Associations of generalized anxiety and social anxiety with perceived difficulties in school in the adolescent general population

INTRODUCTION

Generalized anxiety disorder (GAD), marked by excessive worry, and social anxiety disorder (SAD) are among the clinically most important anxiety disorders in the adolescent population. This study aimed to explore the associations between perceived difficulties in school and heightened levels of self-reported noncomorbid and comorbid GAD and SAD symptoms.

METHODS

Survey data of 37,905 Finnish upper secondary school students with a mean age of 17.33 years (SD = 0.63) were obtained from the School Health Promotion study, implemented in April and May 2015 in Finland. Exploratory factor analysis was used to determine indicators of academic and social difficulties in school. Logistic regression analysis was conducted to examine multivariate associations between anxiety symptoms and difficulties in the school. The anxiety symptom thresholds were based on the seven-item Generalized Anxiety Disorder Scale (≥10 points) for GAD-related symptoms and the Mini-SPIN (≥6 points) for SAD-related symptoms.

RESULTS

Self-reported generalized anxiety and social anxiety were both significantly associated with various perceived difficulties in school among this adolescent general population sample. Noncomorbid and comorbid GAD and SAD symptoms were both associated with an increased risk of academic and social difficulties, even when controlling for school performance. Comorbid symptoms were associated with significantly higher rates of social difficulties than noncomorbid symptoms of GAD or SAD. Furthermore, GAD symptoms were associated with a high risk for academic difficulties, irrespective of comorbidity.

CONCLUSIONS

Excessive worry, a defining feature of GAD, is central to school-related impairments among adolescents. The present study highlights the importance of school-based interventions for anxious adolescents. Interventions to improve adolescents'; school functioning should account for the interference of pathological worry related to GAD.

Prospective association between evening circadian preference and academic functioning in adolescents: the role of daytime sleepiness

BACKGROUND

There is growing evidence for the role of circadian factors in adolescents' sleep and academic adjustment, with greater evening preference being linked to poorer academic functioning. However, studies have yet to evaluate this association prospectively in adolescence, nor have studies examined daytime sleepiness as a putative mechanism linking evening preference to poor academic functioning. The current study used a multi-informant design to test the prospective association of evening circadian preference, daytime sleepiness, and academic functioning (e.g., global academic impairment and grades) across 2 years in adolescence. As evening circadian preference, sleepiness, and academic problems are elevated in adolescents with ADHD, we used a sample enriched for adolescents with ADHD and explored whether ADHD moderated effects.

METHOD

Participants were 302 adolescents (M_age  = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD). In the fall of eighth grade, adolescents reported on their circadian preference, and in the fall of ninth grade, adolescents and parents completed ratings of daytime sleepiness. In the middle of 10th grade, parents and teachers reported on adolescents' academic impairment and at the end of 10th grade, adolescents' grade point average (GPA) was obtained from school records.

RESULTS

Above and beyond covariates (e.g., adolescent sex, ADHD status, medication, sleep duration) and baseline academic impairment, greater self-reported evening preference in 8th grade predicted increased parent ratings of academic impairment in 10th grade indirectly via adolescent and parent ratings of daytime sleepiness in 9th grade. Furthermore, evening preference in 8th grade predicted greater teacher ratings of academic impairment and lower average GPA in 10th grade via parent ratings of daytime sleepiness in 9th grade, controlling for covariates and baseline GPA. ADHD status did not moderate indirect effects.

CONCLUSION

Findings underscore daytime sleepiness as a possible intervening mechanism linking evening preference to poor academic functioning across adolescence. Intervention studies are needed to evaluate whether targeting circadian preference and sleepiness improves academic functioning in adolescents.

Weight discrimination inflates psychological health risk and academic impairment in sexual minority cisgender college students relative to their heterosexual peers

This study examined whether exposure to weight discrimination modified the association between sexual orientation, self-reported eating disorders, self-reported depression and academic impairment in a large sample of college students. Participants (n = 13,782) were from the 2015-2018 College Student Health Survey. Logistic regressions tested whether weight discrimination magnified psychological health concerns and academic impairment in sexual minority students (i.e., lesbian, gay) relative to their heterosexual peers and were stratified by gender (cisgender men and cisgender women). Sexual minority men and women reported more weight discrimination, eating disorders, depression, and academic impairment than their heterosexual peers, even after controlling for BMI and race. Among sexual minority men and women, weight discrimination was associated with increased eating disorders and academic impairment, but not depression. Weight discrimination increased the rate of eating disorders, depression, and academic impairment, however, the rate was still higher among sexual minority students regardless of weight discrimination status or gender. College-based interventions should aim to reduce weight stigmatization and its associated influence on psychological health and academic functioning, and address the needs of sexual minority college students, as they may be at highest risk. Clinicians should work to reduce the harms of weight discrimination, particularly in sexual minority young adults.

