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Atzl VM, Russotti J, Cerulli C, Cicchetti D, Handley ED. Profiles of socioemotional functioning in children with and without CPS-subtantiated maltreatment: Associations with child maltreatment and dating violence. CHILD ABUSE & NEGLECT 2024; 154:106953. [PMID: 39053219 PMCID: PMC11325266 DOI: 10.1016/j.chiabu.2024.106953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/28/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE Person-centered approaches are essential for characterizing heterogeneity in child development as it relates to child maltreatment (CM) and dating violence. The present study had two aims: 1) identify person-centered patterns of childhood socioemotional functioning, 2) examine whether patterns of child socioemotional functioning mediate the association between CM and dating violence. PARTICIPANTS AND SETTING Wave 1 comprised N = 680 children ages 10-12 years with and without experiences of CPS-substantiated CM facing socio-economic challenge. Wave 2 included N = 407 emerging adults ages 18-24 years old. METHODS Children participated in a summer camp research program at Wave 1 and a follow up interview at Wave 2. Participant CM history and socioemotional functioning was assessed at Wave 1. Exposure to dating violence was assessed at Wave 2. A latent profile analysis identified patterns of socioemotional functioning. Then regression analyses examined associations of socioemotional functioning with CM and dating violence. RESULTS Three profiles of child socioemotional functioning were identified (well-regulated/low distress, high externalizing/high aggression, high internalizing). CM was significantly associated with membership in the high externalizing/high aggression class. Patterns of child socioemotional functioning did not mediate the association between CM and dating violence, although number of subtypes of CM had a significant positive direct effect on dating violence. CONCLUSIONS Results underscore the multidimensional nature of socioemotional functioning and the predictive power of number of subtypes of CM on dating violence. Results can be harnessed by clinicians and policy makers to identify those at risk and interrupt cycles of violence.
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Affiliation(s)
- Victoria M Atzl
- Mt. Hope Family Center, University of Rochester, United States of America.
| | - Justin Russotti
- Mt. Hope Family Center, University of Rochester, United States of America
| | - Catherine Cerulli
- Department of Psychiatry, University of Rochester Medical Center, United States of America
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, United States of America; Institute of Child Development, University of Minnesota, United States of America
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Ramamurthy C, Zuo P, Armstrong G, Andriessen K. The impact of storytelling on building resilience in children: A systematic review. J Psychiatr Ment Health Nurs 2024; 31:525-542. [PMID: 38087837 DOI: 10.1111/jpm.13008] [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: 06/19/2023] [Revised: 10/25/2023] [Accepted: 11/28/2023] [Indexed: 07/03/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Storytelling is an effective tool for communication, is universally comprehensible and transcends linguistic barriers, adapting to cultures easily. Storytelling has a strong influence on children and has been used for knowledge retention and for developing imagination, creativity and prosocial behaviours. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The systematic review offers essential insights into the effects of storytelling interventions on the development of resilience in children. It indicates the various forms of storytelling interventions implemented and also the specific measures of resilience employed in the studies. The review has demonstrated that storytelling plays a crucial role in the development of protective factors in children including resilience. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric and mental health nurses working in community, hospital or mental health units play an important role in mental health interventions, particularly when it comes to children and young adults. Employing storytelling techniques can help psychiatric and mental health nurses provide timely and consistent support to children while helping them explore support systems, mechanisms and coping strategies helping build resilience. This holds particular importance for low- and middle-income countries where limited resources pose challenges in providing adequate support for mental health programmes for children. Methods such as storytelling are simple and adaptable to the specific challenges faced in the mental health setting. ABSTRACT INTRODUCTION: Resilience is a crucial aspect of mental health and coping that enables individuals to effectively recover from challenges. Fostering resilience in children becomes a significant objective. Storytelling is known to positively affect resilience, providing opportunities to share and develop narratives that help make sense of difficult experiences, find meaning in them, and building beliefs around our capacity to adapt well to challenging experiences. AIM The aim of this review is to synthesize peer-reviewed studies on the impact of storytelling interventions in developing resilience in children. METHOD The review adhered to the updated PRISMA 2020 guidelines and was registered with PROSPERO (CRD42022365474). We conducted searches in 12 databases with search strings comprising of concepts regarding storytelling, resilience and children. RESULTS The review included 11 studies published between 2012 and 2022. The narrative synthesis of the studies indicates that storytelling interventions enhanced psychological resilience in children. DISCUSSION Storytelling-based interventions in school settings with participatory approaches using cultural stories, and positive psychology-based interventions were effective and feasible. IMPLICATIONS FOR PRACTICE This review has scope for informing future interventions with children, especially those who live in marginalized communities in low- and middle-income countries (LMICs).
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Affiliation(s)
- Chandra Ramamurthy
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Peixin Zuo
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Gregory Armstrong
- Nossal Institute, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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3
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Zani B, Luckett B, Thurman TR. COVID-19 pandemic stressors, familial discord, and anxiety among adolescents living with HIV in South Africa: pathways to non-adherence. AIDS Care 2024; 36:137-144. [PMID: 38301123 DOI: 10.1080/09540121.2024.2308025] [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] [Received: 08/23/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Adolescents living with HIV (ALHIV) have poorer adherence to antiretroviral treatment (ART). This study investigates the interconnectivity of stressors induced by the COVID-19 pandemic, anxiety and family dynamics on adolescents' adherence to ART. A telephone survey was conducted among 196 South African ALHIV previously enrolled in support groups. Generalized structural equations modeling was used to understand how pandemic-related stressors affected ART adherence. Respondents reported experiencing life stressors since the implementation of COVID-19 restrictions, including doing worse at school (32%), loss of household income (44%) and less food available (38%). Forty-two percent reported greater verbal aggression from adults at home and 60% experienced anxiety. The structural equations model demonstrated a direct path from experiencing life stressors to increased verbal aggression from caregivers, which led to anxiety and ultimately, poorer ART adherence. Each stressor experienced increased the odds of experiencing verbal aggression by 51% (OR=1.51, 95%CI=1.14-2.00) which, in turn, increased the odds of having anxiety four-fold (OR=4.1, 95%C =2.16-7.76). Anxiety was associated with a 74% reduction in the odds of being fully ART adherent (OR=0.26, 95%CI=0.08-0.81). COVID-19-induced stressors exacerbated the mental and physical vulnerability of ALHIV. Findings elucidate how both discord at home and anxiety can result in poorer ART adherence.
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Affiliation(s)
- Babalwa Zani
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
| | - Brian Luckett
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
| | - Tonya R Thurman
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
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4
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Dauvermann MR, Moreno-Lopéz L, Vai B, González-García N, Orellana S, Jones PB, Bullmore E, Goodyer IM, van Harmelen AL. Early adolescent perceived friendship quality aids affective and neural responses to social inclusion and exclusion in young adults with and without adverse childhood experiences. Soc Cogn Affect Neurosci 2024; 19:nsae044. [PMID: 38902943 PMCID: PMC11219303 DOI: 10.1093/scan/nsae044] [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: 11/02/2022] [Revised: 05/17/2024] [Accepted: 06/20/2024] [Indexed: 06/22/2024] Open
Abstract
Friendships increase mental wellbeing and resilient functioning in young people with childhood adversity (CA). However, the mechanisms of this relationship are unknown. We examined the relationship between perceived friendship quality at age 14 after the experience of CA and reduced affective and neural responses to social exclusion at age 24. Resilient functioning was quantified as psychosocial functioning relative to the degree of CA severity in 310 participants at age 24. From this cohort, 62 young people with and without CA underwent functional Magnetic Resonance Imaging to assess brain responses to social inclusion and exclusion. We observed that good friendship quality was significantly associated with better resilient functioning. Both friendship quality and resilient functioning were related to increased affective responses to social inclusion. We also found that friendship quality, but not resilient functioning, was associated with increased dorsomedial prefrontal cortex responses to peer exclusion. Our findings suggest that friendship quality in early adolescence may contribute to the evaluation of social inclusion by increasing affective sensitivity to positive social experiences and increased brain activity in regions involved in emotion regulation to negative social experiences. Future research is needed to clarify this relationship with resilient functioning in early adulthood.
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Affiliation(s)
- Maria R Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - Laura Moreno-Lopéz
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, 20127, Italy
| | - Nadia González-García
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
- Laboratory of Neurosciences, Hospital Infantil de México Federico Gómez, Mexico City, 06720, Mexico
| | - Sofia Orellana
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
| | - Ed Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
- Department of Research and Development, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, United Kingdom
| | - Ian M Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 8AH, United Kingdom
- Institute of Education and Child Studies, Leiden University, Leiden, AK 2333, The Netherlands
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5
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Kim SY, Song J, Wen W, Yan J, Tse HW, Chen S, López BG, Shen Y, Hou Y. Language brokering profiles of Mexican-origin adolescents in immigrant communities: Social-cultural contributors and developmental outcomes. Child Dev 2024; 95:1237-1253. [PMID: 38303138 DOI: 10.1111/cdev.14078] [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] [Indexed: 02/03/2024]
Abstract
This study examines social-cultural contributors and developmental outcomes of language brokers. From 2012 to 2020, three waves of data were collected from 604 Mexican-origin adolescent language brokers (Mage = 12.92, SD = 0.92, 54% girls). The study (1) identified four distinct subgroups of language brokers (efficacious, conservative, nonchalant, and burdened) who translated for mothers and fathers, after incorporating objective bilingual proficiency along with multiple dimensions of language brokering; (2) showed that early adolescents' Mexican, rather than U.S., cultural values and orientation were related to later language brokering profiles; and (3) showed that the efficacious group was the most resilient while burdened was the most vulnerable to developmental problems. Preservation of Mexican culture may facilitate language brokering experiences related to more positive developmental outcomes.
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Affiliation(s)
- Su Yeong Kim
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Jiaxiu Song
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Wen Wen
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Jinjin Yan
- Department of Psychology, Fordham University, New York, New York, USA
| | - Hin Wing Tse
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Shanting Chen
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| | - Belem G López
- National Institutes of Health, Bethesda, Maryland, USA
| | - Yishan Shen
- School of Family and Consumer Sciences, Texas State University, San Marcos, Texas, USA
| | - Yang Hou
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, Florida, USA
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6
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Yan J, Wen W, Song J, Liu A, Lorenzo-Blanco E, Shen Y, Zhang M, Kim SY. Understanding adjustment profiles among Mexican-origin adolescents over time: A focus on cultural risk and resilience factors. Child Dev 2024. [PMID: 38818954 DOI: 10.1111/cdev.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
This study used a three-wave longitudinal dataset to: identify adjustment profiles of U.S. Mexican-origin adolescents based on their physical, academic, and psychosocial health adjustment; track adjustment profile changes throughout adolescence; and examine the associations between cultural stressors, family obligation, and adjustment profile membership over time. Participants were 604 Mexican-origin adolescents (54% female, Mage = 12.41, SD = 0.97) in Texas (Wave 1: 2012-2015; Wave 2: 2013-2016; Wave 3: 2017-2020). Three concurrent profiles (Well-adjusted, Moderate, and Poorly-adjusted) emerged at each wave, whereas three transition profiles (Improved, Stable well-adjusted, and Overall poorly-adjusted) were identified across three waves. The results suggest that cultural stressors pose risks for Mexican-origin adolescents' adjustment, and family obligation values play a protective role in these associations.
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Affiliation(s)
- Jinjin Yan
- Psychology Department, Fordham University, New York City, New York, USA
| | - Wen Wen
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Jiaxiu Song
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Angelina Liu
- University of Texas at Austin, Austin, Texas, USA
| | | | - Yishan Shen
- Texas State University, San Marcos, Texas, USA
| | - Minyu Zhang
- Latino Research Institute, University of Texas at Austin, Austin, Texas, USA
| | - Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
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Csirmaz L, Nagy T, Vikor F, Kasos K. Cognitive Behavioral Digital Interventions are Effective in Reducing Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis. JOURNAL OF PREVENTION (2022) 2024; 45:237-267. [PMID: 38093033 PMCID: PMC10981643 DOI: 10.1007/s10935-023-00760-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 04/02/2024]
Abstract
Anxiety disorders are the most prevalent mental health issues in childhood, yet most children do not receive treatment. With recent advances in technology, a growing number of digital anxiety interventions are becoming accessible. This study is the first meta-analysis to evaluate the effectiveness and usefulness of digital cognitive-behavioral anxiety interventions for individuals under the age of 18. Five electronic databases (PsycNET, Web of Science, Science Direct, Pub Med, SAGE Journals.) were systematically searched in 2021. Inclusion criteria were: randomized control trials with a wait list no treatment control, standalone to blended care with minimal therapist involvement, diagnosed anxiety disorder or elevated levels of anxiety, outcome anxiety levels had to be assessed by a clinician, or the patients themselves by a validated anxiety measure. We assessed and controlled for publication bias, and considered the risk of bias using the Cochrane risk-of-bias tool. Eighteen studies were found eligible, which examined 1290 participants in total. Pooled effect sizes using a random-effects model yielded low overall effect for self-ratings (g = 0.28, k = 18, p < 0.001, 95% CI [0.14; 0.41]), and medium effect for ratings of clinicians (g = 0.66, k = 13, p < 0.001, 95% CI [0.50; 0.80]) as well as for parental report (g = 0.49, k = 16, p < 0.001, 95% CI [0.29; 0.69]). We found that the effects were homogenous across studies. Further examining potential moderating factors of treatment efficacy is needed in future research, as well as conducting studies that compare traditional methods of care to their digital counterparts. Digital interventions could contribute to the well-being of children regardless of age, minimizing therapist involvement. We conclude that digital cognitive-behavioral interventions may provide an accessible, cost-effective, and scalable anxiety treatment option for children and adolescents.
