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Bose D, Pettit JW, Silk JS, Ladouceur CD, Olino TM, Forbes EE, Siegle GJ, Dahl RE, Kendall PC, Ryan ND, McMakin DL. Therapeutic Alliance, Attendance, and Outcomes in Youths Receiving CBT or Client-Centered Therapy for Anxiety. J Clin Child Adolesc Psychol 2023:1-11. [PMID: 37796228 PMCID: PMC10995113 DOI: 10.1080/15374416.2023.2261547] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Positive associations between therapeutic alliance and outcome (e.g. youth symptom severity) have been documented in the youth anxiety literature; however, little is known about the conditions under which early alliance contributes to positive outcomes in youth. The present study examined the relations between therapeutic alliance, session attendance, and outcomes in youths (N = 135; 55.6% female) who participated in a randomized clinical trial testing the efficacy of cognitive-behavioral therapy or client-centered therapy for anxiety. METHOD We evaluated a conceptual model wherein: (1) early alliance indirectly contributes to positive outcomes by improving session attendance; (2) alliance-outcome associations differ by intervention type, with stronger associations in cognitive-behavioral therapy compared to client-centered therapy; and (3) alliance-outcome associations vary across outcome measurement timepoints, with the effect of early alliance on outcomes decaying over time. RESULTS Contrary to hypotheses, provider ratings of early alliance predicted greater youth-rated anxiety symptom severity post-treatment (i.e. worse treatment outcomes). Session attendance predicted positive youth-rated outcomes, though there was no indirect effect of early alliance on outcomes through session attendance. CONCLUSIONS Results show that increasing session attendance is important for enhancing outcomes and do not support early alliance as a predictor of outcomes.
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Affiliation(s)
- Deepika Bose
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Jeremy W. Pettit
- Department of Psychology and Center for Children and Families, Florida International University, Miami, FL
| | - Jennifer S. Silk
- Department of Psychology, University of Pittsburgh, and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburg, PA
| | - Cecile D. Ladouceur
- Department of Psychology, University of Pittsburgh, and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburg, PA
| | - Thomas M. Olino
- Department of Psychology, Temple University, Philadelphia, PA
| | - Erika E. Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburg, PA
| | - Greg J. Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburg, PA
| | - Ronald E. Dahl
- School of Public Health, University of California at Berkeley, Berkeley, CA
| | | | - Neal D. Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburg, PA
| | - Dana L. McMakin
- Department of Psychology and Center for Children and Families, Florida International University, Miami, FL
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Uzun Cicek A, Ucuz I, Isık CM, Temelli G. Evaluation of cognitive disengagement syndrome in children with obsessive-compulsive disorder: Clinical implications. Clin Child Psychol Psychiatry 2023; 28:1449-1462. [PMID: 37073420 DOI: 10.1177/13591045231169137] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Cognitive disengagement syndrome (CDS) has been found to be associated with internalizing symptoms. Yet, no study thus far has focused on whether there is an association between obsessive-compulsive disorder (OCD) and CDS. The purpose of this study is to examine the symptom frequency and clinical implications of CDS in children with OCD. The study included sixty-one children with OCD and sixty-six typically developing children. Children were evaluated by a semi-constructed diagnosis interview, Obsessive-Compulsive Inventory, Barkley Child Attention Scale, and Stroop test. The frequency of elevated symptoms of CDS, and total time, total error, and total correction scores of the Stroop test were significantly higher in the OCD group compared to the controls. Elevated CDS symptoms were significantly associated with higher OCD symptom prevalence and poorer performance on the Stroop Test. Moreover, poor insight, hoarding symptoms, mental compulsions, and ADHD comorbidity were significantly higher in those with elevated CDS symptoms than in those without CDS in the OCD group. The findings of this study provide clinical implications that CDS symptoms may contribute to deficits in attentional orientation, conceptual flexibility, and cognitive processing speed in OCD.
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Affiliation(s)
- Ayla Uzun Cicek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Ilknur Ucuz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Cansu Mercan Isık
- Department of Child and Adolescent Psychiatry, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Gürkan Temelli
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, İnönü University, Malatya, Turkey
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Mercan Isik C, Uzun Cicek A, Altuntas EE, Bora A, Sari SA, Akkus S. The Effect of Methylphenidate Treatment on Olfactory Function in Children and Adolescents With ADHD. J Atten Disord 2023:10870547231171727. [PMID: 37148188 DOI: 10.1177/10870547231171727] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVE This study aimed to research whether there is an olfactory disorder in ADHD, and if so, what is the effect of methylphenidate on this condition. METHOD This is a cross-sectional study aiming to evaluate olfactory threshold, identification, discrimination and threshold, discrimination, and identification (TDI) scores in 109 children and adolescents, 33 of whom have ADHD without medication, 29 with ADHD with medication and 47 control groups. RESULT In the post hoc tests, the mean odor discrimination test, the mean odor identification test, and the mean TDI scores of the unmedicated ADHD group were significantly lower than those of the other two groups, and that the mean odor threshold test scores of the medicated ADHD group were significantly lower than those of the control and unmedicated groups. CONCLUSION Olfactory function could be a useful tool to monitor treatment effects and may be a promising candidate as a biomarker in ADHD.
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Affiliation(s)
- Cansu Mercan Isik
- Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | | | | | - Adem Bora
- Cumhuriyet University, Sivas, Turkey
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El-Jamal S, Elfane H, Chamlal H, Barakat I, Daif H, Mziwira M, Fassouane A, Belahsen R. Assessment of diet quality in children and adolescents with type 1 diabetes. Rocz Panstw Zakl Hig 2022; 73:413-422. [PMID: 36546876 DOI: 10.32394/rpzh.2022.0229] [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: 12/24/2022] Open
Abstract
Background Micronutrient malnutrition is a serious public health problem in most developing countries, including Morocco, due to poor and therefore lower quality diets that lack dietary diversity. Objective The present study aimed to assess dietary diversity and variety and their relationship with micronutrient adequacy in children and adolescents with type 1 diabetes (T1D). Materials and methods A cross-sectional study was carried among 240 children and adolescents with T1D. Weight and height were measured and BMI was calculated. Dietary intake data were obtained from two 24-h recalls. A Dietary diversity (DDS) and dietary variety scores (DVS) and mean adequacy ratio (MAR) and nutritional adequacy ratios (NARs) were calculated and compared according to sociodemographic/anthropometric categories. Results 52.1% of the patients were female. The mean age of the patients was 8.49 ± 4.1 years. The mean BMI was 19.44 ± 5.24 kg/m2; the mean DDS was 4.62±1.20 and the mean MAR was 0.66 ± 0.11. Older children living in rural areas have a low DDS/DVS. Parental education and income level are associated with DDS/DVS. General and central obesity were significantly elevated in children with high DDS. In addition, a high intake of vegetables, eggs, fiber and micronutrients (Magnesium, Calcium, Potassium, Zinc, Phosphorus and Vit B1) is associated with a high DDS; however, high DVS is associated with high consumption of dairy products, carbohydrates and low intake of protein and fat. There are also positive correlations between DDS/DVS and NARs for various nutrients. Conclusion The quality of the respondents' diets are moderately diversified. DDS or DVS can be used as indicators of micronutrient adequacy in Moroccan T1D children. Nutritional education needs to be strengthened to improve dietary diversity in children, especially in rural areas.
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Affiliation(s)
- Sanaa El-Jamal
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco
| | - Houda Elfane
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco
| | - Hamid Chamlal
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco
| | - Imane Barakat
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco
| | - Halima Daif
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco
| | - Mohamed Mziwira
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco.,Laboratoire Bio-Géosciences et Ingénierie des Matériaux, École Normale Supérieure, Hassan II University, Casablanca, Morocco
| | - Aziz Fassouane
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco.,Ibn Zohr University, Agadir, Morocco
| | - Rekia Belahsen
- Laboratory of Biotechnology, Biochemistry and Nutrition, Training and Research Unit on Nutrition and Food Sciences, Department of Biology, Faculty of Sciences, Chouaib Doukkali University, El Jadida 24 000, Morocco
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Heyn SA, Bailowitz S, Russell JD, Herringa RJ. Sex-based variations of prefrontal structure and longitudinal symptoms in pediatric posttraumatic stress disorder. Depress Anxiety 2022; 39:902-912. [PMID: 36349877 PMCID: PMC9762118 DOI: 10.1002/da.23296] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Pediatric posttraumatic stress disorder (pPTSD) is more than three times as likely to develop in trauma-exposed female youth than males. Despite the staggering sex differences in the prevalence rates of pPTSD and symptom expression, relatively little is known about the underlying biomarkers of these sex-based variations in pPTSD as compared to typically development. METHODS The Youth PTSD study recruited 97 youth, ages of 7 and 18, to undergo comprehensive clinical assessments and T1-weighted MRI to evaluate the extent to which sex can explain PTSD-related variations in brain structure. Whole-brain VBM as well as whole-brain estimates of cortical thickness and surface area were analyzed to identify group-by-sex interactions. Finally, we tested whether current or future symptom severity was predictive of regions exhibiting sex-based variations. RESULTS Clinically, females with PTSD were significantly more likely to report exposure to and higher severity of interpersonal violence and symptoms of hyperarousal. Sex and PTSD status were predictive of gray matter across the lateral prefrontal cortex (PFC), including the ventrolateral PFC and frontal pole, where increased volume and surface area was found in PTSD females as compared to PTSD males. Interestingly, the ventrolateral prefrontal cortex and frontal pole were negatively predictive of symptoms 1 year later in only males with PTSD. CONCLUSIONS Together, these results establish that youth with PTSD exhibit sex-based variations in clinical and trauma characteristics and prefrontal cortical structure relative to normative development. This work demonstrates the importance of examining the role that sex may play in the behavioral and neurobiological presentation of pPTSD.
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Affiliation(s)
- Sara A. Heyn
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sophie Bailowitz
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Justin D. Russell
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ryan J. Herringa
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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Grassie HL, Kennedy SM, Halliday ER, Bainter SA, Ehrenreich-May J. Symptom-level networks of youth- and parent-reported depression and anxiety in a transdiagnostic clinical sample. Depress Anxiety 2022; 39:211-219. [PMID: 35072967 DOI: 10.1002/da.23241] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/19/2021] [Accepted: 01/08/2022] [Indexed: 11/09/2022] Open
Abstract
Depression and anxiety disorders confer a significant public health concern for youth and their co-occurrence places youth at a higher risk for poorer psychosocial outcomes. In the present study, we use network analysis to investigate the role of and interactions among individual depression and anxiety symptoms in a treatment-seeking clinical sample. METHODS We estimate regularized partial correlation networks for youth- and parent reported symptoms in a transdiagnostic sample of youth (N = 417, ages 8-18). We examined features of the symptom-level networks such as network stability, centrality, bridge symptoms, and communities in both youth- and parent-reported networks. RESULTS Results indicate stable networks with disorder-specific clustering, such that symptoms were more interconnected within compared to between disorders. Symptoms related to self-comparison to peers and negative views of the future were most central in both networks. Symptoms of depression and anxiety were connected by worries for the future and hopelessness in the youth-reported network, whereas self-comparison to peers and low self-efficacy were bridge symptoms in the parent network. Distinct symptom clusters emerged in the parent- and youth-reported networks. CONCLUSIONS Our findings indicate that negative self-evaluation, negative views of the future, and repetitive negative thinking more generally are influential symptoms in the presentation and co-occurrence of depression and anxiety and as such may be promising targets in the treatment and prevention of depression and anxiety in youth.
