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Fukuya Y, Fujiwara T, Isumi A, Doi S, Ochi M. Association of Birth Order With Mental Health Problems, Self-Esteem, Resilience, and Happiness Among Children: Results From A-CHILD Study. Front Psychiatry 2021; 12:638088. [PMID: 33935832 PMCID: PMC8079750 DOI: 10.3389/fpsyt.2021.638088] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/17/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aimed to investigate the association of birth order with mental health problems, self-esteem, resilience, and happiness among children aged 9-10 years. Methods: This was a cross-sectional study using data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, which was a population-based study of children in fourth grade in public schools in Adachi City, Tokyo, Japan in 2018 (N = 3,744). Parent-rated Strengths and Difficulties Questionnaire (SDQ) and self-rated resilience, happiness, and self-esteem score were used to assess child mental health. Multiple regression analysis for continuous outcomes and logistic regression for dichotomous outcomes were used to examine the association of birth order with mental health problems, resilience, happiness, and self-esteem. The analysis was controlled for child sex, mother's age, mother's education, caregiver's depressive symptoms, household income, and living with grandparents. Results: Last-borns showed the lowest total difficulties score in the SDQ, while only children showed the highest (p < 0.001). The highest prosocial behaviors score was found among last-borns (p < 0.001). Resilience score was also highest among last-borns, followed by first-borns, middle-borns, and only children. The lowest happiness score was found among middle-borns. Self-esteem score did not differ by sibling types. These associations were similar in the adjusted model and dichotomized outcomes model. Conclusions: Differential impacts of birth order on child mental health, for both positive and negative sides, were found. Further research is warranted to elucidate the mechanism of the association between birth order and the development of behavior problems and the positive aspects such as resilience, happiness, and self-esteem among children.
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Affiliation(s)
- Yoshifumi Fukuya
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manami Ochi
- Department of Health and Welfare Services, National Institute of Public Health, Saitama, Japan
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Lahey BB, Hinton KE, Meyer FC, Villalta-Gil V, Van Hulle CA, Applegate B, Yang X, Zald DH. Sex differences in associations of socioemotional dispositions measured in childhood and adolescence with brain white matter microstructure 12 years later. PERSONALITY NEUROSCIENCE 2020; 3:e5. [PMID: 32524066 PMCID: PMC7253690 DOI: 10.1017/pen.2020.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/22/2019] [Accepted: 02/09/2020] [Indexed: 01/10/2023]
Abstract
Predictive associations were estimated between socioemotional dispositions measured at 10-17 years using the Child and Adolescent Dispositions Scale (CADS) and future individual differences in white matter microstructure measured at 22-31 years of age. Participants were 410 twins (48.3% monozygotic) selected for later neuroimaging by oversampling on risk for psychopathology from a representative sample of child and adolescent twins. Controlling for demographic covariates and total intracranial volume (TICV), each CADS disposition (negative emotionality, prosociality, and daring) rated by one of the informants (parent or youth) significantly predicted global fractional anisotropy (FA) averaged across the major white matter tracts in brain in adulthood, but did so through significant interactions with sex after false discovery rate (FDR) correction. In females, each 1 SD difference in greater parent-rated prosociality was associated with 0.43 SD greater FA (p < 0.0008). In males, each 1 SD difference in greater parent-rated daring was associated with 0.24 SD lower FA (p < 0.0008), and each 1 SD difference in greater youth-rated negative emotionality was associated with 0.18 SD greater average FA (p < 0.0040). These findings suggest that CADS dispositions are associated with FA, but associations differ by sex. Exploratory analyses suggest that FA may mediate the associations between dispositions and psychopathology in some cases. These associations over 12 years could reflect enduring brain-behavior associations in spite of transactions with the environment, but could equally reflect processes in which dispositional differences in behavior influence the development of white matter. Future longitudinal studies are needed to resolve the causal nature of these sex-moderated associations.
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Affiliation(s)
- Benjamin B. Lahey
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Kendra E. Hinton
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, USA
| | | | | | - Carol A. Van Hulle
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Brooks Applegate
- Department of Educational Leadership, Research, and Technology, Western Michigan University, Kalamazoo, MI, USA
| | - Xiaochan Yang
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - David H. Zald
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, USA
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Meuret AE, Tunnell N, Roque A. Anxiety Disorders and Medical Comorbidity: Treatment Implications. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:237-261. [PMID: 32002933 DOI: 10.1007/978-981-32-9705-0_15] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Anxiety disorders are debilitating psychological disorders characterized by a wide range of cognitive and somatic symptoms. Anxiety sufferers have a higher lifetime prevalence of various medical problems. Chronic medical conditions furthermore increase the likelihood of psychiatric disorders and overall dysfunction. Lifetime rates of cardiovascular, respiratory, gastrointestinal, and other medical problems are disproportionately high in anxiety and panic/fear sufferers. The heightened comorbidity is not surprising as many symptoms of anxiety and panic/fear mimic symptoms of medical conditions. Panic disorder specifically is strongly linked to medical conditions due to its salient somatic symptoms, such as dyspnea, dizziness, numbness, chest pain, and heart palpitations, all of which can signal danger and deterioration for chronic disease sufferers. This chapter identifies shared correlates of medical illness and anxiety disorders and evidence for misinterpretation of symptoms as medically relevant and offers an analysis of implications for treatment of both types of conditions. We will concentrate on medical conditions with high associations for anxiety and panic by aspects of symptomatology, specifically neurological disorders (fibromyalgia, epilepsy, cerebral palsy), diabetes, gastrointestinal illness (irritable bowel syndrome, gastroesophageal reflux disease), and cardiovascular and respiratory illnesses (asthma).
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Affiliation(s)
- Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, TX, USA.
| | - Natalie Tunnell
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Andres Roque
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
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Meuret AE, Kroll J, Ritz T. Panic Disorder Comorbidity with Medical Conditions and Treatment Implications. Annu Rev Clin Psychol 2017; 13:209-240. [PMID: 28375724 DOI: 10.1146/annurev-clinpsy-021815-093044] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Panic disorder (PD) is unique among the anxiety disorders in that panic symptoms are primarily of a physical nature. Consequently, comorbidity with medical illness is significant. This review examines the association between PD and medical illness. We identify shared pathophysiological and psychological correlates and illustrate how physiological activation in panic sufferers underlies their symptom experience in the context of the fight-or-flight response and beyond a situation-specific response pattern. We then review evidence for bodily symptom perception accuracy in PD. Prevalence of comorbidity for PD and medical illness is presented, with a focus on respiratory and cardiovascular illness, irritable bowel syndrome, and diabetes, followed by an outline for potential pathways of a bidirectional association. We conclude by illustrating commonalities in mediating mechanistic pathways and moderating risk factors across medical illnesses, and we discuss implications for diagnosis and treatment of both types of conditions.
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Affiliation(s)
- Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, Texas 75275;
| | - Juliet Kroll
- Department of Psychology, Southern Methodist University, Dallas, Texas 75275;
| | - Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, Texas 75275;
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Blumenthal H. A laboratory-based test of the relation between adolescent alcohol use and panic-relevant responding. Exp Clin Psychopharmacol 2015; 23:303-13. [PMID: 26053320 PMCID: PMC4578981 DOI: 10.1037/pha0000022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A burgeoning literature supports a link between alcohol use and panic-spectrum problems (e.g., panic attacks, disorder) among adolescents, but the direction of influence has yet to be properly examined. From a theoretical perspective, panic-spectrum problems may increase risk for problematic drinking via affect regulation efforts (e.g., self-medication), and problematic consumption also may increase or initiate panic-relevant responding (e.g., learning or kindling models). The objective of the current investigation was to examine the role of prior alcohol use in predicting panic-relevant responding, as well as panic symptom history in predicting the desire to consume alcohol, in the context of either a voluntary hyperventilation or a low-arousal task. Participants were community-recruited adolescents aged 12-17 years (n = 92, Mage = 15.42, SD = 1.51; 39.1% girls). Results indicated that prior alcohol use predicted panic-relevant responding among those undergoing the hyperventilation task (but not the low-arousal task), and that this finding was robust to the inclusion of theoretically relevant covariates (i.e., age, sex, negative affectivity). However, panic symptom history did not predict the desire to consume alcohol as a function of either the hyperventilation or low-arousal condition. This work sheds further light on the nature of the relation between panic-spectrum problems and problematic alcohol use in adolescence. Specifically, the current findings suggest that frequent alcohol use may increase panic vulnerability among adolescents, whereas acute panic symptoms may not elicit the immediate (self-reported) desire to drink.
