1
|
Kajastus K, Haravuori H, Kiviruusu O, Marttunen M, Ranta K. Associations of generalized anxiety and social anxiety with perceived difficulties in school in the adolescent general population. J Adolesc 2024; 96:291-304. [PMID: 37985185 DOI: 10.1002/jad.12275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Generalized anxiety disorder (GAD), marked by excessive worry, and social anxiety disorder (SAD) are among the clinically most important anxiety disorders in the adolescent population. This study aimed to explore the associations between perceived difficulties in school and heightened levels of self-reported noncomorbid and comorbid GAD and SAD symptoms. METHODS Survey data of 37,905 Finnish upper secondary school students with a mean age of 17.33 years (SD = 0.63) were obtained from the School Health Promotion study, implemented in April and May 2015 in Finland. Exploratory factor analysis was used to determine indicators of academic and social difficulties in school. Logistic regression analysis was conducted to examine multivariate associations between anxiety symptoms and difficulties in the school. The anxiety symptom thresholds were based on the seven-item Generalized Anxiety Disorder Scale (≥10 points) for GAD-related symptoms and the Mini-SPIN (≥6 points) for SAD-related symptoms. RESULTS Self-reported generalized anxiety and social anxiety were both significantly associated with various perceived difficulties in school among this adolescent general population sample. Noncomorbid and comorbid GAD and SAD symptoms were both associated with an increased risk of academic and social difficulties, even when controlling for school performance. Comorbid symptoms were associated with significantly higher rates of social difficulties than noncomorbid symptoms of GAD or SAD. Furthermore, GAD symptoms were associated with a high risk for academic difficulties, irrespective of comorbidity. CONCLUSIONS Excessive worry, a defining feature of GAD, is central to school-related impairments among adolescents. The present study highlights the importance of school-based interventions for anxious adolescents. Interventions to improve adolescents'; school functioning should account for the interference of pathological worry related to GAD.
Collapse
Affiliation(s)
- Kati Kajastus
- Department of Psychology, Tampere University, Tampere, Finland
| | - Henna Haravuori
- HUS Helsinki University Hospital, Helsinki, Finland
- Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland
- Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
| | - Olli Kiviruusu
- Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mauri Marttunen
- HUS Helsinki University Hospital, Helsinki, Finland
- Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
| | - Klaus Ranta
- Department of Psychology, Tampere University, Tampere, Finland
- Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
| |
Collapse
|
2
|
Thomson KC, Jenkins E, Gill R, Hastings KG, Richardson CG, Gagné Petteni M, McAuliffe C, Gadermann AM. Parent psychological distress and parent-child relationships two years into the COVID-19 pandemic: Results from a Canadian cross-sectional study. PLoS One 2023; 18:e0292670. [PMID: 37847679 PMCID: PMC10581480 DOI: 10.1371/journal.pone.0292670] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Mental health impacts of the COVID-19 pandemic have not been felt equally within populations. Parents with children living at home were early on identified as a population at heightened mental health risk, with concerns about the potential long-term impacts of the pandemic on parents' mental health, family functioning, and children's well-being. This study investigates impacts of the pandemic on parents' psychological distress, contextual sources of distress, and associations with family functioning nearly two years into the pandemic. METHODS AND FINDINGS Data were drawn from a national cross-sectional survey of adults living in Canada in November and December 2021 that was representative by age, gender, household income, and region. Parents with children < 18 years old living at home (N = 553) reported their experiences of psychological distress, pandemic-related stressors, coping mechanisms, and family functioning (changes in parent-child interactions, children's anxiety). Chi-square tests, logistic regression, and linear regression analyses examined sociodemographic inequities in parents' levels of psychological distress, sources and mitigating mechanisms of distress, and associations between psychological distress and family functioning. Nearly two years into the pandemic, parents with children at home reported nearly double pre-pandemic population estimates of moderate to severe psychological distress. Psychological distress was more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial stressors. Parents with greater psychological distress reported increases in negative parent-child interactions due to the pandemic and higher anxiety among their children. CONCLUSIONS This study identifies sustained negative impacts of the pandemic on parents' mental health and family functioning in Canada nearly two years into the pandemic, despite high vaccine uptake and declining infection rates. Disparities in financial stress, social support structures, and pre-existing mental health were identified as underlying sources of psychological distress. These results highlight that meaningful responses to promote mental health among parents and families must address social and structural inequities.
Collapse
Affiliation(s)
- Kimberly C. Thomson
- Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Randip Gill
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Katherine G. Hastings
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Chris G. Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Monique Gagné Petteni
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Corey McAuliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Anne M. Gadermann
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| |
Collapse
|
3
|
Martin S, Strodl E. The relationship between childhood trauma, eating behaviours, and the mediating role of metacognitive beliefs. Appetite 2023; 188:106975. [PMID: 37454578 DOI: 10.1016/j.appet.2023.106975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Disordered eating poses a significant risk to psychological and physical health. The experience of childhood trauma has been linked to the development of disordered eating behaviours, but the causal psychological mechanisms remain unclear. The metacognitive model holds promise as a potential framework for understanding the mediating psychological processes that explain how childhood trauma may lead to disordered eating. The purpose of this study was to examine the role of metacognitive beliefs mediating the relationship between childhood trauma and disordered eating behaviours. Adults from the Australian community (N = 461) completed an online self-report survey measuring childhood maltreatment (Childhood Trauma Questionnaire - Short Form), disordered eating behaviour (Three Factor Eating Questionnaire - Revised 21), and metacognitive beliefs (Metacognitive Questionnaire 30). Hierarchical multiple regression analyses revealed no independent associations between any forms of childhood maltreatment and cognitive restraint, while childhood emotional abuse was uniquely associated with uncontrolled eating and emotional eating. Through bootstrapping tests, the mediating effect between childhood trauma and uncontrolled and emotional eating consistently involved the metacognitive beliefs that thoughts are uncontrollable and dangerous. Future longitudinal research is required to confirm causal relationships.
Collapse
Affiliation(s)
- Sarah Martin
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Australia.
| |
Collapse
|
4
|
Goldway N, Eldar E, Shoval G, Hartley CA. Computational Mechanisms of Addiction and Anxiety: A Developmental Perspective. Biol Psychiatry 2023; 93:739-750. [PMID: 36775050 PMCID: PMC10038924 DOI: 10.1016/j.biopsych.2023.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
A central goal of computational psychiatry is to identify systematic relationships between transdiagnostic dimensions of psychiatric symptomatology and the latent learning and decision-making computations that inform individuals' thoughts, feelings, and choices. Most psychiatric disorders emerge prior to adulthood, yet little work has extended these computational approaches to study the development of psychopathology. Here, we lay out a roadmap for future studies implementing this approach by developing empirically and theoretically informed hypotheses about how developmental changes in model-based control of action and Pavlovian learning processes may modulate vulnerability to anxiety and addiction. We highlight how insights from studies leveraging computational approaches to characterize the normative developmental trajectories of clinically relevant learning and decision-making processes may suggest promising avenues for future developmental computational psychiatry research.