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Affiliation(s)
- Luca Csirmaz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella u. 6, Budapest, 1064, Hungary
| | - Fanni Vikor
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Krisztian Kasos
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Izabella u. 6, Budapest, 1064, Hungary.
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González-García N, Buimer EEL, Moreno-López L, Sallie SN, Váša F, Lim S, Romero-Garcia R, Scheuplein M, Whitaker KJ, Jones PB, Dolan RJ, Fonagy P, Goodyer I, Bullmore ET, van Harmelen AL. Resilient functioning is associated with altered structural brain network topology in adolescents exposed to childhood adversity. Dev Psychopathol 2023; 35:2253-2263. [PMID: 37493043 DOI: 10.1017/s0954579423000901] [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] [Indexed: 07/27/2023]
Abstract
Childhood adversity is one of the strongest predictors of adolescent mental illness. Therefore, it is critical that the mechanisms that aid resilient functioning in individuals exposed to childhood adversity are better understood. Here, we examined whether resilient functioning was related to structural brain network topology. We quantified resilient functioning at the individual level as psychosocial functioning adjusted for the severity of childhood adversity in a large sample of adolescents (N = 2406, aged 14-24). Next, we examined nodal degree (the number of connections that brain regions have in a network) using brain-wide cortical thickness measures in a representative subset (N = 275) using a sliding window approach. We found that higher resilient functioning was associated with lower nodal degree of multiple regions including the dorsolateral prefrontal cortex, the medial prefrontal cortex, and the posterior superior temporal sulcus (z > 1.645). During adolescence, decreases in nodal degree are thought to reflect a normative developmental process that is part of the extensive remodeling of structural brain network topology. Prior findings in this sample showed that decreased nodal degree was associated with age, as such our findings of negative associations between nodal degree and resilient functioning may therefore potentially resemble a more mature structural network configuration in individuals with higher resilient functioning.
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Affiliation(s)
- Nadia González-García
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Laboratory of Neurosciences, Hospital Infantil de México Federico Gómez, México City, Mexico
| | - Elizabeth E L Buimer
- Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands
| | | | | | - František Váša
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sol Lim
- Public health and Primary Care, Cardiovascular Epidemiology Unit (CEU), University of Cambridge, Cambridge, UK
| | - Rafael Romero-Garcia
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Dpto. de Fisiología Médica y Biofísica. Instituto de Biomedicina de Sevilla (IBiS) HUVR/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Maximilian Scheuplein
- Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands
| | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Raymond J Dolan
- Wellcome Trust Center for Neuroimaging, University College London, London, UK
| | - Peter Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Ian Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands
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9
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Ruini C, Albieri E, Ottolini F, Vescovelli F. Improving Purpose in Life in School Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6772. [PMID: 37754631 PMCID: PMC10530348 DOI: 10.3390/ijerph20186772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/03/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
Background and aim: The dimension of purpose in life (PiL) is one of the core features of eudaimonia and plays a crucial role in developmental settings. However, few studies have examined purpose in life in younger generations and verified if it is amenable to improvements following a wellbeing-promoting intervention. The aim of the present investigation is to explore correlates and predictors of purpose in life in school children and to test if it can be ameliorated after school-based wellbeing interventions. Methods: A total of 614 students were recruited in various schools in Northern Italy. Of these, 456 belonged to junior high and high schools and were randomly assigned to receive a protocol of School Well-Being Therapy (WBT) or a psychoeducational intervention (controls). A total of 158 students were enrolled in elementary schools and received a positive narrative intervention based on fairytales or were randomly assigned to controlled conditions. All students were assessed pre- and post- intervention with Ryff scales of eudaimonic wellbeing (short version) and with other self-report measures of anxiety, depression and somatization. Additionally, the Strengths and Difficulties Questionnaire (SDQ) was administered to their schoolteachers as observed-rated evaluation. Results: In both elementary and high schools, purpose in life after the intervention was predicted by initial depressive symptoms and by group assignment (positive interventions vs. controls). In older students, PiL was predicted by female gender and anxiety levels, while no specific strengths identified by teachers were associated with PiL. Conclusions: PiL plays an important and strategic role in developmental settings, where students can develop skills and capacities to set meaningful goals in life. Depressive symptoms and anxiety can be obstacles to developing PiL in students, while positive school-based interventions can promote this core dimension of eudaimonia.
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Affiliation(s)
- Chiara Ruini
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Elisa Albieri
- Department of Psychology, University of Bologna, 47521 Cesena, Italy (F.V.)
| | - Fedra Ottolini
- Department of Psychology, University of Bologna, 47521 Cesena, Italy (F.V.)
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10
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Wen W, Scott L, Shen Y, Chen S, Kim SY. Perceived Parenting Discrepancy Profiles, Feelings about Language Brokering, and Internalizing Symptoms among Mexican-origin Adolescents in Immigrant Families. J Youth Adolesc 2023; 52:1799-1810. [PMID: 37389715 DOI: 10.1007/s10964-023-01817-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/17/2023] [Indexed: 07/01/2023]
Abstract
While different patterns of perceived parenting discrepancy among mother-adolescent dyads have been shown to be associated with adolescent internalizing symptoms, little is known about the pathway underlying such associations, particularly among immigrant families. The current study considered one culturally salient form of mother-adolescent communication, language brokering (i.e., adolescents translating and interpreting between host and heritage languages for mothers), in order to investigate its mediating role based on two waves of longitudinal data on Mexican-origin immigrant families. Wave 1 included 604 adolescents (54% female; Mage = 12.92, SD = 0.92) and 595 mothers (Mage = 38.89, SD = 5.74); Wave 2 was collected one year later with data from 483 adolescents. Perceived parenting discrepancy patterns at Wave 1 were captured by three profiles based on the levels of both mothers' and adolescents' perceived positive parenting (i.e., Mother High, Adolescent High, and Both High). Compared to the other two profiles, adolescents who reported much lower positive parenting than mothers at Wave 1 (i.e., Mother High) experienced more negative feelings about brokering at Wave 2, relating to more anxiety. Being in the Mother High (vs. Both High) group was also directly related to more depressive symptoms one year later. This study highlights the importance of considering culturally salient forms of communication, such as language brokering, when designing family-level interventions to reduce adolescents' internalizing symptoms by building agreement on high positive parenting among mother-adolescent dyads from immigrant families.
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Affiliation(s)
- Wen Wen
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, USA.
| | - Lorraine Scott
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, USA
| | - Yishan Shen
- School of Family and Consumer Sciences, Texas State University, San Marcos, USA
| | - Shanting Chen
- Department of Psychology, University of Florida, Gainesville, USA
| | - Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, USA
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Xin S, Sheng L, Zhang AY, Su Q, Peng H, Chen Y, Geng X, Liu H. Birth cohort changes in anxiety levels among primary school students in China during 1995-2019: A cross-temporal meta-analysis. Acta Psychol (Amst) 2023; 239:103996. [PMID: 37562320 DOI: 10.1016/j.actpsy.2023.103996] [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] [Received: 10/24/2022] [Revised: 07/12/2023] [Accepted: 07/30/2023] [Indexed: 08/12/2023] Open
Abstract
To investigate birth cohort changes in anxiety levels among primary school students in China, we conducted a cross-temporal meta-analysis of 126 studies (N = 109,957) reporting the anxiety levels among primary school students in China during 1995-2019 using the Mental Health Diagnostic Test (MHT); higher MHT scores indicated higher anxiety. The results showed that: (1) The MHT scores for five types of mental health problems (social anxiety, lonely tendency, physical symptoms, terror tendency, and impulsive tendency) and the total MHT score were significantly negatively correlated with the data-collection year, indicating that the anxiety levels among primary school students in China decreased over time. (2) The MHT score for learning anxiety was significantly positively correlated with the data-collection year, indicating that the learning anxiety levels of primary school students in China increased over time. (3) The overall MHT score did not show significant gender differences, but gender-wise varying trends were observed in the types considered.
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Affiliation(s)
- Sufei Xin
- School of Educational Science, Ludong University, Yantai 264025, China; Collaborative Innovation Center for the Mental Health of Youth from the Era of Conversion of New and Old Kinetic Energy along the Yellow River Basin, Ludong University, Yantai 264025, China
| | - Liang Sheng
- School of Educational Science, Ludong University, Yantai 264025, China; Collaborative Innovation Center for the Mental Health of Youth from the Era of Conversion of New and Old Kinetic Energy along the Yellow River Basin, Ludong University, Yantai 264025, China
| | - A-Yuan Zhang
- Department of Primary Education, Teachers' College, Beijing Union University, Beijing 100011, China; College of Education, Capital Normal University, Beijing 100048, China.
| | - Qian Su
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China; Beijing Guangming Primary School, Beijing 100061, China.
| | - Haiyun Peng
- School of Educational Science, Ludong University, Yantai 264025, China; Collaborative Innovation Center for the Mental Health of Youth from the Era of Conversion of New and Old Kinetic Energy along the Yellow River Basin, Ludong University, Yantai 264025, China
| | - Yinghua Chen
- Beijing Academy of Educational Sciences, Beijing 100036, China
| | - Xiaojie Geng
- Beijing Dongcheng Academy of Educational Sciences, Beijing 100009, China
| | - Hui Liu
- College of Elementary Education, Capital Normal University, Beijing 100048, China
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12
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Mascheretti S, Forni D, Lampis V, Fumagalli L, Paquin S, Andlauer TFM, Wang W, Dionne G, Brendgen MR, Vitaro F, Ouellet-Morin I, Rouleau G, Gouin JP, Côté S, Tremblay RE, Turecki G, Garon-Carrier G, Boivin M, Battaglia M. Adolescent anxiety and pain problems: A joint, genome-wide investigation and pathway-based analysis. PLoS One 2023; 18:e0285263. [PMID: 37146008 PMCID: PMC10162554 DOI: 10.1371/journal.pone.0285263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 04/18/2023] [Indexed: 05/07/2023] Open
Abstract
Both common pain and anxiety problems are widespread, debilitating and often begin in childhood-adolescence. Twin studies indicate that this co-occurrence is likely due to shared elements of risk, rather than reciprocal causation. A joint genome-wide investigation and pathway/network-based analysis of adolescent anxiety and pain problems can identify genetic pathways that subserve shared etiopathogenetic mechanisms. Pathway-based analyses were performed in the independent samples of: The Quebec Newborn Twin Study (QNTS; 246 twin pairs and 321 parents), the Longitudinal Study of Child Development in Quebec (QLSCD; n = 754), and in the combined QNTS and QLSCD sample. Multiple suggestive associations (p<1×10-5), and several enriched pathways were found after FDR correction for both phenotypes in the QNTS; many nominally-significant enriched pathways overlapped between pain problems and anxiety symptoms (uncorrected p<0.05) and yielded results consistent with previous studies of pain or anxiety. The QLSCD and the combined QNTS and QLSCD sample yielded similar findings. We replicated an association between the pathway involved in the regulation of myotube differentiation (GO:0010830) and both pain and anxiety problems in the QLSDC and the combined QNTS and QLSCD sample. Although limited by sample size and thus power, these data provide an initial support to conjoint molecular investigations of adolescent pain and anxiety problems. Understanding the etiology underlying pain and anxiety co-occurrence in this age range is relevant to address the nature of comorbidity and its developmental pathways, and shape intervention. The replication across samples implies that these effects are reliable and possess external validity.
