1
|
Stewart SL, Semovski V, Lapshina N. Adolescent Inpatient Mental Health Admissions: An Exploration of Interpersonal Polyvictimization, Family Dysfunction, Self-Harm and Suicidal Behaviours. Child Psychiatry Hum Dev 2024; 55:963-974. [PMID: 36315373 PMCID: PMC11245427 DOI: 10.1007/s10578-022-01450-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2022]
Abstract
The mental health system is impacted by extreme delays in the provision of care, even in the face of suicidal behaviour. The failure to address mental health issues in a timely fashion result in a dependence on acute mental health services. Improvement to the mental health care system is impacted by the paucity of information surrounding client profiles admitted to inpatient settings. Using archival data from 10,865 adolescents 12-18 years of age (Mage = 14.87, SDage = 1.77), this study aimed to examine the characteristics of adolescents admitted to psychiatric inpatient services in Ontario, Canada. Multivariate binary logistic regression revealed that adolescents reporting interpersonal polyvictimization, greater family dysfunction and higher risk of suicide and self-harm had a greater likelihood of an inpatient mental health admission. The interRAI Child and Youth Mental Health assessment can be used for care planning and early intervention to support adolescents and their families before suicide risk is imminent.
Collapse
Affiliation(s)
- Shannon L Stewart
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada
| | - Valbona Semovski
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada.
| | - Natalia Lapshina
- Faculty of Education, The University of Western Ontario, 1137 Western Road, N6G 1G7, London, ON, Canada
| |
Collapse
|
2
|
Stewart JG, Pizzagalli DA, Auerbach RP. Stress exposure in at-risk, depressed, and suicidal adolescents. J Child Psychol Psychiatry 2024; 65:942-958. [PMID: 38100210 PMCID: PMC11161328 DOI: 10.1111/jcpp.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Stress exposure contributes to the onset, maintenance, and recurrence of major depressive disorder (MDD) in adolescents. However, the precise stress facets (e.g. chronicity, domain) most strongly linked to outcomes at different stages along the depression severity continuum remain unclear. Across two studies, chronic and episodic stressors were comprehensively assessed among: (a) healthy youth with (High-Risk [HR]) and without (Low-Risk [LR]) a maternal history of MDD and (b) adolescents with current MDD and suicide ideation and healthy controls (HC). METHOD Study 1 included LR (n = 65) and HR (n = 22) 12- to 14-year-olds (49 females; 56.32%) with no lifetime history of mental disorders. Study 2 enrolled 87 mid-to-late adolescents (64 females; 73.56%), including 57 MDD youth from a short-term intensive treatment service and 30 HCs from the community. All depressed youth reported recent suicide ideation; some had no lifetime history suicide attempts (SI; n = 31) and others reported at least one past year attempt (SA; n = 26). The Life Events and Difficulties Schedule was used to capture stressor severity in both studies. RESULTS We used multiple linear regression models that adjusted for demographic and clinical covariates. Being in the HR versus LR group was associated with more severe chronic (β = .22, CI95 = 0.01-0.42, p = .041), independent (β = .34, CI95 = 0.12-0.56, p = .003), and interpersonal (β = .23, CI95 = 0.004-0.45, p = .047) stress severity. By contrast, the MDD group reported significantly more severe chronic (β = .62, CI95 = 0.45-0.79, p < .001) and dependent (β = .41, CI95 = 0.21-0.61, p < .001) stress than the HC group, but not independent (p = .083) stress. Stress severity did not differ between recent attempters versus youth who reported suicide ideation alone (SA vs. SI contrast). However, the SA group reported a higher rate of targeted rejection events (RR = 3.53, CI95 = 1.17-10.70, p = .026). CONCLUSIONS Our findings clarify the stressor features that may most strongly contribute to adolescent depression and its clinical correlates at two important points along depression's clinical course.
Collapse
Affiliation(s)
- Jeremy G. Stewart
- Department of Psychology, Queen’s University, Kingston, Ontario, Canada
| | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| |
Collapse
|
3
|
López R, Turnamian MR, Liu RT. Prospective Relations between Life Stress, Emotional Clarity, and Suicidal Ideation in an Adolescent Clinical Sample. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-14. [PMID: 38690948 DOI: 10.1080/15374416.2024.2344735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Although life stress has been linked to adolescent suicidal ideation, most past research has been cross-sectional, and potential processes characterizing this relation remain unclear. One possibility may be a lack of emotional clarity. Informed by stress generation, the current study examined prospective relations between episodic life stress, lack of emotional clarity, and suicidal ideation in an adolescent clinical sample. METHODS The sample consisted of 180 youths (Mage = 14.89; SD = 1.35; 71.7% female; 78.9% White; 43.0% sexual minority) recruited from a psychiatric inpatient facility. Suicidal ideation severity was assessed at baseline and 18-month follow-up. Lack of emotional clarity and life stress were assessed at baseline, as well as 6-, and 12-month follow-ups. Two random-intercepts cross-lagged panel models were created to estimate within-person relations for variables of interest. RESULTS At the within-person level, lack of emotional clarity at baseline predicted greater 6-month impact of interpersonal dependent stressors (b = 0.29, p = .012, 95% CI [0.07, 0.52]), which subsequently predicted a greater 12-month lack of emotional clarity (b = 0.41, p = .005, 95% CI [0.12, 0.70]). Next, a 12-month lack of emotional clarity but not interpersonal dependent stress, predicted greater 18-month suicidal ideation (b = 0.81, p = .006, 95% CI [0.23, 1.30]; R2 = .24, p < .001). No significant relations were found for the lack of emotional clarity and independent stress. CONCLUSIONS Results support the stress generation hypothesis and suggest that future research should be conducted evaluating whether bolstering youth's understanding of their emotional experiences may reduce subsequent suicidal ideation.
Collapse
Affiliation(s)
- Roberto López
- Department of Psychiatry and Biobehavioral Sciences, University of California
| | - Margarid R Turnamian
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital
- Department of Psychiatry, Harvard Medical School
| | - Richard T Liu
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital
- Department of Psychiatry, Harvard Medical School
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard
| |
Collapse
|
4
|
Ma Y, Kochunov P, Kvarta MD, LeGates T, Adhikari BM, Chiappelli J, van der Vaart A, Goldwaser EL, Bruce H, Hatch KS, Gao S, Chen S, Summerfelt A, Nichols TE, Hong LE. Reciprocal relationships between stress and depressive symptoms: the essential role of the nucleus accumbens. Psychol Med 2024; 54:1045-1056. [PMID: 37750294 PMCID: PMC11078439 DOI: 10.1017/s0033291723002866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
BACKGROUND Stress and depression have a reciprocal relationship, but the neural underpinnings of this reciprocity are unclear. We investigated neuroimaging phenotypes that facilitate the reciprocity between stress and depressive symptoms. METHODS In total, 22 195 participants (52.0% females) from the population-based UK Biobank study completed two visits (initial visit: 2006-2010, age = 55.0 ± 7.5 [40-70] years; second visit: 2014-2019; age = 62.7 ± 7.5 [44-80] years). Structural equation modeling was used to examine the longitudinal relationship between self-report stressful life events (SLEs) and depressive symptoms. Cross-sectional data were used to examine the overlap between neuroimaging correlates of SLEs and depressive symptoms on the second visit among 138 multimodal imaging phenotypes. RESULTS Longitudinal data were consistent with significant bidirectional causal relationship between SLEs and depressive symptoms. In cross-sectional analyses, SLEs were significantly associated with lower bilateral nucleus accumbal volume and lower fractional anisotropy of the forceps major. Depressive symptoms were significantly associated with extensive white matter hyperintensities, thinner cortex, lower subcortical volume, and white matter microstructural deficits, mainly in corticostriatal-limbic structures. Lower bilateral nucleus accumbal volume were the only imaging phenotypes with overlapping effects of depressive symptoms and SLEs (B = -0.032 to -0.023, p = 0.006-0.034). Depressive symptoms and SLEs significantly partially mediated the effects of each other on left and right nucleus accumbens volume (proportion of effects mediated = 12.7-14.3%, p < 0.001-p = 0.008). For the left nucleus accumbens, post-hoc seed-based analysis showed lower resting-state functional connectivity with the left orbitofrontal cortex (cluster size = 83 voxels, p = 5.4 × 10-5) in participants with high v. no SLEs. CONCLUSIONS The nucleus accumbens may play a key role in the reciprocity between stress and depressive symptoms.
Collapse
Affiliation(s)
- Yizhou Ma
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mark D. Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tara LeGates
- Department of Biological Sciences, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Bhim M. Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrew van der Vaart
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Eric L. Goldwaser
- Department of Psychiatry, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kathryn S. Hatch
- School of Medicine, University of California, San Diego, CA, USA
| | - Si Gao
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ann Summerfelt
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Thomas E. Nichols
- Department of Statistics, Big Data Science Institute, University of Oxford, Oxford, UK
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
5
|
Madison AA, Bailey MT. Stressed to the Core: Inflammation and Intestinal Permeability Link Stress-Related Gut Microbiota Shifts to Mental Health Outcomes. Biol Psychiatry 2024; 95:339-347. [PMID: 38353184 PMCID: PMC10867428 DOI: 10.1016/j.biopsych.2023.10.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/02/2023] [Accepted: 10/22/2023] [Indexed: 02/16/2024]
Abstract
Stress levels are surging, alongside the incidence of stress-related psychiatric disorders. Perhaps a related phenomenon, especially in urban areas, the human gut contains fewer bacterial species than ever before. Although the functional implications of this absence are unclear, one consequence may be reduced stress resilience. Preclinical and clinical evidence has shown how stress exposure can alter the gut microbiota and their metabolites, affecting host physiology. Also, stress-related shifts in the gut microbiota jeopardize tight junctions of the gut barrier. In this context, bacteria and bacterial products can translocate from the gut to the bloodstream, lymph nodes, and other organs, thereby modifying systemic inflammatory responses. Heightened circulating inflammation can be an etiological factor in stress-related psychiatric disorders, including some cases of depression. In this review, we detail preclinical and clinical evidence that traces these brain-to-gut-to-brain pathways that underlie stress-related psychiatric disorders and potentially affect their responsivity to conventional psychiatric medications. We also review evidence for interventions that modulate the gut microbiota (e.g., antibiotics, probiotics, prebiotics) to reduce stress responses and psychiatric symptoms. Lastly, we discuss challenges to translation and opportunities for innovations that could impact future psychiatric clinical practice.
