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Babinski DE, Huffnagle SM, Bansal PS, Breaux RP, Waschbusch DA. Behavioral Treatment for the Social-Emotional Difficulties of Preadolescent and Adolescent Girls with ADHD. ACTA ACUST UNITED AC 2020; 5:173-188. [PMID: 33718608 DOI: 10.1080/23794925.2020.1759470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Girls with attention-deficit/hyperactivity disorder (ADHD) are at high risk for peer difficulties that often persist into adolescence and adulthood and portend risk for additional difficulties, such as depression, anxiety, and borderline personality disorder. However, very little research has examined interventions that address the widespread peer difficulties of girls with ADHD. This paper describes two open trials of behavior therapy aimed at addressing their social-emotional difficulties. The first trial includes 33 preadolescent girls (ages 7-11) with ADHD enrolled in an eight-week treatment and the second trial includes 22 adolescent girls (ages 12-16) with ADHD enrolled in a 12-week treatment. Measures of treatment feasibility and acceptability and measures of social functioning and psychopathology were collected in both trials. High levels of treatment feasibility and acceptability were reported in both the preadolescent and adolescent trial. In addition, improvements were reported in areas of social functioning and reductions in psychopathology, although the magnitude and specific areas of improvement differed somewhat in the preadolescent versus adolescent group. These preliminary findings provide a first step towards addressing the widespread social-emotional difficulties of girls with ADHD and offer insight into continuing efforts to address their treatment needs.
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Pedersen ML, Holen S, Lydersen S, Martinsen K, Neumer SP, Adolfsen F, Sund AM. School functioning and internalizing problems in young schoolchildren. BMC Psychol 2019; 7:88. [PMID: 31870462 PMCID: PMC6929288 DOI: 10.1186/s40359-019-0365-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 12/08/2019] [Indexed: 12/20/2022] Open
Abstract
Background Symptoms of anxiety and depression are common mental health problems in children and are often referred to as internalizing symptoms. Youth with such symptoms are at greater risk for poor academic achievement, school non-completion, and future mental health problems, all of which, lead to public health consequences and costs to society. The aim of the current study was to investigate associations between young school children’s internalizing symptoms and school functioning, as assessed separately by the teachers and the children. Methods This study is a cross-sectional study including children (N = 750. 58% girls) from the ages of 8–12 years with elevated levels of self-reported symptoms of anxiety (MASC-C) and/or depression (SMFQ). Teachers reported the academic achievement, school adaptation (TRF) and internalizing symptoms (BPM-T) of the children. Associations were analyzed using linear regression analyses. Results Both teacher-reported internalizing symptoms and children’s self-reported depressive symptoms were associated with poor academic achievement and school adaptation, while self-reported symptoms of anxiety were not. Symptoms of depression as assessed by the children were associated with teacher-rated internalizing symptoms, while self-reported symptoms of anxiety were not. Conclusion We found negative associations between school functioning and internalizing symptoms, as assessed by both the teachers and the children. The dual findings strengthen the validity of these relationships. Thus, prevention of depressive and anxiety symptoms in children may lead to positive changes in school domains such as academic achievement and school adaptation. We also identified a negative association between teacher-rated internalizing symptoms and children’s self-report of depressive symptoms, indicating that teachers may have difficulties recognizing children with these symptoms. Trial registration Clinical Trials NCT02340637, Registered on June 12, 2014, Retrospectively registered.
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Affiliation(s)
- Marit Løtveit Pedersen
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Solveig Holen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Stian Lydersen
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kristin Martinsen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Simon-Peter Neumer
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT Arctic University of Norway, Tromsø, Norway
| | - Anne Mari Sund
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
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Is Treatment Working? Detecting Real Change in the Treatment of Child and Adolescent Depression. J Am Acad Child Adolesc Psychiatry 2019; 58:1157-1164. [PMID: 30825497 DOI: 10.1016/j.jaac.2019.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/08/2019] [Accepted: 02/22/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Despite advances in evidence-based treatments for youth depression in recent decades, overall treatment effects are modest at best, with 30% to 50% of youth being nonresponders. Practice parameters consistently recommend systematic assessment and routine monitoring of depressive symptoms, or measurement-based care (MBC), to enhance youth depression treatment. However, the literature offers few guidelines on how to use assessment results to inform care decisions or to detect real and clinically meaningful change. Thus the current study produced reliable change indices (RCIs) per Jacobson and Truax for two commonly used standardized assessments of youth depression (ie, Patient Health Questionnaire-9 items, Modified for Adolescents [PHQ-9A], the Short Moods and Feelings Questionnaire [SMFQ]). METHOD The study sample (N = 1,738) consisted of youths 6 to 18 years old seen in a child and adolescent psychiatry clinic of a regional pediatric medical center who completed at least one of the target depression measures. We examined the factor structure and internal reliability for the PHQ-9A, and calculated RCIs for patients with a depression-related diagnosis for both measures. RESULTS Analyses confirmed a one-factor solution and adequate internal consistency (α = .86) for the PHQ-9A. All measures yielded acceptable test-retest reliabilities (r > 0.75) and RCIs that equate to clinical practice recommendations of using reliable changes scores of 7, 6, and 8 for the PHQ-9A, the SMFQ-Child Report, and the SMFQ-Parent Report, respectively. CONCLUSION Psychometric validation of the PHQ-9A and these RCIs are timely and significant contributions to the treatment of youth depression, by facilitating effective use of MBC-a critical evidence-based strategy for improving treatment outcomes.
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Rey-Casserly C, McGuinn L, Lavin A, LaMonte Askew G, Baum R, Berger-Jenkins E, Gambon TB, Nasir AA, Wissow LS, Weitzman CC, Blum NJ, Childers DO, Levine JM, Peralta-Carcelen AM, Poon JK, Smith PJ, Takayama JI, Voigt RG, Bridgemohan C. School-aged Children Who Are Not Progressing Academically: Considerations for Pediatricians. Pediatrics 2019; 144:peds.2019-2520. [PMID: 31548334 DOI: 10.1542/peds.2019-2520] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Pediatricians and other pediatric primary care providers may be consulted when families have concerns that their child is not making expected progress in school. Pediatricians care not only for an increasingly diverse population of children who may have behavioral, psychological, and learning difficulties but also for increasing numbers of children with complex and chronic medical problems that can affect the development of the central nervous system and can present with learning and academic concerns. In many instances, pediatric providers require additional information about the nature of cognitive, psychosocial, and educational difficulties that affect their school-aged patients. Our purpose for this report is to describe the current state of the science regarding educational achievement to inform pediatricians' decisions regarding further evaluation of a child's challenges. In this report, we review commonly available options for psychological evaluation and/or treatment, medical referrals, and/or recommendations for referral for eligibility determinations at school and review strategies for collaborating with families, schools, and specialists to best serve children and families.
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Affiliation(s)
- Celiane Rey-Casserly
- Department of Psychiatry, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Laura McGuinn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of Alabama, Birmingham, and Children's of Alabama, Birmingham, Alabama; and
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Lynch MK, Dimmitt RA, Goodin BR. Evidence of Disturbed Sleep in Children With Eosinophilic Esophagitis and Persistent Epigastric Pain. J Pediatr Psychol 2019; 43:331-341. [PMID: 29048495 DOI: 10.1093/jpepsy/jsx117] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/29/2017] [Indexed: 12/21/2022] Open
Abstract
Objective To determine whether the experience of persistent epigastric pain is associated with sleep disturbances in children with eosinophilic esophagitis (EoE). We hypothesized that children with EoE and persistent epigastric pain would (1) self-report greater current and worst pain severity, and (2) experience more disturbed sleep on objective and subjective measures in comparison with children with EoE but no persistent pain and healthy children. Methods Fifty children with EoE were recruited for this cross-sectional study, of which 24 (48%) reported experiencing persistent epigastric pain. The remaining 26 (52%) children with EoE denied experiencing persistent pain. An additional 25 healthy children without EoE or persistent pain were included. All children provided severity ratings of current pain and worst pain experienced over the past week. Children then completed 12 consecutive nights of ambulatory sleep monitoring via actigraphy in the home. Caregivers provided information regarding their child's sleep patterns and internalizing symptoms. Results Children with EoE and persistent pain reported significantly greater severity of current pain (p < .001) and worst pain over the past week (p < .001) compared with EoE without persistent pain and healthy children. Compared with the other groups, children with EoE and persistent pain also demonstrated greater actigraphic sleep disturbances, lower sleep efficiency (p = .004) and greater wake after sleep onset (p = .034). Conclusions This study provides novel evidence that a significant proportion of children with EoE experience persistent symptoms of epigastric pain. Persistent pain was associated with significant sleep disturbances in children with EoE.
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Affiliation(s)
| | - Reed A Dimmitt
- Division of Gastroenterology, Hepatology, & Nutrition, Department of Pediatrics
| | - Burel R Goodin
- Department of Psychology.,Division of Pain Medicine, Department of Anesthesiology & Perioperative Medicine, University of Alabama at Birmingham
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56
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Yap MBH, Cardamone-Breen MC, Rapee RM, Lawrence KA, Mackinnon AJ, Mahtani S, Jorm AF. Medium-Term Effects of a Tailored Web-Based Parenting Intervention to Reduce Adolescent Risk of Depression and Anxiety: 12-Month Findings From a Randomized Controlled Trial. J Med Internet Res 2019; 21:e13628. [PMID: 31418422 PMCID: PMC6830751 DOI: 10.2196/13628] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/04/2019] [Accepted: 06/12/2019] [Indexed: 01/04/2023] Open
Abstract
Background Prevention of depression and anxiety disorders early in life is a global health priority. Evidence on risk and protective factors for youth internalizing disorders indicates that the family represents a strategic setting to target preventive efforts. Despite this evidence base, there is a lack of accessible, cost-effective preventive programs for parents of adolescents. To address this gap, we recently developed the Partners in Parenting (PiP) program—an individually tailored Web-based parenting program targeting evidence-based parenting risk and protective factors for adolescent depression and anxiety disorders. We previously reported the postintervention outcomes of a single-blinded parallel-group superiority randomized controlled trial (RCT) in which PiP was found to significantly improve self-reported parenting compared with an active-control condition (educational factsheets). Objective This study aimed to evaluate the effects of the PiP program on parenting risk and protective factors and symptoms of adolescent depression and anxiety using data from the final assessment time point (12-month follow-up) of this RCT. Methods Parents (n=359) and adolescents (n=332) were recruited primarily from secondary schools and completed Web-based assessments of parenting and adolescent depression and anxiety symptoms at baseline, postintervention (3 months later), and 12-month follow-up (317 parents, 287 adolescents). Parents in the PiP intervention condition received personalized feedback about their parenting and were recommended a series of up to 9 interactive modules. Control group parents received access to 5 educational factsheets about adolescent development and mental health. Both groups received a weekly 5-min phone call to encourage progress through their program. Results Intervention group parents completed an average of 73.7% of their intended program. For the primary outcome of parent-reported parenting, the intervention group showed significantly greater improvement from baseline to 12-month follow-up compared with controls, with a medium effect size (Cohen d=0.51; 95% CI 0.30 to 0.72). When transformed data were used, greater reduction in parent-reported adolescent depressive symptoms was observed in the intervention group (Cohen d=−0.21; 95% CI −0.42 to −0.01). Mediation analyses revealed that these effects were mediated by improvements in parenting (indirect effect b=−0.08; 95% CI −0.16 to −0.01). No other significant intervention effects were found for adolescent-reported parenting or adolescent depression or anxiety symptoms. Both groups showed significant reductions in anxiety (both reporters) and depressive (parent reported) symptoms. Conclusions PiP improved self-reported parenting for up to 9 months postintervention, but its effects on adolescent symptoms were less conclusive, and parent-reported changes were not perceived by adolescents. Nonetheless, given its scalability, PiP may be a useful low-cost, sustainable program to empower parents of adolescents. Trial Registration Australian Clinical Trials Registration Number (ACTRN): 12615000328572; http://www.anzctr.org.au/ACTRN12615000328572.aspx (Archived by WebCite at http://www.webcitation.org/6qgsZ3Aqj).
