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Aitken M, Perquier F, Haltigan JD, Wang L, Andrade BF, Battaglia M, Szatmari P, Georgiades K. Individual- and family-level associations between child psychopathology and parenting. Dev Psychopathol 2024; 36:944-952. [PMID: 37017128 DOI: 10.1017/s0954579423000202] [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] [Indexed: 04/06/2023]
Abstract
Parenting can protect against the development of, or increase risk for, child psychopathology; however, it is unclear if parenting is related to psychopathology symptoms in a specific domain, or to broad liability for psychopathology. Parenting differs between and within families, and both overall family-level parenting and the child-specific parenting a child receives may be important in estimating transdiagnostic associations with psychopathology. Data come from a cross-sectional epidemiological sample (N = 10,605 children ages 4-17, 6434 households). Parents rated child internalizing and externalizing symptoms and their parenting toward each child. General and specific (internalizing, externalizing) psychopathology factors, derived with bifactor modeling, were regressed on parenting using multilevel modeling. Less warmth and more aversive/inconsistent parenting in the family, and toward an individual child relative to family average, were associated with higher general psychopathology and specific externalizing problems. Unexpectedly, more warmth in the family, and toward an individual child relative to family average, was associated with higher specific internalizing problems in 4-11 (not 12-17) year-olds. Less warmth and more aversive/inconsistent parenting are broad correlates of child psychopathology. Aversive/inconsistent parenting, is also related to specific externalizing problems. Parents may behave more warmly when their younger children have specific internalizing problems, net of overall psychopathology.
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Affiliation(s)
- Madison Aitken
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Florence Perquier
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
| | - John D Haltigan
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
| | - Li Wang
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Brendan F Andrade
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Marco Battaglia
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
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Thomson A, Lawrence EG, Oliver BR, Wright B, Hosang GM. Self-directed digital interventions for the improvement of emotion regulation-effectiveness for mental health and functioning in adolescents: protocol for a systematic review. BMJ Open 2024; 14:e081556. [PMID: 38658015 PMCID: PMC11043735 DOI: 10.1136/bmjopen-2023-081556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/29/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Research suggests that problems with emotion regulation, that is, how a person manages and responds to an emotional experience, are related to a range of psychological disorders (eg, bipolar disorder, anxiety and depression). Interventions targeting emotion regulation have been shown to improve mental health in adults, but evidence on related interventions for adolescents is still emerging. Increasingly, self-directed digital interventions (eg, mobile apps) are being developed to target emotion regulation in this population, but questions remain about their effectiveness. This systematic review aimed to synthesise evidence on current self-directed digital interventions available to adolescents (aged 11-18 years) and their effectiveness in addressing emotion regulation, psychopathology and functioning (eg, academic achievement). METHODS AND ANALYSIS Several electronic databases will be searched (eg, MEDLINE, PsycINFO, ACM Digital Library) to identify all studies published any time after January 2010 examining self-directed digital interventions for adolescents, which include an emotion regulation component. This search will be updated periodically to identify any new relevant research from the selected databases. Data on the study characteristics (eg, author(s)) and methodology, participant characteristics (eg, age) and the digital interventions used to address emotion (dys-)regulation (eg, name, focus) will be extracted. A narrative synthesis of all studies will be presented. If feasible, the effectiveness data will be synthesised using appropriate statistical techniques. The methodological quality of the included studies will be assessed with the Effective Public Health Practice Project quality assessment tool. ETHICS AND DISSEMINATION Ethical approval is not required for this study. Findings will be disseminated widely via peer-reviewed publications and presentations at conferences related to this field. REGISTRATION DETAILS PROSPERO CRD42022385547.
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Affiliation(s)
- Abigail Thomson
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Erin G Lawrence
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Bonamy R Oliver
- UCL Institute of Education, University College London, London, UK
| | - Ben Wright
- East London NHS Foundation Trust, London, UK
- City University of London, London, UK
| | - Georgina M Hosang
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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3
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Harris JL, LeBeau B, Petersen IT. Reactive and control processes in the development of internalizing and externalizing problems across early childhood to adolescence. Dev Psychopathol 2024:1-23. [PMID: 38584292 DOI: 10.1017/s0954579424000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Reactive and control processes - e.g., negative emotionality and immediacy preference - may predict distinct psychopathology trajectories. However, externalizing and internalizing problems change in behavioral manifestation across development and across contexts, thus necessitating the use of different measures and informants across ages. This is the first study that created developmental scales for both internalizing and externalizing problems by putting scores from different informants and measures onto the same scale to examine temperament facets as risk factors. Multidimensional linking allowed us to examine trajectories of internalizing and externalizing problems from ages 2 to 15 years (N = 1,364) using near-annual ratings by mothers, fathers, teachers, other caregivers, and self report. We examined reactive and control processes in early childhood as predictors of the trajectories and as predictors of general versus specific psychopathology in adolescence. Negative emotionality at age 4 predicted general psychopathology and unique externalizing problems at age 15. Wait times on an immediacy preference task at age 4 were negatively associated with age 15 general psychopathology, and positively associated with unique internalizing problems. Findings demonstrate the value of developmental scaling for examining development of psychopathology across a lengthy developmental span and the importance of considering reactive and control processes in development of psychopathology.
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Affiliation(s)
- Jordan L Harris
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Brandon LeBeau
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Isaac T Petersen
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
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Harris JL, Swanson B, Petersen IT. A Developmentally Informed Systematic Review and Meta-Analysis of the Strength of General Psychopathology in Childhood and Adolescence. Clin Child Fam Psychol Rev 2024; 27:130-164. [PMID: 38112921 PMCID: PMC10938301 DOI: 10.1007/s10567-023-00464-1] [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] [Accepted: 11/06/2023] [Indexed: 12/21/2023]
Abstract
Considerable support exists for higher-order dimensional conceptualizations of psychopathology in adults. A growing body of work has focused on understanding the structure of general and specific psychopathology in children and adolescents. No prior meta-analysis has examined whether the strength of the general psychopathology factor (p factor)-measured by explained common variance (ECV)-changes from childhood to adolescence. The primary objective of this multilevel meta-analysis was to determine whether general psychopathology strength changes across development (i.e. across ages) in childhood and adolescence. Several databases were searched in November 2021; 65 studies, with 110 effect sizes (ECV), nested within shared data sources, were identified. Included empirical studies used a factor analytic modeling approach that estimated latent factors for child/adolescent internalizing, externalizing, and optionally thought-disordered psychopathology, and a general factor. Studies spanned ages 2-17 years. Across ages, general psychopathology explained over half (~ 56%) of the reliable variance in symptoms of psychopathology. Age-moderation analyses revealed that general factor strength remained stable across ages, suggesting that general psychopathology strength does not significantly change across childhood to adolescence. Even if the structure of psychopathology changes with development, the prominence of general psychopathology across development has important implications for future research and intervention.
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Affiliation(s)
- Jordan L Harris
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Avenue G60, Iowa City, IA, 52242, USA.
| | - Benjamin Swanson
- Department of Psychological Sciences, University of Arkansas, Fayetteville, AR, USA
| | - Isaac T Petersen
- Department of Psychological and Brain Sciences, University of Iowa, 340 Iowa Avenue G60, Iowa City, IA, 52242, USA
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5
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Ouss L. Current psychopathology models emphasize very early intersubjectivity-based interventions in children to prevent later mental disorders. Front Psychol 2024; 14:1225108. [PMID: 38327508 PMCID: PMC10847237 DOI: 10.3389/fpsyg.2023.1225108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/28/2023] [Indexed: 02/09/2024] Open
Abstract
Current psychopathology models have evolved toward dimensional models, in which symptoms and diseases are at the extremes of dimensions. Despite these new dimensional proposals, classifications and third-person approach have shown limitations. Their extraordinary evolution nevertheless underlines the contributions of developmental and psychodynamic frameworks. Developmental contributions have made it possible to evolve from disorders centered on a first-person perspective. Complementarily to the first-person/third-person perspectives, we advocate a second-person perspective, based on intersubjectivity. This perspective reverses the intuitive trend to focus our interventions on the most specific symptoms and syndromes, and advocates instead interventions on a "p" general factor that are both generalized and highly targeted. The implications are (1) to intervene as early as possible, (2) to base the definition of our therapeutic targets on an intersubjective perspective, (3) to identify and enhance children's and parents' strengths. These empirically informed directions are not in the current mainstream of psychopathology frameworks, and need to be developed.