Collapse
Affiliation(s)
- Annelise A Madison
- Institute for Behavioral Medicine Research, Ohio State University College of Medicine, Columbus, Ohio; Department of Psychology, Ohio State University, Columbus, Ohio.
| | - Michael T Bailey
- Institute for Behavioral Medicine Research, Ohio State University College of Medicine, Columbus, Ohio; Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio; Center for Microbial Pathogenesis and the Oral and Gastrointestinal Microbiology Research Affinity Group, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
| |
Collapse
|
6
|
Raine KE, Zimmer-Gembeck MJ, Skinner EA. The role of coping in processes of resilience: The sample case of academic coping during late childhood and early adolescence. Dev Psychopathol 2023; 35:2499-2515. [PMID: 37403362 DOI: 10.1017/s095457942300072x] [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: 07/06/2023]
Abstract
Developmentalists have increasingly concluded that systems approaches to resilience provide a useful higher-order home for the study of the development of coping. Building on previous work on the complementarity of resilience and coping, this paper had two goals: (1) to propose a set of strategies for examining the role of coping in processes of resilience, and (2) to test their utility in the academic domain, using poor relationships with the teacher as a risk factor, and classroom engagement as an outcome. This study examined whether coping serves as a: (1) promotive factor, supporting positive development at any level of risk; (2) pathway through which risk contributes to development; (3) protective factor that mitigates the effects of risk; (4) reciprocal process generating risk; (5) mechanism through which other promotive factors operate; (6) mechanism through which other protective factors operate; and (7) participant with other supports that shows cumulative or compensatory effects. Analyses showed that academic coping at this age was primarily a mediator of risk and support, and a promotive factor that added to engagement for students with multiple combinations of risk and support. Implications are discussed, along with next steps in exploring the role of coping in processes of resilience.
Collapse
Affiliation(s)
- Kristen E Raine
- Psychology Department, Portland State University, Portland, OR, USA
| | | | - Ellen A Skinner
- Psychology Department, Portland State University, Portland, OR, USA
| |
Collapse
|
7
|
Ro E, Vittengl JR, Jarrett RB, Clark LA. Disinhibition domain and facets uniquely predict changes in depressive symptoms and psychosocial functioning. Personal Ment Health 2023; 17:363-376. [PMID: 37165469 DOI: 10.1002/pmh.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 05/12/2023]
Abstract
This study aimed to understand the role of disinhibition (low conscientiousness)-in conjunction with the other major personality traits of negative affectivity, detachment, antagonism, and psychoticism-in predicting changes in depressive symptoms and psychosocial functioning. Both the disinhibition trait domain and its primary facets (i.e., irresponsibility, impulsivity, and distractibility) were examined. In a large sample (Time 1 N = 605, Time 2 N = 497) of psychiatric outpatients and high-risk community residents, personality traits, depressive symptoms (both self-reported and interviewer-rated), and psychosocial functioning levels (i.e., daily functioning, interpersonal functioning, health-related quality of life, and global quality of life) were collected across two time points. Results showed that the disinhibition domain was the strongest predictor of changes in depressive symptoms and general quality of life levels. Disinhibition facets also predicted changes in depressive symptoms but showed a less consistent pattern compared to the broader trait domain. Finally, the irresponsibility and distractibility facets significantly and uniquely explained changes in interpersonal functioning. The study highlights the importance of assessing the disinhibition trait rather than only negative and positive affectivity (which are well-known correlates of depression), for understanding changes in depressive symptoms and psychosocial functioning. The findings identify potential targets in psychotherapy for individuals with disinhibition traits and depressive disorders.
Collapse
Affiliation(s)
- Eunyoe Ro
- Department of Psychology, Southern Illinois University Edwardsville, Edwardsville, Illinois, USA
| | - Jeffrey R Vittengl
- Department of Psychology, Truman State University, Kirksville, Missouri, USA
| | - Robin B Jarrett
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Lee Anna Clark
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| |
Collapse
|
8
|
Conway CC, Kotov R, Krueger RF, Caspi A. Translating the hierarchical taxonomy of psychopathology (HiTOP) from potential to practice: Ten research questions. AMERICAN PSYCHOLOGIST 2023; 78:873-885. [PMID: 36227328 PMCID: PMC10097839 DOI: 10.1037/amp0001046] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a novel diagnostic system grounded in empirical research into the architecture of mental illness. Its basic units are continuous dimensions-as opposed to categories-that are organized into a hierarchy according to patterns of symptom co-occurrence observed in quantitative studies. Previous HiTOP discussions have focused on existing evidence regarding the model's structure and ability to account for neurobiological, social, cultural, and clinical variation. The present article looks ahead to the next decade of applied research and clinical practice using the HiTOP rubric. We highlight 10 topics where HiTOP has the potential to make significant breakthroughs. Research areas include genetic influences, environmental contributions, neural mechanisms, real-time dynamics, and lifespan development of psychopathology. We also discuss development of novel assessments, forecasting methods, and treatments. Finally, we consider implications for clinicians and educators. For each of these domains, we propose directions for future research and venture hypotheses as to what HiTOP will reveal about psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Roman Kotov
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert F. Krueger
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina, USA
- Social, Genetic, and Developmental Psychiatry Research Centre, King’s College London, London, United Kingdom
- PROMENTA Center, University of Oslo, Oslo, Norway
| |
Collapse
|
9
|
Jones EE, Reed M, Meyer AH, Gaab J, Ooi YP. Stress, mental health and sociocultural adjustment in third culture kids: exploring the mediating roles of resilience and family functioning. Front Psychol 2023; 14:1093046. [PMID: 37645063 PMCID: PMC10461105 DOI: 10.3389/fpsyg.2023.1093046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/30/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction This cross-sectional study explores the contributions of personal and contextual factors in the adjustment process of a sample of internationally mobile children and adolescents having relocated to Switzerland. Based on evolutionary developmental theories and recommendations by Research Domain Criteria and The Hierarchical Taxonomy of Psychopathology theoretical frameworks, we hypothesized and tested a heuristic model of TCK adjustment, aiming to identify prevention and treatment targets tailored for our sampled population. Methods We assessed the relationships in the hypothesized models, particularly how perceived and acculturative stress influence TCK adjustment and whether the relationship between the predictors of TCK stress and the outcomes of TCK adjustment are mediated by resilience and family functioning. A total of 143 participants aged 7-17, having relocated internationally with their working parent(s), recruited in local and international schools in Switzerland, were included in this study. Data were collected using an online survey after we collected consent. We assessed factors of adjustment using validated questionnaires: perceived stress and acculturative stress and the potential mediating roles of family functioning and resilience. We measured the outcome of adjustment through mental health difficulties and sociocultural adjustment. We used path analysis to test the model. Results Results highlight the contributions of perceived stress and acculturative stress to TCK mental health and sociocultural adjustment. We also we found a mediation effect for resilience in the relationship between perceived stress and mental health. Family functioning was not a significant mediator in any relationship that we assessed. Discussion We discuss implications for future research, promoting TCK adjustment and preventative psychotherapeutic interventions.
Collapse
Affiliation(s)
| | | | | | - Jens Gaab
- University of Basel, Basel, Switzerland
| | - Yoon P. Ooi
- University of Basel, Basel, Switzerland
- Institute of Mental Health, Singapore, Singapore
| |
Collapse
|
10
|
Phillips R, Walsh E, Jensen T, Nagy G, Kinard J, Cernasov P, Smoski M, Dichter G. Longitudinal associations between perceived stress and anhedonia during psychotherapy. J Affect Disord 2023; 330:206-213. [PMID: 36907457 PMCID: PMC10065950 DOI: 10.1016/j.jad.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Chronic stress alters reward sensitivity and contributes to the emergence of anhedonia. In clinical samples, the perception of stress is a strong predictor of anhedonia. While there is substantial evidence demonstrating psychotherapy reduces perceived stress, little is known regarding the effects of treatment-related decreases in perceived stress on anhedonia. METHODS The current study investigated reciprocal relations between perceived stress and anhedonia using a cross-lagged panel model approach in a 15-week clinical trial examining the effects of Behavioral Activation Treatment for Anhedonia (BATA), a novel psychotherapy to treat anhedonia, compared to a Mindfulness-Based Cognitive Therapy (MBCT) comparison intervention (ClinicalTrials.gov Identifiers NCT02874534 and NCT04036136). RESULTS Treatment completers (n = 72) experienced significant reductions in anhedonia (M = -8.94, SD = 5.66) on the Snaith-Hamilton Pleasure Scale (t(71) = 13.39, p < .0001), and significant reductions in perceived stress (M = -3.71, SD = 3.88) on the Perceived Stress Scale (t(71) = 8.11, p < .0001) following treatment. Across all treatment-seeking participants (n = 87), a longitudinal autoregressive cross-lagged model revealed significant paths showing that higher levels of perceived stress at treatment Week 1 predicted reductions in anhedonia at treatment Week 4; lower levels of perceived stress at Week 8 predicted reductions in anhedonia at Week 12. Anhedonia did not significantly predict perceived stress at any stage of treatment. CONCLUSIONS This study showed specific timing and directional effects of perceived stress on anhedonia during psychotherapy treatment. Individuals with relatively high perceived stress at the start of treatment were more likely to report relatively lower anhedonia a few weeks into treatment. At mid-treatment, individuals with low perceived stress were more likely to report lower anhedonia towards the end of treatment. These results demonstrate that early treatment components reduce perceived stress, thus allowing for downstream changes in hedonic functioning during mid-late treatment. The findings presented here suggest it will be critically important for future clinical trials evaluating novel interventions for anhedonia to measure stress levels repeatedly, as an important mechanism of change. TRIAL NAME Development of a Novel Transdiagnostic Intervention for Anhedonia - R61 Phase. TRIAL URL: https://clinicaltrials.gov/ct2/show/NCT02874534. TRIAL REGISTRATION NUMBER NCT02874534.