Collapse
Affiliation(s)
- Noam Goldway
- Department of Psychology, New York University, New York, New York
| | - Eran Eldar
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Cognitive and Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gal Shoval
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey; Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel; Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Catherine A Hartley
- Department of Psychology, New York University, New York, New York; Center for Neural Science, New York University, New York, New York.
| |
Collapse
|
5
|
Hashemipour MA, Mohammadi F, Kamyabi H. Investigate the role of positive and negative memories from dentistry in the anxiety of dental patients in Kerman, Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:427. [PMID: 36824078 PMCID: PMC9942161 DOI: 10.4103/jehp.jehp_1436_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/29/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND AIM Several research works show that anxiety is more common in women, low-income classes, and middle-aged and elderly populations. The present study aimed to investigate the role of positive and negative memories in patients' anxiety referred to the dental clinics, offices, and schools of Kerman, Iran, in 2018-2019. MATERIALS AND METHODS In this cross-sectional, descriptive, analytical study, the participants were selected among individuals referred to the dental offices, schools, and clinics of Kerman, Iran. In this study, 500 questionnaires were distributed among the participants (based on census method), and of these, 482 of which were reviewed (response rate = 96.4%). The questionnaire used in this study contained four categories of questions, including demographic information, general questions about dentistry, Corah's Dental Anxiety Scale, and Autobiographical Memory Questionnaire. Analysis of variance, t-test, and Chi-square test were used to analyze. RESULTS Overall, 281 participants were female, and 201 were male. Based on the findings, dental visits were enjoyable and pleasant experiences for 154 participants, and 165 patients were anxious while the dentist prepared for a restorative treatment. This study showed that people with negative memories had more anxiety. Anxiety was also significantly associated with positive memories, higher education, and gender (female) (P < 0.05). Also, the most negative memories of dental treatments were associated with increased anxiety about dental treatments in adults (P < 0.05), while positive memories did not have a relationship any with decreased anxiety (P > 0.05). CONCLUSION The most negative memories of dental treatments were associated with increased anxiety about dental treatments in adults, while positive memories did not have any expected inverse relationship with anxiety.
Collapse
Affiliation(s)
- Maryam Alsadat Hashemipour
- Professor of Oral Medicine, Department of Oral Medicine, Dental School, Kerman of University of Medical Sciences, Kerman, Iran, Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran, Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Farideh Mohammadi
- Private Practice, Dental School, Kerman of University of Medical Sciences, Kerman, Iran
| | - Homa Kamyabi
- General Dentist, Dental School, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
6
|
Worry in Adolescents: the Role of Metacognitive Beliefs and Thought Control Strategies. TRENDS IN PSYCHOLOGY 2022. [DOI: 10.1007/s43076-022-00233-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
7
|
Adegboye D, Lennon J, Batterbee O, Thapar A, Collishaw S, Shelton K, Langley K, Hobson C, Higgins A, van Goozen S. Understanding de novo onset of anxiety during COVID-19: Pre-pandemic socio-emotional functioning in vulnerable children. JCPP ADVANCES 2022; 2:e12076. [PMID: 35942432 PMCID: PMC9348403 DOI: 10.1002/jcv2.12076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/10/2022] [Indexed: 11/20/2022] Open
Abstract
Background There is a need to understand and mitigate the psychological impacts of the COVID-19 pandemic for children known to be vulnerable. Data from prior to the pandemic are required to provide robust assessments of the socio-emotional impacts of COVID-19 and identify those who are more vulnerable. Method This study capitalises on an ongoing UK study of primary school children (4-8 years) identified prior to the pandemic as "at risk" for mental health problems by teachers. We collected mental health and social-emotional functioning data prior to the pandemic (Time 1) and re-assessed this cohort (N = 143) via researcher-led videocalls during lockdown (Time 2, summer 2020) and post-lockdown, 12 months later (Time 3; summer 2021). Results Mental health problems, particularly clinically significant anxiety, increased from 34% to 43% during lockdown and to 48% post-lockdown. Parental mental health difficulties (anxiety and depression) were prevalent during lockdown (40%) but had decreased 1 year later (20%). Children who developed clinically significant anxiety during the pandemic had impaired socio-emotional functioning at Time 1 (i.e., impaired emotion recognition, low self-esteem and social problems) and a high proportion (44%) had no contact with any peers during lockdown, which may have contributed to their anxiety, especially their school anxiety. Conclusion The pandemic appears to have exacerbated anxiety in already vulnerable children. A profile of socio-emotional problems identified a group of children who developed significant anxieties during the pandemic. These socio-emotional processes can be targeted for intervention to mitigate the negative mental health consequences of the pandemic and contribute to resilience in children.
Collapse
Affiliation(s)
| | | | | | - Anita Thapar
- School of Medicine Cardiff University Cardiff UK
| | | | | | - Kate Langley
- School of Psychology Cardiff University Cardiff UK
| | | | | | | |
Collapse
|
8
|
Yu M, Lv F, Liu Z, Gao D. How negative automatic thoughts trigger Chinese adolescents’ social anxiety: The mediation effect of meta-worry. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03229-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
9
|
Russell BS, Tomkunas AJ, Hutchison M, Tambling RR, Horton AL. The Protective Role of Parent Resilience on Mental Health and the Parent-Child Relationship During COVID-19. Child Psychiatry Hum Dev 2022; 53:183-196. [PMID: 34533667 PMCID: PMC8447807 DOI: 10.1007/s10578-021-01243-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic is linked to particularly potent psychological effects for children and their caregivers while families adjust to new daily routines for work, education, and self-care. Longitudinal associations are presented from a national sample of 271 parents (mean age = 35.29 years, 48.5% female) on resilience, mental health and stress indicators, and parenting outcomes. Multigroup path model results indicate significant associations between resilience and parent stress or parent perceived child stress initiates a sequence of significant linkages to parent depression, followed by caregiver burden and parent-child relationship quality. This final set of linkages between depression and both parenting outcomes were significantly stronger for men, who also reported higher rates of perceived child stress. Results suggest that fathers' depression symptoms and associated spill-over to perceived child stress is producing stronger effects on their parenting experiences than effects reported by mothers.
Collapse
Affiliation(s)
- Beth S Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA.
| | - Alexandria J Tomkunas
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Morica Hutchison
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Rachel R Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Abagail L Horton
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| |
Collapse
|
10
|
The effectiveness of a family-friendly program on parental meta-worry beliefs and health anxiety and social anxiety disorder in children. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02423-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
11
|
Mohammadkhani S, Akbari M, West A, Mazloom M, Gezloo F. The Relationship of Metacognition with Worry: The Mediating Role of Emotional Flexibility and Affective Style. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-021-00422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
Köcher LM, Schneider K, Christiansen H. Thinking about worry: A systematic review and meta-analysis on the assessment of metacognitions in children and adolescents. World J Psychiatry 2021; 11:635-658. [PMID: 34631466 PMCID: PMC8474992 DOI: 10.5498/wjp.v11.i9.635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/04/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The metacognitive model of generalized anxiety disorder identifies three forms of metacognition: Positive metacognitive beliefs about worry (POS), negative metacognitive beliefs about worry (NEG), and meta-worry. Though this model was originally developed relying on adult samples, it has since been applied to children and youth in different studies, and results mostly support its validity for this group. As the roles of POS, meta-worry, and age-effects do not appear to be fully clarified for children and adolescents yet, an integration of studies on children and adolescents and the metacognitive model is both timely and worthwhile.
AIM To summarize the current research on relationships, age-effects, and measurements for POS, NEG, and meta-worry in childhood and youth.
METHODS We carried out a literature search in the electronic databases PsycINFO, PubMed, PSYNDEX, and ERIC in 2017 and updated in 2020. Empirical research in German or English language on metacognition was included with child and adolescent samples diagnosed with anxiety disorders or healthy controls if POS, NEG, or meta-worry were measured. Studies were included for meta-analysis if they reported correlations between these metacognitions and anxiety or worry. Consensus rating for eligibility was done for 20.89% of full-texts with 90.32% agreement. Risk of bias was assessed with the appraisal tool for cross-sectional studies and consensus rating of appraisal tool for cross-sectional studies for 20.83% of included studies attaining agreement of intraclass correlation = 0.898. Overall, correlations between metacognitions, anxiety and worry were calculated with RevMan 5.4.1, assuming random-effects models. Meta-regressions with mean age as the covariate were performed via the online tool MetaMar 2.7.0. PROSPERO-ID: CRD42018078852.
RESULTS Overall, k = 763 records and k = 78 additional records were identified. Of those, k = 48 studies with 12839 participants were included and of those, k = 24 studies were included for meta-analysis. Most studies showed consistent NEG correlations with worry and anxiety, as well as higher values for clinical than for non-clinical samples. POS findings were less consistent. Meta-analysis revealed large effects for NEG correlating with worry and anxiety, small to medium effects for POS correlating with worry and anxiety, as well as small to medium effects for POS correlating with NEG. Meta-regressions did not reveal mean age as a significant covariate. Meta-worry was assessed in only one study. We identified eight questionnaires and one interview-format that assess metacognition about worry in children and adolescents.