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Affiliation(s)
- Hannah L Grassie
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sarah M Kennedy
- Department of Psychiatry, Medical Campus, University of Colorado Anschutz, Aurora, Colorado, USA
| | | | - Sierra A Bainter
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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Lorenzo NE, Novick DR, Seddio K, Degnan KA, Henderson HA, Almas AN, Chronis-Tuscano A, Fox N. Bidirectional and interactive effects of child temperament and parenting in early childhood on the trajectory of social anxiety in adolescence. Depress Anxiety 2022; 39:192-200. [PMID: 34762343 PMCID: PMC8901539 DOI: 10.1002/da.23224] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 10/05/2021] [Accepted: 10/30/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Research suggests that certain parenting behaviors are best suited to promote optimal child development, depending on a child's distinctive temperamental presentation. This multimethod, longitudinal study examines the interactive effect of parenting and temperament in early childhood on the developmental trajectory of social anxiety in adolescence. METHODS Longitudinal growth modeling was used to examine the developmental trajectory of child social anxiety from age 9-15 and the interactive effect of parenting and child temperament at 36 months on the developmental trajectory of child social anxiety from age 9-15. RESULTS The slope of social anxiety from age 9-15 suggested a decrease in social anxiety throughout early adolescence. Furthermore, 36-month behavioral inhibition (BI) predicted the trajectory of child social anxiety from age 9-15 when parents displayed low and high levels of dismissive and supportive parenting (at 36 months). CONCLUSIONS Results support an interactive effect of infant temperament and parenting in early childhood (at 36 months) on the developmental trajectory of child social anxiety from age 9-15. Specifically, results suggest that engaging highly inhibited children with high supportive and low dismissive parenting may help reduce social anxiety over time in adolescence. Furthermore, parenting needs may differ for children high or low in BI to impact the developmental trajectory of social anxiety in adolescence, such that children who are high BI seem to benefit from low dismissive and high supportive parenting, and children who are low in BI seem to benefit more from high dismissive parenting.
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Affiliation(s)
- Nicole E. Lorenzo
- University of Maryland at College Park, 3942 Campus Drive, College Park, Maryland, United States,Correspondence Nicole E. Lorenzo, University of Maryland at College Park, 3942 Campus Drive, College Park, Maryland, United States,
| | - Danielle R. Novick
- University of Maryland at College Park, 3942 Campus Drive, College Park, Maryland, United States
| | | | - Kathryn A. Degnan
- Catholic University, Washington, District of Columbia, United States
| | - Heather A. Henderson
- University of Waterloo, Department of Psychology, Waterloo, Ontario, United States
| | - Alisa N. Almas
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea Chronis-Tuscano
- University of Maryland, Psychology, Biology/Psychology Bldg, College Park, Maryland, United States
| | - Nathan Fox
- University of Maryland, Human Development, 3304 Benjamin Bldg, College Park, Maryland, United States
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Level RA, Shisler SM, Seay DM, Ivanova MY, Kelm MR, Eiden RD, Schuetze P. Within- and between-family transactions of maternal depression and child engagement in the first 2 years of life: Role of prenatal maternal risk and tobacco use. Depress Anxiety 2021; 38:1279-1288. [PMID: 34435727 PMCID: PMC8665021 DOI: 10.1002/da.23211] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/31/2021] [Accepted: 08/03/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND This study examined transactional associations among maternal depression, maternal sensitivity, and child engagement in the context of a low-income, diverse sample with maternal cigarette smoking during pregnancy (MSDP) as a moderator of these transactions. METHODS A random-intercept cross-lagged panel model was used to investigate within- and between-family variability from infancy to toddlerhood. The sample included 247 mother-child dyads (47% girls; 51% African-American; 178 MSDP, 69 non-MSDP). Assessments were conducted once during each trimester of pregnancy and at 2, 9, 16, and 24 months of child ages. RESULTS Between-family associations revealed that children exposed to higher levels of sensitive parenting across time had higher behavioral engagement from infancy to toddlerhood. At the within-family level, increased sensitive parenting at 9 months was predictive of increased child engagement at 16 months which in turn predicted increases in sensitive parenting at 24 months. Increased maternal depression was concurrently associated with lower maternal sensitivity at 2 months and lower child engagement at 16 months. Contrary to hypotheses, changes in maternal depression were not associated to changes in parenting or child engagement. These associations did not vary between prenatally smoking and nonsmoking mothers. However, there was significantly higher stability in maternal depression across time among nonsmoking mothers compared to those in the MSDP group. Additionally, increased maternal depression was related to lower-than-expected child engagement at 9 months only for the nonsmoking group. CONCLUSIONS Results highlight transactional processes at the within-family level and the importance of timing for parent and child effects on transactional processes.
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Affiliation(s)
| | - Shannon M. Shisler
- Research Institute on Addictions, State University of New York at Buffalo
| | | | | | | | - Rina D. Eiden
- Department of Psychology, Pennsylvania State University
| | - Pamela Schuetze
- Department of Psychology, State University of New York at Buffalo
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Buss KA, Zhou AM, Trainer A. Bidirectional effects of toddler temperament and maternal overprotection on maternal and child anxiety symptoms across preschool. Depress Anxiety 2021; 38:1201-1210. [PMID: 34255905 PMCID: PMC8664961 DOI: 10.1002/da.23199] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/16/2021] [Accepted: 06/25/2021] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Existing research highlights interactions among child temperament, parents' own anxiety symptoms, and parenting in predicting increased risk for anxiety symptom development. Theoretical models of child-elicited effects on parents have proposed that parents' behaviors are likely not independent of children's temperament; fearful children likely elicit more protective responses from parents and these parenting behaviors reinforces child anxiety and parents' own anxiety. METHOD The current study tests this model and examines whether there are bidirectional influences between early fearful temperament (i.e., dysregulated fear [DF]), maternal overprotection, and subsequent trajectories of maternal and child anxiety symptoms across early childhood. A total of 166 children and mothers participated in a multimethod, longitudinal study of temperament risk from 2 to 6 years. RESULTS Results largely support our hypotheses, replicating and extending the prior literature. DF was associated with more maternal overprotective behavior, subsequent child anxiety symptoms, and maternal anxiety symptoms. Moreover, there were indirect (mediated) associations through maternal overprotective behavior and both child and mother anxiety symptoms. CONCLUSION Results support the hypothesis that intergenerational transmission of anxiety was meditated through maternal behaviors and that the child-driven temperament effects are central to trajectories of child and maternal anxiety trajectories.
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Affiliation(s)
- Kristin A. Buss
- Department of Psychology The Pennsylvania State University State College Pennsylvania USA
| | - Anna M. Zhou
- Department of Psychology The Pennsylvania State University State College Pennsylvania USA
| | - Austen Trainer
- Department of Psychology The Pennsylvania State University State College Pennsylvania USA
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Pérez-Edgar K, LoBue V, Buss KA. From parents to children and back again: Bidirectional processes in the transmission and development of depression and anxiety. Depress Anxiety 2021; 38:1198-1200. [PMID: 34878704 PMCID: PMC9968398 DOI: 10.1002/da.23227] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Koraly Pérez-Edgar
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Vanessa LoBue
- Department of Psychology, Rutgers University, Newark, New Jersey, USA
| | - Kristin A. Buss
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
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Hastings PD, Ugarte E, Mashash M, Marceau K, Natsuaki MN, Shirtcliff EA, Zahn-Waxler C, Klimes-Dougan B. The codevelopment of adolescents' and parents' anxiety and depression: Moderating influences of youth gender and psychophysiology. Depress Anxiety 2021; 38:1234-1244. [PMID: 34110070 DOI: 10.1002/da.23183] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/22/2021] [Accepted: 05/22/2021] [Indexed: 12/28/2022] Open
Abstract
METHODS In a 2-year longitudinal study of 220 families, we examined how youth gender and adrenocortical and parasympathetic activity moderated reciprocal, bidirectional relations between parent and youth anxiety and depression problems. RESULTS Maternal anxiety predicted subsequent youth anxiety and depression. Maternal depression predicted youth anxiety and, for daughters and youth with low adrenocortical reactivity, youth depression. Youth depression predicted maternal depression only for youth with high adrenocortical reactivity. There were no associations between paternal and youth psychopathology. DISCUSSION Examining youth gender and psychophysiological characteristics that shape the nature of bidirectional influences may inform efforts to identify families at heightened risk for intergenerational transmission of psychopathology.
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Affiliation(s)
- Paul D Hastings
- Department of Psychology, University of California Davis, Davis, California, USA
| | - Elisa Ugarte
- Department of Human Ecology, University of California Davis, Davis, California, USA
| | - Meital Mashash
- Department of Human Ecology, University of California Davis, Davis, California, USA
| | - Kristine Marceau
- Department of Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - Misaki N Natsuaki
- Department of Psychology, University of California Riverside, Riverside, California, USA
| | | | - Carolyn Zahn-Waxler
- Department of Psychology and Center for Healthy Minds, University of Wisconsin, Madison, Wisconsin, USA
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Kiel EJ, Aaron EM, Risley SM, Luebbe AM. Transactional relations between maternal anxiety and toddler anxiety risk through toddler-solicited comforting behavior. Depress Anxiety 2021; 38:1267-1278. [PMID: 34157158 PMCID: PMC9210828 DOI: 10.1002/da.23185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/01/2020] [Revised: 04/15/2021] [Accepted: 06/04/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Transactional developmental and anxiety theories suggest that mothers and toddlers may influence each other's anxiety development across early childhood. Further, toddlers' successful solicitations of comfort during uncertain, yet manageable, situations, may be a behavioral mechanism by which mothers and toddlers impact each other over time. To test these ideas, the current study employed a longitudinal design to investigate bidirectional relations between maternal anxiety and toddler anxiety risk (observed inhibited temperament and mother-perceived anxiety, analyzed separately), through the mediating role of toddler-solicited maternal comforting behavior, across toddlerhood. METHODS Mothers (n = 174; 93.6% European American) and their toddlers (42.4% female; 83.7% European American) participated in laboratory assessments at child ages 1, 2, and 3 years. Mothers self-reported anxiety symptoms. Toddler anxiety risk was observed in the laboratory as inhibited temperament and reported by mothers. Solicited comforting interactions were observed across standardized laboratory tasks. RESULTS Direct and indirect bidirectional effects were tested simultaneously in two longitudinal path models. Toddler anxiety risk, but not maternal anxiety, predicted solicited comforting behavior, and solicited comforting behavior predicted maternal anxiety. No convincing evidence for parent-directed effects on toddler anxiety risk emerged. CONCLUSION Results support continued emphasis on child-elicited effects in child and parent anxiety development in early childhood.
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Silverman WK, Marin CE, Rey Y, Jaccard J, Pettit JW. Directional effects of parent and child anxiety 1 year following treatment of child anxiety, and the mediational role of parent psychological control. Depress Anxiety 2021; 38:1289-1297. [PMID: 34464490 PMCID: PMC8664994 DOI: 10.1002/da.23210] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND We leveraged a recent efficacy trial to investigate directionality between parent anxiety and child anxiety at posttreatment and 12-month follow-up, and the potential role of parent psychological control as a mediator. We also explored child age and sex as moderators. METHOD Two-hundred and fifty-four children were randomized to individual cognitive behavioral therapy (CBT) or to one of two CBT arms with parent involvement. Parent anxiety was not a treatment target in any of the three arms. RESULTS Child anxiety at posttreatment was associated with parent anxiety and psychological control at 12-month follow-up, providing evidence of child-to-parent directionality. Parent anxiety at posttreatment was associated indirectly with child anxiety at 12-month follow-up through associations with parent psychological control, providing evidence of parent-to-child directionality. At posttreatment, parent psychological control contemporaneously mediated the relation between parent and child anxiety. Neither child age nor sex moderated any association. CONCLUSIONS Findings highlight the directional effects between child anxiety, parent anxiety, and psychological control from posttreatment to 12-month follow-up, even when parent anxiety is not a treatment target. Research and clinical implications are discussed, with an emphasis on enhancing durability following treatment effects.
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14
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Courtney DB, Watson P, Chan BW, Bennett K, Krause KR, Offringa M, Butcher NJ, Monga S, Neprily K, Zentner T, Rodak T, Szatmari P. Forks in the road: Definitions of response, remission, recovery, and other dichotomized outcomes in randomized controlled trials for adolescent depression. A scoping review. Depress Anxiety 2021; 38:1152-1168. [PMID: 34312952 DOI: 10.1002/da.23200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/23/2020] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Definitions of dichotomous outcome terms, such as "response," "remission," and "recovery" are central to the design, interpretation, and clinical application of randomized controlled trials of adolescent depression interventions. Accordingly, this scoping review was conducted to document how these terms have been defined and justified in clinical trials. METHOD Bibliographic databases MEDLINE, Embase, APA PsycInfo, and CINAHL were searched from inception to February 2020 for randomized controlled trials evaluating treatments for adolescent depression. Ninety-eight trials were included for data extraction and analysis. RESULTS Assessment of outcome measurement instruments, metric strategies, methods of aggregation, and measurement timing, yielded 53 unique outcome definitions of "response" across 45 trials that assessed response, 47 unique definitions of "remission" in 29 trials that assessed remission, and 19 unique definitions of "recovery" across 11 trials that assessed recovery. A minority of trials (N = 35) provided a rationale for dichotomous outcomes definitions, often by citing other studies that used a similar definition (N = 11). No rationale included input from youth or families with lived experience. CONCLUSION Our review revealed that definitions of "response," "remission," "recovery," and related terms are highly variable, lack clear rationales, and are not informed by key stakeholder input. These limitations impair pooling of trial results and the incorporation of trial findings into pragmatic treatment decisions in clinical practice. Systematic approaches to establishing outcome definitions are needed to enhance the impact of trials examining adolescent depression treatment.