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Affiliation(s)
- Sara Mascheretti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Diego Forni
- Bioinformatics, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Valentina Lampis
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Luca Fumagalli
- Bioinformatics, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Stéphane Paquin
- Department of Psychology, The Pennsylvania State University, State College, PA, United States of America
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Wei Wang
- Centre for Complex Interventions Centre for Addiction and Mental Health, Toronto, Canada
| | - Ginette Dionne
- Ecole de Psychologie, Université Laval, Quebec City, QC, Canada
| | - Mara R Brendgen
- Département de Psychologie, Universite du Quebec a Montreal, Montreal, QC, Canada
| | - Frank Vitaro
- Research Unit for Children's Psychosocial Maladjustment, Montreal, QC, Canada
- School of Psycho-Éducation, Université de Montréal, Québec City, QC, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal & Research Center of the Montreal Mental Health University Institute, Montreal, Canada
| | - Guy Rouleau
- Montreal Neurological Institute-Hospital, McGill University, Montreal, QC, Canada
| | | | - Sylvana Côté
- Département de Médecine Sociale et Préventive, Université de Montreal, Montreal, QC, Canada
| | - Richard E Tremblay
- Départements de Pédiatrie et de Psychologie, Université de Montreal, Montreal, QC, Canada
| | - Gustavo Turecki
- Douglas Research Centre, McGill University, Montreal, QC, Canada
| | | | - Michel Boivin
- Ecole de Psychologie, Université Laval, Quebec City, QC, Canada
| | - Marco Battaglia
- Child, Youth and Emerging Adults Programme Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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13
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Duchesne S, Plamondon A, Ratelle CF. Students' Inattention Symptoms and Psychological Need Satisfaction During the Secondary School Transition: The Protective Role of Teachers' Involvement. J Atten Disord 2022; 26:1846-1856. [PMID: 35699304 PMCID: PMC9597131 DOI: 10.1177/10870547221105061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study examined the prospective relationship from student inattention symptoms to changes in their psychological need satisfaction (PNS) during their transition to secondary school. In doing so, it has explored whether this temporal association was moderated by teachers' involvement (TI). METHOD A sample of 688 students (46% male; Mage = 11.82) followed in Grade 6 and Secondary 1 was selected from a stratified random list. RESULTS Inattention symptoms predicted a decrease in autonomy and competence need satisfaction, after adjusting for gender, anxiety, aggression, and PNS at baseline. In addition, TI in Secondary 1 attenuated the association between inattention and autonomy need satisfaction decline. TI also predicted a smaller decrease in competence need satisfaction, over and above the contribution of inattention. CONCLUSIONS Results support the importance of TI in PNS of students who are struggling with inattention throughout a critical transition. Implications for educational practices and research are discussed.
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Affiliation(s)
- Stéphane Duchesne
- Laval University, Québec, QC,
Canada,Stéphane Duchesne, Pavillon des Sciences de
l’Éducation, Laval University, 2320, Rue des Bibliothèques, Québec, QC G1V 0A6,
Canada.
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14
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Held LK, Vink JM, Vitaro F, Brendgen M, Dionne G, Provost L, Boivin M, Ouellet-Morin I, Roelofs K. The gene environment aetiology of freezing and its relationship with internalizing symptoms during adolescence. EBioMedicine 2022; 81:104094. [PMID: 35696830 PMCID: PMC9194596 DOI: 10.1016/j.ebiom.2022.104094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The freezing response is a universal response to threat, linked to attentive immobility and action preparation. It is relevant for acute stress coping in animals and humans, and subtle deviations in toddler freezing duration (absence of, or excessively long reactions) have been linked to higher risk for internalizing symptoms in adolescence. Yet, while individual freezing tendencies are relatively stable throughout life, little is known about their gene-environment aetiology. METHODS We investigated the heritability of toddler freezing in the Quebec Newborn Twin Study (QNTS; n=508 twins) by fitting behavioural genetic models to video-coded freezing responses during a robot confrontation. Furthermore, we examined the predictive associations between toddler freezing and internalizing symptoms (anxiety and depressive symptoms), as they unfold during adolescence (ages 12-19 years) using linear mixed-effects models. FINDINGS Freezing was found to be moderately heritable (45% of the variance accounted for by genetic factors). The remaining variance was explained by unique environmental factors, including measurement error. No significant contribution of shared environmental factors was noted. Additionally, shorter freezing was associated with more internalizing symptoms in adolescence at trend level, a pattern that was significant for depressive but not anxiety symptoms. INTERPRETATION Freezing is an adaptive coping mechanism in early childhood, which is partly driven by genetic factors. Crucially, the absence or shorter duration of these behaviours may signal vulnerability to depressive problems later in life. FUNDING Canadian Institutes of Health Research and Research Fund of Quebec-Health and Society and Culture. Consolidator grant from the European Research Council (ERC_CoG-2017_772337).
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Affiliation(s)
- Leslie K Held
- Donders Institute for Brain Cognition and Behaviour: Centre for Cognitive Neuroimaging (DCCN). Kapitelweg 29, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, Netherlands.
| | - Jacqueline M Vink
- Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, Netherlands
| | - Frank Vitaro
- School of Psychoeducation, University of Montreal, Pavillon Marie-Victorin 90, av. Vincent-d'Indy Outremont QC, H2V 2S9 Montreal, Canada
| | - Mara Brendgen
- Department of Psychology, University of Quebec at Montreal, Case postale 8888, succursale Centre-ville Montréal, H3C 3P8, Canada
| | - Ginette Dionne
- School of Psychology, Laval University, Université Laval, 2325, rue de l'Université Québec (Québec), G1V 0A6 Quebec city, Canada
| | - Lysandre Provost
- School of Psychology, Laval University, Université Laval, 2325, rue de l'Université Québec (Québec), G1V 0A6 Quebec city, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Université Laval, 2325, rue de l'Université Québec (Québec), G1V 0A6 Quebec city, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal & Research Center of the Montreal Mental Health University Institute, Pavillon Lionel-Groulx C. P. 6128, succ. Centre-ville Montréal (Québec) H3C 3J7, Canada
| | - Karin Roelofs
- Donders Institute for Brain Cognition and Behaviour: Centre for Cognitive Neuroimaging (DCCN). Kapitelweg 29, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, Netherlands
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15
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Song J, Hou Y, Hazen NL, Lorenzo-Blanco EI, Kim SY. Do Mothers' Experiences Count? An Actor-Partner Interdependence Model of Language Brokering Experiences in Mexican Immigrant Families. J Youth Adolesc 2022; 51:888-903. [PMID: 35247159 PMCID: PMC10286826 DOI: 10.1007/s10964-022-01586-5] [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: 11/30/2021] [Accepted: 02/12/2022] [Indexed: 10/18/2022]
Abstract
Language brokering is a shared parent-child experience with implications for parent-child relationships and, in turn, individuals' psychological well-being; however, few studies recognize the role of parents. This study took a dyadic approach to investigate the association between brokering experiences and internalizing symptoms, and the mediating role of parent-child alienation. Participants were 604 Mexican-origin adolescents (54% female, Mage = 12.41) and their mothers (N = 595). Both adolescents' and their mothers' brokering experiences were related to their own internalizing symptoms via their self-reported parent-child alienation. Mothers' brokering experiences also affected adolescents so that when mothers experienced more negative brokering experiences, adolescents perceived greater parent-child alienation, and in turn more internalizing symptoms, suggesting the necessity of considering language brokering's influence on members involved as a dyadic process.
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Affiliation(s)
- Jiaxiu Song
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton St., Stop A2702, Austin, TX, USA
| | - Yang Hou
- School of Human Environmental Sciences, University of Kentucky, Lexington, USA
| | - Nancy L Hazen
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton St., Stop A2702, Austin, TX, USA
| | - Elma I Lorenzo-Blanco
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton St., Stop A2702, Austin, TX, USA
| | - Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton St., Stop A2702, Austin, TX, USA.
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16
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Edun O, Shenderovich Y, Zhou S, Toska E, Okell L, Eaton JW, Cluver L. Predictors and consequences of HIV status disclosure to adolescents living with HIV in Eastern Cape, South Africa: a prospective cohort study. J Int AIDS Soc 2022; 25:e25910. [PMID: 35543100 PMCID: PMC9092159 DOI: 10.1002/jia2.25910] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The World Health Organization recommends full disclosure of HIV-positive status to adolescents who acquired HIV perinatally (APHIV) by age 12. However, even among adolescents (aged 10-19) already on antiretroviral therapy (ART), disclosure rates are low. Caregivers often report the child being too young and fear of disclosure worsening adolescents' mental health as reasons for non-disclosure. We aimed to identify the predictors of disclosure and the association of disclosure with adherence, viral suppression and mental health outcomes among adolescents in sub-Saharan Africa. METHODS Analyses included three rounds (2014-2018) of data collected among a closed cohort of adolescents living with HIV in Eastern Cape, South Africa. We used logistic regression with respondent random-effects to identify factors associated with disclosure, and assess differences in ART adherence, viral suppression and mental health symptoms between adolescents by disclosure status. We also explored differences in the change in mental health symptoms and adherence between study rounds and disclosure groups with logistic regression. RESULTS Eight hundred and thirteen APHIV were interviewed at baseline, of whom 769 (94.6%) and 729 (89.7%) were interviewed at the second and third rounds, respectively. The proportion aware of their HIV-positive status increased from 63.1% at the first round to 85.5% by the third round. Older age (adjusted odds ratio [aOR]: 1.27; 1.08-1.48) and living in an urban location (aOR: 2.85; 1.72-4.73) were associated with disclosure between interviews. There was no association between awareness of HIV-positive status and ART adherence, viral suppression or mental health symptoms among all APHIV interviewed. However, among APHIV not aware of their status at baseline, adherence decreased at the second round among those who were disclosed to (N = 131) and increased among those not disclosed to (N = 151) (interaction aOR: 0.39; 0.19-0.80). There was no significant difference in the change in mental health symptoms between study rounds and disclosure groups. CONCLUSIONS Awareness of HIV-positive status was not associated with higher rates of mental health symptoms, or lower rates of viral suppression among adolescents. Disclosure was not associated with worse mental health. These findings support the recommendation for timely disclosure to APHIV; however, adherence support post-disclosure is important.
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Affiliation(s)
- Olanrewaju Edun
- MRC Centre for Global Infectious Disease AnalysisSchool of Public HealthImperial College LondonLondonUK
| | - Yulia Shenderovich
- Wolfson Centre for Young People's Mental HealthCardiff UniversityCardiffUK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)School of Social SciencesCardiff UniversityCardiffUK
- Centre for Evidence‐Based InterventionDepartment of Social Policy and InterventionUniversity of OxfordOxfordUK
| | - Siyanai Zhou
- Centre for Social Science ResearchUniversity of Cape TownCape TownSouth Africa
| | - Elona Toska
- Centre for Evidence‐Based InterventionDepartment of Social Policy and InterventionUniversity of OxfordOxfordUK
- Centre for Social Science ResearchUniversity of Cape TownCape TownSouth Africa
- AIDS and Society Research UnitUniversity of Cape TownCape TownSouth Africa
| | - Lucy Okell
- MRC Centre for Global Infectious Disease AnalysisSchool of Public HealthImperial College LondonLondonUK
| | - Jeffrey W. Eaton
- MRC Centre for Global Infectious Disease AnalysisSchool of Public HealthImperial College LondonLondonUK
| | - Lucie Cluver
- Centre for Evidence‐Based InterventionDepartment of Social Policy and InterventionUniversity of OxfordOxfordUK
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
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17
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Shah AS, Raghuram A, Kaur K, Lipson S, Shoshany T, Stevens R, O'Brien M, Howell D, Fleischman K, Barnack D, Molind H, Kuemmerle KH, Brodsky JR. Specialty-Specific Diagnoses in Pediatric Patients With Postconcussion Syndrome: Experience From a Multidisciplinary Concussion Clinic. Clin J Sport Med 2022; 32:114-121. [PMID: 33605602 PMCID: PMC8868181 DOI: 10.1097/jsm.0000000000000891] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/13/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the collaborative findings across a broad array of subspecialties in children and adolescents with postconcussion syndrome (PCS) in a pediatric multidisciplinary concussion clinic (MDCC) setting. DESIGN Retrospective analysis. SETTING Multidisciplinary concussion clinic at a pediatric tertiary-level hospital. PATIENTS Fifty-seven patients seen in MDCC for evaluation and management of PCS between June 2014 and January 2016. INTERVENTIONS Clinical evaluation by neurology, sports medicine, otolaryngology, optometry, ophthalmology, physical therapy, and psychology. MAIN OUTCOME MEASURES Specialty-specific clinical findings and specific, treatable diagnoses relevant to PCS symptoms. RESULTS A wide variety of treatable, specialty-specific diagnoses were identified as potential contributing factors to patients' postconcussion symptoms. The most common treatable diagnoses included binocular vision dysfunction (76%), anxiety, (57.7%), depression (44.2%), new or change in refractive error (21.7%), myofascial pain syndrome (19.2%), and benign paroxysmal positional vertigo (17.5%). CONCLUSIONS Patients seen in a MDCC setting receive a high number of treatable diagnoses that are potentially related to patients' PCS symptoms. The MDCC approach may (1) increase access to interventions for PCS-related impairments, such as visual rehabilitation, physical therapy, and psychological counseling; (2) provide patients with coordinated medical care across specialties; and (3) hasten recovery from PCS.
