An overview of common psychiatric problems among adolescent and young adult females: Focus on mood and anxiety

Long-Term Effects of Adverse Maternal Care on Hypothalamic-Pituitary-Adrenal (HPA) Axis Function of Juvenile and Adolescent Macaques

Early life adversity (ELA) is a known risk factor for psychopathology, including stress-related anxiety and depressive disorders. The underlying mechanisms and developmental changes remain poorly understood. A likely underpinning is the impact of ELA on the development of stress response systems, including the hypothalamic-pituitary-adrenal (HPA) axis. Our group studied a translational ELA model of spontaneous infant maltreatment by the mother in rhesus macaques, where we used a cross-fostering design to randomly assign infant macaques to either Control or Maltreating (MALT) foster mothers at birth to examine the impact of adverse caregiving on the development of the HPA axis, while controlling for the confounding effects of heritable and prenatal factors. We previously reported higher levels of plasma and hair cortisol (CORT) across the first 6 postnatal months (equivalent to the first 2 years of life in humans) in the MALT than in the Control infants. Here, we followed the same cohort of infants longitudinally to assess the long-term developmental impact of this adverse experience on HPA axis function during the juvenile (12, 18 months) and late adolescent (~5 years) periods. For this, we collected measurements of diurnal CORT rhythm and glucocorticoid negative feedback using the dexamethasone suppression test (DST). At 12 months, we found higher diurnal CORT secretion in MALT females compared to Control females, and impaired negative feedback in response to the DST in both sexes in the MALT group. However, ELA group differences in the HPA axis function disappeared by 18 months and late adolescence, while sex differences in diurnal CORT rhythm emerged or became stronger. These results suggest that infant maltreatment causes dysregulation of the HPA axis during the first year of life, with HPA axis function normalizing later, during the pre-pubertal juvenile period and adolescence. This suggests that the impact of maltreatment on HPA axis function may be transient, at least if the adverse experience stops. Our findings are consistent with human evidence of recalibration/normalization of HPA axis function during adolescence in children that switch from adverse/deprived environments to supportive adoptive families. This research has broad implications regarding the biological processes that translate ELA to psychopathology during development and the pathways to resiliency.

Gender identity and symptoms of anxiety and depression and their relationship with sleep disorders among Polish adolescents during the Covid-19 pandemic and the outbreak of war in the Ukraine

INTRODUCTION

For most people, gender identity is consistent with biological sex and such people are called cisgender. People in whom such a relationship does not occur or occurs to a lesser extent are referred to as gender non-conforming-and these include transgender, non-binary, agender and gender-fluid people. These individuals are usually affected by minority stress, which, combined with the circumstances of the pandemic and Russian aggression against Ukraine, may have led to mental disorders and sleep disorders in this population. The aim of the study was to analyze the symptoms of anxiety, depression and insomnia in a group of Polish youth during the Covid-19 pandemic and the outbreak of the war in Ukraine, taking into consideration gender differences, including non-binary gender.

METHODS

The study involved 1621 secondary school students aged 14 to 19, the average age was 16.73 ± 1.35, including 857 girls, 690 boys and 74 people who defined their gender as non-binary. A set of questionnaires for the Diagnosis of Depression in Children (CDI 2), the State-Trait Anxiety Inventory (STAI), the X-1 subscale, The Athens Insomnia Scale (AIS) and an original questionnaire of sociodemographic data were used in research.

RESULTS

Analyzing the results obtained in the study group, the respondents scored an average of 17.99 ± 9.55 points in the assessment of depressive symptoms. After division into groups taking into account gender, the corresponding score was 19.69 ± 9.40 points for girls, 15.03 ± 8.68 for boys and 25.86 ± 9.91 for non-binary people. The difference was statistically significant (p = 0.000) in all three study groups. In the anxiety symptoms assessment, the respondents scored an average of 46.92 ± 11.67 points. After division into gender groups, the corresponding score was 49.21 ± 11.12 points for girls, 43.39 ± 11.47 for boys and 53.39 ± 10.41 for non-binary people. The difference was statistically significant (p = 0.000) in all three study groups. Analyzing the results obtained in The Athens Insomnia Scale (AIS), the average score was 8.31 ± 4.58 points, which allows to evaluate sleep onset as a norm. After dividing into groups, the results were 8.95 ± 4.55 points, respectively for girls, 7.19 ± 4.21 points for boys and 11.35 ± 5.43 for non-binary people, the difference was significant in terms of comparisons between all statistically tested groups. The analysis of the relationships between the studied variables was presented for each gender separately. Statistically significant positive correlations were found between the results obtained on the scale assessing depressive symptoms (CDI-2) and anxiety symptoms (STAI-X1) and the results obtained on the AIS scale.

