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Richardson CE, Magson NR, Oar EL, Fardouly J, Johnco CJ, Freeman JYA, Rapee RM. A longitudinal investigation of sleep hygiene as a mediator linking parental warmth with adolescent sleep. Sleep 2023; 46:zsac267. [PMID: 36346339 PMCID: PMC10334483 DOI: 10.1093/sleep/zsac267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/02/2022] [Indexed: 07/20/2023] Open
Abstract
STUDY OBJECTIVES Parental warmth in adolescence protects sleep in early adulthood, yet the nature, directions, and mechanisms of this association across adolescence are unknown. This study examined parental warmth, adolescent sleep hygiene and sleep outcomes (morning/eveningness, school night sleep duration, and daytime sleepiness) across five annual waves, spanning four years, using a cross-lagged panel design. METHODS Adolescents and one primary caregiver (96% mothers) completed questionnaires assessing parental warmth (child- and parent-report) and adolescent sleep hygiene and sleep (child-report), across five annual waves: Wave 1 (N = 531, Mage = 11.18, SD = 0.56, 51% male), Wave 2 (N = 504, Mage = 12.19, SD = 0.53, 52% male), Wave 3 (N = 478, Mage = 13.19, SD = 0.53, 52% male), Wave 4 (N = 440, Mage = 14.76, SD = 0.47, 51% male), and Wave 5 (N = 422, Mage = 15.75, SD = 0.49, 51% male). RESULTS Greater child-reported parental warmth was indirectly associated with better adolescent sleep (greater morningness, longer school night sleep duration, less sleepiness) through healthier sleep hygiene. The inverse was also often observed. Warmth had a direct relationship with sleep duration and sleepiness, independent of sleep hygiene. Parent-reported parental warmth did not predict, nor was predicted by child-reported adolescent sleep. CONCLUSIONS Parental warmth may protect against developmental changes in adolescent sleep, partially by improving sleep hygiene practices. Similarly, inadequate adolescent sleep may negatively impact parental warmth via deteriorating sleep hygiene. Sleep hygiene emerged as a key mechanism for protecting adolescent sleep and parent-child relationships.
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Affiliation(s)
- Cele E Richardson
- Corresponding author: Cele Richardson, University of Western Australia, M304, 35 Stirling Highway, Perth, WA 6009, Australa.
| | - Natasha R Magson
- 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
| | - Jasmine Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- Department of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Carly J Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Justin Y A Freeman
- 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
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Bartlett GR, Magson NM, Richardson CE, Rapee RM, Fardouly J, Oar EL. The meditating role of sleep in the longitudinal associations between peer victimization and internalizing symptoms: A cross-lagged panel analysis. Dev Psychopathol 2023:1-15. [PMID: 36855808 DOI: 10.1017/s0954579423000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Adolescence is a time of heightened vulnerability for both peer victimization (PV) and internalizing symptoms. While the positive association between them is well established, there is little understanding of the mechanisms underpinning this relationship. To address this gap, the current study aimed to investigate sleep hygiene and school night sleep duration as individual and sequential mediators of the relationship between PV and both depressive and social anxiety symptoms during pre- to mid-adolescence. The study drew upon a community sample of 528 Australian youth aged 10-12 years at baseline (M age = 11.19, SD = .55; 51.1% boys) and data were collected over five annual measurement occasions. Direct and indirect longitudinal and bidirectional associations were examined using cross-lagged panel analysis. There was no evidence of sequential mediation through both sleep hygiene and sleep duration to depression and social anxiety. Instead, the findings show that sleep hygiene mediated the prospective association between PV and both depressive and social anxiety symptoms, and between PV and sleep duration. Overall, sleep hygiene represents a modifiable transdiagnostic factor that can be targeted to break the cycle of PV, inadequate sleep, and internalizing symptoms.
