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Huang X, Gao L, Xiao J, Li L, Shan X, Chen H, Chai X, Duan X. Family Environment Modulates Linkage of Transdiagnostic Psychiatric Phenotypes and Dissociable Brain Features in the Developing Brain. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:928-938. [PMID: 38537777 DOI: 10.1016/j.bpsc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/26/2024] [Accepted: 03/16/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Family environment has long been known for shaping brain function and psychiatric phenotypes, especially during childhood and adolescence. Accumulating neuroimaging evidence suggests that across different psychiatric disorders, common phenotypes may share common neural bases, indicating latent brain-behavior relationships beyond diagnostic categories. However, the influence of family environment on the brain-behavior relationship from a transdiagnostic perspective remains unknown. METHODS We included a community-based sample of 699 participants (ages 5-22 years) and applied partial least squares regression analysis to determine latent brain-behavior relationships from whole-brain functional connectivity and comprehensive phenotypic measures. Comparisons were made between diagnostic and nondiagnostic groups to help interpret the latent brain-behavior relationships. A moderation model was introduced to examine the potential moderating role of family factors in the estimated brain-behavior associations. RESULTS Four significant latent brain-behavior pairs were identified that reflected the relationship of dissociable brain network and general behavioral problems, cognitive and language skills, externalizing problems, and social dysfunction, respectively. The group comparisons exhibited interpretable variations across different diagnostic groups. A warm family environment was found to moderate the brain-behavior relationship of core symptoms in internalizing disorders. However, in neurodevelopmental disorders, family factors were not found to moderate the brain-behavior relationship of core symptoms, but they were found to affect the brain-behavior relationship in other domains. CONCLUSIONS Our findings leveraged a transdiagnostic analysis to investigate the moderating effects of family factors on brain-behavior associations, emphasizing the different roles that family factors play during this developmental period across distinct diagnostic groups.
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Affiliation(s)
- Xinyue Huang
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Leying Gao
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Jinming Xiao
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Lei Li
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaolong Shan
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Huafu Chen
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaoqian Chai
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
| | - Xujun Duan
- Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China; MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
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Chowdhury U, Suvro MAH, Farhan SMD, Uddin MJ. Depression and stress regarding future career among university students during COVID-19 pandemic. PLoS One 2022; 17:e0266686. [PMID: 35413076 PMCID: PMC9004757 DOI: 10.1371/journal.pone.0266686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/24/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
Students generally struggle to build a good career after their graduation in developing countries like Bangladesh. Due to the COVID-19 pandemic, such struggle increased and faced with stress and depression. We aimed to inquire about the amplitude of depression and stress among university students during the COVID-19 pandemic regarding their future careers and to identify the factors associated with this depression and stress.
Methods
A total of 516 students at various universities participated in this cross-sectional survey. From October 2020 to February 2021, data was collected through an online survey. An e-questionnaire with socio-demographic, Patient Health Questionnaire (PHQ-9) and Perceived Stress Scale (PSS-10) questions was created using Google Forms and distributed via Facebook, WhatsApp, and other social media platforms. The universities included into the sample were selected randomly from eight divisions of Bangladesh. Descriptive statistics and Pearson chi-square tests were carried out and the association between the risk factors and the outcome (e.g. depression and stress) was assessed by the odds ratio (OR) including 95% confidence interval (CI) obtained from the binary logistic regression model.
Results
Among 516 participants, 380 (73.6%) were male and 136 (26.4%) were female. Around 414 (80.2%) participants had mild to severe depression and 399 (77.3%) reported having low to moderately perceived stress. Female students were 2.1 (95% CI: 1.21–3.76) times more depressed and 3.6 (95% CI: 1.87–6.76) times more stressed than the counterpart. Students, who think delaying graduation due to COVID-19 will reduce the chance of getting a job, were 1.72 (95% CI: 1.07–2.76) times more depressed. Respondents, whose department offers any internship were 36% less depressed (p = 0.053), while skilled students were 46% less stressed though it was not statistically significant (p = 0.43).
Conclusion
According to our findings, there is an increasing prevalence of depression and stress among students, particularly among female students and those who do not receive job-related facilities from their institutions or who are unskilled. Universities can provide mental health programs and strive to have enough space for students to participate in internships. In addition, the government and educational institutions should work together to address the growing challenge.
