Temporal dynamics and longitudinal co-occurrence of depression and different anxiety syndromes in youth: Evidence for reciprocal patterns in a 3-year prospective study

Comparative randomized trial addressing childhood emotional problems: Computerized vs. traditional transdiagnostic Super Skills program

BACKGROUND

Super Skills for Life is a structured intervention rooted in cognitive-behavioral therapy and a transdiagnostic approach, aimed at preventing childhood emotional problems. Over the past decade, it has demonstrated positive outcomes in various formats and countries. This study evaluated the comparative effectiveness of two individual modalities: the computerized and the traditional version enriched with multimedia content, through a comparative randomized effectiveness trial.

METHOD

109 children (55.24 % female) aged 8-12 years participated, randomly assigned to either the traditional (n = 54) or computerized (n = 51) groups. Pre- and post-intervention assessments involved emotional problem measures completed by children and parents.

RESULTS

Both groups exhibited significant reductions in all outcomes according to parent reports, including depression, anxiety, and anxiety-related life interference. Children's self-reports indicated improvements across all general measures. Generalized Estimating Equations indicated marginally better improvements in the traditional group.

LIMITATIONS

Limitations included the absence of follow-up assessment, variability in participant regions across Spain, and input from other informants like teachers.

CONCLUSIONS

This study pioneers the examination of short-term effects of the program in both a fully computerized format supervised by a specialized therapist and an enriched traditional individual format, and the promising results suggest their potential for indicated prevention of childhood emotional problems.

Exploring the Association of Age with Depressive Symptomatology in Childhood and Adolescence: A Network Study

OBJECTIVE

This study aimed to explore the association of age with individual depression and anxiety symptoms and their connectivity (i.e., number/strength of connections with other symptoms) in girls and boys.

METHOD

Our study comprised cross-sectional data from 31,960 Dutch girls and 32,162 Dutch boys aged 8 to 18 and considered 11 depression symptoms and 14 anxiety symptoms measured by the Revised Child Anxiety and Depression Scale. Network estimations were used to examine whether age was associated with individual symptoms and, in a separate step, with the connectivity of depression symptoms with other depression symptoms and with the connectivity of depression symptoms with anxiety symptoms.

RESULTS

Age was, in general, positively associated with depression symptoms in girls, but not in boys, and with the connectivity of depression symptoms with other depression symptoms in both sexes. These findings were the most profound for energy-related symptoms in girls. Age was, in general, negatively associated with anxiety symptoms and not or negatively associated with the connectivity of depression symptoms with anxiety symptoms in girls and boys, respectively. Substantial differences across symptoms were found.

CONCLUSIONS

This study shows that it is important to focus on individual symptoms, for age is mainly associated with energy-related depression symptoms and their connectivity in girls. Future etiologic studies may examine the role of energy-related depression symptoms in the development of depressive symptomatology in girls as these symptoms seem potential targets for the prevention of depression in the female population.

Treating Emotional Disorders in Spanish Children: A Controlled Randomized Trial in a Clinical Setting

Super Skills for Life (SSL) is a CBT-transdiagnostic group intervention currently being translated and validated in multiple countries. In Spanish children, it has shown a positive impact on anxious and depressive symptoms, as well as other variables such as self-concept, prosocial behaviors, or behavioral problems. However, the effectiveness of the program to treat internalizing symptoms in children with a mental disorder in a clinical setting has not been examined so far. The aim of this study was to evaluate the effectiveness of SSL in a Spanish sample of children with a major internalizing disorder. Participants aged 8-12 years (71.6% boys) were randomly allocated to the SSL group (n = 43) or the waiting list control (WLC) group (n = 43). All children and their parents completed a series of measures before the first session and after the last session or at about the same time in the WLC group. The effectiveness of the intervention was assessed using generalized estimating equations. Significant reductions from pretest to posttest across multiple outcomes were found in children who participated in SSL group compared to those in the WLC group, including anxiety symptoms (SCAS, p = .02), anxiety interference (CALIS, p = .002), depressive symptoms (CDI, p = .033) and remission from diagnosis (K-SADS, p < .001). This study provides initial support for SSL as an effective treatment for children with emotional disorders in clinical settings. Future studies are needed to analyze long-term effects and broader benefits of the program in clinical contexts.