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Affiliation(s)
- Gillian R Bartlett
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natasha M Magson
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
| | - Cele E Richardson
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
- School of Psychological Science, Centre for Sleep Science, University of Western Australia, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
- School of Psychology, University of New South Wales, Australia
| | - Ella L Oar
- Centre for Emotional Health, Macquarie University, Sydney, NSW, 2109, Australia
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Rapee RM, Magson NR, Forbes MK, Richardson CE, Johnco CJ, Oar EL, Fardouly J. Risk for social anxiety in early adolescence: Longitudinal impact of pubertal development, appearance comparisons, and peer connections. Behav Res Ther 2022; 154:104126. [DOI: 10.1016/j.brat.2022.104126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/11/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
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Oar EL, Johnco CJ, Waters AM, Fardouly J, Forbes MK, Magson NR, Richardson CE, Rapee RM. Eye-tracking to assess anxiety-related attentional biases among a large sample of preadolescent children. Behav Res Ther 2022; 153:104079. [PMID: 35395478 DOI: 10.1016/j.brat.2022.104079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 01/20/2022] [Accepted: 03/12/2022] [Indexed: 11/02/2022]
Abstract
A considerable body of research in adults has demonstrated that anxiety disorders are characterised by attentional biases to threat. Findings in children have been inconsistent. The present study examined anxiety-related attention biases using eye tracking methodology in 463 preadolescents between 10 and 12 years of age, of whom 92 met criteria for a DSM-5 anxiety disorder and 371 did not. Preadolescent's gaze was recorded while they viewed adolescent face pairs depicting angry-neutral and happy-neutral expressions with each face pair presented for 5000 ms. No group differences were observed across any eye tracking indices including probability of first fixation direction, latency to first fixation, first fixation duration and dwell time. The sample overall showed faster initial attention towards threat cues, followed by a later broadening of attention away from threat. There is a need to identify the types of threats and the developmental period during which visual attention patterns of anxious and non-anxious youth diverge to inform more developmentally sensitive treatments.
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Affiliation(s)
- Ella L Oar
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Carly J Johnco
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD, 4122, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, 2109, Australia; School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | - Miriam K Forbes
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natasha R Magson
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Cele E Richardson
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, 2109, Australia; School of Psychological Science, Centre for Sleep Science, University of Western Australia, Perth, WA, 6009, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, 2109, Australia
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Visvalingam S, Crone C, Street S, Oar EL, Gilchrist P, Norberg MM. The causes and consequences of shame in obsessive-compulsive disorder. Behav Res Ther 2022; 151:104064. [DOI: 10.1016/j.brat.2022.104064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 11/02/2022]
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Johnco CJ, Magson NR, Fardouly J, Oar EL, Forbes MK, Richardson C, Rapee RM. The role of parenting behaviors in the bidirectional and intergenerational transmission of depression and anxiety between parents and early adolescent youth. Depress Anxiety 2021; 38:1256-1266. [PMID: 34255922 DOI: 10.1002/da.23197] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 06/18/2021] [Accepted: 06/25/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Parenting is a modifiable factor proposed to underpin the transmission of anxiety and depression from parents to children. This study examined the role of parenting in the intergenerational transmission of anxiety and depression across pre- and early adolescence. METHOD Participants were 531 youth (Mage = 11.18, SD = 0.56; 50.85% boys) and their parent. Child and parent anxiety and depression, and parental rejection, warmth and overprotection were assessed annually over 3 years. Bidirectional relationships between parent and child anxiety and depression, and the mediating role of parenting behaviors, were examined using cross-lagged panel models. RESULTS Results suggest bidirectional associations over time between parent and child depression, and parental rejection and child depression. Parental rejection and low warmth were associated with increases in child depression, but did not mediate depression transmission. Parental anxiety was associated with increases in child anxiety and depression, but there was no bidirectional association from child psychopathology to parental anxiety. There was little evidence that parenting predicted changes in child anxiety over time. Child anxiety and depression were associated with subsequent increases in parental depression. CONCLUSION Parental depression, rejection and low warmth are independent risk factors for child depression. Parental rejection may also be a consequence of parenting a depressed youth. Parenting did not account for the apparent transmission of parental anxiety to increased child anxiety and depression. Child psychopathology increases risk of parental depression. Parental rejection may be an important modifiable risk factor for youth depression in early adolescence, and may also reduce later risk of parent depression.