Collapse
Affiliation(s)
- Rachel Phillips
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, United States of America.
| | - Erin Walsh
- University of North Carolina at Chapel Hill, Department of Psychiatry, United States of America
| | - Todd Jensen
- University of North Carolina at Chapel Hill, School of Social Work, United States of America
| | - Gabriela Nagy
- Duke University Medical Center, United States of America
| | - Jessica Kinard
- University of North Carolina at Chapel Hill, Department of Psychiatry, United States of America
| | - Paul Cernasov
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, United States of America
| | - Moria Smoski
- Duke University Medical Center, United States of America
| | - Gabriel Dichter
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, United States of America; University of North Carolina at Chapel Hill, Department of Psychiatry, United States of America
| |
Collapse
|
11
|
Thomas JL, Keenan-Miller D, Sumner JA, Hammen C. Early Life Adversity and Clinical Intimate Partner Violence in Adulthood: The Mediating Role of Interpersonal Conflict in Adolescence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21345-NP21365. [PMID: 34870513 DOI: 10.1177/08862605211057267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Intimate partner violence (IPV) is associated with adverse outcomes for both victims and perpetrators, though there is significant heterogeneity in manifestations of relationship violence. A growing amount of research has focused on elucidating predictors of clinical IPV-defined as severe violence involving institutional or medical intervention due to actual or potential injury-so as to better understand potential prevention and intervention targets. Early life adversity (ELA) is associated with IPV in adulthood, yet this literature focuses on discrete, retrospectively reported adversities (e.g., physical abuse and neglect) and has yet to consider clinical IPV as an outcome. Little is known about if and how broadly adverse early environments may confer risk for this specific form of relationship violence. We investigated associations between exposure to ELA prior to age five and clinical IPV victimization and perpetration by age 20 in a longitudinal, community-based sample of men and women in Australia (N = 588). Early life adversity was prospectively indexed by maternal reports of financial hardship, child chronic illness, maternal stressful life events, maternal depressive symptoms, parental discord, and parental separation. Youth interpersonal conflict life events at age 15-an interviewer-rated assessment of episodic stressors involving conflict across relationships in mid-adolescence-was tested as a potential mediator for both victims and perpetrators. Among women, ELA predicted IPV victimization and perpetration, and interpersonal conflict life events partially mediated the link between ELA and victimization, but not perpetration. Neither ELA nor interpersonal conflict life events predicted victimization or perpetration among men. Women exposed to ELA are at-risk for conflictual interpersonal relationships later in life, including violent intimate relationships, and deficits in conflict resolution skills may be one mechanism through which ELA leads to IPV victimization among this subgroup. Violence prevention and intervention efforts should target interpersonal skills, including conflict resolution, among women and girls exposed to adverse early environments.
Collapse
Affiliation(s)
- Jordan L Thomas
- Department of Psychology, 8783University of California, Los Angeles, CA, USA
| | | | - Jennifer A Sumner
- Department of Psychology, 8783University of California, Los Angeles, CA, USA
| | - Constance Hammen
- Department of Psychology, 8783University of California, Los Angeles, CA, USA
| |
Collapse
|
12
|
Allen TA, Dombrovski AY, Soloff PH, Hallquist MN. Borderline personality disorder: stress reactivity or stress generation? A prospective dimensional study. Psychol Med 2022; 52:1014-1021. [PMID: 32713398 PMCID: PMC8988096 DOI: 10.1017/s003329172000255x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Individuals diagnosed with borderline personality disorder (BPD) often describe their lives as stressful and unpredictable. However, it is unclear whether the adversity faced by those with BPD is a product of stress reactivity or stress generation. Here, we examined the dynamic, prospective associations between BPD and stressful life events over 3 years. Given the heterogeneity present in BPD, we sought to understand which empirically derived dimensions of this heterogeneous disorder explain stress reactivity v. stress generation. METHODS Participants included 355 individuals diagnosed with BPD and followed longitudinally at three annual assessments. Auto-regressive cross-lagged panel models were used to examine prospective associations between stressful life events and three latent dimensions implicated in BPD: negative affect, disinhibition, and antagonism. RESULTS Antagonism and disinhibition, but not negative affect, prospectively predicted dependent stressful life events (events the individual may have some role in). Evidence for decompensation under stress was more tenuous, with independent stressful life events (those presumably outside the individual's control) predicting increases in negative affect. CONCLUSIONS Our longitudinal study of a well-characterized clinical sample found more evidence for stress generation than for stress-induced decompensation in BPD. Stress generation in BPD is driven by externalizing dimensions: antagonism and disinhibition. These results highlight the utility of empirically derived dimensions for parsing heterogeneity present in BPD, leading to improvements in diagnostic evaluation, clinical prediction, and individualized approaches to treatment planning.
Collapse
|
13
|
Watson D, Levin-Aspenson HF, Waszczuk MA, Conway CC, Dalgleish T, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs KA, Michelini G, Nelson BD, Sellbom M, Slade T, South SC, Sunderland M, Waldman I, Witthöft M, Wright AGC, Kotov R, Krueger RF. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum. World Psychiatry 2022; 21:26-54. [PMID: 35015357 PMCID: PMC8751579 DOI: 10.1002/wps.20943] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma-related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.
Collapse
Affiliation(s)
- David Watson
- Department of Psychology, University of Notre Dame, South Bend, IN, USA
| | | | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | - Tim Dalgleish
- Medical Research Council, Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Michael N Dretsch
- US Army Medical Research Directorate - West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, WA, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey A Hobbs
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Giorgia Michelini
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Irwin Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Michael Witthöft
- Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, University of Mainz, Mainz, Germany
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
14
|
Barnes DM, Xu S, Cleland CM, McKnight C, Des Jarlais D. Recurrent Injecting Drug Use as a Mediator between Psychiatric Disorder and Non-Fatal Overdose. Subst Use Misuse 2022; 57:1248-1256. [PMID: 35611936 DOI: 10.1080/10826084.2022.2076877] [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: 10/18/2022]
Abstract
BACKGROUND Unintentional drug overdose has increased markedly in the United States. Studies document an association between psychiatric disorder and unintentional overdose; we extend this research through a preliminary test of a causal model of recurrent injection drug use mediating this relationship. METHODS In a cross-sectional study of 241 adults in New York City with a possible current substance use disorder, we conducted conventional and Imai's mediation analyses to examine if psychiatric disorder is associated with increased prevalence of ever overdosing and if recurrent injection drug use mediates this association. Our cross-sectional data permit the first step of assessing causal models: testing if statistical associations are consistent with the model. RESULTS Fifty-eight percent of the sample endorsed previous psychiatric disorder diagnosis and 35.7% reported ever overdosing. Imai's mediation analysis showed that, adjusting for covariates, the total association between psychiatric diagnosis and ever overdosing (adjusted prevalence difference [aPD] = 0.16, 95% CI 0.04-0.28) was composed of a direct effect (aPD = 0.09, 95% CI -0.03 - 0.21, p = 0.136) and an indirect effect (aPD = 0.07, 95% CI 0.02-0.13). Recurrent injecting drug use contributed to 42% (ratio of indirect effect to total effect; 95% CI 12 - 100%, p = 0.02) of the association between psychiatric diagnosis and ever overdosing. Conventional mediation analysis produced similar results. CONCLUSIONS Our results provide a warrant for taking the necessary next step for assessing a causal model using longitudinal data, potentially providing a strong rationale for intervening on psychiatric disorders to stem overdose.
Collapse
Affiliation(s)
- David M Barnes
- School of Global Public Health, New York University, New York, NY, USA
| | - Shu Xu
- School of Global Public Health, New York University, New York, NY, USA
| | - Charles M Cleland
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Courtney McKnight
- School of Global Public Health, New York University, New York, NY, USA
| | - Don Des Jarlais
- School of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
15
|
Etchin AG, Fonda JR, Howard EP, Fortier CB, Milberg WP, Pounds K, McGlinchey RE. Childhood Trauma Differentially Impacts Depression and Stress Associations with Reintegration Challenges Among Post-9/11 U.S. Veterans. Nurs Outlook 2021; 70:323-336. [PMID: 34895737 DOI: 10.1016/j.outlook.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/30/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Post-9/11 veterans exhibit high prevalence of deployment stress, psychological conditions, and traumatic brain injury (TBI) which impact reintegration, especially among those with a history of interpersonal early life trauma (I-ELT). The relative importance of each risk factor is unclear. PURPOSE We examined major deployment and clinical exposures of reintegration challenges among veterans with and without I-ELT. METHOD We analyzed cross-sectional data of 155 post-9/11 veterans from the Translational Research Center for TBI and Stress Disorders study. FINDINGS Depression severity had the strongest association with reintegration challenges, followed by posttraumatic stress disorder (PTSD) severity, post-deployment stress, and deployment safety concerns. Deployment safety concerns had a stronger, significant association among veterans with I-ELT. In nearly every model, PTSD and depression severities were weaker for veterans with I-ELT, compared to those without. DISCUSSION Clinicians should consider the relative risk of concurrent clinical conditions and trauma histories when considering veterans' reintegration needs.
Collapse
Affiliation(s)
- Anna G Etchin
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA.
| | - Jennifer R Fonda
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Boston University Medical Campus, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Elizabeth P Howard
- Connell School of Nursing, Boston College, Chestnut Hill, MA; The Hinda and Arthur Marcus Institute for Aging Research (The Marcus Institute), Hebrew Senior Life, Boston, MA
| | - Catherine B Fortier
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA
| | - William P Milberg
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA
| | - Karen Pounds
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, North Dartmouth, MA
| | - Regina E McGlinchey
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA
| |
Collapse
|
16
|
Goldstein BL, Armeli S, Adams RL, Florimon MA, Hammen C, Tennen H. Patterns of stress generation differ depending on internalizing symptoms, alcohol use, and personality traits in early adulthood: a five year longitudinal study. ANXIETY, STRESS, AND COPING 2021; 34:612-625. [PMID: 33818193 PMCID: PMC8490491 DOI: 10.1080/10615806.2021.1910677] [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: 09/03/2020] [Revised: 03/13/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Depression is thought to generate stressful life events. However, other internalizing symptoms such as anxiety or post-traumatic stress and individual difference variables such as personality traits and alcohol use may contribute to stressful life events. Whether stress generation is specific to depression or generalized to these other variables is unclear. Therefore, we tested whether stress generation was depression specific or generalizable to anxiety, PTSD, alcohol use, neuroticism, and extraversion. DESIGN Two-wave longitudinal study with a five-year follow-up. METHODS 917 young adults completed measures of internalizing symptoms, alcohol use, neuroticism, and extraversion during college and five years later along with an interview-based measure of life events. RESULTS Symptoms of depression, anxiety, PTSD, and neuroticism exhibited bivariate predictive effects on interpersonal-dependent events. When considering internalizing symptoms in the aggregate, stress generation was specific to symptoms rather than neuroticism. Furthermore, interpersonal-dependent life events mediated Time 1 internalizing symptoms predicting Time 2 symptoms. CONCLUSION Our results indicate that stress generation applies to internalizing symptoms broadly rather than specifically to depression. Moreover, neuroticism was no longer a significant predictor of life events when examined with internalizing symptoms simultaneously. These results support the value of integrative models that test numerous factors predicting stressful life events.