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Affiliation(s)
- Upama Chowdhury
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Md. Ahosan Habib Suvro
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Syed M. D. Farhan
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- * E-mail:
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Cummings CM, Caporino NE, Kendall PC. Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull 2014; 140:816-45. [PMID: 24219155 PMCID: PMC4006306 DOI: 10.1037/a0034733] [Citation(s) in RCA: 510] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Brady and Kendall (1992) concluded that although anxiety and depression in youths are meaningfully linked, there are important distinctions, and additional research is needed. Since then, studies of anxiety-depression comorbidity in youths have increased exponentially. Following a discussion of comorbidity, we review existing conceptual models and propose a multiple pathways model to anxiety-depression comorbidity. Pathway 1 describes youths with a diathesis for anxiety, with subsequent comorbid depression resulting from anxiety-related impairment. Pathway 2 refers to youths with a shared diathesis for anxiety and depression, who may experience both disorders simultaneously. Pathway 3 describes youths with a diathesis for depression, with subsequent comorbid anxiety resulting from depression-related impairment. Additionally, shared and stratified risk factors contribute to the development of the comorbid disorder, either by interacting with disorder-related impairment or by predicting the simultaneous development of the disorders. Our review addresses descriptive and developmental factors, gender differences, suicidality, assessments, and treatment-outcome research as they relate to comorbid anxiety and depression and to our proposed pathways. Research since 1992 indicates that comorbidity varies depending on the specific anxiety disorder, with Pathway 1 describing youths with either social phobia or separation anxiety disorder and subsequent depression, Pathway 2 applying to youths with coprimary generalized anxiety disorder and depression, and Pathway 3 including depressed youths with subsequent social phobia. The need to test the proposed multiple pathways model and to examine (a) developmental change and (b) specific anxiety disorders is highlighted.
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Yap MBH, Pilkington PD, Ryan SM, Jorm AF. Parental factors associated with depression and anxiety in young people: a systematic review and meta-analysis. J Affect Disord 2014; 156:8-23. [PMID: 24308895 DOI: 10.1016/j.jad.2013.11.007] [Citation(s) in RCA: 326] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 09/16/2013] [Accepted: 11/12/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is a burgeoning and varied literature examining the associations between parental factors and depression or anxiety disorders in young people. However, there is hitherto no systematic review of this complex literature with a focus on the 12-18 years age range, when the first onset for these disorders peaks. Furthermore, to facilitate the application of the evidence in prevention, a focus on modifiable factors is required. METHODS Employing the PRISMA method, we conducted a systematic review of parental factors associated with depression and anxiety disorders in young people which parents can potentially modify. RESULTS We identified 181 articles altogether, with 140 examining depression, 17 examining anxiety problems, and 24 examining both outcomes. Stouffer's method of combining p values was used to determine whether associations between variables were reliable, and meta-analyses were conducted to estimate the mean effect sizes of associations between each parental factor and outcome. LIMITATIONS Limitations include sacrificing micro-level detail for a macro-level synthesis of the literature, not systematically reviewing moderators and mediators, the lack of generalizability across cultures and to younger or adult children, and the inability to conduct a meta-analysis on all included studies. CONCLUSIONS Parental factors with a sound evidence base indicating increased risk for both depression and anxiety include less warmth, more inter-parental conflict, over-involvement, and aversiveness; and for depression additionally, they include less autonomy granting and monitoring.
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Affiliation(s)
- Marie Bee Hui Yap
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia.
| | - Pamela Doreen Pilkington
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Siobhan Mary Ryan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Anthony Francis Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Australia
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Demir T, Karacetin G, Eralp Demir D, Uysal O. Prevalence and some psychosocial characteristics of social anxiety disorder in an urban population of Turkish children and adolescents. Eur Psychiatry 2012; 28:64-9. [PMID: 22537661 DOI: 10.1016/j.eurpsy.2011.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 12/26/2011] [Accepted: 12/27/2011] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To define the prevalence and some of the psychosocial characteristics of social anxiety disorder (SAD) in an urban population of Turkish children and adolescents. SUBJECTS AND METHODS This was a two-stage cross-sectional urban-based study conducted in Fatih, Istanbul, Turkey. The initial sample included 1,482 students between the 4th and 8th grades. The first stage involved screening using the Social Anxiety Scale for Children-Revised (SASC-R) and the Capa Social Phobia Scale for Children and Adolescents (CSPSCA). According to the test results, 324 children were interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) in the second stage. RESULTS The SAD prevalence rate was 3.9%. According to the multiple regression analysis, low paternal education and trait anxiety were associated with SASC-R scores, whereas female gender and trait anxiety were associated with CSPSCA scores. According to logistic regression analysis, the anxiety subscale of the self-concept scale and trait anxiety were associated with SAD. CONCLUSION SAD is a relatively common disorder that is associated with lower self-concept in children and adolescents. Low paternal education, trait anxiety, and low self-concept may be the intervention targets for SAD prevention and treatment.
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Affiliation(s)
- T Demir
- University of Istanbul, Cerrahpasa Medical Faculty, Department of Child and Adolescent Psychiatry, Fatih 34098 Istanbul, Turkey.
