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Gittins Stone DI, Elkins RM, Gardner M, Boger K, Sperling J. Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis. Child Psychiatry Hum Dev 2024; 55:1398-1412. [PMID: 36749490 PMCID: PMC9902833 DOI: 10.1007/s10578-023-01500-5] [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] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.
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Affiliation(s)
| | - R Meredith Elkins
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | | | - Kathryn Boger
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Jacqueline Sperling
- McLean Hospital Belmont, Belmont, MA, USA
- Harvard Medical School, Cambridge, MA, USA
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2
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Kandemir I, Gudek K, Sahin AY, Aksakal MT, Kucuk E, Yildirim ZNY, Yilmaz A, Nayir A, Bas F. Association of problems, coping styles, and preferred online activity with depression, anxiety, and other psychological disorders in Turkish adolescents diagnosed with chronic kidney disease. Pediatr Nephrol 2024; 39:2779-2788. [PMID: 38772924 PMCID: PMC11272670 DOI: 10.1007/s00467-024-06391-9] [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: 10/27/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND To assess depression, anxiety, and other psychological disorders in adolescents with chronic kidney disease (CKD) and determine the significant factors and the effect of digital media use on its scores among these patient groups. METHODS The study was conducted as a cross-sectional study and included 84 adolescents with CKD and 68 healthy controls. The participants completed the Revised Child Anxiety and Depression Scale (RCADS). We recorded their age, gender, the most problematic issue in their lives, coping methods with problems, and online applications they prefer in their leisure time. RESULTS Elevated rates (scores > 70) of separation anxiety, panic disorder, obsession, depression, total anxiety, and total depression scales were statistically higher in the CKD group. Separation anxiety, panic disorder, obsession, total anxiety, and total depression scales were higher in girls, and panic disorder, obsession, depression, total anxiety, and total depression scores were higher in younger ages in multivariate analysis. In the CKD group, family issues/problems increased panic disorder, obsession, depression, total anxiety, and total depression scales. Crying in tears/yelling response in children while facing a problem was associated with increased separation anxiety and social phobia rates. Also, preferring video applications was associated with separation anxiety and messaging applications with depression, total anxiety, and total depression. CONCLUSIONS Adolescents with CKD are at risk for depression, anxiety, obsession, and panic disorders. Also, crying in tears/yelling response may be at greater risk for anxiety among CKD adolescents. Early psychiatric evaluation and routine psychiatric follow-ups initiated early may improve the mental health of this vulnerable population.
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Affiliation(s)
- Ibrahim Kandemir
- Department of Pediatrics, Faculty of Medicine, Biruni University, Istanbul, Turkey.
| | - Kemal Gudek
- Medical Social Service Unit, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Aylin Yetim Sahin
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Melike Tugrul Aksakal
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elif Kucuk
- Department of Psychiatry, Yuksek Ihtisas University, Ankara, Turkey
| | - Zeynep Nagehan Yuruk Yildirim
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alev Yilmaz
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Nayir
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Firdevs Bas
- Division of Adolescent Medicine, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Kendzerska T, Radhakrishnan D, Amin R, Narang I, Boafo A, Robillard R, Talarico R, Blinder H, Spitale N, Katz SL. Obstructive Sleep Apnea and Mental Health Disorders in the Pediatric Population: A Retrospective, Population-based Cohort Study. Ann Am Thorac Soc 2024; 21:1299-1308. [PMID: 38669619 DOI: 10.1513/annalsats.202311-933oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/25/2024] [Indexed: 04/28/2024] Open
Abstract
Rationale: Information is limited about the association between obstructive sleep apnea (OSA) and mental health disorders in children. Objectives: In children, 1) to evaluate the association between OSA and new mental healthcare encounters; and 2) to compare mental healthcare encounters 2 years after to 2 years before OSA treatment initiation. Methods: We conducted a retrospective longitudinal cohort study using Ontario health administrative data (Canada). Children (0-18 yr) who underwent diagnostic polysomnography (PSG) 2009-2016 and met criteria for definition of moderate-severe OSA (PSG-OSA) were propensity score weighted by baseline characteristics and compared with children who underwent PSG in the same period but did not meet the OSA definition (PSG-No-OSA). Children were followed until March 2021. Weighted cause-specific Cox proportional hazards and modified Poisson regression models were used to compare time from PSG to first mental healthcare encounter and frequency of new mental healthcare encounters per person time, respectively. Among those who underwent adenotonsillectomy (AT) or were prescribed and claimed positive airway pressure therapy (PAP), we used age-adjusted conditional logistic regression models to compare 2 years post-treatment to pretreatment odds of mental healthcare encounters. Results: Of 32,791 children analyzed, 7,724 (23.6%) children met criteria for moderate-severe OSA. In the PSG-OSA group, 7,080 (91.7%) were treated (AT or PAP). Compared with PSG-No-OSA, the PSG-OSA group had a shorter time from PSG to first mental healthcare encounter (hazard ratio, 1.08; 95% confidence interval [CI], 1.05-1.12) but less frequent mental healthcare encounters in follow-up (rate ratio, 0.92; 95% CI, 0.87-0.97). OSA treatment (AT or PAP) was associated with lower odds of mental healthcare encounters 2 years after treatment initiation compared with 2 years before (odds ratio, 0.69; 95% CI, 0.65-0.74). Conclusions: In this large, population-based study of children who underwent PSG for sleep disorder assessment, OSA diagnosis/treatment was associated with an improvement in some mental health indicators, such as fewer new mental healthcare encounters compared with no OSA and lower odds of mental healthcare encounters compared with before OSA treatment.
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Affiliation(s)
- Tetyana Kendzerska
- Faculty of Medicine, Department of Medicine, and
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | - Dhenuka Radhakrishnan
- Faculty of Medicine, Department of Medicine, and
- ICES, Ottawa, Ontario, Canada
- The Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Reshma Amin
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Indra Narang
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Addo Boafo
- The Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Rebecca Robillard
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Sleep Research Unit, University of Ottawa Institute for Mental Health Research at The Royal, Ottawa, Ontario, Canada; and
| | - Robert Talarico
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
| | - Henrietta Blinder
- The Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Naomi Spitale
- Faculty of Medicine, Department of Medicine, and
- The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
| | - Sherri Lynne Katz
- The Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Nimphy CA, Elzinga BM, Van der Does W, Van Bockstaele B, Pérez-Edgar K, Westenberg M, Aktar E. "Nobody Here Likes Her"-The Impact of Parental Verbal Threat Information on Children's Fear of Strangers. Dev Psychobiol 2024; 66:e22526. [PMID: 38979744 DOI: 10.1002/dev.22526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/03/2024] [Accepted: 06/17/2024] [Indexed: 07/10/2024]
Abstract
Parental verbal threat (vs. safety) information about strangers may induce fears of these strangers in adolescents. In this multi-method experimental study, utilizing a within-subject design, parents provided standardized verbal threat or safety information to their offspring (N = 77, Mage = 11.62 years, 42 girls) regarding two strangers in the lab. We also explored whether the impact of parental verbal threat information differs depending on the social anxiety levels of parents or fearful temperaments of adolescents. Adolescent's fear of strangers during social interaction tasks was assessed using cognitive (fear beliefs, attention bias), behavioral (observed avoidance and anxiety), and physiological (heart rate) indices. We also explored whether the impact of parental verbal threat information differs depending on the social anxiety levels of parents or fearful temperaments of adolescents. The findings suggest that a single exposure to parental verbal threat (vs. safety) information increased adolescent's self-reported fears about the strangers but did not increase their fearful behaviors, heart rate, or attentional bias. Furthermore, adolescents of parents with higher social anxiety levels or adolescents with fearful temperaments were not more strongly impacted by parental verbal threat information. Longitudinal research and studies investigating parents' naturalistic verbal expressions of threat are needed to expand our understanding of this potential verbal fear-learning pathway.
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Affiliation(s)
- Cosima A Nimphy
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Bernet M Elzinga
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Willem Van der Does
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden University Treatment Center (LUBEC), Leiden, The Netherlands
| | - Bram Van Bockstaele
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Koraly Pérez-Edgar
- Department of Psychology, Child Study Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michiel Westenberg
- Department of Developmental Psychology, Institute of Psychology, Leiden, The Netherlands
| | - Evin Aktar
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
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Ijaz S, Rohail I, Irfan S. School-based intervention for anxiety using group cognitive behavior therapy in Pakistan: a feasibility randomized controlled trial. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:31. [PMID: 39158777 PMCID: PMC11333417 DOI: 10.1186/s41155-024-00311-4] [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] [Received: 01/27/2024] [Accepted: 07/03/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND Anxiety and mood disorders are the main cause of illness in people under the age of 25, accounting for 45% of the global disease burden, whereas 4.6% of teenagers aged 15 to 19 are predicted to experience anxiety. Pakistan country, with a population of 200 million, has the worst mental health indicators and fewer than 500 psychiatrists. Despite the existence of various treatments for anxiety, this goes unrecognized and untreated. Due to a lack of awareness, evaluation, prevention, and interventional programs related to being implemented among adolescents in Pakistan, there is a rise in mental health issues in the earlier years of life. It calls for a critical need for indigenous, evidence-based interventions. The present study aimed to evaluate the feasibility of cognitive behavioral therapy (CBT)-based interventions to reduce anxiety symptoms among school children in Pakistan. METHODS This study was a pre-post design, two-arm, single-blinded, feasibility, randomized controlled trial. Thirty-four participants (experimental group, n = 17; control group, n = 17) were recruited from four semi-government schools in Rawalpindi with a mean age of 15 (M = 15, SD = 0.73). Two instruments Beck Anxiety Inventory for Youth (BAI-Y II) and BASC-3 Behavioural and Emotional Screening System Student (BESS-SF) were used to assess the severity of symptoms. Participants in the intervention arm received eight-group therapy CBT sessions. A two-way factorial analysis was used to examine the efficacy of CBT in reducing symptom severity. RESULTS This study's findings showed that in comparison to the wait-list control group, CBT successfully improved anxiety symptoms among school children while enhancing their social skills. CONCLUSION This study will help improve the treatment for anxiety in Pakistan by prioritizing school-based intervention and group-based CBT intervention. TRIAL REGISTRATION The trial has been registered at the American Economic Association's registry for randomized controlled trials. RCT ID AEARCTR-0009551 . Registered 2022-07-04.
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Affiliation(s)
- Saman Ijaz
- Clinical Psychology, Public Sector Organization, Islamabad, Pakistan.
| | - Iffat Rohail
- Department of Psychology, Foundation University, Islamabad, Pakistan
| | - Shahid Irfan
- Afghan Migrants and Host Communities, International Organization for Migration, Islamabad, Pakistan
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Cernik R, Journault AA, Charbonneau S, Sauvageau C, Giguère CÉ, Raymond C, Lupien S. When talking goes awry: association between co-rumination and trait anxiety, test anxiety, and anxiety sensitivity in early and late adolescents. ANXIETY, STRESS, AND COPING 2024:1-10. [PMID: 39104257 DOI: 10.1080/10615806.2024.2388249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 06/12/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND AND OBJECTIVES Friends are major sources of social support for adolescents. This support may sometimes lead to co-rumination when the problem is discussed exhaustively with a focus on negative feelings. Co-rumination has been associated with some forms of anxiety, including clinical symptoms. Further studies are needed to investigate whether this association extends to additional and non-clinical forms of anxiety in youth. This study aimed to explore the relationship between co-rumination and trait anxiety, test anxiety, and anxiety sensitivity using secondary data. DESIGN AND METHODS In this 2019 cross-sectional study, 1204 (59% girls) Canadian 6th-grade early adolescents (ages 11-12) and 11th-grade late adolescents (ages 16-17) completed self-report questionnaires measuring co-rumination, trait anxiety, test anxiety, and anxiety sensitivity. RESULTS Co-rumination was associated with anxiety sensitivity in early adolescents and with trait anxiety, test anxiety, and anxiety sensitivity in late adolescents. CONCLUSIONS Developmental factors may play a role in the association between co-rumination and different forms of anxiety. Anxiety sensitivity may appear alongside co-rumination in early adolescence and may broaden to trait and test anxiety in late adolescence. These results extend our understanding of the relationship between co-rumination and anxiety, as well as generate hypotheses for future longitudinal studies.