CONCLUSIONS

Among the studied group of teenagers, the highest intensity of depressive symptoms is demonstrated by non-binary people, followed by females, and finally by males. Similar results were obtained in the assessment of anxiety symptoms. The non-binary group achieved results indicating sleep disorders, while the cisgender group's results of sleep onset were borderline normal. Whatsmore, the greater the severity of depressive and anxiety disorders, the greater the sleep disorders in all study groups, regardless of gender.

Fibre & fermented foods: differential effects on the microbiota-gut-brain axis

The ability to manipulate brain function through the communication between the microorganisms in the gastrointestinal tract and the brain along the gut-brain axis has emerged as a potential option to improve cognitive and emotional health. Dietary composition and patterns have demonstrated a robust capacity to modulate the microbiota-gut-brain axis. With their potential to possess pre-, pro-, post-, and synbiotic properties, dietary fibre and fermented foods stand out as potent shapers of the gut microbiota and subsequent signalling to the brain. Despite this potential, few studies have directly examined the mechanisms that might explain the beneficial action of dietary fibre and fermented foods on the microbiota-gut-brain axis, thus limiting insight and treatments for brain dysfunction. Herein, we evaluate the differential effects of dietary fibre and fermented foods from whole food sources on cognitive and emotional functioning. Potential mediating effects of dietary fibre and fermented foods on brain health via the microbiota-gut-brain axis are described. Although more multimodal research that combines psychological assessments and biological sampling to compare each food type is needed, the evidence accumulated to date suggests that dietary fibre, fermented foods, and/or their combination within a psychobiotic diet can be a cost-effective and convenient approach to improve cognitive and emotional functioning across the lifespan.

Mapping network connection and direction between anxiety and depression symptoms across the early, middle, and late adolescents: Insights from a large Chinese sample

Depression and anxiety are two mental disorders prevailing among adolescents. However, issues regarding the trajectory of depression and anxiety are still controversial on both the disease and symptom dimensions. The novel method of network analysis was used to provide insight into the symptom dimension. 20,544 adolescents (female = 10,743, 52.3%) aged between 14 and 24 years (age mean ± sd = 16.9 ± 2.94) were divided into three subgroups according to age so that the course of depression and anxiety could be traced. Network analysis and the Bayesian network model were used in the current study. The results indicated that uncontrollable worry - excessive worry was the most significant edge for all adolescents, whereas concentration - motor had the highest edge weights for early adolescents, and anhedonia - energy was the most critical pairwise symptom for middle and late adolescents. Irritability can bridge anxiety and depression in the early and middle stages of adolescence, while suicide plays a bridging role in the early and late stages of adolescence. Restlessness and guilt can bridge anxiety and depression in middle- and late-stage adolescents, and feeling afraid plays a unique role in middle-stage adolescents. Except for sad mood, which can trigger middle adolescents' anxiety and depression, the other three subgroups were mainly triggered by nervousness. In addition, all results in our current study were shown to be stable and accurate. In treatment, targeting central and triggering symptoms at different stages of adolescence may be critical to alleviating the comorbidity of anxiety and depression.

Depressive and anxiety symptoms in first generation college students

Objectives: Depression and anxiety contribute to the burden of disease among college students. The current study determined if depressive and anxiety symptoms were more prevalent in first generation students and if social and emotional support moderated this relationship. Methods: Depressive and anxiety symptoms were measured in 432 U.S. college students via an online survey. Single items determined student generation status and available social support. The CES-D10 and GAD-7 measured depression and anxiety, respectively. Structural equation modeling was used to identify significant effects. Results: First generation status was associated with increased cognitive-emotional (p = 0.036) and somatic (p = 0.013) anxiety symptoms, but not depression. High social and emotional support appeared to suppress somatic anxiety symptoms experienced by first generation students (p = 0.004). Conclusions: Greater anxiety symptoms in first generation students may be due to increased general and acculturative stress, although more research is needed. Large national surveys of college students should consider adding a question about first generation status.

Childhood inhibition predicts adolescent social anxiety: Findings from a longitudinal twin study

An enduring issue in the study of mental health is identifying developmental processes that explain how childhood characteristics progress to maladaptive forms. We examine the role that behavioral inhibition (BI) has on social anxiety (SA) during adolescence in 868 families of twins assessed at ages 8, 13, and 15 years. Multimodal assessments of BI and SA were completed at each phase, with additional measures (e.g., parenting stress) for parents and twins. Analyses were conducted in several steps: first, we used a cross-lagged panel model to demonstrate bidirectional paths between BI and SA; second a biometric Cholesky decomposition showed that both genetic and environmental influences on childhood BI also affect adolescent SA; next, multilevel phenotypic models tested moderation effects between BI and SA. We tested seven potential moderators of the BI to SA prediction in individual models and included only those that emerged as significant in a final conditional model examining predictors of SA. Though several main effects emerged as significant, only parenting stress had a significant interaction with BI to predict SA, highlighting the importance of environmental moderators in models examining temperamental effects on later psychological symptoms. This comprehensive assessment continues to build the prototype for such developmental psychopathology models.