Collapse
Affiliation(s)
- Brandon L Goldstein
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, USA
| | - Stephen Armeli
- Department of Psychology, Fairleigh Dickinson University, Teaneck, USA
| | - Rachel L Adams
- Department of Psychology, Fairleigh Dickinson University, Teaneck, USA
| | - Martin A Florimon
- Department of Psychology, Fairleigh Dickinson University, Teaneck, USA
| | - Constance Hammen
- Department of Psychology, University of California, Los Angeles, USA
| | - Howard Tennen
- Public Health Sciences, University of Connecticut School of Medicine, Farmington, USA
| |
Collapse
|
17
|
Carona C, Moreira H, Fonseca A. Maternal depression and anxiety in an interpersonal context: The effects of positive–negative self-expressiveness within the family. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
18
|
Long EE, Young JF, Hankin BL. Stress Mediates the Within-Person Longitudinal Associations Between Depression and Different Anxiety Syndromes in Youth. Res Child Adolesc Psychopathol 2021; 50:403-416. [PMID: 34559342 DOI: 10.1007/s10802-021-00866-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Depressive symptoms predict within-person change in physical symptoms of anxiety and social anxiety symptoms; however, potential mediators of these within-person associations remain understudied. The current study examined whether overall stress, interpersonal stress, and achievement stress mediate the associations between depressive symptoms and physical, social, and separation anxiety symptoms for girls and boys in a sample of 680 community youth aged 8-18 (M = 11.8, SD = 2.4; 55% female) using a random intercept cross-lagged panel model (RI-CLPM). Participants completed measures of anxiety symptoms, depression symptoms, and stress (Adolescent Life Events Questionnaire) every 3 months for 3 years (13 total assessments). Overall and interpersonal stress partly mediated the longitudinal, within-person associations between depression symptoms and physical symptoms of anxiety and between depression symptoms and social anxiety symptoms. Stress did not mediate the longitudinal associations between depression and separation anxiety symptoms. Multigroup models indicated that total stress mediated the associations between depression and physical symptoms of anxiety, and between depression and social anxiety for girls but not for boys. Results support the role of stress as a mediator of the association between depression and anxiety symptoms and suggest that, as youth experience depression-related impairment, they may generate additional stressors, which increase their symptoms of physical and social anxiety.
Collapse
Affiliation(s)
- Erin E Long
- Department of Psychology, University of Illinois-Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA.
| | - Jami F Young
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois-Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA
| |
Collapse
|
19
|
Rappaport LM, Di Nardo N, Brotman MA, Pine DS, Leibenluft E, Roberson-Nay R, Hettema JM. Pediatric anxiety associated with altered facial emotion recognition. J Anxiety Disord 2021; 82:102432. [PMID: 34146888 PMCID: PMC8364876 DOI: 10.1016/j.janxdis.2021.102432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/01/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Multiple psychiatric disorders are associated with difficulties in facial emotion recognition. However, generalized anxiety disorder may be associated with more accurate recognition of others' emotional expressions, particularly expressions of happiness and fear, which index safety and threat. Children aged 9-14 from a community sample (N = 601) completed a facial emotion labeling task. Children's symptoms of depressive and anxiety syndromes were assessed by self- and parent-report. Elevated symptoms of generalized anxiety disorder were associated with more accurate facial emotion recognition (β = 0.16, p = 0.007), specifically recognition of happiness (β = 0.17, p = 0.002) and fear (β = 0.15, p = 0.006). Elevated depressive symptoms were associated with less accurate facial emotion recognition (β = -0.12, p = 0.018), specifically happiness (β = -0.15, p = 0.002). Elevated symptoms of separation anxiety disorder were also associated with less accurate facial emotion recognition (β = -0.16, p = 0.003), specifically happiness (β = -0.15, p = 0.006) and fear (β = -0.15, p = 0.005), which highlights the importance of distinguishing between anxiety syndromes. Results held when adjusting for child age and sex. Evidence that symptoms of generalized anxiety disorder are associated with more accurate recognition of happiness and fear is consistent with theories of heightened social vigilance and support a transdiagnostic role of facial emotion recognition that may inform the psychosocial development of youth with anxiety and depressive symptoms.
Collapse
Affiliation(s)
- Lance M. Rappaport
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada; Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nicole Di Nardo
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Roxann Roberson-Nay
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - John M. Hettema
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA; Department of Psychiatry, Texas A&M Health Sciences Center, Bryan, Texas, USA
| |
Collapse
|
20
|
Krueger RF, Hobbs KA, Conway CC, Dick DM, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Keyes KM, Latzman RD, Michelini G, Patrick CJ, Sellbom M, Slade T, South S, Sunderland M, Tackett J, Waldman I, Waszczuk MA, Wright AG, Zald DH, Watson D, Kotov R. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum. World Psychiatry 2021; 20:171-193. [PMID: 34002506 PMCID: PMC8129870 DOI: 10.1002/wps.20844] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within dis-orders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and "Cluster B" personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.
Collapse
Affiliation(s)
| | - Kelsey A. Hobbs
- Department of PsychologyUniversity of MinnesotaMinneapolisMNUSA
| | | | - Danielle M. Dick
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | - Michael N. Dretsch
- US Army Medical Research Directorate ‐ WestWalter Reed Army Institute of Research, Joint Base Lewis‐McChordWAUSA
| | | | - Miriam K. Forbes
- Centre for Emotional Health, Department of PsychologyMacquarie UniversitySydneyNSWAustralia
| | | | | | | | - Giorgia Michelini
- Semel Institute for Neuroscience and Human BehaviorUniversity of California Los AngelesLos AngelesCAUSA
| | | | - Martin Sellbom
- Department of PsychologyUniversity of OtagoDunedinNew Zealand
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | - Susan C. South
- Department of Psychological SciencesPurdue UniversityWest LafayetteINUSA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | | | - Irwin Waldman
- Department of PsychologyEmory UniversityAtlantaGAUSA
| | | | | | - David H. Zald
- Department of PsychologyVanderbilt UniversityNashvilleTNUSA
| | - David Watson
- Department of PsychologyUniversity of Notre DameNotre DameINUSA
| | - Roman Kotov
- Department of PsychiatryStony Brook UniversityStony BrookNYUSA
| | | |
Collapse
|
21
|
Coifman KG, Seah THS, Nylocks KM, Wise A, Almahmoud S, Summers C, Aurora P, Garcia M, Delahanty DL. Micro Versus Macro Processes: How specific stress exposure impacts sleep, affect, and risk-related behavior on the path to disease in high-risk adults. ANXIETY STRESS AND COPING 2021; 34:381-396. [PMID: 33618565 DOI: 10.1080/10615806.2021.1888933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The stress-to-disease association has been well-accepted for some time. However, the understanding of how stress exposure contributes to psychological disease progression remains unclear. OBJECTIVE To test the real-time impact of variable stress exposure on risk-related clinical phenomena and affective disease progression in a high-risk sample of active-duty firefighters. METHODS Participants completed weekly diaries reporting stressful event exposure, affect, sleep, and risk-related and healthy behaviors over six-months and were evaluated for lifetime and current psychiatric disease using clinical interviews before and after the sampling period. RESULTS Stress exposure impacted clinical phenomena in differing ways. Major personal events and day-to-day hassles predicted health-impairing shifts in sleep and behavior that were associated with increases in symptoms and psychological distress over the 6-month period. In contrast, highly aversive incidents predicted greater adaptive behaviors that were uniquely predictive of symptom decreases over the six-month period. CONCLUSION These findings shed new light on stress-to-disease processes, demonstrating how variable stress exposure influences critical shifts in behavior and sleep, contributing to psychological adjustment of firefighters over time. These data suggest practical ways to monitor risk in high-risk samples (e.g., monitoring sleep latency) and offer avenues for further explication of disease processes in real time.
Collapse
Affiliation(s)
- Karin G Coifman
- Psychological Sciences, Kent State University, Kent, OH, USA
| | | | | | - Anna Wise
- Psychological Sciences, Kent State University, Kent, OH, USA
| | | | | | - Pallavi Aurora
- Psychological Sciences, Kent State University, Kent, OH, USA
| | - Monica Garcia
- Psychological Sciences, Kent State University, Kent, OH, USA
| | | |
Collapse
|
22
|
Zimmer‐gembeck MJ, Dunbar MD, Ferguson S, Rowe SL, Webb H, Skinner EA. Introduction to the special issue. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Melanie J. Zimmer‐gembeck
- Griffith University, School of Applied Psychology and Griffith Health Institute, Behavioural Basis of Health, Gold Coast, QLD, Australia,
| | - Michele D. Dunbar
- Griffith University, School of Applied Psychology and Griffith Health Institute, Behavioural Basis of Health, Gold Coast, QLD, Australia,
| | - Samantha Ferguson
- Griffith University, School of Applied Psychology and Griffith Health Institute, Behavioural Basis of Health, Gold Coast, QLD, Australia,
| | - Susan L. Rowe
- Griffith University, School of Applied Psychology and Griffith Health Institute, Behavioural Basis of Health, Gold Coast, QLD, Australia,
| | - Haley Webb
- Griffith University, School of Applied Psychology and Griffith Health Institute, Behavioural Basis of Health, Gold Coast, QLD, Australia,
| | - Ellen A. Skinner
- Department of Psychology, Portland State University, Portland, OR, USA,
| |
Collapse
|
23
|
Compas BE, Jaser SS, Dunbar JP, Watson KH, Bettis AH, Gruhn MA, Williams EK. Coping and Emotion Regulation from Childhood to Early Adulthood: Points of Convergence and Divergence. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020; 66:71-81. [PMID: 24895462 DOI: 10.1111/ajpy.12043] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Processes of coping with stress and the regulation of emotion reflect basic aspects of development and play an important role in models of risk for psychopathology and the development of preventive interventions and psychological treatments. However, research on these two constructs has been represented in two separate and disconnected bodies of work. We examine possible points of convergence and divergence between these constructs with regard to definitions and conceptualization, research methods and measurement, and interventions to prevent and treat psychopathology. There is clear evidence that coping and emotion regulation are distinct but closely related constructs in all of these areas. The field will benefit from greater integration of methods and findings in future research.
Collapse
|
24
|
Vine V, Byrd AL, Mohr H, Scott LN, Beeney JE, Stepp SD. The Structure of Psychopathology in a Sample of Clinically Referred, Emotionally Dysregulated Early Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1379-1393. [PMID: 32725338 PMCID: PMC7990491 DOI: 10.1007/s10802-020-00684-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This investigation answers and amplifies calls to model the transdiagnostic structure of psychopathology in clinical samples of early adolescents and using stringent psychometric criteria. In 162 clinically referred, clinically evaluated 11-13-year-olds, we compared a correlated two-factor model, containing latent internalizing and externalizing factors, to a bifactor model, which added a transdiagnostic general factor. We also evaluated the bifactor model psychometrically, including criterion validity with broad indicators of psychosocial functioning. In doing so, we compared alternative approaches to defining and interpreting criterion validity: a recently proposed incremental definition based on amounts of variance in criterion factors explained, and the more typical definition based on the presence of conceptually meaningful relationships. While traditional fit statistics favored the bifactor model as expected, psychometric analyses added important nuance. Despite moderate reliability, the general factor was not fully transdiagnostic (i.e., was not informed by several externalizing scores), and was partially redundant with internalizing scores. Approaches to criterion validity yielded opposing results. Compared to the correlated two-factor model, the bifactor model redistributed, without incrementally increasing, the total variance explained in criterion indicators of psychosocial functioning. Yet, the bifactor model did improve the precision of clinically important relationships to psychosocial functioning, raising questions about meaningful tests of bifactor psychopathology models.