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Affiliation(s)
- Rebecca Cernik
- Centre for Studies on Human Stress, Montréal, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Montréal, Canada
- Department of Psychiatry and addiction, Université de Montréal, Montréal, Canada
| | - Audrey-Ann Journault
- Centre for Studies on Human Stress, Montréal, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Montréal, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Sandrine Charbonneau
- Centre for Studies on Human Stress, Montréal, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Montréal, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | | | | | - Catherine Raymond
- Research Centre, Institut universitaire en santé mentale de Montréal, Montréal, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Sonia Lupien
- Centre for Studies on Human Stress, Montréal, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Montréal, Canada
- Department of Psychiatry and addiction, Université de Montréal, Montréal, Canada
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Jiang Z, Xu H, Wang X, Zhang W, Zhang A, Yu L, Hu S, Yang K, Yang Q, Li Y, Cui Y, Li Y. Psychopathology of cognitive disengagement syndrome (CDS): a network analysis based on CBCL scales in 72,106 Chinese school students. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02540-5. [PMID: 39096387 DOI: 10.1007/s00787-024-02540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 07/22/2024] [Indexed: 08/05/2024]
Abstract
Cognitive Disengagement Syndrome (CDS) is a cluster of behavioral problems that severely affect an individual's functioning. Currently, there is no consensus on the main clinical features of CDS, and further exploration in large samples is needed. Using a cluster-stratified random sampling method, 72,106 children and adolescents were recruited from five provinces in mainland China for this study. Using both the traditional two-factor scoring method and the CBCL DSM-oriented scales, we assessed individual behavioral problems from psychopathological and DSM-oriented perspectives. Network analysis was employed to explore the relationship between CDS and behavioral problems. The various networks were compared by gender and age subgroups. Among 72,106 participants (mean age, 11.49 years; minimum age, 5 years; maximum age, 16 years), there were 36,449 males (50.5%) and 35,657 females (49.5%). From a psychopathological perspective, the motor symptoms node was associated with the sad node and the withdrawn node, while the cognitive symptoms node was linked to the nervous node and the self-conscious node. In terms of gender, males had stronger associations of the motor symptoms node with the sad node and the withdrawn node than females (P = 0.043), and weaker associations of the cognitive symptoms node with the nervous node than females (P = 0.027). In terms of growth stage, the adolescent group had stronger associations of the cognitive symptoms node with the nervous node and the self-conscious node than the child group (P = 0.016, 0.001). From DSM perspective, motor symptoms node were associated with sad node, and cognitive symptoms node were related to can't concentrate node, nervous node, and worthless node. With increasing age, there was an upward trend in the strength of the cognitive and motor symptoms node. CDS is closely linked to psychological and behavioral issues, especially internalizing problems, with differences observed by gender and growth stage. The connection between CDS and the affective, anxiety, and ADH symptoms is particularly pronounced.
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Affiliation(s)
- Zhongliang Jiang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Hui Xu
- Big Data Center, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Xianbin Wang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Wenyan Zhang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Anyi Zhang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Liping Yu
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Shujin Hu
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Kai Yang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Qinghao Yang
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China
| | - Yanlin Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, 56 Nanlishi Road, Beijing, 100101, China.
| | - Ying Li
- Department of Psychosomatic Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University 56 Nanlishi Road, Beijing, 100101, China.
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Ko K, Jones A, Francis D, Robidoux S, McArthur G. Physiological correlates of anxiety in childhood and adolescence: A systematic review and meta-analysis. Stress Health 2024; 40:e3388. [PMID: 38451702 DOI: 10.1002/smi.3388] [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: 05/02/2023] [Revised: 11/18/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024]
Abstract
Anxiety is one of the most prevalent problems that affects children and adolescents. The vast majority of diagnostic tools for anxiety depend on written or verbal reports from children and adolescents or their significant others. The validity and reliability of such reports can be compromised by their subjective nature. Thus, there is growing interest in whether anxiety can be indexed with objective physiological measures. The key aim of this systematic review and meta-analysis was to determine which physiological measures are most reliably associated with elevated levels of anxiety amongst children and adolescents. Online databases (e.g., PsycINFO, Embase, Medline) were searched for relevant studies according to pre-determined criteria. Twenty-five studies comprising 2502 participants (N = 1160 with high anxiety) met inclusion, identifying 11 groups of physiological measures. Our meta-analysis revealed that skin conductance level is the most sensitive measure of anxiety (d = 0.83), followed by electromyography (EMG) measures (d = 0.71) and skin conductance response (d = 0.58). However, the included studies varied in terms of subjective measures, study designs, experimental task measures, and physiological measures. Consideration of these differences in methodology offer potential directions for future research.
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Affiliation(s)
- Katherine Ko
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Alana Jones
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Deanna Francis
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Serje Robidoux
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Genevieve McArthur
- Australian Centre for the Advancement of Literacy, Australian Catholic University, Sydney, New South Wales, Australia
- Dyslexia-SPELD Foundation Literacy and Clinical Services, South Perth, Western Australia, Australia
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Marini A, Farmakopoulou I, Dritsas I, Gkintoni E. Clinical Signs and Symptoms of Anxiety Due to Adverse Childhood Experiences: A Cross-Sectional Trial in Adolescents. Healthcare (Basel) 2024; 12:1515. [PMID: 39120218 PMCID: PMC11311440 DOI: 10.3390/healthcare12151515] [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: 03/23/2024] [Revised: 06/12/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents. METHODS A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State-Trait Anxiety Inventory for Children-STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale. RESULTS The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001). CONCLUSIONS This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.
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Affiliation(s)
| | - Ignatia Farmakopoulou
- Department of Education and Social Work, University of Patras, 26504 Patras, Greece; (I.F.); (I.D.)
| | - Ioannis Dritsas
- Department of Education and Social Work, University of Patras, 26504 Patras, Greece; (I.F.); (I.D.)
| | - Evgenia Gkintoni
- Department of Psychiatry, University General Hospital of Patras, 26504 Patras, Greece
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10
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Kim JH, Kim J, Jang SY, Park EC. Association between watching eating broadcasts like mukbang and cookbang and generalized anxiety disorder among Korean adolescents. BMC Psychiatry 2024; 24:536. [PMID: 39080570 PMCID: PMC11290270 DOI: 10.1186/s12888-024-05957-z] [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: 03/25/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Anxiety disorders are common during adolescence; therefore, detecting anxiety disorders among adolescents and providing appropriate treatment are crucial. Studies have suggested that watching online audiovisual broadcasts like mukbang and cookbang (hereafter mukbang), where hosts eat or cook food, may influence anxiety disorders. However, there is insufficient research on the association between watching mukbang and generalized anxiety disorder (GAD). Therefore, we investigated the association between watching mukbang and GAD among Korean adolescents. METHODS We analyzed 51,764 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-Based Survey (KYRBS). The participants were asked how frequently they watched mukbang per week over the past 12 months. Anxiety disorders were assessed using the generalized anxiety disorder-7 (GAD-7) questionnaire. A multiple logistic regression analysis was performed after adjusting for confounding variables. RESULTS The prevalence of GAD was higher among adolescents who watched mukbang compared to those who did not (aOR: 1.100, 95% CI: 1.026-1.180, P = 0.008 in male participants; aOR: 1.090, 95% CI: 1.003-1.185, P = 0.042 in female participants). The frequency of watching mukbang showed a dose-dependent relationship with a greater likelihood of GAD in female adolescents. CONCLUSION This study's results showed that watching mukbang is associated with GAD in Korean adolescents. Proper interventions for mental health are needed for adolescents who watch mukbang.
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Affiliation(s)
- Jung-Hwan Kim
- Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
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11
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Díaz DE, Russman Block SR, Becker HC, Phan KL, Monk CS, Fitzgerald KD. Neural Substrates of Emotion Processing and Cognitive Control Over Emotion in Youth Anxiety: An RDoC-Informed Study Across the Clinical to Nonclinical Continuum of Severity. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00363-0. [PMID: 39059719 DOI: 10.1016/j.jaac.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/19/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE Clinically anxious youth are hypervigilant to emotional stimuli and display difficulty shifting attention from emotional to nonemotional stimuli, suggesting impairments in cognitive control over emotion. However, it is unknown whether the neural substrates of such biases vary across the clinical-to-nonclinical range of anxiety or by age. METHOD Youth aged 7 to 17 years with clinical anxiety (n = 119) or without an anxiety diagnosis (n = 41) matched emotional faces or matched shapes flanked by emotional face distractors during magnetic resonance imaging, probing emotion processing and cognitive control over emotion, respectively. Building from the National Institute of Mental Health Research Domain Criteria (RDoC) framework, clinically anxious youth were sampled across diagnostic categories, and non-clinically affected youth were sampled across minimal-to-subclinical severity. RESULTS Across both conditions, anxiety severity was associated with hyperactivation in the right inferior parietal lobe, a substrate of hypervigilance. Brain-anxiety associations were also differentiated by attentional state; anxiety severity was associated with greater left ventrolateral prefrontal cortex activation during emotion processing (face matching) and greater activation in the left posterior superior temporal sulcus and temporoparietal junction (and slower responses) during cognitive control over emotion (shape matching). Age also moderated associations between anxiety and cognitive control over emotion, such that anxiety was associated with greater right thalamus and bilateral posterior cingulate cortex activation for children at younger and mean ages, but not for older youth. CONCLUSION Aberrant function in brain regions implicated in stimulus-driven attention to emotional distractors may contribute to anxiety in youth. Results support the potential utility of attention modulation interventions for anxiety that are tailored to developmental stage. CLINICAL TRIAL REGISTRATION INFORMATION Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety; https://clinicaltrials.gov; NCT02810171.
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Affiliation(s)
- Dana E Díaz
- Columbia University Irving Medical Center, New York, New York.
| | | | | | | | | | - Kate D Fitzgerald
- Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
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12
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Hauffe V, Vierrath V, Tuschen-Caffier B, Schmitz J. Daily-life reactivity and emotion regulation in children with social anxiety disorder. J Anxiety Disord 2024; 106:102907. [PMID: 39059189 DOI: 10.1016/j.janxdis.2024.102907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 06/01/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
Prominent models of adult social anxiety disorder emphasize the role of hyperreactivity and emotion regulation (ER) difficulties. However, it is unclear whether these factors are relevant in childhood, a critical period for the development of this disorder. We used ecological momentary assessment with mobile phones to assess daily-life emotional reactivity and use and effectiveness of ER strategies in children aged 10-13 years. We compared three groups: Social anxiety disorder (n = 29), clinical controls with mixed anxiety disorders (n = 27) and healthy controls (n = 31). We also investigated long-term effects of ER on trait social anxiety 12 months later. Hierarchical linear modelling revealed higher emotional reactivity and more use of suppression in children with social anxiety disorder compared to clinical and healthy controls. Contrary to our expectations, children with social anxiety disorder reported more use of avoidance and reappraisal compared to clinical, but not healthy, controls. The groups did not differ in subjective effectiveness of ER strategies. Use of suppression, avoidance, and rumination each predicted an increase in social anxiety 12 months later. Taken together, our results extend previous findings from lab and questionnaire studies and illustrate the role of maladaptive ER for child social anxiety disorder.
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Affiliation(s)
- Vera Hauffe
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Freiburg University, Germany.
| | - Verena Vierrath
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Freiburg University, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Freiburg University, Germany
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Germany; Leipzig Research Center for Early Child Development, Leipzig University, Germany
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13
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Estrada-Prat X, Estrada E, Tor J, Mezzatesta M, Aranbarri A, Aizpitarte A, Butjosa A, Albiac N, Fabrega M, Haro JM, Pineda II, Alda JA, Virgili C, Camprodon E, Dolz M, Keating C, Via E. Caregiver-reported emotional-behavioral symptoms in Spanish youth during the COVID-19 pandemic: a longitudinal study. Pediatr Res 2024:10.1038/s41390-024-03364-4. [PMID: 38982168 DOI: 10.1038/s41390-024-03364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND COVID-19 pandemic stressors affected youth's mental health. This longitudinal study aims to explore these effects while considering predictive factors such as age and sex. METHODS An initial sample of 1502 caregivers answered a longitudinal survey evaluating their youths' (4-17 years of age) emotional/behavioral symptoms using the Pediatric Symptom Checklist (PSC) screening tool. First assessment in May-July 2020 included the prior year's retrospective (TR) and since-lockdown-start (T0) PSC, followed by monthly evaluations until February 2021. RESULTS A positive screening PSC (PSC+) was reported in 13.09% of cases at TR and 35.01% at T0, but the likelihood of PSC+ quickly decreased over time. At T0, a more pronounced impact was found on children (39.7%) compared to adolescents (25.4%); male children exhibited higher risk for a PSC+ at T0 and longitudinally than females. Adolescents presented a weaker effect of time-improvement. PSC+ at TR, experienced stressors, and caregiver's stress/depressive symptoms positively predicted PSC+ at T0 and longitudinally; adolescents' unproductive coping style predicted PSC+ at T0. CONCLUSION: The study shows a caregiver-reported increase in emotional/behavioral symptoms in youths during the COVID-19 pandemic, affecting predominantly younger children in the early stages and showing gradual improvement over time, albeit possibly slower in adolescents. IMPACT The results show the anticipated surge in emotional and behavioral symptoms during the COVID-19 lockdown in youth reported by caregivers, followed by subsequent amelioration. Of greater significance, the study reveals a heightened impact on young children initially, yet it suggests a slower improvement trajectory in adolescents. The study also identifies risk factors linked to emotional and behavioral symptoms within each age group. Alongside the longitudinal approach, the authors underscore the remarkable inclusion of a significant representation of young children, an unusual feature in such surveys.
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Affiliation(s)
- Xavier Estrada-Prat
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Eduardo Estrada
- Department of Social Psychology and Methodology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain.
| | - Marcela Mezzatesta
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Aritz Aranbarri
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Alazne Aizpitarte
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Anna Butjosa
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Albiac
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Marina Fabrega
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Immaculada Insa Pineda
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Jose A Alda
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Carles Virgili
- Independent researcher in collaboration with the Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Ester Camprodon
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Charlotte Keating
- Independent researcher in collaboration with the Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain.
