Change in psychopathology in referred children: the role of life events and perceived stress

Mental Health Symptoms and Service Use in Depressed and Anxious Minors at the Onset of COVID-19 in a County Clinic Serving a Predominantly Hispanic Population

OBJECTIVE

The study's primary aim was to compare the utilization rates of services by minors with depression/anxiety in a county mental health clinic before (from December 1, 2019, to March 15, 2020) and during the COVID-19 pandemic (from March 16 to June 30, 2020). The secondary aim was to study demographics and psychiatric symptomatology.

METHODS

Service utilization rates were estimated. Univariate and multivariate logistic regression was used to identify significant predictors of worsening psychiatric symptoms, anxiety, and change in the frequency of therapy between the pre-COVID-19 period and the COVID-19 period.

RESULTS

Service utilization rates increased during the pandemic period. During the pandemic, the presence of mood symptoms, suicidal ideation, and relationship conflicts predicted worsening psychiatric symptoms. In addition, the presence of preexisting sleep problems and physical health issues that continued during COVID-19 exhibited correlations with worsening psychiatric symptoms during COVID-19. COVID-related stressors and physical health issues were associated with anxiety; suicidal ideation predicted a change in the frequency of therapy.

CONCLUSIONS

 Prospective studies to recognize risk factors for worsening mental health in minors with psychiatric illness during a crisis are warranted to identify and allocate services to the high-risk groups.

The Effect of Pythagorean Self-Awareness on Heart Rate Variability, Perceived Stress and Behavior of Preschool Children

Stress is associated with unhealthy habits and non-communicable diseases. It is also linked to communicable diseases due to its impact on immune function. These can be prevented through intervention programs in schools. The aim of this study was to examine the effect of the simplified Pythagorean Self-Awareness Intervention on heart rate variability (HRV) parameters, perceived stress and behaviors of preschool children. The sample of the study consisted of 45 preschool students. A “one group (double) pretest—posttest design” was used, to allow for comparisons of the measurements before and after the intervention. Students were assessed via two questionnaires (“Perceived Stress Scale for Children” (PSS-C) and “Checklist for Screening Behavioral Problems in Preschool Children”) and a photoplethysmographic (PPG) device. The intervention lasted 9 weeks and included practicing of the Pythagorean Self-awareness techniques and the adoption of healthy behaviors. The results showed no statistically significant differences between the two pretests (p > 0.05 for all comparisons) and statistically significant differences between the second pretest and posttest (“Perceived Stress Scale for Children”, (PSS-C) p < 0.0001, “Checklist for Screening Behavioral Problems in Preschool Children” p < 0.0001 and two indices of PPG device: heart rate mean, p < 0.0001, low frequency/very low frequency, p = 0.034). In conclusion, the Pythagorean Self-Awareness Intervention had a beneficial effect on the sample of preschool students examined, as the results showed an improvement in the perceived stress and the HRV parameters tested, and in engaging healthier behaviors, findings that indicate a relaxed psychologic state and a healthier lifestyle.

Parent and Adolescent Agreement for Reports of Life Stressors

In this article, we investigated the extent and nature of informant discrepancies on parent- and adolescent self-report versions of a checklist measuring youth exposure to life stressors. Specifically, we examined (a) mean-level differences, relative consistency, and consensus for family-level and youth-specific stressors and (b) the utility of parent-youth discrepancies in accounting for variance in youth temperament and psychopathology. Participants were 106 parent-child dyads (47 male, 59 female; 90.6% mothers) aged 13 to 18 years old ( M = 16.01, SD = 1.29). The results revealed evidence for both congruence and divergence in parent and youth reports, particularly with respect to respondents' accounts of youth-specific stressors. Discrepancies for youth-specific stressors were associated with adolescents' negative affectivity, surgency, effortful control, and internalizing problems. Discrepancies for youth stressors may therefore reveal individual differences in emotionality and self-regulation, thus reflecting meaningful variance in adolescents' functioning.

Development and Initial Validation of the Student Rating of Environmental Stressors Scale

High school students in accelerated curricula face stressors beyond typical adolescent developmental challenges. The Student Rating of Environmental Stressors Scale (StRESS) is a self-report measure of environmental stressors appropriate for students in Advanced Placement (AP) and International Baccalaureate (IB) courses. We developed the StRESS in parallel with a new measure of coping designed for this same population. Items were derived from sentiments expressed during focus groups and individual interviews with 177 students, 72 parents, and 47 teachers. Multiple iterations of expert review and item analyses focusing on conceptual clarity and comprehensiveness resulted in 75 items reflecting stressors across domains, including school, home, and peers. High school students in AP or IB ( N = 727) completed the 75-item inventory. Exploratory factor analyses and additional item review indicated a five-factor solution with 32 items. Cronbach’s alpha reliabilities ranged from .67 to .88. Five additional items representing a composite of Major Life Events also were included. The five factors and Major Life Events composite had test–retest reliabilities greater than .70. These scores were related to multiple conceptualizations of stress, as well as academic outcomes (GPA and attendance) and mental health (life satisfaction and anxiety), thus supporting the construct validity of the StRESS scores. Further support for the five-factor structure of the StRESS was provided by results of a confirmatory factor analysis (standardized root mean square residual = .051, root mean square error of approximation = .048, comparative fit index = .900) with a separate sample of 2,193 AP and IB students.

Stress, cortisol, and externalizing behavior in adolescent males: an examination in the context of multisystemic therapy

Stress and hypothalamic-pituitary-adrenal (HPA) axis dysregulation have been associated with externalizing behavior in adolescence, but few studies have examined these factors in a treatment context. This study investigated the relationship between stress, cortisol, and externalizing behavior among 120 adolescent males (mean age = 15) receiving Multisystemic Therapy (MST). To examine the differential relationship of cortisol with various types of stressors, self-report measures assessed lifetime stress, current episodic stress, and daily hassles. Morning and afternoon cortisol samples were collected to examine whether the relationship between stress and treatment outcome depended on the youth's biological stress levels. Regression analyses indicated that awakening cortisol levels moderated the relationship between daily hassles and externalizing behaviors at post-treatment. More specifically, higher levels of daily hassles predicted worse outcomes only among adolescents with high levels of morning cortisol. In addition, lifetime stressors and afternoon measures of cortisol interacted to predict changes in caretaker reports of externalizing problems and youth arrests following treatment; lifetime stressors were positively associated with externalizing behavior when adolescents had low levels of afternoon cortisol. Implications for theory and future directions for evidence-based treatment are discussed.