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Barlow DH, Ellard KK, Sauer-Zavala S, Bullis JR, Carl JR. The Origins of Neuroticism. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2014; 9:481-96. [DOI: 10.1177/1745691614544528] [Citation(s) in RCA: 187] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In this article, we provide a fresh perspective on the developmental origins of neuroticism—a dimension of temperament marked by elevated stress reactivity resulting in the frequent experience of negative emotions. This negative affectivity is accompanied by a pervasive perception that the world is a dangerous and threatening place, along with beliefs about one’s inability to manage or cope with challenging events. Historically, neuroticism has been viewed as a stable, genetically based trait. However, recent understanding of ongoing gene–environment interactions that occur throughout the life span suggests there may be a more complex and dynamic etiology. Thus, the purpose of this article is to offer a theory for understanding the development of neuroticism that integrates genetic, neurobiological, and environmental contributions to this trait. Given the strong correlation between neuroticism and the development of negative health outcomes—most notably, the full range of anxiety and mood disorders—an enhanced understanding of how neuroticism originates has implications for the treatment and prevention of a broad range of pathologies and, perhaps, even for the prevention of neuroticism itself.
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Affiliation(s)
- David H. Barlow
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
| | | | - Shannon Sauer-Zavala
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
| | - Jacqueline R. Bullis
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
| | - Jenna R. Carl
- Center for Anxiety and Related Disorders and Department of Psychology, Boston University
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Gordon TL, Steiner ARW, Teachman BA. Physical Triggers of Anxiety in African Americans. JOURNAL OF BLACK PSYCHOLOGY 2014. [DOI: 10.1177/0095798414535637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Understanding the primary triggers of anxiety for African Americans, and the cultural factors associated with these triggers, can enhance our knowledge of emotional responding in African Americans and can ultimately influence how we assess and treat anxiety disorders in this population. In the current study, we investigated the experience of anxiety for African Americans following physical stressors, with an emphasis on cardiovascular arousal. Specifically, anxious responding, following cardiovascular arousal, other physical stressors, and a control task, was evaluated among African American ( n = 23) and European American ( n = 23) groups on affective, cognitive, and physiological measures of anxiety. Findings suggest physical stressors in general (as opposed to cardiovascular arousal specifically) may be a prominent trigger of anxiety for African Americans. Discussion centers on the idea that the observed relationship between anxiety and physical stressors for African Americans may stem from a cultural sense of vulnerability regarding physical disease.
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Preter M, Klein DF. Lifelong opioidergic vulnerability through early life separation: a recent extension of the false suffocation alarm theory of panic disorder. Neurosci Biobehav Rev 2014; 46 Pt 3:345-51. [PMID: 24726574 DOI: 10.1016/j.neubiorev.2014.03.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 03/03/2014] [Accepted: 03/14/2014] [Indexed: 12/11/2022]
Abstract
The present paper is the edited version of our presentations at the "First World Symposium On Translational Models Of Panic Disorder", in Vitoria, E.S., Brazil, on November 16-18, 2012. We also review relevant work that appeared after the conference. Suffocation-False Alarm Theory (Klein, 1993) postulates the existence of an evolved physiologic suffocation alarm system that monitors information about potential suffocation. Panic attacks maladaptively occur when the alarm is erroneously triggered. The expanded Suffocation-False Alarm Theory (Preter and Klein, 2008) hypothesizes that endogenous opioidergic dysregulation may underlie the respiratory pathophysiology and suffocation sensitivity in panic disorder. Opioidergic dysregulation increases sensitivity to CO2, separation distress and panic attacks. That sudden loss, bereavement and childhood separation anxiety are also antecedents of "spontaneous" panic requires an integrative explanation. Our work unveiling the lifelong endogenous opioid system impairing effects of childhood parental loss (CPL) and parental separation in non-ill, normal adults opens a new experimental, investigatory area.
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Affiliation(s)
- Maurice Preter
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| | - Donald F Klein
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, 550 1st Ave, New York, NY 10016, USA.
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Temperamental Dimension and Anxiety Problems in a Clinical Sample of Three- to Six-year old Children: A Study of Variables. SPANISH JOURNAL OF PSYCHOLOGY 2014; 10:399-407. [DOI: 10.1017/s1138741600006661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In the last few years, many researchers have studied the presence of common dimensions of temperament in subjects with symptoms of anxiety. The aim of this study is to examine the association between temperamental dimensions (high negative affect and activity level) and anxiety problems in clinical preschool children. A total of 38 children, ages 3 to 6 years, from the Infant and Adolescent Mental Health Center of Girona and the Center of Diagnosis and Early Attention of Sabadell and Olot were evaluated by parents and psychologists. Their parents completed several screening scales and, subsequently, clinical child psychopathology professionals carried out diagnostic interviews with children from the sample who presented signs of anxiety. Findings showed that children with high levels of negative affect and low activity level have pronounced symptoms of anxiety. However, children with anxiety disorders do not present different temperament styles from their peers without these pathologies.
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11
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Kohlboeck G, Koletzko S, Bauer CP, von Berg A, Berdel D, Krämer U, Schaaf B, Lehmann I, Herbarth O, Heinrich J. Association of atopic and non-atopic asthma with emotional symptoms in school children. Pediatr Allergy Immunol 2013; 24:230-6. [PMID: 23590416 DOI: 10.1111/pai.12056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To date, there is conflicting evidence whether the association between asthma and depression depends on the atopic or non-atopic asthma phenotype. This study investigates associations between emotional symptoms and atopic and non-atopic asthma in school-aged children. METHODS Cross-sectional data on asthma and allergic diseases at the 10-year follow-up of two birth cohorts were collected by parent-reported physician diagnoses. Specific IgE levels including most common inhalant allergens (SX1) and food allergens (FX5) were measured by RAST-CAP FEIA. Atopic asthma was defined as asthma ever and positive specific IgE test, non-atopic asthma as asthma ever and no IgE sensitization. Emotional symptoms were assessed by parent-reported strength and difficulty questionnaire. Logistic regression modeling were applied to determine likelihood of emotional symptoms in children with atopic and non-atopic asthma controlling for socio-demographic factors, body mass index, atopic eczema, allergic rhinitis, and pubertal development. RESULTS Non-atopic asthma was associated with about 3-fold higher likelihood of emotional symptoms compared to children with no asthma (ORadj = 2.90, CI95% = 1.46-5.73). Atopic asthma was not associated with emotional symptoms (ORadj = 1.35, CI95% = 0.81-2.26). CONCLUSIONS Atopic and non-atopic asthma in children might have different etiologies, whereas for non-atopic asthma, emotional symptoms are relevant, this is not the case in atopic asthma. The relationship between the non-atopic asthma phenotype and emotional symptoms might be dependent on gender.
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Affiliation(s)
- Gabriele Kohlboeck
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany.
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12
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Functional programming of the autonomic nervous system by early life immune exposure: implications for anxiety. PLoS One 2013; 8:e57700. [PMID: 23483921 PMCID: PMC3590226 DOI: 10.1371/journal.pone.0057700] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 01/23/2013] [Indexed: 12/13/2022] Open
Abstract
Neonatal exposure of rodents to an immune challenge alters a variety of behavioural and physiological parameters in adulthood. In particular, neonatal lipopolysaccharide (LPS; 0.05 mg/kg, i.p.) exposure produces robust increases in anxiety-like behaviour, accompanied by persistent changes in hypothalamic-pituitary-adrenal (HPA) axis functioning. Altered autonomic nervous system (ANS) activity is an important physiological contributor to the generation of anxiety. Here we examined the long term effects of neonatal LPS exposure on ANS function and the associated changes in neuroendocrine and behavioural indices. ANS function in Wistar rats, neonatally treated with LPS, was assessed via analysis of tyrosine hydroxylase (TH) in the adrenal glands on postnatal days (PNDs) 50 and 85, and via plethysmographic assessment of adult respiratory rate in response to mild stress (acoustic and light stimuli). Expression of genes implicated in regulation of autonomic and endocrine activity in the relevant brain areas was also examined. Neonatal LPS exposure produced an increase in TH phosphorylation and activity at both PNDs 50 and 85. In adulthood, LPS-treated rats responded with increased respiratory rates to the lower intensities of stimuli, indicative of increased autonomic arousal. These changes were associated with increases in anxiety-like behaviours and HPA axis activity, alongside altered expression of the GABA-A receptor α2 subunit, CRH receptor type 1, CRH binding protein, and glucocorticoid receptor mRNA levels in the prefrontal cortex, hippocampus and hypothalamus. The current findings suggest that in addition to the commonly reported alterations in HPA axis functioning, neonatal LPS challenge is associated with a persistent change in ANS activity, associated with, and potentially contributing to, the anxiety-like phenotype. The findings of this study reflect the importance of changes in the perinatal microbial environment on the ontogeny of physiological processes.