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14
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Kassa MA, Anbesaw T, Nakie G, Melkam M, Azmeraw M, Semagn EG, Abate BB. Investigating war trauma, its effects, and associated risk factors on anxiety among high school students in Woldia town, northeast Ethiopia, 2022. Front Psychiatry 2024; 15:1368285. [PMID: 39056017 PMCID: PMC11270624 DOI: 10.3389/fpsyt.2024.1368285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/13/2024] [Indexed: 07/28/2024] Open
Abstract
Background Anxiety symptoms are the most frequent mental health problems in the world, and it is a serious public health concern, especially among adolescents, because if left untreated, adolescent anxiety can have a number of detrimental effects, including lower academic performance, strained relationships with friends and family, substance addiction, thoughts of suicide and homicide, and trouble finding work. While this vulnerability is concerning in all situations, it is particularly critical in armed conflict areas. Ethiopia is one of the most recent war-affected countries, but to the best of our knowledge, limited studies focused on adolescents in this context. Therefore, this study assessed the experience of war trauma and its effects on anxiety symptoms among high school students in Woldia town, Ethiopia. Objective We assessed the experience of war trauma and its effects on anxiety among high school students, as well as associated risk factors, in war-affected areas in Woldia town, northeast Ethiopia. Methods A cross-sectional study design was conducted from May 23 to June 08 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression analyses were used to identify independent factors associated with anxiety. Results A total of 624 out of 660 students participated in the study (94.5% response rate). The prevalence of anxiety among high school students in Woldia town was 39.7%. In the multivariable analysis, having depression (AOR = 9.24, 95% CI: 6.27, 13.64), witnessing the murder of family/friends (AOR = 1.93, 95% CI: 1.05, 3.57), being of female sex (AOR=1.59, 95% CI: 1.08, 2.36), and having a family history of mental illness (AOR=1.69, 95% CI: 1.00, 2.85) were factors significantly associated with anxiety. Conclusions and recommendations The prevalence of anxiety in this study was approximately two in five high school students. Therefore, we recommend that the Ministry of Education collaborate with the Ministry of Health to expand and implement mental health services in high schools to promote the wellbeing of students for the prevention of anxiety.
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Affiliation(s)
- Mulat Awoke Kassa
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Azmeraw
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Elsabet Gezmu Semagn
- Department of Veterinary Parasitology, College of Veterinary Medicine, Wollo University, Dessie, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
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15
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Strom NI, Verhulst B, Bacanu SA, Cheesman R, Purves KL, Gedik H, Mitchell BL, Kwong AS, Faucon AB, Singh K, Medland S, Colodro-Conde L, Krebs K, Hoffmann P, Herms S, Gehlen J, Ripke S, Awasthi S, Palviainen T, Tasanko EM, Peterson RE, Adkins DE, Shabalin AA, Adams MJ, Iveson MH, Campbell A, Thomas LF, Winsvold BS, Drange OK, Børte S, Ter Kuile AR, Nguyen TH, Meier SM, Corfield EC, Hannigan L, Levey DF, Czamara D, Weber H, Choi KW, Pistis G, Couvy-Duchesne B, Van der Auwera S, Teumer A, Karlsson R, Garcia-Argibay M, Lee D, Wang R, Bjerkeset O, Stordal E, Bäckmann J, Salum GA, Zai CC, Kennedy JL, Zai G, Tiwari AK, Heilmann-Heimbach S, Schmidt B, Kaprio J, Kennedy MM, Boden J, Havdahl A, Middeldorp CM, Lopes FL, Akula N, McMahon FJ, Binder EB, Fehm L, Ströhle A, Castelao E, Tiemeier H, Stein DJ, Whiteman D, Olsen C, Fuller Z, Wang X, Wray NR, Byrne EM, Lewis G, Timpson NJ, Davis LK, Hickie IB, Gillespie NA, Milani L, Schumacher J, Woldbye DP, Forstner AJ, Nöthen MM, Hovatta I, Horwood J, Copeland WE, Maes HH, McIntosh AM, Andreassen OA, Zwart JA, Mors O, Børglum AD, Mortensen PB, Ask H, Reichborn-Kjennerud T, Najman JM, Stein MB, Gelernter J, Milaneschi Y, Penninx BW, Boomsma DI, Maron E, Erhardt-Lehmann A, Rück C, Kircher TT, Melzig CA, Alpers GW, Arolt V, Domschke K, Smoller JW, Preisig M, Martin NG, Lupton MK, Luik AI, Reif A, Grabe HJ, Larsson H, Magnusson PK, Oldehinkel AJ, Hartman CA, Breen G, Docherty AR, Coon H, Conrad R, Lehto K, Deckert J, Eley TC, Mattheisen M, Hettema JM. Genome-wide association study of major anxiety disorders in 122,341 European-ancestry cases identifies 58 loci and highlights GABAergic signaling. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.03.24309466. [PMID: 39006447 PMCID: PMC11245051 DOI: 10.1101/2024.07.03.24309466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
The major anxiety disorders (ANX; including generalized anxiety disorder, panic disorder, and phobias) are highly prevalent, often onset early, persist throughout life, and cause substantial global disability. Although distinct in their clinical presentations, they likely represent differential expressions of a dysregulated threat-response system. Here we present a genome-wide association meta-analysis comprising 122,341 European ancestry ANX cases and 729,881 controls. We identified 58 independent genome-wide significant ANX risk variants and 66 genes with robust biological support. In an independent sample of 1,175,012 self-report ANX cases and 1,956,379 controls, 51 of the 58 associated variants were replicated. As predicted by twin studies, we found substantial genetic correlation between ANX and depression, neuroticism, and other internalizing phenotypes. Follow-up analyses demonstrated enrichment in all major brain regions and highlighted GABAergic signaling as one potential mechanism underlying ANX genetic risk. These results advance our understanding of the genetic architecture of ANX and prioritize genes for functional follow-up studies.
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Affiliation(s)
- Nora I Strom
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Brad Verhulst
- Psychiatry and Behavioral Sciences, Texas A&M University, College Station, Texas, USA
| | | | - Rosa Cheesman
- PROMENTA Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Kirstin L Purves
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hüseyin Gedik
- Institute for Genomics in Health, Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
- Life Sciences, Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, Virginia, USA
- Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Brittany L Mitchell
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, Queensland University , Brisbane, Queensland, Australia
| | - Alex S Kwong
- Bristol Medical School, Population Health Sciences, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Centre for Clinical Brain Sciences, Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Annika B Faucon
- Division of Medicine, Human Genetics, Vanderbilt University, Nashville, Tennessee, USA
| | - Kritika Singh
- Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sarah Medland
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Lucia Colodro-Conde
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Kristi Krebs
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Biomedicine, Human Genomics Research Group, University of Basel; University Hospital Basel, Basel, Switzerland
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, Medical Faculty, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, Human Genomics Research Group, University of Basel; University Hospital Basel, Basel, Switzerland
| | - Jan Gehlen
- Center for Human Genetics, University of Marburg, Marburg, Germany
| | - Stephan Ripke
- Dept. of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Swapnil Awasthi
- Dept. of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Teemu Palviainen
- Helsinki Institute of Life Science, Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Elisa M Tasanko
- Faculty of Medicine, Department of Psychology and Logopedics, SleepWell Research Program, University of Helsinki, Helsinki, Finland
| | - Roseann E Peterson
- Institute for Genomics in Health, Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
- Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Daniel E Adkins
- School of Medicine, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Andrey A Shabalin
- School of Medicine, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Mark J Adams
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Matthew H Iveson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Archie Campbell
- College of Medicine and Veterinary Medicine, Institute of Genetics and Cancer; Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Laurent F Thomas
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- BioCore - Bioinformatics Core Facility, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bendik S Winsvold
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Ole Kristian Drange
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Mental Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- NORMENT Centre, University of Oslo, Oslo, Norway
- Centre of Precision Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- Department of Psychiatry, Sørlandet Hospital, Kristiansand, Norway
| | - Sigrid Børte
- Division of Clinical Neuroscience, Department of Research and Innovation; Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Abigail R Ter Kuile
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Tan-Hoang Nguyen
- Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sandra M Meier
- Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Elizabeth C Corfield
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute , Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Laurie Hannigan
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Daniel F Levey
- Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
- Psychiatry, Research, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Darina Czamara
- Department of Genes and Environment, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Karmel W Choi
- Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Giorgio Pistis
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Baptiste Couvy-Duchesne
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- ARAMIS laboratory, Paris Brain Institute, Paris, France
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Miguel Garcia-Argibay
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Donghyung Lee
- Department of Statistics, Miami University, Oxford, Ohio, USA
| | - Rujia Wang
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eystein Stordal
- Department of Psychiatry, Hospital Namsos, Nord-Trøndelag Health Trustt, Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Julia Bäckmann
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Giovanni A Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Child Psychiatry, National Institute of Developmental Psychiatry, São Paulo, Brazil
| | - Clement C Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - James L Kennedy
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Gwyneth Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Arun K Tiwari
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Jaakko Kaprio
- Helsinki Institute of Life Science, Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Martin M Kennedy
- Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Joseph Boden
- Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alexandra Havdahl
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- PROMENTA Centre, Department of Psychology, University of Oslo, Oslo, Norway
- Bristol Medical School, Population Health Sciences, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Christel M Middeldorp
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Fabiana L Lopes
- National Institute of Mental Health, Human Genetics Branch, National Institutes of Health, Bethesda, Maryland, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Nirmala Akula
- National Institute of Mental Health, Genetic Basis of Mood and Anxiety Disorders, National Institutes of Health, Bethesda, Maryland, USA
| | - Francis J McMahon
- National Institute of Mental Health, Genetic Basis of Mood and Anxiety Disorders, National Institutes of Health, Bethesda, Maryland, USA
- Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elisabeth B Binder
- Department of Genes and Environment, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Lydia Fehm
- Department of Psychology, Zentrum für Psychotherapie, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Enrique Castelao
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Henning Tiemeier
- Social and Behavioral Science, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - David Whiteman
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Catherine Olsen
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | | | - Naomi R Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Enda M Byrne
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Glyn Lewis
- UCL Division of Psychiatry, University College London, London, UK
| | - Nicholas J Timpson
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - Lili Milani
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | | | - David P Woldbye
- Department of Neuroscience, Laboratory of Neural Plasticity, University of Copenhagen, Copenhagen, Denmark
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Center for Human Genetics, University of Marburg, Marburg, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Iiris Hovatta
- Faculty of Medicine, Department of Psychology and Logopedics and SleepWell Research Program, University of Helsinki, Helsinki, Finland
| | - John Horwood
- Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - William E Copeland
- UVM Medical Center, Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Hermine H Maes
- Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
- Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Andrew M McIntosh
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ole A Andreassen
- NORMENT Centre, University of Oslo, Oslo, Norway
- Centre of Precision Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- K. G. Jebsen Center for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research and Innovation; Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole Mors
- Department of Psychiatry, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
| | - Anders D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalised Medicine, Aarhus University, Aarhus, Denmark
| | - Preben B Mortensen
- The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Helga Ask
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- NORMENT Centre, University of Oslo, Oslo, Norway
| | - Jackob M Najman
- Faculty of Medicine, School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - Murray B Stein
- Psychiatry, University of California San Diego, La Jolla, CA, USA
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Joel Gelernter
- Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
- Psychiatry Research, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
- Departments of Genetics and Neuroscience, Yale University of Medicine, New Haven, Connecticut, USA
| | - Yuri Milaneschi
- Amsterdam Neuroscience; Amsterdam Public Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Brenda W Penninx
- Amsterdam Neuroscience; Amsterdam Public Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Dorret I Boomsma
- Twin Register and Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Eduard Maron
- Psychiatry, University of Tartu, Tartu, Estonia
- Department of Medicine, Centre for Neuropsychopharmacology,, Division of Brain Sciences, Imperial College London, London, UK
| | - Angelika Erhardt-Lehmann
- Department of Genes and Environment, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Tilo T Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Christiane A Melzig
- Psychology, Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
- Psychology, Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Georg W Alpers
- School of Social Sciences, Department of Psychology, University of Mannheim, Mannheim, Germany
| | - Volker Arolt
- Department of Mental Health, Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
| | - Jordan W Smoller
- Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Nicholas G Martin
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Michelle K Lupton
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, Queensland University , Brisbane, Queensland, Australia
- Faculty of Health, Queensland University of technology, Queensland, Australia
| | - Annemarie I Luik
- Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Henrik Larsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Albertine J Oldehinkel
- Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Catharina A Hartman
- Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anna R Docherty
- School of Medicine, Psychiatry, University of Utah, Salt Lake City, Utah, USA
- School of Medicine, Psychiatry; Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hilary Coon
- School of Medicine, Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Kelli Lehto
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Thalia C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Manuel Mattheisen
- Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - John M Hettema
- Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas, USA
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16
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Conroy K, Urcuyo AE, Schiavone E, Obee A, Frazier SL, Cramer E, Comer JS. Understanding Signs and Sources of Anxiety in Urban Elementary Schools Serving Predominately Ethnically/Racially Minoritized Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-16. [PMID: 38949878 DOI: 10.1080/15374416.2024.2361731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
OBJECTIVE This mixed-methods study examined teachers' perceptions of student anxiety in urban elementary schools serving predominantly low-income and ethnically/racially minoritized youth. METHOD Most participating teachers were female (87.7%) and from minoritized backgrounds themselves (89.2%), teaching in schools serving predominantly Black/African American (40%) or Hispanic (60%) students, and in which > 70% of students are eligible for free meals. Teachers were asked in surveys (N = 82) and interviews (n = 12) about the nature of student anxiety, and cultural/contextual considerations that influence anxiety. RESULTS Overall, teachers reported prevalence and signs of student anxiety that were consistent with the literature, but they reported higher levels of impairment than in previous community samples. Regressions revealed that greater levels of student exposure to community violence and higher proportions of Black students were associated with higher teacher-perceived prevalence and concern about student anxiety, respectively. Moreover, greater emotional exhaustion in teachers was associated with higher reports of anxiety-related impairment in students. Thematic coding of interviews emphasized how teachers perceived 1) most student anxieties to be proportional responses to realistic threats and stress in students' lives (e.g. resource insecurity), 2) systems-level problems (e.g. pressure to perform on standardized tests) contribute to student anxiety, and 3) school-based anxiety sources often interact with traumas and stressors students experience outside of school (e.g. immigration experiences). CONCLUSIONS Relative to the predominant literature that has focused on biological, cognitive, and other intraindividual factors as sources of anxiety, the present work underscores the importance of considering how broader economic and systems-level influences exacerbate anxiety in marginalized youth.