School children's mental health during the COVID-19 pandemic

Introduction

The COVID-19 pandemic significantly impacted the daily routines of children, with social distancing and quarantine leading to reduced social interactions and potential increased conflicts within families. These factors can increase the risk for anxiety and depression while reducing overall quality of life.

Methods

Our study included 1843 school children aged 8 to 12 from 56 schools over a 2.5-year period before and during the pandemic. This multi-wave cross-sectional study utilized baseline data from an optimization trial of an indicated preventive intervention. The main outcomes were self-reported symptoms of anxiety and depression, and quality of life was the secondary outcome measure. Furthermore, responses to COVID-relevant questions were measured using a self-composed scale. Our objectives were to compare anxiety and depression symptom levels between cohorts of children who participated in the study before and during the pandemic, to examine if anxiety or depression predicted the COVID response, and whether anxiety and depression and subtypes of anxiety had an impact on quality of life during the pandemic. Linear regression and interaction models were used to examine relevant associations.

Results

Levels of anxiety and depression were higher in all waves compared to pre-pandemic levels. Quality of life was lower during the pandemic than before the pandemic, particularly among children with generalized anxiety symptoms. Quality of life was negatively associated with loneliness.

Discussion

Our study revealed that children reported higher anxious and depressive symptoms during the pandemic compared to pre-pandemic levels, as well as reduced quality of life. Lockdowns and restrictions may have contributed to this burden. Additionally, self-reported loneliness was a significant possible consequence of the restrictive measures imposed on children during the pandemic. Additional research is needed to investigate the long-term effects of the pandemic on children, particularly regarding the stability of elevated levels of anxiety and depression. Such studies could examine whether these conditions are indicative of a trajectory toward more severe internalizing disorders.Clinical trial registration: NCT04263558.

Longitudinal Covid-19 effects on child mental health: vulnerability and age dependent trajectories

BACKGROUND

Few longitudinal studies have investigated the extended long-term impact of the Covid-19 pandemic for children's and adolescents' mental health, and a lack of uniform findings suggest heterogeneity in the impact of the pandemic.

METHODS

This study investigated child and adolescent mental health symptoms across four occasions (pre-pandemic, initial lockdown, second lockdown, and society post reopening) using data from the Dynamics of Family Conflict study. Child and adolescent depressive vulnerability, age, and sex were explored as trajectory moderators. Children and adolescents (N = 381, Mage = 13.65, SD = 1.74) self-reported their anxiety, depression, and externalizing symptoms. Mixed effects analyses were performed to investigate trajectories across measurement occasions and interaction terms between occasion and moderator variables were included to better understand the heterogeneity in the impact of the pandemic.

RESULTS

Children and adolescents reported increases in anxiety symptoms at the second lockdown (t(523) = -3.66, p < .01) and when society had reopened (t(522) = -4.90, p < .001). An increase in depression symptoms was seen when society had reopened relative to the three previous measurement occasions (ps < 0.01). Depressive vulnerability moderated the trajectory for anxiety symptoms (F(3,498) = 3.05, p = .028), while age moderated the trajectory for depression symptoms (F(3,532) = 2.97, p = .031).

CONCLUSION

The delayed and negative impact on children's and adolescents' mental health underscores the need for continued monitoring, and implementation of support systems to help and mitigate further deterioration.

Depression Prevention in Pediatric Primary Care: Implementation and Outcomes of Interpersonal Psychotherapy-Adolescent Skills Training

This study evaluated the fidelity, feasibility, acceptability, and preliminary outcomes of a depression prevention program, interpersonal psychotherapy-adolescent skills training (IPT-AST), in urban pediatric primary care (PC) with a sample of primarily Black youth. Twenty-two adolescents with elevated depressive symptoms participated in this open clinical trial. Adolescents were identified through a screening questionnaire completed at well visits. Ratings of IPT-AST fidelity and session attendance were recorded. Youth and caregivers reported on their attitudes toward the intervention and completed measures of adolescents' symptoms and functioning pre- and post-intervention. Results demonstrated high levels of fidelity, attendance, and acceptability, despite some difficulties with recruitment. Adolescents and caregivers reported significant improvements in functioning. There were marginally significant reductions in self-reported depression, anxiety, and total mental health symptoms. Caregivers reported a significant decrease in total mental health symptoms. Findings provide preliminary information regarding the implementation and effects of IPT-AST when delivered in PC.