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Affiliation(s)
- Carly J Johnco
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Natasha R Magson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Jasmine Fardouly
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Ella L Oar
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Miriam K Forbes
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Cele Richardson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia.,School of Psychological Science, Centre for Sleep Science, University of Western Australia, Perth, Western Australia, Australia
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
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Magson NR, Freeman JYA, Rapee RM, Richardson CE, Oar EL, Fardouly J. Risk and Protective Factors for Prospective Changes in Adolescent Mental Health during the COVID-19 Pandemic. J Youth Adolesc 2021. [PMID: 33108542 DOI: 10.1007/s10964-020-01332-9]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
The restrictions put in place to contain the COVID-19 virus have led to widespread social isolation, impacting mental health worldwide. These restrictions may be particularly difficult for adolescents, who rely heavily on their peer connections for emotional support. However, there has been no longitudinal research examining the psychological impact of the COVID-19 pandemic among adolescents. This study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents' mental health, and moderators of change, as well as assessing the factors perceived as causing the most distress. Two hundred and forty eight adolescents (Mage = 14.4; 51% girls; 81.8% Caucasian) were surveyed over two time points; in the 12 months leading up to the COVID-19 outbreak (T1), and again two months following the implementation of government restrictions and online learning (T2). Online surveys assessed depressive symptoms, anxiety, and life satisfaction at T1 and T2, and participants' schooling, peer and family relationships, social connection, media exposure, COVID-19 related stress, and adherence to government stay-at-home directives at T2 only. In line with predictions, adolescents experienced significant increases in depressive symptoms and anxiety, and a significant decrease in life satisfaction from T1 to T2, which was particularly pronounced among girls. Moderation analyses revealed that COVID-19 related worries, online learning difficulties, and increased conflict with parents predicted increases in mental health problems from T1 to T2, whereas adherence to stay-at-home orders and feeling socially connected during the COVID-19 lockdown protected against poor mental health. This study provides initial longitudinal evidence for the decline of adolescent's mental health during the COVID-19 pandemic. The results suggest that adolescents are more concerned about the government restrictions designed to contain the spread of the virus, than the virus itself, and that those concerns are associated with increased anxiety and depressive symptoms, and decreased life satisfaction.
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Affiliation(s)
- Natasha R Magson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.
| | - Justin Y A Freeman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Cele E Richardson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Ella L Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Rapee RM, Forbes MK, Oar EL, Richardson CE, Johnco CJ, Magson NR, Fardouly J. Testing a concurrent model of social anxiety in preadolescence. International Journal of Behavioral Development 2020. [DOI: 10.1177/0165025420912014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Social anxiety is a common mental disorder with an average age of onset in early adolescence. Current theories focus largely on risk factors that are present from early in life, but reasons for onset of the disorder as youth move into adolescence are rarely discussed. We recently proposed a model of the onset of certain mental disorders during the adolescent years based on characteristics of adolescent development. While this model will require longitudinal testing, the current article establishes concurrent associations between relevant variables in a cohort of 528 preadolescents ( M age = 11.2 years) at baseline. Youth with social anxiety disorder differed significantly from other youth on measures of social comparison (including physical appearance comparisons, self-rated attractiveness, and negative peer comparisons on social media) as well as positive peer connections (including self-reported school belonging, number of friends, victimization, and peer affiliation). A structural equation model showed that symptom levels of social anxiety were directly related to social comparisons and peer connections, as well as indirectly associated with pubertal development and social comparisons. This pattern was not moderated by sex of youth.
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Fardouly J, Magson NR, Rapee RM, Johnco CJ, Oar EL. The use of social media by Australian preadolescents and its links with mental health. J Clin Psychol 2020; 76:1304-1326. [PMID: 32003901 DOI: 10.1002/jclp.22936] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Preadolescent social media use is normative and could influence mental health. This study investigated: (a) Differences between preadolescent users and non-users of various social media platforms on mental health, (b) unique links between time spent on those platforms, appearance-based activities on social media, and mental health, and (c) the moderating role of biological sex on those relationships. METHOD Preadolescent youth (N = 528; 50.9% male) completed online surveys. RESULTS Users of YouTube, Instagram, and Snapchat reported more body image concerns and eating pathology than non-users, but did not differ on depressive symptoms or social anxiety. Appearance investment uniquely predicted depressive symptoms. Appearance comparisons uniquely predicted all aspects of mental health, with some associations stronger for females than males. CONCLUSIONS Preadolescents could be encouraged to reduce their opportunities to make appearance comparisons and to invest less in their appearance on social media. Preadolescents may benefit from social media intervention programs.