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Affiliation(s)
- Darren B Courtney
- Department of Psychiatry, Child and Youth Mental Health, University of Toronto, Toronto, Ontario
| | - Priya Watson
- Department of Psychiatry, Child and Youth Mental Health, University of Toronto, Toronto, Ontario
| | | | - Kathryn Bennett
- Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster Univeristy, Toronto, Ontario
| | | | - Martin Offringa
- Department of Pediatrics, Neonatology, University of Toronto, Toronto, Ontario
| | - Nancy J Butcher
- Department of Psychiatry, Child and Youth Mental Health, University of Toronto, Toronto, Ontario
| | - Suneeta Monga
- Department of Psychiatry, Child and Youth Mental Health, University of Toronto, Toronto, Ontario
| | - Kirsten Neprily
- Department of Psychology, School and Applied Child Psychology, University of Calgary, Calgary, Alberta
| | - Tabitha Zentner
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario
| | - Terri Rodak
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Peter Szatmari
- Department of Psychiatry, Child and Youth Mental Health, University of Toronto, Toronto, Ontario
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15
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Turin A, Dovč K, Klemenčič S, Bratina N, Battelino T, Lipovšek JK, Uršič K, Shmueli-Goetz Y, Drobnič-Radobuljac M. Carer's Attachment Anxiety, Stressful Life-Events and the Risk of Childhood-Onset Type 1 Diabetes. Front Psychiatry 2021; 12:657982. [PMID: 34140900 PMCID: PMC8205563 DOI: 10.3389/fpsyt.2021.657982] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 04/14/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Objective: Type 1 diabetes (T1D) is among the most common chronic diseases in children/adolescents, and the incidence continues to rise worldwide. Different environmental factors have been evaluated in the etiology. In the present study, we investigated the role of attachment examining whether insecure attachment to carers or carers' own attachment insecurity was related to a higher risk of T1D in children. Methods: We included 101 children with T1D (mean age 11.8 years), 106 healthy controls (11.6 years), and one of their carers. We assessed children's attachment using the Child Attachment Interview and carers' attachment using the Relationship Structures Questionnaire. We constructed binary multinomial logistic regression models using attachment to mothers, carers' attachment representations, and stressful life-events as T1D predictors. Results: Higher carer attachment anxiety was associated with the child's T1D diagnosis (p < 0.05; R 2 = 0.0613) while security of attachment to mothers showed no significant association. When mothers' education was included in the model, both attachment anxiety in higher educated mothers and stressful life events showed a significant association with the child's T1D (p < 0.001; R 2 = 0.293). Conclusions: Our findings suggest that higher attachment-related anxiety in carers with high education and stressful life events are associated with T1D in children.
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Affiliation(s)
- Anja Turin
- Centre for Mental Health, University Psychiatric Hospital Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Klemen Dovč
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Simona Klemenčič
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Nataša Bratina
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Jasna Klara Lipovšek
- Centre for Mental Health, University Psychiatric Hospital Ljubljana, Ljubljana, Slovenia
| | - Katarina Uršič
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Yael Shmueli-Goetz
- Anna Freud National Centre for Children and Families and Psychoanalysis Unit, University College London, London, United Kingdom
| | - Maja Drobnič-Radobuljac
- Centre for Mental Health, University Psychiatric Hospital Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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16
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Mundy LK, Canterford L, Moreno-Betancur M, Hoq M, Sawyer SM, Allen NB, Patton GC. Social networking and symptoms of depression and anxiety in early adolescence. Depress Anxiety 2021; 38:563-570. [PMID: 33225486 DOI: 10.1002/da.23117] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/04/2020] [Revised: 10/04/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Use of social networking in later childhood and adolescence has risen quickly. The consequences of these changes for mental health are debated but require further empirical evaluation. METHODS Using data from the Childhood to Adolescence Transition Study (n = 1,156), duration of social networking use was measured annually at four time points from 11.9 to 14.8 years of age (≥1 h/day indicating high use). Cross-sectional and prospective relationships between social networking use and depressive and anxiety symptoms were examined. RESULTS In adjusted (age, socioeconomic status, prior mental health history) cross-sectional analyses, females with high social networking use had greater odds of depressive (odds ratio [OR]: 2.15; 95% confidence interval [CI]: 1.58-2.91) and anxiety symptoms (OR: 1.99; 95% CI: 1.32-3.00) than those that used a few minutes at most, while males with high social networking use had 1.60 greater odds of reporting depressive symptoms (95% CI: 1.09-2.35). For females, an increased odds of depressive symptoms at age 14.8 was observed for high social networking use at one previous wave and at two or three previous waves, even after adjustment (OR: 1.76; 95% CI: 1.11-2.78; OR: 2.06, 95% CI: 1.27-3.37, respectively) compared to no wave of high use. CONCLUSIONS Our results suggest weak to moderate increased odds of depression and anxiety in girls and boys with high social networking use versus low/normal use. These findings indicate that prevention programs for early mental health problems might benefit from targeting social networking use in early adolescence.
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Affiliation(s)
- Lisa K Mundy
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Louise Canterford
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Margarita Moreno-Betancur
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Monsurul Hoq
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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17
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Murata S, Rezeppa T, Thoma B, Marengo L, Krancevich K, Chiyka E, Hayes B, Goodfriend E, Deal M, Zhong Y, Brummit B, Coury T, Riston S, Brent DA, Melhem NM. The psychiatric sequelae of the COVID-19 pandemic in adolescents, adults, and health care workers. Depress Anxiety 2021; 38:233-246. [PMID: 33368805 PMCID: PMC7902409 DOI: 10.1002/da.23120] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [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: 08/19/2020] [Revised: 10/30/2020] [Accepted: 11/21/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is the most serious global public health crisis since the 1918 influenza pandemic. This study is the first to assess its mental health impact across the lifespan in the United States in adolescents, adults, and health care workers. METHODS We recruited 4909 participants through an online survey advertising on Facebook and Instagram to assess exposure to COVID-19 and psychiatric symptoms from April 27 to July 13. We also recruited through the University of Pittsburgh, University of Pittsburgh Medical Center, and other health care systems around Pittsburgh. The primary outcomes were clinically significant depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms, suicidal ideation or behavior, and grief reactions since COVID-19. RESULTS Adolescents were significantly more likely to report moderate to severe symptoms of depression (55% vs. 29%; χ2 = 122, df = 1; p < .001), anxiety (48% vs. 29%; χ2 = 73; df = 1; p < .001), PTSD (45% vs. 33%; χ2 = 12; df = 1; p < .001), suicidal ideation or behavior (38% vs. 16%; χ2 = 117; df = 1; p < .001), and sleep problems (69% vs. 57%; χ2 = 26; df = 1; p < .001) compared to adults. The rates of intense grief reactions among those who lost someone to COVID-19 was 55%. Loneliness was the most common predictor across outcomes and higher number of hours spent on social media and exposure to media about COVID-19 predicted depression symptoms and suicidal ideation or behavior in adolescents. CONCLUSIONS The COVID-19 pandemic is associated with increased rates of clinically significant psychiatric symptoms. Loneliness could put individuals at increased risk for the onset of psychiatric disorders.
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Affiliation(s)
| | | | - Brian Thoma
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | | | | | | | | | - Meredith Deal
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | - Tiffany Coury
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Sarah Riston
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Nadine M. Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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18
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Laporte PP, Matijasevich A, Munhoz TN, Santos IS, Barros AJD, Pine DS, Rohde LA, Leibenluft E, Salum GA. Disruptive Mood Dysregulation Disorder: Symptomatic and Syndromic Thresholds and Diagnostic Operationalization. J Am Acad Child Adolesc Psychiatry 2021; 60:286-295. [PMID: 32004697 PMCID: PMC9073144 DOI: 10.1016/j.jaac.2019.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/18/2019] [Accepted: 01/22/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To identify the most appropriate threshold for disruptive mood dysregulation disorder (DMDD) diagnosis and the impact of potential changes in diagnostic rules on prevalence levels in the community. METHOD Trained psychologists evaluated 3,562 preadolescents/early adolescents from the 2004 Pelotas Birth Cohort with the Development and Well-Being Behavior Assessment (DAWBA). The clinical threshold was assessed in 3 stages: symptomatic, syndromic, and clinical operationalization. The symptomatic threshold identified the response category in each DAWBA item, which separates normative misbehavior from a clinical indicator. The syndromic threshold identified the number of irritable mood and outbursts needed to capture preadolescents/early adolescents with high symptom levels. Clinical operationalization compared the impact of AND/OR rules for combining irritable mood and outbursts on impairment and levels of psychopathology. RESULTS At the symptomatic threshold, most irritable mood items were normative in their lowest response categories and clinically significant in their highest response categories. For outbursts, some indicated a symptom even when present at only a mild level, while others did not indicate symptoms at any level. At the syndromic level, a combination of 2 out of 7 irritable mood and 3 out of 8 outburst indicators accurately captured a cluster of individuals with high level of symptoms. Analysis combining irritable mood and outbursts delineated nonoverlapping aspects of DMDD, providing support for the OR rule in clinical operationalization. The best DMDD criteria resulted in a prevalence of 3%. CONCLUSION Results provide information for initiatives aiming to provide data-driven and clinically oriented operationalized criteria for DMDD.
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Affiliation(s)
- Paola Paganella Laporte
- Universidade Federal do Rio Grande do Sul, Graduate Program in Psychiatry and Behavioral Sciences, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Brazil.
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil; Faculty of Medicine FMUSP, University of São Paulo, Brazil
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil; Faculty of Psychology, Federal University of Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Daniel Samuel Pine
- Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Luis Augusto Rohde
- Universidade Federal do Rio Grande do Sul, Graduate Program in Psychiatry and Behavioral Sciences, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Brazil
| | - Ellen Leibenluft
- Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Giovanni Abrahão Salum
- Universidade Federal do Rio Grande do Sul, Graduate Program in Psychiatry and Behavioral Sciences, Brazil; Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Brazil
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19
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Stevens C, Zhang E, Cherkerzian S, Chen JA, Liu CH. Problematic internet use/computer gaming among US college students: Prevalence and correlates with mental health symptoms. Depress Anxiety 2020; 37:1127-1136. [PMID: 32939888 PMCID: PMC8635392 DOI: 10.1002/da.23094] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/11/2020] [Accepted: 08/20/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite widespread internet use and computer gaming, as well as concerns about online addiction, little is known regarding the relationship between problematic internet use/computer gaming and mental health (MH) symptomatology among US college students. To address this gap, the present study examines a large, nation-wide sample of US college students to assess the rate of problematic internet use/computer gaming and its association with MH symptoms. METHODS Using data from 43,003 undergraduates participating in the 2017 American College Health Association-National College Health Assessment, we examined rates of problematic internet use/computer gaming, defined as self-reported internet use/computer gaming that negatively affected academic performance. Logistic regression using a generalized estimating equations approach to adjust for clustering by school examined whether rates of MH symptomatology differed among students who reported problematic versus nonproblematic internet use and computer gaming. RESULTS Ten percent of students reported problematic internet use/computer gaming that had negatively impacted academic performance. Adjusting for a range of covariates, students reporting problematic internet use/computer gaming had higher rates of all 11 MH indicators examined, with odds ratios ranging from 1.42 ("ever attempted suicide") to 3.90 ("ever felt overwhelmed by all you had to do"). CONCLUSIONS Problematic internet use/computer gaming is reported by 10% of undergraduate students and represents a significant correlate of MH symptomatology. These findings suggest that problematic internet use/computer gaming will be an important public health focus for college campuses.
