Depressive and socially anxious symptoms, psychosocial maturity, and risk perception: Associations with risk-taking behaviour

Risk avoidance and social anxiety in adolescence: Examination of event-related potentials and theta-dynamics on the Balloon Risk Avoidance Task

Adolescents are at relatively high-risk for developing anxiety, particularly social anxiety. A primary hallmark of social anxiety is the impulse to avoid situations that introduce risk. Here, we examined the neural and behavioral correlates of risk avoidance in adolescents (N=59) 11 to 19 years of age. The Balloon Risk Avoidance Task was used with concurrent electroencephalography to measure event-related potentials (frontal P2; late slow-wave; N2, feedback-related negativity, FRN; posterior P3) and oscillatory dynamics (midfrontal theta, 4-7 Hz) in response to unsuccessful and successful risk avoidance conditions. Social anxiety was measured using the Social Phobia and Anxiety Inventory for Children. Results indicated that, across the whole sample, youth exhibited smaller P3, larger FRN, and larger theta responses to unsuccessful risk avoidance. Youth reporting high (compared to low) levels of social anxiety exhibited larger P2, slow-wave, and FRN responses to unsuccessful, compared to successful, risk avoidance. Further, greater social anxiety was associated with reduced theta responses to successful avoidance. Youth with higher levels of social anxiety showed smaller theta responses to both conditions compared to those with low levels of social anxiety. Taken together, the ERP-component differences and weakened theta power in socially anxious youth following unsuccessful avoidance are informative neural correlates for socially anxious youth during risk avoidance.

The mediating effect of maturity on anxiety and the motives for postponing parenthood

Postponed parenthood is considered one of the most extensive changes in the process of family formation. Among the many reasons for deferred parenthood, those related to greater feelings of incompetence as a potential parent, self-focus, perceiving parenthood as a burden, fearing the changes that the birth of a child may bring to a person's life, financial insecurity, and worrying about the child's future seem particularly important. Since little is known about the motives for delayed parenthood in relation to anxiety and psychological maturity, the main goal of our study was to verify how these variables may be related to each other and whether maturity for parenthood mediates the direct association between anxiety and the motives for delayed parenthood. The sample consisted of 223 Polish adults (the age range of the participants was 18-44 years). The respondents completed the State-Trait Anxiety Inventory (STAI), the Maturity to Parenthood Scale (MPS), and the Multidimensional Scale of Motives for Postponing Parenthood (MSMPP-18). The results showed positive correlations between anxiety and four (uncertainty, burden, change, and finance) of the six motives for postponing parenthood and postponed parenthood overall. Maturity for parenting and all its dimensions correlated negatively with anxiety and all factors of postponed parenthood, except worry about the child's future. In all six of the seven models (except "worry"), at least one of the factors of maturity to parenthood mediated the relationship between trait anxiety and motives for postponing parenthood/total score. Based on the results it can be assumed that a tendency to direct attention to a threat related to the context of child-bearing and child-rearing may lead to lower maturity to parenthood, which in turn may result in various motives for postponing parenthood.

Psychosocial risk and protective factors for youth problem behavior are associated with food addiction in the Generation Z

Objective

Food Addiction (FA) and other well-known risk behavior as substance misuse tend to co-occur and may share similar risk and protective factors. The aim of this study was to assess the association between the diagnosis/severity of FA and psychosocial domains typically related to risk behavior syndrome in a large, nationally representative community sample of Generation Z underage Italian students.

Method

The sample consisted of 8,755 students (3,623 from middle schools, 5,132 from high schools). A short version of the Yale Food Addiction Scale 2.0 was administered to evaluate FA. Risk and protective factors related to demographic, personality, behavior, and family variables were examined. Stepwise multivariate logistic and linear regressions were conducted.

Results

The prevalence of FA was 30.8%. Female gender, social anxiety and depression symptoms, social withdrawal risk, Internet gaming disorder, social media addiction, current substance use, social challenge engagement and experienced doxing boosted the chance of FA diagnosis, whereas eating fruit and vegetables, playing competitive sports and an average sleep duration of 7-8 h per night reduced these odds. FA severity was significantly and positively associated with trait impulsiveness, social anxiety and depressive symptoms, risk of social withdrawal, recent substance use, social media, and gaming addiction, doxing suffered and risky social challenges participation. Negative associations between the severity of FA and fruit and vegetable diet habits were found.

