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Bonduelle SLB, De Raedt R, Braet C, Campforts E, Baeken C. Parental criticism affects adolescents' mood and ruminative state: Self-perception appears to influence their mood response. J Exp Child Psychol 2023; 235:105728. [PMID: 37390784 DOI: 10.1016/j.jecp.2023.105728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/12/2023] [Accepted: 06/02/2023] [Indexed: 07/02/2023]
Abstract
Feeling and/or being criticized is a known risk factor for various psychiatric disorders in adolescents. However, the link between the experience of social stressors and the development of psychopathological symptoms is not yet fully understood. Identifying which adolescent subgroups are more vulnerable to parental criticism could be of great clinical relevance. In this study, 90 nondepressed 14- to 17-year-old adolescents were exposed to a sequence of auditory segments with a positive, neutral, and finally negative valence, mirroring parental criticism. Their mood and ruminative states were assessed before and after exposure to criticism. We observed an overall increase in mood disturbance and ruminative thoughts. Self-perception appeared to influence these mood changes, whereas no significant influence by perceived criticism, self-worth, or the general tendency to ruminate was found. Emotional awareness seemed to account for some of the variance in positive mood state changes. These findings point to the importance of adolescent self-perception (and emotional awareness) in dealing with parental criticism.
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Affiliation(s)
- Sam L B Bonduelle
- Department of Child and Adolescent Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), 1090 Brussels, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, 9000 Ghent, Belgium.
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Universiteit Gent, 9000 Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality, and Social Psychology, Universiteit Gent, 9000 Ghent, Belgium
| | - Edward Campforts
- Department of Child and Adolescent Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), 1090 Brussels, Belgium
| | - Chris Baeken
- Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, 9000 Ghent, Belgium; Department of Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), 1090 Brussels, Belgium; Department of Electrical Engineering, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands
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Rienecke RD, Gorrell S, Johnson M, Duffy A, Mehler PS, Le Grange D. Expressed emotion and treatment outcome in higher levels of care for eating disorders. Int J Eat Disord 2023; 56:628-636. [PMID: 36584076 PMCID: PMC9992295 DOI: 10.1002/eat.23890] [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: 11/10/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Expressed emotion (EE) among caregivers toward the affected offspring is a negative prognostic indicator for adolescent patients with eating disorders (EDs) in outpatient treatment. Less research has examined its impact on adolescents in higher levels of care (HLOC). The current study examined differences in caregiver EE according to the subtype of anorexia nervosa (AN) (restricting [AN-R] versus binge/purge [AN-BP]), and level of care (LOC). We also examined the main effects of baseline caregiver EE (emotional overinvolvement [EOI] or criticism), AN subtype, and their interaction on eating pathology and depression at discharge. METHOD Adolescent patients (N = 203) receiving treatment at HLOCs completed measures of ED pathology (Eating Disorder Examination-Questionnaire) and depression (Patient Health Questionnaire-9) at baseline and discharge, and one caregiver of each patient completed a measure of EE (Family Questionnaire) at baseline. RESULTS No differences in caregiver EE were found between patients with AN-R versus AN-BP, or relative to LOC. Caregiver EE did not predict outcome for ED symptoms or depression at discharge. DISCUSSION The impact of high caregiver EE may be less substantial at HLOCs than outpatient care given that caregivers are less involved in treatment at HLOCs. Future research is needed to determine if high caregiver EOI leads to poor treatment outcome for adolescents as it does for adults, or whether it is an appropriate expression of care for patients who are ill enough to require HLOC treatment. PUBLIC SIGNIFICANCE STATEMENT High caregiver EE was not found to predict treatment outcome for adolescents with eating disorders in higher levels of care (HLOCs), possibly due to the limited involvement of caregivers in HLOCs. However, patients step down to outpatient treatment, where high caregiver EE can have a significant negative impact on outcome. HLOCs should incorporate efforts to reduce high caregiver EE in anticipation of step-down to outpatient treatment.