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Affiliation(s)
| | - Anya E Urcuyo
- Department of Psychology, Florida International University
| | | | - Averill Obee
- Department of Psychology, Florida International University
| | | | - Elizabeth Cramer
- Department of Teaching and Learning, Florida International University
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17
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Inci Izmir SB, Korkmazlar Ü, Ercan ES. Eye Movement Desensitization and Reprocessing Therapy in Adolescents With Panic Disorder: A Twelve-Week Follow-Up Study. Clin Child Psychol Psychiatry 2024; 29:966-981. [PMID: 37328192 DOI: 10.1177/13591045231184757] [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] [Indexed: 06/18/2023]
Abstract
The aim of this study is to investigate the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) treatment in adolescents with panic disorder (PD). This follow-up study consists of 30 adolescents with PD without agoraphobia, aged 14-17 (15.53 ± .97). They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, also the Panic and Agoraphobia Scale (PAS) and Beck Anxiety Inventory (BAI) were administered at baseline, at the end of the 4th and 12th weeks of treatment. EMDR therapy which is an eight-phase treatment approach composed of standardized protocols and procedures was applied for 12 weeks, one session per week. The baseline mean of the total PAS score decreased from 40.06 to 13.13 at fourth week and 1.2 at the end of 12th week of treatment. In addition, BAI score decreased significantly from 33.67 to 13.83 at 4 weeks and 5.31 at the end of 12th week of treatment. Overall, our results underscore the effectiveness of EMDR in adolescents with PD. Moreover, the current study suggests that EMDR may represent an effective intervention technique for PD in adolescents to protect against relapses and to overcome a fear of future attacks.
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Affiliation(s)
- Sevim Berrin Inci Izmir
- Department of Clinical Psychology, Institute on Social Science, Isık University, İstanbul, Turkey
| | - Ümran Korkmazlar
- Child and Adolescent Psychiatry Department, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Eyüp Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey
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18
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Zhang B, Wang J, Abdullah AB. The effects of art therapy interventions on anxiety in children and adolescents: A meta-analysis. Clinics (Sao Paulo) 2024; 79:100404. [PMID: 38936289 PMCID: PMC11260852 DOI: 10.1016/j.clinsp.2024.100404] [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: 02/08/2024] [Accepted: 05/18/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE This study aimed to assess the effects of art therapy on anxiety among children and adolescents. METHODS We searched several databases, including PubMed, Web of Science, Embase (via Ovid), PsychINFO (through EBSCO), and The Cochrane Library, comprising the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials. Additionally, Chinese databases such as CNKI (China National Knowledge Infrastructure) and Wan Fang Data were explored from their beginnings until October 22, 2023. Studies that investigated the impact of art therapy on anxiety compared to a control group were included. The methodological quality of these randomized controlled trials was evaluated using the Cochrane Handbook's risk of bias instrument. RESULTS Six studies involving 422 participants were included. The findings indicated a notable decrease in anxiety symptoms due to art therapy, with a Standardized Mean Difference (SMD) of -1.42, 95% Confidence Interval (95%CI -2.33, -0.51), p < 0.002. Notably, there was pronounced heterogeneity, as evidenced by Tau2 = 1.41, Chi2 = 101.19, df = 6, and I² = 94%, with Z = 3.06. CONCLUSION Art therapy significantly improved the anxiety symptoms of children and adolescents, positioning it as an effective means of treating anxiety.
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Affiliation(s)
- Bo Zhang
- Guizhou Equipment Manufacturing Polytechnic, Guizhou, China; Universiti Utara Malaysia, Malaysia.
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19
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Rauschenbach AL, Hauffe V, Fink-Lamotte J, Tuschen-Caffier B, Schmitz J. Reduced early neural processing of faces in children and adolescents with social anxiety disorder. Biol Psychol 2024; 191:108827. [PMID: 38852877 DOI: 10.1016/j.biopsycho.2024.108827] [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: 02/07/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
Social anxiety disorder (SAD) is one of the most common mental disorders during childhood and adolescence. Yet, little is known about its maintenance in youth. Cognitive models of SAD indicate that attentional biases play a key role in the dysfunctional processing of social information, such as emotional faces. However, previous research investigating neural correlates of childhood SAD has produced inconsistent findings. The current study aims to investigate neural face processing in children and adolescents with SAD, while taking into consideration methodological limitations of previous studies. We measured event-related potentials (P100, N170, EPN, LPP) in response to happy, neutral, and angry adult faces, and non-social household objects, in a sample of youth (aged 10-15 years) with SAD (n = 57), clinical controls with specific phobias (SP; n = 41), and healthy controls (HC; n = 61). Participants completed an emotion/object identification task while continuous EEG was recorded. Analyses revealed lower N170 amplitudes in the SAD group compared to HCs, irrespective of emotion. In addition, younger children (aged 10-12 years) with SAD showed lower EPN amplitudes and higher early LPP amplitudes (only trend level) in response to neutral and happy faces compared to younger HCs. These effects were specific to faces and were not evident in the neural processing of non-social household objects. Overall, the findings indicate that different neural response patterns are already present in youth with SAD. Group differences, particularly in younger children, suggest age-related differences in neural face processing in childhood SAD and underpin the necessity of developmental approaches.
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Affiliation(s)
- Anna-Lina Rauschenbach
- Department of Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9, 04109 Leipzig, Germany.
| | - Vera Hauffe
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, 79106 Freiburg im Breisgau, Germany
| | - Jakob Fink-Lamotte
- Department of Psychology, Clinical Psychology, University of Potsdam, Karl-Liebknecht-Str. 24/45, 14476 Potsdam, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, 79106 Freiburg im Breisgau, Germany
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9, 04109 Leipzig, Germany
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20
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Kösters MP, Chinapaw MJ, Zwaanswijk M, van der Wal MF, Koot HM. Differences in Anxiety and Depression Among Migrant and Non-Migrant Primary School Children in The Netherlands. Child Psychiatry Hum Dev 2024; 55:588-598. [PMID: 36322235 PMCID: PMC11061058 DOI: 10.1007/s10578-022-01454-0] [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: 06/07/2022] [Revised: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
This is the first Dutch study investigating symptoms of five DSM-IV-classified anxiety disorders and depression in a large sample of pre-adolescent children with and without a migration background, adjusting for socioeconomic position (SEP) and social preference. Both are potential explanatory factors for differences in mental health among migrant children. We measured anxiety and depression scores with the self-report Revised Child Anxiety and Depression Scale (RCADS) in 2063 children (aged 8-13 years, 55% girls) in the Netherlands. Surinamese/Antillean, Turkish, and Moroccan children reported significantly higher anxiety scores than Dutch children. SEP and peer rejection partly explained higher anxiety scores. Surinamese/Antillean and Turkish children reported comparable depression scores to Dutch children, but Moroccan children reported lower depression scores after adjusting for SEP and peer rejection. Girls reported higher anxiety and depression levels across all four subgroups. Although differences between children with or without a migration background were small, these may increase in later life as the prevalence of anxiety and depression increases with age.
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Affiliation(s)
- Mia P Kösters
- Healthy Living Department, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Mai Jm Chinapaw
- Amsterdam UMC location Vrije Universiteit Amsterdam, dept Public and Occupational Health, Amsterdam, The Netherlands
| | - Marieke Zwaanswijk
- Dutch Knowledge Centre for Child and Adolescent Psychiatry, Utrecht, The Netherlands
| | - Marcel F van der Wal
- Healthy Living Department, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Hans M Koot
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
- Department of Clinical, Neuro‑ and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
- Department of Clinical, Neuro‑ and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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21
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Whiteside SPH, Biggs BK, Geske JR, Gloe LM, Reneson-Feeder ST, Cunningham M, Dammann JE, Brennan E, Ong ML, Olsen MW, Hofschulte DR. Parent-coached exposure therapy versus cognitive behavior therapy for childhood anxiety disorders. J Anxiety Disord 2024; 104:102877. [PMID: 38788593 DOI: 10.1016/j.janxdis.2024.102877] [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: 02/09/2024] [Revised: 04/30/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
Cognitive-behavioral therapy (CBT) is the strongest evidenced-based therapy for childhood anxiety disorders (CADs). However, CBT's impact is limited by its lack of clear superiority over treatment as usual, excessive length, and greater than 50% of patients remaining symptomatic. Parent-coached exposure therapy (PCET) is designed to treat CADs more effectively and efficiently through a focus on exposure and working with parents and youth together. In a randomized controlled trial, 78 patients (78% female) aged 7 to 17 with CADs were assigned to PCET or the gold-standard CBT. The primary outcome was independent evaluator ratings of anxiety severity at mid- and post-treatment. Secondary outcomes were parent- and child-reported symptoms. Patients receiving PCET had significantly lower mean scores than those receiving CBT on the primary outcome measure at mid-treatment (3.03 ± 0.14, 95% CI, 2.75-3.32 vs. 3.77 ± 0.16 95% CI, 3.45-4.08, p = 0.0010) and post-treatment (2.79 ± 0.14, 95% CI, 2.50-3.07 vs. 3.33 ± 0.16, 95% CI, 2.02-3.64, p = 0.0153). Similar significant results were found with the secondary parent- and child-reported outcomes. These superior results were achieved in PCET with fewer sessions (6.62, SD = 2.8) than those in CBT (8.00, SD = 3.1), p = 0.041. The superior effectiveness and efficiency of PCET likely results from the greater focus on implementing exposure exercises compared to traditional CBT.
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Affiliation(s)
| | - Bridget K Biggs
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Jennifer R Geske
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, USA
| | - Lilianne M Gloe
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Megan Cunningham
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Julie E Dammann
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Elle Brennan
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Mian Li Ong
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Mark W Olsen
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Deanna R Hofschulte
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
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22
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Klein AM, Hagen A, Mobach L, Zimmermann R, Baartmans JMD, Rahemenia J, de Gier E, Schneider S, Ollendick TH. The Importance of Practicing at Home During and Following Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Conceptual Review and New Directions to Enhance Homework Using Mhealth Technology. Clin Child Fam Psychol Rev 2024; 27:602-625. [PMID: 38616213 PMCID: PMC11222243 DOI: 10.1007/s10567-024-00476-5] [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] [Accepted: 03/08/2024] [Indexed: 04/16/2024]
Abstract
Practicing newly acquired skills in different contexts is considered a crucial aspect of Cognitive Behavioral Therapy (CBT) for anxiety disorders (Peris et al. J Am Acad Child Adolesc Psychiatry 56:1043-1052, 2017; Stewart et al. Prof Psychol Res Pract 47:303-311, 2016). Learning to cope with feared stimuli in different situations allows for generalization of learned skills, and experiencing non-occurrence of the feared outcome helps in developing non-catastrophic associations that may enhance treatment outcomes (Bandarian-Balooch et al. J Behav Ther Exp Psychiatry 47:138-144, 2015; Cammin-Nowak et al. J Clin Psychol 69:616-629, 2013; Kendall et al. Cogn Behav Pract 12:136-148, 2005; Tiwari et al. J Clin Child Adolesc Psychol 42:34-43, 2013). To optimize treatment outcome, homework is often integrated into CBT protocols for childhood anxiety disorders during and following treatment. Nevertheless, practicing at home can be challenging, with low motivation, lack of time, and insufficient self-guidance often listed as reasons for low adherence (Tang and Kreindler, JMIR Mental Health 4:e20, 2017). This conceptual review provides an overview of (1) how existing CBT childhood programs incorporate homework, and empirical evidence for the importance of homework practice, (2) evidence-based key elements of practice, and (3) how mHealth apps could potentially enhance practice at home, including an example of the development and application of such an app. This review therefore sets the stage for new directions in developing more effective and engaging CBT-based homework programs for childhood anxiety disorders.
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Affiliation(s)
- Anke M Klein
- Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands.
| | - Annelieke Hagen
- Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands
| | - Lynn Mobach
- Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Pro Persona Institute for Integrated Mental Health Care, Wolfheze, The Netherlands
| | - Robin Zimmermann
- Mental Health Research and Treatment Center (FBZ), Ruhr University, Bochum, Germany
| | | | - Jasmin Rahemenia
- Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands
| | | | - Silvia Schneider
- Mental Health Research and Treatment Center (FBZ), Ruhr University, Bochum, Germany
| | - Thomas H Ollendick
- Department of Psychology, Child Study Center, Virginia Tech, Blacksburg, USA
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23
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Daley MM, Howell DR, Lanois CJ, Berkner PD, Mannix RC, Oldham JR, Meehan WP. Concussion Symptoms and Neurocognitive Performance of Children and Adolescents on Antidepressants. Med Sci Sports Exerc 2024; 56:1018-1025. [PMID: 38233981 DOI: 10.1249/mss.0000000000003383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
INTRODUCTION/PURPOSE There is a well-established association between preexisting depression/anxiety and greater postconcussion symptom burden, but the potential impact of antidepressant medications has not been fully explored. The primary objective of this study was to compare preinjury/baseline and postinjury concussion symptom scores and neurocognitive performance of athletes on antidepressant medications, both with healthy controls and with those with depression/anxiety not on antidepressants. METHODS This is a cross-sectional study using data collected from 49,270 junior and high school athletes from computerized neurocognitive assessments (Immediate Post-Concussion Assessment and Cognitive Test [ImPACT]) administered between 2009 and 2018 held by the Massachusetts Concussion Management Coalition. The main outcome measures were symptom scores and neurocognitive performance measures, all of which were assessed both at baseline and postinjury. Statistical analysis included analysis of variance and Tukey pairwise comparisons for continuous variables and Fisher's exact test for categorical variables. Multivariate regression models were used to adjust for potential confounding variables. RESULTS Both at baseline and postinjury, athletes with depression/anxiety had mean total symptom scores that were more than double that of healthy controls regardless of antidepressant use. Although there were no significant differences in neurocognitive performance at baseline, depression/anxiety was associated with small but significant decreases in postinjury visual memory and visual motor scores. CONCLUSIONS Both at baseline and after sustaining a concussion, young athletes with depression/anxiety experience significantly greater symptom burden compared with healthy controls regardless of antidepressant use.