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Affiliation(s)
- Lisa Ouss
- Child and Adolescent Psychiatry Department, Necker-Enfants Malades Hospital, APHP, Paris, France
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6
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Bolton B, Rooney RM, Hughes A, Hopkins A, Mancini VO. Systematic review and meta-analysis of the prevention of internalizing disorders in early childhood. Front Psychol 2023; 14:1061825. [PMID: 38155699 PMCID: PMC10752964 DOI: 10.3389/fpsyg.2023.1061825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/03/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Internalizing problems comprise a significant amount of the mental health difficulties experienced during childhood. Implementing prevention programs during early childhood may prevent internalizing problems. The present systematic review and meta-analysis aimed to evaluate the effect of both targeted and universal prevention programs in preventing internalizing problems for children aged 3- to 5-years and their parents. Methods PsycINFO, Embase, and MEDLINE were systematically searched, and 17 randomized control trials, consisting of 3,381 children, met eligibility criteria. There were seven universal prevention programs, and 10 targeted prevention programs. Four prevention programs were delivered to children, 10 prevention programs were delivered to parents/caregivers, and three prevention programs were delivered to both parents and children. Results Prevention programs led to significantly fewer internalizing problems at 6- and 7-month post-intervention (n = 7, p = 0.02, CI -0.69, 0.06) with a small-to-moderate effect size (g = -0.38), however, not at post-intervention or at 12-month follow up. Discussion Overall, findings suggest that there may be value in ongoing development and evaluation of prevention programs for internalizing problems, as they improve social and emotional wellbeing in students and reduce internalizing difficulties within the 6- to 7-month timeframe following prevention programs. Systematic review registration PROSPERO: CRD42021261323.
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Affiliation(s)
- Brigid Bolton
- Psychology Department, Curtin School of Population Health, Faculty of Health Sciences, Bentley, WA, Australia
| | - Rosanna Mary Rooney
- Psychology Department, Curtin School of Population Health, Faculty of Health Sciences, Bentley, WA, Australia
| | - Anya Hughes
- Psychology Department, Curtin School of Population Health, Faculty of Health Sciences, Bentley, WA, Australia
| | - Amber Hopkins
- Discipline of Psychology, School of Population Health, Curtin University, Bentley, WA, Australia
| | - Vincent Oreste Mancini
- Psychology Department, Curtin School of Population Health, Faculty of Health Sciences, Bentley, WA, Australia
- Human Development and Community Wellbeing, Telethon Kids Institute, Nedlands, WA, Australia
- Division of Paediatrics, UWA Medical School, University of Western Australia, Perth, WA, Australia
- The Fathering Project, Sydney, NSW, Australia
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Guyon-Harris KL, Plamondon A, Humphreys KL, Wade M, Gleason MM, Tibu F, Nelson CA, Fox NA, Zeanah CH. Structure of Psychopathology in Romanian Preschool-Aged Children in an Epidemiological and a High-Risk Sample. JAACAP OPEN 2023; 1:173-183. [PMID: 38500494 PMCID: PMC10947222 DOI: 10.1016/j.jaacop.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Objective Research on bifactor models of psychopathology in early childhood is limited to community samples with little longitudinal follow-up. We examined general and specific forms of psychopathology within 2 independent samples of preschool-aged Romanian children. Within a sample with children exposed to psychosocial deprivation, we also examined antecedents and longitudinal outcomes of the general factor. Method One sample consisted of 350 Romanian children (mean age = 39.7 months, SD = 10.9) from an epidemiological study; the second sample consisted of 170 Romanian children (mean age = 55.6 months, SD = 1.9) exposed to severe early-life deprivation, as well as community comparison children, with longitudinal follow-up at 8 and 12 years. Psychopathology symptoms were assessed through caregiver-reported structured clinical interviews. Results An SI-1 bifactor model of psychopathology was supported in both samples and included specific factors for externalizing, internalizing, and disturbed relatedness symptoms. In the second sample, longer duration of psychosocial deprivation and lower-quality caregiving were associated with higher scores on the general and all specific factors. Higher scores on the general factor were associated with later cognitive function, competence, and psychopathology symptoms. Considering all factors together, only the general factor explained variance in later childhood outcomes and was slightly stronger compared to a total symptom count for some, but not all, outcomes. Conclusion General psychopathology in early childhood explains meaningful variance in child outcomes across multiple domains of functioning in later childhood. However, important questions remain regarding its clinical utility and usefulness, given complex measurement and limited explanatory power beyond the more accessible approach of a total symptom count. Clinical trial registration information The Bucharest Early Intervention Project; https://clinicaltrials.gov/; NCT00747396.
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Affiliation(s)
- Katherine L Guyon-Harris
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - André Plamondon
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - Kathryn L Humphreys
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - Mark Wade
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - Mary Margaret Gleason
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - Florin Tibu
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - Charles A Nelson
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - Nathan A Fox
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
| | - Charles H Zeanah
- Dr. Guyon-Harris is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Drs. Plamondon and Wade are with the University of Toronto, Toronto, Ontario, Canada. Dr. Plamondon is also with Université Laval, Quebec, Canada. Drs. Humphreys, Gleason, and Zeanah are with Tulane University School of Medicine, New Orleans, Louisiana. Dr. Humphreys is also with Vanderbilt University, Nashville, Tennessee. Dr. Gleason is also with Eastern Virginia Medical School, Norfolk, Virginia. Dr. Tibu is with Stefan cel Mare University of Suceava, Suceava, Romania. Dr. Nelson is with Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, and Harvard Graduate School of Education, Boston, Massachusetts. Dr. Fox is with the University of Maryland, College Park, College Park, Maryland
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Choate AM, Bornovalova MA, Hipwell AE, Chung T, Stepp SD. The general psychopathology factor ( p) from adolescence to adulthood: Exploring the developmental trajectories of p using a multi-method approach. Dev Psychopathol 2023; 35:1775-1793. [PMID: 35815746 PMCID: PMC9832177 DOI: 10.1017/s0954579422000463] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Considerable attention has been directed towards studying co-occurring psychopathology through the lens of a general factor (p-factor). However, the developmental trajectory and stability of the p-factor have yet to be fully understood. The present study examined the explanatory power of dynamic mutualism theory - an alternative framework that suggests the p-factor is a product of lower-level symptom interactions that strengthen throughout development. Data were drawn from a population-based sample of girls (N = 2450) who reported on the severity of internalizing and externalizing problems each year from age 14 to age 21. Predictions of dynamic mutualism were tested using three distinct complementary statistical approaches including: longitudinal bifactor models, random-intercept cross-lagged panel models (RI-CLPMs), and network models. Across methods, study results document preliminary support for mutualistic processes in the development of co-occurring psychopathology (that is captured in p). Findings emphasize the importance of exploring alternative frameworks and methods for better understanding the p-factor and its development.
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Affiliation(s)
| | | | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tammy Chung
- Department of Psychiatry, Institute for Health, Healthcare Policy and Aging Research; Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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9
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Phillips EM, Brock RL, James TD, Nelson JM, Mason WA, Espy KA, Nelson TD. Does preschool executive control mediate the impact of early environmental unpredictability and deprivation on the general factor of psychopathology a decade later? J Child Psychol Psychiatry 2023; 64:1505-1516. [PMID: 36872576 PMCID: PMC10911046 DOI: 10.1111/jcpp.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Although deprivation has been consistently shown to increase risk for psychopathology through impaired executive control, the unique effects of other dimensions of early adversity, such as unpredictability, on executive control development are poorly understood. The current study evaluated whether deprivation and/or unpredictability early in life have unique effects on the general factor of psychopathology through impaired preschool executive control. METHODS Participants included 312 children (51% female) oversampled for greater sociodemographic risk. Preschool executive control was measured using a battery of nine developmentally appropriate executive control tasks. Dimensions of adversity were measured with observational and caregiver assessments, and psychopathology was measured with caregiver and child reports. RESULTS In separate models, both deprivation and unpredictability had significant indirect effects on the adolescent general factor of psychopathology through impaired preschool executive control. However, when both dimensions of adversity were included simultaneously, early life deprivation, but not unpredictability, was uniquely associated with the general factor of psychopathology in adolescence through impaired preschool executive control. CONCLUSIONS Preschool executive control appears to be a transdiagnostic mechanism through which deprivation, but not unpredictability, increases risk for the general factor of psychopathology in adolescence. Results elucidate potential transdiagnostic targets for intervention efforts aimed at reducing the development and maintenance of psychopathology across the life span.
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Affiliation(s)
- Eric M Phillips
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Rebecca L Brock
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Tiffany D James
- Office of Research and Economic Development, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jennifer Mize Nelson
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
- Office of Research and Economic Development, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - W Alex Mason
- Department of Child, Youth, & Family Studies, Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Kimberly Andrews Espy
- Department of Neuroscience, Developmental and Regenerative Biology, University of Texas at San Antonio, San Antonio, TX, USA
- Department of Psychiatry and Behavioral Science, University of Texas Health San Antonio, Long School of Medicine, San Antonio, TX, USA
| | - Timothy D Nelson
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
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Chiang SC, Bai S. Bidirectional associations between parenting stress and child psychopathology: The moderating role of maternal affection. Dev Psychopathol 2023:1-11. [PMID: 37771133 PMCID: PMC10978553 DOI: 10.1017/s0954579423001177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Parenting stress and child psychopathology are closely linked in parent-child dyads, but how the bidirectional association varies across childhood and adolescence, and shifts depending on maternal affection are not well understood. Guided by the transactional model of development, this longitudinal, prospective study examined the bidirectional relations between parenting stress and child internalizing and externalizing problems and investigated the moderating role of maternal affection from childhood to adolescence. Participants were from the Future of Families and Child Wellbeing Study, a diverse, nationally representative sample of 2,143 caregiving mothers who completed assessments at children ages 5, 9, and 15. Using cross-lagged panel modeling, we found bidirectional effects between parenting stress and child internalizing and externalizing problems. However, additional multigroup analyses showed that bidirectional associations depend on the levels of maternal affection. In the high maternal affection group, parenting stress at age 5 predicted higher internalizing and externalizing problems at age 9, and reverse child-to-parent paths were found from age 9 to age 15. In contrast, only one cross-lagged path was found in the low maternal affection group. Findings suggest that maternal affection can heighten the transactional associations between parenting stress and child psychopathology.