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Affiliation(s)
- Marie Bee Hui Yap
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Mairead C Cardamone-Breen
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Katherine A Lawrence
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | | | - Shireen Mahtani
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Durbeej N, Sörman K, Norén Selinus E, Lundström S, Lichtenstein P, Hellner C, Halldner L. Trends in childhood and adolescent internalizing symptoms: results from Swedish population based twin cohorts. BMC Psychol 2019; 7:50. [PMID: 31375136 PMCID: PMC6679471 DOI: 10.1186/s40359-019-0326-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 07/18/2019] [Indexed: 02/07/2023] Open
Abstract
Background Previous research has noted trends of increasing internalizing problems (e.g., symptoms of depression and anxiety), particularly amongst adolescent girls. Cross-cohort comparisons using identical assessments of both anxiety and depression in youth are lacking, however. Methods In this large twin study, we examined trends in internalizing symptoms in samples of 9 year old children and 15 year old adolescents, gathered from successive birth cohorts from 1998 to 2008 (age 9) and 1994–2001 (age 15). Assessments at age 9 were parent-rated, and at age 15 self- and parent-rated. We examined (i) the relation between birth cohorts and internalizing symptoms using linear regressions, and (ii) whether percentages of participants exceeding scale cut-off scores changed over time, using Cochrane Armitage Trend Tests. Results Among 9 year old children, a significantly increasing percentage of participants (both boys and girls) had scores above cut-off on anxiety symptoms, but not on depressive symptoms. At age 15, a significantly increasing percentage of participants (both boys and girls) had scores above cut-off particularly on self-reported internalizing symptoms. On parent-reported internalizing symptoms, only girls demonstrated a corresponding trend. Conclusion In line with previous studies, we found small changes over sequential birth cohorts in frequencies of depression and anxiety symptoms in children. Further, these changes were not exclusive to girls.
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Affiliation(s)
- Natalie Durbeej
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Karolina Sörman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Eva Norén Selinus
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research, County of Västmanland, Uppsala University, Uppsala, Sweden
| | - Sebastian Lundström
- Institute of Neuroscience and Physiology, Gillberg Neuropsychiatry Centre, Centre of Ethics Law and Mental Health, Gothenburg University, Gothenburg, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Clara Hellner
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Linda Halldner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. .,Child and Adolescent Psychiatry Research center, BUP Klinisk forskningsenhet, Stockholm, Sweden. .,Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, SE-901 87 Umeå, Sweden.
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Does perceived overweight increase risk of depressive symptoms and suicidality beyond objective weight status? A systematic review and meta-analysis. Clin Psychol Rev 2019; 73:101753. [PMID: 31715442 DOI: 10.1016/j.cpr.2019.101753] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/22/2019] [Accepted: 07/05/2019] [Indexed: 01/24/2023]
Abstract
Obesity is associated with a significant disease burden, but whether recognising as opposed to failing to recognise personal overweight is beneficial or detrimental to mental health is unclear. Here we examine the associations between perceived overweight and depressive symptoms and suicidality. A systematic search of three electronic databases yielded 10,398 unique records, from which 32 studies (110 observations) were eligible for inclusion. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for each outcome using random effects meta-analyses and potential publication bias was examined. Perceived overweight was associated with an increased risk of depressive symptoms (OR: 1.42, CI: 1.31, 1.54 p <.0001, N >128,585) and suicidality (OR: 1.41, CI: 1.28, 1.56, p <.0001, N = 133,576) in both cross-sectional and longitudinal studies. The association between perceived overweight and poorer mental health was observed irrespective of study origin, participant age (children vs. adults), gender, and whether or not a person was objectively overweight. The pooled statistical relationship between objective weight status and poorer mental health was attenuated to non-significance when perceived overweight was accounted for, suggesting that the detrimental effect of overweight on mental health is largely dependent on whether or not a person identifies as overweight.
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59
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Conlon RPK, Hurst KT, Hayes JF, Balantekin KN, Stein RI, Saelens BE, Brown ML, Sheinbein DH, Welch RR, Perri MG, Schechtman KB, Epstein LH, Wilfley DE. Child and parent reports of children's depressive symptoms in relation to children's weight loss response in family-based obesity treatment. Pediatr Obes 2019; 14:e12511. [PMID: 30664829 PMCID: PMC6546528 DOI: 10.1111/ijpo.12511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/16/2018] [Accepted: 12/03/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Studies of the association between children's depressive symptoms and obesity treatment response show mixed results. Different measurement may contribute to the inconsistent findings, as children's depressive symptoms are often based on parent-report about their child rather than child self-report. OBJECTIVES We assessed both child- and parent-report of child depressive symptoms as predictors of children's obesity treatment response. METHODS Children with overweight/obesity (body mass index [BMI] ≥ 85th percentile; N = 181) and their parents reported on children's depressive symptoms prior to family-based behavioral weight loss treatment. RESULTS Child percent overweight reduction from baseline to post-treatment was not predicted by child self-reported depressive symptoms or parent-report of child symptoms (P > 0.80), but was significantly predicted by the interaction between child self-report and parent-report on child (β = 0.14, P = 0.05). In analyses using clinical cutoffs, amongst children with high self-reported symptoms, those whose parents reported low child depressive symptoms had greater reduction in percent overweight (t = 2.67, P = 0.008), whereas amongst children with low self-reported symptoms, parent ratings were not associated with treatment outcome. CONCLUSIONS Including both child self-report and parent-report of child depressive symptoms may inform obesity care. Research is needed to examine differences amongst child and parent depressive symptom reports and strategies to address symptoms and optimize pediatric obesity treatment.
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Affiliation(s)
| | - Kelly T. Hurst
- National Center for Weight and Wellness, Washington, DC, USA
| | | | | | | | - Brian E. Saelens
- Seattle Children’s Research Institute and the University of Washington, Seattle, WA, USA
| | - Mackenzie L. Brown
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Michael G. Perri
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Leonard H. Epstein
- School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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Campisi SC, Wasan Y, Soofi S, Monga S, Korczak DJ, Lou W, Soder O, Vandermorris A, Humayun KN, Mian A, Szatmari P, Bhutta ZA. Nash-wo-Numa (childhood growth & development) study protocol: factors that impact linear growth in children 9 to 15 years of age in Matiari, Pakistan. BMJ Open 2019; 9:e028343. [PMID: 31196903 PMCID: PMC6575710 DOI: 10.1136/bmjopen-2018-028343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Adolescence is a time of significant physical and emotional change, and there is emerging concern that adolescents living in low- and middle-income countries (LMIC) may face substantial challenges in relation to linear growth and mental health. Data on the global burden of stunting after 5 years of age are limited, but estimates suggest up to 50 per cent of all adolescents in some LMIC are stunted. Additionally, many LMIC lack robust mental health care delivery systems. Pakistan has one of the world's largest populations of adolescents (10 to 19 years) at approximately 40 million. The Nash-wo-Numa study's primary objective is to assess the prevalence and risk factors for stunting among early adolescents in rural Pakistan. The study also aims to determine the prevalence of poor mental health and identify factors associated with common mental health concerns during the childhood to adulthood transition. METHODS This cross-sectional study will include girls (n= 738) 9.0 to 14.9 years of age and boys (n=687) 10.0 to 15.9 years of age who live in the rural district of Matiari, Pakistan. Participants will be assessed for anthropometrical measures, puberty development, nutritional biomarkers as well as symptoms of depression, anxiety and trauma using validated scales. ETHICS AND DISSEMINATION The proposed study aims to complete the picture of child and adolescent health concerning linear growth and mental health by including puberty indicators. Ethics approval has been granted by the Ethics Review Committee at the Aga Khan University, Karachi, Pakistan, #5251-WCH-ERC-18 and Research Ethics Board at SickKids Hospital, Toronto, Canada, #:1000060684. Study results will be presented at relevant conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03647553; Pre-results.
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Affiliation(s)
- Susan C Campisi
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Yaqub Wasan
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sajid Soofi
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Suneeta Monga
- Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Daphne J Korczak
- Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Olle Soder
- Department of Women's and Children's Health, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - Ashley Vandermorris
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Ayesha Mian
- Psychiatry, Aga Khan University, Karachi, Pakistan
| | - Peter Szatmari
- Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public Health, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
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61
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Babinski DE, Welkie J. Feasibility of Ecological Momentary Assessment of Negative Emotion in Girls With ADHD: A Pilot Study. Psychol Rep 2019; 123:1027-1043. [PMID: 30917744 DOI: 10.1177/0033294119838757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study explores the feasibility of using mobile phone ecological momentary assessment to evaluate negative emotion in adolescent girls with attention-deficit/hyperactivity disorder (ADHD). A total of 13 girls with ADHD, ages 12-16 years old (38.5% with comorbid depression), and their mothers completed several daily surveys assessing the intensity and variability of youth negative emotion using mobile phone-based ecological momentary assessment for approximately one week. The rate of response to survey prompts by youth and maternal reports was examined. In addition, associations between girls' and mothers' ratings of negative emotion were calculated. Finally, the severity and fluctuation in negative emotion were compared between girls with and without depression. Girls and their mothers demonstrated a high level of compliance with assessment procedures, and maternal and youth ratings were significantly correlated. In addition, girls with comorbid depression and their mothers endorsed significantly more intense and variable negative emotion compared to girls with ADHD alone. These preliminary findings show that ecological momentary assessment is a feasible and valid method for collecting information on emotion regulation among girls with ADHD and their mothers that can be applied to future work aimed at collecting ecologically valid assessments of functioning in girls with ADHD.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Janelle Welkie
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
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Fiorilli C, Grimaldi Capitello T, Barni D, Buonomo I, Gentile S. Predicting Adolescent Depression: The Interrelated Roles of Self-Esteem and Interpersonal Stressors. Front Psychol 2019; 10:565. [PMID: 30930823 PMCID: PMC6428741 DOI: 10.3389/fpsyg.2019.00565] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/28/2019] [Indexed: 11/13/2022] Open
Abstract
Depression in adolescents can lead to social and educational impairment and is a major risk factor for suicide and substance misuse. Thus, predicting and preventing this disorder are extremely important. The current study aimed to analyze the contribution of adolescents’ self-esteem (i.e., quality of interpersonal relationships, control of life events, and management of negative emotions) and interpersonal stressor sources (relationships with parents, teachers, classmates and friends) in predicting several depression manifestations (i.e., depressed mood, sense of inadequacy, and insecurity). Participants were 182 Italian pre-adolescents and adolescents, aged 10–14 years, were recruited from three Italian schools. They were asked to complete a self-report questionnaire. Results showed that self-esteem was a major factor to be considered in adolescents’ depression. In particular, adolescents’ perception of negative emotion management was the most important protective factor against depression manifestations. Conversely, sources of interpersonal stressors contributed only marginally to depression. Among these, problems with parents and friends increased adolescents’ depressed mood, while troubles with classmates impacted on their sense of inadequacy and insecurity. Implications of these results for positive practices which could enhance adolescents’ self-esteem and further expansions of the study are discussed.