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Affiliation(s)
| | | | | | | | | | - Jessie R Oldham
- Virginia Commonwealth University School of Medicine, Richmond, VA
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24
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Dumont É, Parent S, Castellanos-Ryan N, Jacques S, Freeston MH, Zelazo PD, Séguin JR. The Role of Executive Function at 6 Years in the Association between Behavioral Inhibition at 5 Years and Anxiety at 7 Years. Res Child Adolesc Psychopathol 2024; 52:919-931. [PMID: 38329683 DOI: 10.1007/s10802-024-01175-z] [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: 01/30/2024] [Indexed: 02/09/2024]
Abstract
EF skills play a central role in the etiology and maintenance of anxiety, but it is unclear whether they act as moderators or mediators in the relation between early behavioral inhibition (BI) and later anxiety. The current study tested two models by examining whether two executive functions (EF) skills (cognitive flexibility and working memory) assessed at age 6 acted as moderators or mediators in the relation between BI at 5 years and anxiety symptoms at 7 years. The sample consisted of 422 children from the Quebec Longitudinal Study of Child Development. We tested the moderation model, main and interaction effects using hierarchical multiple regression analyses and the mediation model with the product of coefficients test. Results showed that higher BI at 5 years predicted high anxiety at 7 years only at low levels of cognitive flexibility or working memory at 6 years. This suggests that high levels of cognitive flexibility or working memory at 6 years may act as protective factors. In contrast, neither cognitive flexibility nor working memory at age 6 acted as mediators in the association between BI at 5 years and anxiety at 7 years. Results support the hypothesis that goal-driven cognitive control processes act as moderators and promote adaptive functioning by dampening the effect of early BI on later anxiety.
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Affiliation(s)
- Émilie Dumont
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
- CHU Ste-Justine Research Center, Bureau B17.107; 3175 chemin Côte Ste-Catherine, Montréal, Québec, H3T 1C5, Canada
| | - Sophie Parent
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
- CHU Ste-Justine Research Center, Bureau B17.107; 3175 chemin Côte Ste-Catherine, Montréal, Québec, H3T 1C5, Canada
| | - Natalie Castellanos-Ryan
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
- CHU Ste-Justine Research Center, Bureau B17.107; 3175 chemin Côte Ste-Catherine, Montréal, Québec, H3T 1C5, Canada
| | - Sophie Jacques
- Department of Psychology and Neuroscience, Dalhousie University, Nova Scotia, Canada
| | - Mark H Freeston
- School of Psychology and Affiliated to the Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Philip David Zelazo
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Jean R Séguin
- CHU Ste-Justine Research Center, Bureau B17.107; 3175 chemin Côte Ste-Catherine, Montréal, Québec, H3T 1C5, Canada.
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada.
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25
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Smárason O, Skarphedinsson G, Storch EA. Cognitive Behavioral Therapy for Anxiety and Depression in Children and Adolescents. Psychiatr Clin North Am 2024; 47:311-323. [PMID: 38724122 DOI: 10.1016/j.psc.2024.02.002] [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] [Indexed: 07/10/2024]
Abstract
Anxiety and depression are prevalent and impairing psychiatric problems for children and adolescents. In this review, the authors summarize information about their prevalence and impact, the most common assessment methods, the main components of cognitive behavioral therapy (CBT), and research on the effectiveness of CBT for these disorders. Future directions, including improving access to CBT through technology-based approaches and increasing personalization of treatment, are discussed.
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Affiliation(s)
- Orri Smárason
- Department of Child and Adolescent Psychiatry, Landspitali - The National University Hospital of Iceland, Dalbraut 12 105, Reykjavik.
| | | | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA
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26
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Clarkson TR, Paff HA, Cunningham SJ, Ross J, Haslam C, Kritikos A. Mine for life: Charting ownership effects in memory from adolescence to old age. Q J Exp Psychol (Hove) 2024:17470218241254119. [PMID: 38684487 DOI: 10.1177/17470218241254119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
This study investigates the self-reference effect (SRE) with an ownership memory task across several age groups, providing the first age exploration of implicit ownership memory biases from adolescence to older adulthood (N = 159). Using a well-established ownership task, participants were required to sort images of grocery items as belonging to themselves or to a fictitious unnamed Other. After sorting and a brief distractor task, participants completed a surprise one-step source memory test. Overall, there was a robust SRE, with greater source memory accuracy for self-owned items. The SRE attenuated with age, such that the magnitude of difference between self and other memory diminished into older adulthood. Importantly, these findings were not due to a deterioration of memory for self-owned items, but rather an increase in memory performance for other-owned items. Linear mixed effects analyses showed self-biases in reaction times, such that self-owned items were identified more rapidly compared with other owned items. Again, age interacted with this effect showing that the responses of older adults were slowed, especially for other-owned items. Several theoretical implications were drawn from these findings, but we suggest that older adults may not experience ownership-related biases to the same degree as younger adults. Consequently, SREs through the lens of mere ownership may attenuate with age.
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Affiliation(s)
- Tessa R Clarkson
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Harrison A Paff
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | | | - Josephine Ross
- School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Catherine Haslam
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Ada Kritikos
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
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27
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Nimphy CA, Mitrou V, Elzinga BM, Van der Does W, Aktar E. The Role of Parental Verbal Threat Information in Children's Fear Acquisition: A Systematic Review and Meta-analysis. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00485-4. [PMID: 38789695 DOI: 10.1007/s10567-024-00485-4] [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] [Accepted: 04/21/2024] [Indexed: 05/26/2024]
Abstract
Children can acquire fears of novel stimuli as a result of listening to parental verbal threat information about these stimuli (i.e., instructional learning). While empirical studies have shown that learning via parental information occurs, the effect size of parental verbal threat information on child fear of a novel stimulus has not yet been measured in a meta-analysis. We conducted a systematic review and meta analysis to assess the effect of parents' verbal statements on their children's fear acquisition. Additionally, we explored potential moderators of this effect, namely, parent and child anxiety levels, as well as child age. WebOfScience, Pubmed, Medline, and PsycINFO were used to identify eligible studies that assessed children's (30 months to 18 years old) fear of novel stimuli after being exposed to parental verbal threat information. We selected 17 studies for the meta-analysis and 18 for the systematic review. The meta-analysis revealed a significant causal effect of parental verbal threat information on children's fear reaction towards novel stimuli [g = 1.26]. No evidence was found for a moderation of verbal learning effects, neither by child or parent anxiety levels nor by child age. The effect of parents' verbal threat information on children's fear of novel stimuli is large and not dependent on anxiety levels or child age.
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Affiliation(s)
- Cosima Anna Nimphy
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.
| | - Vasiliki Mitrou
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Bernet M Elzinga
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
| | - Willem Van der Does
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden University Treatment Center (LUBEC), Leiden, The Netherlands
| | - Evin Aktar
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
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28
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Glavonic E, Dragic M, Mitic M, Aleksic M, Lukic I, Ivkovic S, Adzic M. Ketamine's Amelioration of Fear Extinction in Adolescent Male Mice Is Associated with the Activation of the Hippocampal Akt-mTOR-GluA1 Pathway. Pharmaceuticals (Basel) 2024; 17:669. [PMID: 38931336 PMCID: PMC11206546 DOI: 10.3390/ph17060669] [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] [Received: 03/01/2024] [Revised: 03/29/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024] Open
Abstract
Fear-related disorders, including post-traumatic stress disorder (PTSD), and anxiety disorders are pervasive psychiatric conditions marked by persistent fear, stemming from its dysregulated acquisition and extinction. The primary treatment for these disorders, exposure therapy (ET), relies heavily on fear extinction (FE) principles. Adolescence, a vulnerable period for developing psychiatric disorders, is characterized by neurobiological changes in the fear circuitry, leading to impaired FE and increased susceptibility to relapse following ET. Ketamine, known for relieving anxiety and reducing PTSD symptoms, influences fear-related learning processes and synaptic plasticity across the fear circuitry. Our study aimed to investigate the effects of ketamine (10 mg/kg) on FE in adolescent male C57 BL/6 mice at the behavioral and molecular levels. We analyzed the protein and gene expression of synaptic plasticity markers in the hippocampus (HPC) and prefrontal cortex (PFC) and sought to identify neural correlates associated with ketamine's effects on adolescent extinction learning. Ketamine ameliorated FE in the adolescent males, likely affecting the consolidation and/or recall of extinction memory. Ketamine also increased the Akt and mTOR activity and the GluA1 and GluN2A levels in the HPC and upregulated BDNF exon IV mRNA expression in the HPC and PFC of the fear-extinguished mice. Furthermore, ketamine increased the c-Fos expression in specific brain regions, including the ventral HPC (vHPC) and the left infralimbic ventromedial PFC (IL vmPFC). Providing a comprehensive exploration of ketamine's mechanisms in adolescent FE, our study suggests that ketamine's effects on FE in adolescent males are associated with the activation of hippocampal Akt-mTOR-GluA1 signaling, with the vHPC and the left IL vmPFC as the proposed neural correlates.
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Affiliation(s)
- Emilija Glavonic
- Department of Molecular Biology and Endocrinology, “VINČA” Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia; (E.G.); (M.D.); (M.M.); (M.A.); (I.L.); (S.I.)
| | - Milorad Dragic
- Department of Molecular Biology and Endocrinology, “VINČA” Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia; (E.G.); (M.D.); (M.M.); (M.A.); (I.L.); (S.I.)
- Laboratory for Neurobiology, Department of General Physiology and Biophysics, Faculty of Biology, University of Belgrade, 11158 Belgrade, Serbia
| | - Milos Mitic
- Department of Molecular Biology and Endocrinology, “VINČA” Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia; (E.G.); (M.D.); (M.M.); (M.A.); (I.L.); (S.I.)
| | - Minja Aleksic
- Department of Molecular Biology and Endocrinology, “VINČA” Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia; (E.G.); (M.D.); (M.M.); (M.A.); (I.L.); (S.I.)
| | - Iva Lukic
- Department of Molecular Biology and Endocrinology, “VINČA” Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia; (E.G.); (M.D.); (M.M.); (M.A.); (I.L.); (S.I.)
| | - Sanja Ivkovic
- Department of Molecular Biology and Endocrinology, “VINČA” Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia; (E.G.); (M.D.); (M.M.); (M.A.); (I.L.); (S.I.)
| | - Miroslav Adzic
- Department of Molecular Biology and Endocrinology, “VINČA” Institute of Nuclear Sciences-National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia; (E.G.); (M.D.); (M.M.); (M.A.); (I.L.); (S.I.)
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29
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Armstrong GM, Hopper KM, Friedman HP, Bilsky SA. Adolescent Sleep Quality and Alcohol Use: An Initial Examination of the Serial Indirect Effects of Anxiety Symptoms and Coping Motives for Alcohol Use. Subst Use Misuse 2024; 59:1383-1393. [PMID: 38769730 DOI: 10.1080/10826084.2024.2352107] [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] [Indexed: 05/22/2024]
Abstract
Background: Insufficient sleep and insomnia are associated with alcohol use as well as anxiety during adolescence and young adulthood. A negative reinforcement path to explain the association between sleep difficulties and alcohol misuse has been proposed. Within this pathway, it is speculated that while sober, insomnia and insufficient sleep lead to increased anxiety as well as anxiolytic responses to alcohol, thereby increasing the risk for both alcohol use and alcohol use problems. No work to date has examined the negative reinforcement path to alcohol use among adolescents who have consumed alcohol. Objectives: The current study aims to address this gap in the literature by examining if sleep quality is related to adolescent alcohol use problems and frequency through serial indirect effects of adolescent anxiety symptoms and coping motives for alcohol use. A total of 147 adolescents between the ages of 13 and 18 years (Mage = 16.31; SD = 0.96) from all geographic regions in the US were recruited using social media platforms (i.e., Facebook and Instagram). Participants who reported having tried alcohol at least once completed self-report measures to examine sleep quality, anxiety symptoms, alcohol use problems, alcohol use frequency, and coping motives for alcohol use. Results: Adolescent sleep quality was found to be associated with higher levels of both alcohol use problems and alcohol use frequency through the serial indirect effect of anxiety symptoms and coping motives for alcohol use. Conclusions: Overall, these findings represent a step towards understanding the complex relationship between sleep quality, alcohol, anxiety, and coping motives among adolescents.