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Affiliation(s)
- Ankoor S. Shah
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Aparna Raghuram
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Karampreet Kaur
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Sophie Lipson
- Tufts University School of Medicine, Boston, Massachusetts; and
| | | | | | - Michael O'Brien
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - David Howell
- Children's Hospital of Colorado, Aurora, Colorado
| | - Katie Fleischman
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Jacob R. Brodsky
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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18
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Cross-species anxiety tests in psychiatry: pitfalls and promises. Mol Psychiatry 2022; 27:154-163. [PMID: 34561614 PMCID: PMC8960405 DOI: 10.1038/s41380-021-01299-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/16/2021] [Accepted: 09/08/2021] [Indexed: 11/08/2022]
Abstract
Behavioural anxiety tests in non-human animals are used for anxiolytic drug discovery, and to investigate the neurobiology of threat avoidance. Over the past decade, several of them were translated to humans with three clinically relevant goals: to assess potential efficacy of candidate treatments in healthy humans; to develop diagnostic tests or biomarkers; and to elucidate the pathophysiology of anxiety disorders. In this review, we scrutinise these promises and compare seven anxiety tests that are validated across species: five approach-avoidance conflict tests, unpredictable shock anticipation, and the social intrusion test in children. Regarding the first goal, three tests appear suitable for anxiolytic drug screening in humans. However, they have not become part of the drug development pipeline and achieving this may require independent confirmation of predictive validity and cost-effectiveness. Secondly, two tests have shown potential to measure clinically relevant individual differences, but their psychometric properties, predictive value, and clinical applicability need to be clarified. Finally, cross-species research has not yet revealed new evidence that the physiology of healthy human behaviour in anxiety tests relates to the physiology of anxiety symptoms in patients. To summarise, cross-species anxiety tests could be rendered useful for drug screening and for development of diagnostic instruments. Using these tests for aetiology research in healthy humans or animals needs to be queried and may turn out to be unrealistic.
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19
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Desaunay P, Dégeilh F, Guénolé F, Eustache F, Viard A, Bon L, Dayan J, Baleyte JM, Guillery-Girard B. Self-representation in Kleine-Levin syndrome: a single case fMRI study. Neurocase 2021; 27:396-406. [PMID: 34541988 DOI: 10.1080/13554794.2021.1974488] [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] [Indexed: 10/20/2022]
Abstract
Kleine-Levin syndrome (KLS) is characterized by recurrent episodes of hypersomnia, compulsive hyperphagia, disinhibition, hypersexuality and self modifications. To investigate the Self, we used afunctional magnetic resonance imaging paradigm evaluating Self-reference processing (SRP) and Self-reference effect (SRE) in a17-year-old male adolescent at the end of an episode. We observed enhanced activations in right hemisphere and posterior areas- associated with physical Self representations- during the SRP condition, while during the SRE condition, enhanced activations in bilateral but prevailing left frontal areas- associated with the conceptual Self. These results suggest amodified Self during aKLS episode being more physically grounded.
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Affiliation(s)
- P Desaunay
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France.,Service De Psychiatrie De L'enfant Et De L'adolescent, Chu De Caen, Caen, France
| | - F Dégeilh
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France
| | - F Guénolé
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France.,Service De Psychiatrie De L'enfant Et De L'adolescent, Chu De Caen, Caen, France
| | - F Eustache
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France
| | - A Viard
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France
| | - L Bon
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France.,Service De Psychiatrie De L'enfant Et De L'adolescent, Chu De Caen, Caen, France
| | - J Dayan
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France.,Pôle Hospitalo-Universitaire De Psychiatrie De l'Enfant Et De l'Adolescent, Centre Hospitalier Guillaume Régnier, Université Rennes 1, Rennes, France
| | - J M Baleyte
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France.,Service De Psychiatrie De L'enfant Et De L'adolescent, Hôpital Universitaire De Créteil, Créteil, France
| | - B Guillery-Girard
- U1077 Neuropsychologie et Imagerie de la Mémoire Humaine, Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, Caen, France.,Institut Universitaire de, France (IUF)
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20
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Russotti J, Warmingham JM, Duprey EB, Handley ED, Manly JT, Rogosch FA, Cicchetti D. Child maltreatment and the development of psychopathology: The role of developmental timing and chronicity. CHILD ABUSE & NEGLECT 2021; 120:105215. [PMID: 34293550 PMCID: PMC8384692 DOI: 10.1016/j.chiabu.2021.105215] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND The effects of child maltreatment (CM) on psychopathology are well-established, yet the complex effects of timing and chronicity of maltreatment exposure on the development of psychopathology are still unclear. OBJECTIVE To elucidate developmental pathways from distinct dimensions of CM (chronicity and timing) to psychopathology during emerging adulthood using data from a longitudinal, multi-method study. PARTICIPANTS AND SETTING Children with and without maltreatment exposure were recruited at wave 1 (ages 10-12) to participate in a research summer camp. At wave 2, participants were recontacted during emerging adulthood (ages 18-22). The current study includes 391 participants (51.3% female; 77.5% Black, 11.3% white, 7.4% Hispanic, 3.8% other race). METHODS Timing and chronicity of maltreatment exposures were coded from child protective services records using the Maltreatment Classification System. Childhood internalizing and externalizing symptoms were assessed using child- and camp counselor-report. Emerging adults completed self-report questionnaires and were interviewed about their current and past symptoms of psychopathology. Structural equation modeling was used to estimate direct and indirect links between childhood maltreatment dimensions (chronicity and timing) to adult psychopathology via childhood internalizing and externalizing. RESULTS Child maltreatment experiences that spanned several developmental periods, including both early and later childhood stages, predicted a cascade of both internalizing and externalizing symptoms in childhood that eventuated in greater symptoms of anxiety, depression, substance use disorder, and antisocial personality disorder in emerging adulthood. CONCLUSIONS Results suggest that chronic childhood maltreatment exposure is associated with multifinality in psychopathology presentations that can be detected in childhood and extend into emerging adulthood. Early prevention and intervention efforts to promote positive and safe parenting are essential to decrease the burden of mental health symptoms conferred by chronic maltreatment exposures on individuals, families, and public health systems.
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Affiliation(s)
- Justin Russotti
- Mt. Hope Family Center, University of Rochester, United States of America.
| | | | - Erinn B Duprey
- Mt. Hope Family Center, University of Rochester, United States of America; Institute of Child Development, University of Minnesota, United States of America
| | | | - Jody T Manly
- Mt. Hope Family Center, University of Rochester, United States of America
| | - Fred A Rogosch
- Mt. Hope Family Center, University of Rochester, United States of America
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, United States of America; Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, United States of America
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21
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The bidirectional relationships between peer victimization and internalizing problems in school-aged children: An updated systematic review and meta-analysis. Clin Psychol Rev 2021; 85:101979. [DOI: 10.1016/j.cpr.2021.101979] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/01/2020] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
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22
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Adult Gambling Problems and Histories of Mental Health and Substance Use: Findings from a Prospective Multi-Wave Australian Cohort Study. J Clin Med 2021; 10:jcm10071406. [PMID: 33915774 PMCID: PMC8037618 DOI: 10.3390/jcm10071406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 01/08/2023] Open
Abstract
Little is known about the cumulative effect of adolescent and young adult mental health difficulties and substance use problems on gambling behaviour in adulthood. We use data from one of Australia's longest running studies of social and emotional development to examine the extent to which: (1) mental health symptoms (depressive and anxiety symptoms) and substance use (weekly binge drinking, tobacco, and cannabis use) from adolescence (13-18 years) into young adulthood (19-28 years) predict gambling problems in adulthood (31-32 years); and (2) risk relationships differ by sex. Analyses were based on responses from 1365 adolescent and young adult participants, spanning seven waves of data collection (1998-2014). Persistent adolescent to young adult binge drinking, tobacco use and cannabis use predicted gambling at age 31-32 years (OR = 2.30-3.42). Binge drinking and tobacco use in young adulthood also predicted gambling at age 31-32 years (OR = 2.04-2.54). Prior mental health symptoms were not associated with gambling and no risk relationships differed by sex. Findings suggest that gambling problems in adulthood may be related to the earlier development of other addictive behaviours, and that interventions targeting substance use from adolescence to young adulthood may confer additional gains in preventing later gambling behaviours.
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van Harmelen AL, Blakemore S, Goodyer IM, Kievit R. The interplay between adolescent friendship quality and resilient functioning following childhood and adolescent adversity. ADVERSITY AND RESILIENCE SCIENCE 2021; 2:37-50. [PMID: 37915317 PMCID: PMC7615274 DOI: 10.1007/s42844-020-00027-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 11/03/2023]
Abstract
Background Child and adolescent adversity ('CA') is a major predictor of mental health problems in adolescence and early adulthood. However, not all young people who have experienced CA develop psychopathology; their mental health functioning can be described as resilient. We previously found that resilient functioning in adolescence following CA is facilitated by adolescent friendships.However, during adolescence, friendships undergo significant change. It is unknown whether resilient functioning after CA fluctuates with these normative changes in friendship quality. Methods We used Latent Change Score Modelling in a large sample of adolescents (i.e. the ROOTS cohort; N=1238) to examine whether and how emergent friendship quality and resilient functioning at ages 14 and 17 inter-relate and change together. Results We found that friendships quality and resilient functioning had strong associations at age 14, although friendships at 14 did not predict higher resilient functioning at 17. Higher resilient functioning in 14-year-olds with a history of CA was associated with a positive change in friendships from age 14 to 17. Finally, improvements in friendship quality and resilient functioning went hand in hand, even when taking into account baseline levels of both, the change within friendship quality or resilient functioning over time, and the association between resilient functioning and change in friendship quality over time. Conclusions We show that friendship quality and resilient functioning after CA inter-relate and change together between ages 14 and 17. Our results suggest that improving friendship quality or resilient functioning within this timeframe may benefit this vulnerable adolescent group, and this should be tested in future research.
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Affiliation(s)
- A.-L. van Harmelen
- Education and Child Studies, Leiden University, The Netherlands
- Department of Psychiatry, University of Cambridge, UK
| | - S.J. Blakemore
- Department of Psychology, University of Cambridge, UK
- UCL Institute of Cognitive Neuroscience, London, UK
| | - IM Goodyer
- Department of Psychiatry, University of Cambridge, UK
| | - R.A. Kievit
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
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Russotti J, Warmingham JM, Handley ED, Rogosch FA, Cicchetti D. Child maltreatment: An intergenerational cascades model of risk processes potentiating child psychopathology. CHILD ABUSE & NEGLECT 2021; 112:104829. [PMID: 33359770 PMCID: PMC7855935 DOI: 10.1016/j.chiabu.2020.104829] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND Child maltreatment poses substantial risk for compromised mental health in children. Further, child abuse and neglect are potentiated within a cascade of intergenerational and current familial risk processes that require clarification to inform understanding of adverse outcomes and direct prevention and intervention efforts. OBJECTIVE Using a multi-informant design, the current study applied an intergenerational cascades approach to examine the interconnected pathways among several familial risk factors associated with child maltreatment and its consequences. PARTICIPANTS Participants were 378 children (aged 10-12) and their mothers from economically disadvantaged, ethnically diverse backgrounds. The sample included maltreated children recruited via CPS records and demographically comparable non-maltreated children. METHODS Structural equation modeling (SEM) was conducted to test sequential mediation pathways examining the independent and cascading effects of maternal history of childhood maltreatment, maternal adolescent childbearing, current maternal depression, and the child's lifetime history of maltreatment on the child's internalizing and externalizing symptoms. RESULTS Multigenerational developmental cascades were identified. Maternal history of maltreatment predicted chronic maltreatment for offspring, which in turn predicted greater internalizing (β = .167, p = .03) and externalizing symptoms (β = .236, p = .005) in late childhood. Similarly, children born to mothers who began childbearing in adolescence were more likely to experience chronic maltreatment during childhood and develop subsequent symptoms. Effects were found over and above a parallel cascade from maternal maltreatment to offspring psychopathology via a maternal depression pathway. CONCLUSION Findings reveal targets to prevent or ameliorate progressions of intergenerational risk pathways.
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Affiliation(s)
- Justin Russotti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States.
| | - Jennifer M Warmingham
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States
| | - Elizabeth D Handley
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States
| | - Fred A Rogosch
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States; Institute of Child Development, University of Minnesota, United States
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25
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Smith AJ, Moreno-López L, Davidson E, Dauvermann M, Orellana S, Soneson E, Ioannidis K, Kaser M, van Harmelen AL. REACT study protocol: resilience after the COVID-19 threat (REACT) in adolescents. BMJ Open 2021; 11:e042824. [PMID: 33472787 PMCID: PMC7818833 DOI: 10.1136/bmjopen-2020-042824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/22/2020] [Accepted: 12/14/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION COVID-19-related social isolation and stress may have significant mental health effects, including post-traumatic stress, anxiety and depression. These factors are thought to disproportionately affect populations at risk of psychopathology, such as adolescents with a history of childhood adversity (CA). Therefore, examining which factors may buffer the impact of COVID-19-related stress and isolation in vulnerable adolescents is critical. The Resilience After the COVID-19 Threat (REACT) study assesses whether emotion regulation capacity, inflammation and neuroimmune responses to stress induced in the laboratory prior to the pandemic predict responses to COVID-19-related social isolation and stress in adolescents with CA. We aim to elucidate the mechanisms that enable vulnerable adolescents to maintain or regain good mental health when confronted with COVID-19. METHODS AND ANALYSIS We recruited 79 adolescents aged 16-26 with CA experiences from the Resilience After Individual Stress Exposure study in which we assessed emotion regulation, neural and immune stress responses to an acute stress task. Our sample completed questionnaires at the start of the UK lockdown ('baseline'; April 2020) and three (July 2020) and 6 months later (October 2020) providing crucial longitudinal information across phases of the pandemic progression and government response. The questionnaires assess (1) mental health, (2) number and severity of life events, (3) physical health, (4) stress perception and (5) loneliness and friendship support. We will use multilevel modelling to examine whether individual differences at baseline are associated with responses to COVID-19-related social isolation and stress. ETHICS AND DISSEMINATION This study has been approved by the Cambridge Psychology Research Ethics Committee (PRE.2020.037). Results of the REACT study will be disseminated in publications in scientific peer-reviewed journals, presentations at scientific conferences and meetings, publications and presentations for the general public, and through social media.