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Affiliation(s)
- Shou-Chun Chiang
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Sunhye Bai
- The Ballmer Institute for Children’s Behavioral Health, University of Oregon, Eugene, OR, USA
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11
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Michelini G, Gair K, Tian Y, Miao J, Dougherty LR, Goldstein BL, MacNeill LA, Barch DM, Luby JL, Wakschlag LS, Klein DN, Kotov R. Do general and specific factors of preschool psychopathology predict preadolescent outcomes? A transdiagnostic hierarchical approach. Psychol Med 2023; 53:5405-5414. [PMID: 37795688 PMCID: PMC10482704 DOI: 10.1017/s003329172200246x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 06/16/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Preschool psychiatric symptoms significantly increase the risk for long-term negative outcomes. Transdiagnostic hierarchical approaches that capture general ('p') and specific psychopathology dimensions are promising for understanding risk and predicting outcomes, but their predictive utility in young children is not well established. We delineated a hierarchical structure of preschool psychopathology dimensions and tested their ability to predict psychiatric disorders and functional impairment in preadolescence. METHODS Data for 1253 preschool children (mean age = 4.17, s.d. = 0.81) were drawn from three longitudinal studies using a similar methodology (one community sample, two psychopathology-enriched samples) and followed up into preadolescence, yielding a large and diverse sample. Exploratory factor models derived a hierarchical structure of general and specific factors using symptoms from the Preschool Age Psychiatric Assessment interview. Longitudinal analyses examined the prospective associations of preschool p and specific factors with preadolescent psychiatric disorders and functional impairment. RESULTS A hierarchical dimensional structure with a p factor at the top and up to six specific factors (distress, fear, separation anxiety, social anxiety, inattention-hyperactivity, oppositionality) emerged at preschool age. The p factor predicted all preadolescent disorders (ΔR2 = 0.04-0.15) and functional impairment (ΔR2 = 0.01-0.07) to a significantly greater extent than preschool psychiatric diagnoses and functioning. Specific dimensions provided additional predictive power for the majority of preadolescent outcomes (disorders: ΔR2 = 0.06-0.15; functional impairment: ΔR2 = 0.05-0.12). CONCLUSIONS Both general and specific dimensions of preschool psychopathology are useful for predicting clinical and functional outcomes almost a decade later. These findings highlight the value of transdiagnostic dimensions for predicting prognosis and as potential targets for early intervention and prevention.
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Affiliation(s)
- Giorgia Michelini
- Department of Biological & Experimental Psychology, School of Biological & Behavioural Sciences, Queen Mary University of London, London, UK
- Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Kelly Gair
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Yuan Tian
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jiaju Miao
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Lea R. Dougherty
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Brandon L. Goldstein
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Leigha A. MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Deanna M. Barch
- Departments of Psychological & Brain Sciences, Washington University, St. Louis, MO, USA
- Departments of Psychiatry, Washington University, St. Louis, MO, USA
- Departments of Radiology, Washington University, St. Louis, MO, USA
| | - Joan L. Luby
- Departments of Psychiatry, Washington University, St. Louis, MO, USA
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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12
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Lynch SJ, Chapman C, Sunderland M, Slade T, Teesson M, Conrod PJ, Newton NC. The 3-year effects of a personality-targeted prevention program on general and specific dimensions of psychopathology. Prev Med 2023; 173:107595. [PMID: 37385412 DOI: 10.1016/j.ypmed.2023.107595] [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: 03/12/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 07/01/2023]
Abstract
This study aimed to examine the effect of a personality-targeted prevention program (Preventure) on trajectories of general and specific dimensions of psychopathology from early- to mid-adolescence. Australian adolescents (N = 2190) from 26 schools participated in a cluster randomized controlled substance use prevention trial. This study compared schools allocated to deliver Preventure (n = 13 schools; n = 466 students; Mage = 13.42 years), a personality-targeted selective intervention, with a control group (n = 7 schools; n = 235 students, Mage = 13.47 years). All participants were assessed for psychopathology symptoms at baseline, 6-, 12-, 24- and 36-months post-baseline. Outcomes were a general psychopathology factor and four specific factors: fear, distress, alcohol use/harms and conduct/inattention), extracted from a higher-order model. Participants who screened as 'high-risk' on at least one of four personality traits (negative thinking, anxiety sensitivity, impulsivity and sensation seeking) were included in intention-to-treat analyses. Intervention effects were examined using multi-level mixed models accounting for school-level clustering. Among high-risk adolescents, growth in general psychopathology was slower in the Preventure group compared to the control group (b = -0.07, p = 0.038) across the three years. After controlling for effects on general psychopathology, there were no significant, additional effects on the lower order factors. This study provides evidence for the effectiveness of a selective personality-targeted intervention in altering trajectories of general psychopathology during adolescence. This finding represents impacts on multiple symptom domains and highlights the potential for general psychopathology as an intervention target.
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Affiliation(s)
- Samantha J Lynch
- The Matilda Centre for Research in Mental Health & Substance Use, The University of Sydney, Australia.
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health & Substance Use, The University of Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health & Substance Use, The University of Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health & Substance Use, The University of Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health & Substance Use, The University of Sydney, Australia
| | - Patricia J Conrod
- University of Montreal, Canada; Sainte Justine Hospital Research Centre, Canada
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health & Substance Use, The University of Sydney, Australia
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13
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D’Angeli G, Mesce M, Cerniglia L, Cimino S. Observational Tools Using Video Recordings of Parent-Child Feeding Interactions: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121924. [PMID: 36553367 PMCID: PMC9776560 DOI: 10.3390/children9121924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Current research has confirmed that the quality of the caregiver-child relationship influences the child's emotional and behavioral development. Play and feeding contexts, for example, are the best contexts to observe mother-child or father-child interaction. The observation of feeding interaction establishes involvement on the part of both parties and identifies relationship characteristics. The purpose of this study is to select and describe the most frequently used observational methods during feeding interactions in the first three years of a child's life. Instruments that employ video recordings of mealtimes will be detailed to highlight the relevance that specific tools have nowadays. Finally, the SVIA (Scala di Valutazione delle Interazioni Alimentari), a technique for analyzing food interactions by observation that has also been utilized remotely, will be offered. This is intended to provide practitioners and researchers with an overview of tools while also taking into consideration the present scenario in which digital tools are increasingly being employed in health and clinical settings. Furthermore, the purpose of this paper is to review the various observational methods of the parent-child relationship to assist future practitioners and researchers in the field in making an accurate assessment of caregiver-child interaction and selecting a valid tool for the early recognition of problematic relationships and identifying the most appropriate treatment modalities.