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Fryers T, Brugha T. Childhood determinants of adult psychiatric disorder. Clin Pract Epidemiol Ment Health 2013; 9:1-50. [PMID: 23539489 PMCID: PMC3606947 DOI: 10.2174/1745017901309010001] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 06/22/2012] [Accepted: 07/07/2012] [Indexed: 02/06/2023]
Abstract
The aim of this project was to assess the current evidence from longitudinal studies for childhood determinants of adult mental illness. Because of the variable and often prolonged period between factors in childhood and the identification of mental illness in adults, prospective studies, particularly birth cohorts, offer the best chance of demonstrating associations in individuals. A review was undertaken in 2006 of the published literature from longitudinal studies, together with some large-scale retrospective studies and relevant reviews which provided supplementary evidence. The main focus was upon potentially ameliorable characteristics, experiences or situations of childhood; however, other factors, not determinants but pre-cursors, associated with later mental illness could not be left out. Seven major electronic data-bases of published research were interrogated with a range of key-words and the results supplemented from personal searches, enquiries and reference trails. In excess of 1,500 abstracts were read to select 250 papers for full review. The material was assessed in relation to ten factors: Psychological disturbance; Genetic Influences; Neurological Deviance; Neuroticism; Behaviour; School Performance; Adversity; Child Abuse or Neglect; Parenting and parent-child relationships; Disrupted and Disfunctional Families. In 2011 the search was repeated for the period 2006 to mid-2011, using the same search terms and supplemented in the same manner. Over 1,800 abstracts emerged and almost 200 papers selected for more detailed review. These were then integrated into the original text with modifications where necessary. The whole text was then revised and edited in January / February 2012. There is continuing evidence for the association with later mental ill-health for each of these ten factors, but with different degrees of conviction. The evidence for each is discussed in detail and weighed both separately and in relation to others. These are then summarised, and the research implications are considered. Finally, the implications for prevention are discussed together with the practical potential for preventive and health-promoting programmes.
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Affiliation(s)
- Tom Fryers
- International and Public Health, School of Health Sciences, New York Medical College, USA ; Department of Health Sciences, University of Leicester, UK
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Goodwin RD, Seeley JR, Lewinsohn PM. Childhood respiratory symptoms and mental health problems: the role of intergenerational smoking. Pediatr Pulmonol 2013; 48:195-201. [PMID: 22588945 PMCID: PMC3422397 DOI: 10.1002/ppul.22579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 03/13/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the potential role of youth smoking, parental cigarette smoking and parental anxiety/depressive disorders in the relationship between respiratory symptoms and mental health problems among youth. WORKING HYPOTHESIS Adjusting for both parental smoking and parental anxiety/depressive disorders in the association between respiratory symptoms and mental health problems among young persons will significantly reduce the strength of the observed relationship. STUDY DESIGN Prospective cohort study. PATIENT-SUBJECT SELECTION: Data were drawn from a school-based sample of 1709 young persons in Oregon. METHODOLOGY Physical and mental health data were collected on youth. RESULTS Respiratory symptoms were associated with significantly increased odds of mental health problems among youth. After adjusting for youth smoking, the relationship between respiratory symptoms and depressive disorders was no longer statistically significant. The relationships between respiratory symptoms and anxiety and depressive disorders were no longer significant after adjusting for parental smoking. Parental anxiety/depressive disorders did not appear to influence these relationships. CONCLUSIONS These results provide initial evidence that exposure to parental smoking may play a role in the observed co-occurrence of respiratory and mental health problems in youth, and youths' own smoking appears to influence the link with depressive disorders, but not anxiety disorders.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
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Blumenthal H, Leen-Feldner EW, Knapp AA, Bunaciu L, Zamboanga BL. Alcohol use history and panic-relevant responding among adolescents: a test using a voluntary hyperventilation challenge. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:683-692. [PMID: 22369219 PMCID: PMC3395763 DOI: 10.1037/a0027364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Given the onset of alcohol use, neurological sensitivity, and enhanced panic-relevant vulnerability, adolescence is a key period in which to study the documented linkage between alcohol and panic-related problems. The current study was designed to build upon and uniquely extend extant work via (a) utilization of well-established experimental psychopathology techniques and (b) evaluation of unique associations between alcohol use and panic symptoms after controlling for theoretically relevant behavioral, environmental, and individual difference variables (i.e., age, gender, negative affectivity, anxiety sensitivity, child and parent tobacco use, and parental panic disorder). Participants were 111 community-recruited adolescents ages 12-17 years (M = 15.76 years; n = 50 girls). Youth completed a battery of well-established questionnaires and a voluntary hyperventilation challenge, and parents present at the laboratory completed a structured clinical interview. Adolescent alcohol use was categorized as Non-Users, Experimenters, or Users. Panic symptoms were indexed via retrospective self-report and adolescents' response to a biological challenge procedure (i.e., voluntary hyperventilation). After controlling for theoretically relevant covariates, Users evidenced elevated panic-relevant symptoms and responding compared with Non-Users; Experimenters did not differ from Non-Users. Findings suggest alcohol use history is uniquely associated with panic symptomatology among youth, including "real-time" reactivity elicited by a laboratory challenge. Although there is significant work yet to be done, these data advance extant work and lay the groundwork for the types of sophisticated designs that will be needed to answer the most pressing and complex questions regarding the link between alcohol use and panic symptoms among adolescents.
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Affiliation(s)
- Heidemarie Blumenthal
- University of Arkansas, Department of Psychology, Fayetteville, AR, 72701, United States
| | - Ellen W. Leen-Feldner
- University of Arkansas, Department of Psychology, Fayetteville, AR, 72701, United States
| | - Ashley A. Knapp
- University of Arkansas, Department of Psychology, Fayetteville, AR, 72701, United States
| | - Liviu Bunaciu
- University of Arkansas, Department of Psychology, Fayetteville, AR, 72701, United States
| | - Byron L. Zamboanga
- Smith College, Department of Psychology, Northampton, MA, 01063, United States
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Grisham JR, Fullana MA, Mataix-Cols D, Moffitt TE, Caspi A, Poulton R. Risk factors prospectively associated with adult obsessive-compulsive symptom dimensions and obsessive-compulsive disorder. Psychol Med 2011; 41:2495-2506. [PMID: 21672296 DOI: 10.1017/s0033291711000894] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Very few longitudinal studies have evaluated prospective neurodevelopmental and psychosocial risk factors for obsessive-compulsive disorder (OCD). Furthermore, despite the heterogeneous nature of OCD, no research has examined risk factors for its primary symptom dimensions, such as contamination/washing. METHOD Potential risk factors for symptoms or diagnosis of OCD in adulthood and for specific adult obsessive-compulsive (OC) symptom dimensions were examined in the Dunedin Study birth cohort. The presence of obsessions and compulsions and psychological disorders was assessed using the Diagnostic Interview Schedule (DIS) at ages 26 and 32 years. Individuals with a diagnosis of OCD at either age (n=36) were compared to both a healthy control group (n=613) and an anxious control group (n=310) to determine whether associations between a risk factor and an OCD diagnosis were specific. RESULTS Childhood neurodevelopmental, behavioral, personality and environmental risk factors were associated with a diagnosis of OCD and with OC symptoms at ages 26 and 32. Social isolation, retrospectively reported physical abuse and negative emotionality were specific predictors of an adult OCD diagnosis. Of note, most risk factors were associated with OC symptoms in adulthood and several risk factors predicted specific OCD dimensions. Perinatal insults were linked to increased risk for symmetry/ordering and shameful thoughts dimensions, whereas poor childhood motor skills predicted the harm/checking dimension. Difficult temperament, internalizing symptoms and conduct problems in childhood also predicted specific symptom dimensions and lower IQ non-specifically predicted increased risk for most dimensions. CONCLUSIONS The current findings underscore the need for a dimensional approach in evaluating childhood risk factors for obsessions and compulsions.
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Affiliation(s)
- J R Grisham
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.
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Goodwin RD. Association between infection early in life and mental disorders among youth in the community: a cross-sectional study. BMC Public Health 2011; 11:878. [PMID: 22103993 PMCID: PMC3248872 DOI: 10.1186/1471-2458-11-878] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 11/21/2011] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The objective of this study was to examine the association between infection early in life and mental disorders among youth in the community. METHODS Data were drawn from the MECA (Methods in Epidemiology of Child and Adolescent psychopathology), a community-based study of 1,285 youth in the United States conducted in 1992. Multiple logistic regression analyses were used to investigate the association between parent/caregiver-reported infection early in life and DSM/DISC diagnoses of mental disorders at ages 9-17. RESULTS Infection early in life was associated with a significantly increased odds of major depression (OR = 3.9), social phobia (OR = 5.8), overanxious disorder (OR = 6.1), panic disorder (OR = 12.1), and oppositional defiant disorder (OR = 3.7). CONCLUSIONS These findings are consistent with and extend previous results by providing new evidence suggesting a link between infection early in life and increased risk of depression and anxiety disorders among youth. These results should be considered preliminary. Replication of these findings with longitudinal epidemiologic data is needed. Possible mechanisms are discussed.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Rm 1505, New York, NY 10032, USA.