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Affiliation(s)
- Renee D. Rienecke
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Madelyn Johnson
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Alan Duffy
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
| | - Philip S. Mehler
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
- ACUTE Center for Eating Disorders at Denver Health, Denver, Colorado, USA
- University of Colorado School of Medicine, Denver, Colorado, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
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Ye B, Zhao S, Zeng Y, Chen C, Zhang Y. Perceived parental support and college students' depressive symptoms during the COVID-19 pandemic: The mediating roles of emotion regulation strategies and resilience. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 35400981 PMCID: PMC8980203 DOI: 10.1007/s12144-022-03049-3] [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] [Accepted: 03/24/2022] [Indexed: 01/14/2023]
Abstract
The current study examined the mediating roles of emotion regulation strategies (i.e., cognitive reappraisal and expressive suppression) and resilience in the relationship between perceived parental support and depressive symptoms among college students during the first wave of the COVID-19 pandemic in China. A large sample of Chinese college students (N = 2, 423) participated in this investigation. Results indicated that perceived parental support was negatively related to depressive symptoms. The two emotion regulation strategies and resilience partially and serially mediated the relation between perceived parental support and depressive symptoms. Theoretical and practical implications of these results are discussed.
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Affiliation(s)
- Baojuan Ye
- Center of Preschool Education, Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, 99 Ziyang Avenue, Nanchang, 330022 China
| | - Shunying Zhao
- Center of Preschool Education, Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, 99 Ziyang Avenue, Nanchang, 330022 China
| | - Yadi Zeng
- Center of Preschool Education, Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, 99 Ziyang Avenue, Nanchang, 330022 China
| | - Chuansheng Chen
- Department of Psychology and Social Behavior, University of California, Irvine, CA 92697 USA
| | - Yanzhen Zhang
- Department of Psychology, University of California, 900 University Ave, Riverside, CA 92521 USA
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Rienecke RD, Gorrell S, Blalock DV, Smith K, Lock J, Le Grange D. Expressed emotion and long-term outcome among adolescents with anorexia nervosa. Int J Eat Disord 2021; 54:2019-2024. [PMID: 34553396 PMCID: PMC8810289 DOI: 10.1002/eat.23613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The purpose of the current study is to examine expressed emotion (EE) and long-term treatment outcome among adolescents participating in a randomized controlled trial (RCT) for treatment of anorexia nervosa (AN). It was hypothesized that patients with high EE parents at baseline would show more severe symptoms at end-of-treatment, 12-month follow-up, and 4-year follow-up than patients from low EE families. METHOD Secondary data analysis was conducted of original RCT data from a two-site eating disorder treatment trial conducted in the United States. Participants were 121 adolescents with AN who completed measures of EE, eating disorder psychopathology, depression, and self-esteem. RESULTS Generalized estimating equations showed that participants who were in the Low EE group achieved a more accelerated drop in depression scores in the context of treatment (first 12 months) than participants in the High EE group. No other significant Group × Time interactions were found. DISCUSSION Findings suggest that high parental EE at baseline does not indicate that adolescent patients with AN will fare poorly 4 years later.
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Affiliation(s)
- Renee D. Rienecke
- Eating Recovery Center/Pathlight Mood and Anxiety Center, Chicago, Illinois, USA,Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Dan V. Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kathryn Smith
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA,Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
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Rivers AS, Russon J, Winston-Lindeboom P, Ruan-Iu L, Diamond G. Family and Peer Relationships in a Residential Youth Sample: Exploring Unique, Non-Linear, and Interactive Associations with Depressive Symptoms and Suicide Risk. J Youth Adolesc 2021; 51:1062-1073. [PMID: 34647193 PMCID: PMC8513553 DOI: 10.1007/s10964-021-01524-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022]
Abstract
Close relationships are consequential for youth depressive symptoms and suicide risk, but nuanced research examining intersecting factors is needed to improve identification and intervention. This study examines a clinical, residential sample of 939 adolescents and young adults ages 10 to 23 years old (M = 15.84, SD = 1.53; 97.7% white, 99.5% non-Hispanic, 55% female). The final model found that family conflict, parental criticism, verbal bullying, and interactions with friends were associated with depressive symptoms in the expected directions, and there were significant interactions with family, peer, and demographic variables. However, most associations with suicide risk were indirect. Associations involving family factors, peer factors, depressive symptoms, and suicide are not always straightforward, and should be understood within a microsystemic context.