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Affiliation(s)
- Jasmine Fardouly
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Natasha R Magson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Carly J Johnco
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Ella L Oar
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
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Rapee RM, Oar EL, Johnco CJ, Forbes MK, Fardouly J, Magson NR, Richardson CE. Adolescent development and risk for the onset of social-emotional disorders: A review and conceptual model. Behav Res Ther 2019; 123:103501. [DOI: 10.1016/j.brat.2019.103501] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 10/03/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022]
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Abstract
This research investigated associations between socially prescribed and self-orientated perfectionism, and the social functioning of 510 preteens (Mage = 11.2). The study focused on predictions from the Perfectionism Social Disconnection Model (PSDM) by determining whether rejection sensitivity and social isolation, in that sequence, mediated the associations between both perfectionism types and mental health outcomes. Employing both survey and experimental methods, findings indicated that both types of perfectionism in preadolescence were associated with increased interpersonal difficulty, rejection sensitivity and feelings of social isolation, as well as higher levels of eating disorder symptoms, depression, and anxiety. Results from serial mediation analyses found general support for the theoretical predictions of the PSDM for socially prescribed perfectionism, and extending upon previous research, for self-orientated perfectionism. The age of the sample suggests that both forms of perfectionism may be important targets in programs to prevent the development of mental health problems.
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Affiliation(s)
- Natasha R Magson
- Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, 2109, Australia.
| | - Ella L Oar
- Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, 2109, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, 2109, Australia
| | - Carly J Johnco
- Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, 2109, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Balaclava Road, North Ryde, Sydney, 2109, Australia
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Magson NR, Rapee RM, Fardouly J, Forbes MK, Richardson CE, Johnco CJ, Oar EL. Measuring repetitive negative thinking: Development and validation of the Persistent and Intrusive Negative Thoughts Scale (PINTS). Psychol Assess 2019; 31:1329-1339. [PMID: 31328933 DOI: 10.1037/pas0000755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Repetitive negative thinking (RNT) is a key risk and maintenance factor for many psychological disorders and is considered a transdiagnostic process. However, there are few disorder-neutral measures that assess RNT in adults, only 1 of moderate length considered suitable for children, and none that are validated for both children and adults. This study aimed to address this gap by developing a brief measure of RNT that can be used with both children and adults and can be quickly administered in research and clinical contexts. In Study 1, we administered the new 5-item Persistent and Intrusive Negative Thoughts Scale (PINTS) to 527 children (50.3% boys; Mage = 11.2). A 1-factor model fit well and was invariant for boys and girls. The scale showed high internal consistency and good stability across a 2-week interval. The PINTS was significantly associated with measures of depression, anxiety, and disordered eating and was weakly associated with adaptive forms of coping, demonstrating good divergent validity. In Study 2, there were 419 adults (38.9% men; Mage = 31.7) who completed the PINTS. The results replicated and extended the results of Study 1 by demonstrating that the PINTS had good construct, convergent, and criterion validity as well as good internal consistency and stability over time and was invariant across gender and age. It was concluded that the PINTS is a brief, valid, and useful tool for investigating RNT as a transdiagnostic process in the etiology and maintenance of psychological disorders in both children and adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Farrell LJ, Waters AM, Oar EL, Tiralongo E, Garbharran V, Alston‐Knox C, McConnell H, Collings N, Zimmer‐Gembeck M, Donovan CL, Testa C, Storch EA, Ollendick TH. D-cycloserine-augmented one-session treatment of specific phobias in children and adolescents. Brain Behav 2018; 8:e00984. [PMID: 30106248 PMCID: PMC5991588 DOI: 10.1002/brb3.984] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 03/17/2018] [Accepted: 03/24/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND D-Cycloserine has potential to enhance exposure therapy outcomes. The current study presents a preliminary randomized, placebo-controlled double-blind pilot trial of DCS-augmented one-session treatment (OST) for youth (7-14 years) with specific phobia. A secondary aim of this pilot study was to explore the effects of youth age and within-session fear reduction as potential moderators of DCS outcomes in order to generate hypotheses for a larger trial. It was hypothesized that DCS would be associated with greater improvements than placebo, that children (7-10 years) would have greater benefits than adolescents (11-14 years), and that DCS effects would be stronger for participants with the greater within-session fear reduction during the OST. METHODS Thirty-five children and adolescents were randomized to either OST combined with DCS (n = 17), or OST combined with placebo (PBO; n = 18) and assessed at 1 week, 1 month, and 3 month following treatment. RESULTS There were no significant pre- to post-treatment or follow-up benefits of DCS relative to placebo. Secondary analyses of age indicated that relative to PBO, DCS was associated with greater improvements for children (but not adolescents) on measures of severity at 1-month follow-up. Children in the DCS condition also showed significantly greater improvement to 1 month on global functioning relative to other groups. Conversely, adolescents had significant post-treatment benefits in the PBO condition on symptom severity measures relative to DCS, and adolescents in the DCS condition had significantly poorer functioning at 3 months relative to all other groups. Finally, there was a trend for within-session fear reduction to be associated with moderating effects of DCS, whereby greater reduction in fear was associated with greater functioning at one-month follow-up for children who received DCS, relative to PBO. LIMITATIONS The study sample was small and therefore conclusions are tentative and require replication. CONCLUSIONS Age and within-session fear reduction may be important moderators of DCS-augmented one-session exposure therapy, which requires testing in a fully powered randomized controlled trial.