CONCLUSION POS and NEG are measurable from the age of seven upwards and correlate with anxiety and worry without influences by age. Meta-worry requires further investigation.
Collapse
Affiliation(s)
- Laura M Köcher
- Department of Psychology, University of Marburg, Marburg 35037, Germany
| | - Kai Schneider
- Department of Clinical Child and Adolescent Psychology, University of Landau, Landau 76829, Germany
| | | |
Collapse
|
13
|
Metacognitive Beliefs Predict Cognitive Behavioral Therapy Outcome in Children with Anxiety Disorders. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00119-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
14
|
Russell BS, Hutchison M, Park CL, Fendrich M, Finkelstein-Fox L. Short-term impacts of COVID-19 on family caregivers: Emotion regulation, coping, and mental health. J Clin Psychol 2021; 78:357-374. [PMID: 34331773 PMCID: PMC8427037 DOI: 10.1002/jclp.23228] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022]
Abstract
Background The negative mental health impact of coronavirus disease 2019‐related stressors may be heightened for those caring for children, who bear responsibity for their welfare during disasters. Aim Based on the Transactional Model of Stress and Coping, we inquired whether caregivers' emotion regulation and coping behavior were associated with posttraumatic stress symptoms (PTSS). Materials & Methods Data were collected through a national online survey in April 2020, and again 60 days later. Results:Of the 801 longitudinal cases, 176 (63.6% female; mean age = 33.5) reported caring for minors in their homes during the pandemic. Over 20% of caregivers experienced clinically concerning PTSS, rates higher than their noncaregiving counterparts. Regression analysis indicates caregivers' baseline mental health symptoms and emotion regulation predicted PTSS 60 days later. Discussion Implications for needed parenting supports among families experiencing traumatic stress are provided. Conclusion Anxiety symptoms at baseline were the most significant and consistent contributor to all models and were significantly higher among those with clinically concerning levels of PTSS suggesting a clear intervention target.
Collapse
Affiliation(s)
- Beth S Russell
- Department of Human Development & Family Sciences, Storrs, Connecticut, USA
| | - Morica Hutchison
- Department of Human Development & Family Sciences, Storrs, Connecticut, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Michael Fendrich
- School of Social Work, University of Connecticut, Storrs, Connecticut, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| |
Collapse
|
15
|
Mothers' and children's metacognitions and the development of childhood anxiety: a longitudinal investigation of transmission. Eur Child Adolesc Psychiatry 2021; 30:451-459. [PMID: 32303854 DOI: 10.1007/s00787-020-01531-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
Theory and preliminary evidence suggests that parental beliefs and cognitions may be transmitted to their offspring. Transmission of maladaptive cognitions may play a role in the development of anxiety disorders in childhood. However, few studies have investigated such transmission using longitudinal designs. The objective of this study was to investigate the interaction between maternal and child metacognitions and their role in the development of childhood anxiety. We used a longitudinal design with self-report measures of maternal and child anxiety symptoms and metacognitions. Participants were 107 mothers and their children who were assessed when the children were between 7 and 12 years old and again 3 years later. Child metacognitions at baseline did not predict later child anxiety symptoms. Baseline maternal metacognitions approached significance in predicting anxiety symptoms in children at the follow-up, when controlling for known risk factors, including female gender and higher levels of anxiety in mother and child at baseline. Mediation analyses revealed that child metacognitions at baseline, as well as at follow-up fully mediated the relationship between maternal baseline metacognitions and child anxiety 3 years later. Examinations of how child and maternal metacognitions affect child anxiety levels after three years revealed that current levels of child metacognitions play a greater role in predicting child anxiety than child and maternal metacognitions at baseline.
Collapse
|
16
|
Bashford-Largo J, Aloi J, Lukoff J, Johnson K, White SF, Dobbertin M, Blair RJ, Blair KS. Reduced top-down attentional control in adolescents with generalized anxiety disorder. Brain Behav 2021; 11:e01994. [PMID: 33369286 PMCID: PMC7882153 DOI: 10.1002/brb3.1994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/14/2020] [Accepted: 11/24/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) can significantly impair quality of life and is associated with a relatively poor long-term prognosis. Anxiety disorders are often associated with hyper-responsiveness to threat, perhaps coupled with impaired executive functioning. However, GAD, particularly adolescent GAD, has been the focus of little functional neuroimaging work compared to other anxiety disorders. Here, we examine the neural association of adolescent GAD with responsiveness to threat and response control. METHODS The study involved 35 adolescents with GAD and 34 healthy comparison individuals (N = 69) matched on age, gender, and IQ. Participants were scanned during an affective number Stroop task. RESULTS We found significant Group-by-Task Condition interactions in regions involved in response control/motor responding (bilateral precentral gyri and cerebellum) and/or cognitive control/attention (dorsomedial and lateral frontal cortex, posterior cingulate cortex, cuneus, and precuneus). In line with predictions, the youth with GAD showed significantly less recruitment during task trials than the healthy comparison individuals. However, no indications of specific heightened responses to threat were seen. CONCLUSIONS GAD involves reduced capacity for engaging regions involved in response control/motor responding and/or cognitive control/attention. This might reflect either a secondary consequence of the patient's worry or an early risk factor for the development of worry.
Collapse
Affiliation(s)
| | - Joseph Aloi
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jennie Lukoff
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA
| | - Kimberly Johnson
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA
| | - Stuart F White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA
| | - Robert James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA
| |
Collapse
|
17
|
Tambling RR, Tomkunas AJ, Russell BS, Horton AL, Hutchison M. Thematic Analysis of Parent-Child Conversations About COVID-19: "Playing It Safe". JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:325-337. [PMID: 33456294 PMCID: PMC7798006 DOI: 10.1007/s10826-020-01889-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 05/10/2023]
Abstract
Caregivers have primary responsibility for teaching their children self-protective behaviors, including those behaviors recommended by the Center for Disease Control (CDC) to prevent the spread of COVID-19. Parents have an important role in scaffolding adherence to the CDC recommendations and in managing stress and regulate their emotions to adaptively cope during uncertain times like those facing communities nationwide. The present study is a qualitative, thematic analysis of parent-reported (n = 210; 64.8% female; average age = 39.33; 14.3% ethnic/racial minority) interactions with children (focal child age: 25.2% birth to 5 years old, 36.7% 6 to 11 years old, 37.6% 12 to 18 years old) about topics associated to COVID-19-related viral transmission suppression guidelines and stress/coping behaviors. Themes included discussions about personal and social hygiene, and parent reported sources of child stress, and child stress management efforts. Findings from our thematic analysis indicate parents are motivated to make scaffolding personal hygiene fun and engaging, signaling a positive, developmentally appropriate native approach to their role as sources of coping socialization. These findings also underscore the importance of providing information to parents in ways that can be translated to children in developmentally appropriate conversations about viral transmission suppression activities and stress management during disasters.
Collapse
Affiliation(s)
- R. R. Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - A. J. Tomkunas
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - B. S. Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - A. L. Horton
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - M. Hutchison
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| |
Collapse
|
18
|
Russell JK, Strodl E, Kavanagh DJ. Correlates of distress in young people with cystic fibrosis: the role of self-efficacy and metacognitive beliefs. Psychol Health 2020; 36:1497-1513. [PMID: 33370209 DOI: 10.1080/08870446.2020.1861280] [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: 10/22/2022]
Abstract
OBJECTIVES While significantly elevated distress is repeatedly found amongst young people with cystic fibrosis, their determinants remain largely unknown. This study explored whether metacognitive beliefs and self-efficacy for emotion regulation were associated with anxiety and depression after control for physical functioning, age and gender. DESIGN Cross-sectional study using a 110-item online questionnaire. METHODS An online survey was undertaken by 147 young people with CF aged 10-18 from five countries. Associations of Hospital Anxiety and Depression Scale scores with gender, age, physical functioning, Metacognitive Beliefs Questionnaire for Children (MCQ-C) subscales and Self-Efficacy for Emotion Regulation (SE-ER) were examined using hierarchical multiple linear regressions. RESULTS Physical functioning, gender and age accounted for 31% of the variance in anxiety and 39% in depression. The MCQ-C and SE-ER added another 45% to the variance of anxiety and 32% to depression. At the final step of both analyses, physical functioning, SE-ER, MCQ-C Negative Meta-Worry and Superstition, Punishment & Responsibility contributed significantly. Older age was also significantly associated with depression. CONCLUSIONS Self-efficacy for emotion regulation, concern about worrying and shame may be particularly important foci for interventions aimed at ameliorating anxiety and depression in young people with CF.