Scary in the eye of the beholder: Attentional bias and attentional retraining for social anxiety

Consistent with cognitive models of social anxiety, socially anxious individuals show cognitive biases that magnify their perceived level of threat in the environment.

OBJECTIVES

The first objective was to determine whether attentional bias for socially threatening stimuli occurs after concomitant depression has been controlled. The second objective was to test the effectiveness of the Attention Control Training Program for Social Anxiety (ACTP-SA) for reducing social anxiety attentional bias and improving therapeutic indices in people with social anxiety.

METHOD

In the first study, socially anxious (N = 30) and non-anxious individuals (N = 30) completed the Beck Depression Inventory-II, Spielberger's State-Trait Anxiety Inventory, Conner's Social Phobia Inventory, a social-anxiety Stroop test, and a clinical interview. In the second study, individuals with social anxiety (N = 30) were randomly assigned to an experimental group that received 4 sessions of ACTP-SA, or to a sham-intervention control condition. At the post-test and a 3-month follow-up, both groups completed the same measures as in Study 1.

RESULTS

In Study 1, socially anxious individuals showed higher attentional bias for threatening stimuli than the controls, after depression had been controlled for. In Study 2, participants in the experimental group, compared with the controls, showed greater reductions in attentional bias, social anxiety, and trait anxiety at post-test and follow-up.

CONCLUSIONS

The results underscore the importance of information processing biases in social anxiety and the benefits of attentional bias training as a complementary intervention for modifying symptoms of social anxiety.

Relationships between worry and depressive symptoms during two group therapies for generalized anxiety disorder

ABSTRACT Objective: Generalized anxiety disorder (GAD) is a chronic and disabling disorder associated with various impairments and shows a significant prevalence in the worldwide and Brazilian populations. This study aimed to investigate the longitudinal relationship of two symptoms relevant to the disorder (worry and depressive symptoms) in the context of a randomized clinical trial (RCT) by using a cross-lagged panel model (CLPM) analysis. Methods: A total of 92 adult patients with GAD were randomized to receive ten sessions of either acceptance‐based group behavioral therapy (ABBT) or nondirective supportive group therapy (NDST). Treatment had four time-point measures. Worries were measured using the Penn State Worry Questionnaire (PSWQ), and depression was measured using the Depression Anxiety Stress Scales (DASS-D). Results: The NDST model revealed significant paths from worry to depression (first wave) and from depression to worry (second wave). There was no other significant cross-lagged effect. These data show that there was an influence between symptoms only during one of the treatment groups, and without a homogeneous and constant pattern in any of the cross-lagged routes. Conclusion: A supportive group psychotherapy potentially interferes with the pattern of the direct relationship between worries and depressive symptoms in adults with GAD.

Cognitive mechanisms predicting resilient functioning in adolescence: Evidence from the CogBIAS longitudinal study

Resilience is a dynamic process depicted by better than expected levels of functioning in response to significant adversity. This can be assessed statistically, by taking the residuals from a model of psychological functioning regressed onto negative life events. We report the first study to investigate multiple cognitive factors in relation to this depiction of resilient functioning. Life events, internalizing symptoms, and a range of cognitive risk and protective factors were assessed in a large sample of adolescents (N = 504) across three waves spaced 12–18 months apart. Adolescents who displayed fewer symptoms than expected, relative to negative life events, were considered more resilient. Adolescents who displayed more symptoms than expected, relative to negative life events, were considered less resilient. All cognitive factors were associated with resilient functioning to differing degrees. These included memory bias, interpretation bias, worry, rumination, self-esteem, and self-reported trait resilience. Regression models showed that memory bias was a key factor explaining unique variance in prospective resilient functioning. In a subsequent cross-lagged panel model, memory bias and resilient functioning were reinforcing mechanisms across time points, supporting cognitive models of emotional resilience. This study adds to the literature, by highlighting key cognitive mechanisms as potential intervention targets