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Affiliation(s)
- Lara J. Farrell
- School of Applied Psychology and Menzies Health Institute QLDGriffith UniversitySouthportQldAustralia
| | - Allison M. Waters
- School of Applied Psychology and Menzies Health Institute QLDGriffith UniversityMt GravattQldAustralia
| | - Ella L. Oar
- School of Applied Psychology and Menzies Health Institute QLDGriffith UniversitySouthportQldAustralia
| | - Evelin Tiralongo
- School of Pharmacy and Menzies Health Institute QLDGriffith UniversitySouthportQldAustralia
| | - Vinay Garbharran
- Child and Youth Mental Health Services, Queensland HealthSouthportQldAustralia
| | - Clair Alston‐Knox
- Griffith Social and Behavioural Research CollegeGriffith UniversitySouthportQldAustralia
| | - Harry McConnell
- School of Medicine and Menzies Health Institute QLDGriffith UniversitySouthportQldAustralia
| | - Nigel Collings
- Menzies Health Institute QLDGriffith UniversitySouthportQldAustralia
| | - Melanie Zimmer‐Gembeck
- School of Applied Psychology and Menzies Health Institute QLDGriffith UniversitySouthportQldAustralia
| | - Caroline L. Donovan
- School of Applied Psychology and Menzies Health Institute QLDGriffith UniversityMt GravattQldAustralia
| | - Chris Testa
- Tugun Compounding PharmacyTugunGold CoastQldAustralia
| | - Eric A. Storch
- Departments of Pediatrics Psychiatry, and PsychologyUniversity of South FloridaTampaFlorida
- Rogers Behavioral Health – Tampa BayTampaFlorida
- All Children's Hospital – Johns Hopkins MedicineSt. PetersburgFlorida
| | - Thomas H. Ollendick
- Department of PsychologyChild Study CentreVirginia Polytechnic Institute and State UniversityBlacksburgVirginia
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15
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Abstract
Anxiety and depression are highly prevalent disorders in youth. Assessments for these disorders in young people typically include clinician-administered instruments such as diagnostic interviews and parent- and youth-report questionnaires. Cognitive behavioral therapy is considered a well-established treatment for both anxiety and depression. Latest research in the field is exploring innovative methods to enhance treatment outcome and improve access to evidence-based treatments.
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Affiliation(s)
- Ella L Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Level 1 Australian Hearing Hub, 16 University Avenue, Sydney, New South Wales 2109, Australia.
| | - Carly Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Level 1 Australian Hearing Hub, 16 University Avenue, Sydney, New South Wales 2109, Australia
| | - Thomas H Ollendick
- Child Study Center, Virginia Polytechnic Institute and State University, Suite 207, 460 Turner Street, Blacksburg, VA 24060, USA
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16
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Ryan SM, Strege MV, Oar EL, Ollendick TH. One session treatment for specific phobias in children: Comorbid anxiety disorders and treatment outcome. J Behav Ther Exp Psychiatry 2017; 54:128-134. [PMID: 27474792 DOI: 10.1016/j.jbtep.2016.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 07/15/2016] [Accepted: 07/19/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES One-Session Treatment (OST) for specific phobias has been shown to be effective in reducing phobia severity; however, the effect of different types of co-occurring anxiety disorders on OST outcomes is unknown. The present study examined (1) the effects of co-occurring generalized anxiety disorder (GAD), social anxiety disorder (SAD), or another non-targeted specific phobia (OSP) on the efficacy of OST for specific phobias, and (2) the effects of OST on these co-occurring disorders following treatment. METHODS Three groups of 18 youth (7-15 years) with a specific phobia and comorbid GAD, SAD, or OSP were matched on age, gender, and phobia type. Outcome measures included diagnostic status and severity, and clinician rated improvement. RESULTS All groups demonstrated an improvement in their specific phobia following treatment. Treatment was equally effective regardless of co-occurring anxiety disorder. In addition, comorbid anxiety disorders improved following OST; however, this effect was not equal across groups. The SAD group showed poorer improvement in their comorbid disorder than the GAD group post-treatment. However, the SAD group continued to improve and this differential effect was not evident six-months following treatment. LIMITATIONS The current study sample was small, with insufficient power to detect small and medium effect sizes. Further, the sample only included a portion of individuals with primary GAD or SAD, which may have attenuated the findings. CONCLUSIONS The current study demonstrated that co-occurring anxiety disorders did not interfere with phobia treatment. OST, despite targeting a single specific phobia type, significantly reduced comorbid symptomatology across multiple anxiety disorders.