Conclusion

Our findings confirm that FA is widespread among Italian adolescents. The associations between the diagnosis and severity of FA and psychosocial risk factors for health, including, addictive and deviant behaviors related to digital misuse, suggest its belonging to the risk behavior constellation. Health promotion schemes based on a multicomponent strategy of intervention should consider the inclusion of FA and its psychosocial correlates.

Effects of systemic oxytocin receptor activation and blockade on risky decision making in female and male rats

The neuropeptide oxytocin is traditionally known for its roles in parturition, lactation, and social behavior. Other data, however, show that oxytocin can modulate behaviors outside of these contexts, including drug self-administration and some aspects of cost-benefit decision making. Here we used a pharmacological approach to investigate the contributions of oxytocin signaling to decision making under risk of explicit punishment. Female and male Long-Evans rats were trained on a risky decision-making task in which they chose between a small, "safe" food reward and a large, "risky" food reward that was accompanied by varying probabilities of mild footshock. Once stable choice behavior emerged, rats were tested in the task following acute intraperitoneal injections of oxytocin or the oxytocin receptor antagonist L-368,899. Neither drug affected task performance in males. In females, however, both oxytocin and L-368,899 caused a dose-dependent reduction in preference for large risky reward. Control experiments showed that these effects could not be accounted for by alterations in food motivation or shock sensitivity. Together, these results reveal a sex-dependent effect of oxytocin signaling on risky decision making in rats.

The genetic architecture of youth anxiety: a study protocol

BACKGROUND

Anxiety disorders are the most common psychiatric problems among Canadian youth and typically have an onset in childhood or adolescence. They are characterized by high rates of relapse and chronicity, often resulting in substantial impairment across the lifespan. Genetic factors play an important role in the vulnerability toward anxiety disorders. However, genetic contribution to anxiety in youth is not well understood and can change across developmental stages. Large-scale genetic studies of youth are needed with detailed assessments of symptoms of anxiety disorders and their major comorbidities to inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care.

METHODS

The Genetic Architecture of Youth Anxiety (GAYA) study is a Pan-Canadian effort of clinical and genetic experts with specific recruitment sites in Calgary, Halifax, Hamilton, Toronto, and Vancouver. Youth aged 10-19 (n = 13,000) will be recruited from both clinical and community settings and will provide saliva samples, complete online questionnaires on demographics, symptoms of mental health concerns, and behavioural inhibition, and complete neurocognitive tasks. A subset of youth will be offered access to a self-managed Internet-based cognitive behavioral therapy resource. Analyses will focus on the identification of novel genetic risk loci for anxiety disorders in youth and assess how much of the genetic risk for anxiety disorders is unique or shared across the life span.

DISCUSSION

Results will substantially inform early intervention or preventative strategies and suggest novel targets for therapeutics and personalization of care. Given that the GAYA study will be the biggest genomic study of anxiety disorders in youth in Canada, this project will further foster collaborations nationally and across the world.

Effects of reproductive experience on cost-benefit decision making in female rats

Many individuals undergo mating and/or other aspects of reproductive experience at some point in their lives, and pregnancy and childbirth in particular are associated with alterations in the prevalence of several psychiatric disorders. Research in rodents shows that maternal experience affects spatial learning and other aspects of hippocampal function. In contrast, there has been little work in animal models concerning how reproductive experience affects cost-benefit decision making, despite the relevance of this aspect of cognition for psychiatric disorders. To begin to address this issue, reproductively experienced (RE) and reproductively naïve (RN) female Long-Evans rats were tested across multiple tasks that assess different forms of cost-benefit decision making. In a risky decision-making task, in which rats chose between a small, safe food reward and a large food reward accompanied by variable probabilities of punishment, RE females chose the large risky reward significantly more frequently than RN females (greater risk taking). In an intertemporal choice task, in which rats chose between a small, immediate food reward and a large food reward delivered after a variable delay period, RE females chose the large reward less frequently than RN females. Together, these results show distinct effects of reproductive experience on different forms of cost-benefit decision making in female rats, and highlight reproductive status as a variable that could influence aspects of cognition relevant for psychiatric disorders.