Collapse
Affiliation(s)
- Jeremy K Russell
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation, and School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| | - Esben Strodl
- School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| | - David J Kavanagh
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation, and School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
19
|
Assessment of the cognitive attentional syndrome in children: an adaptation of the CAS-1. Behav Cogn Psychother 2020; 49:340-351. [PMID: 33172517 DOI: 10.1017/s135246582000082x] [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: 11/06/2022]
Abstract
BACKGROUND Research suggests that the metacognitive model is applicable to clinical child populations. However, few measures related to the model are available for younger age groups. A key concept of the model is the cognitive attentional syndrome (CAS), which encompasses the individual's worry and rumination, maladaptive coping strategies, and metacognitive beliefs. While the CAS has been successfully measured in adults, this has not yet been attempted in children. AIMS The aim of this study was to adapt a measure of the CAS for use with children and investigate the measure's associations with anxiety, worry, depression and metacognitions. METHODS Our study included 127 children with anxiety disorders aged 7-13 years. The adult measure of CAS was adapted for use with children and administered at pre- and post-treatment. We examined the correlations between variables and the ability of the CAS measure to explain variance in anxious symptomatology, as well as the measure's sensitivity to treatment change. RESULTS The adapted measure, CAS-1C, displayed strong associations with overall anxiety, depression, worry and metacognitions. The CAS-1C explained an additional small amount of variance in anxiety and worry symptoms after accounting for metacognitions, which may be due to the measure also assessing thinking styles and coping strategies. Furthermore, the measure displayed sensitivity to treatment change. CONCLUSIONS The child measure of the CAS is a brief tool for collecting information on metacognitive beliefs and strategies that maintain psychopathology according to the metacognitive model, and it can be used to monitor treatment changes in these components.
Collapse
|
20
|
Social anxiety disorder in children: investigating the relative contribution of automatic thoughts, repetitive negative thinking and metacognitions. Behav Cogn Psychother 2020; 49:159-171. [PMID: 32720630 DOI: 10.1017/s1352465820000430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Social anxiety disorder (SAD) is common in youths. However, our understanding of SAD in children is inferior to that of SAD in adolescents or adults, and it is unclear if known adult SAD maintenance mechanisms may also operate in children with SAD. AIM The paper sets out to investigate the specificity of positive automatic thoughts, social threat negative automatic thoughts, repetitive negative thinking, positive and negative metacognitions in predicting SAD symptoms and diagnoses in clinically anxious children. METHOD We enrolled 122 clinically anxious children aged 7-13 years; of these, 33 had an SAD diagnosis. RESULTS SAD symptoms correlated positively with social threat negative automatic thoughts, repetitive negative thinking, and negative metacognitions, and negatively with positive automatic thoughts. Linear regression indicated that, of these variables, only social threat negative automatic thoughts predicted social anxiety symptoms. Logistic regression indicated that social threat negative automatic thoughts, a higher number of diagnoses and negative metacognitive beliefs specifically predicted the presence of SAD diagnosis. CONCLUSIONS Our findings suggest that content-specific social threat negative automatic thoughts was the only variable that specifically distinguished both higher levels of social anxiety symptoms and diagnoses.
Collapse
|
21
|
Normann N, Esbjørn BH. How do anxious children attempt to regulate worry? Results from a qualitative study with an experimental manipulation. Psychol Psychother 2020; 93:207-222. [PMID: 30506874 DOI: 10.1111/papt.12210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 10/26/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this study was to explore how anxiety-disordered children attempt to regulate their worry. DESIGN An experimental manipulation was applied, followed by a qualitative interview. METHODS Thirty children aged 7-13 were enrolled in this study. Each child was presented with a black mystery box, was told that shortly he/she would have to feel what was inside the box, and was then left alone for 4 min, prior to commencing the task. The purpose of the experimental manipulation was to induce slight levels of worry in the child, so that he/she could better report on worry regulation strategies. Afterwards, an interview about how the child had regulated worry during the experimental manipulation and in everyday life was undertaken. The interviews were coded using thematic analysis. RESULTS Five main themes were uncovered. These were (1) internal regulation of worry, for example, thinking about something else and self-reassurance talk, (2) external regulation of worry, for example, behavioural avoidance and distraction, (3) perceived effect of strategies, (4) shifting between strategies, and (5) absence of a strategy. CONCLUSIONS Our results demonstrate that anxious children use a variety of behavioural and cognitive strategies to regulate worry. They use these strategies in combination, they generally perceive them as ineffective, and they sometimes do not report any strategy for attempting to regulate their worry. These results indicate that clinicians should be curious about which strategies anxious children use to regulate their worry, how these strategies interact with each other, and how they are implemented by the child. PRACTITIONER POINTS Using an experimental manipulation followed by an interview, this study sought to investigate how anxious children seek to regulate their worries. Anxious children attempt to regulate their worry with use of behavioural regulation strategies, such as avoidance and distraction, and with use of cognitive regulation strategies, including thinking about something else, self-reassurance talk, and thought suppression. Sometimes, however, anxious children are not able to report a regulation strategy for a specific worry episode, suggesting that they may not always have a strategy or that they lack the introspective ability to report what they did. Clinicians should be aware that anxious children may use internal (cognitive) regulation strategies while at the same time using behavioural regulation strategies, such as avoidance.
Collapse
|
22
|
Metakognitive und mentalisierungsbasierte Konzepte und Behandlungsmodelle: Implikationen für die Kinder- und Jugendpsychiatrie. Prax Kinderpsychol Kinderpsychiatr 2020; 69:252-271. [DOI: 10.13109/prkk.2020.69.3.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
23
|
Lachat Shakeshaft Y, Lecerf T, Morosan L, Badoud DM, Debbané M. Validation of the French version of the « Meta-Cognition Questionnaire » for adolescents (MCQ-Af): Evolution of metacognitive beliefs with age and their links with anxiety during adolescence. PLoS One 2020; 15:e0230171. [PMID: 32160251 PMCID: PMC7065794 DOI: 10.1371/journal.pone.0230171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/23/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction The Meta-Cognitions Questionnaire for Adolescents (MCQ-A) measures individual differences of metacognitive beliefs and monitoring thought to be involved in the onset and maintenance of psychological disorders, especially in those involving anxiety. This assessment tool has been employed in research and clinical settings involving French-speaking adolescents, but appropriate validation has yet to be conducted. This article aims to first validate the francophone version of the MCQ-Af using measures sensitive to the expression of anxiety, and secondly, to examine the influence of age and gender on metacognitive beliefs, anxiety and their links. Method 214 adolescents (114 females) between 13 and 17 completed the MCQ-Af (French version) as well as the Revised-Children's Manifest Anxiety Scale (R-CMAS), French version, to assess anxiety manifestations. Structural validity was examined with confirmatory factor analyses. Three models were compared to the higher order five factor model proposed in the original validation study. Internal consistency and test-retest reliability were also performed. Student’s t tests as well as simple and stepwise regressions were conducted to assess for age and gender. Results The five correlated factors retained in the original version of the MCQ were replicated, and confirmatory factor analyses yielded comparable fit indices for a covariate factor model, as well as for a bifactor model. The bifactor model was privileged for theoretical reasons. Analyses were performed on a shortened questionnaire of 27 items as 3 items (2, 12 and 14) had non-significant loadings in prior path analyses. Age and gender differences were found in specific sub-factors of the MCQ-Af; positive and negative metacognitive beliefs seem to increase with age; girls seem to score higher on the negative metacognitive beliefs and thought control dimensions. The study further reports specific links between anxiety manifestation and negative and positive metacognitive beliefs, as well as confidence in one’s memory. A modest influence of age and gender on this link was also highlighted. Conclusion The present research provides the first evidence that the MCQ-Af is a valid and reliable instrument to assess individual differences of metacognitive beliefs in French-speaking adolescents. Nevertheless, it highlights that caution should be taken in regards of 3 items in particular (items 2, 12 and 14). Furthermore, age and gender in assessed samples of adolescents might influence the scores of the different dimensions of the questionnaire.