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Abstract
Asthma, the most common chronic disease in children and adolescents in industrialized countries, is typified by airway inflammation and obstruction leading to wheezing, dyspnea, and cough. However, the effect of asthma does not end with pulmonary changes. Research has shown a direct link between asthma and stress and psychiatric illness, which if untreated results in heightened morbidity and effects on society. The link between asthma and psychiatric illness, however, is often underappreciated by many pediatric and child mental health professionals. This article reviews the diagnosis and treatment of asthma as well as the correlation between asthma and psychiatric illness in children in an effort to improve management and treatment strategies for this prevalent disease.
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Affiliation(s)
- Todd E Peters
- Division of Child and Adolescent Psychiatry, Alpert Medical School of Brown University, Providence, RI, USA.
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Vervoort L, Wolters LH, Hogendoorn SM, Prins PJ, de Haan E, Boer F, Hartman CA. Temperament, attentional processes, and anxiety: diverging links between adolescents with and without anxiety disorders? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2011; 40:144-55. [PMID: 21229451 DOI: 10.1080/15374416.2011.533412] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present study first examined the links between reactive temperament (negative affectivity), regulative temperament (effortful control [EC]) and internalizing problems in adolescents (12-18 years) with anxiety disorders (ANX; N = 39) and without anxiety disorders (nANX; N = 35). Links differed between ANX and nANX participants. Negative affectivity predicted internalizing problems, with almost no role of EC in nANX, but a protective role of EC was found in ANX youth. Second, we investigated the role of attentional bias as a mediator between temperament and internalizing problems. Strategic threat-related bias was predicted by initial attention and EC, but these relations differed in both groups. In nANX participants, higher initial bias scores were predictive for lower strategic bias scores and higher levels of EC were associated with higher bias scores. In ANX participants, there was almost no effect of initial bias or EC on strategic attention. Internalizing problems were predicted by strategic attention, but again differently in ANX and nANX participants. High strategic bias scores were associated with an increase in anxiety in ANX and a decrease in anxiety in nANX participants.
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Affiliation(s)
- Leentje Vervoort
- Department of Clinical Psychology, University of Amsterdam, the Netherlands.
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20
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Henkin S, Tucker KL, Gao X, Falcon LM, Qawi I, Brugge D. Association of depression, psycho-social stress and acculturation with respiratory disease among Puerto Rican adults in Massachusetts. J Immigr Minor Health 2011; 13:214-23. [PMID: 20012203 PMCID: PMC4871150 DOI: 10.1007/s10903-009-9307-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To assess associations between acculturation, depression, and self-reported stress score with reported diagnosis of respiratory disease (RD) in Puerto Rican adults, participants (N = 1,168) were identified from areas of high Hispanic density in the Boston, MA metropolitan area. Eligible participants were interviewed in the home by bilingual interviewers in either Spanish or English. Scales included topics ranging from general background to depressive symptomatology. Respiratory disease was self-reported and checked against prescribed medication. More than one-third (37.8%) of subjects reported doctor-diagnosed RD. A final binary logistical regression model (N = 850), which was adjusted for potential confounders (sex, age, education, poverty) showed that RD was significantly associated with psychological acculturation (OR = 1.97, P = 0.005), depressive symptomatology (OR = 1.52, P = 0.03) high perceived stress score (OR = 1.97, P = 0.009), and current smoking (OR = 1.61, P = 0.03). Significant inverse associations included a high level of language acculturation (OR = 0.65, P = 0.03), light (OR = 0.67, P = 0.01) and moderate to heavy physical activity versus sedentary physical activity (OR = 0.40, P = 0.03). We found self reported physician diagnosed RD was associated with high perceived stress and depression, as well as higher levels of psychological acculturation. Longitudinal research is needed to determine if there is a causal pathway for these associations.
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Affiliation(s)
| | - Katherine L. Tucker
- USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Xiang Gao
- School of Public Health, Harvard University, Boston, MA, USA
| | - Luis M. Falcon
- Department of Sociology and Anthropology, Northeastern University, Boston, MA, USA
| | | | - Doug Brugge
- Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA, USA
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21
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Jyonouchi H. Autism spectrum disorders and allergy: observation from a pediatric allergy/immunology clinic. Expert Rev Clin Immunol 2010; 6:397-411. [PMID: 20441426 DOI: 10.1586/eci.10.18] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IgE-mediated allergic diseases (e.g., allergic rhinoconjunctivitis, atopic asthma and food allergy) are prevalent (up to 30%) in the general population and are increasing in developed countries. In infants and young children, non-IgE-mediated food allergy is also prevalent. In addition to easily recognized organ-specific symptoms, allergic diseases can cause neuropsychiatric symptoms, such as irritability and hyperactivity, in otherwise healthy individuals. This is also likely to occur in children with autism spectrum disorder (ASD). Moreover, the discomfort and pain associated with allergic diseases could aggravate behavioral symptoms in ASD children. Allergic conditions are easily treatable; however, ASD children may be underdiagnosed and/or undertreated for allergic and other common childhood diseases, in part due to their impaired communication skills. Practicing physicians should be aware of the potential impact of allergic diseases on behavioral symptoms and cognitive activity in ASD children. However, they also need to be aware that certain symptoms often attributed to 'allergy' by caregivers may not be immune mediated and should understand that behavioral symptoms can also be affected by many non-IgE-mediated causes.
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Affiliation(s)
- Harumi Jyonouchi
- Pediatrics, University of Medicine and Dentistry of New Jersey (UMDNJ)-New Jersey Medical School (NJMS), 185 South Orange Ave, Newark, NJ 07101, USA.
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Abstract
Asthma, the most common chronic disease in children and adolescents in industrialized countries, is typified by airway inflammation and obstruction leading to wheezing, dyspnea, and cough. However, the effect of asthma does not end with pulmonary changes. Research has shown a direct link between asthma and stress and psychiatric illness, which if untreated results in heightened morbidity and effects on society. The link between asthma and psychiatric illness, however, is often underappreciated by many pediatric and child mental health professionals. This article reviews the diagnosis and treatment of asthma as well as the correlation between asthma and psychiatric illness in children in an effort to improve management and treatment strategies for this prevalent disease.
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Affiliation(s)
- Todd E Peters
- Division of Child and Adolescent Psychiatry, Alpert Medical School of Brown University, Providence, RI 02915, USA.
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23
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Rudaz M, Craske MG, Becker ES, Ledermann T, Margraf J. Health anxiety and fear of fear in panic disorder and agoraphobia vs. social phobia: a prospective longitudinal study. Depress Anxiety 2010; 27:404-11. [PMID: 20143435 DOI: 10.1002/da.20645] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study is aimed to evaluate the role of two vulnerability factors, health anxiety and fear of fear, in the prediction of the onset of panic disorder/agoraphobia (PDA) relative to a comparison anxiety disorder. METHODS Young women, aged between 18 and 24 years, were investigated at baseline and, 17 months later, using the Anxiety Disorders Interview Schedule-Lifetime and measures of health anxiety and fear of bodily sensations (subscale disease phobia of the Whiteley Index, and total score of the Body Sensations Questionnaire). First, 22 women with current PDA were compared to 81 women with current social phobia and 1,283 controls. Second, 24 women with an incidence of PDA were compared to 60 women with an incidence of social phobia and 1,036 controls. RESULTS Multiple logistic regression analyses adjusted for history of physical diseases, somatic symptoms, and other psychological disorders revealed that (a) fear of bodily sensations was elevated for women with PDA vs. controls as well as women with social phobia, and (b) health anxiety (and history of physical diseases) was elevated in women who developed PDA vs. controls and vs. women who developed social phobia. CONCLUSIONS These results suggest that health anxiety, as well as history of physical diseases, may be specific vulnerability factors for the onset of PDA relative to social phobia. Whereas fear of bodily sensations was not found to be a risk factor for the onset of panic disorder/agoraphobia, it was a specific marker of existing PDA relative to social phobia.
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Affiliation(s)
- Myriam Rudaz
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA.