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Affiliation(s)
- Alicia Joanne Smith
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - Eugenia Davidson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- College of Medicine and Health, University of Exeter, Exeter, Devon, UK
| | - Maria Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Sofia Orellana
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Emma Soneson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Muzaffer Kaser
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Education and Child Studies, Leiden University, Leiden, Netherlands
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Moreno-López L, Sallie SN, Ioannidis K, Kaser M, Schueler K, Askelund AD, Turner L, van Harmelen AL. RAISE study protocol: a cross-sectional, multilevel, neurobiological study of resilience after individual stress exposure. BMJ Open 2021; 11:e040394. [PMID: 33436466 PMCID: PMC7805358 DOI: 10.1136/bmjopen-2020-040394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION This paper describes the protocol for an ongoing project funded by the Royal Society, the Resilience After Individual Stress Exposure (RAISE) study; which aims to examine the factors and mechanisms that facilitate resilient functioning after childhood adversity (CA). METHODS AND ANALYSIS We aim to recruit up to 200 participants. We will use dimension reduction techniques (principal component analysis) on standard-normally transformed individual parameters of mental health, social functioning and CA to calculate a composite measure of adaptive (ie, 'resilient') psychosocial functioning. To examine the neuroimmune responses to stress and their relationship with the brain and social environment, we will use a well validated functional MRI task; the Montreal imaging stress task and venepuncture. We will run group or dimensional comparisons in multiple levels of biological and psychological outcomes, as well as mediation and moderation analyses to study how key biological systems (ie, the hypothalamic-pituitary-adrenal axis and the immune system) interrelate and interact with brain function and social influences in order to facilitate resilient functioning after CA. We hypothesise that resilient functioning will be facilitated by reduced morning cortisol and cytokine levels before and after the stressor and improved neural responses to such stress, as well as increased gray matter volume in the hippocampus and prefrontal cortex, enhanced inhibitory control and emotion regulation, and more friendship and family support. ETHICS AND DISSEMINATION This study has been reviewed and given favourable opinion by the National Research Ethics Service, NRES Committee East of England-Cambridge Central and external reviewers from the Royal Society (RGF\R1\180064 and RGF\EA\180029). The results of the RAISE study will be disseminated through (1) publications in scientific peer reviewed journals, (2) presentations on relevant scientific conferences and meetings, (3) publications and presentations for the general public and (4) through social media.
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Affiliation(s)
- Laura Moreno-López
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha N Sallie
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, UK
| | - Muzaffer Kaser
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, UK
| | - Katja Schueler
- Department for Clinical and Neuropsychology, Johannes Gutenberg Universitat Mainz, Mainz, Germany
| | | | - Lorinda Turner
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Institute of Education and Child Studies, Leiden University, Leiden, Netherlands
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Qin J, Ding Y, Gao J, Wu Y, Lv H, Wu J. Effects of COVID-19 on Mental Health and Anxiety of Adolescents Aged 13-16 Years: A Comparative Analysis of Longitudinal Data From China. Front Psychiatry 2021; 12:695556. [PMID: 34354615 PMCID: PMC8330831 DOI: 10.3389/fpsyt.2021.695556] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Adolescence is an important stage of psychological development, and the psychological and mental problems of many adults are affected by the COVID-19 epidemic. The aim of this study was to understand the psychological status of this group during the epidemic, and to determine the risk factors leading to psychological stress, as well as protective factors. Methods: An online survey was run on April 2, 2020. The participants were 254 adolescents aged 13-16 years from a junior high school in Jiangsu, China. The results were compared with the pre-epidemic data, which came from the psychological status survey routinely carried out by the school. Mental health variables were assessed via the Mental Health Test that included one validity subscale and eight content subscales. Results: The number of adolescents with poor mental health increased significantly from 12.3 to 24.2%. There was significant increase in learning anxiety (33.7 vs. 56.4%), sensitivity tendency (19.8 vs. 46%), somatic anxiety (13.9 vs. 40.7%) and phobia tendency (4.4 vs. 10.1%). During the epidemic, there were significant differences between adolescents with normal and poor mental health in family structure, personality, relationship with siblings, daily exercise time, and risk of family members coming in contact with COVID-19. Living in stem family, no siblings, and risk of contracting COVID-19 from family members were significant risk factors for teenagers with poor mental health. Risk of contracting COVID-19 from family members was the most influential risk factor for learning anxiety, self-blaming tendency, sensitivity tendency, and somatic anxiety. Exercising for ≥1 h per day was a significant protective factor for poor mental health. Conclusions: During the COVID-19 epidemic, adolescents aged 13-16 years have had psychosocial problems, especially learning anxiety, sensitivity tendency, somatic anxiety, and phobia tendency, as well as risk factors for developing them. Our study provides insights for potential interventions.
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Affiliation(s)
- Jie Qin
- Department of Pediatrics, The Fourth Affiliated Hospital of Nantong University, Yancheng City, China.,Department of Pediatrics, The First People's Hospital of Yancheng, Yancheng City, China
| | - Yueyue Ding
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Jing Gao
- Junior High, Suzhou International Academy, Beijing Foreign Studies University (BFSU), Suzhou, China
| | - Yun Wu
- Yancheng Primary School, Yancheng, China
| | - Haitao Lv
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Jian Wu
- Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
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Greenwood CJ, Youssef GJ, Letcher P, Macdonald JA, Hagg LJ, Sanson A, Mcintosh J, Hutchinson DM, Toumbourou JW, Fuller-Tyszkiewicz M, Olsson CA. A comparison of penalised regression methods for informing the selection of predictive markers. PLoS One 2020; 15:e0242730. [PMID: 33216811 PMCID: PMC7678959 DOI: 10.1371/journal.pone.0242730] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/06/2020] [Indexed: 12/31/2022] Open
Abstract
Background Penalised regression methods are a useful atheoretical approach for both developing predictive models and selecting key indicators within an often substantially larger pool of available indicators. In comparison to traditional methods, penalised regression models improve prediction in new data by shrinking the size of coefficients and retaining those with coefficients greater than zero. However, the performance and selection of indicators depends on the specific algorithm implemented. The purpose of this study was to examine the predictive performance and feature (i.e., indicator) selection capability of common penalised logistic regression methods (LASSO, adaptive LASSO, and elastic-net), compared with traditional logistic regression and forward selection methods. Design Data were drawn from the Australian Temperament Project, a multigenerational longitudinal study established in 1983. The analytic sample consisted of 1,292 (707 women) participants. A total of 102 adolescent psychosocial and contextual indicators were available to predict young adult daily smoking. Findings Penalised logistic regression methods showed small improvements in predictive performance over logistic regression and forward selection. However, no single penalised logistic regression model outperformed the others. Elastic-net models selected more indicators than either LASSO or adaptive LASSO. Additionally, more regularised models included fewer indicators, yet had comparable predictive performance. Forward selection methods dismissed many indicators identified as important in the penalised logistic regression models. Conclusions Although overall predictive accuracy was only marginally better with penalised logistic regression methods, benefits were most clear in their capacity to select a manageable subset of indicators. Preference to competing penalised logistic regression methods may therefore be guided by feature selection capability, and thus interpretative considerations, rather than predictive performance alone.
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Affiliation(s)
- Christopher J. Greenwood
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
- * E-mail:
| | - George J. Youssef
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Primrose Letcher
- Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
| | - Jacqui A. Macdonald
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Lauryn J. Hagg
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
| | - Ann Sanson
- Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
| | - Jenn Mcintosh
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Delyse M. Hutchinson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
- Faculty of Medicine, National Drug and Alcohol Research Centre, University of New South Wales, Randwick, Australia
| | - John W. Toumbourou
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
| | - Matthew Fuller-Tyszkiewicz
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
| | - Craig A. Olsson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, Royal Children’s Hospital, University of Melbourne, Melbourne, Australia
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Bach DR, Moutoussis M, Bowler A, Dolan RJ. Predictors of risky foraging behaviour in healthy young people. Nat Hum Behav 2020; 4:832-843. [PMID: 32393840 PMCID: PMC7115941 DOI: 10.1038/s41562-020-0867-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 03/19/2020] [Indexed: 12/17/2022]
Abstract
During adolescence and early adulthood, learning when to avoid threats and when to pursue rewards becomes crucial. Using a risky foraging task, we investigated individual differences in this dynamic across 781 individuals aged 14-24 years who were split into a hypothesis-generating discovery sample and a hold-out confirmation sample. Sex was the most important predictor of cautious behaviour and performance. Males earned one standard deviation (or 20%) more reward than females, collected more reward when there was little to lose and reduced foraging to the same level as females when potential losses became high. Other independent predictors of cautiousness and performance were self-reported daringness, IQ and self-reported cognitive complexity. We found no evidence for an impact of age or maturation. Thus, maleness, a high IQ or self-reported cognitive complexity, and self-reported daringness predicted greater success in risky foraging, possibly due to better exploitation of low-risk opportunities in high-risk environments.
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Affiliation(s)
- Dominik R Bach
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK.
- Wellcome Centre for Human Neuroimaging, University College London, London, UK.
- Computational Psychiatry Research, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Michael Moutoussis
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Aislinn Bowler
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
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30
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Battaglia M, Garon-Carrier G, Brendgen M, Feng B, Dionne G, Vitaro F, Tremblay RE, Boivin M. Trajectories of pain and anxiety in a longitudinal cohort of adolescent twins. Depress Anxiety 2020; 37:475-484. [PMID: 31944483 DOI: 10.1002/da.22992] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Adolescence is critical to intercept chronic/persistent pain and decipher its association with anxiety. We ascertained adolescent pain trajectories, their demographic and clinical correlates, the longitudinal association with opiate prescriptions at age 19, and the etiology of the covariation between adolescent pain problems and anxiety symptoms. METHODS Longitudinal assessment of: 6 common pain problems at age 12, 13, 14, 15, and 17 years; 7 common anxiety symptoms at age 12, 13, and 14 years; opiates' prescriptions at age 19, in the Quebec Newborn Twin Study birth cohort of 667 twin pairs born between 1995-1998. RESULTS Analyses yielded three trajectories of: "none-to-minimal" (34.3%), "sporadic" (56.7%), and "frequent" (9.0%) pain problems between age 12-17. Anxiety (odds ratios [OR] ORage12 : 2.38; confidence interval [CI]: 1.26-4.47; ORage13 : 3.96; CI: 1.73-9.05; ORage14 : 5.45; CI: 2.67-11.11), the female sex (OR: 3.69; CI: 2.20-6.21), and lower socioeconomic status (OR: 0.87; CI: 0.77-0.98) were associated with the "frequent" compared to the "none-to-minimal" pain trajectory. Only the "frequent" pain trajectory predicted opioid prescriptions at age 19 (OR: 4.14; CI: 1.16-14.55). A twin bivariate latent growth curve model and a cross-lagged model showed that genetic factors and non-shared environmental factors common to both phenotypes influence the longitudinal association between anxiety and adolescent pain problems. CONCLUSIONS The relatively common, adolescent "frequent pain" trajectory predicts early opioid prescriptions, and anxiety and adolescent pain share multiple etiological components. These data can inform diagnostic reasoning, clinical practice, and help reducing opioid prescriptions and abuse.