The Role of Comorbid Depression in Youth Anxiety Treatment Outcomes

Findings have been mixed regarding the relationship between comorbid depression and anxiety and treatment outcomes for anxious youth. The current study compared a sample of anxious youth with a comorbid depressive disorder (n = 20) and those without comorbid depression (n = 137). All participants received 16 weekly sessions of Coping Cat and completed measures assessing anxiety/depression severity, impairment, and functioning at pretreatment and posttreatment. Results indicated that anxiety-focused CBT is efficacious for anxious youth with and without comorbid depressive disorders, with a higher rate of symptom improvement for youth with comorbid depression during treatment. However, comorbid depression was associated with higher severity at baseline and after treatment. Thus, despite the higher rate of symptom improvement, anxious youth with comorbid depression may benefit from additional treatment to address remaining symptoms.

Perceived Symptoms of Depression, Anxiety and Stress amongst Staff in a Malaysian Public University: A Workers Survey

Mental health conditions are a major part of workers’ health that predisposes to poor self-motivation for sustaining productivity. This study was aimed to determine the prevalence of depression, anxiety, and stress among staff in a Malaysian public university and its associated factors. A cross-sectional study was conducted among 459 staff from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. A questionnaire that consisted of items on socio-demographic and socioeconomic characteristics, employment description, lifestyle risk behaviors, personal medical history, and symptoms of depression, anxiety, and stress was administered to participants. Descriptive and inferential statistics were conducted using SPSS version 22.0. The prevalence of perceived symptoms of depression, anxiety, and stress among the respondents was 28.7%, 50.1%, and 14.8%, respectively. Over one-quarter (26.5%) of the participants presented symptoms of two or more mental disorders. Women, those aged less than 40 years old, and non-academic professionals were more likely to exhibit depressive symptoms, while those with medical conditions that required hospitalizations sustained anxiety symptoms. Perceived stress was more likely to be prevalent among staff with secondary education or less and smokers. Proactive support for staff needs to be offered in sustaining their emotional well-being.

Using the Rasch measurement theory to assess the psychometric properties of the Hopkins Symptom Checklist-10 in adolescents

BACKGROUND

The Hopkins Symptom Checklist-10 (HSCL-10) is widely used to measure psychological distress in adolescents. To provide valid and reliable results and generate recommendations for practice and policies, instruments with sound psychometric properties are required. The purpose of this study is to use Rasch measurement theory to assess the psychometric properties of the HSCL-10 among adolescents aged 13-19.

METHODS

In this cross-sectional study, 6445 adolescents responded to a web-based questionnaire. Data were collected from lower and upper secondary schools in Norway during 2018. The data were analysed using the partial credit parameterisation of the unidimensional Rasch model.

RESULTS

HSCL-10 was found to be unidimensional and to have acceptable reliability. One pair of items showed response dependency. The targeting of the instrument could have been better. All items had ordered thresholds. Three items under-discriminated and three displayed differential item functioning regarding gender.

CONCLUSIONS

HSCL-10 has potential for measuring psychological distress in adolescents, though there is room for improvement. To further improve this instrument, some items should be rephrased.

Screening for Anxiety in Pediatric Primary Care: A Systematic Review

CONTEXT

Anxiety is common, screening tools are available, and treatment can be effective. Recently, anxiety screening has been recommended for adolescent girls beginning at 13 years of age.

OBJECTIVE

To evaluate the evidence regarding anxiety screening test accuracy in primary care for children and adolescents and assess the effectiveness of treatment of individuals identified through screening.

DATA SOURCES

We searched PubMed, the Cochrane library, and references to potentially eligible studies cited in other articles.