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Affiliation(s)
- Sarah M Ryan
- Child Study Center, Department of Psychology, Virginia Polytechnic Institute and State University, United States.
| | - Marlene V Strege
- Child Study Center, Department of Psychology, Virginia Polytechnic Institute and State University, United States
| | - Ella L Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia
| | - Thomas H Ollendick
- Child Study Center, Department of Psychology, Virginia Polytechnic Institute and State University, United States
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17
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Abstract
This article discusses considerations for adapting cognitive behavioral therapy (CBT) techniques and processes with anxious children and adolescents. To successfully deliver CBT with this population, the therapist must take into consideration the child's developmental level and other contextual factors that may affect treatment outcome. Suggested adaptions to CBT include the use of rewards, technology, and interactive activities to increase child motivation and engagement. Moreover, dependent on the child's or adolescent's cognitive capacity, cognitive techniques will need to be simplified and concrete examples provided to increase children's understanding. It may be beneficial to have parents and/or schools involved in children's treatment to assist them to implement CBT strategies outside of the therapy setting. A case example is presented to illustrate the implementation of CBT with a child.
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Affiliation(s)
- Ella L Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Lauren F McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
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18
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Oar EL, Farrell LJ, Ollendick TH. One Session Treatment for Specific Phobias: An Adaptation for Paediatric Blood-Injection-Injury Phobia in Youth. Clin Child Fam Psychol Rev 2016; 18:370-94. [PMID: 26374227 DOI: 10.1007/s10567-015-0189-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Blood-injection-injury (BII) phobia is a chronic and debilitating disorder, which has largely been neglected in the child literature. The present paper briefly reviews the aetiology of specific phobias with particular attention to BII and provides an integrated developmental model of this disorder in youth. Evidence-based treatments for child-specific phobias are discussed, and the development of a modified one session treatment (OST) approach to enhance treatment outcomes for BII phobia in children and adolescents is described. This approach is illustrated in two children with a primary diagnosis of BII phobia. The cases illustrate the unique challenges associated with treating BII in youth and the need for a modified intervention. Modifications included addressing the role of pain (e.g., psychoeducation, more graduated exposure steps) and disgust (e.g., disgust eliciting exposure tasks) in the expression of the phobia and fainting in the maintenance of this phobia. Moreover, it is recommended that parents be more actively involved throughout treatment (e.g., education session prior to OST, contingency management training, guidance regarding planning exposure tasks following treatment) and for families to participate in a structured e-therapy maintenance programme post-treatment.
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Affiliation(s)
- Ella L Oar
- School of Applied Psychology, Behavioural Basis of Health and Menzies Health Institute, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.