Collapse
Affiliation(s)
- Vera Vine
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA.
| | - Amy L Byrd
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Harmony Mohr
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Lori N Scott
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Joseph E Beeney
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Stephanie D Stepp
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
- Department of Psychology, University of Pittsburgh School of Arts and Sciences, Pittsburgh, PA, USA
| |
Collapse
|
25
|
Richardson CE, Magson NR, Fardouly J, Oar EL, Forbes MK, Johnco CJ, Rapee RM. Longitudinal Associations between Coping Strategies and Psychopathology in Pre-adolescence. J Youth Adolesc 2020; 50:1189-1204. [PMID: 33118093 DOI: 10.1007/s10964-020-01330-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/12/2020] [Indexed: 11/30/2022]
Abstract
Much of the literature investigating the association between coping and psychopathology is cross-sectional, or associations have been investigated in a unidirectional manner; hence, bidirectionality between coping and psychopathology remains largely untested. To address this gap, this study investigated bidirectional relations between coping and psychopathology during pre-adolescence. Participants (N = 532, 51% male) and their primary caregiver both completed questionnaires assessing pre-adolescents' coping (i.e., avoidant, problem solving, social support seeking) and symptoms of psychopathology (i.e., generalized anxiety, social anxiety, depression, eating pathology) in Wave 1 (Mage = 11.18 years, SD = 0.56, range = 10-12) and Wave 2 (Mage = 12.18 years, SD = 0.53, range = 11-13, 52% male), one year later. Cross-lagged panel models showed child-reported avoidant coping predicted increases in symptoms of generalized and social anxiety, and eating pathology. In separate child and parent models, symptoms of depression predicted increases in avoidant coping. Greater parent-reported child depressive symptoms also predicted decreases in problem solving coping. Taken together, results suggest unique longitudinal associations between coping and psychopathology in pre-adolescence, with avoidant coping preceding increases in symptoms of anxiety and eating pathology, and depressive symptoms predicting later increases in maladaptive coping.
Collapse
Affiliation(s)
- Cele E Richardson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia. .,Centre for Sleep Science, School of Psychological Science, Faculty of Science, University of Western Australia, Perth, WA, Australia.
| | - Natasha R Magson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Ella L Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Carly J Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| |
Collapse
|
26
|
Morrison CL, Rhee SH, Smolker HR, Corley RP, Hewitt JK, Friedman NP. Genetic and Environmental Influences on Stressful Life Events and their Associations with Executive Functions in Young Adulthood: A Longitudinal Twin Analysis. Behav Genet 2020; 51:30-44. [PMID: 32959091 DOI: 10.1007/s10519-020-10017-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
Although stress is frequently considered an environmental factor, dependent stressful life events (SLEs)--stressors that result from one's actions or behaviors--may in fact be evoked by a genetic liability. It has been suggested that dependent SLEs may be partially caused by poor executive function (EFs), higher-level cognitive abilities that enable individuals to implement goal-directed behavior. We investigated the possibility of genetic and environmental overlap between SLEs and EFs in a longitudinal twin study. We found high genetic stability in the number of dependent SLEs from age 23 to age 29, suggesting that the number of dependent stressors show persistence across time due to their genetic etiology. In addition, there was a nominally significant negative genetic correlation between a Common EF latent factor and dependent SLEs at age 23. The genetic stability of dependent SLEs and association with Common EF provides insight into how some behaviors may lead to persistent stress.
Collapse
Affiliation(s)
- Claire L Morrison
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA. .,Institute for Behavioral Genetics, University of Colorado Boulder, 447 UCB, Boulder, CO, 80309, USA.
| | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.,Institute for Behavioral Genetics, University of Colorado Boulder, 447 UCB, Boulder, CO, 80309, USA
| | - Harry R Smolker
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.,Institute for Behavioral Genetics, University of Colorado Boulder, 447 UCB, Boulder, CO, 80309, USA
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, 447 UCB, Boulder, CO, 80309, USA
| | - John K Hewitt
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.,Institute for Behavioral Genetics, University of Colorado Boulder, 447 UCB, Boulder, CO, 80309, USA
| | - Naomi P Friedman
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.,Institute for Behavioral Genetics, University of Colorado Boulder, 447 UCB, Boulder, CO, 80309, USA
| |
Collapse
|
27
|
Schirmbeck F, Konijn M, Hoetjes V, Vermeulen J, Zink M, Dekker J, de Haan L. Stressful experiences affect the course of co-occurring obsessive-compulsive and psychotic symptoms: A focus on within-subject processes. Schizophr Res 2020; 216:69-76. [PMID: 31919031 DOI: 10.1016/j.schres.2019.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/26/2019] [Accepted: 12/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Obsessive-compulsive symptoms (OCS) frequently occur in patients with psychotic disorders and are associated with higher burden and poorer prognosis. This study prospectively investigated the effect of stressful experiences on the severity of OCS and co-occurring psychotic and affective symptoms, with a focus on within-subject processes. METHOD Monthly assessments over 6 months in patients with a psychotic disorder (n = 56) and unaffected siblings (n = 49) resulted in 309 and 277 observations, respectively. Linear mixed-effects models investigated the disaggregated effects of within-subject changes and between-subject differences in stressful events on OCS, positive, negative and depressive symptoms. Subsequently, moderating effects of coping strategies and dysfunctional metacognitive beliefs were assessed. Mediation analyses investigated direct and indirect effects of stressful events on OCS four weeks later. RESULTS Stressful experiences were associated with severity in almost all symptom domains on the between- and within-subject levels. Dysfunctional coping and metacognitive beliefs moderated these associations. Patients and siblings with a tendency for passive coping showed higher within-subject increase in depressive symptoms, whereas passive coping and dysfunctional beliefs moderated the association between stressful experiences and severity of positive symptoms and OCS on the between-subject level. Effects of stressful experiences on OCS four weeks later were partially mediated by depressive and positive symptoms in patients and siblings. CONCLUSIONS Findings suggest that severity and variability of co-occurring psychopathology can partly be explained by recent stressful events and the way individuals cope with these experiences. The implementation of coping-oriented interventions could possibly help to prevent development and/or aggravation of co-occurring symptom severity.
Collapse
Affiliation(s)
- Frederike Schirmbeck
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands.
| | - Max Konijn
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Vera Hoetjes
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Jentien Vermeulen
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; District Hospital Mittelfranken, Ansbach, Germany
| | - Jack Dekker
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
| |
Collapse
|
28
|
Fassett-Carman AN, DiDomenico GE, von Steiger J, Snyder HR. Clarifying stress-internalizing associations: Stress frequency and appraisals of severity and controllability are differentially related to depression-specific, anxiety-specific, and transdiagnostic internalizing factors. J Affect Disord 2020; 260:638-645. [PMID: 31542557 PMCID: PMC6864742 DOI: 10.1016/j.jad.2019.09.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/03/2019] [Accepted: 09/08/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Dependent (self-generated) stress is a strong risk factor for depression and anxiety, but perceptions of stress can alter its impact. Appraisals of dependent stress controllability and severity additionally relate to depression and anxiety over and above stress exposure. Due to the high comorbidity of depression and anxiety, it is unclear whether dependent stress frequency and appraisals relate specifically to depression or anxiety or are transdiagnostically associated shared aspects of internalizing disorders. Consistent with the tripartite model, the current study represented internalizing symptoms with three latent factors - depression-specific, anxiety-specific, and common internalizing - and tested how dependent stress frequency and appraisals of controllability and severity were associated with these factors. METHODS Bifactor modeling was used to create the latent internalizing factors in a treatment-seeking sample of emerging adults (n = 356). Structural equation models tested dependent stress frequency and appraisals of controllability and severity as predictors of these latent factors. RESULTS Dependent stress frequency was associated with common internalizing while perceived controllability was associated uniquely with depression-specific variance. Continuous stress severity was not associated with latent factors, but high-severity stressors were associated with anxiety-specific variance. LIMITATIONS Without longitudinal data conclusions regarding temporal directionality cannot be made. Participants' appraisals of stressors could not be compared to expert ratings. CONCLUSIONS Dependent stress frequency, controllability appraisals, and high-severity stressful events have distinct links with different dimensions of internalizing psychopathology. This suggests there may be several distinct mediating mechanisms between stress constructs and psychopathology, which have potential to serve as targets for intervention.
Collapse
Affiliation(s)
- Alyssa N. Fassett-Carman
- Brandeis University Psychology and Neuroscience Departments,1 Corresponding Author: Alyssa Fassett-Carman, CoPE Lab, Psychology Department, 062, Brandeis University, 415 South Street, Waltham MA 02453-2728, Phone: 612-298-2655, Fax: 781-736-3291,
| | | | | | | |
Collapse
|
29
|
Belmans E, Bastin M, Raes F, Bijttebier P. Temporal associations between social anxiety and depressive symptoms and the role of interpersonal stress in adolescents. Depress Anxiety 2019; 36:960-967. [PMID: 31437332 DOI: 10.1002/da.22939] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 05/02/2019] [Accepted: 06/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is characterized by an increased vulnerability for internalizing psychopathologies such as depression and anxiety. A positive association between anxiety and depression has consistently been found in research. However, the specific direction of this association is less clear. In this study, we investigated the temporal associations between (social) anxiety and depressive symptoms. Furthermore, the role of dependent interpersonal stress as a potential mediating factor in these temporal associations was examined. METHODS Data were part of a larger longitudinal study on the emotional development of adolescents, which was initiated in February 2013. The total sample consisted of 2011 adolescents between the ages of 11 and 19. Data were analyzed using cross-lagged models. RESULTS Bidirectional positive associations were found between social anxiety symptoms and depressive symptoms. However, dependent interpersonal stress was not a mediator in the link between social anxiety and depression. Our results indicate that dependent interpersonal stress seems to be particularly related to depressive symptoms and not to social anxiety symptoms. CONCLUSIONS Findings suggest that bidirectional associations between social anxiety and depressive symptoms exist. This implies that clinicians should be specifically vigilant for the development of depressive symptoms in socially anxious adolescents and the development of social anxiety symptoms in depressed adolescents. Our findings further highlight the importance of targeting dependent interpersonal stress in the context of depression.