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24
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Craske MG, Kircanski K, Epstein A, Wittchen HU, Pine DS, Lewis-Fernández R, Hinton D. Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V. Depress Anxiety 2010; 27:93-112. [PMID: 20099270 DOI: 10.1002/da.20654] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This review covers the literature since the publication of DSM-IV on the diagnostic criteria for panic attacks (PAs) and panic disorder (PD). Specific recommendations are made based on the evidence available. In particular, slight changes are proposed for the wording of the diagnostic criteria for PAs to ease the differentiation between panic and surrounding anxiety; simplification and clarification of the operationalization of types of PAs (expected vs. unexpected) is proposed; and consideration is given to the value of PAs as a specifier for all DSM diagnoses and to the cultural validity of certain symptom profiles. In addition, slight changes are proposed for the wording of the diagnostic criteria to increase clarity and parsimony of the criteria. Finally, based on the available evidence, no changes are proposed with regard to the developmental expression of PAs or PD. This review presents a number of options and preliminary recommendations to be considered for DSM-V.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology, University of California, Los Angeles, California.
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25
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Goodwin RD. Intergenerational transmission of chronic physical disease via chronic mental disorders: the potential role of addictive behaviors. Addict Behav 2008; 33:1432-1440. [PMID: 18657913 PMCID: PMC3340905 DOI: 10.1016/j.addbeh.2008.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Revised: 05/22/2008] [Accepted: 05/28/2008] [Indexed: 10/22/2022]
Abstract
There has been growing evidence of a link between chronic respiratory diseases, asthma in particular, and mental disorders among youth. The mechanism for this link remains unknown. Several studies have empirically addressed the question of this pathway, and accumulating results may shed new light on the nature of this association. The goal of the current paper is to provide an integrative summary of the literature to date and to present a new interdisciplinary hypothesis for one possible mechanism explaining the link between asthma and anxiety/depression among youth. This hypothesis posits that comorbid anxiety/depression and nicotine dependence among adults, may be one pathway leading to the comorbidity of asthma and anxiety/depression among youth. We propose this mechanism operates via exposure to environmental tobacco smoke and/or prenatal tobacco use, which confers an increased risk for asthma, and parental anxiety/depression which confers increased risk of anxiety/depression among offspring via familial transmission. We predict that further testing of this hypothesis will help to reveal the largely neglected problem of nicotine dependence especially among women - and the far-reaching impact of this addiction on the health of children.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Rm 1706, New York, New York 10032, United States.
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26
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Leen-Feldner EW, Blanchard L, Babson K, Reardon LE, Bacon AK, Zvolensky MJ. The moderating role of health fear on the relation between smoking status and panic symptoms among adolescents. J Anxiety Disord 2008; 22:772-80. [PMID: 17884329 DOI: 10.1016/j.janxdis.2007.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2007] [Revised: 08/06/2007] [Accepted: 08/15/2007] [Indexed: 11/29/2022]
Abstract
The present study examined the moderating role of health fear on the concurrent relation between smoking status and panic attack symptoms among 249 adolescents (132 females, M(age)=14.86 years). As hypothesized, youth high in health fear reported elevations in panic attack symptoms, whereas this relation was relatively weak among those low in health fear. Importantly, these associations were significant after controlling for age, gender, negative affectivity, and anxiety sensitivity. Also as expected, health fear did not moderate the association between smoking status and depressive symptoms, supporting model specificity. Results are discussed in terms of implications for the panic-smoking association among youth.
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27
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Anxiety disorders and comorbid medical illness. Gen Hosp Psychiatry 2008; 30:208-25. [PMID: 18433653 DOI: 10.1016/j.genhosppsych.2007.12.006] [Citation(s) in RCA: 367] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 12/11/2007] [Accepted: 12/11/2007] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To provide an overview of the role of anxiety disorders in medical illness. METHOD The Anxiety Disorders Association of America held a multidisciplinary conference from which conference leaders and speakers reviewed presentations and discussions, considered literature on prevalence, comorbidity, etiology and treatment, and made recommendations for research. Irritable bowel syndrome (IBS), asthma, cardiovascular disease (CVD), cancer and chronic pain were reviewed. RESULTS A substantial literature supports clinically important associations between psychiatric illness and chronic medical conditions. Most research focuses on depression, finding that depression can adversely affect self-care and increase the risk of incident medical illness, complications and mortality. Anxiety disorders are less well studied, but robust epidemiological and clinical evidence shows that anxiety disorders play an equally important role. Biological theories of the interactions between anxiety and IBS, CVD and chronic pain are presented. Available data suggest that anxiety disorders in medically ill patients should not be ignored and could be considered conjointly with depression when developing strategies for screening and intervention, particularly in primary care. CONCLUSIONS Emerging data offer a strong argument for the role of anxiety in medical illness and suggest that anxiety disorders rival depression in terms of risk, comorbidity and outcome. Research programs designed to advance our understanding of the impact of anxiety disorders on medical illness are needed to develop evidence-based approaches to improving patient care.
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28
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Marshall EC, Zvolensky MJ, Sachs-Ericsson N, Schmidt NB, Bernstein A. Panic attacks and physical health problems in a representative sample: singular and interactive associations with psychological problems, and interpersonal and physical disability. J Anxiety Disord 2008; 22:78-87. [PMID: 17275252 DOI: 10.1016/j.janxdis.2006.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Revised: 09/27/2006] [Accepted: 10/10/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Panic attacks may be a risk marker for a variety of psychological problems and are associated with increased impairment in a host of domains. However, previous studies have not investigated the role of physical illness in the panic attack-disability relations, which is striking due to findings that physical illness is linked to both panic attacks and disability. The present investigation examined the singular and interactive effects of panic attacks and physical illness in relation to psychological, interpersonal, and physical types of impairment. METHOD Adult participants (4,745) recruited from the statewide Colorado Social Health Survey were administered the diagnostic interview schedule. RESULTS As predicted, main effects of panic attacks and physical illness were significantly related to psychiatric comorbidity, depressive symptoms, interpersonal functioning, physical functioning, and perceived general health (p<.05 for all associations). Also as predicted, interaction of panic attacks and physical illness was significantly related to all of the outcome variables (p<.05 for all associations). CONCLUSIONS These findings suggest that individuals with both panic attacks and physical illness experience elevated disability across a variety of dimensions.
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Affiliation(s)
- Erin C Marshall
- University of Vermont, Department of Psychology, United States
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Preter M, Klein DF. Panic, suffocation false alarms, separation anxiety and endogenous opioids. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:603-12. [PMID: 17765379 PMCID: PMC2325919 DOI: 10.1016/j.pnpbp.2007.07.029] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Revised: 07/24/2007] [Accepted: 07/24/2007] [Indexed: 01/21/2023]
Abstract
This review paper presents an amplification of the suffocation false alarm theory (SFA) of spontaneous panic [Klein DF (1993). False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis. Arch Gen Psychiatry; 50:306-17.]. SFA postulates the existence of an evolved physiologic suffocation alarm system that monitors information about potential suffocation. Panic attacks maladaptively occur when the alarm is erroneously triggered. That panic is distinct from Cannon's emergency fear response and Selye's General Alarm Syndrome is shown by the prominence of intense air hunger during these attacks. Further, panic sufferers have chronic sighing abnormalities outside of the acute attack. Another basic physiologic distinction between fear and panic is the counter-intuitive lack of hypothalamic-pituitary-adrenal (HPA) activation in panic. Understanding panic as provoked by indicators of potential suffocation, such as fluctuations in pCO(2) and brain lactate, as well as environmental circumstances fits the observed respiratory abnormalities. However, that sudden loss, bereavement and childhood separation anxiety are also antecedents of "spontaneous" panic requires an integrative explanation. Because of the opioid system's central regulatory role in both disordered breathing and separation distress, we detail the role of opioidergic dysfunction in decreasing the suffocation alarm threshold. We present results from our laboratory where the naloxone-lactate challenge in normals produces supportive evidence for the endorphinergic defect hypothesis in the form of a distress episode of specific tidal volume hyperventilation paralleling challenge-produced and clinical panic.
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Affiliation(s)
- Maurice Preter
- New York State Psychiatric Institute, Columbia University College of Physicians&Surgeons
- * Corresponding author. Mailing Address: 1160 Fifth Avenue, Suite 112, New York, NY 10029. Phone 1-212-713-5336, Fax 1-212-713-5336, e-mail
| | - Donald F. Klein
- New York State Psychiatric Institute, Columbia University College of Physicians&Surgeons, 1051 Riverside Drive, New York, NY 10032, Phone 1-212-543-6249, e-mail
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A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis. Psychosom Med 2008; 70:102-16. [PMID: 18158379 DOI: 10.1097/psy.0b013e31815c1b71] [Citation(s) in RCA: 219] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There is growing epidemiological literature focusing on the bidirectional association between psychosocial factors and atopic disorders, but no efforts to quantify the relationship systematically have been published. METHODS We searched Medline, PsycINFO, Web of Science, and PubMed up to June 2007. The studies included were prospective cohort studies investigating the influence of psychosocial factors on atopic disorders and the effect of atopic disorders on mental health. Two investigators independently extracted data and determined study quality. RESULTS There were 43 studies (in 22 articles), of which 34 evaluated the effect of psychosocial factors on atopic disorders and 9 evaluated the effect of atopic disorders on mental health. The major atopic disease assessed in these studies was asthma (90.7%) with allergic rhinitis, 4.7%; atopic dermatitis, 2.3%; and food allergies, 2.3%. The overall meta-analysis exhibited a positive association between psychosocial factors and future atopic disorder (correlation coefficient (r) as combined size effect .024; 95% confidence interval, 0.014-0.035; p < .001) as well as between atopic disorders and future poor mental health (r = .044, 95% confidence interval, 0.021-0.067, p < .001). More notably, the subgroup meta-analysis on the healthy and atopic disorder populations showed psychosocial factors had both an etiological and prognostic effect on atopic disorders. CONCLUSIONS The current review revealed a robust relationship between psychosocial factors and atopic disorders. This supports the use of psychological in addition to conventional physical and pharmacological interventions, in the successful prevention and management of atopic disorders.