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Affiliation(s)
- Caterina Fiorilli
- Dipartimento di Scienze Umane, Libera Università Maria SS. Assunta di Roma, Rome, Italy
| | | | - Daniela Barni
- Dipartimento di Scienze Umane, Libera Università Maria SS. Assunta di Roma, Rome, Italy
| | - Ilaria Buonomo
- Dipartimento di Scienze Umane, Libera Università Maria SS. Assunta di Roma, Rome, Italy.,Consorzio Universitario Humanitas, Rome, Italy
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Eastman ML, Moore AA, Cecilione J, Hettema JM, Roberson-Nay R. Confirmatory factor structure and psychometric properties of the Multidimensional Peer Victimization Scale. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018; 40:725-735. [PMID: 30416254 DOI: 10.1007/s10862-018-9678-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The Multidimensional Peer Victimization Scale (MPVS; Mynard & Joseph, 2000) is a 16-item self-report scale that captures peer victimization across four dimensions: physical victimization, verbal victimization, social manipulation, and attacks on property. Performance of the scale has not been evaluated among older adolescents. We examined the factor structure, internal consistency reliability, and performance of the scale in two separate epidemiological U.S. samples representing different age groups: 9-14 year olds (N=610) and 15-17 year olds (N=524). The four-factor structure of the scale was affirmed in both samples, however; there was not metric invariance by gender in the younger age group. The scale and its subscales were found to have good internal consistency. Expected relationships between the MPVS and measures of irritability, anxiety, and depression were affirmed. Results support continued use of the MPVS among child and adolescent samples.
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Affiliation(s)
- Meridith L Eastman
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh St., Suite 101, P.O. Box 980126, Richmond, VA, 23298, USA
| | - Ashlee A Moore
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh St., Suite 101, P.O. Box 980126, Richmond, VA, 23298, USA
| | - Jennifer Cecilione
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh St., Suite 101, P.O. Box 980126, Richmond, VA, 23298, USA
| | - John M Hettema
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh St., Suite 101, P.O. Box 980126, Richmond, VA, 23298, USA
| | - Roxann Roberson-Nay
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh St., Suite 101, P.O. Box 980126, Richmond, VA, 23298, USA
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64
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Thabrew H, Stasiak K, Bavin LM, Frampton C, Merry S. Validation of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) in New Zealand help-seeking adolescents. Int J Methods Psychiatr Res 2018; 27:e1610. [PMID: 29465165 PMCID: PMC6877137 DOI: 10.1002/mpr.1610] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/27/2017] [Accepted: 01/05/2018] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study examines the reliability and validity of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) for measuring depression in New Zealand help-seeking adolescents. METHOD A sample of 183 adolescents completed the 33-item MFQ, which includes all 13 items on the SMFQ, at three time points during a trial of a computerized intervention for depression. RESULTS Both the MFQ and SMFQ demonstrated good to excellent Cronbach's alphas, moderate to strong item-total score correlations, moderate to strong correlations with quality of life and anxiety measures, and strong correlations with the clinician-rated Children's Depression Rating Scale-Revised and the Reynolds Adolescent Depression Scale 2 at all time points, indicating good reliability and content, convergent, and concurrent validities, respectively. Favoring sensitivity over specificity, the optimal cut-off value for differentiating depressed from nondepressed cases for the MFQ was ≥28 and for the SMFQ was ≥12. Both instruments demonstrated satisfactory diagnostic accuracy and sensitivity to change. CONCLUSION The MFQ and SMFQ are free and simple instruments that can be used to identify depression and measure symptom change in New Zealand help-seeking adolescents.
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Affiliation(s)
- Hiran Thabrew
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Lynda-Maree Bavin
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Chris Frampton
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Sally Merry
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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Parental Control of the Time Preadolescents Spend on Social Media: Links with Preadolescents’ Social Media Appearance Comparisons and Mental Health. J Youth Adolesc 2018; 47:1456-1468. [DOI: 10.1007/s10964-018-0870-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 12/23/2022]
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66
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Cardamone-Breen MC, Jorm AF, Lawrence KA, Rapee RM, Mackinnon AJ, Yap MBH. A Single-Session, Web-Based Parenting Intervention to Prevent Adolescent Depression and Anxiety Disorders: Randomized Controlled Trial. J Med Internet Res 2018; 20:e148. [PMID: 29699964 PMCID: PMC5945988 DOI: 10.2196/jmir.9499] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/19/2018] [Accepted: 03/08/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Depression and anxiety disorders are significant contributors to burden of disease in young people, highlighting the need to focus preventive efforts early in life. Despite substantial evidence for the role of parents in the prevention of adolescent depression and anxiety disorders, there remains a need for translation of this evidence into preventive parenting interventions. To address this gap, we developed a single-session, Web-based, tailored psychoeducation intervention that aims to improve parenting practices known to influence the development of adolescent depression and anxiety disorders. OBJECTIVE The aim of this study was to evaluate the short-term effects of the intervention on parenting risk and protective factors and symptoms of depression and anxiety in adolescent participants. METHODS We conducted a single-blind, parallel group, superiority randomized controlled trial comparing the intervention with a 3-month waitlist control. The intervention is fully automated and consists of two components: (1) completion of an online self-assessment of current parenting practices against evidence-based parenting recommendations for the prevention of adolescent depression and anxiety disorders and (2) an individually tailored feedback report highlighting each parent’s strengths and areas for improvement based on responses to the self-assessment. A community sample of 349 parents, together with 327 adolescents (aged 12-15 years), were randomized to either the intervention or waitlist control condition. Parents and adolescents completed online self-reported assessments of parenting and adolescent symptoms of depression and anxiety at baseline, 1-month (parent-report of parenting only), and 3-month follow-up. RESULTS Compared with controls, intervention group parents showed significantly greater improvement in parenting risk and protective factors from baseline to 1-month and 3-month follow-up (F2,331.22=16.36, P<.001), with a small to medium effect size at 3-month follow-up (d=0.33). There were no significant effects of the intervention on adolescent-report of parenting or symptoms of depression or anxiety in the adolescents (all P>.05). CONCLUSIONS Findings suggest that a single-session, individually tailored, Web-based parenting intervention can improve parenting factors that are known to influence the development of depression and anxiety in adolescents. However, our results do not support the effectiveness of the intervention in improving adolescent depression or anxiety symptoms in the short-term. Long-term studies are required to adequately assess the relationship between improving parenting factors and adolescent depression and anxiety outcomes. Nonetheless, this is a promising avenue for the translation of research into a low-cost, sustainable, universal prevention approach. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12615000247572; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12615000247572 (Archived by WebCite at http://www.webcitation.org/6v1ha19XG)
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Affiliation(s)
- Mairead C Cardamone-Breen
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Katherine A Lawrence
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | | | - Marie Bee Hui Yap
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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67
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Ferrari M, Yap K, Scott N, Einstein DA, Ciarrochi J. Self-compassion moderates the perfectionism and depression link in both adolescence and adulthood. PLoS One 2018; 13:e0192022. [PMID: 29466452 PMCID: PMC5821438 DOI: 10.1371/journal.pone.0192022] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 01/16/2018] [Indexed: 01/05/2023] Open
Abstract
Background Psychological practitioners often seek to directly change the form or frequency of clients’ maladaptive perfectionist thoughts, because such thoughts predict future depression. Indirect strategies, such as self-compassion interventions, that seek to change clients’ relationships to difficult thoughts, rather than trying to change the thoughts directly could be just as effective. This study aimed to investigate whether self-compassion moderated, or weakened, the relationship between high perfectionism and high depression symptoms in both adolescence and adulthood. Methods The present study utilised anonymous self-report questionnaires to assess maladaptive perfectionism, depression, and self-compassion across two samples covering much of the lifespan. Questionnaires were administered in a high school setting for the adolescent sample (Study 1, Mage = 14.1 years, n = 541), and advertised through university and widely online to attract a convenience sample of adults (Study 2, Mage = 25.22 years, n = 515). Results Moderation analyses revealed that self-compassion reduced the strength of relationship between maladaptive perfectionism and depression in our adolescent Study 1 (β = -.15, p < .001, R2 = .021.) and our adult study 2 (β = -.14, p < .001, R2 = .020). Limitations Cross-sectional self-reported data restricts the application of causal conclusions and also relies on accurate self-awareness and willingness to respond to questionnaire openly. Conclusions The replication of this finding in two samples and across different age-appropriate measures suggests that self-compassion does moderate the link between perfectionism and depression. Self-compassion interventions may be a useful way to undermine the effects of maladaptive perfectionism, but future experimental or intervention research is needed to fully assess this important possibility.
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Affiliation(s)
- Madeleine Ferrari
- School of Psychology, Australian Catholic University, Sydney, New South Wales, Australia
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia
- * E-mail:
| | - Keong Yap
- School of Psychology, Australian Catholic University, Sydney, New South Wales, Australia
| | - Nicole Scott
- School of Health Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Danielle A. Einstein
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Joseph Ciarrochi
- Institute of Positive Psychology and Education, Australian Catholic University, Sydney, New South Wales, Australia
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Gudmundsen GR, Rhew IC, McCauley E, Kim J, Vander Stoep A. Emergence of Depressive Symptoms from Kindergarten to Sixth Grade. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:501-515. [PMID: 29411996 DOI: 10.1080/15374416.2017.1410823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study documents the emergence of symptoms of anxiety and depression in a community sample of school-age children and describes the temporal progression of symptoms leading to depressive episodes. Caregivers of 468 seventh graders reported retrospectively the manifestation of 14 symptoms of depression and anxiety in their children from kindergarten through sixth grade. The sample was balanced by sex and reflected the racial and economic diversity of the urban school district. Childhood period prevalence was calculated for each symptom, and discrete time survival analyses compared likelihoods of early symptom emergence in children who did and did not meet diagnostic criteria for major depressive disorder (MDD) by ninth grade. Symptom prevalence ranged between 20% (excessive guilt) and 50% (concentration problems) during the elementary school years. The 4-year period prevalence of MDD was 8.9%, 95% confidence interval [6.5%, 12.1%]. Low energy, excessive worry, excessive guilt, anhedonia, social withdrawal, and sadness or depressed mood were each associated with a significantly higher likelihood of onset of MDD. Compared to girls, boys were more likely to exhibit sad mood, fatigue, and trouble concentrating. Children who later met criteria for MDD demonstrated a significantly higher likelihood of showing core features of depressive and anxiety disorders during their elementary school years. The findings underscore the importance of recognizing early signs and developing interventions to help children manage early symptoms and prevent later psychiatric illness.