Collapse
Affiliation(s)
- Eline Belmans
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Margot Bastin
- School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Filip Raes
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Patricia Bijttebier
- School Psychology and Development in Context, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
30
|
Jenzer T, Meisel SN, Blayney JA, Colder CR, Read JP. Reciprocal processes in trauma and coping: Bidirectional effects over a four-year period. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2019; 12:207-218. [PMID: 31414867 DOI: 10.1037/tra0000500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Both trauma exposure and coping are strong predictors of mental health outcomes. There is evidence that trauma and coping are linked, with cross-sectional work suggesting that individuals with more trauma exposure show poorer coping ability (i.e., more avoidance coping, less approach coping). To date, no study has examined the temporal directionality of this association, a question with important clinical implications. METHOD Using a longitudinal data set over 4 years of college (N = 787), we examined bidirectional associations between trauma exposure and 3 coping styles (approach, avoidance, social support seeking). Our data analytic approach allowed us to examine both within-person and between-person effects, to better determine how change occurs at the individual level. Coping was assessed using the Brief Cope (Carver, 1997), and trauma exposure was assessed using the Traumatic Life Experiences Questionnaire (Kubany et al., 2000). Gender, baseline posttraumatic stress disorder symptoms, and precollege trauma were included as statistical control variables. RESULTS The between-person effects were consistent with the cross-sectional literature. Interestingly, rather than an increase in avoidance coping and trauma exposure over time, the within-person findings suggested an adaptive cycle over time, in which increased trauma exposure marginally predicted an increase in approach coping (B = .05, p = .07), and approach coping predicted decreased trauma exposure (B = -.07, p = .04). CONCLUSIONS Our study sheds new light on how coping and stressful events may impact one another across time. Findings suggest that a focus on approach-based coping skills may be an important direction for prevention efforts. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
|
31
|
Conway CC, Li YI, Starr LR. Trait anhedonia is a transdiagnostic correlate of internalizing problems during adolescence. JOURNAL OF RESEARCH IN PERSONALITY 2019. [DOI: 10.1016/j.jrp.2019.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
32
|
Separating within-person from between-person effects in the longitudinal co-occurrence of depression and different anxiety syndromes in youth. JOURNAL OF RESEARCH IN PERSONALITY 2019. [DOI: 10.1016/j.jrp.2019.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
33
|
Fusar‐Poli P, Solmi M, Brondino N, Davies C, Chae C, Politi P, Borgwardt S, Lawrie SM, Parnas J, McGuire P. Transdiagnostic psychiatry: a systematic review. World Psychiatry 2019; 18:192-207. [PMID: 31059629 PMCID: PMC6502428 DOI: 10.1002/wps.20631] [Citation(s) in RCA: 186] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The usefulness of current psychiatric classification, which is based on ICD/DSM categorical diagnoses, remains questionable. A promising alternative has been put forward as the "transdiagnostic" approach. This is expected to cut across existing categorical diagnoses and go beyond them, to improve the way we classify and treat mental disorders. This systematic review explores whether self-defining transdiagnostic research meets such high expectations. A multi-step Web of Science literature search was performed according to an a priori protocol, to identify all studies that used the word "transdiagnostic" in their title, up to May 5, 2018. Empirical variables which indexed core characteristics were extracted, complemented by a bibliometric and conceptual analysis. A total of 111 studies were included. Most studies were investigating interventions, followed by cognition and psychological processes, and neuroscientific topics. Their samples ranged from 15 to 91,199 (median 148) participants, with a mean age from 10 to more than 60 (median 33) years. There were several methodological inconsistencies relating to the definition of the gold standard (DSM/ICD diagnoses), of the outcome measures and of the transdiagnostic approach. The quality of the studies was generally low and only a few findings were externally replicated. The majority of studies tested transdiagnostic features cutting across different diagnoses, and only a few tested new classification systems beyond the existing diagnoses. About one fifth of the studies were not transdiagnostic at all, because they investigated symptoms and not disorders, a single disorder, or because there was no diagnostic information. The bibliometric analysis revealed that transdiagnostic research largely restricted its focus to anxiety and depressive disorders. The conceptual analysis showed that transdiagnostic research is grounded more on rediscoveries than on true innovations, and that it is affected by some conceptual biases. To date, transdiagnostic approaches have not delivered a credible paradigm shift that can impact classification and clinical care. Practical "TRANSD"iagnostic recommendations are proposed here to guide future research in this field.
Collapse
Affiliation(s)
- Paolo Fusar‐Poli
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,OASIS Service, South London and Maudsley NHS Foundation TrustLondonUK,Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,Neuroscience Department, Psychiatry UnitUniversity of PaduaPaduaItaly
| | - Natascia Brondino
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Cathy Davies
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Chungil Chae
- Applied Cognitive Science Lab, Department of Information Science and TechnologyPennsylvania State University, University ParkPAUSA
| | - Pierluigi Politi
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | | | | | - Josef Parnas
- Center for Subjectivity ResearchUniversity of CopenhagenCopenhagenDenmark
| | - Philip McGuire
- OASIS Service, South London and Maudsley NHS Foundation TrustLondonUK,Department of Psychosis Studies, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,National Institute for Health Research Maudsley Biomedical Research CentreSouth London and Maudsley NHS Foundation TrustLondonUK
| |
Collapse
|
34
|
Conway CC, Forbes MK, Forbush KT, Fried EI, Hallquist MN, Kotov R, Mullins-Sweatt SN, Shackman AJ, Skodol AE, South SC, Sunderland M, Waszczuk MA, Zald DH, Afzali MH, Bornovalova MA, Carragher N, Docherty AR, Jonas KG, Krueger RF, Patalay P, Pincus AL, Tackett JL, Reininghaus U, Waldman ID, Wright AG, Zimmermann J, Bach B, Bagby RM, Chmielewski M, Cicero DC, Clark LA, Dalgleish T, DeYoung CG, Hopwood CJ, Ivanova MY, Latzman RD, Patrick CJ, Ruggero CJ, Samuel DB, Watson D, Eaton NR. A Hierarchical Taxonomy of Psychopathology Can Transform Mental Health Research. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2019; 14:419-436. [PMID: 30844330 PMCID: PMC6497550 DOI: 10.1177/1745691618810696] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
For more than a century, research on psychopathology has focused on categorical diagnoses. Although this work has produced major discoveries, growing evidence points to the superiority of a dimensional approach to the science of mental illness. Here we outline one such dimensional system-the Hierarchical Taxonomy of Psychopathology (HiTOP)-that is based on empirical patterns of co-occurrence among psychological symptoms. We highlight key ways in which this framework can advance mental-health research, and we provide some heuristics for using HiTOP to test theories of psychopathology. We then review emerging evidence that supports the value of a hierarchical, dimensional model of mental illness across diverse research areas in psychological science. These new data suggest that the HiTOP system has the potential to accelerate and improve research on mental-health problems as well as efforts to more effectively assess, prevent, and treat mental illness.
Collapse
Affiliation(s)
- Christopher C. Conway
- Department of Psychological Sciences, College of William & Mary, Williamsburg, VA, USA
| | - Miriam K. Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | | | - Eiko I. Fried
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Michael N. Hallquist
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
| | - Roman Kotov
- Department of Psychiatry, State University of New York, Stony Brook, NY, USA
| | | | - Alexander J. Shackman
- Department of Psychology and Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA
| | - Andrew E. Skodol
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Susan C. South
- Purdue University, Department of Psychological Sciences, West Lafayette, IN, USA
| | - Matthew Sunderland
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Monika A. Waszczuk
- Department of Psychiatry, State University of New York, Stony Brook, NY, USA
| | - David H. Zald
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | | | - Natacha Carragher
- Medical Education and Student Office, Faculty of Medicine, University of New South Wales Australia, Sydney, New South Wales, Australia
| | - Anna R. Docherty
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Katherine G. Jonas
- Department of Psychiatry, State University of New York, Stony Brook, NY, USA
| | - Robert F. Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Praveetha Patalay
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Aaron L. Pincus
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
| | | | - Ulrich Reininghaus
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | | | - Aidan G.C. Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Bo Bach
- Psychiatric Research Unit, Slagelse Psychiatric Hospital, Slagelse, Denmark
| | - R. Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | | | - David C. Cicero
- Department of Psychology, University of Hawaii at Manoa, HI, USA
| | - Lee Anna Clark
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Colin G. DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | - Masha Y. Ivanova
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Robert D. Latzman
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | | | - Camilo J. Ruggero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Douglas B. Samuel
- Purdue University, Department of Psychological Sciences, West Lafayette, IN, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Nicholas R. Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
35
|
Abstract
Stress generation has potential to account for recurrent suicidal behavior. The current study represents a first step toward evaluating this possibility in a sample of adolescent psychiatric inpatients (n = 99; 79.80% female) followed over six months. At index admission, participants completed baseline measures of depressive symptom severity, suicidal ideation, lifetime history of suicide attempts, and negative life events using a contextual threat life stress interview. Negative life events since baseline were assessed at the follow-up assessment. Consistent with the stress generation hypothesis, lifetime number of suicide attempts prospectively predicted higher rates of dependent, but not independent, stress. Bayesian analyses also yielded substantial support for an association with overall dependent stress, but provided more modest support for specificity to this form of life stress relative to independent stress. Implications of these findings and directions for future research further clarifying the role of stress generation in suicidal behavior are discussed.
Collapse
Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior Alpert Medical School of Brown University
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior Alpert Medical School of Brown University
| |
Collapse
|
36
|
Waszczuk MA, Ruggero C, Li K, Luft BJ, Kotov R. The role of modifiable health-related behaviors in the association between PTSD and respiratory illness. Behav Res Ther 2019; 115:64-72. [PMID: 30401484 PMCID: PMC6622464 DOI: 10.1016/j.brat.2018.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/26/2018] [Accepted: 10/31/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) increases risk of future respiratory illness. However, mechanisms that underpin the association between these common and debilitating conditions remain unknown. The aim of this study was to identify modifiable, health-related behaviors they may explain the link between PTSD and respiratory problems. METHODS World Trade Center responders (N = 452, 89% male, mean age = 55 years) completed baseline PTSD and sleep questionnaires, followed by 2-weeks of daily diaries, actigraphy and ambulatory spirometry to monitor lower respiratory symptoms, pulmonary function, activity levels, stressors, and sleep. Lipid levels were obtained from electronic medical records. RESULTS Cross-sectional mediation analyses revealed that the association between PTSD and self-reported respiratory symptoms was explained by poor sleep, low activity, and daily stressors. The association between PTSD symptoms and pulmonary function was explained by insomnia and low activity. CONCLUSIONS A range of health-related daily behaviors and experiences, especially sleep disturbances and inactivity, may explain excess respiratory illness morbidity in PTSD. The findings were generally consistent across daily self-report and spirometry measures of respiratory problems. Targeting these behaviors might enhance prevention of and intervention in respiratory problems in traumatized populations.