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Hirshfeld-Becker DR, Micco JA, Simoes NA, Henin A. High risk studies and developmental antecedents of anxiety disorders. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2008; 148C:99-117. [DOI: 10.1002/ajmg.c.30170] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Katon W, Lozano P, Russo J, McCauley E, Richardson L, Bush T. The prevalence of DSM-IV anxiety and depressive disorders in youth with asthma compared with controls. J Adolesc Health 2007; 41:455-63. [PMID: 17950165 PMCID: PMC2153460 DOI: 10.1016/j.jadohealth.2007.05.023] [Citation(s) in RCA: 178] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 05/25/2007] [Accepted: 05/30/2007] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the prevalence of anxiety and depressive disorders in youth with asthma compared with a control sample of youth and to determine the sociodemographic and clinical characteristics associated with having one or more anxiety/depressive disorders among youth with asthma. METHODS A telephone interview was offered to all youth aged 11-17 years with asthma (N = 781) and a random sample of similar aged controls (N = 598) enrolled in a Health Maintenance Organization. The C-DISC-4.0 was used to diagnose anxiety and depressive disorders and reliable and valid questionnaires were used to assess severity of anxiety and depressive symptoms. Automated diagnostic, pharmacy and health use data were used to measure asthma treatment intensity, asthma severity and nonasthmatic medical comorbidity. One parent was interviewed to assess sociodemographic variables, child/adolescent psychiatric symptoms and to confirm the asthma diagnosis. RESULTS In all, 16.3% of youth with asthma compared with 8.6% of youth without asthma met DSM-IV criteria for one or more anxiety and depressive disorders (OR = 1.92, 95% CI = 1.13-3.28). Independent factors associated with a significantly higher likelihood of meeting criteria for one or more anxiety or depressive disorders included female gender [OR = 1.96 (95% CI = 1.27, 3.03)], living in a single-parent household, [OR = 1.96 (95% CI = 1.26, 3.07)], more parent-reported externalizing behaviors [OR = 1.03 (95% CI = 1.01, 1.05)], more recent diagnosis of asthma [OR = 0.94 (95% CI = 0.89, 0.98)], and more impairment on the asthma physical health scale [OR = 0.95 (95% CI = 0.94, 0.96)]. CONCLUSIONS Youth with asthma have an almost twofold higher prevalence of comorbid DSM-IV anxiety and depressive disorders compared with control youth. Clinical factors associated with meeting criteria for one or more anxiety and depressive included more recent asthma diagnosis, more impairment on the asthma physical health scale, and increased externalizing behaviors.
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Affiliation(s)
- Wayne Katon
- Department of Psychiatry, University of Washington School of Medicine, Seattle, Washington 98195-6560, USA.
| | - Paula Lozano
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, Center for Health Studies, Group Health Cooperative, Seattle, WA
| | - Joan Russo
- Department of Psychiatry, University of Washington School of Medicine, Seattle, WA
| | - Elizabeth McCauley
- Department of Psychiatry, University of Washington School of Medicine, Seattle, WA
| | - Laura Richardson
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
| | - Terry Bush
- Center for Health Studies, Group Health Cooperative, Seattle, WA
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Abstract
This chapter provides a review of recent empirical developments, current controversies, and areas in need of further research in relation to factors that are common as well as specific to the etiology and maintenance of panic disorder, phobias, and generalized anxiety disorder. The relative contribution of broad risk factors to these disorders is discussed, including temperament, genetics, biological influences, cognition, and familial variables. In addition, the role that specific learning experiences play in relation to each disorder is reviewed. In an overarching hierarchical model, it is proposed that generalized anxiety disorder, and to some extent panic disorder, loads most heavily on broad underlying factors, whereas specific life history contributes most strongly to circumscribed phobias.
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Affiliation(s)
- Michelle G Craske
- Department of Psychology, University of California, Los Angeles, California 90095, USA.
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34
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Leen-Feldner EW, Reardon LE, Zvolensky MJ. Pubertal status and emotional reactivity to a voluntary hyperventilation challenge predicting panic symptoms and somatic complaints: a laboratory-based multi-informant test. Behav Modif 2007; 31:8-31. [PMID: 17179529 DOI: 10.1177/0145445506295058] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The main and interactive effects of pubertal status and emotional reactivity to bodily sensations elicited by a voluntary hyperventilation challenge were examined in relation to panic symptoms and self- and parent-reported somatic complaints among 123 (56 females) adolescents between the ages of 12 and 17 years (M(age) = 15.05; SD = 1.50). As expected, after controlling for baseline anxiety, age, and gender, there was a significant interaction between pubertal status and challenge response in predicting the outcome variables. Specifically, adolescents reporting more advanced pubertal status and greater reactivity to the challenge evidenced greater levels of panic symptoms and somatic complaints, whereas pubertal status had relatively less of an effect on these variables among adolescents who did not respond as fearfully to the challenge. Results are discussed in terms of extant theory and research on anxiety vulnerability among adolescents.
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Affiliation(s)
- Ellen W Leen-Feldner
- University of Arkansas, Fulbright College of Arts and Sciences, Fayetteville, AR 72701, USA.
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35
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Richardson LP, Lozano P, Russo J, McCauley E, Bush T, Katon W. Asthma symptom burden: relationship to asthma severity and anxiety and depression symptoms. Pediatrics 2006; 118:1042-51. [PMID: 16950996 DOI: 10.1542/peds.2006-0249] [Citation(s) in RCA: 148] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The purpose of this work was to examine the relationship between youth-reported asthma symptoms, presence of anxiety or depressive disorders, and objective measures of asthma severity among a population-based sample of youth with asthma. METHODS We conducted a telephone survey of 767 youth with asthma (aged 11-17 years) enrolled in a staff model health maintenance organization. The Diagnostic Interview Schedule for Children was used to diagnose Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, anxiety and depressive disorders; the Child Health Status-Asthma questionnaire (modified) was used to assess asthma symptoms; and automated administrative data were used to measure asthma treatment intensity and severity. Analyses of covariance were performed to determine whether the number of anxiety and depressive symptoms was related to the number of asthma symptoms. Logistic regression analyses were used to evaluate the strength of association between individual symptoms of asthma and the presence of an anxiety or depressive disorder and objective measures of asthma severity. RESULTS After adjusting for demographic characteristics, objective measures of asthma severity, medical comorbidity, and asthma treatment intensity, youth with > or = 1 anxiety or depressive disorder (N = 125) reported significantly more days of asthma symptoms over the previous 2 weeks than youth with no anxiety or depressive disorders. The overall number of reported asthma symptoms was significantly associated with the number of anxiety and depressive symptoms endorsed by youth. In logistic regression analyses, having an anxiety or depressive disorder was also strongly associated with each of the 6 asthma-specific symptoms, as well as the 5 related nonspecific somatic symptoms contained in the Child Health Status-Asthma questionnaire. CONCLUSIONS The presence of an anxiety or depressive disorder is highly associated with increased asthma symptom burden for youth with asthma.
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Affiliation(s)
- Laura P Richardson
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington 98115, USA.
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Zvolensky MJ, Schmidt NB, Bernstein A, Keough ME. Risk-factor research and prevention programs for anxiety disorders: A translational research framework. Behav Res Ther 2006; 44:1219-39. [PMID: 16867299 DOI: 10.1016/j.brat.2006.06.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Accepted: 06/14/2006] [Indexed: 10/24/2022]
Abstract
The aim of the present essay is to discuss the interconnection between risk-factor research and prevention program development for panic-spectrum psychopathology. We argue that prevention of panic-spectrum psychopathology specifically, and anxiety disorders more generally, is likely to be best advanced through active, systematic translation of basic, risk-factor research. After operationalizing key terminology, we present some exemplar risk-factor candidates for panic-spectrum psychopathology, summarize research related to their role as risk-factors for panic problems, and link this discussion to risk-factor nomenclature. We then present a translational framework for extrapolating extant knowledge on these and other potential risk-factors for panic-spectrum psychopathology with respect to the development of preventative interventions. The proposed translational framework is intended to describe a forward-feeding process by which risk-factor research could be used by clinical researchers to inform prevention programs; and reciprocally, how such prevention knowledge could be most effectively utilized to drive new, clinically focused risk-factor research.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, The University of Vermont, Colchester Avenue, John Dewey Hall, Burlington, VT 05405-0134, USA.