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Affiliation(s)
- Gretchen R Gudmundsen
- a Department of Psychiatry and Behavioral Sciences , University of Washington School of Medicine
| | - Isaac C Rhew
- a Department of Psychiatry and Behavioral Sciences , University of Washington School of Medicine
| | - Elizabeth McCauley
- a Department of Psychiatry and Behavioral Sciences , University of Washington School of Medicine.,b Division of Child and Adolescent Psychiatry , Seattle Children's Hospital
| | - Jahun Kim
- c College of Nursing , Seattle University
| | - Ann Vander Stoep
- d Department of Epidemiology , University of Washington School of Public Health
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Schneider SC, Baillie AJ, Mond J, Turner CM, Hudson JL. The classification of body dysmorphic disorder symptoms in male and female adolescents. J Affect Disord 2018; 225:429-437. [PMID: 28858657 DOI: 10.1016/j.jad.2017.08.062] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/10/2017] [Accepted: 08/20/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) was categorised in DSM-5 within the newly created 'obsessive-compulsive and related disorders' chapter, however this classification remains subject to debate. Confirmatory factor analysis was used to test competing models of the co-occurrence of symptoms of BDD, obsessive-compulsive disorder, unipolar depression, anxiety, and eating disorders in a community sample of adolescents, and to explore potential sex differences in these models. METHODS Self-report questionnaires assessing disorder symptoms were completed by 3149 Australian adolescents. The fit of correlated factor models was calculated separately in males and females, and measurement invariance testing compared parameters of the best-fitting model between males and females. RESULTS All theoretical models of the classification of BDD had poor fit to the data. Good fit was found for a novel model where BDD symptoms formed a distinct latent factor, correlated with affective disorder and eating disorder latent factors. Metric non-invariance was found between males and females, and the majority of factor loadings differed between males and females. Correlations between some latent factors also differed by sex. LIMITATIONS Only cross-sectional data were collected, and the study did not assess a broad range of DSM-5 defined eating disorder symptoms or other disorders in the DSM-5 obsessive-compulsive and related disorders chapter. CONCLUSIONS This study is the first to statistically evaluate competing models of BDD classification. The findings highlight the unique features of BDD and its associations with affective and eating disorders. Future studies examining the classification of BDD should consider developmental and sex differences in their models.
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Affiliation(s)
- Sophie C Schneider
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Andrew J Baillie
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, Australia
| | - Jonathan Mond
- Centre for Rural Health, School of Health Sciences, University of Tasmania, Launceston, Australia; Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia
| | - Cynthia M Turner
- School of Psychology, Australian Catholic University, Brisbane, Australia
| | - Jennifer L Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
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Babinski DE, Mills SL, Bansal PS. The Effects of Behavioral Parent Training With Adjunctive Social Skills Training for a Preadolescent Girl With ADHD and Borderline Personality Features. Clin Case Stud 2017. [DOI: 10.1177/1534650117741707] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Girls with attention deficit hyperactivity disorder (ADHD) are at high risk of a range of social–emotional difficulties, including peer rejection, suicide attempts, and borderline personality disorder (BPD), which are associated with serious, long-term impairment and have not emerged as clearly in samples of boys with ADHD. BPD is a particularly concerning long-term outcome of ADHD in girls, given the high risk for suicidality and long-lasting relationship difficulties. Very little research has focused on treatment for the interpersonal impairments of girls with ADHD, or on addressing risk for developing BPD. This case study describes the use of behavioral parent training (BPT) with adjunctive social skills training (SST) to address the social–emotional difficulties of a 9-year-old girl, “Violet,” who was diagnosed with ADHD Combined Presentation and was being treated with medication for anxiety. Violet presented with many social difficulties, including low self-esteem, emotional dysregulation, and unstable relationships, which were conceptualized as borderline personality features (BPF). Treatment was associated with improvements in parent functioning, including reductions in caregiver strain and inconsistent discipline, as well as improvements in child functioning, including reductions in ADHD symptoms, a range of impairments, and BPF. This case study illustrates the benefit of a brief psychosocial intervention in reducing multiple indices of interpersonal impairment, including BPF, for a girl with ADHD.
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Sucupira E, Sabino M, de Lima EL, Dini GM, de Brito MJA, Ferreira LM. Short Mood and Feelings Questionnaire for screening children and adolescents for plastic surgery: cross-cultural validation study. SAO PAULO MED J 2017; 135:518-528. [PMID: 29116306 PMCID: PMC10016018 DOI: 10.1590/1516-3180.2017.0036030517] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 05/03/2017] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Patient-reported outcome measurements assessing the emotional state of children and adolescents who seek plastic surgery are important for determining whether the intervention is indicated or not. The aim of this study was to cross-culturally adapt and validate the Short Mood and Feelings Questionnaire (child/adolescent and parent versions) for Brazilian Portuguese, test its psychometric properties and assess the emotional state of children and adolescents who seek plastic surgery. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic at a public university hospital. METHODS A total of 124 consecutive patients of both sexes were selected between September 2013 and February 2014. Forty-seven patients participated in the cultural adaptation of the questionnaire. The final version was tested for reliability on 20 patients. Construct validity was tested on 57 patients by correlating the Short Mood and Feelings Questionnaire (child/adolescent and parent versions) with the Strengths and Difficulties Questionnaire and the Rosenberg Self-Esteem scale. RESULTS The child/adolescent and parent versions of the Short Mood and Feelings Questionnaire showed Cronbach's alpha of 0.768 and 0.874, respectively, and had good inter-rater reliability (intraclass correlation coefficient, ICC = 0.757 and ICC = 0.853, respectively) and intra-rater reliability (ICC = 0.738 and ICC = 0.796, respectively). CONCLUSIONS The Brazilian-Portuguese version of the Short Mood and Feelings Questionnaire is a reproducible instrument with face, content and construct validity.The mood state and feelings among children and adolescents seeking cosmetic surgery were healthy.
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Affiliation(s)
- Eduardo Sucupira
- MD. Master’s Student, Postgraduate Program on Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Miguel Sabino
- MD, PhD. Associate Professor, Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Edson Luiz de Lima
- MD, MSc. Physician, Instituto Federal de Educação, Ciência e Tecnologia do Sul de Minas (IFSuldeMinas), Pouso Alegre (MG), Brazil.
| | - Gal Moreira Dini
- (in memoriam) PhD. Adjunct Professor, Postgraduate Program on Translational Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Maria José Azevedo de Brito
- PhD. Affiliate Professor, College of Health Science, Universidade do Vale do Sapucaí (UNIVÁS), Minas Gerais; Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Lydia Masako Ferreira
- MD, PhD. Full Professor, Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
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Cardamone-Breen MC, Jorm AF, Lawrence KA, Mackinnon AJ, Yap MBH. The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders. PeerJ 2017; 5:e3825. [PMID: 28951815 PMCID: PMC5609518 DOI: 10.7717/peerj.3825] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/29/2017] [Indexed: 11/20/2022] Open
Abstract
Background Despite substantial evidence demonstrating numerous parental risk and protective factors for the development of adolescent depression and anxiety disorders, there is currently no single measure that assesses these parenting factors. To address this gap, we developed the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS) as a criterion-referenced measure of parental concordance with a set of evidence-based parenting guidelines for the prevention of adolescent depression and anxiety disorders. In this paper, we used a sample of Australian parents of adolescents to: (1) validate the PRADAS as a criterion-referenced measure; (2) examine parental concordance with the guidelines in the sample; and (3) examine correlates of parental concordance with the guidelines. Methods Seven hundred eleven parents completed the PRADAS, as well as two established parenting measures, and parent-report measures of adolescent depression and anxiety symptoms. Six hundred sixty adolescent participants (aged 12–15) also completed the symptom measures. Concordance with the guidelines was assessed via nine subscale scores and a total score. Reliability of the scores was assessed with an estimate of the agreement coefficient, as well as 1-month test-retest reliability. Convergent validity was examined via correlations between the scale and two established parenting measures. Results One proposed subscale was removed from the final version of the scale, resulting in a total of eight subscales. Reliability was high for the total score, and acceptable to high for seven of the eight subscales. One-month test-retest reliability was acceptable to high for the total score. Convergent validity was supported by moderate to high correlations with two established measures of parenting. Overall, rates of parental concordance with the guidelines were low in our sample. Higher scores were associated with being female and higher levels of parental education. Greater parental concordance with the guidelines was associated with fewer symptoms of depression and anxiety in adolescent participants. Discussion This initial validation study provides preliminary support for the reliability and validity of the PRADAS. The scale has potential for use in both clinical and research settings. It may be used to identify parents’ strengths and potential targets for intervention, and as an outcome measure in studies of preventive parenting interventions.
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Affiliation(s)
- Mairead C Cardamone-Breen
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine A Lawrence
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia
| | - Andrew J Mackinnon
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Marie B H Yap
- School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Schneider SC, Turner CM, Mond J, Hudson JL. Prevalence and correlates of body dysmorphic disorder in a community sample of adolescents. Aust N Z J Psychiatry 2017; 51:595-603. [PMID: 27585880 DOI: 10.1177/0004867416665483] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Body dysmorphic disorder typically begins in adolescence, yet little is known about the prevalence and correlates of the disorder in this age group. The current study aimed to explore the presenting features of adolescents meeting probable criteria for body dysmorphic disorder in a large community sample, and compare levels of comorbid psychopathology, quality of life and mental health service use between adolescents with probable body dysmorphic disorder and those without. METHOD Questionnaires were completed at school by 3149 adolescents: 63% male, aged 12-18 years ( M = 14.58). These assessed Diagnostic and Statistical Manual of Mental Disorders (4th ed.) body dysmorphic disorder criteria, past mental health service use and symptoms of body dysmorphic disorder, anxiety, depression, obsessive-compulsive disorder and eating disorders. In male participants, additional measures assessed quality of life, muscularity concerns, emotional symptoms, peer problems, conduct problems and hyperactivity. RESULTS The prevalence of probable body dysmorphic disorder was 1.7%; there was no sex difference in prevalence, but older adolescents reported higher prevalence than younger adolescents. Probable body dysmorphic disorder participants reported substantially elevated levels of psychopathology, quality of life impairment and mental health service use compared to non-body dysmorphic disorder participants. CONCLUSIONS The prevalence of body dysmorphic disorder in adolescents is similar to adult samples, and probable body dysmorphic disorder is associated with comorbidity, distress and functional impairment in a community sample. Further research is required to better understand the presentation of body dysmorphic disorder in adolescents, and to improve diagnosis and treatment.
