuals use social media with varying quantity, emotional, and behavioral at- tachment that may have differential associations with mental health outcomes. In this study, we sought to identify distinct patterns of social media use (SMU) and to assess associations between those patterns and depression and anxiety symptoms. METHODS In October 2014, a nationally-representative sample of 1730 US adults ages 19 to 32 completed an online survey. Cluster analysis was used to identify patterns of SMU. Depression and anxiety were measured using respective 4-item Patient-Reported Outcome Measurement Information System (PROMIS) scales. Multivariable logistic regression models were used to assess associations between clus- ter membership and depression and anxiety. RESULTS Cluster analysis yielded a 5-cluster solu- tion. Participants were characterized as "Wired," "Connected," "Diffuse Dabblers," "Concentrated Dabblers," and "Unplugged." Membership in 2 clusters - "Wired" and "Connected" - increased the odds of elevated depression and anxiety symptoms (AOR = 2.7, 95% CI = 1.5-4.7; AOR = 3.7, 95% CI = 2.1-6.5, respectively, and AOR = 2.0, 95% CI = 1.3-3.2; AOR = 2.0, 95% CI = 1.3-3.1, respectively). CONCLUSIONS SMU pattern characterization of a large population suggests 2 pat- terns are associated with risk for depression and anxiety. Developing educational interventions that address use patterns rather than single aspects of SMU (eg, quantity) would likely be useful.
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Affiliation(s)
- Ariel Shensa
- Center for Research on Media, Technology, and Health, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Mary Amanda Dew
- Departments of Psychiatry, Psychology, Epidemiology, and Biostatistics, University of Pittsburgh, Pittsburgh, PA
| | - César G. Escobar-Viera
- Center for Research on Media, Technology, and Health, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brian A. Primack
- Center for Research on Media, Technology, and Health, University Honors College, Division of Adolescent Medicine, Department of Pediatrics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh
School of Medicine, University of Pittsburgh, Pittsburgh, PA
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Pinho RCM, da Silva Barbosa AC, Caldas-Júnior ADF, Vasconcelos MMVB, Cimões R, Santos MTBRD. State, trait, and dental anxiety in caregivers of individuals with disabilities. SPECIAL CARE IN DENTISTRY 2017. [PMID: 28636131 DOI: 10.1111/scd.12230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of this study was to compare state anxiety, trait anxiety, and dental anxiety in caregivers of patients with special needs and caregivers of pediatric patients without special needs at dental clinics. MATERIALS AND METHODS A quantitative, cross-sectional study was conducted. Data were collected using a semistructured questionnaire. All respondents were older than 18 years of age. Individuals with cognitive impairment and those taking anxiolytics, antidepressants, or sleep-inducing medication were excluded from the study. The sample consisted of 55 caregivers of patients with special needs and 55 caregivers of pediatric dental patients. A questionnaire was administered to determine the sociodemographic profile of the patients based on the 2015 Brazilian Economic Classification Criteria. Anxiety regarding dental treatment was measured using the dental anxiety scale. The state-trait anxiety inventory was used to identify state and trait anxiety levels. RESULTS Caregivers of individuals with disabilities had a similar level of anxiety as caregivers of pediatric dental patients. Most caregivers of individuals with disabilities were mothers with an older age and a greater frequency of trait anxiety, especially when these mothers had health problems. State anxiety was associated with a lower education level. CONCLUSIONS Higher dental anxiety levels were found among caregivers with a higher level of trait anxiety, independently of the type of patient to which care was given.
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Affiliation(s)
| | | | | | | | - Renata Cimões
- Department of Prosthesis and Oral Surgery, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Postnatal development of neurotransmitter systems and their relevance to extinction of conditioned fear. Neurobiol Learn Mem 2017; 138:252-270. [DOI: 10.1016/j.nlm.2016.10.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/22/2016] [Accepted: 10/31/2016] [Indexed: 12/14/2022]
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Davies SJC, Pearson RM, Stapinski L, Bould H, Christmas DM, Button KS, Skapinakis P, Lewis G, Evans J. Symptoms of generalized anxiety disorder but not panic disorder at age 15 years increase the risk of depression at 18 years in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study. Psychol Med 2016; 46:73-85. [PMID: 26315278 PMCID: PMC4886844 DOI: 10.1017/s003329171500149x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 07/06/2015] [Accepted: 07/08/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) and panic disorder (PD) differ in their biology and co-morbidities. We hypothesized that GAD but not PD symptoms at the age of 15 years are associated with depression diagnosis at 18 years. METHOD Using longitudinal data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort we examined relationships of GAD and PD symptoms (measured by the Development and Well-Being Assessment) at 15 years with depression at 18 years (by the Clinical Interview Schedule - Revised) using logistic regression. We excluded adolescents already depressed at 15 years and adjusted for social class, maternal education, birth order, gender, alcohol intake and smoking. We repeated these analyses following multiple imputation for missing data. RESULTS In the sample with complete data (n = 2835), high and moderate GAD symptoms in adolescents not depressed at 15 years were associated with increased risk of depression at 18 years both in unadjusted analyses and adjusting for PD symptoms at 15 years and the above potential confounders. The adjusted odds ratio (OR) for depression at 18 years in adolescents with high relative to low GAD scores was 5.2 [95% confidence interval (CI) 3.0-9.1, overall p < 0.0001]. There were no associations between PD symptoms and depression at 18 years in any model (high relative to low PD scores, adjusted OR = 1.3, 95% CI 0.3-4.8, overall p = 0.737). Missing data imputation strengthened the relationship of GAD symptoms with depression (high relative to low GAD scores, OR = 6.2, 95% CI 3.9-9.9) but those for PD became weaker. CONCLUSIONS Symptoms of GAD but not PD at 15 years are associated with depression at 18 years. Clinicians should be aware that adolescents with GAD symptoms may develop depression.
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Affiliation(s)
- S. J. C. Davies
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Geriatric Psychiatry Division, CAMH, University of Toronto, Toronto, Canada
| | - R. M. Pearson
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - L. Stapinski
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - H. Bould
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - D. M. Christmas
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - K. S. Button
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - P. Skapinakis
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - G. Lewis
- Division of Psychiatry, University College London, London, UK
| | - J. Evans
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
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