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Affiliation(s)
- Marco Battaglia
- Department of Psychiatry, The University of Toronto, Toronto, Canada.,Child, Youth and Emerging Adults Programme, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Mara Brendgen
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Bei Feng
- School of Psychology, Université Laval, Québec, Canada
| | | | - Frank Vitaro
- School of Psychoeducation, Université de Montréal, Montréal, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, Université de Montréal, Montréal, Canada.,School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
| | - Michel Boivin
- School of Psychology, Université Laval, Québec, Canada
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31
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Psychological Intervention and Prevention Programs for Child and Adolescent Exposure to Community Violence: A Systematic Review. Clin Child Fam Psychol Rev 2020; 23:365-378. [PMID: 32215777 DOI: 10.1007/s10567-020-00315-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this article is to systematically review the existing literature regarding intervention and prevention programs that ameliorate the negative effects of exposure to community violence (ECV) on children and adolescents. Using the Preferred Reporting Items for Systematic Review (PRISMA) Guidelines, we conducted a systematic review of the literature aimed at providing a synthesis of the extant Randomized Control Trials (RCT) and peer-reviewed empirical literature on intervention and prevention programs for those affected by ECV. Nine randomized controlled trials were identified: seven studies with elementary school students in the USA, one study with elementary school students in Colombia, and one study with middle school students in the USA. Most trials compared intervention and no-treatment control groups; three studies compared active interventions. The intervention and prevention trials conducted in school settings in the USA showed most impact on reducing internalizing and PTSD symptoms. The evidence base of intervention and prevention programs for child and adolescent exposure to community violence is very limited. This systematic review synthesizes extant evidence of the effectiveness of intervention programs in reducing internalizing and externalizing symptoms, PTSD, exposure to community violence, and in enhancing academic performance. More studies are needed to provide a better understanding of how interventions might ameliorate the adverse consequences of exposure to community violence.
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32
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Zhang WJ, Yan C, Shum D, Deng CP. Responses to academic stress mediate the association between sleep difficulties and depressive/anxiety symptoms in Chinese adolescents. J Affect Disord 2020; 263:89-98. [PMID: 31818801 DOI: 10.1016/j.jad.2019.11.157] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/23/2019] [Accepted: 11/30/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Sleep difficulties are pervasive in Chinese adolescents, which exert aversive influence on their emotional health. However, the underlying mechanisms of this effect remain unclear. This study addressed whether stress responses mediate the concurrent and prospective relationship between sleep difficulties and depressive/anxiety symptoms in Chinese adolescents. METHOD 17,946 adolescents (14-18 years-old) were administrated the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, Revised Children's Manifest Anxiety Scale and the Responses to Stress Questionnaire. Further, 710 of them finished the one-year follow-up assessments. Structural equation models were conducted to determine the concurrent and prospective mediation effects of stress responses and the moderated effect of gender and age. RESULTS Involuntary engagement and disengagement responses, as well as engagement coping, significantly mediated the cross-sectional relationship between sleep difficulties and depressive/anxiety symptoms. Moreover, sleep difficulties at baseline predicted enhanced involuntary engagement responses but reduced the use of engagement coping strategies one year later, resulting in an elevated level of depressive/anxiety symptoms. Finally, females and younger adolescents with greater sleep difficulties were more likely to generate maladaptive stress responses. LIMITATIONS First, sleep difficulties were only measured using self-reported approaches. Second, potential confounding variables (e.g., socioeconomic status) were not adjusted for. Third, our study only focused on typically-developing youth samples rather than clinical samples. CONCLUSIONS Our findings highlight the important role of stress responses in the relationship between sleep difficulties and depressive/anxiety symptoms. The findings might also shed some light on the psychological intervention of sleep difficulties and mood disorder in adolescent populations.
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Affiliation(s)
- Wen-Jun Zhang
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, 3663 North Zhongshan Road, Shanghai, China
| | - Chao Yan
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, 3663 North Zhongshan Road, Shanghai, China.
| | - David Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University; Hong Kong Special Administrative Region, China; Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Neuropsychology and Applied Cognitive Neuroscience Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
| | - Ci-Ping Deng
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, 3663 North Zhongshan Road, Shanghai, China.
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Carlier S, Van der Paelt S, Ongenae F, De Backere F, De Turck F. Empowering Children with ASD and Their Parents: Design of a Serious Game for Anxiety and Stress Reduction. SENSORS 2020; 20:s20040966. [PMID: 32054025 PMCID: PMC7070716 DOI: 10.3390/s20040966] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/27/2020] [Accepted: 02/07/2020] [Indexed: 12/22/2022]
Abstract
Autism Spectrum Disorder (ASD) is characterized by social interaction difficulties and communication difficulties. Moreover, children with ASD often suffer from other co-morbidities, such as anxiety and depression. Finding appropriate treatment can be difficult as symptoms of ASD and co-morbidities often overlap. Due to these challenges, parents of children with ASD often suffer from higher levels of stress. This research aims to investigate the feasibility of empowering children with ASD and their parents through the use of a serious game to reduce stress and anxiety and a supporting parent application. The New Horizon game and the SpaceControl application were developed together with therapists and according to guidelines for e-health patient empowerment. The game incorporates two mini-games with relaxation techniques. The performance of the game was analyzed and usability studies with three families were conducted. Parents and children were asked to fill in the Spence’s Children Anxiety Scale (SCAS) and Spence Children Anxiety Scale-Parents (SCAS-P) anxiety scale. The game shows potential for stress and anxiety reduction in children with ASD.
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Affiliation(s)
- Stéphanie Carlier
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
- Correspondence:
| | - Sara Van der Paelt
- Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
| | - Femke Ongenae
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
| | - Femke De Backere
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
| | - Filip De Turck
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
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Understanding Open Access Data Using Visuals: Integrating Prospective Studies of Children's Responses to Natural Disasters. CHILD & YOUTH CARE FORUM 2019; 48:563-583. [PMID: 34290490 DOI: 10.1007/s10566-019-09496-7] [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: 10/27/2022]
Abstract
Background As access to open data is increasing, researchers gain the opportunity to build integrated datasets and to conduct more powerful statistical analyses. However, using open access data presents challenges for researchers in understanding the data. Visuals allow researchers to address these challenges by facilitating a greater understanding of the information available. Objectives This paper illustrates how visuals can address the challenges that researchers face when using open access data, such as: (1) becoming familiar with the data, (2) identifying patterns and trends within the data, and (3) determining how to integrate data from multiple studies. Method This paper uses data from an integrative data analysis study that combined data from prospective studies of children's responses to four natural disasters: Hurricane Andrew, Hurricane Charley, Hurricane Katrina, and Hurricane Ike. The integrated dataset assessed hurricane exposure, posttraumatic stress symptoms, anxiety, social support, and life events among 1707 participants (53.61% female). The children's ages ranged from 7 to 16 years (M = 9.61, SD = 1.60). Results Visuals serve as an effective method for understanding new and unfamiliar datasets. Conclusions In response to the growth of open access data, researchers must develop the skills necessary to create informative visuals. Most research-based graduate programs do not require programming-based courses for graduation. More opportunities for training in programming languages need to be offered so that future researchers are better prepared to understand new data. This paper discusses implications of current graduate course requirements and standard journal practices on how researchers visualize data.
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Devynck F, Rousseau A, Romo L. Does Repetitive Negative Thinking Influence Alcohol Use? A Systematic Review of the Literature. Front Psychol 2019; 10:1482. [PMID: 31333536 PMCID: PMC6616275 DOI: 10.3389/fpsyg.2019.01482] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/11/2019] [Indexed: 11/16/2022] Open
Abstract
Over the past 20 years, researchers have used various methodologies to assess different forms of repetitive negative thinking (RNT) and their influence on alcohol consumption. Contrasting results between clinical and general populations were observed. To summarize the current literature on RNT and alcohol use, a systematic review was conducted according to the Preferred Reporting for Systematic Review and Meta-Analysis (PRISMA) guidelines (Moher et al., 2009). Among the 27 included studies, the seven conducted among patients with alcohol use disorder (AUD) and the three focusing on other adult samples demonstrated a strong positive association between RNT and alcohol use or alcohol-related problems, regardless of the form of RNT. The results were more heterogeneous in the 17 studies conducted among adolescents and students, leading the authors to conclude that the results varied as a function of the severity of alcohol use. The results of this study suggest to focus on RNT from a transdiagnostic perspective in AUD. This processual approach may improve AUD treatment and relapse prevention. Finally, some gaps in the literature must be addressed: (1) the gender differences in the link between RNT and alcohol use and (2) the specific influence of RNT on alcohol use among young adults.
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Affiliation(s)
- Faustine Devynck
- EA 4072 - PSITEC - Psychologie: Interaction, Temps, Emotions, Cognition, Université de Lille, Lille, France
| | - Amélie Rousseau
- EA 4072 - PSITEC - Psychologie: Interaction, Temps, Emotions, Cognition, Université de Lille, Lille, France
| | - Lucia Romo
- EA 4430-CLIPSYD, Université Paris Nanterre, Nanterre, France.,INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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36
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Viard A, Mutlu J, Chanraud S, Guenolé F, Egler PJ, Gérardin P, Baleyte JM, Dayan J, Eustache F, Guillery-Girard B. Altered default mode network connectivity in adolescents with post-traumatic stress disorder. NEUROIMAGE-CLINICAL 2019; 22:101731. [PMID: 30831461 PMCID: PMC6402428 DOI: 10.1016/j.nicl.2019.101731] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 02/14/2019] [Accepted: 02/20/2019] [Indexed: 11/22/2022]
Abstract
Post-traumatic stress disorder (PTSD) is characterized by intrusions, re-experiencing, avoidance and hyperarousal. These symptoms might be linked to dysfunction in core neurocognitive networks subserving self-referential mental processing (default mode network, DMN), detection of salient stimuli (salience network, SN) and cognitive dysfunction (central executive network, CEN). Resting state studies in adolescent PTSD are scarce and findings are inconsistent, probably due to differences in patient symptom severity. Resting state brain activity was measured in 14 adolescents with severe PTSD and 24 age-matched controls. Seed-based connectivity analyses were used to examine connectivity between the DMN and the whole brain, including regions from other networks (SN and CEN). The relationships of network properties with symptom dimensions (severity, anxiety and depression) and episodic memory were also examined. Analyses revealed decreased within-DMN connectivity (between PCC and occipital cortex) in patients compared to controls. Furthermore, within-DMN connectivity (between PCC and hippocampus) correlated negatively with symptom dimensions (severity and anxiety), while increased connectivity (DMN-SN and DMN-CEN) correlated positively with episodic memory measures. These abnormal network properties found in adolescent PTSD corroborate those previously reported in adult PTSD. Decreased within-DMN connectivity and disrupted DMN-SN and DMN-CEN coupling could form the basis for intrusive trauma recollection and impaired episodic autobiographical recall in PTSD. Adolescent PTSD is linked to dysfunction in core neurocognitive networks. Results show decreased within-DMN connectivity in patients compared to controls. Within-DMN connectivity correlates negatively with severity and anxiety. Increased DMN-SN connectivity correlates positively with episodic memory. Disrupted connectivity may form the basis for intrusive trauma recollection in PTSD.
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Affiliation(s)
- Armelle Viard
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France.
| | - Justine Mutlu
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Sandra Chanraud
- INCIA CNRS UMR 5287, PSL Research University, EPHE, Université Bordeaux, Bordeaux, France
| | - Fabian Guenolé
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie de l'Enfant et de l'Adolescent, Caen, France
| | - Pierre-Jean Egler
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie de l'Enfant et de l'Adolescent, Caen, France
| | - Priscille Gérardin
- CHU de Rouen, Fédération hospitalo-universitaire de psychiatrie de l'enfant et de l'adolescent, Rouen, France
| | - Jean-Marc Baleyte
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie de l'Enfant et de l'Adolescent, Caen, France
| | - Jacques Dayan
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; CHGR Rennes-I, Service de Psychiatrie de l'Enfant et de l'Adolescent, Rennes, France
| | - Francis Eustache
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Bérengère Guillery-Girard
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
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37
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O’Keeffe S, Martin P, Target M, Midgley N. 'I Just Stopped Going': A Mixed Methods Investigation Into Types of Therapy Dropout in Adolescents With Depression. Front Psychol 2019; 10:75. [PMID: 30804827 PMCID: PMC6370696 DOI: 10.3389/fpsyg.2019.00075] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/10/2019] [Indexed: 12/17/2022] Open
Abstract
What does it mean to 'drop out' of therapy? Many definitions of 'dropout' have been proposed, but the most widely accepted is the client ending treatment without agreement of their therapist. However, this is in some ways an external criterion that does not take into account the client's experience of therapy, or reasons for ending it prematurely. This study aimed to identify whether there were more meaningful categories of dropout than the existing dropout definition, and to test whether this refined categorization of dropout was associated with clinical outcomes. This mixed-methods study used a subset of data from the IMPACT trial, which investigated psychological therapies for adolescent depression. Adolescents were randomly allocated to a treatment arm (Brief Psychosocial Intervention; Cognitive-Behavioral Therapy; Short-Term Psychoanalytic Psychotherapy). The sample for this study comprised 99 adolescents, aged 11-17 years. Thirty-two were classified as having dropped out of treatment and participated in post-therapy qualitative interviews about their experiences of therapy. For 26 dropout cases, the therapist was also interviewed. Sixty-seven cases classified as having completed treatment were included to compare their outcomes to dropout cases. Interview data for dropout cases were analyzed using ideal type analysis. Three types of dropout were constructed: 'dissatisfied' dropout, 'got-what-they-needed' dropout, and 'troubled' dropout. 'Dissatisfied' dropouts reported stopping therapy because they did not find it helpful. 'Got-what-they-needed' dropouts reported stopping therapy because they felt they had benefitted from therapy. 'Troubled' dropouts reported stopping therapy because of a lack of stability in their lives. The findings indicate the importance of including the perspective of clients in definitions of drop out, as otherwise there is a risk that the heterogeneity of 'dropout' cases may mask more meaningful distinctions. Clinicians should be aware of the range of issues experienced by adolescents in treatment that lead to disengagement. Our typology of dropout may provide a framework for clinical decision-making in managing different types of disengagement from treatment.