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Affiliation(s)
- Sophie C Schneider
- 1 Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Cynthia M Turner
- 2 School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Jonathan Mond
- 1 Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Jennifer L Hudson
- 1 Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
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Schneider SC, Mond J, Turner CM, Hudson JL. Sex Differences in the Presentation of Body Dysmorphic Disorder in a Community Sample of Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 48:516-528. [PMID: 28541768 DOI: 10.1080/15374416.2017.1321001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The current study sought to explore sex differences in the presentation of probable full-syndrome and subthreshold body dysmorphic disorder (BDD) in adolescents from an Australian community sample. Specifically, it examined sex differences in the types of BDD symptoms endorsed, body areas of concern, and the association with elevated symptoms of comorbid disorders. In male participants, it also compared the presenting features of those with and without muscle dysmorphia. Of 3,149 adolescents assessed using self-report questionnaires, 162 (5.1%) reported probable BDD (57.4% male, Mage = 14.89 years, SD = 1.33, primarily from Oceanian or European cultural backgrounds). All participants completed measures of BDD symptoms; past mental health service use; and symptoms of anxiety, depression, obsessive-compulsive disorder, and eating disorders. Male participants completed additional measures of quality of life, drive for muscularity, hyperactivity, conduct disorder, peer problems, and emotional symptoms. Controlling for demographic variables that varied by sex, male and female participants reported similar BDD symptom severity, rates of most elevated comorbid symptoms, and mental health service use. Concerns regarding muscularity, breasts/nipples, and thighs differed by sex. Female participants were more likely than male participants to report elevated generalized anxiety symptoms. In male participants, muscle dysmorphia was not associated with greater severity across most measures. The presenting features of BDD were broadly similar in male and female participants, and in male participants with and without muscle dysmorphia. Future research should seek to increase mental health service use in adolescents with BDD and to improve rates of disorder detection in clinical settings.
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Affiliation(s)
| | - Jonathan Mond
- b School of Medicine , Western Sydney University.,c School of Health Sciences , University of Tasmania
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Tennant RG, Martin KK, Rooney R, Hassan S, Kane RT. Preventing Internalizing Problems in Young Children: A Randomized Controlled Trial of the Feelings and Friends (Year 3) Program with a Motor Skills Component. Front Psychol 2017; 8:291. [PMID: 28326047 PMCID: PMC5339246 DOI: 10.3389/fpsyg.2017.00291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/15/2017] [Indexed: 11/13/2022] Open
Abstract
Anxiety and depression are common mental health problems experienced by children in Australia. The impact of these internalizing disorders is pervasive, affecting many areas of life. By the time problems have been detected in children they can be severe in nature and harder to treat. Hence, early intervention is of utmost importance. Despite the existence of numerous prevention programs for children, there is limited empirical evidence for a program that has an impact on symptoms of both anxiety and depression. Physical activity and improved motor coordination have been indicated as having positive effects on children's mental health, although the impact of including these in a program targeting internalizing disorders has not been established. This study aimed to evaluate the efficacy of the Feelings and Friends (Year 3) program (FFY3), revised to include activities to build motor-coordination and encourage physical activity. Participants were 24 children from the Perth metropolitan area alongside one of each of their parents. Results indicated significant short-term intervention effects on one of the primary outcome variables; intervention group parents reported significant pre-post improvement in child depressive symptoms, which were maintained at 3-month follow-up (η p2 = 0.10). There were also intervention effects observed for parent-reported separation anxiety (η p2 = 0.10), externalizing symptoms (η p2 = 0.19), and conduct problems (η p2 = 0.16). An additional finding indicated the intervention students reported significant improvement from session one to session two in global distress (η p2 = 0.22). No other significant intervention effects were evident. Findings from this study indicate that FFY3 is a promising intervention to address internalizing and externalizing symptoms in 8-9 year-old children.
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Affiliation(s)
| | | | - Rosanna Rooney
- Faculty of Health Sciences, School of Psychology and Speech Pathology, Curtin UniversityPerth, WA, Australia
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76
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Patras J, Martinsen KD, Holen S, Sund AM, Adolfsen F, Rasmussen LMP, Neumer SP. Study protocol of an RCT of EMOTION: An indicated intervention for children with symptoms of anxiety and depression. BMC Psychol 2016; 4:48. [PMID: 27671742 PMCID: PMC5037866 DOI: 10.1186/s40359-016-0155-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/16/2016] [Indexed: 11/23/2022] Open
Abstract
Background High levels of anxiety and depression are common psychological symptoms among children and adolescents. These symptoms affect young people in multiple life domains and are possible precursors of long-term psychological distress. Despite relatively high prevalence, few children with emotional problems are referred for clinical treatment, indicating the need for systematic prevention. The primary aim of this study is to evaluate an indicated preventive intervention, EMOTION Coping Kids Managing Anxiety and Depression (EMOTION), to reduce high levels of anxiety and depressive symptoms. Methods/Design This is a clustered randomized controlled trial involving 36 schools, which are assigned to one of two conditions: (a) group cognitive behavioral intervention EMOTION or (b) treatment as usual (TAU). Assessments will be undertaken at pre-, mid - intervention, post-, and one year after intervention. The children (8–11 years old) complete self-report questionnaires. Parents and teachers report on children. The primary outcome will be changes in depressive and anxiety symptoms as measured by the Short Mood and Feelings Questionnaire (SMFQ) and Multidimensional Anxiety Scale for Children (MASC) respectively. Secondary outcomes will be changes in self-esteem, quality of life, and school and daily functioning. Observers will assess implementation quality with ratings of fidelity based on video recordings of group leaders leading the EMOTION group sessions. Discussion The present study is an important contribution to the field regarding working with children with symptoms of anxiety and depression. The results of this study will provide an indication whether or not the EMOTION program is an effective intervention for the prevention of later depression and/or anxiety in children. The study will also provide information about the EMOTION program’s effect on quality of life, self-esteem, and school functioning of the children participating in the study. Finally, the project will provide insight into implementation of an indicated intervention for school-aged children within Norwegian health, education, and mental health services. Trial registration Clinical Trials NCT02340637, Registered on June 12, 2014, last updated on January 15, 2015. Retrospectively registered.
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Affiliation(s)
- Joshua Patras
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges arktiske universitet, 9037, Tromsø, Norway.
| | - Kristin Dagmar Martinsen
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623 Nydalen, 0405, Oslo, Norway
| | - Solveig Holen
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623 Nydalen, 0405, Oslo, Norway
| | - Anne Mari Sund
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Pb 8905, MTFS, N-7491, Trondheim, Norway.,St. Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030, Trondheim, Norway
| | - Frode Adolfsen
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges arktiske universitet, 9037, Tromsø, Norway
| | - Lene-Mari Potulski Rasmussen
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges arktiske universitet, 9037, Tromsø, Norway
| | - Simon-Peter Neumer
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623 Nydalen, 0405, Oslo, Norway
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77
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Age and Gender Differences in the Associations of Self-Compassion and Emotional Well-being in A Large Adolescent Sample. J Youth Adolesc 2016; 46:840-853. [PMID: 27632177 DOI: 10.1007/s10964-016-0567-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 08/31/2016] [Indexed: 10/21/2022]
Abstract
Adolescence is a challenging developmental period marked with declines in emotional well-being; however, self-compassion has been suggested as a protective factor. This cross-sectional survey study (N = 765, grades 7th to 12th; 53 % female; 4 % Hispanic ethnicity; 64 % White and 21 % Black) examined whether adolescents' self-compassion differed by age and gender, and secondly, whether its associations with emotional well-being (perceived stress, life satisfaction, distress intolerance, depressive symptoms, and anxiety) also differed by age and gender. The findings indicated that older females had the lowest self-compassion levels compared to younger females or all-age males. Self-compassion was associated with all emotional well-being measures, and gender and/or age moderated the associations with anxiety and depressive symptoms. Among older adolescents, self-compassion had a greater protective effect on anxiety for boys than for girls. Additionally, older adolescents with low and average self-compassion had greater levels of depressive symptoms than those with high self-compassion. These results may inform for whom and at what age self-compassion interventions may be implemented to protect adolescents from further declines in emotional well-being.
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78
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Martinsen KD, Neumer SP, Holen S, Waaktaar T, Sund AM, Kendall PC. Self-reported quality of life and self-esteem in sad and anxious school children. BMC Psychol 2016; 4:45. [PMID: 27624487 PMCID: PMC5022161 DOI: 10.1186/s40359-016-0153-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 08/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background Anxiety and depressive symptoms are common in childhood, however problems in need of intervention may not be identified. Children at risk for developing more severe problems can be identified based on elevated symptom levels. Quality of life and self-esteem are important functional domains and may provide additional valuable information. Methods Schoolchildren (n = 915), aged 9–13, who considered themselves to be more anxious or sad than their peers, completed self-reports of anxiety (Multidimensional Anxiety Scale for children (MASC-C), depression (The Short Mood and Feelings Questionnaire; SMFQ), quality of life (Kinder Lebensqualität Fragebogen; KINDL) and self-esteem (Beck self-concept inventory for youth (BSCI-Y) at baseline of a randomized controlled indicative study. Using multivariate analyses, we examined the relationships between internalizing symptoms, quality of life and self-esteem in three at-risk symptom groups. We also examined gender and age differences. Results 52.1 % of the screened children scored above the defined at-risk level reporting elevated symptoms of either Anxiety and Depression (Combined group) (26.6 %), Depression only (15.4 %) or Anxiety only (10.2 %). One-way ANOVA analysis showed significant mean differences between the symptom groups on self-reported quality of life and self-esteem. Regression analysis predicting quality of life and self-esteem showed that in the Depression only group and the Combined group, symptom levels were significantly associated with lower self-reported scores on both functional domains. In the Combined group, older children reported lower quality of life and self-esteem than younger children. Internalizing symptoms explained more of the variance in quality of life than in self-esteem. Symptoms of depression explained more of the variance than anxious symptoms. Female gender was associated with higher levels of internalizing symptoms, but there was no gender difference in quality of life and self-esteem. Conclusion Internalizing symptoms were associated with lower self-reported quality of life and self-esteem in children in the at-risk groups reporting depressive or depressive and anxious symptoms. A transdiagnostic approach targeting children with internalizing symptoms may be important as an early intervention to change a possible negative trajectory. Tailoring the strategies to the specific symptom pattern of the child will be important to improve self-esteem. Trial registration Trial registration in Clinical trials: NCT02340637, June 12, 2014.
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Affiliation(s)
- Kristin D Martinsen
- Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway.
| | - Simon-Peter Neumer
- Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Solveig Holen
- Centre for Child and Adolescent Mental Health, Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Trine Waaktaar
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
| | - Anne Mari Sund
- NTNU, Regionalt kunnskapssenter for barn og unge (RKBU), Klostergata 46, 7030 Trondheim/St. Olav's Hospital, Trondheim, Norway
| | - Philip C Kendall
- Temple University, 1701 North 13th Street, Weiss Hall, Philadelphia, PA, USA
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79
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Iverach L, Jones M, McLellan LF, Lyneham HJ, Menzies RG, Onslow M, Rapee RM. Prevalence of anxiety disorders among children who stutter. JOURNAL OF FLUENCY DISORDERS 2016; 49:13-28. [PMID: 27638189 DOI: 10.1016/j.jfludis.2016.07.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/13/2016] [Accepted: 07/15/2016] [Indexed: 05/13/2023]
Abstract
PURPOSE Stuttering during adulthood is associated with a heightened rate of anxiety disorders, especially social anxiety disorder. Given the early onset of both anxiety and stuttering, this comorbidity could be present among stuttering children. METHOD Participants were 75 stuttering children 7-12 years and 150 matched non-stuttering control children. Multinomial and binary logistic regression models were used to estimate odds ratios for anxiety disorders, and two-sample t-tests compared scores on measures of anxiety and psycho-social difficulties. RESULTS Compared to non-stuttering controls, the stuttering group had six-fold increased odds for social anxiety disorder, seven-fold increased odds for subclinical generalized anxiety disorder, and four-fold increased odds for any anxiety disorder. CONCLUSION These results show that, as is the case during adulthood, stuttering during childhood is associated with a significantly heightened rate of anxiety disorders. Future research is needed to determine the impact of those disorders on speech treatment outcomes.