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Feldman JM, Ortega AN, McQuaid EL, Canino G. Comorbidity between asthma attacks and internalizing disorders among Puerto Rican children at one-year follow-up. PSYCHOSOMATICS 2006; 47:333-9. [PMID: 16844893 PMCID: PMC2966278 DOI: 10.1176/appi.psy.47.4.333] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Authors examined the association between internalizing disorders and asthma attacks at 1-year follow-up among a community sample of 1,789 children and adolescents ages 5-18 years living on the island of Puerto Rico. The Diagnostic Interview Schedule for Children was administered to assess DSM-IV internalizing disorders during the past year. Children with a lifetime history of asthma attacks at baseline had greater odds of having an internalizing disorder at 1-year follow-up, independent of socio-demographic measures. However, an association was not found between asthma attacks and persistence of internalizing disorders. These findings show that the association between internalizing disorders and asthma attacks was replicated 1 year later in the same sample.
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Affiliation(s)
- Jonathan M Feldman
- Ferkauf Graduate School of Psychology, Yeshiva Univ., Rousso Building, 1300 Morris Park Ave., Bronx, NY 10461, USA.
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Friedman AH, Morris TL. Allergies and Anxiety in Children and Adolescents: A Review of the Literature. J Clin Psychol Med Settings 2006. [DOI: 10.1007/s10880-006-9026-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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O'Connell J, Novins DK, Beals J, Croy C, Barón AE, Spicer P, Buchwald D. The relationship between patterns of alcohol use and mental and physical health disorders in two American Indian populations. Addiction 2006; 101:69-83. [PMID: 16393193 DOI: 10.1111/j.1360-0443.2005.01308.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS First, define alcohol use categories among two reservation-based American Indian (AI) populations based on the relationship between alcohol consumption and dependence. Secondly, examine associations between the alcohol use categories and other indicators of health status. DESIGN, PARTICIPANTS AND MEASUREMENTS Epidemiological data on 1287 AIs aged 18-57 years who consumed alcohol during the past year. CHAID tree analysis, a hierarchical partitioning method, was used to analyze alcohol quantity (highest number of drinks consumed during 1 day) and frequency (number of days drank during the past month) data to define quantity-frequency categories distinguished by differing rates of alcohol dependence. Multivariate analyses assessed relationships between the alcohol use categories thus identified and a number of health outcomes. FINDINGS People who reported drinking 12 or more drinks during 1 day and more than 4 days a month had the highest prevalence of alcohol dependence. Among the males who drank > 18 drinks the prevalence was 42.12% and among females who drank 12 or more drinks, 44.58%. The prevalence among males who drank > 18 drinks yet drank less frequently was also high (24.06%). Although findings differed by gender, drinkers in the highest risk category for alcohol dependence were most likely to report drug use disorders, mood/anxiety disorders, alcohol-related physical disorders and lower quality of life. CONCLUSIONS The quantity thresholds defined to identify AIs at highest risk for alcohol dependence in this study differed by gender and were higher than typically reported for non-AIs. They are consistent with previous findings regarding the pattern of high-quantity, low-frequency alcohol consumption among AIs residing on reservations.
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Affiliation(s)
- Joan O'Connell
- American Indian and Alaska Native Programs, Department of Psychiatry, University of Colorado Health Sciences Center, Aurora, CO 80045-0508, USA.
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Goodwin RD, Messineo K, Bregante A, Hoven CW, Kairam R. Prevalence of probable mental disorders among pediatric asthma patients in an inner-city clinic. J Asthma 2005; 42:643-7. [PMID: 16266954 DOI: 10.1080/02770900500264770] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the screen-positive prevalence of anxiety disorders and depression among pediatric asthma patients in an inner-city asthma clinic and to investigate the association between probable diagnoses of anxiety disorders and depression and medical service use among inner-city pediatric asthma patients. METHOD In this pilot study, a consecutive sample of pediatric asthma patients aged 5-11 in the waiting room of an inner-city asthma clinic was screened for mental disorders using the DISC Predictive Scales (DPS), which produces probable DSM-IV diagnoses. In addition, data on health service use for asthma were collected. Statistical analyses were performed to examine the relationship between probable anxiety disorders and depression and health service use for asthma among pediatric asthma patients. RESULTS Approximately one in four (25.7%) pediatric asthma patients in an inner-city asthma clinic met criteria for a probable diagnosis of current anxiety disorders or depression (past 4-week prevalence). Specifically, childhood separation anxiety disorder was common among 8.1%, panic among 14.9%, generalized anxiety disorder among 4.1%, agoraphobia among 5.4%, and 2.7% had depression. Having more than one anxiety disorder or depression diagnosis was associated with higher levels of inpatient and outpatient medical services, compared with patients who were negative on screening for anxiety or depressive disorders, although differences failed to reach statistical significance. CONCLUSIONS These findings are the first to provide preliminary evidence suggesting that mental health problems are common among pediatric asthma patients in an inner-city clinic. The results also suggest that mental health problems in pediatric asthma patients may be associated with elevated levels of medical service use for asthma. Replication of this pilot study is needed with a larger sample, more precise diagnostic methodology, and a comparison group with chronic medical illness.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
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Goodwin RD, Lewinsohn PM, Seeley JR. Cigarette smoking and panic attacks among young adults in the community: the role of parental smoking and anxiety disorders. Biol Psychiatry 2005; 58:686-93. [PMID: 16018987 DOI: 10.1016/j.biopsych.2005.04.042] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2004] [Revised: 04/18/2005] [Accepted: 04/20/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND The goal of the current study is to examine the association between cigarette smoking and panic attacks and panic disorder among youth and to investigate parental anxiety disorders and parental cigarette smoking in these links. METHODS Data were drawn from the Oregon Adolescent Depression Project (OADP) (n = 1709). Cigarette smoking and panic attacks and panic disorder were assessed at three time points from adolescence to young adulthood. RESULTS Daily cigarette smoking at Time 1 was associated with a significantly increased risk of panic attacks (odds ratio [OR] = 2.6 [1.3, 5.3]) and panic disorder (OR = 4.2 [2.0, 8.9]) at Time 3. After adjusting for parental anxiety disorder and parental smoking, the association between cigarette smoking and panic attack was no longer statistically significant (OR = 2.0 [.9, 4.5]), though the association between cigarette smoking and panic disorder remained (OR = 3.7 [1.6, 8.9]). The association between smoking and panic was not evident between smoking and other anxiety disorders. CONCLUSIONS These findings replicate previous results showing cigarette smoking in adolescence is associated with an increased risk of panic attacks and panic disorder in early adulthood and provide initial evidence that parental anxiety and parental smoking may play a role.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
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Abstract
With the maturation of community studies of adults in the past decade, there has been growing awareness of the importance of the magnitude and impact of anxiety disorders in the general population. The convergence of findings from adult and child epidemiology reveals that the onset of anxiety disorders occurs in childhood, and a substantial proportion of youth with anxiety continues to manifest lifelong problems with anxiety and other mental disorders. In this article, the major risk factors for the development of anxiety disorders in childhood and adolescence are reviewed.
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van Beek N, Schruers KRJ, Griez EJL. Prevalence of respiratory disorders in first-degree relatives of panic disorder patients. J Affect Disord 2005; 87:337-40. [PMID: 15979152 DOI: 10.1016/j.jad.2005.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2004] [Revised: 05/09/2005] [Accepted: 05/12/2005] [Indexed: 11/17/2022]
Abstract
BACKGROUND Panic Disorder (PD) patients often report a history of respiratory pathology, such as asthma. It is known that both PD and respiratory disorders, like asthma, run in families. A common diathesis for PD and some respiratory disorders may be present both in PD patients and their first-degree relatives. We examined whether the lifetime prevalence of respiratory disorders is higher in first-degree relatives of PD patients than in first-degree relatives of patients with other anxiety disorders. METHODS The lifetime history of respiratory pathology was assessed in 379 first-degree relatives of patients with an anxiety disorder by means of a questionnaire. RESULTS We found the first-degree relatives of PD patients to report more chronic obstructive pulmonary diseases (COPD) in general (24.8%) and asthma (10.5%) in particular than the comparison group (13.2% and 3.3%, respectively). LIMITATIONS Our data rely on retrospective self-reports. CONCLUSIONS Our findings are consistent with and extend previous studies suggesting a specific association between COPD, asthma in particular, and PD.