A Mixed-Methods Approach to Refining and Measuring the Construct of Positive Risk-Taking in Adolescence

Adolescence is a peak period for risk-taking, but research has largely overlooked positive manifestations of adolescent risk-taking due to ambiguity regarding operationalization and measurement of positive risk-taking. We address this limitation using a mixed-methods approach. We elicited free responses from contemporary college students (N = 74, Mage  = 20.1 years) describing a time they took a risk. Qualitative analysis informed the construction of a self-report positive risk-taking scale, which was administered to a population-based sample of adolescents (N = 1,249, Mage  = 16 years) for quantitative validation and examination of associations with normative and impulsive personality. Sensation seeking predicted negative and positive risk-taking, whereas extraversion and openness were predominantly related to positive risk-taking. Results provide promising evidence for a valid measure of adolescents' engagement in positive risks.

Mental and Physical Health, Psychosocial Maturity, and Desistance in Young Adulthood

Recent theoretical and empirical work has drawn increased attention to the role that mental and physical health can play in promoting life-course success and desistance from crime. This study integrates literature on youth development with the health-based desistance framework to investigate a key developmental pathway through which health influences desistance among system-involved youth. Using multiple waves of data from the Pathways to Desistance Study, the current study uses generalized structural equation modeling to examine whether and to what extent mental and physical health influence offending and substance use directly and indirectly through psychosocial maturity. Findings indicate that both depression and poor health stall the development of psychosocial maturity, and that those with higher psychosocial maturity are less likely to engage in offending and substance use. The model provides general support for the health-based desistance framework, finding an indirect process linking better health states to normative developmental desistance processes. Results hold important implications for the development of age-graded policies and programs geared toward promoting desistance among serious adolescent offenders both within correctional and community settings.

The Genetic and Neural Substrates of Externalizing Behavior

Background

To gain more insight into the biological factors that mediate vulnerability to display externalizing behaviors, we leveraged genome-wide association study summary statistics on 13 externalizing phenotypes.

Methods

After data classification based on genetic resemblance, we performed multivariate genome-wide association meta-analyses and conducted extensive bioinformatic analyses, including genetic correlation assessment with other traits, Mendelian randomization, and gene set and gene expression analyses.

Results

The genetic data could be categorized into disruptive behavior (DB) and risk-taking behavior (RTB) factors, and subsequent genome-wide association meta-analyses provided association statistics for DB and RTB (N _eff = 523,150 and 1,506,537, respectively), yielding 50 and 257 independent genetic signals. The statistics of DB, much more than RTB, signaled genetic predisposition to adverse cognitive, mental health, and personality outcomes. We found evidence for bidirectional causal influences between DB and substance use behaviors. Gene set analyses implicated contributions of neuronal cell development (DB/RTB) and synapse formation and transcription (RTB) mechanisms. Gene-brain mapping confirmed involvement of the amygdala and hypothalamus and highlighted other candidate regions (cerebellar dentate, cuneiform nucleus, claustrum, paracentral cortex). At the cell-type level, we noted enrichment of glutamatergic neurons for DB and RTB.

Conclusions

This bottom-up, data-driven study provides new insights into the genetic signals of externalizing behaviors and indicates that commonalities in genetic architecture contribute to the frequent co-occurrence of different DBs and different RTBs, respectively. Bioinformatic analyses supported the DB versus RTB categorization and indicated relevant biological mechanisms. Generally similar gene-brain mappings indicate that neuroanatomical differences, if any, escaped the resolution of our methods.

Adolescents' adherence to Centers for Disease Control and Prevention guidelines during the COVID-19 pandemic

BACKGROUND

The outbreak of the coronavirus (COVID-19) pandemic in the United States resulted in safety guidelines from the Centers for Disease Control and Prevention (CDC) intended to curb the spread of the virus. Adolescents are potentially at risk for disregarding these guidelines due to their reduced psychosocial maturity compared with adults. The current study examined the relationship between adolescents' psychosocial maturity, perceived importance of the CDC guidelines and adherence to the CDC guidelines within some of the highest risk groups for contracting COVID-19 in a county particularly impacted by the pandemic (i.e., Hispanic and low-SES youth in El Paso, Texas).