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Affiliation(s)
- Lisa Iverach
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, NSW 2109, Australia; School of Public Health, University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD 4006, Australia.
| | - Mark Jones
- School of Public Health, University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD 4006, Australia.
| | - Lauren F McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, NSW 2109, Australia.
| | - Heidi J Lyneham
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, NSW 2109, Australia.
| | - Ross G Menzies
- Australian Stuttering Research Centre, The University of Sydney, P.O. Box 170, Lidcombe, NSW 1825, Australia.
| | - Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, P.O. Box 170, Lidcombe, NSW 1825, Australia.
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, NSW 2109, Australia.
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80
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Zavos HMS, Eley TC, McGuire P, Plomin R, Cardno AG, Freeman D, Ronald A. Shared Etiology of Psychotic Experiences and Depressive Symptoms in Adolescence: A Longitudinal Twin Study. Schizophr Bull 2016; 42:1197-206. [PMID: 26994398 PMCID: PMC4988737 DOI: 10.1093/schbul/sbw021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Psychotic disorders and major depression, both typically adult-onset conditions, often co-occur. At younger ages psychotic experiences and depressive symptoms are often reported in the community. We used a genetically sensitive longitudinal design to investigate the relationship between psychotic experiences and depressive symptoms in adolescence. A representative community sample of twins from England and Wales was employed. Self-rated depressive symptoms, paranoia, hallucinations, cognitive disorganization, grandiosity, anhedonia, and parent-rated negative symptoms were collected when the twins were age 16 (N = 9618) and again on a representative subsample 9 months later (N = 2873). Direction and aetiology of associations were assessed using genetically informative cross-lagged models. Depressive symptoms were moderately correlated with paranoia, hallucinations, and cognitive disorganization. Lower correlations were observed between depression and anhedonia, and depression and parent-rated negative symptoms. Nonsignificant correlations were observed between depression and grandiosity. Largely the same genetic effects influenced depression and paranoia, depression and hallucinations, and depression and cognitive disorganization. Modest overlap in environmental influences also played a role in the associations. Significant bi-directional longitudinal associations were observed between depression and paranoia. Hallucinations and cognitive disorganization during adolescence were found to impact later depression, even after controlling for earlier levels of depression. Our study shows that psychotic experiences and depression, as traits in the community, have a high genetic overlap in mid-adolescence. Future research should test the prediction stemming from our longitudinal results, namely that reducing or ameliorating positive and cognitive psychotic experiences in adolescence would decrease later depressive symptoms.
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Affiliation(s)
- Helena M S Zavos
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK;
| | - Thalia C Eley
- Medical Research Council, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Robert Plomin
- Medical Research Council, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alastair G Cardno
- Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Birkbeck, Department of Psychological Sciences, University of London, London, UK
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81
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Thapar AK, Hood K, Collishaw S, Hammerton G, Mars B, Sellers R, Potter R, Craddock N, Thapar A, Rice F. Identifying key parent-reported symptoms for detecting depression in high risk adolescents. Psychiatry Res 2016; 242:210-217. [PMID: 27288739 DOI: 10.1016/j.psychres.2016.05.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 04/27/2016] [Accepted: 05/18/2016] [Indexed: 11/17/2022]
Abstract
Adolescent offspring of depressed parents are at particularly heightened risk of developing early onset Major Depressive Disorder (MDD) yet are unlikely to access services. We therefore aimed to identify a parsimonious combination of parent-reported symptoms that accurately detected offspring MDD. We used a multi-sample study comprising a development sample of 335 offspring of adults with recurrent MDD assessed on three occasions (mean age 12.4-14.8 years) and an independent validation sub-sample of 807 adolescents from a general population cohort (mean age 13.1 years). Parent ratings of psychiatric symptoms in adolescent offspring were assessed using established questionnaires. The best performing four-item combination of symptoms was identified. Accuracy in detecting concurrent DSM-IV MDD diagnosis, assessed by direct adolescent and parent interviews, was compared to the well-established 13-item short Moods and Feelings Questionnaire (sMFQ) using ROC curve analysis. The combination identified (concentration problems, anhedonia, worrying excessively and feeling unloved) performed equivalently to the sMFQ both in the development dataset and in the validation dataset. We concluded that a combination of four parent-reported mental health items performs equivalently to an established, longer depression questionnaire measure in detecting a diagnosis of adolescent major depressive disorder among offspring of parents with recurrent MDD and needs further evaluation.
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Affiliation(s)
- Ajay K Thapar
- Taff Riverside Practice, Wellington Street, Cardiff CF11 9SH, Wales, UK; Institute of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HX, Wales, UK
| | - Kerenza Hood
- Cardiff Centre for Trials Research, Neuadd Merionnydd, University Hospital of Wales, Cardiff University, Cardiff CF14 4XN, Wales, UK
| | - Stephan Collishaw
- Institute of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HX, Wales, UK
| | - Gemma Hammerton
- Institute of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HX, Wales, UK
| | - Becky Mars
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Whatley Road, Bristol BS8 2PS, England, UK
| | - Ruth Sellers
- Institute of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HX, Wales, UK
| | - Robert Potter
- Child and Adolescent Mental Health Services, Trehafod, Waunarlwydd Road, Swansea SA2 0GB, Wales, UK
| | - Nick Craddock
- Institute of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HX, Wales, UK
| | - Anita Thapar
- Institute of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HX, Wales, UK
| | - Frances Rice
- Institute of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HX, Wales, UK; Division of Psychology and Language Sciences, University College, Bedford Way, London WC1H 0AP, England, UK
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82
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Angel BØ. Client Self-Management: Promoting Self-Help for Parents of Children in Foster-Care. BRITISH JOURNAL OF SOCIAL WORK 2016; 46:1027-1043. [PMID: 27559212 PMCID: PMC4986088 DOI: 10.1093/bjsw/bcv025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Drawing upon Foucault's concepts of power, this article shows how a course given to parents whose children are in foster-care encourages a particular form of self-management-most notably, that their internal dialogues must be altered so that the parents can view themselves as people in control of their behaviour who are in a position to choose new behaviour. The article is based on a qualitative study conducted in Norway and centres on the support and development of participants in the course. Study results show increased self-confidence and self-respect in the participants, both as individuals and as parents. In addition, significant benefits were stated as finding that they could verbalise and describe difficult events and emotions, experiencing being 'normal' within a group and receiving feedback. From the perspective of child protective services, dialogue with parents is central, as it not only commits clients to specific behaviours, but-more importantly-commits them to a particular inner dialogue about parenthood. The course can be seen as a management tool in which the parent's 'self' becomes the central object, seeking to contradict the conventional conception of parents with children in foster-care as having nothing to contribute to their children's upbringing.
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Affiliation(s)
- Bjørn Øystein Angel
- University of Agder, Department of Sociology and Social Work, University of Agder, Kristiansand, Norway
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83
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Ormhaug SM, Jensen TK. Investigating treatment characteristics and first-session relationship variables as predictors of dropout in the treatment of traumatized youth. Psychother Res 2016; 28:235-249. [PMID: 27232208 DOI: 10.1080/10503307.2016.1189617] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Attrition is a common problem in youth trauma treatment, but there is currently little knowledge of why so many youths drop out. In this study, treatment variables (caregiver attendance in the first session and exposure vs. non-exposure-based treatment) and first-session process variables (the therapeutic alliance and youths' perceptions of parental treatment approval) were investigated as predictors of dropout. METHOD Participants (N = 156, mean age = 15.1) were randomly assigned to trauma-focused cognitive behavioral therapy or therapy as usual in a community trial. RESULTS Dropout (n = 39, 25.0%) was predicted by a lack of caregiver attendance, lower rates of youth-perceived parental treatment approval, and weaker therapist-rated youth alliance. Neither type of treatment, youth-rated alliance or caregiver alliance, predicted dropout. CONCLUSIONS The findings indicate that in addition to caregivers' actual participation in the first session, youths' perception of their parents' approval of treatment seems to influence treatment attendance. This finding implies that therapists should engage caregivers in therapy and address possible discordance in treatment goals and tasks. Furthermore, consistent with adult studies, exposure-based treatments do not appear to increase dropout rates.
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Affiliation(s)
- Silje M Ormhaug
- a Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS) , Oslo , Norway.,b Department of Psychology , University of Oslo , Oslo , Norway
| | - Tine K Jensen
- a Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS) , Oslo , Norway.,b Department of Psychology , University of Oslo , Oslo , Norway
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84
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Rhew IC, Monahan KC, Oesterle S, Hawkins JD. The Communities That Care Brief Depression Scale: Psychometric Properties and Criterion Validity. JOURNAL OF COMMUNITY PSYCHOLOGY 2016; 44:391-398. [PMID: 27872502 PMCID: PMC5115786 DOI: 10.1002/jcop.21766] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
For community-level approaches to preventing depression, measures of depression that are brief as well as valid are needed, particularly given competing demands in surveys for assessment of other outcomes including substance use, delinquency, and their associated risk factors. This study examined the validity of a four-item adolescent depression measure, the Communities That Care Brief Depression Scale (CTC-BDS). Data were from a survey of adolescents (N = 3,939) participating in the Community Youth Development Study (CYDS), a community-randomized trial involving 24 U.S. towns. The Patient Health Questionnaire nine-item (PHQ-9) was the criterion standard used to define major depressive disorder (MDD). Sensitivity and specificity of the CTC-BDS were both > .8 at a cutpoint of 6 and the area under the receiver operating characteristic curve was .91. Its strong psychometric properties and brevity make the CTC-BDS a useful measure for communities to monitor levels of youth depression.
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Affiliation(s)
- Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington
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85
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Babinski DE, Nene NV. Persistent Family Stress in the Course of Cognitive-Behavioral Therapy for a 7-Year-Old Girl With Social Anxiety Disorder. Clin Case Stud 2016. [DOI: 10.1177/1534650116636218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This case study describes the use of cognitive-behavioral therapy (CBT) for a 7-year-old girl, “Lauren,” who was diagnosed with social anxiety disorder (SAD) and was experiencing significant family stress. Manualized CBT was conducted and substantial reductions in SAD symptoms and impairment were demonstrated. Given additional difficulties remaining in the home setting, booster sessions were continued following manualized treatment to target Lauren’s functioning at home. These follow-up sessions were associated with maintained functioning, and only minimal additional benefits emerged. This case study calls attention to the importance of considering family stress in individual CBT for children with SAD, as well as the difficulties associated with addressing family stress in CBT for SAD. Existing treatments do not routinely address family stress in the context of child SAD, despite the potential to enhance CBT outcomes for children with SAD.