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Affiliation(s)
- Gessica D’Angeli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00186 Rome, Italy
| | - Martina Mesce
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00186 Rome, Italy
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, 00186 Rome, Italy
- Correspondence: ; Tel.: +39-06697621
| | - Silvia Cimino
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00186 Rome, Italy
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14
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Paetzold I, Schick A, Rauschenberg C, Hirjak D, Banaschewski T, Meyer-Lindenberg A, Butz S, Floesser C, Schueltke L, Boehnke JR, Boecking B, Reininghaus U. A Hybrid Ecological Momentary Compassion–Focused Intervention for Enhancing Resilience in Help-Seeking Young People: Prospective Study of Baseline Characteristics in the EMIcompass Trial. JMIR Form Res 2022; 6:e39511. [PMID: 36331526 PMCID: PMC9675017 DOI: 10.2196/39511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/19/2022] [Accepted: 08/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background Young people are a target population for mental health–related early intervention and prevention. Although evidence for early intervention is promising, availability of and access to youth mental health services remain limited. Therefore, the development of an evidence-based hybrid intervention is urgently needed. Objective This study aimed to present a manual for a hybrid intervention, combining an ecological momentary intervention and face-to-face sessions aimed for enhancing resilience in help-seeking young people based on compassion-focused interventions, and explore whether participants’ baseline characteristics are associated with putative mechanisms and outcomes of the EMIcompass intervention. Specifically, we aimed to explore initial signals as to whether participants’ sociodemographic, clinical, and functional characteristics at baseline are associated with putative mechanisms (ie, change in self-compassion, change in emotion regulation, working alliance, training frequency); and whether participants’ sociodemographic, clinical, and functional characteristics, self-compassion, and emotion regulation at baseline are associated with clinical outcomes (ie, psychological distress and general psychopathology at postintervention and 4-week follow-ups) in the experimental condition and obtain first parameter estimates. Methods We recruited young people aged 14 to 25 years, with psychological distress, Clinical High At-Risk Mental State, or first episodes of severe mental disorder for an exploratory randomized controlled trial with assessments at baseline and postintervention and 4-week follow-ups. A structured manual was developed and optimized based on a pilot study’s manual, a scoping review of existing literature and manuals, exchange with experts, the team’s clinical experience of working with compassion-focused interventions, and the principles of ecological momentary interventions. This analysis focuses on the experimental condition receiving the EMIcompass intervention. Results A total of 46 young individuals were randomized to the experimental condition. There was evidence for initial signals of effects of age (B=0.11, 95% CI 0.00-0.22), general psychopathology (B=0.08, 95% CI −0.01 to 0.16), and clinical stage (B=1.50, 95% CI 0.06-2.93) on change in momentary self-compassion and change in emotion regulation from baseline to postintervention assessments. There was no evidence for associations of other baseline characteristics (eg, gender, minority status, and level of functioning) and putative mechanisms (eg, overall self-compassion, working alliance, and training frequency). In addition, except for an initial signal for an association of momentary self-compassion at baseline and psychological distress (B=−2.83, 95% CI −5.66 to 0.00), we found no evidence that baseline characteristics related to clinical outcomes. Conclusions The findings indicated the reach of participants by the intervention largely independent of sociodemographic, clinical, and functional baseline characteristics. The findings need to be confirmed in a definitive trial. Trial Registration German Clinical Trials Register NDRKS00017265; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017265 International Registered Report Identifier (IRRID) RR2-10.2196/27462
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Affiliation(s)
- Isabell Paetzold
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Rauschenberg
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Butz
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Chiara Floesser
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Leonie Schueltke
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Benjamin Boecking
- Tinnitus Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Social Epidemiology Research Group, King's College London, London, United Kingdom
- Health Service and Population Research Department, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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15
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Ivanova MY, Achenbach TM, Turner LV. Associations of Parental Depression with Children’s Internalizing and Externalizing Problems: Meta-Analyses of Cross-Sectional and Longitudinal Effects. JOURNAL OF CLINICAL CHILD & ADOLESCENT PSYCHOLOGY 2022; 51:827-849. [DOI: 10.1080/15374416.2022.2127104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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16
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Phillips EM, Brock RL, James TD, Nelson JM, Espy KA, Nelson TD. Empirical support for a dual process model of the p-factor: Interaction effects between preschool executive control and preschool negative emotionality on general psychopathology. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:817-829. [PMID: 36326624 PMCID: PMC9718359 DOI: 10.1037/abn0000777] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Recent work indicates that a general factor, often referred to as the p-factor, underlies nearly all forms of psychopathology. Although the criterion validity and utility of this general factor have been well supported, questions remain about the substantive meaning of the p-factor. The purpose of the present longitudinal study was to empirically test the hypothesis that the p-factor reflects dysregulation arising from a combination of high dispositional negative emotionality and low executive control. The current study examined preschool executive control, measured using a battery of 9 developmentally appropriate executive control tasks, as a moderator of the association between preschool negative emotionality and both concurrent and subsequent levels of general psychopathology in preschool and elementary school using a community sample (N = 497). Latent moderated structural equation models demonstrated that preschool executive control significantly moderated the associations between preschool negative emotionality and general psychopathology both in preschool and approximately 5 years later in elementary school. These results suggest that the general factor of psychopathology may reflect dysregulation arising from a tendency to experience high negative affect, without sufficient executive control to effectively down-regulate that affect. This work has important implications for identifying transdiagnostic targets for prevention and intervention efforts, as well as furthering understanding of the substantive meaning and construct validity of the general factor of psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Tiffany D James
- Office of Research and Economic Development, University of Nebraska-Lincoln
| | | | - Kimberly Andrews Espy
- Department of Neuroscience, Developmental, and Regenerative Biology, University of Texas at San Antonio
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17
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Kotov R, Cicero DC, Conway CC, DeYoung CG, Dombrovski A, Eaton NR, First MB, Forbes MK, Hyman SE, Jonas KG, Krueger RF, Latzman RD, Li JJ, Nelson BD, Regier DA, Rodriguez-Seijas C, Ruggero CJ, Simms LJ, Skodol AE, Waldman ID, Waszczuk MA, Watson D, Widiger TA, Wilson S, Wright AGC. The Hierarchical Taxonomy of Psychopathology (HiTOP) in psychiatric practice and research. Psychol Med 2022; 52:1666-1678. [PMID: 35650658 DOI: 10.1017/s0033291722001301] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.
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Affiliation(s)
- Roman Kotov
- Stony Brook University, Stony Brook, New York, USA
| | | | | | | | | | | | - Michael B First
- Columbia University College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | | | - Steven E Hyman
- Stanley Center for Psychiatric Research at the Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | | | | | | | - James J Li
- University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Darrel A Regier
- Uniformed Services University, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | | | | | | | - Andrew E Skodol
- University of Arizona College of Medicine, Tucson, Arizona, USA
| | | | - Monika A Waszczuk
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | | | | | - Sylia Wilson
- University of Minnesota, Minneapolis, Minnesota, USA
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18
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Lovato I, Vanes LD, Sacchi C, Simonelli A, Hadaya L, Kanel D, Falconer S, Counsell S, Redshaw M, Kennea N, Edwards AD, Nosarti C. Early Childhood Temperamental Trajectories following Very Preterm Birth and Their Association with Parenting Style. CHILDREN (BASEL, SWITZERLAND) 2022; 9:508. [PMID: 35455552 PMCID: PMC9025945 DOI: 10.3390/children9040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/21/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
Childhood temperament is an early characteristic shaping later life adjustment. However, little is currently known about the stability of early temperament and its susceptibility to the environment in children born very preterm (VPT; <33 weeks’ gestation). Here, we investigated infant-to-childhood temperamental trajectories, and their interaction with parental practices, in VPT children. Maternal reports of infant temperament were collected in 190 infants (mean age: 11.27 months; range 9−18 months) enrolled in the longitudinal Evaluation of Preterm Imaging (ePrime; Eudra: CT 2009-011602-42) study, using the ePrime questionnaire on infant temperament. At 4−7 years of age, further assessments of child temperament (Children’s Behavior Questionnaire—Very Short Form) and parenting style (Arnold’s Parenting Scale) were conducted. Results showed that more difficult temperament in infancy was associated with increased Negative Affectivity in childhood, regardless of parenting practices. This lends support to the stability of early temperamental traits reflecting negative emotionality. In contrast, a lax parenting style moderated the relationship between easy infant temperament and Negative Affectivity at 4−7 years, such that an easier infant temperament was increasingly associated with higher childhood Negative Affectivity scores as parental laxness increased. These results highlight a potential vulnerability of VPT infants considered by their mothers to be easy to handle, as they may be more susceptible to the effects of suboptimal parenting in childhood.
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Affiliation(s)
- Irene Lovato
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Developmental Psychology and Socialization, University of Padova, 35151 Padova, Italy; (C.S.); (A.S.)
| | - Lucy D. Vanes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Chiara Sacchi
- Department of Developmental Psychology and Socialization, University of Padova, 35151 Padova, Italy; (C.S.); (A.S.)
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padova, 35151 Padova, Italy; (C.S.); (A.S.)
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Dana Kanel
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
| | - Serena Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
| | - Maggie Redshaw
- National Perinatal Epidemiology Unit, University of Oxford, Oxford OX3 7LF, UK;
| | - Nigel Kennea
- Neonatal Unit, St George’s Hospital, London SW17 0QT, UK;
| | - Anthony David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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19
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Conway CC, Forbes MK, South SC. A Hierarchical Taxonomy of Psychopathology (HiTOP) Primer for Mental Health Researchers. Clin Psychol Sci 2022; 10:236-258. [PMID: 35599839 PMCID: PMC9122089 DOI: 10.1177/21677026211017834] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Mental health research is at an important crossroads as the field seeks more reliable and valid phenotypes to study. Dimensional approaches to quantifying mental illness operate outside the confines of traditional categorical diagnoses, and they are gaining traction as a way to advance research on the causes and consequences of mental illness. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a leading dimensional research paradigm that synthesizes decades of data on the major dimensions of psychological disorders. In this article, we demonstrate how to use the HiTOP model to formulate and test research questions through a series of tutorials. To boost accessibility, data and annotated code for each tutorial are included at OSF (https://osf.io/8myzw). After presenting the tutorials, we outline how investigators can use these ideas and tools to generate new insights in their own substantive research programs.