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Affiliation(s)
| | - Emily Zhang
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Sara Cherkerzian
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Justin A. Chen
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Cindy H. Liu
- Department of Pediatric Newborn Medicine & Psychiatry, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
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20
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Sinopoli VM, Erdman L, Burton CL, Park LS, Dupuis A, Shan J, Goodale T, Shaheen SM, Crosbie J, Schachar RJ, Arnold PD. Serotonin system genes and hoarding with and without other obsessive-compulsive traits in a population-based, pediatric sample: A genetic association study. Depress Anxiety 2020; 37:760-770. [PMID: 32092211 DOI: 10.1002/da.22996] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 11/20/2019] [Accepted: 12/17/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hoarding, originally only considered a symptom of obsessive-compulsive disorder (OCD), is now categorized as a separate disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). We studied candidate serotonergic genes and the distinctness of hoarding in children and adolescents and hypothesized that unique gene variants would be associated with hoarding alone. METHODS We examined obsessive-compulsive (OC) traits, including hoarding, in a total of 5,213 pediatric participants in the community. We genotyped candidate serotonin genes (5-HTTLPR polymorphism in SLC6A4 for 2,018 individuals and single nucleotide polymorphisms [SNPs] across genes SLC6A4, HTR2A, and HTR1B for 4,711 individuals). In a previous study conducted by our group in the same sample, we identified a significant association between 5-HTTLPR and hoarding in males. In this study, we examined hoarding more closely by testing the association between serotonin gene variants and hoarding traits with and without other accompanying OC traits. RESULTS The [LG +S] variant in 5-HTTLPR was significantly associated with hoarding alone in males (p-value of 0.009). There were no significant findings for 5-HTTLPR in females. There were no significant findings after correction for multiple comparisons using SNP array data, but top SNP findings suggested that variation downstream of HTR1B may be implicated in hoarding alone in females. CONCLUSIONS Our results suggest specific serotonin gene variants are associated with hoarding traits alone, differing between sexes. Top findings are in line with our former study, suggesting that individuals with hoarding alone were driving previous results. Our paper supports hoarding disorder's new designation.
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Affiliation(s)
- Vanessa M Sinopoli
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Lauren Erdman
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Computer Science, University of Toronto, Toronto, ON, Canada
| | - Christie L Burton
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Laura S Park
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Dupuis
- Clinical Research Services, The Hospital for Sick Children, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Janet Shan
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Tara Goodale
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - S-M Shaheen
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jennifer Crosbie
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Russell J Schachar
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul D Arnold
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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21
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Oh H, Falbo T, Lee K. Culture Moderates the Relationship between Family Obligation Values and the Outcomes of Korean and European American College Students. J Cross Cult Psychol 2020; 51:511-525. [PMID: 33093686 DOI: 10.1177/0022022120933682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/16/2022]
Abstract
Family obligation values have been described as an important element of collectivistic cultures that are related to the development of positive emotional well-being and motivation in high school and college students. The present study tested the hypothesis that culture moderates the relationship between family obligation values and the outcomes of Korean (n = 249) and European American (n = 251) college students. The results provided support for this hypothesis. Specifically, for Koreans, family obligation values were significantly and positively correlated with descriptions of parents as being more supportive of the self-determination of their children, which was found to mediate the relationship between family obligation values and student outcomes. Furthermore, family obligation values were more strongly associated with the motivation, self-esteem, and depression of Koreans than European Americans. European American students expressed lower family obligation values and the intensity of these values were unrelated to their emotional well-being. Family obligation values were positively correlated with reports of self-determined motivation for Korean students, and negatively correlated with reports of self-determined motivation for European American students. The results are discussed in terms of cultural moderation and self-determination theory.
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Affiliation(s)
- Haein Oh
- University of Texas at Austin, USA
| | | | - Kejin Lee
- University of Texas at Austin, USA.,University of Nebraska-Lincoln
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22
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Hentges RF, Graham SA, Fearon P, Tough S, Madigan S. The chronicity and timing of prenatal and antenatal maternal depression and anxiety on child outcomes at age 5. Depress Anxiety 2020; 37:576-586. [PMID: 32419282 DOI: 10.1002/da.23039] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 07/11/2019] [Revised: 05/02/2020] [Accepted: 05/03/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Maternal depression and anxiety have been associated with deleterious child outcomes. It is, however, unclear how the chronicity and timing of maternal mental health problems predict child development outcomes. The aim of the current study was to assess the effect of both chronicity and timing of maternal anxiety and depression in pregnancy, infancy, and the toddler period on children's internalizing and externalizing symptoms, as well as social and communication skills at age 5. METHOD Participants were 1,992 mother-child pairs drawn from a large prospective pregnancy cohort. Mothers reported on anxiety and depression symptoms with clinical screening tools at six time points between <25 weeks gestation and 3 years postpartum. Child outcomes were assessed at age 5. RESULTS Effect sizes were small for brief incidents of depression/anxiety and increased for intermittent and chronic problems (i.e., three or more timepoints) compared with mothers who had never experienced clinical-level anxiety or depression. Maternal anxiety/depression during pregnancy, infancy, and toddlerhood predicted all child outcomes, even after controlling for depression/anxiety during the other timepoints. However, maternal anxiety and depression during toddlerhood had a stronger association with child internalizing/externalizing symptoms and communication skills than either prenatal or postpartum depression/anxiety. CONCLUSIONS Increasing number of exposures to clinical-level anxiety and depression is related to poorer child outcomes. Neither prenatal nor postpartum periods emerged as "sensitive" periods. Rather, maternal depression and anxiety during toddlerhood was more strongly associated with child outcomes at age 5. Results highlight the need for continued support for maternal mental health across early childhood.
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Affiliation(s)
- Rochelle F Hentges
- Department of Psychology, University of Calgary, Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Canada
| | - Susan A Graham
- Department of Psychology, University of Calgary, Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Canada
| | - Pasco Fearon
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK.,Developmental Neuroscience Unit, Anna Freud National Centre for Children and Families, London, UK
| | - Suzanne Tough
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Canada
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23
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Schneider SC, Knott L, Cepeda SL, Hana LM, McIngvale E, Goodman WK, Storch EA. Serious negative consequences associated with exposure and response prevention for obsessive-compulsive disorder: A survey of therapist attitudes and experiences. Depress Anxiety 2020; 37:418-428. [PMID: 32048376 DOI: 10.1002/da.23000] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 10/08/2019] [Revised: 12/30/2019] [Accepted: 01/27/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Many therapists are reluctant to conduct exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD). Negative beliefs about the safety and tolerability of ERP are common, especially for harm-related OCD symptoms. The study examined the nature and frequency of ERP-related serious negative consequences (SNC) and therapist attitudes and experiences providing ERP for harm-related OCD. METHODS An anonymous survey was completed by 277 therapists with experience treating OCD using ERP. Questions assessed clinical experiences of harm-related exposures, the nature of SNC, and concerns and clinical considerations regarding ERP. RESULTS Therapist's willingness to treat harm-related OCD was high. SNCs were reported for 6 clients (per-client risk: adults 0.05%, youth 0.01%) and 13 therapists (per therapist risk 4.73%, therapist per-year risk 0.004%). Qualitative analysis identified themes relating to the conduct of treatment, specific exposure types, professional issues, and negative perceptions of ERP. CONCLUSION SNC associated with ERP for OCD are rare and primarily represent unintended secondary consequences of OCD or misunderstandings regarding the process and rationale behind ERP. Improving access to ERP will require good communication with clients, families, and other professionals regarding the rationale and safety of ERP.
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Affiliation(s)
- Sophie C Schneider
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Lindsey Knott
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Sandra L Cepeda
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Lynn M Hana
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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24
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Cervin M, Storch EA, Piacentini J, Birmaher B, Compton SN, Albano AM, Gosch E, Walkup JT, Kendall PC. Symptom-specific effects of cognitive-behavioral therapy, sertraline, and their combination in a large randomized controlled trial of pediatric anxiety disorders. J Child Psychol Psychiatry 2020; 61:492-502. [PMID: 31471911 DOI: 10.1111/jcpp.13124] [Citation(s) in RCA: 6] [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] [Accepted: 08/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pediatric anxiety disorders are highly prevalent and associated with significant functional disabilities and lifelong morbidity. Cognitive-behavioral therapy (CBT), sertraline, and their combination are effective treatments, but little is known about how these treatments exert their effects. METHODS Using network intervention analysis (NIA), we analyzed data from the largest randomized controlled treatment trial of pediatric anxiety disorders (Child/Adolescent Anxiety Multimodal Study, NCT00052078, clinicaltrials.gov/ct2/show/NCT00052078) and outlined the causal symptom domain-specific effects of CBT, sertraline, and their combination over the course of the 12-week treatment while taking into account both specificity and overlap between symptom domains. RESULTS All active treatments produced positive effects with the most pronounced and consistent effects emerging in relation to psychological distress, family interference, and avoidance. Psychological distress was consistently the most and physical symptoms the least central symptom domain in the disorder network. CONCLUSIONS All active treatments showed beneficial effects when compared to placebo, and NIA identified that these effects were exerted similarly across treatments and primarily through a reduction of psychological distress, family interference, and avoidance. CBT and sertraline may have differential mechanisms of action in relation to psychological distress. Given the lack of causal effects on interference outside family and physical symptoms, interventions tailored to target these domains may aid in the building of more effective treatments. Psychological distress and avoidance should remain key treatment focuses because of their central roles in the disorder network. The findings inform and promote developing more effective interventions.
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Affiliation(s)
- Matti Cervin
- Department of Clinical Sciences Lund, Lund University and Skåne Child and Adolescent Psychiatry, Lund, Sweden
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - John Piacentini
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Scott N Compton
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | | | - Elizabeth Gosch
- Department of Clinical Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - John T Walkup
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
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25
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Ludlow C, Hurn R, Lansdell S. A Current Review of the Children and Young People's Improving Access to Psychological Therapies (CYP IAPT) Program: Perspectives on Developing an Accessible Workforce. Adolesc Health Med Ther 2020; 11:21-28. [PMID: 32104131 PMCID: PMC7023850 DOI: 10.2147/ahmt.s196492] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/14/2020] [Indexed: 12/01/2022] Open
Abstract
The CYP IAPT program has played a leading role in workforce development in the Child and Adolescent Mental Health Service (CAMHS) in England since its inception in 2011. Despite promising evidence of CYP IAPT's benefits, significant wait times for CAHMS have convinced policy makers that a new direction for CYP IAPT is required. Since 2017, the CYP IAPT program has changed its aim from workforce development to workforce expansion, with the project aiming to train 1700 new psychological practitioners by 2021. The CYP IAPT program now consists of three training streams (a) a low-intensity workforce, (b) a schools-based workforce, and (c) a high-intensity workforce based on the original CYP IAPT curriculum. The purpose of this paper is to outline the three CYP IAPT workforce streams. As will be reviewed, changes to CYP IAPT have occurred within the context of emerging ideas from dissemination science and government reviews that outline the shortcomings of traditional service models. Consequently, CYP IAPT practitioners are now increasingly being trained in the delivery of novel psychological interventions to address some of these shortcomings. A range of low-intensity interventions are being deployed by CYP IAPT practitioners to target mild-to-moderate anxiety, depression, and conduct. A recent meta-analysis indicates that low-intensity psychological interventions show promise for children and adolescents in efficacy trials. Nevertheless, further research is required to understand its effectiveness in real-world settings and to see if treatment effects are sustained over time. As such, this paper recommends that CYP IAPT services evaluate the long-term effectiveness of low-intensity work and subject their methods and findings to peer review.