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Affiliation(s)
- Alannah Shelby Rivers
- Center for Family Intervention Science, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Jody Russon
- Department of Human Development and Family Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Payne Winston-Lindeboom
- Center for Family Intervention Science, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA
| | - Linda Ruan-Iu
- Center for Family Intervention Science, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA
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Bonduelle SLB, Chen Q, Wu GR, Braet C, De Raedt R, Baeken C. Exposure to Criticism Modulates Left but Not Right Amygdala Functional Connectivity in Healthy Adolescents: Individual Influences of Perceived and Self-Criticism. Front Psychiatry 2021; 12:673805. [PMID: 34295271 PMCID: PMC8290839 DOI: 10.3389/fpsyt.2021.673805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Frequent exposure to criticism is a known risk factor for various adult psychiatric disorders. Adolescents may be even more vulnerable to (parental) criticism, as their imbalanced brain maturation makes them prone to stronger mood changes and less effective emotional regulation. Identifying which adolescent subgroups are more vulnerable than others could be of great clinical relevance. Perceived criticism (PC) and self-criticism (SC), two related but distinct traits, could well be crucial vulnerability factors. Hypotheses: After exposure to criticism during fMRI scanning, rapid changes in amygdalar functional connectivity (FC) with other brain areas involved in emotion regulation and social cognitive processing will occur. These changes will depend on trait moderators, such as the adolescents' proneness to (a) perceive others as critical of them (PC) or (b) perceive themselves positively or negatively (SC). Methods: Sixty-four healthy 14-17-year-olds were exposed to a series of auditory comments. Changes in mood states were assessed based on the Profile of Mood States (POMS) prior to and after exposure to these segments. Pre- and post-experiment FC of the left and right amygdalae with other brain areas were also measured. Correlates between FC changes and psychometric measures-including the perceived criticism measure (PCM) and self-perception profile for adolescents (SPPA)-were assessed. Results: First, after being criticized, FC increases of the left amygdala seed region with brain areas related to sustained emotional processing were found, but no right amygdalar FC changes. Second, there was a significant positive partial correlation between individual PCM scores and FC changes between the left amygdala seed region and the left precuneus and left superior parietal cortex, both part of the default mode network. Conclusion: Exposure to criticism resulted in a rapid negative mood change accompanied by an increase in FC between the left amygdala and regions known to be involved in sustained emotional processing, but no right amygdalar FC changes. Furthermore, higher PC but not SC was correlated with stronger left amygdalar FC increases with these regions, suggesting an elevated vulnerability for disturbed emotional processing, as observed in mood disorders, in healthy adolescents with higher PCM scores.
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Affiliation(s)
- Sam Luc Bart Bonduelle
- Department of Child and Adolescent Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), Brussels, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, Ghent, Belgium
| | - Qinyuan Chen
- Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, Ghent, Belgium
| | - Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing, China
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Universiteit Gent, Ghent, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Universiteit Gent, Ghent, Belgium
| | - Chris Baeken
- Ghent Experimental Psychiatry (GHEP) Lab, Department of Head and Skin, UZ Gent/Universiteit Gent, Ghent, Belgium.,Department of Psychiatry, UZ Brussel/Vrije Universiteit Brussel-VUB (Free University of Brussels), Brussels, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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