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Affiliation(s)
| | - Miriam K. Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University
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20
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Davidsen KA, Munk-Laursen T, Foli-Andersen P, Ranning A, Harder S, Nordentoft M, Thorup AAE. Mental and pediatric disorders among children 0-6 years of parents with severe mental illness. Acta Psychiatr Scand 2022; 145:244-254. [PMID: 34351617 DOI: 10.1111/acps.13358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Parental severe mental illness (SMI) increases the lifetime risk of mental and pediatric disorders in the offspring but little is known about specific disorders during early childhood. The primary aim was to investigate the incidence of mental and pediatric disorders among children 0-6 years old exposed to parental SMI, and secondarily to investigate the distribution of disorders on specific child age. METHODS A nationwide, register-based cohort study of 1,477,185 children born in Denmark between 1994.01.01 and 2016.12.31. Incidence rate ratios were calculated using Poisson regression analysis for any and specific mental and pediatric disorders. RESULTS IRR for any psychiatric disorder was elevated by a factor 2-5 among SMI offspring. Maternal schizophrenia resulted in the highest IRR = 5.23 (4.80-5.69) of any child psychiatric disorder. The risk of anxiety/OCD and attachment disorder among offspring exposed to parental, and in particular maternal, SMI was markedly raised with IRRs for anxiety/OCD between 7.59 and 17.02 and attachment disorders between 6.26 and 15.40. IRRs of mental disorders were highest at age 0-1 year and declined with age. IRR for any pediatric disorder was also elevated with IRRs between 1.01 and 1.28. Disorders of the digestive system and ill-defined symptoms were associated with the highest IRRs. Maternal (vs. paternal) SMI was associated with higher IRRs. IRRs declined slightly with child age. CONCLUSION Children exposed to parental SMI are at increased risk of mental and pediatric disorders during early childhood, particularly anxiety/OCD and attachment disorders. If associations are estimates of a modifiable causal relationship, our results indicate a need for early intervention to promote mental and pediatric health among SMI offspring.
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Affiliation(s)
- Kirstine Agnete Davidsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Child and Adolescent Mental Health Services, Region of Southern Denmark, Odense, Denmark
| | - Thomas Munk-Laursen
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
| | | | - Anne Ranning
- Mental Health Services Copenhagen, Capital Region of Denmark, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Harder
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Mental Health Services Copenhagen, Capital Region of Denmark, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen, Denmark
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21
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Moltrecht B, Patalay P, Bear HA, Deighton J, Edbrooke-Childs J. A Transdiagnostic, Emotion Regulation App (Eda) for Children: Design, Development, and Lessons Learned. JMIR Form Res 2022; 6:e28300. [PMID: 35044312 PMCID: PMC8811693 DOI: 10.2196/28300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 10/04/2021] [Accepted: 11/16/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Digital interventions, including mobile apps, represent a promising means of providing effective mental health support to children and young people. Despite the increased availability of mental health apps, there is a significant gap for this age group, especially for children (aged 10-12 years). Research investigating the effectiveness and development process of child mental health apps is limited, and the field faces persistent issues in relation to low user uptake and engagement, which is assumed to be a result of limited user involvement in the design process. OBJECTIVE This study aims to present the development and design process of a new mental health app for children that targets their emotion regulation abilities. We describe the creation of a new interdisciplinary development framework to guide the design process and explain how each activity informed different app features. METHODS The first 2 stages of the framework used a variety of methods, including weekly classroom observations over a 6-month period (20 in total); public engagement events with the target group (N=21); synthesis of the existing evidence as part of a meta-analysis; a series of co-design and participatory workshops with young users (N=33), clinicians (N=7), researchers (N=12), app developers (N=1), and designers (N=2); and finally, testing of the first high-tech prototype (N=15). RESULTS For the interdisciplinary framework, we drew on methods derived from the Medical Research Council framework for complex interventions, the patient-clinician framework, and the Druin cooperative inquiry. The classroom observations, public engagement events, and synthesis of the existing evidence informed the first key pillars of the app and wireframes. Subsequently, a series of workshops shaped and reshaped the content and app features, including games, psychoeducational films, and practice modules. On the basis of the prototype testing sessions, we made further adjustments to improve the app. CONCLUSIONS Although mobile apps could be highly suitable to support children's mental health on a wider scale, there is little guidance on how these interventions could be designed and developed. The involvement of young users across different design activities is very valuable. We hope that our interdisciplinary framework and description of the used methods will be helpful to others who are hoping to develop mental health apps for children and young people.
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Affiliation(s)
- Bettina Moltrecht
- Evidence-based practice unit, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.,Centre for Longitudinal Studies, Institute of Education, University College London, London, United Kingdom
| | - Praveetha Patalay
- Centre for Longitudinal Studies, Institute of Education, University College London, London, United Kingdom
| | - Holly Alice Bear
- Evidence-based practice unit, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Jessica Deighton
- Evidence-based practice unit, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Julian Edbrooke-Childs
- Evidence-based practice unit, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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22
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Krantz MF, Ellersgaard D, Andersen KK, Hemager N, Christiani C, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve A, Gantriis DL, Ohland J, Mortensen PB, Werge T, Nudel R, Wang Y, Hougaard DM, Plessen KJ, Bliksted V, Jepsen JRM, Thorup AAE, Mors O, Nordentoft M. Accumulation of Disadvantages Across Multiple Domains Amongst Subgroups of Children of Parents With Schizophrenia or Bipolar Disorder: Clustering Data from the Danish High Risk and Resilience Study VIA 7. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac010. [PMID: 39144761 PMCID: PMC11206045 DOI: 10.1093/schizbullopen/sgac010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Objective Children with familial high-risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) are frequently affected in a range of domains known to be precursors of severe mental illness. No previous studies have gathered known precursors to examine whether they distribute evenly across familial high risk (FHR) children or if they cluster among a smaller group. Since such examination holds the potential to identify high and low risk of severe mental illness groups, we aimed to cluster FHR and control children affected to various degrees. Method In The Danish High Risk and Resilience Study VIA 7, a clinical cohort study, 514 7-year-old children with FHR-SZ or FHR-BP and matched controls were assessed in domains of motor function, neurocognition, emotional control, behavior, social cognition, self-perception, language, psychotic experiences, and psychopathology, and grouped using cluster analysis. Associations between clusters and parents' level of education, functioning, caregiver status, child's level of stimulation and support in the home, and polygenic risk scores were examined. Results A total of four groups including one of broadly affected children were identified. The broadly affected group was represented 4-5-fold (18.1%) amongst FHR-SZ children and 2-3-fold (10.2%) amongst FHR-BP children, compared to controls (4.1%) (P < .001), and the broadly affected group had lower levels of caregiver functioning (P < .001) and stimulation and support at home (P < .001). Conclusion Precursors of severe mental illness distribute unevenly among FHR children; while approximately half are not affected in any domains, the other half are affected to various degrees. Targeted support towards the affected groups is indicated.