Collapse
Affiliation(s)
- Yasmina Lachat Shakeshaft
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Thierry Lecerf
- Differential Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Larisa Morosan
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Deborah Myriam Badoud
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Martin Debbané
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| |
Collapse
|
24
|
Abstract
Worry is common in children and adolescents, yet some youth experience excessive worries that persist over time and cause significant distress. Whilst the literature on worry and generalised anxiety disorder (GAD) in adults is well established, relatively less is known about the cognitive mechanisms underlying child and adolescent worry. An influential cognitive model of adult pathological worry (Hirsch and Matthews in Behav Res Therapy 50:636–646, 10.1016/j.brat.2012.06.007, 2012) proposes that negative information-processing biases, reduced executive functions, and verbal worry are critical in the aetiology of GAD in adults. The current systematic review investigated whether this cognitive model of worry could be extended to understand child and adolescent worry. Following a systematic search of the literature and screening for eligibility, 30 studies were identified. Evidence indicates that negative information-processing biases and reduced executive functions play an important role in worry and GAD in children and adolescents. However, evidence that children and adolescents experience verbal worry is inconclusive. Building upon Hirsch and Matthews' cognitive model (Behav Res Therapy 50:636–646, 10.1016/j.brat.2012.06.007, 2012), we propose a model of child and adolescent worry to provide a guiding framework for future research. We conclude that cognitive models of worry should incorporate a developmental framework in order to provide greater insight into the mechanisms uniquely associated with worry in children and adolescents and help to identify the cognitive processes to target for early interventions and treatments.
Collapse
|
25
|
Thorslund J, McEvoy PM, Anderson RA. Group metacognitive therapy for adolescents with anxiety and depressive disorders: A pilot study. J Clin Psychol 2020; 76:625-645. [PMID: 31916590 DOI: 10.1002/jclp.22914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE(S) The metacognitive model suggests that beliefs about cognition maintain repetitive negative thinking (RNT), a transdiagnostic process that underlies commonly comorbid, emotional disorders. To date, there has been the limited application of metacognitive therapy (MCT) to adolescents. This study aimed to evaluate a six-session group transdiagnostic MCT program for adolescents with anxiety and/or depressive disorders. METHOD Participants (N = 10; 3 male, 7 female; average age 15.2 years) completed measures of metacognition and RNT at assessment, baseline period, during treatment, and at 1- and 3-month follow-ups. RESULTS Nine participants attended all six treatment sessions and one discontinued after four sessions. At posttreatment and follow-ups, the majority of participants no longer met diagnostic criteria for anxiety or depressive disorders and evidenced a clinically significant or reliable change in metacognitions and RNT. CONCLUSIONS Results suggest that group MCT is promising in terms of acceptability and effectiveness for adolescents with anxiety and/or depressive disorders.
Collapse
Affiliation(s)
| | - Peter M McEvoy
- School of Psychology, Curtin University, Perth, Australia.,Centre for Clinical Interventions, Perth, Australia
| | | |
Collapse
|
26
|
Russell BS, Hutchison M, Tambling R, Tomkunas AJ, Horton AL. Initial Challenges of Caregiving During COVID-19: Caregiver Burden, Mental Health, and the Parent-Child Relationship. Child Psychiatry Hum Dev 2020; 51:671-682. [PMID: 32749568 PMCID: PMC7398861 DOI: 10.1007/s10578-020-01037-x] [Citation(s) in RCA: 337] [Impact Index Per Article: 84.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Research confirms that the mental health burdens following community-wide disasters are extensive, with pervasive impacts noted in individuals and families. It is clear that child disaster outcomes are worst among children of highly distressed caregivers, or those caregivers who experience their own negative mental health outcomes from the disaster. The current study used path analysis to examine concurrent patterns of parents' (n = 420) experience from a national sample during the early months of the U.S. COVID-19 pandemic. The results of a multi-group path analysis, organized by parent gender, indicate good fit to the data [X2(10) = 159.04, p < .01]. Results indicate significant linkages between parents' caregiver burden, mental health, and perceptions of children's stress; these in turn are significantly linked to child-parent closeness and conflict, indicating possible spillover effects for depressed parents and compensatory effects for anxious parents. The impact of millions of families sheltering in place during the COVID-19 pandemic for an undefined period of time may lead to unprecedented impacts on individuals' mental health with unknown impacts on child-parent relationships. These impacts may be heightened for families whose caregivers experience increased mental health symptoms, as was the case for fathers in the current sample.
Collapse
Affiliation(s)
- B S Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA.
| | - M Hutchison
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
| | - R Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
| | - A J Tomkunas
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
| | - A L Horton
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
| |
Collapse
|
27
|
Shaw ZA, Hilt LM, Starr LR. The developmental origins of ruminative response style: An integrative review. Clin Psychol Rev 2019; 74:101780. [PMID: 31739123 DOI: 10.1016/j.cpr.2019.101780] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 09/07/2019] [Accepted: 10/15/2019] [Indexed: 01/03/2023]
Abstract
Rumination has been conceptualized as a stable, trait-level response style involving repetitive and passive focus on the symptoms of distress and the possible causes and consequences of those symptoms. This theoretical review examines developmental risk factors of ruminative response style, incorporating a developmental psychopathology perspective. A model integrating these developmental factors within a conceptual framework is proposed, wherein risk factors for distress (i.e., temperamental negative affectivity, stressful environments, parenting, and genetic vulnerability) lead to engagement in rumination. We propose that when rumination is well-practiced, it will consolidate into a trait-like response style, especially among adolescents who experience cognitive control deficits. Reciprocal relationships and moderators that may contribute to the formation of a ruminative response style are also included. To understand how these factors converge and influence the formation of ruminative response styles, we review patterns of stability and change in physical and cognitive development to demonstrate that individual differences in rumination may emerge and consolidate into enduring, trait-level response styles during early adolescence.
Collapse
Affiliation(s)
- Zoey A Shaw
- Department of Clinical and Social Sciences in Psychology, University of Rochester, 491 Meliora Hall, Box 270266, Rochester, NY 14627-0266, United States of America.
| | - Lori M Hilt
- Department of Psychology, Lawrence University, 711 E. Boldt Way, SPC 24, Appleton, WI 54911, United States of America
| | - Lisa R Starr
- Department of Clinical and Social Sciences in Psychology, University of Rochester, 491 Meliora Hall, Box 270266, Rochester, NY 14627-0266, United States of America
| |
Collapse
|
28
|
Geronimi EMC, Richards A, Gramszlo C, Woodruff-Borden J. A Preliminary Investigation of Cognitive Features Associated With Worry Among African American Youth. JOURNAL OF BLACK PSYCHOLOGY 2019. [DOI: 10.1177/0095798419870076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although knowledge of the cognitive factors that place children at risk for worry has grown, little is known about these processes within African American youth. The present study investigated cognitive factors associated with worry in a sample of 47 African American children, ages 8 to 13. Participants completed self-report measures of worry, intolerance of uncertainty, positive and negative beliefs about worry, and negative problem orientation. Results supported the hypothesis that cognitive factors demonstrated significant positive associations with worry. Based on a model predicting worry from all cognitive factors, negative beliefs about worry emerged as the only individual predictor. This is the first study to examine cognitive factors associated with worry in an African American sample of children and provides initial support for the applicability of these cognitive factors in future examinations of worry within this population. Future research should continue to explore cognitive as well as other factors that predispose African America children to worry.