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Affiliation(s)
- Nicole van Beek
- Department of Psychiatry and Neuropsychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Wilson KA, Hayward C. A prospective evaluation of agoraphobia and depression symptoms following panic attacks in a community sample of adolescents. J Anxiety Disord 2005; 19:87-103. [PMID: 15488369 DOI: 10.1016/j.janxdis.2003.11.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2003] [Revised: 11/03/2003] [Accepted: 11/07/2003] [Indexed: 11/24/2022]
Abstract
In a community sample of high schoolers who experienced their first panic attack, we examined the prospective relationships among pre-panic vulnerabilities, panic attack severity, and post-panic agoraphobia and depression symptoms. Students were evaluated yearly over 4 years to test the following four hypotheses: (1) pre-panic anxiety sensitivity, negative affect, and childhood behavioral inhibition will serve as vulnerabilities that predict agoraphobia and depression symptoms following a panic attack; (2) these vulnerabilities will lead to more severe panic attacks; (3) severe and spontaneous panic attacks will predict subsequent agoraphobia and depressive symptoms; and (4) the interaction between panic severity and vulnerabilities will be associated with worse outcomes following a panic attack. Results supported the first three hypotheses, but no evidence emerged for an interactive effect. Findings are discussed in light of recent modernized classical conditioning models that address factors contributing to development of more severe panic related psychopathology after panic attacks.
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Affiliation(s)
- Kimberly A Wilson
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, 401 Quarry Road, Stanford, CA 94305-5722, USA.
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Slattery MJ. Psychiatric Comorbidity Associated with Atopic Disorders in Children and Adolescents. Immunol Allergy Clin North Am 2005; 25:407-20, viii. [PMID: 15878463 DOI: 10.1016/j.iac.2005.02.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article examines evidence of an association between psychiatric disorders and atopic disorders in children and adolescents. Findings are discussed within a developmental framework and compared with adult studies, when available, to illustrate similarities and differences between youth and adults. Finally, the article discusses the clinical relevance of comorbid psychiatric and atopic disorders.
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Affiliation(s)
- Marcia J Slattery
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Wisconsin Medical School, 6001 Research Park Boulevard, Madison, WI 53719, USA
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Alati R, O'Callaghan M, Najman JM, Williams GM, Bor W, Lawlor DA. Asthma and internalizing behavior problems in adolescence: a longitudinal study. Psychosom Med 2005; 67:462-70. [PMID: 15911911 DOI: 10.1097/01.psy.0000161524.37575.42] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Clinical studies of asthmatic children have found an association between lung disease and internalizing behavior problems. The causal direction of this association is, however, unclear. This article examines the nature of the relationship between behavior and asthma problems in childhood and adolescence. METHODS Data were analyzed on 5135 children from the Mater University Study of Pregnancy and its outcomes (MUSP), a large birth cohort of mothers and children started in Brisbane, Australia, in 1981. Lung disease was measured from maternal reports of asthma/bronchitis when the children were aged 5 and maternal reports of asthma symptoms when the children were aged 14. Symptoms of internalizing behaviors were obtained by maternal reports (Child Behavior Checklist) at 5 years and by maternal and children's reports at 14 years (Child Behavior Checklist and Youth Self Report). RESULTS Although there was no association between prevalence of asthma and externalizing symptoms, asthma and internalizing symptoms were significantly associated in cross-sectional analyses at 5 and 14 years. In prospective analyses, after excluding children with asthma at 5 years, internalizing symptoms at age 5 were not associated with the development of asthma symptoms at age 14. After excluding children with internalizing symptoms at 5 years, those who had asthma at 5 years had greater odds of developing internalizing symptoms at age 14. CONCLUSION Children who have asthma/bronchitis by the age of 5 are at greater risk of having internalizing behavior problems in adolescence.
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Affiliation(s)
- Rosa Alati
- School of Population Health, University of Queensland, Queensland 4101, Australia.
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Hasler G, Gergen PJ, Kleinbaum DG, Ajdacic V, Gamma A, Eich D, Rössler W, Angst J. Asthma and panic in young adults: a 20-year prospective community study. Am J Respir Crit Care Med 2005; 171:1224-30. [PMID: 15764721 PMCID: PMC2718460 DOI: 10.1164/rccm.200412-1669oc] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Psychologic factors are increasingly recognized to influence the onset and course of asthma. Previous cross-sectional community-based studies have provided evidence for a relatively specific association between asthma and panic. OBJECTIVES To examine concurrent and longitudinal associations between asthma and panic in young adults. MEASUREMENTS AND MAIN RESULTS Prospective community-based cohort study of young adults (n = 591) followed between ages 19 and 40. Information was derived from six subsequent semistructured diagnostic interviews conducted by professionals. Cross-sectionally (over the whole study period), asthma was more strongly associated with panic disorder (odds ratio [OR] = 4.0; 95% confidence interval [CI], 1.7, 9.3) than with any panic, which included panic disorder and panic attacks (OR = 2.1; 95% CI, 1.1, 4.5). Longitudinally, after adjusting for potentially confounding variables, active asthma predicted subsequent panic disorder (OR = 4.5; 95% CI, 1.1, 20.1), and the presence of panic disorder predicted subsequent asthma activity (OR = 6.3; 95% CI, 2.8, 14.0). Asthma predicted any panic (OR = 2.7; 95% CI, 1.1, 7.1), whereas any panic did not predict subsequent asthma activity. Associations were stronger in smokers than in nonsmokers, and stronger in women than in men. Smoking, early-childhood anxiety, and a family history of allergy were important confounders of the asthma-panic association. CONCLUSIONS This is the first long-term follow-up study on asthma and panic. It showed dose-response-type relationships between panic and asthma, and bidirectional longitudinal associations between the two conditions. It provided evidence for familial factors and smoking as possible shared etiologic explanations.
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Affiliation(s)
- Gregor Hasler
- National Institutes of Health, National Institute of Mental Health, Mood and Anxiety Disorders Program, 15K North Drive, Room 200, MSC 2670, Bethesda, MD 20892-2670, USA.
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Hayward C, Wilson KA, Lagle K, Killen JD, Taylor CB. Parent-reported predictors of adolescent panic attacks. J Am Acad Child Adolesc Psychiatry 2004; 43:613-20. [PMID: 15100568 DOI: 10.1097/00004583-200405000-00015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify parent-reported risk factors for adolescent panic attacks. METHOD Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder [SAD], childhood chronic illness, and childhood loss) as well as characteristics of the parent (parental panic disorder or agoraphobia [PDA], parental major depression, and parental chronic illness). RESULTS Bivariate predictors of adolescent panic attacks included parent history of PDA, parent history of chronic illness, child negative affect, and child SAD. Using signal detection methods, three subgroups of participants at risk for panic attacks were identified. Fifty-eight percent of adolescents with panic attacks belonged to one of these high-risk groups. Adolescents with a positive parental history of PDA were at highest risk: 24% of this group experienced panic attacks. Among those without a positive parental history of PDA, those with high childhood negative affect or history of SAD were at increased risk for panic attacks (14% and 20%, respectively). CONCLUSIONS The use of parent-reported data provides cross-validation for previously identified risk factors of adolescent panic attacks. Signal detection results suggest there are multiple paths (equifinality) to the development of adolescent panic attacks.
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Affiliation(s)
- Chris Hayward
- Department of Psychiatry and Behavioral Sciences, Stanford University, USA.
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Abstract
OBJECTIVE To determine the association between asthma and panic attacks among youth in the community. METHOD Data were drawn from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study (n = 1285), a community-based sample of youth age 9-17 in the United States. Multivariate logistic regression analyses were used to determine the association between asthma and both panic attacks and panic disorder, adjusting for differences in sociodemographic characteristics and comorbid mental disorders. RESULTS Asthma was associated with a significantly increased likelihood of panic attacks [OR= 1.5 (1.01, 2.2)]. This effect was specific and persisted after adjusting for differences in demographics and psychiatric comorbidity. Severe asthma was associated with an even greater likelihood of panic attacks [OR = 2.2 (1.3, 4.0)]. There was a dose-response relationship between number of panic symptoms during a panic attack and the likelihood of asthma [OR = 1.2 (1.1, 1.3)] and severe asthma [OR = 1.3 (1.1, 1.4)], which remained significant after adjusting for differences in sociodemographic characteristics and comorbid mental disorders. CONCLUSIONS These data suggest a significant association between asthma, severe asthma, and panic attacks among youth in the community. Replication of these findings is needed, as are future studies that investigate the nature of these links. In light of the increasing prevalence of asthma and hospitalization for asthma among youth in the United States and worldwide, these associations may be worthwhile to consider in future investigations.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
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