Collapse
Affiliation(s)
- Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.
| | - Camilo Ruggero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Kaiqiao Li
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Benjamin J Luft
- Department of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
37
|
Snyder HR, Friedman NP, Hankin BL. Transdiagnostic mechanisms of psychopathology in youth: Executive functions, dependent stress, and rumination. COGNITIVE THERAPY AND RESEARCH 2019; 43:834-851. [PMID: 31551642 DOI: 10.1007/s10608-019-10016-z] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Executive function (EF) deficits have been proposed as transdiagnostic risk factors for psychopathology, and recent research suggests EF impairments are associated with what is shared across forms of psychopathology (p factor). However, most research has not employed methods that differentiate between EF components, and little is known about the mediating mechanisms linking EF and psychopathology dimensions. The current study tested associations between the latent unity/diversity model of EF and latent dimensions of psychopathology and investigated mediating mechanisms in a community sample of 292 youth age 13-22. The results confirmed the finding that poor EF is associated with internalizing psychopathology in older youth via higher dependent stress and rumination, and showed that this pathway was transdiagnostic, predicting the p factor rather than internalizing specifically. Links with psychopathology were specific to the common EF factor, rather than updating- or shifting-specific EF.
Collapse
Affiliation(s)
- Hannah R Snyder
- Department of Psychology, Brandeis University, Brown 125, 415 South St. Waltham, MA
| | - Naomi P Friedman
- Department of Psychology and Neuroscience and Institute for Behavioral Genetics, University of Colorado Boulder, 345 UCB, Boulder CO 80309
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E. Daniel Street, Champaign IL 61820
| |
Collapse
|
38
|
Fassett-Carman A, Hankin BL, Snyder HR. Appraisals of dependent stressor controllability and severity are associated with depression and anxiety symptoms in youth. ANXIETY, STRESS, AND COPING 2019; 32:32-49. [PMID: 30303017 PMCID: PMC6709974 DOI: 10.1080/10615806.2018.1532504] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Stress is well established as a strong risk factor for internalizing psychopathology. Learned helplessness research demonstrates that perceived controllability of stressors affects internalizing symptoms. Furthermore, subjective perceived stress is associated with psychopathology. However, most recent research has focused on measuring the frequency and expert-rated severity of stressful life events despite evidence for the importance of stress perceptions. The present study brings together past and current literatures to investigate the importance of perceived severity and controllability of recent life events in the association between stressors and internalizing symptoms. DESIGN AND METHODS We used a revised version of the Adolescent Life Events Questionnaire (ALEQ) that asked participants (ages 13-22, N = 328) to rate the frequency of 65 stressful events typical to youth, as well as the perceived stressfulness and control they felt over each event. Events were categorized prior to analysis as dependent (self-generated), independent (fateful) or neither. RESULTS Controllability and severity appraisals were associated with depression and anxiety symptoms, controlling for stressor frequency (which also predicted symptoms), for dependent but not independent stressors. CONCLUSIONS These results highlight the importance of controllability and severity appraisals as potential risk factors for internalizing disorders, exposing a potential target for therapy.
Collapse
Affiliation(s)
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
| | - Hannah R. Snyder
- Departments of Psychology and Neuroscience, Brandeis University, Waltham, USA
| |
Collapse
|
39
|
Moya-Higueras J, Cuevas A, Marques-Feixa L, Mezquita L, Mayoral M, Fañanás L, Ortet G, Ibáñez MI. Recent Stressful Life Events (SLE) and Adolescent Mental Health: Initial Validation of the LEIA, a New Checklist for SLE Assessment According to Their Severity, Interpersonal, and Dependent Nature. Assessment 2018; 27:1777-1795. [PMID: 30539643 DOI: 10.1177/1073191118817648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The main aim of the present study was to develop and validate a checklist for adolescents, the Life Events Inventory for Adolescents (LEIA), for screening stressful life events (SLEs) of different nature (major-minor, dependent-independent, and personal-interpersonal). The LEIA was administered together with another SLE checklist (Escala de Acontecimientos Vitales [Life Events Scale], EAV), and with measures of life satisfaction and externalizing and internalizing symptoms. The results showed that the kappa and the percentage agreement reliability indices were adequate. Regarding validity evidences, the correlations found between the LEIA and the EAV ranged from .65 to .69, and between the LEIA and the psychopathological symptoms ranged from .26 to .38. Specifically, major dependent noninterpersonal SLEs were the best predictors of externalizing psychopathology; while major independent noninterpersonal SLEs were the best predictors of internalizing symptoms and low life satisfaction. To conclude, the LEIA could be considered an adequate checklist to screen for SLEs in adolescents.
Collapse
Affiliation(s)
- Jorge Moya-Higueras
- Universitat de Lleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Laia Marques-Feixa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Laura Mezquita
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
| | - María Mayoral
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Lourdes Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Generós Ortet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
| | - Manuel I Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
| |
Collapse
|
40
|
Hudson CC, Shamblaw AL, Wilson GA, Roes MM, Sabbagh MA, Harkness KL. Theory of Mind, Excessive Reassurance-Seeking, and Stress Generation in Depression: A Social-Cognitive-Interpersonal Integration. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2018. [DOI: 10.1521/jscp.2018.37.9.725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: According to the interpersonal model of depression, individuals with depression engage in excessive reassurance-seeking (ERS) about others’ beliefs regarding their self-worth, which can ultimately result in interpersonal rejection. We present the novel hypothesis that maladaptive ERS behaviors in depression may be driven by difficulties with “theory of mind”—the foundational ability to decode and reason about others’ mental states. Method: Participants included 31 young adults in a current episode of a unipolar depressive disorder, and 91 never-depressed adults. Theory of mind was assessed with standard, objective laboratory tasks. Stressful life events were assessed with a gold-standard contextual interview and independent rating system. Results: Consistent with hypotheses, in the depressed group only, lower accuracy of theory of mind decoding was associated with greater ERS, which was significantly associated with exposure to greater interpersonal, but not non-interpersonal, stress. Surprisingly, higher accuracy of theory of mind reasoning was associated with greater ERS. Discussion: The intriguing dissociation is discussed in terms of expanding the interpersonal model of depression to include the foundational social cognitive processes that underlie effective social communication.
Collapse
|
41
|
Conway CC, Boudreaux M, Oltmanns TF. Dynamic associations between borderline personality disorder and stressful life events over five years in older adults. Personal Disord 2018; 9:521-529. [PMID: 29461847 PMCID: PMC6098988 DOI: 10.1037/per0000281] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The time course of borderline personality disorder (BPD) is far more variable than traditionally assumed. Shifting environmental conditions are theorized to account, at least in part, for fluctuations in symptom presentation over time. In the present study, we evaluated the reciprocal influences of stressful life events and borderline pathology in a representative community sample of 1,630 older adults assessed 3 times over 5 years. An autoregressive cross-lagged model revealed strong, but imperfect, stability in symptoms of BPD over the study time frame. After adjusting for this continuity in BPD, the prospective effect of life stress on borderline pathology was virtually nil, contrary to expectations. On the other hand, borderline pathology was prospectively related to subsequent dependent event (i.e., stressors to which individuals may have contributed), but not independent event (i.e., fateful stressors), exposure. This pattern of associations was consistent with a stress generation effect. We conclude that stressful life events do not substantially redirect the trajectory of BPD in older adults, possibly owing to inertia of borderline pathology at this developmental stage. Instead, symptoms of BPD seem to promote stress exposure, thereby setting the stage for continued social impairment and comorbid psychiatric problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Michael Boudreaux
- Department of Psychological and Brain Sciences, Washington University in St. Louis, MO, USA
| | - Thomas F. Oltmanns
- Department of Psychological and Brain Sciences, Washington University in St. Louis, MO, USA
| |
Collapse
|
42
|
Abstract
I have been given a priceless opportunity to reflect on my career in the remarkably productive field of risk factors for depression. Psychological research on depression exploded in the early years of my work. I try to give an account of the choices and challenges, and reflect on the influences, some calculated and some serendipitous, that determined the paths I have followed. I focus mostly on the robust depression risk factors that have influenced my research, including dysfunctional cognitions, stressful life events and circumstances, parental depression, interpersonal dysfunction, and being female, and I cover some of what I did but also the influential work of others. This is a selective review of depression research in the past 40 or so years, noting some of the big developments that set the stage for the remarkable activity that continues today. In the conclusion, there is a brief statement of aspirations for future developments in our field.
Collapse
Affiliation(s)
- Constance Hammen
- Department of Psychology, University of California, Los Angeles, California 90095, USA;
| |
Collapse
|
43
|
Vannucci A, Ohannessian CM, Flannery KM, De Los Reyes A, Liu S. Associations between friend conflict and affective states in the daily lives of adolescents. J Adolesc 2018; 65:155-166. [PMID: 29602158 DOI: 10.1016/j.adolescence.2018.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 02/06/2023]
Abstract
This study examined the associations between friend conflict, defined as arguments with friends, and affective states using a daily diary design in a community sample of adolescents. Participants were 100 U.S. adolescents (13-17 years; 40% girls; 79% white). Adolescents completed an online survey on 14 consecutive evenings. Adolescents reported significantly higher anger/hostility, confusion, and tension/anxiety and less friendliness on days during which they experienced friend conflict relative to no-conflict days. However, no same-day associations for depressed affect, fatigue, or vigor were found. Adolescents experiencing friend conflict reported increased next-day anger/hostility, depressed affect, and tension/anxiety, but not other affective states. Higher levels of anger/hostility and depressed affect predicted an increased likelihood of next-day friend conflict. Conversely, higher levels of friendliness and vigor predicted a decreased likelihood of next-day friend conflict. These findings suggest that directional relationships between adolescents' friend conflicts and their affective states vary by affective domain.