METHODS

Participants completed a phone interview with a research assistant regarding their thoughts and behaviours in the initial months of the COVID-19 pandemic. Adolescents (N = 68) were 15.38 years old on average (SD = 1.05, range = 13, 17), predominantly male (60.3%) and nearly exclusively Hispanic/Latino (94.1%).

RESULTS

Results indicated that although more psychosocially mature adolescents reported greater adherence to the CDC guidelines than less psychosocially mature adolescents, the association between psychosocial maturity and adherence was fully mediated by how important adolescents felt it was to follow the guidelines. Specifically, greater perceived importance was associated with greater adherence to the guidelines.

CONCLUSIONS

The current study found that more psychosocially mature adolescents adhere to CDC's safety guidelines better than less psychosocially mature adolescents because they are more likely to view the guidelines as important. Information that attempts to increase adolescent adherence to the guidelines should therefore emphasize not only that following the guidelines is important, but why following the guidelines is so important. Less psychosocially mature adolescents may benefit most from interventions efforts and targeted messages regarding the importance of following the CDC's guidelines, as more psychosocially mature adolescents already recognize this importance.

The Association of Anxiety Severity With Health Risk Behaviors in a Large Representative Sample of Korean Adolescents

Objectives

Anxiety disorders are the most common psychiatric disorders in adolescents and seem to occur the earliest among all forms of psychopathology. The aim of this study was to investigate the association of anxiety severity with health risk behaviors and mental health in adolescents.

Methods

Data from the 2020 Korean Youth Risk Behavior Web-Based Survey were analyzed. A total of 54948 adolescents responded to the 7-item Generalized Anxiety Disorder Scale (GAD-7) for the assessment of their anxiety severity as well as to the mental health and health risk behavior survey. Logistic regression analysis, t tests, and variance analysis of a complex sample general linear model were used to examine the association of anxiety severity with health behaviors and mental health.

Results

After statistical adjustment for sociodemographic characteristics, the subjects in the severe anxiety group were significantly more likely to be current smokers (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.72-2.50), current drinkers (OR: 1.91, 95% CI: 1.67-2.19), experience habitual substance use (OR: 10.89, 95% CI: 8.22-14.42), have sexual intercourse (OR: 2.10, 95% CI: 1.76-2.51), and have unprotected intercourse (OR: 2.21, 95% CI: 1.67-2.92) than those in the normal group. Anxiety severity negatively correlated with sleep satisfaction and happiness, but positively correlated with stress perception, loneliness, depressive symptoms, and suicidality.

Conclusion

Adolescent anxiety is associated with health risk behaviors and poor mental health. Thus, early screening and intervention for anxiety in adolescents could contribute to the management and coping of youth health risk behaviors in the community.

Executive and Daily Life Functioning Influence the Relationship Between ADHD and Mood Symptoms in University Students

Objectives: Many studies have indicated a close relationship between ADHD and mood symptoms in university students. In the present study, we explore the role of daily functional impairments and executive functioning in the ADHD-mood relationship. Method: A total of 343 adults (126 males) filled out (a) the Conners' Adult ADHD Rating Scale, (b) the Depression Anxiety and Stress Scale, (c) the Weiss Functional Impairment Rating Scale, and (d) the Executive Function Index Scale. Results: The correlation between mood symptoms and ADHD was .48 (moderate correlation) and dropped to .15 (weak correlation) when controlling for functional problems and executive functioning. Hierarchical regression analyses showed that both functional impairments and executive functioning significantly explained 42% to 53% of the variance of mood symptoms. The addition of ADHD symptoms to the model slightly increased the explained mood variance by only 1%. Conclusion: These findings underline the role of experienced difficulties in triggering mood symptoms in ADHD symptomatology.

School-based interventions to prevent anxiety, depression and conduct disorder in children and young people: a systematic review and network meta-analysis

Background

Schools in the UK increasingly have to respond to anxiety, depression and conduct disorder as key causes of morbidity in children and young people.

Objective

The objective was to assess the comparative effectiveness of educational setting-based interventions for the prevention of anxiety, depression and conduct disorder in children and young people.

Design

This study comprised a systematic review, a network meta-analysis and an economic evaluation.

Data sources

The databases MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), PsycInfo® (American Psychological Association, Washington, DC, USA) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to 4 April 2018, and the NHS Economic Evaluation Database (NHS EED) was searched on 22 May 2019 for economic evaluations. No language or date filters were applied.