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Affiliation(s)
| | - Kayce M Hopper
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
| | - Hannah P Friedman
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
| | - Sarah A Bilsky
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
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30
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Riglin L, Dennison C, Martin J, Tseliou F, Armitage JM, Shakeshaft A, Heron J, Tilling K, Thapar A, Collishaw S. Emotional problems across development: examining measurement invariance across childhood, adolescence and early adulthood. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02461-3. [PMID: 38755320 DOI: 10.1007/s00787-024-02461-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
Emotional problems (anxiety, depression) are prevalent in children, adolescents and young adults with varying ages at onset. Studying developmental changes in emotional problems requires repeated assessments using the same or equivalent measures. The parent-rated Strengths and Difficulties Questionnaire is commonly used to assess emotional problems in childhood and adolescence, but there is limited research about whether it captures a similar construct across these developmental periods. Our study addressed this by investigating measurement invariance in the scales' emotional problems subscale (SDQ-EP) across childhood, adolescence and early adulthood. Data from two UK population cohorts were utilised: the Millennium Cohort Study (ages 3-17 years) and the Avon Longitudinal Study of Parents and Children (4-25 years). In both samples we observed weak (metric) measurement invariance by age, suggesting that the parent-rated SDQ-EP items contribute to the underlying construct of emotional problems similarly across age. This supports the validity of using the subscale to rank participants on their levels of emotional problems in childhood, adolescence and early adulthood. However strong (scalar) measurement invariance was not observed, suggesting that the same score may correspond to different levels of emotional problems across developmental periods. Comparisons of mean parent-rated SDQ-EP scores across age may therefore not be valid.
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Affiliation(s)
- Lucy Riglin
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
- Wolfson Centre for Young People's Mental Health, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK.
| | - Charlotte Dennison
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Joanna Martin
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Foteini Tseliou
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jessica M Armitage
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Amy Shakeshaft
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jon Heron
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Tilling
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Anita Thapar
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental Health and Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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31
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Amir N, Holbrook A, Kallen A, Santopetro N, Klawohn J, McGhie S, Bruchnak A, Lowe M, Taboas W, Brush CJ, Hajcak G. Multiple Adaptive Attention-Bias-Modification Programs to Alter Normative Increase in the Error-Related Negativity in Adolescents. Clin Psychol Sci 2024; 12:447-467. [PMID: 39040548 PMCID: PMC11262561 DOI: 10.1177/21677026231170563] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
In the current article, we examined the impact of two home-delivered attentional-bias-modification (ABM) programs on a biomarker of anxiety (i.e., the error-related negativity [ERN]). The ERN is sensitivity to ABM-related changes; however, it is unclear whether ABM exerts its influence on the ERN and anxiety by increasing general attentional control or by disengaging spatial allocation of attention. In this study, we measured the ERN, anxiety, attention bias, and attention control before and after two versions of ABM training and a waitlist control group in 546 adolescents. An ABM designed to increase attention control modulated the ERN but had no impact on anxiety. An ABM designed to reduce attentional bias changed bias and self-reported anxiety in youths but had no impact on the ERN or parent-reported anxiety. These results suggest that the ERN and normative anxiety may be modified using attention training.
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Affiliation(s)
- Nader Amir
- Department of Psychology, San Diego State University
| | | | - Alex Kallen
- Department of Psychology, Florida State University
| | | | | | - Shaan McGhie
- Department of Psychology, San Diego State University
| | | | - Magen Lowe
- Department of Psychology, Florida State University
| | | | - C. J. Brush
- Department of Psychology, Florida State University
| | - Greg Hajcak
- Department of Psychology, Florida State University
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32
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Brzuszek M, Kochman M, Mazur A. Psychodiabetology: The Challenge of the Future? J Clin Med 2024; 13:2236. [PMID: 38673509 PMCID: PMC11051208 DOI: 10.3390/jcm13082236] [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: 03/13/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
The number of people suffering from diabetes, including type 1, is constantly increasing both in Poland and worldwide. Type 1 diabetes is a chronic disease characterized by uncertain prognosis and relapses, as well as permanent, irreversible, and progressive changes in health status. The ongoing disease results in dysfunction or disability, and the patient requires specialized supervision, care, and rehabilitation. However, the success of therapy does not depend solely on the perfection of treatment, but also on the patient's readiness to change their lifestyle and cooperate with the therapeutic team. The patient's constant alertness in making therapeutic decisions does not always lead to expected treatment results, and the risk of hypoglycemia associated with intensive insulin treatment depletes the patient's motivation for treatment, leading over time to the development of 'therapeutic burnout' and psychiatric disorders. This narrative review is an attempt to summarize the knowledge and possible future solutions in diabetes type 1 in Poland as well as highlight the importance of comprehensive care, including psychological care, which appears fundamental in a chronic disease such as type 1 diabetes. Therefore, the aim of the study was to present generational changes and psychosocial problems of patients with type 1 diabetes and to identify urgent challenges in diabetic care. Attention should be paid to the deteriorating mental condition of the young generations, who, in the course of diabetes, are exposed to additional psychological and psychiatric health problems. The next generation of patients will require more psychological care, which is why the challenge of the future is to create psychodiabetology centers.
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Affiliation(s)
- Marta Brzuszek
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, ul. Warzywna 1a, 35-310 Rzeszów, Poland
| | - Maciej Kochman
- Department of Physiotherapy, Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, ul. Marszałkowska 24, 35-215 Rzeszów, Poland
| | - Artur Mazur
- Institute of Medical Science, College of Medical Sciences, University of Rzeszów, ul. Warzywna 1a, 35-215 Rzeszów, Poland
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33
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Krause K, Zhang XC, Schneider S. Long-Term Effectiveness of Cognitive Behavioral Therapy in Routine Outpatient Care for Youth with Anxiety Disorders. PSYCHOTHERAPY AND PSYCHOSOMATICS 2024; 93:181-190. [PMID: 38615662 PMCID: PMC11151973 DOI: 10.1159/000537932] [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: 06/17/2023] [Accepted: 02/14/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION This study examined the long-term effectiveness of cognitive behavioral therapy (CBT) (≥ 2 years after the end of therapy) in the routine care of youth (mean 11.95 years; SD = 3.04 years) with primary anxiety disorder (AD). METHODS Two hundred and ten children with any AD as a primary diagnosis and with any comorbidity were included in the "Kids Beating Anxiety (KibA)" clinical trial and received evidence-based CBT. Diagnoses, severity of diagnoses, and further dimensional outcome variables of symptoms and functioning were assessed before (baseline), after the last treatment session (POST), and at two follow-up (FU) assessments in the child and caregiver report: 6 months (6MONTHS-FU) and >2 years (mean 4.31; SD = 1.07 years) after the last treatment session (long-term FU). RESULTS At POST, 61.38% showed total remission of all and any ADs. At long-term FU, the remission rate was 63.64%. Compared to baseline, ratings of severity, anxiety, impairment/burden, and life quality improved significantly after CBT in child and caregiver report. All pre-post/FU improvements and global success ratings were stable in child (Pre-Post: Hedges' g = 3.57; Pre-6MONTHS-FU: Hedges' g = 3.43; Pre-LT-FU: Hedges' g = 2.34) and caregiver report (Pre-Post: Hedges' g = 2.00; Pre-6MONTHS-FU: Hedges' g = 2.31; Pre-LT-FU: Hedges' g = 2.31) across all POST- and FU-assessment points. Some outcomes showed further significant improvement, and no deterioration was found over the course of time. Effect sizes calculated in the present study correspond to, or even exceed, effect sizes reported in previous meta-analysis. CONCLUSIONS Stable long-term effects of "KibA" CBT for youth with ADs, comparable to those results from efficacy studies, were achieved in a routine practice setting by applying treatment manuals tested in randomized controlled trials. These findings are remarkable, as the patient group studied here consisted of an age group within the main risk phase of developing further mental disorders, and therefore an increase in new-onset anxiety and further mental disorders would be expected over the long time span studied here.
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Affiliation(s)
- Karen Krause
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Xiao Chi Zhang
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
- Deutsches Zentrum für Psychische Gesundheit (DZPG), Bochum, Germany
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Liu X, Yang F, Huang N, Zhang S, Guo J. Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study. Gen Psychiatr 2024; 37:e101288. [PMID: 38595856 PMCID: PMC11002340 DOI: 10.1136/gpsych-2023-101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/25/2024] [Indexed: 04/11/2024] Open
Abstract
Background Anxiety disorders are the most common psychiatric problems, affecting approximately 1 in 12 children and 1 in 4 adolescents. Understanding the incidence, burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success, stagnation and emerging threats, thereby facilitating effective improvement strategies. Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries. To examine the association between anxiety disorders and social indicators (healthcare access and quality of life). Methods Data were obtained from the Global Burden of Disease Study 2019. The age-standardised incidence rates (ASIRs) and disability-adjusted life years (DALYs) were reported to assess the burden of anxiety disorders, and the estimated annual percentage change was calculated to quantify the temporal trends. Pearson's correlation was used to investigate country-level risk factors for incidence and DALYs. Results Globally, there were 932 million incident cases of anxiety disorders in children and adolescents, 739.29 per 100 000 ASIRs and 380.62 million DALYs in 2019. From 1990 to 2019, the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%. Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries. Portugal reported the highest ASIR of anxiety disorders, while Mexico had the largest increase rate of ASIR. In 2019, Portugal reported the highest number of DALYs (1001.71 million), and India (212.09 million) reported the lowest number of DALYs. The burden of anxiety disorders was positively correlated with the average number of psychiatrists, psychologists and nurses in the mental health sector (per 100 000), and quality of life and the correlation coefficients were 0.58, 0.67, 0.43 and 0.53, respectively. Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years. However, the incidence and disease burden in developed countries are still increasing steadily. Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status, as well as the cultural and regional characteristics of each country.
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Affiliation(s)
- Xiaohan Liu
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Fan Yang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Ning Huang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Shan Zhang
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
| | - Jing Guo
- School of Public Health, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, China
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Hua Z, Wang S, Yuan X. Trends in age-standardized incidence rates of depression in adolescents aged 10-24 in 204 countries and regions from 1990 to 2019. J Affect Disord 2024; 350:831-837. [PMID: 38242215 DOI: 10.1016/j.jad.2024.01.009] [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: 07/09/2023] [Revised: 11/24/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND The objective of this study was to provide a comprehensive analysis of the spatial distribution and temporal trends in the age-standardized incidence rates (ASIRs) of depression in adolescents aged 10-24 worldwide. METHODS Data from the Global Burden of Disease Study (GBD) 2019 were analyzed, adopting Sawyer's broad definition of adolescence encompassing ages 10 to 24. Estimated annual percentage changes (EAPCs) were used to assess temporal trends. RESULTS Globally, from 1990 to 2019, there was a decrease in the ASIR of depression in adolescents (EAPC = -0.23). Notably, this decrease was more pronounced in female adolescents compared to their male counterparts (EAPC = -0.12 and - 0.29, respectively). Conversely, high Sociodemographic Index (SDI) regions experienced a significant increase in the ASIR of depression among adolescents (EAPC = 0.87). Furthermore, it is worth mentioning that individuals aged 20-24 exhibited the highest incidence rate for depression followed by those aged 15-19 and then those aged 10-14. The largest increases in the ASIRs of depression occurred in High-income North America (EAPC = 1.19) and Malaysia (EAPC = 2.4), respectively. LIMITATIONS Mathematical models were used to reconstruct and adjust data of different qualities, which might have introduced bias. CONCLUSIONS The global burden of disease for depression among adolescents aged 10-24 years declined from 1990 to 2019. Special attention must be paid to older adolescents and areas with higher SDIs.
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Affiliation(s)
- Zuguang Hua
- Department of Plastic Surgery, The First Affiliated Hospital of Ningbo University, No.59, Liuting Street Haishu District, Ningbo 315010, Zhejiang, China
| | - Shuyu Wang
- Chinese Center for Disease Control and Prevention, 13 Zhengfu Street, Changping District, 102200 Beijing, China
| | - Xinhua Yuan
- Department of Orthopedics, Ningbo No.2 Hospital, No.41 Northwest Street, Haishu District, Ningbo 315099, Zhejiang, China.
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Mehra LM, Hajcak G, Meyer A. The associations among sleep-related difficulties, anxiety, and error-related brain activity in youth. Biol Psychol 2024; 188:108790. [PMID: 38580098 PMCID: PMC11162828 DOI: 10.1016/j.biopsycho.2024.108790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/14/2024] [Accepted: 04/01/2024] [Indexed: 04/07/2024]
Abstract
Given the high prevalence of anxiety disorders and their associated impairment, elucidating neural mechanisms related to these disorders has been increasingly prioritized. The error-related negativity (ERN) has been identified as a neural marker that indexes risk for anxiety across development. The ERN seems to confer risk for developing anxiety, especially in the context of stressful life events. The present study sought to examine sleep-related difficulties as another stressful factor that might impact the ERN. In a sample of 221 girls, aged 8 to 15 years old, we first examined the relationship between longer-term (i.e., over the past month) and shorter-term (i.e., over the past week) sleep difficulties and the ERN. We then investigated whether specific sleep difficulties uniquely predict the ERN. In exploratory analyses, we assessed whether sleep difficulties moderate the relationship between the ERN and anxiety. Results indicated that youth who report longer-term lower sleep duration, longer-term worse sleep, and shorter-term lower sleep duration on school days over the past week have a larger (i.e., more negative) ERN. Additionally, only shorter-term sleep duration on school days over the past week uniquely predicted the ERN. Finally, an elevated ERN predicted greater clinical anxiety in the context of longer-term sleep difficulties. Future studies should clarify the direction of these associations via longitudinal designs.