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Affiliation(s)
- Mette Falkenberg Krantz
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Ditte Ellersgaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Klaus Kaae Andersen
- Danish Cancer Society Research Center, Department of Statistics and Pharmacoepidemiology, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Nicoline Hemager
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Camilla Christiani
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Katrine Søborg Spang
- Copenhagen Research Unit, Child and Adolescent Mental Health Center, Gentofte Hospitalsvej 3A, opg. 3A, 1. sal, 2900 Hellerup, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Birgitte Klee Burton
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- Copenhagen Research Unit, Child and Adolescent Mental Health Center, Gentofte Hospitalsvej 3A, opg. 3A, 1. sal, 2900 Hellerup, Denmark
| | - Maja Gregersen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Anne Søndergaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Aja Greve
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Ditte Lou Gantriis
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
| | - Jessica Ohland
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Preben Bo Mortensen
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 26, Bygning R2640-R2641, 8210 Aarhus V, Denmark
| | - Thomas Werge
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Boserupvej 2, 4000 Roskilde, Denmark
- Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Ron Nudel
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Boserupvej 2, 4000 Roskilde, Denmark
| | - Yunpeng Wang
- Department of Psychology, Centre for Lifespan Changes in Brain and Cognition, University of Oslo, Forskningsveien 3A, 0317 Oslo, Norway
| | - David M Hougaard
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- Department for Congenital Disorders, Center for Neonatal Screening, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen, Denmark
| | - Kerstin Jessica Plessen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne,Switzerland
| | - Vibeke Bliksted
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Copenhagen Research Unit, Child and Adolescent Mental Health Center, Gentofte Hospitalsvej 3A, opg. 3A, 1. sal, 2900 Hellerup, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- Mental Health Services – Capital Region of Denmark, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Nordstjernevej 41, 2600 Glostrup,Denmark
| | - Anne A E Thorup
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- Copenhagen Research Unit, Child and Adolescent Mental Health Center, Gentofte Hospitalsvej 3A, opg. 3A, 1. sal, 2900 Hellerup, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
| | - Ole Mors
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Merete Nordentoft
- CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Fuglesangs Allé 26, 8210 Aarhus V, Denmark
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Moltrecht B, Patalay P, Deighton J, Edbrooke-Childs J. A School-Based Mobile App Intervention for Enhancing Emotion Regulation in Children: Exploratory Trial. JMIR Mhealth Uhealth 2021; 9:e21837. [PMID: 34259642 PMCID: PMC8319776 DOI: 10.2196/21837] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/03/2021] [Accepted: 04/28/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Most mental health disorders are first experienced in childhood. The rising rates of mental health difficulties in children highlight the need for innovative approaches to supporting children and preventing these difficulties. School-based digital interventions that address shared risk factors and symptoms, such as emotion dysregulation, present exciting opportunities to enhance mental health support for children on a larger scale. OBJECTIVE This study investigates the use of a new app-based intervention designed to support children's emotion regulation in schools. The aim is to optimize the usability, acceptability, and utility of the app and explore its scope for implementation with the target user in the school context. METHODS As part of an interdisciplinary development framework, the app is being evaluated in a 3-month trial across 4 primary schools. In total, 144 children (aged 10-12 years) took part and accessed the intervention app in the classroom or at home. Outcomes regarding usability, acceptability, and implementation opportunities were assessed through digital user data, self-report questionnaires (132/144, 91.6%), and semistructured interviews with children (19/144, 13.2%) and teachers (6/8, 75%). RESULTS The app usage data showed that 30% (128/426) of the users were returning users. Self-report data indicated that 40.1% (53/132) of the children had not used the app, whereas 57.5% (76/132) had used it once or more. Of the children who had used the app, 67% (51/76) reported that the app was helpful. Interviews with children and teachers suggested positive experiences with the app and that it helped them to calm down and relax. Children reported that they perceived the app as acceptable, usable, and helpful. In terms of the intervention's usability, most features functioned well; however, certain technical issues were reported, which may have led to reduced engagement levels. Teachers not only reported overall positive experiences but also discussed access difficulties and reported a lack of content as one of the main barriers to implementing the app. Having a web-based app significantly enhanced accessibility across devices and settings and provided teachers with more opportunities to use it. We identified the need for new, activating app features in addition to the existing, primarily relaxing ones. The findings indicated that it is possible to use and evaluate an app intervention in the school context and that the app could help enhance children's emotion regulation. We discuss areas for improvement regarding the app, study design, and future implementation strategies. CONCLUSIONS We share important insights with regard to the development, implementation, and evaluation of a new app for supporting children's emotion regulation in schools. Our results demonstrate that mental health apps represent a promising means to facilitate effective mental health service provision in and outside of the school context. Important lessons learned are shared to support other researchers and clinicians on similar journeys.
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Affiliation(s)
- Bettina Moltrecht
- Evidence-based Practice Unit, University College London & Anna Freud National Centre, London, United Kingdom.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Jessica Deighton
- Evidence-based Practice Unit, University College London & Anna Freud National Centre, London, United Kingdom
| | - Julian Edbrooke-Childs
- Evidence-based Practice Unit, University College London & Anna Freud National Centre, London, United Kingdom
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24
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Lynch SJ, Sunderland M, Newton NC, Chapman C. A systematic review of transdiagnostic risk and protective factors for general and specific psychopathology in young people. Clin Psychol Rev 2021; 87:102036. [PMID: 33992846 DOI: 10.1016/j.cpr.2021.102036] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/30/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022]
Abstract
A large body of research has emerged over the last decade examining empirical models of general and specific psychopathology, which take into account comorbidity among psychiatric disorders and enable investigation of risk and protective factors that are common across disorders. This systematic review presents findings from studies of empirical models of psychopathology and transdiagnostic risk and protective factors for psychopathology among young people (10-24 years). PsycInfo, Medline and EMBASE were searched from inception to November 2020, and 41 studies were identified that examined at least one risk or protective factor in relation to broad, empirically derived, psychopathology outcomes. Results revealed several biological (executive functioning deficits, earlier pubertal timing, genetic risk for ADHD and schizophrenia, reduced gray matter volume), socio-environmental (stressful life events, maternal depression) and psychological (low effortful control, high neuroticism, negative affectivity) transdiagnostic risk factors for broad psychopathology outcomes, including general psychopathology, internalising and externalising. Methodological complexities are discussed and recommendations for future studies of empirical models of psychopathology are presented. These results contribute to a growing body of support for transdiagnostic approaches to prevention and intervention for psychiatric disorders and highlight several promising avenues for future research.
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Affiliation(s)
- Samantha J Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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25
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Emotion Dysregulation within the CBT-E Model of Eating Disorders: A Narrative Review. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10225-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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26
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Miller AB, Machlin L, McLaughlin KA, Sheridan MA. Deprivation and psychopathology in the Fragile Families Study: A 15-year longitudinal investigation. J Child Psychol Psychiatry 2021; 62:382-391. [PMID: 32407580 PMCID: PMC7666037 DOI: 10.1111/jcpp.13260] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Early adversity consistently predicts youth psychopathology. However, the pathways linking unique dimensions of early adversity, such as deprivation, to psychopathology are understudied. Here, we evaluate a theoretical model linking early deprivation exposure with psychopathology prospectively through language ability. METHODS Participants included 2,301 youth (47.5% female) enrolled in the Fragile Families and Child Wellbeing Study. We include data from assessment points at ages 1, 3, 5, 9, and 15. Latent factors for deprivation and threat were modeled from multiple indicators at ages 1 and 3. Youth language ability was assessed at Age 5. Indicators of psychopathology were assessed at ages 5, 9, and 15. A structural equation model tested longitudinal paths to internalizing and externalizing psychopathology from experiences of deprivation and threat. RESULTS Deprivation from birth to Age 3 was associated with an indirect effect on internalizing and externalizing symptoms in early childhood (Age 5), later childhood (Age 9), and adolescence (Age 15) via language ability in early childhood (Age 5). Early threat exposure was associated with increased internalizing and externalizing psychopathology across all ages. There was no significant indirect effect from threat to psychopathology via language ability. CONCLUSIONS The effects of deprivation on psychopathology during early childhood, late childhood, and adolescence are explained, in part, through early childhood language ability. Results provide insight into language ability as a possible opportunity for intervention.
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Affiliation(s)
- Adam Bryant Miller
- Department of Psychology and Neurosciences, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura Machlin
- Department of Psychology and Neurosciences, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Margaret A. Sheridan
- Department of Psychology and Neurosciences, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
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27
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Wade M, Plamondon A, Jenkins JM. A Family Socialization Model of Transdiagnostic Risk for Psychopathology in Preschool Children. Res Child Adolesc Psychopathol 2021; 49:975-988. [PMID: 33687647 DOI: 10.1007/s10802-021-00789-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 12/17/2022]
Abstract
This longitudinal study examined the presence of general (P) and specific internalizing (INT) and externalizing (EXT) psychopathology factors in a community sample of preschool children. We assessed child and contextual correlates of P, INT, and EXT, and tested a model connecting socioeconomic risk to these factors through family socialization processes and child cognitive abilities. Participants were 501 children recruited at birth and followed up at 18 months and 3 years. Child and family functioning were measured using parental reports, observation, and standardized assessments. Both mothers and their partners reported on children's mental health, permitting the estimation of a trifactor model of psychopathology that captured caregivers' shared and unique perspectives with respect to P, INT, and EXT. Results revealed several transdiagnostic correlates of the common-perspective P factor, including family income, maternal education, maternal depression, and maternal responsiveness, as well as marginal associations with sibling negativity and children's language and theory of mind abilities. Several shared and unique correlates of INT and EXT were also observed. Structural equation modelling revealed that the effects of family income and maternal education on P operated indirectly through maternal responsiveness, while the effects of maternal education on INT and EXT operated through maternal reflective capacity, albeit in opposite directions. Together, these results suggest that the effects of socioeconomic disadvantage on general psychopathology are organized in a temporal cascade from distal to proximal risk.
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Affiliation(s)
- Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street West, Toronto, ON, M5S1V6, Canada.
| | - Andre Plamondon
- Département Des Fondements Et Pratiques en Éducation, Laval University, Québec, Canada.
| | - Jennifer M Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street West, Toronto, ON, M5S1V6, Canada
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28
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Forbes MK, Sunderland M, Rapee RM, Batterham PJ, Calear AL, Carragher N, Ruggero C, Zimmerman M, Baillie AJ, Lynch SJ, Mewton L, Slade T, Krueger RF. A detailed hierarchical model of psychopathology: From individual symptoms up to the general factor of psychopathology. Clin Psychol Sci 2021; 9:139-168. [PMID: 33758691 PMCID: PMC7983870 DOI: 10.1177/2167702620954799] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Much of our knowledge about the relationships among domains of psychopathology is built on the diagnostic categories described in the Diagnostic and Statistical Manual of Mental Disorders (DSM), with relatively little research examining the symptom-level structure of psychopathology. The aim of this study was to delineate a detailed hierarchical model of psychopathology-from individual symptoms up to a general factor of psychopathology-allowing both higher- and lower-order dimensions to depart from the structure of the DSM. We explored the hierarchical structure of hundreds of symptoms spanning 18 DSM disorders, in two large samples-one from the general population in Australia (n = 3175), and the other a treatment-seeking clinical sample from the USA (n = 1775). There was marked convergence between the two samples, offering new perspectives on higher-order dimensions of psychopathology. We also found several noteworthy departures from the structure of the DSM in the symptom-level data.