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Affiliation(s)
- Chris Ludlow
- Child Wellbeing Practitioner Program (CYP IAPT), Postgraduate Studies Department, Anna Freud Centre, London, UK
| | - Russell Hurn
- CYP IAPT Therapy Program, Postgraduate Studies Department, Anna Freud Centre, London, UK
| | - Stuart Lansdell
- Child Wellbeing Practitioner Program (CYP IAPT), Postgraduate Studies Department, Anna Freud Centre, London, UK
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26
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Alshekaili M, Al-Balushi N, Mohammed Al-Alawi, Mirza H, Al-Huseini S, Al-Balushi M, Panchatcharam SM, Mahadevan S, Al-Sibani N, Al-Farsi YM, Al-Adawi S. Risk factors underlying depressive symptoms among parents/primary care providers of kids with autism spectrum disorder: A study from Muscat, Oman. Perspect Psychiatr Care 2019; 55:600-606. [PMID: 30891771 DOI: 10.1111/ppc.12374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/22/2018] [Revised: 02/08/2019] [Accepted: 03/07/2019] [Indexed: 11/30/2022] Open
Abstract
AIM To explore the prevalence and correlates of depressive symptoms among parents/primary care providers of children with autism spectrum disorder (ASD). DESIGN AND METHODS A cross-sectional analytical study was conducted among a systematic random sample of parents/caregivers of children with diagnosis of ASD in Muscat, Oman. Depressive symptoms were quantified using the Patient Health Questionnaire-9. FINDINGS The response rate was at 86% (n = 80) and the prevalence of depressive symptoms, at 71.3% (95% confidence interval, 60.5-80.1). Logistic regression analyses indicated that unemployment and being the sole parent/caregiver in the family were both significant correlates of depressive symptoms. PRACTICE IMPLICATIONS With an increase in the number of children being diagnosed with ASD, multidimensional preventive and remedial service programs for parents/caregivers will be essential.
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Affiliation(s)
- Muna Alshekaili
- Department of Child and Adolescent Psychiatry, Al Massara Hospital, Ministry of Health, Muscat, Oman
| | - Naser Al-Balushi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Mohammed Al-Alawi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Hassan Mirza
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Salim Al-Huseini
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Manal Al-Balushi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | - Sangeetha Mahadevan
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Nasser Al-Sibani
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Yahya M Al-Farsi
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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27
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Clarkson T, Eaton NR, Nelson EE, Fox NA, Leibenluft E, Pine DS, Heckelman AC, Sequeira SL, Jarcho J. Early childhood social reticence and neural response to peers in preadolescence predict social anxiety symptoms in midadolescence. Depress Anxiety 2019; 36:676-689. [PMID: 31140687 PMCID: PMC6679747 DOI: 10.1002/da.22910] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 08/29/2018] [Revised: 03/26/2019] [Accepted: 04/19/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Early childhood social reticence (SR) and preadolescent social anxiety (SA) symptoms increase the risk for more severe SA in later adolescence. Yet, not all at-risk youth develop more severe SA. The emergence of distinct patterns of neural response to socially evocative contexts during pivotal points in development may help explain this discontinuity. We tested the extent to which brain function during social interactions in preadolescence influenced the effects of SA and early childhood SR on predicting SA symptoms in midadolescence. METHODS Participants (N = 53) were assessed for SR from ages 2 to 7. At age 11, SA symptoms were assessed and brain function was measured using functional magnetic resonance imaging (fMRI) as participants anticipated social evaluation from purported peers with a reputation for being unpredictable, nice, and mean. At age 13, SA symptoms were re-assessed. Moderated-mediation models tested the extent to which early childhood SR, preadolescent SA, and preadolescent brain function predicted midadolescent SA. RESULTS In individuals with preadolescent SA, the presence of early childhood SR and SR-linked differences in brain activation predicted more severe SA in midadolescence. Specifically, in those who exhibited preadolescent SA, greater early childhood SR was associated with enhanced bilateral insula engagement while anticipating unpredictable-versus-nice social evaluation in preadolescence, and more severe SA in midadolescence. CONCLUSIONS SR-linked neural responses to socially evocative peer interactions may predict more severe SA symptoms in midadolescence among individuals with greater preadolescent SA symptoms and childhood SR. This same pattern of neural response may not be associated with more severe SA symptoms in youth with only one risk factor.
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Affiliation(s)
- Tessa Clarkson
- Department of Psychology, Temple University, Philadelphia, PA
| | | | - Eric E. Nelson
- Center for Biobehavioral Health, Nationwide Children’s Hospital, Columbus, Ohio Department of Pediatrics, Ohio State University
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health
| | | | | | - Johanna Jarcho
- Department of Psychology, Temple University, Philadelphia, PA
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28
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Auday ES, Pérez-Edgar KE. Limbic and prefrontal neural volume modulate social anxiety in children at temperamental risk. Depress Anxiety 2019; 36:690-700. [PMID: 31373755 PMCID: PMC6684311 DOI: 10.1002/da.22941] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 05/22/2019] [Accepted: 06/05/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Clinical levels of a social anxiety disorder (SAD) often appear during childhood and rise to a peak during late adolescence. The temperament trait behavioral inhibition (BI), evident early in childhood, has been linked to increased risk for SAD. Functional and structural variations in brain regions associated with the identification of, and response to, fear may support the BI-SAD relation. Whereas relevant functional studies are emerging, the few extant structural studies have focused on adult samples with mixed findings. METHODS A moderated-mediation model was used to examine the relations between BI, SAD symptoms, and brain-volume individual differences in a sample of children at risk for anxiety (ages 9-12; N = 130, 52 BI). RESULTS Our findings indicate that at higher levels of BI, children with smaller anterior insula volumes showed stronger correlations between BI and SAD. In addition, larger ventrolateral prefrontal cortex (vlPFC) volumes were associated with fewer SAD symptoms. CONCLUSIONS These findings support previous reports linking SAD levels with variations in volume and reactivity in both limbic (insula) and prefrontal (vlPFC) regions. These findings set the foundation for further examination of networks of neural structures that influence the transition from BI to SAD across development, helping further clarify mechanisms of risk and resilience.
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Affiliation(s)
- Eran S. Auday
- The Pennsylvania State University,Geisinger Health System
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29
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Barzilay R, Patrick A, Calkins ME, Moore TM, Gur RC, Gur RE. Association between early-life trauma and obsessive compulsive symptoms in community youth. Depress Anxiety 2019; 36:586-595. [PMID: 31066996 DOI: 10.1002/da.22907] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 12/14/2018] [Revised: 03/27/2019] [Accepted: 04/05/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Obsessive-compulsive symptoms (OCS) in youth are common, have heterogeneous manifestations, and have been shown to be associated with serious psychopathology. While early-life trauma exposure is associated with increased risk for obsessive-compulsive disorder (OCD), its association with different OCS and its clinical relevance for serious psychopathology is unclear. Here we aimed to evaluate associations among traumatic stressful events (TSE), OCS, and serious psychiatric conditions in community youth. METHODS We studied nonmental-help seeking youths from the Philadelphia Neurodevelopmental Cohort (N = 7054, aged 11-21, 54% females, 52% prepubertal), assessed for lifetime TSE exposure and OCS. Regression models investigated cross-sectional associations of TSEs with OCS, and associations with depression, suicide ideation and psychosis. Models examined sex and puberty effects, controlling for age and socioeconomic status. RESULTS Trauma exposure was associated with higher OCS rates, especially in females (Trauma × Sex interaction Wald = 7.93, p = 0.005) and prepuberty (Trauma × Puberty interaction Wald = 7.68, p = 0.006). TSEs were associated with all OCS manifestations, most prominently with bad intrusive thoughts (odds ratio [OR] = 1.63). Assaultive TSEs, especially sexual assault, showed stronger associations with OCS compared with nonassaultive TSEs. While TSEs and OCS were independently associated with depression, suicide ideation, and psychosis, a significant interaction was observed only in association with increased rates of psychosis (Trauma × OCS interaction Wald = 5.08, p = 0.024). CONCLUSION Early-life trauma is associated with OCS in a dose-response manner, more so in females and prepuberty. The trauma-OCS association varied by load, type of trauma, and by OCS subtypes. Trauma-OCS appears a detrimental combination in association with psychosis.
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Affiliation(s)
- Ran Barzilay
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Ariana Patrick
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Monica E Calkins
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Tyler M Moore
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Ruben C Gur
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Raquel E Gur
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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30
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Abstract
Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) have a high prevalence of obesity, but the relationship between these two problems is not clear. Chronotype preferences may be one of the possible mechanisms underlying the link between ADHD and obesity. This is the first study to investigate whether chronotype preferences are a mechanism linking ADHD symptoms to obesity in children and adolescents. This cross-sectional study included 110 drug-naive children and adolescents aged 7-17 years with ADHD. The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) was used to diagnose ADHD or to exclude psychiatric comorbidity. The Conners' Parents Rating Scale-Revised Short Version (CPRS-RS) and Children's Chronotype Questionnaire (CCQ) were used to assess the severity of ADHD symptoms and chronotype preferences. Body mass index (BMI) was calculated and classified according to national age- and gender-specific reference values. The participants were divided into three groups as normal weight (<85%, n = 38), overweight (85%-95%, n = 30) and obesity (>95%, n = 42) according to their BMI percentile. There were statistically significant differences between the three groups in terms of chronotype preference (p = .000). Morningness preference was 86.84% in the normal BMI group and 26.19% in the obese BMI group. Eveningness preference was 7.89% in the normal BMI group and 61.90% in the obese BMI group. There was a correlation between the BMI percentile scores and the morningness/eveningness scale (M/E) scores. Moreover, there was a correlation between the BMI percentile scores and the oppositional and ADHD index scores. According to logistic regression analysis, the odds ratio of having evening type for obesity was 5.66 and the odds ratio of having morning type for normal weight was 13.03. Independently from ADHD symptoms, eveningness was directly related to obesity and morningness was directly related to normal weight. Prospective studies should be performed to better understand the relationship between ADHD, overweight/obesity and chronotype.
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Affiliation(s)
- Serhat Türkoğlu
- a Department of Child and Adolescent Psychiatry , Selçuk University Faculty of Medicine , Konya , Turkey
| | - Fatih Hilmi Çetin
- a Department of Child and Adolescent Psychiatry , Selçuk University Faculty of Medicine , Konya , Turkey
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31
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Halonen JI, Merikukka M, Gissler M, Kerkelä M, Virtanen M, Ristikari T, Hiilamo H, Lallukka T. Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood-The 1987 Finnish Birth Cohort. Depress Anxiety 2019; 36:305-312. [PMID: 30329200 DOI: 10.1002/da.22847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 06/12/2018] [Revised: 08/14/2018] [Accepted: 09/22/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence. METHODS Study population consisted of the 1987 Finnish Birth Cohort. Data on parents' psychiatric care or work disability due to mental diagnosis between 1987 and 2000 and the cohort participants' health and social factors between 2001 and 2005 were derived from administrative national registers. From 2006 through 2015, 52,182 cohort participants were followed for admittance of psychiatric work disability due to depressive or anxiety disorders. First, we applied a pathway analysis to examine the occurrence of each path. We then used mediation analysis to assess the proportion of association between parental mental disorders and work disability mediated by offspring's health and social disadvantage. RESULTS The pathway model indicated that the association from parental mental disorders to offspring's work disability due to depressive or anxiety disorder is through mental disorders and social disadvantage in adolescence. Odds Ratio for the total effect of parental mental disorders on offspring's psychiatric work disability was 1.85 (95% confidence interval [CI] 1.46-2.34) in the model including offspring's mental disorders that mediated this association by 35%. Corresponding results were 1.86 (95% CI 1.47-2.35) and 28% for social disadvantage in adolescence. CONCLUSIONS These findings suggest that intergenerational determination of work disability due to mental disorders could be addressed by actions supporting mental health and social circumstances in adolescence.
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Affiliation(s)
| | - Marko Merikukka
- Department of Welfare, National Institute for Health and Welfare (THL), Oulu, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Mika Gissler
- Information Services Department, National Institute for Health and Welfare (THL), Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martta Kerkelä
- Department of Welfare, National Institute for Health and Welfare (THL), Oulu, Finland
| | - Marianna Virtanen
- Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden
| | - Tiina Ristikari
- Department of Welfare, National Institute for Health and Welfare (THL), Oulu, Finland
| | - Heikki Hiilamo
- Social and Public Policy, Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
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32
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Hangartner RB, Wienke Totura CM, Labouliere CD, Gryglewicz K, Karver MS. Benchmarking the "Question, Persuade, Refer" Program Against Evaluations of Established Suicide Prevention Gatekeeper Trainings. Suicide Life Threat Behav 2019; 49:353-370. [PMID: 29470846 PMCID: PMC6105730 DOI: 10.1111/sltb.12430] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 03/07/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022]
Abstract
Gatekeeper training is a common approach for aiding suicidal youth. This study utilizes comparative effectiveness "benchmarks" from established programs to evaluate the Question, Persuade, Refer (QPR) program. The QPR program was implemented with adults (N = 2,389) working in youth-serving community agencies. Questionnaires assessed suicide prevention knowledge, attitudes, subjective norms, perceived behavioral control, and behaviors. Consistent with benchmarked studies, participants in QPR demonstrated knowledge and suicide prevention behavior gains compared with control groups. Future research should utilize benchmarking methods as a measure of effectiveness, and more thoroughly assess mechanisms that promote behavior change.