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Affiliation(s)
- Lushna M Mehra
- Department of Psychology, Florida State University, 1107 W Call St, Tallahassee, FL 32304, USA.
| | - Greg Hajcak
- School of Education and Counseling, Santa Clara University, 455 El Camino Real, Guadalupe Hall, Santa Clara, CA 95053, USA
| | - Alexandria Meyer
- School of Education and Counseling, Santa Clara University, 455 El Camino Real, Guadalupe Hall, Santa Clara, CA 95053, USA
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Qiu Q, Chai G, Xie S, Wu T. Association of sugar-sweetened beverage consumption and sleep quality with anxiety symptoms: a cross-sectional study of Tibetan college students at high altitude. Front Psychol 2024; 15:1383042. [PMID: 38601824 PMCID: PMC11004489 DOI: 10.3389/fpsyg.2024.1383042] [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: 02/06/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
Background Research on the association between sugar-sweetened beverages (SSBs) consumption and sleep quality with anxiety symptoms has been highly emphasized. However, past studies have focused on college students in plains areas, while fewer research studies have been conducted on Tibetan college students at high altitudes. Whether this association changes due to ethnicity or altitude is unclear. The present study will contribute to the prevention and intervention of depressive symptoms among Tibetan college students at high altitude. Methods A self-assessment questionnaire was administered to 3,026 university students (1,491 boys students, 49.27%) on SSBs consumption, sleep quality and anxiety symptoms status in the Tibetan Plateau, a high-altitude region of China. Logistic regression analysis and ordered logistic regression analysis in generalized linear model were used to analyze the association between SSBs consumption and sleep quality with anxiety symptoms. Results The prevalence of anxiety symptoms among Tibetan college students at high altitude was 26.9%. SSBs consumption of ≤1 times/week, 2-5 times/week, and ≥ 6 times/week were 20.7, 28.1, and 45.7%, respectively, with statistically significant differences (χ2 value of 134.353, p < 0.001). Anxiety detection rates for Sleep quality of Good (PSQI ≤5), Moderate (PSQI 6-7), and Poor (PSQI >7) were 16.8, 19.8, and 32.0%, respectively, and the difference was also statistically significant (χ2 value was 73.761, p < 0.001). The ordered logistic regression analysis in the generalized linear model showed that, overall, the group of college students with SSBs ≤1 times/week and sleep quality of Good served as the reference group, and the group with SSBs ≥6 times/week and sleep quality of Poor (OR: 5.06, 95% CI: 3.75-6.83) had the highest risk of anxiety symptoms. Conclusion SSBs consumption and sleep quality were associated with anxiety symptoms, and there was an interaction effect. Effective control of SSBs consumption and improvement of sleep quality may be important factors in preventing and reducing the occurrence of anxiety symptoms.
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Affiliation(s)
| | - Guangxin Chai
- School of Physical Education and Health, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
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Raymond C, Cernik R, Beaudin M, Arcand M, Pichette F, Marin MF. Maternal attachment security modulates the relationship between vulnerability to anxiety and attentional bias to threat in healthy children. Sci Rep 2024; 14:6025. [PMID: 38472274 DOI: 10.1038/s41598-024-55542-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
This study aimed to investigate whether attentional bias to threat, commonly observed in clinically anxious children, also manifests in healthy children, potentially aiding the early detection of at-risk individuals. Additionally, it sought to explore the moderating role of parent-child attachment security on the association between vulnerability factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) as indicators of vulnerability to anxiety, and attentional bias towards threat in healthy children. A total of 95 children aged 8 to 12 years completed the Visual Search Task to assess attentional bias. Vulnerability to anxiety was measured using a composite score derived from the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire. Parent-child attachment security was assessed using the Security Scale-Child Self-Report. Analyses revealed that higher vulnerability to anxiety was associated with faster detection of anger-related stimuli compared to neutral ones, and this association was further influenced by high maternal security. These findings in healthy children suggest an interaction between specific factors related to anxiety vulnerability and the security of the mother-child relationship, leading to cognitive patterns resembling those seen in clinically anxious individuals. These results hold promise for early identification of children at risk of developing anxiety disorders.
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Affiliation(s)
- Catherine Raymond
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada.
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada.
| | - Rebecca Cernik
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Myriam Beaudin
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Maryse Arcand
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Florence Pichette
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
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Niwenahisemo LC, Hong S, Kuang L. Assessing anxiety symptom severity in Rwandese adolescents: cross-gender measurement invariance of GAD-7. Front Psychiatry 2024; 15:1346267. [PMID: 38528981 PMCID: PMC10962260 DOI: 10.3389/fpsyt.2024.1346267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/15/2024] [Indexed: 03/27/2024] Open
Abstract
Background Anxiety disorders are among the most common mental health problems experienced by adolescents worldwide because of their evident significant impact on their quality of life and functioning. The generalized anxiety disorder item (GAD-7) was manufactured to identify the severity of self-reported anxiety symptoms. Efforts to address and screen for mental health problems in Rwanda have been limited, and the importance of screening for anxiety disorders is high. The primary aim of this study was to analyze the psychometric properties of the Kinyarwanda version of the Generalized Anxiety Disorder GAD-7, and then test the measurement invariance of the GAD-7 by gender. Methods We used the Rwandese version of GAD-7 among secondary school students in Kigali city (n=1813). Measurement invariance of the GAD-7 across gender and report on anxiety symptom severity prevalence. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine measurement invariance. Results Our findings demonstrated that in the sample of 1813 adolescents aged between 12 and 17 years, generalized anxiety symptoms prevalence rates were higher in females (46.4%) than males (n= 29.8%) GAD-7 demonstrated good reliability and validity coefficients with a Cronbach's α of .077 and KMO and Bartlett test of Sphericity = 0.835. In addition to these psychometric properties, the GAD-7 screening scale had equivalence for configural and metric invariance across groups with excellent fit indices, and we confirmed partial scalar invariance across groups. Conclusion The GAD-7 can be used in cross-group comparison of generalized anxiety disorder prevalence, and we acknowledge that full scalar invariance is generally difficult to confirm, especially due to gender differences. We recommend that future studies further investigate populations living in rural areas and conduct trials that will focus on anxiety-specific treatment in Rwandan Clinical health care centers to determine the diagnostic accuracy of this screening tool.
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Affiliation(s)
| | - Su Hong
- *Correspondence: Su Hong, ; Li Kuang,
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Baker AE, Padgaonkar NT, Galván A, Peris TS. Anxiety may alter the role of fronto-striatal circuitry in adolescent risky decision-making. J Affect Disord 2024; 348:238-247. [PMID: 38160886 DOI: 10.1016/j.jad.2023.12.063] [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: 04/20/2023] [Revised: 11/20/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Anxiety disorders often emerge in adolescence and are associated with risk aversion. Risk aversion conflicts with the typical adolescent approach-motivated phenotype and can interfere with learning and contribute to symptom maintenance. METHODS We investigated the neural and behavioral correlates of risk avoidance in a diverse sample of adolescents (N = 137; MAge = 11.3; 34.3 % white, 22.1 % Latino, 20 % Asian, 14.3 % Black, 9.3 % Mixed Race) as they completed a task involving risky decision-making and response inhibition during fMRI. Voluntary cautious choice was compared to successful response inhibition to isolate the neural systems underlying the decision to avoid a risk and identify their relation to risk-taking and anxiety in adolescents. RESULTS Anxious adolescents self-reported more avoidance but demonstrated normative risk-taking on the laboratory task. Interestingly, they responded quickly during response inhibition but took longer to decide in the face of risk. All youth showed widespread recruitment of decision-making and salience network regions when deciding to avoid risk. The neural mechanisms driving avoidance differed based on anxiety such that left inferior frontal gyrus (IFG) activation was linked to risk avoidance in adolescents with low anxiety and risk-taking in anxious adolescents, while striatal connectivity was linked to risk avoidance in anxious adolescents and risk-taking in those with low anxiety. LIMITATIONS This work is cross-sectional and therefore cannot speak to causality or directionality of effects. CONCLUSIONS These results suggest that the neural mechanisms contributing to adolescent risk-taking may function to promote avoidance in anxious youth, increasing vulnerability to maladaptive avoidance and further anxiety development.
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Affiliation(s)
- Amanda E Baker
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, United States of America.
| | - Namita Tanya Padgaonkar
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, United States of America
| | - Adriana Galván
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, United States of America; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, United States of America
| | - Tara S Peris
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, United States of America
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Crowe K, Spiro-Levitt C. Sleep-Related Problems and Pediatric Anxiety Disorders. Psychiatr Clin North Am 2024; 47:213-228. [PMID: 38302208 DOI: 10.1016/j.psc.2023.06.014] [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] [Indexed: 02/03/2024]
Abstract
Sleep-related problems are highly prevalent among childhood and adolescent anxiety disorders. The objective of this review was to summarize the relevant clinical research literature as it pertains to the nature of the association between sleep-related problems and youth anxiety, developmental factors relevant to this association, and intervention efforts to target comorbid sleep challenges and anxiety. Limitations of the literature and future directions are discussed.
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Affiliation(s)
- Katherine Crowe
- Home for Anxiety, Repetitive Behaviors, OCD, and Related Disorders (HARBOR), 1518 Walnut Street, Suite 1506, Philadelphia, PA 19102, USA.
| | - Carolyn Spiro-Levitt
- Department of Child and Adolescent Psychiatry at Hassenfeld Children's Hospital at New York University (NYU) Langone, 1 Park Avenue, Seventh Floor, New York, NY 10016, USA
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Gaffey AE, Spatz ES. Psychological Health and Ischemic Heart Disease in Women: A Review of Current Evidence and Clinical Considerations across the Healthspan. Curr Atheroscler Rep 2024; 26:45-58. [PMID: 38240928 PMCID: PMC11219074 DOI: 10.1007/s11883-023-01185-0] [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: 12/20/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE OF REVIEW Psychological health encompasses a constellation of negative and positive factors-i.e., psychosocial stress, depression, anxiety, trauma, loneliness and social isolation, anger and hostility, optimism, and a sense of purpose. This narrative review presents current evidence at the intersection of psychological health, risk of ischemic heart disease (IHD), and IHD-related outcomes, with an emphasis on associations in women. RECENT FINDINGS For women, relations between psychological health and IHD reflect important sex and gender differences in biological and psychosocial factors. Although efforts devoted to understanding psychological health and IHD risk have varied by psychological factor-scientific evidence is strongest for psychosocial stress and depression, while anxiety, trauma, and positive psychological factors warrant more investigation-less optimal psychological health is consistently associated with an earlier and greater risk of IHD morbidity and mortality in women. Still, many past prospective studies of psychological factors and IHD risk had a limited representation of women, did not include analyses by sex, or failed to account for other influential, sex-specific factors. Thus, there are multiple pathways for further, rigorous investigation into psychological health-IHD associations, mechanisms, and empirically supported psychological interventions to mitigate IHD risk among women. Given the robust evidence linking psychological health with women's risk for IHD, implementing routine, brief, psychological screening is recommended. Significant life events, developmental milestones specific to women, and IHD diagnoses or events could cue further psychological assessment and referral, efforts which will mutually strengthen the evidence for integrated psychological and IHD care and delivery of such care to this vulnerable group.
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Affiliation(s)
- Allison E Gaffey
- Department of Internal Medicine (Section of Cardiovascular Medicine), Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.
| | - Erica S Spatz
- Department of Internal Medicine (Section of Cardiovascular Medicine), Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Department of Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA
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Zugman A, Winkler AM, Qamar P, Pine DS. Current and Future Approaches to Pediatric Anxiety Disorder Treatment. Am J Psychiatry 2024; 181:189-200. [PMID: 38425255 PMCID: PMC11256210 DOI: 10.1176/appi.ajp.20231037] [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] [Indexed: 03/02/2024]
Abstract
This overview critically appraises the literature on the treatment of pediatric anxiety disorders. The two established treatments for these conditions comprise cognitive-behavioral therapy (CBT) and antidepressant medications. Many youths receiving these treatments fail to achieve remission, which creates a need for new treatments. After summarizing the literature on CBT and currently available medications, the authors describe research that lays a foundation for improvements in the treatment of pediatric anxiety disorders. This foundation leverages neuroscientific investigations, also described in the overview, which provide insights on mechanisms of successful treatment.
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Affiliation(s)
- Andre Zugman
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (EDB), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States
| | - Anderson M. Winkler
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (EDB), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States
- Division of Human Genetics, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, Texas, United States
| | - Purnima Qamar
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (EDB), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (EDB), National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States
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Chen X, Wei D, Fang F, Song H, Yin L, Kaijser M, Gurholt TP, Andreassen OA, Valdimarsdóttir U, Hu K, Duan M. Peripheral vertigo and subsequent risk of depression and anxiety disorders: a prospective cohort study using the UK Biobank. BMC Med 2024; 22:63. [PMID: 38336700 PMCID: PMC10858592 DOI: 10.1186/s12916-023-03179-w] [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: 07/03/2023] [Accepted: 11/15/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Peripheral vertigo is often comorbid with psychiatric disorders. However, no longitudinal study has quantified the association between peripheral vertigo and risk of psychiatric disorders. Furthermore, it remains unknown how the white matter integrity of frontal-limbic network relates to the putative peripheral vertigo-psychiatric disorder link. METHODS We conducted a cohort study including 452,053 participants of the UK Biobank with a follow-up from 2006 through 2021. We assessed the risks of depression and anxiety disorders in relation to a hospitalization episode involving peripheral vertigo using Cox proportional hazards models. We also examined the associations of peripheral vertigo, depression, and anxiety with MRI fractional anisotropy (FA) in a subsample with brain MRI data (N = 36,087), using multivariable linear regression. RESULTS Individuals with an inpatient diagnosis of peripheral vertigo had elevated risks of incident depression (hazard ratio (HR) 2.18; 95% confidence interval (CI) 1.79-2.67) and anxiety (HR 2.11; 95% CI 1.71-2.61), compared to others, particularly within 2 years after hospitalization (HR for depression 2.91; 95% CI 2.04-4.15; HR for anxiety 4.92; 95% CI 3.62-6.69). Depression was associated with lower FA in most studied white matter regions, whereas anxiety and peripheral vertigo did not show statistically significant associations with FA. CONCLUSIONS Individuals with an inpatient diagnosis of peripheral vertigo have increased subsequent risks of depression and anxiety disorders, especially within 2 years after hospitalization. Our findings further indicate a link between depression and lower microstructural connectivity as well as integrity beyond the frontal-limbic network.