Collapse
Affiliation(s)
- Anna Vannucci
- Center for Behavioral Health, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA.
| | - Christine McCauley Ohannessian
- Center for Behavioral Health, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA; Department of Pediatrics and Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030, USA
| | - Kaitlin M Flannery
- Department of Psychology, State University of New York at Cortland, P.O. Box 2000, Cortland, NY 13045, USA
| | - Andres De Los Reyes
- Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA
| | - Songqi Liu
- Department of Managerial Sciences, J. Mack Robinson College of Business, Georgia State University, 35 Broad St. NE, Atlanta, GA 30303, USA
| |
Collapse
|
44
|
Co-Rumination Exacerbates Stress Generation among Adolescents with Depressive Symptoms. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:985-995. [PMID: 27624335 DOI: 10.1007/s10802-016-0205-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Through stress generation, individuals' own thoughts and behaviors can actually lead to increases in their experience of stress. Unfortunately, stress generation is especially common among individuals who are already suffering from elevated depressive symptoms. However, despite the acknowledgement that some individuals with depressive symptoms generate greater stress than others, few studies have identified specific factors that could exacerbate stress generation among individuals with depressive symptoms. The present study examines co-rumination as a factor that might exacerbate stress generation among adolescents with depressive symptoms using a short-term longitudinal design. Considering these processes among adolescents was critical given that many youth experience increases in depressive symptoms at this developmental stage and that co-rumination also becomes more common at adolescence. Participants were 628 adolescents (326 girls; 302 boys) who reported on their depressive symptoms, experiences of stress, and co-rumination with a best friend. Interpersonal stressors (peer and family stress) and non-interpersonal stressors (school and sports stress) were assessed. Consistent with past research, adolescents with depressive symptoms experienced greater interpersonal and non-interpersonal stress over time. Importantly, co-rumination interacted with both depressive symptoms and gender in predicting increases in peer stress. Depressive symptoms predicted the generation of peer stress only for girls who reported high levels of co-rumination with friends. Implications for protecting youth with depressive symptoms against stress generation are discussed.
Collapse
|
45
|
Shih JH, Barstead MG, Dianno N. Interpersonal predictors of stress generation: Is there a super factor? Br J Psychol 2017; 109:466-486. [PMID: 29226316 DOI: 10.1111/bjop.12278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/30/2017] [Indexed: 11/28/2022]
Abstract
Hammen's (1991, Journal of Abnormal Psychology, 100, 555-561) seminal paper on stress generation highlighted the reciprocal relationship between stress and depression. Not only does stress predict depression, but women with a diagnosis of depression also experienced subsequent increased levels of stress. In the ensuing years, depression researchers have moved beyond clinical predictors and examined whether depression vulnerability factors also contribute to stress generation. This interest has led to a growing focus on interpersonal vulnerability factors that contribute to stress generation. To date, the research examining interpersonal predictors of stress generation has tended to examine vulnerability factors singly and thus potential overlap and unique predictions among vulnerability factors have not been determined. This study examines interpersonal vulnerability factors from various schools of thought (dependency, attachment, and unmitigated communion) as predictors of interpersonal stress generation. Three hundred and sixty-four young adults completed baseline measures of interpersonal vulnerabilities and provided weekly reports of depressive symptoms and stressful life events. Multilevel models were estimated to examine their unique predictions of interpersonal stress generation. Despite converging theories, there does not appear to be a single super factor. Of the interpersonal vulnerability factors tested, anxious attachment emerged as a consistent predictor of interpersonal stress generation both when examined singly and when in combination with related variables.
Collapse
Affiliation(s)
- Josephine H Shih
- Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA
| | | | - Nicole Dianno
- Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
46
|
van de Pavert I, Sunderland M, Luijten M, Slade T, Teesson M. The general relationship between internalizing psychopathology and chronic physical health conditions: a population-based study. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1257-1265. [PMID: 28744565 DOI: 10.1007/s00127-017-1422-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/14/2017] [Indexed: 11/25/2022]
Abstract
Studies have consistently demonstrated a reciprocal relationship between internalizing disorders and several chronic physical health conditions. Yet, much of the extant literature fails to take into account the role of comorbidity among internalizing disorders when examining the relationship with poor physical health. The current study applied latent variable modelling to investigate the shared and specific relationships between internalizing (fear and distress factors) and a range of physical health conditions. Data comprised 8841 respondents aged 16-85 years who took part in the 2007 Australian National Survey of Mental Health and Wellbeing. Multiple indicator, multiple causes models were used to parse the shared and specific relationships between internalizing disorders and variables associated with poor physical health. The study found that several physical conditions were significantly related to mean levels of fear and distress. The results were broadly similar but minor differences emerged depending on whether lifetime or past 12 months indicators of mental disorders and physical conditions were utilized in the model. Finally, the results demonstrated that the association between individual mental disorders and physical health conditions are better accounted for by indirect relationships with broad transdiagnostic dimensions rather than including additional disorder-specific relationships. The results indicate that researchers should focus on common mechanisms across multiple internalizing disorders and poor physical health when developing prevention and treatment initiatives.
Collapse
Affiliation(s)
- Iris van de Pavert
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Matthew Sunderland
- Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052, Australia.
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Tim Slade
- Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052, Australia
| | - Maree Teesson
- Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052, Australia
| |
Collapse
|
47
|
Meyer AE, Curry JF. Pathways from anxiety to stressful events: An expansion of the stress generation hypothesis. Clin Psychol Rev 2017; 57:93-116. [PMID: 28865244 DOI: 10.1016/j.cpr.2017.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/05/2017] [Accepted: 08/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - John F Curry
- Duke University, United States; Duke University Medical Center, United States
| |
Collapse
|
48
|
Dworkin ER, Menon SV, Bystrynski J, Allen NE. Sexual assault victimization and psychopathology: A review and meta-analysis. Clin Psychol Rev 2017; 56:65-81. [PMID: 28689071 PMCID: PMC5576571 DOI: 10.1016/j.cpr.2017.06.002] [Citation(s) in RCA: 340] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/22/2017] [Accepted: 06/18/2017] [Indexed: 01/18/2023]
Abstract
Sexual assault (SA) is a common and deleterious form of trauma. Over 40years of research on its impact has suggested that SA has particularly severe effects on a variety of forms of psychopathology, and has highlighted unique aspects of SA as a form of trauma that contribute to these outcomes. The goal of this meta-analytic review was to synthesize the empirical literature from 1970 to 2014 (reflecting 497 effect sizes) to understand the degree to which (a) SA confers general risk for psychological dysfunction rather than specific risk for posttraumatic stress, and (b) differences in studies and samples account for variation in observed effects. Results indicate that people who have been sexually assaulted report significantly worse psychopathology than unassaulted comparisons (average Hedges' g=0.61). SA was associated with increased risk for all forms of psychopathology assessed, and relatively stronger associations were observed for posttraumatic stress and suicidality. Effects endured across differences in sample demographics. The use of broader SA operationalizations (e.g., including incapacitated, coerced, or nonpenetrative SA) was not associated with differences in effects, although including attempted SA in operationalizations resulted in lower effects. Larger effects were observed in samples with more assaults involving stranger perpetrators, weapons, or physical injury. In the context of the broader literature, our findings provide evidence that experiencing SA is major risk factor for multiple forms of psychological dysfunction across populations and assault types.
Collapse
|
49
|
Hamilton JL, Burke TA, Stange JP, Kleiman EM, Rubenstein LM, Scopelliti KA, Abramson LY, Alloy LB. Trait Affect, Emotion Regulation, and the Generation of Negative and Positive Interpersonal Events. Behav Ther 2017; 48:435-447. [PMID: 28577581 PMCID: PMC5600285 DOI: 10.1016/j.beth.2017.01.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 01/26/2017] [Accepted: 01/31/2017] [Indexed: 01/27/2023]
Abstract
Positive and negative trait affect and emotion regulatory strategies have received considerable attention in the literature as predictors of psychopathology. However, it remains unclear whether individuals' trait affect is associated with responses to state positive affect (positive rumination and dampening) or negative affect (ruminative brooding), or whether these affective experiences contribute to negative or positive interpersonal event generation. Among 304 late adolescents, path analyses indicated that individuals with higher trait negative affect utilized dampening and brooding rumination responses, whereas those with higher trait positive affect engaged in rumination on positive affect. Further, there were indirect relationships between trait negative affect and fewer positive and negative interpersonal events via dampening, and between trait positive affect and greater positive and negative interpersonal events via positive rumination. These findings suggest that individuals' trait negative and positive affect may be associated with increased utilization of emotion regulation strategies for managing these affects, which may contribute to the occurrence of positive and negative events in interpersonal relationships.
Collapse
Affiliation(s)
- Jessica L. Hamilton
- Department of Psychology, Temple University, 1701 N. 17th St., Philadelphia PA 19122
| | - Taylor A. Burke
- Department of Psychology, Temple University, 1701 N. 17th St., Philadelphia PA 19122
| | - Jonathan P. Stange
- Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL 60612
| | - Evan M. Kleiman
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138
| | - Liza M. Rubenstein
- Department of Psychology, Temple University, 1701 N. 17th St., Philadelphia PA 19122
| | - Kate A. Scopelliti
- Department of Psychology, Temple University, 1701 N. 17th St., Philadelphia PA 19122
| | - Lyn Y. Abramson
- Department of Psychology, University of Wisconsin-Madison, 1202 West Johnson St., Madison, WI 53706
| | - Lauren B. Alloy
- Department of Psychology, Temple University, 1701 N. 17th St., Philadelphia PA 19122
| |
Collapse
|
50
|
Snyder HR, Young JF, Hankin BL. Chronic Stress Exposure and Generation Are Related to the P-Factor and Externalizing Specific Psychopathology in Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 48:306-315. [PMID: 28541762 DOI: 10.1080/15374416.2017.1321002] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Psychopathology is posited to be transdiagnostically linked to chronic stress. Yet efforts to understand the specificity and directionality of these links have been sparse, and the ubiquitous comorbidity of psychopathology has made the seemingly nonspecific links between psychological disorders and chronic stress difficult to interpret. The current study used a latent dimensional bifactor model of psychopathology to account for comorbidity and a multiwave prospective design to disentangle temporal associations between psychopathology and chronic stress longitudinally during the critical adolescent period for psychopathology risk and stress reactivity. A community sample of 567 youth (55.5% female, age M = 11.8 at baseline, M = 15.1 at end of study) were followed prospectively for 3 years, with chronic stress assessed with the Youth Life Stress Interview and psychopathology symptoms assessed via both self and parent report. Exposure to chronic stress predicted what is common across forms of psychopathology (the p factor), which in turn predicted generation of chronic stress over time. After accounting for comorbidity via the p factor, externalizing behaviors also had specific transactional links to chronic stress, whereas links between internalizing psychopathology and chronic stress were completely accounted for by common psychopathology. The results provide the first direct evidence that chronic stress is transdiagnostically and reciprocally linked to psychopathology, during a critical youth period for psychopathology onset and stress reactivity.
Collapse
Affiliation(s)
| | - Jami F Young
- b Graduate School of Applied and Professional Psychology , Rutgers University
| | - Benjamin L Hankin
- c Department of Psychology , University of Illinois Urbana-Champaign
| |
Collapse
|