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Affiliation(s)
| | | | - Christa D. Labouliere
- Division of Behavioral Health Services & Policy Research, New York State Psychiatric Institute, Columbia University
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33
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Herres J, Shearer A, Kodish T, Kim B, Wang SB, Diamond GS. Differences in Suicide Risk Severity Among Suicidal Youth With Anxiety Disorders. Crisis 2019; 40:333-339. [PMID: 30813828 DOI: 10.1027/0227-5910/a000571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Adolescent suicidality is a growing public health concern. Although evidence supports a link between anxiety and suicidality, little is known about risk associated with specific anxiety disorders. Aims: This study examined the prevalence of anxiety disorders in a sample of adolescents with depression and suicidal ideation and the associations between specific anxiety disorders and suicide ideation severity and attempt history. Method: The sample consisted of 115 adolescents (Mage = 14.96 years; 55.8% African American) entering a clinical trial for suicidal ideation and depressive symptoms. Prior to treatment, adolescents completed self-report and interview measures. Results: In all, 48% of the sample met criteria for an anxiety disorder, 22% met criteria for social anxiety disorder (SAD), and 40% met criteria for major depressive disorder (MDD). SAD was uniquely associated with more severe suicidal ideation. Limitations: Findings may not generalize to all suicidal adolescents, and non-measured variables may account for the observed relationships. Conclusion: Future research should examine whether targeting social anxiety would improve treatment response for suicidal adolescents.
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Affiliation(s)
- Joanna Herres
- Department of Psychology, The College of New Jersey, Ewing, NJ, USA
| | - Annie Shearer
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tamar Kodish
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Barunie Kim
- Department of Couple and Family Therapy, Drexel University, Philadelphia, PA, USA
| | - Shirley B Wang
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Guy S Diamond
- Department of Couple and Family Therapy, Drexel University, Philadelphia, PA, USA
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34
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Kim KL, Christensen RE, Ruggieri A, Schettini E, Freeman JB, Garcia AM, Flessner C, Stewart E, Conelea C, Dickstein DP. Cognitive performance of youth with primary generalized anxiety disorder versus primary obsessive-compulsive disorder. Depress Anxiety 2019; 36:130-140. [PMID: 30375085 DOI: 10.1002/da.22848] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 02/14/2018] [Revised: 09/12/2018] [Accepted: 09/22/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Despite gains made in the study of childhood anxiety, differential diagnosis remains challenging because of indistinct boundaries between disorders and high comorbidity. This is certainly true for generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD) as they share multiple cognitive processes (e.g., rumination, intolerance of uncertainty, and increased attention to threat). Disentangling such cognitive characteristics and, subsequently, underlying mechanisms could serve to inform assessment and treatment practices, and improve prognoses. METHODS The current study sought to compare the cognitive performance (working memory, visuospatial memory, planning ability/efficiency, and cognitive flexibility), indexed by the Cambridge Neuropsychological Automated Battery (CANTAB) among three nonoverlapping groups of youth: (1) those diagnosed with OCD (n = 28), (2) those diagnosed with GAD, not OCD (n = 34), and (3) typically-developing controls (TDC) (n = 65). RESULTS Results showed that OCD and GAD youth demonstrated neurocognitive deficits in planning ability/efficiency, cognitive flexibility, and visual processing when compared to TDC, with potential diagnostic specificity such that youth with GAD or OCD had unique deficits compared to TDC and to one another. Specifically, youth with OCD demonstrated significantly impaired planning ability compared to youth in the GAD and TDS groups, whereas youth with GAD demonstrated greater cognitive inflexibility and delayed visual processing compared to youth in the OCD and TDC groups. CONCLUSIONS Future studies should expand upon these findings with more comprehensive assessment of cognitive functioning by including self- and parent-report forms, and neuroimaging to link behavioral findings with subjective ratings and neurocircuitry. Altogether, data can then inform future assessment and treatment targets.
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Affiliation(s)
- Kerri L Kim
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Rachel E Christensen
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Amanda Ruggieri
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Elana Schettini
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jennifer B Freeman
- Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island.,PARC Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Abbe M Garcia
- Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island.,PARC Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Christopher Flessner
- Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island.,PARC Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Elyse Stewart
- Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island.,PARC Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Christine Conelea
- Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island.,PARC Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island
| | - Daniel P Dickstein
- PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior in the Alpert Medical School, Brown University, Providence, Rhode Island
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Li YI, Starr LR, Wray-Lake L. Insomnia mediates the longitudinal relationship between anxiety and depressive symptoms in a nationally representative sample of adolescents. Depress Anxiety 2018; 35:583-591. [PMID: 29697888 PMCID: PMC5992096 DOI: 10.1002/da.22764] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 04/26/2017] [Revised: 12/28/2018] [Accepted: 03/31/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Anxiety and depression are commonly comorbid with each other, with anxiety often temporally preceding the development of depression. Although increasingly research has begun to investigate the role of sleep problems in depression, no study has examined insomnia as a mediator in the longitudinal relationship between anxiety and subsequent depression. METHODS The current study utilizes data from Waves I, II, and IV of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative prospective study conducted over a 14-year period (n = 20,745, 50.5% female, M age at Wave I = 16.20). Participants completed portions of the Center for Epidemiologic Studies Depression Scale at Waves I and IV to assess depressive symptoms, a six-item anxiety measure at Wave I, and three items assessing insomnia, sleep quality, and sleep duration at Wave II. RESULTS Structural equation modeling indicated that insomnia and unrestful sleep significantly mediated the relationship between anxiety and subsequent depression. The relationship between anxiety and depression was not significantly mediated by sleep duration. CONCLUSIONS Findings suggest that anxiety may increase risk for the development of later depression through insomnia.
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Affiliation(s)
- Y. Irina Li
- Clinical and Social Sciences in Psychology, University of Rochester, Rochester, New York, USA
| | - Lisa R. Starr
- Clinical and Social Sciences in Psychology, University of Rochester, Rochester, New York, USA
| | - Laura Wray-Lake
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
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36
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Gray WN, Netz M, McConville A, Fedele D, Wagoner ST, Schaefer MR. Medication adherence in pediatric asthma: A systematic review of the literature. Pediatr Pulmonol 2018; 53:668-684. [PMID: 29461017 DOI: 10.1002/ppul.23966] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 10/28/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To provide a systematic review of correlates of adherence to inhaled corticosteroids (ICS) in pediatric asthma across the individual, family, community, and healthcare system domains. METHODS Articles assessing medication adherence in pediatric asthma published from 1997 to 2016 were identified using PsychINFO, Medline, and CINAHL. Search terms included asthma, compliance, self-management, adherence, child, and youth. Search results were limited to articles: 1) published in the US; 2) using a pediatric population (0-25 years old); and 3) presenting original data related to ICS adherence. Correlates of adherence were categorized according to the domains of the Pediatric Self-Management Model. Each article was evaluated for study quality. RESULTS Seventy-nine articles were included in the review. Family-level correlates were most commonly reported (N = 51) and included socioeconomic status, race/ethnicity, health behaviors, and asthma knowledge. Individual-level correlates were second-most common (N = 37), with age being the most frequently identified negative correlate of adherence. Health care system correlates (N = 24) included enhanced asthma care and patient-provider communication. Few studies (N = 10) examined community correlates of adherence. Overall study quality was moderate, with few quantitative articles (26.38%) and qualitative articles (21.4%) referencing a theoretical basis for their studies. CONCLUSIONS All Pediatric Self-Management Model domains were correlated with youth adherence, which suggests medication adherence is influenced across multiple systems; however, most studies assessed adherence correlates within a single domain. Future research is needed that cuts across multiple domains to advance understanding of determinants of adherence.
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Affiliation(s)
- Wendy N Gray
- Department of Psychology, Auburn University, Auburn University, AL
| | - Mallory Netz
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Andrew McConville
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - David Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Scott T Wagoner
- Department of Psychology, Auburn University, Auburn University, AL
| | - Megan R Schaefer
- Department of Psychology, Auburn University, Auburn University, AL
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37
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Wald N, Carthy T, Shenaar-Golan V, Tadmor-Zisman Y, Ziskind M. Influence of maternal negative emotion reactivity and cognitive reappraisal on child anxiety disorder. Depress Anxiety 2018; 35:353-359. [PMID: 29624211 DOI: 10.1002/da.22745] [Citation(s) in RCA: 9] [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: 08/16/2017] [Revised: 12/26/2017] [Accepted: 02/09/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Anxiety disorders are among the most common psychopathologies in childhood. Two underlying contributors to child anxiety disorders (ADs) are negative emotional hyper-reactivity and deficits in reappraisal, a cognitive strategy of emotion regulation. Given that emotion regulation develops in the context of parent-child interaction, the aim of this study was to fill a research gap regarding the association between maternal negative emotional reactivity (NER) and reappraisal and child anxiety by examining (a) whether mothers of children with ADs display abnormalities in emotional reactivity and reappraisal compared to mothers of children without ADs; (b) whether maternal NER and reappraisal are associated with child anxiety; and (c) whether maternal reactivity and reappraisal significantly explain the variance in the level of child anxiety beyond the level of maternal anxiety. METHOD Forty-nine mothers and their AD children (aged 10-17) were assessed at admission to an anxiety disorder clinic and were compared to a control group of 42 mothers and their non-anxious (NA) children. Child and maternal anxiety were assessed, as well as maternal NER and reappraisal. RESULTS Mothers of AD children showed a higher NER as well as reappraisal deficits compared to the control group. Self-rated child anxiety was associated with maternal deficits in reappraisal. The variance in child anxiety was significantly explained by the level of maternal anxiety as well as maternal reappraisal deficits. CONCLUSIONS This study suggests that maternal NER and reappraisal play an important role in child anxiety and should be considered in prevention and intervention of childhood ADs.
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Affiliation(s)
- Nava Wald
- Bar-Ilan University, Ramat Gan, Israel.,Ziv Medical Center, Zefat, Israel.,Tel-Hai College, Tel-Hai, Israel
| | - Tal Carthy
- Interdisciplinary Center (IDC), Herzliya, Israel
| | | | - Yael Tadmor-Zisman
- Bar-Ilan University, Ramat Gan, Israel.,Schneider's Children Medical Center of Israel, Petah Tikva, Israel.,Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Abend R, de Voogd L, Salemink E, Wiers RW, Pérez-Edgar K, Fitzgerald A, White LK, Salum GA, He J, Silverman WK, Pettit JW, Pine DS, Bar-Haim Y. Association between attention bias to threat and anxiety symptoms in children and adolescents. Depress Anxiety 2018; 35:229-238. [PMID: 29212134 PMCID: PMC6342553 DOI: 10.1002/da.22706] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [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: 02/11/2017] [Revised: 07/07/2017] [Accepted: 11/08/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The aim of this report is to examine the association between threat bias and pediatric anxiety symptoms using standardized measures in a large, international, multi-site youth sample. METHODS A total of 1,291 children and adolescents from seven research sites worldwide completed standardized attention bias assessment task (dot-probe task) and child anxiety symptoms measure (Screen for Child Anxiety Related Emotional Disorders). Using a dimensional approach to symptomatology, we conducted regression analyses predicting overall, and disorder-specific, anxiety symptoms severity, based on threat bias scores. RESULTS Threat bias correlated positively with overall anxiety symptoms severity (ß = 0.078, P = .004). Furthermore, threat bias was positively associated specifically with social anxiety (ß = 0.072, P = .008) and school phobia (ß = 0.076, P = .006) symptoms severity, but not with panic, generalized anxiety, or separation anxiety symptoms. These associations were not moderated by age or gender. CONCLUSIONS These findings indicate associations between threat bias and pediatric anxiety symptoms, and suggest that vigilance to external threats manifests more prominently in symptoms of social anxiety and school phobia, regardless of age and gender. These findings point to the role of attention bias to threat in anxiety, with implications for translational clinical research. The significance of applying standardized methods in multi-site collaborations for overcoming challenges inherent to clinical research is discussed.