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Integrating etiological models of social anxiety and depression in youth: evidence for a cumulative interpersonal risk model. Clin Child Fam Psychol Rev 2012; 14:329-76. [PMID: 22080334 DOI: 10.1007/s10567-011-0101-8] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Models of social anxiety and depression in youth have been developed separately, and they contain similar etiological influences. Given the high comorbidity of social anxiety and depression, we examine whether the posited etiological constructs are a correlate of, or a risk factor for, social anxiety and/or depression at the symptom level and the diagnostic level. We find core risk factors of temperament, genetics, and parent psychopathology (i.e., depression and anxiety) are neither necessary nor sufficient for the development of social anxiety and/or depression. Instead, aspects of children's relationships with parents and/or peers either mediates (i.e., explains) or moderates (i.e., interacts with) these core risks being related to social anxiety and/or depression. We then examine various parent- and peer-related constructs contained in the separate models of social anxiety and depression (i.e., parent-child attachment, parenting, social skill deficits, peer acceptance and rejection, peer victimization, friendships, and loneliness). Throughout our review, we report evidence for a Cumulative Interpersonal Risk model that incorporates both core risk factors and specific interpersonal risk factors. Most studies fail to consider comorbidity, thus little is known about the specificity of these various constructs to depression and/or social anxiety. However, we identify shared, differential, and cumulative risks, correlates, consequences, and protective factors. We then put forth demonstrated pathways for the development of depression, social anxiety, and their comorbidity. Implications for understanding comorbidity are highlighted throughout, as are theoretical and research directions for developing and refining models of social anxiety, depression, and their comorbidity. Prevention and treatment implications are also noted.
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Drake KL, Ginsburg GS. Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders. Clin Child Fam Psychol Rev 2012; 15:144-62. [DOI: 10.1007/s10567-011-0109-0] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Different sources of loneliness are associated with different forms of psychopathology in adolescence. JOURNAL OF RESEARCH IN PERSONALITY 2011. [DOI: 10.1016/j.jrp.2010.12.005] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Knappe S, Beesdo-Baum K, Wittchen HU. Familial risk factors in social anxiety disorder: calling for a family-oriented approach for targeted prevention and early intervention. Eur Child Adolesc Psychiatry 2010; 19:857-71. [PMID: 20922550 DOI: 10.1007/s00787-010-0138-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 09/21/2010] [Indexed: 02/05/2023]
Abstract
Within the last decade, social anxiety disorder (SAD) has been identified as a highly prevalent and burdensome disorder. Both the characterization of its symptomatology and effective treatment options are widely documented. Studies particularly indicate that SAD aggregates in families and has its onset in early adolescence. Given the family as an important context for children's cognitive, emotional and behavioural development, familial risk factors could be expected to significantly contribute to the reliable detection of populations at risk for SAD. Reviewing studies on familial risk factors for SAD argues for the importance of parental psychopathology and unfavourable family environment, but also denotes to several shortcomings such as cross-sectional designs, short follow-up periods, diverging methodologies and the focus on isolated factors. Using a prospective longitudinal study that covers the high-risk period for SAD, including a broader spectrum of putative risk factors may help to overcome many of the methodological limitations. This review sets out to develop a more family-oriented approach for predicting the onset and maintenance of SAD that may be fruitful to derive targeted prevention and early intervention in SAD.
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Affiliation(s)
- Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
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Schreier SS, Heinrichs N. Parental fear of negative child evaluation in child social anxiety. Behav Res Ther 2010; 48:1186-93. [DOI: 10.1016/j.brat.2010.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Revised: 08/28/2010] [Accepted: 09/02/2010] [Indexed: 11/25/2022]
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Fisak B, Mann A. The Relation between Parent Rearing Practices and Adolescent Social Anxiety: A Factor Analytic Approach. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2010. [DOI: 10.1080/02673843.2010.9748037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Fox JK, Halpern LF, Forsyth JP. Mental health checkups for children and adolescents: A means to identify, prevent, and minimize suffering associated with anxiety and mood disorders. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1468-2850.2008.00129.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Starr LR, Davila J. Differentiating interpersonal correlates of depressive symptoms and social anxiety in adolescence: implications for models of comorbidity. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2008; 37:337-49. [PMID: 18470771 DOI: 10.1080/15374410801955854] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Research on psychosocial correlates of depression and social anxiety often has not accounted for their comorbidity. Differentiating correlates of depression and social anxiety may inform the development of comorbidity models. Building on research linking both disorders to interpersonal dysfunction, this study examined interpersonal correlates of depressive symptoms and social anxiety in nonreferred early adolescent (M age = 13.46) girls (n = 83), controlling for comorbid symptoms. Although both showed significant bivariate correlations with peer and family variables, partial correlations revealed that social anxiety (controlling for depressive symptoms) was more strongly related to peer variables (e.g., social competence and trust and communication in friendships), whereas depressive symptoms (controlling for social anxiety) were more strongly related to family variables (e.g., lower trust and greater alienation and conflict). Comorbid girls showed heightened peer and family alienation compared to purely dysphoric or anxious girls. Implications for casual models of comorbidity and for understanding poorer outcomes associated with comorbidity and discussed.
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Affiliation(s)
- Lisa R Starr
- State University of New York at Stony Brook, USA
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Performance Anxiety Among African-American College Students. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2006. [DOI: 10.1300/j035v20n04_04] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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