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Affiliation(s)
- Sally O’Keeffe
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Peter Martin
- Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children and Families, London, United Kingdom
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Mary Target
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Nick Midgley
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children and Families, London, United Kingdom
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Kiddle B, Inkster B, Prabhu G, Moutoussis M, Whitaker KJ, Bullmore ET, Dolan RJ, Fonagy P, Goodyer IM, Jones PB. Cohort Profile: The NSPN 2400 Cohort: a developmental sample supporting the Wellcome Trust NeuroScience in Psychiatry Network. Int J Epidemiol 2019; 47:18-19g. [PMID: 29177462 PMCID: PMC5837633 DOI: 10.1093/ije/dyx117] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Beatrix Kiddle
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - Becky Inkster
- Department of Psychiatry, University of Cambridge, United Kingdom
| | - Gita Prabhu
- Wellcome Trust Centre for Neuroimaging, University College London, United Kingdom
| | - Michael Moutoussis
- Wellcome Trust Centre for Neuroimaging, University College London, United Kingdom
| | | | - Edward T Bullmore
- Department of Psychiatry, University of Cambridge, United Kingdom.,Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, United Kingdom.,Medical Research Council/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom.,ImmunoPsychiatry, GlaxoSmithKline Research and Development, Stevenage, United Kingdom
| | - Raymond J Dolan
- Wellcome Trust Centre for Neuroimaging, University College London, United Kingdom.,Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, United Kingdom
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
| | - Ian M Goodyer
- Department of Psychiatry, University of Cambridge, United Kingdom.,Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, United Kingdom
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, United Kingdom.,Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, United Kingdom
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Warmingham JM, Handley ED, Rogosch FA, Manly JT, Cicchetti D. Identifying maltreatment subgroups with patterns of maltreatment subtype and chronicity: A latent class analysis approach. CHILD ABUSE & NEGLECT 2019; 87:28-39. [PMID: 30224068 PMCID: PMC6348036 DOI: 10.1016/j.chiabu.2018.08.013] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/01/2018] [Accepted: 08/19/2018] [Indexed: 05/26/2023]
Abstract
Maltreatment experiences are complex, and it is difficult to characterize the heterogeneity in types of maltreatment. Subtypes, such as emotional maltreatment, sexual abuse, physical abuse, and neglect commonly co-occur and may persist across development. Therefore, treating individual maltreatment subtypes as independently occurring is not representative of the nature of maltreatment as it occurs in children's lives. Latent class analysis (LCA) is employed herein to identify subgroups of maltreated children based on commonalities in maltreatment subtype and chronicity. In a sample of 674 low-income urban children, 51.6% of whom experienced officially documented maltreatment, our analyses identified four classes of children, with three distinct classes based on maltreatment subtypes and chronicity, and one group of children who did not experience maltreatment. The largest class of maltreated children identified was the chronic, multi-subtype maltreatment class (57% of maltreated children); a second class was characterized by only neglect in a single developmental period (31% of maltreated children), and the smallest class was characterized by a single subtype of maltreatment (emotional maltreatment, physical, or sexual abuse) occurring in a single developmental period (12% of maltreated children). Characterization of these groups confirms the overlapping nature of maltreatment subtypes. There were notable differences between latent classes on child behavioral and socio-emotional outcomes measured by child self-report and camp counselors report during a one-week summer camp. The largest differences were between the non-maltreated class and the chronic maltreatment class. Children who experienced chronic, multi-subtype maltreatment showed higher levels of externalizing behavior, emotion dysregulation, depression, and anxiety.
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Affiliation(s)
- Jennifer M Warmingham
- University of Rochester, Mt Hope Family Center, 187 Edinburgh St, Rochester, NY 14608, United States.
| | - Elizabeth D Handley
- University of Rochester, Mt Hope Family Center, 187 Edinburgh St, Rochester, NY 14608, United States
| | - Fred A Rogosch
- University of Rochester, Mt Hope Family Center, 187 Edinburgh St, Rochester, NY 14608, United States.
| | - Jody T Manly
- University of Rochester, Mt Hope Family Center, 187 Edinburgh St, Rochester, NY 14608, United States
| | - Dante Cicchetti
- University of Rochester, Mt Hope Family Center, 187 Edinburgh St, Rochester, NY 14608, United States; University of Minnesota, United States
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40
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Xie F, Xin Z, Chen X, Zhang L. Gender Difference of Chinese High School Students’ Math Anxiety: The Effects of Self-Esteem, Test Anxiety and General Anxiety. SEX ROLES 2018. [DOI: 10.1007/s11199-018-0982-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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41
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Kim SY, Hou Y, Song J, Schwartz SJ, Chen S, Zhang M, Perreira KM, Parra-Medina D. Profiles of Language Brokering Experiences and Contextual Stressors: Implications for Adolescent Outcomes in Mexican Immigrant Families. J Youth Adolesc 2018; 47:1629-1648. [PMID: 29603049 PMCID: PMC6045961 DOI: 10.1007/s10964-018-0851-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
Abstract
Adolescents from Mexican immigrant families are often embedded in a challenging social environment and experience multiple contextual stressors, including economic stress, discrimination, and foreigner stress. We consider how the effects of these contextual stressors may be amplified or diminished for adolescents who function as language brokers, interpreting and mediating for their English-limited parents. Using two waves of survey data collected from a sample (N = 604 at Wave 1; N = 483 at Wave 2) of Mexican American adolescents with ages ranging from 11 to 15 (Mage = 12.41, 54% female), four distinct brokering-stress profiles were identified. Latent profile analyses revealed that with moderate levels of contextual stress, adolescents with more positive language brokering experiences (protective group) demonstrated more favorable outcomes than those with neutral language brokering experiences (moderate group) and those who did not involve themselves as frequently in language brokering activities (less-involved group). In contrast, high levels of contextual stress, coupled with more negative language brokering experiences (risk group), produced the least favorable outcomes among adolescents.
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Affiliation(s)
- Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton Street, Stop A2702, Austin, TX, 78712, USA.
| | - Yang Hou
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton Street, Stop A2702, Austin, TX, 78712, USA
| | - Jiaxiu Song
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton Street, Stop A2702, Austin, TX, 78712, USA
| | - Seth J Schwartz
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Shanting Chen
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton Street, Stop A2702, Austin, TX, 78712, USA
| | - Minyu Zhang
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 East Dean Keeton Street, Stop A2702, Austin, TX, 78712, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina-Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Deborah Parra-Medina
- Department of Mexican American and Latina/o Studies, University of Texas at Austin, Austin, TX, 78712, USA
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Goodyer IM, Reynolds S, Barrett B, Byford S, Dubicka B, Hill J, Holland F, Kelvin R, Midgley N, Roberts C, Senior R, Target M, Widmer B, Wilkinson P, Fonagy P. Cognitive-behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial. Health Technol Assess 2018; 21:1-94. [PMID: 28394249 DOI: 10.3310/hta21120] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. OBJECTIVE To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment. DESIGN Observer-blind, parallel-group, pragmatic superiority randomised controlled trial. SETTING A total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London. PARTICIPANTS Adolescents aged 11-17 years with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses. INTERVENTIONS In total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up. MAIN OUTCOME MEASURES Mean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post randomisation. RESULTS There were non-inferiority effects of CBT compared with STPP [treatment effect by final follow-up = -0.578, 95% confidence interval (CI) -2.948 to 4.104; p = 0.748]. There were no superiority effects for the two specialist treatments (CBT + STPP) compared with BPI (treatment effect by final follow-up = -1.898, 95% CI -4.922 to 1.126; p = 0.219). At final assessment there was no significant difference in the mean depressive symptom score between treatment groups. There was an average 49-52% reduction in depression symptoms by the end of the study. There were no differences in total costs or quality-of-life scores between treatment groups and prescribing a selective serotonin reuptake inhibitor (SSRI) during treatment or follow-up did not differ between the therapy arms and, therefore, did not mediate the outcome. CONCLUSIONS The three psychological treatments differed markedly in theoretical and clinical approach and are associated with a similar degree of clinical improvement, cost-effectiveness and subsequent maintenance of lowered depressive symptoms. Both STPP and BPI offer an additional patient treatment choice, alongside CBT, for depressed adolescents attending specialist Child and Adolescent Mental Health Services. Further research should focus on psychological mechanisms that are associated with treatment response, the maintenance of positive effects, determinants of non-response and whether or not brief psychotherapies are of use in primary care and community settings. LIMITATIONS Neither reason for SSRI prescribing or monitoring of medication compliance was controlled for over the course of the study, and the economic results were limited by missing data. TRIAL REGISTRATION Current Controlled Trials ISRCTN83033550. FUNDING This project was funded by the National Institute for Heath Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 12. See the National Institute for Heath Research Journals Library website for further project information. Funding was also provided by the Department of Health. The funders had no role in the study design, patient recruitment, data collection, analysis or writing of the study, any aspect pertinent to the study or the decision to submit to The Lancet.
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Affiliation(s)
- Ian M Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | | | - Sarah Byford
- David Goldberg Centre, King's College London, London, UK
| | - Bernadka Dubicka
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Jonathan Hill
- Child and Adolescent Psychiatry, University of Manchester, Manchester, UK.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Fiona Holland
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Raphael Kelvin
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Nick Midgley
- Anna Freud National Centre for Children and Families, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Chris Roberts
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Rob Senior
- Tavistock and Portman NHS Foundation Trust, London, UK
| | - Mary Target
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Barry Widmer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paul Wilkinson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Handley ED, Rogosch FA, Cicchetti D. From child maltreatment to emerging adult problem drinking: Identification of a multilevel internalizing pathway among African American youth. Dev Psychopathol 2017; 29:1807-1821. [PMID: 29162188 PMCID: PMC5718172 DOI: 10.1017/s0954579417001419] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study tested the role of FKBP5 binding protein 5 (FKBP5) genetic variation in an internalizing pathway from child maltreatment to emerging adult problem drinking among a sample of African American youth (N = 280) followed prospectively from ages 11 to 20. Specifically, whether childhood internalizing symptoms and emerging adult tension reduction alcohol expectancies sequentially mediate the effect of child maltreatment on emerging adult problem drinking and whether FKBP5 moderates these associations were investigated. The results indicate that individuals with at least one copy of the FKBP5 CATT haplotype (minor alleles) are more vulnerable to traversing the hypothesized internalizing pathway of risk than individuals without this genotypic profile. Taken together our findings highlight the importance of FKBP5 genetic variation in the context of early adversity; support the role of two prospective sequential mediators of an internalizing pathway to problematic drinking, namely, childhood internalizing symptoms and emerging adult tension reduction alcohol expectancies; and identify a subgroup of maltreated children most susceptible to progressing along this less common pathway of risk.
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O'Keeffe S, Martin P, Goodyer IM, Wilkinson P, Consortium I, Midgley N. Predicting dropout in adolescents receiving therapy for depression. Psychother Res 2017; 28:708-721. [PMID: 29084488 DOI: 10.1080/10503307.2017.1393576] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Therapy dropout is a common occurrence, especially in adolescence. This study investigated whether dropout could be predicted from a range of child, family, and treatment factors in a sample of adolescents receiving therapy for depression. METHOD This study draws on data from 406 participants of the IMPACT study, a randomized controlled trial, investigating three types of therapy in the treatment of adolescent depression. Logistic regression was used to estimate the effects of predictors on the odds of dropout. RESULTS Few pre-treatment predictors of dropout were found, with the only significant predictors being older age, antisocial behaviour, and lower scores of verbal intelligence. Missed sessions and poorer therapeutic alliance early in treatment also predicted dropout. Most child and family factors investigated were not significantly associated with dropout. CONCLUSIONS There may be little about depressed adolescents' presentation prior to therapy starting that indicates their risk of dropout. However, within-treatment factors indicated that warning signs of dropout may be identifiable during the initial phase of therapy. Identifying and targeting early treatment indicators of dropout may provide possibilities for improving engagement. Clinical and methodological significance of this article: In the literature, a great deal of attention has been paid to child and family factors that predict therapy dropout, yet in this study, few pre-treatment characteristics were predictive of dropout. However, findings revealed possible warning signs of dropout in the early part of treatment, as poor therapeutic alliance and missed sessions were both found to be predictive of dropout. These findings call for therapists to be aware of such warning signs and clinical guidelines for managing cases at risk of dropout are warranted.