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Affiliation(s)
- Rany Abend
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Leone de Voogd
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Elske Salemink
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Reinout W. Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Koraly Pérez-Edgar
- Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | | | - Lauren K. White
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA,Childrens Hospital of Philadelphia, Philadelphia, PA, USA
| | - Giovanni A. Salum
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jie He
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | | | - Jeremy W. Pettit
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
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Carson N, Progovac A, Wang Y, Cook BL. A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills. Depress Anxiety 2017; 34:1147-1156. [PMID: 28962069 PMCID: PMC5895183 DOI: 10.1002/da.22681] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 01/19/2017] [Revised: 06/19/2017] [Accepted: 08/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Food and Drug Administration's 2004 antidepressant warning was followed by decreases in antidepressant prescribing for youth. This was due to declines in all types of depression treatment, not just the intended changes in antidepressant prescribing patterns. Little is known about how these patterns varied by race/ethnicity. METHOD Data are Medicaid claims from four U.S. states (2002-2009) for youth ages 5-17. Interrupted time series analyses measured changes due to the warning in levels and trends, by race/ethnicity, of three outcomes: antidepressant prescription fills, depression treatment visits, and incident fluoxetine prescription fills. RESULTS Prewarning, antidepressant fills were increasing across all racial/ethnic groups, fastest for White youth. Postwarning, there was an immediate drop and continued decline in the rate of fills among White youth, more than double the decline in the rate among Black and Latino youth. Prewarning, depression treatment visits were increasing for White and Latino youth. Postwarning, depression treatment stabilized among Latinos, but declined among White youth. Prewarning, incident fluoxetine fills were increasing for all groups. Postwarning, immediate increases and increasing trends of fluoxetine fills were identified for all groups. CONCLUSIONS Antidepressant prescription fills declined most postwarning for White youth, suggesting that risk information may have diffused less rapidly to prescribers or caregivers of minorities. Decreases in depression treatment visits help to explain the declines in antidepressant prescribing and were largest for White youth. An increase in incident fluoxetine fills, the only medication indicated for pediatric depression at the time, suggests that the warning may have shifted prescribing practices.
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Affiliation(s)
- Nicholas Carson
- Center for Multicultural Mental Health Research, Cambridge Health Alliance & Harvard Medical School, 1035 Cambridge Street, Suite 26, Cambridge, MA 02141, Fax: (617) 806-8740, Office: (617) 617-5269
| | - Ana Progovac
- Center for Multicultural Mental Health Research, Cambridge Health Alliance & Harvard Medical School
| | - Ye Wang
- Massachusetts General Hospital
| | - Benjamin L. Cook
- Center for Multicultural Mental Health Research, Cambridge Health Alliance & Harvard Medical School
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Shomaker LB, Kelly NR, Radin RM, Cassidy OL, Shank LM, Brady SM, Demidowich AP, Olsen CH, Chen KY, Stice E, Tanofsky-Kraff M, Yanovski JA. Prevention of insulin resistance in adolescents at risk for type 2 diabetes with depressive symptoms: 1-year follow-up of a randomized trial. Depress Anxiety 2017; 34:866-876. [PMID: 28370947 PMCID: PMC5623599 DOI: 10.1002/da.22617] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/24/2017] [Accepted: 02/07/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Depression is associated with poor insulin sensitivity. We evaluated the long-term effects of a cognitive behavioral therapy (CBT) program for prevention of depression on insulin sensitivity in adolescents at risk for type 2 diabetes (T2D) with depressive symptoms. METHODS One-hundred nineteen adolescent females with overweight/obesity, T2D family history, and mild-to-moderate depressive symptoms were randomized to a 6-week CBT group (n = 61) or 6-week health education (HE) control group (n = 58). At baseline, posttreatment, and 1 year, depressive symptoms were assessed, and whole body insulin sensitivity (WBISI) was estimated from oral glucose tolerance tests. Dual energy X-ray absorptiometry assessed fat mass at baseline and 1 year. Primary outcomes were 1-year changes in depression and insulin sensitivity, adjusting for adiposity and other relevant covariates. Secondary outcomes were fasting and 2-hr insulin and glucose. We also evaluated the moderating effect of baseline depressive symptom severity. RESULTS Depressive symptoms decreased in both groups (P < .001). Insulin sensitivity was stable in CBT and HE (ΔWBISI: .1 vs. .3) and did not differ between groups (P = .63). However, among girls with greater (moderate) baseline depressive symptoms (N = 78), those in CBT developed lower 2-hr insulin than those in HE (Δ-16 vs. 16 μIU/mL, P < .05). Additional metabolic benefits of CBT were seen for this subgroup in post hoc analyses of posttreatment to 1-year change. CONCLUSIONS Adolescent females at risk for T2D decreased depressive symptoms and stabilized insulin sensitivity 1 year following brief CBT or HE. Further studies are required to determine if adolescents with moderate depression show metabolic benefits after CBT.
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Affiliation(s)
- Lauren B. Shomaker
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS),Department of Human Development and Family Studies and Colorado School of Public Health, Colorado State University
| | - Nichole R. Kelly
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Counseling Psychology and Human Services and the Prevention Science Institute, College of Education, University of Oregon
| | - Rachel M. Radin
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Omni L. Cassidy
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Lisa M. Shank
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Sheila M. Brady
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
| | - Cara H. Olsen
- Biostatistics, Department of Preventive Medicine, Uniformed Services University of the Health Sciences
| | - Kong Y. Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, NIH
| | | | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH),Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS)
| | - Jack A. Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)
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Miguel EM, Chou T, Golik A, Cornacchio D, Sanchez AL, DeSerisy M, Comer JS. Examining the scope and patterns of deliberate self-injurious cutting content in popular social media. Depress Anxiety 2017; 34:786-793. [PMID: 28661053 DOI: 10.1002/da.22668] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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] [Received: 12/13/2016] [Revised: 06/05/2017] [Accepted: 06/08/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Social networking services (SNS) have rapidly become a central platform for adolescents' social interactions and media consumption patterns. The present study examined a representative sample of publicly accessible content related to deliberate self-injurious cutting across three SNS platforms: Twitter, Tumblr, and Instagram. METHODS Data collection simulated searches for publicly available deliberate self-injury content on Twitter, Tumblr, and Instagram. Over a six-month period at randomly generated time points, data were obtained by searching "#cutting" on each SNS platform and collecting the first 10 posts generated. Independent evaluators coded posts for presence of the following: (a) graphic content, (b) negative self-evaluations, (c) references to mental health terms, (d) discouragement of deliberate self-injury, and (e) recovery-oriented resources. Differences across platforms were examined. RESULTS Data collection yielded a sample of 1,155 public posts (770 of which were related to mental health). Roughly 60% of sampled posts depicted graphic content, almost half included negative self-evaluations, only 9.5% discouraged self-injury, and <1% included formal recovery resources. Instagram posts displayed the greatest proportion of graphic content and negative self-evaluations, whereas Twitter exhibited the smallest proportion of each. CONCLUSIONS Findings characterize the graphic nature of online SNS deliberate self-injury content and the relative absence of SNS-posted resources for populations seeking out deliberate self-injurious cutting content. Mental health professionals must recognize the rapidly changing landscape of adolescent media consumption, influences, and social interaction as they may pertain to self-harm patterns.
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Affiliation(s)
- Elizabeth M Miguel
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Tommy Chou
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Alejandra Golik
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Danielle Cornacchio
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Amanda L Sanchez
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL, USA
| | - Mariah DeSerisy
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Jonathan S Comer
- Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL, USA
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Huang CY, Cheah CSL, Lamb ME, Zhou N. Associations Between Parenting Styles and Perceived Child Effortful Control Within Chinese Families in the United States, the United Kingdom, and Taiwan. J Cross Cult Psychol 2017; 48:795-812. [PMID: 29276309 PMCID: PMC5714157 DOI: 10.1177/0022022117706108] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current study examined the associations between parentally perceived child effortful control (EC) and the parenting styles of 122 Chinese mothers (36 first-generation Chinese immigrants in the United Kingdom, 40 first-generation Chinese immigrants in the United States, and 46 Taiwanese mothers) of 5- to 7-year-old (M age = 5.82 years, SD = .805; 68 boys and 54 girls) children. The findings showed significant cultural group differences in mothers' reported authoritarian parenting style. Significant associations also emerged between mothers' reports of their children's EC and some parenting dimensions, although there were no cultural group differences in perceived child EC. Different patterns of associations between perceived child EC and parenting styles in these three groups also demonstrated heterogeneity within the Chinese population, and highlighted the need to consider differences between original and receiving societies when seeking to understand parenting and child development in different immigrant groups.
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Affiliation(s)
- Ching-Yu Huang
- University of Cambridge, UK
- Bournemouth University, Poole, UK
| | | | | | - Nan Zhou
- Capital Normal University, Beijing, China
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Chou T, Carpenter AL, Kerns CE, Elkins RM, Green JG, Comer JS. Disqualified qualifiers: evaluating the utility of the revised DSM-5 definition of potentially traumatic events among area youth following the Boston marathon bombing. Depress Anxiety 2017; 34:367-373. [PMID: 27433832 PMCID: PMC5247406 DOI: 10.1002/da.22543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/13/2016] [Revised: 06/20/2016] [Accepted: 06/21/2016] [Indexed: 11/09/2022] Open
Abstract
The DSM-5 includes a revised definition of the experiences that qualify as potentially traumatic events. This revised definition now offers a clearer and more exclusive definition of what qualifies as a traumatic exposure, but little is known about the revision's applicability to youth populations. The present study evaluated the predictive utility of the revised DSM definitional boundaries of traumatic exposure in a sample of youth exposed to the 2013 Boston Marathon bombing and related events METHODS: Caregivers (N = 460) completed surveys 2 to 6 months postbombing about youth experiences during the events and youth posttraumatic stress (PTS) symptoms RESULTS: Experiencing DSM-5 qualifying traumatic events (DSM-5 QTEs) significantly predicted child PTS symptoms (PTSS), whereas DSM-5 nonqualifying stressful experiences (DSM-5 non-QSEs) did not after accounting for DSM-5 QTEs. Importantly, child age moderated the relationship between DSM-5 QTEs and PTSS such that children 7 and older who experienced DSM-5 QTEs showed greater postbombing PTSS, whereas there was no such relationship in children ages 6 and below CONCLUSIONS: Data largely support the revised posttraumatic stress disorder (PTSD) definition of QTEs in older youth, and also highlight the need for further refinement of the QTE definition for children ages 6 and below.
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Affiliation(s)
- Tommy Chou
- Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL
| | - Aubrey L. Carpenter
- Department of Psychological and Brain Sciences, Center for Anxiety and Related Disorders (CARD), Boston University, Boston, MA
| | | | - R. Meredith Elkins
- Columbia University Clinic for Anxiety and Related Disorders (CUCARD), Department of Child and Adolescent Psychiatry, Columbia University Medical Center, New York, NY
| | | | - Jonathan S. Comer
- Department of Psychology, Mental Health Interventions and Technology (MINT) Program, Center for Children and Families, Florida International University, Miami, FL
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Fridman M, Banaschewski T, Sikirica V, Quintero J, Erder MH, Chen KS. Caregiver perspective on pediatric attention-deficit/hyperactivity disorder: medication satisfaction and symptom control. Neuropsychiatr Dis Treat 2017; 13:443-455. [PMID: 28243096 PMCID: PMC5315351 DOI: 10.2147/ndt.s121639] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The caregiver perspective on pediatric attention-deficit/hyperactivity disorder (ADHD) study (CAPPA) was a web-based, cross-sectional survey of caregivers of children and adolescents (6-17 years of age) with ADHD and was conducted in 10 European countries. CAPPA included caregiver assessments of global medication satisfaction, global symptom control, and satisfaction with ADHD medication attributes. Overall, 2,326 caregiver responses indicated that their child or adolescent was currently receiving ADHD medication and completed the "off medication" assessment required for inclusion in the present analyses. Responses to the single-item global medication satisfaction question indicated that 88% were satisfied (moderately satisfied to very satisfied) with current medication and 18% were "very satisfied" on the single-item question. Responses to the single-item global symptom control question indicated that 47% and 19% of caregivers considered their child or adolescent's symptoms to be "controlled" or "very well controlled", respectively. Significant variations in response to the questions of medication satisfaction and symptom control were observed between countries. The correlation between the global medication satisfaction and global symptom control questions was 0.677 (P<0.001). Global medication satisfaction was significantly correlated (P<0.001) with all assessed medication attributes, with the highest correlations observed for symptom control (r=0.601) and effect duration (r=0.449). Correlations of medication attributes with global symptom control were generally lower than with global medication satisfaction but were all statistically significant (P<0.001). CAPPA medication satisfaction and symptom control were also significantly correlated (P<0.001) with symptom control as based on the ADHD-Rating Scale-IV symptom score and the number of bad days per month when on medication. In conclusion, caregiver responses in this European sample suggest that current treatment could potentially be improved. The observed correlations of global medication satisfaction with global symptom control and other CAPPA assessments, including medication attributes, provide support for the inter-connectivity of the medication satisfaction and symptom control.