| | - Lara J Farrell
- School of Applied Psychology, Behavioural Basis of Health and Menzies Health Institute, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
| | - Thomas H Ollendick
- Child Study Centre, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
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19
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Farrell LJ, Oar EL, Waters AM, McConnell H, Tiralongo E, Garbharran V, Ollendick T. Brief intensive CBT for pediatric OCD with E-therapy maintenance. J Anxiety Disord 2016; 42:85-94. [PMID: 27395805 DOI: 10.1016/j.janxdis.2016.06.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 06/04/2016] [Accepted: 06/15/2016] [Indexed: 12/21/2022]
Abstract
Cognitive behaviour therapy (CBT), incorporating exposure and response prevention (ERP), has received strong empirical support for the treatment of paediatric OCD, and moreover, is considered the first line treatment of choice (Geller & March, 2012). However, despite the availability of effective treatments for this chronic and debilitating disorder, only a small proportion of youth receive these evidence-based approaches. The present study aimed to examine the effectiveness of an intensive ERP-based treatment for youth OCD, using a multiple baseline controlled design. Children and youth (N=10; aged 11-16 years) with a primary diagnosis of OCD were randomly assigned to a 1- or 2-week baseline monitoring condition followed by the intervention. The efficacy of the intensive treatment, involving 1 session psychoeducation, 2-sessions ERP plus e-therapy maintenance was examined across parent- child- and clinician-rated measures at post-treatment and 6-month follow-up. Overall, there were significant reductions across time on almost all measures (except self-report anxiety), and moreover, the majority of the sample (80%) were considered reliably improved, and meeting clinically significant change. At post-treatment, 60% were in remission of symptoms, and at 6-month follow-up this increased to 70%. These findings provide strong support for intensive, time-limited approaches to ERP-based CBT for children and youth with OCD.
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Affiliation(s)
- Lara J Farrell
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Australia.
| | - Ella L Oar
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Australia
| | - Allison M Waters
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Australia
| | - Harry McConnell
- School of Medicine and Menzies Health Institute QLD, Griffith University, Australia
| | - Evelin Tiralongo
- School of Pharmacy and Menzies Health Institute QLD, Griffith University, Australia
| | | | - Thomas Ollendick
- Child Study Centre, Department of Psychology, Virginia Polytechnic Institute and State University, USA
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20
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Roberts CL, Farrell LJ, Waters AM, Oar EL, Ollendick TH. Parents' Perceptions of Novel Treatments for Child and Adolescent Specific Phobia and Anxiety Disorders. Child Psychiatry Hum Dev 2016; 47:459-71. [PMID: 26349600 DOI: 10.1007/s10578-015-0579-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study aimed to examine parents' perceptions of established treatments, including cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs), relative to novel treatments of D-cycloserine (DCS) and attention bias modification (ABM) augmented CBT to determine if novel treatments are perceived as more or less favorable than established treatments. Participants included parents of children with a specific phobia, enrolled in one of two randomized controlled trials of either one-session augmented DCS (n = 38, Gold Coast) or ABM augmented one-session treatment (n = 34, Brisbane), as well as parents from a community sample (n = 38). Parents of children with a specific phobia perceived CBT most favorably. There was no difference between the sites on perceptions of ABM. However, parents of children enrolled in the DCS trial perceived DCS more favorably than parents of children enrolled in the ABM trial and the community sample. These results demonstrate parents' greater acceptance of psychological treatments over pharmacological treatments for the treatment of childhood phobias, highlighting the importance of educating parents to novel treatments.
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Affiliation(s)
- Carly L Roberts
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
| | - Lara J Farrell
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.
| | - Allison M Waters
- School of Applied Psychology and Menzies Health Institute, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD, 4122, Australia
| | - Ella L Oar
- School of Applied Psychology and Menzies Health Institute QLD, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
| | - Thomas H Ollendick
- Child Study Centre, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
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21
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Oar EL, Farrell LJ, Waters AM, Ollendick TH. Blood-Injection-Injury Phobia and Dog Phobia in Youth: Psychological Characteristics and Associated Features in a Clinical Sample. Behav Ther 2016; 47:312-24. [PMID: 27157026 DOI: 10.1016/j.beth.2016.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 12/26/2022]
Abstract
Blood-Injection-Injury (BII) phobia is a particularly debilitating condition that has been largely ignored in the child literature. The present study examined the clinical phenomenology of BII phobia in 27 youths, relative to 25 youths with dog phobia-one of the most common and well-studied phobia subtypes in youth. Children were compared on measures of phobia severity, functional impairment, comorbidity, threat appraisals (danger expectancies and coping), focus of fear, and physiological responding, as well as vulnerability factors including disgust sensitivity and family history. Children and adolescents with BII phobia had greater diagnostic severity. In addition, they were more likely to have a comorbid diagnosis of a physical health condition, to report more exaggerated danger expectancies, and to report fears that focused more on physical symptoms (e.g., faintness and nausea) in comparison to youth with dog phobia. The present study advances knowledge relating to this poorly understood condition in youth.
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