Collapse
|
29
|
Abstract
PURPOSE OF REVIEW This review describes (a) key features of the metacognitive model as they relate to anxiety and related disorders, (b) central components of metacognitive therapy (MCT), (c) the current empirical status of MCT, (d) recent developments, (e) controversies and (f) future research directions. RECENT FINDINGS Evidence is accumulating that MCT is effective for anxiety and related disorders. Emerging evidence suggests that MCT may be effective with children and adolescents and compares well to other evidence-supported treatments such as cognitive behaviour therapy and mindfulness-based approaches. Evidence for distinct mechanisms across therapies is mixed. While MCT appears to be effective for anxiety and related disorders, more research is required to evaluate (a) efficacy and unique (vs. common) mechanisms of change compared to other therapies, (b) effectiveness for children and adolescents, (c) alternative delivery methods (e.g., via internet, group vs. individual), (d) transdiagnostic impacts and (e) applications to a broader array of disorders.
Collapse
|
30
|
Zimmermann M, Glemser M, Ertle A. Dysfunktionale Metakognitionen im Jugendalter. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2018. [DOI: 10.1026/1616-3443/a000492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das metakognitive Modell legt nahe, dass dysfunktionale Metakognitionen für die Entwicklung und Aufrechterhaltung verschiedener emotionaler Störungen eine Rolle spielen. Diese Annahme konnte in Studien sowohl für Erwachsene als auch für Kinder und Jugendliche bestätigt werden. Fragestellung: Struktur und psychometrische Eigenschaften einer deutschen Version des Meta-cognitions Questionnaire – Adolescent Version (MCQ-A) zur Erfassung störungsrelevanter Metakognitionen wurden untersucht. Methode: Nach Erhebung von Daten an einer nicht-klinischen Stichprobe ( N = 221) wurde eine konfirmatorische Faktorenanalyse durchgeführt. Interne Konsistenz, Test-Retest-Reliabilität sowie konvergente Validität wurden ermittelt. Ergebnisse: Die Struktur der englischen Originalversion konnte repliziert werden. Die deutschsprachigen Skalen des MCQ-A weisen gute Reliabilitäts- und Validitätskennwerte auf. Schlussfolgerungen: Die vorliegende deutsche Version des MCQ-A kann vorläufig als ein reliables und valides Instrument zur Erfassung dysfunktionaler Metakognitionen betrachtet werden.
Collapse
|
31
|
Hiller RM, Creswell C, Meiser-Stedman R, Lobo S, Cowdrey F, Lyttle MD, Ehlers A, Halligan SL. A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 47:683-693. [PMID: 30264278 PMCID: PMC6439173 DOI: 10.1007/s10802-018-0477-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cognitive models of posttraumatic stress disorder (PTSD) highlight maladaptive posttrauma appraisals, trauma memory qualities, and coping strategies, such as rumination or thought suppression, as key processes that maintain PTSD symptoms. Anxiety, depression and externalising symptoms can also present in children in the aftermath of trauma, yet there has been little empirical investigation of the potential relevance of posttrauma cognitive processes for such difficulties. Here, we examined whether: a) acute maladaptive cognitive processes (specifically, maladaptive appraisals, memory qualities, and cognitive coping) were associated with symptoms of PTSD, internalising, and externalising at 1-month posttrauma (T1); and b) changes in these cognitive processes predicted symptom change at a follow-up assessment 6 months later (T2). We recruited 132 6–13 year old children and their parents from emergency departments following the child’s experience of an acute trauma. Children self-reported on their maladaptive appraisals, trauma-memory and cognitive coping strategies, along with symptoms of PTSD, anxiety and depression. Parents also rated children’s internalising and externalising symptoms. We found each cognitive process to be robustly associated with PTSD and non-PTSD internalising symptoms at T1, and change in each predicted change in symptoms to T2. Maladaptive appraisals and cognitive coping were unique predictors of children’s posttrauma internalising. Effects were partially retained even controlling for co-occurring PTSD symptoms. There was less evidence that trauma-specific cognitive processes were associated with externalising symptoms. Findings suggest aspects of cognitive models of PTSD are applicable to broader posttrauma psychopathology, and have implications for how we understand and target children’s posttrauma psychological adjustment.
Collapse
Affiliation(s)
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Sarah Lobo
- Department of Psychology, University of Bath, Bath, UK
| | - Felicity Cowdrey
- Department of Psychology, University of Bath, Bath, UK.,Oxford Health NHS Foundation Trust, Cotswold House, Specialist Eating Disorder Service, Savernake Hospital, Marlborough, UK
| | - Mark D Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.,Faculty of Health and Applied Sciences, University of West England, Bristol, UK
| | - Anke Ehlers
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | |
Collapse
|
32
|
The efficacy of group metacognitive therapy for children (MCT-c) with generalized anxiety disorder: An open trial. J Anxiety Disord 2018; 53:16-21. [PMID: 29145078 DOI: 10.1016/j.janxdis.2017.11.002] [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: 06/08/2016] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 02/07/2023]
Abstract
Metacognitive therapy is an effective treatment for anxiety disorders in adults. Studies have demonstrated that the underlying theoretical model is also supported in children. It has therefore been suggested that metacognitive therapy for children may be effective. Our study is an open trial of metacognitive therapy for children with generalized anxiety as their primary disorder. Therapy was provided in groups. Families were interviewed with the Anxiety Disorders Interview Schedule - child/parent versions. They reported on the child's anxiety levels using the Revised Childrens Anxiety and Depression Scale - child/parent versions. Children reported on metacognitive beliefs using the Metacognitions Questionnaire for Children - 30 item version. Fourty-four children aged 7-13 years (50% girls) were enrolled, and one family dropped out during treatment. Fifty percent of the children had received counseling or psychological treatment for their anxiety disorder previously. Following treatment, 86.4% of the children were free of their primary disorder and 72.7% were free of all anxiety disorders, the corresponding figures were 75% and 65.9% at 6-months follow-up. The effect sizes were large for all measures and clinically significant improvements were obtained for 70% of the children at posttest and 77% at follow-up. Our study suggests that metacognitive therapy for children with generalized anxiety disorder may be a highly promising treatment approach.
Collapse
|
33
|
Hearn CS, Donovan CL, Spence SH, March S. Do worry and its associated cognitive variables alter following CBT treatment in a youth population with Social Anxiety Disorder? Results from a randomized controlled trial. J Anxiety Disord 2018; 53:46-57. [PMID: 29195187 DOI: 10.1016/j.janxdis.2017.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 08/10/2017] [Accepted: 11/22/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Cate S Hearn
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD, 4122, Australia.
| | - Caroline L Donovan
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD, 4122, Australia.
| | - Susan H Spence
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD, 4122, Australia.
| | - Sonja March
- Institute for Resilient Regions & School of Psychology and Counselling, University of Southern Queensland, Springfield, QLD, 4300, Australia.
| |
Collapse
|
34
|
Rochat L, Manolov R, Billieux J. Efficacy of metacognitive therapy in improving mental health: A meta-analysis of single-case studies. J Clin Psychol 2017; 74:896-915. [DOI: 10.1002/jclp.22567] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/11/2017] [Accepted: 11/13/2017] [Indexed: 01/24/2023]
|
35
|
Hearn CS, Donovan CL, Spence SH, March S, Holmes MC. What's the Worry with Social Anxiety? Comparing Cognitive Processes in Children with Generalized Anxiety Disorder and Social Anxiety Disorder. Child Psychiatry Hum Dev 2017; 48:786-795. [PMID: 27917455 DOI: 10.1007/s10578-016-0703-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Social anxiety disorder (SAD) in children is often comorbid with generalized anxiety disorder (GAD). We investigated whether worry, intolerance of uncertainty, beliefs about worry, negative problem orientation and cognitive avoidance, that are typically associated with GAD, are present in children with SAD. Participants included 60 children (8-12 years), matched on age and gender. Groups included children: with primary GAD and without SAD (GAD); with primary SAD and without GAD (SAD); and without an anxiety disorder (NAD). GAD and SAD groups scored significantly higher than the NAD group on worry, intolerance of uncertainty, negative beliefs about worry and negative problem orientation, however, they did not score differently from each other. Only the GAD group scored significantly higher than the NAD group on cognitive avoidance. These findings further understanding of the structure of SAD and suggest that the high comorbidity between SAD and GAD may be due to similar underlying processes within the disorders.
