Children's self-talk under conditions of mild anxiety

Is the cognitive triad a clear marker of depressive symptoms in youngsters?

Research on depression showed patterns of maladaptive thinking reflecting themes of negative self-evaluation, a pessimistic view on the world and hopelessness regarding the future, the so-called cognitive triad. However, it is still unclear if these cognitive aspects are also a clear marker of depressive symptoms in children. Therefore in the current study we will investigate to what extent the cognitive triad contributes to the prediction of depressive symptoms. Four hundred and seventy-one youngsters with a mean age of 12.41 years, of which 53% were male, participated in this study. They filled in self-report questionnaires to measure depressive symptoms, anxious symptoms, emotional and behavioral problem behavior and the cognitive triad. The cognitive triad explained 43.5% of the variance in depressive symptoms as reported by the children themselves without controlling for comorbid psychopathology. When controlling for comorbid anxiety and externalizing behavior problems, adding the cognitive triad contributes to depressive symptoms with 11% on top of the 45% explained variance by comorbid problems. The findings were observed both in the child (10-12 years) and adolescent (13-15 years) subsample. The standardized betas for the view on the World were low and did only reach the significance level in the adolescent sample. The cognitive triad represents a key component of depressive symptoms, also in younger age groups. Specifically the negative view on the Self and the negative view on the Future is already associated with depressive symptoms in both the child and adolescent subsample. The common variance among different psychopathologies (depression, anxiety and behavioral problems) still needs to be sorted out clearly.

The role of self-talk in the awareness of physiological state and physical performance

Different studies have suggested that the majority of self-talk during exercise is either positive or neutral in character. The majority of 'thoughts' during low-intensity exercise have been described as being dissociative conversational chatter. However, with increasing exercise intensity, there is a greater percentage of associative and motivational thoughts, which includes thoughts about feeling and affect, body monitoring, command, instruction and pace monitoring. It has been suggested that self-talk is necessary for creating a time 'wedge' between the activity described by the self-talk, and the self-talk itself. The information redundancy created by this time-wedge allows the capacity for reflection about what is occurring, and self-awareness of the part played by the individual themselves in the activity being performed. Self-talk may be a discussion between a singular 'I' and a singular 'me', or may be a multi-party dialogue. There are anatomical correlates to self-talk, with neural activity in a number of brain areas related to the occurrence of both overt and subvocal self-talk, particularly in Broca's region in the left frontal cortex, and Wernicke's region in the left posterior superior temporal cortex. Whether specific training of self-talk can improve performance is controversial, although recent studies have suggested that task-specific self-talk appears to have a beneficial effect on physical performance. Further studies are required to assess the ability of physical or mental training to modify self-talk in a beneficial and permanent manner, and whether these changes affect an individual's exercise performance and sense of self.

A qualitative investigation of school-aged children's answers to items from a generic quality of life measure

BACKGROUND

The development of instruments to measure child self-reported quality of life (QOL) is dependent on whether children can understand the concepts behind items. Researchers need more information on how children are interpreting and answering items. This paper aims to investigate the strategies school-aged children use to answer QOL items.

METHODS

A generic 30-item QOL measure (the TedQL) was administered to 266 healthy children (5-6, 7-9 years old). Children were asked to 'think aloud' while answering a selection of 10 TedQL items (n = 4 ability, n = 4 social, n = 2 mood items), and their responses were recorded verbatim.

RESULTS

The strategies children reported using when answering items were coded into five categories: (1) social comparisons; (2) stable character references; (3) concrete examples; (4) other reasons; or (5) no reason given. Concrete examples were used most frequently by children. Strategy type was dependent on age, with 7-9-year-olds reporting social comparisons and concrete examples more frequently than 5-6-year-olds. Five-to-six-year-olds gave no reasons for their response choices more frequently than 7-9-year-olds. Strategy type also differed by item type, with social comparisons used more frequently for ability items, and stable character references for social items. However, concrete examples were used consistently highly across ability and social items.

CONCLUSIONS

Children aged 5-9 years most commonly report using concrete examples of specific instances when answering QOL items. However, strategy use varies as a function of age and types of items. Our results highlight the importance of keeping in mind children's developmental age when interpreting responses from child QOL instruments.

Implementation and evaluation of the modified feeling great program for oncology children

Purpose

Designed to reduce anxiety and boost self‐concept, The Modified Feeling Great Program (MFGP) consisted of a series of mental training exercises used to improve the quality of life for 6‐17 year old children (N=20) with cancer. More specifically, the children were taught how to relax, look for highlights (good things that happen to them), and turn‐off negative thoughts that came into their heads. This paper aims to assess the program's effectiveness.

Design/methodology/approach

A pre‐/post‐test design was used to determine the effectiveness of the MFGP. To participate, children had to be of school age and diagnosed with cancer during the past five years. Six questionnaires/scripts were administered to obtain pre and post information on the dependent variables: highlights, relaxation, stress control, heart rate imagery/excitement and heart rate imagery/relaxation, self concept, and anxiety. Heart rate monitors (DT1000, Polar, New York) measured the physiological effects of the MFGP relaxation component. The 37‐item Revised Children's Manifest Anxiety Scale (RCMAS) and Song and Hattie's 15‐item self‐concept scale were also used in this investigation to measure the dependent variables. All instruments had established validity and reliability.

Findings

An examination of pre‐ versus post‐test results showed that the MFGP program produced significant (0.05 level) reduction in (RCMAS) worry/over‐sensitivity, (RCMAS) social concerns/concentration, e.g. physical anxiety, highlights, exciting heart rate/imagery, and relaxation heart rate/imagery. Further statistical analysis revealed that the MFGP was equally effective for boys and girls.

Research limitations/implications

Six children were unable to do the mental training exercises on a regular basis due to ill health from chemotherapy treatments. There was no control group and sample size was small (N=20). A more robust research design should be used during future investigations.

Practical implications

To date, most of the treatment for children with cancer is concerned with the physical aspects of the problem, i.e. the use of chemotherapy to kill cancer cells. The results of the present investigation demonstrate that greater attention needs to be given to psychological factors, e.g. anxiety, poor self‐concept and problematic interpersonal relations with parents, teachers and medical personnel. These results suggest that positive effects can be obtained by using the MFGP.

Originality/value

These results are useful for hospital personnel, parents, teachers, and other persons who provide services to children with cancer.

Cognitive specificity in internalizing and externalizing problems in community and clinic-referred children

Examined whether cognitive features in Beck's (1967) model of depression and his cognitive content-specificity hypothesis (Beck, Brown, Steer, Eidelson, & Riskind, 1987) are broadband specific features that distinguish internalizing problems from externalizing problems. From a community (n = 389; 196 boys, 193 girls; age M = 9.98, SD = 1.52) and clinic (n = 82; 55 boys, 27 girls; age M = 10.42, SD = 2.91) sample, 4 groups were defined on behavioral measures and then examined on cognitive measures: externalizing only (n = 33), internalizing only (n = 41), comorbid externalizing and internalizing (n = 53), and control (neither externalizing nor internalizing; n = 35). Both the internalizing only and comorbid groups reported significantly more cognitive disturbances (negative cognitive triad, cognitive processing distortions, and "depressive" and "anxious" thought content) than both of the externalizing only and control groups in both the community and clinic samples. The results were not related to either overall level of psychopathology (as reported by mothers) or social desirability in children's reporting. These findings suggest that the cognitive features in Beck's model distinguish internalizing from externalizing problems and add to a growing literature that calls for further conceptual refinement of cognitive models for understanding both narrow-band and broadband syndromes.