STUDY SELECTION

Screening studies were included if they were conducted in primary care or a similar population and employed a reference standard based on DSM criteria. Treatment studies were included if subjects were identified through screening and there was at least 1 comparator intervention or a placebo arm.

DATA EXTRACTION

At least 2 reviewers evaluated each identified reference.

RESULTS

Two screening studies (1 with low risk of bias and 1 with high risk of bias) and 1 treatment study with a low risk of bias were included. The screening study with a low risk of bias reported a sensitivity of 56% and specificity of 80%. The treatment study found individual cognitive behavioral therapy to be effective for screen-detected adolescents with social phobia.

LIMITATIONS

This review only included screening or treatment studies with clear evidence that the study populations were derived from an unselected population reflective of typical primary care. Relevant studies not indexed in PubMed or the Cochrane library could have been missed.

CONCLUSIONS

There are significant gaps in evidence related to anxiety screening in the primary care setting.

The Continuum Between Temperament and Mental Illness as Dynamical Phases and Transitions

The full range of biopsychosocial complexity is mind-boggling, spanning a vast range of spatiotemporal scales with complicated vertical, horizontal, and diagonal feedback interactions between contributing systems. It is unlikely that such complexity can be dealt with by a single model. One approach is to focus on a narrower range of phenomena which involve fewer systems but still cover the range of spatiotemporal scales. The suggestion is to focus on the relationship between temperament in healthy individuals and mental illness, which have been conjectured to lie along a continuum of neurobehavioral regulation involving neurochemical regulatory systems (e.g., monoamine and acetylcholine, opiate receptors, neuropeptides, oxytocin), and cortical regulatory systems (e.g., prefrontal, limbic). Temperament and mental illness are quintessentially dynamical phenomena, and need to be addressed in dynamical terms. A meteorological metaphor suggests similarities between temperament and chronic mental illness and climate, between individual behaviors and weather, and acute mental illness and frontal weather events. The transition from normative temperament to chronic mental illness is analogous to climate change. This leads to the conjecture that temperament and chronic mental illness describe distinct, high level, dynamical phases. This suggests approaching biopsychosocial complexity through the study of dynamical phases, their order and control parameters, and their phase transitions. Unlike transitions in physical systems, these biopsychosocial phase transitions involve information and semiotics. The application of complex adaptive dynamical systems theory has led to a host of markers including geometrical markers (periodicity, intermittency, recurrence, chaos) and analytical markers such as fluctuation spectroscopy, scaling, entropy, recurrence time. Clinically accessible biomarkers, in particular heart rate variability and activity markers have been suggested to distinguish these dynamical phases and to signal the presence of transitional states. A particular formal model of these dynamical phases will be presented based upon the process algebra, which has been used to model information flow in complex systems. In particular it describes the dual influences of energy and information on the dynamics of complex systems. The process algebra model is well-suited for dealing with the particular dynamical features of the continuum, which include transience, contextuality, and emergence. These dynamical phases will be described using the process algebra model and implications for clinical practice will be discussed.

Internalized psychopathology dimensions in middle childhood: Cross-sectional and temporal associations

BACKGROUND

Anxiety, depression, and obsessive-compulsive symptoms often onset during middle childhood and are major causes of disability in young individuals. A better understanding of how these symptoms are linked and unfold over time is important to develop valid etiological models and effective prevention and treatment.

METHODS

In the present study, 950 community children (8-14 years) reported on a broad range of internalised symptoms at three time points over the course of a year. First, factor analysis was used to examine the overarching dimensions of these symptoms. Second, network analysis was used to examine unique cross-sectional associations among these empirically supported symptom dimensions. Last, longitudinal structural equation models (SEMs) were used to examine temporal associations among the symptom dimensions.

RESULTS

Six broad symptom dimensions fitted the self-report data well at all time points. These dimensions were conceptualized as depression, general anxiety, situational fears, compulsivity, intrusive thoughts, and somatic anxiety. Network analysis showed that these dimensions formed a highly interconnected network with general anxiety and somatic anxiety being most central (i.e., most strongly associated with other dimensions) at all time points. Longitudinal SEMs supported the central role played by general anxiety in the temporal associations among these dimensions.