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Affiliation(s)
- Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Natacha Carragher
- Office of Medical Education, University of New South Wales, Sydney, Australia
- Alcohol, Drugs and Addictive Behaviors, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | | | | | - Andrew J Baillie
- Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Samantha J Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Mewton
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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29
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Kil H, Aitken M, Henry S, Hoxha O, Rodak T, Bennett K, Andrade BF. Transdiagnostic Associations Among Parental Causal Locus Attributions, Child Behavior and Psychosocial Treatment Outcomes: A Systematic Review. Clin Child Fam Psychol Rev 2021; 24:267-293. [PMID: 33598852 DOI: 10.1007/s10567-020-00341-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/18/2022]
Abstract
Parents' interpretations of the cause of their children's behavior, i.e., parental attributions, are linked to parenting behavior and child development. However, it is not yet known whether parental attributions are systematically associated with children's internalizing and externalizing symptoms and behavior or psychosocial treatment engagement and outcomes across diagnostic categories. This systematic review aimed to fill this knowledge gap using a transdiagnostic perspective to synthesize the literature on the associations between parent-causal and child-responsible attributions and children's internalizing and externalizing behavior, treatment engagement, and treatment outcomes for parents and children. A total of 67 studies were identified. Overall, biased child-responsible attributions were associated with elevated child internalizing and externalizing symptoms and behavior across diagnoses, while findings on the association between parent-causal attributions and child behavior were inconsistent. The link between parental attributions and treatment engagement was also mixed, varying across treatment type, child diagnosis, and focus of attributions. Regarding treatment outcomes, less biased parent-causal and child-responsible attributions were linked to post-treatment improvements in children's behaviors, while mixed findings were reported on post-treatment improvements in parental attributions. Findings are discussed with a focus on approaches to enhance the effectiveness of assessment and psychosocial treatment approaches across diagnostic categories with consideration of parental attributions.
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Affiliation(s)
- Hali Kil
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Madison Aitken
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Shanelle Henry
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Ortenc Hoxha
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health Library, Toronto, ON, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence and Impact (Formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, ON, Canada
| | - Brendan F Andrade
- McCain Centre for Child Youth and Family Mental Health, Child Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Damari B, Sharifi V, Asgardoon MH, Hajebi A. Community Action Package in Iran's Comprehensive Mental and Social Health Services (the SERAJ Program). IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:76-86. [PMID: 34054986 PMCID: PMC8140293 DOI: 10.18502/ijps.v16i1.5382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 07/15/2020] [Accepted: 07/24/2020] [Indexed: 11/24/2022]
Abstract
Objective: The social component of health plays a significant role in improving the mental health of the people of a district. A national program on providing comprehensive social and mental health services, entitled "SERAJ", was developed and piloted in three districts of Iran. The present study aims to determine its model for improving the indicators of the social component of mental health. Method : This study is a system design for which a literature review, interviews with experts, and focused group discussions with stakeholders were used. Results: Community action in promoting the mental health of the districts has three main components: strengthening intersectoral collaboration through the memorandum of understandings (MoU), increasing people's participation by establishing People's Participation House (PPH) with the presence of the representative of current People's network, and social protection of people suffering from mental disorders by establishing the Social Support Unit (SSU) for self-reliance activity. All three components are controlled by the governor and with supervision and technical consult of the health network of the district and stakeholder participation. Conclusion: The model uses the inner capacities of the city instead of creating new structures. The prerequisites for the effective function of the main three components are educating departments, educating members of the PPH, and hiring a social worker at the SSU. The effective measures taken by the departments to reduce the risk factors for mental disorders are dependent on the technical and financial support of relevant organizations at the provincial and national levels.
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Affiliation(s)
- Behzad Damari
- Department of Governance and Health, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vandad Sharifi
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Asgardoon
- Department of Governance and Health, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Student Society for Immunodeficiencies, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Hajebi
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
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Etkin P, Mezquita L, López-Fernández FJ, Ortet G, Ibáñez MI. Five Factor model of personality and structure of psychopathological symptoms in adolescents. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Aitken M, Haltigan JD, Szatmari P, Dubicka B, Fonagy P, Kelvin R, Midgley N, Reynolds S, Wilkinson PO, Goodyer IM. Toward precision therapeutics: general and specific factors differentiate symptom change in depressed adolescents. J Child Psychol Psychiatry 2020; 61:998-1008. [PMID: 31930507 PMCID: PMC7496892 DOI: 10.1111/jcpp.13194] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The longitudinal course of multiple symptom domains in adolescents treated for major depression is not known. Revealing the temporal course of general and specific psychopathology factors, including potential differences between psychotherapies, may aid therapeutic decision-making. METHODS Participants were adolescents with major depressive disorder (aged 11-17; 75% female; N = 465) who were part of the IMPACT trial, a randomized controlled trial comparing cognitive behavioral therapy, short-term psychoanalytic psychotherapy, and brief psychosocial intervention. Self-reported symptoms at baseline and 6, 12, 36, 52, and 86 weeks postrandomization were analyzed with bifactor modeling. RESULTS General psychopathology factor scores decreased across treatment and one-year follow-up. Specific melancholic features and depressive cognitions factors decreased from baseline to 6 weeks. Conduct problems decreased across treatment and follow-up. Anxiety increased by 6 weeks and then reverted to baseline levels. Obsessions-compulsions did not change. Changes in general and specific factors were not significantly different between the three psychotherapies during treatment. During follow-up, however, conduct problems decreased more in brief psychosocial intervention versus cognitive behavioral therapy (1.02, 95% Bayes credible interval 0.25, 1.96), but not versus short-term psychoanalytic psychotherapy. CONCLUSIONS The clinical response signature in this trial is best revealed by rapid reductions in depression symptoms and general psychopathology. Protracted improvements in general psychopathology and conduct problems subsequently occur. Psychosocial treatments for adolescent depression have comparable effects on general and specific psychopathology, although a psychoeducational, goal-focused approach may be indicated for youth with comorbid conduct problems.
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Affiliation(s)
- Madison Aitken
- Cundill Centre for Child and Youth DepressionCentre for Addiction and Mental HealthTorontoONCanada,Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - John D. Haltigan
- Cundill Centre for Child and Youth DepressionCentre for Addiction and Mental HealthTorontoONCanada,Department of PsychiatryUniversity of TorontoTorontoONCanada,Hospital for Sick ChildrenTorontoONCanada
| | - Peter Szatmari
- Cundill Centre for Child and Youth DepressionCentre for Addiction and Mental HealthTorontoONCanada,Department of PsychiatryUniversity of TorontoTorontoONCanada,Hospital for Sick ChildrenTorontoONCanada
| | - Bernadka Dubicka
- Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Peter Fonagy
- Division of Psychology and Language SciencesUniversity College LondonLondonUK
| | - Raphael Kelvin
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Nick Midgley
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Shirley Reynolds
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | | | - Ian M. Goodyer
- Department of PsychiatryUniversity of CambridgeCambridgeUK
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Lynch SJ, Sunderland M, Newton NC, Chapman C. Transdiagnostic Risk and Protective Factors for Psychopathology in Young People: Systematic Review Protocol. JMIR Res Protoc 2020; 9:e19779. [PMID: 32815821 PMCID: PMC7471887 DOI: 10.2196/19779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 12/19/2022] Open
Abstract
Background Mental and substance use disorders are among the leading causes of burden of disease worldwide, with risk of onset peaking between the ages of 13 and 24 years. Comorbidity is also common among young people and complicates research, diagnosis and assessment, and clinical decision making. There is increasing support for empirically derived models of psychopathology that overcome issues of comorbidity and provide a transdiagnostic framework for investigating the specificity and generality of risk and protective factors for psychopathology. Objective This systematic review aims to identify transdiagnostic risk and protective factors for psychopathology in young people by synthesizing and evaluating findings from research investigating empirically based models of psychopathology. Methods Searches will be conducted in Medline, EMBASE, and PsycINFO databases. Reference lists of selected articles will also be hand searched for other relevant publications. All studies will be screened against eligibility criteria designed to identify studies that examined empirical models of psychopathology in relation to risk and/or protective factors in young people with a mean age between 10 and 24 years. Study quality will be assessed using the Joanna Briggs Institute Critical Appraisal Checklists for Cohort Studies and Analytical Cross-Sectional Studies. Findings will be summarized in a narrative synthesis, and a meta-analysis will be conducted if sufficient data are available. Results This review is ongoing. At the time of submission, full-text screening was completed, and hand searching of selected articles was underway. Results are expected to be completed by the end of 2020. Conclusions This protocol is for a systematic review of evidence for transdiagnostic risk and protective factors associated with empirically based models of psychopathology in young people. To our knowledge, the critical synthesis of this evidence will be the first to date and will provide a better understanding of the factors that contribute to the onset and maintenance of psychopathology in young people. Insights drawn from the review will provide critical new knowledge to improve the targeting of interventions to prevent or reduce mental health problems. Trial Registration This systematic review is registered with PROSPERO (CRD42020161368) and is available via Open Science Framework. International Registered Report Identifier (IRRID) DERR1-10.2196/19779
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Affiliation(s)
- Samantha Jane Lynch
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Nicola Claire Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Bornovalova MA, Choate AM, Fatimah H, Petersen KJ, Wiernik BM. Appropriate Use of Bifactor Analysis in Psychopathology Research: Appreciating Benefits and Limitations. Biol Psychiatry 2020; 88:18-27. [PMID: 32199605 PMCID: PMC10586518 DOI: 10.1016/j.biopsych.2020.01.013] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 01/01/2023]
Abstract
Co-occurrence of psychiatric disorders is well documented. Recent quantitative efforts have moved toward an understanding of this phenomenon, with the general psychopathology or p-factor model emerging as the most prominent characterization. Over the past decade, bifactor model analysis has become increasingly popular as a statistical approach to describe common/shared and unique elements in psychopathology. However, recent work has highlighted potential problems with common approaches to evaluating and interpreting bifactor models. Here, we argue that bifactor models, when properly applied and interpreted, can be useful for answering some important questions in psychology and psychiatry research. We review problems with evaluating bifactor models based on global model fit statistics. We then describe more valid approaches to evaluating bifactor models and highlight 3 types of research questions for which bifactor models are well suited to answer. We also discuss the utility and limits of bifactor applications in genetic and neurobiological research. We close by comparing advantages and disadvantages of bifactor models with other analytic approaches and note that no statistical model is a panacea to rectify limitations of the research design used to gather data.