Collapse
Affiliation(s)
- Cate S Hearn
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, 176 Messines Ridge Rd, M24 4th Floor Reception, Mount Gravatt, QLD, 4122, Australia.
| | - Caroline L Donovan
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, 176 Messines Ridge Rd, M24 4th Floor Reception, Mount Gravatt, QLD, 4122, Australia
| | - Susan H Spence
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, 176 Messines Ridge Rd, M24 4th Floor Reception, Mount Gravatt, QLD, 4122, Australia
| | - Sonja March
- Institute for Resilient Regions & School of Psychology and Counselling, University of Southern Queensland, Springfield, QLD, 4300, Australia
| | - Monique C Holmes
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, 176 Messines Ridge Rd, M24 4th Floor Reception, Mount Gravatt, QLD, 4122, Australia
| |
Collapse
|
36
|
Comparison of Early Maladaptive Schemas and Metacognitive Beliefs between the Students with Social Phobia and the ones with no Psychiatric Problems. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2017. [DOI: 10.5812/rijm.12689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
37
|
Bart O, Bar-Shalita T, Mansour H, Dar R. Relationships among Sensory Responsiveness, Anxiety, and Ritual Behaviors in Children with and without Atypical Sensory Responsiveness. Phys Occup Ther Pediatr 2017; 37:322-331. [PMID: 27366925 DOI: 10.1080/01942638.2016.1185504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM To explore relationships between sensory responsiveness, anxiety, and ritual behaviors in boys with typical and atypical sensory responsiveness. METHOD Forty-eight boys, ages 5-9 participated in the study (28 boys with atypical sensory responsiveness and 20 controls). Atypical sensory responsiveness was defined as a score of ≤154 on the Short Sensory Profile. Parents completed the Sensory Profile, the Screen for Child Anxiety Related Emotional Disorders, and the Childhood Routines Inventory. RESULTS Children with atypical sensory responsiveness had significantly higher levels of anxiety and a higher frequency of ritual behaviors than controls. Atypical sensory responsiveness was significantly related to both anxiety and ritual behaviors, with anxiety mediating the relationship between sensory modulation and ritual behaviors. CONCLUSIONS The findings elucidate the potential consequences of atypical sensory responsiveness and could support the notion that ritual behaviors develop as a coping mechanism in response to anxiety stemming from primary difficulty in modulating sensory input.
Collapse
Affiliation(s)
- Orit Bart
- a Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Tami Bar-Shalita
- a Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Hanin Mansour
- a Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Reuven Dar
- b School of Psychological Sciences , Tel Aviv University , Tel Aviv , Israel
| |
Collapse
|
38
|
Do Mother’s Metacognitions, Beliefs, and Behaviors Predict Child Anxiety-Related Metacognitions? CHILD & YOUTH CARE FORUM 2017. [DOI: 10.1007/s10566-017-9396-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
39
|
Cotter J, Yung AR, Carney R, Drake RJ. Metacognitive beliefs in the at-risk mental state: A systematic review and meta-analysis. Behav Res Ther 2017; 90:25-31. [DOI: 10.1016/j.brat.2016.12.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/28/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
|
40
|
Hearn CS, Donovan CL, Spence SH, March S. A worrying trend in Social Anxiety: To what degree are worry and its cognitive factors associated with youth Social Anxiety Disorder? J Affect Disord 2017; 208:33-40. [PMID: 27744124 DOI: 10.1016/j.jad.2016.09.052] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/27/2016] [Accepted: 09/30/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Comorbidity between Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) is extremely common. This study investigated whether factors commonly associated with GAD, including worry, intolerance of uncertainty (IU), positive and negative beliefs about worry (PBW, NBW), negative problem orientation (NPO) and cognitive avoidance (CA) were associated with SAD severity, symptoms and overall functioning. METHOD Participants included 126 youth aged 8-17 years (M=11.29, SD=2.67, Males n=50) with a primary diagnosis of SAD. Participants and a parent underwent a diagnostic interview and completed questionnaires at pre- and 12-week post assessment, and 6-month follow-up. Correlations and hierarchical multiple regression analyses were conducted. RESULTS Each of the cognitive variables, with the exception of PBW, was found to correlate with SAD symptoms, SAD severity and overall functioning. NPO emerged as an important predictor of SAD severity, self-reported ratings of SAD symptoms, and poorer levels of overall functioning. IU and worry also predicted self-rated SAD symptoms. LIMITATIONS Measures were chosen on the basis of their sound psychometrics however some were yet to undergo rigorous testing with youth populations. The study design is cross-sectional, which restricts firm conclusions regarding causal and temporal associations between the variables. CONCLUSIONS Findings from this study have implications for the specificity of GAD and SAD in youth. Further research is required to understand whether these cognitive variables play a maintaining role in youth SAD and the extent to which they might influence treatment.
Collapse
Affiliation(s)
- Cate S Hearn
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD 4122, Australia.
| | - Caroline L Donovan
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD 4122, Australia.
| | - Susan H Spence
- School of Applied Psychology and the Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Mount Gravatt, QLD 4122, Australia.
| | - Sonja March
- School of Psychology, Institute for Resilient Regions & School of Psychology and Counselling, University of Southern Queensland, Springfield, QLD 4300, Australia.
| |
Collapse
|
41
|
Bendezú JJ, Sarah EDP, Martha EW. What constitutes effective coping and efficient physiologic regulation following psychosocial stress depends on involuntary stress responses. Psychoneuroendocrinology 2016; 73:42-50. [PMID: 27448527 PMCID: PMC5296770 DOI: 10.1016/j.psyneuen.2016.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 07/05/2016] [Accepted: 07/06/2016] [Indexed: 11/19/2022]
Abstract
This study utilized a random-assignment experimental design to examine the interactive contributions of youth-reported trait involuntary stress responses (ISRs) and effortful coping on physiologic reactivity and recovery patterns in preadolescent boys and girls. Fourth- and fifth-grade child-parent dyads (N=126) participated in this study. Children were exposed to the Trier Social Stress Test (TSST-C) and then to one of two randomly-assigned experimental coping conditions: behavioral distraction and cognitive avoidance. Children's ISRs were examined as predictors of salivary cortisol and alpha-amylase (sAA) reactivity as well as moderators of the effect of coping condition on cortisol and sAA recovery trajectories. Multi-level modeling analyses did not link ISRs to physiologic reactivity patterning. ISRs and coping condition interacted to predict differential physiologic recovery trajectories. In the distraction condition, children reporting high ISR levels displayed less efficient cortisol and sAA recovery than children reporting low ISR levels. Surprisingly, the opposite was found for children reporting high ISR levels in the avoidance condition. These children displayed more efficient physiologic recovery relative to their high ISR level peers in the distraction condition. Findings suggest that the efficiency of preadolescents' physiologic recovery following stress may depend on regulatory fit between children's ISR levels and cues from their coping environment.