CONCLUSIONS

Overarching expressions of internalized psychopathology are highly interconnected in middle childhood with possible central roles played by general and somatic anxiety. Interventions aimed at a general proneness for anxiety may be warranted in preventing and treating internalizing symptoms in middle childhood.

The role of childhood generalized anxiety in the internalizing cluster

BACKGROUND

Anxiety, depression and somatization (the internalizing cluster) are highly comorbid, prevalent and associated with significant individual and societal costs. Although prior studies have examined their natural course, there has been a little investigation into how symptoms unfold at the individual level. We examined the intraindividual (within-person) temporal patterning of symptom development and the impact of risk factors (sex, ethnicity, socioeconomic indicators, bullying victimization, child maltreatment) on symptom means and trajectories (between-person), comparing youth and parent reports.

METHOD

Over a 7-year interval from age 11 to 17, children (n = 669; 54% girls; 79% White) and parents (89% mothers) reported on symptoms of anxiety and depression from age 11 and somatization from age 13. Autoregressive latent trajectory models with structured residuals were used to uncouple within- and between-person sources of variance.

RESULTS

According to self-reports, generalized anxiety consistently predicted depression, while anxiety and depression consistently predicted somatization. Anxiety also had an indirect effect on somatization via depression. According to parent reports, there were several bidirectional effects between anxiety and depression and between depression and somatization. Experiences of abuse were consistent risk factors for self-reported internalizing symptoms, and across informants, girls had higher symptom means and rising trajectories compared to boys.

CONCLUSION

Generalized anxiety plays an important role in adolescent depressive and somatic symptoms. Primary prevention of anxiety may be warranted to curb symptom continuity and the development of comorbidity. Research is needed to determine whether self-reports of anxiety should be prioritized over parent reports and continued efforts are needed to reduce bullying and child maltreatment.

The Prevalence of Depression, Anxiety and Stress and Their Associated Factors in College Students

AIM

To estimate the prevalence of symptoms of depression, anxiety, stress and associated factors in a population of college students.

METHOD

Cross-sectional study of psychological distress measured through the Depression, Anxiety and Stress Scale (DASS-21) in a sample of 1074 college students.

RESULTS

We found a moderate prevalence of depression (18.4%), anxiety (23.6%) and stress (34.5%) symptoms in our study population. Being <21, having problematic Internet use behavior, smoking, presenting insomnia and having a low self-esteem were independently associated with symptoms of depression, anxiety and stress. Being a woman, living with their family, having a stable partner, consuming alcohol frequently and having poor nutritional habits were significantly associated with symptoms of stress; lacking a stable partner was significantly associated with depressive symptoms; and frequent consumption of alcohol was significantly associated with symptoms of anxiety.

CONCLUSION

We found a moderate prevalence of depression, anxiety and stress symptoms in our population. Interventions aimed at promoting mental health among college students should be implemented.

Causal Factors of Anxiety and Depression in College Students: Longitudinal Ecological Momentary Assessment and Causal Analysis Using Peter and Clark Momentary Conditional Independence

BACKGROUND

Across college campuses, the prevalence of clinically relevant depression or anxiety is affecting more than 27% of the college population at some point between entry to college and graduation. Stress and self-esteem have both been hypothesized to contribute to depression and anxiety levels. Although contemporaneous relationships between these variables have been well-defined, the causal relationship between these mental health factors is not well understood, as frequent sampling can be invasive, and many of the current causal techniques are not well suited to investigate correlated variables.

OBJECTIVE

This study aims to characterize the causal and contemporaneous networks between these critical mental health factors in a cohort of first-year college students and then determine if observed results replicate in a second, distinct cohort.

METHODS

Ecological momentary assessments of depression, anxiety, stress, and self-esteem were obtained weekly from two cohorts of first-year college students for 40 weeks (1 academic year). We used the Peter and Clark Momentary Conditional Independence algorithm to identify the contemporaneous (t) and causal (t-1) network structures between these mental health metrics.