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Affiliation(s)
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Vanja Sikirica
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Javier Quintero
- Psychiatry Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain
| | - M Haim Erder
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Kristina S Chen
- Global Health Economics Outcomes Research and Epidemiology, Shire, Lexington, MA, USA
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Lebowitz ER, Silverman WK, Martino AM, Zagoory-Sharon O, Feldman R, Leckman JF. Oxytocin response to youth-mother interactions in clinically anxious youth is associated with separation anxiety and dyadic behavior. Depress Anxiety 2017; 34:127-136. [PMID: 28052452 PMCID: PMC5503301 DOI: 10.1002/da.22585] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 08/15/2016] [Revised: 09/20/2016] [Accepted: 11/05/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Anxiety disorders are common in youth and cause significant distress and impairment to the individual and family. Oxytocin (OT), a nine amino acid peptide, is implicated in anxiety regulation and modulation of close interpersonal and attachment behavior. Anxiety disorders have been linked to low levels of salivary OT in youth. Research has also linked oxytocinergic functioning to social support, warm contact, and bonding, and indicated that contact with attachment figures stimulates OT response. We examined OT response to a brief, positive youth-mother interaction in clinically anxious youth. We investigated whether quality of the youth-mother interaction as well as the presence of particular anxiety disorders, are associated with youth OT response. METHOD Salivary OT from 41 youth with primary DSM-5 anxiety disorders was assayed before and after a 7-min youth-mother interaction that was later systematically coded by two reliable coders. Youth and mothers also completed rating scales of youth anxiety symptoms. RESULTS Affective touch, maternal sensitivity, maternal intrusiveness, youth engagement, and youth initiative all contributed significantly to predicting youth OT response. Repeated measures analyses showed that when affective touch was high youth had greater OT response. OT response was positively associated with the presence of separation anxiety disorder (SAD) and with child ratings of separation anxiety. CONCLUSIONS The findings highlight the importance of maternal and dyadic behavior patterns to oxytocinergic response in clinically anxious youth, shed light on the association between OT and SAD, and point to possible intervention strategies.
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Affiliation(s)
| | | | | | | | - Ruth Feldman
- Child Study Center, Yale University, New Haven, CT, USA,Gonda Brain Research, Bar Ilan University, Ramat Gan, Israel
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Amole MC, Cyranowski JM, Wright AGC, Swartz HA. Depression impacts the physiological responsiveness of mother-daughter dyads during social interaction. Depress Anxiety 2017; 34:118-126. [PMID: 28060443 PMCID: PMC5798861 DOI: 10.1002/da.22595] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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] [Received: 06/06/2016] [Revised: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Maternal depression is associated with increased risk of psychiatric illness in offspring. While risk may relate to depressed mothers' difficulties regulating emotions in the context of interacting with offspring, physiological indicators of emotion regulation have rarely been examined during mother-child interactions-and never among mother-adolescent dyads in which both mother and adolescent have histories of major depressive disorder (MDD). METHODS We examined changes in high-frequency heart rate variability (HF-HRV), an indicator of parasympathetic (vagal) function that has been related to depression, stress, social engagement, and emotion regulation, in 46 mother-daughter dyads (23 in which both mother and daughter had an MDD history and 23 never-depressed controls). Hierarchical linear models evaluated changes in HF-HRV while mother-daughter dyads engaged in discussions about shared pleasant events and relationship conflicts. RESULTS While control dyads displayed positive slopes (increases) in HF-HRV during both discussions, MDD dyads displayed minimal change in HF-HRV across discussions. Among controls, HF-HRV slopes were positively correlated between mothers and daughters during the pleasant events' discussion. In contrast, HF-HRV slopes were negatively correlated between MDD mothers and daughters during both discussions. CONCLUSIONS Vagal responses observed in control mother-daughter dyads suggest a pattern of physiological synchrony and reciprocal positive social engagement, which may play a role in adolescent development of secure social attachments and healthy emotion regulation. In contrast, MDD mothers and daughters displayed diminished and discordant patterns of vagal responsiveness. More research is needed to understand the development and consequences of these patterns of parasympathetic responses among depressed mother-daughter dyads.
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Affiliation(s)
- Marlissa C. Amole
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Holly A. Swartz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Meiser-Stedman R, McKinnon A, Dixon C, Boyle A, Smith P, Dalgleish T. Acute stress disorder and the transition to posttraumatic stress disorder in children and adolescents: Prevalence, course, prognosis, diagnostic suitability, and risk markers. Depress Anxiety 2017; 34:348-355. [PMID: 28135019 PMCID: PMC5381710 DOI: 10.1002/da.22602] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/09/2016] [Accepted: 12/24/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Early recovery from trauma exposure in youth is poorly understood. This prospective longitudinal study examined the early course of traumatic stress responses in recently trauma-exposed youth, evaluated the revised DSM-5 acute stress disorder (ASD) and PTSD diagnoses and alternative diagnoses, and identified risk factors for persistent traumatic stress. METHOD Participants were 8- to 17-year-old emergency departments attendees exposed to single incident traumas. Structured clinical interviews were undertaken at 2 (n = 226) and 9 weeks (n = 208) posttrauma. RESULTS Using the revised criteria in DSM-5, 14.2% met criteria for ASD at week 2 and 9.6% met criteria for PTSD at week 9. These prevalences were similar to the corresponding DSM-IV diagnoses (18.6% ASD at week 2; 8.7% PTSD at week 9). Using the same diagnostic criteria (DSM-IV or DSM-5) across assessments (i.e., "2-week PTSD") suggested that caseness declined in prevalence by approximately half. Overlap between DSM-IV and DSM-5 ASD and DSM-5 preschool child PTSD diagnoses was considerable. Two diagnoses were strongly predictive of corresponding week 9 diagnoses. Youth with ASD who subsequently had PTSD reported more negative alterations in cognition and mood at 2 weeks than those youth who did not develop PTSD. CONCLUSIONS Youth exposed to single-event traumas experience considerable natural recovery in the first months posttrauma. Using DSM-5 criteria, ASD may not capture all clinically significant traumatic stress in the acute phase and is only moderately sensitive for later PTSD. Future research needs to address the role and etiology of negative alterations in cognition and mood symptoms.
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Affiliation(s)
- Richard Meiser-Stedman
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge.,Department of Clinical Psychology, University of East Anglia, Norwich, UK
| | - Anna McKinnon
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge
| | - Clare Dixon
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge
| | - Adrian Boyle
- Cambridge University Hospitals NHS Foundation Trust
| | - Patrick Smith
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge.,Cambridgeshire and Peterborough NHS Foundation Trust
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Tisak MS, Tisak J, Chen Y, Fang Q, Baker ER. Adolescent Misconduct Behaviors: A Cross-Cultural Perspective of Adolescents and Their Parents. J Cross Cult Psychol 2016; 48:155-167. [PMID: 29051630 DOI: 10.1177/0022022116681844] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 11/16/2022]
Abstract
The primary goal of the current study was to examine cultural differences in Chinese and U.S. adolescents' and parents' perceptions and evaluations of adolescent misconduct behaviors. A total of 395 U.S. and Chinese adolescents (ages 11-19 years) and 255 parents participated in this study. Each participant generated adolescent misconduct behaviors and rated each misconduct behavior as to the degree of wrongness. The misconduct behaviors were coded into 10 categories across three themes (moral offenses, drugs, and conventions). Results revealed significant cultural differences in a number of adolescent misconduct behaviors. For example, the United States generated more misconduct behaviors in weapon offenses and drug use than did China. These cultural differences were further complicated by an interaction between culture and generation. Chinese adolescents were more likely than U.S. adolescents to use categories of school, home, and social conventional violations, and considered these adolescent misconduct behaviors to be more wrong. However, it was the U.S. parents who considered adolescent misconduct behaviors in these categories to be more wrong than did Chinese parents.
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Allchin A, Melchior M, Fombonne E, Surkan PJ. Parental social networks during childhood and offspring depression in early adulthood: a lifecourse approach. Depress Anxiety 2016; 33:1031-1038. [PMID: 27373544 DOI: 10.1002/da.22538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/02/2015] [Revised: 04/11/2016] [Accepted: 06/12/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Little is known on how parental social relationships may affect their children's mental health. We sought to examine the relation between parental social relationship characteristics and subsequent offspring depression in young adulthood. METHODS We used 2009 Trajectoires Épidémiologiques en Population (TEMPO) study data from 1087 French young adults ages 22 to 35 and parental data from the corresponding Gaz et Eléctricité (GAZEL) study in 1991. Multivariable logistic regression was used to examine parental social networks, quality of parental relationships, and reciprocity of parental social support measured in 1991 in relation to offspring depression in young adulthood measured using the Adult Self Report in 2009. Analyses were stratified by participant sex. RESULTS In adjusted models, daughters of parents who reported giving more support to others than they received had 1.72 higher odds (95% CI, 1.09-2.70) of depression in young adulthood. Daughters of parents who were unsatisfied with their social relationships had 2.14 (95% CI, 1.22-3.76) higher odds of depression. Among male participants, there was no statistically significant association between parental relationship satisfaction, reciprocity of parental exchanges, and depression. CONCLUSIONS Parental relationships during mid-childhood have long-term associations with offspring depression. Results suggest that enhancing social support for parents may have positive implications for their children's mental health.
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Affiliation(s)
- Adelyn Allchin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria Melchior
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Gold AL, Shechner T, Farber MJ, Spiro CN, Leibenluft E, Pine DS, Britton JC. Amygdala-Cortical Connectivity: Associations with Anxiety, Development, and Threat. Depress Anxiety 2016; 33:917-926. [PMID: 27699940 PMCID: PMC5096647 DOI: 10.1002/da.22470] [Citation(s) in RCA: 52] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/08/2015] [Accepted: 01/05/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Amygdala-prefrontal cortex (PFC) functional connectivity may be influenced by anxiety and development. A prior study on anxiety found age-specific dysfunction in the ventromedial PFC (vmPFC), but not amygdala, associated with threat-safety discrimination during extinction recall (Britton et al.). However, translational research suggests that amygdala-PFC circuitry mediates responses following learned extinction. Anxiety-related perturbations may emerge in functional connectivity within this circuit during extinction recall tasks. The current report uses data from the prior study to examine how anxiety and development relate to task-dependent amygdala-PFC connectivity. METHODS Eighty-two subjects (14 anxious youths, 15 anxious adults, 25 healthy youths, 28 healthy adults) completed an extinction recall task, which directed attention to different aspects of stimuli. Generalized psychophysiological interaction analysis tested whether task-dependent functional connectivity with anatomically defined amygdala seed regions differed across anxiety and age groups. RESULTS Whole-brain analyses showed significant interactions of anxiety, age, and attention task (i.e., threat appraisal, explicit threat memory, physical discrimination) on left amygdala functional connectivity with the vmPFC and ventral anterior cingulate cortex (Talairach XYZ coordinates: -16, 31, -6 and 1, 36, -4). During threat appraisal and explicit threat memory (vs. physical discrimination), anxious youth showed more negative amygdala-PFC coupling, whereas anxious adults showed more positive coupling. CONCLUSIONS In the context of extinction recall, anxious youths and adults manifested opposite directions of amygdala-vmPFC coupling, specifically when appraising and explicitly remembering previously learned threat. Future research on anxiety should consider associations of both development and attention to threat with functional connectivity perturbations.
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Affiliation(s)
- Andrea L. Gold
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA,Corresponding Author: Andrea Gold, Ph.D., Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bldg. 15K, MSC 2670, Bethesda, MD 20892-2670, Phone: 301-827-9804, Fax: 301-402-2010,
| | | | - Madeline J. Farber
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Carolyn N. Spiro
- Department of Psychology, Rutgers University, New Brunswick, NJ, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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