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Affiliation(s)
| | | | - Haya Fatimah
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Karl J Petersen
- Department of Biological Sciences, University of South Florida St. Petersburg, St. Petersburg, Florida
| | - Brenton M Wiernik
- Department of Psychology, University of South Florida, Tampa, Florida.
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The structure of psychopathology and association with poor sleep, self-harm, suicidality, risky sexual behavior, and low self-esteem in a population sample of adolescents. Dev Psychopathol 2020; 33:1208-1219. [PMID: 32468983 DOI: 10.1017/s0954579420000437] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is a growing body of evidence highlighting the presence of a single general dimension of psychopathology that can account for multiple associations across mental and substance use disorders. However, relatively little evidence has emerged regarding the validity of this model with respect to a range of factors that have been previously implicated across multiple disorders. The current study utilized a cross-sectional population survey of adolescents (n = 2,003) to examine the extent to which broad psychopathology factors account for specific associations between psychopathology and key validators: poor sleep, self-harm, suicidality, risky sexual behavior, and low self-esteem. Confirmatory factor models, latent class models, and factor mixture models were estimated to identify the best structure of psychopathology. Structural equation models were then estimated to examine the broad and specific associations between each psychopathology indicator and the validators. A confirmatory factor model with three lower-order factors, representing internalizing, externalizing, and psychotic-like experiences, and a single higher-order factor evidenced the best fit. The associations between manifest indicators of psychopathology and validators were largely nonspecific. However, significant and large direct effects were found between several pairwise associations. These findings have implications for the identification of potential targets for intervention and/or tailoring of prevention programs.
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Combined prevention for substance use, depression, and anxiety in adolescence: a cluster-randomised controlled trial of a digital online intervention. LANCET DIGITAL HEALTH 2020; 2:e74-e84. [PMID: 33334564 DOI: 10.1016/s2589-7500(19)30213-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/04/2019] [Accepted: 11/12/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Substance use, depression, and anxiety in adolescence are major public health problems requiring new scalable prevention strategies. We aimed to assess the effectiveness of a combined online universal (ie, delivered to all pupils) school-based preventive intervention targeting substance use, depression, and anxiety in adolescence. METHODS We did a multicentre, cluster-randomised controlled trial in secondary schools in Australia, with pupils in year 8 or 9 (aged 13-14 years). Participating schools were randomly assigned (1:1:1:1) to one of four intervention conditions: (1) Climate Schools-Substance Use, focusing on substance use only; (2) Climate Schools-Mental Health, focusing on depression and anxiety only; (3) Climate Schools-Combined, focusing on the prevention of substance use, depression, and anxiety; or (4) active control. The interventions were delivered in school classrooms in an online delivery format and used a mixture of peer cartoon storyboards and classroom activities that were focused on alcohol, cannabis, anxiety, and depression. The interventions were delivered for 2 years and primary outcomes were knowledge related to alcohol, cannabis, and mental health; alcohol use, including heavy episodic drinking; and depression and anxiety symptoms at 12, 24, and 30 months after baseline. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000723785) and an extended follow-up is underway. FINDINGS Between Sept 1, 2013, and Feb 28, 2014, we recruited 88 schools (12 391 pupils), of whom 71 schools and 6386 (51·5%) pupils were analysed (17 schools dropped out and 1308 pupils declined to participate). We allocated 18 schools (1739 [27·25%] pupils; 1690 [97·2%] completed at least one follow-up) to the substance use condition, 18 schools (1594 [25·0%] pupils; 1560 [97·9%] completed at least one follow-up) to the mental health condition, 16 schools (1497 [23·4%] pupils; 1443 [96·4%] completed at least one follow-up) to the combined condition, and 19 schools (1556 [23·4%] pupils; 1513 [97·2%] completed at least one follow-up) to the control condition. Compared with controls, the combined intervention group had increased knowledge related to alcohol and cannabis at 12, 24, and 30 months (standardised mean difference [SMD] for alcohol 0·26 [95% CI 0·14 to 0·39] and for cannabis 0·17 [0·06 to 0·28] at 30 months), increased knowledge related to mental health at 24 months (0·17 [0·08 to 0·27]), reduced growth in their odds of drinking and heavy episodic drinking at 12, 24, and 30 months (odds ratio for drinking 0·25 [95% CI 0·12 to 0·51], and for heavy episodic drinking 0·15 [0·04 to 0·58] at 30 months), and reduced increases in anxiety symptoms at 12 and 30 months (SMD -0·12 [95% CI -0·22 to -0·01] at 30 months). We found no difference in symptoms or probable diagnosis of depression. The combined intervention group also showed improvement in alcohol use outcomes compared with the substance use and mental health interventions and improvements in anxiety outcomes when compared with the mental health intervention only. INTERPRETATION Combined online prevention of substance use, depression, and anxiety led to increased knowledge of alcohol, cannabis, and mental health, reduced increase in the odds of any drinking and heavy episodic drinking, and reduced symptoms of anxiety over a 30-month period. These findings provide the first evidence of the effectiveness of an online universal school-based preventive intervention targeting substance use, depression, and anxiety in adolescence. FUNDING Australian National Health and Medical Research Council.
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Rapee RM, Oar EL, Johnco CJ, Forbes MK, Fardouly J, Magson NR, Richardson CE. Adolescent development and risk for the onset of social-emotional disorders: A review and conceptual model. Behav Res Ther 2019; 123:103501. [DOI: 10.1016/j.brat.2019.103501] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 10/03/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022]
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Hankin BL. A choose your own adventure story: Conceptualizing depression in children and adolescents from traditional DSM and alternative latent dimensional approaches. Behav Res Ther 2019; 118:94-100. [PMID: 31026717 PMCID: PMC6547377 DOI: 10.1016/j.brat.2019.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/09/2019] [Accepted: 04/17/2019] [Indexed: 01/15/2023]
Abstract
For the past several decades, the phenomenon of depression largely has been defined, classified, and thus assessed and analyzed, according to criteria based on the Diagnostic and Statistical Manual (now DSM5). A substantial body of knowledge on epidemiology, course, risk factors, correlates, consequences, assessment, and intervention for youth depression is based on this classical nosological approach to conceptualizing depression. Yet, recent structural and classification approaches, such as latent dimensional bifactor models (e.g., P factor model; Caspi et al., 2014) and hierarchical organizations (e.g., HiTOP; Kotov, Waszczuk, Krueger, Forbes, & Watson, 2017), have been proposed and supported as alternative options to characterize features of depression. This paper considers conceptualizations of depression among youth with a particular focus on validity: how important clinical outcomes and risks (genetic, neural, temperament, early pubertal timing, stress, and cognitive) relate to depression when ascertained via traditional DSM-defined depression versus more recent latent dimensional model approaches. The construct validity of depression, in terms of associations within respective nomological networks, varies by depression conceptualization. Clinical scientists and applied practitioners need to clearly think through the nature of what depression is and how the latent construct is conceptualized and measured. Conclusions reached for research, teaching, and evidence-based clinical work are affected and may not be the same across different conceptual and nosological organizational schemes.
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