Does Working Memory Impact Functional Outcomes in Individuals With ADHD: A Qualitative and Comprehensive Literature Review

OBJECTIVE

Working Memory (WM) is a domain of executive functioning often impaired in individuals with ADHD. Although assumed to cause difficulties across functioning, the scope of impairments from WM deficits in ADHD has not been investigated. The aim of this study was to examine outcomes associated with WM deficits in ADHD.

METHOD

We conducted a search of the scientific literature on WM deficits, and Freedom From Distractibility (FFD), in ADHD using PubMed and PsycInfo databases.

RESULTS

The final sample included 11 controlled studies of WM/FFD deficits in ADHD with operationalized assessment of outcomes in academic, social, and emotional areas. WM assessment was divided into auditory-verbal memory (AVM) and spatial-visual memory (SWM). Seven studies examined WM deficits in academic functioning, eight studies assessed WM deficits in social functioning, and three assessed WM deficits in psychopathology.

CONCLUSION

The majority of the literature suggests that WM deficits affect primarily academic functioning.

Symptom Manifestation and Impairments in College Students With ADHD

To better understand the nature of impairment resulting from attention-deficit/hyperactivity disorder (ADHD) for students in a post-secondary education (PSE) setting, the authors analyzed the symptoms and associated impairment of 135 students with a diagnosis of ADHD who were recruited via Student Disability Services in Canadian post-secondary institutions. The authors (a) developed a novel semistructured telephone interview based on the 6-item Adult ADHD Self-Report Scale Screener-Telephone Interview With Probes (ASRS-TIPS) to elicit students' descriptions of their behavior for each symptom they endorsed, (b) administered standardized tests of executive functioning (EF) and academic fluency, and (c) obtained self-reports of grade point averages (GPAs), EF, cognitive failures, psychopathology, distress, and resilience. Qualitative analysis of the ASRS-TIPS revealed significant impairment relating to symptoms of ADHD in the PSE setting. Students reported clinically significant symptoms of ADHD, psychological distress, and impairment in EF (67%, severe range) and cognitive failure (62%, atypical range) in everyday life. By contrast, their GPAs and standardized scores of EF and academic fluency were in the average range. Standardized scores and GPAs did not capture the impairment that participants experienced in their PSE settings. The ASRS-TIPS may provide a useful tool to help document how these students' symptoms impair functioning in the PSE setting.

A greater number of somatic pain sites is associated with poor mental health in adolescents: a cross-sectional study

BACKGROUND

Identifying indicators of poor mental health during adolescence is a significant public health issue. Previous studies which suggested an association between the number of somatic pains and depression have mainly focused on adults or have employed samples with a narrow age range. To date, results from previous studies have been inconsistent regarding the association between somatic pain and academic impairment. Therefore, the main aims of the present study were to 1) investigate the association between the number of somatic pain sites and poor mental health using a community sample of adolescents aged 12 to 18 years and employing a simple method of assessment, and 2) examine the association between the number of somatic pain sites and perceived academic impairment.

METHODS

Data analysis was conducted using a large cross-sectional survey of adolescents in grades 7 to 12. The one-month prevalence rates for three sites of somatic pain including head, neck and shoulders, and abdomen were examined. Poor mental health was evaluated using the General Health Questionnaire, and perceived academic impairment was measured using a self-report questionnaire.

RESULTS

A total of 18,104 adolescents participated in the survey. A greater number of pain sites was associated with poor mental health, and this association was consistent across age and gender. There was no difference in effect on mental health between any of the pain sites. Although there was an association between the number of somatic pain sites and perceived academic impairment, the results suggested that the association was mediated by poor mental health.

CONCLUSIONS

Simple reporting methods for assessing the number of pain sites may be a feasible indicator of poor mental health in adolescents. Professionals working with adolescents should consider the possibility of poor mental health, especially when students report multiple somatic pains.