Health information helps mitigate adolescent depression: A multivariate analysis of the links between health information use and depression management

BACKGROUND

Depression has brought a range of detrimental effects on adolescents. Despite the identified adverse outcomes, it is unclear what mechanisms contribute to the onset of adolescent depression. The limitation calls for innovative ways of managing the mental disorder, including embedding the methods and concepts from the humanities and social sciences into caring depressed teens. This study analyses how adolescents' health information use helps mitigate depressive symptoms.

METHODS

Guided by the information processing theories, this study proposes the health information processing model and uses it to analyse the impact of health information use on self-management of depressive symptoms among Chinese urban adolescents aged 10-18. A total of 310 urban teens were recruited from elementary, middle and high schools in Changchun in North China. The data collection was part of a project conducted jointly by China's National Health Commission and the United Nations Children's Fund.

RESULTS

Chinese teens' health knowledge and health literacy helped alleviate depressive symptoms. More health knowledge and self-efficacy predicted positive health behaviour changes, leading to better depression management. Older teens were more depressive and had more health knowledge than younger ones. Depressive symptoms were also associated with gender, school performance, family income and parents' education. Both parents' education levels significantly affected their children's depression, but in different ways. The more urban adolescents trusted health information from parents or teachers, the less they felt depressive, while the health information from peers did not have the same effect.

CONCLUSION

The study indicates that health information use may represent a unique form of intervention that could help mitigate the mental health issues Chinese youth experience. The findings add new insights to the knowledge of adolescents' depression management and health decision-making.

Psychometrics of the Spanish Version of the Screen for Adult Anxiety Related Disorders (SCAARED)

Objectives: To translate and validate the Screen for Adult Anxiety Related Disorders (SCAARED) questionnaire into Spanish. Method: The original SCAARED was translated into Spanish and administered to a non-clinical sample of 131 university students (92.4% women, mean age 22 years) in Valencia, Spain. To assess the concurrent validity of the SCAARED, the Depression, Anxiety and Stress Scale-21(DASS) and the Beck's Anxiety Inventory (BAI) were also administered. Test-retest reliability was evaluated 2 weeks after the first administration. Results: The internal consistency of SCAARED was high (α = 0.91) and the stability of the measurement was also high (test-retest 0.81). The results of the Exploratory Factor Analysis showed four factors comparable to the original SCAARED (generalized anxiety disorder, social phobia disorder, panic disorder, and separation anxiety disorder). The Area Under the Curve was excellent (0.88). Conclusions: The Spanish version of the SCAARED showed good psychometric properties comparable to the original SCAARED suggesting that it may be a useful instrument to screen for anxiety disorders in Spanish-speaking adult populations. Future studies are needed to replicate these findings in larger community and clinical samples.

The Co-occurrence of Pediatric Chronic Pain and Depression: A Narrative Review and Conceptualization of Mutual Maintenance

OBJECTIVES

Internalizing mental health issues co-occur with pediatric chronic pain at high rates and are linked to worse pain and functioning. Although the field has prioritized anxiety and posttraumatic stress disorder, little is known about co-occurring depression and chronic pain in youth, despite its high prevalence. The purpose of this narrative review was to examine the existing literature on the co-occurrence of pediatric chronic pain and depressive disorders and symptoms and propose a conceptual model of mutual maintenance to guide future research.

METHODS

The literature from both fields of pediatric pain and developmental psychology were searched to review the evidence for the co-occurrence of pediatric chronic pain and depression. Conceptual models of co-occurring mental health issues and chronic pain, as well as child depression, were reviewed. From both literatures, we provide evidence for a number of proposed child, parent, and neurobiological factors that may serve to mutually maintain both conditions over time. On the basis of this evidence, we propose a conceptual model of mutual maintenance and highlight several areas for future research in this area.

RESULTS

Evidence was found for the prevalence of depression in pediatric chronic pain as well as the co-occurrence of both conditions. The key mutually maintaining factors identified and proposed included neurobiological, intrapersonal (eg, cognitive biases, sleep disturbances, emotion regulation, and behavioral inactivation), and interpersonal (eg, parent mental health and pain, genes, and parenting) factors.

DISCUSSION

Given the dearth of research on mutual maintenance in this area, this review and conceptual model could drive future research in this area. We argue for the development of tailored treatments for this unique population of youth to improve outcomes.