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Krömer L, Jarczok TA, Althen H, Mühlherr AM, Howland V, Jungmann SM, Freitag CM. Implicit assumptions and interpretation bias in youth with severe, chronic social phobia. Eur Child Adolesc Psychiatry 2023; 32:501-512. [PMID: 34596762 PMCID: PMC10038968 DOI: 10.1007/s00787-021-01879-3] [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: 07/01/2020] [Accepted: 09/16/2021] [Indexed: 11/28/2022]
Abstract
Interpretation bias and dysfunctional social assumptions are proposed to play a pivotal role in the development and maintenance of social phobia (SP), especially in youth. In this study, we aimed to investigate disorder-specific implicit assumptions of rejection and implicit interpretation bias in youth with severe, chronic SP and healthy controls (CG). Twenty-seven youth with SP in inpatient/day-care treatment (M age = 15.6 years, 74% female) and 24 healthy controls (M age = 15.7 years, 54% female) were included. The Implicit Association Test (IAT) and the Affect Misattribution Procedure (AMP) were completed to assess implicit assumptions and interpretation bias related to the processing of social and affective stimuli. No group differences were observed for the IAT controlling for depressive symptoms in the analyses. However, group differences were found regarding interpretation bias (p = .017, η2p = .137). Correlations between implicit scores and explicit questionnaire results were medium to large in the SP group (r =|.28| to |.54|, pall ≤ .05), but lower in the control group (r =|.04| to |.46|, pall ≤ .05). Our results confirm the finding of an interpretation bias in youth SP, especially regarding the implicit processing of faces, whereas implicit dysfunctional social assumptions of being rejected do not seem to be specific for SP. Future research should investigate the causal relationship of assumptions/interpretation bias and SP.
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Affiliation(s)
- Lisa Krömer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany.
| | - Tomasz A Jarczok
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
| | - Heike Althen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
| | - Andreas M Mühlherr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
| | - Vanessa Howland
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
- Department of Neonatology and Pediatric Intensive Care, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Stefanie M Jungmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University Mainz, 55122, Mainz, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528, Frankfurt am Main, Germany
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Mühlherr AM, Yousaf A, Freitag CM. [Discrimination of anxiety disorders by parent ratings: A study based on the Questionnaire for Anxiety and Obsessive-Compulsive Disorders (FBB-ANZ)]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2021; 49:201-212. [PMID: 33834844 DOI: 10.1024/1422-4917/a000795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Discrimination of anxiety disorders by parent ratings: A study based on the Questionnaire for Anxiety and Obsessive-Compulsive Disorders (FBB-ANZ) Abstract. Parent ratings are often used for screening during the diagnostic evaluation of anxiety disorders. Clinically, it is important to correctly differentiate between anxiety and other psychiatric disorders and to distinguish specific anxiety disorders. The present study examined the validity of the screening results obtained by the Parent Questionnaire for Anxiety and Obsessive-Compulsive Disorders (FBB-ANZ). We examined whether the FBB-ANZ discriminated (1) anxiety and other psychiatric disorders and (2) specific anxiety disorders in children and adolescents using ROC analyses. 972 parents of 4;00-11;11-year-old children and 12;00-17;11-year-old adolescents with anxiety disorders, depressive episodes, or externalizing disorders completed the FBB-ANZ. Discrimination of anxiety disorders and externalizing disorders in children (AUC = .72) and adolescents (AUC = .76) as well as depressive episodes in children (AUC = .77) was moderate. Good discrimination of different anxiety disorders was found only for separation anxiety in children (AUC = .84) and adolescents (AUC = .87). The results indicate the limited diagnostic benefit of parent ratings for discriminating different anxiety disorders in children and adolescents. Potential explanations for the results are critically discussed.
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Affiliation(s)
- Andreas M Mühlherr
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Klinikum der Goethe-Universität, Frankfurt am Main
| | - Afsheen Yousaf
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Klinikum der Goethe-Universität, Frankfurt am Main
| | - Christine M Freitag
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Klinikum der Goethe-Universität, Frankfurt am Main
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Golub Y, Stonawski V, Plank AC, Eichler A, Kratz O, Waltes R, von Hoersten S, Roessner V, Freitag CM. Anxiety Is Associated With DPPIV Alterations in Children With Selective Mutism and Social Anxiety Disorder: A Pilot Study. Front Psychiatry 2021; 12:644553. [PMID: 34267682 PMCID: PMC8275849 DOI: 10.3389/fpsyt.2021.644553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/31/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Both selective mutism (SM) and social anxiety disorder (SAD) are severe pediatric anxiety disorders with the common trait of behavioral inhibition (BI). The underlying pathophysiology of these disorders remains poorly understood, however converging evidence suggests that alterations in several peripheral molecular pathways might be involved. In a pilot study, we investigated alterations in plasma molecular markers (dipeptidyl peptidase-4 [DPPIV], interleukin-6 [IL-6], tumor necrosis factor-β [TNF-β] and neuropeptide-Y [NPY]) in children with SM, SAD, and healthy controls, as well as the correlation of these markers to symptom severity. Methods: We included 51 children and adolescents (aged 5-18 years; n = 29 girls): n = 20 children in the SM-, n = 16 in the SAD- and n = 15 in the control-group (CG). Peripheral blood samples were analyzed for DPPIV, IL-6, TNF-β, and NPY concentrations. Diverse psychometric measures were used for BI, anxiety, and mutism symptoms. Results: Lower DPPIV-levels were correlated with more anxiety symptoms. However, we could not find a difference in any molecular marker between the patients with SAD and SM in comparison to the CG. Conclusion: DPPIV is proposed as relevant marker for child and adolescent anxiety. Investigating the pathophysiology of SM and SAD focusing on state and trait variables as anxiety or BI might help better understanding the underlying mechanisms of these disorders. Further studies with especially larger cohorts are needed to validate the current pilot-findings.
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Affiliation(s)
- Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Valeska Stonawski
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Anne C Plank
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Regina Waltes
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Stephan von Hoersten
- Department of Experimental Therapy and Preclinical Center, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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