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Affiliation(s)
| | - Neel V. Nene
- Penn State College of Medicine, Hershey, PA, USA
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86
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Larsson B, Ingul J, Jozefiak T, Leikanger E, Sund AM. Prevalence, stability, 1-year incidence and predictors of depressive symptoms among Norwegian adolescents in the general population as measured by the Short Mood and Feelings Questionnaire. Nord J Psychiatry 2016; 70:290-6. [PMID: 26817811 DOI: 10.3109/08039488.2015.1109137] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background In numerous surveys the prevalence of depressive symptoms in adolescents has been examined in single sites and at one time point. Aims We examined depressive symptoms among adolescents aged 10-19 years in four different large school samples including two cohorts over a 10-year period in different locations in the same health region in central Norway including a total of 5804 adolescents. Two cohorts were retested within a 1-year time period to predict high versus low depressive symptom scores. Changes over a 6-year period in depressive symptom levels were examined in two of the samples of 12-14-year olds. Methods Depressive symptoms were estimated by the 13-item Short Mood and Feelings Questionnaire (SMFQ). Covariates were student age, sex, school size and location. Results "Miserable or unhappy", "Tired", "Restlessness" and "Poor concentration" were the most commonly reported depressive symptoms. Depressive symptom levels and proportions of high scoring students were consistently higher among girls, in particular in mid and late adolescence. Poisson regression analysis showed that all SMFQ items significantly predicted total scores for the whole sample, while sex (girls having a higher risk) emerged as a consistent 1-year predictor of high depressive symptom levels. Conclusions The SMFQ constitutes a short, practical and feasible measure. We recommend that this standardized measure should be used in the assessment of depressive symptoms among adolescents in school, primary care and clinical settings but also to evaluate treatment outcome. High scorers should be evaluated in subsequent clinical interviews for the presence of a depressive disorder.
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Affiliation(s)
- Bo Larsson
- a Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway
| | - JoMagne Ingul
- b Department of Child and Adolescent Psychiatry , Levanger Hospital , Levanger , Norway ;,d Department of Psychology , Norwegian University of Science and Technology , Trondheim , Norway
| | - Thomas Jozefiak
- a Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway ;,c Department of Child and Adolescent Psychiatry , St Olav's Hospital, Trondheim University Hospital , Trondheim , Norway
| | - Einar Leikanger
- a Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway ;,e Department of Child and Adolescent Psychiatry , Helse Sunnmøre HF, Volda Hospital , Volda , Norway
| | - Anne Mari Sund
- a Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway ;,c Department of Child and Adolescent Psychiatry , St Olav's Hospital, Trondheim University Hospital , Trondheim , Norway
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Grasso DJ, Felton JW, Reid-Quiñones K. The Structured Trauma-Related Experiences and Symptoms Screener (STRESS): Development and Preliminary Psychometrics. CHILD MALTREATMENT 2015; 20:214-220. [PMID: 26092442 DOI: 10.1177/1077559515588131] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Structured Trauma-Related Experiences and Symptoms Screener (STRESS) is a self-report instrument for youth of age 7-18 that inventories 25 adverse childhood experiences and potentially traumatic events and assesses symptoms of post-traumatic stress disorder using the revised criteria published in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The STRESS can be administered by computer such that questions are read aloud and automatic scoring and feedback are provided. Data were collected on a sample of 229 children and adolescents of age 7-17 undergoing a forensic child abuse and neglect evaluation. The purpose of the current study was to examine preliminary psychometric characteristics of the computer-administered STRESS as well as its underlying factor structure in relation to the four-factor DSM-5 model. Results provide initial support for the use of the STRESS in assessing adverse and potentially traumatic experiences and traumatic stress in children and adolescents.
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Affiliation(s)
- Damion J Grasso
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Julia W Felton
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Kathryn Reid-Quiñones
- Child Abuse Program, Children's Hospital of the King's Daughters, Norfolk, VA, USA Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
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88
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Rothon C, Stansfeld SA, Mathews C, Kleinhans A, Clark C, Lund C, Flisher AJ. Reliability of self report questionnaires for epidemiological investigations of adolescent mental health in Cape Town, South Africa. J Child Adolesc Ment Health 2015; 23:119-28. [PMID: 25860086 DOI: 10.2989/17280583.2011.634551] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to assess the reliability of a number of self report questionnaires for epidemiological investigations of adolescents' mental health in Cape Town, South Africa. The scales used were: the Short Mood and Feelings Questionnaire (SMFQ), Zung Self-rating Anxiety Scale (SAS), Self-esteem Questionnaire (SEQ), Harvard Trauma Questionnaire (HTQ) and Multi-Dimensional Scale of Perceived Social Support (MSPSS). METHOD The self-report questionnaire (available in Afrikaans, English and isiXhosa) was administered to 237 grade 8 students (14-15 years) on 2 occasions in metropolitan Cape Town high schools. The mean interval between first and second administration of the questionnaire was 8.3 days. Test-retest reliability was assessed using Cohen's kappa and observed agreement. Pearson's correlation coefficients were used to assess consistency across total scores between occasion 1 and occasion 2. Cronbach's alpha was used to assess the internal consistency of each scale. RESULTS All items had at least fair test-retest reliability (kappa > 0.20) apart from two items on the Self-rating Anxiety Scale and one item on the Harvard Trauma questionnaire. Test-retest reliability was strong for the HTQ (Pearson's correlation coefficient >0.75), moderate for the SAS, SEQ and MSPSS (0.50-0.74) and weak for the SMFQ (0.25-0.49). Cronbach's alpha for all scales was acceptable (>0.60). Analysis by the different language versions (Afrikaans/English and isi-Xhosa/ English) of the questionnaire indicated good internal consistency for most measures for all three languages. CONCLUSIONS The results indicate that many of these instruments may be used reliably in South Africa to assess adolescent mental health and that the different language versions of the instruments used in the questionnaire are generally reliable for use in South African schools. However, some caution is required with the use of the SAS and SEQ in different language groups.
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Affiliation(s)
- Catherine Rothon
- a Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry , Queen Mary University of London , Old Anatomy Building Charterhouse Square , London , EC1M 6BQ , UK
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89
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Health promotion behaviors in adolescents: prevalence and association with mental health status in a statewide sample. J Behav Health Serv Res 2015; 41:140-52. [PMID: 24114409 DOI: 10.1007/s11414-013-9370-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study is to estimate the proportion of adolescents meeting Healthy People 2020 health behavior recommendations for the prevention of chronic disease and to determine the association between mental health status (depression and/or conduct problems) and the likelihood of meeting these recommendations. The data used for this study are from the 2010 Washington State Healthy Youth Survey. Descriptive statistics and linear regression were utilized to estimate the proportion of adolescents meeting recommendations and associations between youth mental health status indicators and health-promoting behaviors. A small minority (5.8 %) of youth met all six recommendations in domains of tobacco abstinence, substance use abstinence, daily physical activity, breakfast consumption, weight below obese levels, and adequate sleep, though most (84.3 %) met at least three. At the aggregate level, the proportion of Washington State youth who met Healthy People 2020 guidelines exceeded targets, with the exception of substance use abstinence. A minority of youth reported guideline levels of daily physical activity (23.3 %) and sleep (39.8 %). Mental health status was strongly associated with the number of health-promoting behaviors adolescents endorsed. Interventions to increase the adoption of sleep hygiene and exercise habits should be added to an integrative positive youth development framework within school-, community-, and primary care-based adolescent health initiatives. Attention to adolescent mental health and shared risk factors may be critical for reducing barriers to healthy behavior.
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90
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Conn KM, Swanson D, McQuaid E, Douthit K, Fisher SG. The relationship between helplessness and the child's asthma symptoms: the role of social support. J Asthma 2014; 52:135-45. [PMID: 25212630 DOI: 10.3109/02770903.2014.952437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Objectives of this study were to survey parents and children independently regarding feelings of helplessness specific to asthma and to examine the relationship between helplessness and the child's symptom-free days. METHODS Parent-child dyads (children 7-12 years) from Rochester, NY were enrolled (November 2011-August 2012) from general pediatric clinics, pulmonary clinics, an Emergency Department, and area youth and asthma programs. Assessments included demographics, symptoms, ratings of helplessness related to asthma and parent social support. A multivariate linear regression was conducted to examine the relationship between feelings of helplessness and symptoms-free days: post hoc analysis assessed the moderating role of social support. RESULTS Overall, 107 parent-child dyads enrolled (participation rate: 72%); 104 were included in analysis. Most children were male (58%), 7-9 years (58%) and White (46%). The child's feelings of helplessness scores were positively correlated with symptom-free days indicating less feelings of helplessness as symptom-free days increased (rs = 0.273, p = 0.01). In a stratified analysis, among parents who reported minimal social support (<1 sources of support), child's helplessness scores were positively correlated with symptom-free days (rs = 0.335, p = 0.02). Conversely, among parents reporting >2 supports, no relationship was found (rs = 0.195, p = 0.15). CONCLUSIONS This study found less feelings of helplessness among children with asthma as symptom-free days increased. Social support appears to moderate this relationship; however further studies to confirm these findings are needed.
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Affiliation(s)
- Kelly M Conn
- University of Rochester Warner School Rochester , New York , USA
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91
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Knight T, Skouteris H, Townsend M, Hooley M. The act of giving: a pilot and feasibility study of theMy Life Storyprogramme designed to foster positive mental health and well-being in adolescents and older adults. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2014. [DOI: 10.1080/02673843.2014.881297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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92
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Cerdá M, Bordelois PM, Keyes KM, Galea S, Koenen KC, Pardini D. Cumulative and recent psychiatric symptoms as predictors of substance use onset: does timing matter? Addiction 2013; 108:2119-28. [PMID: 23941263 PMCID: PMC3833999 DOI: 10.1111/add.12323] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/01/2013] [Accepted: 08/01/2013] [Indexed: 11/30/2022]
Abstract
AIMS We examined two questions about the relationship between conduct disorder (CD), depression and anxiety symptoms and substance use onset: (i) what is the relative influence of recent and more chronic psychiatric symptoms on alcohol and marijuana use initiation and (ii) are there sensitive developmental periods when psychiatric symptoms have a stronger influence on substance use initiation? DESIGN Secondary analysis of longitudinal data from the Pittsburgh Youth Study, a cohort study of boys followed annually from 7 to 19 years of age. SETTING Recruitment occurred in public schools in Pittsburgh, Pennsylvania, USA. PARTICIPANTS A total of 503 boys. MEASUREMENTS The primary outcomes were age of alcohol and marijuana use onset. Discrete-time hazard models were used to determine whether (i) recent (prior year); and (ii) cumulative (from age 7 until 2 years prior to substance use onset) psychiatric symptoms were associated with substance use onset. FINDINGS Recent anxiety symptoms [hazard ratio (HR) = 1.10, 95% confidence interval (CI) = 1.03-1.17], recent (HR = 1.59, 95% CI = 1.35-1.87), cumulative (HR = 1.45, 95% CI = 1.03-2.03) CD symptoms, and cumulative depression symptoms (HR = 1.04, 95% CI = 1.01-1.08) were associated with earlier alcohol use onset. Recent (HR = 1.39, 95% CI = 1.22-1.58) and cumulative CD symptoms (HR = 1.38, 95% CI = 1.02-1.85) were associated with marijuana use onset. Recent anxiety symptoms were only associated with alcohol use onset among black participants. CONCLUSIONS Timing matters in the relationship between psychiatric symptoms and substance use onset in childhood and adolescence, and the psychiatric predictors of onset are substance-specific. There is no single sensitive developmental period for the influence of psychiatric symptoms on alcohol and marijuana use initiation.