RESULTS

All reported results are significant at P<.001 unless otherwise stated. Depression was causally influenced by self-esteem (t-1 r_p, cohort 1 [C1]=-0.082, cohort 2 [C2]=-0.095) and itself (t-1 r_p, C1=0.388, C2=0.382) in both cohorts. Anxiety was causally influenced by stress (t-1 r_p, C1=0.095, C2=0.104), self-esteem (t-1 r_p, C1=-0.067, C2=-0.064, P=.002), and itself (t-1 r_p, of C1=0.293, C2=0.339) in both cohorts. A causal link between anxiety and depression was observed in the first cohort (t-1 r_p, C1=0.109) and only observed in the second cohort with a more liberal threshold (t-1 r_p, C2=0.044, P=.03). Self-esteem was only causally influenced by itself (t-1 r_p, C1=0.389, C2=0.393). Stress was only causally influenced by itself (t-1 r_p, C1=0.248, C2=0.273). Anxiety had positive contemporaneous links to depression (t r_p, C1=0.462, C2=0.444) and stress (t r_p, C1=0.354, C2=0.358). Self-esteem had negative contemporaneous links to each of the other three mental health metrics, with the strongest negative relationship being stress (t r_p, C1=-0.334, C2=-0.340), followed by depression (t r_p, C1=-0.302, C2=-0.274) and anxiety (t r_p, C1=-0.256, C2=-0.208). Depression had positive contemporaneous links to anxiety (previously mentioned) and stress (t r_p, C1=0.250, C2=0.231).

CONCLUSIONS

This paper is an initial attempt to describe the contemporaneous and causal relationships among these four mental health metrics in college students. We replicated previous research identifying concurrent relationships between these variables and extended them by identifying causal links among these metrics. These results provide support for the vulnerability model of depression and anxiety. Understanding how causal factors impact the evolution of these mental states over time may provide key information for targeted treatment or, perhaps more importantly, preventative interventions for individuals at risk for depression and anxiety.

Youth's school experience: Testing the role of symptoms of anxiety and co-occurring symptoms of depression

Although symptoms of anxiety often coexist with symptoms of depression, little is known on how such coexistence affects youth's school experiences.

OBJECTIVES

We tested how the two types of behaviors, when coexisting, were associated with youth's negative attitude toward teachers, school, and poor peer relations.

METHOD

Data were collected from 203 ethnically and socioeconomically diverse youth (male: 24.6%; mean = 15.8 years, standard deviation = 2.4) with the 3rd edition of the Behavioral Assessment for Children: Self-Report of Personality.

RESULTS

Scores for symptoms of depression alone explained negative attitude toward teachers (β = .28; R²  = 17.88%), negative attitude toward school (β = .27; R²  = 14.74%), and poor peer relations (β = .42; R²  = 44.60%) as effectively as scores for both types of behaviors did.

CONCLUSION

The coexistence of symptoms of anxiety and depression did not appear to impair youth's attitude toward teachers, school and peer relations more than symptoms of depression did alone.

[Levels of structural integration in adolescents and the relationship to later mental disorders - A longitudinal study]

Levels of structural integration in adolescents and the relationship to later mental disorders - A longitudinal study Abstract. Objective: Psychological disorders frequently manifest during adolescence. Because of the multifactorial influencing factors, the courses of the diseases are heterogeneous, from relapsing-remitting to chronic. This study investigated whether the level of structural integration of the Operationalized Psychodynamic Diagnostics in Childhood and Adolescence (OPD-CA) correlates with later symptomatic burden. Method: This long-term study assessed the levels of structural integration according to the OPD-CA of 60 adolescents (mean age = 15.6; SD = 0.9). Seven years later, we then measured symptomatic burden (SCID axis I and II) and overall burden (GAF, BSI-GSI) (73.3 % follow-up participation rate). Results: The results showed high correlations between deficient structural integration in adolescence and later symptoms and overall burden in early adulthood. Conclusion: The follow-up examination after a 7-year time period showed significant correlations, which argue for the predictive value of structural integration. This suggests that early specific treatment, e.g., in the form of intensive psychotherapy, be urgently recommended in order to influence this course.