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Affiliation(s)
- Sally O'Keeffe
- a Research Department of Clinical, Educational and Health Psychology , University College London , London , UK.,b Child Attachment and Psychological Therapies Research Unit (ChAPTRe) , Anna Freud National Centre for Children and Families , London , UK
| | - Peter Martin
- b Child Attachment and Psychological Therapies Research Unit (ChAPTRe) , Anna Freud National Centre for Children and Families , London , UK.,c Department of Applied Health Research , University College London , London , UK
| | - Ian M Goodyer
- d Department of Psychiatry , University of Cambridge , Cambridge , UK
| | - Paul Wilkinson
- d Department of Psychiatry , University of Cambridge , Cambridge , UK
| | - Impact Consortium
- d Department of Psychiatry , University of Cambridge , Cambridge , UK
| | - Nick Midgley
- a Research Department of Clinical, Educational and Health Psychology , University College London , London , UK.,b Child Attachment and Psychological Therapies Research Unit (ChAPTRe) , Anna Freud National Centre for Children and Families , London , UK
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The Relationship Between Early Neural Responses to Emotional Faces at Age 3 and Later Autism and Anxiety Symptoms in Adolescents with Autism. J Autism Dev Disord 2017; 46:2450-63. [PMID: 27055415 DOI: 10.1007/s10803-016-2780-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Both autism spectrum (ASD) and anxiety disorders are associated with atypical neural and attentional responses to emotional faces, differing in affective face processing from typically developing peers. Within a longitudinal study of children with ASD (23 male, 3 female), we hypothesized that early ERPs to emotional faces would predict concurrent and later ASD and anxiety symptoms. Greater response amplitude to fearful faces corresponded to greater social communication difficulties at age 3, and less improvement by age 14. Faster ERPs to neutral faces predicted greater ASD symptom improvement over time, lower ASD severity in adolescence, and lower anxiety in adolescence. Early individual differences in processing of emotional stimuli likely reflect a unique predictive contribution from social brain circuitry early in life.
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van Harmelen AL, Kievit RA, Ioannidis K, Neufeld S, Jones PB, Bullmore E, Dolan R, Fonagy P, Goodyer I. Adolescent friendships predict later resilient functioning across psychosocial domains in a healthy community cohort. Psychol Med 2017; 47:2312-2322. [PMID: 28397612 PMCID: PMC5820532 DOI: 10.1017/s0033291717000836] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 03/08/2017] [Accepted: 03/14/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND Adolescence is a key time period for the emergence of psychosocial and mental health difficulties. To promote adolescent adaptive ('resilient') psychosocial functioning (PSF), appropriate conceptualisation and quantification of such functioning and its predictors is a crucial first step. Here, we quantify resilient functioning as the degree to which an individual functions better or worse than expected given their self-reported childhood family experiences, and relate this to adolescent family and friendship support. METHOD We used Principal Component and regression analyses to investigate the relationship between childhood family experiences and PSF (psychiatric symptomatology, personality traits and mental wellbeing) in healthy adolescents (the Neuroscience in Psychiatry Network; N = 2389; ages 14-24). Residuals from the relation between childhood family experiences and PSF reflect resilient functioning; the degree to which an individual is functioning better, or worse, than expected given their childhood family experiences. Next, we relate family and friendship support with resilient functioning both cross-sectionally and 1 year later. RESULTS Friendship and family support were positive predictors of immediate resilient PSF, with friendship support being the strongest predictor. However, whereas friendship support was a significant positive predictor of later resilient functioning, family support had a negative relationship with later resilient PSF. CONCLUSIONS We show that friendship support, but not family support, is an important positive predictor of both immediate and later resilient PSF in adolescence and early adulthood. Interventions that promote the skills needed to acquire and sustain adolescent friendships may be crucial in increasing adolescent resilient PSF.
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Affiliation(s)
| | - R. A. Kievit
- Medical Research Council,
Cognition and Brain Sciences Unit,
Cambridge, UK
- Wellcome trust Center for Neuroimaging, University
College London, London, UK
| | - K. Ioannidis
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
| | - S. Neufeld
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
| | - P. B. Jones
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
| | - E. Bullmore
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
| | - R. Dolan
- Wellcome trust Center for Neuroimaging, University
College London, London, UK
| | - The NSPN Consortium
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
- Wellcome trust Center for Neuroimaging, University
College London, London, UK
| | - P. Fonagy
- Department of Clinical,
Educational and Health Psychology, University College
London, London, UK
| | - I. Goodyer
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
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Parent-Adolescent Discrepancies in Reports of Parenting and Adolescent Outcomes in Mexican Immigrant Families. J Youth Adolesc 2017; 47:430-444. [PMID: 28689348 DOI: 10.1007/s10964-017-0717-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 06/24/2017] [Indexed: 10/19/2022]
Abstract
Parents and adolescents often have discrepant views of parenting which pose challenges for researchers regarding how to deal with information from multiple informants. Although recent studies indicate that parent-adolescent discrepancies in reports of parenting can be useful in predicting adolescent outcomes, their findings are mixed regarding whether discrepancies relate to more positive or more negative adolescent outcomes. This study examined the longitudinal implications of parent-adolescent discrepancies in reports of parenting (warmth, monitoring, and reasoning) on adolescent behavioral, psychological, academic, and physical health outcomes among Mexican immigrant families in the United States. Participants were 604 adolescents (54% female, M age.wave1 = 12.41 years) and their parents. Taking a person-centered approach, this study identified distinct patterns of parent-adolescent discrepancies in parenting and their different associations with later adolescent outcomes. Adolescents' more negative perceptions of parenting relative to parents were associated with more negative adolescent outcomes, whereas adolescents' more positive perceptions relative to parents related to more positive adolescent outcomes. There were also variations in discrepancy patterns and their associations with adolescent outcomes between mother-adolescent vs. father-adolescent dyads. Findings of the current study highlight individual variations of discrepancies among parent-adolescent dyads and the importance of considering both the magnitude and direction of discrepancies regarding their associations with adolescent well-being.
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Tocker L, Ben-Amitay G, Horesh-Reinman N, Lask M, Toren P. Predictors of Clinical Outcomes in Sexually Abused Adolescents. JOURNAL OF CHILD SEXUAL ABUSE 2017; 26:487-505. [PMID: 28537850 DOI: 10.1080/10538712.2017.1300204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This cross-sectional, case control study examines the association between child sexual abuse and interpersonal and intrapersonal outcomes among 54 adolescents, examining specific clinical measures (depression, anxiety, dissociation, and posttraumatic stress disorder, attachment patterns, self-esteem, self-disclosure, and family environment characteristics). The research results point to a correlation between sexual abuse and higher levels of the clinical measures. In addition, a correlation was found between sexual abuse and level of avoidant attachment, self-esteem, and family environment characteristics. Stepwise hierarchical regressions were conducted to examine how adolescent attributes predicted depression, anxiety, and dissociation beyond the prediction based on sexual abuse. A combination of self-esteem, anxiety attachment, and family cohesiveness made sexual abuse insignificant when predicting levels of depression, anxiety, and dissociation. This study contributes to characterizing the emotional, personal, and family attributes of adolescents who experienced sexual abuse. It also raises questions about the clinical outcomes usually associated with sexual abuse.
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Affiliation(s)
- Lotem Tocker
- a Department of Clinical Psychology , Bar Ilan University , Ramat Gan , Israel
| | - Galit Ben-Amitay
- b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | | | - Michal Lask
- b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Paz Toren
- b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
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Tennant RG, Martin KK, Rooney R, Hassan S, Kane RT. Preventing Internalizing Problems in Young Children: A Randomized Controlled Trial of the Feelings and Friends (Year 3) Program with a Motor Skills Component. Front Psychol 2017; 8:291. [PMID: 28326047 PMCID: PMC5339246 DOI: 10.3389/fpsyg.2017.00291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/15/2017] [Indexed: 11/13/2022] Open
Abstract
Anxiety and depression are common mental health problems experienced by children in Australia. The impact of these internalizing disorders is pervasive, affecting many areas of life. By the time problems have been detected in children they can be severe in nature and harder to treat. Hence, early intervention is of utmost importance. Despite the existence of numerous prevention programs for children, there is limited empirical evidence for a program that has an impact on symptoms of both anxiety and depression. Physical activity and improved motor coordination have been indicated as having positive effects on children's mental health, although the impact of including these in a program targeting internalizing disorders has not been established. This study aimed to evaluate the efficacy of the Feelings and Friends (Year 3) program (FFY3), revised to include activities to build motor-coordination and encourage physical activity. Participants were 24 children from the Perth metropolitan area alongside one of each of their parents. Results indicated significant short-term intervention effects on one of the primary outcome variables; intervention group parents reported significant pre-post improvement in child depressive symptoms, which were maintained at 3-month follow-up (η p2 = 0.10). There were also intervention effects observed for parent-reported separation anxiety (η p2 = 0.10), externalizing symptoms (η p2 = 0.19), and conduct problems (η p2 = 0.16). An additional finding indicated the intervention students reported significant improvement from session one to session two in global distress (η p2 = 0.22). No other significant intervention effects were evident. Findings from this study indicate that FFY3 is a promising intervention to address internalizing and externalizing symptoms in 8-9 year-old children.
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Affiliation(s)
| | | | - Rosanna Rooney
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin UniversityPerth, WA, Australia
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Goodyer IM, Reynolds S, Barrett B, Byford S, Dubicka B, Hill J, Holland F, Kelvin R, Midgley N, Roberts C, Senior R, Target M, Widmer B, Wilkinson P, Fonagy P. Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial. Lancet Psychiatry 2017; 4:109-119. [PMID: 27914903 PMCID: PMC5285447 DOI: 10.1016/s2215-0366(16)30378-9] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/23/2016] [Accepted: 10/24/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Psychological treatments for adolescents with unipolar major depressive disorder are associated with diagnostic remission within 28 weeks in 65-70% of patients. We aimed to assess the medium-term effects and costs of psychological therapies on maintenance of reduced depression symptoms 12 months after treatment. METHODS We did this multicentre, pragmatic, observer-blind, randomised controlled superiority trial (IMPACT) at 15 National Health Service child and adolescent mental health service (CAMHS) clinics in three regions in England. Adolescent patients (aged 11-17 years) with a diagnosis of DSM IV major depressive disorder were randomly assigned (1:1:1), via a web-based randomisation service, to receive cognitive behavioural therapy (CBT) or short-term psychoanalytical therapy versus a reference brief psychological intervention. Randomisation was stochastically minimised by age, sex, self-reported depression sum score, and region. Patients and clinicians were aware of group allocation, but allocation was concealed from outcome assessors. Patients were followed up and reassessed at weeks 6, 12, 36, 52, and 86 post-randomisation. The primary outcome was self-reported depression symptoms at weeks 36, 52, and 86, as measured with the self-reported Mood and Feelings Questionnaire (MFQ). Because our aim was to compare the two psychological therapies with the brief psychosocial intervention, we first established whether CBT was inferior to short-term psychoanalytical psychotherapy for the same outcome. Primary analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN83033550. FINDINGS Between June 29, 2010, and Jan 17, 2013, we randomly assigned 470 patients to receive the brief psychosocial intervention (n=158), CBT (n=155), or short-term psychoanalytical therapy (n=157); 465 patients comprised the intention-to-treat population. 392 (84%) patients had available data for primary analysis by the end of follow-up. Treatment fidelity and differentiation were established between the three interventions. The median number of treatment sessions differed significantly between patients in the brief psychosocial intervention group (n=6 [IQR 4-11]), CBT group (n=9 [5-14]), and short-term psychoanalytical therapy group (n=11 [5-23]; p<0·0001), but there was no difference between groups in the average duration of treatment (27·5 [SD 21·5], 24·9 [17·7], 27·9 [16·8] weeks, respectively; Kruskal-Wallis p=0·238). Self-reported depression symptoms did not differ significantly between patients given CBT and those given short-term psychoanalytical therapy at weeks 36 (treatment effect 0·179, 95% CI -3·731 to 4·088; p=0·929), 52 (0·307, -3·161 to 3·774; p=0·862), or 86 (0·578, -2·948 to 4·104; p=0·748). These two psychological treatments had no superiority effect compared with brief psychosocial intervention at weeks 36 (treatment effect -3·234, 95% CI -6·611 to 0·143; p=0·061), 52 (-2·806, -5·790 to 0·177; p=0·065), or 86 (-1·898, -4·922 to 1·126; p=0·219). Physical adverse events (self-reported breathing problems, sleep disturbances, drowsiness or tiredness, nausea, sweating, and being restless or overactive) did not differ between the groups. Total costs of the trial interventions did not differ significantly between treatment groups. INTERPRETATION We found no evidence for the superiority of CBT or short-term psychoanalytical therapy compared with a brief psychosocial intervention in maintenance of reduced depression symptoms 12 months after treatment. Short-term psychoanalytical therapy was as effective as CBT and, together with brief psychosocial intervention, offers additional patient choice for psychological therapy, alongside CBT, for adolescents with moderate to severe depression who are attending routine specialist CAMHS clinics. FUNDING National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, and the Department of Health.
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