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Affiliation(s)
- Magdalena Cerdá
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Paula M. Bordelois
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | | | - Dustin Pardini
- University of Pittsburgh School of Medicine and Western Psychiatric Institute
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93
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Vander Stoep A, Adrian MC, Rhew IC, McCauley E, Herting JR, Kraemer HC. Identifying comorbid depression and disruptive behavior disorders: comparison of two approaches used in adolescent studies. J Psychiatr Res 2012; 46:873-81. [PMID: 22575333 PMCID: PMC3704316 DOI: 10.1016/j.jpsychires.2012.03.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 02/15/2012] [Accepted: 03/29/2012] [Indexed: 11/17/2022]
Abstract
Interest in commonly co-occurring depression and disruptive behavior disorders in children has yielded a small body of research that estimates the prevalence of this comorbid condition and compares children with the comorbid condition and children with depression or disruptive behavior disorders alone with respect to antecedents and outcomes. Prior studies have used one of two different approaches to measure comorbid disorders: (1) meeting criteria for two DSM or ICD diagnoses or (2) scoring .5 SD above the mean or higher on two dimensional scales. This study compares two snapshots of comorbidity taken simultaneously in the same sample with each of the measurement approaches. The Developmental Pathways Project administered structured diagnostic interviews as well as dimensional scales to a community-based sample of 521 11-12 year olds to assess depression and disruptive behavior disorders. Clinical caseness indicators of children identified as "comorbid" by each method were examined concurrently and 3-years later. Cross-classification of adolescents via the two approaches revealed low agreement. When other indicators of caseness, including functional impairment, need for services, and clinical elevations on other symptom scales were examined, adolescents identified as comorbid via dimensional scales only were similar to those who were identified as comorbid via DSM-IV diagnostic criteria. Findings suggest that when relying solely on DSM diagnostic criteria for comorbid depression and disruptive behavior disorders, many adolescents with significant impairment will be overlooked. Findings also suggest that lower dimensional scale thresholds can be set when comorbid conditions, rather than single forms of psychopathology, are being identified.
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Affiliation(s)
- Ann Vander Stoep
- University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle 98195, USA.
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94
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Kingston D, Heaman M, Fell D, Dzakpasu S, Chalmers B. Factors associated with perceived stress and stressful life events in pregnant women: findings from the Canadian Maternity Experiences Survey. Matern Child Health J 2012; 16:158-68. [PMID: 21165763 DOI: 10.1007/s10995-010-0732-2] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Prenatal maternal stress has been linked to multiple adverse outcomes. Researchers have used a variety of methods to assess maternal stress. The purpose of this study was to explore and compare factors associated with stress in pregnancy as measured by perceived stress and stressful life events. We analyzed data from the Canadian Maternity Experiences Survey. A randomly selected sample of 8,542 women who had recently given birth was drawn from the 2006 Canadian Census. Women were eligible if they were at least 15 years of age, had delivered a live, singleton infant, and were living with their infant at the time of the interview (5-14 months postpartum). Prevalence estimates and odds ratios were calculated using sample weights of the survey and their variances were calculated using bootstrapping methods. Bivariate analyses identified statistically significant factors associated with each stress measure. Backward stepwise multivariate logistic regression models were constructed. A total of 6,421 women (78%) participated in the computer assisted telephone interview. Twelve percent of women experienced high levels of perceived stress and 17.1% reported having three or more stressful life events in the year prior to the birth of their baby. In the final model, psychosocial variables were associated with both outcomes, whereas demographic factors were associated only with life event stress. Different factors contributed to perceived stress and life event stress, suggesting that these concepts measure different aspects of stress. These findings can inform routine psychosocial risk assessment in pregnancy.
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Affiliation(s)
- Dawn Kingston
- Faculty of Nursing, University of Manitoba, Helen Glass Centre for Nursing, Winnipeg, MB R3T 2N2, Canada.
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95
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Allgaier AK, Pietsch K, Frühe B, Prast E, Sigl-Glöckner J, Schulte-Körne G. Depression in pediatric care: is the WHO-Five Well-Being Index a valid screening instrument for children and adolescents? Gen Hosp Psychiatry 2012; 34:234-41. [PMID: 22325631 DOI: 10.1016/j.genhosppsych.2012.01.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 01/05/2012] [Accepted: 01/06/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study investigated the criterion validity of the WHO-Five Well-Being Index (WHO-5) in screening for depression in pediatric care. METHOD A total of 446 children aged 9 to 12 and 324 adolescents aged 13 to 16, recruited from pediatric hospitals, completed the WHO-5 and a structured diagnostic interview serving as the gold standard. Diagnoses of depressive disorder included major depression and minor depression. Criterion validity was analyzed using the area under the receiver operating curve (AUC). Sensitivity and specificity were computed for optimal cutoffs. Additionally, unaided clinical diagnoses of depression made by the attending pediatricians were assessed. RESULTS Diagnoses of depressive disorder were established for 3.6% of children and 11.7% of adolescents. AUCs were .88 for the child and .87 for the adolescent sample. A cutoff score of 10 for children maximized sensitivity (.75) and specificity (.92). For the adolescent sample, decreasing the cutoff score to 9 yielded optimal sensitivity (.74) and specificity (.89). Sensitivity of the unaided clinical diagnosis of depression was .09, while specificity was .96. CONCLUSIONS The WHO-5 demonstrated good diagnostic accuracy for both age groups. Further evidence is needed to support the feasibility of the WHO-5 as a depression screening instrument used in pediatric care.
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Affiliation(s)
- Antje-Kathrin Allgaier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany.
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96
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Schmeelk-Cone K, Pisani AR, Petrova M, Wyman PA. Three scales assessing high school students' attitudes and perceived norms about seeking adult help for distress and suicide concerns. Suicide Life Threat Behav 2012; 42:157-72. [PMID: 22324773 PMCID: PMC3323704 DOI: 10.1111/j.1943-278x.2011.00079.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Validated measures that can be administered to school populations are needed to advance knowledge of help-seeking processes and to evaluate suicide prevention programs that target help-seeking. With 6,370 students from 22 high schools, we assessed the psychometric properties of three brief measures: Help-Seeking Acceptability at School, Adult Help for Suicidal Youth, and Reject Codes of Silence. Internal consistency coefficients ranged from .64 to .84. In support of construct validity, lower scores on each scale were associated with more maladaptive coping norms; for each one unit increase on each scale, students were one third to one half as likely to report suicidal ideation, suicide attempts, and elevated depression.
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Affiliation(s)
- Karen Schmeelk-Cone
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Anthony R. Pisani
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Mariya Petrova
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Peter A. Wyman
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY
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97
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Saraceno L, Heron J, Munafò M, Craddock N, van den Bree MBM. The relationship between childhood depressive symptoms and problem alcohol use in early adolescence: findings from a large longitudinal population-based study. Addiction 2012; 107:567-77. [PMID: 21939461 DOI: 10.1111/j.1360-0443.2011.03662.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Depressive symptomatology can increase risk of development of alcohol problems in young people. Tension reduction and family interactional theories may explain the relationship between depression and problematic alcohol use in youth. This study addresses the nature of the longitudinal relationship between these two behaviours. The available literature is currently inconclusive about whether there are gender differences in these relationships; this is also examined. DESIGN The association between childhood depressive behaviours and adolescence problematic alcohol use was examined using ordered logistic regression models. Evidence of gender differences and the impact of relevant covariates on these relations were examined. Missing data were imputed using a Multiple Imputation by Chained Equation (MICE) approach. SETTINGS The Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK population-based birth cohort. PARTICIPANTS A total of 4220 British boys and girls. MEASUREMENTS Depressive symptomatology was assessed in childhood (mean age = 10.6, SD = 0.2) using the Short Mood and Feelings Questionnaire (SMFQ). Problematic alcohol use was assessed from several questions queried in adolescence (mean age = 13.8, SD = 0.2). FINDINGS Childhood depressive symptoms were associated with increased risk of problematic alcohol use in early adolescence for girls [odds ratio (OR) = 1.14, P = 0.016] but not boys. This association for girls weakened (OR = 1.12, P = 0.058) when a priori selected covariates were taken into account, particularly the family and greater social environment. CONCLUSIONS Problematic alcohol use in girls (but not boys) is associated with prior depressive symptoms. This association may be attributable to several family and social environment factors, suggesting that a family interactional theoretical model may explain these findings.
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Affiliation(s)
- Luca Saraceno
- Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, UK
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98
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McKenzie DP, Toumbourou JW, Forbes AB, Mackinnon AJ, McMorris BJ, Catalano RF, Patton GC. Predicting future depression in adolescents using the Short Mood and Feelings Questionnaire: a two-nation study. J Affect Disord 2011; 134:151-9. [PMID: 21669461 PMCID: PMC3734932 DOI: 10.1016/j.jad.2011.05.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 05/13/2011] [Accepted: 05/13/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adolescence is a key life period for the development of depression. Predicting the development of depression in adolescence through detecting specific early symptoms may aid in the development of timely screening and intervention programmes. METHODS We administered the Short Mood and Feelings Questionnaire (SMFQ) to 5769 American and Australian students aged 10 to 15 years, at two time points, separated by 12 months. We attempted to predict high levels of depression symptoms at 12 months from symptoms at baseline, using statistical approaches based upon the quality, as well as the quantity, of depression symptoms present. These approaches included classification and regression trees (CART) and logistic regression. RESULTS A classification tree employing four SMFQ items, such as feelings of self-hatred and of being unloved, performed almost as well as all 13 SMFQ items at predicting subsequent depression symptomatology. LIMITATIONS Depression was measured using a self-report instrument, rather than a criterion standard diagnostic interview. CONCLUSION Further validation on other populations of adolescents is required: however the results suggest that several symptoms of depression, especially feelings of self-hatred, and being unloved, are associated with increased levels of self-reported depression at 12 months post baseline. Although screening for depression can be problematic, symptoms such as the ones above should be considered for inclusion in screening tests for adolescents.
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Affiliation(s)
- Dean P McKenzie
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.
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99
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White SW, Schry AR, Maddox BB. Brief Report: The Assessment of Anxiety in High-Functioning Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2011; 42:1138-45. [PMID: 21874396 DOI: 10.1007/s10803-011-1353-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Susan W White
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall 0436, Blacksburg, VA 24061, USA.
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