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Affiliation(s)
- Xiaowan Chen
- Department of Otolaryngology Head and Neck Surgery, the First Hospital of Lanzhou University, Lanzhou, Gansu Province, China
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Otolaryngology Head and Neck Surgery & Audiology and Neurotology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Dang Wei
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Fang Fang
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Li Yin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Kaijser
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Tiril Pedersen Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital &, University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Institute of Clinical Medicine, Oslo University Hospital &, University of Oslo, Oslo, Norway
| | - Unnur Valdimarsdóttir
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kejia Hu
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Maoli Duan
- Department of Otolaryngology Head and Neck Surgery & Audiology and Neurotology, Karolinska University Hospital, Stockholm, Sweden.
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77, Stockholm, Sweden.
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45
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Anning KL, Langley K, Hobson C, De Sonneville L, Van Goozen SHM. Inattention symptom severity and cognitive processes in children at risk of ADHD: the moderating role of separation anxiety. Child Neuropsychol 2024; 30:264-288. [PMID: 36960813 DOI: 10.1080/09297049.2023.2190964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/24/2023] [Indexed: 03/25/2023]
Abstract
Impairments in cognitive processes and their associations with dimensional measures of inattention, hyperactivity-impulsivity and anxiety were examined in children at risk of Attention-Deficit Hyperactivity Disorder. Children referred by teachers for exhibiting ADHD-type problems (n = 116; 43 meeting full diagnostic criteria for ADHD; 4-8 years) completed computerized tasks measuring episodic memory, response inhibition, visuomotor control and sustained attention, while parents were interviewed (DAWBA) to assess ADHD and anxiety symptoms. Of the 116 children assessed, 72% exhibited impaired cognitive processes; 47% had impaired visuomotor control, 37% impaired response inhibition, and 35% had impaired episodic memory. Correlational and hierarchical regression analyses using our final analytic sample (i.e., children who completed all cognitive tasks and a vocabulary assessment, n = 114) showed that poorer task performance and greater within-subject variability were significantly associated with more severe inattention symptoms but not with hyperactivity-impulsivity severity. Symptoms of separation anxiety, which were reported in over half of the sample, moderated associations between inattention and episodic memory, and between inattention and inhibition. Only children without separation anxiety showed significant correlations between ADHD symptoms and poor performance. However, separation anxiety had no moderating effect on associations between inattention and visuomotor control or sustaining attention. Children exhibiting signs of ADHD show impairments across a range of cognitive tasks. Further research to improve our understanding of these processes may be useful in the development of early interventions. Our results suggest that separation anxiety should be taken into account when considering interventions to address emerging neuropsychological deficits associated with this disorder.
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Affiliation(s)
- Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Leo De Sonneville
- Department of Clinical Neurodevelopmental Studies, Leiden University, Leiden, The Netherlands
| | - Stephanie H M Van Goozen
- School of Psychology, Cardiff University, Cardiff, UK
- Department of Clinical Neurodevelopmental Studies, Leiden University, Leiden, The Netherlands
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Lidle LR, Schmitz J. Assessing Visual Avoidance of Faces During Real-Life Social Stress in Children with Social Anxiety Disorder: A Mobile Eye-Tracking Study. Child Psychiatry Hum Dev 2024; 55:24-35. [PMID: 35708796 PMCID: PMC10796484 DOI: 10.1007/s10578-022-01383-y] [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: 05/23/2022] [Indexed: 12/01/2022]
Abstract
This study measured visual attention (fixation count, dwell time) during two real-life social stress tasks using mobile eye-tracking glasses in children (9-13 years) diagnosed with social anxiety disorder (SAD; n = 25) and a healthy control group (HC; n = 30). The influence of state anxiety on attention allocation and negative self-evaluation biases regarding gaze behavior were also examined. Compared to the HC group, children with SAD showed visual avoidance (i.e., fewer fixations) of the faces of interaction partners during the second social stress task. While visual avoidance in HC children decreased with declining state anxiety from the first to the second social stress task, no such effect was found in children with SAD. A negative self-evaluation bias regarding gaze behavior in children with SAD was not found. In sum, measuring visual attention during real-life social situations may help enhance our understanding of social attention in childhood SAD.
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Affiliation(s)
- Leonie Rabea Lidle
- Department for Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9-19, 04109, Leipzig, Germany.
- Leipzig Research Centre for Early Child Development, Leipzig University, Leipzig, Germany.
| | - Julian Schmitz
- Department for Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Neumarkt 9-19, 04109, Leipzig, Germany
- Leipzig Research Centre for Early Child Development, Leipzig University, Leipzig, Germany
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Anand P, Patil RS, Puri P, Patil S. The Psychosocial Effects of Lockdown Due to the COVID-19 Pandemic on Children in 2021. Cureus 2024; 16:e53614. [PMID: 38449990 PMCID: PMC10916525 DOI: 10.7759/cureus.53614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Objectives The COVID-19 pandemic led to a nationwide lockdown that isolated numerous children and adolescents, significantly affecting their mental well-being. Therefore, this study aimed to assess the challenges faced by children during the pandemic and identify the potential contributing factors. Additionally, given the existing concerns surrounding the mental health of female children and adolescents, our study aimed to investigate the presence of sex-based disparities in children's observed emotional and behavioral difficulties during the COVID-19 lockdown. Methods Participants in this study were parents of children aged 6-17 years. An observational cross-sectional study was conducted through verbal administration of a validated semi-structured questionnaire, the Parent Report Measure, from June 2021 to August 2021 at a nearby community health center. The questionnaire collected socio-demographic details and utilized the Strengths and Difficulties Questionnaire (SDQ), a screening tool to assess children's emotional and behavioral aspects during the six-month lockdown period. The responses were then analyzed using appropriate statistical tools like SPSS statistics, and cumulative SDQ scores were used to categorize participants. Results Out of the total 280 responses analyzed, the prosocial subscale exhibited the highest number of abnormal responses, 73 (26.1%), followed by conduct (42; 15%), hyperactivity (41; 14.6%), and peer (41; 14.6%) subscales. These results indicated that children displayed decreased empathy towards others, restlessness, fidgetiness, reduced attention span, frequent tantrums, and a preference for solitary activities. Furthermore, there was a significant association between abnormal subscale scores and the sex of children. Females showed a considerably higher prevalence of emotional problems (172; 61.5%) than males. Among the behavioral responses, a more significant proportion of females displayed abnormal scores in the conduct subscale (170; 60.7%), while abnormal hyperactivity scores were more frequently observed among males (178; 63.4%). Regarding the peer problems subscale, the proportion of females was slightly higher than males (150; 53.7%) and nearly equal in the prosocial domain. A more significant proportion of females displayed abnormal scores for overall difficulties 144 (51.5%), indicating a notable sex-based disparity. Conclusion Our findings highlight the pandemic's significant impact on many children's psychological well-being. The results emphasize the need for targeted interventions to address the mental health concerns that arose in this population. The observed disparity in emotional and behavioral difficulties among female children is particularly concerning, highlighting the need for gender-sensitive support and care. Various strategies can be helpful, such as virtual support groups, indoor recreational activities, reduced screen time and excessive news consumption, and effective communication with parents. Furthermore, our study also indicates the need to dive deep into such areas of pediatric research to understand and plan timely interventions.
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Affiliation(s)
- Puneet Anand
- Pediatrics, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, New York City, USA
| | - Rutuja S Patil
- Medicine, Bharati Vidyapeeth Medical College Pune, Pune, IND
| | - Piyush Puri
- Internal Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
| | - Sanjivani Patil
- Community Medicine, Bharati Vidyapeeth Medical College, Pune, IND
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Bauer JA, Romano ME, Jackson BP, Bellinger D, Korrick S, Karagas MR. Associations of Perinatal Metal and Metalloid Exposures with Early Child Behavioral Development Over Time in the New Hampshire Birth Cohort Study. EXPOSURE AND HEALTH 2024; 16:135-148. [PMID: 38694196 PMCID: PMC11060719 DOI: 10.1007/s12403-023-00543-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/13/2023] [Accepted: 03/01/2023] [Indexed: 05/04/2024]
Abstract
Research on the neurodevelopmental effects of metal(loid)s has focused mainly on outcomes assessed at one time point, even though brain development progresses over time. We investigated biomarkers of perinatal exposure to metals and changes in child behavior over time. We followed 268 participants from the prospective New Hampshire Birth Cohort Study between birth and age 5 years. We measured arsenic (As), copper (Cu), manganese (Mn), lead (Pb), selenium (Se), and zinc (Zn) in toenails from 6-week-old infants. The Behavioral Symptoms Index (BSI), externalizing, and internalizing symptoms were assessed using the Behavior Assessment System for Children, 2nd edition (BASC-2) at ages 3 and 5 years. Multivariable linear regression was used to estimate associations of metals with behavior change, calculated as the difference in symptom raw scores between 3 and 5 years, in addition to the associations for symptom scores at 3 and 5 years separately. Sex-specific associations were also explored using stratified models and a sex-metal interaction term. Adjusted associations of metals and change in behavior varied by exposure and outcome. Each 1 μg/g increase in ln toenail Cu was associated with improved behavior between 3 and 5 years [BSI: β = - 3.88 (95%CI: - 7.12, - 0.64); Externalizing problems: β = - 2.20 (95%CI: - 4.07, - 0.33)]. Increasing Zn was associated with increased externalizing behavior over time (β = 3.42 (95%CI: 0.60, 6.25). Sex-stratified analyses suggested more pronounced associations among boys compared to girls. Perinatal exposure to metals may alter behavioral development between ages 3 and 5 years. Findings support the need for more research on associations between metals and neurodevelopment over longer time periods.
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Affiliation(s)
- Julia A. Bauer
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr., Lebanon, Hanover, NH 03756, USA
| | - Megan E. Romano
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr., Lebanon, Hanover, NH 03756, USA
| | - Brian P. Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - David Bellinger
- Departments of Neurology and Psychiatry, Boston Children’s Hospital, Boston, MA, USA
- Departments of Neurology and Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Susan Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr., Lebanon, Hanover, NH 03756, USA
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Yıldırım Demirdöğen E, Tanrıverdi Ç, Kara İ, Donbaloğlu MA, Özgeriş FB. Oxidative Imbalance in Pediatric Anxiety Disorders: A Preliminary Comparative Study. Cureus 2024; 16:e54796. [PMID: 38529433 PMCID: PMC10961602 DOI: 10.7759/cureus.54796] [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] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
Background It is important to determine the possible related factors of anxiety disorder, one of the common psychiatric disorders of childhood. Our aims in this study were to compare oxidative stress markers between anxiety disorders in pediatric patients and healthy controls and to examine the relationship between anxiety symptom severity and oxidative stress indicators. Methods The study included 25 patients and 25 healthy controls. We measured the total oxidant capacity (TOS) and total antioxidant capacity (TAS) from the collected serum samples and calculated the oxidative stress index (OSI). We evaluated the clinical severity of the anxiety symptoms by the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV). Results The groups did not exhibit a noteworthy distinction in terms of TOS (p=0.128) and TAS (p=0.329). However, OSI was markedly elevated in the group with anxiety disorder (p=0.044). In the correlation analysis between anxiety symptom severity and oxidative stress indicators in the group with anxiety disorder, we found a positive correlation between TOS and RCADS total anxiety score (p=0.08). Conclusion These results may point to an oxidative dysfunction in anxiety disorders and the potential role of oxidative stress in their aetiology. Prospective, large-scale, randomized studies are needed to investigate if oxidative stress indicators can be used in the diagnosis of anxiety disorders and as new treatment targets.
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Affiliation(s)
- Esen Yıldırım Demirdöğen
- Department of Child and Adolescent Psychiatry, Atatürk University Faculty of Medicine, Erzurum, TUR
| | - Çiğdem Tanrıverdi
- Department of Child and Adolescent Psychiatry, Erzurum Regional Training and Research Hospital, Erzurum, TUR
| | - İhsan Kara
- Department of Child and Adolescent Psychiatry, Erzurum Regional Training and Research Hospital, Erzurum, TUR
| | - Mehmet Ali Donbaloğlu
- Department of Child and Adolescent Psychiatry, Atatürk University Faculty of Medicine, Erzurum, TUR
| | - Fatma Betül Özgeriş
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ataturk University, Erzurum, TUR
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50
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Scoberg B, Hobson C, van Goozen S. Psychometric Properties and Validity of the Screen for Child Anxiety Related Emotional Disorders: Parent Version (SCARED-P) in an Early Childhood Sample. Assessment 2024:10731911231225203. [PMID: 38258550 DOI: 10.1177/10731911231225203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
The Screen for Child Anxiety Related Emotional Disorders: Parent Version (SCARED-P) was originally developed for use in middle childhood and adolescence. The present study examined the psychometric properties and validity of the SCARED-P in an early childhood sample (predominantly aged 4-7 years). The 41-item version of the SCARED-P was administered to the parents of 233 children (mean age = 6.31 years, SD = 1.08; females = 34.3%). Confirmatory factor analysis provided mixed support for the original five-factor model of the SCARED-P. The SCARED-P demonstrated good to excellent internal consistency (total α = .94, subscale α = .68-.89), and good construct validity with the Child Behavior Checklist, Strengths and Difficulties Questionnaire, and the Developmental and Well-being Assessment. These findings indicate overall initial support for the SCARED-P's utility as a measure of anxiety in early childhood, but further psychometric and validation studies are needed in larger community-based samples of young children.
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