Collapse
Affiliation(s)
- Jason J Bendezú
- The Pennsylvania State University, Moore Building, University Park, PA 16803, United States.
| | - E D Perzow Sarah
- The Pennsylvania State University, Moore Building, University Park, PA 16803, United States.
| | - E Wadsworth Martha
- The Pennsylvania State University, Moore Building, University Park, PA 16803, United States.
| |
Collapse
|
42
|
|
43
|
The Metacognitive Model of Anxiety in Children: Towards a Reliable and Valid Measure. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9725-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
44
|
Thielsch C, Andor T, Ehring T. Metacognitions, intolerance of uncertainty and worry: An investigation in adolescents. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2014.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
45
|
Esbjørn BH, Normann N, Reinholdt-Dunne ML. Adapting Metacognitive Therapy to Children with Generalised Anxiety Disorder: Suggestions for a Manual. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2015; 45:159-166. [PMID: 26190860 PMCID: PMC4496502 DOI: 10.1007/s10879-015-9294-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The metacognitive model and therapy has proven to be a promising theory and intervention for emotional disorders in adults. The model has also received empirical support in normal and clinical child samples. The purpose of the present study was to adapt metacognitive therapy to children (MCT-c) with generalised anxiety disorder (GAD) and create suggestions for an adapted manual. The adaptation was based on the structure and techniques used in MCT for adults with GAD. However, the developmental limitations of children were taken into account. For instance, therapy was aided with worksheets, practical exercises and delivered in a group format. Overall, the intervention relied heavily on practising MCT techniques in vivo with therapist assistance. A detailed description of how the manual was adapted for this age group is given, and examples from a group of four children are presented in a case series. Findings indicate that the adapted version of the metacognitive techniques and manual for children is feasible.
Collapse
Affiliation(s)
- Barbara Hoff Esbjørn
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Copenhagen, Denmark
| | - Nicoline Normann
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Copenhagen, Denmark
| | - Marie Louise Reinholdt-Dunne
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Copenhagen, Denmark
| |
Collapse
|
46
|
Esbjørn BH, Lønfeldt NN, Nielsen SK, Reinholdt-Dunne ML, Sømhovd MJ, Cartwright-Hatton S. Meta-worry, worry, and anxiety in children and adolescents: relationships and interactions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2014; 44:145-56. [PMID: 24555865 DOI: 10.1080/15374416.2013.873980] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The metacognitive model has increased our understanding of the development and maintenance of generalized anxiety disorders in adults. It states that the combination of positive and negative beliefs about worry creates and sustains anxiety. A recent review argues that the model can be applied to children, but empirical support is lacking. The aim of the 2 presented studies was to explore the applicability of the model in a childhood sample. The first study employed a Danish community sample of youth (n = 587) ages 7 to 17 and investigated the relationship between metacognitions, worry and anxiety. Two multiple regression analyses were performed using worry and metacognitive processes as outcome variables. The second study sampled Danish children ages 7 to 12, and compared the metacognitions of children with a GAD diagnosis (n = 22) to children with a non-GAD anxiety diagnosis (n = 19) and nonanxious children (n = 14). In Study 1, metacognitive processes accounted for an additional 14% of the variance in worry, beyond age, gender, and anxiety, and an extra 11% of the variance in anxiety beyond age, gender, and worry. The Negative Beliefs about Worry scale emerged as the strongest predictor of worry and a stronger predictor of anxiety than the other metacognitive processes and age. In Study 2, children with GAD have significantly higher levels of deleterious metacognitions than anxious children without GAD and nonanxious children. The results offer partial support for the downward extension of the metacognitive model of generalized anxiety disorders to children.
Collapse
Affiliation(s)
- B H Esbjørn
- a Department of Psychology , University of Copenhagen
| | | | | | | | | | | |
Collapse
|
47
|
Welsh P, Cartwright-Hatton S, Wells A, Snow L, Tiffin PA. Metacognitive beliefs in adolescents with an at-risk mental state for psychosis. Early Interv Psychiatry 2014; 8:82-6. [PMID: 23682978 DOI: 10.1111/eip.12052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 03/23/2013] [Indexed: 11/29/2022]
Abstract
AIM The self-regulatory executive function model suggests that metacognitive beliefs play a role in all forms of psychological disorder, including psychosis. However, our understanding of these beliefs and their relationship with symptoms in adolescents with an at-risk mental state (ARMS) for psychosis is limited. METHODS The Metacognitions Questionnaire short form (MCQ-30) was administered to 31 adolescents with an identified ARMS. Scores were subsequently compared to a control group of 76 adolescents drawn from a community population. RESULTS As predicted, ARMS patients scored significantly higher on metacognition subscales, with negative beliefs (F = 42.97, P = 0.001), cognitive confidence (F = 17.11, P = 0.001) and need for control (F = 22.48, P = 0.001) subscales of the MCQ-30 distinguishing them from the comparison group. CONCLUSIONS The finding that metacognitive beliefs are significantly elevated in comparison to a community sample of adolescents is in keeping with previous adult-orientated research. Possible implications for clinical practice are discussed.
Collapse
Affiliation(s)
- Patrick Welsh
- School for Health, The Wolfson Research Institute, Durham University, Stockton-on-Tees, UK; South Durham Early Intervention in Psychosis Service, Tees, Esk and Wear Valleys NHS Foundation Trust, Bishop Auckland, UK
| | | | | | | | | |
Collapse
|
48
|
Meta-worry in adolescents: examination of the psychometric properties of the meta-worry questionnaire in an adolescent sample. Behav Cogn Psychother 2013; 42:491-6. [PMID: 23735158 DOI: 10.1017/s1352465813000374] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Meta-worry is considered a central component of the Metacognitive Model of Generalized Anxiety Disorder. Although initial research provides support for the applicability of this model to adolescent samples, the construct of meta-worry has yet to be examined in adolescents. AIMS The purpose of this study was to examine the psychometric properties of the Meta-Worry Questionnaire (MWQ), a measure designed to assess negative beliefs about worry, in an adolescent sample, and to examine the degree to which meta-worry is associated with pathological worry in adolescents. METHOD A non-referred sample of 175 adolescents completed a modified version of the MWQ along with the Meta-Cognitions Questionnaire-Children (MCQ-C) and the Penn State Worry Questionnaire for Children (PSWQ-C). RESULTS The MWQ was found to exhibit strong psychometric properties. Most noteworthy, the MWQ was found to be a particularly robust predictor of scores on the PSWQ-C, and incremental validity was also demonstrated. CONCLUSIONS Overall, the current findings provide support for the reliability and validity of the MWQ in adolescents and support for meta-worry as a predictor of worry symptoms in adolescents.
Collapse
|
49
|
Smith KE, Hudson JL. Metacognitive beliefs and processes in clinical anxiety in children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2013; 42:590-602. [PMID: 23356384 DOI: 10.1080/15374416.2012.755925] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Recent research has explored the role of metacognitive beliefs and processes in clinical anxiety in youth. The aim of this study was to examine the relationship between metacognitions and anxiety in 7- to 12-year-old children with and without clinical anxiety disorders. A secondary aim of the study was to investigate the psychometric properties of the recently developed Metacognitions Questionnaire for Children (MCQ-C). The sample consisted of 83 children (60.2% female; Oceanian 71.1%), comprising 49 children with anxiety disorders and 34 nonclinical children. All children completed self-report measures of anxiety, emotional difficulties, and metacognitions. A subsample of 7- to 8-year-old participants was used to explore whether young children could wholly comprehend all items on the MCQ-C. Positive and negative metacognitive beliefs and cognitive monitoring were significantly correlated with anxiety and emotional difficulties. Clinical children endorsed significantly more negative and more positive metacognitive beliefs than nonclinical children. Each subscale of the MCQ-C had poor internal consistency. Support for the criterion and convergent validity of the MCQ-C was found. The results suggest that certain metacognitions play a role in clinical anxiety in children but that psychometrically and developmentally validated measures of these concepts in younger individuals are needed.
Collapse
|
50
|
Esbjørn BH, Reinholdt-Dunne ML, Caspersen ID, Christensen LB, Chorpita BF. Penn State Worry Questionnaire: Findings Form Normative and Clinical Samples in Denmark. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2012. [DOI: 10.1007/s10862-012-9320-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|