Main outcomes

The main outcomes were post-intervention self-reported anxiety, depression or conduct disorder symptoms.

Review methods

Randomised/quasi-randomised trials of universal or targeted interventions for the prevention of anxiety, depression or conduct disorder in children and young people aged 4–18 years were included. Screening was conducted independently by two reviewers. Data extraction was conducted by one reviewer and checked by a second. Intervention- and component-level network meta-analyses were conducted in OpenBUGS. A review of the economic literature and a cost–consequence analysis were conducted.

Results

A total of 142 studies were included in the review, and 109 contributed to the network meta-analysis. Of the 109 studies, 57 were rated as having an unclear risk of bias for random sequence generation and allocation concealment. Heterogeneity was moderate. In universal secondary school settings, mindfulness/relaxation interventions [standardised mean difference (SMD) –0.65, 95% credible interval (CrI) –1.14 to –0.19] and cognitive–behavioural interventions (SMD –0.15, 95% CrI –0.34 to 0.04) may be effective for anxiety. Cognitive–behavioural interventions incorporating a psychoeducation component may be effective (SMD –0.30, 95% CrI –0.59 to –0.01) at preventing anxiety immediately post intervention. There was evidence that exercise was effective in preventing anxiety in targeted secondary school settings (SMD –0.47, 95% CrI –0.86 to –0.09). There was weak evidence that cognitive–behavioural interventions may prevent anxiety in universal (SMD –0.07, 95% CrI –0.23 to 0.05) and targeted (SMD –0.38, 95% CrI –0.84 to 0.07) primary school settings. There was weak evidence that cognitive–behavioural (SMD –0.04, 95% CrI –0.16 to 0.07) and cognitive–behavioural + interpersonal therapy (SMD –0.18, 95% CrI –0.46 to 0.08) may be effective in preventing depression in universal secondary school settings. Third-wave (SMD –0.35, 95% CrI –0.70 to 0.00) and cognitive–behavioural interventions (SMD –0.11, 95% CrI –0.28 to 0.05) incorporating a psychoeducation component may be effective at preventing depression immediately post intervention. There was no evidence of intervention effectiveness in targeted secondary, targeted primary or universal primary school settings post intervention. The results for university settings were unreliable because of inconsistency in the network meta-analysis. A narrative summary was reported for five conduct disorder prevention studies, all in primary school settings. None reported the primary outcome at the primary post-intervention time point. The economic evidence review reported heterogeneous findings from six studies. Taking the perspective of a single school budget and based on cognitive–behavioural therapy intervention costs in universal secondary school settings, the cost–consequence analysis estimated an intervention cost of £43 per student.

Limitations

The emphasis on disorder-specific prevention excluded broader mental health interventions and restricted the number of eligible conduct disorder prevention studies. Restricting the study to interventions delivered in the educational setting may have limited the number of eligible university-level interventions.

Conclusions

There was weak evidence of the effectiveness of school-based, disorder-specific prevention interventions, although effects were modest and the evidence not robust. Cognitive–behavioural therapy-based interventions may be more effective if they include a psychoeducation component.

Future work

Future trials for prevention of anxiety and depression should evaluate cognitive–behavioural interventions with and without a psychoeducation component, and include mindfulness/relaxation or exercise comparators, with sufficient follow-up. Cost implications must be adequately measured.

Study registration

This study is registered as PROSPERO CRD42016048184.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 8. See the NIHR Journals Library website for further project information.

Brain and Behavior Correlates of Risk Taking in Pediatric Anxiety Disorders

Avoidant behavior is a defining feature of pediatric anxiety disorders. Although prior research has examined it from the perspective of early information processing events, there has been relatively less consideration of the processes by which anxious youth make avoidant decisions and how these choices are reinforced over time. Studies of risk taking are valuable in this regard because they consider how individuals identify the pros and cons of their choices, how they weigh potential gains and losses and estimate their respective probabilities, and how they tolerate the uncertainty intrinsic to any decision. In this review, we place risk taking within existing models of information processing in pediatric anxiety disorders and highlight the particular value of this construct for informing models of developmental psychopathology and individual differences in outcome over time. We review existing behavioral and neurobiological studies of risk taking in anxious youth and conclude by identifying directions for future research.